WorldWideScience

Sample records for apparent life-threatening events

  1. Apparent life threatening events (ALTE: diagnostic approach

    Directory of Open Access Journals (Sweden)

    Erick Manuel Toro-Monjaraz

    2014-08-01

    Full Text Available Apparent Life-Threatening Events (ALTE are a form of clinical presen- tation of various problems or diseases in children under one year of age. A frequency of 0.6/1000 newborns is estimated. In Mexico, there is no known incidence, systematic approach or guidelines for hospital discharge, so we performed a literature review. Its etiology may be gastrointestinal, neurological, cardiovascular, metabolic, endocrine or-idiopathic. The detailed history and physical examination provide an outline to select the laboratory and imaging studies to perform.

  2. Apparent life-threatening event in infancy

    Science.gov (United States)

    Choi, Hee Joung

    2016-01-01

    An apparent life-threatening event (ALTE) is defined as the combination of clinical presentations such as apnea, marked change in skin and muscle tone, gagging, or choking. It is a frightening event, and it predominantly occurs during infancy at a mean age of 1–3 months. The causes of ALTE are categorized into problems that are: gastrointestinal (50%), neurological (30%), respiratory (20%), cardiovascular (5%), metabolic and endocrine (2%–5%), or others such as child abuse. Up to 50% of ALTEs are idiopathic, where the cause cannot be diagnosed. Infants with an ALTE are often asymptomatic at hospital and there is no standard workup protocol for ALTE. Therefore, a detailed initial history and physical examination are important to determine the extent of the medical evaluation and treatment. Regardless of the cause of an ALTE, all infants with an ALTE should require hospitalization and continuous cardiorespiratory monitoring and evaluation for at least 24 hours. The natural course of ALTEs has seemed benign, and the outcome is generally associated with the affected infants' underlying disease. In conclusion, systemic diagnostic evaluation and adequate treatment increases the survival and quality of life for most affected infants.

  3. Apparent Life-Threatening Event following Maternal Use of Temazepam during Labour

    Directory of Open Access Journals (Sweden)

    L. Damen

    2014-01-01

    Full Text Available Benzodiazepines are one of the most frequently prescribed psychotropic drugs during pregnancy. Despite the fact that these drugs have been in use for a long time, there is still debate about the safety for the developing fetus and neonate. We present a case of a newborn with an apparent life-threatening event shortly after birth following maternal temazepam use during labour and advise to be reserved in prescribing any dose of any kind of benzodiazepine during labour.

  4. [How I EXPLORE ... AN APPARENT LIFE THREATENING EVENT OF THE INFANT].

    Science.gov (United States)

    Zambelli, L; Battisti, O

    2016-04-01

    The ALTE (Apparent Life Threatening Event) of the infant is a frequent presenting complaint. The clinical presentation is varied, ranging from an innocuous event (as a change in skin color) to something as tragic as a sudden infant death. In all circumstances, it is always a very worrying event for the parents and the family circle. Many etiologies can explain the ALTE, and their investigation can be complicated. In this paper, the etiologies and diagnostic tests will be briefly introduced, with a reminder of the sudden infant death syndrome.

  5. OBSERVATION OF MOVEMENTS DURING SLEEP IN ALTE (APPARENT LIFE-THREATENING EVENT) AND APNEIC INFANTS - A PILOT-STUDY

    NARCIS (Netherlands)

    EINSPIELER, C; PRECHTL, HFR; VANEYKERN, L; DEROOS, B

    1994-01-01

    Fourteen infants of 2 months or 6 months of age were video-recorded during polysomnography. Four were normal infants, five had a history of ALTE (apparent life threatening event) and five had repeated and prolonged apnoea during sleep. Two ALTE infants have been recorded at 2 months as well as at 6

  6. Evento com aparente risco de morte: uma revisão Evento con aparente riesgo de muerte (alte: una revisión Apparent life-threatening event: a review

    Directory of Open Access Journals (Sweden)

    Mariana Tresoldi das N. Romaneli

    2012-12-01

    Full Text Available OBJETIVO: Realizar uma revisão crítica reunindo informações disponíveis a respeito dos eventos com aparente risco de morte. FONTES DE DADOS: Revisão bibliográfica dos artigos (em português, inglês e espanhol obtidos dos bancos de dados eletrônicos Medline, Lilacs e SciELO, utilizando as palavras-chave: eventos com aparente risco de morte, evento com aparente risco de vida infantil, lactente, apneia, monitorização e cianose. SÍNTESE DOS DADOS: Os eventos com aparente risco de mortesão súbitos e caracterizados por uma combinação de apneia, alteração na coloração da pele e tônus muscular, com inúmeras causas subjacentes. Sua incidência verdadeira é desconhecida e a faixa etária mais acometida é de 11 a 12 semanas. Não há correlação entre o evento com aparente risco de morte e a síndrome da morte súbita do lactente, embora já tenham sido consideradas manifestações da mesma doença. Muitas vezes, o lactente tem aparência saudável ao ser avaliado pelo pediatra após apresentar eventos com aparente risco de morte, porém, isso não afasta a possibilidade de existir uma doença grave associada ao evento, que deve ser investigada e tratada. Quando não são encontradas as causas, o evento é idiopático, geralmente com boa evolução. CONCLUSÕES: É necessário investigar os lactentes levados ao pronto-socorro após apresentarem eventos com aparente risco de morte, devido ao risco de sequelas e mortalidade. Não há uma padronização das condutas a serem realizadas diante de um lactente com aparência saudável que tenha evento com aparente risco de morte, mas recomenda-se que o paciente seja internado e a causa do evento, investigada. A observação e o monitoramento em ambiente hospitalar devem ocorrer no mínimo 24 horas após o evento.OBJETIVO: Realizar una revisión crítica, reuniendo las informaciones disponibles respecto a los Eventos con Aparente Riesgo de Muerte (ALTE - Apparent life-threatening event

  7. Evento com aparente risco de morte recorrente como manifestação inicial de síndrome miastênica congênita Evento con aparente riesgo de muerte recurrente como manifestación inicial de síndrome miasténico congénito Recurrent apparent life-threatening event as the first manifestation of congenital myasthenia

    Directory of Open Access Journals (Sweden)

    Mariana Tresoldi das N. Romaneli

    2013-03-01

    miastenia congénita. Después de la confirmación del diagnóstico, se mantuvo el tratamiento ambulatorial con piridostigmina, con recuperación nutricional y neurológica, sin nuevos eventos con aparente riesgo de muerte en los tres años siguientes. COMENTARIOS: La investigación minuciosa de las causas de eventos con aparente riesgo de muerte puede llevar a diagnósticos menos frecuentes que exigen tratamiento específico, como la miastenia congénita.OBJECTIVE: To alert pediatricians about the importance of a careful investigation on recurrent apparent life-threatening events. Reports of the association of these events with congenital myasthenic syndromes were not found. CASE DESCRIPTION: A seven-month-old infant with recurrent apparent life-threatening events was admitted for investigation. During hospital stay, she presented cyanosis and respiratory failure, requiring mechanical ventilation for three days. After clinical improvement, hypotheses of gastroesophageal reflux and pulmonary aspiration were ruled out. The presence of eyelid ptosis, general hypotonia and weak crying led to the suspicion of congenital myasthenia, which was confirmed. Treatment with oral piridostigmine led to neurological and nutritional normalization, without any other apparent life-threatening event during the next three years. COMMENTS: The careful etiological investigation of apparent life-threatening events may lead to rare diagnosis that requires specific treatments, such as congenital myasthenia.

  8. Near-death experiences in non-life-threatening events and coma of different etiologies

    Directory of Open Access Journals (Sweden)

    Vanessa eCharland-Verville

    2014-05-01

    Full Text Available Background: Near death experiences (NDEs are increasingly being reported as a clearly identifiable physiological and psychological reality of clinical significance. However, the definition and causes of the phenomenon as well as the identification of NDE experiencers is still a matter of debate. To date, the most widely used standardized tool to identify and characterize NDEs in research is the Greyson NDE Scale. Using this scale, retrospective and prospective studies have been trying to estimate their incidence in various populations but few studies have tackled to associate the experiences’ intensity and content related to etiology. Methods: This retrospective investigation assessed the most frequently recounted features of self-reported NDEs after a non-life-threatening event (i.e., NDE-like experience or after a pathological coma (i.e., classical NDEs and according to the etiology of the acute brain insult. We also compared our retrospectively acquired data in anoxic coma with historical data from the published literature on prospective post-anoxic studies using the Greyson NDE Scale. Results: From our 190 reports who met the criteria for NDE (i.e., NDE scale total score Conclusions: It appears that real NDEs after coma of different etiologies are similar to NDE-like experiences occurring after non-life threatening events. Subjects reporting NDEs retrospectively tend to have experienced a different content compared to the prospective experiencers

  9. Life-Threatening Adverse Events Following Therapeutic Opioid Administration in Adults: Is Pharmacogenetic Analysis Useful?

    Directory of Open Access Journals (Sweden)

    Parvaz Madadi

    2013-01-01

    Full Text Available BACKGROUND: Systemic approaches are needed to understand how variations in the genes associated with opioid pharmacokinetics and response can be used to predict patient outcome. The application of pharmacogenetic analysis to two cases of life-threatening opioid-induced respiratory depression is presented. The usefulness of genotyping in the context of these cases is discussed.

  10. Recurrent apparent life-threatening event as the first manifestation of congenital myasthenia

    OpenAIRE

    Romaneli,Mariana Tresoldi das N.; Castro, Carla Cristina T. de S.; Fraga, Andrea de Melo A; Elizete Aparecida Lomazi; Anamarli Nucci; Antonia Teresinha Tresoldi

    2013-01-01

    OBJETIVO: Alertar os pediatras sobre a necessidade de investigar criteriosamente a etiologia de eventos com aparente risco de morte recorrente. Não foram encontrados relatos associando tais eventos à miastenia congênita. DESCRIÇÃO DO CASO: Lactente de sete meses apresentando história de eventos com aparente risco de morte recorrente foi internado para investigação. Durante a internação, apresentou cianose e dispneia progressiva, com necessidade de ventilação mecânica por três dias. Após a mel...

  11. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey.

    Science.gov (United States)

    Cheah, Yee Lee; Simpson, Mary Ann; Pomposelli, James J; Pomfret, Elizabeth A

    2013-05-01

    The incidence of morbidity and mortality after living donor liver transplantation (LDLT) is not well understood because reporting is not standardized and relies on single-center reports. Aborted hepatectomies (AHs) and potentially life-threatening near-miss events (during which a donor's life may be in danger but after which there are no long-term sequelae) are rarely reported. We conducted a worldwide survey of programs performing LDLT to determine the incidence of these events. A survey instrument was sent to 148 programs performing LDLT. The programs were asked to provide donor demographics, case volumes, and information about graft types, operative morbidity and mortality, near-miss events, and AHs. Seventy-one programs (48%), which performed donor hepatectomy 11,553 times and represented 21 countries, completed the survey. The average donor morbidity rate was 24%, with 5 donors (0.04%) requiring transplantation. The donor mortality rate was 0.2% (23/11,553), with the majority of deaths occurring within 60 days, and all but 4 deaths were related to the donation surgery. The incidences of near-miss events and AH were 1.1% and 1.2%, respectively. Program experience did not affect the incidence of donor morbidity or mortality, but near-miss events and AH were more likely in low-volume programs (≤50 LDLT procedures). In conclusion, it appears that independently of program experience, there is a consistent donor mortality rate of 0.2% associated with LDLT donor procedures, yet increased experience is associated with lower rates of AH and near-miss events. Potentially life-threatening near-miss events and AH are underappreciated complications that must be discussed as part of the informed consent process with any potential living liver donor.

  12. Febrile pleuropericarditis, a potentially life-threatening adverse event of balsalazide--case report and literature review of the side effects of 5-aminosalicylates.

    Science.gov (United States)

    Coman, Roxana M; Glover, Sarah C; Gjymishka, Altin

    2014-05-01

    Ulcerative colitis (UC) is an idiopathic chronic inflammatory disorder that affects the colonic mucosa. One class among the drugs used for its treatment is the 5-aminosalicylates (5-ASAs). While highly efficacious in treating mild-to-moderate UC, 5-ASAs are associated with rare but potentially life-threatening side effects such as pericarditis, myocarditis and pneumonitis. These adverse events appear to be caused by a hypersensitivity reaction and resolve after cessation of 5-ASA drugs. This article presents a case report of febrile pleuropericarditis in a UC patient treated with balsalazide, and provides a thorough literature review of the rare side effects of 5-ASAs, their incidence, clinical presentation, differential diagnosis and treatment. In conclusion, the clinicians should be aware that this type of adverse events to 5-ASA compounds can be easily overlooked but it has significant morbidity if not promptly diagnosed.

  13. Mutations in cytoplasmic loops of the KCNQ1 channel and the risk of life-threatening events

    DEFF Research Database (Denmark)

    Barsheshet, Alon; Goldenberg, Ilan; O-Uchi, Jin

    2012-01-01

    β-Adrenergic stimulation is the main trigger for cardiac events in type 1 long-QT syndrome (LQT1). We evaluated a possible association between ion channel response to β-adrenergic stimulation and clinical response to β-blocker therapy according to mutation location.......β-Adrenergic stimulation is the main trigger for cardiac events in type 1 long-QT syndrome (LQT1). We evaluated a possible association between ion channel response to β-adrenergic stimulation and clinical response to β-blocker therapy according to mutation location....

  14. Life-threatening motor vehicle crashes in bright sunlight

    Science.gov (United States)

    Redelmeier, Donald A.; Raza, Sheharyar

    2017-01-01

    Abstract Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight. This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later. The majority of patients (n = 6962) were injured during daylight hours and bright sunlight was the most common weather condition at the time and place of the crash. The risk of a life-threatening crash was 16% higher during bright sunlight than normal weather (95% confidence interval: 9–24, P < 0.001). The increased risk was accentuated in the early afternoon, disappeared at night, extended to patients with different characteristics, involved crashes with diverse features, not apparent with cloudy weather, and contributed to about 5000 additional patient-days in hospital. The increased risk extended to patients with high crash severity as indicated by ambulance involvement, surgical procedures, length of hospital stay, intensive care unit admission, and patient mortality. The increased risk was not easily attributed to differences in alcohol consumption, driving distances, or anomalies of adverse weather. Bright sunlight is associated with an increased risk of a life-threatening motor vehicle crash. An awareness of this risk might inform driver education, trauma staffing, and safety warnings to prevent a life-threatening motor vehicle crash. Level of evidence: Epidemiologic Study, level III. PMID:28072708

  15. Transgender Youth and Life-Threatening Behaviors

    Science.gov (United States)

    Grossman, Arnold H.; D'Augelli, Anthony R.

    2007-01-01

    Sexual minority status is a key risk factor for suicide among lesbian, gay, and bisexual youth; however, it has not been studied among transgender youth. Fifty-five transgender youth reported on their life-threatening behaviors. Nearly half of the sample reported having seriously thought about taking their lives and one quarter reported suicide…

  16. Life threatening illness and hospice care.

    Science.gov (United States)

    Stein, A; Forrest, G C; Woolley, H; Baum, J D

    1989-01-01

    A retrospective study was undertaken of 25 families and their 26 ill children attending the first children's hospice in the United Kingdom. The study examined the family's perceptions of the care offered and the impact of chronic and life threatening illness. Eighteen (72%) of the families felt they had been well supported by the hospice and valued the family like atmosphere, perceiving the staff to be friendly, approachable, and helpful. The actual nature of hospice care, in an environment with other terminally ill children, was, however, considered a drawback for a few families. A number of families still had unmet needs, notably appropriate child minding when away from the hospice. The impact of chronic life threatening illness on the families was substantial. The parents (particularly the mothers), the index children, and their siblings all experienced much higher levels of psychological symptomatology than would have been expected from normal samples. While families felt greatly helped over symptom control, a proportion remained very worried about certain symptoms, particularly breathlessness, seizures, and pain. A high proportion of families were experiencing financial and employment difficulties as a result of their children's illnesses. PMID:2730123

  17. The psychosocial impact of life-threatening childhood food allergies.

    Science.gov (United States)

    Broome-Stone, S Brantlee

    2012-01-01

    The purpose of this integrated literature review was to bring understanding to medical professionals of the psychosocial impact of parenting a child with life-threatening food allergies. Prevalence of life-threatening food allergy among children is increasing, and families continue to navigate the effects it can have on all members of a family. A comprehensive literature review was performed related to chronic childhood illnesses and life-threatening food allergies. Commonalities among the conditions exist related to stress, coping, and adaptive responses when parental perceptions and experiences are considered. This information may provide a conceptual context for the adaptation process involved with parenting a young child with life-threatening food allergies, revealing areas where nursing can serve to intervene and support this process.

  18. Life-Threatening Laryngeal Edema and Hyponatremia during Hysteroscopy

    Directory of Open Access Journals (Sweden)

    Barbara Wegmüller

    2011-01-01

    Hysteroscopy usually has low risks. However, absorption of the irrigation fluid can result in life-threatening fluid overload and electrolyte disturbances. Accurate fluid balancing and limiting the operation time may prevent these complications.

  19. Pseudohypoaldosteronism in a neonate presenting as life-threatening arrhythmia

    OpenAIRE

    Rajpoot, Sudeep K.; Maggi, Carlos; Bhangoo, Amrit

    2014-01-01

    Summary Neonatal hyperkalemia and hyponatremia are medical conditions that require an emergent diagnosis and treatment to avoid morbidity and mortality. Here, we describe the case of a 10-day-old female baby presenting with life-threatening hyperkalemia, hyponatremia, and metabolic acidosis diagnosed as autosomal dominant pseudohypoaldosteronism type 1 (PHA1). This report aims to recognize that PHA1 may present with a life-threatening arrhythmia due to severe hyperkalemia and describes the ma...

  20. Happy ending of life-threatening upper GI bleeding

    Science.gov (United States)

    Islam, Quazi Tarikul; Siddiqui, Mahmudur Rahman; Rahman, Md Anisur; Ahmed, Syed Salahuddin

    2011-01-01

    Strongyloides stercoralis is an intestinal nematode in humans, and estimated about tens of millions of people are infected worldwide. This parasite is endemic in tropical or temperate and subtropical climates like Bangladesh. The authors report a 33-year-old man who presented with recurrent life-threatening upper gastrointestinal bleeding from gastric infection by S stercoralis. PMID:22673715

  1. Siblings of the Child with a Life-Threatening Illness.

    Science.gov (United States)

    Sourkes, Barbara M.

    1987-01-01

    The experience of siblings of a child with a life-threatening illness may be seen at the juncture of the following perspectives: (1) the family system; (2) a focus on living rather than on dying; and (3) a view toward positive adaptation rather than toward psychopathology. The most critical focus is on the sibling-patient relationship itself. (BJV)

  2. Swimming-induced immersion pulmonary edema while snorkeling can be rapidly life-threatening: case reports.

    Science.gov (United States)

    Cochard, G; Henckes, A; Deslandes, S; Noël-Savina, E; Bedossa, M; Gladu, G; Ozier, Y

    2013-01-01

    It is well known that immersion pulmonary edema can be life-threatening for divers using a self-contained underwater breathing apparatus (scuba). Swimming-induced pulmonary edema in otherwise healthy individuals is not an object of dispute but its real severity is not well known and is probably underestimated. We report two cases of life-threatening acute respiratory distress while swimming and snorkeling, one of which is well documented for swimming-induced pulmonary edema. The interest of these case reports lies in the suddenness of these life-threatening events. Such accidents can mimic a loss of consciousness due to cardiac dysrhythmia and lead to drowning. In the case of swimming-induced pulmonary edema, the prognosis is far better than for a cardiac disorder, but it is also dependent on the efficiency of the supervision. Swimmers, divers, race organizers and supervising physicians should be given knowledge of this pathology and its potentially acute occurrence. Adequate organizational dispositions are mandatory to prevent swimming-induced pulmonary edema-related deaths.

  3. Late Life-Threatening Hemorrhage after Percutaneous Tracheostomy

    Directory of Open Access Journals (Sweden)

    Torsten Richter

    2011-01-01

    Full Text Available Purpose. Formation of a tracheoinnominate artery fistula (TIF and consecutive hemorrhage is a rare and life-threatening complication with high mortality. Warning symptoms can be absent. The current literature contains only few considerations for misleading signs, especially in cases where the contact between the tissue and the cannula is tight. Method and Results. We report two cases of life-threatening hemorrhages that appeared six days and two months after percutaneous dilatational tracheostomy (PDT in two patients, respectively. In these cases, diagnosis of tracheoinnominate artery fistula (TIF was difficult. Tracheal ring fracture after PDT and pressure ulceration caused by cannula were implicated in TIF formation. The cannula was overblocked to buy time before surgical closure. Both patients survived without any additional neurological deficiency. Conclusion. Massive hemorrhage in patients after tracheostomy is likely due to TIF. Ultrasound scanning before PDT and careful periodical followup of the trachea are required.

  4. Phenytoin induced life threatening macroglossia in a child

    Directory of Open Access Journals (Sweden)

    Rakesh Mondal

    2013-01-01

    Full Text Available Isolated acquired macroglossia of tongue rarely reported. It occurs due to causes like hereditary angioedema, localized angioedema, etc., Here we describe an 8-year-old boy developing life threatening localized angioedema of tongue due to phenytoin without any association with drug reaction with eosinophilia and systemic symptoms (DRESS syndrome or pseudolymphoma encountered in rural medical college. Anticonvulsants, that is, phenytoin induced this isolated peculiar complication, which was not described before.

  5. Life-threatening motor vehicle crashes in bright sunlight.

    Science.gov (United States)

    Redelmeier, Donald A; Raza, Sheharyar

    2017-01-01

    Bright sunlight may create visual illusions that lead to driver error, including fallible distance judgment from aerial perspective. We tested whether the risk of a life-threatening motor vehicle crash was increased when driving in bright sunlight.This longitudinal, case-only, paired-comparison analysis evaluated patients hospitalized because of a motor vehicle crash between January 1, 1995 and December 31, 2014. The relative risk of a crash associated with bright sunlight was estimated by evaluating the prevailing weather at the time and place of the crash compared with the weather at the same hour and location on control days a week earlier and a week later.The majority of patients (n = 6962) were injured during daylight hours and bright sunlight was the most common weather condition at the time and place of the crash. The risk of a life-threatening crash was 16% higher during bright sunlight than normal weather (95% confidence interval: 9-24, P vehicle crash. An awareness of this risk might inform driver education, trauma staffing, and safety warnings to prevent a life-threatening motor vehicle crash.

  6. Can femoral dialysis catheter insertion cause a life threatening complication?

    Directory of Open Access Journals (Sweden)

    Nurkay Katrancıoğlu

    2014-09-01

    Full Text Available Venous catheter (VC insertion may be necessary for the patients with renal failure facing vascular access problem. Femoral VCs are commonly used for their lower complication rates especially in emergency clinics. The incidence of bleeding associated with VC is reported 0.5-1.6%, however, life threatening hemorrhage and complications requiring surgical intervention are very rare. In this manuscript, we aimed to present a case with hemolytic uremic syndrome complicated with retroperitoneal hematoma after femoral VC insertion. J Clin Exp Invest 2014; 5 (3: 472-474

  7. Discussion on Teacher’s Role under Life Threatening Circumstances

    Institute of Scientific and Technical Information of China (English)

    彭璐

    2014-01-01

    This paper first reviewed a controversial case in which a teacher ran away from his students in a earthquake. Several ed-ucational ethnic questions were aroused from the case: Is protecting students part of teacher ’s job? To what extent should it be applied? etc. Then the author aims to answer these questions based on a real case study from philosophical perspective, that is, ana-lyzing teacher’s role (i) as a human being; (ii) as a educator; (iii) as a educatee. Finally the paper concludes that teachers should protect their students even under life threatening circumstances.

  8. Cesarean Delivery for a Life-threatening Preterm Placental Abruption

    Science.gov (United States)

    Okafor, II; Ugwu, EO

    2015-01-01

    Placental abruption is one of the major life-threatening obstetric conditions. The fetomaternal outcome of a severe placental abruption depends largely on prompt maternal resuscitation and delivery. A case of severe preterm placental abruption with intrauterine fetal death. Following a failed induction of labor with a deteriorating maternal condition despite resuscitation, emergency cesarean delivery was offered with good maternal outcome. Cesarean delivery could avert further disease progression and possible maternal death in cases of severe preterm placental abruption where vaginal delivery is not imminent. However, further studies are necessary before this could be recommended for routine clinical practice. PMID:27057388

  9. Antipsychotic-induced life-threatening 'esophageal dyskinesia'.

    Science.gov (United States)

    Horiguchi, J; Shingu, T; Hayashi, T; Kagaya, A; Yamawaki, S; Horikawa, Y; Kitadai, Y; Inoue, M; Nishikawa, T

    1999-03-01

    We report two patients with lingual dyskinesia and complaints of food regurgitation following long-term antipsychotic therapy. Esophageal contrast radiography revealed dyskinetic movements extending from the pharynx to the upper portion of the esophagus. The elevation of intraesophageal pressure was confirmed by esophageal manometry. The dyskinetic movements almost disappeared along with improvement of lingual dyskinesia following the administration of sulpiride in one patient. Another patient suddenly died due to asphyxiation of foods before the beginning of treatment. We termed this life-threatening movement, 'esophageal dyskinesia'. It should be emphasized that 'esophageal dyskinesia' associated with lingual dyskinesia is a potentially fatal adverse reaction to antipsychotic therapy.

  10. Identification of Stress Change Within a Rock Mass Through Apparent Stress of Local Seismic Events

    Science.gov (United States)

    Brown, Laura; Hudyma, Martin

    2017-01-01

    Mine blasting produces excavation geometry changes which induce stress change that can be observed in the seismic source parameter apparent stress calculated for local seismic events. Using high apparent stress as a proxy for increasing stress within a rock mass, areas experiencing increases in the local stress conditions can be determined. This paper presents the use of apparent stress of seismic events to identify areas within a rock mass experiencing local stress change. Examples from a deep Canadian mine, operating in excess of 2900 m below surface, are provided.

  11. Life-threatening asthma attack during prolonged fingolimod treatment: case report

    Directory of Open Access Journals (Sweden)

    Zecca C

    2014-07-01

    Full Text Available Chiara Zecca,1,* Matteo Caporro,1,* Sandor Györik,2 Claudio Gobbi11Neurocenter of Southern Switzerland, Department of Neurology, Ospedale Regionale di Lugano, Lugano, Switzerland; 2Department of Internal Medicine, Ospedale Regionale di Bellinzona, Bellinzona, Switzerland*These authors contributed equally to this workBackground: Fingolimod (FTY mediates bronchoconstriction by interacting with sphingosine-1-phosphate receptors. The majority of the reported adverse respiratory events occur during the first weeks of treatment.Case presentation: A 49-year-old woman developed a life-threatening asthma attack after 6 months of continuous FTY treatment. The adverse event required prolonged hospitalization, and the patient recovered without sequelae after FTY interruption. A history of previous airway hyperreactivity and a concurrent viral respiratory infection possibly acted as predisposing factors.Conclusion: This first description of a severe, life-threatening asthma attack during prolonged FTY treatment suggests the need for long-term clinical surveillance, especially in patients with known predisposing factors.Keywords: multiple sclerosis, bronchial hyper-reactivity

  12. Life-threatening complications after ureteroscopy for urinary stones: survey and revision of the current literature.

    Science.gov (United States)

    Cindolo, Luca; Castellan, Pietro; Primiceri, Giulia; Hoznek, Andras; Cracco, Cecilia M; Scoffone, Cesare M; Galfano, Antonio; Petralia, Giovanni; DE Angelis, Michele; Annino, Filippo; Malacasa, Emilio; Cormio, Luigi; Acquati, Pietro; DE Lorenzis, Elisa; Maugeri, Orazio; Arena, Giuseppe; Celia, Antonio; Giusti, Guido; Schips, Luigi

    2017-02-01

    Retrograde ureteroscopy (URS) has become a common procedure for the management of urinary stones. Although its efficacy and safety are well known, the literature about major complications is still poor. This study highlighted some cases of life-threatening complications after semirigid ureteroscopy (s-URS) or flexible ureteroscopy (f-URS). We enrolled experienced endourologists (more than 75 cases/year in the last 3 years) and we performed a survey asking to review their series and report the cases encumbered by major complications (Clavien-Dindo IIIb-IV grade). Eleven urologists reported on 12 major complications (4 after s-URS, 8 after f-URS). Eight patients developed a kidney injury, 1 an arteriovenous fistula, 2 a ureter avulsion and 1 acute sepsis. Six patients underwent open nephrectomy, two surgical repair, one open pyeloplasty, one coil artery embolization and two superselective artery embolization. Guidelines and clinical practice give useful recommendations about intraoperative safety and prevention of life-threatening events. The careful postoperative observation and the surgical active treatment of this complications play a key role in reducing morbidity, kidney loss and mortality. This study encourages a strict and active care of patients, supports a routine reporting of complications, and highlights the need for systematic use of standardized classification systems.

  13. Warfarin-induced sublingual hematoma mimicking Ludwig angina: Conservative management of a potentially life-threatening condition.

    LENUS (Irish Health Repository)

    Cashman, Emma

    2012-02-01

    Sublingual hematoma secondary to excessive anticoagulation is a rare, life-threatening condition. Reports in the literature have emphasized the importance of a prompt reversal of the causative coagulopathy by intravenous administration of vitamin K and fresh frozen plasma. In the event of an unstable airway, surgical intervention via tracheostomy or cricothyroidectomy is advocated. We report a case of sublingual hematoma that was treated conservatively, and we discuss the presentation and management of this entity.

  14. Warfarin-induced sublingual hematoma mimicking Ludwig angina: Conservative management of a potentially life-threatening condition.

    LENUS (Irish Health Repository)

    Cashman, Emma

    2011-02-01

    Sublingual hematoma secondary to excessive anticoagulation is a rare, life-threatening condition. Reports in the literature have emphasized the importance of a prompt reversal of the causative coagulopathy by intravenous administration of vitamin K and fresh frozen plasma. In the event of an unstable airway, surgical intervention via tracheostomy or cricothyroidectomy is advocated. We report a case of sublingual hematoma that was treated conservatively, and we discuss the presentation and management of this entity.

  15. Life-threatening Cerebral Venous Thrombosis: a case report

    Directory of Open Access Journals (Sweden)

    Daniel Agustin Godoy

    2016-06-01

    Full Text Available Cerebral venous sinus thrombosis (CVT can compromise dural sinus, cerebral veins or both. It is an uncommon condition and it is more prevalent in young women. Several prothrombotic states are the principal predisposing factors. Clinical spectrum of presentation is wide, so this entity requires a high suspect index for correct and prompt diagnosis. CVT may develop serious complications that can be life-threatening such as hemorrhagic venous infarctions, cerebral edema, and intracranial hypertension. This report describes the case of a woman who was in treatment for unspecific vaginal bleeding with oral contraceptives. Suddenly she deteriorated to coma with severe respiratory compromise. Neuroimaging showed thrombosis of multiple venous sinus. Physiological neuroprotection, osmotherapy, mechanical ventilation and anticoagulation therapy were the keystones of treatment. In a few months, the patient has recovered a good functional status, while maintaining a motor deficit on the right hand.

  16. Life-threatening complications of deep neck space infections.

    Science.gov (United States)

    Dalla Torre, Daniel; Brunold, Silvia; Kisielewsky, Irene; Kloss, Frank R; Burtscher, Doris

    2013-11-01

    Odontogenic infections represented a challenge for every craniomaxillofacial surgeon in the pre-antibiotic era, not least due to the frequent association with septic complications and lethal consequences. Nowadays, the incidences of serious infection-related complications are less frequent thanks to the medical progress. Nevertheless, the development of severe infections is still hard to foresee. The following analysis provides an overview of four patients with severe, life-threatening odontogenic deep neck space infections treated at the University Clinic for Oral and Maxillofacial Surgery in Innsbruck and describes the etiology, therapy, and outcome for each patient while analyzing differences between the single cases. Crucial aspects in origin, progression, and treatment of DNIs are highlighted, comparing the results with the international literature.

  17. The generalized second law of gravitational thermodynamics on the apparent and event horizons in FRW cosmology

    Energy Technology Data Exchange (ETDEWEB)

    Karami, K; Ghaffari, S; Soltanzadeh, M M, E-mail: KKarami@uok.ac.i [Department of Physics, University of Kurdistan, Pasdaran St, Sanandaj (Iran, Islamic Republic of)

    2010-10-21

    We investigate the validity of the generalized second law (GSL) of gravitational thermodynamics on the apparent and event horizons in a non-flat Friedmann-Robertson-Walker (FRW) universe containing dark energy interacting with dark matter. We show that for the dynamical apparent horizon, the GSL is always satisfied throughout the history of the universe for any spatial curvature and it is independent of the equation of state parameter of the interacting dark energy model. On the other hand, for the cosmological event horizon, the validity of the GSL depends on the equation of state parameter of the model.

  18. Event and Apparent Horizon Finders for 3+1 Numerical Relativity

    Directory of Open Access Journals (Sweden)

    Thornburg Jonathan

    2007-06-01

    Full Text Available Event and apparent horizons are key diagnostics for the presence and properties of black holes. In this article I review numerical algorithms and codes for finding event and apparent horizons in numerically-computed spacetimes, focusing on calculations done using the 3+1 ADM formalism. The event horizon of an asymptotically-flat spacetime is the boundary between those events from which a future-pointing null geodesic can reach future null infinity and those events from which no such geodesic exists. The event horizon is a (continuous null surface in spacetime. The event horizon is defined nonlocally in time: it is a global property of the entire spacetime and must be found in a separate post-processing phase after all (or at least the nonstationary part of spacetime has been numerically computed.There are three basic algorithms for finding event horizons, based on integrating null geodesics forwards in time, integrating null geodesics backwards in time, and integrating null surfaces backwards in time. The last of these is generally the most efficient and accurate.In contrast to an event horizon, an apparent horizon is defined locally in time in a spacelike slice and depends only on data in that slice, so it can be (and usually is found during the numerical computation of a spacetime. A marginally outer trapped surface (MOTS in a slice is a smooth closed 2-surface whose future-pointing outgoing null geodesics have zero expansion Theta. An apparent horizon is then defined as a MOTS not contained in any other MOTS. The MOTS condition is a nonlinear elliptic partial differential equation (PDE for the surface shape, containing the ADM 3-metric, its spatial derivatives, and the extrinsic curvature as coefficients. Most “apparent horizon” finders actually find MOTSs.There are a large number of apparent horizon finding algorithms, with differing trade-offs between speed, robustness, accuracy, and ease of programming. In axisymmetry, shooting

  19. Ectopic pregnancy: a life-threatening gynecological emergency

    Directory of Open Access Journals (Sweden)

    Lawani OL

    2013-08-01

    Full Text Available Osaheni L Lawani, Okechukwu B Anozie, Paul O Ezeonu Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: The aim of this work was to determine and evaluate the incidence, clinical presentation, risk factors, and management outcomes of ectopic pregnancies at Ebonyi State University Teaching Hospital (EBSUTH in Abakaliki. Methods: This was a retrospective, descriptive study of ectopic pregnancies managed in EBSUTH during the study period (June 1, 2002 to May 31, 2012. The medical records of the patients managed for ectopic pregnancy as well as the total birth record and gynecological admission records during the period under review were retrieved, and data were collected with the aid of data-entry forms designed for this purpose. There were 4,610 gynecological admissions and 9,828 deliveries, with 215 cases of ectopic pregnancies. A total of 205 cases were suitable for analysis after excluding cases with incomplete records. The relevant data collected were analyzed with SPSS version 15.0 for Windows. Results: Ectopic pregnancy constituted 4.5% of all gynecological admissions, and its incidence was 2.1%. The mean age of the patients was 27 ± 2 years, 196 of 205 (95.6% had ruptured ectopic pregnancies, and the remaining nine (4.4% were unruptured. The commonest (166 of 205, 80.0% clinical presentation was abdominal pain, and the commonest (105 of 205, 51.2% identified risk factor was a previous history of induced abortion. Three deaths were recorded, giving a case-fatality rate of 1.4% (three of 205. Conclusion: Ectopic pregnancy is a recognized cause of maternal morbidity and mortality and has remained a reproductive health challenge to Nigerian women, as well as a threat to efforts in achieving the UN's Millennium Development Goal 5 in sub-Saharan Africa

  20. Detection of visual events along the apparent motion trace in patients with paranoid schizophrenia.

    Science.gov (United States)

    Sanders, Lia Lira Olivier; Muckli, Lars; de Millas, Walter; Lautenschlager, Marion; Heinz, Andreas; Kathmann, Norbert; Sterzer, Philipp

    2012-07-30

    Dysfunctional prediction in sensory processing has been suggested as a possible causal mechanism in the development of delusions in patients with schizophrenia. Previous studies in healthy subjects have shown that while the perception of apparent motion can mask visual events along the illusory motion trace, such motion masking is reduced when events are spatio-temporally compatible with the illusion, and, therefore, predictable. Here we tested the hypothesis that this specific detection advantage for predictable target stimuli on the apparent motion trace is reduced in patients with paranoid schizophrenia. Our data show that, although target detection along the illusory motion trace is generally impaired, both patients and healthy control participants detect predictable targets more often than unpredictable targets. Patients had a stronger motion masking effect when compared to controls. However, patients showed the same advantage in the detection of predictable targets as healthy control subjects. Our findings reveal stronger motion masking but intact prediction of visual events along the apparent motion trace in patients with paranoid schizophrenia and suggest that the sensory prediction mechanism underlying apparent motion is not impaired in paranoid schizophrenia.

  1. Life-Threatening Hypokalemic Paralysis in a Young Bodybuilder

    Directory of Open Access Journals (Sweden)

    Kitty K. T. Cheung

    2014-01-01

    Full Text Available We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR 3.5–5.0 mmol/L. He was admitted to the intensive care unit (ICU and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology.

  2. Pseudohypoaldosteronism in a Neonate Presenting as Life-Threatening Hyperkalemia

    Directory of Open Access Journals (Sweden)

    Najya A. Attia

    2016-01-01

    Full Text Available Context. Pseudohypoaldosteronism type 1 (PHA1 is a life-threatening disease that causes severe hyperkalemia and cardiac arrest if not treated appropriately or if diagnosis is missed. Objective. To report a case of a newborn with vomiting and lethargy, ultimately diagnosed with pseudohypoaldosteronism. Patient. This case presented to the ED at an age of 14 days in hypovolemic shock. There was a family history of sudden infant death, her sister who was diagnosed with CAH and passed away at 3 months of age despite regular hormone replacement. Our patient had cardiac arrest in ED, due to hyperkalemia; while receiving fluid boluses, cardiopulmonary resuscitation was initiated. After stabilization, diagnostic workup demonstrated persistently low sodium, acidosis, and high potassium, which required peritoneal dialysis. Based on these findings, the patient was diagnosed with CAH. It turned out later that the patient had PHA1. Two years later, the patient had a new sibling with the same disease diagnosed at birth and started immediately on treatment without any complication. Conclusions and Outcome. This case highlights the significant diagnostic and therapeutic challenges in treating children with PHA1. Adrenal crisis is not always CAH; delayed diagnosis can lead to complication and even death. The presence of high plasma renin activity, aldosterone, and cortisol, along with the presence of hyponatremia and hyperkalemia, established the diagnosis of PHA type 1 and ruled out CAH.

  3. Life-threatening hypokalemic paralysis in a young bodybuilder.

    Science.gov (United States)

    Cheung, Kitty K T; So, Wing-Yee; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C

    2014-01-01

    We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6 mmol/L, reference range (RR) 3.5-5.0 mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology.

  4. Pseudohypoaldosteronism in a Neonate Presenting as Life-Threatening Hyperkalemia.

    Science.gov (United States)

    Attia, Najya A; Marzouk, Yousef I

    2016-01-01

    Context. Pseudohypoaldosteronism type 1 (PHA1) is a life-threatening disease that causes severe hyperkalemia and cardiac arrest if not treated appropriately or if diagnosis is missed. Objective. To report a case of a newborn with vomiting and lethargy, ultimately diagnosed with pseudohypoaldosteronism. Patient. This case presented to the ED at an age of 14 days in hypovolemic shock. There was a family history of sudden infant death, her sister who was diagnosed with CAH and passed away at 3 months of age despite regular hormone replacement. Our patient had cardiac arrest in ED, due to hyperkalemia; while receiving fluid boluses, cardiopulmonary resuscitation was initiated. After stabilization, diagnostic workup demonstrated persistently low sodium, acidosis, and high potassium, which required peritoneal dialysis. Based on these findings, the patient was diagnosed with CAH. It turned out later that the patient had PHA1. Two years later, the patient had a new sibling with the same disease diagnosed at birth and started immediately on treatment without any complication. Conclusions and Outcome. This case highlights the significant diagnostic and therapeutic challenges in treating children with PHA1. Adrenal crisis is not always CAH; delayed diagnosis can lead to complication and even death. The presence of high plasma renin activity, aldosterone, and cortisol, along with the presence of hyponatremia and hyperkalemia, established the diagnosis of PHA type 1 and ruled out CAH.

  5. Suppurative meningitis: A life-threatening complication in male macroprolactinomas

    Directory of Open Access Journals (Sweden)

    Farida Chentli

    2013-01-01

    Full Text Available Background: Suppurative meningitis (SM or bacterial meningitis is a life-threatening condition, which is exceptionally due to pituitary tumors (PT. Our aim was to analyze its frequency among male macroprolactinomas (MPRL deemed to be aggressive, to report the cases we observed in our practice and describe the circumstances under which SM appeared. Materials and Methods: We retrospectively analyzed 82 male MPRL in order to look for a history of well proved SM and the circumstances under which SM appeared. We also took into account the possibility of SM relapsing. Results: Four out of 82 male MPRL had SM = 4.87%. Three consulted for SM symptoms. SM was confirmed in Infectious Diseases department, but only one had rhinorrhea. Hormonal assessment and cerebral magnetic resonance imaging pleaded for aggressive prolactinomas. After antibiotics, SM was sterilized. Then, MPRL were treated with bromocriptine, which normalized prolactin and reduced PT. SM never relapsed. The 4 th case was hospitalized for a large multidirectional prolactinoma invading and/or arising from the skull base. He was operated on 3 times and then he was given Bromocriptine. After 3 months, he had rhinorrhea and then SM which was successfully treated by antibiotics. SM never relapsed after tumor reduction. Conclusion: SM was demonstrated in 4.87%. SM has revealed MPRL in 3 cases and appeared after bromocriptine intake in the 4 th one. Endocrinologists should be aware of this severe condition, which can be avoided by repairing as soon as possible the bony defect secondary to aggressive tumors, unless it is clogged by fibrosis: What probably happened in our cases.

  6. A life-threatening flecainide overdose treated with intravenous fat emulsion.

    Science.gov (United States)

    Ellsworth, Heather; Stellpflug, Samuel J; Cole, Jon B; Dolan, Joseph A; Harris, Carson R

    2013-03-01

    Flecainide is a Vaughan Williams Class Ic antidysrhythmic associated with PR, QRS, and QTc prolongation on the electrocardiogram and development of life-threatening cardiac toxicity in overdose. The cornerstone of treatment is fluid resuscitation and the administration of magnesium and sodium bicarbonate. We report a case of flecainide overdose associated with life-threatening hemodynamic compromise successfully treated with intravenous fat emulsion (IFE) therapy. IFE should be considered as a novel adjunctive therapy in patients with life-threatening toxicity following flecainide overdose.

  7. Life-threatening Cerebral Edema Caused by Acute Occlusion of a Superior Vena Cava Stent

    Energy Technology Data Exchange (ETDEWEB)

    Sofue, Keitaro, E-mail: keitarosofue@yahoo.co.jp; Takeuchi, Yoshito, E-mail: yotake62@qg8.so-net.ne.jp; Arai, Yasuaki, E-mail: arai-y3111@mvh.biglobe.ne.jp [National Cancer Center Hospital, Department of Diagnostic Radiology (Japan); Sugimura, Kazuro, E-mail: sugimura@med.kobe-u.ac.jp [Kobe University, Department of Radiology, Graduate School of Medicine (Japan)

    2013-02-15

    A71-year-old man with advanced lung cancer developed a life-threatening cerebral edema caused by the acute occlusion of a superior vena cava (SVC) stent and was successfully treated by an additional stent placement. Although stent occlusion is a common early complication, no life-threatening situations have been reported until now. Our experience highlights the fact that acute stent occlusion can potentially lead to the complete venous shutdown of the SVC, resulting in life-threatening cerebral edema, after SVC stent placement. Immediate diagnosis and countermeasures are required.

  8. Apparently-deep events in the Middle Atlas resolved to be shallow: Implications for lithospheric deformation

    Science.gov (United States)

    Singh, Shashwat K.; Bezada, Maximiliano J.; Elouai, Driss; Harnafi, Mimoun

    2016-11-01

    The occurrence of intermediate depth seismicity in intracontinental settings is rare, but it has been postulated with various degrees of certainty in several regions. One such region is the Middle Atlas of Morocco. Since 1960, 75 intermediate depth earthquakes have been reported in this region by Spain's National Geographic Institute (IGN). The apparent deep nature of these events is hard to reconcile with well-established geophysical evidence of a thin lithosphere under the Middle Atlas, but has been associated with mantle delamination processes. We relocate 4 events with IGN-reported depths > 80 km that were recorded by a relatively dense temporary deployment; using a recent regional 3D velocity model obtained through teleseismic body and surface wave tomography. The relocation procedure uses a grid-search approach to minimize the mean normalized misfit, where each travel-time misfit is normalized by the estimated pick uncertainty. We find that our observed arrivals are much better fit by shallow ( 80 km. We propose that these shallow foci earthquakes are the result of regional crustal deformation of this region caused by the present convergence between Africa and Eurasian Plate. We infer that if there are any ongoing delamination processes in the area, they are aseismic. This study is an example of how local earthquake locations in tectonically complex areas can be significantly improved by using a dense local seismic array and a well-constrained 3-D velocity model.

  9. Odontogenic deep neck space infection as life-threatening condition in pregnancy.

    Science.gov (United States)

    Dalla Torre, D; Burtscher, D; Höfer, D; Kloss, F R

    2014-09-01

    Odontogenic deep neck space infections represent a severe disease with possible life-threatening complications. Despite knowledge of these infectious diseases, treatment remains a challenge for every maxillofacial surgeon. Therapy of severe neck infections is even more crucial during pregnancy because of the possible life-threatening situation for both the mother and the foetus. The possible compromise of oral health during pregnancy is well known, however severe odontogenic infections are rarely considered in the literature. The following case report describes the dramatic course of a deep neck space infection in a pregnant patient, commencing with typical symptoms of localized odontogenic infection and ending in a critical, life-threatening condition for the patient and a lethal condition for the foetus. The case represents the first description of intrauterine, foetal death caused by a deep neck space infection. Implications for dental and medical treatment during pregnancy, especially regarding odontogenic infections, are presented and discussed with findings in the international literature.

  10. Self-reported recognition of undiagnosed life threatening conditions in chiropractic practice: a random survey

    Directory of Open Access Journals (Sweden)

    Daniel Dwain M

    2012-07-01

    Full Text Available Abstract Background The purpose of this study was to identify the type and frequency of previously undiagnosed life threatening conditions (LTC, based on self-reports of chiropractic physicians, which were first recognized by the chiropractic physician. Additionally this information may have a preliminary role in determining whether chiropractic education provides the knowledge necessary to recognize these events. Methods The study design was a postal, cross-sectional, epidemiological self-administered survey. Two thousand Doctors of Chiropractic in the US were randomly selected from a list of 57878. The survey asked respondents to state the number of cases from the list where they were the first physician to recognize the condition over the course of their practice careers. Space was provided for unlisted conditions. Results The response rate was 29.9%. Respondents represented 11442 years in practice and included 3861 patients with a reported undiagnosed LTC. The most commonly presenting conditions were in rank order: carcinoma, abdominal aneurysm, deep vein thrombosis, stroke, myocardial infarction, subdural hematoma and a large group of other diagnoses. The occurrence of a previously undiagnosed LTC can be expected to present to the chiropractic physician every 2.5 years based on the responding doctors reports. Conclusion Based on this survey chiropractic physicians report encountering undiagnosed LTC’s in the normal course of practice. The findings of this study are of importance to the chiropractic profession and chiropractic education. Increased awareness and emphasis on recognition of LTC is a critical part of the education process and practice life.

  11. The Encounter With Life-Threatening Danger: Its Nature and Impact.

    Science.gov (United States)

    Noyes, Russell, Jr.

    1981-01-01

    A factor analysis of questionnaire responses from (N=189) victims of life-threatening accidents identified three dimensions of the altered state of consciousness produced by dangerous circumstances. These dimensions, included depersonalization, hyperalertness, and mystical consciousness, appeared meaningful in terms of the endangered personality's…

  12. Candida albicans-associated necrotizing vasculitis producing life-threatening gastrointestinal hemorrhage.

    LENUS (Irish Health Repository)

    Sargent, Jeremy

    2012-02-01

    Patients undergoing treatment of acute lymphoblastic leukemia are at risk for fungal infections including disseminated candidiasis. We describe a case of systemic Candida albicans infection associated with life-threatening gastrointestinal hemorrhage due to unusual necrotizing vasculitis involving the gastrointestinal tract. We explore the association between Candida and such vasculopathy.

  13. Propranolol treatment in life-threatening airway hemangiomas: a case series and review of literature

    NARCIS (Netherlands)

    Broeks, I.J.; Hermans, D.J.J.; Dassel, A.C.; Vleuten, C.J.M. van der; Beynum, I.M. van

    2013-01-01

    OBJECTIVES: Infantile hemangiomas (IHs) in the airway may be potentially life-threatening during the proliferative phase. Available treatments like oral corticosteroids (OCS) and chemotherapeutic agents usually showed variable responses and serious side effects. Propranolol is a new and promising tr

  14. Sex Differences in Violent versus Non-Violent Life-Threatening Altruism

    Directory of Open Access Journals (Sweden)

    Carey J. Fitzgerald

    2009-07-01

    Full Text Available Many studies on Hamilton's (1964 inclusive fitness theory have used the burning house and kidney donation examples of life-threatening altruism. However, these examples may not be sufficiently exhibiting the risk involved with life-threatening altruism that would have occurred in hunter-gatherer societies, such as fighting off attackers and/or predators. The present study examined participants' estimated likelihood to perform altruistic acts for specific kin members/friends in two violent life-threatening situations (i.e., being mugged and being chased and two non-violent life-threatening situations (i.e., the burning house and kidney donation examples. Participants were 216 undergraduate students who completed a questionnaire on altruism toward an actual kin member/friend. Each questionnaire contained four life-or-death scenarios (two violent and two non-violent in which either the participant's sibling, cousin, or best friend was in danger and needed help. Results indicated that people were more likely to help siblings than cousins and friends in both the violent and non-violent hypothetical scenarios. Participants indicated a greater likelihood to help people in violent situations than in non-violent situations. Women indicated a greater estimated likelihood than men to help people in non-violent situations while men indicated a greater estimated likelihood than women to help people in violent situations. Both male and female participants indicated a greater estimated likelihood to help women than men in violent situations.

  15. Guidelines for Managing Life-Threatening Food Allergies in Massachusetts Schools

    Science.gov (United States)

    Sheetz, Anne H.; Goldman, Patricia G.; Millett, Kathleen; Franks, Jane C.; McIntyre, C. Lynne; Carroll, Constance R.; Gorak, Diane; Harrison, Christanne Smith; Carrick, Michele Abu

    2004-01-01

    During the past decade, prevalence of food allergies among children increased. Caring for children with life-threatening food allergies has become a major challenge for school personnel Prior to 2002, Massachusetts did not provide clear guidelines to assist schools in providing a safe environment for these children and preparing for an emergency…

  16. Preparing School Personnel to Assist Students with Life-Threatening Food Allergies.

    Science.gov (United States)

    Hay, Genevieve H.; And Others

    1994-01-01

    Knowledge of and preparation for life-threatening food allergies will enable school personnel to better respond to students who have severe allergic reactions. Given the high incidence of food-related anaphylaxis in public places, teachers and school personnel should be aware of and prepared to handle severe food allergy reactions. (SM)

  17. 20 CFR 416.1248 - Exclusion of gifts to children with life-threatening conditions.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Exclusion of gifts to children with life-threatening conditions. 416.1248 Section 416.1248 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL SECURITY INCOME FOR THE AGED, BLIND, AND DISABLED Resources and Exclusions § 416.1248 Exclusion...

  18. Participation of Life-Threatened Children and Their Parents in Therapeutic Decision Making

    Science.gov (United States)

    Bishop, Agnes Joyce

    1978-01-01

    Describes a model of therapeutic decision-making for life-threatened children, i.e., the balancing of benefits versus risks of the disease and treatment for the child. Impact of therapy on the child and his parents and the time frame for the decision-making are outlined. (Author)

  19. A life-threatening case of disseminated nocardiosis due to Nocardia brasiliensis

    Directory of Open Access Journals (Sweden)

    Elisabeth Paramythiotou

    2012-01-01

    Full Text Available Nocardiosis is a rare disease caused by infection with Nocardia species, aerobic actinomycetes with a worldwide distribution. A rare life-threatening disseminated Nocardia brasiliensis infection is described in an elderly, immunocompromised patient. Microorganism was recovered from bronchial secretions and dermal lesions, and was identified using molecular assays. Prompt, timely diagnosis and appropriate treatment ensured a favorable outcome.

  20. Life-threatening extrarenal lupus in children despite improvement in serologic findings.

    Science.gov (United States)

    Butani, Lavjay; Makker, Sudesh P

    2003-03-01

    Systemic lupus erythematosus (SLE) is an autoimmune disorder with the potential for multiorgan involvement. Serologic tests are helpful in establishing the diagnosis of SLE and predicting disease flares. However, there are few data on the relationship between the onset of new organ involvement and lupus serologies, especially in children. This report details our experience in managing two children with lupus nephritis. Both developed life-threatening extrarenal complications (cerebritis and carditis) soon after receiving high-dose immunosuppressive therapy and despite normalizing serologies. This lack of concordance between serologies and the development of carditis and cerebritis needs to be recognized so that health care professionals treating children with SLE can promptly intensify immunosuppressive medications and avoid life-threatening delays from seeking alternative explanations for symptomatology.

  1. Life threatening hyperkalemia and acidosis secondary to trimethoprim-sulfamethoxazole treatment.

    Science.gov (United States)

    Margassery, S; Bastani, B

    2001-01-01

    We present a 77-year-old male with moderate chronic renal insufficiency from diabetic nephropathy who developed severe metabolic acidosis and life threatening hyperkalemia on treatment with regular dose of trimethoprim-sulfamethoxazole (TMP-SMZ) for urinary tract infection. The metabolic acidosis and hyperkalemia resolved upon appropriate medical intervention and discontinuation of TMP-SMZ. While hyperkalemia has commonly been reported with high dose of TMP-SMZ, severe metabolic acidosis is quite uncommon with regular dose TMP-SMZ. We emphasize that patients with renal tubular acidosis (RTA), renal insufficiency, aldosterone deficiency, old age with reduced renal mass and function, and angiotensin converting enzyme (ACE)-inhibitor therapy are at high risk of developing these severe and potentially life threatening complications.

  2. Successfull management of a life threatening cerebellar haemorrhage following spine surgery - a case report -.

    Science.gov (United States)

    Pallud, Johan; Belaïd, Hayat; Aldea, Sorin

    2009-06-01

    Cerebellar haemorrhages are rare life-threatening complications following spine surgery that present challenges for their diagnostic and their therapeutic management. Their patho-physiology remains unclear.We report a case of a life-threatening cerebellar haemorrhage secondary to an occult dural tear following a planned L5-S1 laminectomy. The patient was treated with emergent external ventriculostomy following by a posterior fossa decompressive craniectomy. Cerebellar haemorrhages have to be suspected systematically when unexpected neurological signs occur after spine surgery since their rapid management lead to favourable outcomes. The present imaging findings allow us proposing that cerebellar haemorrhages result primarily from superior cerebellar venous stretching and tearing, and that cerebellar infarction and swelling occur secondarily.

  3. Drug-Related Hyponatremic Encephalopathy: Rapid Clinical Response Averts Life-Threatening Acute Cerebral Edema

    Science.gov (United States)

    Siegel, Arthur J.; Forte, Sophie S.; Bhatti, Nasir A.; Gelda, Steven E.

    2016-01-01

    Patient: Female, 63 Final Diagnosis: Drug-induced hyponatremic encephalopathy Symptoms: Seizures • coma Medication: Hypertonic 3% saline infusion Clinical Procedure: — Specialty: Internal Medicine Objective: Unusual clinical course Background: Drug-induced hyponatremia characteristically presents with subtle psychomotor symptoms due to its slow onset, which permits compensatory volume adjustment to hypo-osmolality in the central nervous system. Due mainly to the syndrome of inappropriate antidiuretic hormone secretion (SIADH), this condition readily resolves following discontinuation of the responsible pharmacological agent. Here, we present an unusual case of life-threatening encephalopathy due to adverse drug-related effects, in which a rapid clinical response facilitated emergent treatment to avert life-threatening acute cerebral edema. Case Report: A 63-year-old woman with refractory depression was admitted for inpatient psychiatric care with a normal physical examination and laboratory values, including a serum sodium [Na+] of 144 mEq/L. She had a grand mal seizure and became unresponsive on the fourth day of treatment with the dual serotonin and norepinephrine reuptake inhibitor [SNRI] duloxetine while being continued on a thiazide-containing diuretic for a hypertensive disorder. Emergent infusion of intravenous hypertonic (3%) saline was initiated after determination of a serum sodium [Na+] of 103 mEq/L with a urine osmolality of 314 mOsm/kg H20 and urine [Na+] of 12 mEq/L. Correction of hyposmolality in accordance with current guidelines resulted in progressive improvement over several days, and she returned to her baseline mental status. Conclusions: Seizures with life-threatening hyponatremic encephalopathy in this case likely resulted from co-occurring SIADH and sodium depletion due to duloxetine and hydrochlorothiazide, respectively. A rapid clinical response expedited diagnosis and emergent treatment to reverse life-threatening acute cerebral edema

  4. Duodenal Wedge Resection for Large Gastrointestinal Stromal Tumour Presenting with Life-Threatening Haemorrhage

    Directory of Open Access Journals (Sweden)

    Alexander Shaw

    2013-01-01

    Full Text Available Background. Duodenal gastrointestinal stromal tumours (GISTs are an uncommon malignancy of the gastrointestinal (GI tract. We present a case of life-threatening haemorrhage caused by a large ulcerating duodenal GIST arising from the third part of the duodenum managed by a limited duodenal wedge resection. Case Presentation. A 61-year-old patient presented with acute life-threatening gastrointestinal bleeding. After oesophagogastroduodenoscopy failed to demonstrate the source of bleeding, a 5 cm ulcerating exophytic mass originating from the third part of the duodenum was identified at laparotomy. A successful limited wedge resection of the tumour mass was performed. Histopathology subsequently confirmed a duodenal GIST. The patient remained well at 12-month followup with no evidence of local recurrence or metastatic spread. Conclusion. Duodenal GISTs can present with life-threatening upper GI haemorrhage. In the context of acute haemorrhage, even relatively large duodenal GISTs can be treated by limited wedge resection. This is a preferable alternative to duodenopancreatectomy with lower morbidity and mortality but comparable oncological outcome.

  5. Chalearn looking at people 2015: Apparent age and cultural event recognition datasets and results

    DEFF Research Database (Denmark)

    Escalera, Sergio; Fabian, Junior; Baro, Xavier;

    2015-01-01

    Following previous series on Looking at People (LAP) competitions [14, 13, 11, 12, 2], in 2015 ChaLearn ran two new competitions within the field of Looking at People: (1) age estimation, and (2) cultural event recognition, both in still images. We developed a crowd-sourcing application to collec...

  6. [Pre-hospital management of adults with life-threatening emergencies].

    Science.gov (United States)

    Wattel, Francis; Dubois, François

    2012-01-01

    In France, acute life-threatening situations are handled by the French Secours a Personne (assistance to persons) and emergency medical facilities. An unequivocal success, this early management of life-threatening emergency situations relies upon centralized call reception, medical dispatching, and immediate on-site emergency medical care. We describe the different emergency care providers and steps involved in the response to emergency situations. Each call centre (Samu, phone number 15; Sapeurs-Pompiers, 18) provides a response tailored to the nature of incoming calls for assistance. A check-list of grounds for an "automatic response" by the SDIS (Service Départemental d'Incendie et de Secours--the French fire brigade) is in use, ensuring that firefighters are often the first on the spot, while the knowledge and skills of the dispatching physician are essential to ascertain the patient's needs, to preserve life and vital functions, and to ensure the patient is sent to the appropriate emergency healthcare facility. In life-threatening emergency situations, patients must be brought straight to the appropriate reference emergency healthcare facility, as quickly as possible, without prior admittance to an emergency department. This is the procedure for extremely acute emergency situations in the following areas: trauma (multiple trauma and/or uncontrolled bleeding, spinal cord trauma), delivery bleeding, other life-threatening situations such as ischemic heart disease, cardiac arrest (sudden death), cerebrovascular stroke and ensuing brain damage, some acute respiratory situations such as anaphylactic shock, foreign-body inhalation, electrocution, drowning, drug overdose, certain forms of poisoning, and conditions requiring initial hyperbaric oxygen (diving accidents, acute carbon monoxide and smoke poisoning). The reasons for suboptimal emergency care in life-threatening situations are currently a major issue, with medical facilities being reduced in some areas

  7. Life-threatening hemobilia caused by hepatic artery pseudoaneurysm:A rare complication of chronic cholangitis

    Institute of Scientific and Technical Information of China (English)

    Tsu-Te Liu; Ming-Chih Hou; Han-Chieh Lin; Full-Young Chang; Shou-Dong Lee

    2003-01-01

    Hemobilia is one of the causes of obscure gastrointestinal haemorrhage. Most cases of hemobilia are of iatrogenic or traumatic origin. Hemobilia caused by a hepatic artery pseudoaneurysm due to ascending cholangitis is very rare and its mechanism is undear. We report a 74-year-old woman with a history of surgery for choledocholithiasis 30 years ago, suffering from a protracted course of life-threatening gastrointestinal bleeding. A small intestines series and endoscopic retrograde cholangiopancreatography revealed a chronic cholangitis with marked contrast reflux into the biliary tree. Angiography confirmed the bleeding from a pseudoaneurysm of the middle hepatic artery. Coil embolization achieved successful hemostasis. We discussed the mechanism and reviewed the literature.

  8. Successful reversal of life threatening cardiac effect following dosulepin overdose using intravenous lipid emulsion

    DEFF Research Database (Denmark)

    Boegevig, Soeren; Rothe, Anders; Tfelt-Hansen, Jacob;

    2011-01-01

    CONTEXT. We report a successful acute reversal of potential life threatening QRS complex widening and prolonged QT interval following dosulepin overdose using intravenous lipid emulsion 20% in an unstable patient. CASE DETAILS. A 36-year-old female following the ingestion of 5.25 g of dosulepin...... became shorter. DISCUSSION. Cyclic antidepressants affect the cardiac conduction system and the myocardium. The exact mechanism of action from intravenous lipid emulsions may not be determined from the data presented, and the obtained effect does not rule out the supposed effects of alkalinisation...

  9. Cutaneous Cryptococcosis: a marker of life threatening disseminated cryptococcosis in HIV AIDS

    Directory of Open Access Journals (Sweden)

    Hari Kishan Kumar Yadalla

    2011-10-01

    Full Text Available Cryptococcosis is an opportunistic infection caused by a ubiquitous encapsulated yeast, Cryptococcus neoformans. Affects 5 – 10 % of patients with HIV worldwide. Disseminated cryptococcosis is one of the AIDS defining criteria and the most common cause of life threatening meningitis. Upto 20% of patients with disseminated disease can have skin involvement. Cutaneous lesions in disseminated cryptococcosis are seldom pathognomonic and portent neurological involvement. The significance of skin lesions may provide the first evidence of dissemination and indicate a poor prognosis, however, earlier recognition and treatment would improve survival. Herein we report a case of cryptococcal meningitis with skin lesions in a HIV seropositive patient.

  10. Life-Threatening Hypernatremia In A Case Of Diabetes Insipidus/Panhypopituitarism

    Directory of Open Access Journals (Sweden)

    Ekamol Tantisattamo

    2012-06-01

    Water balance is controlled by thyroid, glucocorticoid, and principally ADH working at the renal effector level while the RAAS principally controls sodium balance. Together these hormones tightly regulate serum sodium concentration. Managing hospitalized patients with DI/panhypopituitarism requires knowledge of the intricate interplay between ADH and thyroid/glucocorticoid tone to minimize the risk for dangerous sodium fluctuations. It is usually better to err on the side of mild hyponatremia than holding DDAVP in these complex patients which can lead to life threatening hypernatremia.

  11. Life Threatening, Allopurinol-related Dress Syndrome as a Rare Cause of Fever of Unknown Origin.

    Science.gov (United States)

    Civardi, Giuseppe; Zanlari, Luca; Bassi, Emanuele; Zangrandi, Adriano; Maria Cesinaro, Anna; Nosseir, Sofia; De Maria, Nicola

    2015-01-01

    Drug reaction eosinophilia with systemic symptoms (DRESS) syndrome is a potentially life threatening condition secondary to the usage of a wide type of drugs. A 38-year-old woman under allopurinol therapy for hyperuricemia was admitted in our department with fever and a diffuse cutaneous erythematous eruption. A few days after admission she developed rapidly progressive signs of acute liver and kidney failure. Subsequently, her clinical conditions shortly improved. The histologic findings obtained from skin and liver biopsies were consistent with a toxic drug reaction. The patient completely recovered and has been healthy for five years.

  12. Citric acid ingestion: a life-threatening cause of metabolic acidosis.

    Science.gov (United States)

    DeMars, C S; Hollister, K; Tomassoni, A; Himmelfarb, J; Halperin, M L

    2001-11-01

    We present a case that illustrates the acute (acidosis accompanied by an increase in the plasma anion gap that was not caused by L -lactic acidosis, hyperkalemia, and the abrupt onset of hypotension. A unique feature was a dramatic clinical improvement when ionized calcium was infused. The case illustrates the importance of considering the properties of the conjugate base (anion) of the added acid because, in this instance, the citrate anion had a unique and life-threatening consequence (lower ionized calcium level) that was rapidly reversible.

  13. A pediatric case of life-threatening airway obstruction caused by a cervicomediastinal thymic cyst

    Energy Technology Data Exchange (ETDEWEB)

    Komura, Makoto; Kanamori, Yutaka; Sugiyama, Masahiko; Iwanaka, Tadashi [University of Tokyo Hospital, Department of Pediatric Surgery, Tokyo (Japan); Fukushima, Noriyoshi [University of Tokyo Hospital, Department of Pathology, Tokyo (Japan)

    2010-09-15

    Most patients with thymic cysts complain of a slowly enlarging, asymptomatic cervical mass. Only 6-10% suffer dysphagia, dyspnoea, stridor, cervical pain or vocal paralysis. In some rare cases sudden onset of severe dyspnoea or asphyxia is the first symptom, especially in neonates and small infants. We report a unique case of a 20-month-old child, who required emergency tracheal intubation due to asphyxia. Cervicomediastinal thymic cyst might need to be included in causes of life-threatening airway obstruction in young children. (orig.)

  14. Life-Threatening Obstructive Sleep Apnea Caused by Adenoid Hypertrophy in an Infant with Noonan Syndrome

    Directory of Open Access Journals (Sweden)

    Sonia Khirani

    2012-01-01

    Full Text Available Adenoidectomy is a commonly performed surgery in children, even though its effectiveness is still under investigation. However, in children with risk factors such as age under 3 years old, associated comorbidities, or severe obstructive sleep apneas, a high postoperative respiratory morbidity is possible. We report the case of a 15-month-old boy with Noonan syndrome and a complex clinical history, who presented with a life-threatening obstructive sleep apnea due to hypertrophy of the adenoids which resolved completely after adenoidectomy.

  15. The Event Detection and the Apparent Velocity Estimation Based on Computer Vision

    Science.gov (United States)

    Shimojo, M.

    2012-08-01

    The high spatial and time resolution data obtained by the telescopes aboard Hinode revealed the new interesting dynamics in solar atmosphere. In order to detect such events and estimate the velocity of dynamics automatically, we examined the estimation methods of the optical flow based on the OpenCV that is the computer vision library. We applied the methods to the prominence eruption observed by NoRH, and the polar X-ray jet observed by XRT. As a result, it is clear that the methods work well for solar images if the images are optimized for the methods. It indicates that the optical flow estimation methods in the OpenCV library are very useful to analyze the solar phenomena.

  16. Embolization of Life-Threatening Arterial Rupture in Patients with Vascular Ehlers–Danlos Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Frank, Michael, E-mail: michael.frank@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Pellerin, Olivier, E-mail: olivier@pellerin.as; Primio, Massimiliano Di, E-mail: massimiliano.di.primio@gmail.com; Angelopoulos, Georgios, E-mail: giorginos78@msn.com [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Boughenou, Marie-Fazia, E-mail: marie-fazia.boughenou@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Anesthesia and Surgical Intensive Care Unit (France); Pagny, Jean-Yves, E-mail: jean-yves.pagny@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France); Messas, Emmanuel, E-mail: emmanuel.messas@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Rare Vascular Diseases Reference Center (France); Sapoval, Marc, E-mail: marc.sapoval2@egp.aphp.fr [Assistance Publique des Hôpitaux de Paris, Georges Pompidou European Hospital, Interventional Radiology Department (France)

    2013-05-09

    PurposeTo evaluate the safety and efficacy of transarterial embolization of life-threatening arterial rupture in patients with vascular Ehlers–Danlos syndrome (vEDS) in a single tertiary referral center.MethodsWe retrospectively analyzed transarterial embolization for vEDS performed at our institution from 2000 to 2012. The indication of embolization was spontaneous arterial rupture or pseudoaneurysm with acute bleeding. All interventions used a percutaneous approach through a 5F or less introducer sheath. Embolic agents were microcoils and glue in 3 procedures, glue alone in 2, and microcoils alone in 2.ResultsFive consecutive vEDS patients were treated by 7 embolization procedures (4 women, mean age 29.8 years). All procedures were successfully performed. Two patients required a second procedure for newly arterial lesions at a different site from the first procedure. Four of the five patients were still alive after a mean follow-up of 19.4 (range 1–74.7) months. One patient died of multiple organ failure 2 days after procedure. Minor procedural complications were observed in 3 procedures (43 %), all directly managed during the same session. Remote arterial lesions occurred after 3 procedures (43 %); one underwent a second embolization, and the other 2 were observed conservatively. Puncture site complication was observed in only one procedure (14 %).ConclusionEmbolization for vEDS is a safe and effective method to manage life-threatening arterial rupture.

  17. Threatened fertility and gonadal function after a polytraumatic, life-threatening injury

    Directory of Open Access Journals (Sweden)

    Ward Michael

    2010-01-01

    Full Text Available Trauma literature regarding management of genitalia trauma affecting future fertility and gonadal function in the face of coexisting life-threatening injuries is underdeveloped. We present a unique case that necessitated integrative management of a 24-year-old male who became entangled within the blades of a manure spreader and presented with life-threatening trauma in addition to severe genital trauma, including penile degloving, bilateral testicular avulsion and bilateral spermatic cord laceration. During the initial stabilization and surgical management, urology and plastic surgery were consulted to assess the urogenital injuries. Together, the surgical team orchestrated potentially life-saving interventions while successfully performing both a testicular sperm extraction and a testicular revascularization. Viable sperm was collected on the day of surgery and initial follow-up showed preserved sexual function and adequate perfusion to the testicle. This report presents a case and provides a review discussing the management of traumatic genital injuries and the importance of early involvement of surgical specialties in genitalia trauma to optimize future fertility and gonadal function. The literature search was performed in August 2008 using Medline for articles only in English, including any of the following terms: polytrauma, trauma, penis, testicle, degloving, avulsion, spermatic cord, laceration, fertility, reproduction or revascularization.

  18. Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases.

    Science.gov (United States)

    Gasser, Peter; Holstein, Dominique; Michel, Yvonne; Doblin, Rick; Yazar-Klosinski, Berra; Passie, Torsten; Brenneisen, Rudolf

    2014-07-01

    A double-blind, randomized, active placebo-controlled pilot study was conducted to examine safety and efficacy of lysergic acid diethylamide (LSD)-assisted psychotherapy in 12 patients with anxiety associated with life-threatening diseases. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions 2 to 3 weeks apart. The participants received either 200 μg of LSD (n = 8) or 20 μg of LSD with an open-label crossover to 200 μg of LSD after the initial blinded treatment was unmasked (n = 4). At the 2-month follow-up, positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety (p = 0.033) with an effect size of 1.1, and state anxiety was significantly reduced (p = 0.021) with an effect size of 1.2, with no acute or chronic adverse effects persisting beyond 1 day after treatment or treatment-related serious adverse events. STAI reductions were sustained for 12 months. These results indicate that when administered safely in a methodologically rigorous medically supervised psychotherapeutic setting, LSD can reduce anxiety, suggesting that larger controlled studies are warranted.

  19. Two Case Reports of Life-Threatening Ethanol-Induced Anaphylaxis

    Directory of Open Access Journals (Sweden)

    S.L. Fernando

    2009-04-01

    Full Text Available Adverse reactions to alcoholic beverages are common and diverse in aetiology. Ethanol-induced anaphylaxis, however, is a rare but often life-threatening condition that warrants careful evaluation in suspected individuals. We present the cases of two patients who developed urticaria, angioedema and throat constriction within minutes of consuming white wine. Both individuals demonstrated no adverse reaction to double-blind placebo-controlled challenges to metabisulphite or sodium salicylate. However, an open challenge to white wine elicited urticaria in both subjects. This reaction was reproduced with a double-blind placebo-controlled challenge to ethanol and was accompanied by a rise in serum total tryptase levels. Positive skin test responses to 2% acetic acid, a breakdown product of ethanol, were elicited from both patients but not from three normal controls. These two cases demonstrate the need for a systematic approach for the evaluation of allergic reactions to alcohol.

  20. Diffuse Alveolar Hemorrhage: A Rare Life-Threatening Condition in Systemic Lupus Erythematosus

    Directory of Open Access Journals (Sweden)

    Ravi Paul Singh Virdi

    2012-01-01

    Full Text Available Diffuse alveolar hemorrhage (DAH is a rare life-threatening complication in systemic lupus erythematosus (SLE associated with high mortality rates. DAH is more common in women, and mean age of onset is around 30 years. It mostly occurs in patients with established diagnosis of SLE but can be the initial presentation of lupus in approximately 20%. DAH should be suspected in lupus patient presenting with new pulmonary infiltrates, decline in hemoglobin, hemoptysis, dyspnea, hypoxemia, and increase in carbon monoxide diffusion capacity. Radiographic evidence of bilateral pulmonary alveolar infiltrates that are usually perihilar or basilar with sparing of apices is seen. DAH can often mimic clinically and radiologically severe pneumonia or ARDS. Treatment includes high-dose corticosteroids, cyclophosphamide, and plasmapheresis. We report a case of diffuse alveolar hemorrhage complicating SLE flare-up in a male patient.

  1. Life-threatening neurovascular injuries associated with recreational use of "banana" boats.

    Science.gov (United States)

    Cohen, José E; Moscovici, Samuel; Rosenthal, Guy; Benifla, Mony; Itshayek, Eyal

    2012-09-01

    Banana boat rides are a popular form of recreation worldwide. Recommendations that speed should not exceed 15 mph, passengers should wear protective gear, and an observer should be present on the towing boat are generally ignored. Medical personnel at tourist venues and general practitioners may not be attuned to the risk of serious injury. We present our experience in the management carotid- and vertebral artery dissections sustained by 44- and 23-year-old males during banana boat rides. In both cases, the dissections were misdiagnosed until patients presented to the Emergency Department two days after injury. In the first patient, medical management failed and endovascular treatment was required due to neurological deterioration. In patient two, anticoagulation therapy prevented embolic sequelae. Boat operators, passengers, and the medical personnel who are first to see these patients should be aware of the risk of arterial dissection to facilitate early detection of these potentially life-threatening injuries.

  2. Premenstrual Exacerbation of Life-Threatening Asthma: Effect of Gonadotrophin Releasing Hormone Analogue Therapy

    Directory of Open Access Journals (Sweden)

    Alun L Edwards

    1996-01-01

    Full Text Available Variability in the severity of asthma during various phases of the menstrual cycle has been frequently suspected. However, the hormonal changes that might affect mediators of bronchospasm have yet to be elucidated. The case of a 41-year-old woman suffering from longstanding asthma with life-threatening exacerbations is reported. The patient was treated with buserelin, a gonadotropin releasing hormone (GnRH analogue, which created a temporary chemical menopause and thus permitted diagnosis of a premenstrual exacerbation of asthma and offered insight into potential therapy. GnRH analogues may therefore be of value in assessing women with severe asthma suspected to vary with the menstrual cycle. The addition of estrogens and progestins at the same time as treatment with GnRH analogue may be of value in determining the role of these hormones in the pathogenesis of menstrually related exacerbations of asthma.

  3. Penile calciphylaxis: a life-threatening condition successfully treated with sodium thiosulfate.

    Science.gov (United States)

    Sandhu, Gagangeet; Gini, Marcelo Barrios; Ranade, Aditi; Djebali, David; Smith, Steven

    2012-01-01

    Calciphylaxis or calcific uremic arteriolopathy is a life-threatening condition that predominantly affects patients with end-stage renal disease on hemodialysis. A prevalence of up to 4% and a 6-month mortality rate of up to 80% have been reported in those with proximal disease (thighs, abdomen wall, and buttocks). Penile calciphylaxis is very rare but has a mortality rate of 69% within 6 months. Its treatment is controversial. For small lesions, conservative treatment with local wound care and debridement may suffice. Partial or complete penectomy may be needed for more extensive lesions, and especially those associated with signs of local infection. In addition to surgical intervention, as with any other case of calcific uremic arteriolopathy, the cornerstones of therapy should be to keep serum phosphorus sodium thiosulfate was used in addition to the standard medical and surgical therapy. Two months after surgery, the patient's wound completely healed and he has experienced no new lesions over the past 11 months.

  4. Severe Sepsis Associated with Lemierre’s Syndrome: A Rare but Life-Threatening Disease

    Directory of Open Access Journals (Sweden)

    Audrey Tawa

    2016-01-01

    Full Text Available Background. The incidence of Lemierre’s syndrome has increased in the past decade. This posttonsillitis complication may be life threatening. Case Presentation. A 19-year-old patient was admitted to Surgical Intensive Care Unit of a French University Hospital for high fever, low blood pressure, and haemoptysis following a sore throat episode. Blood analysis revealed a thrombopenia, an acute renal failure, and an elevated lactate serum. Fusobacterium necrophorum was found in blood cultures. Computed tomography of the neck and lungs confirmed the diagnosis of Lemierre’s syndrome: pleural effusions, bilateral lung infiltrates, and an internal jugular vein thrombosis. Fluid administration and antibiotic treatment were quickly initiated. Patient left the unit four days after his admission without any organ dysfunction. Conclusion. Lemierre’s syndrome may lead to multiorgan dysfunction and should be rapidly identified.

  5. Endoclipping treatment of life-threatening rectal bleeding after prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Panagiotis Katsinelos,; Jannis Kountouras,; Georgios Dimitriadis,; Grigoris Chatzimavroudis,; Christos Zavos,; Ioannis Pilpilidis,; George Paroutoglou,; George Germanidis,; Kostas Mimidis

    2009-01-01

    Rectal bleeding is frequently seen in patients undergoing transrectal ultrasound (TRUS)-guided multiple biopsy of the prostate, but is usually mild and stops spontaneously. We report what is believed to be the first case of life-threatening rectal bleeding following this procedure, which was successfully treated by endoscopic intervention through placement of three clips on the sites of bleeding. This case emphasizes endoscopic intervention associated with endoclipping as a safe and effective method to achieve hemostasis in massive rectal bleeding after prostate biopsy. Additionally, current data on the complications of the TRUS-guided multiple biopsy of the prostate and the options for treating fulminant rectal bleeding, a consequence of this procedure, are described.

  6. No apparent superluminal motion in the first-known jetted tidal disruption event Swift J1644+5734

    CERN Document Server

    Yang, J; Gurvits, L I; Campbell, R M; Giannios, D; An, T; Komossa, S

    2016-01-01

    The first-known tidal disruption event (TDE) with strong evidence for a relativistic jet -- based on extensive multi-wavelength campaigns -- is Swift J1644+5734. In order to directly measure the apparent speed of the radio jet, we performed very long baseline interferometry (VLBI) observations with the European VLBI network (EVN) at 5 GHz. Our observing strategy was to identify a very nearby and compact radio source with the real-time e-EVN, and then utilise this source as a stationary astrometry reference point in the later five deep EVN observations. With respect to the in-beam source FIRST J1644+5736, we have achieved a statistical astrometric precision about 12 micro-arcsecond (68 % confidence level) per epoch. This is one of the best phase-referencing measurements available to date. No proper motion has been detected in the Swift J1644+5734 radio ejecta. We conclude that the apparent average ejection speed between 2012.2 and 2015.2 was less than 0.3c with a confidence level of 99 %. This tight limit is d...

  7. No apparent superluminal motion in the first-known jetted tidal disruption event Swift J1644+5734

    Science.gov (United States)

    Yang, J.; Paragi, Z.; van der Horst, A. J.; Gurvits, L. I.; Campbell, R. M.; Giannios, D.; An, T.; Komossa, S.

    2016-10-01

    The first-known tidal disruption event (TDE) with strong evidence for a relativistic jet - based on extensive multiwavelength campaigns - is Swift J1644+5734. In order to directly measure the apparent speed of the radio jet, we performed very long baseline interferometry (VLBI) observations with the European VLBI network (EVN) at 5 GHz. Our observing strategy was to identify a very nearby and compact radio source with the real-time e-EVN, and then utilize this source as a stationary astrometry reference point in the later five deep EVN observations. With respect to the in-beam source FIRST J1644+5736, we have achieved a statistical astrometric precision about 12 μas (68 per cent confidence level) per epoch. This is one of the best phase-referencing measurements available to date. No proper motion has been detected in the Swift J1644+5734 radio ejecta. We conclude that the apparent average ejection speed between 2012.2 and 2015.2 was less than 0.3c with a confidence level of 99 per cent. This tight limit is direct observational evidence for either a very small viewing angle or a strong jet deceleration due to interactions with a dense circum-nuclear medium, in agreement with some recent theoretical studies.

  8. Attitudes of Japanese Medical Students towards Disclosure of a Diagnosis of Life-threatening Illness

    Directory of Open Access Journals (Sweden)

    Ohtsu,Tadahiro

    2009-02-01

    Full Text Available

    In this study we investigated the attitudes of Japanese medical students toward being informed of a diagnosis of life-threatening illness. Fourth-year medical students from 20 randomly sampled universities were administered questionnaires that examined their opinion about whether they would welcome disclosure of medical information if they were diagnosed as having an ultimately fatal disease. Data from 1,619 students (male 1,074, female 545, effective collection rate 90.6% were analyzed. With regard to attitudes about disclosure of a diagnosis of life-threatening illness, 87.7% of the students stated that they would wish to be informed even if there was little chance of recovery, and 11.6% expressed a wish to be informed of their condition only if there was a chance of recovery. Students who did not wish to be informed even if there was a chance of recovery accounted for 0.7% of those surveyed. Our study reveals that medical students are more positive than are members of the general population with regard to being informed of the truth. The proportion of those who wished to be informed even if there was little chance of recovery was higher among students from national and public universities than among those from private universities, and the inter-group difference was statistically significant. Among male students, answers to the survey were significantly correlated with 12-item General Health Questionnaire scores and mental health status, suggesting that mental health status may have affected how this study population viewed being informed of their diagnosis.

  9. Renal parenchymal histopathology predicts life-threatening chronic kidney disease as a result of radical nephrectomy.

    Science.gov (United States)

    Sejima, Takehiro; Honda, Masashi; Takenaka, Atsushi

    2015-01-01

    The preoperative prediction of post-radical nephrectomy renal insufficiency plays an important role in the decision-making process regarding renal surgery options. Furthermore, the prediction of both postoperative renal insufficiency and postoperative cardiovascular disease occurrence, which is suggested to be an adverse consequence caused by renal insufficiency, contributes to the preoperative policy decision as well as the precise informed consent for a renal cell carcinoma patient. Preoperative nomograms for the prediction of post-radical nephrectomy renal insufficiency, calculated using patient backgrounds, are advocated. The use of these nomograms together with other types of nomograms predicting oncological outcome is beneficial. Post-radical nephrectomy attending physicians can predict renal insufficiency based on the normal renal parenchymal pathology in addition to preoperative patient characteristics. It is suggested that a high level of global glomerulosclerosis in nephrectomized normal renal parenchyma is closely associated with severe renal insufficiency. Some studies showed that post-radical nephrectomy severe renal insufficiency might have an association with increased mortality as a result of cardiovascular disease. Therefore, such pathophysiology should be recognized as life-threatening, surgically-related chronic kidney disease. On the contrary, the investigation of the prediction of mild post-radical nephrectomy renal insufficiency, which is not related to adverse consequences in the postoperative long-term period, is also promising because the prediction of mild renal insufficiency might be the basis for the substitution of radical nephrectomy for nephron-sparing surgery in technically difficult or compromised cases. The deterioration of quality of life caused by post-radical nephrectomy renal insufficiency should be investigated in conjunction with life-threatening matters.

  10. Citric acid as the last therapeutic approach in an acute life-threatening metabolic decompensation of propionic acidaemia.

    Science.gov (United States)

    Siekmeyer, Manuela; Petzold-Quinque, Stefanie; Terpe, Friederike; Beblo, Skadi; Gebhardt, Rolf; Schlensog-Schuster, Franziska; Kiess, Wieland; Siekmeyer, Werner

    2013-01-01

    The tricarboxylic acid (TCA) cycle represents the key enzymatic steps in cellular energy metabolism. Once the TCA cycle is impaired in case of inherited metabolic disorders, life-threatening episodes of metabolic decompensation and severe organ failure can arise. We present the case of a 6 ½-year-old girl with propionic acidaemia during an episode of acute life-threatening metabolic decompensation and severe lactic acidosis. Citric acid given as an oral formulation showed the potential to sustain the TCA cycle flux. This therapeutic approach may become a treatment option in a situation of acute metabolic crisis, possibly preventing severe disturbance of energy metabolism.

  11. Brazilian network for the surveillance of maternal potentially life threatening morbidity and maternal near-miss and a multidimensional evaluation of their long term consequences

    Directory of Open Access Journals (Sweden)

    Surita Fernanda G

    2009-09-01

    Full Text Available Abstract Background It has been suggested that the study of women who survive life-threatening complications related to pregnancy (maternal near-miss cases may represent a practical alternative to surveillance of maternal morbidity/mortality since the number of cases is higher and the woman herself is able to provide information on the difficulties she faced and the long-term repercussions of the event. These repercussions, which may include sexual dysfunction, postpartum depression and posttraumatic stress disorder, may persist for prolonged periods of time, affecting women's quality of life and resulting in adverse effects to them and their babies. Objective The aims of the present study are to create a nationwide network of scientific cooperation to carry out surveillance and estimate the frequency of maternal near-miss cases, to perform a multicenter investigation into the quality of care for women with severe complications of pregnancy, and to carry out a multidimensional evaluation of these women up to six months. Methods/Design This project has two components: a multicenter, cross-sectional study to be implemented in 27 referral obstetric units in different geographical regions of Brazil, and a concurrent cohort study of multidimensional analysis. Over 12 months, investigators will perform prospective surveillance to identify all maternal complications. The population of the cross-sectional component will consist of all women surviving potentially life-threatening conditions (severe maternal complications or life-threatening conditions (the maternal near miss criteria and maternal deaths according to the new WHO definition and criteria. Data analysis will be performed in case subgroups according to the moment of occurrence and determining cause. Frequencies of near-miss and other severe maternal morbidity and the association between organ dysfunction and maternal death will be estimated. A proportion of cases identified in the cross

  12. Trends in a life threatening condition : Morbid obesity in Dutch, Turkish and Moroccan children in the Netherlands

    NARCIS (Netherlands)

    Van Dommelen, Paula; Schönbeck, Yvonne; Van Buuren, Stef; HiraSing, Remy A.

    2014-01-01

    Background: Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997. Methods and Findings: Cross-sectional height and w

  13. Trends in a Life Threatening Condition: Morbid Obesity in Dutch, Turkish and Moroccan Children in The Netherlands

    NARCIS (Netherlands)

    Dommelen, P. van; Schönbeck, Y.; Buuren, S. van; Hirasing, R.

    2014-01-01

    Background: Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997. Methods and Findings: Cross-sectional height and w

  14. Pulmonary hemorrhage complicating radiofrequency ablation, from mild hemoptysis to life-threatening pattern

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A.; Naguib, Nagy N.N.; Mack, Martin; Abskharon, John E.; Vogl, Thomas J. [Johann Wolfgang Goethe-University Hospital, Institute for Diagnostic and Interventional Radiology, Frankfurt am Main (Germany)

    2011-01-15

    To assess risk factors and the extent of pulmonary hemorrhage complicating radiofrequency ablation (RFA) of pulmonary neoplasms. This retrospective study involved 248 ablation sessions for lung tumors (20 primary lesions and 228 metastatic lesions) in 164 patients (mean age 59.7 years, SD: 10.2). Both unipolar and bipolar radiofrequency systems were used under CT fluoroscopic guidance. Extent and underlying factors associated with development of pulmonary hemorrhage were analyzed. Incidence of intra-parenchymal pulmonary hemorrhage, pleural effusion, and hemoptysis were 17.7% (44/248 sessions), 4% (8/248 sessions), and 16.1% (40/248 sessions), respectively. Death because of massive bleeding occurred in one session (0.4%). Significant risk factors associated with intra-parenchymal hemorrhage included: lesions of <1.5 cm diameter (P = 0.007); basal and middle lung zone lesions (P = 0.026); increased needle track distance traversing the lung parenchyma >2.5 cm (P = 0.0017); traversing pulmonary vessels in the track of ablation (P < 0.001); and the use of multi-tined electrodes (P = 0.004). Concomitant incidence of pulmonary hemorrhage and pneumothorax was 29.2% (14/48 sessions). While typically safe, RFA of pulmonary neoplasms can result in pulmonary hemorrhage ranging from mild to life-threatening. Management of this complication is mainly preventive through adequate patient selection for ablation therapy and exclusion of technically avoidable risk factors. (orig.)

  15. An Interesting Case of Life-Threatening Hypercalcemia Secondary to Atypical Parathyroid Adenoma versus Parathyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Ankur Mishra

    2014-01-01

    Full Text Available Context. Severe hypercalcemia is a life-threatening condition. Atypical parathyroid adenoma and parathyroid carcinomas are uncommon causes which can be difficult to differentiate. Objective. We report a case of a 36-year-old male with very high serum calcium due to a possible atypical parathyroid adenoma versus parathyroid carcinoma. Case Illustration. A serum calcium level of 23.2 mg/dl was noted on admission. He was initially treated with IV hydration, pamidronate, and salmon calcitonin to lower his calcium levels. He also underwent a surgical en bloc resection of parathyroid mass. Pathology showed a mixed picture consistent with possible atypical adenoma versus parathyroid carcinoma. However, due to the possible involvement of the recurrent laryngeal nerve, parathyroid carcinoma was more likely. Also after operation the patient developed hungry bones syndrome and his calcium was replaced vigorously. He continues to be on calcium, vitamin D, and calcitriol supplementation. Results. A review of the literature was conducted to identify previous studies pertaining to parathyroid adenomas and parathyroid cancer. Conclusion. We thereby conclude that hypercalcemia requires very careful monitoring especially after operation. Also it can be very difficult to distinguish between atypical parathyroid adenomas and parathyroid carcinomas as in our case and no clear cut guidelines yet exist to differentiate the two based on histology.

  16. Transsphenoidal surgery for a life-threatening prolactinoma apoplexy during pregnancy.

    Science.gov (United States)

    Witek, Przemysław; Zieliński, Grzegorz; Maksymowicz, Maria; Zgliczyński, Wojciech

    2012-01-01

    Prolactinoma is the most common secreting pituitary adenoma. It is typically diagnosed in women of reproductive age and is common cause of infertility. Currently the treatment of choice is pharmacotherapy with dopamine agonists, whereas surgical treatment is reserved for a selected group of patients. Pituitary-tumor apoplexy is a rare, life-threatening condition associated with significant morbidity and mortality. The authors present the case of a 25-year-old woman with prolactinoma treated with dopamine agonist. In course of such a treatment the patient became pregnant. The bromocriptine was gradually withdrawn. In the 14th week of pregnancy she was admitted for symptoms suggesting pituitary tumor apoplexy. The treatment with bromocriptine was reinitiated. In the 20th week of pregnancy further deterioration of the patient's neurological condition and visual-field abnormalities were observed. The patient was qualified for surgical treatment - selective transsphenoidal adenomectomy. The successful surgery led to improvement of neurological condition. The early postoperative PRL level decreased significantly and hormonal function of the pituitary was preserved. The pregnancy ended in 38th week with a caesarean section. Endocrinological evaluation conducted after the uneventful delivery confirmed normal function of the pituitary. Magnetic resonance imaging (MRI) did not reveal tumor re-growth. The patient is kept under constant medical care. In this case study the authors discussed therapeutic management and reviewed literature regarding gestational pituitary-tumor apoplexy with particular emphasis on surgical treatment.

  17. Delayed cardiac tamponade: A rare but life-threatening complication of catheter ablation.

    Science.gov (United States)

    Yetter, Elizabeth; Brazg, Jared; Del Valle, Diane; Mulvey, Laura; Dickman, Eitan

    2016-11-17

    Delayed cardiac tamponade (DCT) is a rare and life-threatening complication of catheter ablation performed as a treatment of atrial fibrillation, with few cases described in the medical literature. We present the case of a 57year-old man presenting with DCT 61days following a catheter ablation procedure. To the best of our knowledge, this is the most delayed case of cardiac tamponade (CT) following catheter ablation described in the literature. We also discuss the importance of point of care ultrasound (POCUS) in the diagnosis and treatment of CT. Emergency physicians must maintain a high index of suspicion in making the diagnosis of CT as patients may present with vague symptoms such as neck or back pain, shortness of breath, fatigue, dizziness, or altered mental status, often without chest pain. Common risk factors for CT include cancer, renal failure, pericarditis, cardiac surgery, myocardial rupture, trauma, and retrograde aortic dissection. In addition, although rare, both catheter ablation and use of anticoagulation carry risks of developing CT. A worldwide survey of medical centers performing catheter ablation found CT as a complication in less than 2% of cases [1]. Some proposed mechanisms of DCT include small pericardial hemorrhages following post-procedural anticoagulation or rupture of the sealed ablation-induced left atrial wall [2]. Clinical examination and electrocardiography may be helpful. However, the criterion standard for diagnosing CT is echocardiography [3].

  18. [Life-threatening injuries of the subcutaneous ventral abdominal veins in dairy cows].

    Science.gov (United States)

    Schmid, B; Muggli, E; Schmid, T; Nuss, K

    2011-05-01

    Injuries of the superficial veins on the ventral abdomen of dairy cows can result in life-threatening haemorrhage. Treatment of these injuries can be difficult because of the characteristics of the veins. Five cows aged 6.5 to 12 years were referred to the Animal Hospitale Zurich, because of intermittent haemorrhage from a ventral abdominal vein. Four of the cows were near term and one had calved two weeks before referral. Intermittent bleeding was seen from the highly convoluted and dilated subcutaneous tributaries to the cranial superficial epigastric vein (milk vein). The haematocrit of 2 cows was markedly lower than normal. Emergency slaughter of one of the cows was carried out because of advanced age. The other 4 cows were sedated and after application of local anaesthetic, the wounds were debrided and sutured. Two of the cows required a blood transfusion before being operated. There were no postoperative complications. This type of injury seems to occur predominantly in pluriparous dairy cows close to term, in which the tributaries to the milk vein have undergone varicose changes. Treatment should consist of surgical resection of the injured tissue and suturing of the venous wall, subcutaneous tissues and skin.

  19. Life-threatening hyperkalemia following zoledronic acid infusion for Paget's disease: a case report

    Directory of Open Access Journals (Sweden)

    Naysmith Morag

    2011-08-01

    Full Text Available Abstract Introduction Zoledronic acid is a highly effective treatment in Paget's disease for persistent bone pain and prevention of further progression of the disease. The commonest electrolyte abnormality is hypocalcemia. To the best of our knowledge this is the first case of hyperkalemia secondary to zoledronic acid to be published in the world literature. The commonest arrhythmia related to zoledronic acid is atrial fibrillation. Case presentation We describe the case of an 80-year-old Caucasian man, with a history of ischemic heart disease, who had an in-hospital cardiac arrest related to hyperkalemia. Increasing potassium levels were noted following his first zoledronic acid infusion for symptomatic control of bone pain secondary to Paget's disease. Our patient suffered a cardiac arrest 10 days following the zoledronic acid infusion. Our patient's biochemistry and electrocardiogram output were monitored until his death 26 days after his cardiac arrest. Our patient developed paroxysmal atrial fibrillation in the post-resuscitation period and there was persistent hyperkalemia that required prolonged treatment with calcium resonium. All other possible causes of hyperkalemia were excluded. Conclusion In our patient's case persistent hyperkalemia and life-threatening arrhythmias were associated with use of zoledronic acid. These side effects have not been reported before and the causative mechanism is far from clear as there are no obvious systemic effects of zoledronic acid. The combination of zoledronic acid with predisposing factors such as structural heart disease might account for the clinical picture we witnessed. As a result, electrolyte monitoring should be adopted early in zoledronic acid use. Further studies are required to elucidate the underlying mechanism of hyperkalemia and identify the target group of patients where zoledronic acid can be safely administered. Great caution is advised in patients with underlying heart conditions.

  20. Outcome of children with life-threatening asthma necessitating pediatric intensive care

    Directory of Open Access Journals (Sweden)

    Cheung Kam-Lau

    2010-07-01

    Full Text Available Abstract Objective To report the outcome of children with life-threatening asthma (LTA admitted to a university Pediatric Intensive Care Unit (PICU. Methods Retrospective study between October 2002 and May 2010 was carried out. Every child with LTA and bronchospasm was included. Results 30 admissions of 28 patients (13 M, 17 F were identified which accounted for 3% of total PICU admissions (n = 1033 over the study period. The majority of patients were toddlers (median age 3.1 years. Few had past history of prematurity, lung diseases, or neuro-developmental conditions. Approximately half had previous admissions for asthma and one-forth with history of non-compliance to recommended treatment for asthma. One patient had parainfluenza virus and one had rhinovirus isolated. None of these factors were associated with need for mechanical ventilation (n = 6 admissions. Comparing with patients who did not receive mechanical ventilation, ventilated children had significantly higher PIM2 score (1.65 versus 0.4, p 2 levels (9.3 kPa versus 5.1 kPa, p = 0.01 and longer PICU stay (median 2.5 days versus 2 days, p = 0.03 The majority of patients received systemic corticosteroids, intravenous or inhaled bronchodilators. There was one pneumothorax but no death in this series. Conclusions LTA accounted for a small percentage of PICU admissions. Previous hospital admissions for asthma and history of non-compliance were common. Approximately one quarters required ventilatory supports. Regardless of the need for mechanical ventilation, all patients survived with prompt treatment.

  1. Life-Threatening Adenovirus Infections in the Setting of the Immunocompromised Allogeneic Stem Cell Transplant Patients

    Directory of Open Access Journals (Sweden)

    Cedar J. Fowler

    2010-01-01

    Full Text Available A single institution case series of adenovirus infections after allogeneic hematopoietic stem cell transplantation is presented to highlight the consideration for adenovirus infections as an etiology in patients with rapid hepatic or other sudden organ deterioration in the setting of apparent GVHD stabilization. The series also highlights that survival is limited with these infections often due in part to concomitant opportunistic infections. In addition, the pathophysiological events, such as GVHD and hepatic dysfunction, may complicate the clinical picture and delay therapy of an opportunistic infection. This is particularly true for adenoviral infections as they also have a distinct clinical picture in immunocompromised patients when compared to immune competent patients. Adenovirus infections also have the additional challenge that its treatment, cidofovir, has associated toxicities that can delay its administration. Recent developments has yielded an assay that can be used in the early detection and for serial determinations of adenovirus in patients with advanced GVHD, as well as a new therapeutic agent currently undergoing clinical trials.

  2. Near-death-like experiences without life-threatening conditions or brain disorders: a hypothesis from a case report

    Directory of Open Access Journals (Sweden)

    Enrico eFacco

    2012-11-01

    Full Text Available Near-death experiences (NDEs are profound psychic experiences commonly occurring in life-threatening conditions. They include feeling a sense of peace, of seeing a bright light, encountering deceased relatives or religious figures, and of transcending space and time. To explain them, it has been suggested that they stem from brain disorders and/or psychological reactions to approaching death, a sort of wishful thinking in response to the perceived threat.This is a report on a case with most of the features typical of NDEs except that it occurred entirely without any life-threatening conditions. This evidence is theoretically incompatible with either of the above hypotheses, suggesting that a broader interpretation of the phenomenon is needed.

  3. [Structural requirements for the management of patients with highly contagious life-threatening infectious diseases: update 2015].

    Science.gov (United States)

    Grünewald, Thomas

    2015-07-01

    The care of highly contagious life-threatening infectious diseases (HLID) requires specialized treatment facilities that are capable of strict isolation measures and appropriate medical treatment. The German approach to the management of these diseases, which is maintained by the Permanent Working Group of Medical Competence and Treatment Centers for Highly Contagious and Life-Threatening Diseases (STAKOB) is adjusted in the present publication with regards to recent experiences and upcoming needs. Clear synergies in using infrastructures and bundling of resources have led to similar efforts at the European level. The German concept, therefore, has a pioneering role. This update is intended to improve professional patient care and also minimize the risk of disease spread and transmission.

  4. Effectiveness of hemodialysis with high-flux polysulfone membrane in the treatment of life-threatening methanol intoxication.

    Science.gov (United States)

    Peces, Ramón; Alvarez, Rafael

    2002-02-01

    Methanol poisoning may result in metabolic acidosis, blindness and death. In this report, we describe a case of life-threatening methanol intoxication in a 44-year-old man who was treated successfully with supportive care, ethanol infusion, folic acid and early hemodialysis with a high-flux polysulfone dialyzer. We conclude that hemodialysis as implemented in this case is a safe and effective approach to the management of methanol poisoning.

  5. Recurrent life-threatening reactions to platelet transfusion in an aplastic anaemia patient with a paroxysmal nocturnal haemoglobinuria clone.

    Science.gov (United States)

    Mohamed, M; Bates, G; Richardson, D; Burrows, L

    2014-09-01

    A 60-year-old woman was diagnosed with non-severe aplastic anaemia when she presented with anaemia and thrombocytopenia. She developed recurrent life-threatening hypotensive reactions during transfusion of leukodepleted platelet concentrates, and washed platelet concentrates prevented the development of such reactions subsequently. A paroxysmal nocturnal haemoglobinuria clone was detected on investigating for aplastic anaemia, which has been speculated to play a role in the recurrent hypotensive reactions.

  6. Relationship of External Influence to Parental Distress in Decision Making Regarding Children with a Life-Threatening Illness

    OpenAIRE

    Miller, Victoria A.; Luce, Mary Frances; Nelson, Robert M.

    2011-01-01

    Objective To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. Methods Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. Results More external influence was associated with more hostility, uncertainty, and con...

  7. Flow Cytometry as a Diagnostic Tool in the Early Diagnosis of Aggressive Lymphomas Mimicking Life-Threatening Infection

    Directory of Open Access Journals (Sweden)

    Nikolaos J. Tsagarakis

    2011-01-01

    Full Text Available Aggressive lymphomas can present with symptoms mimicking life-threatening infection. Flow cytometry (FC is usually recommended for the classification and staging of lymphomas in patients with organomegaly and atypical cells in effusions and blood, after the exclusion of other possible diagnoses. FC may also have a place in the initial diagnostic investigation of aggressive lymphoma. Three cases are presented here of highly aggressive lymphomas in young adults, which presented with the clinical picture of fever of unknown origin (FUO in patients severely ill. All followed a life-threatening clinical course, and two developed the hemophagocytic syndrome (HPS, but microbiological, immunological, and morphological evaluation and immunohistochemistry (IHC failed to substantiate an early diagnosis. FC was the technique that provided conclusive diagnostic evidence of lymphoma, subsequently verified by IHC. Our experience with these three cases highlights the potential role of FC as an adjunct methodology in the initial assessment of possible highly aggressive lymphoma presenting with the signs and symptoms of life-threatening infection, although the definitive diagnosis should be established by biopsy. In such cases, FC can contribute to the diagnosis of lymphoma, independently of the presence of HPS.

  8. Deficient supplies of drugs for life threatening diseases in an African community

    Directory of Open Access Journals (Sweden)

    Andrew Marit

    2007-06-01

    Full Text Available Abstract Background In Malawi essential drugs are provided free of charge to patients at all public health facilities in order to ensure equitable access to health care. The country thereby spends about 30% of the national health budget on drugs. In order to investigate the level of drug shortages and eventually find the reasons for the drugs shortages in Malawi, we studied the management of the drug supplies for common and life threatening diseases such as pneumonia and malaria in a random selection of health centres. Methods In July and August 2005 we visited eight out of a total of 37 health centres chosen at random in the Lilongwe District, Malawi. We recorded the logistics of eight essential and widely used drugs which according to the treatment guidelines should be available at all health centres. Five drugs are used regularly to treat pneumonia and three others to treat acute malaria. Out-of-stock situations in the course of one year were recorded retrospectively. We compared the quantity of each drug recorded on the Stock Cards with the actual stock of the drug on the shelves at the time of audit. We reviewed 8,968 Patient Records containing information on type and amount of drugs prescribed during one month. Results On average, drugs for treating pneumonia were out of stock for six months during one year of observation (median value 167 days; anti-malarial drugs were lacking for periods ranging from 42 to138 days. The cross-sectional audit was even more negative, but here too the situation was more positive for anti-malarial drugs. The main reason for the shortage of drugs was insufficient deliveries from the Regional Medical Store. Benzyl penicillin was in shortest supply (4% received. The median value for non-availability was 240 days in the course of a year. The supply was better for anti-malarial drugs, except for quinine injections (9 %. Only 66 % of Stock Card records of quantities received were reflected in Patient Records

  9. Clinical risk factors for life-threatening lower respiratory tract infections in children: a retrospective study in an urban city in Malaysia.

    Directory of Open Access Journals (Sweden)

    Anna Marie Nathan

    Full Text Available AIM: Lower respiratory tract infections (LRTIs are an important cause of morbidity and mortality, especially in low income countries. The aim of this study was to determine risk factors of life-threatening LRTIs in hospitalised children in Malaysia. METHODS: This retrospective study included children aged less than 18 years admitted for LRTIs over 13 months in a tertiary referral centre in Kuala Lumpur, Malaysia. Neonates, children with asthma and those with either no or a normal chest radiograph were excluded. Life-threatening infection was defined as that needing non-invasive ventilation or admission to the paediatric intensive care unit. Routine blood investigations and nasopharyngeal secretion results (bacterial and viral were obtained. Chest radiographs were reviewed by a designated radiologist. Environmental data (rainfall, particulate matter ≤ 10 µm [PM10] and air pollution index [API] was obtained from the respective government departments. RESULTS: Three hundred and ninety-one episodes of LRTIs were included. Viruses were implicated in 48.5% of LRTIs, with respiratory syncytial virus (RSV being detected in 44% of viral LRTIs. Forty-six (11.8% children had life-threatening disease and the overall mortality rate was 1.3% (5 children. RSV was detected in 26% of children with life-threatening LRTIs. In multivariate logistic regression, chronic lung disease, presenting history of apnoea and signs of hypoxia, was associated with life threatening LRTIs. Increased LRTI admissions were associated with low rainfall but not PM10 nor API. Of those on follow-up, 39% had persistent respiratory symptoms. CONCLUSION: One in nine children admitted with LRTI had a life-threatening LRTI. The aetiology was viral in almost half of admitted children. RSV was detected in a quarter of children with life-threatening LRTIs. Children who present with LRTIs and either have chronic lung disease, presenting history of apnoea or signs of hypoxia, should be

  10. Life-threatening rupture of a renal angiomyolipoma in a patient taking over-the-counter horse chestnut seed extract.

    LENUS (Irish Health Repository)

    Snow, Aisling

    2011-02-09

    BACKGROUND: Alternative medical therapies are increasingly being prescribed due to their good safety profile and perceived limited side effects. They are often unregulated and prescribed over the counter. One such medication is horse chestnut seed extract (HCSE), which is used for the treatment of chronic venous insufficiency and is known to affect blood coagulation. Angiomyolipoma (AML) is a benign fat-containing mesenchymal tumor of the kidney. It is often found incidentally and in most cases can be managed conservatively. Rupture of the kidney with hemorrhage is a well-known complication that may be serious and life-threatening. Known risk factors for hemorrhage include anticoagulation as well as pregnancy, increased size of the lesion, high lesion vascularity, and aneurysm formation within the tumor. OBJECTIVES: The aim is to raise awareness of potential HCSE-induced anticoagulation, including, as in the case presented, acute renal AML hemorrhage. CASE REPORT: The case of a patient taking HCSE for venous insufficiency is presented. The patient suffered a life-threatening rupture of the kidney in the presence of known renal AML. She underwent emergency embolization with a successful outcome. Because HCSE-containing products are thought to be generally safe in the treatment of chronic venous insufficiency, it is important to be mindful of their potential anticoagulant properties and, therefore, their relative contraindication both in patients taking other anticoagulants and those with known renal AML. CONCLUSION: We demonstrate a potentially life-threatening association between HSCE-containing products and renal AML, highlighting the risk associated with HSCE-induced anticoagulation.

  11. Mind's response to the body's betrayal: Gestalt/Existential therapy for clients with chronic or life-threatening illnesses.

    Science.gov (United States)

    Imes, Suzanne A; Clance, Pauline Rose; Gailis, Andra T; Atkeson, Ellen

    2002-11-01

    In the literature on chronic or life-threatening illness, there is an overriding emphasis on clients' psychological coping styles and how they relate to psychological functioning. By contrast, in our approach, we look at the subjective mind/body experiences that clients have of their illness and how their lives are impacted by their illness. As psychotherapists, we address their existential distress, pain, body experience, thoughts, and feelings, as well as their efforts to cope or find meaning in their illness. We summarize Gestalt/Existential therapy for chronic illness, illustrate the approach with three case-vignettes, and stress the importance of attending to each client's unique responses to illness.

  12. Life-threatening gastrointestinal system bleeding in Hodgkin disease: multidetector CT findings and review of the literature.

    Science.gov (United States)

    Akpinar, Erhan; Türkbey, Bariş; Cil, Barbaros Erhan; Canyiğit, Murat; Dündar, Ziya; Balkanci, Ferhun

    2007-06-01

    Acute lower gastrointestinal system (GIS) bleeding is a life-threatening condition. Immediate determination of the origin of the bleeding is crucial, since hemostatic management must be initiated as rapidly as possible. Colonoscopy, radionuclide studies, and conventional angiography are considered the most important methods for assessing the origin of the bleeding. There are few published reports about the feasibility of computed tomography (CT) in acute GIS bleeding. We present multidetector CT (MDCT) findings in a case of Hodgkin disease status one month post-chemotherapy (CHOP protocol; cyclophosphamide, doxorubicin, vincristine, prednisone) that presented with acute lower GIS bleeding.

  13. An intracranial event-related potential study on transformational apparent motion. Does its neural processing differ from real motion?

    Science.gov (United States)

    Bertrand, Josie-Anne; Lassonde, Maryse; Robert, Manon; Nguyen, Dang Khoa; Bertone, Armando; Doucet, Marie-Ève; Bouthillier, Alain; Lepore, Franco

    2012-01-01

    How the brain processes visual stimuli has been extensively studied using scalp surface electrodes and magnetic resonance imaging. Using these and other methods, complex gratings have been shown to activate the ventral visual stream, whereas moving stimuli preferentially activate the dorsal stream. In the current study, a first experiment assessed brain activations evoked by complex gratings using intracranial electroencephalography in 10 epileptic patients implanted with subdural electrodes. These stimuli of intermediate levels of complexity were presented in such a way that transformational apparent motion (TAM) was perceived. Responses from both the ventral and the dorsal pathways were obtained. The response characteristics of visual area 4 and the fusiform cortex were of similar amplitudes, suggesting that both ventral areas are recruited for the processing of complex gratings. On the other hand, TAM-induced responses of dorsal pathway areas were relatively noisier and of lower amplitudes, suggesting that TAM does not activate motion-specific structures to the same extent as does real motion. To test this hypothesis, we examined the activity evoked by TAM in comparison to the one produced by real motion in a patient implanted with the same subdural electrodes. Findings demonstrated that neural response to real motion was much stronger than that evoked by TAM, in both the primary visual cortex (V1) and other motion-sensitive areas within the dorsal pathway. These results support the conclusion that apparent motion, even if perceptually similar to real motion, is not processed in a similar manner.

  14. Identifying Life-Threatening Admissions for Drug Dependence or Abuse (ILIADDA): Derivation and Validation of a Model.

    Science.gov (United States)

    Nguyen, Tri-Long; Boudemaghe, Thierry; Leguelinel-Blache, Géraldine; Eiden, Céline; Kinowski, Jean-Marie; Le Manach, Yannick; Peyrière, Hélène; Landais, Paul

    2017-01-01

    Given that drug abuse and dependence are common reasons for hospitalization, we aimed to derive and validate a model allowing early identification of life-threatening hospital admissions for drug dependence or abuse. Using the French National Hospital Discharge Data Base, we extracted 66,101 acute inpatient stays for substance abuse, dependence, mental disorders or poisoning associated with medicines or illicit drugs intake, recorded between January 1st, 2009 and December 31st, 2014. We split our study cohort at the center level to create a derivation cohort and a validation cohort. We developed a multivariate logistic model including patient’s age, sex, entrance mode and diagnosis as predictors of a composite primary outcome of in-hospital death or ICU admission. A total of 2,747 (4.2%) patients died or were admitted to ICU. The risk of death or ICU admission was mainly associated with the consumption of opioids, followed by cocaine and other narcotics. Particularly, methadone poisoning was associated with a substantial risk (OR: 35.70, 95% CI [26.94–47.32], P < 0.001). In the validation cohort, our model achieved good predictive properties in terms of calibration and discrimination (c-statistic: 0.847). This allows an accurate identification of life-threatening admissions in drug users to support an early and appropriate management. PMID:28290530

  15. Brief resolved unexplained event

    Science.gov (United States)

    Arane, Karen; Claudius, Ilene; Goldman, Ran D.

    2017-01-01

    Abstract Question For many years, the term apparent life-threatening event (ALTE) was associated with sudden infant death syndrome, and parents who described an acute event in their infants were sent to the hospital for admission. I understand that for infants new terminology is recommended. What is the current approach to a near-death experience of an infant? Answer A recent clinical practice guideline revised the name and definition of an ALTE to a brief resolved unexplained event (BRUE). The diagnosis of BRUE in infants younger than 1 year of age is made when infants experience 1 of the following BRUE symptoms: a brief episode (ie, less than 1 minute and usually less than 20 to 30 seconds) that is entirely resolved (infant is at baseline), which remains unexplained after the history and physical examination are completed, and includes an event characterized by cyanosis or pallor; absent, decreased, or irregular breathing; hypertonia or hypotonia; or altered responsiveness. Low-risk infants should not be admitted to the hospital and overtesting is discouraged. PMID:28115439

  16. Potential Life-Threatening Events in Schools Involving Rescue Inhalers, Epinephrine Autoinjectors, and Glucagon Delivery Devices: Reports from School Nurses

    Science.gov (United States)

    Allen, Katherine; Henselman, Kimbra; Laird, Brian; Quinones, Ana; Reutzel, Thomas

    2012-01-01

    The purpose of this research is to use the reports of school nurses to facilitate the understanding of how schools experience and manage asthmatic, anaphylactic, and diabetic emergencies by quantitative and qualitative analysis of online surveys. E-mails with a link to SurveyMonkey[R] were sent to all U.S. members of the National Association of…

  17. Meaning made of stress among veterans transitioning to college: examining unique associations with suicide risk and life-threatening behavior.

    Science.gov (United States)

    Holland, Jason M; Malott, Jesse; Currier, Joseph M

    2014-04-01

    Meaning made of stress has been shown to be a unique predictor of mental and physical health. In this study, we examined the unique associations between two facets of meaning made of stress (comprehensibility and footing in the world) and suicide risk and life-threatening behavior among military veterans who have transitioned to college were examined, controlling for demographic factors, religiousness, combat-related physical injury, combat exposure, depressive symptoms, and posttraumatic stress symptoms. Findings suggest that comprehensibility (having “made sense” of a stressor) is uniquely associated with lower suicide risk and a lower likelihood of driving under the influence of drugs or alcohol and engaging in self-mutilating behaviors.

  18. Crouzon’s Syndrome with Life-Threatening Ear Bleed: Ruptured Jugular Vein Diverticulum Treated by Endovascular Embolization

    Energy Technology Data Exchange (ETDEWEB)

    Mondel, Prabath Kumar, E-mail: prabathmondel@gmail.com; Anand, Sunanda, E-mail: sunandaanand@gmail.com; Limaye, Uday S., E-mail: uslkem@gmail.com [Lilavati Hospital and Research Centre, Department of Interventional Neuroradiology (India)

    2015-08-15

    Crouzon’s syndrome is the commonest variety of syndromic craniosynostosis. Life-threatening ear bleed due to ruptured jugular venous diverticulum in Crouzon’s syndrome has not been described previously. In patients with syndromic craniosynostosis, definitive repair of jugular diverticulum by open surgery is fraught with high risk of bleeding, poor functional outcomes, and even death. A 24-year-old woman with Crouzon’s syndrome presented with conductive hearing loss and recurrent episodes of torrential bleeding from her left ear. On computed tomography, a defect in the roof of jugular fossa containing jugular venous diverticulum immediately inferior to the bony external auditory canal was seen. The clinical presentation, imaging features, and endovascular management of Crouzon’s syndrome due to a ruptured jugular venous diverticulum is described.

  19. Ceftriaxone-induced immune hemolytic anemia as a life-threatening complication of antibiotic treatment of 'chronic Lyme disease'.

    Science.gov (United States)

    De Wilde, Maarten; Speeckaert, Marijn; Callens, Rutger; Van Biesen, Wim

    2017-04-01

    'Chronic Lyme disease' is a controversial condition. As any hard evidence is lacking that unresolved systemic symptoms, following an appropriately diagnosed and treated Lyme disease, are related to a chronic infection with the tick-borne spirochaetes of the Borrelia genus, the term 'chronic Lyme disease' should be avoided and replaced by the term 'post-treatment Lyme disease syndrome.' The improper prescription of prolonged antibiotic treatments for these patients can have an impact on the community antimicrobial resistance and on the consumption of health care resources. Moreover, these treatments can be accompanied by severe complications. In this case report, we describe a life-threatening ceftriaxone-induced immune hemolytic anemia with an acute kidney injury (RIFLE-stadium F) due to a pigment-induced nephropathy in a 76-year-old woman, who was diagnosed with a so-called 'chronic Lyme disease.'

  20. A case of life-threatening obstetrical hemorrhage secondary to placental abruption at 17 weeks of gestation

    Directory of Open Access Journals (Sweden)

    Toshihiko Kinoshita

    2014-03-01

    Full Text Available A 40-year old woman, gravida 4, para 4, presented with sudden lower abdominal pain and severe vaginal bleeding at 17 weeks of gestation. Clinical symptoms and ultrasonographic finding revealed placental abruption. The volume of bleeding was heavy and led to disseminated intravascular coagulation and hypovolemic shock. We performed blood transfusion and therapy to treat the critical condition. However, the mother’s condition continued to worsen. Therefore, we performed a hysterotomy and aborted the pregnancy to save the mother. Since heavy bleeding caused by placental abruption leading to a life-threatening condition for a mother before the 20 weeks of gestation is very rare, the present case is an important case study.

  1. Denosumab Related Osteonecrosis of the Jaw with Spontaneous Necrosis of the Soft Palate: Report of a Life Threatening Case

    Directory of Open Access Journals (Sweden)

    Mohammed Qaisi

    2016-01-01

    Full Text Available Bisphosphonates have been used for years in the treatment of patients with distant bony metastasis and in the prevention of osteoporosis. One of main side effects of these medications is the development of bisphosphonate related osteonecrosis of the jaw (BRONJ in a small subset of patients. A new class of medications with a shorter half-life, known as receptor activator of nuclear factor kappa-B ligand (RANKL inhibitors, was introduced with the hopes of avoiding this side effect. However, reports of osteonecrosis of the jaw after the use of RANKL inhibitors have also been documented. We report on a patient who developed a life threatening osteonecrosis of the jaw with sepsis shortly after switching from a bisphosphonate to a RANKL inhibitor for osteoporosis treatment. This patient developed several soft tissue defects including spontaneous necrosis of the soft palate. To our knowledge this is the first time this presentation has been described.

  2. Endogenous Nocardial Endophthalmitis in an Immunosuppressed Patient: A Serious Warning of an Underlying Life Threatening and Blinding Disorder

    Science.gov (United States)

    Trehan, Hemant; Kaushik, Jaya; Jain, Vaibhav Kumar; Parihar, Jitendra Kumar Singh; Avasthi, Abhijit

    2017-01-01

    Purpose: To report a case of bilateral endogenous nocardial endophthalmitis with central nervous system involvement in an immunocompromised individual with an extremely poor outcome. Case Report: A 35-year-old man with a history of long-term, prescribed oral steroid use for membranoproliferative glomerulonephritis presented with profound bilateral vision loss. Patient's diagnosis of bilateral endogenous nocardial endophthalmitis was delayed. Nocardia was finally isolated from a brain biopsy after a repeat magnetic resonance imaging revealed a brain abscess. With anti-nocardia therapy, patient improved systemically, but the visual outcome was poor, with no light perception in both eyes. Conclusion: Ocular nocardiosis is a serious vision and life threatening disorder, particularly in patients on immunosuppressive therapy. A high index of suspicion is required for successful treatment.

  3. Cirrhosis, cellulitis and cats: a 'purrfect' combination for life-threatening spontaneous bacterial peritonitis from Pasteurella multocida.

    Science.gov (United States)

    Hey, Penelope; Gow, Paul; Torresi, Joseph; Testro, Adam

    2012-11-11

    Pasteurella multocida is a Gram-negative coccobacillus that colonises the upper airways of many animals, in particular, dogs and cats. It acts as an opportunistic infection in humans following an animal bite or scratch and is associated with soft tissue infections, septicaemia and pneumonia, particularly in patients with a compromised immune response, such as patients with liver failure. Spontaneous bacterial peritonitis (SBP) is a serious complication of cirrhosis with a death rate of 10-15%. We report a case of a 47-year-old man with cirrhosis who presented with life-threatening P multocida SBP and bacteraemia secondary to a lick from a cat to a cellulitic leg wound. This case highlights the potential severity of an infection from domestic animals and an otherwise innocuous organism in an immunocompromised host.

  4. Acquired hemophilia as the cause of life-threatening hemorrhage in a 94-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Blanchard Elizabeth

    2010-07-01

    Full Text Available Abstract Introduction Acquired factor VIII deficiency is a rare entity that can lead to severe and life-threatening bleeding. We describe a case of severe bleeding from the tongue secondary to acquired hemophilia and discuss treatment options, including aminocaproic acid and recombinant factor VIII, which have not been widely reported in the literature for the management of such patients. Case presentation A 94-year-old Caucasian man presented to our institution with diffuse bruising and extensive bleeding from the tongue secondary to mechanical trauma. He had no prior history of bleeding and his medical history was unremarkable except for dementia and hypertension. Coagulation studies revealed a prolonged activated partial thromboplastin time and a mixing study was consistent with the presence of an inhibitor. Quantitative assays revealed a reduced level of factor VIII activity (1% and the presence of a factor VIII inhibitor, measured at seven Bethesda units, in the serum. Oral prednisone therapy (60mg/day was given. He also received intravenous aminocaproic acid and human concentrate of factor VIII (Humate-P and topical anti-thrombolytic agents (100 units of topical thrombin cream. His hospital course was prolonged because of persistent bleeding and the development of profuse melena. He required eight units of packed red blood cells for transfusion. Hospitalization was also complicated by bradycardia of unclear etiology, which started after infusion of aminocaproic acid. His activated partial thromboplastin time gradually normalized. He was discharged to a rehabilitation facility three weeks later with improving symptoms, stable hematocrit and resolving bruises. Conclusions Clinicians should suspect a diagnosis of acquired hemophilia in older patients with unexplained persistent and profound bleeding from uncommon soft tissues, including the tongue. Use of factor VIII (Humate-P and aminocaproic acid can be useful in this coagulopathy but

  5. Sodium hypochlorite accident resulting in life-threatening airway obstruction during root canal treatment: a case report

    Directory of Open Access Journals (Sweden)

    Al-Sebaei MO

    2015-03-01

    Full Text Available Maisa O Al-Sebaei,1 Omar A Halabi,2 Ibrahim E El-Hakim3 1Department of Oral and Maxillofacial Surgery, King Abdulaziz University – Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia; 2Saudi Board of Oral and Maxillofacial Surgery, Al-Noor Specialist Hospital, Makkah, Kingdom of Saudi Arabia; 3Department of Oral and Maxillofacial Surgery, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Kingdom of Saudi Arabia Aim: This case report describes a serious and life-threatening complication of the use of sodium hypochlorite as an irrigation solution in root canal therapy. Summary: This case report describes a hypochlorite accident that occurred in a healthy 42-year-old female who was undergoing routine root canal therapy for the lower right central incisor (tooth #41. After approximately 1 hour of irrigation with 3% sodium hypochlorite (for a total of 12 cc, the patient complained of severe pain and burning in the lip. The swelling progressed over the next 8 hours to involve the sublingual and submental fascial spaces with elevation of the tongue and resultant upper airway obstruction. The patient was intubated and remained on mechanical ventilation for 3 days. She recovered without any skin necrosis or nerve deficits. Key learning points: This case report highlights the importance of carefully performing root canal irrigation with sodium hypochlorite to avoid complications. Careful injection without pressure, the use of proper rubber dam isolation, and the use of the endodontic needle are necessary to avoid this type of complication. Although it is a safe root canal irrigation solution, its use may lead to life-threatening complications. Early recognition and management of the untoward effects of sodium hypochlorite are vital for the patient's safety. Keywords: complications of root canal, facial edema, root canal irrigation, root canal therapy, sodium hypochlorite, upper airway obstruction

  6. [Life threatening salicylate poisoning caused by percutaneous absorption in severe ichthyosis vulgaris].

    Science.gov (United States)

    Germann, R; Schindera, I; Kuch, M; Seitz, U; Altmeyer, S; Schindera, F

    1996-08-01

    In a 7-year-old boy, ichthyosis vulgaris was treated with a 10% ointment for application over a large area of the body surface. In this way, the child received 400 g salicylic acid (0.6 g/kg body weight per day) percutaneously over a period of 4 weeks. The patient was referred to hospital by the family doctor: he was in a deep somnolent state, apparently caused by hyperventilation following wheezing, vomiting, tinnitus and vertigo. Salicylate intoxication was suspected because of metabolic acidosis, an anion gap and respiratory overcompensation. The diagnosis was confirmed by a serum salicylate level of 985 micrograms/ml (therapeutic level 150-300 micrograms/ml). Following forced diuresis and alkalization with sodium bicarbonate, haemodialysis was unnecessary. As the salicylate level declined to values within the therapeutic range, the patient started to recover consciousness, waking on the 4th day. By day 6 there were still obvious neurological deficiencies. Fecal incontinence, bilateral ptosis and intermittent diverging strabismus on the right persisted for some weeks. It was 6 months before complete neurological resolution was achieved. The pathogenesis of salicylate toxicity and the need for safer therapies for ichthyosis vulgaris are discussed.

  7. Focused sonography of the heart, lungs, and deep veins identifies missed life-threatening conditions in admitted patients with acute respiratory symptoms

    DEFF Research Database (Denmark)

    Laursen, Christian B; Sloth, Erik; Lambrechtsen, Jess;

    2014-01-01

    Patients with acute respiratory symptoms still remain a diagnostic challenge. The aim of the study was to evaluate whether focused sonography could potentially diagnose life-threatening conditions missed at the primary assessment in a patient population consisting of admitted patients with acute...

  8. The Importance of Awareness and Communication for the Inclusion of Young People with Life-Limiting and Life-Threatening Conditions in Mainstream Schools and Colleges

    Science.gov (United States)

    Asprey, Anthea; Nash, Tricia

    2006-01-01

    Anthea Asprey and Tricia Nash both belong to the Children's Hospice South West Research Group, based at the University of Exeter. In this article, they report one aspect of a research project designed to determine the adequacy of support for young people with life-limiting and life-threatening conditions in the education system. They describe here…

  9. [Successful treatment of life-threatening, treatment resistant Clostridium difficile infection associated pseudomembranous colitis with faecal transplantation].

    Science.gov (United States)

    Nagy, Gergely György; Várvölgyi, Csaba; Paragh, György

    2012-12-30

    Due to world-wide spread of hypervirulent and antibiotic resistant Clostridium difficile strains, the incidence of these infections are dramatically increasing in Hungary with appalling mortality and recurrence rates. Authors present a case of a 59-year-old patient who developed a severe, relapsing pseudomembranous colitis after antibiotic treatment. Life-threatening symptoms of fulminant colitis were successfully treated with prolonged administration of metronidazole and vancomycin, careful supportive therapy and weeks of intensive care. However, a well-documented, severe relapse developed within a week and this time faecal bacteriotherapy was performed. This treatment resulted in a complete cure without any further antibiotic treatment. In relation to this life-saving faecal transplantation, methodology and indications are briefly discussed. In addition, microbiological issues, epidemiological data and threats associated with antibiotic treatment of Clostridium difficile infections are also covered. Finally, relevant professional societies are urged to prepare a national protocol for faecal transplantation, which could allow introduction of this valuable, cost-effective procedure into the routine clinical practice.

  10. Right coronary artery perforation by an active-fixation atrial pacing lead resulting in life-threatening tamponade.

    Science.gov (United States)

    Nakagawa, Eiichiro; Abe, Yukio; Komatsu, Ryushi; Naruko, Takahiko; Itoh, Akira

    2015-10-01

    Cardiac tamponade resulting from perforation of a cardiac chamber is a relatively rare complication of pacemaker implantation. We report the first case of perforation of the right coronary artery related to the implantation of a screw-in atrial pacing lead, presenting as life-threatening cardiac tamponade. We report the case of a 72-year-old woman with complete atrioventricular block and dyspnea on exertion. A permanent pacemaker was implanted with bipolar Medtronic active-fixation leads positioned in the right atrial appendage and at the right ventricular basal septum without any difficulty. Approximately 3.5 h after the procedure, the patient complained of nausea, and the systolic blood pressure decreased to less than 60 mmHg. Echocardiography revealed a large pericardial effusion. Because the effects of pericardiocentesis lasted for less than an hour, the patient underwent a thoracotomy. After evacuation of a massive hemopericardium, bright red blood was seen gushing out from the right coronary artery, which was located on the opposite site of the right atrial appendage where a small portion of the screw tip was observed to be penetrating the atrial wall. The right coronary artery perforation was repaired using autologous pericardium-reinforced 7-0 prolene mattress sutures. Perforation of the right coronary artery is a potential complication and should be part of the differential diagnosis of cardiac tamponade after pacemaker implantation.

  11. Relationship between Respiratory Load Perception and Perception of Nonrespiratory Sensory Modalities in Subjects with Life-Threatening Asthma

    Directory of Open Access Journals (Sweden)

    Kathleen L. Davenport

    2012-01-01

    Full Text Available Subjects with life-threatening asthma (LTA have reported decreased sensitivity to inspiratory resistive (R loads. It is unknown if decreased sensitivity is specific for inspiratory R loads, other types of respiratory loads, or a general deficit affecting sensory modalities. This study hypothesized that impairment is specific to respiratory stimuli. This study tested perceptual sensitivity of LTA, asthmatic (A, and nonasthmatic (NA subjects to 4 sensory modalities: respiratory, somatosensory, auditory, visual. Perceptual sensitivity was measured with magnitude estimation (ME: respiratory loads ME, determined using inspiratory R and pressure threshold (PT loads; somatosensory ME, determined using weight ranges of 2–20 kg; auditory ME, determined using graded magnitudes of 1 kHz tones delivered for 3 seconds bilaterally; visual ME, determined using gray-to-white disk intensity gradations on black background. ME for inspiratory R loads lessened for LTA over A and NA subjects. There was no significant difference between the 3 groups in ME for PT inspiratory loads, weight, sound, and visual trials. These results demonstrate that LTA subjects are poor perceivers of inspiratory R loads. This deficit in respiratory perception is specific to inspiratory R loads and is not due to perceptual deficits in other types of inspiratory loads, somatosensory, auditory, or visual sensory modalities.

  12. Life-threatening allergic vasculitis after clipping an unruptured aneurysm: Case report, weighing the risk of nickel allergy

    Directory of Open Access Journals (Sweden)

    Andrew Grande

    2014-01-01

    Full Text Available Background: This case report represents one of the estimated 17,000 aneurysms clipped annually in the United States, often with nickel-containing clips. The authors highlight the development of life-threatening allergic vasculitis in a 33-year-old woman after aneurysm clipping. Case Description: After suffering subarachnoid hemorrhage, the patient had coil embolization at another facility for rupture of a right internal carotid artery (ICA aneurysm. An incidental finding, an unruptured left posterior communicating artery aneurysm unamenable to coiling, was then successfully clipped via a left pterional craniotomy. Arriving in our emergency department 11 days later, she progressively declined during the next weeks, facing deteriorating clinical status (i.e. seizures and additional infarctions in the left frontal lobe, midline shift, and new infarctions in the bilateral frontal lobe, right sylvian, right insular regions, and posterior cerebral artery distribution. During decompressive surgery, biopsy findings raised the possibility of lymphocytic vasculitis; consultations with rheumatology, allergy, and immunology specialists identified that our patient had a nickel allergy. After reoperation to replace the nickel-containing clip with one of a titanium alloy, the patient had an uncomplicated postoperative course and was discharged 6 days later to a rehabilitation facility. Conclusions: Nickel-related allergies are more common than appreciated, affecting up to 10% of patients. Fortunately, severe reactions are rare; nevertheless, vascular neurosurgeons should be aware of this potential complication when using cobalt alloy aneurysms clips. The use of titanium alloy clips eliminates this risk.

  13. Efficacy of selective arterial embolisation for the treatment of life-threatening post-partum haemorrhage in a large population.

    Directory of Open Access Journals (Sweden)

    Cyril Touboul

    Full Text Available BACKGROUND: The objective of this study was to assess efficacy and determine the optimal indication of selective arterial embolisation (SAE in patients with life-threatening post-partum haemorrhage (PPH. METHODOLOGY/PRINCIPAL FINDINGS: One hundred and two patients with PPH underwent SAE and were included from January 1998 to January 2002 in our university care center. Embolisation was considered effective when no other surgical procedure was required. Univariate and multivariate statistical analysis were performed. SAE was effective for 73 patients (71.5%, while 29 required surgical procedures. SAE was effective in 88.6% of women with uterine atony that was associated with positive outcome (OR 4.13, 1.35-12.60, whereas caesarean deliveries (OR 0.16, 0.04-0.5 and haemodynamic shock (OR 0.21, 0.07-0.60 were associated with high failure rates, 47.6% and 39.1%, respectively. CONCLUSIONS/SIGNIFICANCE: Success rate for SAE observed in a large population is lower than previously reported. It is most likely to succeed for uterine atony but not recommended in case of haemodynamic shock or after caesarean section.

  14. Awareness about a Life-Threatening Condition: Ectopic Pregnancy in a Network for Surveillance of Severe Maternal Morbidity in Brazil

    Directory of Open Access Journals (Sweden)

    Edilberto Alves Rocha Filho

    2014-01-01

    Full Text Available Objective. To assess occurrence of severe maternal complications associated with ectopic pregnancy (EP. Method. A multicenter cross-sectional study was conducted, with prospective surveillance of potentially life-threatening conditions (PLTC, maternal near miss (MNM, and maternal death (MD. EP complications, patient sociodemographic/obstetric characteristics, and conditions of severity management were assessed, estimating prevalence ratios with respective 95% CI. Factors independently associated with greater severity were identified using multiple regression analysis. Results. Of the 9.555 severe maternal morbidity patients, 312 women (3.3% had complications after EP: 286 (91.7% PLTC, 25 (8.0% MNM, and 1 (0.3% MD. Severe maternal outcome ratio (SMOR was 0.3/1000 LB among EP cases and 10.8/1000 LB among other causes. Complicated EP patients faced a higher risk of blood transfusion, laparotomy, and lower risk of ICU admission and prolonged hospitalization than women developing complications resulting from other causes. Substandard care was the most common in more severe maternal morbidity and EP cases (22.7% MNM and MD versus 15% PLTC, although not significant. Conclusion. Increased maternal morbidity due to EP raised awareness about the condition and its impact on female reproductive life. No important risk factors for greater severity were identified. Care providers should develop specific guidelines and interventions to prevent severe maternal morbidity.

  15. Pharmacokinetics and safety of intravenous cidofovir for life-threatening viral infections in pediatric hematopoietic stem cell transplant recipients.

    Science.gov (United States)

    Caruso Brown, Amy E; Cohen, Mindy N; Tong, Suhong; Braverman, Rebecca S; Rooney, James F; Giller, Roger; Levin, Myron J

    2015-07-01

    Children undergoing hematopoietic stem cell transplantation (HSCT) are at risk for life-threatening viral infections. Cidofovir is often used as a first-line agent for adenovirus infections, despite the absence of randomized controlled trials with HSCT patients, and as a second-line agent for resistant herpesvirus infections. The frequency and severity of adverse effects, particularly nephrotoxicity, in pediatric HSCT recipients are unclear, and pharmacokinetics (PK) of cidofovir in children have not previously been reported. This study was an open-label, nonrandomized, single-dose pilot study to determine the safety and PK of cidofovir in pediatric HSCT recipients with symptomatic adenovirus, nucleoside-resistant cytomegalovirus (CMV) or herpes simplex virus (HSV), and/or human papovavirus infections. Subsequent dosing and frequency were determined by clinical response and side effects, as assessed by the treating physician. Blood and urine samples were obtained from patients for PK studies and assessment of toxicity and virologic response. Twelve patients were enrolled (median age, 9 years; 33.5 days posttransplantation). Four of seven patients with adenovirus infection were successfully treated and eventually cleared their infections. Four of twelve patients died of disseminated viral disease and multiorgan failure. Two of twelve patients had evidence of acute kidney injury after the first dose, and one of these patients developed chronic kidney disease; two other patients developed late nephrotoxicity. The mean drug half-life was 9.5 h. There was no correlation between nephrotoxicity and plasma maximum concentration, clearance, or half-life. PK were similar to those reported for adults, although the drug half-life was significantly longer than that for adults. Cidofovir was well tolerated in the majority of patients. However, effective therapeutic strategies are urgently needed to support patients until immune reconstitution is achieved.

  16. An assessment of meaning in life-threatening illness: development of the Healing Experience in All Life Stressors (HEALS)

    Science.gov (United States)

    Sloan, Danetta Hendricks; BrintzenhofeSzoc, Karlynn; Kichline, Tiffany; Baker, Karen; Pinzon, Jean-Paul; Tafe, Christina; Li, Lingsheng; Cheng, M Jennifer; Berger, Ann

    2017-01-01

    Context Patients with life-threatening or chronic illness report an experience of increased positive psychological, social, and/or spiritual change during diagnosis and/or treatment of their illness, even in the face of unfavorable prognosis. This transformation begins through the ability to make their life meaningful by forming meaningful connections that emerge through self-introspection and relationships with a divine entity, nature, and other people. The Healing Experience in All Life Stressors (HEALS) assessment provides a way to identify distress-causing changes that may interfere with the development of meaning and psycho–social–spiritual homeostasis. Objective Preliminary examination of responses to items on the HEALS and examination of the factor structure. Method The 48-item HEALS questionnaire was developed using a multistep process: literature review for concept development, item generation from qualitative data, and face and content validity by expert panel. In the current study, HEALS was completed by 100 patients diagnosed with life-limiting disease and seen by the palliative care team at a large research institution in the US. Exploratory factor analysis techniques were used to determine scale structure of the instrument. Results Outcome testing of sample adequacy using Kaiser–Meyer–Olkin statistic was 0.75, which exceeds the recommended value of 0.60. The HEALS show very good internal consistency with a Cronbach’s a of 0.94. Overall results of the exploratory factor analysis established a four-factor questionnaire: 1) religion; 2) spirituality, demonstrated by a) interaction with a religious community and b) belief in higher power; 3) intrapersonal; and 4) interpersonal relationships expressed through psychological changes resulting in enhanced outlook and improvement in relationships with family and friends. Conclusion This study involved the initial step to commence the process of scale validation, with promising outcomes identifying

  17. Impact of Age, Sex and Route of Administration on Adverse Events after Opioid Treatment in the Emergency Department: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Raoul Daoust

    2015-01-01

    Full Text Available BACKGROUND: The efficacy of opioids for acute pain relief in the emergency department (ED is well recognized, but treatment with opioids is associated with adverse events ranging from minor discomforts to life-threatening events.

  18. How should we manage a patient with invasive mucoromycosis who develops life-threatening reaction to amphotericin B? Report of two cases and literature review

    Directory of Open Access Journals (Sweden)

    Fereshte Sheybani

    2015-06-01

    Full Text Available This report presents two cases of invasive rhino-orbital mucormycosis who had life-threatening reactions to amphotericin B. Both cases were treated with a combination of posaconazole–caspofungin favorably with no evidence of recurrence upon long-term follow-up. To our knowledge, this is the first report of successful treatment of invasive mucormycosis with azole–echinocandin combination. It may suggest that caspofungin exerts additional or even synergistic antimucoral effects to posaconazole.

  19. An assessment of meaning in life-threatening illness: development of the Healing Experience in All Life Stressors (HEALS

    Directory of Open Access Journals (Sweden)

    Sloan DH

    2017-02-01

    Full Text Available Danetta Hendricks Sloan,1 Karlynn BrintzenhofeSzoc,2 Tiffany Kichline,1 Karen Baker,1 Jean-Paul Pinzon,1 Christina Tafe,1 Lingsheng Li,1 M Jennifer Cheng,1 Ann Berger1 1Pain and Palliative Care, National Institutes of Health, Clinical Center, Bethesda, MD, 2School of Social Work, College of Allied Health Sciences, University of Cincinnati, Cincinnati, OH, USA Context: Patients with life-threatening or chronic illness report an experience of increased positive psychological, social, and/or spiritual change during diagnosis and/or treatment of their illness, even in the face of unfavorable prognosis. This transformation begins through the ability to make their life meaningful by forming meaningful connections that emerge through self-introspection and relationships with a divine entity, nature, and other people. The Healing Experience in All Life Stressors (HEALS assessment provides a way to identify distress-causing changes that may interfere with the development of meaning and psycho–social–spiritual homeostasis.Objective: Preliminary examination of responses to items on the HEALS and examination of the factor structure.Method: The 48-item HEALS questionnaire was developed using a multistep process: literature review for concept development, item generation from qualitative data, and face and content validity by expert panel. In the current study, HEALS was completed by 100 patients diagnosed with life-limiting disease and seen by the palliative care team at a large research institution in the US. Exploratory factor analysis techniques were used to determine scale structure of the instrument.Results: Outcome testing of sample adequacy using Kaiser–Meyer–Olkin statistic was 0.75, which exceeds the recommended value of 0.60. The HEALS show very good internal consistency with a Cronbach’s a of 0.94. Overall results of the exploratory factor analysis established a four-factor questionnaire: 1 religion; 2 spirituality, demonstrated by a

  20. [Effectiveness of pre-emptive hemodialysis with high-flux membranes for the treatment of life-threatening alcohol poisoning].

    Science.gov (United States)

    Peces, R; Fernández, R; Peces, C; González, E; Olivas, E; Renjel, F; Jiménez, M; Costero, O; Montero, A; Selgas, R

    2008-01-01

    Alcohol intoxication (methanol, ethanol and ethylene glycol) may result in metabolic acidosis with increased anion gap, increased serum osmolal gap, and neurologic abnormalities ranging from drunkenness to coma, and death. The mortality and morbidity rates remain very high despite intensive care therapy. The toxicity of methanol and ethylene glycol is clearly correlated to the degree of metabolic acidosis. The established treatment of severe methanol and ethylene glycol intoxication is ethanol administration and hemodialysis (HD). By inhibiting the main metabolic pathway of methanol and ethylene glycol (alcohol dehydrogenase), ethanol prevents the formation of major toxic metabolites (formic acid, glycolic acid and oxalic acid). Conventional HD can reduce serum methanol, ethanol and ethylene glycol and its metabolites rapidly, but high-flux membranes should be capable of removing more toxic per hour of HD. In this report, we describe 14 cases of life-threatening alcohol intoxication (11 methanol, 1 ethanol, and 2 ethylene glycol) who were treated successfully with supportive care, ethanol infusion (methanol and ethylene glycol), and early HD with a high-flux dialyser. The median pH was 7.04 +/- 0.06 (range 6.60-7.33), median bicarbonate 9.9 +/- 1.9 mmol/l (range 1.4-25), and median base deficit 18.4 +/- 2.6 mmol/l (range 2-33). The median anion gap was 29.1 +/- 2.3 mmol/l (range 16-45) and the median osmolal gap was 119 +/- 47 mOsm/l (range 16-402). On admission there was an excellent linear correlation between the serum toxic alcohol concentrations and the osmolal gaps (R2 = 0.98, p = 0.0006). In all cases early HD corrected metabolic acidosis and osmolal abnormalities. The mortality was 7 % (1 from 14). We conclude that pre-emptive HD should be performed in severe intoxications to remove both the parent compound and its metabolites. The HD prescription should include a large surface area dialyser with high-flux membrane, a blood flow rate in excess of 250 ml

  1. Successful treatment of life-threatening Evans syndrome due to antiphospholipid antibody syndrome by rituximab-based regimen: a case with long-term follow-up.

    Science.gov (United States)

    Rückert, A; Glimm, H; Lübbert, M; Grüllich, C

    2008-08-01

    An association of antiphospholipid antibody syndrome with antibodies directed against either phospholipids or plasma proteins strongly suggest that B-cell dysfunction may be involved in its pathogenesis. Antiphospholipid antibody syndrome with autoimmune cytopenias shows a poor response rate to conventional treatment with anticoagulants, glucocorticosteroids, immunosuppressive agents, intravenous immunoglobulin or plasmapheresis. We report a case of life-threatening antiphospholipid antibody syndrome with Evans syndrome receiving successful multimodal treatment including anti-CD20 monoclonal antibody rituximab with long-term follow-up.

  2. Life-threatening postpartum hemolysis, elevated liver functions tests, low platelets syndrome versus thrombocytopenic purpura - Therapeutic plasma exchange is the answer

    Directory of Open Access Journals (Sweden)

    Prashant Nasa

    2011-01-01

    Full Text Available The differential diagnosis of life-threatening microangiopathic disorders in a postpartum female includes severe preeclampsia-eclampsia, hemolysis, elevated liver functions tests, low platelets syndrome and thrombotic thrombocytopenic purpura. There is considerable overlapping in the clinical and laboratory findings between these conditions, and hence an exact diagnosis may not be always possible. However, there is considerable maternal mortality and morbidity associated with these disorders. This case underlines the complexity of pregnancy-related microangiopathies regarding their differential diagnosis, multiple organ dysfunction and role of therapeutic plasma exchange in their management.

  3. Delayed, life-threatening lower gastrointestinal hemorrhage in an infant after serial transverse enteroplasty: treatment with transcatheter n-butyl-2-cyanoacrylate embolization

    Energy Technology Data Exchange (ETDEWEB)

    Bogue, Conor O.; Alzahrani, Amin I.; John, Philip R.; Amaral, Joao G. [Hospital for Sick Children, Division of Image Guided Therapy, Department of Diagnostic Imaging, Toronto (Canada); Wales, Paul W. [Hospital for Sick Children, Department of Surgery and the Group for Improvement of Intestinal Function and Treatment (GIFT), Toronto (Canada)

    2009-10-15

    We report a case of n-butyl-2-cyanoacrylate glue embolization of life-threatening lower gastrointestinal (LGI) hemorrhage in a 10-month-old boy. The child had a history of gastroschisis and short-bowel syndrome. Six months prior to the LGI bleed, he had undergone a serial transverse enteroplasty (STEP) to lengthen his intestine. To the best of our knowledge this is both the first report of successful glue embolization for LGI bleeding in a child and also the first report of severe hemorrhage after the STEP procedure. (orig.)

  4. Life-threatening course of pemphigus vulgaris complicated by sepsis caused by azathioprine-induced bone marrow suppression, successfully managed with combination therapy.

    Science.gov (United States)

    Tichy, Martin; Urbanek, Jaroslav; Sternbersky, Jan; Ditrichova, Dagmar; Hercogova, Jana

    2014-01-01

    Severe forms of pemphigus vulgaris (PV) that are resistant to standard treatment present a life-threatening disease with a mortality of 5-10%. The treatment is usually individualized. The most popular procedures used today include intravenous applications of immunoglobulins and rituximab. Currently the common use of pulse corticosteroids, often in first-line treatment, is being neglected. This particular case documented the severity of the disease and also the need for combined and comprehensive care, in which corticosteroid pulse therapy still plays an important role.

  5. Drug Induced Pneumonitis Secondary to Treatment with Paritaprevir/Ritonavir/Ombitasvir and Dasabuvir (VIEKIRA PAK®) for Chronic Hepatitis C: Case Report of an Unexpected Life-Threatening Adverse Reaction

    Science.gov (United States)

    Faire, Bridget; Gane, Edward

    2017-01-01

    VIEKIRA PAK (ritonavir-boosted paritaprevir/ombitasvir and dasabuvir) is an approved treatment for compensated patients with genotype 1 (GT1) chronic hepatitis C virus (HCV) infection. This oral regimen has minimal adverse effects and is well tolerated. Cure rates are 97% in patients infected with HCV GT 1a and 99% in those with HCV GT 1b. We report the first case of life-threatening allergic pneumonitis associated with VIEKIRA PAK. This unexpected serious adverse event occurred in a 68-year-old Chinese female with genotype 1b chronic hepatitis C and Child-Pugh A cirrhosis. One week into treatment with VIEKIRA PAK without ribavirin, she was admitted to hospital with respiratory distress and acute kidney injury requiring intensive care input. She was initially diagnosed with community acquired pneumonia and improved promptly with intravenous antibiotics and supported care. No bacterial or viral pathogens were cultured. Following complete recovery, she recommenced VIEKIRA PAK but represented 5 days later with more rapidly progressive respiratory failure, requiring intubation and ventilation, inotropic support, and haemodialysis. The final diagnosis was drug induced pneumonitis.

  6. Small size new silastic drains: life-threatening hypovolemic shock after thoracic surgery associated with a non-functioning chest tube.

    Science.gov (United States)

    Clark, Gregory; Licker, Marc; Bertin, Daniel; Spiliopoulos, Anastase

    2007-03-01

    We report a case of a massive haemothorax following bilateral surgical resection of apical bullae. Occult bleeding was not recognized until the onset of a life-threatening circulatory collapse associated with metabolic acidosis and a fall in haemoglobin level. Using a thoracotomy, large amounts of blood were evacuated from the thoracic cavity and bleeding originating from ruptured pleural adhesion was easily controlled. Thrombotic material with talc particles was found to obstruct the 19-French 4-channel Blake drain. Although this new silastic Blake tube has been recommended in cardiac surgical patients, extending its indication in thoracic surgery, particularly when talc pleurodesis is used, should be questioned given the enhanced postoperative prothrombotic state and risk of drain obstruction. In conclusion, caution should be exercised when new small-sized material is introduced in clinical practice, especially after talc pleurodesis following thoracic surgery.

  7. 'I have to live with the decisions I make': laying a foundation for decision making for children with life-limiting conditions and life-threatening illnesses.

    Science.gov (United States)

    Bluebond-Langner, Myra; Hargrave, Darren; Henderson, Ellen M; Langner, Richard

    2016-12-05

    The relationship between parents and clinician is critical to the care and treatment of children with life-limiting conditions (LLCs) and life-threatening illnesses (LTIs). This relationship is built and maintained largely in consultations. In this article we lay out factors that bear on the success of clinical consultations and the maintenance of the essential clinician-parent relationship at progression or deterioration of LLCs or LTIs. We suggest an approach to engaging parents in conversations about care and treatment that recognises and appreciates the dilemmas which clinicians and parents face and in so doing provides a way for everyone to live with the decisions that are made. A close analysis of a consultation at progression and excerpts of encounters among parents, clinician and researcher are used to illustrate our approach to research, analysis and development of recommendations for clinical practice.

  8. Perspectives of Simplified Graphical Domain-Specific Languages as Communication Tools in Developing Mobile Systems for Reporting Life-Threatening Situations

    Directory of Open Access Journals (Sweden)

    Żyła Kamil

    2015-12-01

    Full Text Available Reporting systems, based on mobile technologies and feedback from regular citizens, are constantly gaining popularity, especially when it comes to environmental and cultural heritage protection. Reporting life-threatening situations, such as sudden natural disasters or traffic accidents, constitutes the same class of problems and could be aided by IT systems of similar architecture. Emergency services also could benefit from such kinds of solutions, e.g., by getting an accurate location of the place where help is needed as well as fast exchange of information. Designing and developing systems for reporting life-threatening situations is not a trivial task, requiring tight cooperation among software developers and experts of different domains, who most likely would have trouble with industrially recognized languages and notations. Thus, the question is whether using simplified graphical domain-specific languages (SGDSLs could help in creating a common communication platform. In order to answer that question, short workshops were conducted at the University of Economics in Prague, Czech Republic and in Lublin, Poland. They involved people trained during their studies to work in administration and emergency services, among others, as policy makers, medicine specialists, environmentalists, or managers. All participants received brief training in graphical modeling languages in the context of modeling mobile applications and were asked to voluntarily fill in an anonymous survey in order to check their knowledge about and attitude toward the presented technologies. Most respondents claimed that SGDSLs oriented on defining a flow of actions might be valuable as tools for creating a common communication platform.

  9. Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Paul, Matthias; Acil, Tayfun; Breithardt, Guenter; Wichter, Thomas [Hospital of the University of Muenster, Department of Cardiology and Angiology, Muenster (Germany); Schaefers, Michael; Kies, Peter; Schaefers, Klaus; Schober, Otmar [Hospital of the University of Muenster, Department of Nuclear Medicine, Muenster (Germany)

    2006-08-15

    Idiopathic ventricular fibrillation (IVF) is defined as VF in the absence of any identifiable structural or functional cardiac disease. The underlying pathophysiological mechanisms are unknown. This study was performed to investigate the potential impact of sympathetic dysfunction, assessed by {sup 123}I-meta-iodo-benzylguanidine scintigraphy ({sup 123}I-MIBG SPECT), on the long-term prognosis of patients with IVF. {sup 123}I-MIBG SPECT was performed in 20 patients (mean age 37{+-}13 years) with IVF. Mean follow-up of patients after study entry was 7.2{+-}1.5 years (range 4.9-10.5 years). Ten patients (five men, five women; mean age 43{+-}12 years; p=NS versus study group) with medullary carcinoma of the thyroid gland served as an age-matched control group. Abnormal {sup 123}I-MIBG uptake was observed in 13 patients (65%). During follow-up, 18 episodes of VF/fast polymorphic ventricular tachycardias occurred in four IVF patients with abnormal {sup 123}I-MIBG uptake whereas only two episodes of monomorphic ventricular tachycardia (and no VF) occurred in a single IVF patient with normal {sup 123}I-MIBG uptake. Impairment of sympathetic innervation may indicate a higher risk of future recurrent episodes of life-threatening ventricular tachyarrhythmias in patients with IVF. Studies in larger cohorts are required to validate the significance of {sup 123}I-MIBG SPECT during the long-term follow-up of these patients. (orig.)

  10. A Review of and Recommendations for the Management of Patients With Life-Threatening Dabigatran-Associated Hemorrhage: A Single-Center University Hospital Experience.

    Science.gov (United States)

    Kumar, Rohit; Smith, Roy E; Henry, Brian L

    2015-12-01

    Dabigatran is an oral direct thrombin inhibitor that is approved for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. Dabigatran has several advantages over warfarin including predictable pharmacokinetics and pharmacodynamics which eliminates the need for routine laboratory monitoring, superiority over warfarin in preventing stroke, or systemic embolism without having an increased risk of bleeding. However, as with any anticoagulant, there remains a real chance of bleeding, including major or life-threatening hemorrhage. Many physicians feel comfortable managing bleeding complications on older anticoagulants like warfarin and heparin, due to extensive experience with the medications along with antidotes to reverse their effects as well as established protocols for treating anticoagulant-associated hemorrhage. However, most physicians have limited clinical experience with dabigatran, there is no specific antidote for dabigatran reversal and there is a paucity of protocols, guidelines, and recommendations for how to manage dabigatran-associated hemorrhage. In this review, we present a case series of patients admitted to our institution for management of bleeding while receiving dabigatran. We retrospectively reviewed these cases to evaluate the efficacy and rationale of the various anticoagulation reversal strategies employed in the context of the existing evidence found in the literature. Specific focus is placed on the therapies utilized and the coagulation studies used to manage these patients.

  11. Impact, meaning and need for help and support: The experience of parents caring for children with disabilities, life-limiting/life-threatening illness or technology dependence.

    Science.gov (United States)

    Whiting, Mark

    2013-03-01

    Parenting a child with complex needs or disabilities is a challenging proposition. This study, which drew upon of the experiences of the parents of 34 children (in 33 families), set out to explore the themes of impact, need for help and support and meaning/sense-making as they were related by parents. Data were collected using semi-structured interviews, and an emerging theoretical framework was validated through the use of a series of mind-maps(®) which were presented to individual parents as the basis for a second round (verificational) interview. Parents were nominated into the study by health care professions who were asked to identify the subject children to one of three separate sub-groups: children with a disability; children with a life-limiting/life-threatening illness or children with a technology dependence. Comparisons were made between the three study sub-groups in order to identify areas of consistency and of inconsistency. A fourth study theme - 'battleground' emerged from entirely within the data set. Sense-making occupied a central position within the overall theoretical framework for the study and parental perception of 'battleground' presented as significant element of parental sense-making, particularly in the context of their relationships with professional staff.

  12. Life-Threatening Hypocalcemia following Subtotal Parathyroidectomy in a Patient with Renal Failure and Previous Roux-en-Y Gastric Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Betsy Palal

    2011-01-01

    Full Text Available Background. Roux-en-Y gastric bypass (RYGB can result in calcium and vitamin D deficiency. Parathyroid surgery carries the risk of immediate and long-term hypocalcemia. Methods and Results. We describe a 54-year-old woman with history of end-stage renal disease and gastric bypass surgery who developed calciphylaxis requiring a 3.5-gland parathyroidectomy. Seven weeks later, she presented with weakness, perioral numbness, leg cramps, a positive Chvostek's sign, hypotension, prolonged QT-interval, and serum calcium of 5.4 mg/dL. Oral and intravenous calcium, calcitriol, and high calcium bath hemodialysis were given. She required 18 days of intravenous calcium and an outpatient maintenance regimen of calcitriol 6 mcg/day, calcium carbonate 8 grams/day, calcium citrate 1.2 grams/day, and ergocalciferol 50,000 IU/week. Conclusion. The patient's life-threatening prolonged hypocalcemia and large requirements of calcium and calcitriol were due to a combination of malabsorption, hypoparathyroidism, and renal failure. Special considerations should be given to bariatric surgery patients undergoing neck exploration.

  13. Non-cardiogenic pulmonary edema and life-threatening shock due to calcium channel blocker overdose: a case report and clinical review.

    Science.gov (United States)

    Siddiqi, Tauseef Afaq; Hill, Jennifer; Huckleberry, Yvonne; Parthasarathy, Sairam

    2014-02-01

    Calcium channel blockers (CCBs) overdose can be life-threatening when manifest as catastrophic shock and non-cardiogenic pulmonary edema. We describe a case of massive overdose of multiple medications, including sustained-release verapamil, which was resistant to conventional support. Initial treatment for CCB overdose is primarily supportive, and includes fluid resuscitation. The mechanism of non-cardiogenic pulmonary edema is not well known, and reported cases have been successfully treated with mechanical ventilation. Circulatory shock may fail to respond to atropine, glucagon, and calcium in severely poisoned patients, and vasopressors are usually required. Attempting to overcome calcium-channel antagonism with the supra-therapeutic doses of calcium salts is clinically indicated to reverse hypotension and bradycardia. There is evidence that hyperinsulinemia-euglycemia therapy is superior to other therapies for CCB poisoning, and the mechanism is thought to be the insulin-mediated active transport of glucose into the cells, which counters the CCB-induced intra-cellular carbohydrate-deficient state. Conventional decontamination measures are ineffective in accelerating clearance of CCB. Experience with intravenous lipid emulsion for lipophilic drug overdose, such as verapamil, is limited, but has been proposed as a rescue therapy and might improve cardiac inotropy through intravascular sequestration of the lipophilic CCB.

  14. Treatment of life-threatening wounds with a combination of allogenic platelet-rich plasma, fibrin glue and collagen matrix, and a literature review.

    Science.gov (United States)

    Asadi, Mehdi; Alamdari, Daryoush Hamidi; Rahimi, Hamid Reza; Aliakbarian, Mohsen; Jangjoo, Ali; Abdollahi, Abbas; Bahar, Mostafa Mehrabi; Azadmand, Ali; Forghani, Naser; Sadegh, Mohammad Nori; Khayamy, Mohammad Esmail; Seifalian, Alexander

    2014-08-01

    Currently there is no ideal procedure for the treatment of recalcitrant ulcers that are unresponsive to the majority of common treatments. However, several novel approaches have been proposed, including bone marrow stem cells, platelets, fibrin glue and collagen matrix. For the first approach treatment of a chronic wound, a non-invasive method is highly desirable. The present study was undertaken with the aim of evaluating the effect of a combination of platelets, fibrin glue and collagen matrix (PFC) in one treatment. A total of ten patients with aggressive, refractory, life-threatening wounds were recruited for the study and their treatment effects were evaluated. Initially, the ulcers were extensively debrided, measured and photographed at weekly intervals. The PFC combination was applied topically to the wound every two days. Following treatment, the wound was completely closed in nine patients and was markedly reduced in the other patient. The mean 100% healing time for the nine patients was 11.3±5.22 weeks. There was no evidence of local or systemic complications or any abnormal tissue formation, keloid or hypertrophic scarring. Therefore, the results of the present study indicate that in the first approach, the combination of PFC components may be used safely in order to synergize the effect of chronic wound healing.

  15. Apparent Clustering and Apparent Background Earthquakes Biased by Undetected Seismicity

    CERN Document Server

    Sornette, D

    2005-01-01

    In models of triggered seismicity and in their inversion with empirical data, the detection threshold m_d is commonly equated to the magnitude m_0 of the smallest triggering earthquake. This unjustified assumption neglects the possibility of shocks below the detection threshold triggering observable events. We introduce a formalism that distinguishes between the detection threshold m_d and the minimum triggering earthquake m_0 < m_d. By considering the branching structure of one complete cascade of triggered events, we derive the apparent branching ratio n_a (which is the apparent fraction of aftershocks in a given catalog) and the apparent background source S_a that are observed when only the structure above the detection threshold m_d is known due to the presence of smaller undetected events that are capable of triggering larger events. If earthquake triggering is controlled in large part by the smallest magnitudes as several recent analyses have shown, this implies that previous estimates of the cluster...

  16. Events

    Directory of Open Access Journals (Sweden)

    Igor V. Karyakin

    2016-02-01

    Full Text Available The 9th ARRCN Symposium 2015 was held during 21st–25th October 2015 at the Novotel Hotel, Chumphon, Thailand, one of the most favored travel destinations in Asia. The 10th ARRCN Symposium 2017 will be held during October 2017 in the Davao, Philippines. International Symposium on the Montagu's Harrier (Circus pygargus «The Montagu's Harrier in Europe. Status. Threats. Protection», organized by the environmental organization «Landesbund für Vogelschutz in Bayern e.V.» (LBV was held on November 20-22, 2015 in Germany. The location of this event was the city of Wurzburg in Bavaria.

  17. "Card sorting": a tool for research in ethics on treatment decision-making at the end of life in Alzheimer patients with a life threatening complication

    Directory of Open Access Journals (Sweden)

    Cretin Elodie

    2011-03-01

    Full Text Available Abstract Background End stage dementia is a particularly difficult aspect of care for patients with Alzheimer's disease and related dementias. In care institutions, caregivers and family are concerned by treatment decision-making for an acute life threatening complication occurring in Alzheimer patients at the end of life. How should the best treatment pathway be decided: to treat or not to treat? Which arguments are used for decision-making? These are mainly ethical questions which are currently difficult to express and investigate. Methods/Design Cross sectional multicentre study of clinical cases involving 67 health centres (university hospitals, general hospitals, local hospitals and homes for the elderly in the east of France. The method was based on the "card sorting" technique, with a set of 36 cards, each labelled with a different item relating to arguments for treatment decision-making. For each clinical case, medical staff and carers expressed in a meeting the pieces of information which they believed had been taken into account in the decision. Each participant received a card game, selected fewer than ten and ranked them according to the importance they attached to each one. All selected cards were then put on the table anonymously for participants, respecting the order of importance of the cards in each pile. Lastly, all games were photographed together in order to analyse occurrence and order frequencies. The cards were then classified on the table by frequency to open the discussion. Discussion time, which was conducted by the head carer of the department, concerned the clinical situation of the patient based on the shared responses. Discussion During team meetings, the "card sorting" method was quickly adopted by professionals as a tool to assist with discussion beyond the context of the study. The participants were not compelled to mention their feelings in relation to a case, and it is significant that the anonymity which we

  18. 危及生命的重症颈部外伤的诊治体会%The management of life-threatening neck trauma

    Institute of Scientific and Technical Information of China (English)

    吴静; 刘业海; 吴开乐; 赵益; 童步升; 高潮兵; 李亦凡; 王杨

    2014-01-01

    目的:探讨危及生命的重症颈部外伤有效的诊治方法。方法回顾性分析我科2005年1月~2010年1月间收住入院的各种颈部外伤病例资料,对危及生命的重症颈部外伤的18例诊治过程及预后情况进行回顾性分析。此类病例,首先根据具体病情进行急救,再根据颈部外伤的具体情况进行不同的处理,急救方法主要包括紧急止血、抗休克治疗、气管切开术、重要脏器合并伤的处理。结果18例颈部外伤中入院前伴有出血性休克症状者7例,同时伴有出血性休克症状和喉梗阻者或开放性喉气管贯通损伤者6例,伴有喉梗阻者3例,伴有气胸或血气胸者2例。本组病例皆急救成功,其中9例行气管切开术,随诊6个月~5年,3例拔管困难,其中1例气管套管上方肉芽组织增生,肉芽切除术后2周拔管;1例胸段气管轻度狭窄,随访半年无堵管后无呼吸困难后予以拔管;1例声门下狭窄,保留气管套管。2例声音嘶哑好转不明显,其中1例喉返神经损伤行修复后声带运动部分恢复,1例因杓区损伤未完全康复。所有患者均无气管食管瘘、咽瘘。结论迅速而准确判断颈部外伤的临床特点,及时采取不同的急救措施和具体有效的颈部探查修复术是治疗重症颈部外伤、防止术后并发症的安全有效方法。%Objective To investigate the effective management of life-threatening neck trauma. Methods We retrospectively analyzed on 18 cases of life-threatening neck trauma inpatients of our hospital from 2005 to 2010. To severe cases, took first-aid firstly according to the specific condition, then adopted approriate treatments to individual condition. Emergency methods mainly include these aspects, firstly, treating for shock to patients who accompanied by shock symptoms. Secondly, stopping bleeding to massive active bleeding. At the same time ,the airway must be secured immediately

  19. The apparent Universe

    Science.gov (United States)

    Binétruy, P.; Helou, A.

    2015-10-01

    We exploit the parallel between dynamical black holes and cosmological spacetimes to describe the evolution of Friedmann-Lemaître-Robertson-Walker universes from the point of view of an observer in terms of the dynamics of the apparent horizon. Using the Hayward-Kodama formalism of dynamical black holes, we clarify the role of the Clausius relation to derive the Friedmann equations for a Universe, in the spirit of Jacobson’s work on the thermodynamics of spacetime. We also show how dynamics at the horizon naturally leads to the quantum-mechanical process of Hawking radiation. We comment on the connection of this work with recent ideas to consider our observable Universe as a Bose-Einstein condensate and on the corresponding role of vacuum energy.

  20. Noninvasive imaging modalities and sudden cardiac arrest in the young: can they help distinguish subjects with a potentially life-threatening abnormality from normals?

    Science.gov (United States)

    Printz, Beth Feller

    2012-03-01

    Sudden cardiac arrest (SCA) in the young is always tragic, but fortunately it is an unusual event. When it does occur, it usually happens in active individuals, often while they are participating in physical activity. Depending on the population's characteristics, the most common causes of sudden cardiac arrest in these subjects are hypertrophic cardiomyopathy, congenital coronary abnormalities, arrhythmia in the presence of a structurally normal heart (ion channelopathies or abnormal conduction pathways), aortic rupture, and arrhythmogenic right-ventricular cardiomyopathy. Two-dimensional echocardiography (2-DE) has been proposed as a screening tool that can potentially detect four of these five causes of SCA, and many groups now sponsor community-based 2-DE SCA-screening programs. "Basic" 2-DE screening may include assessment of ventricular volumes, mass, and function; left atrial size; and cardiac and thoracic vascular (including coronary) anatomy. "Advanced" echocardiographic techniques, such as tissue Doppler and strain imaging, can help in diagnosis when the history, electrocardiogram (ECG), and/or standard 2-DE screening suggest there may be an abnormality, e.g., to help differentiate those with "athlete's heart" from hypertrophic or dilated cardiomyopathy. Cardiac magnetic resonance imaging or cardiac computed tomography can be added to increase diagnostic sensitivity and specificity in select cases when an abnormality is suggested during SCA screening. Test availability, cost, and ethical issues related to who to screen, as well as the detection of those with potential disease but low risk, must be balanced when deciding what tests to perform to assess for increased SCA risk.

  1. Use of the non-pneumatic anti-shock garment (NASG for life-threatening obstetric hemorrhage: a cost-effectiveness analysis in Egypt and Nigeria.

    Directory of Open Access Journals (Sweden)

    Tori Sutherland

    Full Text Available OBJECTIVE: To assess the cost-effectiveness of a non-pneumatic anti-shock garment (NASG for obstetric hemorrhage in tertiary hospitals in Egypt and Nigeria. METHODS: We combined published data from pre-intervention/NASG-intervention clinical trials with costs from study sites. For each country, we used observed proportions of initial shock level (mild: mean arterial pressure [MAP] >60 mmHg; severe: MAP ≤60 mmHg to define a standard population of 1,000 women presenting in shock. We examined three intervention scenarios: no women in shock receive the NASG, only women in severe shock receive the NASG, and all women in shock receive the NASG. Clinical data included frequencies of adverse health outcomes (mortality, severe morbidity, severe anemia, and interventions to manage bleeding (uterotonics, blood transfusions, hysterectomies. Costs (in 2010 international dollars included the NASG, training, and clinical interventions. We compared costs and disability-adjusted life years (DALYs across the intervention scenarios. RESULTS: For 1000 women presenting in shock, providing the NASG to those in severe shock results in decreased mortality and morbidity, which averts 357 DALYs in Egypt and 2,063 DALYs in Nigeria. Differences in use of interventions result in net savings of $9,489 in Egypt (primarily due to reduced transfusions and net costs of $6,460 in Nigeria, with a cost per DALY averted of $3.13. Results of providing the NASG for women in mild shock has smaller and uncertain effects due to few clinical events in this data set. CONCLUSION: Using the NASG for women in severe shock resulted in markedly improved health outcomes (2-2.9 DALYs averted per woman, primarily due to reduced mortality, with net savings or extremely low cost per DALY averted. This suggests that in resource-limited settings, the NASG is a very cost-effective intervention for women in severe hypovolemic shock. The effects of the NASG for mild shock are less certain.

  2. Life-Threatening Sochi Virus Infections, Russia.

    Science.gov (United States)

    Kruger, Detlev H; Tkachenko, Evgeniy A; Morozov, Vyacheslav G; Yunicheva, Yulia V; Pilikova, Olga M; Malkin, Gennadiy; Ishmukhametov, Aydar A; Heinemann, Patrick; Witkowski, Peter T; Klempa, Boris; Dzagurova, Tamara K

    2015-12-01

    Sochi virus was recently identified as a new hantavirus genotype carried by the Black Sea field mouse, Apodemus ponticus. We evaluated 62 patients in Russia with Sochi virus infection. Most clinical cases were severe, and the case-fatality rate was as high as 14.5%.

  3. Life-Threatening Cardiac Manifestations of Pheochromocytoma

    Directory of Open Access Journals (Sweden)

    Luiz R. Leite

    2010-01-01

    Full Text Available Pheochromocytoma is a catecholamine-secreting tumor of the adrenal glands, usually with benign manifestations, whose typical clinical presentation includes the triad of headache, palpitations and diaphoresis. However, a wide range of signs and symptoms may be present. In the cardiovascular system, the most common signs are labile hypertension and sinus tachycardia. Systolic heart failure and ST-segment deviations mimicking myocardial infarction have also been reported, as well as QT interval prolongation and, rarely, ventricular tachycardia. We describe a challenging diagnosis of pheochromocytoma with many cardiovascular manifestations, which could have been missed due to the absence of typical symptoms.

  4. A-TWinnipeg: Pathogenesis of rare ATM missense mutation c.6200C>A with decreased protein expression and downstream signaling, early-onset dystonia, cancer, and life-threatening radiotoxicity.

    Science.gov (United States)

    Nakamura, Kotoka; Fike, Francesca; Haghayegh, Sara; Saunders-Pullman, Rachel; Dawson, Angelika J; Dörk, Thilo; Gatti, Richard A

    2014-07-01

    We studied 10 Mennonite patients who carry the c.6200C>A missense mutation (p.A2067D) in the ATM gene, all of whom exhibited a phenotypic variant of ataxia-telangiectasia (A-T) that is characterized by early-onset dystonia and late-onset mild ataxia, as previously described. This report provides the pathogenetic evidence for this mutation on cellular functions. Several patients have developed cancer and subsequently experienced life-threatening adverse reactions to radiation (radiotoxicity) and/or chemotherapy. As the c.6200C>A mutation is, thus far, unique to the Mennonite population and is always associated with the same haplotype or haplovariant, it was important to rule out any possible confounding DNA variant on the same haplotype. Lymphoblastoid cells derived from Mennonite patients expressed small amounts of ATM protein, which had no autophosphorylation activity at ATM Ser1981, and trace-to-absent transphosphorylation of downstream ATM targets. A-T lymphoblastoid cells stably transfected with ATM cDNA which had been mutated for c.6200C>A did not show a detectable amount of ATM protein. The same stable cell line with mutated ATM cDNA also showed a trace-to-absent transphosphorylation of downstream ATM targets SMC1pSer966 and KAP1pSer824. From these results, we conclude that c.6200A is the disease-causing ATM mutation on this haplotype. The presence of at least trace amounts of ATM kinase activity on some immunoblots may account for the late-onset, mild ataxia of these patients. The cause of the dystonia remains unclear. Because this dystonia-ataxia phenotype is often encountered in the Mennonite population in association with cancer and adverse reactions to chemotherapy, an early diagnosis is important.

  5. Partner experiences of "near-miss" events in pregnancy and childbirth in the UK: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Lisa Hinton

    Full Text Available OBJECTIVE: Severe life-threatening complications in pregnancy that require urgent medical intervention are commonly known as "near-miss" events. Although these complications are rare (1 in 100 births, there are potentially 8,000 women and their families in the UK each year who live through a life-threatening emergency and its aftermath. Near-miss obstetric emergencies can be traumatic and frightening for women, and their impact can last for years. There is little research that has explored how these events impact on partners. The objective of this interview study was to explore the impact of a near-miss obstetric emergency, focusing particularly on partners. DESIGN: Qualitative study based on narrative interviews, video and audio recorded and transcribed for analysis. A qualitative interpretative approach was taken, combining thematic analysis with constant comparison. The analysis presented here focuses on the experiences of partners. PARTICIPANTS: Maximum variation sample included 35 women, 10 male partners, and one lesbian partner who had experienced a life-threatening obstetric emergency. SETTING: Interviews were conducted in participants' own homes. RESULTS: In the hospital, partner experiences were characterized by powerlessness and exclusion. Partners often found witnessing the emergency shocking and distressing. Support (from family or staff was very important, and clear, honest communication from medical staff highly valued. The long-term emotional effects for some were profound; some experienced depression, flashbacks and post-traumatic stress disorder months and years after the emergency. These, in turn, affected the whole family. Little support was felt to be available, nor acknowledgement of their ongoing distress. CONCLUSION: Partners, as well as women giving birth, can be shocked to experience a life-threatening illness in childbirth. While medical staff may view a near-miss as a positive outcome for a woman and her baby, there

  6. Study of multi black hole and ring singularity apparent horizons

    CERN Document Server

    Jaramillo, Gabriela

    2010-01-01

    We study critical black hole separations for the formation of a common apparent horizon in systems of $N$ - black holes in a time symmetric configuration. We study in detail the aligned equal mass cases for $N=2,3,4,5$, and relate them to the unequal mass binary black hole case. We then study the apparent horizon of the time symmetric initial geometry of a ring singularity of different radii. The apparent horizon is used as indicative of the location of the event horizon in an effort to predict a critical ring radius that would generate an event horizon of toroidal topology. We found that a good estimate for this ring critical radius is $20/(3\\pi) M$. We briefly discuss the connection of this two cases through a discrete black hole 'necklace' configuration.

  7. Apparent Bicarbonate Space in Children

    Directory of Open Access Journals (Sweden)

    Horacio A. Repetto

    2006-01-01

    Full Text Available The amount needed to change the concentration of a solute requires the knowledge of its volume of distribution in the solution. Electrolytes that do not participate in active metabolic reactions have a fixed volume of distribution that corresponds to the volume of water in which they solubilize. Bicarbonate infusion is used to correct hyperchloremic metabolic acidosis. Its volume of distribution (bicarbonate space changes with its participation in the blood buffer systems. In other words, it is not a fixed physical volume, like that of other solutes. In this paper, we shall review experimental studies that supported evidence for this knowledge and analyze the basic hypothesis to explain the phenomena. Since we have not found clinical studies in children, we shall report our experience in a group of patients with metabolic acidosis treated with bicarbonate infusion in whom apparent bicarbonate space was measured and compared with data in adults from the literature. Guidelines for amount of bicarbonate needed to increase its concentration according to baseline bicarbonate concentration will be suggested.

  8. Uncovering undetected hypoglycemic events

    Directory of Open Access Journals (Sweden)

    Unger J

    2012-03-01

    Full Text Available Jeff UngerCatalina Research Institute, Chino, CA, USAAbstract: Hypoglycemia is the rate-limiting factor that often prevents patients with diabetes from safely and effectively achieving their glycemic goals. Recent studies have reported that severe hypoglycemia is associated with a significant increase in the adjusted risks of major macrovascular events, major microvascular events, and mortality. Minor hypoglycemic episodes can also have serious implications for patient health, psychological well being, and adherence to treatment regimens. Hypoglycemic events can impact the health economics of the patient, their employer, and third-party payers. Insulin treatment is a key predictor of hypoglycemia, with one large population-based study reporting an overall prevalence of 7.1% (type 1 diabetes mellitus and 7.3% (type 2 diabetes mellitus in insulin-treated patients, compared with 0.8% in patients with type 2 diabetes treated with an oral sulfonylurea. Patients with type 1 diabetes typically experience symptomatic hypoglycemia on average twice weekly and severe hypoglycemia once annually. The progressive loss of islet cell function in patients with type 2 diabetes results in a higher risk of both symptomatic and unrecognized hypoglycemia over time. Patients with diabetes who become hypoglycemic are also more susceptible to developing defective counter-regulation, also known as hypoglycemia awareness autonomic failure, which is life-threatening and must be aggressively addressed. In patients unable to recognize hypoglycemia symptoms, frequent home monitoring or use of continuous glucose sensors are critical. Primary care physicians play a key role in the prevention and management of hypoglycemia in patients with diabetes, particularly in those requiring intensive insulin therapy, yet physicians are often unaware of the multitude of consequences of hypoglycemia or how to deal with them. Careful monitoring, adherence to guidelines, and use of optimal

  9. Life-threatening angioedema of the tongue: the detection of the RNA of B henselae in the saliva of a male patient and his dog as well as of the DNA of three Bartonella species in the blood of the patient.

    Science.gov (United States)

    Lösch, Barbara; Wank, Rudolf

    2014-03-20

    Non-hereditary angioedema is a common disease with a prevalence between 5% and 19% and approximately half of the patients experience a swelling of the tongue. We report a case of a 49-year-old Caucasian man with a gross life-threatening angioedema of the tongue, whose attacks occurred every 4 weeks. The most frequent causes of angioedema were excluded. We detected DNA and RNA from Bartonella henselae in the blood and saliva of the patient and in the saliva of the patient's hunting dog. Treatment with azithromycin plus minocycline cleared the blood and saliva of RNA and DNA of Bartonella species, and the patient has been free from angioedema for 1 year. None of the therapy modalities used to treat the hereditary form or ACE or allergy-induced angioedema affect the detrimental course caused by Bartonella species. We therefore suggest that a molecular Bartonella test be included in the analysis of angioedema.

  10. Distribution of apparent stress in western China

    Institute of Scientific and Technical Information of China (English)

    吴忠良; 黄静; 林碧苍

    2002-01-01

    Distribution of apparent stress in Chinese mainland and its surrounding regions was presented using the NEIC broadband radiated energy catalogue and the Harvard CMT catalogue from January 1987 to December 1998. Due to the limitation on the number of samples, reliable results are only for the western China. It is observed that the average apparent stress in Chinese mainland is 0.8 MPa; The maximum apparent stress to the east of the Tibetan plateau is 2.6 MPa; And the average apparent stress in the north-south seismic belt is more than one time higher than its adjacent regions. Distribution pattern of apparent stress seems to have a large-scale correlation with the cumulative energy release level in the 20th century.

  11. The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium

    Science.gov (United States)

    Benjet, C.; Bromet, E.; Karam, E. G.; Kessler, R. C.; McLaughlin, K. A.; Ruscio, A. M.; Shahly, V.; Stein, D. J.; Petukhova, M.; Hill, E.; Alonso, J.; Atwoli, L.; Bunting, B.; Bruffaerts, R.; Caldas-de-Almeida, J. M.; de Girolamo, G.; Florescu, S.; Gureje, O.; Huang, Y.; Lepine, J. P.; Kawakami, N.; Kovess-Masfety, Viviane; Medina-Mora, M. E.; Navarro-Mateu, F.; Piazza, M.; Posada-Villa, J.; Scott, K. M.; Shalev, A.; Slade, T.; ten Have, M.; Torres, Y.; Viana, M. C.; Zarkov, Z.; Koenen, K. C.

    2016-01-01

    Background Considerable research has documented that exposure to traumatic events has negative effects on physical and mental health. Much less research has examined the predictors of traumatic event exposure. Increased understanding of risk factors for exposure to traumatic events could be of considerable value in targeting preventive interventions and anticipating service needs. Method General population surveys in 24 countries with a combined sample of 68 894 adult respondents across six continents assessed exposure to 29 traumatic event types. Differences in prevalence were examined with cross-tabulations. Exploratory factor analysis was conducted to determine whether traumatic event types clustered into interpretable factors. Survival analysis was carried out to examine associations of sociodemographic characteristics and prior traumatic events with subsequent exposure. Results Over 70% of respondents reported a traumatic event; 30.5% were exposed to four or more. Five types – witnessing death or serious injury, the unexpected death of a loved one, being mugged, being in a life-threatening automobile accident, and experiencing a life-threatening illness or injury – accounted for over half of all exposures. Exposure varied by country, sociodemographics and history of prior traumatic events. Being married was the most consistent protective factor. Exposure to interpersonal violence had the strongest associations with subsequent traumatic events. Conclusions Given the near ubiquity of exposure, limited resources may best be dedicated to those that are more likely to be further exposed such as victims of interpersonal violence. Identifying mechanisms that account for the associations of prior interpersonal violence with subsequent trauma is critical to develop interventions to prevent revictimization. PMID:26511595

  12. Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

    Directory of Open Access Journals (Sweden)

    Kuljić Blagoje

    2004-01-01

    Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

  13. Wilcox Group Apparent Thickness, Gulf Coast (wlcxthkg)

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The Apparent Wilcox Group thickness maps are contoured from location and top information derived from the Petroleum Information (PI) Wells database. The Wilcox...

  14. Viscous Cosmology and Thermodynamics of Apparent Horizon

    Institute of Scientific and Technical Information of China (English)

    M. Akbar

    2008-01-01

    @@ It is shown that the differential form of Friedmann equations of Friedman-Robertson-Walker (FRW) universe can be recast as a similar form of the first law ThdSh=dE + W dV of thermodynamics at the apparent horizon of FRW universe filled with the viscous fluid.It is also shown that by employing the general expression of temperature Th=|k|/2π=1/2π(r)A(1-(r)A/2H(r)A) associated with the apparent horizon of an FRW universe and assumed that the temperature Tm of the energy inside the apparent horizon is proportional to the horizon temperature Tm = bTh,we are able to show that the generalized second law of thermodynamics holds in the Einstein gravity provided Th-Tm/(r)A≤(p+(P)).

  15. Mass screenings at mass participation events: MedFest at Special Olympics.

    Science.gov (United States)

    Seidenberg, Peter H; Eggers, Jason L

    2015-01-01

    MedFest events offer preparticipation physical evaluations to Special Olympics athletes. This free service can occur as free-standing events or can take place during Special Olympics Games. The goals of MedFest are to screen for conditions that are potentially life threatening or disabling or may predispose the athlete to injury or illness. The medication, cardiac, and neurologic histories are essential components of the evaluation. The majority of athletes screened during a MedFest event will be cleared for sports participation, but many will require some type of referral for further care. It is important for the organizers of the MedFest to have prearranged protocols to ensure that the athletes efficiently receive the required evaluations.

  16. Mass density at geostationary orbit and apparent mass refilling

    Science.gov (United States)

    Denton, R. E.; Takahashi, Kazue; Amoh, Justice; Singer, H. J.

    2016-04-01

    We used the inferred equatorial mass density ρm,eq based on measurements of Alfvén wave frequencies measured by the GOES satellites during 1980-1991 in order to construct a number of different models of varying complexity for the equatorial mass density at geostationary orbit. The most complicated models are able to account for 66% of the variance with a typical variation from actual values of a factor of 1.56. The factors that influenced ρm,eq in the models were, in order of decreasing importance, the F10.7 EUV index, magnetic local time, the solar wind dynamic pressure Pdyn, the phase of the year, and the solar wind BZ (GSM Z direction). During some intervals, some of which were especially geomagnetically quiet, ρm,eq rose to values that were significantly higher than those predicted by our models. For 10 especially quiet intervals, we examined long-term (>1 day) apparent refilling, the increase in ρm,eq at a fixed location. We found that the behavior of ρm,eq varies for different events. In some cases, there is significant apparent refilling, whereas in other cases ρm,eq stays the same or even decreases slightly. Nevertheless, we showed that on average, ρm,eq increases exponentially during quiet intervals. There is variation of apparent refilling with respect to the phase of the solar cycle. On the third day of apparent refilling, ρm,eq has on average a similar value at solar maximum or solar minimum, but at solar maximum, ρm,eq begins with a larger value and rises relatively less than at solar minimum.

  17. Rubber friction on (apparently) smooth lubricated surfaces

    Science.gov (United States)

    Mofidi, M.; Prakash, B.; Persson, B. N. J.; Albohr, O.

    2008-02-01

    We study rubber sliding friction on hard lubricated surfaces. We show that even if the hard surface appears smooth to the naked eye, it may exhibit short-wavelength roughness, which may make the dominant contribution to rubber friction. That is, the observed sliding friction is mainly due to the viscoelastic deformations of the rubber by the counterface surface asperities. The results presented are of great importance for rubber sealing and other rubber applications involving (apparently) smooth surfaces.

  18. Rubber friction on (apparently) smooth lubricated surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Mofidi, M; Prakash, B [Division of Machine Elements, Luleaa University of Technology, Luleaa SE-97187 (Sweden); Persson, B N J [IFF, FZ-Juelich, 52425 Juelich (Germany); Albohr, O [Pirelli Deutschland AG, 64733 Hoechst/Odenwald, Postfach 1120 (Germany)

    2008-02-27

    We study rubber sliding friction on hard lubricated surfaces. We show that even if the hard surface appears smooth to the naked eye, it may exhibit short-wavelength roughness, which may make the dominant contribution to rubber friction. That is, the observed sliding friction is mainly due to the viscoelastic deformations of the rubber by the counterface surface asperities. The results presented are of great importance for rubber sealing and other rubber applications involving (apparently) smooth surfaces.

  19. Comment: An Apparent Controversy in Auroral Physics

    Science.gov (United States)

    Haerendel, Gerhard

    2007-03-01

    In his article ``A turning point in auroral physics,'' Bryant argued against what he called the `standard' theory of auroral acceleration, according to which the electrons ``gain their energy from static electric fields,'' and offered wave acceleration as an alternative. Because of the importance of the process, not only for the aurora borealis but also for other cosmic plasmas, a clarification of this apparent controversy seems to be in place.

  20. Apparent exchange rate mapping with diffusion MRI.

    Science.gov (United States)

    Lasič, Samo; Nilsson, Markus; Lätt, Jimmy; Ståhlberg, Freddy; Topgaard, Daniel

    2011-08-01

    Water exchange through the cell membranes is an important feature of cells and tissues. The rate of exchange is determined by factors such as membrane lipid composition and organization, as well as the type and activity of aquaporins. A method for noninvasively estimating the rate of water exchange would be useful for characterizing pathological conditions, e.g., tumors, multiple sclerosis, and ischemic stroke, expected to be associated with a change of the membrane barrier properties. This study describes the filter exchange imaging method for determining the rate of water exchange between sites having different apparent diffusion coefficients. The method is based on the filter-exchange pulsed gradient spin-echo NMR spectroscopy experiment, which is here modified to be compatible with the constraints of clinical MR scanners. The data is analyzed using a model-free approach yielding maps of the apparent exchange rate, here being introduced in analogy with the concept of the apparent diffusion coefficient. Proof-of-principle experiments are performed on microimaging and whole-body clinical scanners using yeast suspension phantoms. The limitations and appropriate experimental conditions are examined. The results demonstrate that filter exchange imaging is a fast and reliable method for characterizing exchange, and that it has the potential to become a powerful diagnostic tool.

  1. Life-threatening acute lung injury after gamma butyrolactone ingestion

    NARCIS (Netherlands)

    van Gerwen, M.; Scheper, H.; Touw, D. J.; van Nieuwkoop, C.

    2015-01-01

    We describe a case of a 44-year-old woman with a borderline personality disorder and chronic gamma-butyrolactone (GBL) use who presented with progressive dyspnoea and an altered mental status. A high anion gap metabolic acidosis and acute lung injury was diagnosed. We hypothesise this was caused by

  2. Life-threatening meningitis resulting from transrectal prostate biopsy

    Institute of Scientific and Technical Information of China (English)

    Zhou-Jun Shen; Shan-Wen Chen; Hua Wang; Xie-Lai Zhou; Ju-Ping Zhao

    2005-01-01

    After antibiotic prophylaxis with metronidazole and levofloxacin, a transrectal sextant biopsy was performed under the guide of transrectal ultrasonography (TRUS) for a 75-year-old suspicious patient with prostate adenocarcinoma.Although antibiotics were also given after this procedure, the patient still developed fever, anxious, agrypnia and headache. Blood cultures remained negative. Lumbar puncture was performed and was consistent with Escherichia coli bacterial meningitis.

  3. Neurologic and Cardiovascular Complications in Pediatric Life Threatening Imipramine Poisoning.

    Science.gov (United States)

    Hon, Kam L; Fung, Ching K; Lee, Vivian W; Cheung, Kam L; Wong, William; Leung, Alexander K C

    2015-01-01

    We present an 18-month boy with imipramine poisoning to illustrate the neuro-cardiac toxic effects of this potentially deadly poison in children. The toddler ingested an unknown amount of imipramine from a non-childproof bottle which clearly labelled that the drug must be kept out of reach from children. He developed neurologic and cardiac symptoms. Electrocardiography (ECG) showed tachycardia and widened QRS. He was immediately treated with bicarbonate infusion and made an uneventful recovery. This is the youngest and only reported case of symptomatic imipramine ingestion in our locality. Imipramine has been surpassed by newer antidepressants for the treatment of depression in the past decade. Literature is searched to review the mortality rate in young children. Intensive care neuro-cardiac support contributes to the favorable outcome. Despite clear labelling of the bottle, carelessness on the part of the adult and the use of non-childproof bottle are definite preventable factor to such potentially fatal ingestion.

  4. A life-threatening association of coronary anomalies

    Directory of Open Access Journals (Sweden)

    Devasia T

    2016-10-01

    Full Text Available Anomalous origin of the left coronary artery from the right sinus of Valsalva, even though rare, has been documented well in literature. However the association of this anomaly with coronary fistulae has been rarely reported so far. We report the case of a 76-year-old female who presented to us with exertional dyspnoea. General physical and cardiovascular examination revealed no significant abnormalities. All laboratory investigations were normal. Chest radiograph was normal. Electrocardiogram showed left bundle branch block. Echocardiogram revealed a globally hypokinetic left ventricle with reduced ejection fraction. Coronary angiogram showed anomalous origin of left coronary artery from right coronary sinus along with a small coronary-cameral fistula connecting obtuse marginal artery to left ventricle, there was no significant stenosis of epicardial coronaries. This case report, documents the rare association of an anomalous coronary origin of left coronary artery with coronary fistula.

  5. Life-threatening hyperkalemia: a potentially lethal drug combination.

    Science.gov (United States)

    Juvet, Tristan; Gourineni, Venkata C; Ravi, Sandeep; Zarich, Stuart W

    2013-09-01

    Hyperkalemia is commonly seen in the elderly and is occasionally fatal. Inadvertently combining potassium sparing medications can result in profound hyperkalemia which may result in cardiac dysrhythmias, especially in the setting of chronic kidney disease. An 85 year-old woman on a drug regimen of sotalol, valsartan, spironolactone, and trimethoprim-sulfamethoxazole presented to the emergency department with hypotension and bradycardia. Presumptive treatment for hyperkalemia was started based on her initial electrocardiogram. This diagnosis was later confirmed with a serum potassium value of 10.1 mmol/L. Following pharmacologic treatment, emergency hemodialysis was performed and the patient subsequently recovered. It is known that several drug classes can cause hyperkalemia, with elderly patients at a higher risk of developing this side effect. It is believed that this was a major contributor to the degree of hyperkalemia seen in this patient.

  6. Strongyloides hyper-infection causing life-threatening gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Lajos Csermely; Hassan Jaafar; Jorgen Kristensen; Antonio Castella; Waldemar Gorka; Ahmed Ali Chebli; Fawaz Trab; Hussain Alizadeh; Béla Hunyady

    2006-01-01

    A 55-year old male patient was diagnosed with strongyloides hyper-infection with stool analysis and intestinal biopsy shortly after his chemotherapy for myeloma.He was commenced on albendazole anthelmintic therapy. After initiation of the treatment he suffered lifethreatening gastrointestinal (GI) bleeding. Repeated endoscopies showed diffuse multi-focal intestinal bleeding. The patient required huge amounts of red blood cells and plasma transfusions and correction of haemostasis with recombinant activated factor Ⅶ.Abdominal aorto-angiography showed numerous microinferior mesenteric arteries' territories. While the biopsy taken prior to the treatment with albendazole did not show evidence of vasculitis, the biopsy taken after initiation of therapy revealed leukoclastic aggregations around the vessels. These findings suggest that, in addition to direct destruction of the mucosa, vasculitis could be an important additive factor causing the massive GI bleeding during the anthelmintic treatment.This might result from substances released by the worms that have been killed with anthelmintic therapy.Current guidelines advise steroids to be tapered and stopped in case of systematic parasitic infections as they might reduce immunity and precipitate parasitic hyper-infection. In our opinion, steroid therapy might be of value in the management of strongyloides hyperinfection related vasculitis, in addition to the anthelmintic treatment. Indeed, steroid therapy of vasculitis with other means of supportive care resulted in cessation of the bleeding and recovery of the patient.

  7. Life-threatening vascular complications after central venous catheter placement

    Energy Technology Data Exchange (ETDEWEB)

    Wicky, S.; Meuwly, J.-Y.; Doenz, F.; Uske, A.; Schnyder, P.; Denys, A. [Department of Radiology, University Hospital, Lausanne (Switzerland)

    2002-04-01

    The purpose of this retrospective study was to report 11 cases of severe vascular complications after central venous catheter misplacement. For each patient, data collection included body mass index, the diagnosis at admission, the site of the procedure, the type of catheter, coagulation parameters, the imaging modalities performed and the applied treatment. Eight patients had a lesion of the subclavian artery. Brachiocephalic vein perforations were assessed in three more patients. All patients had a chest roentgenogram after the procedure, six a CT examination, and four an angiographic procedure. Seven patients had a body mass index above 30, and 5 patients had coagulation disorders prior to the procedure. Seven patients were conservatively managed, 2 patients died despite resuscitation, 1 patient was treated with a stent graft, and one by superselective embolization. Subclavian or jugular vein temporary catheter positioning is a practical approach. Identification of any iatrogenic perforation of the subclavian artery or central veins urges obtainment a chest roentgenogram and, when required, a chest CT, selective angiograms or venograms. Body mass index superior to 30, previous unsuccessful catheterization attempts, and coagulation factor depletion seemed to account for risk factors. Recognition of clinical and radiological complications is mandatory. (orig.)

  8. [Neonatal subgaleal haemorrhage; a potential life-threatening extracranial haemorrhage

    NARCIS (Netherlands)

    Fuijkschot, J.; Antonius, T.A.J.; Meijers, P.W.; Vrancken, S.L.A.G.

    2008-01-01

    A female neonate delivered at term developed hypovolemic shock due to a subgaleal haemorrhage, i.e. extracranial bleeding between the galea aponeurotica and the cranial periosteum. The subgaleal haemorrhage was most likely the result of a traumatic vacuum extraction. The patient was treated with lar

  9. Life threatening zygomyces infection of the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Al-Qaisi M

    2014-08-01

    Full Text Available A 25 year old diabetic woman was admitted into the Intensive Care Unit because of ketoacidosis, hypotension and upper gastrointestinal bleeding. Emergency endoscopic biopsy of the upper gastrointestinal tract demonstrated invasive, non-septate fungal hyphae suggestive of either a Zygomyces or Basidiobolus. Amphotericin B was not used because of its ineffectiveness against Basidiobolus and her renal failure. In addition, first generation antifungal azoles were not used because of their ineffectiveness against Zygomyces. The patient responded to medical therapy and the broad-spectrum azole antifungal posaconazole which has activity against both Basidiobolus and Zygomyces. The patient recovered from her critical illness and on follow up was without residual problems.

  10. Subcutaneous mucor zygomycosis with potential life-threatening visceral complication

    Directory of Open Access Journals (Sweden)

    Angeline

    2013-01-01

    Full Text Available A mass in right supraclavicular fossa in a diabetic patient mimicking tuberculosis (TB adenitis that ultimately proved to be subcutaneous zygomycosis. A high degree of clinical suspicion is needed for diagnosis especially when these lesions occur at typical sites for the more common indolent infections like TB. This case is being presented not only because of its rarity, but to emphasize the role of early diagnosis and appropriate treatment to prevent serious complications due to proximity to major structures. Fluconazole was used despite not being the ideal drug, solely due to cost constraints. Our patient responded well. However, we do emphasize that response to fluconazole is the exception rather than the rule.

  11. Life-threatening paraspinal muscle hematoma after percutaneous vertebroplasty

    Directory of Open Access Journals (Sweden)

    Chang-Hoon Jeon

    2016-01-01

    Full Text Available Bleeding and hematoma formation is rarely reported in percutaneous vertebroplasty procedure. An 84 year old male presented with a large paraspinal muscle hematoma after a percutaneous vertebroplasty. The patient had neither any prior bleeding disorder nor any anticoagulant treatment. Vital signs of the patient were unstable, and his hemoglobin level decreased daily. After a month of conservative treatment, including transfusion, cryotherapy, pain control and bed rest, his hemoglobin level remained stable and he showed relief from pain. Four months later, hematoma resolved spontaneously and he could walk without back pain.

  12. INFLUENCE OF TEXTURE AND MINERALOGY IN APPARENT POROSITY, WATER ABSORPTION AND APPARENT DENSITY OF IGNEOUS ROCKS

    Directory of Open Access Journals (Sweden)

    Ana Paula Meyer

    2014-12-01

    Full Text Available The work consists in evaluating the results of physical indices (apparent porosity, water absorption and apparent density obtained in granitoids exploited as ornamental and revetment stones in the state of São Paulo and Espírito Santo. The results of physical indices were qualified as parameters specification published by Abirochas use and compared the characteristics observed in petrographic samples.

  13. Apparent magnitude of earthshine: a simple calculation

    Science.gov (United States)

    Agrawal, Dulli Chandra

    2016-05-01

    The Sun illuminates both the Moon and the Earth with practically the same luminous fluxes which are in turn reflected by them. The Moon provides a dim light to the Earth whereas the Earth illuminates the Moon with somewhat brighter light which can be seen from the Earth and is called earthshine. As the amount of light reflected from the Earth depends on part of the Earth and the cloud cover, the strength of earthshine varies throughout the year. The measure of the earthshine light is luminance, which is defined in photometry as the total luminous flux of light hitting or passing through a surface. The expression for the earthshine light in terms of the apparent magnitude has been derived for the first time and evaluated for two extreme cases; firstly, when the Sun’s rays are reflected by the water of the oceans and secondly when the reflector is either thick clouds or snow. The corresponding values are -1.30 and -3.69, respectively. The earthshine value -3.22 reported by Jackson lies within these apparent magnitudes. This paper will motivate the students and teachers of physics to look for the illuminated Moon by earthlight during the waning or waxing crescent phase of the Moon and to reproduce the expressions derived here by making use of the inverse-square law of radiation, Planck’s expression for the power in electromagnetic radiation, photopic spectral luminous efficiency function and expression for the apparent magnitude of a body in terms of luminous fluxes.

  14. Apparent exchange rate imaging in anisotropic systems

    DEFF Research Database (Denmark)

    Sønderby, Casper Kaae; Lundell, Henrik M; Søgaard, Lise V;

    2014-01-01

    Double-wave diffusion experiments offer the possibility of probing correlation between molecular diffusion at multiple time points. It has recently been shown that this technique is capable of measuring the exchange of water across cellular membranes. The aim of this study was to investigate the ...... the effect of macroscopic tissue anisotropy on the measurement of the apparent exchange rate (AXR) in multicompartment systems.......Double-wave diffusion experiments offer the possibility of probing correlation between molecular diffusion at multiple time points. It has recently been shown that this technique is capable of measuring the exchange of water across cellular membranes. The aim of this study was to investigate...

  15. Apparent speed increases at low luminance

    OpenAIRE

    Vaziri-Pashkam, Maryam; Cavanagh, Patrick

    2008-01-01

    To investigate the effect of luminance on apparent speed, subjects adjusted the speed of a low-luminance rotating grating (0.31 cd/m2) to match that of a high-luminance one (1260 cd/m2). Above 4 Hz, subjects overestimated the speed of the low-luminance grating. This overestimation increased as a function of temporal rate and reached 30% around 10 Hz temporal rates. The speed overestimation became significant once the lower luminance was 2.4 log units lower than the high luminance comparison. ...

  16. Apparent contact angle of an evaporating drop

    Science.gov (United States)

    Morris, S. J. S.

    2012-11-01

    In experiments by Poulard et al. (2005), a sessile drop of perfectly wetting liquid evaporates from a non-heated substrate into an under-saturated mixture of vapour with an inert gas; evaporation is limited by vapour diffusion. The system exhibits an apparent contact angle θ that is a flow property. Under certain conditions, the apparent contact line was stationary relative to the substrate; we predict θ for this case. Observed values of θ are small, allowing lubrication analysis of the liquid film. The liquid and vapour flows are coupled through conditions holding at the phase interface; in particular, vapour partial pressure there is related to the local value of liquid pressure through the Kelvin condition. Because the droplet is shallow, the interfacial conditions can be transferred to the solid-liquid interface at y = 0 . We show that the dimensionless partial pressure p (x , y) and the film thickness h (x) are determined by solving ∇2 p = 0 for y > 0 subject to a matching condition at infinity, and the conditions - p = L hxx +h-3 and (h3px) x + 3py = 0 at y = 0 . The parameter L controls the ratio of Laplace to disjoining pressure. We analyse this b.v.p. for the experimentally-relevant case L --> 0 .

  17. A "fair sampling" perspective on an apparent violation of duality

    CERN Document Server

    Bolduc, Eliot; Miatto, Filippo M; Leuchs, Gerd; Boyd, Robert W

    2014-01-01

    In the event in which a quantum mechanical particle can pass from an initial state to a final state along two possible paths, the duality principle states that "the simultaneous observation of wave and particle behavior is prohibited". [M. O. Scully, B.-G. Englert, and H. Walther. Nature, 351:111-116, 1991.] emphasized the importance of additional degrees of freedom in the context of complementarity. In this paper, we show how the consequences of duality change when allowing for biased sampling, that is, postselected measurements on specific degrees of freedom of the environment of the two-path state. Our work contributes to the explanation of previous experimental apparent violations of duality [R. Menzel, D. Puhlmann, A. Heuer, and W. P. Schleich. Proc. Natl. Acad. Sci., 109(24):9314-9319, 2012.] and opens up the way for novel experimental tests of duality.

  18. Event Management

    OpenAIRE

    Havlenová, Tereza

    2016-01-01

    Event is an experience that is perceived by all the senses. Event management is a process involving the various activities that are assigned to staffers. Organizing special events became an individual field. If the manager understand the events as a communication platform gets into the hands of a modern, multifunctional and very impressive tool. The procedure to implement a successful event in a particular area is part of this work. The first part explains the issues of event management on th...

  19. Field signature for apparently superluminal particle motion

    CERN Document Server

    Land, Martin

    2016-01-01

    In the context of Stueckelberg's covariant symplectic mechanics, Horwitz and Aharonovich have proposed a simple mechanism by which a particle traveling below light speed almost everywhere may exhibit a transit time that suggests superluminal motion. This mechanism, which requires precise measurement of the particle velocity, involves a subtle perturbation affecting the particle's recorded time coordinate caused by virtual pair processes. The Stueckelberg framework is particularly well suited to such problems, because it permits pair creation/annihilation at the classical level. In this paper, we study a trajectory of the type proposed by Horwitz and Aharonovich, and derive the Maxwell 4-vector potential associated with the motion. We show that the resulting fields carry a signature associated with the apparent superluminal motion, providing an independent test for the mechanism that does not require direct observation of the trajectory, except at the detector.

  20. Distribution of apparent magnetization for Asia

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Magsat total field anomalies over Asia were used to construct an equivalent magnetization model, which represents the apparent magnetization distribution within an equivalent layer 40 km thick and correlates well with large-scale tectonics, for example, the Kazakhstan, Tarim, Yangtze, India, Sino-Korea and Indochina blocks. The basin, plain, sea basin, and islands are delineated by magnetization lows whereas the plateau and marine ridge correspond to magnetization highs. The boundary between Tibetan Plateau and India marked by a strong gradient along its length coincides with the Yarlung Zangbo River fault roughly. The Tanlu fault belt is the boundary between positive and negative anomalies. This boundary stretches in southwest direction and joins Sanjiang fault belt. The boundary between the Southeast China block and the Yangtze block is also clearly delineated by the magnetization anomalies. Generally, the magnetization boundaries are consistent with the collisional suture of blocks.

  1. Apparent energy distribution of sea waves

    Institute of Scientific and Technical Information of China (English)

    孙孚; 丁平兴

    1995-01-01

    A concept of apparent energy distribution of sea waves is suggested and named "the outer frequency spectrum" to distinguish it from the frequency spectrum in common sense In line with the concept, a kind of outer spectrum with three parameters in Cauchy’ s form is derived theoretically from the joint distribution of wave periods and heights reached previously by the present authors and the Bretschneider spectrum is rededuced simply in a distinct manner. The foundation of mechanics of the similarity between the frequency spectrum in common sense and the outer one is briefly discussed. In view of the fact that Bretschneider spectrum has a wide application in engineering, the advantages and probability of using the outer spectrum as a common one are also considered.

  2. AGN jet physics and apparent opening angles

    CERN Document Server

    Clausen-Brown, Eric; Pushkarev, Alexander B; Kovalev, Yuri Y; Lister, Matthew L

    2013-01-01

    We present a new method to measure Gamma*theta_j in flux-limited samples of active galactic nuclei (AGN) jets, where Gamma is the bulk Lorentz factor and theta_j is the jet's half-opening angle. The Gamma*theta_j parameter is physically important for models of jet launching, and also determines the effectiveness of jet instabilities and magnetic reconnection. We measure Gamma*theta_j by analyzing the observed distribution of apparent opening angles in very long baseline interferometry (VLBI) flux-limited samples of jets, given some prior knowledge of the active galactic nuclei (AGN) radio luminosity function. We then apply this method to the MOJAVE flux-limited sample of radio loud objects and find Gamma*theta_j = 0.1 +- 0.03, which implies that AGN jets are subject to a variety of physical processes that require causal connection.

  3. Ambiguity in Tactile Apparent Motion Perception.

    Directory of Open Access Journals (Sweden)

    Emanuela Liaci

    Full Text Available In von Schiller's Stroboscopic Alternative Motion (SAM stimulus two visually presented diagonal dot pairs, located on the corners of an imaginary rectangle, alternate with each other and induce either horizontal, vertical or, rarely, rotational motion percepts. SAM motion perception can be described by a psychometric function of the dot aspect ratio ("AR", i.e. the relation between vertical and horizontal dot distances. Further, with equal horizontal and vertical dot distances (AR = 1 perception is biased towards vertical motion. In a series of five experiments, we presented tactile SAM versions and studied the role of AR and of different reference frames for the perception of tactile apparent motion.We presented tactile SAM stimuli and varied the ARs, while participants reported the perceived motion directions. Pairs of vibration stimulators were attached to the participants' forearms and stimulator distances were varied within and between forearms. We compared straight and rotated forearm conditions with each other in order to disentangle the roles of exogenous and endogenous reference frames.Increasing the tactile SAM's AR biased perception towards vertical motion, but the effect was weak compared to the visual modality. We found no horizontal disambiguation, even for very small tactile ARs. A forearm rotation by 90° kept the vertical bias, even though it was now coupled with small ARs. A 45° rotation condition with crossed forearms, however, evoked a strong horizontal motion bias.Existing approaches to explain the visual SAM bias fail to explain the current tactile results. Particularly puzzling is the strong horizontal bias in the crossed-forearm conditions. In the case of tactile apparent motion, there seem to be no fixed priority rule for perceptual disambiguation. Rather the weighting of available evidence seems to depend on the degree of stimulus ambiguity, the current situation and on the perceptual strategy of the individual

  4. Event marketing

    OpenAIRE

    Novotná, Michaela

    2008-01-01

    This study aims to analyze event-marketing activities of the small firm and propose new events. At first the theoretical part describes marketing and communication mix and then especially planning and development of event marketing campaign. Research data were collected by the method of survey to propose the new events. Randomly selected customers were asked to fill the questionnaire. Its results were integrated into the proposal of the new events. The interview was realized with the owner of...

  5. Apparent exchange rate for breast cancer characterization.

    Science.gov (United States)

    Lasič, Samo; Oredsson, Stina; Partridge, Savannah C; Saal, Lao H; Topgaard, Daniel; Nilsson, Markus; Bryskhe, Karin

    2016-05-01

    Although diffusion MRI has shown promise for the characterization of breast cancer, it has low specificity to malignant subtypes. Higher specificity might be achieved if the effects of cell morphology and molecular exchange across cell membranes could be disentangled. The quantification of exchange might thus allow the differentiation of different types of breast cancer cells. Based on differences in diffusion rates between the intra- and extracellular compartments, filter exchange spectroscopy/imaging (FEXSY/FEXI) provides non-invasive quantification of the apparent exchange rate (AXR) of water between the two compartments. To test the feasibility of FEXSY for the differentiation of different breast cancer cells, we performed experiments on several breast epithelial cell lines in vitro. Furthermore, we performed the first in vivo FEXI measurement of water exchange in human breast. In cell suspensions, pulsed gradient spin-echo experiments with large b values and variable pulse duration allow the characterization of the intracellular compartment, whereas FEXSY provides a quantification of AXR. These experiments are very sensitive to the physiological state of cells and can be used to establish reliable protocols for the culture and harvesting of cells. Our results suggest that different breast cancer subtypes can be distinguished on the basis of their AXR values in cell suspensions. Time-resolved measurements allow the monitoring of the physiological state of cells in suspensions over the time-scale of hours, and reveal an abrupt disintegration of the intracellular compartment. In vivo, exchange can be detected in a tumor, whereas, in normal tissue, the exchange rate is outside the range experimentally accessible for FEXI. At present, low signal-to-noise ratio and limited scan time allows the quantification of AXR only in a region of interest of relatively large tumors.

  6. Apparent diffusion coefficient of normal adrenal glands

    Directory of Open Access Journals (Sweden)

    Sara Reis Teixeira

    Full Text Available Abstract Objective: To assess the feasibility and reliability of apparent diffusion coefficient (ADC measurements of normal adrenal glands. Materials and methods: This was a retrospective study involving 32 healthy subjects, divided into two groups: prepubertal (PreP, n = 12, aged from 2 months to 12.5 years (4 males; 8 females; and postpubertal (PostP, n = 20, aged from 11.9 to 61 years (5 males; 15 females. Diffusion-weighted magnetic resonance imaging (DW-MRI sequences were acquired at a 1.5 T scanner using b values of 0, 20, 500, and 1000 s/mm2. Two radiologists evaluated the images. ADC values were measured pixel-by-pixel on DW-MRI scans, and automatic co-registration with the ADC map was obtained. Results: Mean ADC values for the right adrenal glands were 1.44 × 10-3 mm2/s for the PreP group and 1.23 × 10-3 mm2/s for the PostP group, whereas they were 1.58 × 10-3 mm2/s and 1.32 × 10-3 mm2/s, respectively, for the left glands. ADC values were higher in the PreP group than in the PostP group (p < 0.05. Agreement between readers was almost perfect (intraclass correlation coefficient, 0.84-0.94; p < 0.05. Conclusion: Our results demonstrate the feasibility and reliability of performing DW-MRI measurements of normal adrenal glands. They could also support the feasibility of ADC measurements of small structures.

  7. Apparent diffusion coefficient of normal adrenal glands*

    Science.gov (United States)

    Teixeira, Sara Reis; Elias, Paula Condé Lamparelli; Leite, Andrea Farias de Melo; de Oliveira, Tatiane Mendes Gonçalves; Muglia, Valdair Francisco; Elias Junior, Jorge

    2016-01-01

    Objective To assess the feasibility and reliability of apparent diffusion coefficient (ADC) measurements of normal adrenal glands. Materials and methods This was a retrospective study involving 32 healthy subjects, divided into two groups: prepubertal (PreP, n = 12), aged from 2 months to 12.5 years (4 males; 8 females); and postpubertal (PostP, n = 20), aged from 11.9 to 61 years (5 males; 15 females). Diffusion-weighted magnetic resonance imaging (DW-MRI) sequences were acquired at a 1.5 T scanner using b values of 0, 20, 500, and 1000 s/mm2. Two radiologists evaluated the images. ADC values were measured pixel-by-pixel on DW-MRI scans, and automatic co-registration with the ADC map was obtained. Results Mean ADC values for the right adrenal glands were 1.44 × 10-3 mm2/s for the PreP group and 1.23 × 10-3 mm2/s for the PostP group, whereas they were 1.58 × 10-3 mm2/s and 1.32 × 10-3 mm2/s, respectively, for the left glands. ADC values were higher in the PreP group than in the PostP group (p < 0.05). Agreement between readers was almost perfect (intraclass correlation coefficient, 0.84-0.94; p < 0.05). Conclusion Our results demonstrate the feasibility and reliability of performing DW-MRI measurements of normal adrenal glands. They could also support the feasibility of ADC measurements of small structures. PMID:28057963

  8. Mechanics of Apparent Horizon in Two Dimensional Dilaton Gravity

    CERN Document Server

    Cai, Rong-Gen

    2016-01-01

    In this article, we give a definition of apparent horizon in a two dimensional general dilaton gravity theory. With this definition, we construct the mechanics of the apparent horizon by introducing a quasi-local energy of the theory. Our discussion generalizes the apparent horizons mechanics in general spherically symmetric spactimes in four or higher dimensions to the two dimensional dilaton gravity case.

  9. Nephrotic Syndrome and Acute Renal Failure Apparently Induced by Sunitinib

    Directory of Open Access Journals (Sweden)

    Ying-Shou Chen

    2009-10-01

    Full Text Available We report a case of nephrotic syndrome and acute renal failure apparently induced by sunitinib. A 67-year-old man with a history of metastatic renal cell carcinoma presented with progressive kidney dysfunction with proteinuria, general edema, and body weight gain of 21 kg after undergoing 3 weeks of sunitinib therapy. The patient had taken no other over-the-counter medications, and all other possible causes of nephrotic syndrome were excluded. The Naranjo Adverse Drug Reaction Probability Scale score for this event was 6, indicating a high probability that the observed presentations were associated with use of the drug. However, despite the discontinuation of sunitinib, his condition deteriorated, and hemodialysis was initiated for respiratory distress. A renal biopsy was performed, which revealed ischemic acute tubular necrosis with minimal change nephropathy. In conclusion, nephrologists and oncologists should be aware that nephrotic syndrome with ischemic acute tubular necrosis is a possible adverse effect of sunitinib. For early diagnosis of this condition and to avoid renal damage, we recommend differential diagnosis of serum creatinine and proteinuria in patients undergoing sunitinib therapy.

  10. Depression and resilience mediate the relationship between traumatic life events and ill physical health: results from a population study.

    Science.gov (United States)

    Karatzias, Thanos; Jowett, Sally; Yan, Elsie; Raeside, Robert; Howard, Ruth

    2016-11-10

    We set out to investigate the mediating roles of depression, resilience, smoking, and alcohol use, in the relationship between potentially traumatic life events and objective and subjective, physical and mental health in a single study. A face-to-face, population-based survey was conducted in Hong Kong (N = 1147). Information on health conditions and traumatic life events was obtained, and participants completed measures of subjective physical and mental health, depression, and resilience. Smoking and drinking were not significant mediators of the relationship between life events and both objective and subjective health. Depressive symptomatology was found to mediate the relationship between life threatening illness and subjective physical health, the relationship between abuse (physical and sexual) and subjective mental health, and the relationship between the death of a parent/partner and subjective mental health. Resilience was found to mediate the relationships between multiple traumatic life events and subjective physical and mental health. Our results indicate that psychological factors rather than biological are important mediators of the relationship between life events exposure and health. Our findings provide evidence that depressive symptomatology has a mediating role only in the case of specific potentially traumatic life events and that resilience is only a critical factor in the face of exposure to multiple traumatic events, rather than single events. Our results also indicate that behavioural factors, such as smoking and drinking, are not significant mediators of the relationship between life events and health.

  11. Event Modeling

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    2001-01-01

    The purpose of this chapter is to discuss conceptual event modeling within a context of information modeling. Traditionally, information modeling has been concerned with the modeling of a universe of discourse in terms of information structures. However, most interesting universes of discourse...... are dynamic and we present a modeling approach that can be used to model such dynamics. We characterize events as both information objects and change agents (Bækgaard 1997). When viewed as information objects events are phenomena that can be observed and described. For example, borrow events in a library can...

  12. Event Modeling

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    2001-01-01

    The purpose of this chapter is to discuss conceptual event modeling within a context of information modeling. Traditionally, information modeling has been concerned with the modeling of a universe of discourse in terms of information structures. However, most interesting universes of discourse...... are dynamic and we present a modeling approach that can be used to model such dynamics.We characterize events as both information objects and change agents (Bækgaard 1997). When viewed as information objects events are phenomena that can be observed and described. For example, borrow events in a library can...

  13. Observations on the Apparent Solubility of Carbonate-Apatites.

    Science.gov (United States)

    Shellis; Lee; Wilson

    1999-10-15

    Previousreports indicating that the apparent solubilities of carbonate-apatites are low appear to conflict with findings that carbonate incorporation into the apatite structure tends to reduce stability. Carbonate-apatites were prepared by a precipitation method and by hydrolysis of monetite and brushite. Apparent solubility profiles were determined by measuring dissolution after exposure for 24 h to acetate buffers with known saturations with respect to hydroxyapatite. All preparations showed a range of apparent solubilities, in agreement with previous work. Precipitated samples had higher apparent solubilities than samples prepared by hydrolysis and this was correlated with differences in crystallinity. Further experiments showed that pyrophosphate ion reduced the apparent solubility, but it was concluded that pyrophosphate occurring naturally in synthetic apatites would be insufficient to cause low apparent solubilities. Microscopical observations showed that precipitated carbonate-apatites were composed of small crystals of uniform size, whereas carbonate-apatites prepared by hydrolysis consisted of both small crystals and very large crystals. The low apparent solubilities observed in the latter preparations are attributed to the large crystals. The surface phenomena possibly involved in apparent solubility behavior are discussed. Copyright 1999 Academic Press.

  14. "Apparent Weight": A Concept that Is Confusing and Unnecessary

    Science.gov (United States)

    Bartlett, Albert A.

    2010-01-01

    Two recent articles make prominent use of the concept of "apparent weight." The concept of "apparent weight" leads to two confusing inconsistencies. We need to know that with very little change in our representations, we can give our students an improved understanding of "weight" without ever having to invent the appealing but confusing concept of…

  15. Improvement of the Earthquake Early Warning System with Wavefield Extrapolation with Apparent Velocity and Direction

    Science.gov (United States)

    Sato, A.; Yomogida, K.

    2014-12-01

    The early warning system operated by Japan Meteorological Agency (JMA) has been available in public since October 2007.The present system is still not effective in cases, that we cannot assume a nearly circular wavefront expansion from a source. We propose a new approach based on the extrapolation of the early observed wavefield alone without estimating its epicenter. The idea is similar to the migration method in exploration seismology, but we use not only the information of wave field at an early stage (i.e., at time T2 in Figure, but also its normal derivatives the difference between T1 and T2), that is, we utilize the apparent velocity and direction of early-stage wave propagation to predict the wavefield later (at T3 in Fig.). For the extrapolation of wavefield, we need a reliable Green's function from the observed point to a target point at which the wave arrives later. Since the complete 3-D wave propagation is extremely complex, particularly in and around Japan of highly heterogeneous structures, we shall consider a phenomenological 2-D Green's function, that is, a wavefront propagates on the surface with a certain apparent velocity and direction of P wave. This apparent velocity and direction may vary significantly depending on, for example, event depth and an area of propagation, so we examined those of P wave propagating in Japan in various situations. For example, the velocity of shallow events in Hokkaido is 7.1km/s while that in Nagano prefecture is about 5.5km/s. In addition, the apparent velocity depends on event depth, 7.1km/s for the depth of 10km and 8.9km/s for 100km in Hokkaido. We also conducted f-k array analyses of adjacent five or six stations where we can accurately estimate the apparent velocity and direction of P wave. For deep events with relatively simple waveforms, they are easily obtained, but we may need site corrections to enhance correlations of waveforms among stations for shallow ones. In the above extrapolation scheme, we can

  16. Thermodynamics of apparent horizon and modified Friedman equations

    CERN Document Server

    Sheykhi, Ahmad

    2010-01-01

    Starting from the first law of thermodynamics, $dE=T_hdS_h+WdV$, at apparent horizon of a FRW universe, and assuming that the associated entropy with apparent horizon has a quantum corrected relation, $S=\\frac{A}{4G}-\\alpha \\ln \\frac{A}{4G}+\\beta \\frac{4G}{A}$, we derive modified Friedmann equations describing the dynamics of the universe with any spatial curvature. We also examine the time evolution of the total entropy including the quantum corrected entropy associated with the apparent horizon together with the matter field entropy inside the apparent horizon. Our study shows that, with the local equilibrium assumption, the generalized second law of thermodynamics is fulfilled in a region enclosed by the apparent horizon.

  17. Multiple weather factors affect apparent survival of European passerine birds.

    Directory of Open Access Journals (Sweden)

    Volker Salewski

    Full Text Available Weather affects the demography of animals and thus climate change will cause local changes in demographic rates. In birds numerous studies have correlated demographic factors with weather but few of those examined variation in the impacts of weather in different seasons and, in the case of migrants, in different regions. Using capture-recapture models we correlated weather with apparent survival of seven passerine bird species with different migration strategies to assess the importance of selected facets of weather throughout the year on apparent survival. Contrary to our expectations weather experienced during the breeding season did not affect apparent survival of the target species. However, measures for winter severity were associated with apparent survival of a resident species, two short-distance/partial migrants and a long-distance migrant. Apparent survival of two short distance migrants as well as two long-distance migrants was further correlated with conditions experienced during the non-breeding season in Spain. Conditions in Africa had statistically significant but relatively minor effects on the apparent survival of the two long-distance migrants but also of a presumably short-distance migrant and a short-distance/partial migrant. In general several weather effects independently explained similar amounts of variation in apparent survival for the majority of species and single factors explained only relatively low amounts of temporal variation of apparent survival. Although the directions of the effects on apparent survival mostly met our expectations and there are clear predictions for effects of future climate we caution against simple extrapolations of present conditions to predict future population dynamics. Not only did weather explains limited amounts of variation in apparent survival, but future demographics will likely be affected by changing interspecific interactions, opposing effects of weather in different seasons, and

  18. Multiple weather factors affect apparent survival of European passerine birds.

    Science.gov (United States)

    Salewski, Volker; Hochachka, Wesley M; Fiedler, Wolfgang

    2013-01-01

    Weather affects the demography of animals and thus climate change will cause local changes in demographic rates. In birds numerous studies have correlated demographic factors with weather but few of those examined variation in the impacts of weather in different seasons and, in the case of migrants, in different regions. Using capture-recapture models we correlated weather with apparent survival of seven passerine bird species with different migration strategies to assess the importance of selected facets of weather throughout the year on apparent survival. Contrary to our expectations weather experienced during the breeding season did not affect apparent survival of the target species. However, measures for winter severity were associated with apparent survival of a resident species, two short-distance/partial migrants and a long-distance migrant. Apparent survival of two short distance migrants as well as two long-distance migrants was further correlated with conditions experienced during the non-breeding season in Spain. Conditions in Africa had statistically significant but relatively minor effects on the apparent survival of the two long-distance migrants but also of a presumably short-distance migrant and a short-distance/partial migrant. In general several weather effects independently explained similar amounts of variation in apparent survival for the majority of species and single factors explained only relatively low amounts of temporal variation of apparent survival. Although the directions of the effects on apparent survival mostly met our expectations and there are clear predictions for effects of future climate we caution against simple extrapolations of present conditions to predict future population dynamics. Not only did weather explains limited amounts of variation in apparent survival, but future demographics will likely be affected by changing interspecific interactions, opposing effects of weather in different seasons, and the potential for

  19. The effect of visual apparent motion on audiovisual simultaneity.

    Science.gov (United States)

    Kwon, Jinhwan; Ogawa, Ken-ichiro; Miyake, Yoshihiro

    2014-01-01

    Visual motion information from dynamic environments is important in multisensory temporal perception. However, it is unclear how visual motion information influences the integration of multisensory temporal perceptions. We investigated whether visual apparent motion affects audiovisual temporal perception. Visual apparent motion is a phenomenon in which two flashes presented in sequence in different positions are perceived as continuous motion. Across three experiments, participants performed temporal order judgment (TOJ) tasks. Experiment 1 was a TOJ task conducted in order to assess audiovisual simultaneity during perception of apparent motion. The results showed that the point of subjective simultaneity (PSS) was shifted toward a sound-lead stimulus, and the just noticeable difference (JND) was reduced compared with a normal TOJ task with a single flash. This indicates that visual apparent motion affects audiovisual simultaneity and improves temporal discrimination in audiovisual processing. Experiment 2 was a TOJ task conducted in order to remove the influence of the amount of flash stimulation from Experiment 1. The PSS and JND during perception of apparent motion were almost identical to those in Experiment 1, but differed from those for successive perception when long temporal intervals were included between two flashes without motion. This showed that the result obtained under the apparent motion condition was unaffected by the amount of flash stimulation. Because apparent motion was produced by a constant interval between two flashes, the results may be accounted for by specific prediction. In Experiment 3, we eliminated the influence of prediction by randomizing the intervals between the two flashes. However, the PSS and JND did not differ from those in Experiment 1. It became clear that the results obtained for the perception of visual apparent motion were not attributable to prediction. Our findings suggest that visual apparent motion changes temporal

  20. Anisotropy of the apparent resistivity variation rate near the epicentral region for strong earthquakes

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The apparent resistivity data of 11 stations observed in or near the epicentral regions for 6 strong earthquakes are processed by the normalized monthly rate method. The result show that in the medium-short and short-imminent terms of earthquake preparation the variation rate of apparent resistivity perpendicular (or near perpendicular) to the direction of maximum principal stress is greater than that parallel (or near parallel) to the direction. Such an-isotropic phenomenon is interpreted as follow: the predominant alignment of cracks containing conductive fluid in the maximum principal stress direction caused the anisotropy of the fluid migration during the dilatancy process in the late period of earthquake preparation and resulted in the anisotropy of true resistivity variation rate for rock (or solid) medium which induced the variation rate anisotropy of apparent resistivity on the ground. The study of this paper provides some seismic examples to show the apparent resistivity anisotropy which may be helpful to study the stress status in or near the source zone in the late period of earthquake preparation of strong events.

  1. Detection of Flux Emergence, Splitting, Merging, and Cancellation of Network Fields. II Apparent Unipolar Flux Change and Cancellation

    CERN Document Server

    Iida, Y; Yokoyama, T

    2015-01-01

    In this second paper in the series, we investigate occurrence frequencies of apparent unipolar processes, cancellation, and emergence of patch structures in quiet regions. Apparent unipolar events are considerably more frequent than cancellation and emergence as per our definition, which is consistent with Lamb et al. (2013). Furthermore, we investigate the frequency distributions of changes in flux during apparent unipolar processes are and found that they concentrate around the detection limit of the analysis. Combining these findings with the results of our previous paper, Iida et al. (2012), that merging and splitting are more dominant than emergence and cancellation, these results support the understanding that apparent unipolar processes are actually interactions with and among patches below the detection limit and that there still are numerous flux interactions between the flux range in this analysis and below the detection limit. We also investigate occurrence frequency distributions of flux decrease ...

  2. Analysis of Apparent Elasticity Constants of Woven Fabrics

    Institute of Scientific and Technical Information of China (English)

    董侠; 张建春; 张燕

    2001-01-01

    The woven fabric can be defined as orthogonal elastomer if the extension force that puts on the fabric is very small. Based on the precondition, the apparent elasticity constants of a woven fabric were analyzed theoretically in the paper. The bias angle (which is between weft yarns and extension direction ) affects apparent elasticity modulus and elasticity coefficient of the fabric in the extension direction. And the experiment describes fluxes of elasticity constants going with the bias angle of the fabric.

  3. Thermodynamics of the apparent horizon in massive cosmology

    CERN Document Server

    Li, Hui

    2013-01-01

    Applying Clausius relation with energy-supply defined by the unified first law of thermodynamics formalism to the apparent horizon of a massive cosmological model proposed lately, the corrected entropic formula of the apparent horizon is obtained with the help of the modified Friedmann equations. This entropy-area relation, together with the identified internal energy, verifies the first law of thermodynamics for the apparent horizon with a volume change term for consistency. On the other hand, by means of the corrected entropy-area formula and the Clausius relation $\\delta Q=T dS$, where the heat flow $\\delta Q$ is the energy-supply of pure matter projecting on the vector $\\xi$ tangent to the apparent horizon and should be looked on as the amount of energy crossing the apparent horizon during the time interval $dt$ and the temperature of the apparent horizon for energy crossing during the same interval is $1/(2\\pi \\widetilde{r}_A)$, the modified Friedmann equations governing the dynamical evolution of the un...

  4. The Relationship Between Religion, Illness and Death in Life Histories of Family Members of Children With Life-Threatening Diseases Historias de vida de familiares de niños con enfermedades graves: relación entre religión, enfermedad y muerte Histórias de vida de familiares de crianças com doenças graves: relação entre religião, doença e morte

    Directory of Open Access Journals (Sweden)

    Regina Szylit Bousso

    2010-04-01

    Full Text Available This qualitative study aimed to get to know the relationship between the experiences of families of children with a life-threatening disease and their religion, illness and life histories. The methodological framework was based on Oral History. The data were collected through interviews and the participants were nine families from six different religions who had lived the experience of having a child with a life-threatening disease. The interviews, held with one or two family members, were transcribed, textualized and, through their analysis, the Vital Tone was elaborated, representing the moral synthesis of each narrative. Three dimensions of spirituality were related to illness and death in their life histories: a Higher Being with a healing power; Development and Maintenance of a Connection with God and Faith Encouraging Optimism. The narratives demonstrated the family's search to attribute meanings to their experiences, based on their religious beliefs.Se trata de una investigación cualitativa con el objetivo de conocer la relación entre las experiencias de familias, con niños que tenían una enfermedad grave, con religión, enfermedad, e historias de sus vidas. El marco metodológico usado fue la Historia Oral. Participaron de este estudio nueve familias practicantes de seis religiones diferentes, las cuales pasaron por la experiencia de tener un niño gravemente enfermo. Las entrevistas, realizadas con uno o dos miembros de la familia del niño, fueron transcritas, textualizadas y, a partir de su análisis, fue elaborado el Tono Vital que representa la síntesis moral de la narración. Tres dimensiones de la religiosidad/espiritualidad fueron relacionadas a la enfermedad y muerte en sus historias de vida: un Ser Superior con Poder de Cura; el Desarrollo y Manutención de una Conexión con Dios y la Fe Incentivando el Optimismo. Las narraciones evidenciaron la búsqueda de la familia, partiendo de sus creencias religiosas, por

  5. Standard Test Method for Water Absorption, Bulk Density, Apparent Porosity, and Apparent Specific Gravity of Fired Whiteware Products

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2006-01-01

    1.1 This test method covers procedures for determining water absorption, bulk density, apparent porosity, and apparent specific gravity of fired unglazed whiteware products. 1.2 This standard may involve hazardous materials, operations, and equipment. This standard does not purport to address all of the safety problems associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  6. Climate control of decadal-scale increases in apparent ages of eogenetic karst spring water

    Science.gov (United States)

    Martin, Jonathan B.; Kurz, Marie J.; Khadka, Mitra B.

    2016-09-01

    Water quantity and quality in karst aquifers may depend on decadal-scale variations in recharge or withdrawal, which we hypothesize could be assessed through time-series measurements of apparent ages of spring water. We tested this hypothesis with analyses of various age tracers (3H/3He, SF6, CFC-11, CFC-12, CFC-113) and selected solute concentrations [dissolved oxygen (DO), NO3, Mg, and SO4] from 6 springs in a single spring complex (Ichetucknee springs) in northern Florida over a 16-yr period. These springs fall into two groups that reflect shallow short (Group 1) and deep long (Group 2) flow paths. Some tracer concentrations are altered, with CFC-12 and CFC-113 concentrations yielding the most robust apparent ages. These tracers show a 10-20-yr monotonic increase in apparent age from 1997 to 2013, including the flood recession that followed Tropical Storm Debby in mid-2012. This increase in age indicates most water discharged during the study period recharged the aquifer within a few years of 1973 for Group 2 springs and 1980 for Group 1 springs. Inverse correlations between apparent age and DO and NO3 concentrations reflect reduced redox state in older water. Positive correlations between apparent age and Mg and SO4 concentrations reflect increased water-rock reactions. Concentrated recharge in the decade around 1975 resulted from nearly 2 m of rain in excess of the monthly average that fell between 1960 and 2014, followed by a nearly 4 m deficit to 2014. This excess rain coincided with two major El Niño events during the maximum cool phase in the Atlantic Multidecadal Oscillation. Although regional water withdrawal increased nearly 5-fold between 1980 and 2005, withdrawals represent only 2-5% of Ichetucknee River flow and are less important than decadal-long variations in precipitation. These results suggest that groundwater management should consider climate cycles as predictive tools for future water resources.

  7. Fatal thyrocardiac event

    Directory of Open Access Journals (Sweden)

    Samit Kumar Khutia

    2010-01-01

    Full Text Available Atrial fibrillation occurs frequently (2-20% in chronic hyperthyroidism patients. Poorly treated thyrotoxic patients may present with a life-threatening cerebrovascular accident giving little scope to revert the situation. At times, it is difficult to make a patient euthyroid with conventional management. The definitive treatment of choice is 131 I, radioiodine. An adjusted dose of an oral anticoagulant is highly efficacious for the prevention of all types of strokes. Timely intervention by a skilled airway manager with right instruments is the key to success in airway management. A 50-year-old thyrotoxic, semiconscious male presented with a sudden onset of haemiplegia. He had chronic AF, a huge thyroid swelling with gross tracheal deviation and dilated cardiomyopathy. A CT scan showed infarction in the left middle cerebral artery territory. After initial improvement with conservative management, patient′s condition deteriorated in the next 48 h. Repeat CT scan showed increase in the infarct size with haemorrhage and midline shift. Finally, he died despite all resuscitative measures.

  8. Shape reconstruction from apparent contours theory and algorithms

    CERN Document Server

    Bellettini, Giovanni; Paolini, Maurizio

    2015-01-01

    Motivated by a variational model concerning the depth of the objects in a picture and the problem of hidden and illusory contours, this book investigates one of the central problems of computer vision: the topological and algorithmic reconstruction of a smooth three dimensional scene starting from the visible part of an apparent contour. The authors focus their attention on the manipulation of apparent contours using a finite set of elementary moves, which correspond to diffeomorphic deformations of three dimensional scenes. A large part of the book is devoted to the algorithmic part, with implementations, experiments, and computed examples. The book is intended also as a user's guide to the software code appcontour, written for the manipulation of apparent contours and their invariants. This book is addressed to theoretical and applied scientists working in the field of mathematical models of image segmentation.

  9. Foliation dependence of black hole apparent horizons in spherical symmetry

    CERN Document Server

    Faraoni, Valerio; Firouzjaee, Javad T; Helou, Alexis; Musco, Ilia

    2016-01-01

    Numerical studies of gravitational collapse to black holes make use of apparent horizons, which are intrinsically foliation-dependent. We expose the problem and discuss possible solutions using the Hawking quasilocal mass. In spherical symmetry, we present a physically sensible approach to the problem by restricting to spherically symmetric spacetime slicings. In spherical symmetry the apparent horizons are gauge-independent in any spherically symmetric foliation but physical quantities associated with them, such as surface gravity and temperature, are not. The widely used comoving and Kodama foliations, which are of particular interest, are discussed in detail.

  10. Foliation dependence of black hole apparent horizons in spherical symmetry

    Science.gov (United States)

    Faraoni, Valerio; Ellis, George F. R.; Firouzjaee, Javad T.; Helou, Alexis; Musco, Ilia

    2017-01-01

    Numerical studies of gravitational collapse to black holes make use of apparent horizons, which are intrinsically foliation dependent. We expose the problem and discuss possible solutions using the Hawking-Hayward quasilocal mass. In spherical symmetry, we present a physically sensible approach to the problem by restricting to spherically symmetric spacetime slicings. In spherical symmetry, the apparent horizons enjoy a restricted gauge independence in any spherically symmetric foliation, but physical quantities associated with them, such as surface gravity and temperature, are fully gauge dependent. The widely used comoving and Kodama foliations, which are of particular interest, are discussed in detail as examples.

  11. No apparent lock-in depth of the Laschamp geomagnetic excursion: Evidence from the Malan loess

    Institute of Scientific and Technical Information of China (English)

    ZHU Rixiang; LIU Qingsong; PAN Yongxin; DENG Chenglong; ZHANG Rui; WANG Xianfeng

    2006-01-01

    The first-order chronological framework of the long-term Chinese loess/paleosol sequences was based mainly on magnetostratigraphy. However, there remain arguments on the lock-in ages of the major geomagnetic reversals. This study systematically compared the stratigraphic locations of the Laschamp excursion and Henrich events (H4 at~39 ka and H5 at~48 ka) recorded by the Luochuan loess profile in the central Chinese Loess Plateau. Results show that the Lascchamp excursion is bracketed well by these two cold events, and the corresponding estimated age is between about 41.7-43.7 ka, which is close to the widely accepted age of ~40-41 ka for the excursion.Therefore, our new results do not suggest apparent lock-in effects in the last glacial Malan loess.

  12. Visual Benefits in Apparent Motion Displays: Automatically Driven Spatial and Temporal Anticipation Are Partially Dissociated.

    Directory of Open Access Journals (Sweden)

    Merle-Marie Ahrens

    Full Text Available Many behaviourally relevant sensory events such as motion stimuli and speech have an intrinsic spatio-temporal structure. This will engage intentional and most likely unintentional (automatic prediction mechanisms enhancing the perception of upcoming stimuli in the event stream. Here we sought to probe the anticipatory processes that are automatically driven by rhythmic input streams in terms of their spatial and temporal components. To this end, we employed an apparent visual motion paradigm testing the effects of pre-target motion on lateralized visual target discrimination. The motion stimuli either moved towards or away from peripheral target positions (valid vs. invalid spatial motion cueing at a rhythmic or arrhythmic pace (valid vs. invalid temporal motion cueing. Crucially, we emphasized automatic motion-induced anticipatory processes by rendering the motion stimuli non-predictive of upcoming target position (by design and task-irrelevant (by instruction, and by creating instead endogenous (orthogonal expectations using symbolic cueing. Our data revealed that the apparent motion cues automatically engaged both spatial and temporal anticipatory processes, but that these processes were dissociated. We further found evidence for lateralisation of anticipatory temporal but not spatial processes. This indicates that distinct mechanisms may drive automatic spatial and temporal extrapolation of upcoming events from rhythmic event streams. This contrasts with previous findings that instead suggest an interaction between spatial and temporal attention processes when endogenously driven. Our results further highlight the need for isolating intentional from unintentional processes for better understanding the various anticipatory mechanisms engaged in processing behaviourally relevant stimuli with predictable spatio-temporal structure such as motion and speech.

  13. Common mechanisms in apparent motion perception and visual pattern matching.

    Science.gov (United States)

    Larsen, Axel; Bundesen, Claus

    2009-12-01

    Common mechanisms in apparent motion perception and visual pattern matching. Scandinavian Journal of Psychology, 50, 526-534.There are close functional similarities between apparent motion perception and visual pattern matching. In particular, striking functional similarities have been demonstrated between perception of rigid objects in apparent motion and purely mental transformations of visual size and orientation used in comparisons of objects with respect to shape but regardless of size and orientation. In both cases, psychophysical data suggest that differences in visual size are resolved as differences in depth, such that transformation of size is done by translation in depth. Furthermore, the process of perceived or imagined translation appears to be stepwise additive such that a translation over a long distance consists of a sequence of smaller translations, the durations of these steps being additive. Both perceived and imagined rotation also appear to be stepwise additive, and combined transformations of size and orientation appear to be done by alternation of small steps of pure translation and small steps of pure rotation. The functional similarities suggest that common mechanisms underlie perception of apparent motion and purely mental transformations. In line with this suggestion, functional brain imaging has isolated neural structures in motion area MT used in mental transformation of size.

  14. Eudynamis Minima, an apparently new Cuckoo from Southwestern New Guinea

    NARCIS (Netherlands)

    Oort, van E.D.

    1911-01-01

    Only an adult male of this apparently new form of the genus Eudynamis has been collected near Bivak Island, in the Noord River, Southwestern New Guinea, at 9 January 1910 by the members of the last Lorentz-expedition to the snowy mountains. (Coll. Lorentz n°. 508). The plumage is black, glossed with

  15. Apparent horizons in Clifton-Mota-Barrow inhomogeneous universe

    CERN Document Server

    Vitagliano, Vincenzo; Sotiriou, Thomas P; Liberati, Stefano

    2013-01-01

    We analyze the apparent horizon dynamics in the inhomogeneous Clifton-Mota-Barrow solution of Brans-Dicke theory. This solution models a central matter configuration embedded in a cosmological background. In certain regions of the parameter space we find solutions exhibiting dynamical creation or merging of two horizons.

  16. Studying the cosmological apparent horizon with quasistatic coordinates

    Indian Academy of Sciences (India)

    Rui-Yan Yu; Towe Wang

    2013-02-01

    This article aims at a natural generalization of the static coordinates to the ( + 1)-dimensional Friedmann–Lemaître–Robertson–Walker (FLRW) Universe. After demonstrating a no-go theorem, we put forward the quasistatic coordinates for the FLRW Universe. Then, the quasistatic coordinates are utilized to study the unified first law and the scalar-type perturbations on the cosmological apparent horizon.

  17. An Apparent Paradox: Catt's Anomaly

    Science.gov (United States)

    Pieraccini, M.; Selleri, S.

    2013-01-01

    Catt's anomaly is a sort of "thought experiment" (a "gedankenexperiment") where electrons seem to travel at the speed of light. Although its author argued with conviction for many years, it has a clear and satisfactory solution and it can be considered indubitably just an apparent paradox. Nevertheless, it is curious and…

  18. Children with fever without apparent source: diagnosis and dilemmas

    NARCIS (Netherlands)

    S.E. Bleeker (Sacha)

    2002-01-01

    textabstractTills thesis describes the results of diagnostic research in young children presenting with fever without apparent source at the emergency department. The study was conducted at the Sophia Children's University Hospital in Rotterdam and the Juliana Children's Hospital in The Hague, both

  19. Requirement of the laying hen for apparent fecal digestible lysine

    NARCIS (Netherlands)

    Schutte, J.B.; Smink, W.

    1998-01-01

    A study was conducted to determine the requirement for lysine of a White Leghorn strain of hens with a body weight of approximately 1,600 g. Before starting the experiment, apparent fecal digestibility of amino acids of the basal diet was determined in an in vivo digestibility trial with six individ

  20. Automatic real and apparent age estimation in still images

    OpenAIRE

    Pardo Garcia, Pablo

    2015-01-01

    We performed a study on age estimation via still images creating a new face image database containing real age and apparent age label annotations. Two age estimation methods are proposed using the state of the art techniques and analyse their performance with the proposed database.

  1. A New Theory of Leadership: "Realwert" Versus Apparent Good.

    Science.gov (United States)

    Lang, Donald

    1999-01-01

    "Realwert" ("real good") stems from an understanding of humanity's "raison d'etre"--treating others with respect and dignity. It can be contrasted with "apparent good," a condition wherein one mistakenly thinks real good is being pursued. Drawing on Aquinas and Hodginson, this paper argues for a…

  2. Increasing Range Of Apparent Depth In A Stereoscopic Display

    Science.gov (United States)

    Busquets, Anthony M.; Parrish, Russell V.; Williams, Steven P.

    1995-01-01

    Optical configuration conceived for increasing range of apparent depth provided by stereoscopic display system, without imposing concomitant reduction in field of view. Observer wears shuttered goggles synchronized with alternating left- and right-eye views on display. However, instead of looking directly at display screen, observer looks at screen via reflection in mirror collimating light emitted by screen.

  3. Apparent Barrier Height in Scanning Tunneling Microscopy Revisited

    DEFF Research Database (Denmark)

    Olesen, L.; Brandbyge, Mads; Sørensen, Mads Reinholdt;

    1996-01-01

    The apparent barrier height phi(ap), that is, the rate of change of the logarithm of the conductance with tip-sample separation in a scanning tunneling microscope (STM), has been measured for Ni, Pt, and Au single crystal surfaces. The results show that phi(ap) is constant until point contact...

  4. Events diary

    Science.gov (United States)

    2000-01-01

    as Imperial College, the Royal Albert Hall, the Royal College of Art, the Natural History and Science Museums and the Royal Geographical Society. Under the heading `Shaping the future together' BA2000 will explore science, engineering and technology in their wider cultural context. Further information about this event on 6 - 12 September may be obtained from Sandra Koura, BA2000 Festival Manager, British Association for the Advancement of Science, 23 Savile Row, London W1X 2NB (tel: 0171 973 3075, e-mail: sandra.koura@britassoc.org.uk ). Details of the creating SPARKS events may be obtained from creating.sparks@britassoc.org.uk or from the website www.britassoc.org.uk . Other events 3 - 7 July, Porto Alegre, Brazil VII Interamerican conference on physics education: The preparation of physicists and physics teachers in contemporary society. Info: IACPE7@if.ufrgs.br or cabbat1.cnea.gov.ar/iacpe/iacpei.htm 27 August - 1 September, Barcelona, Spain GIREP conference: Physics teacher education beyond 2000. Info: www.blues.uab.es/phyteb/index.html

  5. Fertility and apparent genetic anticipation in Lynch syndrome.

    Science.gov (United States)

    Stupart, Douglas; Win, Aung Ko; Jenkins, Mark; Winship, Ingrid M; Goldberg, Paul; Ramesar, Rajkumar

    2014-09-01

    Genetic anticipation is the phenomenon in which age of onset of an inherited disorder decreases in successive generations. Inconsistent evidence suggests that this occurs in Lynch syndrome. A possible cause for apparent anticipation is fecundity bias, which occurs if the disease adversely affects fertility. The purpose of this study was to determine the effect of age of diagnosis of colorectal cancer (CRC) on lifetime fertility in Lynch syndrome, and whether this can falsely create the appearance of genetic anticipation. A computer model simulated age of diagnosis of CRC in hypothetical Lynch syndrome carriers and their offspring. The model assumed similar age distribution of CRC across generations (i.e. that there was no true anticipation). Age distribution of CRC diagnosis, and lifetime fertility rates (grouped by age of diagnosis of CRC) were determined from the Australasian Colorectal Cancer Family Registry (ACCFR). Apparent anticipation was calculated by comparing ages of diagnosis of CRC in affected parent-child pairs. A total of 1,088 patients with CRC were identified from the ACCFR. Total lifetime (cohort) fertility was related to age of diagnosis of CRC (correlation coefficient 0.13, P = 0.0001). In the simulation, apparent anticipation was 1.8 ± 0.54 years (P = 0.0044). Observed apparent anticipation in the ACCFR cohort was 4.8 ± 1.73 years (P = 0.0064). There was no difference in apparent anticipation between the simulate d and observed parent-child pairs (P = 0.89). The appearance of genetic anticipation in Lynch syndrome can be falsely created due to changes in fertility.

  6. Low ADAMTS-13 activity during hemorrhagic events with disseminated intravascular coagulation.

    Science.gov (United States)

    Chinen, Yoshiaki; Kuroda, Junya; Ohshiro, Muneo; Shimura, Yuji; Mizutani, Shinsuke; Nagoshi, Hisao; Sasaki, Nana; Nakayama, Ryuko; Kiyota, Miki; Yamamoto-Sugitani, Mio; Kobayashi, Tsutomu; Matsumoto, Yosuke; Horiike, Shigeo; Taniwaki, Masafumi

    2013-04-01

    Disseminated intravascular coagulation (DIC) is a life-threatening complication, and its control is essential for therapeutic success. Recombinant human soluble thrombomodulin alfa (rTM) is a novel therapeutic agent for DIC. The efficacy of rTM in the treatment of DIC is reportedly superior to that of conventional anti-DIC treatments, such as unfractionated heparin or low molecular weight heparin, but hemorrhagic events occasionally interfere with the therapeutic benefits of rTM. We assessed the clinical features of 20 consecutive patients who were given rTM for DIC associated with various hematologic disorders. Eight patients achieved remission of both primary disease and DIC, eight died due to progression of the primary disease, and four died of various hemorrhagic complications. Assessment of 16 biomarkers for coagulation showed that the four patients who died of hemorrhagic complications despite remission of their primary disease showed lower ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin Type 1 motif, member 13) plasma activity than other patients (P = 0.016). The optimal cut-off level of ADAMTS-13 for predicting risk of hemorrhagic complications was 42 % (P = 0.007). Plasma ADAMTS-13 activity determined at diagnosis of DIC may help predict the risk of hemorrhagic events during and/or following DIC treatment with hematologic disorders.

  7. The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus and the Management of Hypoglycemic Events

    Science.gov (United States)

    Kassem, Mahmoud Attia Mohamed; Durda, Michael Andrew; Stoicea, Nicoleta; Cavus, Omer; Sahin, Levent; Rogers, Barbara

    2017-01-01

    Recent studies discussed the benefit of bariatric surgery on obese patients diagnosed with type 2 diabetes mellitus (T2DM). Several factors play an essential role in predicting the impact of bariatric surgery on T2DM, such as ABCD score (age, BMI, C-peptide, and duration of the disease), HbA1c, and fasting blood glucose, incretins [glucagon-like peptide-1 (GLP-1) and gastric inhibitory peptide (GIP)]. DiaRem score known to include factors such as age, HbA1c, medication, and insulin usage used to predict the remission of T2DM, but it has some limitations. An extensive literature search was conducted on PubMed and Google Scholar using keywords such as gastric bypass, T2DM, bariatric surgery, GLP-1, GIP, and post bariatric hypoglycemia. Restrictive-malabsorptive procedures are most effective in treating T2DM patients based on changes induced in appetite through regulation of gastrointestinal hormones, with decreased hunger and increased satiation. We provide a review of bariatric surgery influence on T2DM and management of post-intervention hypoglycemic events. Post-bariatric surgery hypoglycemia is a serious complication especially when patients develop life-threatening neuroglycopenia with loss of consciousness and seizure. The avoidance of this adverse event may be achieved by strict dietary modification including a restriction on carbohydrates as well as foods with high glycemic index. Further research will provide more information on post-bariatric surgery hyperinsulinemic hypoglycemia pathophysiology and management. PMID:28298900

  8. Association of traumatic police event exposure with sleep quality and quantity in the BCOPS Study cohort.

    Science.gov (United States)

    Bond, Jonathan; Hartley, Tara A; Sarkisian, Khachatur; Andrew, Michael E; Charles, Luenda E; Violanti, John M; Burchfiel, Cecil M

    2013-01-01

    Police officers are exposed to traumatic and life-threatening events, which may lead to sleep problems. Prior studies of police officers have found them to have poor sleep quality and reduced sleep time. This study examined associations between traumatic events and sleep quality. Participants were 372 police officers from the Buffalo Cardio-metabolic Occupational Police Stress (BCOPS) Study. Police incidents were measured by the Police Incident Survey; sleep quality and quantity were derived from the Pittsburgh Sleep Quality Index (PSQI). Analysis of covariance (ANCOVA) was used to examine mean PSQI scores across categories of traumatic event frequency. Models were adjusted for age, education and ethnicity and stratified by sex and workload. In men, significant associations were found for the 'shooting of another officer' and sleep quality (p-value = 0.024) and sleep disturbances (p-value = 0.022). In women, seeing more 'abused children' was associated with poorer sleep quality (p-value = 0.050); increasing frequency of 'seeing victims of a serious traffic accident' was associated with shorter sleep duration (p-value = 0.032). Increased frequency of 'seeing dead bodies' was associated with poorer sleep quality (p-value = 0.040) and shorter sleep duration (p-value = 0.048). Among women with a high workload, a significant inverse association was found between 'seeing serious traffic accident victims' and global sleep quality (p-value = 0.031). In conclusion, a significant inverse association between frequency of select traumatic events and sleep quality was found in male and female police officers. The significant events differed by sex. Future research could examine longitudinal associations between career-long traumatic event exposures and sleep quality and how these associations differ by sex.

  9. Apparent Dissolution Kinetics of Diatomite in Alkaline Solution

    Institute of Scientific and Technical Information of China (English)

    DU Gaoxiang; L(U) Guocheng; HE Xuwen

    2013-01-01

    The dissolution kinetics of diatomite in alkaline solution is the theoretical basis for the process optimization of alkali-diatomite reaction and its applications.In this study,the dissolution kinetics of diatomite in NaOH solution is investigated.The results indicate that the dissolution reaction fits well the unreacted shrinking core model for solid-liquid heterogeneous reactions.The apparent reaction order for NaOH is 2 and the apparent activation energy for the reaction (Ea) is 28.06 kJ.mol-1.The intra-particle diffusion through the sodium silicate layer is the rate-controlling step.When the dissolution reaction occurs at the interface of unreacted diatomite solid core,the diffusion in the trans-layer (the liquid film around the wetted particle) reduces the rate of whole dissolution process.

  10. Lead-Free Metamaterials with Enormous Apparent Piezoelectric Response.

    Science.gov (United States)

    Zhou, Wanfeng; Chen, Pan; Pan, Qi; Zhang, Xiaotong; Chu, Baojin

    2015-11-01

    Lead-free flexoelectric piezoelectric metamaterials are created by applying an asymmetric chemical reduction to Na1/2 Bi1/2 TiO3 -BaTiO3 ceramics. The reduction induces two gradient-generating mechanisms, curvature structure and chemical inhomogeneity, and enhances the flexoelectric effect. The ceramics behave like piezoelectric materials, exhibiting an enormous and high-temperature stable apparent piezoelectric response, outperforming existing lead-oxide-based piezoelectrics.

  11. Definition of apparent activation energy on DTG curves

    Directory of Open Access Journals (Sweden)

    A. K. Serikbayeva

    2016-07-01

    Full Text Available The article gives the results of sulphidation oxidized copper ores and tailings with sulfur. Defined by the apparent activation energy in the conditions of heating the mixture of substances interacting with a constant speed by differential thermogravimetry (DTG. It was established that the sulfiding may occur in a kinetic mode , since the interaction is charged, in the presence of liquid and gaseous sulfur , i.e. transport of sulfur to the surface of the mineral is not a limiting process.

  12. Definition of apparent activation energy on DTG curves

    OpenAIRE

    Serikbayeva, A. K.; Zhumashev, K.; N. Sh. Janaliyeva; M. Rakhimberdina

    2016-01-01

    The article gives the results of sulphidation oxidized copper ores and tailings with sulfur. Defined by the apparent activation energy in the conditions of heating the mixture of substances interacting with a constant speed by differential thermogravimetry (DTG). It was established that the sulfiding may occur in a kinetic mode , since the interaction is charged, in the presence of liquid and gaseous sulfur , i.e. transport of sulfur to the surface of the mineral is not a limiting process.

  13. Product design enhancement using apparent usability and affective quality.

    Science.gov (United States)

    Seva, Rosemary R; Gosiaco, Katherine Grace T; Santos, Ma Crea Eurice D; Pangilinan, Denise Mae L

    2011-03-01

    In this study, apparent usability and affective quality were integrated in a design framework called the Usability Perception and Emotion Enhancement Model (UPEEM). The UPEEM was validated using structural equation modeling (SEM). The methodology consists of four phases namely product selection, attribute identification, design alternative generation, and design alternative evaluation. The first stage involved the selection of a product that highly involves the consumer. In the attribute identification stage, design elements of the product were identified. The possible values of these elements were also determined for use in the experimentation process. Design of experiments was used to identify how the attributes will be varied in the design alternative stage and which of the attributes significantly contribute to affective quality, apparent usability, and desirability in the design evaluation stage. Results suggest that product attributes related to form are relevant in eliciting intense affect and perception of usability in mobile phones especially those directly related to functionality and aesthetics. This study considered only four product attributes among so many due to the constraints of the research design employed. Attributes related to aesthetic perception of a product enhance apparent usability such as those related to dimensional ratios.

  14. Coherent and random apparent stresses in periodically unsteady flows

    Science.gov (United States)

    Kehoe, Anthony Byrd

    1990-08-01

    The transitional flow field downstream of a smooth, symmetrically constricted Sylgard pipe was measured with a two color, two component Laser Doppler Anemometer for both pulsatile and steady flows. Vibrations in the flow system were induced with an exciter/shaker and were monitored with an accelerator. The vibration has little effect on the value of the maximum axial and radial turbulence intensities. A frequency domain signal processing technique to separate the disturbance velocity into coherent and random components was modified to guarantee that the sum of the decomposed velocity components equaled the original disturbance velocity. Results of the velocity separation demonstrated that the velocity disturbances prior to turbulent transition consisted almost entirely of coherent velocity fluctuations. The maximum apparent shear stress was found to occur just after the turbulent transition and consisted almost entirely of the random component. The data suggest that if the absolute magnitude of the apparent stress is the determining factor in red blood cell destruction, then the coherent apparent stress is not a significant destruction mechanism. However, the exact mechanism in hemolysis are not identified.

  15. The apparent state of droplets on a rough surface

    Institute of Scientific and Technical Information of China (English)

    CHEN XiaoLing; LU Tian

    2009-01-01

    The factors influencing the state and wetting transition of droplets on a rough surface are both complex and obscure. The change in wetting is directly reflected by changes under the contact condition of the droplets with the surface. The recent study about the wettability of the superhydrophobic surface under the condensing condition arouses the new understanding about the apparent state of droplets on a rough surface, in this work, to validate the existence of droplets in an intermediate state, a microscale pillar topological polydimethylsiloxane (PDMS) surface was manufactured and its wettability under various conditions was studied. According to the experimental data, it is proposed that the wetting state of a rough surface may be embodied using the contact area ratio of a solid/liquid/gas droplet with the projective plane. A general calculation model for the apparent contact angle of droplets is given and expressed diagrammatically. It is found that the measured apparent contact angles of droplets at dif-ferent states on the surface falls within the range predicted by our proposed equation.

  16. Apparent kinetics of high temperature oxidative decomposition of microalgal biomass.

    Science.gov (United States)

    Ali, Saad Aldin M; Razzak, Shaikh A; Hossain, Mohammad M

    2015-01-01

    The oxidative thermal characteristics of two microalgae species biomass Nannochloropsis oculta and Chlorella vulgaris have been investigated. The apparent kinetic parameters for the microalgal biomass oxidation process are estimated by fitting the experimental data to the nth order rate model. Also, the iso-conversional methods Kissinger-Akahira-Sunose (KAS) and Flynn-Wall-Ozawa (FWO) were used to evaluate the apparent activation energy. The results indicate that biomass of different microalgae strains exhibit different thermal behavior and characteristics. In addition, growth parameters and medium composition can affect the biomass productivity and composition. This would have significant impact on the thermal decomposition trend of the biomass. The kinetic modeling of the oxidation reaction with direct model fitting method shows good prediction to the experimental data. The apparent activation energies estimated by KAS and FWO methods for N. oculta were 149.2 and 151.8kJ/mol, respectively, while for C. vulgaris were 214.4 and 213.4kJ/mol, respectively.

  17. The apparent state of droplets on a rough surface

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    The factors influencing the state and wetting transition of droplets on a rough surface are both complex and obscure. The change in wetting is directly reflected by changes under the contact condition of the droplets with the surface. The recent study about the wettability of the superhydrophobic surface under the condensing condition arouses the new understanding about the apparent state of droplets on a rough surface. In this work, to validate the existence of droplets in an intermediate state, a microscale pillar topological polydimethylsiloxane (PDMS) surface was manufactured and its wettability under various conditions was studied. According to the experimental data, it is proposed that the wetting state of a rough surface may be embodied using the contact area ratio of a solid/liquid/gas droplet with the projective plane. A general calculation model for the apparent contact angle of droplets is given and expressed diagrammatically. It is found that the measured apparent contact angles of droplets at dif- ferent states on the surface falls within the range predicted by our proposed equation.

  18. The Risk Assessment of Adverse Events of Nursing Activities as the Element of Quality Management in Healhcare

    Directory of Open Access Journals (Sweden)

    Wiśniewska Malgorzata Z.

    2015-02-01

    Full Text Available The purpose of the paper is to present MedCARVER+Shock method and Pareto analysis and its usability for the risk assessment of adverse events of nursing activities. 888 activities carried out by all 190 nurses working at the District Hospital X located in Poland were taken into account. During the research the qualitative approach was used. As the result sixteen groups of nursing activities causing the highest risk of adverse events were selected. Special attention required in: admission of a patient to the ward, sterilization, verbal communication with the patient, using of intravenous cannulas, needles, syringes, devices for transfusion of infusion liquids, servicing of hospital rooms, first aid in life-threatening situations, using medical devices and equipment. Ten basic causes of the risk of adverse events were identified, among others: lack of trainings, of modern equipment, of staff, failure to comply with procedures, lack of staff supervision, poor quality of ancillary materials, lack of management commitment. Finally MedCARVER+Shock method and Pareto analysis usability has been confirmed but it appeared that it is time-consuming and requires support from skilled professionals. Several suggestions have been put forward to improve the utility of MedCARVER+Shock.

  19. Development of a drug safety ePlatform for physicians, pharmacists, and consumers based on post-marketing adverse events

    Directory of Open Access Journals (Sweden)

    Keith B. Hoffman

    2013-07-01

    Full Text Available Rigorous clinical trials under the watchful eye of regulators remain the cornerstone of drug safety. However, the emergence of serious and life-threatening Adverse Events (AEs across best-selling drug classes [sometimes many years after winning Food and Drug Administration (FDA approval] underscores the limitations of current clinical trial processes and reinforces the need for careful post-approval pharmacovigilance. The FDA’s sizeable repository of patient case reports linking AEs to approved drugs is the Adverse Event Reporting System (FAERS. We believe that open and user-friendly access to the millions of case reports in FAERS would help advance the field of post-marketing pharmacovigilance. However, FAERS data are virtually inaccessible to most physicians, pharmacists, and consumers. Accordingly, we have recently launched a big data platform (www.AdverseEvents.com that, unlike previous efforts, provides on-demand, user-friendly, and high-impact access to FAERS data. Bringing the power of big data to regular users, such as clinicians, pharmacists, and patients, is the logical next step in the transformation of health care to a model of shared decision making between consumers and the system.

  20. Event Index - an LHCb Event Search System

    CERN Document Server

    Ustyuzhanin, Andrey

    2015-01-01

    During LHC Run 1, the LHCb experiment recorded around 1011 collision events. This paper describes Event Index | an event search system. Its primary function is to quickly select subsets of events from a combination of conditions, such as the estimated decay channel or number of hits in a subdetector. Event Index is essentially Apache Lucene [1] optimized for read-only indexes distributed over independent shards on independent nodes.

  1. Gastrointestinal events with clopidogrel

    DEFF Research Database (Denmark)

    Grove, Erik Lerkevang; Würtz, Morten; Schwarz, Peter

    2013-01-01

    Clopidogrel prevents cardiovascular events, but has been linked with adverse gastrointestinal (GI) complications, particularly bleeding events.......Clopidogrel prevents cardiovascular events, but has been linked with adverse gastrointestinal (GI) complications, particularly bleeding events....

  2. Ultrasonic backscatter from cancellous bone: the apparent backscatter transfer function.

    Science.gov (United States)

    Hoffmeister, Brent K; Mcpherson, Joseph A; Smathers, Morgan R; Spinolo, P Luke; Sellers, Mark E

    2015-12-01

    Ultrasonic backscatter techniques are being developed to detect changes in cancellous bone caused by osteoporosis. Many techniques are based on measurements of the apparent backscatter transfer function (ABTF), which represents the backscattered power from bone corrected for the frequency response of the measurement system. The ABTF is determined from a portion of the backscatter signal selected by an analysis gate of width τw delayed by an amount τd from the start of the signal. The goal of this study was to characterize the ABTF for a wide range of gate delays (1 μs ≤ τd ≤ 6 μs) and gate widths (1 μs ≤ τw ≤ 6 μs). Measurements were performed on 29 specimens of human cancellous bone in the frequency range 1.5 to 6.0 MHz using a broadband 5-MHz transducer. The ABTF was found to be an approximately linear function of frequency for most choices of τd and τw. Changes in τd and τw caused the frequency-averaged ABTF [quantified by apparent integrated backscatter (AIB)] and the frequency dependence of the ABTF [quantified by frequency slope of apparent backscatter (FSAB)] to change by as much as 24.6 dB and 6.7 dB/MHz, respectively. τd strongly influenced the measured values of AIB and FSAB and the correlation of AIB with bone density (-0.95 ≤ R ≤ +0.68). The correlation of FSAB with bone density was influenced less strongly by τd (-0.97 ≤ R ≤ -0.87). τw had a weaker influence than τd on the measured values of AIB and FSAB and the correlation of these parameters with bone density.

  3. Apparent faster than light propagation from light sterile neutrinos

    CERN Document Server

    Hannestad, Steen

    2011-01-01

    Recent data from the OPERA experiment seem to point to neutrinos propagating faster than light. One possible physics explanation for such a result is the existence of light sterile neutrinos which can propagate in a higher dimensional bulk and achieve apparent superluminal velocities when measured by an observer confined to the 4D brane of the standard model. Such a model has the advantage of easily being able to explain the non-observation of superluminal neutrinos from SN1987A. Here we discuss the phenomenological implications of such a model and show that it can provide an explanation for the observed faster than light propagation of neutrinos.

  4. Study on Apparent Viscosity and Structure of Foaming Slag

    Science.gov (United States)

    Martinsson, Johan; Glaser, Björn; Sichen, Du

    2016-10-01

    Foaming slag was generated using induction heating. The foam was found non-Newtonian having much higher apparent viscosity compared to the dynamic viscosity of pure slag. Quenched foam was examined. The appearance of the foaming slag was very different from silicone oil-gas foam. The size of gas bubbles ranged from 0.1 to 4 mm (while in the case of silicone oil, 1 to 2 mm). The gas fraction in the foam was considerably lower than in the case of silicone oil.

  5. Solutions of the Einstein Constraint Equations with Apparent Horizon Boundary

    CERN Document Server

    Maxwell, D

    2003-01-01

    We construct asymptotically Euclidean solutions of the vacuum Einstein constraint equations with apparent horizon boundary condition. Specifically, we give sufficient conditions for the constant mean curvature conformal method to generate such solutions. The method of proof is based on the barrier method introduced by Isenberg for compact manifolds without boundary, suitably extended to accommodate semilinear boundary conditions and low regularity metrics. As a consequence of our results for manifolds with boundary, we also obtain improvements to the theory of the constraint equations on asymptotically Euclidean manifolds without boundary.

  6. Apparent Coulomb reacceleration of neutrons in electrodissociation of the deuteron

    Energy Technology Data Exchange (ETDEWEB)

    Bianconi, A.; Jeschonnek, S.; Nikolaev, N.N.; Zakharov, B.G. (Istituto Nazionale di Fisica Nucleare, Sezione di Pavia, Pavia (Italy) Dipartimento Fisica Nucleare e Teorica, Universita di Pavia (Italy) IKP (Theorie), Forschungszentrum Juelich GmbH., D-52425 Juelich (Germany) L. D. Landau Institute for Theoretical Physics, GSP-1, 117940, ul.-Kosygina 2, V-334 Moscow (Russian Federation))

    1995-03-01

    We demonstrate that the final state [ital p]-[ital n] interaction in the reaction of electrodissociation of the deuteron at large [ital Q][sup 2] in a static external field leads to the apparent reacceleration of neutrons. The shift of the neutron velocity from the velocity of the deuteron beam is related to the quantum-mechanical forward-backward asymmetry of the missing momentum distribution in the [sup 2]H ([ital e],[ital e][prime][ital p])[ital n] scattering.

  7. Mechanical Components from Highly Recoverable, Low Apparent Modulus Materials

    Science.gov (United States)

    Padula, Santo, II (Inventor); Noebe, Ronald D. (Inventor); Stanford, Malcolm K. (Inventor); DellaCorte, Christopher (Inventor)

    2015-01-01

    A material for use as a mechanical component is formed of a superelastic intermetallic material having a low apparent modulus and a high hardness. The superelastic intermetallic material is conditioned to be dimensionally stable, devoid of any shape memory effect and have a stable superelastic response without irrecoverable deformation while exhibiting strains of at least 3%. The method of conditioning the superelastic intermetallic material is described. Another embodiment relates to lightweight materials known as ordered intermetallics that perform well in sliding wear applications using conventional liquid lubricants and are therefore suitable for resilient, high performance mechanical components such as gears and bearings.

  8. Discovery of an Apparent Nova in M81

    Science.gov (United States)

    Hornoch, K.; Vaduvescu, O.; Gonzalez, A.

    2013-04-01

    We report the discovery of an apparent nova in the M81 galaxy on a co-added 2000-s narrow-band H-alpha CCD image taken with the 2.5-m Isaac Newton Telescope (INT) + WFC at La Palma in ~1.4" seeing on Apr. 5.946 UT. The new object is visible on individual 400-s frames and well visible on the co-added image (see the finding chart linked below), but is not present on numerous narrow-band H-alpha archival images from the INT down to limiting magnitude as faint as H-alpha = 21.7.

  9. Creating Special Events

    Science.gov (United States)

    deLisle, Lee

    2009-01-01

    "Creating Special Events" is organized as a systematic approach to festivals and events for students who seek a career in event management. This book looks at the evolution and history of festivals and events and proceeds to the nuts and bolts of event management. The book presents event management as the means of planning, organizing, directing,…

  10. A Case of Apparent Contact Dermatitis Caused by Toxocara Infection

    Directory of Open Access Journals (Sweden)

    Rosanna Qualizza

    2014-01-01

    Full Text Available Infection from Toxocara species may give rise to a large array of clinical symptoms, including apparent manifestations of allergy such as asthma, urticaria/angioedema, and dermatitis. We report a case, thus far not described, of contact dermatitis attributed to nickel allergy but caused by Toxocara infection. The patient was a 53-year-old woman presenting from 10 years a dermatitis affecting head, neck, and thorax. Patch tests initially performed gave a positive result to nickel, but avoidance of contact with nickel did not result in recovery. The patient referred to our Allergy Service in 2010 because of dermatitis to feet. Patch testing confirmed the positive result for nickel, but expanding the investigation a positive result for IgG antibodies to Toxocara was detected by Western blotting and ELISA. Treatment with mebendazole achieved immediate efficacy on feet dermatitis. Then, two courses of treatment with albendazole resulted in complete regression of dermatitis accompanied by development of negative ELISA and Western blotting for Toxocara antibodies. This report adds another misleading presentation of Toxocara infection as apparent contact dermatitis caused by nickel and suggests bearing in mind, in cases of contact dermatitis not responding to avoidance of the responsible hapten and to medical treatment, the possible causative role of Toxocara.

  11. Apparent nitrogen digestibility data: AACC-ASTM collaborative study.

    Science.gov (United States)

    Happich, M L; Bodwell, C E; Hackler, L R; Phillips, J G; Derse, P H; Elliott, J G; Hopkins, D T; Parsons, G F; Prescher, E E; Robaidek, E S

    1984-01-01

    Apparent nitrogen digestibility data were obtained from 4 laboratories for 6 protein sources and 2 diet levels, 6 and 10% protein, after a 2-day adaptation period during the AACC-ASTM protein efficiency ratio (PER) and net protein ratio (NPR) collaborative studies. For 5 protein sources fed as 10% of the diet, the interlaboratory variation as measured by coefficient of variation (CV) values was low (1.5-3.5%), indicating high precision of the method. Wheat flour (6% protein diet) had the highest variation and, therefore, the lowest precision (CV of 7.10%). The interlaboratory variation (CV value) for 3 of the 4 laboratories was considerably lower, less than half that for the 4 laboratories. An analysis of variance of apparent nitrogen digestibility data indicated significant (P less than 0.05) effects for the 4-laboratory group due to laboratories and protein diets at both 10 and 6% protein levels, and for the 3-laboratory group at the 10% protein level. The 3-laboratory ANOVA for the 6% diets indicated a significant effect (P less than 0.05) due to diet only.

  12. Management of adverse events related to new cancer immunotherapy (immune checkpoint inhibitors).

    Science.gov (United States)

    Bourke, Jack M; O'Sullivan, Michael; Khattak, Muhammad A

    2016-11-07

    New immunotherapies have significantly improved survival in certain advanced cancers in recent years, particularly metastatic melanoma and lung cancer. The most effective of these therapies are the immune checkpoint inhibitors (ICIs) such as ipilimumab, nivolumab and pembrolizumab. The use of ICIs will continue to increase in the coming years as evidence of their benefit in a range of other cancers builds. ICIs are associated with novel immune-related adverse events (irAEs), which can involve a wide range of organs. The most common irAEs involve the skin (rash, pruritus), gastrointestinal tract (diarrhoea, colitis) and endocrine system (thyroid, pituitary). While severity is generally mild, life-threatening complications can occur if not recognised and treated promptly. Due to the diverse manifestations of irAEs, patients may present to doctors who are not familiar with these drugs, which creates the potential for delays in management. Management of irAEs depends on severity and the organ affected. Systemic steroids are often required and ICI therapy may be withheld or discontinued. Additional immunosuppressive medications may be necessary in steroid-refractory cases. This review provides an overview of the potential toxicities and their management for general clinicians. Broader awareness of these issues among medical professionals will hopefully reduce unnecessary delays in diagnosis and treatment. Patient and carer education regarding irAEs is extremely important; patients and carers should be advised to seek urgent medical attention if required.

  13. Refractory Pulmonary Edema Caused by Late Pulmonary Vein Thrombosis After Lung Transplantation: A Rare Adverse Event.

    Science.gov (United States)

    Denton, Eve J; Rischin, Adam; McGiffin, David; Williams, Trevor J; Paraskeva, Miranda A; Westall, Glen P; Snell, Greg

    2016-09-01

    After lung transplantation, pulmonary vein thrombosis is a rare, potentially life-threatening adverse event arising at the pulmonary venous anastomosis that typically occurs early and presents as graft failure and hemodynamic compromise with an associated mortality of up to 40%. The incidence, presentation, outcomes, and treatment of late pulmonary vein thrombosis remain poorly defined. Management options include anticoagulant agents for asymptomatic clots, and thrombolytic agents or surgical thrombectomy for hemodynamically significant clots. We present a rare case highlighting a delayed presentation of pulmonary vein thrombosis occurring longer than 2 weeks after lung transplantation and manifesting clinically as graft failure secondary to refractory pulmonary edema. The patient was treated successfully with surgical thrombectomy and remains well. We recommend a high index of suspicion of pulmonary vein thrombosis when graft failure after lung transplantation occurs and is not responsive to conventional therapy, and consideration of investigation with transesophageal echocardiography or computed tomography with venous phase contrast in such patients even more than 2 weeks after lung transplantation.

  14. Large apparent electric size of solid-state nanopores due to spatially extended surface conduction.

    Science.gov (United States)

    Lee, Choongyeop; Joly, Laurent; Siria, Alessandro; Biance, Anne-Laure; Fulcrand, Rémy; Bocquet, Lydéric

    2012-08-08

    Ion transport through nanopores drilled in thin membranes is central to numerous applications, including biosensing and ion selective membranes. This paper reports experiments, numerical calculations, and theoretical predictions demonstrating an unexpectedly large ionic conduction in solid-state nanopores, taking its origin in anomalous entrance effects. In contrast to naive expectations based on analogies with electric circuits, the surface conductance inside the nanopore is shown to perturb the three-dimensional electric current streamlines far outside the nanopore in order to meet charge conservation at the pore entrance. This unexpected contribution to the ionic conductance can be interpreted in terms of an apparent electric size of the solid-state nanopore, which is much larger than its geometric counterpart whenever the number of charges carried by the nanopore surface exceeds its bulk counterpart. This apparent electric size, which can reach hundreds of nanometers, can have a major impact on the electrical detection of translocation events through nanopores, as well as for ionic transport in biological nanopores.

  15. Why does the apparent mass of a coronal mass ejection increase?

    CERN Document Server

    Feng, Li; Shen, Fang; Shen, Chenglong; Inhester, Bernd; Lu, Lei; Gan, Weiqun

    2015-01-01

    Mass is one of the most fundamental parameters characterizing the dynamics of a coronal mass ejection (CME). It has been found that CME apparent mass measured from the brightness enhancement in coronagraph images shows an increasing trend during its evolution in the corona. However, the physics behind it is not clear. Does the apparent mass gain come from the mass outflow from the dimming regions in the low corona, or from the pileup of the solar wind plasma around the CME when it propagates outwards from the Sun? We analyzed the mass evolution of six CME events. Their mass can increase by a factor of 1.6 to 3.2 from 4 to 15 Rs in the field of view (FOV) of the coronagraph on board the Solar Terrestrial Relations Observatory (STEREO). Over the distance about 7 to 15 Rs, where the coronagraph occulting effect can be negligible, the mass can increase by a factor of 1.3 to 1.7. We adopted the `snow-plough' model to calculate the mass contribution of the piled-up solar wind in the height range from about 7 to 15 ...

  16. The hidden face of Kanizsa's triangle: apparent movement of subjective figures in three-dimensional space.

    Science.gov (United States)

    Vallortigara, G

    1987-01-01

    Several demonstrations on the apparent movement in depth of subjective figures are presented. They include: (a) apparent rotational movement as a result of shape invariance or rigidity; (b) apparent rotational movement with three-dimensional subjective figures not accompanied by a brightness gradient; and (c) apparent rotational movement by kinetic occlusion.

  17. Energy Dissipation and Apparent Viscosity of Semi-solid Metal during Rheological Processes Part Ⅱ: Apparent Viscosity

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This study investigated the rheological properties of semi-solid metal. An analytical model of apparent viscosity was built up based on analysis of energy dissipation during rheological processes such as slurry preparing,delivering and model filling. The rheological properties of SSM (semi-solid metal) slurry was described by an analytical model in terms of microstructural parameters, which consist of effective solid fraction, particle size and shape, and flow parameters such as mean velocity, fluctuant velocity and relative velocity between liquid and solid phase. The model was verified in the experiment of A356 alloys with a coaxial double-bucket rheometer. And the maximum relative error between the theoretical value and measured one is less than 10%.The results of experiment and theoretical calculation also indicate that the microstructural parameters and flow parameters are two major factors that affect the apparent viscosity of semi-solid alloys, and fluctuant velocity and relative velocity between liquid and solid phase are the key factors to distinguish between steady and transient rheological properties.

  18. Galvanic apparent internal impedance: an intrinsic tissue property.

    Science.gov (United States)

    Golberg, Alex; Rabinowitch, Haim D; Rubinsky, Boris

    2009-11-01

    Using basic galvanic cell principles, the ability of tissues to generate electrical current through electrolysis was characterized. Studying Zn/Cu electrolysis in animal organs revealed a fundamental and measurable tissue-specific property - the galvanic apparent internal impedance (GAII), that is most likely related to the salt bridge function of tissues delineated by electrodes. Further to the fundamental knowledge acquired, GAII enables a new diagnostic method to distinguish between tissue types and to determine their health status without a need for expensive calibration, as often required when external power source is used. We demonstrated the GAII sensitivity in detecting tissue ablation with microwave heating or irreversible electroporation. The results open the way for a novel, inexpensive self-powered tissue diagnostic system for a wide range of applications such as minimally invasive tissue health status, ischemia, hydration, real time intra-operative control of minimally invasive surgery, medical imaging, virtual biopsy and many others.

  19. Vitrectomy for bilateral macular schisis without apparent optic disc anomalies

    Science.gov (United States)

    Andonegui, José; Maya, José Ramón; Echeverría, Marta; Alcaine, Araceli

    2016-01-01

    A 78-year-old man complained of bilateral visual acuity loss. Optical coherence tomography examination showed bilateral macular schisis with fluid accumulation in the external retinal layers without vitreous traction. Fundus examination and fluorescein angiography were normal in both eyes. Both eyes were treated by phacoemulsification, intraocular lens implantation, and vitrectomy without laser, gas exchange, or retinal fenestration. Slow and progressive fluid resorption and improvement in VA were observed in both eyes. Macular schisis similar to the one associated with optic disc anomalies is a possibility in patients without apparent disc anomalies. Vitrectomy without laser, gas, or retinal fenestration may be a good therapeutic option even in patients with a PVD preoperatively. PMID:27703873

  20. Plant-mediated 'apparent effects' between mycorrhiza and insect herbivores.

    Science.gov (United States)

    Gilbert, Lucy; Johnson, David

    2015-08-01

    Plants mediate indirect 'apparent' effects between above-ground herbivores and below-ground mutualistic mycorrhizal fungi. The herbivore-plant-mycorrhiza continuum is further complicated because signals produced by plants in response to herbivores can be transmitted to other plants via shared fungal networks below ground. Insect herbivores, such as aphids, probably affect the functioning of mycorrhizal fungi by changing the supply of recent photosynthate from plants to mycorrhizas, whereas there is evidence that mycorrhizas affect aphid fitness by changing plant signalling pathways, rather than only through improved nutrition. New knowledge of the transfer of signals through fungal networks between plant species means we now need a better understanding of how this process occurs in relation to the feeding preferences of herbivores to shape plant community composition and herbivore behaviour in nature.

  1. Apparent motion perception in patients with paranoid schizophrenia.

    Science.gov (United States)

    Sanders, Lia Lira Olivier; de Millas, Walter; Heinz, Andreas; Kathmann, Norbert; Sterzer, Philipp

    2013-04-01

    Impaired perceptual inference has been suggested to be at the core of positive symptoms in schizophrenia. Apparent motion (AM) is a visual illusion in which perceptual inference gives rise to the experience of a single object moving back and forth when two spatially separated objects are flashed in alternation. Here, we investigated the strength of AM perception in patients with paranoid schizophrenia. Patients were less susceptible to the illusion as indicated by a lower probability of motion perception at the individual's optimal presentation frequency for AM. In addition, the probability of AM perception was inversely related to delusional conviction in the patient group. These results suggest that schizophrenia may be associated with a reduced susceptibility to visual phenomena that commonly rely on perceptual inference.

  2. Determination of apparent sampling thickness of sea surface microlayer

    Science.gov (United States)

    Li, Jun; Ding, Hai-Bing; Wu, Zhi-Jian; Zhang, Zheng-Bin; Liu, Lian-Sheng

    1998-06-01

    In situ and laboratory studies of sea—surface microlayer sampling methods using glass plate, rotating drum, screen and funnel samplers were conducted. For glass plate and rotating drum samplers, surface microlayer samples of different thickness were collected by controlling their withdrawal rate and rotating rate. The relationships between pH, surface tension, the concentration of dissolved trace metals Cu and Pb, phosphate, particulate matters and sampling thickness were carefully investigated. It was shown that physicochemical and biological properties change obviously at the sampling thickness of about 50 μm, which is consistent with the mean thickness of the boundary film in the models of gas exchange across the sea surface. It is proposed that the apparent sampling thickness of the surface microlayer should be less than 40 μm. The factors affecting the sampling thickness are discussed, and the feasibility and applicable conditions for different sampling methods are evaluated.

  3. Gravitational energy as dark energy: Cosmic structure and apparent acceleration

    CERN Document Server

    Wiltshire, David L

    2011-01-01

    Below scales of about 100/h Mpc our universe displays a complex inhomogeneous structure dominated by voids, with clusters of galaxies in sheets and filaments. The coincidence that cosmic expansion appears to start accelerating at the epoch when such structures form has prompted a number of researchers to question whether dark energy is a signature of a failure of the standard cosmology to properly account, on average, for the distribution of matter we observe. Here I discuss the timescape scenario, in which cosmic acceleration is understood as an apparent effect, due to gravitational energy gradients that grow when spatial curvature gradients become significant with the nonlinear growth of cosmic structure. I discuss conceptual issues related to the averaging problem, and their impact on the calibration of local geometry to the solutions of the volume-average evolution equations corrected by backreaction, and the question of nonbaryonic dark matter in the timescape framework. I further discuss recent work on ...

  4. When luminance increment thresholds depend on apparent lightness.

    Science.gov (United States)

    Maertens, Marianne; Wichmann, Felix A

    2013-05-31

    A fundamental question in visual perception research is whether the sensitivity to stimulus differences is limited by the sensory representation of the external stimulus, that is, the proximal stimulus, or by its perceptual representation, i.e., stimulus appearance. In the domain of lightness perception, the question translates into whether discrimination thresholds depend on the local luminance in the retinal image or on the apparent lightness of the corresponding image region. The majority of findings seem to indicate that sensitivity is limited by the sensory stimulus representation, which would imply different mechanisms for stimulus discrimination and appearance. We think this conclusion needs to be qualified. We report data suggesting that the relationship between discrimination and appearance judgments depends on how exactly they are being measured. We propose a theoretical account that provides a common mechanism for appearance and sensitivity. An interesting corollary of this model is that it also accounts for the perceptual phenomenon of assimilation.

  5. Psychological impact of chronic hepatitis C: Comparison with other stressful life events and chronic diseases

    Institute of Scientific and Technical Information of China (English)

    Laurent Castera; Aymery Constant; Pierre-Henri Bernard; Victor de Ledinghen; Patrice Couzigou

    2006-01-01

    AIM: To examine the psychological impact of chronic hepatitis C (CHC) diagnosis in a large cohort of CHC patients as compared with other stressful life events and chronic diseases carrying a risk of life-threatening complications.METHODS: One hundred and eighty-five outpatients with compensated CHC were asked to self-grade, using a 100-mm visual analogue scale (VAS), the degree of stress caused by the learning of CHC diagnosis and the perceived severity of their disease. Diagnosis-related stress was compared to four other stressful life events and perceived CHC severity was compared to four other common chronic diseases.RESULTS: Learning of CHC diagnosis was considered a major stressful event (mean ± SD scores: 72±25),significantly less than death of a loved-one (89±13,P<0.0001) and divorce (78± 23, P<0.007), but more than job dismissal (68 ± 30, P<0.04) and home removal (26±24, P< 0.0001). CHC was considered a severe disease (74±19), after AIDS (94±08, P<0.001) and cancer (91±11, P<0.001), but before diabetes (66±23,P<0.001) and hypertension (62±20, P<0.001).Perceived CHC severity was not related to the actual severity of liver disease, assessed according to Metavir fibrosis score. In multivariate analysis, diagnosisrelated stress was related to perceived disease severity (P< 0.001), trait anxiety (P< 0.001) and infection through blood transfusion (P< 0.001).CONCLUSION: Our results show the considerable psychological and emotional burden that a diagnosis of CHC represents, even in the absence of significant liver disease. They should be taken into account when announcing a diagnosis of CHC in order to reduce its negative effects.

  6. The Astronomical Pulse of Global Extinction Events

    Directory of Open Access Journals (Sweden)

    David F.V. Lewis

    2006-01-01

    Full Text Available The linkage between astronomical cycles and the periodicity of mass extinctions is reviewed and discussed. In particular, the apparent 26 million year cycle of global extinctions may be related to the motion of the solar system around the galaxy, especially perpendicular to the galactic plane. The potential relevance of Milankovitch cycles is also explored in the light of current evidence for the possible causes of extinction events over a geological timescale.

  7. The astronomical pulse of global extinction events.

    Science.gov (United States)

    Lewis, David F V; Dorne, Jean-Lou C M

    2006-06-23

    The linkage between astronomical cycles and the periodicity of mass extinctions is reviewed and discussed. In particular, the apparent 26 million year cycle of global extinctions may be related to the motion of the solar system around the galaxy, especially perpendicular to the galactic plane. The potential relevance of Milankovitch cycles is also explored in the light of current evidence for the possible causes of extinction events over a geological timescale.

  8. Keterlibatan Event Stakeholders pada Keberhasilan Event PR

    Directory of Open Access Journals (Sweden)

    Lidya Wati Evelina

    2013-03-01

    Full Text Available The objective of this article is to determine how event organizers collaborate with stakeholders including the media, particular community, sponsors, participants, venue providers, accommodation providers, carteres, legal and finance personnel, production, local trade, transportation providers, government and associations for implementation Public Relations event. This paper discusses about the things that must be done for the cooperation and the benefits of cooperation undertaken. The method used in this paper is qualitative research method based on observations, literature and case studies. The results of this research note that the event organizers or companies can together with the stakeholders (the other party make an event as mutually beneficial Public Relations. This means that all parties can achieve through the event. At the conclusion of an event Public Relations, all stakeholders involved for their own purposes. Event organizer must ensure that all stakeholders work together effectively in accordance with the agreed schedule and budget. One important feature of the agreement is to maintain a good flow of communication according to the needs of its stakeholders. All information is documented to avoid misunderstandings. Collaboration between stakeholders continuously until the event is completed. Discussion of issues that arise during the event takes place between the committee with various stakeholders is an important thing for the evaluation and response to the events that occurred.

  9. Contribution of Chlorophyll Fluorescence to the Apparent Reflectance of Vegetation

    Science.gov (United States)

    Campbell, P. K. Entcheva; Middleton, E. M.; Kim, M. S.

    2007-01-01

    Current strategies for monitoring the physiologic status of terrestrial vegetation rely on remote sensing reflectance (R) measurements, whi ch provide estimates of relative vegetation vigor based primarily on chlorophyll content. Vegetation chlorophyll fluorescence (CF) offers a non-destructive alternative and a more direct approach for diagnosis of vegetation stress before a significant reduction in chlorophyll content has occurred. Thus, monitoring of vegetation vigor based on CF may allow earlier stress detection and more accurate carbon sequestra tion estimates, than is possible using R data alone. However, the observed apparent vegetation reflectance (Ra) in reality includes contrib utions from both the reflected and fluoresced radiation. The aim of t his study is to determine the relative R and CF fractions contributing to Ra from the vegetation in the red to near-infrared region of the spectrum. The practical objectives of the study are to: 1) evaluate t he relationship between CF and R at the foliar level for corn, soybean, maple; and 2) for corn, determine if the relationship established f or healthy (optimal N) vegetation changes under N defiiency. To obtai n generally applicable results, experimental measurements were conducted on unrelated crop and tree species (maple, soybean and corn), unde r controlled conditions and a gradient of inorganic N fertilization l evels. Optical R spectra and actively induced CF emissions were obtained on the same foliar samples, in conjunction with measurements of p hotosynthetic function, pigment levels, and C and N content. The comm on spectral trends or similarities were examined. On average, 10-20% of apparent R at 685 nm was actually due to CF. The spectral trends in steady and maximum F varied significantly, with Fs (especially red) showing higher ability for species and treatment separation. The relative contribution of ChF to R varied significantly among species, with maple emitting much higher F amounts, as

  10. Knoop Hardness - Apparent Yield Stress Relationship in Ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Swab, Jeffrey J [ORNL; LaSalvia, Jerry [U.S. Army research Laboratory, Adelphi, MD; Wereszczak, Andrew A [ORNL; Strong, Kevin T [ORNL; Danna, Dominic [U.S. Army research Laboratory, Adelphi, MD; Ragan, Meredith E [ORNL; Ritt, Patrick J [ORNL

    2012-01-01

    In Tabor's classical studies of the deformation of metals, the yield stress (Y) and hardness (H) were shown to be related according to H/Y {approx} 3 for complete or fully plastic deformation. Since then it has been anecdotally shown for ceramics that this ratio is <3. Interest exists to explore this further so Hertzian indentation was used to measure the apparent yield stress of numerous ceramics and metals and their results were compared with each material's load-dependent Knoop hardness. The evaluated ceramics included standard reference materials for hardness (silicon nitride and tungsten carbide), silicon carbide, alumina, and glass. Several steel compositions were also tested for comparison. Knoop hardness measurements at 19.6 N (i.e., toward 'complete or fully plastic deformation'), showed that 2 < H/Y < 3 for the metals and 0.8 < H/Y < 1.8 for the glasses and ceramics. Being that H/Y {ne} 3 for the ceramics indicates that Tabor's analysis is either not applicable to ceramics or that full plastic deformation is not achieved with a Knoop indentation or both.

  11. Mixed quotation: The grammar of apparently transparent opacity

    Directory of Open Access Journals (Sweden)

    Emar Maier

    2014-05-01

    Full Text Available The phenomenon of mixed quotation exhibits clear signs of both the apparent transparency of compositional language use and the opacity of pure quotation. I argue that the interpretation of a mixed quotation in- volves the resolution of a metalinguistic presupposition. The leading idea behind my proposal is that a mixed-quoted expression, say, “has an anomalous feature”, means what x referred to with the words ‘has an anomalous feature’. To understand how this solves the paradox, I set up a precise grammatical framework, explicitly connecting various levels of linguistic analysis: phonological forms, categorial syntax, and a dynamic picture of the semantics–pragmatics interface. In this framework I formalize and evaluate a presuppositional account of mixed quotation. Finally, I address the phenomenon of unquotation and argue that it is an essential ingredient for an elegant and empirically adequate analysis of mixed quotation in natural language. http://dx.doi.org/10.3765/sp.7.7 BibTeX info

  12. The influence of spontaneous brain oscillations on apparent motion perception.

    Science.gov (United States)

    Sanders, Lia Lira Olivier; Auksztulewicz, Ryszard; Hohlefeld, Friederike U; Busch, Niko A; Sterzer, Philipp

    2014-11-15

    A good example of inferential processes in perception is long-range apparent motion (AM), the illusory percept of visual motion that occurs when two spatially distinct stationary visual objects are presented in alternating sequence. The AM illusion is strongest at presentation frequencies around 3 Hz. At lower presentation frequencies, the percept varies from trial to trial between AM and sequential alternation, while at higher frequencies perception varies between AM and two simultaneously flickering objects. Previous studies have demonstrated that prestimulus alpha oscillations explain trial-to-trial variability in detection performance for visual stimuli presented at threshold. In the present study, we investigated whether fluctuations of prestimulus alpha oscillations can also account for variations in AM perception. Prestimulus alpha power was stronger when observers reported AM perception in subsequent trials with low presentation frequencies, while at high presentation frequencies there were no significant differences in alpha power preceding AM and veridical flicker perception. Moreover, when observers perceived AM the prestimulus functional connectivity between frontal and occipital channels was increased in the alpha band, as revealed by the imaginary part of coherency, which is insensitive to artefacts from volume conduction. Dynamic causal modelling of steady-state responses revealed that the most likely direction of this fronto-occipital connectivity was from frontal to occipital sources. These results point to a role of ongoing alpha oscillations in the inferential process that gives rise to the perception of AM and suggest that fronto-occipital interactions bias perception towards internally generated predictions.

  13. Discrimination of paediatric brain tumours using apparent diffusion coefficient histograms

    Energy Technology Data Exchange (ETDEWEB)

    Bull, Jonathan G.; Clark, Christopher A. [UCL Institute of Child Health, Imaging and Biophysics Unit, London (United Kingdom); Saunders, Dawn E. [Great Ormond Street Hospital for Children NHS Trust, Department of Radiology, London (United Kingdom)

    2012-02-15

    To determine if histograms of apparent diffusion coefficients (ADC) can be used to differentiate paediatric brain tumours. Imaging of histologically confirmed tumours with pre-operative ADC maps were reviewed (54 cases, 32 male, mean age 6.1 years; range 0.1-15.8 years) comprising 6 groups. Whole tumour ADC histograms were calculated; normalised for volume. Stepwise logistic regression analysis was used to differentiate tumour types using histogram metrics, initially for all groups and then for specific subsets. All 6 groups (5 dysembryoplastic neuroectodermal tumours, 22 primitive neuroectodermal tumours (PNET), 5 ependymomas, 7 choroid plexus papillomas, 4 atypical teratoid rhabdoid tumours (ATRT) and 9 juvenile pilocytic astrocytomas (JPA)) were compared. 74% (40/54) were correctly classified using logistic regression of ADC histogram parameters. In the analysis of posterior fossa tumours, 80% of ependymomas, 100% of astrocytomas and 94% of PNET-medulloblastoma were classified correctly. All PNETs were discriminated from ATRTs (22 PNET and 4 supratentorial ATRTs) (100%). ADC histograms are useful in differentiating paediatric brain tumours, in particular, the common posterior fossa tumours of childhood. PNETs were differentiated from supratentorial ATRTs, in all cases, which has important implications in terms of clinical management. (orig.)

  14. Estimating phosphorus concentrations following alum treatment using apparent settling velocity

    Science.gov (United States)

    Panuska, John; Robertson, Dale M.

    2009-01-01

    he apparent settling velocity (Vs) is a term used in empirical, steady-state, mass-balance lake models to represent the net phosphorus flux from the water column. The Vollenweider (1969) mixed-reactor lake model was rearranged and used to calculate Vs values for total phosphorus (TP) for three lakes treated with alum to reduce the internal flux of P to the water column (Delavan Lake, Wisconsin; Lake Morey, Vermont; and West Twin Lake, Ohio). An analysis of Vs values was conducted using data from these three lakes for both the pre- and post-alum treated conditions. Analysis of Vs values for both the pre- and post-alum conditions in Lake Morey and West Twin Lake resulted in a post-treatment mean Vs value of 7 ± 2.0 m·yr−1. The effect of the alum treatment, although short-lived in Delavan Lake, resulted in a mean post-treatment Vs value of 3.4 ± 0.3 m·yr−1. The consistency in the post-treatment Vs values in Lake Morey and West Twin Lake is used to demonstrate a predictive analysis method for water column TP concentrations in lakes following a successful treatment of the anoxic sediment area with alum. Additional pre- and post-alum in-lake and watershed loading data are needed to advance this concept into a management model.

  15. Two Qatari siblings with cystic fibrosis and apparent mineralocorticoid excess

    Directory of Open Access Journals (Sweden)

    Khalid Zahraldin

    2015-01-01

    Full Text Available Cystic fibrosis (CF and apparent mineralocorticoid excess (AME syndrome are both autosomal recessive disorders that result from mutations of specific identified genes for each condition. CF is caused by defects in the Cystic fibrosis trans membrane conductance regulator (CFTR gene which encodes for a protein that functions as a chloride channel and regulates the flow of other ions across the apical surface of epithelial cells. AME is due to the deficiency of 11β-hydroxysteroid dehydrogenase type 2 enzyme (11βHSD2, which is responsible for the peripheral inactivation of cortisol to cortisone. Cortisol excess stimulates the mineralocoritoid receptors (MR resulting in intense sodium retention, hypokalemia and hypertension. We report on a consanguineous Arab family, in which two sibs inherited both CF and AME. Gene testing for AME revealed previously unreported mutation in the 11βHSD2 gene. This report draws attention to the importance of recognizing the possibility of two recessive disorders in the same child in complex consanguineous families. Moreover, it provides a unique opportunity to highlight the implications of the coexistence of two genetic disorders on patient care and genetic counseling of the family.

  16. Microlensing optical depth as a function of source apparent magnitude

    CERN Document Server

    Wood, Alexander

    2007-01-01

    Measurements of the microlensing optical depth, tau, towards the Galactic bulge appear to depend on the method used to obtain them. Those values based on the lensing of red clump giants (RCGs) appear to be significantly lower than those based on the lensing of all stars along the line of sight. This discrepancy is still not understood. Through Monte Carlo simulations, it is found that the discrepancy cannot be explained by a dependance on the flux limits of the two methods. The optical depth is expected to be generally constant as a function of source apparent magnitude for I_0 >~ 13.0, except in the range 13.5 <~ I_0 <~ 15.5. Here many RCGs are detected, causing a significant oscillation in tau. The amplitude of this oscillation is a function of the inclination angle of the Galactic bar, theta_bar, which may thus be constrained. A further constraint comes from a similar dependance of tau with theta_bar: combining the predicted trends with the measured values provides 1-sigma upper limits, which exclude...

  17. Catheter-induced dissection of a normal right coronary artery: Reappraisal of the underlying mechanisms

    Directory of Open Access Journals (Sweden)

    Wassam El Din HadadEl Shafey

    2016-06-01

    Full Text Available Iatrogenic coronary artery dissection during diagnostic coronary catheterization is a rare but life-threatening event with a reported incidence of less than 0.1%. The current case report addresses the issue of catheter-induced dissection of an apparently normal right coronary artery (RCA. I tried to explain the factors underlying its occurrence, in view of the current knowledge of the aortic root motion during the cardiac cycle, and the spatial orientation of the RCA ostium.

  18. [Severe laryngitis associated to gastroesophageal reflux].

    Science.gov (United States)

    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.

  19. Apparent Luminosity Function and Statistical Properties of Fast Radio Bursts

    CERN Document Server

    Li, LongBiao; Zhang, ZhiBin; Li, Di; Li, Bing

    2016-01-01

    Fast Radio Bursts (FRBs) are intense radio flashes from the sky that are astonishingly characterized by millisecond durations and Jansky-level flux densities. Only 16 FRBs have been reported in the literature till now. We carry out a statistical analysis on these events. Their mean dispersion measure, after subtracting the contribution from the interstellar medium of our Galaxy, is found to be $\\sim 655 \\; \\rm pc\\,cm^{-3}$, strongly supporting the idea that they are of cosmological origin. Their energy release in radio band spans about three orders of magnitude, with a mean value of $\\sim 6.42\\times10^{38}$ ergs. The radio energy is found to be positively correlated with the observed fluence and the dispersion measure excess, and the fluence also shows a clear positive correlation with the FRB duration. Among all these events, FRBs 010621 and 010724 seem to form a distinct group in a few plots, indicating that there may be at lease two classes of FRBs. More interestingly, although the FRB study is still in a ...

  20. Apparent resistivity and spectral induced polarization in the submarine environment

    Directory of Open Access Journals (Sweden)

    HERCULES DE SOUZA

    2001-09-01

    Full Text Available Relatively few investigations have employed electrical methods in the submarine environment, which may be promising for mineral deposits or threatened by environmental problems. We have measured the electric field using both disk and bar electrodes in the sea water at three different levels: sea surface, seven meters deep, and sea bottom at a depth of ten meters, employing a 2 m spacing dipole-dipole array with 7 array spacings of investigation, and 13 values of frequencies at steps of (2N hertz, N = -2, -1, 0, 1, 2,.....10. The measurement allowed the analysis of the electric field as a function of frequency and spacing, and of the spectral induced polarization. Modelling and interpretation of the apparent resistivity yielded a good fit with previous drilling data. Analysis of the spectrum of the complex apparent resistivity and the comparison with equivalent circuits, provided information about the grain size, the mineral composition and the major induced polarization phenomenon occurring below the sea. Therefore the result of the present research show the feasibility of measuring the variation of seawater resistivity in situ, as well as the resistivity of sea bottom sediments.Relativamente poucas investigações têm empregado métodos elétricos no ambiente submarino, o qual pode ser promissor para depósitos minerais ou ameaçado por problemas ambientais. Nós medimos o campo elétrico usando eletrodos em forma de disco e de barra na água do mar, em três níveis distintos: superfície, sete metros de profundidade, e fundo do mar a dez metros de profundidade, empregando um dispositivo dipolo-dipolo com 2m de afastamento, 7 níveis de investigação e 13 valores de freqüência a intervalos de (2N hertz, N = -2, -1, 0, 1, 2, ... 10. A medida permitiu a análise do campo elétrico como uma função de freqüência e afastamento, e da polarização induzida espectral. A modelagem e a interpretação da resistividade aparente se ajustaram bem

  1. Apparent in vivo nutrient digestibility of maize silages in horses

    Directory of Open Access Journals (Sweden)

    Adriana PÍŠOVÁ

    2016-12-01

    Full Text Available The aim of the experiment was to analyzed coefficients of digestibility of the maize silage nutrients in horse feeding. Horses of Slovak warmblood breed engaged in the research were 2.5 ± 0.5 years old. Horses in boxes without bedding to avoid eating it and excrement contamination were stabled. Horses individually with ad libitum access to water were housed. The boxes with trough for corn silage were equiped. The corn silage contained 362.3 g of dry matter, 74.1 g of crude protein, 27.1 g of crude fat and 948.2 g of organic matter in kg of dry matter. The feed twice a day, in the morning and in the evening was given. The feed intake and leftovers were weighed every day. Excrements immediately after excreting to avoid urine contamination into plastic containers were collected and weighed. The content of nutrients in the feed intake and in the excrements were analysed. In analysed samples the gravimetric dry matter amount by drying at 103 ± 2 °C, crude protein content by Kjeldahl method, fat content by extraction method according to Soxhlett – Henkel, ash content by burning the sample at 530 ± 20 °C in muffle furnace and organic matter content by calculation were determined. Coefficients of apparent digestibility in percent from taken in and excreted nutrients were calculated. In maize silage for horse feeding an average coefficient of digestibility of dry matter 61.94%, of crude protein 56.03%, of crude fat 72.34% and of organic matter 65.19% was found.

  2. Estimating groundwater velocity using apparent resistivity tomography: A sandbox experiment

    Science.gov (United States)

    Chen, J. L.; Chen, C. H.; Kuo, C. L.; Fen, C. S.; Wu, C. C.

    2016-08-01

    The electrical resistivity tomography (ERT) technique can estimate groundwater velocity to within 5% of the pre-set groundwater velocity. The apparent conductivity obtained by the ERT technique is linearly related to the groundwater conductivity, as described by Archie's law. Gaussian-like profiles of the tracer concentration were demonstrated with the ERT technique, and the estimated dispersion coefficient was between 0.0015 and 0.0051 cm2/sec. In terms of monitoring changes in groundwater conductivity, the ERT technique has two major advantages over monitoring wells: (1) it measures a larger area and provides more representative results; and, (2) it does not withdraw groundwater samples, and therefore does not affect the groundwater flow. The objective of this research is to measure groundwater velocity with the ERT technique using only one well. The experiments in this research were divided into two parts. The first part evaluated the accuracy and repeatability of the ERT technique using a dipole-dipole array, and the second part estimated the groundwater velocity in a sandbox using the ERT technique. The length, width, and height of the sandbox, which was made of acrylic, were 1.5, 5, and 1.0 m, respectively. The ERT sandbox was sequentially filled with 5-cm layers of the silica sand to a total height of 70 cm. A total of 32 electrodes spaced every 5-cm were installed in the center of the sandbox. Three monitoring wells were installed along the line of the electrodes. Both no-flow and constant flow (NaCl solution with electrical conductivity and concentration of 5,000 μs/cm and 2.456 g/L, respectively) tracer experiments were conducted.

  3. Gene Tree Discordance Causes Apparent Substitution Rate Variation.

    Science.gov (United States)

    Mendes, Fábio K; Hahn, Matthew W

    2016-07-01

    Substitution rates are known to be variable among genes, chromosomes, species, and lineages due to multifarious biological processes. Here, we consider another source of substitution rate variation due to a technical bias associated with gene tree discordance. Discordance has been found to be rampant in genome-wide data sets, often due to incomplete lineage sorting (ILS). This apparent substitution rate variation is caused when substitutions that occur on discordant gene trees are analyzed in the context of a single, fixed species tree. Such substitutions have to be resolved by proposing multiple substitutions on the species tree, and we therefore refer to this phenomenon as Substitutions Produced by ILS (SPILS). We use simulations to demonstrate that SPILS has a larger effect with increasing levels of ILS, and on trees with larger numbers of taxa. Specific branches of the species trees are consistently, but erroneously, inferred to be longer or shorter, and we show that these branches can be predicted based on discordant tree topologies. Moreover, we observe that fixing a species tree topology when performing tests of positive selection increases the false positive rate, particularly for genes whose discordant topologies are most affected by SPILS. Finally, we use data from multiple Drosophila species to show that SPILS can be detected in nature. Although the effects of SPILS are modest per gene, it has the potential to affect substitution rate variation whenever high levels of ILS are present, particularly in rapid radiations. The problems outlined here have implications for character mapping of any type of trait, and for any biological process that causes discordance. We discuss possible solutions to these problems, and areas in which they are likely to have caused faulty inferences of convergence and accelerated evolution.

  4. [Very rare and life-threatening complications of bocavirus bronchiolitis: pneumomediastinum and bilateral pneumothorax].

    Science.gov (United States)

    Yeşilbaş, Osman; Kıhtır, Hasan Serdar; Talip Petmezci, Mey; Balkaya, Seda; Hatipoğlu, Nevin; Meşe, Sevim; Şevketoğlu, Esra

    2016-01-01

    Human bocavirus (HBoV), that was first identified in 2005 and classified in Parvoviridae family, is a small, non-enveloped, single-stranded DNA virus, responsible for upper and lower respiratory tract infections, especially in young children. Although HBoV generally causes self-limited influenza-like illness, it may also lead to pneumonia, bronchiolitis, croup and asthma attacks. In this report, a case of acute bronchiolitis complicated with pneumomediastinum and bilateral pneumothorax caused by HBoV has been presented. A three-year-old boy was referred to our pediatric intensive care unit with a two day history of fever, tachypnea, hypoxia and respiratory failure. On auscultation, there were widespread expiratory wheezing and inspiratory crackles. The chest radiography yielded paracardiac infiltration and air trapping on the right lung and infiltration on the left lung. The patient had leukocytosis and elevated C-reactive protein level. On the second day of admission, respiratory distress worsened and chest radiography revealed right pneumothorax and subcutaneous emphysema in bilateral cervical region and left chest wall. He was intubated because of respiratory failure. In the thorax computed tomography, pneumomediastinum and bilateral pneumothorax were detected and right chest tube was inserted. Repetitive blood and tracheal aspirate cultures were negative. A nasopharyngeal swab sample was analyzed by multiplex real-time polymerase chain reaction method with the use of viral respiratory panel (FTD(®) Respiratory Pathogens 21 Kit, Fast-Track Diagnostics), and positive result was detected for only HBoV. On the ninth day of admission, pneumomediastinum and bilateral pneumothorax improved completely and he was discharged with cure. In conclusion, HBoV bronchiolitis may progress rare but severe complications, it should be kept in mind as an etiological agent of the respiratory tract infections especially children younger than five years old.

  5. A rare case of life-threatening penetrating oropharyngeal trauma caused by toothbrush in a child

    Directory of Open Access Journals (Sweden)

    Sagar S

    2010-06-01

    Full Text Available We present a case of 10year-old boy with oropharyngeal injury caused by a toothbrush which penetrated the parapharyngeal space. Initial examination revealed broken end of the toothbrush in oral cavity with the head of the toothbrush having bristles, beyond the soft palate. Tongue and palate were lacerated and there were blood and oral secretions in the oral cavity. Patient was having bradycardia. Computed tomography (CT scan showed the toothbrush head near the carotid artery, the carotid being laterally displaced. The foreign body was surgically removed without any intraoperative or postoperative complications.

  6. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops

    Directory of Open Access Journals (Sweden)

    Abhijeet D Sawant

    2016-04-01

    Full Text Available Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  7. Ionic Liquids as Unforeseen Assets to Fight Life-Threatening Mycotic Diseases.

    Science.gov (United States)

    Hartmann, Diego O; Petkovic, Marija; Silva Pereira, Cristina

    2016-01-01

    Ionic liquids discovery has celebrated 100 years. They consist solely of ions, one of which is typically organic and asymmetrical. Remarkable physical and chemical properties stirred their use as alternative solvents in many chemical processes. The recent demonstration of their occurrence in nature might boost their interest in biological sciences. In the search of mechanistic understandings of ionic liquids' ecotoxicological impacts in fungi, we have analyzed the proteome, transcriptome, and metabolome responses to this chemical stress. Data illuminated new hypotheses that altered our research path - exploit ionic liquids as tools for the discovery of pathways and metabolites that may impact fungal development and pathogenicity. As we get closer to solve the primary effects of each ionic liquid family and their specific gene targets, the vision of developing antifungal ionic liquids and/or materials, by taking advantage of elegant progresses in this field, might become a reality. Task-designed formulations may improve the performance of conventional antifungal drugs, build functional coatings for reducing allergens production, or aid in the recovery of antifungal plant polymers. The frontier research in this cross-disciplinary field may provide us unforeseen means to address the global concern of mycotic diseases. Pathogenic and opportunistic fungi are responsible for numerous infections, killing annually nearly 1.5 million immunocompromised individuals worldwide, a similar rate to malaria or tuberculosis. This perspective will review our major findings and current hypotheses, contextualizing how they might bring us closer to efficient strategies to prevent and fight mycotic diseases.

  8. Life-threatening autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura: successful seletive splenic artery embolization

    Directory of Open Access Journals (Sweden)

    matteo molica

    2016-04-01

    Full Text Available Selective splenic artery embolization (SSAE is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP and warm auto-immune hemolytic anemia (AIHA both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy.

  9. Life-Threatening Autoimmune Hemolytic Anemia and Idhiopatic Thrombocytopenic Purpura. Successful Selective Splenic Artery Embolization

    Science.gov (United States)

    Molica, Matteo; Massaro, Fulvio; Annechini, Giorgia; Baldacci, Erminia; D’Elia, Gianna Maria; Rosati, Riccardo; Trisolini, Silvia Maria; Volpicelli, Paola; Foà, Robin; Capria, Saveria

    2016-01-01

    Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy. PMID:27158433

  10. Autologous Peripheral Blood Stem Cell Transplantation in Patients With Life Threatening Autoimmune Diseases

    Science.gov (United States)

    2005-06-23

    Purpura, Schoenlein-Henoch; Graft Versus Host Disease; Anemia, Hemolytic, Autoimmune; Rheumatoid Arthritis; Churg-Strauss Syndrome; Hypersensitivity Vasculitis; Wegener's Granulomatosis; Systemic Lupus Erythematosus; Giant Cell Arteritis; Pure Red Cell Aplasia; Juvenile Rheumatoid Arthritis; Polyarteritis Nodosa; Autoimmune Thrombocytopenic Purpura; Takayasu Arteritis

  11. Emphysematous pyelonephritis: A rare life-threatening complication after extracorporeal shock wave lithotripsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Su Ho; Chung, Dong Jin; Yeo, Dong Myung; Sonh, Dong Wan; Hahn, Sung Tae [Yeouido St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2015-09-15

    Emphysematous pyelonephritis (EPN), caused by extracorporeal shock wave lithotripsy (ESWL), has not been reported in the literature; and the mechanism of this disease is unknown. Although many studies have conjectured about the various causes of EPN, ESWL was not one of them. The patient in this report was a 65-year-old woman with a past medical history of diabetes; the patient underwent an ESWL that caused the EPN. To the best of our knowledge, this is the first report of an EPN case that was caused by ESWL.

  12. Metabolic Syndrome, Chronic Kidney Disease, and Cardiovascular Disease: A Dynamic and Life-Threatening Triad

    Directory of Open Access Journals (Sweden)

    Mário Raimundo

    2011-01-01

    Full Text Available The metabolic syndrome (MS and chronic kidney disease (CKD have both become global public health problems, with increasing social and economic impact due to their high prevalence and remarkable impact on morbidity and mortality. The causality between MS and CKD, and its clinical implications, still does remain not completely understood. Moreover, prophylactic and therapeutic interventions do need to be properly investigated in this field. Herein, we critically review the existing clinical evidence that associates MS with renal disease and cardiovascular disease, as well as the associated pathophysiologic mechanisms and actual treatment options.

  13. [Life threatening postpartal haemorrhage after rupture of the vagina, uterine cervix, caesarean section or hysterectomy].

    Science.gov (United States)

    Kozovski, I; Radoinova, D

    2010-01-01

    The authors discuss 10 cases--seven after vaginal and cervical rupture, 2 after Caesarean section and 1 after hysterectomy. Six of them died--5 after rupture of the vagina and cervix and one after Caesarean section. The lethal issue was avoidable in all cases because it was a result of untimely done or not done at all hysterectomy and other interventions, e.g., ligation of the hypogastric arteries, as well as of faulty surgical performance. Basic principles of surgical behavior in such cases are postulated.

  14. Wing pathology of white-nose syndrome in bats suggests life-threatening disruption of physiology

    Science.gov (United States)

    Cryan, Paul M.; Meteyer, Carol U.; Boyles, Justin G.; Blehert, David S.

    2010-01-01

    White-nose syndrome (WNS) is causing unprecedented declines in several species of North American bats. The characteristic lesions of WNS are caused by the fungus Geomyces destructans, which erodes and replaces the living skin of bats while they hibernate. It is unknown how this infection kills the bats. We review here the unique physiological importance of wings to hibernating bats in relation to the damage caused by G. destructans and propose that mortality is caused by catastrophic disruption of wing-dependent physiological functions. Mechanisms of disease associated with G. destructans seem specific to hibernating bats and are most analogous to disease caused by chytrid fungus in amphibians.

  15. Gastro-tracheal fistula - unusual and life threatening complication after esophagectomy for cancer: a case report

    Directory of Open Access Journals (Sweden)

    Droissart Raphaël

    2009-11-01

    Full Text Available Abstract Background A gastro-tracheal fistula following esophagectomy for cancer is a rare but potentially lethal complication. We report the successful surgical closure after failed endoscopic treatment, of a gastro-tracheal fistula following esophago-gastrectomy for cancer after induction chemo-radiotherapy. Case presentation A 58 year-old male patient presented with a distal third uT3N1 carcinoma of the esophagus. After induction chemo-radiotherapy, he underwent an esophago-gastrectomy with radical lymphadenectomy and reconstruction by gastric pull-up. Immediate postoperative outcome was uneventful. On the 15th postoperative day however, our patient was readmitted in the Intensive Care Unit with severe bilateral basal pneumonia. Three days later a gastro-tracheal fistula was diagnosed upon gastroscopy and bronchoscopy. His good general condition allowed for an endoscopic primary approach which consisted in the insertion of a covered stent in the trachea along with clipping and glueing of the gastric fistular orifice. Two attempts proved unsuccessful. Conclusion After several weeks of conservative measures, surgical re-intervention through a right thoracotomy with transection of the fistula and closure by primary interrupted sutures of both fistular orifices along with intercostal muscle flap interposition led to excellent patient outcome. Oral feeding was started and our patient was discharged.

  16. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies.

    Science.gov (United States)

    Zuidmeer-Jongejan, Laurian; Fernandez-Rivas, Montserrat; Poulsen, Lars K; Neubauer, Angela; Asturias, Juan; Blom, Lars; Boye, Joyce; Bindslev-Jensen, Carsten; Clausen, Michael; Ferrara, Rosa; Garosi, Paula; Huber, Hans; Jensen, Bettina M; Koppelman, Stef; Kowalski, Marek L; Lewandowska-Polak, Anna; Linhart, Birgit; Maillere, Bernard; Mari, Adriano; Martinez, Alberto; Mills, Clare En; Nicoletti, Claudio; Opstelten, Dirk-Jan; Papadopoulos, Nikos G; Portoles, Antonio; Rigby, Neil; Scala, Enrico; Schnoor, Heidi J; Sigurdardottir, Sigurveig T; Stavroulakis, George; Stolz, Frank; Swoboda, Ines; Valenta, Rudolf; van den Hout, Rob; Versteeg, Serge A; Witten, Marianne; van Ree, Ronald

    2012-03-09

    The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1) and lipid transfer protein (Pru p 3), respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models), SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC) clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication.

  17. Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer

    Directory of Open Access Journals (Sweden)

    Chirag Sheth

    2016-09-01

    Full Text Available Acquired factor VIII deficiency (acquired hemophilia A is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII. The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with autoimmune diseases, pregnancy, postpartum period, drugs, and malignancy. Management of this condition begins with attempts to arrest an acute bleed based on the site and severity of bleeding and inhibitor titer. The next priority is eradication of the fVIII antibodies using immunosuppressive therapies. We report the case of a 66-year-old male who presented with spontaneous right thigh hematoma with prolonged activated partial prothrombin time and normal prothrombin time. Mixing studies confirmed the presence of an inhibitor. Further investigation for the underlying etiology of acquired hemophilia A leads to diagnosis of prostate cancer. Treatment consisted of bypassing agents including activated factor VII and activated prothrombin plasma concentrate to arrest the bleeding. Steroids and cyclophosphamide were added to suppress the fVIII inhibitors. Concomitant treatment of locally advanced prostate cancer with chemotherapy confirmed the eradication of the inhibitors. To our knowledge, this is the first reported case of prostate cancer diagnosed and treated simultaneously with acquired hemophilia A resulting in favorable patient outcome.

  18. PTU-induced ANCA-positive vasculitis: an innocent or a life-threatening adverse effect?

    Science.gov (United States)

    Bilge, N Sule Yaşar; Kaşifoğlu, Timuçin; Korkmaz, Cengiz

    2013-01-01

    Antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitides are rare, but they can be triggered by chemicals, infections and drugs; among them, antithyroid drugs are common. Autoimmune disorders, such as vasculitis, are unusual, but serious complications of antithyroid therapy. Both propylthiouracil (PTU) and methimazole may induce ANCA-associated vasculitis. PTU-induced vasculitides may have different organ involvement patterns. Herein, we report four cases with ANCA-associated vasculitis with different clinical manifestations.

  19. The Life Threatened Child and the Life Enhancing Clown: Towards a Model of Therapeutic Clowning

    Directory of Open Access Journals (Sweden)

    Donna Koller

    2008-01-01

    Full Text Available In the last decade, there has been a rapid growth in the presence of clowns in hospitals, particularly in pediatric settings. The proliferation of clowns in health care settings has resulted in varying levels of professionalism and accountability. For this reason, there is a need to examine various forms of clowning, in particular therapeutic clowning in pediatric settings. The purpose of this article is to address what therapeutic clowning is and to describe the extent to which it can provide a complementary form of health care. In an attempt to apply theory to practice, the article will draw upon the experiences of a therapeutic clown within a pediatric setting while providing a historical and theoretical account of how clowns came to be in hospitals. Toward this end, a proposed model of therapeutic clowning will be offered which can be adapted for a variety of settings where children require specialized forms of play in order to enhance their coping, development and adjustment to life changes. Finally, current research on clowning in children's hospitals will be reviewed including a summary of findings from surveys administered at the Hospital for Sick Children.

  20. The life threatened child and the life enhancing clown: towards a model of therapeutic clowning.

    Science.gov (United States)

    Koller, Donna; Gryski, Camilla

    2008-03-01

    In the last decade, there has been a rapid growth in the presence of clowns in hospitals, particularly in pediatric settings. The proliferation of clowns in health care settings has resulted in varying levels of professionalism and accountability. For this reason, there is a need to examine various forms of clowning, in particular therapeutic clowning in pediatric settings. The purpose of this article is to address what therapeutic clowning is and to describe the extent to which it can provide a complementary form of health care. In an attempt to apply theory to practice, the article will draw upon the experiences of a therapeutic clown within a pediatric setting while providing a historical and theoretical account of how clowns came to be in hospitals. Toward this end, a proposed model of therapeutic clowning will be offered which can be adapted for a variety of settings where children require specialized forms of play in order to enhance their coping, development and adjustment to life changes. Finally, current research on clowning in children's hospitals will be reviewed including a summary of findings from surveys administered at the Hospital for Sick Children.

  1. Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient

    Directory of Open Access Journals (Sweden)

    Ashraf F. Hefny

    2015-01-01

    Conclusion: Bleeding into the subcutaneous plane in closed degloving injury can cause severe hypovolemic shock. It is important for the clinicians managing trauma patients to be aware this serious injury.

  2. Life-threatening hypokalaemia and quadriparesis in a patient with ureterosigmoidostomy

    NARCIS (Netherlands)

    J.W. van Bekkum; D.J. Bac (Dirk Jan); I.E. Nienhuis; A. Dees; P.W. de Leeuw (Peter)

    2002-01-01

    textabstractWe report quadriparesis as a result of severe hypokalaemia and acidosis in a 50-year-old man who had undergone ureterosigmoidostomy for bladder extrophy 48 years earlier. Aggressive suppletion with intravenous potassium and bicarbonate combined with potassium-sparing di

  3. Peritoneal adhesion: it can be life-threatening, and life-saving

    Directory of Open Access Journals (Sweden)

    Huang Jiun-Chi

    2012-09-01

    Full Text Available Abstract Background The inevitable post-inflammatory fibrosis and adhesion often compromises future treatment in peritoneal dialysis patients. Here, we describe a patient who experienced an unusual form of peritoneal adhesion that made her give up peritoneal dialysis. However, its unique pattern also saved her from infection caused by bowel perforation. Case presentation The female patient discontinued peritoneal dialysis due to gradual dialysis inadequacy. Two months after shifting to hemodialysis with generally improved sense of well-being and no sign of abdominal illness, she was admitted to remove the Tenckhoff catheter. The procedure was smooth, but fever and abdominal pain not at the site of operation developed the next day. Abdominal ultrasound showed the presence of ascites and aspiration revealed slimy, green-yellowish pus that gave a negative result on bacterial culture. Abdominal computed tomography (CT with oral contrast medium was performed, but failed to demonstrate the suspected bowel perforation. The examination, however, did show accumulation of pus inside the abdomen but outside the peritoneal cavity. We drained the pus with two 14-F Pig-tail catheters and the total amount of drainage approached 4000 ml. The second CT was performed with double dose of the contrast medium and found a leak of the contrast from the jejunum. She then received laparotomy and had the perforation site closed. Conclusions In summary, this uremic patient suffered from pus accumulation inside her abdomen without obvious systemic toxic effect. The bowel perforation and pus formation might be caused by repeated peritonitis, but the peritoneal adhesion itself might also isolate her peritoneal cavity from the anticipated toxic injuries of bowel perforation.

  4. Life threatening pulmonary embolus in a factor V Leiden carrier on oral contraceptives: a case report.

    Science.gov (United States)

    Saif, M W; Volpe, B T; Dailey, M; Tsongalis, G J

    1997-06-01

    Venous thromboembolism is a serious, potentially lethal health problem affecting one per 1,000 people annually. Major surgery, the use of oral contraceptives, complicated pregnancy, fractures, and immobilization increase the risk of thrombosis. In addition to these factors, thrombosis is associated with inherited deficiencies of antithrombin III, protein C, and protein S. Together these do not account for more than five to 10% of the cases. Hereditary activated protein C resistance has been recognized as a basis for a majority of cases of familial thrombosis. It accounted for more than a 10 times higher number than that of other known genetic defects. We describe a case of a young female who presented with a pulmonary embolism and was discovered to have activated protein C resistance. This patient had a heterozygous mutation for factor V Leiden and was taking oral contraceptives. This report underlines: 1) increased risk of venous thrombosis in oral contraceptive users who carry factor V Leiden mutation associated with functional resistance to the normal anticoagulation activities of protein C; 2) most episodes occurring in the young are minor, but pulmonary embolus can occur; 3) the importance of identifying other affected members of the family; and 4) the importance of anticoagulation prophylaxis at times of enhanced risk, particularly during pregnancy, postpartum, and major surgery.

  5. Benzocaine-induced methaemoglobinaemia: a life-threatening complication after a transoesophageal echocardiogram (TEE).

    Science.gov (United States)

    Aryal, Madan Raj; Gupta, Shobhit; Giri, Smith; Fraga, Julian Diaz

    2013-09-16

    Acquired methaemoglobinaemia is a potentially fatal impairment in oxygen delivery if not recognised early and treated appropriately. Benzocaine used as an anaesthetic for endoscopic procedures is an uncommon but clinically important precipitant of acquired methaemoglobinaemia. We present a case of an elderly woman who developed perioral cyanosis and desaturation 20 min after a transoesophageal echocardiogram. Further evaluation led to the diagnosis of benzocaine-induced methaemoglobinaemia and timely treatment with intravenous methylene blue was initiated.

  6. The Life Threatened Child and the Life Enhancing Clown: Towards a Model of Therapeutic Clowning

    OpenAIRE

    Donna Koller; Camilla Gryski

    2007-01-01

    In the last decade, there has been a rapid growth in the presence of clowns in hospitals, particularly in pediatric settings. The proliferation of clowns in health care settings has resulted in varying levels of professionalism and accountability. For this reason, there is a need to examine various forms of clowning, in particular therapeutic clowning in pediatric settings. The purpose of this article is to address what therapeutic clowning is and to describe the extent to which it can provid...

  7. Development of an Educational Packet for Persons with Life-Threatening Food Allergies

    Science.gov (United States)

    Olson, Bradley F.; Teuber, Suzanne; Bruhn, Christine M.

    2009-01-01

    Previous studies have shown that those with severe food allergies have significant gaps in knowledge about their disease and how to prevent recurrences. The purpose of this study was to address these deficiencies by creating and testing an educational packet, "Coping with Food Allergies." Participants included 46 of 58 adults with documented…

  8. Life-Threatening Cardiac Tamponade Secondary to Chylopericardium Following Orthotopic Heart Transplantation-A Case Report.

    Science.gov (United States)

    Wierzbicki, Karol; Mazur, Piotr; Węgrzyn, Piotr; Kapelak, Bogusław

    2016-08-23

    Chylopericardium is a rare complication in cardiac surgery, and an extremely rare occurrence in patients following orthotopic heart transplantation (OHT), which, however, can lead to cardiac tamponade. Here we present a case of a 59-year-old man who underwent OHT and suffered from chylopericardium resulting in cardiac tamponade late in the postoperative course, despite the initially uneventful early postoperative period (decreasing blood drainage was observed directly after the procedure, and the drains were safely removed). After the diagnosis of chylopericardium was made, the conservative treatment was initiated, which turned out to be insufficient, and eventually invasive approach for the recurrence of tamponade secondary to chylopericardium was required. We discuss the available therapeutic options for chylopericardium and demonstrate the successful invasive therapeutic approach with use of the absorbable fibrin sealant patch.

  9. Late Onset Ipilimumab-Induced Pericarditis and Pericardial Effusion: A Rare but Life Threatening Complication

    Directory of Open Access Journals (Sweden)

    Seongseok Yun

    2015-01-01

    Full Text Available Metastatic cutaneous melanoma has poor prognosis with 2-year survival rate of 10–20%. Melanoma cells express various antigens including gp100, melanoma antigen recognized by T cells 1 (MART-1, and tyrosinase, which can induce immune-mediated anticancer response via T cell activation. Cytotoxic T-lymphocyte associated antigen-4 (CTLA-4 is an immune check point molecule that negatively regulates T cell activation and proliferation. Accordingly, recent phase III clinical trials demonstrated significant survival benefit with ipilimumab, a human monoclonal antibody (IgG1 that blocks the interaction of CTLA-4 with its ligands. Since the efficacy of ipilimumab depends on T cell activation, it is associated with substantial risk of immune mediated adverse reactions such as colitis, hepatitis, thyroiditis, and hypophysitis. We report the first case of late onset pericarditis and cardiac tamponade associated with ipilimumab treatment in patient with metastatic cutaneous melanoma.

  10. A Rare And Life Threatening Complication Of Percutaneously Inserted Central Venous Catheters: Cardiac Tamponade.

    Directory of Open Access Journals (Sweden)

    seyma Kayali

    2016-09-01

    Full Text Available Percutaneously inserted central venous catheters are commonly used to provide parenteral nutrition for premature neonates. This study presents report of two preterm neonates who developed pericardial effusion resulting from osmotic damage of parenteral nutrition. When a neonate with percutaneously inserted central venous catheter clinical status worsens a high index of clinical suspicion for diagnosing pericardial effusion and immediate treatment might be life saving. [J Contemp Med 2016; 6(3.000: 226-230

  11. Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage

    Science.gov (United States)

    Powell, Kristin

    2017-01-01

    Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy. Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding. Pathology was consistent with intraoperative findings. She required transfusion of numerous blood products perioperatively. Her postoperative course was uncomplicated. Conclusion. It is rare for a uterine fibroid to spontaneously rupture. However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management. PMID:28127487

  12. Life-Threatening Hypernatremia In A Case Of Diabetes Insipidus/Panhypopituitarism

    OpenAIRE

    Ekamol Tantisattamo; Thomas B. Francis

    2012-01-01

    Management of diabetes insipidus (DI) accompanied by panhypopituitarism requires understanding of the relationships between ADH and thyroid/glucocorticoid tone. Low thyroid/glucocorticoid tone decreases free water clearance which protects against DI and may lead to hyponatremia while high thyroid/glucocorticoid tone may unmask DI and facilitate hypernatremia. A 31 year-old man with DI/panhypopituitarism was stable until his levothyroxine was incorrectly lowered based on TSH levels. He beca...

  13. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Science.gov (United States)

    2012-01-01

    The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1) and lipid transfer protein (Pru p 3), respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models), SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC) clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication. PMID:22409908

  14. Life-threatening haematological complication occurring in a cat after chronic carbimazole administration

    Directory of Open Access Journals (Sweden)

    Andrea Mosca

    2016-09-01

    Full Text Available Case summary An 11-year-old spayed female domestic shorthair cat with a history of hyperthyroidism treated with carbimazole for 7 months was presented for a check-up after a few episodes of vomiting. The cat had been receiving prednisolone at 0.5 mg/kg PO q12h for recent pancreatitis and concurrent inflammation of liver and small intestines confirmed by biopsies. Clinical examination revealed pale mucous membranes with a capillary refill time of 120 s and fibrinogen serum concentration (3.5 g/l. Morphological changes of thrombocytes in the absence of thrombocytopenia were also noted. In-saline agglutination test was positive. Abdominal radiographic and ultrasonographic examinations excluded the presence of organ abnormalities and peritoneal effusion. Blood biochemistry was unremarkable. Feline leukaemia virus and feline immunodeficiency virus tests were negative. On the basis of these findings, immune-mediated anaemia secondary to chronic carbimazole administration was suspected. Prednisolone was increased to 2 mg/kg PO q24h and carbimazole tablets were stopped. Despite close monitoring and intensive care, the cat died the same evening of admission to the hospital. Relevance and novel information This report suggests that severe haemotoxicity may occur as a sequel of chronic carbimazole administration in cats. Routine bloodwork and accurate follow-up of cats under treatment with thyrotoxic therapy may be advisable, in order to detect haematological changes before lethal complications occur.

  15. [The handling of acute life-threatening choking in geriatric and nursing home patients].

    Science.gov (United States)

    van Poelgeest, A; Melis, R J F; Ritmeijer, C; Olde Rikkert, M G M

    2006-09-01

    It is unknown how often choking occurs in geriatric wards and in nursing homes and what the treatment and outcomes are in regular practice. A questionnaire was sent to Dutch geriatricians (N = 130), nursing home physicians (N = 130), and trainees for these disciplines (N = 215), in order to gain information about the experience, practice and competence of physicians in choking in geriatric and nursing home patients. We also analysed to what extent geriatric and nursing home wards were prepared for accurate handling of choking. The response rate was 30%. More than half of the responders had experienced an episode of food choking at least once in the past five years. The mortality rate in the reported cases was high (30%). The majority of the patients who died of choking had not received the Heimlich-manoeuvre. Physicians who had attended resuscitation training long ago felt as competent to manage a choking episode as physicians that had recently attended resuscitation training. Of all geriatric wards and nursing homes, the majority lacked a guideline on how to handle in acute food choking. Geriatric wards and nursing homes do not seem to be well prepared for acute food choking in several aspects. Despite methodological shortcomings of this study, the results underline the necessity of clarification of the terms used, and development and implementation of guidelines for this important problem.

  16. [The handling of acute life-threatening choking in geriatric and nursing home patients

    NARCIS (Netherlands)

    Poelgeest, A. van; Melis, R.J.F.; Ritmeijer, C.; Olde Rikkert, M.G.M.

    2006-01-01

    It is unknown how often choking occurs in geriatric wards and in nursing homes and what the treatment and outcomes are in regular practice. A questionnaire was sent to Dutch geriatricians (N = 130), nursing home physicians (N = 130), and trainees for these disciplines (N = 215), in order to gain inf

  17. Life-threatening hemorrhage from acquired hemophilia A as a presenting manifestation of prostate cancer

    Science.gov (United States)

    Sheth, Chirag; Gill, Amandeep; Sekhon, Sumeet

    2016-01-01

    Acquired factor VIII deficiency (acquired hemophilia A) is a rare condition characterized by the acquisition of autoantibodies that affect the clotting activity of factor VIII (fVIII). The most common manifestation in affected patients is a hemorrhagic diathesis. This disorder is associated with autoimmune diseases, pregnancy, postpartum period, drugs, and malignancy. Management of this condition begins with attempts to arrest an acute bleed based on the site and severity of bleeding and inhibitor titer. The next priority is eradication of the fVIII antibodies using immunosuppressive therapies. We report the case of a 66-year-old male who presented with spontaneous right thigh hematoma with prolonged activated partial prothrombin time and normal prothrombin time. Mixing studies confirmed the presence of an inhibitor. Further investigation for the underlying etiology of acquired hemophilia A leads to diagnosis of prostate cancer. Treatment consisted of bypassing agents including activated factor VII and activated prothrombin plasma concentrate to arrest the bleeding. Steroids and cyclophosphamide were added to suppress the fVIII inhibitors. Concomitant treatment of locally advanced prostate cancer with chemotherapy confirmed the eradication of the inhibitors. To our knowledge, this is the first reported case of prostate cancer diagnosed and treated simultaneously with acquired hemophilia A resulting in favorable patient outcome. PMID:27609734

  18. Wing pathology of white-nose syndrome in bats suggests life-threatening disruption of physiology

    Science.gov (United States)

    Cryan, P.M.; Meteyer, C.U.; Boyles, J.G.; Blehert, D.S.

    2010-01-01

    White-nose syndrome (WNS) is causing unprecedented declines in several species of North American bats. The characteristic lesions of WNS are caused by the fungus Geomyces destructans, which erodes and replaces the living skin of bats while they hibernate. It is unknown how this infection kills the bats. We review here the unique physiological importance of wings to hibernating bats in relation to the damage caused by G. destructans and propose that mortality is caused by catastrophic disruption of wing-dependent physiological functions. Mechanisms of disease associated with G. destructans seem specific to hibernating bats and are most analogous to disease caused by chytrid fungus in amphibians. ?? 2010 Cryan et al; licensee BioMed Central Ltd.

  19. Oropharyngeal dysphagia as dominant and life-threatening symptom in dermatomyositis

    Directory of Open Access Journals (Sweden)

    Đaković Zorana

    2009-01-01

    Full Text Available Background. Dysphagia can be a serious problem in patients with inflammatory myopathies. It may be associated with nutritional deficit, aspiration pneumonia, and poor prognosis. Case report. We presented a 60-year-old male, suffering from difficulty in swallowing, pain and weaknes in the proximal parts of his extremities, and skin manifestation. Laboratory findings showed increased creatine kinase and aldolase. Antinuclear antibodies to HEP-2 subtrate revealed titer of 1:40. Electromyoneurography demonstrated evidence of a proximal myopathy. A muscle biopsy revealed myositis. The baruim swallow test was remarkable for regurgitation, and nasal emerging of barium. Nuclear magnetic resonance images of cranium was normal. Tumor markers CEA, and Ca 19-9 were increased. A dose of 1 mg daily prednisolone was administered and percutaneous enteral feeding was performed. Two months later, the patient developed febrile state, aspiration pneumonia, and died due to respiratory failure. Conclusion. In cases of dermatomyositis with the serious dysphagia, percutaneous endoscopic gastrostomy should be performed as soon as possible. Owerall survival rate is low, even with an adequate therapy administration. Inflammatory myopathies should be considered in any patient with oropharyngeal dysphagia.

  20. Autoethnography: reflective journaling and meditation to cope with life-threatening breast cancer.

    Science.gov (United States)

    Sealy, Patricia Ann

    2012-02-01

    Autoethnography is a qualitative research approach whereby the researcher shares personal stories that relate to the broader cultural context. Living through breast cancer showed me how reflective journaling and meditation can help one to cope with locally advanced breast cancer. The purpose of this autoethnography is to assist nurses in gaining a greater understanding of the primary cultural implications of (a) unresolved emotional issues from the past complicating current treatment and recovery for locally advanced breast cancer, and that (b) reflective journaling and meditation can provide an opportunity to "socially reconstruct" past psychological injury. In this example of autoethnography, I reconstructed the past by re-experiencing childhood wounds through meditation, accompanied by myself in the role of the nurturing mother providing comfort and support to the wounded inner child. That approach affirmed me in my current mothering role and provided imagery of the comfort that I was lacking in my childhood. Such duality empowered me toward self-acceptance and self-worth. Loss, grief, fear, and anxiety are considered universal states and emotions that interfere with quality of life. Finding meaning in suffering can heal pain and free energy for the pursuit of justice, peace, and joy.

  1. A Rare Cause of Chronic Life Threatening Bleeding in a Girl: The Ulcerated Blind Loops.

    Science.gov (United States)

    Sawant, Abhijeet D; Shah, Rasik; Shah, Nitin; Gupta, Tarun

    2016-01-01

    Ulceration in a blind loop can lead to massive gastrointestinal tract (GIT) bleeding. A 13-year old girl presented with symptomatic melena requiring repeated blood transfusion since childhood. She was an operated case of small bowel atresia in neonatal life. Her upper and lower gastrointestinal endoscopies were normal. Operation showed presence of multiple ulcers in two blind loops (parts of previous side to side anastomosis) and at the anastomotic site. She underwent resection and end-to-end anastomosis of the small bowel leading to complete resolution of melena and anemia.

  2. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Directory of Open Access Journals (Sweden)

    Zuidmeer-Jongejan Laurian

    2012-03-01

    Full Text Available Abstract The FAST project (Food Allergy Specific Immunotherapy aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT, using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1 and lipid transfer protein (Pru p 3, respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models, SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication.

  3. Non-Life Threatening Maternal Morbidity: Cross Sectional Surveys from Malawi and Pakistan.

    Directory of Open Access Journals (Sweden)

    Shamsa Zafar

    Full Text Available For more accurate estimation of the global burden of pregnancy associated disease, clarity is needed on definition and assessment of non-severe maternal morbidity. Our study aimed to define maternal morbidity with clear criteria for identification at primary care level and estimate the distribution of and evaluate associations between physical (infective and non-infective and psychological morbidities in two different low-income countries.Cross sectional study with assessment of morbidity in early pregnancy (34%, late pregnancy (35% and the postnatal period (31% among 3459 women from two rural communities in Pakistan (1727 and Malawi (1732. Trained health care providers at primary care level used semi-structured questionnaires documenting signs and symptoms, clinical examination and laboratory tests which were bundled to reflect infectious, non-infectious and psychological morbidity.One in 10 women in Malawi and 1 in 5 in Pakistan reported a previous pregnancy complication with 1 in 10 overall reporting a previous neonatal death or stillbirth. In the index pregnancy, 50.1% of women in Malawi and 53% in Pakistan were assessed to have at least one morbidity (infective or non-infective. Both infective (Pakistan and non-infective morbidity (Pakistan and Malawi was lower in the postnatal period than during pregnancy. Multiple morbidities were uncommon ( 9. Complications during a previous pregnancy, infective morbidity (p <0.001, intra or postpartum haemorrhage (p <0.02 were associated with psychological morbidity in both settings.Our findings highlight the need to strengthen the availability and quality of antenatal and postnatal care packages. We propose to adapt and improve the framework and criteria used in this study, ensuring a basic set of diagnostic tests is available, to ensure more robust assessment of non-severe maternal morbidity.

  4. Arterial embolization for iatrogenic life-threatening bleeding from subcutaneous hypervascular tumor in prone position

    Institute of Scientific and Technical Information of China (English)

    Seiji Morita; Tomoatsu Tsuji; Toru Sawamoto; Hiromichi Aoki; Naoya Miura; Hiroyuki Otsuka; Sadaki Inokuchi

    2010-01-01

    Performing angiography in the prone position is a difficult technique; however it is useful in some emergency situation. We experienced a 60 years old male who was performed lipoma excision on his back in his family doctor's clinic. Since massive arterial bleeding could not be controlled with manual astriction, he transferred to our hospital in prone position with hemodynamic instability. Operating field was not kept because of massive bleeding; there-fore surgical treatment was impossible. We planed emer-gency arterial embolization (AE) in prone position. Hence we chose the left radial artery for vascular access. The left subclavicle arteriography showed many major and minor feeding arteries from left subclavicular and axillary arteries and a massive extravasation of the contrast medium. Three major feeding arteries were performed AE with gelatin sponge and steel coils. After AE, massive bleeding was controlled.He could discharge from our hospital on the 5th hospital day without any complication. Arterial embolization for lifethreatening bleeding from subcutaneous hypervascular tumor in the prone position is first report to our knowledge,and it is extremely rare. However we thought that this tech-nique is useful for patients who could not turn in the supine position, e.g. massive bleeding during renal biopsy and penetrating trauma from back.

  5. Sexuality and Life-Threatening Illness: Implications for Social Work and Palliative Care

    Science.gov (United States)

    Cagle, John G.; Bolte, Sage

    2009-01-01

    Social workers in hospice and palliative care settings have been charged with the responsibility of addressing sexuality with their patients and families. However, little direction has been offered as to how to approach this difficult subject within the context of palliative care. This article provides a critical analysis of the previous…

  6. A case of traumatic intracranial vertebral artery injury presenting with life-threatening symptoms

    Directory of Open Access Journals (Sweden)

    Kishi S

    2012-04-01

    Full Text Available Seiji Kishi1, Kenji Kanaji2, Toshio Doi1, Tadashi Matsumura21Department of Nephrology, Tokushima University Hospital, Kuramoto-cho Tokushima, 2Department of General Internal Medicine, Rakuwakai Otowa Hospital, Otowachinji-cho Yamashina-ku Kyoto, JapanAbstract: Traumatic intracranial vertebral artery injury is a relatively rare but potentially fatal disease. We present a case of a 63-year-old man who presented with sudden onset of loss of consciousness after hitting his head. After immediate resuscitation, he showed quadriplegia and absence of spontaneous breathing. Brain and cervical spine magnetic resonance imaging revealed an atlantoaxial subluxation, fractured C2 odontoid process, left vertebral artery occlusion, and bilateral extensive ischemia in the medulla oblongata and high cervical spinal cord. Digital subtraction angiography demonstrated left vertebral artery dissection just below the level of vertebral body C2.Keywords: vertebral artery dissection, brainstem infarction, bilateral spinal cord infarction, neck trauma

  7. A life-threatening infective pseudoaneurysm of the left ventricle in a toddler

    Directory of Open Access Journals (Sweden)

    Mani Ram Krishna

    2015-01-01

    Full Text Available Pseudoaneurysms of the ventricle are an uncommon occurrence in children. They may be secondary to previous cardiac surgery or infection of the pericardial space. Infective pseudoaneurysms require urgent surgery because rupture of the pseudoaneurysm may have catastrophic consequences. The outcome with surgery is excellent. We report a toddler with ruptured pseudoaneurysm secondary to purulent pericarditis who recovered with an emergency surgical closure of the opening of the pseudo-aneurysm.

  8. Life threatening deep scald burns in a neonate: A rare case report

    Directory of Open Access Journals (Sweden)

    Vijay Y Bhatia

    2013-01-01

    Full Text Available Domestic burns in neonate are rare in literature. Neonates are high risk for burns because of their thin and fragile skin, fluid overload or dehydration as the fluid balance range is small and immature immune system leading to septicaemia. Neonates are not small adults, owing to their different physiological response makes the management of neonates challenging as the clinical signs are different from the adults and the resuscitation protocols or end points are also different. We present a case of 11 days old neonate, who sustained 51% scald burns when the hot water bag being used by her mother accidentally burst, the youngest reported case of domestic scald burns with such high percentage. The baby was managed by fluid resuscitation, antibiotics, dressings, ventilatory support for septicaemia and subsequently homograft application. The neonate was discharged with completely healed areas after 35 days of burns and is on regular follow up and no complications have been observed.

  9. Massive and life-threatening upper gastrointestinal bleeding due to invasive hepatocellular carcinoma: A case report

    Directory of Open Access Journals (Sweden)

    Semih Hot, M.D.

    2016-01-01

    Conclusions: The incidence of patients with massive bleeding due to gastric invasion of HCC is low, and only a few cases have been reported in the literature. Our purpose while presenting this rare case is to increase the awareness about the issue.

  10. Life-threatening ACE inhibitor-induced angio-oedema successfully treated with icatibant

    DEFF Research Database (Denmark)

    Ostenfeld, Sarah; Bygum, Anette; Rasmussen, Eva Rye

    2015-01-01

    We present a case of a 75-year-old woman treated with an ACE inhibitor, who presented with angio-oedema of the tongue and had difficulty speaking. No symptoms of anaphylaxis or urticaria were present. The patient was treated intravenously with antihistamine and glucocorticoid in combination with ...... of choice instead of antiallergic medications, which have no proven efficacy in this condition....

  11. A critical evaluation of reports associating ayahuasca with life-threatening adverse reactions.

    Science.gov (United States)

    dos Santos, Rafael Guimarāes

    2013-01-01

    Ayahuasca is a botanical hallucinogenic preparation traditionally consumed by Northwestern Amazonian indigenous groups. Scientific evidence suggests good tolerability after acute administration of ayahuasca and also after years or even decades of its ritual consumption. Nevertheless, some scientific and media reports associate ayahuasca or some of its alkaloids with severe intoxications. The purpose of the present text is to do a critical evaluation of these reports. The evaluation of the cases highlights the fact that some lack accurate forensic/toxicological information, while others are not directly relevant to traditional ayahuasca preparations. These limitations reduce the possibility of an accurate risk assessment, which could indicate potential contraindications and susceptibilities for ayahuasca consumption. Nevertheless, even with these limitations, the cases suggest that previous cardiac and hepatic pathologies and current use of serotonergic drugs/medications are contraindications to ayahuasca use, and that caution should be taken when using different botanical species and extracted/synthetic alkaloids to prepare ayahuasca analogues.

  12. Involvement of the aorta in brucellosis: the forgotten, life-threatening complication. A systematic review.

    Science.gov (United States)

    Cascio, Antonio; De Caridi, Giovanni; Lentini, Salvatore; Benedetto, Filippo; Stilo, Francesco; Passari, Gabriele; Iaria, Chiara; Spinelli, Francesco; Pappas, Georgios

    2012-10-01

    Human brucellosis is a disease of protean manifestations, and has been implicated in complications and focal disease in many human organ systems. However, little is collectively known about the background, the course, the clinical characteristics, the diagnostic issues raised, and the short- and long-term therapeutic approaches in patients with aortic involvement as a complication of brucellosis. With the aim to glean from the literature useful information to better understand and manage this complication, a computerized search without language restriction was conducted using PubMed and SCOPUS. An article was considered eligible for inclusion in the systematic review if it reported data on patients with involvement of the aorta due to a Brucella infection. The epidemiologic and clinical characteristics of 44 cases of brucellar aortic involvement found through the systematic review of the literature were analyzed together with those of two new cases that we treated in the recent past. This complication involved the ascending thoracic aorta in 18 cases (in 16 of them as a consequence of brucellar endocarditis), and the descending thoracic aorta or the abdominal aorta in the remaining 30 cases. In the latter it was associated with spondylodiscitis of the lumbar spine in 13 cases. History of or symptoms indicative of brucellosis were not universally present. Brucellar aortic involvement represents a possibly underdiagnosed and underreported complication with major morbidity and mortality potential. Experience with novel invasive therapeutic approaches remains limited. Early suspicion through detailed history and diagnosis, aided by advances in aortic imaging, would allow for better planning of therapeutic interventions.

  13. Common adder bite to the tongue causing life threatening toxicity from airway compromise

    DEFF Research Database (Denmark)

    Hoegberg, Lotte C G; Jessen, Casper L; Lambertsen, Karin;

    2010-01-01

    We illustrate the acute phase and development of symptoms in a 24-year-old man following a European Common Viper bite to the tongue.......We illustrate the acute phase and development of symptoms in a 24-year-old man following a European Common Viper bite to the tongue....

  14. Contribution of chlorophyll fluorescence to the apparent vegetation reflectance

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, P.K. Entcheva [Joint Center for Earth Systems Technology, UMBC, Baltimore, MD 21228 (United States); Biospheric Sciences Branch, Hydrospheric and Biospheric Sciences Laboratory, NASA/GSFC, Greenbelt, MD 20771 (United States)], E-mail: pcampbel@pop900.gsfc.nasa.gov; Middleton, E.M. [Biospheric Sciences Branch, Hydrospheric and Biospheric Sciences Laboratory, NASA/GSFC, Greenbelt, MD 20771 (United States); Corp, L.A. [Biospheric Sciences Branch, Hydrospheric and Biospheric Sciences Laboratory, NASA/GSFC, Greenbelt, MD 20771 (United States); Agricultural Research Service, USDA, Beltsville, MD 20705 (United States); Kim, M.S. [Agricultural Research Service, USDA, Beltsville, MD 20705 (United States)

    2008-10-15

    Current strategies for monitoring the physiologic status of terrestrial vegetation rely on remote sensing reflectance data, which provide estimates of vigor based primarily on chlorophyll content. Chlorophyll fluorescence (ChlF) measurements offer a non-destructive alternative and a more direct approach for diagnosis of vegetation stress before a significant reduction in chlorophyll content has occurred. Thus, technology based on ChlF may allow more accurate carbon sequestration estimates and earlier stress detection than is possible when using reflectance data alone. However, the observed apparent vegetation reflectance (Ra) in reality includes contributions from both the reflected and fluoresced radiation. The aim of this study is to determine the relative contributions of reflectance and ChlF fractions to Ra in the red to near-infrared region (650-800 nm) of the spectrum. The practical objectives of the study are to: 1) evaluate the relationship between ChlF and reflectance at the foliar level for corn, soybean and maple; and 2) for corn, determine if the relationship established for healthy vegetation changes under nitrogen (N) deficiency. To obtain generally applicable results, experimental measurements were conducted on unrelated crop and tree species (corn, soybean and maple) under controlled conditions and a gradient of inorganic N fertilization levels. Optical reflectance spectra and actively induced ChlF emissions were collected on the same foliar samples, in conjunction with measurements of photosynthetic function, pigment levels, and carbon (C) and N content. The spectral trends were examined for similarities. On average, 10-20% of Ra at 685 nm was actually due to ChlF. The spectral trends in steady state and maximum fluorescence varied significantly, with steady state fluorescence (especially red, 685 nm) showing higher ability for species and treatment separation. The relative contribution of ChlF to Ra varied significantly among species, with maple

  15. Episodes, events, and models

    Directory of Open Access Journals (Sweden)

    Sangeet eKhemlani

    2015-10-01

    Full Text Available We describe a novel computational theory of how individuals segment perceptual information into representations of events. The theory is inspired by recent findings in the cognitive science and cognitive neuroscience of event segmentation. In line with recent theories, it holds that online event segmentation is automatic, and that event segmentation yields mental simulations of events. But it posits two novel principles as well: first, discrete episodic markers track perceptual and conceptual changes, and can be retrieved to construct event models. Second, the process of retrieving and reconstructing those episodic markers is constrained and prioritized. We describe a computational implementation of the theory, as well as a robotic extension of the theory that demonstrates the processes of online event segmentation and event model construction. The theory is the first unified computational account of event segmentation and temporal inference. We conclude by demonstrating now neuroimaging data can constrain and inspire the construction of process-level theories of human reasoning.

  16. The global event system

    Energy Technology Data Exchange (ETDEWEB)

    Winans, J.

    1994-03-02

    The support for the global event system has been designed to allow an application developer to control the APS event generator and receiver boards. This is done by the use of four new record types. These records are customized and are only supported by the device support modules for the APS event generator and receiver boards. The use of the global event system and its associated records should not be confused with the vanilla EPICS events and the associated event records. They are very different.

  17. Fair sampling perspective on an apparent violation of duality

    Science.gov (United States)

    Bolduc, Eliot; Leach, Jonathan; Miatto, Filippo M.; Leuchs, Gerd; Boyd, Robert W.

    2014-01-01

    In the event in which a quantum mechanical particle can pass from an initial state to a final state along two possible paths, the duality principle states that “the simultaneous observation of wave and particle behavior is prohibited” [Scully MO, Englert B-G, Walther H (1991) Nature 351:111–116]. Whereas wave behavior is associated with the observation of interference fringes, particle behavior generally corresponds to the acquisition of which-path information by means of coupling the paths to a measuring device or part of their environment. In this paper, we show how the consequences of duality change when allowing for biased sampling, that is, postselected measurements on specific degrees of freedom of the environment of the two-path state. Our work gives insight into a possible mechanism for obtaining simultaneous high which-path information and high-visibility fringes in a single experiment. Further, our results introduce previously unidentified avenues for experimental tests of duality. PMID:25114237

  18. Real causes of apparent abnormal results in heavy ion reactions

    Directory of Open Access Journals (Sweden)

    Mandaglio G.

    2015-01-01

    Full Text Available We study the effect of the static characteristics of nuclei and dynamics of the nucleus-nucleus interaction in the capture stage of reaction, in the competition between quasifission and complete fusion processes, as well as the angular momentum dependence of the competition between fission and evaporation processes along the de-excitation cascade of the compound nucleus. The results calculated for the mass-asymmetric and less mass-asymmetric reactions in the entrance channel are analyzed in order to investigate the role of the dynamical effects on the yields of the evaporation residue nuclei. We also discuss about uncertainties at the extraction of such relevant physical quantities as Γn/Γtot ratio or also excitation functions from the experimental results due to the not always realistic assumptions in the treatment and analysis of the detected events. This procedure can lead to large ambiguity when the complete fusion process is strongly hindered or when the fast fission contribution is large. We emphasize that a refined multiparameter model of the reaction dynamics as well as a more detailed and checked data analysis are strongly needed in heavy-ion collisions.

  19. Event dependent sampling of recurrent events

    DEFF Research Database (Denmark)

    Kvist, Tine Kajsa; Andersen, Per Kragh; Angst, Jules

    2010-01-01

    The effect of event-dependent sampling of processes consisting of recurrent events is investigated when analyzing whether the risk of recurrence increases with event count. We study the situation where processes are selected for study if an event occurs in a certain selection interval. Motivation...... retrospective and prospective disease course histories are used. We examine two methods to correct for the selection depending on which data are used in the analysis. In the first case, the conditional distribution of the process given the pre-selection history is determined. In the second case, an inverse......-probability-of-selection weighting scheme is suggested. The ability of the methods to correct for the bias due to selection is investigated with simulations. Furthermore, the methods are applied to affective disease data from a register-based study (Kessing et al. Br J Psychiatry 185:372-377, 2004a) and from a long-term clinical...

  20. Traumatic events and children

    Science.gov (United States)

    ... stabbing of a person Sudden death of a parent or trusted caregiver Hospitalization Examples of traumatic events that your child experiences over and over are: Physical or emotional abuse Sexual abuse Gang violence War Terrorist events

  1. Fatal venous air embolism during anesthesia in an apparently healthy adult Chihuahua.

    Science.gov (United States)

    Mouser, Pamela J; Wilson, Jeffrey D

    2015-01-01

    An apparently healthy adult female Chihuahua was presented for elective ovariohysterectomy. After induction of general anesthesia, but prior to the start of the surgery, air was inadvertently administered to the patient via the i.v. fluid line. The patient convulsed, became apneic, arrested, and died despite attempted cardiopulmonary resuscitation. At necropsy, the pericardial sac was incised and filled with water to entirely submerge the intact heart. The right ventricular free wall was punctured, releasing several air bubbles from the right ventricle. Death was attributed to venous air embolism based on the clinical history, gross findings, and paucity of underlying gross and microscopic pathology that might have predisposed the dog to an anesthetic-related death. The discussion of this case includes a review of previously reported veterinary cases of fatal venous air embolism, including the varied mechanisms of embolus formation, the potential impact of pre-existing cardiopulmonary disease, and the methods used to detect emboli. This report outlines the events of fatal iatrogenic venous air embolization and emphasizes the importance of considering this entity in the case of sudden death of a patient with an indwelling catheter in order to pursue either appropriate diagnostic tests or necropsy techniques to aid in the diagnosis.

  2. Drug therapy of apparent treatment-resistant hypertension: focus on mineralocorticoid receptor antagonists.

    Science.gov (United States)

    Glicklich, Daniel; Frishman, William H

    2015-04-01

    Apparent treatment-resistant hypertension (aTRH) is defined as blood pressure (BP) >140/90 mmHg despite three different antihypertensive drugs including a diuretic. aTRH is associated with an increased risk of cardiovascular events, including stroke, chronic renal failure, myocardial infarction, congestive heart failure, aortic aneurysm, atrial fibrillation, and sudden death. Preliminary studies of renal nerve ablation as a therapy to control aTRH were encouraging. However, these results were not confirmed by the Symplicity 3 trial. Therefore, attention has refocused on drug therapy. Secondary forms of hypertension and associated conditions such as obesity, sleep apnea, and primary aldosteronism are common in patients with aTRH. The pivotal role of aldosterone in the pathogenesis of aTRH in many cases is well recognized. For patients with aTRH, the Joint National Committee-8, the European Society of Hypertension, and a recent consensus conference recommend that a diuretic, ACE inhibitor, or angiotensin receptor blocker and calcium channel blocker combination be used to maximally tolerated doses before starting a 'fourth-line' drug such as a mineralocorticoid receptor (MR) antagonist. Although the best fourth-line drug for aTRH has not been extensively investigated, a number of studies summarized here show that an MR antagonist is effective in reducing BP when added to the standard multi-drug regimen.

  3. Rainfall event profiles: importance in ecohydrology, geomorphology, and soil management

    Science.gov (United States)

    Dunkerley, D.

    2012-04-01

    The importance of the temporal structure of rainfall events is widely, but not universally, recognised. In agricultural research, the role of event structure has been quite well explored (e.g. in relation to leachates from manure, or in agrochemical washoff). However, in dryland hydrology, and in soil erosion research, much less attention has been paid to the role of aspects such as intensity variations or rain intermittency. Moreover, changes in rainfall event profiles form a little-explored aspect of ongoing climatic change, but one that may have great significance in ecohydrology and in geomorphology. The importance of rain event structure is clearly demonstrated from rainfall simulation experiments on dryland soils in arid NSW Australia. A series of small plot experiments using drop-forming rainfall simulation was established in order to explore the effects of varying event profiles on infiltration and the generation of runoff. Experiments all had the same rain event duration, the same mean rain rate, and the same total event depth. However, event profile, including peak intensity, and intermittency, were varied by using computer-controlled pumps. The rain rates and event profiles were designed to mimic the character of natural rainfall events in the study area. Results show that events with uniform rainfall rates, as widely used in rainfall simulations in soil erosion research and in hydrology, yield the highest apparent soil infiltrability and the least runoff volume. Events with peak intensity late in the event, when soils are already wet, yield the lowest apparent infiltrability and the highest runoff volume, as well as the highest runoff intensity. These results need to be confirmed for other soil types, but suggest that event profile is an important determinant of soil hydraulic behaviour that warrants increased attention in many fields, including ecohydrology, geomorphology, and soil management.

  4. Advertising Effectiveness In Events

    OpenAIRE

    Jain, Sushilkumar

    2012-01-01

    Confronted with decreasing effectiveness of the classic marketing communications, events have become an increasingly popular alternative for marketers. Events constitute one of the most exciting and fastest growing forms of leisure and business. With time, the decreasing effectiveness of classical marketing communications boosted the use of events for marketing and making brand awareness. Event marketing is seen as the unique opportunity to integrate the firm’s communication activities like p...

  5. Event generators at BESⅢ

    Institute of Scientific and Technical Information of China (English)

    PING Rong-Gang

    2008-01-01

    We present a brief remark and introduction to event generators for tau-charm physics currently used at BESⅢ,including KKMC,BesEvtGen,Bhlumi,Bhwide,Babayaga and inclusive Monte-Carlo event generators.This paper provides basic information on event generators for BESⅢ users.

  6. Post-Marketing Surveillance of Human Rabies Diploid Cell Vaccine (Imovax in the Vaccine Adverse Event Reporting System (VAERS in the United States, 1990‒2015.

    Directory of Open Access Journals (Sweden)

    Pedro L Moro

    2016-07-01

    Full Text Available In 1980, human diploid cell vaccine (HDCV, Imovax Rabies, Sanofi Pasteur, was licensed for use in the United States.To assess adverse events (AEs after HDCV reported to the US Vaccine Adverse Event Reporting System (VAERS, a spontaneous reporting surveillance system.We searched VAERS for US reports after HDCV among persons vaccinated from January 1, 1990-July 31, 2015. Medical records were requested for reports classified as serious (death, hospitalization, prolonged hospitalization, disability, life-threatening-illness, and those suggesting anaphylaxis and Guillain-Barré syndrome (GBS. Physicians reviewed available information and assigned a primary clinical category to each report using MedDRA system organ classes. Empirical Bayesian (EB data mining was used to identify disproportional AE reporting after HDCV.VAERS received 1,611 reports after HDCV; 93 (5.8% were serious. Among all reports, the three most common AEs included pyrexia (18.2%, headache (17.9%, and nausea (16.5%. Among serious reports, four deaths appeared to be unrelated to vaccination.This 25-year review of VAERS did not identify new or unexpected AEs after HDCV. The vast majority of AEs were non-serious. Injection site reactions, hypersensitivity reactions, and non-specific constitutional symptoms were most frequently reported, similar to findings in pre-licensure studies.

  7. Post-Marketing Surveillance of Human Rabies Diploid Cell Vaccine (Imovax) in the Vaccine Adverse Event Reporting System (VAERS) in the United States, 1990‒2015

    Science.gov (United States)

    Moro, Pedro L.; Woo, Emily Jane; Paul, Wendy; Lewis, Paige; Petersen, Brett W.; Cano, Maria

    2016-01-01

    Background In 1980, human diploid cell vaccine (HDCV, Imovax Rabies, Sanofi Pasteur), was licensed for use in the United States. Objective To assess adverse events (AEs) after HDCV reported to the US Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting surveillance system. Methods We searched VAERS for US reports after HDCV among persons vaccinated from January 1, 1990–July 31, 2015. Medical records were requested for reports classified as serious (death, hospitalization, prolonged hospitalization, disability, life-threatening-illness), and those suggesting anaphylaxis and Guillain-Barré syndrome (GBS). Physicians reviewed available information and assigned a primary clinical category to each report using MedDRA system organ classes. Empirical Bayesian (EB) data mining was used to identify disproportional AE reporting after HDCV. Results VAERS received 1,611 reports after HDCV; 93 (5.8%) were serious. Among all reports, the three most common AEs included pyrexia (18.2%), headache (17.9%), and nausea (16.5%). Among serious reports, four deaths appeared to be unrelated to vaccination. Conclusions This 25-year review of VAERS did not identify new or unexpected AEs after HDCV. The vast majority of AEs were non-serious. Injection site reactions, hypersensitivity reactions, and non-specific constitutional symptoms were most frequently reported, similar to findings in pre-licensure studies. PMID:27410239

  8. Multiple mortality events in bats: a global review

    Science.gov (United States)

    O'Shea, Thomas J.; Cryan, Paul; Hayman, David TH; Plowright, Raina K.; Streicker, Daniel G.

    2016-01-01

    Despite conservation concerns for many species of bats, factors causing mortality in bats have not been reviewed since 1970. Here, we review and qualitatively describe trends in the occurrence and apparent causes of multiple mortality events (MMEs) in bats around the world.

  9. Initiating Events for Multi-Reactor Plant Sites

    Energy Technology Data Exchange (ETDEWEB)

    Muhlheim, Michael David [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Flanagan, George F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Poore, III, Willis P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    Inherent in the design of modular reactors is the increased likelihood of events that initiate at a single reactor affecting another reactor. Because of the increased level of interactions between reactors, it is apparent that the Probabilistic Risk Assessments (PRAs) for modular reactor designs need to specifically address the increased interactions and dependencies.

  10. Apparent stress, fault maturity and seismic hazard for normal-fault earthquakes at subduction zones

    Science.gov (United States)

    Choy, G.L.; Kirby, S.H.

    2004-01-01

    The behavior of apparent stress for normal-fault earthquakes at subduction zones is derived by examining the apparent stress (?? a = ??Es/Mo, where E s is radiated energy and Mo is seismic moment) of all globally distributed shallow (depth, ?? 1 MPa) are also generally intraslab, but occur where the lithosphere has just begun subduction beneath the overriding plate. They usually occur in cold slabs near trenches where the direction of plate motion across the trench is oblique to the trench axis, or where there are local contortions or geometrical complexities of the plate boundary. Lower ??a (tectonic regime suggests that the level of ?? a is related to fault maturity. Lower stress drops are needed to rupture mature faults such as those found at plate interfaces that have been smoothed by large cumulative displacements (from hundreds to thousands of kilometres). In contrast, immature faults, such as those on which intraslab-normal-fault earthquakes generally occur, are found in cold and intact lithosphere in which total fault displacement has been much less (from hundreds of metres to a few kilometres). Also, faults on which high ??a oceanic strike-slip earthquakes occur are predominantly intraplate or at evolving ends of transforms. At subduction zones, earthquakes occurring on immature faults are likely to be more hazardous as they tend to generate higher amounts of radiated energy per unit of moment than earthquakes occurring on mature faults. We have identified earthquake pairs in which an interplate-thrust and an intraslab-normal earthquake occurred remarkably close in space and time. The intraslab-normal member of each pair radiated anomalously high amounts of energy compared to its thrust-fault counterpart. These intraslab earthquakes probably ruptured intact slab mantle and are dramatic examples in which Mc (an energy magnitude) is shown to be a far better estimate of the potential for earthquake damage than Mw. This discovery may help explain why loss of

  11. Dose-Effect Relationships for Adverse Events After Cranial Radiation Therapy in Long-term Childhood Cancer Survivors

    Energy Technology Data Exchange (ETDEWEB)

    Dijk, Irma W.E.M. van, E-mail: i.w.vandijk@amc.uva.nl [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Cardous-Ubbink, Mathilde C. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Pal, Helena J.H. van der [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Heinen, Richard C. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Leeuwen, Flora E. van [Department of Epidemiology, Netherlands Cancer Institute, Amsterdam (Netherlands); Oldenburger, Foppe; Os, Rob M. van [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Ronckers, Cécile M. [Dutch Childhood Oncology Group, Long-term Effects after Childhood Cancer, The Hague (Netherlands); Schouten–van Meeteren, Antoinette Y.N. [Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Caron, Huib N. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands); Koning, Caro C.E. [Department of Radiation Oncology, Academic Medical Center, Amsterdam (Netherlands); Kremer, Leontien C.M. [Department of Medical Oncology, Academic Medical Center, Amsterdam (Netherlands); Department of Pediatric Oncology, Emma Children' s Hospital/Academic Medical Center, Amsterdam (Netherlands)

    2013-03-01

    Purpose: To evaluate the prevalence and severity of clinical adverse events (AEs) and treatment-related risk factors in childhood cancer survivors treated with cranial radiation therapy (CRT), with the aim of assessing dose-effect relationships. Methods and Materials: The retrospective study cohort consisted of 1362 Dutch childhood cancer survivors, of whom 285 were treated with CRT delivered as brain irradiation (BI), as part of craniospinal irradiation (CSI), and as total body irradiation (TBI). Individual CRT doses were converted into the equivalent dose in 2-Gy fractions (EQD{sub 2}). Survivors had received their diagnoses between 1966 and 1996 and survived at least 5 years after diagnosis. A complete inventory of Common Terminology Criteria for Adverse Events grade 3.0 AEs was available from our hospital-based late-effect follow-up program. We used multivariable logistic and Cox regression analyses to examine the EQD{sub 2} in relation to the prevalence and severity of AEs, correcting for sex, age at diagnosis, follow-up time, and the treatment-related risk factors surgery and chemotherapy. Results: There was a high prevalence of AEs in the CRT group; over 80% of survivors had more than 1 AE, and almost half had at least 5 AEs, both representing significant increases in number of AEs compared with survivors not treated with CRT. Additionally, the proportion of severe, life-threatening, or disabling AEs was significantly higher in the CRT group. The most frequent AEs were alopecia and cognitive, endocrine, metabolic, and neurologic events. Using the EQD{sub 2}, we found significant dose-effect relationships for these and other AEs. Conclusion: Our results confirm that CRT increases the prevalence and severity of AEs in childhood cancer survivors. Furthermore, analyzing dose-effect relationships with the cumulative EQD{sub 2} instead of total physical dose connects the knowledge from radiation therapy and radiobiology with the clinical experience.

  12. Repetitive transcranial magnetic stimulation of human MT+ reduces apparent motion perception.

    Science.gov (United States)

    Matsuyoshi, Daisuke; Hirose, Nobuyuki; Mima, Tatsuya; Fukuyama, Hidenao; Osaka, Naoyuki

    2007-12-18

    We investigated the effects of repetitive transcranial magnetic stimulation (rTMS) over the human cerebral cortex on apparent motion perception. Previous studies have shown that human extrastriate visual area MT+ (V5) processes not only real but also apparent motion. However, the functional relevance of MT+ on long-range apparent motion perception remains unclear. Here, we show direct evidence for the involvement of MT+ in apparent motion perception using rTMS, which is known to temporarily inhibit a localized region in the cerebral cortex. The results showed that apparent motion perception decreased after applying rTMS over MT+, but not after applying rTMS over the control region (inferior temporal gyrus). The decrease in performance caused by applying rTMS to MT+ suggests that MT+ is a causally responsible region for apparent motion perception, and thus, further supports the idea that MT+ plays a major role in the perception of motion.

  13. Electric potential and apparent resistivity in rocks containing non-uniformly distributed cracks

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In this paper, the formula of electric field distribution and ground apparent resistivity of high resistance rock medi-um containing low resistance crack are deduced and simulated. The result shows that interstitial parameters, such as buried depth, scale, strike, and real resistivity, etc, have influence on observation and computing result of apparent resistivity. This study provided a useful foundation for earthquake prediction using apparent resistivity method.

  14. Apparent size contrasts of retinal images and size constancy as determinants of the moon illusion.

    Science.gov (United States)

    Smith, O W; Smith, P C; Geist, C C; Zimmermann, R R

    1978-06-01

    Kaufman and Rock (1962) and Rock and Kaufman (1962) concluded that the moon illusion is a function of and attributable to apparent distance. They also reported a large framing effect as an exception. Analysis of the effect suggests two components which can account for the illusion independently of apparent distance. These are apparent size contrasts of visual images of discriminable features or objects of the earth with the moon's image and size constancy of the features or objects plus the interactions of the two. Apparent distances to horizons are always a consequence of the necessary conditions for the illusion. They are related to the illusion but are not a determinant of it.

  15. A Candida albicans early stage biofilm detachment event in rich medium

    Directory of Open Access Journals (Sweden)

    Nantel Andre

    2009-02-01

    Full Text Available Abstract Background Dispersal from Candida albicans biofilms that colonize catheters is implicated as a primary factor in the link between contaminated catheters and life threatening blood stream infections (BSI. Appropriate in vitro C. albicans biofilm models are needed to probe factors that induce detachment events. Results Using a flow through system to culture C. albicans biofilms we characterized a detachment process which culminates in dissociation of an entire early stage biofilm from a silicone elastomer surface. We analyzed the transcriptome response at time points that bracketed an abrupt transition in which a strong adhesive association with the surface is weakened in the initial stages of the process, and also compared batch and biofilm cultures at relevant time points. K means analysis of the time course array data revealed categories of genes with similar patterns of expression that were associated with adhesion, biofilm formation and glycoprotein biosynthesis. Compared to batch cultures the biofilm showed a pattern of expression of metabolic genes that was similar to the C. albicans response to hypoxia. However, the loss of strong adhesion was not obviously influenced by either the availability of oxygen in the medium or at the silicone elastomer surface. The detachment phenotype of mutant strains in which selected genes were either deleted or overexpressed was characterized. The microarray data indicated that changes associated with the detachment process were complex and, consistent with this assessment, we were unable to demonstrate that transcriptional regulation of any single gene was essential for loss of the strong adhesive association. Conclusion The massive dispersal of the early stage biofilm from a biomaterial surface that we observed is not orchestrated at the level of transcriptional regulation in an obvious manner, or is only regulated at this level by a small subpopulation of cells that mediate adhesion to the

  16. The PHENIX Event Builder

    Science.gov (United States)

    Winter, David

    2004-10-01

    The PHENIX Event Builder is a critical part of the back-end of the PHENIX DAQ. It is reponsible for assembling event fragments from each subsystem into complete events ready for archiving. It allows subsystems to be read out either in parallel or simultaneously while supporting a high rate of archiving. Additionally, it implements an environment where Level-2 trigger algorithms may be optionally executed, providing the ability to tag and/or filter rare physics events. Up to and including RHIC Run-4, the Event Builder was implemented as a set of three Windows NT/2000 multithreaded executables that run on a farm of over 100 dual-cpu 1U servers connected via a Foundry Layer2/3 Gigabit switch. Under this architecture it has been capable of recording a wide range of event sizes from central Au-Au to p-p interactions, with data archiving rates of over 400 MB/s at 2 KHz event rates. Between Runs 4 and 5, the Event Builder will be ported to Linux. Preliminary work has shown we can expect great improvements in performance when moving to this platform for Run 5. The PHENIX Event Builder design and implementation, as well as performance and plans for future development, will be discussed.

  17. The Terrorist Event

    OpenAIRE

    Nichols, Bill

    2007-01-01

    In his article "The Terrorist Event," Bill Nichols examines how the US media attempted to make meaning of the events of 9/11. How were news anchors and producers to explain an event that escaped their comprehension? Without context or historical equivalence in the US, news outlets groped for a narrative in which to frame the event even if that meant creating the meaning themselves. In their attempt to create meaning, what sorts of fetishes and fantasies did they draw-on and in turn create? Th...

  18. Features, Events, and Processes: Disruptive Events

    Energy Technology Data Exchange (ETDEWEB)

    J. King

    2004-03-31

    The primary purpose of this analysis is to evaluate seismic- and igneous-related features, events, and processes (FEPs). These FEPs represent areas of natural system processes that have the potential to produce disruptive events (DE) that could impact repository performance and are related to the geologic processes of tectonism, structural deformation, seismicity, and igneous activity. Collectively, they are referred to as the DE FEPs. This evaluation determines which of the DE FEPs are excluded from modeling used to support the total system performance assessment for license application (TSPA-LA). The evaluation is based on the data and results presented in supporting analysis reports, model reports, technical information, or corroborative documents that are cited in the individual FEP discussions in Section 6.2 of this analysis report.

  19. Features, Events, and Processes: Disruptive Events

    Energy Technology Data Exchange (ETDEWEB)

    P. Sanchez

    2004-11-08

    The purpose of this analysis report is to evaluate and document the inclusion or exclusion of the disruptive events features, events, and processes (FEPs) with respect to modeling used to support the total system performance assessment for license application (TSPA-LA). A screening decision, either ''Included'' or ''Excluded,'' is given for each FEP, along with the technical basis for screening decisions. This information is required by the U.S. Nuclear Regulatory Commission (NRC) at 10 CFR 63.114 (d), (e), and (f) [DIRS 156605]. The FEPs addressed in this report deal with both seismic and igneous disruptive events, such as fault displacements through the repository and an igneous intrusion into the repository. For included FEPs, this analysis summarizes the implementation of the FEP in TSPA-LA (i.e., how the FEP is included). For excluded FEPs, this analysis provides the technical basis for exclusion from TSPA-LA (i.e., why the FEP is excluded). Previous versions of this report were developed to support the total system performance assessments (TSPA) for various prior repository designs. This revision addresses the repository design for the license application (LA).

  20. The Agency of Event

    DEFF Research Database (Denmark)

    Nicholas, Paul; Tamke, Martin; Riiber, Jacob

    2014-01-01

    This paper explores the notion of agency within event-based models. We present an event-based modeling approach that links interdependent generative, analytic and decision making sub-models within a system of exchange. Two case study projects demonstrate the underlying modeling concepts and metho...

  1. CHED Events: Philadelphia

    Science.gov (United States)

    Wink, Donald J.

    2008-08-01

    These Division of Chemical Education (CHED) Committee meetings and events are planned for the Fall 2008 ACS Meeting in Philadelphia. Most will take place in the Sheraton Philadelphia City Center Hotel, 17th and Race Streets: This includes the Sunday evening Reception and Social Event; there will be no CHED Banquet.

  2. Activating Event Knowledge

    Science.gov (United States)

    Hare, Mary; Jones, Michael; Thomson, Caroline; Kelly, Sarah; McRae, Ken

    2009-01-01

    An increasing number of results in sentence and discourse processing demonstrate that comprehension relies on rich pragmatic knowledge about real-world events, and that incoming words incrementally activate such knowledge. If so, then even outside of any larger context, nouns should activate knowledge of the generalized events that they denote or…

  3. Committed Sport Event Volunteers

    Science.gov (United States)

    Han, Keunsu; Quarterman, Jerome; Strigas, Ethan; Ha, Jaehyun; Lee, Seungbum

    2013-01-01

    The purpose of this study was to investigate the relationships among selected demographic characteristics (income, education and age), motivation and commitment of volunteers at a sporting event. Three-hundred and five questionnaires were collected from volunteers in a marathon event and analyzed using structural equation modeling (SEM). Based on…

  4. The ATLAS Event Builder

    CERN Document Server

    Vandelli, W; Battaglia, A; Beck, H P; Blair, R; Bogaerts, A; Bosman, M; Ciobotaru, M; Cranfield, R; Crone, G; Dawson, J; Dobinson, Robert W; Dobson, M; Dos Anjos, A; Drake, G; Ermoline, Y; Ferrari, R; Ferrer, M L; Francis, D; Gadomski, S; Gameiro, S; Gorini, B; Green, B; Haberichter, W; Haberli, C; Hauser, R; Hinkelbein, C; Hughes-Jones, R; Joos, M; Kieft, G; Klous, S; Korcyl, K; Kordas, K; Kugel, A; Leahu, L; Lehmann, G; Martin, B; Mapelli, L; Meessen, C; Meirosu, C; Misiejuk, A; Mornacchi, G; Müller, M; Nagasaka, Y; Negri, A; Pasqualucci, E; Pauly, T; Petersen, J; Pope, B; Schlereth, J L; Spiwoks, R; Stancu, S; Strong, J; Sushkov, S; Szymocha, T; Tremblet, L; Ünel, G; Vermeulen, J; Werner, P; Wheeler-Ellis, S; Wickens, F; Wiedenmann, W; Yu, M; Yasu, Y; Zhang, J; Zobernig, H; 2007 IEEE Nuclear Science Symposium and Medical Imaging Conference

    2008-01-01

    Event data from proton-proton collisions at the LHC will be selected by the ATLAS experiment in a three-level trigger system, which, at its first two trigger levels (LVL1+LVL2), reduces the initial bunch crossing rate of 40~MHz to $sim$3~kHz. At this rate, the Event Builder collects the data from the readout system PCs (ROSs) and provides fully assembled events to the Event Filter (EF). The EF is the third trigger level and its aim is to achieve a further rate reduction to $sim$200~Hz on the permanent storage. The Event Builder is based on a farm of O(100) PCs, interconnected via a Gigabit Ethernet to O(150) ROSs. These PCs run Linux and multi-threaded software applications implemented in C++. All the ROSs, and substantial fractions of the Event Builder and Event Filter PCs have been installed and commissioned. We report on performance tests on this initial system, which is capable of going beyond the required data rates and bandwidths for Event Building for the ATLAS experiment.

  5. Does a cardiovascular event change adherence to statin treatment in patients with type 2 diabetes? A matched cohort design

    NARCIS (Netherlands)

    De Vries, Dianna; Denig, Petra; Vegter, Stefan; Bos, H.J.; Postma, Maarten J.; Hak, Eelko

    2014-01-01

    Background: Statin treatment is associated with a reduction in the risk of cardiovascular events. To be effective, adherence is essential but this may be influenced by the occurrence of a cardiovascular event while being on treatment. Objectives: To assess the effect of an apparent first event on st

  6. Adrenal Crisis : Still a Deadly Event in the 21(st) Century

    NARCIS (Netherlands)

    Puar, Troy H K; Stikkelbroeck, Nike M M L; Smans, Lisanne C C J; Zelissen, Pierre M J; Hermus, Ad R M M

    2015-01-01

    Adrenal crisis is a life-threatening medical emergency, associated with a high mortality unless it is appropriately recognized and early treatment is rendered. Despite it being a treatable condition for almost 70 years, failure of adequate preventive measures or delayed treatment has often led to un

  7. Apparent Rate Constant for Diffusion-Controlled Three molecular (catalytic) reaction

    OpenAIRE

    Burlatsky, S. F.; Moreau, M

    1996-01-01

    We present simple explicit estimates for the apparent reaction rate constant for three molecular reactions, which are important in catalysis. For small concentrations and $d> 1$, the apparent reaction rate constant depends only on the diffusion coefficients and sizes of the particles. For small concentrations and $d\\le 1$, it is also time -- dependent. For large concentrations, it gains the dependence on concentrations.

  8. Financial Barriers for Students with Non-Apparent Disabilities within Canadian Postsecondary Education

    Science.gov (United States)

    Chambers, Tony; Bolton, Melissa; Sukhai, Mahadeo A.

    2013-01-01

    This study examined the education-related debt, sources of debt, and the process of acquiring accommodations for students with non-apparent (such as learning disabilities and mental health disabilities) and apparent disabilities in Canadian postsecondary education. A third group emerged during analyses, students with medical disabilities, which…

  9. Taking a Hands-On Approach: Apparent Grasping Ability Scales the Perception of Object Size

    Science.gov (United States)

    Linkenauger, Sally A.; Witt, Jessica K.; Proffitt, Dennis R.

    2011-01-01

    We examined whether the apparent size of an object is scaled to the morphology of the relevant body part with which one intends to act on it. To be specific, we tested if the visually perceived size of graspable objects is scaled to the extent of apparent grasping ability for the individual. Previous research has shown that right-handed…

  10. Thermodynamical properties of interacting holographic dark energy model with apparent horizon

    CERN Document Server

    Liu, Bin; Deng, Jian-Bo

    2011-01-01

    We have investigated the thermodynamical properties of the universe with dark energy. It is demonstrated that in a universe with spacial curvature the natural choice for IR cutoff could be the apparent horizon radius. We shown that any interaction of pressureless dark matter with holographic dark energy, whose infrared cutoff is set by the apparent horizon radius, implying a constant effective equation of state of dark component in a universe. In addition we found that for the static observer in space, the comoving distance has a faster expansion than the apparent horizon radius with any spatial curvature. We also verify that in some conditions the modified first law of thermodynamics could return to the classic form at apparent horizon for a universe filled with dark energy and dark matter. Besides, the generalized second law of thermodynamics is discussed in a region enclosed by the apparent horizon.

  11. Linguistic spatial classifications of event domains in narratives of crime

    Directory of Open Access Journals (Sweden)

    Blake Stephen Howald

    2010-07-01

    Full Text Available Structurally, formal definitions of the linguistic narrative minimally require two temporally linked past-time events. The role of space in this definition, based on spatial language indicating where events occur, is considered optional and non-structural. However, based on narratives with a high frequency of spatial language, recent research has questioned this perspective, suggesting that space is more critical than may be readily apparent. Through an analysis of spatially rich serial criminal narratives, it will be demonstrated that spatial information qualitatively varies relative to narrative events. In particular, statistical classifiers in a supervised machine learning task achieve a 90% accuracy in predicting Pre-Crime, Crime, and Post-Crime events based on spatial (and temporal information. Overall, these results suggest a deeper spatial organization of discourse, which not only provides practical event resolution possibilities, but also challenges traditional formal linguistic definitions of narrative.

  12. On temporal and spatial distribution of seismic apparent stresses in Yunnan area

    Institute of Scientific and Technical Information of China (English)

    QIN Jia-zheng; QIAN Xiao-dong

    2006-01-01

    motion is applied to a detailed study on the temporal and spatial distribution of the seismic apparent stresses (σa)for the moderate and small earthquakes and two aftershock sequences in Yunnan area. The results show that there exists an obvious non-homogeneity for the seismic apparent stresses in the spatial distribution. The concentrated regions of the high apparent stresses are related to the active places of the moderate and small earthquakes. Before the Dayao M=6.2 earthquake, there was a period in which the apparent stresses were high and the value was 5times of the average value, 0.25 MPa. The relatively high values of apparent stresses distribute around the epicentral area of the major shock and nearby. It indicates that the variation characteristics of the apparent stresses can be taken as a new kind of criterion for the earthquake-risk forecast. Usually the ratio of the apparent stresses of the aftershock sequence σaA to the ones σaM of main shock is less than 1.0.

  13. Primary visual cortex activity along the apparent-motion trace reflects illusory perception.

    Directory of Open Access Journals (Sweden)

    Lars Muckli

    2005-08-01

    Full Text Available The illusion of apparent motion can be induced when visual stimuli are successively presented at different locations. It has been shown in previous studies that motion-sensitive regions in extrastriate cortex are relevant for the processing of apparent motion, but it is unclear whether primary visual cortex (V1 is also involved in the representation of the illusory motion path. We investigated, in human subjects, apparent-motion-related activity in patches of V1 representing locations along the path of illusory stimulus motion using functional magnetic resonance imaging. Here we show that apparent motion caused a blood-oxygenation-level-dependent response along the V1 representations of the apparent-motion path, including regions that were not directly activated by the apparent-motion-inducing stimuli. This response was unaltered when participants had to perform an attention-demanding task that diverted their attention away from the stimulus. With a bistable motion quartet, we confirmed that the activity was related to the conscious perception of movement. Our data suggest that V1 is part of the network that represents the illusory path of apparent motion. The activation in V1 can be explained either by lateral interactions within V1 or by feedback mechanisms from higher visual areas, especially the motion-sensitive human MT/V5 complex.

  14. All-time Apparent Vertical Conductance Interpretation for CLTEM and Its Application

    Institute of Scientific and Technical Information of China (English)

    YanLiangjun; HuWenbao; Xushizhe; LuYi

    2003-01-01

    This paper is based on the transient electromagnetic theory of a thin sheet. The induced EMF formula (as a function of vertical conductance and depth in the central loop transient electromagnetic method) was derived by using the reciprocation law and the formula from the electrical component of EMF induced by a magnetic dipole source over a thin sheet. At the same time, the inversion algorithm of all-time apparent vertical conductance and apparent depth was derived by using the induced EMF and its first derivative. In the transition area there is no distortion for the calculated apparent vertical conductance curve. The location where the curves slope was changing corresponds to an electric interface of the layer. This is because the curve of the slope is directly proportional to the conductivity. Comparing the shapes of the neighboring curves in the same section line, the interfaces of the same layer can be continuously traced, resulting in a high quality CLTEM get-electric section. Theoretical testing with two models shows that the curves of all-time apparent vertical conductance represents the electric property of each layer and its variation. Finally, the authors show application examples of apparent vertical conductance interpretation. The mapped apparent vertical conductance section has fine electric division from the inversion algorithm and is in good co-herence with the inverted resistivity section. This demonstrates that the interpretation method of all-time apparent vertical conductance is feasible and effective

  15. CCG - News & Events

    Science.gov (United States)

    NCI's Center for Cancer Genomics (CCG) has been widely recognized for its research efforts to facilitiate advances in cancer genomic research and improve patient outcomes. Find the latest news about and events featuring CCG.

  16. RAS Initiative - Events

    Science.gov (United States)

    The NCI RAS Initiative has organized multiple events with outside experts to discuss how the latest scientific and technological breakthroughs can be applied to discover vulnerabilities in RAS-driven cancers.

  17. Electrifying Current Events.

    Science.gov (United States)

    Smith, Philip

    1980-01-01

    The author describes how he has adapted the television quiz show format of "College Bowl" to current events study for junior high school students. An insert explains use of the same technique with fourth graders. (SJL)

  18. "Universe" event at AIMS

    Science.gov (United States)

    2008-06-01

    Report of event of 11 May 2008 held at the African Institute of Mathematical Sciences (Muizenberg, Cape), with speakers Michael Griffin (Administrator of NASA), Stephen Hawking (Cambridge), David Gross (Kavli Institute, Santa Barbara) and George Smoot (Berkeley).

  19. Event visualization in ATLAS

    CERN Document Server

    Bianchi, Riccardo-Maria; The ATLAS collaboration

    2017-01-01

    At the beginning, HEP experiments made use of photographical images both to record and store experimental data and to illustrate their findings. Then the experiments evolved and needed to find ways to visualize their data. With the availability of computer graphics, software packages to display event data and the detector geometry started to be developed. Here, an overview of the usage of event display tools in HEP is presented. Then the case of the ATLAS experiment is considered in more detail and two widely used event display packages are presented, Atlantis and VP1, focusing on the software technologies they employ, as well as their strengths, differences and their usage in the experiment: from physics analysis to detector development, and from online monitoring to outreach and communication. Towards the end, the other ATLAS visualization tools will be briefly presented as well. Future development plans and improvements in the ATLAS event display packages will also be discussed.

  20. Paroxysmal Nonepileptic Events

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2007-11-01

    Full Text Available Paroxysmal events that mimic epilepsy, and their precipitants, prodromes, and distinguishing features are reviewed by researchers at Texas Tech University, Lubbock, TX, and American University of Beirut, New York.

  1. CHED Events: New Orleans

    Science.gov (United States)

    Wink, Donald J.

    2008-03-01

    These Division of Chemical Education (CHED) Committee meetings and events are planned for the Spring 2008 ACS Meeting in New Orleans. Most will take place in the Hilton Riverside Hotel, 2 Poydras Street; this includes the Sunday evening Reception and Social Event; there will be no CHED Banquet. Exceptions are the Sunday evening Poster Session and the Undergraduate Poster Sessions, which will be in Hall A of the Morial Convention Center.

  2. Gargamelle: neutral current event

    CERN Multimedia

    1973-01-01

    This event shows real tracks of particles from the 1200 litre Gargamelle bubble chamber that ran on the PS from 1970 to 1976 and on the SPS from 1976 to 1979. In this image a neutrino passes close to a nucleon and reemerges as a neutrino. Such events are called neutral curent, as they are mediated by the Z0 boson which has no electric charge.

  3. Tritium/Helium-3 Apparent Ages of Shallow Ground Water, Portland Basin, Oregon, 1997-98

    Science.gov (United States)

    Hinkle, Stephen R.

    2009-01-01

    Water samples for tritium/helium-3 age dating were collected from 12 shallow monitoring wells in the Portland basin, Oregon, in 1997, and again in 1998. Robust tritium/helium-3 apparent (piston-flow) ages were obtained for water samples from 10 of the 12 wells; apparent ages ranged from 1.1 to 21.2 years. Method precision was demonstrated by close agreement between data collected in 1997 and 1998. Tritium/helium-3 apparent ages generally increase with increasing depth below the water table, and agree well with age/depth relations based on assumptions of effects of recharge rate on vertical ground-water movement.

  4. Concepts of event-by-event analysis

    Energy Technology Data Exchange (ETDEWEB)

    Stroebele, H. [Universitaet Frankfurt (Germany)

    1995-07-15

    The particles observed in the final state of nuclear collisions can be divided into two classes: those which are susceptible to strong interactions and those which are not, like leptons and the photon. The bulk properties of the {open_quotes}matter{close_quotes} in the reaction zone may be read-off the kinematical characteristics of the particles observable in the final state. These characteristics are strongly dependent on the last interaction these particles have undergone. In a densly populated reaction zone strongly interacting particles will experience many collisions after they have been formed and before they emerge into the asymptotic final state. For the particles which are not sensitive to strong interactions their formation is also their last interaction. Thus photons and leptons probe the period during which they are produced whereas hadrons reflect the so called freeze-out processes, which occur during the late stage in the evolution of the reaction when the population density becomes small and the mean free paths long. The disadvantage of the leptons and photons is their small production cross section; they cannot be used in an analysis of the characteristics of individual collision events, because the number of particles produced per event is too small. The hadrons, on the other hand, stem from the freeze-out period. Information from earlier periods requires multiparticle observables in the most general sense. It is one of the challenges of present day high energy nuclear physics to establish and understand global observables which differentiate between mere hadronic scenarios, i.e superposition of hadronic interactions, and the formation of a partonic (short duration) steady state which can be considered a new state of matter, the Quark-Gluon Plasma.

  5. Response of Swimming Paramecia to in situ changes in their apparent weight

    Science.gov (United States)

    Jung, Ilyong; Mickalide, Harry; Valles, James M., Jr.

    2012-02-01

    There is a class of marine micro-organisms that are small enough that low Reynold's number hydrodynamics dictates their swimming mechanics and large enough that the force of gravity exerts a noticeable influence on their motion. Experiments on populations of paramecia suggest that they exert a greater propulsion when swimming against gravity. This negative gravi-kinesis is surprising because it suggests that they sense their tiny apparent weight of about 80 pN. To understand this response in more detail, we are investigating how individual paramecia caudatum change their swimming speed and helical trajectories in response to changes in their apparent weight. We vary the apparent weight with the technique of Magnetic Force Buoyancy Variation employing a high field resistive magnet at the National High Magnetic Field Laboratory. We will present analysis of the swimming for apparent weight changes as large as a factor of 8.

  6. Apparent Activation Energy of Concrete in Early Age Determined by Adiabatic Test

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The apparent activation energy of concrete in early age was determined by adiabatic temperature rise test with different initial temperatures. The influence of mineral admixtures such as fly ash, slag and silica fume on the apparent activation energy of concrete was investigated. The equivalent age that expresses the maturity of concrete was calculated to evaluate the cracking risk of concrete in structures. The results reveal that a substitution of 20% fly ash for Portland cement obviously decreases the apparent activation energy of concrete, however, a substitution of 10% silica fume for Portland cement increases the apparent activation. Finite element method analysis of a simulating concrete wall shows that the concrete containing 20% fly ash has the lowest cracking risk.

  7. NUMERICAL STUDY OF THE RELATIONSHIP BETWEEN APPARENT SLIP LENGTH AND CONTACT ANGLE BY LATTICE BOLTZMANN METHOD

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ren-liang; DI Qin-feng; WANG Xin-liang; DING Wei-peng; GONG Wei

    2012-01-01

    The apparent slip between solid wall and liquid is studied by using the Lattice Boltzmann Method (LBM) and the Shan-Chen multiphase model in this paper.With a no-slip bounce-back scheme applied to the interface,flow regimes under different wall wettabilities are investigated.Because of the wall wettability,liquid apparent slip is observed.Slip lengths for different wall wettabilities are found to collapse nearly onto a single curve as a function of the static contact angle,and thereby a relationship between apparent slip length and contact angle is suggested.Our results also show that the wall wettability leads to the formation of a low-density layer between solid wall and liquid,which produced apparent slip in the micro-scale.

  8. First law of thermodynamics for dynamical apparent horizons and the entropy of Friedmann universes

    CERN Document Server

    Viaggiu, Stefano

    2015-01-01

    Recently, we have generalized the Bekenstein-Hawking entropy formula for black holes embedded in expanding Friedmann universes. In this letter, we begin the study of this new formula to obtain the first law of thermodynamics for dynamical apparent horizons. In this regard we obtain a generalized expression for the internal energy $U$ together with a distinction between the dynamical temperature $T_D$ of apparent horizons and the related one due to thermodynamics formulas. Remarkable, when the expression for $U$ is applied to the apparent horizon of the universe, we found that this internal energy is a constant of motion. Our calculations thus show that the total energy of our spatially flat universe including the gravitational contribution, when calculated at the apparent horizon, is an universal constant that can be set to zero from simple dimensional considerations. This strongly support the holographic principle.

  9. Time operator for the quantum harmonic oscillator resolution of an apparent paradox

    CERN Document Server

    Granik, A; Granik, Alex

    2000-01-01

    An apparent paradox is resolved that concerns the existence of time operators which have been derived for the quantum harmonic oscillator. There is an apparent paradox because, although a time operator is canonically conjugate to the Hamiltonian, it has been asserted that no operator exists that is canonically conjugate to the Hamiltonian. In order to resolve the apparent paradox, we work in a representation where the phase operator is diagonal. The boundary condition on wave functions is such that they be periodic in the phase variable, which is related to the (continuous) eigenvalue of the time operator. Matrix elements of the commutator of the time operator with the Hamiltonian involve the phase variable itself in addition to periodic functions of the phase variable. The Hamiltonian is not hermitian when operating in space that includes the phase variable itself. The apparent paradox is resolved when this non-hermeticity is taken into account correctly in the evaluation of matrix elements of the commutatio...

  10. Model of apparent crystal growth rate and kinetics of seeded precipitation from sodium aluminate solution

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-bin; LIU Zhi-jian; XU Xiao-hui; ZHOU Qiu-sheng; PENG Zhi-hong; LIU Gui-hua

    2005-01-01

    Based on the population balance equation in a batch crystallizer characteristic of seeded precipitation, a model to calculate the rate of apparent crystal growth of aluminum hydroxide from the size distribution was deve-loped. The simulation results indicate that the rate of apparent crystal growth during seeded precipitation exhibits a manifest dependence on the crystal size. In general, there is an obvious increase in the apparent crystal growth rate with the augment in crystal size. The apparent activation energy increases with the increase of characteristic crystal size, which indicates that the growth of small crystals is controlled by surface chemical reaction; it is gradually controlled by both the surface reaction and diffusion with the augment in crystal size.

  11. Estimating true instead of apparent survival using spatial Cormack-Jolly-Seber models

    Science.gov (United States)

    Schaub, Michael; Royle, J. Andrew

    2014-01-01

    Survival is often estimated from capture–recapture data using Cormack–Jolly–Seber (CJS) models, where mortality and emigration cannot be distinguished, and the estimated apparent survival probability is the product of the probabilities of true survival and of study area fidelity. Consequently, apparent survival is lower than true survival unless study area fidelity equals one. Underestimation of true survival from capture–recapture data is a main limitation of the method.

  12. Apparent contact angle and contact angle hysteresis on liquid infused surfaces

    OpenAIRE

    Semprebon, Ciro; McHale, Glen; Kusumaatmaja, Halim

    2017-01-01

    We theoretically investigate the apparent contact angle and contact angle hysteresis of a droplet placed on a liquid infused surface. We show that the apparent contact angle is not uniquely defined by material parameters, but also has a strong dependence on the relative size between the droplet and its surrounding wetting ridge formed by the infusing liquid. We derive a closed form expression for the contact angle in the limit of vanishing wetting ridge, and compute the correction for small b...

  13. What should be the apparent viscosity target of a coal-water slurry fuel for combustion?

    Energy Technology Data Exchange (ETDEWEB)

    Pisupati, S.V.; Morrison, J.L.; Scaroni, A.W. [Pennsylvania State Univ., University Park, PA (United States)

    1997-12-31

    The rheological properties of a coal water slurry fuel (CWSF) affect its handling, atomization, and combustion behavior. The flow behavior and apparent viscosity are two rheological properties that are often specified by the end user. A pseudoplastic (shear thinning) flow behavior is preferred since there is a decrease in the apparent viscosity as the fuel is pumped to, and then atomized into the boiler. Specifying an apparent viscosity target for the CWSF is more problematic since there are often competing forces to maximize the solids loading of the fuel while minimizing the apparent viscosity. The apparent viscosity is a function of the particle size distribution of the coal, the solids loading of the CWSF, the physical and chemical properties of the coal, and the additive package used to prepare the CWSF. Targeting an apparent viscosity is necessary during the formulation and production of a CWSF. The trade off between maximizing the solids loading in order to increase the BTU content and maintaining an acceptable apparent viscosity to ensure good atomization behavior is not well established. In order to better define this trade-off, an investigation was carried out to examine the interrelationship between solids loading, apparent viscosity, atomization behavior, and the combustion performance of a CWSF. The CWSF was prepared in a continuous ball mill and isolated in a storage tank. Small batches of CWSF were taken from the storage tank and then diluted to determine how the changes in the CWSF`s rheology and solids loading affected it`s atomization and combustion behavior.

  14. Anomalous Increase of Apparent Mass in a Silo due to Percolation

    Institute of Scientific and Technical Information of China (English)

    Ram Chand; Abdul Qadir; SHI Qing-Fan; ZHENG Ning; SUN Gang

    2011-01-01

    The apparent mass at the bottom of a granular pile confined in a vertical tube decreases for denser granular packing. We report that the denser granular packing comprising two different diameters of granules augments the apparent mass instead. This anomalous behavior occurs when small granules are stacked on the large ones. In the case of anomalous increase, a percolation effect is found and correlated with the augment of apparent mass at the bottom of the granular column. Finally, the results are qualitatively explained by using the Janssen model.%@@ The apparent mass at the bottom of a granular pile confined in a vertical tube decreases for denser granular packing.We report that the denser granular packing comprising two different diameters of granules augments the apparent mass instead.This anomalous behavior occurs when small granules are stacked on the large ones.In the case of anomalous increase,a percolation effect is found and correlated with the augment of apparent mass at the bottom of the granular column.Finally,the results are qualitatively explained by using the Janssen model.

  15. Discrete-Event Simulation

    Directory of Open Access Journals (Sweden)

    Prateek Sharma

    2015-04-01

    Full Text Available Abstract Simulation can be regarded as the emulation of the behavior of a real-world system over an interval of time. The process of simulation relies upon the generation of the history of a system and then analyzing that history to predict the outcome and improve the working of real systems. Simulations can be of various kinds but the topic of interest here is one of the most important kind of simulation which is Discrete-Event Simulation which models the system as a discrete sequence of events in time. So this paper aims at introducing about Discrete-Event Simulation and analyzing how it is beneficial to the real world systems.

  16. Detection of anomalous events

    Energy Technology Data Exchange (ETDEWEB)

    Ferragut, Erik M.; Laska, Jason A.; Bridges, Robert A.

    2016-06-07

    A system is described for receiving a stream of events and scoring the events based on anomalousness and maliciousness (or other classification). The system can include a plurality of anomaly detectors that together implement an algorithm to identify low-probability events and detect atypical traffic patterns. The anomaly detector provides for comparability of disparate sources of data (e.g., network flow data and firewall logs.) Additionally, the anomaly detector allows for regulatability, meaning that the algorithm can be user configurable to adjust a number of false alerts. The anomaly detector can be used for a variety of probability density functions, including normal Gaussian distributions, irregular distributions, as well as functions associated with continuous or discrete variables.

  17. Forecasting Turbine Icing Events

    DEFF Research Database (Denmark)

    Davis, Neil; Hahmann, Andrea N.; Clausen, Niels-Erik

    In this study, we present a method for forecasting icing events. The method is validated at two European wind farms in with known icing events. The icing model used was developed using current ice accretion methods, and newly developed ablation algorithms. The model is driven by inputs from the WRF...... mesoscale model, allowing for both climatological estimates of icing and short term icing forecasts. The current model was able to detect periods of icing reasonably well at the warmer site. However at the cold climate site, the model was not able to remove ice quickly enough leading to large ice...... accumulations, which have not been seen in observations. In addition to the model evaluation we were able to investigate the potential occurrence of ice induced power loss at two wind parks in Europe using observed data. We found that the potential loss during an icing event is large even when the turbine...

  18. Forecasting Turbine Icing Events

    DEFF Research Database (Denmark)

    Davis, Neil; Hahmann, Andrea N.; Clausen, Niels-Erik;

    2012-01-01

    is not shut down for its protection. We also found that there is a a large spread across the various turbines within a wind park, in the amount of icing. This is currently not taken into account by our model. Evaluating and adding these small scale differences to the model will be undertaken as future work....... accumulations, which have not been seen in observations. In addition to the model evaluation we were able to investigate the potential occurrence of ice induced power loss at two wind parks in Europe using observed data. We found that the potential loss during an icing event is large even when the turbine......In this study, we present a method for forecasting icing events. The method is validated at two European wind farms in with known icing events. The icing model used was developed using current ice accretion methods, and newly developed ablation algorithms. The model is driven by inputs from the WRF...

  19. Events and Effects

    DEFF Research Database (Denmark)

    Rytter, Mikkel

    2010-01-01

    Analyzing the period of ‘intensive transnationalism’ among Pakistani migrants in Denmark precipitated by the 2005 earthquake in Kashmir, this article explores the relationship between events and effects on a global scale. One significant initiative after the disaster was the founding of an ad hoc......, and national identity politics in Denmark. Despite the medical doctors’ efforts and intentions, the out- come was framed by 9/11, which has become the major critical event of the decade—one that has supported a developing cleavage between the Danish majority and Denmark’s Muslim immigrant minority....

  20. Adverse events and patients’ perceived health-related quality of life at the end of multidrug-resistant tuberculosis treatment in Namibia

    Science.gov (United States)

    Sagwa, Evans L; Ruswa, Nunurai; Mavhunga, Farai; Rennie, Timothy; Leufkens, Hubert GM; Mantel-Teeuwisse, Aukje K

    2016-01-01

    Purpose The health-related quality of life (HRQoL) of patients completing multidrug-resistant tuberculosis (MDR-TB) treatment in Namibia and whether the occurrence of adverse events influenced patients’ rating of their HRQoL was evaluated. Patients and methods A cross-sectional analytic survey of patients completing or who recently completed MDR-TB treatment was conducted. The patients rated their HRQoL using the simplified Short Form-™ (SF-8) questionnaire consisting of eight Likert-type questions. Three supplemental questions on the adverse events that the patients may have experienced during their MDR-TB treatment were also included. Scoring of HRQoL ratings was norm-based (mean =50, standard deviation =10) ranging from 20 (worst health) to 80 (best health), rather than the conventional 0–100 scores. We evaluated the internal consistency of the scale items using the Cronbach’s alpha, performed descriptive analyses, and analyzed the association between the patients’ HRQoL scores and adverse events. Results Overall, 36 patients (20 males, 56%) aged 17–54 years (median =40 years) responded to the questionnaire. The median (range) HRQoL score for the physical component summary was 58.6 (35.3–60.5), while the median score for the mental component summary was 59.3 (26.6–61.9), indicating not-so-high self-rating of health. There was good internal consistency of the scale scores, with a Cronbach’s alpha value of >0.80. In all, 32 (89%) of the 36 patients experienced at least one adverse drug event of any severity during their treatment (median events =3, range 1–6), of which none was life-threatening. The occurrence of adverse events was not related to HRQoL scores. For patients reporting zero to two events, the median (range) HRQoL score was 56.8 (44.4–56.8), while for those reporting three or more events, the median score was 55.2 (38.6–56.8); P=0.34 for difference between these scores. Conclusion Patients completing treatment for MDR-TB in

  1. Event Classification using Concepts

    NARCIS (Netherlands)

    Boer, M.H.T. de; Schutte, K.; Kraaij, W.

    2013-01-01

    The semantic gap is one of the challenges in the GOOSE project. In this paper a Semantic Event Classification (SEC) system is proposed as an initial step in tackling the semantic gap challenge in the GOOSE project. This system uses semantic text analysis, multiple feature detectors using the BoW mod

  2. On Objects and Events

    DEFF Research Database (Denmark)

    Eugster, Patrick Thomas; Guerraoui, Rachid; Damm, Christian Heide

    2001-01-01

    This paper presents linguistic primitives for publish/subscribe programming using events and objects. We integrate our primitives into a strongly typed object-oriented language through four mechanisms: (1) serialization, (2) multiple sub typing, (3) closures, and (4) deferred code evaluation. We...

  3. Language As Social Event.

    Science.gov (United States)

    Harste, Jerome C.

    A taxonomy developed for the study of the growth and development of written language from the perspective of social event was tested with a group of 68 children, aged three to six years. The subjects were presented with a wide variety of environmental print messages (road signs, toys, fast food signs, and household products) and were questioned…

  4. Television Ceremonial Events.

    Science.gov (United States)

    Dayan, Daniel; Katz, Elihu

    1985-01-01

    Analyzes the impact of televised ceremonies (such as the marriage of Prince Charles and Lady Diana) as "media events" which allow viewers to vicariously enter into the ceremony. Compares them with cult movies that, over repeated viewing, encourage audience "participation." Focuses on the narrator's/commentator's role in shaping…

  5. The CMS Event Builder

    CERN Document Server

    Brigljevic, V; Cano, E; Cittolin, Sergio; Csilling, Akos; Gigi, D; Glege, F; Gómez-Reino, Robert; Gulmini, M; Gutleber, J; Jacobs, C; Kozlovszky, Miklos; Larsen, H; Magrans de Abril, Ildefons; Meijers, F; Meschi, E; Murray, S; Oh, A; Orsini, L; Pollet, L; Rácz, A; Samyn, D; Scharff-Hansen, P; Schwick, C; Sphicas, Paris; ODell, V; Suzuki, I; Berti, L; Maron, G; Toniolo, N; Zangrando, L; Ninane, A; Erhan, S; Bhattacharya, S; Branson, J G

    2003-01-01

    The data acquisition system of the CMS experiment at the Large Hadron Collider will employ an event builder which will combine data from about 500 data sources into full events at an aggregate throughput of 100 GByte/s. Several architectures and switch technologies have been evaluated for the DAQ Technical Design Report by measurements with test benches and by simulation. This paper describes studies of an EVB test-bench based on 64 PCs acting as data sources and data consumers and employing both Gigabit Ethernet and Myrinet technologies as the interconnect. In the case of Ethernet, protocols based on Layer-2 frames and on TCP/IP are evaluated. Results from ongoing studies, including measurements on throughput and scaling are presented. The architecture of the baseline CMS event builder will be outlined. The event builder is organised into two stages with intelligent buffers in between. The first stage contains 64 switches performing a first level of data concentration by building super-fragments from fragmen...

  6. Dynamics of three anomalous SST events in the Coral Sea

    Science.gov (United States)

    Schiller, A.; Ridgway, K. R.; Steinberg, C. R.; Oke, P. R.

    2009-03-01

    Variability of the circulation in the Coral Sea, accompanied by large heat transport anomalies, has the potential to have detrimental impacts on underlying ecosystems, including the Great Barrier Reef. In this study we analyze the dynamics of three events, characterized by extremes in sea-surface temperature, as simulated in an eddy-resolving ocean reanalysis. We show that a cooling in April 1997 results from strong wind anomalies and is supported by vertical and horizontal advective heat losses. A warm event in October 1998 is attributable to a heat gain by horizontal advection. A heat budget of the mixed-layer within a closed box shows that warm anomalies in January 2002 involve a quasi-balance between horizontal advection and vertical entrainment with a large local heat gain through the ocean surface near-shore that apparently caused a coral bleaching event. The dynamics of these extreme events are all quite different, with both local and remote influences.

  7. "Near-miss" obstetric events and maternal deaths in Sagamu, Nigeria: a retrospective study

    Directory of Open Access Journals (Sweden)

    Daniel Olusoji J

    2005-11-01

    Full Text Available Abstract Aim To determine the frequency of near-miss (severe acute maternal morbidity and the nature of near-miss events, and comparatively analysed near-miss morbidities and maternal deaths among pregnant women managed over a 3-year period in a Nigerian tertiary centre. Methods Retrospective facility-based review of cases of near-miss and maternal death which occurred between 1 January 2002 and 31 December 2004. Near-miss case definition was based on validated disease-specific criteria, comprising of five diagnostic categories: haemorrhage, hypertensive disorders in pregnancy, dystocia, infection and anaemia. The near-miss morbidities were compared with maternal deaths with respect to demographic features and disease profiles. Mortality indices were determined for various disease processes to appreciate the standard of care provided for life-threatening obstetric conditions. The maternal death to near-miss ratios for the three years were compared to assess the trend in the quality of obstetric care. Results There were 1501 deliveries, 211 near-miss cases and 44 maternal deaths. The total near-miss events were 242 with a decreasing trend from 2002 to 2004. Demographic features of cases of near-miss and maternal death were comparable. Besides infectious morbidity, the categories of complications responsible for near-misses and maternal deaths followed the same order of decreasing frequency. Hypertensive disorders in pregnancy and haemorrhage were responsible for 61.1% of near-miss cases and 50.0% of maternal deaths. More women died after developing severe morbidity due to uterine rupture and infection, with mortality indices of 37.5% and 28.6%, respectively. Early pregnancy complications and antepartum haemorrhage had the lowest mortality indices. Majority of the cases of near-miss (82.5% and maternal death (88.6% were unbooked for antenatal care and delivery in this hospital. Maternal mortality ratio for the period was 2931.4 per 100

  8. The effect of hatchery release strategy on marine migratory behaviour and apparent survival of Seymour River steelhead smolts (Oncorhynchus mykiss.

    Directory of Open Access Journals (Sweden)

    Shannon Balfry

    Full Text Available Early marine migratory behaviour and apparent survival of hatchery-reared Seymour River steelhead (Oncorhynchus mykiss smolts was examined over a four year period (2006-2009 to assess the impact of various management strategies on improving early marine survival. Acoustically tagged smolts were released to measure their survival using estuary and coastal marine receivers forming components of the Pacific Ocean Shelf Tracking (POST array. Early marine survival was statistically indistinguishable between releases of summer run and winter run steelhead races, night and day releases, and groups released 10 days apart. In 2009, the survival of summer run steelhead released into the river was again trialed against groups released directly into the ocean at a distance from the river mouth. Apparent survival was improved significantly for the ocean released groups. The health and physiological status of the various release groups were monitored in years 2007-2009, and results indicate that the fish were in good health, with no clinical signs of disease at the time of release. The possibility of a disease event contributing to early marine mortality was further examined in 2009 by vaccinating half of the released fish against common fish diseases (vibriosis, furunculosis. The results suggest that marine survival may be enhanced using this approach, although not to the extent observed when the smolts were transported away from the river mouth before release. In summary, direct experimental testing of different release strategies using the POST array to measure ocean survival accelerated the scientific process by allowing rapid collection of data which enabled the rejection of several existing theories and allowed tentative identification of several new alternative approaches that might improve early marine survival of Seymour River steelhead.

  9. Thermodynamics of the Apparent Horizon in FRW Universe with Massive Gravity

    Institute of Scientific and Technical Information of China (English)

    LI Hui; ZHANG Yi

    2013-01-01

    Applying Clausius relation with energy-supply defined by the unified first law of thermodynamics formalism to the apparent horizon of a massive gravity model in cosmology proposed lately,the corrected entropic formula of the apparent horizon is obtained with the help of the modified Friedmann equations.This entropy-area relation,together with the identified Misner-Sharp internal energy,verifies the first law of thermodynamics for the apparent horizon with a volume change term for consistency.On the other hand,by means of the corrected entropy-area formula and the Clausius relation δQ =T dS,where the heat flow δQ is the energy-supply of pure matter projecting on the vector ξ tangent to the apparent horizon and should be looked on as the amount of energy crossing the apparent horizon during the time interval dt and the temperature of the apparent horizon for energy crossing during the same interval is 1/(2π(r)A),the modified Friedmann equations governing the dynamical evolution of the universe are reproduced with the known energy density and pressure of massive graviton.The integration constant is found to correspond to a cosmological term which could be absorbed into the energy density of matter.Having established the correspondence of massive cosmology with the unified first law of thermodynamics on the apparent horizon,the validity of the generalized second law of thermodynamics is also discussed by assuming the thermal equilibrium between the apparent horizon and the matter field bounded by the apparent horizon.It is found that,in the limit Hc → 0,which recovers the Minkowski reference metric solution in the flat case,the generalized second law of thermodynamics holds if α3 + 4α4 < 0.Without this condition,even for the simplest model of dRGT massive cosmology with α3 =α4 =0,the generalized second law of thermodynamics could be violated.

  10. Apparent density patterns in subchondral bone of the sloth and anteater forelimb.

    Science.gov (United States)

    Patel, Biren A; Carlson, Kristian J

    2008-10-23

    Vertebrate morphologists often are interested in inferring limb-loading patterns in animals characterized by different locomotor repertoires. Because bone apparent density (i.e. mass per unit volume of bone inclusive of porosities) is a determinant of compressive strength, and thus indicative of compressive loading, recent comparative studies in primates have proposed a structure-function relationship between apparent density of subchondral bone and locomotor behaviours that vary in compressive loading. If such patterns are found in other mammals, then these relationships would be strengthened further. Here, we examine the distal radius of suspensory sloths that generally load their forelimbs (FLs) in tension and of quadrupedal anteaters that generally load their FLs in compression. Computed tomography osteoabsorptiometry was used to visualize the patterns in subchondral apparent density. Suspensory sloths exhibit relatively smaller areas of high apparent density than quadrupedal anteaters. This locomotor-based pattern is analogous to the pattern observed in suspensory and quadrupedal primates. Similarity between xenarthran and primate trends suggests broad-scale applicability for analysing subchondral bone apparent density and supports the idea that bone functionally alters its material properties in response to locomotor behaviours.

  11. The apparent contact angle of water droplet on the micro-structured hydrophobic surface

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    The apparent contact angle of Cassie-Baxter state water droplets can be calculated by the existing theoretical formula, but due to the defects of the micro-structured hydrophobic surface and some inevitable tiny disturbances in the experiment, Cassie-Baxter state water droplets will appear partly in Wenzel state, that is, the mixed state water droplets. In this paper, apparent contact angles of Cassie-Baxter state and mixed state water droplets on micro-structured hydrophobic surfaces are compared. The research shows that if the projected area fraction of water-solid F in the Cassie-Baxter formula is replaced by the local projected area fraction of water-solid F′, the apparent contact angles of water droplets in both Cassie-Baxter state and the mixed state can be calculated. Further experimental results indicate that the contact state of water droplets nearby the outermost three-phase contact line plays a more important role in determining the apparent contact angle. This conclusion is significant to the understanding of the apparent contact angle and wetting property.

  12. Apparent plasticity in functional traits determining competitive ability and spatial distribution: a case from desert.

    Science.gov (United States)

    Xie, Jiang-Bo; Xu, Gui-Qing; Jenerette, G Darrel; Bai, Yong-fei; Wang, Zhong-Yuan; Li, Yan

    2015-07-20

    Species competitive abilities and their distributions are closely related to functional traits such as biomass allocation patterns. When we consider how nutrient supply affects competitive abilities, quantifying the apparent and true plasticity in functional traits is important because the allometric relationships among traits are universal in plants. We propose to integrate the notion of allometry and the classical reaction norm into a composite theoretical framework that quantifies the apparent and true plasticity. Combining the framework with a meta-analysis, a series of field surveys and a competition experiment, we aimed to determine the causes of the dune/interdune distribution patterns of two Haloxylon species in the Gurbantonggut Desert. We found that (1) the biomass allocation patterns of both Haloxylon species in responses to environmental conditions were apparent rather than true plasticity and (2) the allometric allocation patterns affected the plants' competition for soil nutrient supply. A key implication of our results is that the apparent plasticity in functional traits of plants determines their response to environmental change. Without identifying the apparent and true plasticity, we would substantially overestimate the magnitude, duration and even the direction of plant responses in functional traits to climate change.

  13. Thermodynamic Behavior of Friedmann Equations at Apparent Horizon of FRW Universe

    CERN Document Server

    Akbar, M; Cai, Rong-Gen

    2006-01-01

    It is shown that the differential form of Friedmann equations of a FRW universe can be rewritten as a thermodynamical identity $TdS = dE + PdV$ at apparent horizon, where $E$ is the Misner-Sharp energy, $V$ is the volume inside the apparent horizon, and $P$ is the pressure of the perfect fluid in the universe. From the thermodynamic identity one can derive that the apparent horizon $\\tilde r_A$ has associated temperature $T=1/2\\pi \\tilde r_A$ and entropy $S= A/4G$ in Einstein general relativity, where $A$ is the area of apparent horizon. We extend our procedure to the Gauss-Bonnet gravity and more general Lovelock gravity and show that the field equations in these gravities can also be identified as a thermodynamical system satisfying $TdS = dE + PdV$ at the apparent horizon of FRW universe with entropy $S$ being given by expression previously known via black hole thermodynamics.

  14. Investigations of the Response of Swimming Paramecia to Variations in their Apparent Weight

    Science.gov (United States)

    Valles, James; Jung, Ilyong; Guevorkian, Karine; Mickalide, Harry; Wagman, Michael

    2011-11-01

    There is a set of micro-organisms that are small enough that they swim at low Reynolds number and large enough that gravity exerts an influence on their behavior Many protists, like paramecia, for example, exhibit negative gravi-taxis by orienting their swimming upward and negative gravi-kinesis by increasing their propulsion when swimming against their apparent weight. It is not clear whether these responses to a very weak force (about 100 pN) are active or passive. We have developed a technique, Magnetic Force Buoyancy Variation, which enables us to vary the apparent weight of the swimmers in situ. We will describe experiments on paramecia conducted at the National High Magnetic Field Laboratory. In particular, we will describe how increasing the apparent weight induces paramecia to accumulate at upper surfaces. A simple force model suggests that this accumulation is a passive response. Supported by NSF-PHY0750360 and a grant to the NHMFL, NSF DMR-0654118.

  15. Evaluation of apparent viscosity of Para rubber latex by diffuse reflection near-infrared spectroscopy.

    Science.gov (United States)

    Sirisomboon, Panmanas; Chowbankrang, Rawiphan; Williams, Phil

    2012-05-01

    Near-infrared spectroscopy in diffuse reflection mode was used to evaluate the apparent viscosity of Para rubber field latex and concentrated latex over the wavelength range of 1100 to 2500 nm, using partial least square regression (PLSR). The model with ten principal components (PCs) developed using the raw spectra accurately predicted the apparent viscosity with correlation coefficient (r), standard error of prediction (SEP), and bias of 0.974, 8.6 cP, and -0.4 cP, respectively. The ratio of the SEP to the standard deviation (RPD) and the ratio of the SEP to the range (RER) for the prediction were 4.4 and 16.7, respectively. Therefore, the model can be used for measurement of the apparent viscosity of field latex and concentrated latex in quality assurance and process control in the factory.

  16. Apparent Deviations from Keplerian Acceleration for Stars Around the Supermassive Black Hole at the Galactic Center

    CERN Document Server

    Loeb, A

    2003-01-01

    We show that the time-dependent Doppler effect should induce measureable deviations of the time history of the projected orbit of a star around the supermassive black hole in the Galactic center (SgrA*) from the expected Keplerian history. In particular, the line-of-sight acceleration of the star generates apparent acceleration of its image along its velocity vector on the sky, even if its actual Keplerian acceleration in this direction vanishes. The excess apparent acceleration simply results from the transformation of time between the reference frames of the observer and the star. Although the excess acceleration averages to zero over a full closed orbit, it could lead to systematic offsets of a few percent in estimates of the dynamical mass or position of the black hole that rely on partially sampled orbits with pericentric distances of ~100AU. Deviations of this magnitude from apparent Keplerian dynamics of known stars should be detectable by future observations.

  17. Apparent competition and native consumers exacerbate the strong competitive effect of an exotic plant species.

    Science.gov (United States)

    Orrock, John L; Dutra, Humberto P; Marquis, Robert J; Barber, Nicholas

    2015-04-01

    Direct and indirect effects can play a key role in invasions, but experiments evaluating both are rare. We examined the roles of direct competition and apparent competition by exotic Amur honeysuckle (Lonicera maackii) by manipulating (1) L. maackii vegetation, (2) presence of L. maackii fruits, and (3) access to plants by small mammals and deer. Direct competition with L. maackii reduced the abundance and richness of native and exotic species, and native consumers significantly reduced the abundance and richness of native species. Although effects of direct competition and consumption were more pervasive, richness of native plants was also reduced through apparent competition, as small-mammal consumers reduced richness only when L. maackii fruits were present. Our experiment reveals the multiple, interactive pathways that affect the success and impact of an invasive exotic plant: exotic plants may directly benefit from reduced attack by native consumers, may directly exert strong competitive effects on native plants, and may also benefit from apparent competition.

  18. Apparent contact angle and contact angle hysteresis on liquid infused surfaces.

    Science.gov (United States)

    Semprebon, Ciro; McHale, Glen; Kusumaatmaja, Halim

    2016-12-21

    We theoretically investigate the apparent contact angle and contact angle hysteresis of a droplet placed on a liquid infused surface. We show that the apparent contact angle is not uniquely defined by material parameters, but also has a dependence on the relative size between the droplet and its surrounding wetting ridge formed by the infusing liquid. We derive a closed form expression for the contact angle in the limit of vanishing wetting ridge, and compute the correction for small but finite ridge, which corresponds to an effective line tension term. We also predict contact angle hysteresis on liquid infused surfaces generated by the pinning of the contact lines by the surface corrugations. Our analytical expressions for both the apparent contact angle and contact angle hysteresis can be interpreted as 'weighted sums' between the contact angles of the infusing liquid relative to the droplet and surrounding gas phases, where the weighting coefficients are given by ratios of the fluid surface tensions.

  19. Apparent contact angle and contact angle hysteresis on liquid infused surfaces

    Science.gov (United States)

    Semprebon, Ciro; McHale, Glen; Kusumaatmaja, Halim

    We theoretically investigate the apparent contact angle and contact angle hysteresis of a droplet placed on a liquid infused surface. We show that the apparent contact angle is not uniquely defined by material parameters, but also has a strong dependence on the relative size between the droplet and its surrounding wetting ridge formed by the infusing liquid. We derive a closed form expression for the contact angle in the limit of vanishing wetting ridge, and compute the correction for small but finite ridge, which corresponds to an effective line tension term. We also predict contact angle hysteresis on liquid infused surfaces generated by the pinning of the contact lines by the surface corrugations. Our analytical expressions for both the apparent contact angle and contact angle hysteresis can be interpreted as `weighted sums' between the contact angles of the infusing liquid relative to the droplet and surrounding gas phases, where the weighting coefficients are given by ratios of the fluid surface tensions.

  20. Elastic properties and apparent density of human edentulous maxilla and mandible.

    Science.gov (United States)

    Seong, W-J; Kim, U-K; Swift, J Q; Heo, Y-C; Hodges, J S; Ko, C-C

    2009-10-01

    The aim of this study was to determine whether elastic properties and apparent density of bone differ in different anatomical regions of the maxilla and mandible. Additional analyses assessed how elastic properties and apparent density were related. Four pairs of edentulous maxilla and mandibles were retrieved from fresh human cadavers. Bone samples from four anatomical regions (maxillary anterior, maxillary posterior, mandibular anterior, mandibular posterior) were obtained. Elastic modulus (EM) and hardness (H) were measured using the nano-indentation technique. Bone samples containing cortical and trabecular bone were used to measure composite apparent density (cAD) using Archimedes' principle. Statistical analyses used repeated measures ANOVA and Pearson correlations. Bone physical properties differed between regions of the maxilla and mandible. Generally, mandible had higher physical property measurements than maxilla. EM and H were higher in posterior than in anterior regions; the reverse was true for cAD. Posterior maxillary cAD was significantly lower than that in the three other regions.

  1. APPARENT DIGESTIBILTY EXPERIMENT WITH NILE TILAPIA (OREOCHROMIS NILOTICUS FED DIETS CONTAINING CITRULLUS LANATUS SEEDMEAL

    Directory of Open Access Journals (Sweden)

    Wasiu Adeyemi JIMOH

    2015-12-01

    Full Text Available Apparent digestibility coefficients of nutrients in Citrullus lanatus based diets were determined for Nile tilapia (Oreochromis niloticus using AIA as marker or indicator. 150 tilapia fingerlings of average weight 6.12±0.05g were acclimatized for a week, weighed and allotted into five dietary treatments; CTR, DT2, DT3, DT4 and DT5 containing 0, 15, 30, 45 and 60% Citrullus lanatus respectively. The diets were isonitrogenous, isocaloric and isolipidic. Each treatment was replicated three times with ten fish per replicate. Fish were fed 5% body weight on two equal proportions per day. The results from the study indicated that there was no significant variation (p>0.05 in the apparent organic matter and gross energy digestibility coefficients of the diets; that there was significant (p0.05 in the apparent digestibility coefficients of nutrients (protein, energy, lipid and carbohydrates between the diets up to 30% replacement levels for tilapia.

  2. Traumatic-event headaches

    Directory of Open Access Journals (Sweden)

    Haas David C

    2004-10-01

    Full Text Available Abstract Background Chronic headaches from head trauma and whiplash injury are well-known and common, but chronic headaches from other sorts of physical traumas are not recognized. Methods Specific information was obtained from the medical records of 15 consecutive patients with chronic headaches related to physically injurious traumatic events that did not include either head trauma or whiplash injury. The events and the physical injuries produced by them were noted. The headaches' development, characteristics, duration, frequency, and accompaniments were recorded, as were the patients' use of pain-alleviative drugs. From this latter information, the headaches were classified by the diagnostic criteria of the International Headache Society as though they were naturally-occurring headaches. The presence of other post-traumatic symptoms and litigation were also recorded. Results The intervals between the events and the onset of the headaches resembled those between head traumas or whiplash injuries and their subsequent headaches. The headaches themselves were, as a group, similar to those after head trauma and whiplash injury. Thirteen of the patients had chronic tension-type headache, two had migraine. The sustained bodily injuries were trivial or unidentifiable in nine patients. Fabrication of symptoms for financial remuneration was not evident in these patients of whom seven were not even seeking payments of any kind. Conclusions This study suggests that these hitherto unrecognized post-traumatic headaches constitute a class of headaches characterized by a relation to traumatic events affecting the body but not including head or whiplash traumas. The bodily injuries per se can be discounted as the cause of the headaches. So can fabrication of symptoms for financial remuneration. Altered mental states, not systematically evaluated here, were a possible cause of the headaches. The overall resemblance of these headaches to the headaches after

  3. Color signal integration for color discrimination along a long-range apparent motion trajectory.

    Science.gov (United States)

    Nagai, Takehiro; Kimura, Hiroto; Nakauchi, Shigeki

    2013-01-01

    In contrast to the classical view that fundamental visual attributes such as color and motion are independently processed in the visual system (e.g. Livingstone and Hubel, 1987; Marr, 1982), recent studies have revealed various forms of cross-attribute interactions, such as averaging of color appearance along the motion trajectory of an object (Nishida et al., 2007). In this study, we investigated whether such color signal integration along a motion trajectory can be induced only by motion mechanisms having large receptive fields, without simple integration within direction-selective neurons with small receptive fields, like those in V1. The stimulus consisted of discs with long-range apparent motion along a circular trajectory. The stimulus onset asynchrony (SOA) between disc presentations controlled the strength of the apparent motion perception. We measured observers' sensitivity in detecting color modulation on the discs. The results showed that the measured sensitivity was lowest at SOAs corresponding to the strongest motion perception. This can be interpreted as follows: color signals were integrated along an apparent motion path, and this integration reduced chromatic sensitivity by averaging color signals. Another experiment that controlled apparent motion perception in a different way also supported this idea. However, this integration effect seemed to be linked to responses of motion detectors for the apparent motion stimuli, not directly to perceptual motion representation in the visual system. These results suggest that the human visual system handles color information from retinal inputs regarding moving objects based not only on a retinotopic coordinate but also on object-based coordinates, even when the moving object yields only long-range apparent motion.

  4. Solar extreme events

    CERN Document Server

    Hudson, Hugh S

    2015-01-01

    Solar flares and CMEs have a broad range of magnitudes. This review discusses the possibility of "extreme events," defined as those with magnitudes greater than have been seen in the existing historical record. For most quantitative measures, this direct information does not extend more than a century and a half into the recent past. The magnitude distributions (occurrence frequencies) of solar events (flares/CMEs) typically decrease with the parameter measured or inferred (peak flux, mass, energy etc. Flare radiation fluxes tend to follow a power law slightly flatter than $S^{-2}$, where S represents a peak flux; solar particle events (SPEs) follow a still flatter power law up to a limiting magnitude, and then appear to roll over to a steeper distribution, which may take an exponential form or follow a broken power law. This inference comes from the terrestrial $^{14}$C record and from the depth dependence of various radioisotope proxies in the lunar regolith and in meteorites. Recently major new observation...

  5. PREVENTABLE ERRORS: NEVER EVENTS

    Directory of Open Access Journals (Sweden)

    Narra Gopal

    2014-07-01

    Full Text Available Operation or any invasive procedure is a stressful event involving risks and complications. We should be able to offer a guarantee that the right procedure will be done on right person in the right place on their body. “Never events” are definable. These are the avoidable and preventable events. The people affected from consequences of surgical mistakes ranged from temporary injury in 60%, permanent injury in 33% and death in 7%”.World Health Organization (WHO [1] has earlier said that over seven million people across the globe suffer from preventable surgical injuries every year, a million of them even dying during or immediately after the surgery? The UN body quantified the number of surgeries taking place every year globally 234 million. It said surgeries had become common, with one in every 25 people undergoing it at any given time. 50% never events are preventable. Evidence suggests up to one in ten hospital admissions results in an adverse incident. This incident rate is not acceptable in other industries. In order to move towards a more acceptable level of safety, we need to understand how and why things go wrong and have to build a reliable system of working. With this system even though complete prevention may not be possible but we can reduce the error percentage2. To change present concept towards patient, first we have to change and replace the word patient with medical customer. Then our outlook also changes, we will be more careful towards our customers.

  6. LHCb Event display

    CERN Document Server

    Trisovic, Ana

    2014-01-01

    The LHCb Event Display was made for educational purposes at the European Organization for Nuclear Research, CERN in Geneva, Switzerland. The project was implemented as a stand-alone application using C++ and ROOT, a framework developed by CERN for data analysis. This paper outlines the development and architecture of the application in detail, as well as the motivation for the development and the goals of the exercise. The application focuses on the visualization of events recorded by the LHCb detector, where an event represents a set of charged particle tracks in one proton-proton collision. Every particle track is coloured by its type and can be selected to see its essential information such as mass and momentum. The application allows students to save this information and calculate the invariant mass for any pair of particles. Furthermore, the students can use additional calculating tools in the application and build up a histogram of these invariant masses. The goal for the students is to find a $D^0$ par...

  7. Geographic variation in apparent competition between native and invasive Phragmites australis.

    Science.gov (United States)

    Bhattarai, Ganesh P; Meyerson, Laura A; Cronin, James T

    2017-02-01

    Apparent competition, the negative interaction between species mediated by shared natural enemies, is thought to play an important role in shaping the structure and dynamics of natural communities. However, its importance in driving species invasions, and whether the strength of this indirect interaction varies across the latitudinal range of the invasion, has not been fully explored. We performed replicated field experiments at four sites spanning 900 km along the Atlantic Coast of the United States to assess the presence and strength of apparent competition between sympatric native and invasive lineages of Phragmites australis. Four herbivore guilds were considered: stem-feeders, leaf-miners, leaf-chewers and aphids. We also tested the hypothesis that the strength of this interaction declines with increasing latitude. Within each site, native and invasive plants of P. australis were cross-transplanted between co-occurring native and invasive patches in the same marsh habitat and herbivore damage was evaluated at the end of the growing season. Apparent competition was evident for both lineages and involved all but the leaf-chewer guild. For native plants, total aphids per plant was 296% higher and the incidence of stem-feeding and leaf-mining herbivores was 34% and 221% higher, respectively, when transplanted into invasive than native patches. These data suggest that invasive P. australis has a negative effect on native P. australis via apparent competition. Averaged among herbivore types, the indirect effects of the invasive lineage on the native lineage was 57% higher than the reverse situation, suggesting that apparent competition was asymmetric. We also found that the strength of apparent competition acting against the native lineage was comparable to the benefits to the invasive lineage from enemy release (i.e., proportionately lower mean herbivory of the invasive relative to the native taxa). Finally, we found the first evidence that the strength of

  8. Two-dimensional modeling of apparent resistivity pseudosections in the Cerro Prieto region

    Energy Technology Data Exchange (ETDEWEB)

    Vega, R.; Martinez, M.

    1981-01-01

    Using a finite-difference program (Dey, 1976) for two-dimensional modeling of apparent resistivity pseudosections obtained by different measuring arrays, four apparent resistivity pseudosections obtained at Cerro Prieto with a Schlumberger array by CFE personnel were modeled (Razo, 1978). Using geologic (Puente and de la Pena, 1978) and lithologic (Diaz, et al., 1981) data from the geothermal region, models were obtained which show clearly that, for the actual resistivity present in the zone, the information contained in the measured pseudosections is primarily due to the near-surface structure and does not show either the presence of the geothermal reservoir or the granitic basement which underlies it.

  9. Turner Syndrome and apparent absent uterus: a case report and review of the literature.

    Science.gov (United States)

    Akierman, Sarah V; Skappak, Christopher D; Girgis, Rose; Ho, Josephine

    2013-01-01

    We report on a patient who initially presented with delayed puberty and an absent uterus on imaging with ultrasound and MRI. She was subsequently diagnosed with Turner Syndrome. Turner Syndrome typically presents with early loss of ovarian function and should be considered when primary ovarian insufficiency is present with apparent absent uterus on imaging. Follow-up imaging of the apparent absent uterus post-estrogen replacement therapy is important to confirm a normal uterus. A diagnosis of an absent uterus can be psychologically traumatic for patients and families, and can have significant implications for future fertility options.

  10. Anomalous Sinking of Spheres due to Local Fluidization of Apparently Fixed Powder Beds.

    Science.gov (United States)

    Oshitani, Jun; Sasaki, Toshiki; Tsuji, Takuya; Higashida, Kyohei; Chan, Derek Y C

    2016-02-12

    The sinking of an intruder sphere into a powder bed in the apparently fixed bed regime exhibits complex behavior in the sinking rate and the final depth when the sphere density is close to the powder bed density. Evidence is adduced that the intruder sphere locally fluidizes the apparently fixed powder bed, allowing the formation of voids and percolation bubbles that facilitates spheres to sink slower but deeper than expected. By adjusting the air injection rate and the sphere-to-powder bed density ratio, this phenomenon provides the basis of a sensitive large particle separation mechanism.

  11. Tunnelling phenomenon near an apparent horizon in two-dimensional dilaton gravity

    CERN Document Server

    Cao, Li-Ming; Peng, Yuxuan

    2016-01-01

    Based on the definition of the apparent horizon in a general two-dimensional dilaton gravity theory, we analyze the tunnelling phenomenon of the apparent horizon by using Hamilton-Jacobi method. In this theory the definition of the horizon is very different from those in higher-dimensional gravity theories. The spectrum of the radiation is obtained and the temperature of the radiation is read out from this spectrum and it satisfies the usual relationship with the surface gravity. Besides, the calculation with Parikh's null geodesic method for a simple example conforms to our result in general stationary cases.

  12. Event-Based Conceptual Modeling

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    2009-01-01

    The purpose of the paper is to obtain insight into and provide practical advice for event-based conceptual modeling. We analyze a set of event concepts and use the results to formulate a conceptual event model that is used to identify guidelines for creation of dynamic process models and static...... information models. We characterize events as short-duration processes that have participants, consequences, and properties, and that may be modeled in terms of information structures. The conceptual event model is used to characterize a variety of event concepts and it is used to illustrate how events can...... be used to integrate dynamic modeling of processes and static modeling of information structures. The results are unique in the sense that no other general event concept has been used to unify a similar broad variety of seemingly incompatible event concepts. The general event concept can be used...

  13. Sample Spaces and Events(2)

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Definition: An event is a subset E of the sample space S. The impossible event is the subset E = φ (empty set). The certain event is the subset E = S (sample space).Note that any subset of S represents an event, according to this defintion. Thus, in rolling a die the subset E={1,2,5} represents an event, which we can describe in words as "the die comes up 1,2, or 5. "

  14. EventSlider User Manual

    Science.gov (United States)

    2016-09-01

    FrameworkElement parent class), which allows for efficient batch setting of these main properties without changing the display until the initialization is...a single click, or a tap, near or on an event line. 4. Library and Namespace The EventSlider control has been compiled into the following dynamic...namespace:WPFControls.EventSlider;assembly=WPFControls.EventSlider" Only a single class is exposed in this namespace, the EventSlider class. All methods, properties, and

  15. An investigation of the apparent breast cancer epidemic in France: screening and incidence trends in birth cohorts

    Directory of Open Access Journals (Sweden)

    Olsen Jørn

    2011-09-01

    Full Text Available Abstract Background Official descriptive data from France showed a strong increase in breast-cancer incidence between 1980 to 2005 without a corresponding change in breast-cancer mortality. This study quantifies the part of incidence increase due to secular changes in risk factor exposure and in overdiagnosis due to organised or opportunistic screening. Overdiagnosis was defined as non progressive tumours diagnosed as cancer at histology or progressive cancer that would remain asymptomatic until time of death for another cause. Methods Comparison between age-matched cohorts from 1980 to 2005. All women residing in France and born 1911-1915, 1926-1930 and 1941-1945 are included. Sources are official data sets and published French reports on screening by mammography, age and time specific breast-cancer incidence and mortality, hormone replacement therapy, alcohol and obesity. Outcome measures include breast-cancer incidence differences adjusted for changes in risk factor distributions between pairs of age-matched cohorts who had experienced different levels of screening intensity. Results There was an 8-fold increase in the number of mammography machines operating in France between 1980 and 2000. Opportunistic and organised screening increased over time. In comparison to age-matched cohorts born 15 years earlier, recent cohorts had adjusted incidence proportion over 11 years that were 76% higher [95% confidence limits (CL 67%, 85%] for women aged 50 to 64 years and 23% higher [95% CL 15%, 31%] for women aged 65 to 79 years. Given that mortality did not change correspondingly, this increase in adjusted 11 year incidence proportion was considered as an estimate of overdiagnosis. Conclusions Breast cancer may be overdiagnosed because screening increases diagnosis of slowly progressing non-life threatening cancer and increases misdiagnosis among women without progressive cancer. We suggest that these effects could largely explain the reported

  16. Uranium-lead isotope systematics and apparent ages of zircons and other minerals in precambrian granitic rocks, Granite Mountains, Wyoming

    Science.gov (United States)

    Ludwig, K. R.; Stuckless, J.S.

    1978-01-01

    Zircon suites from the two main types of granite in the Granite Mountains, Wyoming, yielded concordia-intercept ages of 2,640??20 m.y. for a red, foliated granite (granite of Long Creek Mountain) and 2,595??40 m.y. for the much larger mass of the granite of Lankin Dome. These ages are statistically distinct (40??20 m.y. difference) and are consistent with observed chemical and textural differences. The lower intercepts of the zircon chords of 50??40 and 100+ 75 m.y. for the granite of Long Creek Mountain and granite of Lankin Dome, respectively, are not consistent with reasonable continuous diffusion lead-loss curves but do correspond well with the known (Laramide) time of uplift of the rocks. Epidote, zircon, and apatite from silicified and epidotized zones in the granites all record at least one postcrystallization disturbance in addition to the Laramide event and do not define a unique age of silicification and epidotization. The lower limit of ???2,500 m.y. provided by the least disturbed epidote, however, suggests that these rocks were probably formed by deuteric processes shortly after emplacement of the granite of the Lankin Dome. The earlier of the two disturbances that affected the minerals of the silicified-epidotized rock can be bracketed between 1,350 and 2,240 m.y. ago and is probably the same event that lowered mineral K-Ar and ages in the region. Zircon suites from both types of granite show well-defined linear correlations among U content, common-Pb content, and degree of discordance. One of the zircon suites has an extremely high common-Pb content (up to 180 ppm) and exhibits a component of radiogenic-Pb loss that is apparently unrelated to radiation damage. ?? 1978 Springer-Verlag.

  17. Thermodynamics of Apparent Horizon and Friedmann Equations in Big Bounce Universe

    CERN Document Server

    Liu, Molin; Lv, Jianbo; Xu, Lixin

    2014-01-01

    In this paper, the thermodynamics of apparent horizon and Friedmann equations are studied in a big bounce universe typified by a non-singular big bounce, as opposed to a singular big bang. This cosmological model can describe radiation dominated early universe and matter dominated late universe in FRW model. Our calculational results show that Einstein gravitational field equations could be derived by the first law of thermodynamics and the fluid's continuity equation. The connections between thermodynamics and gravity are observed in big bounce universe. In the late stages of cold and hot universes, the apparent horizons are convergent and the time when apparent horizons begin to bounce essentially in agreement with that of universe's scalar factor. In the early stage of both cold and hot universes, we find there is only one geometry containing a 4D de Sitter universe with general state parameter. Furthermore, we also find the form of apparent horizon in early universe is strongly dependent on the extra dime...

  18. Influence of feeding various phosphorus sources on apparent digestibility of phosphorus in dairy cows

    NARCIS (Netherlands)

    Ekelund, A.; Sporndly, R.; Valk, H.; Murphy, M.

    2003-01-01

    The present investigated differences in the apparent digestibility of phosphorus (ADP) in lactating cows fed various feed materials containing organic forms of phosphorus (P) or a highly available inorganic phosphorus source. Cows milking an average of 36 kg energy corrected milk (ECM) were used in

  19. Thermal conductivity as influenced by the temperature and apparent viscosity of dairy products.

    Science.gov (United States)

    Gonçalves, B J; Pereira, C G; Lago, A M T; Gonçalves, C S; Giarola, T M O; Abreu, L R; Resende, J V

    2017-03-02

    This study aimed to evaluate the rheological behavior and thermal conductivity of dairy products, composed of the same chemical components but with different formulations, as a function of temperature. Subsequently, thermal conductivity was related to the apparent viscosity of yogurt, fermented dairy beverage, and fermented milk. Thermal conductivity measures and rheological tests were performed at 5, 10, 15, 20, and 25°C using linear probe heating and an oscillatory rheometer with concentric cylinder geometry, respectively. The results were compared with those calculated using the parallel, series, and Maxwell-Eucken models as a function of temperature, and the discrepancies in the results are discussed. Linear equations were fitted to evaluate the influence of temperature on the thermal conductivity of the dairy products. The rheological behavior, specifically apparent viscosity versus shear rate, was influenced by temperature. Herschel-Bulkley, power law, and Newton's law models were used to fit the experimental data. The Herschel-Bulkley model best described the adjustments for yogurt, the power law model did so for fermented dairy beverages, and Newton's law model did so for fermented milk and was then used to determine the rheological parameters. Fermented milk showed a Newtonian trend, whereas yogurt and fermented dairy beverage were shear thinning. Apparent viscosity was correlated with temperature by the Arrhenius equation. The formulation influenced the effective thermal conductivity. The relationship between the 2 properties was established by fixing the temperature and expressing conductivity as a function of apparent viscosity. Thermal conductivity increased with viscosity and decreased with increasing temperature.

  20. To Think or Not to Think: The Apparent Paradox of Expert Skill in Music Performance

    Science.gov (United States)

    Geeves, Andrew; McIlwain, Doris J. F.; Sutton, John; Christensen, Wayne

    2014-01-01

    Expert skill in music performance involves an apparent paradox. On stage, expert musicians are required accurately to retrieve information that has been encoded over hours of practice. Yet they must also remain open to the demands of the ever-changing situational contingencies with which they are faced during performance. To further explore this…

  1. 45 CFR 73.735-904 - Resolution of apparent or actual conflicts of interest.

    Science.gov (United States)

    2010-10-01

    ... ADMINISTRATION STANDARDS OF CONDUCT Reporting Financial Interests § 73.735-904 Resolution of apparent or actual... appropriate method of resolving such conflicts when: (1) The trust is qualified under section 202(f) of the Ethics in Government Act of 1978 (Pub. L. 95-521), as amended, and subject to the regulations of...

  2. Presence of European bat lyssavirus RNas in apparently healthy Rousettus aegyptiacus bats

    NARCIS (Netherlands)

    Wellenberg, G.J.; Audry, L.; Ronsholt, L.; Poel, van der W.H.M.; Bruschke, C.J.M.; Bourhy, H.

    2002-01-01

    Apparently healthy Rousettus aegyptiacus bats were randomly chosen from a Dutch colony naturally infected with European bat lyssavirus subgenotype 1a (EBL1a). These bats were euthanised three months after the first evidence of an EBL1a infection in the colony. EBL1a genomic and antigenomic RNAs of t

  3. Structure of Gamma-Ray Burst jets: intrinsic versus apparent properties

    CERN Document Server

    Salafia, O S; Pescalli, A; Ghirlanda, G; Nappo, F

    2015-01-01

    With this paper we introduce the concept of apparent structure of a GRB jet, as opposed to its intrinsic structure. The latter is customarily defined specifying the functions epsilon(theta) (the energy emitted per jet unit solid angle) and Gamma(theta) (the Lorentz factor of the emitting material); the apparent structure is instead defined by us as the isotropic equivalent energy E_iso(theta_v) as a function of the viewing angle theta_v. We show how to predict the apparent structure of a jet given its intrinsic structure. We find that a Gaussian intrinsic structure yields a power law apparent structure: this opens a new viewpoint on the Gaussian (which can be understood as a proxy for a realistic narrow, well collimated jet structure) as a possible candidate for a quasi-universal GRB jet structure. We show that such a model (a) is consistent with recent constraints on the observed luminosity function of GRBs; (b) implies fewer orphan afterglows with respect to the standard uniform model; (c) can break out the...

  4. The effect of interaural-time-difference fluctuations on apparent source width

    DEFF Research Database (Denmark)

    Käsbach, Johannes; May, Tobias; Oskarsdottir, Gudrun;

    2014-01-01

    For the perception of spaciousness, the temporal fluctuations of the interaural time differences (ITDs) and interaural level differences (ILDs) provide important binaural cues. One major characteristic of spatial perception is apparent source width (ASW), which describes the perceived width of a ...

  5. Primary School Students' Ideas Concerning the Apparent Movement of the Moon

    Science.gov (United States)

    Starakis, John; Halkia, Krystallia

    2010-01-01

    In the present study, primary school students' ideas concerning the apparent movement of the Moon are investigated. The research was carried out in five primary schools of Athens (Greece) with a sample of forty (40), fifth and sixth grade students. Semistructured interviews were used to gather scientific data and students had the opportunity to…

  6. Stewart analysis of apparently normal acid-base state in the critically ill

    NARCIS (Netherlands)

    Moviat, M.; Boogaard, M. van den; Intven, F.; Voort, P. van der; Hoeven, H. van der; Pickkers, P.

    2013-01-01

    PURPOSE: This study aimed to describe Stewart parameters in critically ill patients with an apparently normal acid-base state and to determine the incidence of mixed metabolic acid-base disorders in these patients. MATERIALS AND METHODS: We conducted a prospective, observational multicenter study of

  7. Standardization of soil apparent electrical conductivity using multi-temporal surveys across multiple production fields

    Science.gov (United States)

    Apparent soil electrical conductivity (ECa) is an efficient technique for understanding within-field variability of physical and chemical soil characteristics. Commercial devices are readily available for collecting ECa on whole fields and used broadly for crop management in precision agriculture; h...

  8. Apparent-contact-angle model at partial wetting and evaporation: Impact of surface forces

    Science.gov (United States)

    Janeček, V.; Nikolayev, V. S.

    2013-01-01

    This theoretical and numerical study deals with evaporation of a fluid wedge in contact with its pure vapor. The model describes a regime where the continuous wetting film is absent and the actual line of the triple gas-liquid-solid contact appears. A constant temperature higher than the saturation temperature is imposed at the solid substrate. The fluid flow is solved in the lubrication approximation. The introduction of the surface forces in the case of the partial wetting is discussed. The apparent contact angle (the gas-liquid interface slope far from the contact line) is studied numerically as a function of the substrate superheating, contact line velocity, and parameters related to the solid-fluid interaction (Young and microscopic contact angles, Hamaker constant, etc.). The dependence of the apparent contact angle on the substrate temperature is in agreement with existing approaches. For water, the apparent contact angle may be 20∘ larger than the Young contact angle for 1 K superheating. The effect of the surface forces on the apparent contact angle is found to be weak.

  9. Calculation of Apparent Activation Energy of Coal Oxidation at Low Temperatures by Measuring CO Yield

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    By analyzing previous studies on activation energy of coal oxidation at low temperatures, a theoretical calculation model of apparent activation energy is established. Yield of CO is measured by using the characteristic detector of coal oxidation at 30-90 ℃. The impact of parameters, such as airflow and particle size, on activation energies is analyzed. Finally, agreement was obtained between activation energies and the dynamic oxygen absorbed in order to test the accuracy of the model. The results show that: 1) a positive exponential relation between concentration of CO and temperature in the process of the experiment is obtained: increases are almost identical and the initial CO is low; 2) the apparent activation energies increase gradually with the sizes of particle at the same airflow, but the gradients increase at a decreasing rate; 3) the apparent activation energies increase linearly with airflow. For the five coal particles, the differences among the energies are relatively high when the airflow was low, but the differences were low when the airflow was high; 4) the optimum sizes of particle, 0.125-0.25 mm, and the optimum volume of airflow, 100 mL/min, are determined from the model; 5) the apparent activation energies decrease with an increase in oxygen absorbed. A negative exponential relation between the two is obtained.

  10. Concurrent temporal stability of the apparent electrical conductivity and soil water content

    Science.gov (United States)

    Knowledge of spatio-temporal soil water content (SWC) variability within agricultural fields is useful to improve crop management. Spatial patterns of soil water contents can be characterized using the temporal stability analysis, however high density sampling is required. Soil apparent electrical c...

  11. Posttreatment Apparent Diffusion Coefficient Changes in the Periresectional Area in Patients with Glioblastoma

    NARCIS (Netherlands)

    van der Hoorn, Anouk; Yan, Jiun-Lin; Larkin, Timothy J.; Boonzaier, Natalie R.; Matys, Tomasz; Price, Stephen J.

    2016-01-01

    BACKGROUND: Although targeted by radiotherapy, recurrence in glioblastoma occurs mainly periresectionally owing to tumor infiltration. An increase in the apparent diffusion coefficient (ADC) has been shown in the large high-T2 area on magnetic resonance imaging post-treatment; however, until now ADC

  12. Liquorice-induced sodium retention. Merely an acquired condition of apparent mineralocorticoid excess? A case report.

    Science.gov (United States)

    Negro, A; Rossi, E; Regolisti, G; Perazzoli, F

    2000-01-01

    Excessive ingestion of liquorice may result in sodium retention, hypertension, hypokalemia, and suppression of renin and aldosterone. Similarities between liquorice-induced effects and congenital apparent mineralocorticoid excess have recently been emphasized, as in both conditions, reduced activity of the enzyme 11 beta-hydroxysteroid dehydrogenase type 2 allows cortisol to act as a potent mineralocorticoid. We report a case of generalized edema without any increase in blood pressure, with biochemical and hormonal features of apparent mineralocorticoid excess, in a young woman who had been ingesting substantial amounts of liquorice for several years. Liquorice-induced wide-spread edema without hypertension in our patient, as well as in a few other cases previously reported, and the more common occurrence of edema associated with hypertension challenge the current explanation of liquorice syndrome as a purely acquired apparent mineralocorticoid excess. Indeed, in both congenital apparent and true mineralocorticoid excess, edema is typically absent, as a result of the sodium escape phenomenon. As pressure-natriuresis may be an essential mechanism accounting for the sodium escape phenomenon, some component of liquorice could partially or completely oppose the circulatory response that converts liquorice-induced sodium retention into blood pressure elevation. In patients with unexplained generalized edema and hypokalemia without hypertension, liquorice ingestion should be carefully investigated and the renin-aldosterone system should be assayed.

  13. Deciding what to see: the role of intention and attention in the perception of apparent motion.

    Science.gov (United States)

    Kohler, Axel; Haddad, Leila; Singer, Wolf; Muckli, Lars

    2008-03-01

    Apparent motion is an illusory perception of movement that can be induced by alternating presentations of static objects. Already in Wertheimer's early investigation of the phenomenon [Wertheimer, M. (1912). Experimentelle Studien über das Sehen von Bewegung. Zeitschrift fur Psychologie, 61, 161-265], he mentions that voluntary attention can influence the way in which an ambiguous apparent motion display is perceived. But until now, few studies have investigated how strong the modulation of apparent motion through attention can be under different stimulus and task conditions. We used bistable motion quartets of two different sizes, where the perception of vertical and horizontal motion is equally likely. Eleven observers participated in two experiments. In Experiment 1, participants were instructed to either (a) hold the current movement direction as long as possible, (b) passively view the stimulus, or (c) switch the movement directions as quickly as possible. With the respective instructions, observers could almost double phase durations in (a) and more than halve durations in (c) relative to the passive condition. This modulation effect was stronger for the large quartets. In Experiment 2, observers' attention was diverted from the stimulus by a detection task at fixation while they still had to report their conscious perception. This manipulation prolonged dominance durations for up to 100%. The experiments reveal a high susceptibility of ambiguous apparent motion to attentional modulation. We discuss how feature- and space-based attention mechanisms might contribute to those effects.

  14. Effect of dietary carbohydrate sources on apparent nutrient digestibility of olive flounder (Paralichthys olivaceus feed

    Directory of Open Access Journals (Sweden)

    Md Mostafizur Rahman

    2016-06-01

    Full Text Available Abstract Apparent digestibility coefficients (ADCs of dry matter, crude protein, crude lipid, nitrogen-free extract, and energy in selected carbohydrate sources including wheat flour (WF, α-potato starch (PS, α-corn starch (CS, Na alginate (AL, dextrin (DEX, and carboxymethyl cellulose (CMC were determined for olive flounder. The olive flounder averaging 150 ± 8.0 g were held in 300-L tanks at a density of 30 fish per tank. Chromic oxide was used as the inert marker. Feces were collected from the flounder by a fecal collector attached to a fish rearing tank. Apparent dry matter and energy digestibilities of flounder fed WF, PS, CS, and DEX diets were significantly higher than those of fish fed AL and CMC diets. Apparent crude protein digestibility coefficients of flounder fed PS and CS diets were significantly higher than those of fish fed AL, DEX, and CMC diets. Apparent crude lipid and nitrogen-free extract digestibility coefficients of flounder fed PS and DEX diets were significantly higher than those of fish fed WF, CS, AL, and CMC diets. The present findings indicate that PS and DEX could be effectively used as dietary carbohydrate energy compared to WF, CS, AL, and CMC for olive flounder.

  15. APPARENT CROSS-FIELD SUPERSLOW PROPAGATION OF MAGNETOHYDRODYNAMIC WAVES IN SOLAR PLASMAS

    Energy Technology Data Exchange (ETDEWEB)

    Kaneko, T.; Yokoyama, T. [Department of Earth and Planetary Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 (Japan); Goossens, M.; Doorsselaere, T. Van [Centre for Mathematical Plasma Astrophysics, Katholieke Universiteit Leuven, Celestijnenlaan 200B, Bus 2400, B-3001 Herverlee (Belgium); Soler, R.; Terradas, J. [Departament de Física, Universitat de les Illes Balears, E-07122 Palma de Mallorca (Spain); Wright, A. N., E-mail: kaneko@eps.s.u-tokyo.ac.jp [School of Mathematics and Statistics, University of St Andrews, St Andrews, KY16 9SS (United Kingdom)

    2015-10-20

    In this paper we show that the phase-mixing of continuum Alfvén waves and/or continuum slow waves in the magnetic structures of the solar atmosphere as, e.g., coronal arcades, can create the illusion of wave propagation across the magnetic field. This phenomenon could be erroneously interpreted as fast magnetosonic waves. The cross-field propagation due to the phase-mixing of continuum waves is apparent because there is no real propagation of energy across the magnetic surfaces. We investigate the continuous Alfvén and slow spectra in two-dimensional (2D) Cartesian equilibrium models with a purely poloidal magnetic field. We show that apparent superslow propagation across the magnetic surfaces in solar coronal structures is a consequence of the existence of continuum Alfvén waves and continuum slow waves that naturally live on those structures and phase-mix as time evolves. The apparent cross-field phase velocity is related to the spatial variation of the local Alfvén/slow frequency across the magnetic surfaces and is slower than the Alfvén/sound velocities for typical coronal conditions. Understanding the nature of the apparent cross-field propagation is important for the correct analysis of numerical simulations and the correct interpretation of observations.

  16. Gas Phase Pressure Effects on the Apparent Thermal Conductivity of JSC-1A Lunar Regolith Simulant

    Science.gov (United States)

    Yuan, Zeng-Guang; Kleinhenz, Julie E.

    2011-01-01

    Gas phase pressure effects on the apparent thermal conductivity of a JSC-1A/air mixture have been experimentally investigated under steady state thermal conditions from 10 kPa to 100 kPa. The result showed that apparent thermal conductivity of the JSC-1A/air mixture decreased when pressure was lowered to 80 kPa. At 10 kPa, the conductivity decreased to 0.145 W/m/degree C, which is significantly lower than 0.196 W/m/degree C at 100 kPa. This finding is consistent with the results of previous researchers. The reduction of the apparent thermal conductivity at low pressures is ascribed to the Knudsen effect. Since the characteristic length of the void space in bulk JSC-1A varies over a wide range, both the Knudsen regime and continuum regime can coexist in the pore space. The volume ratio of the two regimes varies with pressure. Thus, as gas pressure decreases, the gas volume controlled by Knudsen regime increases. Under Knudsen regime the resistance to the heat flow is higher than that in the continuum regime, resulting in the observed pressure dependency of the apparent thermal conductivity.

  17. A Study of the Probe Effect on the Apparent Image of Biological Atomic Force Microscopy

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    The probe effect on the apparent image of biological atomic force microscopy was explored in this study, and the potential of AFM in conformational study of gene related biological processes was illustrated by the specific nanostructural information of a new antitumor drug binding to DNA.

  18. Irreversible thermodynamics of dark energy on the entropy-corrected apparent horizon

    Energy Technology Data Exchange (ETDEWEB)

    Karami, K; Sahraei, N [Department of Physics, University of Kurdistan, Pasdaran Street, Sanandaj (Iran, Islamic Republic of); Jamil, M, E-mail: KKarami@uok.ac.i, E-mail: mjamil@camp.nust.edu.p [Center for Advanced Mathematics and Physics (CAMP), National University of Sciences and Technology (NUST), Islamabad (Pakistan)

    2010-10-15

    We study the irreversible (non-equilibrium) thermodynamics of the Friedmann-Robertson-Walker (FRW) universe containing only dark energy. Using the modified entropy-area relation that is motivated by loop quantum gravity, we calculate the entropy-corrected form of the apparent horizon of the FRW universe.

  19. Estimation of soil physical properties from sensor-based soil strength and apparent electrical conductivity

    Science.gov (United States)

    Quantification of soil physical properties has traditionally been through soil sampling and laboratory analyses, which is time-, cost-, and labor-consuming, making it difficult to obtain the spatially-dense data required for precision agriculture. Soil strength and apparent electrical conductivity (...

  20. Gamow's bicycle: The Appearance of Bodies at Relativistic Speeds and Apparent Superluminal Velocities

    CERN Document Server

    Nowojewski, A

    2005-01-01

    A human creates an image basing on the information delivered by photons that arrived at his retina simultaneously. Due to finite and constant velocity of light these photons left the moving body at different times, since not all points of the body are equidistant. In other words its image represents the body as it was in several different times i.e. it is distorted and does not correspond to its real appearance. The useful experimental arrangement is set and then used to derive the general expression that transforms two-dimensional stationary shapes to their apparent forms, which could be photographed once they are set in motion. It is then used to simulate the so-called Gamow's bicycle combined out of circles and straight lines. The simulation outlines two important aspects of bike's motion: apparent distance of two points and apparent velocity which are then discussed thoroughly. It is found that the approaching body is elongated and its apparent speed is greater than its real one (under certain conditions ...

  1. Linseed dietary fibers reduce apparent digestibility of energy and fat and weight gain in growing rats

    DEFF Research Database (Denmark)

    Kristensen, M.; Knudsen, K. E. B.; Jørgensen, H.;

    2013-01-01

    Dietary fibers (DF) may affect energy balance, an effect often ascribed to the viscous nature of some water soluble DF, which affect luminal viscosity and thus multiple physiological processes. We have tested the hypothesis that viscous linseed DF reduce apparent nutrient digestibility, and limit...

  2. Detection of solar events

    Science.gov (United States)

    Fischbach, Ephraim; Jenkins, Jere

    2013-08-27

    A flux detection apparatus can include a radioactive sample having a decay rate capable of changing in response to interaction with a first particle or a field, and a detector associated with the radioactive sample. The detector is responsive to a second particle or radiation formed by decay of the radioactive sample. The rate of decay of the radioactive sample can be correlated to flux of the first particle or the field. Detection of the first particle or the field can provide an early warning for an impending solar event.

  3. The COMPASS event store

    CERN Document Server

    Duic, V; Fuchs, U; Gobbo, B; Lamanna, M; Martin, A; Nowak, M

    2004-01-01

    COMPASS, the fixed-target experiment at CERN studying the structure of the nucleon and spectroscopy, has collected over 500 TB during 2002 and 2003 runs. At the beginning of the experiment these data together with the reconstructed events information were put in a database infrastructure based on Objectivity/DB and on the hierarchical storage manager CASTOR. Starting from 2003 Oracle has been adopted as the database technology. The experience in the usage of the databases is reviewed, and the evolution of the system outlined.

  4. CATASTROPHIC EVENTS MODELING

    Directory of Open Access Journals (Sweden)

    Ciumas Cristina

    2013-07-01

    Full Text Available This paper presents the emergence and evolution of catastrophe models (cat models. Starting with the present context of extreme weather events and features of catastrophic risk (cat risk we’ll make a chronological illustration from a theoretical point of view of the main steps taken for building such models. In this way the importance of interdisciplinary can be observed. The first cat model considered contains three modules. For each of these indentified modules: hazard, vulnerability and financial losses a detailed overview and also an exemplification of a potential case of an earthquake that measures more than 7 on Richter scale occurring nowadays in Bucharest will be provided. The key areas exposed to earthquake in Romania will be identified. Then, based on past catastrophe data and taking into account present conditions of housing stock, insurance coverage and the population of Bucharest the impact will be quantified by determining potential losses. In order to accomplish this work we consider a scenario with data representing average values for: dwelling’s surface, location, finishing works. On each step we’ll make a reference to the earthquake on March 4 1977 to see what would happen today if a similar event occurred. The value of Bucharest housing stock will be determined taking firstly the market value, then the replacement value and ultimately the real value to quantify potential damages. Through this approach we can find the insurance coverage of potential losses and also the uncovered gap. A solution that may be taken into account by public authorities, for example by Bucharest City Hall will be offered: in case such an event occurs the impossibility of paying compensations to insured people, rebuilding infrastructure and public buildings and helping the suffering persons should be avoided. An actively public-private partnership should be created between government authorities, the Natural Disaster Insurance Pool, private

  5. Vaccine adverse events.

    Science.gov (United States)

    Follows, Jill

    2012-01-01

    Millions of adults are vaccinated annually against the seasonal influenza virus. An undetermined number of individuals will develop adverse events to the influenza vaccination. Those who suffer substantiated vaccine injuries, disabilities, and aggravated conditions may file a timely, no-fault and no-cost petition for financial compensation under the National Vaccine Act in the Vaccine Court. The elements of a successful vaccine injury claim are described in the context of a claim showing the seasonal influenza vaccination was the cause of Guillain-Barré syndrome.

  6. LIU 2011 event

    CERN Multimedia

    BE Department

    2011-01-01

    The LHC injectors upgrade (LIU) project was launched at the end of 2010 to coordinate the preparation of the CERN accelerator complex to meet the needs of the High Luminosity LHC (HL-LHC) until at least 2030. It should be completed by the end of the second long LHC shutdown, presently scheduled for 2018.   The goal of the LIU-2011 event is to present the status and plans of the LIU project, describing the needs and the actions foreseen in the different accelerators, from Linac4 to the PSB, PS and SPS.  

  7. Whole Exome Sequencing Identifies TSC1/TSC2 Biallelic Loss as the Primary and Sufficient Driver Event for Renal Angiomyolipoma Development.

    Science.gov (United States)

    Giannikou, Krinio; Malinowska, Izabela A; Pugh, Trevor J; Yan, Rachel; Tseng, Yuen-Yi; Oh, Coyin; Kim, Jaegil; Tyburczy, Magdalena E; Chekaluk, Yvonne; Liu, Yang; Alesi, Nicola; Finlay, Geraldine A; Wu, Chin-Lee; Signoretti, Sabina; Meyerson, Matthew; Getz, Gad; Boehm, Jesse S; Henske, Elizabeth P; Kwiatkowski, David J

    2016-08-01

    Renal angiomyolipoma is a kidney tumor in the perivascular epithelioid (PEComa) family that is common in patients with Tuberous Sclerosis Complex (TSC) and Lymphangioleiomyomatosis (LAM) but occurs rarely sporadically. Though histologically benign, renal angiomyolipoma can cause life-threatening hemorrhage and kidney failure. Both angiomyolipoma and LAM have mutations in TSC2 or TSC1. However, the frequency and contribution of other somatic events in tumor development is unknown. We performed whole exome sequencing in 32 resected tumor samples (n = 30 angiomyolipoma, n = 2 LAM) from 15 subjects, including three with TSC. Two germline and 22 somatic inactivating mutations in TSC2 were identified, and one germline TSC1 mutation. Twenty of 32 (62%) samples showed copy neutral LOH (CN-LOH) in TSC2 or TSC1 with at least 8 different LOH regions, and 30 of 32 (94%) had biallelic loss of either TSC2 or TSC1. Whole exome sequencing identified a median of 4 somatic non-synonymous coding region mutations (other than in TSC2/TSC1), a mutation rate lower than nearly all other cancer types. Three genes with mutations were known cancer associated genes (BAP1, ARHGAP35 and SPEN), but they were mutated in a single sample each, and were missense variants with uncertain functional effects. Analysis of sixteen angiomyolipomas from a TSC subject showed both second hit point mutations and CN-LOH in TSC2, many of which were distinct, indicating that they were of independent clonal origin. However, three tumors had two shared mutations in addition to private somatic mutations, suggesting a branching evolutionary pattern of tumor development following initiating loss of TSC2. Our results indicate that TSC2 and less commonly TSC1 alterations are the primary essential driver event in angiomyolipoma/LAM, whereas other somatic mutations are rare and likely do not contribute to tumor development.

  8. Whole Exome Sequencing Identifies TSC1/TSC2 Biallelic Loss as the Primary and Sufficient Driver Event for Renal Angiomyolipoma Development.

    Directory of Open Access Journals (Sweden)

    Krinio Giannikou

    2016-08-01

    Full Text Available Renal angiomyolipoma is a kidney tumor in the perivascular epithelioid (PEComa family that is common in patients with Tuberous Sclerosis Complex (TSC and Lymphangioleiomyomatosis (LAM but occurs rarely sporadically. Though histologically benign, renal angiomyolipoma can cause life-threatening hemorrhage and kidney failure. Both angiomyolipoma and LAM have mutations in TSC2 or TSC1. However, the frequency and contribution of other somatic events in tumor development is unknown. We performed whole exome sequencing in 32 resected tumor samples (n = 30 angiomyolipoma, n = 2 LAM from 15 subjects, including three with TSC. Two germline and 22 somatic inactivating mutations in TSC2 were identified, and one germline TSC1 mutation. Twenty of 32 (62% samples showed copy neutral LOH (CN-LOH in TSC2 or TSC1 with at least 8 different LOH regions, and 30 of 32 (94% had biallelic loss of either TSC2 or TSC1. Whole exome sequencing identified a median of 4 somatic non-synonymous coding region mutations (other than in TSC2/TSC1, a mutation rate lower than nearly all other cancer types. Three genes with mutations were known cancer associated genes (BAP1, ARHGAP35 and SPEN, but they were mutated in a single sample each, and were missense variants with uncertain functional effects. Analysis of sixteen angiomyolipomas from a TSC subject showed both second hit point mutations and CN-LOH in TSC2, many of which were distinct, indicating that they were of independent clonal origin. However, three tumors had two shared mutations in addition to private somatic mutations, suggesting a branching evolutionary pattern of tumor development following initiating loss of TSC2. Our results indicate that TSC2 and less commonly TSC1 alterations are the primary essential driver event in angiomyolipoma/LAM, whereas other somatic mutations are rare and likely do not contribute to tumor development.

  9. Impact of gas injection on the apparent viscosity and viscoelastic property of waste activated sewage sludge.

    Science.gov (United States)

    Bobade, Veena; Baudez, Jean Christophe; Evans, Geoffery; Eshtiaghi, Nicky

    2017-05-01

    Gas injection is known to play a major role on the particle size of the sludge, the oxygen transfer rate, as well as the mixing efficiency of membrane bioreactors and aeration basins in the waste water treatment plants. The rheological characteristics of sludge are closely related to the particle size of the sludge floc. However, particle size of sludge floc depends partly on the shear induced in the sludge and partly on physico-chemical nature of the sludge. The objective of this work is to determine the impact of gas injection on both the apparent viscosity and viscoelastic property of sludge. The apparent viscosity of sludge was investigated by two methods: in-situ and after sparging. Viscosity curves obtained by in-situ measurement showed that the apparent viscosity decreases significantly from 4000 Pa s to 10 Pa s at low shear rate range (below 10 s(-1)) with an increase in gas flow rate (0.5LPM to 3LPM); however the after sparging flow curve analysis showed that the reduction in apparent viscosity throughout the shear rate range is negligible to be displayed. Torque and displacement data at low shear rate range revealed that the obtained lower apparent viscosity in the in-situ method is not the material characteristics, but the slippage effect due to a preferred location of the bubbles close to the bob, causing an inconsistent decrease of torque and increase of displacement at low shear rate range. In linear viscoelastic regime, the elastic and viscous modulus of sludge was reduced by 33% & 25%, respectively, due to gas injection because of induced shear. The amount of induced shear measured through two different tests (creep and time sweep) were the same. The impact of this induced shear on sludge structure was also verified by microscopic images.

  10. Effect of increased methionine level on performance and apparent ileal digestibility of amino acids in ducks.

    Science.gov (United States)

    Jamroz, D; Wiliczkiewicz, A; Lemme, A; Orda, J; Skorupińska, J; Wertelecki, T

    2009-10-01

    The experiment was conducted with 960 one-day-old ducklings fed mixtures (I control - 0.28% methionine) additionally supplemented with DL-methionine (DL-Met) at amounts: 0.03% (group II), 0.07% (III), 0.12% (IV) and 0.18% (V). The performance, carcass quality and apparent ileal digestibility of amino acids as the criterions of methionine (Met) effectivity were considered. The analysis of growth and development of ducks as an effect of diversified DL-Met supplements indicate that increased content of this amino acid in the diets has not affected clearly the performance parameters. The body weight of 21-day-old ducklings was significantly affected only by the level of 0.12% of added Met in comparison to control group. On day 42, the differences among groups were negligible; only the addition of 0.12% DL-Met has increased the body weight by 2.4% when compared with control (p > 0.05). Feed conversion estimated for a period of 1-42 days has not been influenced by Met supplementation. The indistinct, however, visible tendency of better ileal amino acids' apparent digestibility (for Asp.a.,Thr, Ser, Glu, Lys) was noted in the groups fed supplemented diets. Application of 0.07% and 0.18% of DL-met, has significantly (p < 0.05) improved the coefficient of cysteine (Cys) apparent ileal digestibility; however, the improvement of Met apparent ileal digestibility has been achieved by the addition of 0.18% Met. The mortality of ducklings in the experiment was very low and varied between 3.15% (II) and 0.0% (groups I and III). In general, application of 0.12% of DL-Met to mixture containing 0.28% Met had positive effect on the productive output of birds and also improved the apparent ileal digestibility of Cys and Met.

  11. Event Shape Sorting: selecting events with similar evolution

    Directory of Open Access Journals (Sweden)

    Tomášik Boris

    2017-01-01

    Full Text Available We present novel method for the organisation of events. The method is based on comparing event-by-event histograms of a chosen quantity Q that is measured for each particle in every event. The events are organised in such a way that those with similar shape of the Q-histograms end-up placed close to each other. We apply the method on histograms of azimuthal angle of the produced hadrons in ultrarelativsitic nuclear collisions. By selecting events with similar azimuthal shape of their hadron distribution one chooses events which are likely that they underwent similar evolution from the initial state to the freeze-out. Such events can more easily be compared to theoretical simulations where all conditions can be controlled. We illustrate the method on data simulated by the AMPT model.

  12. Talking about Causing Events

    Directory of Open Access Journals (Sweden)

    Christopher A. Vogel

    2014-12-01

    Full Text Available Questions about the nature of the relationship between language and extralinguistic cognition are old, but only recently has a new view emerged that allows for the systematic investigation of claims about linguistic structure, based on how it is understood or utilized outside of the language system. Our paper represents a case study for this interaction in the domain of event semantics. We adopt a transparency thesis about the relationship between linguistic structure and extralinguistic cognition, investigating whether different lexico-syntactic structures can differentially recruit the visual causal percept. A prominent analysis of causative verbs like move suggests reference to two distinct events and a causal relationship between them, whereas non-causative verbs like push do not so refer. In our study, we present English speakers with simple scenes that either do or do not support the perception of a causal link, and manipulate (between subjects a one-sentence instruction for the evaluation of the scene. Preliminary results suggest that competent speakers of English are more likely to judge causative constructions than non-causative constructions as true of a scene where causal features are present in the scene. Implications for a new approach to the investigation of linguistic meanings and future directions are discussed.

  13. The Pluto event generator

    Energy Technology Data Exchange (ETDEWEB)

    Froehlich, Ingo [Institut fuer Kernphysik, 60438 Frankfurt am Main (Germany); Holzmann, Romain [Gesellschaft fuer Schwerionenphysik, 64291 Darmstadt (Germany)

    2008-07-01

    Pluto is a Monte-Carlo event generator designed for hadronic interactions from close-to-threshold to intermediate energies, as well as for studies of heavy ion reactions. The package is entirely based on Root, without the need of additional packages, and uses the embedded C++ interpreter of root to control the event production. The package includes realistic models of resonance production by using mass-dependent Breit-Wigner sampling. The calculation of partial and total widths for resonances is taken into account. Particular attention is paid to the electromagnetic decays, motivated by the physics program of HADES. For elementary reactions, angular distributions (e.g. for the primary meson emission) can be attached by the user in a very simple way as well as multi-particle correlations. Hand-made models (which may change all decay parameters) can be included by the user without recompilation using the CINT interpreter. This contribution gives an overview of the technical implementation of the framework and presents examples of the included physics.

  14. Fibrations of financial events

    CERN Document Server

    Carf\\i, David

    2011-01-01

    In this paper we shall prove that the plane of financial events, introduced and applied to financial problems by the author himself (see [2], [3] and [4]) can be considered as a fibration in two different ways. The first one, the natural one, reveals itself to be isomorphic to the tangent- bundle of the real line, when the last one is considered as a differentiable manifold in the natural way; the second one is a fibration induced by the status of compound interest capitalization at a given rate i in the interval ] - 1, \\rightarrow [. Moreover, in the paper we define on the first fibration an affine connection, also in this case induced by the status of compound interest at a given rate i. The final goal of this paper is the awareness that all the effects determined by the status of compound interest are nothing but the consequences of the fact that the space of financial events is a fibration endowed with a particular affine connection, so they are consequences of purely geometric properties, at last, depend...

  15. Solar Eruptive Events

    Science.gov (United States)

    Holman, Gordon D.

    2012-01-01

    It s long been known that the Sun plays host to the most energetic explosions in the solar system. But key insights into the forms that energy takes have only recently become available. Solar flares have been phenomena of both academic and practical interest since their discovery in 1859. From the academic point of view, they are the nearest events for studying the explosive release of energy in astrophysical magnetized plasmas. From the practical point of view, they disrupt communication channels on Earth, from telegraph communications in 1859 to radio and television signals today. Flares also wreak havoc on the electrical power grid, satellite operations, and GPS signals, and energetic charged particles and radiation are dangerous to passengers on high-altitude polar flights and to astronauts. Flares are not the only explosive phenomena on the Sun. More difficult to observe but equally energetic are the large coronal mass ejections (CMEs), the ejection of up to ten billion tons of magnetized plasma into the solar wind at speeds that can exceed 1000 km/s. CMEs are primarily observed from the side, with coronagraphs that block out the bright disk of the Sun and lower solar atmosphere so that light scattered from the ejected mass can be seen. Major geomagnetic storms are now known to arise from the interaction of CMEs with Earth's magnetosphere. Solar flares are observed without CMEs, and CMEs are observed without flares. The two phenomena often occur together, however, and almost always do in the case of large flares and fast CMEs. The term solar eruptive event refers to the combination of a flare and a CME. Solar eruptive events generate a lot of heat: They can heat plasma to temperatures as high at 50 million Kelvin, producing radiation across the electromagnetic spectrum. But that s not all. A fascinating aspect of solar eruptive events is the acceleration of electrons and ions to suprathermal often relativistic energies. The accelerated particles are primarily

  16. 25 MeV Solar Proton Events in Cycle 24 and Previous Cycles

    Science.gov (United States)

    Richardson, I. G.; Cane, H. V.; von Rosenvinge, T. T.

    2014-12-01

    We summarize observations of nearly 1000 solar energetic particle events that include 25 MeV protons made by Goddard instruments on various spacecraft (IMPs IV, V, 7, 8, ISEE-3) and by other instruments on SOHO, since 1967, encompassing solar cycles 20 to 24. We also include recent observations of such events from the STEREO spacecraft. These extended observations place studies focusing on Cycles 23 and 24 in a broader context. For example, the time distribution of 25 MeV proton events varies from cycle to cycle such that each cycle is unique. In the current cycle, ~25 MeV proton events were absent during the preceding solar minimum, whereas earlier minima showed occasional, often reasonably intense events, and there have been, so far, fewer exceptionally intense events compared to Cycles 22 and 23, though Cycle 21 also apparently lacked such events.

  17. Achieving High Resolution Timer Events in Virtualized Environment.

    Directory of Open Access Journals (Sweden)

    Blazej Adamczyk

    Full Text Available Virtual Machine Monitors (VMM have become popular in different application areas. Some applications may require to generate the timer events with high resolution and precision. This however may be challenging due to the complexity of VMMs. In this paper we focus on the timer functionality provided by five different VMMs-Xen, KVM, Qemu, VirtualBox and VMWare. Firstly, we evaluate resolutions and precisions of their timer events. Apparently, provided resolutions and precisions are far too low for some applications (e.g. networking applications with the quality of service. Then, using Xen virtualization we demonstrate the improved timer design that greatly enhances both the resolution and precision of achieved timer events.

  18. Kidney Function Decline and Apparent Treatment-Resistant Hypertension in the Elderly.

    Directory of Open Access Journals (Sweden)

    Jean Kaboré

    Full Text Available Cross-sectional studies show a strong association between chronic kidney disease and apparent treatment-resistant hypertension, but the longitudinal association of the rate of kidney function decline with the risk of resistant hypertension is unknown.The population-based Three-City included 8,695 participants older than 65 years, 4265 of them treated for hypertension. We estimated the odds ratios (OR of new-onset apparent treatment-resistant hypertension, defined as blood pressure ≥ 140/90 mmHg despite use of 3 antihypertensive drug classes or ≥ 4 classes regardless of blood pressure, associated with the mean estimated glomerular filtration rate (eGFR level and its rate of decline over 4 years, compared with both controlled hypertension and uncontrolled nonresistant hypertension with ≤ 2 drugs. GFR was estimated with three different equations.Baseline prevalence of apparent treatment-resistant hypertension and of controlled and uncontrolled nonresistant hypertension, were 6.5%, 62.3% and 31.2%, respectively. During follow-up, 162 participants developed apparent treatment-resistant hypertension. Mean eGFR decline with the MDRD equation was 1.5±2.9 mL/min/1.73 m² per year: 27.7% of the participants had an eGFR ≥3 and 10.1% ≥ 5 mL/min/1.73 m² per year. After adjusting for age, sex, obesity, diabetes, and cardiovascular history, the ORs for new-onset apparent treatment-resistant hypertension associated with a mean eGFR level, per 15 mL/min/1.73 m² drop, were 1.23 [95% confidence interval 0.91-1.64] compared to controlled hypertension and 1.10 [0.83-1.45] compared to uncontrolled nonresistant hypertension; ORs associated with a decline rate ≥ 3 mL/min/1.73 m² per year were 1.89 [1.09-3.29] and 1.99 [1.19-3.35], respectively. Similar results were obtained when we estimated GFR with the CKDEPI and the BIS1 equations. ORs tended to be higher for an eGFR decline rate ≥ 5 mL/min/1.73 m² per year.The speed of kidney function decline is

  19. Event-Based Conceptual Modeling

    DEFF Research Database (Denmark)

    Bækgaard, Lars

    The paper demonstrates that a wide variety of event-based modeling approaches are based on special cases of the same general event concept, and that the general event concept can be used to unify the otherwise unrelated fields of information modeling and process modeling. A set of event......-based modeling approaches are analyzed and the results are used to formulate a general event concept that can be used for unifying the seemingly unrelated event concepts. Events are characterized as short-duration processes that have participants, consequences, and properties, and that may be modeled in terms...... of information structures. The general event concept can be used to guide systems analysis and design and to improve modeling approaches....

  20. Coping with a Traumatic Event

    Science.gov (United States)

    ... Traumatic events are marked by a sense of horror, helplessness, serious injury, or the threat of serious ... the number of times an event happened, a history of past trauma, and psychological problems before the ...