Sample records for avoid hypothermia caused

  1. Hypothermia (United States)

    ... of warming blood is the use of a hemodialysis machine, which is normally used to filter blood ... . Mayo Clinic Footer Legal Conditions and ...

  2. Hypothermia (United States)

    ... References Danzl DF, Zafren K. Accidental hypothermia. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ... chap 109. Zafren K, Danzl DF. Frostbite. In: Marx JA, Hockberger RS, Walls RM, et al, eds. ...

  3. Hypothermia in neonatal piglets: Interactions and causes of individual differences

    DEFF Research Database (Denmark)

    Kammersgaard, Trine S; Pedersen, Lene Juul; Jørgensen, Erik


    Hypothermia is a major cause of mortality in neonatal piglets. However, there are considerable individual differences in the successful recovery from postnatal hypothermia in the common farrowing environment, and so far the causes and interactions of causes have not been studied in detail. Using......: birth weight, hypoxia at birth (viability score and lactate in umbilical cord blood), latency to first udder contact and first suckle, scans of individual piglet position during the first 2 h after birth, and rectal temperature at birth and 2 h post partum. A graphical chain model was used to analyze...... to the birth process had no direct connection to thermoregulatory success but were additive in the explanation of piglet behavior. The individual piglet’s rectal temperature at 2 h depends largely on piglet birth weight and on piglet position in relation to sow and littermates. Birth weight is the most...

  4. Early Implementation of THAM for ICP Control: Therapeutic Hypothermia Avoidance and Reduction in Hypertonics/Hyperosmotics

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    F. A. Zeiler


    Full Text Available Background. Tromethamine (THAM has been demonstrated to reduce intracranial pressure (ICP. Early consideration for THAM may reduce the need for other measures for ICP control. Objective. To describe 4 cases of early THAM therapy for ICP control and highlight the potential to avoid TH and paralytics and achieve reduction in sedation and hypertonic/hyperosmotic agent requirements. Methods. We reviewed the charts of 4 patients treated with early THAM for ICP control. Results. We identified 2 patients with aneurysmal subarachnoid hemorrhage (SAH and 2 with traumatic brain injury (TBI receiving early THAM for ICP control. The mean time to initiation of THAM therapy was 1.8 days, with a mean duration of 5.3 days. In all patients, after 6 to 12 hours of THAM administration, ICP stability was achieved, with reduction in requirements for hypertonic saline and hyperosmotic agents. There was a relative reduction in mean hourly hypertonic saline requirements of 89.1%, 96.1%, 82.4%, and 97.0% for cases 1, 2, 3, and 4, respectively, comparing pre- to post-THAM administration. Mannitol, therapeutic hypothermia, and paralytics were avoided in all patients. Conclusions. Early administration of THAM for ICP control could potentially lead to the avoidance of other ICP directed therapies. Prospective studies of early THAM administration are warranted.

  5. Avoidance: grammatical or semantic causes?

    NARCIS (Netherlands)

    Hulstijn, J.H.; Marchena, E.


    This article follows up on a study by Dagut and Laufer (1985), who found that Hebrew learners of English avoid phrasal verbs, such as ‘let down’, while preferring one-word verbs, such as ‘;disappoint’, since phrasal verbs do not exist in Hebrew. A corollary derived from Dagut and Laufer's study is t

  6. Avoiding hypothermia in neonatal pigs: effect of duration of floor heating at different room temperatures. (United States)

    Pedersen, L J; Malmkvist, J; Kammersgaard, T; Jørgensen, E


    The effect of different farrowing room temperatures (15, 20, or 25°C), combined with floor heating (FH) at the birth site, on the postnatal rectal temperature of pigs, use of creep area, and latency to first colostrum uptake was investigated with 61 litters born by loose-housed sows. Pig rectal temperature was measured at birth, as well as at 0.25, 0.5, 1, 1.5, 2, 3, 4, 12, 24, and 48 h after birth. The drop in rectal temperature from birth to 0.5 h postpartum was less (Ptemperature of 25°C compared with 20 and 15°C. Minimum rectal temperature was less (Ptemperature to increase above 37°C was longer (Ptemperature was 15°C than 20 and 25°C. Rectal temperatures at 24 (Ptemperature of 15°C than 20 and 25°C. Duration of FH (12 or 48 h) did not influence (P>0.28) the rectal temperature at 24 or 48 h after birth. More pigs used the creep area 12 to 60 h after birth of the first pig at a room temperature of 15°C with 12 h FH compared with all other treatments. During the latter part of this period, more pigs stayed in the creep area also at 20°C with 12 h FH. After 60 h, more pigs (Plow compared with high room temperatures (15°C>20°C>25°C). Odds ratio of pigs dying before they had suckled was 6.8 times greater (P=0.03) at 15 than 25°C (95% CI of 1.3 to 35.5), whereas the odds ratio of dying during the first 7 d was 1.6 greater (P=0.05) for 48 vs. 12 h of FH (95% CI of 1.0 to 2.57), mainly due to more pigs being crushed. In conclusion, FH for 48 h was no more favorable than 12 h for pigs because the risk of hypothermia was equal in the 2 treatments, and the risk of dying increased with the longer FH duration. Increasing the room temperature to 25°C reduced hypothermia and the risk of pigs dying before colostrum intake.

  7. Pulmonary embolism as a cause of cardiac arrest: Hypothermia in post-resuscitation period (cooling therapy

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    Niković Vuk


    Full Text Available Introduction. Pulmonary embolism as a possible cause of acute heart failure is a potentially fatal condition that can cause death in all age groups. Patients successfully resuscitated after cardiac arrest have a high risk of increased mortality and their poor long­term outcome is often associated with severe neurological complications. Case Outline. This is a case report of a 67­year­old man after a successful cardiopulmonary resuscitation (CPR which was followed by therapeutic hypothermia (TH. The patient visited the dermatological outpatients’ department with clinical presentation of pain and swelling of the right leg, shortness of breath and chest pain. During examination the patient lost consciousness, stopped breathing and had cardiac arrest. ECG was done which registered asystole. We began CPR. After 59 minutes of resuscitation return of heartbeat was achieved. The patient was transported to the Emergency Department. On admission, after computerized tomography (CT of the chest confirmed massive pulmonary embolism (PE, the patient was administered thrombolytic therapy with Metalyse (tenecteplase and anti­coagulation therapy (heparin. After stabilization, therapeutic hypothermia was applied. Combination of EMCOOLSpad on the chest and abdomen and cold Ringer lactate 500 ml at 4°C was flushed. Temperature was decreased to 33°C and kept stabile for 24 hours. After eight days the patient was conscious with a minimal neurological deficit. Conclusion. As shown in this case report, and according to the rich experience elsewhere, cooling therapy after out­of­hospital cardiac arrest and successful CRP may be useful in preventing neurological complications.

  8. Accidental hypothermia

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    Ivo Casagranda


    Full Text Available Hypothermia is defined as an unintentional decrease of core body temperature below 35 °C. In this article we discuss pathophysiology, clinical aspects and treatment of hypothermic patients. The most important treatment of hypothermia is the identification of the most appropriate method of rewarming. We report a case of cardiac arrest secondary to severe accidental hypothermia, that occured in a young man, do to prolonged exposure to low temperature in river water, successfully treated with extracorporeal blood warming.

  9. Accidental Hypothermia, (United States)


    the pulmonary , digestive, and endocrine systems.16� Cardiovascular Cardiovascular responses in hypothermia are vell described. Following an early...decline. Included in this group are patients with hypothalamic lesions and agenesis of the corpus callosum, termed the Shapiro Syndrome.46 1�...Hypothermia with agenesis of the corpus callosum has also been associated with hypercalcemia and status epilepticus.230 Since experimental sectioning of the

  10. Analyzing the Objective Causes of Oral Chinglish and Error Avoidance

    Institute of Scientific and Technical Information of China (English)



    Due to the inevitable influence of the mother tongue and some other objective causes, Chinglish is troubling Chinese learners of English in various ways, which has an bad effect on quality of oral communication. Therefore, minimizing or eliminating oral Chinglish will greatly improve the quality of communication. This paper will firstly explain the definition of Chinglish,then focus on description and analyzing of oral Chinglish mistakes, what’s more, the objective causes of oral Chinglish will be analyzed and founded, especially on the aspect of negative transfer. At last, some avoidance of oral Chinglish will be offered.

  11. Recognizing Hypothermia

    Centers for Disease Control (CDC) Podcasts


    Hypothermia is a serious medical condition that strikes during very cold weather or when people are chilled from rain, sweat, or cold water.  Created: 11/1/2007 by Emergency Communications System.   Date Released: 12/13/2007.

  12. Hypothermia & Hodgkin lymphoma in children


    Köse, Doğan; Köksal, Yavuz; Çalışkan, Ümran


    Hypothermia associated with Hodgkin lymphoma is defined rarely. This may be caused by a dysfunction that shall occur in hypothalamus, central and peripheral vascular system, skin and muscles. In this study, two Hodgkin lymphoma cases with developed hypothermia are presented. Case 1: An “Hodgkin lymphoma, mixed cellular type” was diagnosed by a biopsy conducted due to lesions found in her spleen on a girl in 7 ages, who applied to the hospital with complaints such as fever, weight loss and nig...

  13. Our experiences with therapeutic hypothermia

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    Petrović Milovan


    Full Text Available Introduction. The single most important clinically relevant cause of global cerebral ischemia is cardiac arrest. The estimated rate of sudden cardiac arrest is between 40 and 130 cases per 100.000 people per year. Almost 80% of patients initially resuscitated from cardiac arrest remain comatose for more than one hour. One year after cardiac arrest only 10-30% of these patients survive with good neurological outcome. The ability to survive anoxic no-flow states is dramatically increased with protective and preservative hypothermia. The results of clinical studies show a marked neuroprotective effect of mild hypothermia in resuscitation. Material and Methods. In our clinic, 12 patients were treated with therapeutic hypothermia. A combination of intravascular and external method of cooling was used according to the ILCOR (International Liaison Committee on Resuscitation guidelines. The target temperature was 33oC, while the duration of cooling was 24 hours. After that, passive rewarming was allowed. All patients also received other necessary therapy. Results. Six patients (50% had a complete neurological recovery. Two patients (16.6% had partial neurological recovery. Four patients (33.3% remained comatose. Five patients (41.66% survived, while 7 (58.33% patients died. The main cause of cardiac arrest was acute myocardial infarction (91.6%. One patient had acute myocarditis. Conclusion. Mild resuscitative hypothermia after cardiac arrest improves neurological outcome and reduces mortality in comatose survivors. .

  14. Therapeutic hypothermia for acute brain injuries. (United States)

    Andresen, Max; Gazmuri, Jose Tomás; Marín, Arnaldo; Regueira, Tomas; Rovegno, Maximiliano


    Therapeutic hypothermia, recently termed target temperature management (TTM), is the cornerstone of neuroprotective strategy. Dating to the pioneer works of Fay, nearly 75 years of basic and clinical evidence support its therapeutic value. Although hypothermia decreases the metabolic rate to restore the supply and demand of O₂, it has other tissue-specific effects, such as decreasing excitotoxicity, limiting inflammation, preventing ATP depletion, reducing free radical production and also intracellular calcium overload to avoid apoptosis. Currently, mild hypothermia (33°C) has become a standard in post-resuscitative care and perinatal asphyxia. However, evidence indicates that hypothermia could be useful in neurologic injuries, such as stroke, subarachnoid hemorrhage and traumatic brain injury. In this review, we discuss the basic and clinical evidence supporting the use of TTM in critical care for acute brain injury that extends beyond care after cardiac arrest, such as for ischemic and hemorrhagic strokes, subarachnoid hemorrhage, and traumatic brain injury. We review the historical perspectives of TTM, provide an overview of the techniques and protocols and the pathophysiologic consequences of hypothermia. In addition, we include our experience of managing patients with acute brain injuries treated using endovascular hypothermia.

  15. Hypothermia following antipsychotic drug use

    NARCIS (Netherlands)

    van Marum, Rob J.; Wegewijs, Michelle A.; Loonen, Anton J. M.; Beers, Erna


    Objective Hypothermia is an adverse drug reaction (ADR) of antipsychotic drug (APD) use. Risk factors for hypothermia in ADP users are unknown. We studied which risk factors for hypothermia can be identified based on case reports. Methods Case reports of hypothermia in APD-users found in PUBMED or E

  16. Hypothermia following antipsychotic drug use

    NARCIS (Netherlands)

    Marum, R.J. van; Wegewijs, M.A.; Loonen, A.J.M.; Beers, E.


    Objective: Hypothermia is an adverse drug reaction (ADR) of antipsychotic drug (APD) use. Risk factors for hypothermia in ADP users are unknown. We studied which risk factors for hypothermia can be identified based on case reports. Method: Case reports of hypothermia in APD-users found in PUBMED or

  17. [Prolonged hypothermia in refractory intracranial hypertension. Report of one case]. (United States)

    Rovegno, Maximiliano; Valenzuela, José Luis; Mellado, Patricio; Andresen, Max


    The use of hypothermia after cardiac arrest caused by ventricular fibrillation is a standard clinical practice, however its use for neuroprotection has been extended to other conditions. We report a 23-year-old male with intracranial hypertension secondary to a parenchymal hematoma associated to acute hydrocephalus. An arterial malformation was found and embolized. Due to persistent intracranial hypertension, moderate hypothermia with a target temperature of 33°C was started. After 12 hours of hypothermia, intracranial pressure was controlled. After 13 days of hypothermia a definitive control of intracranial pressure was achieved. The patient was discharged 40 days after admission, remains with a mild hemiparesia and is reassuming his university studies.

  18. New frontiers in hypothermia

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    Gina Ancora


    Full Text Available Therapeutic hypothermia has currently become a standard of care for asphyctic newborns with moderate-severe hypoxic-ischemic encephalopathy (HIE. Strict criteria are required to include these newborns in the hypothermic treatment. On some occasions, in the clinical practice, some discrepancies were found among the 3 inclusion criteria. In such circumstances the knowledge of the accuracy of each criterion, the knowledge of the evolution of clinical and neurophysiologic parameters in the few hours following birth, and the knowledge of the pathogenesis of the asphyxia can help to take the right decision on who to treat with hypothermia. The usefulness of hypothermia in newborns of gestational age lower than 36 weeks or when started beyond the 6th hour of life remains unclear. Perinatal stroke, as HIE, is an evolving process and if early diagnosed could benefit from hypothermia. In addition, infants may experience hypoxic-ischemic episodes that are not related to the birth such as early apparent life-threatening events (ALTEs or near miss events. Also in these cases hypothermia can be theoretically efficacious in preventing the progression of brain damage. The above issues will be discussed in the present paper. Proceedings of the 9th International Workshop on Neonatology · Cagliari (Italy · October 23rd-26th, 2013 · Learned lessons, changing practice and cutting-edge research

  19. Preventing Hypothermia and Frostbite

    Centers for Disease Control (CDC) Podcasts


    Protect yourself against hypothermia and frostbite during cold weather. Wear warm clothing that covers your skin and remove any wet clothing immediately.  Created: 11/1/2007 by Emergency Communications System.   Date Released: 12/13/2007.

  20. Mild induced hypothermia

    DEFF Research Database (Denmark)

    Johansen, Maria E; Jensen, Jens-Ulrik; Bestle, Morten H


    INTRODUCTION: Coagulopathy associates with poor outcome in sepsis. Mild induced hypothermia has been proposed as treatment in sepsis but it is not known whether this intervention worsens functional coagulopathy. MATERIALS AND METHODS: Interim analysis data from an ongoing randomized controlled tr...

  1. Hypothermia associated with clobazam use in adult epilepsy. (United States)

    Gauthier, Angela C; Quraishi, Imran H; Mattson, Richard H


    Clobazam, a 1,5-benzodiazepine FDA-approved in 2011, is commonly used to treat anxiety and epilepsy. It has not associated with hypothermia until very recently, in a case report involving two pediatric patients. Here, we report the first case of hypothermia development in an adult patient with epilepsy associated with clobazam use. A couple months after starting clobazam, the patient started developing episodes of hypothermia every several weeks, with temperatures ranging from 90 °F-95 °F. Normothermia was achieved with Bair Hugger therapy. Thyroid-stimulating hormone and cortisol levels were normal, and there was no evidence of infection in most instances. After 11 total episodes of hypothermia over a year of clobazam use, the drug was discontinued. It has now been 7 months after discontinuation, and the patient has not experienced any more episodes of hypothermia. Early recognition of the link between clobazam and hypothermia may prevent avoidable Emergency Department visits and hospitalizations.

  2. Hypothermia associated with clobazam use in adult epilepsy

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    Angela C. Gauthier


    Full Text Available Clobazam, a 1,5-benzodiazepine FDA-approved in 2011, is commonly used to treat anxiety and epilepsy. It has not been associated with hypothermia until very recently, in a case report involving two pediatric patients. Here, we report the first case of hypothermia development in an adult patient with epilepsy associated with clobazam use. A couple months after starting clobazam, the patient started developing episodes of hypothermia every several weeks, with temperatures ranging from 90 °F–95 °F. Normothermia was achieved with Bair Hugger therapy. Thyroid-stimulating hormone and cortisol levels were normal, and there was no evidence of infection in most instances. After 11 total episodes of hypothermia over a year of clobazam use, the drug was discontinued. It has now been 7 months after discontinuation, and the patient has not experienced any more episodes of hypothermia. Early recognition of the link between clobazam and hypothermia may prevent avoidable Emergency Department visits and hospitalizations.

  3. Maternal mortality in Bahrain 1987-2004: an audit of causes of avoidable death. (United States)

    Sandhu, A K; Mustafa, F E


    The aim of this report was to establish the national maternal mortality rate in Bahrain over the period 1987-2004, to identify preventable factors in maternal deaths and to make recommendations for safe motherhood. There were 60 maternal deaths out of 243 232 deliveries giving an average maternal mortality rate of 24.7 per 100 000 total births. The main causes of death were sickle-cell disease (25.0%), hypertension (18.3%), embolism (13.3%), haemorrhage (13.3%), heart disease (11.7%), infection (8.3%) and other (10.0%). In an audit of care, 17 (28.3%) out of 60 deaths were judged to be avoidable, nearly half of which were due to a shortage of intensive care beds. We recommend that a confidential enquiry of maternal deaths be conducted at the national level every 3 to 5 years.

  4. Postmortem pulmonary CT in hypothermia. (United States)

    Schweitzer, Wolf; Thali, Michael; Giugni, Giannina; Winklhofer, Sebastian


    Fatal hypothermia has been associated with pulmonary edema. With postmortem full body computed tomography scanning (PMCT), the lungs can also be examined for CT attenuation. In fatal hypothermia cases low CT attenuation appeared to prevail in the lungs. We compared 14 cases of fatal hypothermia with an age-sex matched control group. Additionally, 4 cases of carbon monoxide (CO) poisoning were examined. Furthermore, 10 test cases were examined to test predictability based on PMCT. Two readers measured CT attenuation on four different axial slices across the lungs (blinded to case group and other reader's results). Hypothermia was associated with statistically significantly lower lung PMCT attenuation and lower lung weights than controls, and there was a dose-effect relationship at an environmental temperature cutoff of 2 °C. CO poisoning yielded low pulmonary attenuation but higher lung weights. General model based prediction yielded a 94% probability for fatal hypothermia deaths and a 21% probability for non-hypothermia deaths in the test group. Increased breathing rate is known to accompany both CO poisoning and hypothermia, so this could partly explain the low PMCT lung attenuation due to an oxygen dissociation curve left shift. A more marked distension in fatal hypothermia, compared to CO poisoning, indicates that further, possibly different mechanisms, are involved in these cases. Increased dead space and increased stiffness to deflation (but not inflation) appear to be effects of inhaling cold air (but not CO) that may explain the difference in low PMCT attenuation seen in hypothermia cases.

  5. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter


    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature i...

  6. Preoperative warming combined with intraoperative skin-surface warming does not avoid hypothermia caused by spinal anesthesia in patients with midazolam premedication


    Simone Maria D'Angelo Vanni; Yara Marcondes Machado Castiglia; Eliana Marisa Ganem; Geraldo Rolim Rodrigues Júnior; Rosa Beatriz Amorim; Fábio Ferrari; Leandro Gobbo Braz; José Reinaldo Cerqueira Braz


    CONTEXTO E OBJETIVO: Hipotermia inadvertida no perioperatório é freqüente durante anestesia subaracnóidea e após a administração de midazolam. O objetivo foi avaliar os efeitos do aquecimento da pele no intra-operatório, associado ou não ao aquecimento da pele durante o período de 45 minutos no pré-operatório, na prevenção de hipotermia intra- e pós-operatória determinada pela anestesia subaracnóidea em pacientes com medicação pré-anestésica com midazolam. TIPO DE ETUDO E LOCAL: Estudo prospe...

  7. Years of Life Lost (YLL in Colombia 1998-2011: Overall and Avoidable Causes of Death Analysis.

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    Liliana Castillo-Rodríguez

    Full Text Available Estimate the Years of Life Lost (YLL for overall and avoidable causes of death (CoD in Colombia for the period 1998-2011.From the reported deaths to the Colombian mortality database during 1998-2011, we classified deaths from avoidable causes. With the reference life table of the Global Burden of Disease (GBD 2010 study, we estimated the overall YLL and YLL due to avoidable causes. Calculations were performed with the difference between life expectancy and the age of death. Results are reported by group of cause of death, events, sex, year and department. Comparative analysis between number of deaths and YLL was carried out.A total of 83,856,080 YLL were calculated in Colombia during period 1998-2011, 75.9% of them due to avoidable CoD. The year 2000 reported the highest number of missed YLL by both overall and avoidable CoD. The departments with the highest YLL rates were Caquetá, Guaviare, Arauca, Meta, and Risaralda. In men, intentional injuries and cardiovascular and circulatory diseases had the higher losses, while in women YLL were mainly due to cardiovascular and circulatory diseases.The public health priorities should focus on preventing the loss of YLL due to premature death and differentiated interventions by sex.

  8. [Accidental hypothermia in adults: taking charge by the SAMU of Paris]. (United States)

    Deny, N; Bresard, D; Bertrand, J; Poisvert, M


    Thirty one cases of accidental hypothermia have been taken in care by the SAMU de Paris during the year of 1987. The accidental hypothermias happening in the cities are, most of the time, moderated and not very serious. The search for a cause is a prime necessity. The prognosis is based on that search to guide and advise the patients.

  9. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter


    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... is directly related to stroke severity and outcome, and fever after stroke is associated with substantial increases in morbidity and mortality. Normalisation of temperature in acute stroke by antipyretics is generally recommended, although there is no direct evidence to support this treatment. Despite its...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  10. Mechanism underlying the inner membrane retention of Escherichia coli lipoproteins caused by Lol avoidance signals. (United States)

    Hara, Takashi; Matsuyama, Shin-ichi; Tokuda, Hajime


    Escherichia coli lipoproteins are localized to either the inner or outer membrane depending on the residue at position 2. The inner membrane retention signal, Asp at position 2 in combination with certain residues at position 3, functions as a Lol avoidance signal, i.e. the signal inhibits the recognition of lipoproteins by LolCDE that releases lipoproteins from the inner membrane. To understand the role of the residue at position 2, outer membrane-specific lipoproteins with Cys at position 2 were subjected to chemical modification followed by the release reaction in reconstituted proteoliposomes. Sulfhydryl-specific introduction of nonprotein molecules or a negative charge to Cys did not inhibit the LolCDE-dependent release. In contrast, oxidation of Cys to cysteic acid resulted in generation of the Lol avoidance signal, indicating that the Lol avoidance signal requires a critical length of negative charge at the second residue. Furthermore, not only modification of the carboxylic acid of Asp at position 2 but also that of the amine of phosphatidylethanolamine abolished the Lol avoidance function. Based on these results, the Lol avoidance mechanism is discussed.

  11. Efficient trawl avoidance by mesopelagic fishes causes large underestimation of their biomass

    KAUST Repository

    Kaartvedt, Stein


    Mesopelagic fishes occur in all the world’s oceans, but their abundance and consequently their ecological significance remains uncertain. The current global estimate based on net sampling prior to 1980 suggests a global abundance of one gigatonne (109 t) wet weight. Here we report novel evidence of efficient avoidance of such sampling by the most common myctophid fish in the Northern Atlantic, i.e. Benthosema glaciale. We reason that similar avoidance of nets may explain consistently higher acoustic abundance estimates of mesopelagic fish from different parts of the world’s oceans. It appears that mesopelagic fish abundance may be underestimated by one order of magnitude, suggesting that the role of mesopelagic fish in the oceans might need to be revised.

  12. Accidental hypothermia-an update

    DEFF Research Database (Denmark)

    Paal, Peter; Gordon, Les; Strapazzon, Giacomo


    BACKGROUND: This paper provides an up-to-date review of the management and outcome of accidental hypothermia patients with and without cardiac arrest. METHODS: The authors reviewed the relevant literature in their specialist field. Summaries were merged, discussed and approved to produce this nar...

  13. Hypothermia and room air resuscitation in NT2-N neurons, immature rats and newborn pigs



    Perinatal asphyxia remains one of the major causes of perinatal mortality and morbidity worldwide. Mild therapeutic hypothermia reduces brain injury after perinatal asphyxia. There is an ongoing search for strategies to further improve outcome, including best practice resuscitation and interventions that can be used in combination with hypothermia. The use of supplemental oxygen during resuscitation causes a number of harmful effects including increased cerebral injury. It is not known whethe...

  14. Cause of death and potentially avoidable deaths in Australian adults with intellectual disability using retrospective linked data (United States)

    Srasuebkul, Preeyaporn; Xu, Han; Howlett, Sophie


    Objectives To investigate mortality and its causes in adults over the age of 20 years with intellectual disability (ID). Design, setting and participants Retrospective population-based standardised mortality of the ID and Comparison cohorts. The ID cohort comprised 42 204 individuals who registered for disability services with ID as a primary or secondary diagnosis from 2005 to 2011 in New South Wales (NSW). The Comparison cohort was obtained from published deaths in NSW from the Australian Bureau of Statistics (ABS) from 2005 to 2011. Main outcome measures We measured and compared Age Standardised Mortality Rate (ASMR), Comparative Mortality Figure (CMF), years of productive life lost (YPLL) and proportion of deaths with potentially avoidable causes in an ID cohort with an NSW general population cohort. Results There were 19 362 adults in the ID cohort which experienced 732 (4%) deaths at a median age of 54 years. Age Standardised Mortality Rates increased with age for both cohorts. Overall comparative mortality figure was 1.3, but was substantially higher for the 20–44 (4.0) and 45–64 (2.3) age groups. YPLL was 137/1000 people in the ID cohort and 49 in the comparison cohort. Cause of death in ID cohort was dominated by respiratory, circulatory, neoplasm and nervous system. After recoding deaths previously attributed to the aetiology of the disability, 38% of deaths in the ID cohort and 17% in the comparison cohort were potentially avoidable. Conclusions Adults with ID experience premature mortality and over-representation of potentially avoidable deaths. A national system of reporting of deaths in adults with ID is required. Inclusion in health policy and services development and in health promotion programmes is urgently required to address premature deaths and health inequalities for adults with ID. PMID:28179413

  15. Limitations of Mild, Moderate, and Profound Hypothermia in Protecting Developing Hippocampal Neurons After Simulated Ischemia. (United States)

    Gregersen, Maren; Lee, Deok Hee; Gabatto, Pablo; Bickler, Philip E


    Mild hypothermia (33°C-34°C) after cerebral ischemia in intact animals or ischemia-like conditions in vitro reduces neuron death. However, it is now clear that more profound hypothermia or delayed hypothermia may not provide significant protection. To further define the limitations of hypothermia after cerebral ischemia, we used hippocampal slice cultures to examine the effects of various degrees, durations, and delays of hypothermia on neuron death after an ischemia-like insult. Organotypic cultures of the hippocampus from 7- to 8 day-old rat pups were cooled to 32°C, 23°C, 17°C, or 4°C immediately or after a 2-4 hour delay from an injurious insult of oxygen and glucose deprivation (OGD). Cell death in CA1, CA3 and dentate regions of the cultures was assessed 24 hours later with SYTOX(®) or propidium iodide, both of which are fluorescent markers labeling damaged cells. OGD caused extensive cell death in CA1, CA3, and dentate regions of the hippocampal cultures. Hypothermia (32°C, 23°C and 17°C) for 4-6 hours immediately after OGD was protective at 24 hours, but when hypothermia was applied for longer periods or delayed after OGD, no protection or increased death was seen. Ultra-profound hypothermia (4°C) increased cell death in all cell areas of the hippocampus even when after a milder insult of only hypoxia. In an in vitro model of recovery after an ischemia-like insult, mild to profound hypothermia is protective only when applied without delay and for limited periods of time (6-8 hours). Longer durations of hypothermia, or delayed application of the hypothermia can increase neuron death. These findings may have implications for clinical uses of therapeutic hypothermia after hypoxic or ischemic insults, and suggest that further work is needed to elucidate the limitations of hypothermia as a protective treatment after ischemic stress.

  16. Adherence to drug label recommendations for avoiding drug interactions causing statin-induced myopathy--a nationwide register study.

    Directory of Open Access Journals (Sweden)

    Jennifer Settergren

    Full Text Available PURPOSE: To investigate the extent to which clinicians avoid well-established drug-drug interactions that cause statin-induced myopathy. We hypothesised that clinicians would avoid combining erythromycin or verapamil/diltiazem respectively with atorvastatin or simvastatin. In patients with statin-fibrate combination therapy, we hypothesised that gemfibrozil was avoided to the preference of bezafibrate or fenofibrate. When combined with verapamil/diltiazem or fibrates, we hypothesized that the dispensed doses of atorvastatin/simvastatin would be decreased. METHODS: Cross-sectional analysis of nationwide dispensing data. Odds ratios of interacting erythromycin, verapamil/diltiazem versus respective prevalence of comparator drugs doxycycline, amlodipine/felodipine in patients co-dispensed interacting statins simvastatin/atorvastatin versus patients unexposed (pravastatin/fluvastatin/rosuvastatin was calculated. For fibrates, OR of gemfibrozil versus fenofibrate/bezafibrate in patients co-dispensed any statin was assessed. RESULTS: OR of interacting erythromycin versus comparator doxycycline did not differ between patients on interacting and comparator statins either in patients dispensed high or low statin doses (adjusted OR 0.87; 95% CI 0.60-1.25 and 0.92; 95% CI 0.69-1.23. Interacting statins were less common among patients dispensed verapamil/diltiazem as compared to patients on amlodipine/felodipine (OR high dose 0.62; CI 0.56-0.68 and low dose 0.63; CI 0.58-0.68. Patients on any statin were to a lesser extent dispensed gemfibrozil compared to patients not dispensed a statin (OR high dose 0.65; CI 0.55-0.76 and low dose 0.70; CI 0.63-0.78. Mean DDD (SD for any statin was substantially higher in patients co-dispensed gemfibrozil 178 (149 compared to patients on statin monotherapy 127 (93, (p<0.001. CONCLUSIONS: Prescribers may to some extent avoid co-prescription of statins with calcium blockers and fibrates with an increased risk of myopathy

  17. Effect of therapeutic hypothermia on chromosomal aberration in perinatal asphyxia

    Directory of Open Access Journals (Sweden)

    Bahubali D Gane


    Full Text Available Introduction: Perinatal asphyxia is a major cause for neonatal mortality and morbidity around the world. The reduction of O2results in the generation of reactive oxygen species which interact with nucleic acid and make alteration in the structure and functioning of the genome. We studied the effect of therapeutic hypothermia on chromosomes with karyotyping. Subjects and Methods: Babies in the hypothermia group were cooled for the first 72 h, using gel packs. Rectal temperature of 33–34°C was maintained. Blood sample was collected after completion of therapeutic hypothermia for Chromosomal analysis. It was done with IKAROS Karyotyping system, Metasystems, based on recommendations of International system of human cytogenetic nomenclature. Results: The median chromosomal aberration was lower in hypothermia [2(0-5] than control group [4(1-7] and chromatid breakage was commonest aberration seen. Chromosomal aberration was significantly higher in severe encephalopathy group than moderate encephalopathy group. Conclusion: We conclude that the TH significantly reduces DNA damage in perinatal asphyxia.

  18. Role of neurotensin in radiation-induced hypothermia in rats

    Energy Technology Data Exchange (ETDEWEB)

    Kandasamy, S.B.; Hunt, W.A.; Harris, A.H. (Armed Forces Radiobiology Research Institute, Bethesda, MD (USA))


    The role of neurotensin in radiation-induced hypothermia was examined. Intracerebroventricular (ICV) administration of neurotensin produced dose-dependent hypothermia. Histamine appears to mediate neurotensin-induced hypothermia because the mast cell stabilizer disodium cromoglycate and antihistamines blocked the hypothermic effects of neurotensin. An ICV pretreatment with neurotensin antibody attenuated neurotensin-induced hypothermia, but did not attenuate radiation-induced hypothermia, suggesting that radiation-induced hypothermia was not mediated by neurotensin.

  19. Therapeutic hypothermia after cardiac arrest in Long QT syndrome: Could it be an adjunctive treatment to prevent dysrhythmias?

    Directory of Open Access Journals (Sweden)

    Kumar Jatti


    Full Text Available Therapeutic hypothermia has been used for neuroprotection following cardiac arrest presenting with ventricular tachycardia or ventricular fibrillation regardless of underlying cause. Long QT syndrome is a cause for polymorphic ventricular tachycardia, and we know that therapeutic hypothermia increases the QT interval. We managed a 27-year-old woman, who was 10 weeks post-partum, who collapsed secondary to ventricular fibrillation at home. Bystander cardiopulmonary resuscitation was started with successful resuscitation after a rescue shock from paramedics. On hospital admission, her computerised tomography head, computerised tomography pulmonary angiogram and echocardiography did not show any abnormality. Her baseline electrocardiogram showed prolonged QTc interval of 504 ms without ischaemic changes. After intubation and ventilation, she was treated with therapeutic hypothermia for 48 h. She had a further episode of polymorphic ventricular tachycardia requiring rescue shock just prior to starting therapeutic hypothermia in hospital. No dysrhythmias occurred during therapeutic hypothermia, although the QTc further increased. After stopping the therapeutic hypothermia, she had two further ventricular tachycardia episodes. After commencement of beta blockers, she remained free of arrhythmias, and an implantable cardioverter defibrillator was implanted, she has recovered without any neurological deficit. Ventricular dysrhythmias caused by prolongation of the QT interval during or after therapeutic hypothermia are not well understood. There has been a report of a patient also having ventricular dysrhythmia 2 h after re-warming post therapeutic hypothermia and also a report of arrhythmia free period during therapeutic hypothermia in a long QT syndrome patient; both these features are present in our patient. Re-warming is not usually known to cause any arrhythmias; however, it could be a problem in those with long QT syndrome. Whether

  20. Hypothermia reduces VEGF-165 expression, but not osteogenic differentiation of human adipose stem cells under hypoxia (United States)

    Bakker, Astrid D.; Hogervorst, Jolanda M. A.; Nolte, Peter A.; Klein-Nulend, Jenneke


    Cryotherapy is successfully used in the clinic to reduce pain and inflammation after musculoskeletal damage, and might prevent secondary tissue damage under the prevalent hypoxic conditions. Whether cryotherapy reduces mesenchymal stem cell (MSC) number and differentiation under hypoxic conditions, causing impaired callus formation is unknown. We aimed to determine whether hypothermia modulates proliferation, apoptosis, nitric oxide production, VEGF gene and protein expression, and osteogenic/chondrogenic differentiation of human MSCs under hypoxia. Human adipose MSCs were cultured under hypoxia (37°C, 1% O2), hypothermia and hypoxia (30°C, 1% O2), or control conditions (37°C, 20% O2). Total DNA, protein, nitric oxide production, alkaline phosphatase activity, gene expression, and VEGF protein concentration were measured up to day 8. Hypoxia enhanced KI67 expression at day 4. The combination of hypothermia and hypoxia further enhanced KI67 gene expression compared to hypoxia alone, but was unable to prevent the 1.2-fold reduction in DNA amount caused by hypoxia at day 4. Addition of hypothermia to hypoxic cells did not alter the effect of hypoxia alone on BAX-to-BCL-2 ratio, alkaline phosphatase activity, gene expression of SOX9, COL1, or osteocalcin, or nitric oxide production. Hypothermia decreased the stimulating effect of hypoxia on VEGF-165 gene expression by 6-fold at day 4 and by 2-fold at day 8. Hypothermia also decreased VEGF protein expression under hypoxia by 2.9-fold at day 8. In conclusion, hypothermia decreased VEGF-165 gene and protein expression, but did not affect differentiation, or apoptosis of MSCs cultured under hypoxia. These in vitro results implicate that hypothermia treatment in vivo, applied to alleviate pain and inflammation, is not likely to harm early stages of callus formation. PMID:28166273

  1. Brain delta2 opioid receptors mediate SNC-80-evoked hypothermia in rats. (United States)

    Rawls, Scott Manning; Hewson, Jennifer Marie; Inan, Saadet; Cowan, Alan


    Despite insights into an increasingly significant role for delta opioid receptors in thermoregulation, it is unclear whether delta receptors located in the brain or periphery play the more critical role in body temperature regulation. Moreover, it is not entirely clear which delta receptor phenotype, delta1 or delta2, mediates the hypothermic actions of delta agonists. Because SNC-80 distributes into central and peripheral compartments and produces rapid hypothermia following systemic injection, the nonpeptide delta agonist is particularly useful in discriminating the site of action of delta receptor-mediated hypothermia. To determine the locus and phenotype of delta receptor which mediates SNC-80-induced hypothermia, we injected SNC-80 and phenotype selective delta antagonists to male Sprague-Dawley rats. SNC-80 (10-50 mg/kg, im) evoked hypothermia that peaked 30 min post-injection. Naltrexone (5 mg/kg, sc), an opioid antagonist, or naltrindole (5 mg/kg, sc), a delta antagonist, blocked the hypothermic response to SNC-80 (35 mg/kg, im). The hypothermia caused by SNC-80 (35 mg/kg, im) was blocked by a delta2 antagonist, naltriben (2.5 mg/kg, sc), but was not affected by BNTX (5 and 10 mg/kg, sc), a delta1 antagonist. The administration of naltriben (10 microg/rat, icv) 30 min before SNC-80 (35 mg/kg, im) prevented SNC-80-evoked hypothermia. In contrast, methylnaltrexone (5 mg/kg, sc), a peripherally restricted opioid antagonist, did not affect the hypothermia caused by SNC-80. The present data demonstrate that selective activation of brain delta2 receptors is a major mechanism of SNC-80-evoked hypothermia in rats.

  2. Neonatal seizures and therapeutic hypothermia for hypoxic-ischemic encephalopathy



    Neonatal seizures are associated with morbidity and mortality. Hypoxic-ischemic encephalopathy (HIE) is the most common cause of seizures in newborns. Neonatal animal models suggest that therapeutic hypothermia can reduce seizures and epileptiform activity in the setting of hypoxia-ischemia, however data from human studies have conflicting results. In this research highlight, we will discuss the findings of our recent study that demonstrated a decreased seizure burden in term newborns with mo...

  3. Research progress in study of accidental hypothermia

    Directory of Open Access Journals (Sweden)

    Rui YUAN


    Full Text Available Accidental hypothermia refers to a state of lowering of core body temperature down to 35 ℃induced by drowning, burial in snow and prolonged exposure to cold environment, etc. Hypothermia may affect the cardiovascular system, respiratory system, digestive system, etc. The triad consisting "hypothermia, acidosis and coagulopathy" is an important factor accelerating the death of patients. Early, timely application of rewarming measures is regarded as the basic principle in treatment of hypothermia. A series of rewarming measures, such as infusion of warm fluids, inspiration of warm air, abdominal infusion of warm fluid, instruction of warm fluid into pleural cavity, intravenous infusion of warm fluid, rewarming through ECMO, etc. have been used recently. Advance in research on the classification of hypothermia, its impact to the body and the treatment methods are reviewed in present paper. DOI: 10.11855/j.issn.0577-7402.2016.04.15

  4. Prevention of peroperative hypothermia in abdominal surgery. (United States)

    Kristensen, G; Guldager, H; Gravesen, H


    It is important to reduce or prevent heat loss during anaesthesia, especially in patients with restricted cardiopulmonary reserves. To test a specially developed esophageal thermal tube (GK-esophageal thermal tube) for this purpose, 33 patients were randomly divided into two groups: Group A were given heat transferred to the central core during operation, using the GK-tube with circulating 41.7 degrees C warm water. Group B received no active warming. All patients were scheduled for major abdominal operation. In both groups there was a temperature fall in the induction phase. In Group B the temperature continued to fall slowly during operation, resulting in a median end-temperature of 34.9 degrees C. In Group A the temperature rose slowly after induction of heat via the tube, resulting in a median end-temperature of 36.8 degrees C in this actively warmed group. The temperature difference is significant (P less than 0.001). The median operating time was 3h 30 min in both groups. After 2 h of anaesthesia the median temperature in Group A was 36.1 degrees C and in Group B 35.0 degrees C. This difference is also significant (P less than 0.001). The described method was easy to use and without complications. We recommend this method to prevent peroperative hypothermia in all patients suspected to have limited cardiopulmonary reserves. The possible hazards and how to avoid these are described.

  5. GABAA receptors modulate cannabinoid-evoked hypothermia. (United States)

    Rawls, S M; Tallarida, R J; Kon, D A; Geller, E B; Adler, Martin W


    Cannabinoids evoke hypothermia by stimulating central CB(1) receptors. GABA induces hypothermia via GABA(A) or GABA(B) receptor activation. CB(1) receptor activation increases GABA release in the hypothalamus, a central locus for thermoregulation, suggesting that cannabinoid and GABA systems may be functionally linked in body temperature regulation. We investigated whether GABA receptors modulate the hypothermic actions of [4,5-dihydro-2-methyl-4(4-morpholinylmethyl)-1-(1-naphthalenyl-carbonyl)-6H-pyrrolo[3,2,1ij]quinolin-6-one] (WIN 55212-2), a selective cannabinoid agonist, in male Sprague-Dawley rats. WIN 55212-2 (2.5 mg/kg im) produced a rapid hypothermia that peaked 45-90 min postinjection. The hypothermia was attenuated by bicuculline (2 mg/kg ip), a GABA(A) antagonist. However, SCH 50911 (1-10 mg/kg ip), a GABA(B) blocker, did not antagonize the hypothermia. Neither bicuculline (2 mg/kg) nor SCH 50911 (10 mg/kg) by itself altered body temperature. We also investigated a possible role for CB(1) receptors in GABA-generated hypothermia. Muscimol (2.5 mg/kg ip), a GABA(A) agonist, or baclofen (5 mg/kg ip), a GABA(B) agonist, evoked a significant hypothermia. Blockade of CB(1) receptors with SR141716A (2.5 mg/kg im) did not antagonize muscimol- or baclofen-induced hypothermia, indicating that GABA-evoked hypothermia does not contain a CB(1)-sensitive component. Our results implicate GABA(A) receptors in the hypothermic actions of cannabinoids and provide further evidence of a functional link between cannabinoid and GABA systems.

  6. Stridor in asphyxiated neonates undergoing therapeutic hypothermia. (United States)

    Orme, Judith; Kissack, Christopher; Becher, Julie-Clare


    Therapeutic hypothermia is an established standard of care in the treatment of hypoxic-ischemic encephalopathy. Application of therapeutic hypothermia in the clinical setting may reveal a wider spectrum of adverse events than previously reported. We report 5 cases of transient respiratory stridor in 51 infants, occurring at different time points in the cooling process, which appeared to be unrelated to the intubation procedure. Therapeutic hypothermia was associated with transient stridor in this case series. Formal laryngoscopy is required to determine the underlying pathologic etiology.

  7. Chloroplast Avoidance Movement Causes Increasing PAR Reflectance in Water Stressed Plants and May Distort Biophysical Estimates Based On Spectral Indices (United States)

    Zygielbaum, A. I.; Arkebauer, T. J.; Walter-Shea, E.


    Vegetation photoprotective responses impact the reflected spectra in the visible or photosynthetically active (PAR) spectral region. Earlier, we presented a case that the increasing PAR reflectance which accompanies increasing water stress was due to one such response, chloroplast avoidance movement. This increasing reflectance has been reported in published papers for several decades and dismissed as operator error or a result of changes in leaf turgor or optical pathway. We showed, however, that such changes in the PAR region, which occurred with no significant change in chlorophyll content, were caused by decreasing absorption, not changes in light scatter. Further, we demonstrated that the changes in reflectance were correlated with changes in ambient light (downwelling radiance). To further refine the case that chloroplast movement is the basis of these observations, excised leaves were exposed separately to either red light or white light illumination of equal photon flux densities. The transmittance observed as these leaves dried increased in the leaves exposed to white light and remained constant in the leaves exposed to red light. Since chloroplast movement is driven by blue light, our conjecture is strengthened. We have also observed distinct morning vs. afternoon differences in reflectance spectra of greenhouse-grown plants; indices derived from these spectra also vary diurnally--leading us to coin the phase 'apparent chlorophyll'. All observations previously reported were the result of greenhouse experiments. We report herein on observations of leaf and canopy reflectances under field conditions and on the impact the increasing reflectance has on estimation of chlorophyll content using spectral indices. We also present evidence that increasing reflectance which is concomitant with increasing plant stress may not correlate with stress indications using the photochemical reflectance index (PRI) and discuss the implications of that observation.

  8. Toll-Like Receptor 4 Deficiency Causes Reduced Exploratory Behavior in Mice Under Approach-Avoidance Conflict. (United States)

    Li, Chunlu; Yan, Yixiu; Cheng, Jingjing; Xiao, Gang; Gu, Jueqing; Zhang, Luqi; Yuan, Siyu; Wang, Junlu; Shen, Yi; Zhou, Yu-Dong


    Abnormal approach-avoidance behavior has been linked to deficits in the mesolimbic dopamine (DA) system of the brain. Recently, increasing evidence has indicated that toll-like receptor 4 (TLR4), an important pattern-recognition receptor in the innate immune system, can be directly activated by substances of abuse, resulting in an increase of the extracellular DA level in the nucleus accumbens. We thus hypothesized that TLR4-dependent signaling might regulate approach-avoidance behavior. To test this hypothesis, we compared the novelty-seeking and social interaction behaviors of TLR4-deficient (TLR4(-/-)) and wild-type (WT) mice in an approach-avoidance conflict situation in which the positive motivation to explore a novel object or interact with an unfamiliar mouse was counteracted by the negative motivation to hide in exposed, large spaces. We found that TLR4(-/-) mice exhibited reduced novelty-seeking and social interaction in the large open spaces. In less stressful test apparatuses similar in size to the mouse cage, however, TLR4(-/-) mice performed normally in both novelty-seeking and social interaction tests. The reduced exploratory behaviors under approach-avoidance conflict were not due to a high anxiety level or an enhanced fear response in the TLR4(-/-) mice, as these mice showed normal anxiety and fear responses in the open field and passive avoidance tests, respectively. Importantly, the novelty-seeking behavior in the large open field induced a higher level of c-Fos activation in the nucleus accumbens shell (NAcSh) in TLR4(-/-) mice than in WT mice. Partially inactivating the NAcSh via infusion of GABA receptor agonists restored the novelty-seeking behavior of TLR4(-/-) mice. These data suggested that TLR4 is crucial for positive motivational behavior under approach-avoidance conflict. TLR4-dependent activation of neurons in the NAcSh may contribute to this phenomenon.

  9. Teachers Avoiding Learners' Avoidance: Is It Possible? (United States)

    Tadayyon, Maedeh; Zarrinabadi, Nourollah; Ketabi, Saeed


    Dealing with learners who prefer to take the back seat and avoid classroom participation can be every teacher's nightmare. This lack of participation may cause teacher frustration, and possibly the only way to reduce this lack of participation is to access the concept of avoidance strategy. Avoidance strategy is the abandonment of a classroom task…

  10. Choreoathetosis after cardiac surgery with hypothermia and extracorporeal circulation. (United States)

    Gherpelli, J L; Azeka, E; Riso, A; Atik, E; Ebaid, M; Barbero-Marcial, M


    Eleven children, 4-48 months old, with congenital cyanotic heart defects developed choreoathetoid movements 2-12 days after cardiac surgery with hypothermia and extracorporeal circulation (ECC). The abnormal movements mainly involved the limbs, facial musculature, and tongue, leading to a severe dysphagia. The symptoms had an acute onset, after a period of apparent neurologic normality, and had a variable outcome. Of the nine children that survive, three had abnormal movements when last seen (41 days to 12 months of follow-up). The other six children had a complete regression of the choreoathetoid movements 1-4 weeks after onset. No specific finding was observed in the CT scans, cerebrospinal fluid examination, or EEG that could be related to the abnormal movements. Symptomatic therapy with haloperidol with or without benzodiazepines led to symptomatic improvement in six children, although there was no evidence that this treatment modified the evolution of the disease. The authors conclude that the choreoathetoid syndrome after cardiac surgery with deep hypothermia and ECC is an ill-defined entity requiring additional study to better understand its pathogenesis so that preventive measures can be taken to avoid a condition that can lead to permanent and incapacitating neurologic sequelae.

  11. Hypothermia for Neuroprotection in Convulsive Status Epilepticus. (United States)

    Legriel, Stephane; Lemiale, Virginie; Schenck, Maleka; Chelly, Jonathan; Laurent, Virginie; Daviaud, Fabrice; Srairi, Mohamed; Hamdi, Aicha; Geri, Guillaume; Rossignol, Thomas; Hilly-Ginoux, Julia; Boisramé-Helms, Julie; Louart, Benjamin; Malissin, Isabelle; Mongardon, Nicolas; Planquette, Benjamin; Thirion, Marina; Merceron, Sybille; Canet, Emmanuel; Pico, Fernando; Tran-Dinh, Yves-Roger; Bedos, Jean-Pierre; Azoulay, Elie; Resche-Rigon, Matthieu; Cariou, Alain


    Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit). The main secondary outcomes were mortality at 90 days, progression to electroencephalographically (EEG) confirmed status epilepticus, refractory status epilepticus on day 1, "super-refractory" status epilepticus (resistant to general anesthesia), and functional sequelae on day 90. Results A GOS score of 5 occurred in 67 of 138 patients (49%) in the hypothermia group and in 56 of 130 (43%) in the control group (adjusted common odds ratio, 1.22; 95% confidence interval [CI], 0.75 to 1.99; P=0.43). The rate of progression to EEG-confirmed status epilepticus on the first day was lower in the hypothermia group than in the control group (11% vs. 22%; odds ratio, 0.40; 95% CI, 0.20 to 0.79; P=0.009), but there were no significant differences between groups in the other secondary outcomes. Adverse events were more frequent in the hypothermia group than in the control group. Conclusions In this trial, induced hypothermia added to standard care was not associated with significantly better 90-day outcomes than standard care alone in patients with convulsive status epilepticus. (Funded by the French Ministry of Health; HYBERNATUS number, NCT01359332 .).

  12. Causes and avoidance of container damages by means of biocorrosion; Ursachen und Vermeidung von Behaelterschaeden durch Biokorrosion

    Energy Technology Data Exchange (ETDEWEB)

    Kuever, Jan [Amtliche Materialpruefungsanstalt Bremen (MPA), Bremen (Germany)


    The contribution under consideration deals with the causes and prevention of vessel damages due to corrosion by microorganisms (MIC, microbially induced corrosion) in the presence and absence of oxygen. In particular, the microbially induced corrosion by sulfate-reducing bacteria and the formation of sulfuric acid by microorganisms are described. Consequential damage caused by microorganisms are inactivation of filters and catalysts, degradation products from the fermentation process and deposits in the pipe system.

  13. Hypothermia at Birth and its Associated Com- plications in Newborn infants: a Follow up Study

    Directory of Open Access Journals (Sweden)

    F Nayeri


    Full Text Available Hypothermia is one of the main causes of neonatal mortality in developing countries. The aim of this prospective study was to determine the relationship between hypothermia at birth and the risk of mortality or morbidity among neonates born in Imam Hospital in Tehran, Iran. During a one-year period, body temperature was taken from all newborns using a low-reading rectal thermometer, immediately after their admission into the Neonatal ward of the above hospital. A temperature less than 36.5C was considered as hypothermia. A questionnaire was filled for each subject. Using logistic regression the risk of development of respiratory distress in the first six hours of birth, hypoglycemia, metabolic acidosis, hyperbilirubinemia, scleroderma, pulmonary hemorrhage, Disseminated Intravascular Coagulopathy (DIC in the first three days of birth were assessed and compared with the hypothermic and normothermic newborn infants. Nine hundred and forty neonates were enrolled into the study. A significant relationship was found between hypothermia and respiratory distress in the first six hours of birth and death, as well as with jaundice, hypoglycemia and metabolic acidosis in the first three days of birth (P=0.0001. Logistic regression showed that, regardless of weight and gestational age, hypothermia at birth alone could increase the risk of neonatal death (OR=3.64, CI=1.85-7.18, Respiratory distress (OR=2.12, CI=1.53-2.93, metabolic acidosis (OR=2.83, CI=1.74-4.59 and jaundice (OR=2.01, CI=1.45-2.79. Neonatal hypothermia at birth increases mortality as well as significant morbidity and hospitalization period.

  14. Hypothermia for Stroke: call to action 2010

    DEFF Research Database (Denmark)

    Macleod, Malcolm R; Petersson, Jesper; Norrving, Bo;


    ) and a pivotal Phase III clinical trial. The proposed integrated Phase II and III clinical study programme would test the effectiveness of this optimised intervention, and would allow the development of evidence-based Clinical Practice Guidelines describing the optimal use of therapeutic hypothermia...

  15. Arctic Cold Weather Medicine and Accidental Hypothermia (United States)


    ZIP Code) Tb . ADDRESS (City. State, and ZIP Code) Panama City, Ft 32407-5001 8a. NDJE OF FUNDING/SPONSORING 6b. OFFICE SYMBOL 9. PROCUREMENT...patient not being that cold. h. Abdomen/ Urogenital . With the intense shivering and increased muscle tone of mild hypothermia, it is very difficult to

  16. Cooling strategies and transport theories for brain hypothermia resuscitation

    Institute of Scientific and Technical Information of China (English)

    LIU Jing


    The brain is one of the most important organs in a biological body whose normal function depends heavily on an uninterrupted delivery of oxygen.Unlike skeletal muscles that can survive for hours without oxygen,neuron cells in the brain are easily subjected to an irreversible damage within minutes from the onset of oxygen deficiency.With the interruption of cardiopulmonary circulation in many cardiac surgical procedures or accidental events leading to cerebral circulation arrest,an imbalance between energy production and consumption will occur which causes a rapid depletion of oxygen due to the interrupted blood-flow to the brain.Meanwhile,the cooling function of the blood flow on the hot tissue will be stopped,while metabolic heat generation in the tissues still keeps running for awhile.Under such adverse situations,the potential for cerebral protection through hypothermia has been intensively investigated in clinics by lowering brain temperature to restrain the cerebral oxygen demands.The reason can be attributed to the decreased metabolic requirements of the cold brain tissues,which allows a longer duration for the brain to endure reduced oxygen delivery.It is now clear that hypothermia would serve as the principal way for neurologic protection in a wide variety of emergency medicines,especially in cerebral damage,anoxia,circulatory arrest,respiratory occlusion,etc.However,although brain cooling has been found uniquely significant in clinical practices,the serious lack of knowledge on the mechanisms involved prevents its further advancement in brain resuscitation.Compared with the expanded trials in clinics,only very limited efforts were made to probe the engineering issues involved,which turns out to be a major obstacle for the successful operation of brain hypothermia resuscitation.From the viewpoint of biothermal medical engineering,the major theories and strategies for administering brain cooling can generally be classified into three categories:heat transfer

  17. Approach to indicators of avoidable cause of death among infants in Sichuan province%四川省婴儿可避免死亡分析

    Institute of Scientific and Technical Information of China (English)

    蒋迎佳; 吴方银; 曹静; 赵梓伶; 熊庆


    [Objective]To determine avoidable death indication among infants in Sichuan province and reduce mortality of infants.[Method]Relative risk(RR) of mortality in infants between USA and Sichuan, rural and urban areas of Sichuan were measured to determine avoidable death indicators among Sichuan province.[Results]Septicemia, pneumonia, diarrhea, tetanus, neonatal scleredema, intracerebral hemorrhage, Down's syndrome, birth asphyxia, accident suffocation, drowning, accident falling were considered as avoidable death causes of Sichuan province.[Conclusion]Avoidable causes of death mortality among infants in Sichuan should be controlled by medical intervention.%[目的]明确四川省婴儿可避免死亡指标,为制定该省婴儿死亡率的卫生政策和医疗保健措施提供一定的理论依据.[方法]根据Rutstein等提出的可避免死亡指标,采用四川省与美国、本省城乡婴儿死因死亡率对比,计算相对危险度.[结果]四川省婴儿可避免死因为:败血症、肺炎、腹泻、新生儿破伤风、新生儿硬肿症、颅内出血、先天愚型、出生窒息、意外窒息、溺水和意外跌落.[结论]要降低本省婴儿死亡率,应加强可避免死因疾病的控制.

  18. Mild hypothermia as a treatment for central nervous system injuries Positive or negative effects?

    Institute of Scientific and Technical Information of China (English)

    Rami Darwazeh; Yi Yan


    Besides local neuronal damage caused by the primary insult, central nervous system injuries may secondarily cause a progressive cascade of related events including brain edema, ischemia, oxida-tive stress, excitotoxicity, and dysregulation of calcium homeostasis. Hypothermia is a beneficial strategy in a variety of acute central nervous system injuries. Mild hypothermia can treat high intra-cranial pressure fol owing traumatic brain injuries in adults. It is a new treatment that increases sur-vival and quality of life for patients suffering from ischemic insults such as cardiac arrest, stroke, and neurogenic fever fol owing brain trauma. Therapeutic hypothermia decreases free radical produc-tion, inflammation, excitotoxicity and intracranial pressure, and improves cerebral metabolism after traumatic brain injury and cerebral ischemia, thus protecting against central nervous system dam-age. Although a series of pathological and physiological changes as wel as potential side effects are observed during hypothermia treatment, it remains a potential therapeutic strategy for central nervous system injuries and deserves further study.

  19. Experience of valve replacement under mild hypothermia on pump-beating heart:an analysis of 800 cases

    Institute of Scientific and Technical Information of China (English)

    陈柏成; 肖颖彬; 陈林; 钟前进; 王学锋; 周骐; 易广兵


    Objective: To assess the outcome of valve replacement under mild hypothermia on pump-beating heart and to discuss the risk factors of cardiac valve surgery. Methods: In the period from November 1997 to May 2003, a total of 800cases of valve replacement were carried out in our institute. The clinical data were reviewed and the technique of mild hypothermia and pump-beating heart to replace cardiac valve was described in detail. Results: 800 patients, 308 male and 492female, with age range from 8 to 66 years, weighing 19 to 88 kg, underwent operation. The average cardiopulmonary bypass time was (109.38 ± 40.64) min, the average clamping time of the vena cava was (77.87 ± 27.99) min and the average mechanical ventilation time was (17.78 ± 12.21) h. There were 17 patients died in the early postoperative stage with an early mortality rate of 2.13%. The causes of death were failure in the weaning of extracorporeal circulation in 2 cases, severe low output syndrome in 3 cases, ventricular fibrillation in 3 cases, obstruction of coronary ostium of mechanical prosthetic valve in 1 case, hepatic failure in 2 cases, pulmonary failure in 1 case, multiorgan failure in 4 cases, and prosthetic valve dysfunction in 1 case. Severe postopertive complications occurred in 51 cases (6.375%), which included reexploration because of excessive bleeding in 16 cases (2.0%), lavage of poststemal infection in 2 cases (0.25%), postoperative strike in 7 cases (0.875%), pulmonary failure in 5 cases (0.625%), hepatic failure in 4 cases (0.5%), multiorgan failure in 11 cases (1.375 % ), ventricular arrhythmia in 5 cases (0.625%) and peripheral circulation failure in 1 case(0. 125 % ). Conclusion: Mild hypothermia and pump-beating heart result in satisfying clinical outcome in patients undergoing valve replacement. The integrated sequenced deairing procedure ensures the avoidance of air embolism during operation.Pump-beating heart technique offers a safe and practical option especially in

  20. Outcome of accidental hypothermia with or without circulatory arrest

    DEFF Research Database (Denmark)

    Wanscher, Michael; Agersnap, Lisbeth; Ravn, Jesper;


    Resuscitation guidelines for the treatment of accidental hypothermia are based primarily on isolated cases. Mortality rates are high despite aggressive treatment aimed at restoring spontaneous circulation and normothermia....

  1. Serum cortisol concentrations during induced hypothermia for perinatal asphyxia are associated with neurological outcome in human infants. (United States)

    Scaramuzzo, Rosa T; Giampietri, Matteo; Fiorentini, Erika; Bartalena, Laura; Fiori, Simona; Guzzetta, Andrea; Ciampi, Mariella; Boldrini, Antonio; Ghirri, Paolo


    Birth asphyxia is a cause of neonatal death or adverse neurological sequelae. Biomarkers can be useful to clinicians in order to optimize intensive care management and communication of prognosis to parents. During perinatal adverse events, increased cortisol secretion is due to hypothalamo-pituitary-adrenal axis activation. We aimed to investigate if cortisol variations during therapeutic hypothermia are associated with neurodevelopmental outcome. We compared 18 cases (neonates with birth asphyxia) with 18 controls (healthy term newborns) and confirmed increased serum cortisol concentrations following the peri-partum adverse event. Among cases, we stratified patients according to neurological outcome at 18 months (group A - good; group B - adverse) and found that after 24 h of therapeutic hypothermia serum cortisol concentration was significantly lower in group A vs group B (28.7 ng/mL vs 344 ng/mL, *p = 0.01). In group B serum, cortisol concentration decreased more gradually during therapeutic hypothermia. We conclude that monitoring serum cortisol concentration during neonatal therapeutic hypothermia can add information to clinical evaluation of neonates with birth asphyxia; cortisol values after the first 24 h of hypothermia can be a biomarker associated with neurodevelopmental outcome at 18 months of age.

  2. Body cooling, modelling & risk assessment - Immersion Hypothermia Chapter

    NARCIS (Netherlands)

    Tikuisis, P; Daanen, H.A.M.


    This chapter describes a model that can be used to predict hypothermia during cold water immersion. Drowning in cold water might precede the onset of hypothermia due to cold shock, injury or incapacitation. As pointed out in Chap. 129, there are three phases of increasing incapacitation leading to l

  3. Prolonged drug-induced hypothermia in experimental stroke

    DEFF Research Database (Denmark)

    Johansen, Flemming Fryd; Jørgensen, Henrik Stig; Reith, Jakob


    In experimental and human stroke, hypothermia is strongly related to a favorable outcome. Previous attempts to manipulate the core temperature in focal cerebral ischemia have been based on mechanical cooling. The purpose of the study is to establish a model for long-term drug-induced hypothermia...

  4. Treatment temperature and insult severity influence the neuroprotective effects of therapeutic hypothermia



    Therapeutic hypothermia (HT) is standard care for moderate and severe neonatal hypoxic-ischaemic encephalopathy (HIE), the leading cause of permanent brain injury in term newborns. However, the optimal temperature for HT is still unknown, and few preclinical studies have compared multiple HT treatment temperatures. Additionally, HT may not benefit infants with severe encephalopathy. In a neonatal rat model of unilateral hypoxia-ischaemia (HI), the effect of five different HT temperatures was ...

  5. A Proposed Methodology to Control Body Temperature in Patients at Risk of Hypothermia by means of Active Rewarming Systems

    Directory of Open Access Journals (Sweden)

    Silvia Costanzo


    Full Text Available Hypothermia is a common complication in patients undergoing surgery under general anesthesia. It has been noted that, during the first hour of surgery, the patient’s internal temperature (Tcore decreases by 0.5–1.5°C due to the vasodilatory effect of anesthetic gases, which affect the body’s thermoregulatory system by inhibiting vasoconstriction. Thus a continuous check on patient temperature must be carried out. The currently most used methods to avoid hypothermia are based on passive systems (such as blankets reducing body heat loss and on active ones (thermal blankets, electric or hot-water mattresses, forced hot air, warming lamps, etc.. Within a broader research upon the environmental conditions, pollution, heat stress, and hypothermia risk in operating theatres, the authors set up an experimental investigation by using a warming blanket chosen from several types on sale. Their aim was to identify times and ways the human body reacts to the heat flowing from the blanket and the blanket’s effect on the average temperature Tskin and, as a consequence, on Tcore temperature of the patient. The here proposed methodology could allow surgeons to fix in advance the thermal power to supply through a warming blanket for reaching, in a prescribed time, the desired body temperature starting from a given state of hypothermia.

  6. Alpha-lipoic acid protects mitochondrial enzymes and attenuates lipopolysaccharide-induced hypothermia in mice (United States)

    Abstract: Hypothermia is a key symptom of sepsis and the mechanism(s) leading to hypothermia during sepsis is largely unknown. To investigate a potential mechanism and find an effective treatment for hypothermia in sepsis, we induced hypothermia in mice by lipopolysaccharide (LP...

  7. Optimal timing of hypothermia in relation to myocardial reperfusion. (United States)

    Götberg, Matthias; van der Pals, Jesper; Götberg, Michael; Olivecrona, Göran K; Kanski, Mikael; Koul, Sasha; Otto, Andreas; Engblom, Henrik; Ugander, Martin; Arheden, Håkan; Erlinge, David


    Two previous clinical trials investigating hypothermia as an adjunct therapy for myocardial infarction have failed. Recently a pilot study has demonstrated a significant reduction in infarct size. The aims of this study were to elucidate the effects of hypothermia on reperfusion injury and to investigate the optimal hypothermia protocol for a future clinical trial. Pigs (40-50 kg) were anesthetized and a normal pig temperature of 38°C was established utilizing an endovascular temperature modulating catheter. The pigs were randomized to a combination hypothermia group (1,000 ml of 4°C saline solution and endovascular cooling, n = 8), or to normothermic controls (n = 8). A PCI balloon was then inflated in the LAD for 40 min (control) or 45 min with hypothermia induced during the last 5 min. Furthermore, hypothermia induced by cold saline alone (n = 8), and prolonged combination hypothermia during reperfusion (n = 7) were also examined. Infarct size and area at risk were determined ex vivo after 4 h of reperfusion using gadolinium-enhanced MRI and Tc-99-tetrofosmin SPECT, respectively. All pigs in the combination hypothermia group were cooled to <35°C within 5 min. Combination hypothermia reduced IS/AAR by 18% compared with normothermic controls despite 5 min longer ischemic time (61 ± 5 vs. 74 ± 4%, p = 0.03). Cold saline did not reduce IS/AAR. Prolonging hypothermia treatment after onset of reperfusion by an additional 45 min over that used in a previous paper did not confer any additional benefit. The cardioprotective effects of hypothermia treatment are due to an attenuation of myocardial injury during both ischemia and reperfusion. The results suggest that a hypothermia protocol using a cold saline infusion and endovascular cooling enables hypothermia to be induced in a clinical setting without delaying reperfusion therapy.

  8. Thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    QIU Wu-si; WANG Wei-min; DU Hong-ying; LIU Wei-guo; SHEN Hong; SHEN Lei-fen; ZHU Ming-lan


    Objective: To investigate the clinical characteristics and significance of thrombocytopenia after therapeutic hypothermia in severe traumatic brain injury (TBI).Methods: Ninety-six inpatients with severe brain injury were randomized into three groups: SBC (selective brain cooling ) group (n =24), MSH ( mild systemic hypothermia ) group ( n = 30), and control (normothermia) group ( n = 42). The platelet counts and prognosis were retrospectively analyzed.Results: Thrombocytopenia was present in 18 (75 % ), 23 (77 % ) and 15 (36 % ) patients in SBC group,MSH group and control group, respectively (P <0.01 ).Thrombocytopenia, in which the minimum platelet count was seen 3 days after hypothermia, showed no significant difference between SBC and MSH group (P > 0.05). Most platelet counts (37 cases, 90% ) in hypothermia group were returned to normal level after 1 to 2 days of natural rewarming. The platelet count in SBC group reduced by 16%, 27% and 29% at day 1, 3 and 5 respectively compared with the baseline value. Good recovery (GOS score 4-5) rate of thrombocytopenia 1 year after injury for hypothermia group ( 17 cases, 37 % ) was significantly lower than that of control group (P <0.01).Conclusions: Therapeutic hypothermia increases the incidence of thrombocytopenia in severe TBI, and patients with thrombocytopenia after therapeutic hypothermia are associated with unfavorable neurological prognosis.

  9. Intraoperative Hypothermia During Surgical Fixation of Hip Fractures. (United States)

    Frisch, Nicholas B; Pepper, Andrew M; Jildeh, Toufic R; Shaw, Jonathan; Guthrie, Trent; Silverton, Craig


    Hip fractures are common orthopedic injuries and are associated with significant morbidity/mortality. Intraoperative normothermia is recommended by national guidelines to minimize additional morbidity/mortality, but limited evidence exists regarding hypothermia's effect on orthopedic patients. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients with operatively treated hip fractures and evaluate its effect on complications and outcomes. Retrospective chart review was performed on clinical records from 1541 consecutive patients who sustained a hip fracture and underwent operative fixation at the authors' institution between January 2005 and October 2013. A total of 1525 patients were included for analysis, excluding those with injuries requiring additional surgical intervention. Patient demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis with univariate and multivariate logistic regression modeling evaluated associations with hypothermia and effect on complications/outcomes. The incidence of intraoperative hypothermia in operatively treated hip fractures was 17.0%. Hypothermia was associated with an increase in the rate of deep surgical-site infection (odds ratio, 3.30; 95% confidence interval, 1.19-9.14; P=.022). Lower body mass index and increasing age demonstrated increased association with hypothermia (P=.004 and P=.005, respectively). To the authors' knowledge, this is the first and largest study analyzing the effect of intraoperative hypothermia in orthopedic patients. In patients with hip fractures, the study's findings confirm evidence found in other surgical specialties that hypothermia may be associated with an increased risk of deep surgical-site infection and that lower body mass index and increasing age are risk factors

  10. Intraoperative Hypothermia in Total Hip and Knee Arthroplasty. (United States)

    Frisch, Nicholas B; Pepper, Andrew M; Rooney, Edward; Silverton, Craig


    Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes. The clinical records of 2580 consecutive patients who underwent TKA or THA at a single institution between January 1, 2011, and December 31, 2013 were reviewed. After excluding patients with complex or revision procedures, a total of 2397 patients comprised the study population. Patient demographic data, surgery-specific data, postoperative complications, length of hospital stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis evaluated associations with hypothermia and the effect on complications and outcomes. The incidence of mean intraoperative hypothermia was 37%, 43.9%, and 32.6% for arthroplasty, THA, and TKA, respectively. General anesthesia was significantly associated with hypothermia (P<.001). Women and THA patients were at higher risk for hypothermia. In the arthroplasty and THA cohorts, longer operating room time and re-warmer use were associated with hypothermia (P=.010). Overall, hypothermia was associated with increased estimated blood loss, but no increase in associated transfusion was demonstrated (P=.006). Hypothermia was not associated with postoperative complications. [Orthopedics. 201x; xx(x):xx-xx.].

  11. A new microcontroller supervised thermoelectric renal hypothermia system. (United States)

    Işik, Hakan


    In the present study, a thermoelectric system controlled by a microcontroller is developed to induce renal hypothermia. Temperature value was managed by 8-byte microcontroller, PIC16F877, and was programmed using microcontroller MPASM package. In order to ensure hypothermia in the kidney 1-4 modules and sensors perceiving temperature of the area can be selected. Temperature values are arranged proportionately for the selected area and the determined temperature values can be monitored from an Liquid Crystal Display (LCD) screen. The temperature range of the system is between -50 and +50 degrees C. Renal hypothermia system was tried under in vivo conditions on the kidney of a dog.

  12. Mechanisms responsible for decreased glomerular filtration in hibernation and hypothermia (United States)

    Tempel, G. E.; Musacchia, X. J.; Jones, S. B.


    Measurements of blood pressure, heart rate, red blood cell and plasma volumes, and relative distribution of cardiac output were made on hibernating and hypothermic adult male and female golden hamsters weighing 120-140 g to study the mechanisms underlying the elimination or marked depression of renal function in hibernation and hypothermia. The results suggest that the elimination or marked depression in renal function reported in hibernation and hypothermia may partly be explained by alterations in cardiovascular system function. Renal perfusion pressure which decreases nearly 60% in both hibernation and hypothermia and a decrease in plasma volume of roughly 35% in the hypothermic animal might both be expected to markedly alter glomerular function.

  13. Hipotermia accidental secundaria a brote de psoriasis generalizada Accidental hypothermia due to generalized psoriasis

    Directory of Open Access Journals (Sweden)

    O. Agudo


    Full Text Available La hipotermia accidental es una alteración de la termorregulación corporal, definida como una temperatura central igual o inferior a 35ºC. Según la intensidad se puede clasificar en ligera (35-32,2ºC, moderada (32,2-28ºC y grave (The accidental hypothermia is a disorder of corporal termoregulation, defined as a central temperature below 35ºC. According to the intensity may be classified in mild (35-32.2 ºC, moderate (32.2-28ºC and severe (below 28ºC. The most frequent causes are the exposure to cold, use of depressant drugs of central nervous system and hypoglycemia, although there are other less frequent. We present a case of moderate hypothermia due to generalized psoriasis which required admission in the Intensive Care Unit of Hospital García Orcoyen. The termoregulation, pathogenesis, pathophysiology, diagnosis and management of accidental hypothermia are reviewed.

  14. Therapeutic hypothermia for acute liver failure

    DEFF Research Database (Denmark)

    Stravitz, R.T.; Larsen, Finn Stolze


    Cerebral edema is a potentially life-threatening complication of acute liver failure, the syndrome of abrupt loss of liver function in a patient with a previously healthy liver. Although the prevalence of cerebral edema appears to be decreasing, patients with rapidly progressive (hyperacute) liver...... liver failure often can be temporarily controlled by manipulating body position, increasing the degree of sedation, and increasing blood osmolarity through pharmacologic means. However, these maneuvers often postpone, but do not eliminate, the risk of brainstem herniation unless orthotopic liver...... transplantation or spontaneous liver regeneration follows in short order. To buy time, the induction of therapeutic hypothermia (core temperature 32 degrees C-35 degrees C) has been shown to effectively bridge patients to transplant. Similar to the experience in patients with cerebral edema after other neurologic...

  15. Selective therapeutic hypothermia: A review of invasive and noninvasive techniques


    David Straus; Vinay Prasad; Lorenzo Munoz


    OBJECTIVE: Therapeutic hypothermia is a promising treatment to prevent secondary neurologic injury. Clinical utility is limited by systemic complications of global hypothermia. Selective brain cooling remains a largely uninvestigated application. We review techniques of inducing selective brain cooling. METHOD: Literature review. RESULTS: Strategies of inducing selective brain cooling were divided between non-invasive and invasive techniques. Non-invasive techniques were surface cooling and c...

  16. Avoid Logs to Avoid Ticks

    Institute of Scientific and Technical Information of China (English)



    扁虱是莱姆关节炎的罪魁祸首。研究人员为了弄明白何处扁虱最猖獗, 不惜以身作饵,他们发现:The ticks were all over the log surface。因此告诫人 们:Avoid sitting on logs。

  17. Quantitative measurement of cerebral blood flow during hypothermia with a time-resolved near-infrared technique (United States)

    Fazel Bakhsheshi, Mohammad; Diop, Mamadou; St Lawrence, Keith; Lee, Ting-Yim


    Hypothermia, in which the brain is cooled to 32-33 °C, has been shown to be neuroprotective for brain injury caused by hypoxia-ischemia, head trauma, or neonatal asphyxia. Neuroprotective effect of Hypothermia is partly due to suppression of brain metabolism and cerebral blood flow (CBF). The ability to measure CBF at the bedside provides a means of detecting, and thereby preventing, secondary ischemia during neuro intensive care before brain injury occurs. The purpose of the present study is to investigate the ability of a time-resolved near-infrared (TR-NIR) bolus-tracking method using indocyanine green as an intravascular flow tracer to measure CBF during cooling in a newborn animal model. For validation, CBF was independently measured by computed tomography (CT) perfusion. The results show a good agreement between CBF obtained with the two methods (R2 ~ 0.84, Δ ~ 5.84 ml. min -1.100 g -1, 32-38.5 °C), demonstrating the ability of the TR-NIR technique to non-invasively measure absolute CBF in-vivo during dynamic hypothermia. The TR-NIR technique reveals that CBF decreases from 54.3 +/- 5.4 ml. min -1.100 g -1, at normothermia (Tbrain of 38.5 °C), to 33.8 +/- 0.9 ml. min -1.100 g -1 at Tbrain of 32 °C during the hypothermia treatment.

  18. Mild hypothermia reduces cardiac post-ischemic reactive hyperemia

    Directory of Open Access Journals (Sweden)

    Van der Pals Jesper


    Full Text Available Abstract Background In experimentally induced myocardial infarction, mild hypothermia (33–35°C is beneficial if applied prior to ischemia or reperfusion. Hypothermia, when applied after reperfusion seems to confer little or no benefit. The mechanism by which hypothermia exerts its cell-protective effect during cardiac ischemia remains unclear. It has been hypothesized that hypothermia reduces the reperfusion damage; the additional damage incurred upon the myocardium during reperfusion. Reperfusion results in a massive increase in blood flow, reactive hyperemia, which may contribute to reperfusion damage. We postulated that hypothermia could attenuate the post-ischemic reactive hyperemia. Methods Sixteen 25–30 kg pigs, in a closed chest model, were anesthetized and temperature was established in all pigs at 37°C using an intravascular cooling catheter. The 16 pigs were then randomized to hypothermia (34°C or control (37°C. The left main coronary artery was then catheterized with a PCI guiding catheter. A Doppler flow wire was placed in the mid part of the LAD and a PCI balloon was then positioned proximal to the Doppler wire but distal to the first diagonal branch. The LAD was then occluded for ten minutes in all pigs. Coronary blood flow was measured before, during and after ischemia/reperfusion. Results The peak flow seen during post-ischemic reactive hyperemia (during the first minutes of reperfusion was significantly reduced by 43 % (p Conclusion Mild hypothermia significantly reduces post-ischemic hyperemia in a closed chest pig model. The reduction of reactive hyperemia during reperfusion may have an impact on cardiac reperfusion injury.

  19. Anticonvulsant Effectiveness and Hemodynamic Safety of Midazolam in Full-Term Infants Treated with Hypothermia

    NARCIS (Netherlands)

    van den Broek, MPH; Van Straaten, Henrica L M; Huitema, Alwin D R; Egberts, Toine; Toet, MC; De Vries, Linda S.; Rademaker, Karin; Groenendaal, Floris


    Background: Midazolam is used as an anticonvulsant in neonatology, including newborns with perinatal asphyxia treated with hypothermia. Hypothermia may affect the safety and effectiveness of midazolam in these patients. Objectives: The objective was to evaluate the anticonvulsant effectiveness and h

  20. Anticonvulsant effectiveness and hemodynamic safety of midazolam in full-term infants treated with hypothermia

    NARCIS (Netherlands)

    Van Den Broek, Marcel P H; Van Straaten, Henrica L M; Huitema, Alwin D R; Egberts, Toine|info:eu-repo/dai/nl/162850050; Toet, Mona C.; De Vries, Linda S.; Rademaker, Karin; Groenendaal, Floris


    Background: Midazolam is used as an anticonvulsant in neonatology, including newborns with perinatal asphyxia treated with hypothermia. Hypothermia may affect the safety and effectiveness of midazolam in these patients. Objectives: The objective was to evaluate the anticonvulsant effectiveness and h

  1. Nitrous oxide-induced hypothermia in the rat

    Energy Technology Data Exchange (ETDEWEB)

    Quock, R.M.; Panek, R.W.; Kouchich, F.J.; Rosenthal, M.A.


    Exposure of rats to high levels of nitrous oxide (N2O) in oxygen reduced body temperature in a concentration-related manner. The hypothermia was partly reversed by pretreatment with naloxone but not naltrexone. But in rats rendered tolerant to morphine by pellet implantation, exposure to 75% N2O/25% O2 evoked a marked hypothermia similar to that observed in morphine-naive animals. In another experiment, the hypothermic effect of chloral hydrate was also sensitive to antagonism by pretreatment with naloxone but not naltrexone. These observations lead the authors to suspect that N2O-induced hypothermia in rats is possibly not mediated by opiate receptors. The thermotropic activity of N2O may result from some non-opioid action of N2O. Its selective antagonism by naloxone (but not naltrexone) may be due to a unique non-opioid analeptic action of naloxone. 32 references, 4 figures.

  2. Therapeutic Hypothermia: Critical review of the molecular mechanisms of action.

    Directory of Open Access Journals (Sweden)

    Fernando Pavel Gonzalez-Ibarra


    Full Text Available Therapeutic Hypothermia (TH is nowadays one of the most important methods of neuroprotection. The events that occur after an episode of ischemia are multiple and hypothermia can affect the various steps of this cascade. The mechanisms of action of TH are varied and the possible explanation for the benefits of this therapy is probably the multiple mechanisms of action blocking the cascade of ischemia on many levels. TH can affect many metabolic pathways, reactions of inflammation, apoptosis processes and promote neuronal integrity. To know the mechanisms of action of TH will allow a better understanding about the indications for this therapy and the possibility of searching for other therapies when used in conjunction with hypothermia will provide a therapeutic synergistic effect.

  3. Hypothermia and hypokalemia in a patient with diabetic ketoacidosis

    Directory of Open Access Journals (Sweden)

    Osamu Saito


    Full Text Available We present the case of a 36-year-old man with type-1 diabetes who was hospitalized with diabetic ketoacidosis (DKA. On admission, he had hypothermia, hypokalemia and combined metabolic and respiratory alkalosis, in addition to hyperglycemia. Hypothermia, hypokalemia and metabolic alkalosis, with a concurrent respiratory alkalosis, are not commonly seen in DKA. After admission, intravenous infusion of 0.45% saline was administered, which resulted in the development of pure metabolic acidosis. After starting insulin infusion, hypokalemia and hypophosphatemia became evident and finally resulted in massive rhabdomyolysis. Hyperkalemia accompanying oliguric acute kidney injury (AKI warranted initiation of hemodialysis (HD on Day-five. On the 45th hospital day, his urine output started to increase and a total of 22 HD sessions were required. We believe that in this case severe dehydration, hypothermia and hypokalemia might have contributed to the initial symptoms of DKA as well as the prolongation of AKI.

  4. Facts and Fiction: The Impact of Hypothermia on Molecular Mechanisms following Major Challenge

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    Michael Frink


    Full Text Available Numerous multiple trauma and surgical patients suffer from accidental hypothermia. While induced hypothermia is commonly used in elective cardiac surgery due to its protective effects, accidental hypothermia is associated with increased posttraumatic complications and even mortality in severely injured patients. This paper focuses on protective molecular mechanisms of hypothermia on apoptosis and the posttraumatic immune response. Although information regarding severe trauma is limited, there is evidence that induced hypothermia may have beneficial effects on the posttraumatic immune response as well as apoptosis in animal studies and certain clinical situations. However, more profound knowledge of mechanisms is necessary before randomized clinical trials in trauma patients can be initiated.

  5. Effects of Graded Hypothermia on Hypoxic-ischemic Brain Damage in the Neonatal Rat

    Institute of Scientific and Technical Information of China (English)

    Xiao-yan Xia; Yi-xin Xia


    Objective To investigate the effect of graded hypothermia on neuropathologic alteratiors of neonatal rat brain after exposed to hypoxic-ischemic insult at 37℃, 33℃, 31℃, and 28℃, respectively, and to observe the effect of hypothermia on 72-kDa heat shock protein (HSP72) expression after hypoxic-ischemic insult. Methods Seven days old Wistar rats were subjected to unilateral common carotid artery ligation followed by exposure to hypoxia in 8% oxygen for 2 hours at 37℃, 33℃, 31℃, and 28℃, respectively. The brain temperature was monitored indirectly by inserting a mini-thermocouple probe into the temporal muscle during hypoxia. After hypoxia-ischemia their mortality was assessed. Neuronal damage was assessed with HE staining 72 hours after hypoxia. HSP72 expression at 0.5, 24, and 72 hours of recovery was immunohistochemically assessed using a monoclonal antibody to HSP72. Results Hypoxia-ischemia caused 10.5% (2/19) of mortality in rat of 37℃ group, but no death occurred in 33℃, 31℃ or 28℃ groups. HE staining showed neuropathologic damage was extensive in rats exposed to hypoxia-ischemia at 37℃ (more than 80.0%). The incidence of severe brain damage was significantly decreased in 33℃ (53.3%) and 31℃ groups (44.4%), and no histologic injury was seen in the 28℃ group of rats. Expression of HSP72 was manifest and persistent in the rat brain of 37℃ group, but minimum in the rat brain of 28℃ group. Conclusion Mild and moderate hypothermia might prevent cerebral visible neuropathologic damage associated with hypoxic-ischemic injury by decreasing stress response.

  6. Excitotoxic median raphe lesions aggravate working memory storage performance deficits caused by scopolamine infusion into the dentate gyrus of the hippocampus in the inhibitory avoidance task in rats

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    Babar E.


    Full Text Available The interactions between the median raphe nucleus (MRN serotonergic system and the septohippocampal muscarinic cholinergic system in the modulation of immediate working memory storage performance were investigated. Rats with sham or ibotenic acid lesions of the MRN were bilaterally implanted with cannulae in the dentate gyrus of the hippocampus and tested in a light/dark step-through inhibitory avoidance task in which response latency to enter the dark compartment immediately after the shock served as a measure of immediate working memory storage. MRN lesion per se did not alter response latency. Post-training intrahippocampal scopolamine infusion (2 and 4 µg/side produced a more marked reduction in response latencies in the lesioned animals compared to the sham-lesioned rats. Results suggest that the immediate working memory storage performance is modulated by synergistic interactions between serotonergic projections of the MRN and the muscarinic cholinergic system of the hippocampus.

  7. Evolution of the Therapeutic Effects of Induced Local Hypothermia in Neonates with Hypoxic-Ischemic Encephalopathy

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    B. Basiri


    Full Text Available Introduction & Objective: Hypoxic-ischemic encephalopathy is one of the most important causes of permanent damage to brain tissue that redound to mortality and/or late sequelae such as cerebral palsy or delayed neural development. 15-20 percent of Hypoxic-ischemic encephalopathy (HIE cases die during neonatal period and 25-30 percent of those who survive suffer from neural development problems such as cerebral palsy and mental retardation. Hypothermia or lowering temperature of brain or total body is a new and promising treatment. The present study was done to assess therapeutic effects of induced local hypothermia in hypoxic-ischemic encephalopathy (HIE among neonates admitted to Fatemieh and Beset hospitals of Hamadan city.Materials & Method: The present study was performed as a randomized clinical trial upon 36 neonates who had inclusion criteria to be imported into the study. In the first 6 hours after birth, the neonates were randomly classified into two 18 person groups. In the control group the neonates were managed with routine treatments consisted of preservative measures and anti-convulsive treatments, if necessary. In the case group the neonates received induced local hypothermia for 6 hours in addition to routine therapeutic managements. The data were analyzed using SPSS Version 13.Results: 72.7% of the neonates of the case and control groups were male. There was no significant difference between the case and control groups in sex, birth weight, gestational age and perinatal obstetric complications. The mean duration of admission was 7.72±4.23 days in the case group and 10.06±5.99 days in the control group with no significant difference between the two groups (P=0.199. The mean time of starting oral feeding was 3.44±3.11 days and 4.53±2.74 days in the control and case groups respectively and this difference was not statistically significant either (P=0.737.The mean time of regaining consciousness was 3.72±3.19 days in the case

  8. Out-of-hospital therapeutic hypothermia in cardiac arrest victims

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    Holzer Michael


    Full Text Available Abstract Despite many years of research, outcome after cardiac arrest is dismal. Since 2005, the European Resuscitation Council recommends in its guidelines the use of mild therapeutic hypothermia (32-34° for 12 to 24 hours in patients successfully resuscitated from cardiac arrest. The benefit of resuscitative mild hypothermia (induced after resuscitation is well established, while the benefit of preservative mild to moderate hypothermia (induced during cardiac arrest needs further investigation before recommending it for clinical routine. Animal data and limited human data suggest that early and fast cooling might be essential for the beneficial effect of resuscitative mild hypothermia. Out-of-hospital cooling has been shown to be feasible and safe by means of intravenous infusion with cold fluids or non-invasively with cooling pads. A combination of these cooling methods might further improve cooling efficacy. If out-of-hospital cooling will further improve functional outcome as compared with in-hospital cooling needs to be determined in a prospective, randomised, sufficiently powered clinical trial.

  9. Fatal hypothermia: an analysis from a sub-arctic region

    Directory of Open Access Journals (Sweden)

    Helge Brändström


    Full Text Available Objectives. To determine the incidence as well as contributing factors to fatal hypothermia. Study design. Retrospective, registry-based analysis. Methods. Cases of fatal hypothermia were identified in the database of the National Board of Forensic Medicine for the 4 northernmost counties of Sweden and for the study period 1992–2008. Police reports, medical records and autopsy protocols were studied. Results. A total of 207 cases of fatal hypothermia were noted during the study period, giving an annual incidence of 1.35 per 100,000 inhabitants. Seventy-two percent occurred in rural areas, and 93% outdoors. Many (40% were found within approximately 100 meters of a building. The majority (75% occurred during the colder season (October to March. Some degree of paradoxical undressing was documented in 30%. Ethanol was detected in femoral vein blood in 43% of the victims. Contributing co-morbidity was common and included heart disease, earlier stroke, dementia, psychiatric disease, alcoholism, and recent trauma. Conclusions. With the identification of groups at high risk for fatal hypothermia, it should be possible to reduce risk through thoughtful interventions, particularly related to the highest risk subjects (rural, living alone, alcohol-imbibing, and psychiatric diagnosis-carrying citizens.

  10. Prognosis of coma after therapeutic hypothermia: a prospective cohort study.

    NARCIS (Netherlands)

    Bouwes, A.; Binnekade, J.M.; Kuiper, M.A.; Bosch, F.H.; Zandstra, D.F.; Toornvliet, A.C.; Biemond, H.S.; Kors, B.M.; Koelman, J.H.; Verbeek, M.M.; Weinstein, H.C.; Hijdra, A.; Horn, J.


    OBJECTIVE: This study was designed to establish the reliability of neurologic examination, neuron-specific enolase (NSE), and median nerve somatosensory-evoked potentials (SEPs) to predict poor outcome in patients treated with mild hypothermia after cardiopulmonary resuscitation (CPR). METHODS: This

  11. Hemodynamics and vasopressor support in therapeutic hypothermia after cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Søholm, Helle;


    AIM: Inducing therapeutic hypothermia (TH) in Out-of-Hospital Cardiac Arrest (OHCA) can be challenging due to its impact on central hemodynamics and vasopressors are frequently used to maintain adequate organ perfusion. The aim of this study was to assess the association between level of vasopres...

  12. Therapeutic effect of mild hypothermia on severe traumatic head injury

    Institute of Scientific and Technical Information of China (English)

    裘五四; 刘伟国; 沈宏; 王卫民; 章志量; 张瑛; 江素君; 杨小锋


    Objective: To investigate the therapeutic effect of mild hypothermia on severe traumatic brain injury.Methods: Eighty-six in-patients with severe traumatic brain injury treated ordinarily were consecutively randomized into two groups: a hypothermia group (n=43) and a normothermia group (the control group, n=43). In the hypothermia group, the core temperature (i.e., nasopharyngeal or brain temperature) of the patient was reduced to and maintained at 33-35℃ with a systemic cooling blanket. Natural rewarming began after 3-5 days (mean: 4.3 days) of hypothermia treatment. In the control group, the patient received no hypothermia treatment. The vital sign, extradural pressure and serum superoxide dismutase were observed and measured during treatment, and the complications as well as the Glasgow outcome scale were evaluated at 2 years after injury.Results: The mean extradural pressure in the hypothermia group (27.38 mm Hg±4.88 mm Hg at 24 hours, 29.40 mm Hg±4.50 mm Hg at 48 hours and 26.40 mm Hg±4.13 mm Hg at 72 hours after injury) was much lower than that in the control group (32.63 mm Hg±3.00 mm Hg, 34.80 mm Hg±6.00 mm Hg and 31.81 mm Hg±4.50 mm Hg respectively at 24, 48 and 72 hours, P<0.05). The mean serum superoxide dismutase levels in the hypothermia group on days 3 and 7 (583.7 μg/L±99.6 μg/L and 699.4 μg/L±217.3 μg/L, respectively) were much higher than those in the control group at the same time period (446.6 μg/L±79.5 μg/L and 497.1 μg/L±101.2 μg/L, respectively, P<0.01). The recovery rates at 2 years after injury were 65.1% in the hypothermia group and 37.2% in the control group (P<0.05). The mortality rates were 25.6% in the hypothermia group and 51.2% in the control group (P<0.05). The complications, including pulmonary infections, thrombocytopenia (platelet count <100×109/L), hemorrhage in the digestive tract, electrolyte disorders and renal malfunction, were managed without severe sequelae .Conclusions: Mild hypothermia is a safe and

  13. Prolonged mild therapeutic hypothermia versus fever control with tight hemodynamic monitoring and slow rewarming in patients with severe traumatic brain injury: a randomized controlled trial. (United States)

    Maekawa, Tsuyoshi; Yamashita, Susumu; Nagao, Seigo; Hayashi, Nariyuki; Ohashi, Yasuo


    Although mild therapeutic hypothermia is an effective neuroprotective strategy for cardiac arrest/resuscitated patients, and asphyxic newborns, recent randomized controlled trials (RCTs) have equally shown good neurological outcome between targeted temperature management at 33 °C versus 36 °C, and have not shown consistent benefits in patients with traumatic brain injury (TBI). We aimed to determine the effect of therapeutic hypothermia, while avoiding some limitations of earlier studies, which included patient selection based on Glasgow coma scale (GCS), delayed initiation of cooling, short duration of cooling, inter-center variation in patient care, and relatively rapid rewarming. We conducted a multicenter RCT in patients with severe TBI (GCS 4-8). Patients were randomly assigned (2:1 allocation ratio) to either therapeutic hypothermia (32-34 °C, n = 98) or fever control (35.5-37 °C, n = 50). Patients with therapeutic hypothermia were cooled as soon as possible for ≥ 72 h and rewarmed at a rate of fever control groups, respectively. There were no significant differences in the likelihood of poor neurological outcome (relative risk [RR] 1.24, 95% confidence interval [CI] 0.62-2.48, p = 0.597) or mortality (RR 1.82, 95% CI 0.82-4.03, p = 0.180) between the two groups. We concluded that tight hemodynamic management and slow rewarming, together with prolonged therapeutic hypothermia (32-34 °C) for severe TBI, did not improve the neurological outcomes or risk of mortality compared with strict temperature control (35.5-37 °C).

  14. Involvement of endogenous central hydrogen sulfide (H2S) in hypoxia-induced hypothermia in spontaneously hypertensive rats. (United States)

    Sabino, João Paulo J; Soriano, Renato N; Donatti, Alberto F; Fernandez, Rodrigo Restrepo; Kwiatkoski, Marcelo; Francescato, Heloísa D C; Coimbra, Terezila M; Branco, Luiz G S


    Spontaneously hypertensive rats (SHR) display autonomic imbalance and abnormal body temperature (Tb) adjustments. Hydrogen sulfide (H2S) modulates hypoxia-induced hypothermia, but its role in SHR thermoregulation is unknown. We tested the hypothesis that SHR display peculiar thermoregulatory response to hypoxia and that endogenous H2S overproduced in the caudal nucleus of the solitary tract (NTS) of SHR modulates this response. SHR and Wistar rats were microinjected into the fourth ventricle with aminooxyacetate (AOA, H2S-synthezing enzyme inhibitor) or sodium sulfide (Na2S, H2S donor) and exposed to normoxia (21% inspired O2) or hypoxia (10% inspired O2, 30 min). Tb was continuously measured, and H2S production rate was assessed in caudal NTS homogenates. In both groups, AOA, Na2S, or saline (i.e., control; 1 μL) did not affect euthermia. Hypoxia caused similar decreases in Tb in both groups. AOA presented a longer latency to potentiate hypoxic hypothermia in SHR. Caudal NTS H2S production rate was higher in SHR. We suggest that increased bioavailability of H2S in the caudal NTS of SHR enables the adequate modulation of excitability of peripheral chemoreceptor-activated NTS neurons that ultimately induce suppression of brown adipose tissue thermogenesis, thus accounting for the normal hypoxic hypothermia.

  15. Early predictors of outcome in infants treated with hypothermia for hypoxic-ischaemic encephalopathy. (United States)

    Merchant, Nazakat; Azzopardi, Denis


    Hypoxic-ischaemic encephalopathy (HIE) is a leading cause of acquired neonatal brain injury. Assessment of the severity of cerebral injury and likely neurological outcome in infants with HIE is important for determining management and prognosis, for counselling parents, and for selection for neuroprotective trials. The condition of the infant at birth, the severity of HIE, neurophysiological tests, including amplitude-integrated electroencephalography (aEEG), biochemical markers, and neuroimaging have been used to assess prognosis and predict long-term outcome. The predictive accuracy of these indicators in the early postnatal period is modest. Neurophysiological assessment seems to be most helpful during the first 24 to 48 hours after birth whilst magnetic resonance imaging (MRI) seems most informative later. Several biochemical markers, including serum S100β and neuron-specific enolase (NSE), are also associated with HIE but their levels depend on the timing of sampling and their prognostic value is uncertain. Comprehensive neurophysiological assessment and neuroimaging may be limited to specialist centres. Therapeutic hypothermia is now standard care in infants with moderate to severe HIE so it is important to examine the influence of hypothermia on the assessment of prognosis in these infants.

  16. Baclofen and NOS inhibitors interact to evoke synergistic hypothermia in rats. (United States)

    Rawls, Scott M; Jacobs, Kyle; Tallarida, Ronald J


    Our laboratory recently demonstrated that a drug combination of baclofen and L-NAME, a nonspecific nitric oxide synthase (NOS) inhibitor, evokes synergistic hypothermia in rats. These data are the first demonstration of synergy between a GABA agonist and NOS inhibitor. While the hypothermic synergy suggests a role for NOS in baclofen pharmacology, it is unclear whether the super-additive hypothermia is specific for baclofen and L-NAME or extends to drug combinations of baclofen and other NOS inhibitors. The site of action (central or peripheral) and isoforms of NOS that mediate the synergy are also unknown. Here, we confirm the hypothermic synergy with additional data and discuss potential mechanisms of the drug interaction. Baclofen (2.5, 3.5, 5 and 7.5 mg/kg, i.p.) was administered to rats by itself or with 7-nitroindazole (7-NI), a neuronal NOS inhibitor. 7-NI (10 mg/kg, i.p.) did not affect body temperature. For combined administration, 7-NI (10 mg/kg, i.p.) increased the relative potency of baclofen (F=18.9, P<0.05). The present data validate the hypothermic synergy caused by the drug combination of baclofen and L-NAME and implicate nNOS in the synergy. In a context broader than thermoregulation, NO production and transmission may play an important role in baclofen pharmacology.

  17. On the role of brain 5-HT7 receptor in the mechanism of hypothermia: comparison with hypothermia mediated via 5-HT1A and 5-HT3 receptor. (United States)

    Naumenko, Vladimir S; Kondaurova, Elena M; Popova, Nina K


    Intracerebroventricular administration of selective agonist of serotonin 5-HT(7) receptor LP44 (4-[2-(methylthio)phenyl]-N-(1,2,3,4-tetrahydro-1-naphthalenyl)-1-pyperasinehexanamide hydrochloride; 10.3, 20.5 or 41.0 nmol) produced considerable hypothermic response in CBA/Lac mice. LP44-induced (20.5 nmol) hypothermia was significantly attenuated by the selective 5-HT(7) receptor antagonist SB 269970 (16.1 fmol, i.c.v.) pretreatment. At the same time, intraperitoneal administration of LP44 in a wide range of doses 1.0, 2.0 or 10.0 mg/kg (2.0, 4.0, 20.0 μmol/kg) did not cause considerable hypothermic response. These findings indicate the implication of central, rather than peripheral 5-HT(7) receptors in the regulation of hypothermia. The comparison of LP44-induced (20.5 nmol) hypothermic reaction in eight inbred mouse strains (DBA/2J, CBA/Lac, C57BL/6, BALB/c, ICR, AKR/J, C3H and Asn) was performed and a significant effect of genotype was found. In the same eight mouse strains, functional activity of 5-HT(1A) and 5-HT(3) receptors was studied. The comparison of hypothermic responses produced by 5-HT(7) receptor agonist LP44 (20.5 nmol, i.c.v.) and 5-HT(1A) receptor agonist 8-OH-DPAT 1.0 mg/kg, i.p. (3.0 μmol/kg), 5-HT(3) receptor agonist m-CPBG (40.0 nmol, i.c.v.) did not reveal considerable interstrain correlations between 5-HT(7) and 5-HT(1A) or 5-HT(3) receptor-induced hypothermia. The selective 5-HT(7) receptor antagonist SB 269970 (16.1 fmol, i.c.v.) failed to attenuate the hypothermic effect of 8-OH-DPAT 1.0 mg/kg, i.p. (3.0 μmol/kg) and m-CPBG (40.0 nmol, i.c.v.) indicating that the brain 5-HT(7) receptor is not involved in the hypothermic effects of 8-OH-DPAT or m-CPBG. The obtained results suggest that the central 5-HT(7) receptor plays an essential role in the mediation of thermoregulation independent of 5-HT(1A) and 5-HT(3) receptors.

  18. Postanoxic coma: prognosis after therapeutic hypothermia

    NARCIS (Netherlands)

    Bouwes, A.


    Postanoxic coma, also known as anoxic-ischemic coma, is a state of unconsciousness caused by global anoxia of the brain. The most common cause is primary cardiac arrest followed by successful cardiopulmonary resuscitation (CPR). Other causes include primary respiratory arrest, near-drowning, strangu

  19. Clinical, electrophysiological, and prognostic study of postinjection sciatic nerve injury: An avoidable cause of loss of limb in the peripheral medical service

    Directory of Open Access Journals (Sweden)

    Wani Maqbool


    Full Text Available Background: Post injection sciatic nerve injury is a common cause of sciatic nerve mononeuropathy in the developing world largely due to inadequate health care facilites in the rural regions. Objective: The study was conducted to analyse the pattern of this nerve lesion in clinical and electrophysiological parameters and also to study the outcome in a conservatively treated cohort. Materials and Methods: One hundred and six patients who underwent evaluation at our laboratory from 2000 to 2006 for post injection sciatic neuropathy formed the study population. Twenty two of these were followed up (mean 6.6 months for the outcome. Results: In the cases with full data, common peroneal division of the sciatic nerve was affected alone or predominantly. On follow up, 72% cases showed little or partial recovery. Thirty two percent patients had residual trophic changes and causalgia at their last visit. Conclusion: The majority of cases of postinjection sciatic nerve injury have poor prognosis on conservative treatment.

  20. Can induced hypothermia be assured during brain MRI in neonates with hypoxic-ischemic encephalopathy?

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    Wintermark, Pia [Children' s Hospital Boston, Division of Newborn Medicine, Boston, MA (United States); Children' s Hospital Boston, Department of Radiology, Boston, MA (United States); Montreal Children' s Hospital, Division of Newborn Medicine, Montreal, QC (Canada); Labrecque, Michelle; Hansen, Anne [Children' s Hospital Boston, Division of Newborn Medicine, Boston, MA (United States); Warfield, Simon K.; DeHart, Stephanie [Children' s Hospital Boston, Department of Radiology, Boston, MA (United States)


    Until now, brain MRIs in asphyxiated neonates who are receiving therapeutic hypothermia have been performed after treatment is complete. However, there is increasing interest in utilizing early brain MRI while hypothermia is still being provided to rapidly understand the degree of brain injury and possibly refine neuroprotective strategies. This study was designed to assess whether therapeutic hypothermia can be maintained while performing a brain MRI. Twenty MRI scans were obtained in 12 asphyxiated neonates while they were treated with hypothermia. The median difference between esophageal temperature on NICU departure and return was 0.1 C (range: -0.8 to 0.8 C). We found that therapeutic hypothermia can be safely and reproducibly maintained during a brain MRI. Hypothermia treatment should not prevent obtaining an early brain MRI if clinically indicated. (orig.)

  1. Postanoxic coma: prognosis after therapeutic hypothermia



    Postanoxic coma, also known as anoxic-ischemic coma, is a state of unconsciousness caused by global anoxia of the brain. The most common cause is primary cardiac arrest followed by successful cardiopulmonary resuscitation (CPR). Other causes include primary respiratory arrest, near-drowning, strangulation, and prolonged severe hypotension. Patients may recover consciousness after variable periods of time, or remain unconscious indefinitely. The main focus of this thesis is on prediction of ou...

  2. Selective therapeutic hypothermia: A review of invasive and noninvasive techniques

    Directory of Open Access Journals (Sweden)

    David Straus


    Full Text Available OBJECTIVE: Therapeutic hypothermia is a promising treatment to prevent secondary neurologic injury. Clinical utility is limited by systemic complications of global hypothermia. Selective brain cooling remains a largely uninvestigated application. We review techniques of inducing selective brain cooling. METHOD: Literature review. RESULTS: Strategies of inducing selective brain cooling were divided between non-invasive and invasive techniques. Non-invasive techniques were surface cooling and cooling via the upper airway. Invasive cooling methods include transvascular and compartmental (epidural, subdural, subarachnoid and intraventricular cooling methods to remove heat from the brain. CONCLUSION: Selective brain cooling may offer the best strategy for achieving hypothermic neuroprotection. Non-invasive strategies have proven disappointing in human trials. There is a paucity of human experiments using invasive methods of selective brain cooling. Further application of invasive cooling strategies is needed.

  3. Systematic Review and Meta-Analysis of Therapeutic Hypothermia in Animal Models of Spinal Cord Injury


    Batchelor, Peter E; Peta Skeers; Ana Antonic; Taryn E Wills; David W Howells; Macleod, Malcolm R; Sena, Emily S.


    Background Therapeutic hypothermia is a clinically useful neuroprotective therapy for cardiac arrest and neonatal hypoxic ischemic encephalopathy and may potentially be useful for the treatment of other neurological conditions including traumatic spinal cord injury (SCI). The pre-clinical studies evaluating the effectiveness of hypothermia in acute SCI broadly utilise either systemic hypothermia or cooling regional to the site of injury. The literature has not been uniformly positive with con...

  4. A new microcontroller-based human brain hypothermia system. (United States)

    Kapidere, Metin; Ahiska, Raşit; Güler, Inan


    Many studies show that artificial hypothermia of brain in conditions of anesthesia with the rectal temperature lowered down to 33 degrees C produces pronounced prophylactic effect protecting the brain from anoxia. Out of the methods employed now in clinical practice for reducing the oxygen consumption by the cerebral tissue, the most efficacious is craniocerebral hypothermia (CCH). It is finding even more extensive application in cardiovascular surgery, neurosurgery, neurorenimatology and many other fields of medical practice. In this study, a microcontroller-based designed human brain hypothermia system (HBHS) is designed and constructed. The system is intended for cooling and heating the brain. HBHS consists of a thermoelectric hypothermic helmet, a control and a power unit. Helmet temperature is controlled by 8-bit PIC16F877 microcontroller which is programmed using MPLAB editor. Temperature is converted to 10-bit digital and is controlled automatically by the preset values which have been already entered in the microcontroller. Calibration is controlled and the working range is tested. Temperature of helmet is controlled between -5 and +46 degrees C by microcontroller, with the accuracy of +/-0.5 degrees C.

  5. Estudo da hipotermia acidental em idosos institucionalizados Study on accidental hypothermia in institutionalized elderly

    Directory of Open Access Journals (Sweden)

    António Palma Seman


    Full Text Available OBJETIVO: Analisar a prevalência, causas e evolução da hipotermia acidental em idosos institucionalizados. MÉTODOS: Estudo prospectivo realizado entre janeiro e dezembro de 2004, no Hospital Geriátrico e de Convalescentes D. Pedro II, com 483 internos. Hipotermia foi confirmada por termômetro esofágico, utilizado em todos os pacientes com temperatura axilar menor ou igual a 35ºC (95ºF. Tanto o diagnóstico etiológico quanto as complicações da hipotermia foram observados em exames clínico e subsidiários de urgência como eletrocardiograma, radiografia de tórax, hemograma, gasometria arterial, glicemia, metabólitos, amilase, função hepática e renal, sorologias para HIV, sífilis e hepatite B e urina tipo I. Foram adotadas medidas de reaquecimento entre outras do protocolo de tratamento. RESULTADOS: A prevalência de hipotermia foi de 7,2% especialmente em mulheres (65,7%, e a média de idade do grupo foi 76,4 anos. A maioria dos pacientes (77,1% apresentava elevado grau de dependência (Katz "F" e "G". Hipotermia leve foi identificada na maioria dos idosos (71,4%. A taxa de mortalidade foi de 62,8%, sendo 31,4% em vigência de hipotermia e 31,4% após sua reversão. Em 100,0% dos casos, a etiologia foi infecciosa: pneumonia em 80%, infecção urinária em 60,0%, e úlceras por pressão em 17,1%. Em 60% dos casos havia mais de um foco infeccioso. CONCLUSÃO: A hipotermia em idosos institucionalizados é uma grave condição clínica, com altos índices de mortalidade. A prevenção, o diagnóstico precoce e medidas de reaquecimento central corroboram para um melhor prognóstico.OBJECTIVE: To analyze the prevalence, causes and outcome of hypothermia in institutionalized elderly. METHODS: prospective study held from January to December, 2004 at the Hospital Geriátrico e de Convalescentes Dom Pedro II (Geriatric and Convalescent Hospital Dom Pedro II, with 483 long-term care beds. Hypothermia was diagnosed by esophageal thermometer

  6. La mortalidad evitable: lista de consenso para la actualización del indicador en España Avoidable mortality: a consensus list of causes to update the indicator in Spain

    Directory of Open Access Journals (Sweden)

    Rosa Gispert


    Full Text Available Objetivo: Los indicadores de mortalidad podrían reflejar el efecto de las intervenciones sanitarias sobre la salud de la población, aunque no hay acuerdo sobre el más adecuado. El objetivo del trabajo fue obtener una lista de causas de mortalidad evitable que pueda ser de uso común en España. Métodos: Se ha realizado un proceso de consenso entre médicos asistenciales, elaboradores y usuarios de indicadores sanitarios, basado en las publicaciones sobre el tema y las aportaciones de los expertos participantes. Se ha valorado el grado de acuerdo obtenido en los distintos ítems. Resultados: Se han consensuado 34 causas de mortalidad evitable, así como el tipo de intervenciones que podrían evitar la muerte. El consenso fue medio o alto en la mayor parte de causas e intervenciones (sólo en 4 fue bajo, así como para el conjunto de la lista y sublistas (de servicios sanitarios y de políticas intersectoriales elaboradas. El consenso fue mayor en relación a la evitabilidad de las causas de muerte que al tipo de intervenciones que la pueden evitar. La discrepancia fue mayor en las intervenciones del ámbito asistencial que en las de políticas intersectoriales. Conclusiones: La reflexión y la discusión a que ha sido sometida esta lista de mortalidad evitable, así como la publicitación de los criterios y del procedimiento seguido, supone un valor añadido. La lista mejora la comparabilidad de los datos y de los resultados entre los distintos sistemas de salud del territorio, por lo cual se recomienda su utilización en el contexto español.Objective: Mortality indicators could reflect the effect of health services interventions on the population's health, although there is no agreement about which indicator would be the most appropriate. The objective of this study was to obtain a consensus list of causes of avoidable mortality that could be used as a reference in Spain. Methods: Based on existing publications and participants' knowledge

  7. Brain diffusivity in infants with hypoxic-ischemic encephalopathy following whole body hypothermia: preliminary results. (United States)

    Artzi, Moran; Sira, Liat Ben; Bassan, Haim; Gross-Tsur, Varda; Berger, Irit; Marom, Ronella; Leitner, Yael; Bental, Yoram; Shiff, Yakov; Geva, Ronny; Weinstein, Maya; Bashat, Dafna Ben


    Hypoxic-ischemic encephalopathy is an important cause of neuropsychological deficits. Little is known about brain diffusivity in these infants following cooling and its potential in predicting outcome. Diffusion tensor imaging was applied to 3 groups: (1) three infants with hypoxic-ischemic encephalopathy: cooled; (2) three infants with hypoxic-ischemic encephalopathy: noncooled; and (3) four controls. Diffusivity values at the corticospinal tract, thalamus, and putamen were correlated with Apgar scores and early neurodevelopmental outcome. While cooled infants exhibited lower Apgar scores than noncooled infants, their developmental scores at a mean age of 8 months were higher. All groups differed in their diffusivity values with the cooled infants showing better values compared with the noncooled, correlating with early neurodevelopmental outcome. These preliminary results indicate that diffusion tensor imaging performed at an early age in infants with hypoxic-ischemic encephalopathy may forecast clinical outcome and support the neuroprotective effect of hypothermia treatment.

  8. Outcome after resuscitation beyond 30 minutes in drowned children with cardiac arrest and hypothermia : Dutch nationwide retrospective cohort study

    NARCIS (Netherlands)

    Kieboom, J. K.; Verkade, H. J.; Burgerhof, J. G.; Bierens, J. J.; van Rheenen, P. F.; Kneyber, M. C.; Albers, M. J.


    OBJECTIVES To evaluate the outcome of drowned children with cardiac arrest and hypothermia, and to determine distinct criteria for termination of cardiopulmonary resuscitation in drowned children with hypothermia and absence of spontaneous circulation. DESIGN Nationwide retrospective cohort study. S

  9. Systematic review and meta-analysis of therapeutic hypothermia in animal models of spinal cord injury.

    Directory of Open Access Journals (Sweden)

    Peter E Batchelor

    Full Text Available Therapeutic hypothermia is a clinically useful neuroprotective therapy for cardiac arrest and neonatal hypoxic ischemic encephalopathy and may potentially be useful for the treatment of other neurological conditions including traumatic spinal cord injury (SCI. The pre-clinical studies evaluating the effectiveness of hypothermia in acute SCI broadly utilise either systemic hypothermia or cooling regional to the site of injury. The literature has not been uniformly positive with conflicting studies of varying quality, some performed decades previously.In this study, we systematically review and meta-analyse the literature to determine the efficacy of systemic and regional hypothermia in traumatic SCI, the experimental conditions influencing this efficacy, and the influence of study quality on outcome. Three databases were utilised; PubMed, ISI Web of Science and Embase. Our inclusion criteria consisted of the (i reporting of efficacy of hypothermia on functional outcome (ii number of animals and (iii mean outcome and variance in each group.Systemic hypothermia improved behavioural outcomes by 24.5% (95% CI 10.2 to 38.8 and a similar magnitude of improvement was seen across a number of high quality studies. The overall behavioural improvement with regional hypothermia was 26.2%, but the variance was wide (95% CI -3.77 to 56.2. This result may reflect a preponderance of positive low quality data, although a preferential effect of hypothermia in ischaemic models of injury may explain some of the disparate data. Sufficient heterogeneity was present between studies of regional hypothermia to reveal a number of factors potentially influencing efficacy, including depth and duration of hypothermia, animal species, and neurobehavioural assessment. However, these factors could reflect the influence of earlier lower quality literature.Systemic hypothermia appears to be a promising potential method of treating acute SCI on the basis of meta-analysis of the


    Institute of Scientific and Technical Information of China (English)


    Objective Recent studies in neonatal animals have shown that even slightly decreasing in brain or core temperature could ameliorate the damage resulting from hypoxic-ischemia insults. But the influence of hypothermia which had been used after the end of hypoxia-ischemia of the model hypoxia-ischemia brain damage(HIBD)was unknown. This research wanted to investigate whether hypothermia of defferent begin time after HIBD still could protect the brain in neonatal rats. Methods Pericranial temperatures were adjusted to 31 C in neonatal rats immediately or 2h after the end of hypoxia-ischemia(HI),the number of apoptosis cells in HIBD rats' brain had been counted,rat pups' storing food ability had been observed. Results Apoptosis increased obviously when rat pups were 8 days old, while hypothermia reduced apoptosis ,and postponed apoptosis expression in group that 31 C hypothermia was used immediately or 1h after the end of HI,and hypothermia improved the rat pups' storing food ability. This effect was more obviously in the group that hypothermia was used immediately after the HI than in the group that hypothermia was used 1h after the HI. But the protective effect was not clear in the group that hypothermia was used 2 h after the HI. Conclusion Hypothermia which was used within 1h after the end of HI could protect the HIBD neonatal rat pups brain, this effect was more obviously in the hypothermia be used early after the end of HI group than in the hypothermia be used late after the end of HI group.

  11. Optimal control of inspired perfluorocarbon temperature for induction of hypothermia by total liquid ventilation in juvenile lamb model. (United States)

    Nadeau, Mathieu; Sage, Michael; Praud, Jean-Paul; Tissier, Renaud; Walti, Herve; Micheau, Philippe; Nadeau, Mathieu; Sage, Michael; Praud, Jean-Paul; Tissier, Renaud; Walti, Herve; Micheau, Philippe; Sage, Michael; Micheau, Philippe; Praud, Jean-Paul; Nadeau, Mathieu; Walti, Herve; Tissier, Renaud


    Mild hypothermia is well known for its therapeutic value in cardio- and neuroprotection. Many recent experimental studies have shown that the swiftness of the cooling offered by total liquid ventilation (TLV) holds great promise in achieving maximal therapeutic effect. TLV is an emerging ventilation technique in which the lungs are filled with breathable liquids, namely perfluorocarbons (PFCs). A liquid ventilator ensures subject ventilation by periodically renewing a volume of oxygenated, CO2-free and temperature-controlled breathable PFC. The substantial difference between breathing air and liquid is related to the fact that PFCs have over 500 times the volumetric thermal capacity of air 100% relative humidity. The PFC-filled lungs thus turn into an efficient heat exchanger with pulmonary circulation. The objective of the present study was to compute a posteriori the optimal inspired PFC temperature for ultrafast induction of mild hypothermia by TLV in a juvenile lamb experimentation using direct optimal control. The continuous time model and the discretized cycle-by-cycle model are presented. The control objectives of the direct optimal control are also presented and the results are compared with experimental data in order to validate the improved control performances. The computed direct optimal control showed that the inspired PFC temperature command can be improved to avoid temperature undershoots without altering the cooling performances.

  12. Preserved metabolic coupling and cerebrovascular reactivity during mild hypothermia after cardiac arrest.

    NARCIS (Netherlands)

    Bisschops, L.L.A.; Hoedemaekers, C.W.E.; Simons, K.S.; Hoeven, J.G. van der


    OBJECTIVE: Although mild hypothermia improves outcome in patients after out-of-hospital cardiac arrest, the cardiodepressive effects of hypothermia may lead to secondary brain damage. This study was performed to assess the cerebral blood flow, cerebral oxygen extraction, and cerebrovascular reactivi

  13. Prevention of Hypothermia in Surgical Neonates in Operation Theatre: Recommendations of Neonatal Surgery Research Group


    Mumtaz Qureshi


    Hypothermia in surgical neonates is associated with serious implications and during surgery may lead to the damage to various organs of the body and therefore affects the ultimate outcome. Neonatal hypothermia affects the vital organs' circulation such as cerebral, myocardial and renal and these organs are more sensitive to resultant ischemia.

  14. Hippocampal synaptophysin immunoreactivity is reduced during natural hypothermia in ground squirrels

    NARCIS (Netherlands)

    Strijkstra, AM; Hut, RA; de Wilde, MC; Stieler, J; Van der Zee, EA; Wilde, Martijn C. de


    Natural hypothermia during hibernation results in physiological and behavioral deficits. These changes may be traced at the level of hippocampal signal transduction. We investigated synaptophysin immunoreactivity (SYN-ir) in the hippocampus after short and long periods of hypothermia and short and l

  15. Systemic hypothermia after neonatal encephalopathy: outcomes of RCT

    DEFF Research Database (Denmark)

    Simbruner, Georg; Mittal, Rashmi A; Rohlmann, Friederike;


    Mild hypothermia after perinatal hypoxic-ischemic encephalopathy (HIE) reduces neurologic sequelae without significant adverse effects, but studies are needed to determine the most-efficacious methods.......Mild hypothermia after perinatal hypoxic-ischemic encephalopathy (HIE) reduces neurologic sequelae without significant adverse effects, but studies are needed to determine the most-efficacious methods....

  16. Anticonvulsant treatment of asphyxiated newborns under hypothermia with lidocaine : efficacy, safety and dosing

    NARCIS (Netherlands)

    van den Broek, Marcel P. H.; Rademaker, Carin M. A.; van Straaten, Henrica L. M.; Huitema, Alwin D. R.; Toet, Mona C.; de Vries, Linda S.; Egberts, Antoine C. G.; Groenendaal, Floris


    BACKGROUND: Lidocaine is an antiarrythmicum used as an anticonvulsant for neonatal seizures, also during therapeutic hypothermia following (perinatal) asphyxia. Hypothermia may affect the efficacy, safety and dosing of lidocaine in these patients. OBJECTIVE: To study the efficacy and safety of lidoc

  17. The impact of therapeutic hypothermia on neurological function and quality of life after cardiac arrest

    DEFF Research Database (Denmark)

    Bro-Jeppesen, John; Kjaergaard, Jesper; Horsted, Tina I;


    AIMS: To assess the impact of therapeutic hypothermia on cognitive function and quality of life in comatose survivors of out of Hospital Cardiac arrest (OHCA). METHODS: We prospectively studied comatose survivors of OHCA consecutively admitted in a 4-year period. Therapeutic hypothermia was imple...

  18. Impact of hypothermia on predictors of poor outcome : How do we decide to redirect care?

    NARCIS (Netherlands)

    Bonifacio, S. L.; deVries, L. S.; Groenendaal, F.


    Therapeutic hypothermia is now considered the standard of care for neonates with neonatal encephalopathy due to perinatal asphyxia. Outcomes following hypothermia treatment are favorable, as demonstrated in recent meta-analyses, but 45-50% of these neonates still suffer major disability or die due t

  19. Multicenter trial of early hypothermia in severe brain injury. (United States)

    Clifton, Guy L; Drever, Pamala; Valadka, Alex; Zygun, David; Okonkwo, David


    The North American Brain Injury Study: Hypothermia IIR (NABIS:H IIR) is a randomized clinical trial designed to enroll 240 patients with severe brain injury between the ages of 16 and 45 years. The primary outcome measure is the dichotomized Glasgow Outcome Scale (GOS) at 6 months after injury. The study has the power to detect a 17.5% absolute difference in the percentage of patients with a good outcome with a power of 80%. All patients are randomized by waiver of consent unless family is immediately available. Enrollment is within 2.5 h of injury. Patients may be enrolled in the field by emergency medical services personnel affiliated with the study or by study personnel when the patient arrives at the emergency department. Patients who do not follow commands and have no exclusion criteria and who are enrolled in the hypothermia arm of the study are cooled to 35 degrees C as rapidly as possible by intravenous administration of up to 2 liters of chilled crystalloid. Those patients who meet the criteria for the second phase of the protocol (primarily a post-resuscitation GCS 3-8 without hypotension and without severe associated injuries) are cooled to 33 degrees C. Patients enrolled in the normothermia arm receive standard management at normothermia. As of December 2007, 74 patients had been randomized into phase II of the protocol. Patients in the hypothermia arm reached 35 degrees C in 2.7 +/- 1.1 (SD) h after injury and reached 33 degrees C at 4.4 +/- 1.5 h after injury.

  20. Duration of deep hypothermia during aortic surgery and the risk of perioperative blood transfusion

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi


    Full Text Available Deep hypothermia, which is used during thoracic aortic surgery for neuroprotection, is associated with coagulation abnormalities in animal and in vitro models. However, there is a paucity of data regarding the impact of deep hypothermia duration on perioperative bleeding. The objective of the current study was to examine the relationship between the duration of deep hypothermia and perioperative bleeding. A retrospective review of 507 consecutive thoracic aortic surgery patients who had surgery with deep hypothermic circulatory arrest was performed. The degree of bleeding and coagulopathy was estimated using perioperative transfusion. Log linear modeling with Poisson regression was used to analyze the relationship between deep hypothermia duration and perioperative bleeding, while controlling for other preselected variables. There was a significant association between deep hypothermia duration and RBC transfusion (P = 0.001. There was no significant association between deep hypothermia duration and FFP and platelet transfusion (P = 0.18 and P = 0.06. The association between deep hypothermia duration and the amount of bleeding (RBC transfusion was dependent on total CPB time. In general, for shorter CPB times (approximately 120 to 180 minutes there was an upward sloping line or positive relationship between deep hypothermia duration and bleeding. However, for cases with longer CPB times (300 to 360 minutes, there was no such relationship. The relationship between deep hypothermia duration and perioperative bleeding is dependent on CPB time. For surgeries with short CPB times (120 to 180 minutes, prolonged deep hypothermia is associated with increased post-operative bleeding, as estimated by RBC transfusion. For cases with longer CPB times (300 to 360 minutes, there appears to be no relationship.

  1. Pharmacologically induced hypothermia attenuates traumatic brain injury in neonatal rats. (United States)

    Gu, Xiaohuan; Wei, Zheng Zachory; Espinera, Alyssa; Lee, Jin Hwan; Ji, Xiaoya; Wei, Ling; Dix, Thomas A; Yu, Shan Ping


    Neonatal brain trauma is linked to higher risks of mortality and neurological disability. The use of mild to moderate hypothermia has shown promising potential against brain injuries induced by stroke and traumatic brain injury (TBI) in various experimental models and in clinical trials. Conventional methods of physical cooling, however, are difficult to use in acute treatments and in induction of regulated hypothermia. In addition, general anesthesia is usually required to mitigate the negative effects of shivering during physical cooling. Our recent investigations demonstrate the potential therapeutic benefits of pharmacologically induced hypothermia (PIH) using the neurotensin receptor (NTR) agonist HPI201 (formerly known as ABS201) in stroke and TBI models of adult rodents. The present investigation explored the brain protective effects of HPI201 in a P14 rat pediatric model of TBI induced by controlled cortical impact. When administered via intraperitoneal (i.p.) injection, HPI201 induced dose-dependent reduction of body and brain temperature. A 6-h hypothermic treatment, providing an overall 2-3°C reduction of brain and body temperature, showed significant effect of attenuating the contusion volume versus TBI controls. Attenuation occurs whether hypothermia is initiated 15min or 2h after TBI. No shivering response was seen in HPI201-treated animals. HPI201 treatment also reduced TUNEL-positive and TUNEL/NeuN-colabeled cells in the contusion area and peri-injury regions. TBI-induced blood-brain barrier damage was attenuated by HPI201 treatment, evaluated using the Evans Blue assay. HPI201 significantly decreased MMP-9 levels and caspase-3 activation, both of which are pro-apototic, while it increased anti-apoptotic Bcl-2 gene expression in the peri-contusion region. In addition, HPI201 prevented the up-regulation of pro-inflammatory tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and IL-6. In sensorimotor activity assessments, rats in the HPI201

  2. A recirculating cooling system for improved topical cardiac hypothermia. (United States)

    Rosenfeldt, F L; Fambiatos, A; Pastoriza-Pinol, J; Stirling, G R


    A simple system is described that recirculates cooling fluid for topical cardiac hypothermia. This disposable system can produce a flow of 1,500 ml/min at 2 degrees to 4 degrees C. The recirculating cooler produced significantly lower myocardial temperatures than a conventional fluid-discard system in 22 patients having coronary operation. This system has been used as part of the technique of hypothermic cardioplegia in more than 600 patients. During various cardiac procedures, septal temperatures were maintained well below 20 degrees C for 60 minutes or more without the need to reinfuse the cardioplegic solution.

  3. [Knowledge of hypothermia in nursing professionals of surgical center]. (United States)

    Mendoza, Isabel Yovana Quispe; Peniche, Aparecida de Cássia Giani; Püschel, Vilanice Alves de Araujo


    The objective was to identify the difference in knowledge about hypothermia in nursing assistant after an educational intervention. The conceptual basis of education is based on the prospect of meaningful learning allied to the construction of the conceptual map and the case study. Data were collected through the questionnaire validated by experts. The average knowledge after the educational intervention was (-3.49), however, there was no significant difference in knowledge as related to sociodemographic variables studied. We conclude that the educational intervention was satisfactory in that new information was anchored modified and expanded the cognitive structure of study subjects.

  4. Susceptibility of Rat Hippocampal Neurons to Hypothermia during Development


    Kyung Ah Seo; Sehhyun Kim; Na Mi Lee; Soo Ahn Chae


    Purpose: This study evaluated the extent of damage due to hypothermia in the mature and immature brain. Methods: Hippocampal tissue cultures at 7 and 14 days in vitro (DIV) were used to represent the immature and mature brain, respectively. The cultures were exposed at 25?#608;for 0, 10, 30, and 60 minutes (n=30 in each subgroup). Propidium iodide fluorescent images were captured 24 and 48 hours after hypothermic injury. Damaged areas of the cornu ammonis 1 (CA1), CA3, and dentate gyrus (...

  5. Out-of-Hospital therapeutic hypothermia. A Systematic Review

    Directory of Open Access Journals (Sweden)

    María Nélida Conejo Pérez


    Full Text Available Recent studies have demonstrated therapeutic mild hypothermia improves neurological outcome of patients after suffering an out-of-hospital cardiac arrest.Other studies in animals suggest that the sooner hypothermia is started after return of spontaneous circulation, the lower neurological symptoms are suffered by patients.The aim of this work is to know the efficiency of the therapeutic moderated hipotermia after the cardiopulmonar resuscitation realized extra hospitable.Methods: We made a literature search in Medline (Pubmed, Cinahl, Cuiden, Cochrane Library and the Joanna Briggs Institute, combining mesh and free terms; and searched in the journals Circulation, Resuscitation and Emergency Medicine Journal manually last year. We selected systematic reviews and randomized and nonrandomized clinical trials which had contrasted in-hospital and out-of-hospital TMH with over 18 years patients.Results: Only 5 articles met the inclusion criteria of the 35 selected: four randomized clinical trials and one nonrandomized. They were then subjected to a critical methodological evaluation (CASPe and statistic evaluation (IDIPaz.Conclusions: Pre hospital TMH is an effective and safe technique in comatose patients after being resuscitated from cardiac arrest, improving the neurological status at hospital discharge.

  6. Ethanol-induced hypothermia in rats is antagonized by dexamethasone

    Directory of Open Access Journals (Sweden)

    Carreño C.F.T.


    Full Text Available The effect of dexamethasone on ethanol-induced hypothermia was investigated in 3.5-month old male Wistar rats (N = 10 animals per group. The animals were pretreated with dexamethasone (2.0 mg/kg, ip; volume of injection = 1 ml/kg 15 min before ethanol administration (2.0, 3.0 and 4.0 g/kg, ip; 20% w/v and the colon temperature was monitored with a digital thermometer 30, 60 and 90 min after ethanol administration. Ethanol treatment produced dose-dependent hypothermia throughout the experiment (-1.84 ± 0.10, -2.79 ± 0.09 and -3.79 ± 0.15oC for 2.0, 3.0 and 4.0 g/kg ethanol, respectively, 30 min after ethanol but only the effects of 2.0 and 3.0 g/kg ethanol were significantly antagonized (-0.57 ± 0.09 and -1.25 ± 0.10, respectively, 30 min after ethanol by pretreatment with dexamethasone (ANOVA, P<0.05. These results are in agreement with data from the literature on the rapid antagonism by glucocorticoids of other effects of ethanol. The antagonism was obtained after a short period of time, suggesting that the effect of dexamethasone is different from the classical actions of corticosteroids

  7. The Effect of Moderate Hypothermia on Renin-Angiotensin – Aldosterone System in Male Rats

    Directory of Open Access Journals (Sweden)

    M. Kourosh Arami


    Full Text Available Hypothermia in nature occurs in hibernating animals. It has applications in medicine in open heart surgery,organ and connective tissue preserving, altitude medicine and geriatrics. Despite the vastness of studies on hypothermia many of its biologic and physiologic effects including endocrine system alterations are still poorly recognized. In this study the effect of hypothermia on renin- angiotensin-aldosterone axis was explored. Ten male wistar albino rats (mean age 5 months were anesthetized by intraperitoneal injection of chloralhydrat (0.5 m1/100gr body weight. Then animals were placed in hypothermia apparatus . Their body temperature were reduced to 250 C. AngiotensinI(ANGI and aldosterone (ALD levels of serum were measured by radioimmunoassay before and after hypothermia induction and once every 24 hours for three days. Plasma renin activity (PRA was also measured by using the standard formula of angiotensin determinates at two temperatures of 40C and 370C . The results showed that PRA,ANGI and ALD increased significantly immedietly after hypothermia (p<0.03. Later changes were followed as these factors decreased to basal level, except in the case of aldosterone which maintained its increased level significantly for 24 hours (p<0.05. It seems that moderate hypothermia have stimulatory effect on PRA,ANGI and ALD that results of this study confirm it.

  8. Moderate hypothermia technique for chronic implantation of a total artificial heart in calves. (United States)

    Karimov, Jamshid H; Grady, Patrick; Sinkewich, Martin; Sunagawa, Gengo; Dessoffy, Raymond; Byram, Nicole; Moazami, Nader; Fukamachi, Kiyotaka


    The benefit of whole-body hypothermia in preventing ischemic injury during cardiac surgical operations is well documented. However, application of hypothermia during in vivo total artificial heart implantation has not become widespread because of limited understanding of the proper techniques and restrictions implied by constitutional and physiological characteristics specific to each animal model. Similarly, the literature on hypothermic set-up in total artificial heart implantation has also been limited. Herein we present our experience using hypothermia in bovine models implanted with the Cleveland Clinic continuous-flow total artificial heart.

  9. Estudo funcional e morfológico da hipotermia sistêmica ou tópica no fígado de cães Functional and morphological study of the local and systemic hypothermia on dog's liver

    Directory of Open Access Journals (Sweden)

    Venilton José Siqueira


    , both of the biochemical profile and of the microscopy showed that in the group of animals with selective hypothermia, the hepatic lesions were more intense when compared to the systemic hypothermia group. CONCLUSION: The selective hypothermia causes more lesions to the liver than the systemic.

  10. Combination of mild hypothermia with neuroprotectants has greater neuroprotective effects during oxygen-glucose deprivation and reoxygenation-mediated neuronal injury. (United States)

    Gao, Xiao-Ya; Huang, Jian-Ou; Hu, Ya-Fang; Gu, Yong; Zhu, Shu-Zhen; Huang, Kai-Bin; Chen, Jin-Yu; Pan, Su-Yue


    Co-treatment of neuroprotective reagents may improve the therapeutic efficacy of hypothermia in protecting neurons during ischemic stroke. This study aimed to find promising drugs that enhance the neuroprotective effect of mild hypothermia (MH). 26 candidate drugs were selected based on different targets. Primary cultured cortical neurons were exposed to oxygen-glucose deprivation and reoxygenation (OGD/R) to induce neuronal damage, followed by either single treatment (a drug or MH) or a combination of a drug and MH. Results showed that, compared with single treatment, combination of MH with brain derived neurotrophic factor, glibenclamide, dizocilpine, human urinary kallidinogenase or neuroglobin displayed higher proportion of neuronal cell viability. The latter three drugs also caused less apoptosis rate in combined treatment. Furthermore, co-treatment of those three drugs and MH decreased the level of reactive oxygen species (ROS) and intracellular calcium accumulation, as well as stabilized mitochondrial membrane potential (MMP), indicating the combined neuroprotective effects are probably via inhibiting mitochondrial apoptosis pathway. Taken together, the study suggests that combined treatment with hypothermia and certain neuroprotective reagents provide a better protection against OGD/R-induced neuronal injury.

  11. Avoiding health information. (United States)

    Barbour, Joshua B; Rintamaki, Lance S; Ramsey, Jason A; Brashers, Dale E


    This study investigated why and how individuals avoid health information to support the development of models of uncertainty and information management and offer insights for those dealing with the information and uncertainty inherent to health and illness. Participants from student (n = 507) and community (n = 418) samples reported that they avoided health information to (a) maintain hope or deniability, (b) resist overexposure, (c) accept limits of action, (d) manage flawed information, (e) maintain boundaries, and (f) continue with life/activities. They also reported strategies for avoiding information, including removing or ignoring stimuli (e.g., avoiding people who might provide health advice) and controlling conversations (e.g., withholding information, changing the subject). Results suggest a link between previous experience with serious illness and health information avoidance. Building on uncertainty management theory, this study demonstrated that health information avoidance is situational, relatively common, not necessarily unhealthy, and may be used to accomplish multiple communication goals.

  12. [Experiences with transparenchymal coral calculi removal under local hypothermia]. (United States)

    Albert, L; Zacher, W; Meyer, S


    Under certain conditions genuine coral calculi are an absolute offication for nephrotomy. In order to achieve complete hygienization of the cavity ischaemia times of more than 25-30 min are often necessary. Controlled surface cooling proved to be very good for improving ischaemia tolerance and reducing post-ischaemic loss of function in 21 necessary nephrotomies out of a total of 651 operations for concrements in the calyx system of the renal pelvis (= 3.2%; = 32.8% of all nephrotomies). A kidney thermometer with a temperature feeler developed by us allows fine control of the hypothermia induced by means of plastic bags filled with ice crystals. The technique of operation together with its advantages and disadvantages are described.

  13. Hypothermia in VGKC antibody-associated limbic encephalitis. (United States)

    Jacob, S; Irani, S R; Rajabally, Y A; Grubneac, A; Walters, R J; Yazaki, M; Clover, L; Vincent, A


    Voltage-gated potassium channel antibody (VGKC-Ab)-associated limbic encephalitis (LE) is a recently described syndrome that broadens the spectrum of immunotherapy-responsive central nervous system disorders. Limbic encephalitis is typically characterised by a sub-acute onset of disorientation, amnesia and seizures, but the clinical spectrum is not yet fully defined and the syndrome could be under-diagnosed. We here describe the clinical profile of four patients with VGKC-Ab-associated LE who had intermittent, episodic hypothermia. One of the patients also described a prodrome of severe neuropathic pain preceding the development of limbic symptoms. Both of these novel symptoms responded well to immunosuppressive therapy, with concurrent amelioration of amnesia/seizures.

  14. Angiogenesis dysregulation in term asphyxiated newborns treated with hypothermia.

    Directory of Open Access Journals (Sweden)

    Henna Shaikh

    Full Text Available Neonatal encephalopathy following birth asphyxia is a major predictor of long-term neurological impairment. Therapeutic hypothermia is currently the standard of care to prevent brain injury in asphyxiated newborns but is not protective in all cases. More robust and versatile treatment options are needed. Angiogenesis is a demonstrated therapeutic target in adult stroke. However, no systematic study examines the expression of angiogenesis-related markers following birth asphyxia in human newborns.This study aimed to evaluate the expression of angiogenesis-related protein markers in asphyxiated newborns developing and not developing brain injury compared to healthy control newborns.Twelve asphyxiated newborns treated with hypothermia were prospectively enrolled; six developed eventual brain injury and six did not. Four healthy control newborns were also included. We used Rules-Based Medicine multi-analyte profiling and protein array technologies to study the plasma concentration of 49 angiogenesis-related proteins. Mean protein concentrations were compared between each group of newborns.Compared to healthy newborns, asphyxiated newborns not developing brain injury showed up-regulation of pro-angiogenic proteins, including fatty acid binding protein-4, glucose-6-phosphate isomerase, neuropilin-1, and receptor tyrosine-protein kinase erbB-3; this up-regulation was not evident in asphyxiated newborns eventually developing brain injury. Also, asphyxiated newborns developing brain injury showed a decreased expression of anti-angiogenic proteins, including insulin-growth factor binding proteins -1, -4, and -6, compared to healthy newborns.These findings suggest that angiogenesis pathways are dysregulated following birth asphyxia and are putatively involved in brain injury pathology and recovery.

  15. Neonatal recurrent prolonged hypothermia associated with maternal mirtazapine treatment during pregnancy. (United States)

    Sokolover, Nir; Merlob, Paul; Klinger, Gil


    We present a case of recurrent hypothermia in concordant monozygotic twins born to a mirtazapine treated mother. The twins were born at 35 weeks gestation at birth weights of 2426 g and 2355 g. Both twins presented with recurrent hypothermia continuing until day 10 of life. Possible etiologies of hypothermia were excluded. The degree of prematurity and the weight of the twins were not consistent with prolonged thermal instability. The twins' mother was treated with mirtazapine during the entire pregnancy. Due to its serotonin and alpha 2 receptors antagonism mirtazapine is known to influence thermoregulation in adult humans and other mammals. We suggest that maternal mirtazapine treatment during pregnancy was associated with recurrent hypothermia in both identical twins.

  16. Mild hypothermia for refractory focal status epilepticus in an infant with hemimegalencephaly

    NARCIS (Netherlands)

    Elting, Jan Willem; van der Naalt, Joukje; Fock, Johanna Maria


    Hypothermia can reduce seizure frequency in animal models of status epilepticus, and its effectiveness in human status epilepticus has been reported occasionally. We report an infant with hemimegalencephaly who presented with generalized status epilepticus. After high dose intravenous drug therapy,

  17. Hippocampal expression of apoptotic protease activating factor-1 following diffuse axonal injury under mild hypothermia

    Institute of Scientific and Technical Information of China (English)

    Peng Yang; Limin Zhang; Yunhe Zhang; Xifeng Zou; Qunxi Li; Yun Li; Jun Zhu; Jianmin Li; Aijun Fu; Qingjun Liu; Tong Chen; Zelin Sun; Zhiyong Zhang


    The influence of mild hypothermia on neural cell apoptosis remains poorly understood. Therefore, the present study established rat models of diffuse axonal injury (DAI) at 33 °C. Morris water maze results demonstrated significantly better learning and memory functions in DAI rats with hypothermia compared with DAI rats with normothermia. Expression of apoptotic protease activating factor-1 in the hippocampal CA1 region was significantly lower in the DAI hypothermia group compared with the DAI normothermia group. Expression of apoptotic protease activating factor-1 positively correlated with latency, but negatively correlated with platform location times and time of swimming in the quadrant area. Results suggested that post-traumatic mild hypothermia in a rat model of DAI could provide cerebral protection by attenuating expression of apoptotic protease activating factor-1.

  18. The pathways by which mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injur y

    Institute of Scientific and Technical Information of China (English)

    Chun Luo; Su-yue Pan


    Several studies have demonstrated that mild hypothermia exhibits a neuroprotective role and it can inhibit endothelial cell apoptosis following ischemia/reperfusion injury by decreasing casp-ase-3 expression. It is hypothesized that mild hypothermia exhibits neuroprotective effects on neurons exposed to ischemia/reperfusion condition produced by oxygen-glucose deprivation. Mild hypothermia signiifcantly reduced the number of apoptotic neurons, decreased the expres-sion of pro-apoptotic protein Bax and increased mitochondrial membrane potential, with the peak of anti-apoptotic effect appearing between 6 and 12 hours after the injury. These ifndings indicate that mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injury by protecting the mitochondria and that the effective time window is 6–12 hours after ischemia/reperfusion injury.

  19. The pathways by which mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injury

    Directory of Open Access Journals (Sweden)

    Chun Luo


    Full Text Available Several studies have demonstrated that mild hypothermia exhibits a neuroprotective role and it can inhibit endothelial cell apoptosis following ischemia/reperfusion injury by decreasing casp-ase-3 expression. It is hypothesized that mild hypothermia exhibits neuroprotective effects on neurons exposed to ischemia/reperfusion condition produced by oxygen-glucose deprivation. Mild hypothermia significantly reduced the number of apoptotic neurons, decreased the expression of pro-apoptotic protein Bax and increased mitochondrial membrane potential, with the peak of anti-apoptotic effect appearing between 6 and 12 hours after the injury. These findings indicate that mild hypothermia inhibits neuronal apoptosis following ischemia/reperfusion injury by protecting the mitochondria and that the effective time window is 6-12 hours after ischemia/reperfusion injury

  20. Donor dopamine treatment limits pulmonary oedema and inflammation in lung allografts subjected to prolonged hypothermia

    NARCIS (Netherlands)

    Hanusch, Christine; Nowak, Kai; Toerlitz, Patrizia; Gill, Ishar S.; Song, Hui; Rafat, Neysan; Brinkkoetter, Paul T.; Leuvenink, Henri G.; Van Ackern, Klaus C.; Yard, Benito A.; Beck, Grietje C.


    Background. Endothelial barrier dysfunction severely compromises organ function after reperfusion. Because dopamine pretreatment improves hypothermia mediated barrier dysfunction, we tested the hypothesis that dopamine treatment of lung allografts positively affects tissue damage associated with hyp

  1. Heat and cold acclimation in helium-cold hypothermia in the hamster. (United States)

    Musacchia, X. J.


    A study was made of the effects of acclimation of hamsters to high (34-35 C) and low (4-5 C) temperatures for periods up to 6 weeks on the induction of hypothermia in hamsters. Hypothermia was achieved by exposing hamsters to a helox mixture of 80% helium and 20% oxygen at 0 C. Hypothermic induction was most rapid (2-3 hr) in heat-acclimated hamsters and slowest (6-12 hr) in cold-acclimated hamsters. The induction period was intermediate (5-8 hr) in room temperature nonacclimated animals (controls). Survival time in hypothermia was relatable to previous temperature acclimations. The hypothesis that thermogenesis in cold-acclimated hamsters would accentuate resistance to induction of hypothermia was substantiated.

  2. Moderate Hypothermia Significantly Decreases Hippocampal Cell Death Involving Autophagy Pathway after Moderate Traumatic Brain Injury. (United States)

    Jin, Yichao; Lin, Yingying; Feng, Jun-feng; Jia, Feng; Gao, Guo-yi; Jiang, Ji-yao


    Here, we evaluated changes in autophagy after post-traumatic brain injury (TBI) followed by moderate hypothermia in rats. Adult male Sprague-Dawley rats were randomly divided into four groups: sham injury with normothermia group (37 °C); sham injury with hypothermia group (32 °C); TBI with normothermia group (TNG; 37 °C); and TBI with hypothermia group (THG; 32 °C). Injury was induced by a fluid percussion TBI device. Moderate hypothermia (32 °C) was achieved by partial immersion in a water bath (0 °C) under general anesthesia for 4 h. All rats were killed at 24 h after fluid percussion TBI. The ipsilateral hippocampus in all rats was analyzed with hematoxylin and eosin staining; terminal deoxynucleoitidyl transferase-mediated nick end labeling staining was used to determine cell death in ipsilateral hippocampus. Immunohistochemistry and western blotting of microtubule-associated protein light chain 3 (LC3), Beclin-1, as well as transmission electron microscopy performed to assess changes in autophagy. At 24 h after TBI, the cell death index was 27.90 ± 2.36% in TNG and 14.90 ± 1.52% in THG. Expression level of LC3 and Beclin-1 were significantly increased after TBI and were further up-regulated after post-TBI hypothermia. Further, ultrastructural observations showed that there was a marked increase of autophagosomes and autolysosomes in ipsilateral hippocampus after post-TBI hypothermia. Our data demonstrated that moderate hypothermia significantly attenuated cell death and increased autophagy in ipsilateral hippocampus after fluid percussion TBI. In conclusion, autophagy pathway may participate in the neuroprotective effect of post-TBI hypothermia.


    Hromadko, Miroslav; Fatović-Ferenčić, Stella


    On October 25, 1957, the first open heart surgery in hypothermia was performed in Zagreb, at the Department of Surgery, Dr. Ozren Novosel University Hospital (now Merkur University Hospital), in a female patient with pulmonary valve stenosis under the control of the eye and with interruption of venous circulation. It was the first such operation performed in hypothermia not only in Croatia, but probably in the territory of former Yugoslavia.

  4. Cost-effective therapeutic hypothermia treatment device for hypoxic ischemic encephalopathy

    Directory of Open Access Journals (Sweden)

    Allen RH


    Full Text Available John J Kim,1,2 Nathan Buchbinder,1,† Simon Ammanuel,1,4,5,† Robert Kim,1,† Erika Moore,1 Neil O'Donnell,1 Jennifer K Lee,3 Ewa Kulikowicz,3 Soumyadipta Acharya,1 Robert H Allen,1,9 Ryan W Lee,6,7 Michael V Johnston4–81Department of Biomedical Engineering, Whiting School of Engineering, The Johns Hopkins University, 2The James Buchanan Brady Urological Institute, Department of Urology, The Johns Hopkins University School of Medicine, 3Department of Anesthesia and Critical Care Medicine, Johns Hopkins University, 4Kennedy Krieger Institute, 5Hugo W Moser Research Institute, 6Department of Neurology, 7Department of Pediatrics, 8Department of Physical Medicine and Rehabilitation Johns Hopkins University School of Medicine, Baltimore, MD; 9Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA†These authors contributed equally to this workAbstract: Despite recent advances in neonatal care and monitoring, asphyxia globally accounts for 23% of the 4 million annual deaths of newborns, and leads to hypoxic-ischemic encephalopathy (HIE. Occurring in five of 1000 live-born infants globally and even more in developing countries, HIE is a serious problem that causes death in 25%–50% of affected neonates and neurological disability to at least 25% of survivors. In order to prevent the damage caused by HIE, our invention provides an effective whole-body cooling of the neonates by utilizing evaporation and an endothermic reaction. Our device is composed of basic electronics, clay pots, sand, and urea-based instant cold pack powder. A larger clay pot, lined with nearly 5 cm of sand, contains a smaller pot, where the neonate will be placed for therapeutic treatment. When the sand is mixed with instant cold pack urea powder and wetted with water, the device can extract heat from inside to outside and maintain the inner pot at 17°C for more than 24 hours with monitoring by LED lights and thermistors

  5. An unusual case of hypothermia associated with therapeutic doses of olanzapine: a case report

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    Ratnayake Shiroma L


    Full Text Available Abstract Introduction We report a case of a 42-year-old man who had symptomatic hypothermia as a result of taking olanzapine for paranoid schizophrenia. According to published data, only a few cases of hypothermia associated with olanzapine have been reported since its introduction into clinical use. Case presentation A 42-year-old Sri Lankan man with schizophrenia who was being treated with a therapeutic dose of olanzapine presented with reduced level of consciousness. He had a core temperature of 32°C and was bradycardic. At the time of admission, the electrocardiogram showed sinus bradycardia with J waves. He did not have any risk factors for developing hypothermia except the use of olanzapine. There was improvement in his clinical condition with reversal of electrocardiogram changes following gradual rewarming and the omission of olanzapine. Conclusion Hypothermia induced by antipsychotic medications is not uncommon, but olanzapine-induced hypothermia is rare and occurrence has been reported during initiation or increasing the dose. But here the patient developed hypothermia without dose adjustment.

  6. Maintenance of whole-body therapeutic hypothermia during patient transport and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Tai-Wei; McLean, Claire; Friedlich, Philippe; Seri, Istvan [Children' s Hospital Los Angeles, Center for Fetal and Neonatal Medicine and the USC Division of Neonatal Medicine, Department of Pediatrics, Los Angeles, CA (United States); University of Southern California, LAC/USC Medical Center, Keck School of Medicine, Los Angeles, CA (United States); Grimm, John; Bluml, Stefan [University of Southern California, LAC/USC Medical Center, Keck School of Medicine, Los Angeles, CA (United States); Children' s Hospital Los Angeles, Department of Radiology, Los Angeles, CA (United States)


    Therapeutic hypothermia has become standard treatment for neonatal hypoxic-ischemic encephalopathy (HIE), with brain MRI commonly performed after the child has been rewarmed. However, early imaging during hypothermia might provide information important in designing clinical trials that refine and personalize therapeutic hypothermia. We tested a protocol to ensure safety and maintenance of hypothermia during in-hospital transport and MRI. MRI during therapeutic hypothermia was performed in 13 newborns on the 2nd-3rd postnatal days. Mean one-way transport time was 20.0 ± 3.3 min. Mean rectal temperatures ( C) leaving the unit, upon arrival at the MR suite, during MRI scan and upon return to the unit were 33.5 ± 0.3 C, 33.3 ± 0.3 C, 33.1 ± 0.4 C and 33.4 ± 0.3 C, respectively. Using our protocol therapeutic hypothermia was safely and effectively continued during in-hospital transport and MRI without adverse effects. (orig.)

  7. Mild Hypothermia May Offer Some Improvement to Patients with MODS after CPB Surgery

    Directory of Open Access Journals (Sweden)

    Xiaoqi Zhao

    Full Text Available ABSTRACT Objective: To summarize the effect of mild hypothermia on function of the organs in patients with multiple organ dysfunction syndrome after cardiopulmonary bypass surgery. Methods: The patients were randomly divided into two groups, northermia group (n=71 and hypothermia group (n=89. We immediately began cooling the hypothermia group when test results showed multiple organ dysfunction syndrome, meanwhile all patients of two groups were drawn blood to test blood gas, liver and kidney function, blood coagulation function, and evaluated the cardiac function using echocardiography from 12 to 36 hours. We compared the difference of intra-aortic balloon pump, extracorporeal membrane oxygenation rate and mortality within one month after intensive care unit admission. Results: Among the 160 patients, 36 died, 10 (11.24% patients were from the hypothermia group and 26 (36.6% from the northermia group (P 0.05. But the platelet count has significantly difference between the two groups at the 36th hour (P <0.05. The aspartate transaminase, alanine transaminase and creatinine were improved significantly in the hypothermia group, and they were significantly better than the northermia group (P <0.05. Conclusion: Mild hypothermia is feasible and safe for patients with multiple organ dysfunction syndrome after cardiopulmonary bypass surgery.

  8. Activation of mitochondrial STAT-3 and reduced mitochondria damage during hypothermia treatment for post-cardiac arrest myocardial dysfunction. (United States)

    Huang, Chien-Hua; Tsai, Min-Shan; Chiang, Chih-Yen; Su, Yu-Jen; Wang, Tzung-Dau; Chang, Wei-Tien; Chen, Huei-Wen; Chen, Wen-Jone


    While therapeutic hypothermia improves the outcomes of individuals in cardiac arrest, the hemodynamic responses and mechanisms which underlie hypothermia-induced cardioprotection are not fully understood. Therefore, we investigated the mechanism by which induced hypothermia preserves cardiac function and protects against mitochondrial damage following cardiac arrest. Cardiac arrest was induced in adult male Wistar rats by asphyxiation for 8.5 min. Following resuscitation, the animals were randomly assigned to a hypothermia (32 °C) or normothermia (37 °C) group. Monitoring results showed that cardiac output at the fourth hour after resuscitation was significantly better in rats treated with hypothermia when compared to rats treated with normothermia (P mitochondrial permeability transition pores occurred less frequently in the hypothermic group. While complex I/III activity in the electron transport reaction was damaged after cardiac arrest and resuscitation, the degree of injury was ameliorated by hypothermia treatment (P mitochondrial integrity and electron transport activity.

  9. Learning to Avoid Risky Actions


    Malfaz, María; Miguel A. Salichs


    When a reinforcement learning agent executes actions that can cause frequent damage to itself, it can learn, by using Q-learning, that these actions must not be executed again. However, there are other actions that do not cause damage frequently but only once in a while, for example, risky actions such as parachuting. These actions may imply punishment to the agent and, depending on its personality, it would be better to avoid them. Nevertheless, using the standard Q-learning algorithm, the a...

  10. ThermoSpots to detect hypothermia in children with severe acute malnutrition.

    Directory of Open Access Journals (Sweden)

    Thomas B Mole

    Full Text Available INTRODUCTION: Hypothermia is a risk factor for increased mortality in children with severe acute malnutrition (SAM. Yet frequent temperature measurement remains unfeasible in under-resourced units in developing countries. ThermoSpot is a continuous temperature monitoring sticker designed originally for neonates. When applied to skin, its liquid crystals are designed to turn black with hypothermia and remain green with normothermia. AIMS: To (i estimate the diagnostic accuracy of ThermoSpots for detecting WHO-defined hypothermia (core temperature <35.5°C or peripheral temperature <35.0°C in children with SAM and (ii determine their acceptability amongst mothers. METHODS: Children with SAM in a malnutrition unit in Malawi were enrolled during March-July 2010. The sensitivity and specificity of ThermoSpots were calculated by comparing the device colour against 'gold standard' rectal temperatures taken on admission and follow up peripheral temperatures taken until discharge. Guardians completed a questionnaire to assess acceptability. RESULTS: Hypothermia was uncommon amongst the 162 children enrolled. ThermoSpot successfully detected the one rectal temperature and two peripheral temperatures recorded that met the WHO definition of hypothermia. Overall, 3/846 (0.35% temperature measurements were in the WHO-defined hypothermia range. Interpreting the brown transition colour (between black and green as hypothermia improved sensitivities. For milder hypothermia definitions, sensitivities declined (<35.4°C, 50.0%; <35.9°C, 39.2%. Specificity was consistently above 94%. From questionnaires, 40/43 (93% mothers reported they were 90-100% happy with the device overall. Free-text answers revealed themes of "Skin Rashes", "User-satisfaction" and "Empowerment". CONCLUSION: Although hypothermia was uncommon in this study, ThermoSpots successfully detected these episodes in malnourished children and were acceptable to mothers. Research in settings where

  11. Hypothermia induced by adenosine 5'-monophosphate attenuates early stage injury in an acute gouty arthritis rat model. (United States)

    Miao, Zhimin; Guo, Weiting; Lu, Shulai; Lv, Wenshan; Li, Changgui; Wang, Yangang; Zhao, Shihua; Yan, Shengli; Tao, Zhenyin; Wang, Yunlong


    To investigate whether the hypothermia induced by Adenosine 5'-Monophosphate (5'-AMP) could attenuate early stage injury in a rat acute gouty arthritis model. Ankle joint injection with monosodium urate monohydrate crystals (MSU crystals) in hypothermia rat model which was induced by 5'-AMP and then observe whether hypothermia induced by 5'-AMP could be effectively inhibit the inflammation on acute gouty arthritis in rats. AMP-induced hypothermia has protective effects on our acute gouty arthritis, which was demonstrated by the following criteria: (1) a significant reduction in the ankle swelling (p gouty arthritis model.

  12. Local hypothermia and optimal temperature for stroke therapy in rats

    Institute of Scientific and Technical Information of China (English)

    WU Hao; JIANG Li-dan; Karsten H.Wrede; JI Xun-ming; ZHAO Xi-qing; TIAN Xin; GAO Yu-fei; LING Feng


    Background Local hypothermia induced by intravascular infusion of cold saline solution effectively reduces brain damage in stroke. We further determined the optimal temperature of local hypothermia in our study. Methods Seventy-eight adult male Sprague Dawley rats (260-300 g) were randomly divided into 3 groups: group A, ischemia/reperfusion without cold saline infusion (n=-26) (control group); group B, infusion with 20℃ saline before reperfusion (n=26); group C: infusion with 10~C saline before reperfusion (n=26). In each group, we chose 15 rats for monitoring physical indexes and the temperature of the brain (cortex and striatum) and body (anus), measurement of brain infarction volume, assessment of neurological deficits and the survival rate of reperfusion at 48 hours. Another 8 rats from each group was chosen for examining brain edema, another 3 from each group for histological observation by electron microscopy (EM) and light microscopy (LM) at 48 hours after reperfusion. Results There was no significant difference among the 3 groups for physical indexes during the examination (F(2,45)=0.577, P=0.568; F(2, 45)= 0.42, P=0.78 for blood pressure and blood gas analysis, respectively). The brain temperature was significantly reduced in the group C compared to the other groups (F(2, 45)=37.074, P=0.000; F(2, 45)=32.983, P=0.000, for cortex and striatum temperature respectively), while the difference in rectal temperature between group A and B or C after reperfusion was not significant (F(2, 45)= 0.17115, P=0.637). And the brain infarct volume was significantly reduced in group C (from 40%±10% in group A, 26%±8% in group B, to 12%±6% in group C, F<(2,45)=43.465, P=0.000) with the neurological deficits improving in group C (X2=27.626, P=0.000). The survival rate at 48 hours after 10℃ and 20℃ saline reperfusion was increased by 132.5% and 150%, respectively, as compared to the control group (X2=10.489, P=0.005). The extent of the brain edema showed no

  13. Bird Avoidance Model (United States)

    US Fish and Wildlife Service, Department of the Interior — This is an unpublished report on the bird avoidance model to predict bird strike hazards with low flying aircraft. Included is peak periods for different species of...

  14. Avoiding Computer Viruses. (United States)

    Rowe, Joyce; And Others


    The threat of computer sabotage is a real concern to business teachers and others responsible for academic computer facilities. Teachers can minimize the possibility. Eight suggestions for avoiding computer viruses are given. (JOW)

  15. Regional and time-dependent neuroprotective effect of hypothermia following oxygen-glucose deprivation. (United States)

    Allard, Justine; Paci, Paula; Vander Elst, Luce; Ris, Laurence


    The neuroprotective effect of hypothermia has been demonstrated in in vivo and in vitro models of cerebral ischemia. In regard to the hippocampus, previous studies have mainly focused on CA1 pyramidal neurons, which are very vulnerable to ischemia. But the dentate gyrus (DG), in which neuronal proliferation occurs, can also be damaged by ischemia. In this study, we explored the neuroprotective effect of postischemic hypothermia in different areas of the hippocampus after mild or severe ischemia. Organotypic hippocampal slice cultures were prepared from 6- to 8-day-old rats and maintained for 12 days. Cultures were exposed to 25 or 35 min of oxygen and glucose deprivation (OGD). Neuronal damage was quantified after 6, 24, 48, and 72 h by propidium iodide fluorescence. Mild hypothermia (33°C) was induced 1 h after the end of OGD and was maintained for a period of 24 h. Short OGD produced delayed neuronal damage in the CA1 area and in the DG and to a lesser extend in the CA3 area. Damage in CA1 pyramidal cells was totally prevented by hypothermia whereas neuroprotection was limited in the DG. Thirty-five-minute OGD induced more rapid and more severe cell death in the three regions. In this case, hypothermia induced 1 h after OGD was unable to protect CA1 pyramidal cells whereas hypothermia induced during OGD was able to prevent cell loss. This study provides evidence that neuroprotection by hypothermia is limited to specific areas and depends on the severity of the ischemia.

  16. Changes of evoked potentials and evaluation of mild hypothermia for treatment of severe brain injury

    Institute of Scientific and Technical Information of China (English)


    Objective: To observe the changes of evoked pote ntials after severe brain injury and the effect of mild hypothermia on acute sev ere brain injury.   Methods: A total of 44 patients with severe closed head injury (GCS 3-8, admitted within 10 hours from injury) admitted from May 1998 to March 1999 were selected for this study. All patients were admitted into the intensiv e care unit and divided into 2 groups, Group A (GCS 3-5) and Group B (GCS 6 -8). Patients were also randomly assigned to either normothermia or hypothermia subgroups. Patients in the hypothermia group were cooled to 32-34℃. Median nerve short-latency somatosensory evoked potentials (SLSEP) and brain stem aud itory evoked potentials (BAEP) were recorded before cooling and 4, 24, 48, 72, 9 6 and 120 hours, respectively after cooling and temperature resuming. SLSEP and BAEP were measured at the same time in the normothermia group (control group). T he changes of evoked potentials (EP) were analyzed by statistical methods.   Results: In the Group B, N20 amplitudes in SLSEP and I/V amplitudes in BAEP after mild hypothermia treatment in the hypothermia group dif fered significantly from those in the control group (P<0.05). However, in the Group A, no significant difference in all paramet ers was found.   Conclusions: These results demonstrate that mild hypothermia tr eatment (32-34℃) in the Group B has a significant neuroelectrophysiological effect on severe brain injury. Nevertheless, the effect of mild hypothermia in t he Group A is not apparent and needs further studying.

  17. The effect of hypothermia therapy on cortical laminar disruption following ischemic injury in neonatal mice.

    Directory of Open Access Journals (Sweden)

    Hiroyuki Kida

    Full Text Available Hypothermia has been proposed as a treatment for reducing neuronal damage in the brain induced by hypoxic ischemia. In the developing brain, hypoxic ischemia-induced injury may give rise to cerebral palsy (CP. However, it is unknown whether hypothermia might affect the development of CP. The purpose of this study was to investigate whether hypothermia would have a protective effect on the brains of immature, 3-day old (P3 mice after a challenge of cerebral ischemia. Cerebral ischemia was induced in P3 mice with a right common carotid artery ligation followed by hypoxia (6% O2, 37°C for 30 min. Immediately after hypoxic ischemia, mice were exposed to hypothermia (32°C or normothermia (37°C for 24 h. At 4 weeks of age, mouse motor development was tested in a behavioral test. Mice were sacrificed at P4, P7, and 5 weeks to examine brain morphology. The laminar structure of the cortex was examined with immunohistochemistry (Cux1/Ctip2; the number of neurons was counted; and the expression of myelin basic protein (MBP was determined. The hypothermia treatment was associated with improved neurological outcomes in the behavioral test. In the normothermia group, histological analyses indicated reduced numbers of neurons, reduced cortical laminar thickness in the deep, ischemic cortical layers, and significant reduction in MBP expression in the ischemic cortex compared to the contralateral cortex. In the hypothermia group, no reductions were noted in deep cortical layer thickness and in MBP expression in the ischemic cortex compared to the contralateral cortex. At 24 h after the hypothermia treatment prevented the neuronal cell death that had predominantly occurred in the ischemic cortical deep layers with normothermia treatment. Our findings may provide a preclinical basis for testing hypothermal therapies in patients with CP induced by hypoxic ischemia in the preterm period.

  18. Color-avoiding percolation

    CERN Document Server

    Krause, Sebastian M; Zlatić, Vinko


    Many real world networks have groups of similar nodes which are vulnerable to the same failure or adversary. Nodes can be colored in such a way that colors encode the shared vulnerabilities. Using multiple paths to avoid these vulnerabilities can greatly improve network robustness. Color-avoiding percolation provides a theoretical framework for analyzing this scenario, focusing on the maximal set of nodes which can be connected via multiple color-avoiding paths. In this paper we extend the basic theory of color-avoiding percolation that was published in [Krause et. al., Phys. Rev. X 6 (2016) 041022]. We explicitly account for the fact that the same particular link can be part of different paths avoiding different colors. This fact was previously accounted for with a heuristic approximation. We compare this approximation with a new, more exact theory and show that the new theory is substantially more accurate for many avoided colors. Further, we formulate our new theory with differentiated node functions, as s...

  19. Hypothermia and normothermia effects on mortality rate of cardiopulmonary bypass

    Directory of Open Access Journals (Sweden)

    Ali Rahdari


    Full Text Available Introduction: Cardiopulmonary bypass is associated with higher risk of mortality and morbidity, thus it should be investigated regarding the major risk factors. Temperature management have a significant role in postoperative cerebral and neurological complications; however the optimum temperature during cardiopulmonary surgery is not certainly detected. This systematic review has investigated the differences between hypothermia and normothermia regarding postoperative mortality. Method: PubMed was searched for the relevant articles. Only English language articles were included with no time limitation. Data regarding in-hospital patient deaths provided in each article mostly within 30 days after the surgery, were extracted and compared based on relative risk reduction (RRR, absolute risk reduction (ARR, and number needed to treat (NNT.Result: Totally, 28 articles were retrieved and extracted. The mortality rate was zero in hypothermic and normotehrmic groups of 8/28 included studies, thus the RRR, ARR, and NNT could not be calculated. There were no significant differences between investigated groups of each included studies regarding the patients’ age, gender, and preoperative conditions.Conclusions: No significant difference was obtained between two studied groups. Similar prevalence of death observed between hypothermic and normothermic groups might be due to the sample size of studies, or the subsequent cares performed in intensive care units that assist to reduce the postoperative mortality rate. According to the obtained results, both of these procedures might be similarly safe regarding mortality rate.

  20. Anaesthesia generates neuronal insulin resistance by inducing hypothermia

    Directory of Open Access Journals (Sweden)

    Sutherland Calum


    Full Text Available Abstract Background Anaesthesia is commonly employed prior to surgical investigations and to permit icv injections in rodents. Indeed it is standard practise in many studies examining the subsequent actions of hormones and growth factors on the brain. Recent evidence that the basal activity of specific intracellular signalling proteins can be affected by anaesthesia prompted us to examine the effect of anaesthesia not only on the basal activity but also the insulin sensitivity of the major insulin signalling pathways. Results We find that urethane- and ketamine-induced anaesthesia results in rapid activation of the phosphatidylinositol (PI 3-kinase-protein kinase B (PKB signalling pathway in the brain, increases tau phosphorylation while at the same time reducing basal activity of the Ras-ERK pathway. Subsequent injection of insulin does not alter the activity of either the PI 3-kinase or ERK signalling pathways, indicating a degree of neuronal molecular insulin resistance. However, if body temperature is maintained during anaesthesia then there is no alteration in the basal activity of these signalling molecules. Subsequent response of both pathways to insulin injection is restored. Conclusion The data is consistent with a hypothermia related alteration in neuronal signalling following anaesthesia, and emphasises the importance of maintaining the body temperature of rodents when monitoring insulin (or growth factor/neurotrophic agent action in the brain of anesthetised rodents.

  1. Induced hypothermia and fever control for prevention and treatment of neurological injuries. (United States)

    Polderman, Kees H


    Increasing evidence suggests that induction of mild hypothermia (32-35 degrees C) in the first hours after an ischaemic event can prevent or mitigate permanent injuries. This effect has been shown most clearly for postanoxic brain injury, but could also apply to other organs such as the heart and kidneys. Hypothermia has also been used as a treatment for traumatic brain injury, stroke, hepatic encephalopathy, myocardial infarction, and other indications. Hypothermia is a highly promising treatment in neurocritical care; thus, physicians caring for patients with neurological injuries, both in and outside the intensive care unit, are likely to be confronted with questions about temperature management more frequently. This Review discusses the available evidence for use of controlled hypothermia, and also deals with fever control. Besides discussing the evidence, the aim is to provide information to help guide treatments more effectively with regard to timing, depth, duration, and effective management of side-effects. In particular, the rate of rewarming seems to be an important factor in establishing successful use of hypothermia in the treatment of neurological injuries.

  2. Head cooling with mild systemic hypothermia in anesthetized piglets is neuroprotective. (United States)

    Tooley, James R; Satas, Saulius; Porter, Helen; Silver, Ian A; Thoresen, Marianne


    Hypothermia is potentially therapeutic in the management of neonatal hypoxic-ischemic brain injury. However, not all studies have shown a neuroprotective effect. It is suggested that the stress of unsedated hypothermia may interfere with neuroprotection. We propose that selective head cooling (SHC) combined with mild total-body hypothermia during anesthesia enhances local neuroprotection while minimizing the occurrence of systemic side effects and stress associated with unsedated whole-body cooling. Our objective was to determine whether SHC combined with mild total-body hypothermia while anesthetized for a period of 24 hours reduces cerebral damage in our piglet survival model of global hypoxia-ischemia. Eighteen anesthetized piglets received a 45-minute global hypoxic-ischemic insult. The pigs were randomized either to remain normothermic or to receive SHC. We found that the severity of the hypoxic-ischemic insult was similar in the SHC versus the normothermic group, and that the mean neurology scores at 30 and 48 hours and neuropathology scores were significantly better in the SHC group versus the normothermic group. We conclude that selective head cooling combined with mild systemic hypothermia and anesthesia is neuroprotective when started immediately after the insult in our piglet model of hypoxic-ischemic encephalopathy.

  3. Effects of hypothermia on blood endogenous endotoxin levels during cardiopulmonary bypass. (United States)

    Gerçekoglu, H; Tarim, O; Agar, I; Korukçu, A; Karabulut, H; Soydemir, H; Sokullu, O; Toklu, H; Johansson, C B; Yigiter, B; Kopman, E


    Endotoxin activates white blood cells and complement and produces a spectrum of clinical syndromes ranging from fever to septic shock. Although production of endogenous endotoxemia during cardiopulmonary bypass (CPB) has recently been reported, the role of hypothermia on endotoxemia is not clear. In this study, we evaluated the effects of moderate (24-28 degrees C) and mild (32-34 degrees C) hypothermia on blood endotoxin levels. The study population consisted of 20 patients who underwent coronary artery bypass grafting (CABG) with CPB. Moderate systemic hypothermia was applied during aortic cross-clamping in ten patients (group 1) and mild hypothermia in the remaining ten patients (group 2). The mean rectal temperatures were 26.8 +/- 1.2 degrees C in group 1 and 33.8 +/- 0.8 degrees C in group 2. The blood samples for endotoxin level measurements were obtained before CPB, during aortic cross-clamping, immediately after the release of the cross-clamp, 20 minutes after the release of the cross-clamp, after CPB, and 2 hours postoperatively. There were no endotoxins in any of the samples before CPB, but it was detected after CPB in both groups. The endotoxin levels were significantly higher in group 1 than in group 2. The present study suggests that when hypothermia is the technique of choice, the deleterious effects of endotoxemia on patients with comorbidity must be considered.

  4. Effects of therapeutic hypothermia on inflammasome signaling after traumatic brain injury. (United States)

    Tomura, Satoshi; de Rivero Vaccari, Juan Pablo; Keane, Robert W; Bramlett, Helen M; Dietrich, W Dalton


    Traumatic brain injury (TBI) activates the NALP1/NLRP1 inflammasome, which is an important component of the early innate inflammatory response to injury. We investigated the influence of therapeutic hypothermia on inflammasome activation after TBI. Adult male Sprague-Dawley rats were subjected to moderate fluid percussion brain injury. Temperature manipulation (33°C or 37°C) was initiated 30 minutes after TBI and maintained for 4 hours. At 4 or 24 hours after TBI, traumatized cortex and hippocampus were prepared for immunoblot or immunohistochemical analysis. In the normothermic groups, caspase-1, caspase-11 and expression of the purinergic receptor P2X7 increased at 24 hours after TBI. Posttraumatic hypothermia lead to decreased expression of these proteins at 24 hours compared with normothermic levels. Immunocytochemical studies showed that posttraumatic hypothermia also decreased caspase-1 staining in cerebral cortical neurons compared with normothermic TBI. Cultured cortical neurons subjected to stretch injury demonstrated significant secretion of caspase-1 into the culture medium and caspase-3 activation, both results reduced by hypothermic treatment. Posttraumatic hypothermia decreases inflammasome signaling in neurons and reduces the innate immune response to TBI at 24 hours after injury. Therapeutic hypothermia may protect the injured central nervous system by targeting the detrimental consequences of the innate immune response to injury.

  5. Computational Analysis of the Effects of Reduced Temperature on Thrombin Generation: The Contributions of Hypothermia to Coagulopathy (United States)


    hypothermia-induced dif- ferences (for each parameter, except PH, tested independently): normal tempera- ture parameter values versus hypother- mic ...activated clotting time in detecting clinically relevant clotting abnormali- ties after hypothermia, hemorrhagic shock and resuscitation in pigs . J...Macaitis JM, Bliss J, Wojtaszczyk J, Christensen S, Currier H, Pusateri AE. Effect of recombinant FVIIa in hypothermic, coagulo- pathic pigs with liver

  6. Batroxobin plus hypothermia for protection of cerebral ischemia/reperfusion injury models in gerbils

    Institute of Scientific and Technical Information of China (English)

    Lin Zhang; Pixing Zhang; Yinming Zeng; Qun Chen


    BACKGROUND: Hypothermia plays a protective role in cerebral ischemia/reperfusion injury. Dose combination with batroxobin, an active drug for treating cerebrovascular disease, will enhance its protection? OBJECTIVE: To explore the effects of hypothermia, batroxobin, hypothermia combined with batroxobin on complete cerebral ischemia/reperfusion injury in gerbils.DESIGN: A randomized block comparison observation. SETTING: Jiangsu Key Lab of Anesthesiology. MATERIALS: Experimental animal: Sixty Mongolia gerbils weighing 50-80 g, male or female, were provided by the Animals Center of Xuzhou Medical College. Drugs and agents: Batroxobin was provided by Dongling Phar maceutical Industry Organization (Japan). Superoxide dismutase (SOD) and malondiadehyde (MDA) kits were offered by Nanjing Jiancheng Bioengineering Institute. Other reagents were all import or national analytical pure grade. HITACHI R22A refrigerated high-speed centrifuge, and HARRIS ultra-hypothermia refrigerator were used.METHODS: The experiments were completed in Jiangsu Key Lab of Anesthesiology from May 2004 to January 2005. ① The animals were divided into 6 groups by random member table method: sham-operated group (n =6), ischemia control group (n =6), normothermia group (n =12), hypothermia group (n =12), batroxobin group (n =12) and hypothermia+batroxobin group (n =12). Gerbil rats were abdominally anesthetized with sodium pentobarbital. The neck skin was incised to separate bilateral common carotid arteries. Complete cerebral ischemia models were established by occluding bilateral common carotid arteries with artery clamp for 10 minutes, then the clamp was loosened to perfuse the arteries. Iso-electric level of brain electric wave showed the models were established successfully. The gerbils in the batroxobin group and hypothermia+batroxobin group were abdominally injected with batroxobin (8 BU/kg) while reperfusion, and isovolumetric saline was administered to the gerbils in the other groups

  7. Severe brain hypothermia as a factor underlying behavioral immobility during cold-water forced swim. (United States)

    Taltavull, J F; Chefer, V I; Shippenberg, T S; Kiyatkin, E A


    Behavioral immobility during forced swim is usually considered a consequence of inescapable stress, and is used to screen antidepressant drugs. However, immobility in this test may also result from inhibition of neural functions because of brain hypothermia due to body cooling. To explore this possibility, we measured brain temperature dynamics during a 10-min forced swim in cold (25 degrees C) and warm (37 degrees C) water and correlated brain temperatures with behavioral changes. Cold water forced swim resulted in significant brain hypothermia (-6-7 degrees C) and immobility, while no immobility was observed during warm water forced swim, when brain temperature transiently increased (0.5 degrees C) then decreased below baseline in the post-swim period. These data suggest that immobility, which rapidly develops during forced swim in cold water, may result from dramatic inhibition of neural functions because of severe brain hypothermia.

  8. Hypothermia, immune suppression and SDD: can we have our cake and eat it? (United States)

    Polderman, Kees H


    In vitro studies and clinical observations suggest that both accidental and controlled/therapeutic hypothermia have a strong immunosuppressive effect, and that hypothermia increases the risk of infections, especially wound infections and pneumonia. In the previous issue of Critical Care, Kamps and colleagues report that when hypothermia was used for prolonged periods in patients with severe traumatic brain injury in conjunction with selective decontamination of the digestive tract, the risks of infection were the same or lower in patients treated with therapeutic cooling. The risk of infection is widely regarded as the most important danger of therapeutic cooling. The findings of Kamps and colleagues need to be verified in prospective trials and in higher-resistance environments, but raise the possibility of cooling for prolonged periods with greatly reduced risk. We may be able to have our cake and eat it.

  9. Perioperative hypothermia and incidence of surgical wound infection: a bibliographic study. (United States)

    Silva, Aline Batista da; Peniche, Aparecida de Cassia Giani


    The purpose of this review article was to understand and analyze the scientific production related to the occurrence of perioperative hypothermia and the incidence of infection on the surgical site. For this purpose, a search was conducted in the databases LILACS, MEDLINE, PubMed, CINAHL and Cochrane, using the health science descriptors DECS, from 2004 to 2009. A total of 91 articles were found. After eliminating duplicate items and using selection criteria for inclusion, six manuscripts remained for analysis. The studies were classified as retrospective, prospective, case studies, and clinical trials. After analysis, the majority of studies showed that hypothermia must be prevented during the perioperative period to reduce complications in the healing process of the surgical incision. Therefore, unadverted hypothermia directly influences in surgical site healing, increasing the incidence of infection in the surgical wound.

  10. Effects of mild hypothermia on patients with lower intracranial pressure following severe brain injury

    Institute of Scientific and Technical Information of China (English)

    王维平; 任海军; 池京洋; 徐福林; 全勇


    Objective: To study the effects of mild hypothermia therapy on severe brain-injured patients whose intracranial pressure (ICP) could be maintained below 25 mm Hg.Methods: Forty severe brain-injured patients with ICP below 25 mm Hg were divided randomly into one treatment group (n=20, mild hypothermia therapy) and one control group (n=20, normothermia therapy) to observe the changes of the concentration of excitatory amino acids (glutamate and glycine) and cytokines (interleukin-1β and interleukin-6). Results: There were no significant differences in the daily changes of the concentration of excitatory amino acid and cytokines between two groups. The outcome of two groups had no significant differences. Conclusions: Mild hypothermia has no additional beneficial effects on severe brain-injured patients compared with normothermia therapy if ICP can be maintained below 25 mm Hg by using conventional therapy.

  11. Therapeutic Hypothermia and Out-of-Hospital Cardiac Arrest in a Child with Hypertrophic Obstructive Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Nancy Spurkeland


    Full Text Available Neurologic outcomes following pediatric cardiac arrest are consistently poor. Early initiation of cardiopulmonary resuscitation has been shown to have positive effects on both survival to hospital discharge, and improved neurological outcomes after cardiac arrest. Additionally, the use of therapeutic hypothermia may improve survival in pediatric cardiac arrest patients admitted to the intensive care unit. We report a child with congenital hypertrophic obstructive cardiomyopathy and an out-of-hospital cardiac arrest, in whom the early initiation of effective prolonged cardiopulmonary resuscitation and subsequent administration of therapeutic hypothermia contributed to a positive outcome with no gross neurologic sequelae. Continuing efforts should be made to promote and employ high-quality cardiopulmonary resuscitation, which likely contributed to the positive outcome of this case. Further research will be necessary to develop and solidify national guidelines for the implementation of therapeutic hypothermia in selected subpopulations of children with OHCA.

  12. Combined use of intravenous anesthetics and hypothermia in treating refractory status epilepticus

    Directory of Open Access Journals (Sweden)

    Guo-ping REN


    Full Text Available The primary choice of treating refractory status epilepticus (RSE is intravenous anesthetics, but the seizures of some patients can not get a good control. Thus, other therapies must be combined. Hypothermia not only can terminate seizures, but also play a part in brain protection. Though combined use of intravenous anesthetics and hypothermia is not a regular clinical scheme, the favorable effect has been proved by a lot of clinical research. This paper mainly focuses on the dose of intravenous anesthetics, the time, temperature and procedure of hypothermia, the indications and contraindications of combined therapy, and so on. DOI: 10.3969/j.issn.1672-6731.2015.11.006

  13. Neuroprotective effects of cold-inducible RNA-binding protein during mild hypothermia on traumatic brain injur y

    Institute of Scientific and Technical Information of China (English)

    Guan Wang; Jian-ning Zhang; Jia-kui Guo; Ying Cai; Hong-sheng Sun; Kun Dong; Cheng-gang Wu


    Cold-inducible RNA-binding protein (CIRP), a key regulatory protein, could be facilitated by mild hypothermia in the brain, heart and liver. This study observed the effects of mild hypothermia at 31 ± 0.5°C on traumatic brain injury in rats. Results demonstrated that mild hypothermia suppressed apoptosis in the cortex, hippocampus and hypothalamus, facilitated CIRP mRNA and protein expression in these regions, especially in the hypothalamus. The anti-apoptotic effect of mild hypothermia disappeared after CIRP silencing. There was no correlation between mitogen-activated extracellular signal-regulated kinase activation and CIRP silencing. CIRP silencing inhibited extracellular signal-regulated kinase-1/2 activation. These indicate that CIRP inhibits apoptosis by affecting extracellular signal-regulated kinase-1/2 activation, and exerts a neuroprotective effect during mild hypothermia for traumatic brain injury.

  14. The effect of hypothermia on the expression of TIMP-3 after traumatic brain injury in rats. (United States)

    Jia, Feng; Mao, Qing; Liang, Yu-Min; Jiang, Ji-Yao


    Here we investigate the effect of hypothermia on the expression of apoptosis-regulating protein TIMP-3 after fluid percussion traumatic brain injury (TBI) in rats. We began with 210 adult male Sprague-Dawley rats and randomly assigned them to three groups: TBI with hypothermia treatment (32°C), TBI with normothermia (37°C), and sham-injured controls. TBI was induced by a fluid percussion TBI device. Mild hypothermia (32°C) was achieved by partial immersion in a water bath (0°C) under general anesthesia for 4 h. The rats were killed at 4, 6, 12, 24, 48, and 72 h and 1 week after TBI. The mRNA and protein level of TIMP-3 in both the injured and uninjured hemispheres of the brains from each group were measured using RT-PCR and Western blotting. In the normothermic group, TIMP-3 levels in both the injured and uninjured hemispheres were significantly increased after TBI compared with those of sham-injured animals (p traumatic hypothermia significantly attenuated this increase. According to the RT-PCR and Western blot analyses, the maximum mRNA levels of TIMP-3 were reduced to 60.60 ± 2.30%, 55.83 ± 1.80%, 66.03 ± 2.10%, and 64.51 ± 1.50%, respectively, of the corresponding values in the normothermic group in the injured and uninjured hemispheres (cortex and hippocampus) of the hypothermia group (p brain injury significantly upregulates TIMP-3 expression, and that this increase may be suppressed by hypothermia treatment.

  15. Electroencephalography during surgery with cardiopulmonary bypass and hypothermia. (United States)

    Bashein, G; Nessly, M L; Bledsoe, S W; Townes, B D; Davis, K B; Coppel, D B; Hornbein, T F


    After more than 30 yr of use, electroencephalographic (EEG) monitoring during cardiopulmonary bypass has not gained wide clinical acceptance. To assess its utility to predict central nervous system injury, two-channel recordings were made from 78 patients undergoing cardiopulmonary bypass and anesthetized with fentanyl/diazepam/enflurane. The perfusion regimen included the use of high pump flow, a bubble oxygenator, and no arterial tubing filter. Target values were 28-32 degrees C for the minimum rectal temperature, 60-80 mmHg for mean arterial pressure, and 20-25% for hematocrit. Eight descriptors of the Fourier power spectra of the EEG were calculated off-line, and outcome comparisons were made with the results from neuropsychological tests. Among 58 patients yielding complete data of acceptable quality, a statistically significant reduction in total power was observed from prebypass to postbypass, accompanied by an increase in the fractional power in the theta and beta frequency bands and in the spectral edge frequency. The shifts in total and theta power were weakly associated with short-term but not with long-term changes in neuropsychological scores. Nearly 40% of the patients' EEGs were corrupted with electrical noise at some time during bypass. In 15 patients selected for having high-quality recordings and no neuropsychological deficit, an extensive statistical analysis failed to reveal any consistent variation in the EEG descriptors with hypothermia. Under the conditions studied, it appears that for other than gross signal dropout, the strong background variability in the EEG makes it have little value for detecting harbingers of brain injury.

  16. On partitions avoiding right crossings

    CERN Document Server

    Yan, Sherry H F


    Recently, Chen et al. derived the generating function for partitions avoiding right nestings and posed the problem of finding the generating function for partitions avoiding right crossings. In this paper, we derive the generating function for partitions avoiding right crossings via an intermediate structure of partial matchings avoiding 2-right crossings and right nestings. We show that there is a bijection between partial matchings avoiding 2-right crossing and right nestings and partitions avoiding right crossings.

  17. Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

    Institute of Scientific and Technical Information of China (English)

    Yinghui Bao; Yumin Liang; Jiyao Jiang; Qizhong Luo; Yicheng Lu


    BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them.OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial.SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University.MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5 - 5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100micro-injection pump (Carnegie Company, Sweden).METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ①Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood Ph value, arterial partial pressure of carbon dioxide (PaCCh), arterial partial pressure of carbon dioxide (PaCO2), HCO3-].②Rectal temperature was monitored with mercurial thermometer.③Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCCh), HCO3- and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34℃ using ice bags, and the body

  18. S100B modulates IL-6 release and cytotoxicity from hypothermic brain cells and inhibits hypothermia-induced axonal outgrowth. (United States)

    Schmitt, Katharina R L; Kern, Claudia; Lange, Peter E; Berger, Felix; Abdul-Khaliq, Hashim; Hendrix, Sven


    Brain protection is essential during neonatal and pediatric cardiac surgery. Deep hypothermia is still the most important method for achieving neuroprotection during cardiopulmonary bypass. Previously, we could demonstrate that deep hypothermia induces substantial cytotoxicity in brain cells as well as increased release of the pro-inflammatory cytokine interleukin-6 (IL-6), which plays an important role in neuroprotection and neuroregeneration. Deep hypothermia is also associated with increased levels of the astrocytic protein S100B in the serum and cerebrospinal fluid of patients. Since S100B may modulate pro-inflammatory cytokines and may stimulate neurite outgrowth, we have tested the hypothesis that nanomolar concentrations of S100B may increase IL-6 release from brain cells and support axonal outgrowth from organotypic brain slices under hypothermic conditions. S100B administration substantially reduced neuronal and glial cytotoxicity under hypothermic conditions. In the presence of S100B hypothermia-induced IL-6 release in primary astrocytes was significantly increased but reduced in BV-2 microglial cells and primary neurons. Surprisingly, deep hypothermia increased axonal outgrowth from brain slices and--in contrast to our hypothesis--this hypothermia-induced neurite outgrowth was inhibited by S100B. These data suggest that S100B differentially influences cytokine release and cytotoxicity from distinct brain cells and may inhibit neuroregeneration by suppressing hypothermia-induced axonal outgrowth.

  19. Deep hypothermia-enhanced autophagy protects PC12 cells against oxygen glucose deprivation via a mitochondrial pathway. (United States)

    Tang, Dang; Wang, Cheng; Gao, Yongjun; Pu, Jun; Long, Jiang; Xu, Wei


    Deep hypothermia is known for its organ-preservation properties, which is introduced into surgical operations on the brain and heart, providing both safety in stopping circulation as well as an attractive bloodless operative field. However, the molecular mechanisms have not been clearly identified. This study was undertaken to determine the influence of deep hypothermia on neural apoptosis and the potential mechanism of these effects in PC12 cells following oxygen-glucose deprivation. Deep hypothermia (18°C) was given to PC12 cells while the model of oxygen-glucose deprivation (OGD) induction for 1h. After 24h of reperfusion, the results showed that deep hypothermia decreased the neural apoptosis, and significantly suppressed overexpression of Bax, CytC, Caspase 3, Caspase 9 and cleaved PARP-1, and inhibited the reduction of Bcl-2 expression. While deep hypothermia increased the LC3II/LC3I and Beclin 1, an autophagy marker, which can be inhibited by 3-methyladenine (3-MA), indicating that deep hypothermia-enhanced autophagy ameliorated apoptotic cell death in PC12 cells subjected to OGD. Based on these findings we propose that deep hypothermia protects against neural apoptosis after the induction of OGD by attenuating the mitochondrial apoptosis pathway, moreover, the mechanism of these antiapoptosis effects is related to the enhancement of autophagy, which autophagy might provide a means of neuroprotection against OGD.

  20. Hypothermia ameliorates gastrointestinal ischemic injury sustained in a porcine cardiac arrest model

    Institute of Scientific and Technical Information of China (English)

    LU Yi; WANG Shuo; LI Chun-sheng


    Background During cardiac arrest,the gastrointestinal tract is sensitive to ischemia.Protection of the gastrointestinal tract is a critical factor in determining prognosis following cardiopulmonary resuscitation (CPR).This study seeks to determine the extent of gastrointestinal tract injury and the potential protective effect of inducing hypothermia following a porcine cardiac arrest model and CPR.Methods Ventricular fibrillation was induced by programmed electrical stimulation in 16 male domestic pigs (n=8 per group).Four minutes after ventricular fibrillation,CPR was performed.Pigs that successfully restored spontaneous circulation then received intravenous infusions of saline at either 4C or room temperature to produce hypothermic and control conditions respectively.Serum diamine oxidase and gastrointestinal adenosine triphosphate enzyme activity were determined and histopathology of the gastrointestinal tract was performed by light microscopy and electron microscopy.Results Significant injury of the gastrointestinal tract after CPR was found.Na+-K+ and Ca2+ adenosine triphosphate enzyme activity in the gastric tissue were significantly high in animals receiving hypothermia treatment compared to controls.Hypothermia also significantly reduced serum diamine oxidase after CPR compared to the control group.Moreover,severe injury sustained by the gastrointestinal tissue was significantly ameliorated under hypothermic conditions compared to controls.Conclusions Gastrointestinal injury and abnormal energy metabolism are strikingly evident following CPR.Hypothermia,which is induced by an infusion of 4C saline,can rapidly reduce internal body temperature,improve energy metabolism,and ameliorate injury to the gastrointestinal mucosa after CPR.

  1. Application of mild therapeutic hypothermia on stroke: a systematic review and meta-analysis. (United States)

    Lakhan, Shaheen E; Pamplona, Fabricio


    Background. Stroke occurs due to an interruption in cerebral blood supply affecting neuronal function. Body temperature on hospital admission is an important predictor of clinical outcome. Therapeutic hypothermia is promising in clinical settings for stroke neuroprotection. Methods. MEDLINE/PubMed, CENTRAL, Stroke Center, and were systematically searched for hypothermia intervention induced by external or endovascular cooling for acute stroke. NIH Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were the main stroke scales used, and mortality was also reported. A meta-analysis was carried out on stroke severity and mortality. Results. Seven parallel-controlled clinical trials were included in the meta-analysis. Sample sizes ranged from 18 to 62 patients, yielding a total of 288. Target temperature (∼33°C) was reached within 3-4 hours. Stroke severity (Cohen's d = -0.17, 95% CI: -0.42 to 0.08, P = 0.32; I(2) = 73%; Chi(2) = 21.89, P = 0.0001) and mortality (RR = 1.60, 95% CI: 0.93 to 2.78, P = 0.11; I(2) = 0%; Chi(2) = 2.88, P = 0.72) were not significantly affected by hypothermia. Discussion. Hypothermia does not significantly improve stroke severity; however, this finding should be taken with caution due to the high heterogeneity and limited number of included studies. No impact on mortality was observed.

  2. Hypothermia and afterdrop following open water swimming: the Alcatraz/San Francisco Swim Study. (United States)

    Nuckton, T J; Claman, D M; Goldreich, D; Wendt, F C; Nuckton, J G


    To determine whether or not participants in open water swim events experience hypothermia and afterdrop, rectal temperature was measured for up to 45 minutes in 11 subjects following the New Year's Day Alcatraz Swim. This event was held in open water (11.7 degrees C [53.0 degrees F]) in the San Francisco Bay, and participants did not wear wetsuits or other protective clothing. Biophysical parameters, including surfacelvolume ratio, body mass index, and percent body fat were measured before the swim, and statistical analysis was done to determine predictors of temperature decrease and afterdrop duration. Applying the American Heart Association definition of hypothermia (less than 36.0 C [96.8 degrees F]), hypothermia was seen in 5 of the 11 subjects. Using a more rigorous and traditional definition (less than 35.0 degrees C [95.0 degrees F]), hypothermia was seen in only one subject. Afterdrop, defined as continued cooling following removal from cold stress, was seen in 10 of the 11 subjects. Surface/volume ratio (S/V) and body mass index (BMI) predicted the lowest recorded temperatures (P water swimming, and that participants should be observed for signs of temperature decrease following removal from cold stress.

  3. Predictors of poor neurologic outcome in patients after cardiac arrest treated with hypothermia: a retrospective study

    NARCIS (Netherlands)

    Bisschops, L.L.A.; Alfen, N. van; Bons, S.; Hoeven, J.G. van der; Hoedemaekers, C.W.E.


    INTRODUCTION: Outcome studies in patients with anoxic-ischemic encephalopathy focus on the early and reliable prediction of an outcome no better than a vegetative state or severe disability. We determined the effect of mild therapeutic hypothermia on the validity of the currently used clinical pract


    Directory of Open Access Journals (Sweden)

    Hector Lafuente


    Full Text Available Background: Hypothermia is standard treatment for neonatal encephalopathy, but near 50% of treated infants have adverse outcomes. Pharmacological therapies can act through complementary mechanisms to hypothermia and would improve neuroprotection. Cannabidiol could be a good candidate.Objective: To test whether immediate treatment with cannabidiol and hypothermia act through complementary brain pathways in hypoxic-ischemic newborn piglets.Methods: Hypoxic-ischemic animals were randomized to receive 30 min after the insult: 1 normothermia- and vehicle-treated group; 2 normothermia- and cannabidiol-treated group; 3 hypothermia- and vehicle-treated group; and 4 hypothermia- and cannabidiol-treated group. Six hours after treatment, brains were processed to qualify the number of neurons by Nissl staining. Proton nuclear magnetic resonance spectra were obtained and analyzed for lactate, N-acetyl-aspartate and glutamate. Metabolite ratios were calculated to assess neuronal damage (lactate/N-acetyl-aspartate and excitotoxicity (glutamate/Nacetyl-aspartate. Western blot studies were performed to quantify protein nitrosylation (oxidative stress and expression of caspase-3 (apoptosis and TNFα (inflammation.Results: Individually, the hypothermia and the cannabidiol treatments reduced the glutamate/Nacetyl-aspartate ratio, as well as TNFα and oxidized protein levels. Also, both therapies reduced the number of necrotic neurons and prevented an increase in lactate/N-acetyl-aspartate ratio. The combined effect of hypothermia and cannabidiol on excitotoxicity, inflammation and oxidative stress, and on histological damage, was greater than either hypothermia or cannabidiol alone.Conclusion: Cannabidiol and hypothermia act complementarily and show additive effects on the main factors leading to hypoxic-ischemic brain damage.

  5. Predicting attention and avoidance: when do avoiders attend? (United States)

    Klein, Rupert; Knäuper, Bärbel


    Three avoidance measures, the Miller Behavioural Style Scale (MBSS), Index of Self-Regulation of Emotion (ISE) and Mainz Coping Inventory (MCI), were compared in their ability to predict attention and avoidance of threats in the emotional Stroop task. It was also examined if the avoidance mechanism of individuals who would normally avoid threat-indicating words becomes disrupted under conditions of dopamine reduction. Results show that only the ISE predicted attention/avoidance of threat-indicating words. In addition, the avoidance mechanism, as measured by the ISE and MCI, was not activated when regular smokers abstained from smoking.

  6. Effects of immediate and delayed mild hypothermia on endogenous antioxidant enzymes and energy metabolites following global cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Hong; ZHANG Jun-jian; MEI Yuan-wu; SUN Sheng-gang; TONG E-tang


    Background The optimal time window for the administration of hypothermia following cerebral ischemia has been studied for decades,with disparity outcomes.In this study,the efficacy of mild brain hypothermia beginning at different time intervals on brain endogenous antioxidant enzyme and energy metabolites was investigated in a model of global cerebral ischemia.Methods Forty-eight male Sprague-Dawley rats were divided into a sham-operated group,a normothermia (37℃-38℃) ischemic group and a mild hypothermic (31℃-32℃) ischemia groups.Rats in the last group were subdivided into four groups:240 minutes of hypothermia,30 minutes of normothermia plus 210 minutes of hypothermia,60 minutes of normothermia plus 180 minutes of hypothermia and 90 minutes of normothermia plus 150 minutes of hypothermia (n=8).Global cerebral ischemia was established using the Pulsinelli four-vessel occlusion model for 20minutes and mild hypothermia was applied after 20 minutes of ischemia.Brain.tissue was collected following 20 minutes of cerebral ischemia and 240 minutes of reperfusion,and used to measure the levels of superoxide dismutase (SOD),glutathione peroxidase (GSH-Px),reduced glutathione (GSH) and adenosine triphosphate (ATP).Results Mild hypothermia that was started within 0 to 60 minutes delayed the consumption of SOD,GSH-Px,GSH,and ATP (P <0.05 or P <0.01) in ischemic tissue,as compared to a normothermic ischemia group.In contrast,mild hypothermia beginning at 90 minutes had little effect on the levels of SOD,GSH-Px,GSH,and ATP (P>0.05).Conclusions Postischemic mild brain hypothermia can significantly delay the consumption of endogenous antioxidant enzymes and energy metabolites,which are critical to the process of cerebral protection by mild hypothermia.These results show that mild hypothermia limits ischemic injury if started within 60 minutes,but loses its protective effects when delayed until 90 minutes following cerebral ischemia.

  7. Avoidable waste management costs

    Energy Technology Data Exchange (ETDEWEB)

    Hsu, K.; Burns, M.; Priebe, S.; Robinson, P.


    This report describes the activity based costing method used to acquire variable (volume dependent or avoidable) waste management cost data for routine operations at Department of Energy (DOE) facilities. Waste volumes from environmental restoration, facility stabilization activities, and legacy waste were specifically excluded from this effort. A core team consisting of Idaho National Engineering Laboratory, Los Alamos National Laboratory, Rocky Flats Environmental Technology Site, and Oak Ridge Reservation developed and piloted the methodology, which can be used to determine avoidable waste management costs. The method developed to gather information was based on activity based costing, which is a common industrial engineering technique. Sites submitted separate flow diagrams that showed the progression of work from activity to activity for each waste type or treatability group. Each activity on a flow diagram was described in a narrative, which detailed the scope of the activity. Labor and material costs based on a unit quantity of waste being processed were then summed to generate a total cost for that flow diagram. Cross-complex values were calculated by determining a weighted average for each waste type or treatability group based on the volume generated. This study will provide DOE and contractors with a better understanding of waste management processes and their associated costs. Other potential benefits include providing cost data for sites to perform consistent cost/benefit analysis of waste minimization and pollution prevention (WMIN/PP) options identified during pollution prevention opportunity assessments and providing a means for prioritizing and allocating limited resources for WMIN/PP.

  8. The challenges for scientists in avoiding plagiarism. (United States)

    Fisher, E R; Partin, K M


    Although it might seem to be a simple task for scientists to avoid plagiarism and thereby an allegation of research misconduct, assessment of trainees in the Responsible Conduct of Research and recent findings from the National Science Foundation Office of Inspector General regarding plagiarism suggests otherwise. Our experiences at a land-grant academic institution in assisting researchers in avoiding plagiarism are described. We provide evidence from a university-wide multi-disciplinary course that understanding how to avoid plagiarism in scientific writing is more difficult than it might appear, and that a failure to learn the rules of appropriate citation may cause dire consequences. We suggest that new strategies to provide training in avoiding plagiarism are required.

  9. The Causes of the Avoidance of Violent Revolution during the Early Stage of Thailand’s Political Modernization%论泰国政治现代化初期未发生暴力革命之原因

    Institute of Scientific and Technical Information of China (English)



    The eraly stage of Thailand's political modernization which took place during the late 19th and early 20th century has two main stages: the first round was called Chakri Reform (1851 - 1932), which was composed of a series of reforms carried out by King Mongkut, King Chulalongkorn and King Vajiravudh; the second round was the Siamese Revolution of 1932 brought about by the Khana Ratsadon (Peoples' Party), which was founded by a group of young scholars and soldiers. Unlike most countries, Thailand's modernization in its early years was com-paratively smooth and peaceful. From the perspectives of culturology as well as Samuel Huntington's political devel-opment theory, this paper summarizes three interconnected main reasons why Thailand's early stage of modernization reform avoided violent revolution: first, the reform avoided political vacuum; second, moderate forces predomina-ted throughout the transformation; and third, the particular cultural and religious factors restrained potential popu-list storms.%泰国的政治现代化发生在19世纪末至20世纪初,其初期分为两个阶段:第一轮变革发生于1851-1932年之间,称为却克里改革,是由蒙固王、朱拉隆功王和瓦栖拉兀王祖孙三代国王发起的一系列改革;第二轮变革是1932年由主要是青年学者和少壮派军人组成的人民党发起的立宪革命。与多数国家不同,泰国的两轮改革均为较平稳而温和的渐进式变革,并未发生暴力革命。本文从分析泰国现代化初期的历史脉络出发,从亨廷顿政治发展理论和文化学的视角,将泰国早期现代化改革之所以能和平过渡的主要原因,总结为相互联系的三个方面:变革过程中政治权威未出现真空、温和势力在变革中始终占据主导地位、文化宗教因素遏制了民粹的爆发。

  10. An atypical case of successful resuscitation of an accidental profound hypothermia patient, occurring in a temperate climate.

    LENUS (Irish Health Repository)

    Coleman, E


    Cases of accidental profound hypothermia occur most frequently in cold, northern climates. We describe an atypical case, occurring in a temperate climate, where a hypothermic cardiac-arrested patient was successfully resuscitated using extracorporeal circulation (ECC).

  11. Effects of citicoline used alone and in combination with mild hypothermia on apoptosis induced by focal cerebral ischemia in rats. (United States)

    Sahin, S; Alkan, T; Temel, S G; Tureyen, K; Tolunay, S; Korfali, E


    The effects of citicoline used either alone or in combination with hypothermia on the suppression of apoptotic processes after transient focal cerebral ischemia were investigated. Middle cerebral artery occlusion (MCAo) was performed for 2 hours on Sprague-Dawley (SD) rats using intraluminal thread insertion. The treatment groups were as follows: Group 1, sham-operated; Group 2, saline; Group 3, citicoline (400mg/kg intraperitoneal.); Group 4, hypothermia (34+/-1 degrees C); Group 5, citicoline+hypothermia. All rats were reperfused for 24 hours, and after sacrifice and transcardiac perfusion, immunohistochemical studies were performed for markers of apoptosis. In Group 2, the Bcl-2 immunostaining score (mean+/-standard deviation, 0.71+/-0.75) was lower compared to Groups 3, 4 and 5 (2.33+/-0.81; 3.00+/-0.00; 2.20+/-0.83; pciticoline with hypothermia is more effective than either used alone in ameliorating cerebral damage after transient focal ischemia.

  12. Motor And Sensory Effects Of Ipsilesional Upper Extremity Hypothermia And Contralesional Sensory Training For Chronic Stroke Patients


    Lima, de, M.; Nubia Maria; Menegatti; Karina Candido; Yu; Erica; Sacomoto; Natalia Yumi; Oberg; Telma Dagmar; Honorato; Donizeti Cesar


    As hypothermia by immersion can reduce the sensory nerve conduction velocity, this study hypothesized that the reduction of sensory input to the ipsilesional upper extremity (UE) using cryotherapy would reduce the inhibitory activity of the contralesional hemisphere in chronic stroke subjects. Objective: In this study, hypothermia was applied by immersing the ipsilesional UE in association with sensory training of the contralesional UE of stroke patients to assess the immediate (e.g. sensorim...

  13. Legionnaire's disease avoidance planning. (United States)

    Broadbent, Clive


    Hospital-acquired infection is the cause of about 5,000 deaths a year in the UK. In New Zealand, there are more than three times as many such deaths as from the annual road toll. The costs in loss of income, in pain and suffering and in direct costs to hospitals are staggering.

  14. Telerobotics with whole arm collision avoidance

    Energy Technology Data Exchange (ETDEWEB)

    Wilhelmsen, K.; Strenn, S.


    The complexity of teleorbotic operations in a cluttered environment is exacerbated by the need to present collision information to the operator in an understandable fashion. In addition to preventing movements which will cause collisions, a system providing some form of virtual force reflection (VFR) is desirable. With this goal in mind, Lawrence Livermore National Laboratory (LLNL) has installed a kinematically master/slave system and developed a whole arm collision avoidance system which interacts directly with the telerobotic controller. LLNL has also provided a structure to allow for automated upgrades of workcell models and provide collision avoidance even in a dynamically changing workcell.

  15. Hospitalization of children under five years of age due to avoidable causes Hospitalizaciones en menores de cinco años por causas evitables Hospitalizações de menores de cinco anos por causas evitáveis

    Directory of Open Access Journals (Sweden)

    Rosana Rosseto de Oliveira


    Full Text Available This study characterizes the profile of hospital morbidity according to the main diagnosis upon admission, in individuals younger than five years old, residents of three cities (Maringá, Sarandi and Paiçandu in the Paraná state, Brazil. Information contained in hospital admission forms from 1998 to 2009 was used. The hospitalizations of 41,220 individuals younger than five years old were analyzed. The results indicate a decline of 16.1% in hospital admissions of patients younger than five years old in relation to the total number of admissions in all age groups. As for the main diagnoses, there were diseases of the respiratory system (55.6%, infectious and parasitic diseases (14.8% and diseases originating in the perinatal period (12.9%. Such conditions can be avoided by implementing primary health care measures, which shows the need to intensify the actions recommended by the programs directed to child health.El objetivo de este estudio fue caracterizar el perfil de la morbilidad hospitalaria según el diagnóstico principal de internación, en menores de cinco años, residentes en las ciudades de Maringá, Sarandi y Paiçandu. Fueron utilizadas informaciones registradas en los formularios de Autorización de Internación Hospitalaria, en los años de 1998 a 2009. Se analizaron 41.220 internaciones en menores de 5 años. Los resultados evidencian una disminución de 16,1% de internaciones de menores de cinco años en relación al total de internaciones en todos los intervalos de edad. En cuanto a las principales causas de hospitalización se encontraron las enfermedades del aparato respiratorio (55,6%, enfermedades infecciosas y parasitarias (14,8% y afecciones originadas en el período perinatal (12,9%; estas enfermedades pueden evitadas con medidas de atención básica, señalando la necesidad de intensificar las acciones preconizadas por los programas dirigidos a la salud del niño.O estudo objetivou caracterizar o perfil da morbidade

  16. Effect of hypothermia on the thalamocortical function in the rat model. (United States)

    Maybhate, Anil; Chen, Cheng; Thakor, Nitish V; Jia, Xiaofeng


    Neuroprotective effects of hypothermia are well documented in many injuries of the central nervous system in animal models as well as clinical studies. However, the underlying mechanisms are not fully understood. An important yet unexplored background issue is the effect of hypothermic cooling on the regional functionality of the healthy CNS. In a pilot study with the rat model, we seek to characterize the effect of moderate bodily cooling on the thalamo-cortical (T-C) function. Multiunit activity (MUA) and local field potentials (LFPs) were recorded from the thalamus (VPL nucleus) and the somatosensory cortex (S1) for normothermic, mild hypothermic and mild hyperthermic conditions in healthy rats and the thalamo-cortical dynamics was characterized with Granger Causal Interaction (GCI). The GCI indicated that the thalamic driving of the cortical activity significantly increases in strength with bodily cooling and weakens with mild heating. These results could have important implications towards understanding of hypothermia.

  17. Effect of sub-hypothermia therapy on coagulopathy after severe head injury

    Institute of Scientific and Technical Information of China (English)

    LI Gang; XU Ru-xiang; KE Yi-quan; JIANG Xiao-dan; ZHANG Shu-fen; DENG Bi-lan; YU Xing


    @@ Sub-hypothermia therapy is one of the treatments for patients with severe head injury.The objective of the therapy is to treat traumatic brain injury (TBI) by alleviating brain edema,protecting blood brain barrier (BBB),and preventing subsequent damage to neurons.It can protect brain function by depressing metabolism,reducing the release of excitatory amino acids and free radicals,reducing the level of lactic acid,and lowering the damage of cytoskeletal structure.1 However,sub-hypothemia may-affect patients' coagulatory function including amendment to hypercoagulation state or hyperfibrinolysis and platelet (PLT) functional disturbance.2,3 This study aimed to observe how sub-hypothermia therapy exerts effects on coagulopathy of patients after head injury.

  18. Septicemia in a Neonate following Therapeutic Hypothermia: The Literature Review of Evidence

    Directory of Open Access Journals (Sweden)

    Kam Lun Hon


    Full Text Available We report a term neonate with hypoxic ischemic encephalopathy who underwent a 72-hour therapeutic hypothermia. He developed unstable body temperature associated with coagulase negative staphylococcus septicemia 2 weeks later which was promptly treated with intravenous antibiotics and made a good recovery. PubMed (a service of the U.S. National Library of Medicine was searched for the terms “therapeutic hypothermia” and “septicemia,” with limits activated (humans, English, age 0–18 years. There were only 6 randomized controlled trials, 1 non-randomized controlled trial, 1 retrospective cohort, and 1 case-control trial, which showed no definite evidence of increased risk of septicemia or neutrophil dysfunction in infants following hypothermia therapy.

  19. Myocardial correlates of helium-cold induction and maintenance of hypothermia. (United States)

    Anderson, G. L.; Prewitt, R., Jr.; Musacchia, X. J.


    Hypothermia was induced in the golden hamster Mesocricetus auratus, using the helium-cold method. The first group of hamsters was sacrificed immediately after induction to rectal temperature 7 C, a second group was sacrificed after being maintained at a body temperature of 7 C for 18-24 hr, and a third group consisted of unexposed controls. The hearts were excised and the ventricles analyzed for hypoxic damage, glycogen, and catecholamines. In the short-term hypothermic animals, resting tension was increased while peak isometric tension, generated tension after 10 min of anoxic exposure, glycogen, and catecholamines were all reduced. All of the functional parameters recovered in the long-term hypothermic group, while glycogen and catecholamines showed a trend toward recovery. It is concluded that myocardial hypoxia develops during induction into hypothermia when using the helium-cold method. This effect is reversible and hypoxic damage does not increase as the hypothermic exposure is prolonged.

  20. Assessment of brain tissue injury after moderate hypothermia in neonates with hypoxic–ischaemic encephalopathy: a nested substudy of a randomised controlled trial


    Rutherford, Mary; Ramenghi, Luca A; Edwards, A. David; Brocklehurst, Peter; Halliday, Henry; Levene, Malcolm; Strohm, Brenda; Thoresen, Marianne; Whitelaw, Andrew; Azzopardi, Denis


    Summary Background Moderate hypothermia in neonates with hypoxic–ischaemic encephalopathy might improve survival and neurological outcomes at up to 18 months of age, although complete neurological assessment at this age is difficult. To ascertain more precisely the effect of therapeutic hypothermia on neonatal cerebral injury, we assessed cerebral lesions on MRI scans of infants who participated in the Total Body Hypothermia for Neonatal Encephalopathy (TOBY) trial. Methods In the TOBY trial ...

  1. Subdural haemorrhage and severe coagulopathy resulting in transtentorial uncal herniation in a neonate undergoing therapeutic hypothermia


    Wang, Dianna; McMillan, Hugh; Bariciak, Erika


    Therapeutic hypothermia has been shown to be efficacious for improving long-term neurodevelopmental outcomes following perinatal asphyxia. Thus, cooling protocols have been adopted at most tertiary neonatal centres. We present a case of a term neonate who underwent therapeutic whole-body cooling for hypoxic ischaemic encephalopathy following a difficult forceps delivery. She abruptly deteriorated, exhibiting signs of transtentorial uncal herniation and severe disseminated intravascular coagul...

  2. The Effects of Hypothermia on Fibrinogen Metabolism and Coagulation Function in Swine (United States)


    Continuous arteriovenous rewarming: experimental results and thermodynamic model simula- tion of treatment for hypothermia. J Trauma 1990;30:1436-49. [6...of fibrinogen in cirrhosis of the liver. J Clin Invest 1971;50:1690-701. [22] Rand MD, Lock JB, van’t Veer C, et al. Blood clotting in minimally...fibrinogen synthesis in hemodialysis patients with normal nutritional status. J Am Soc Nephrol 2001;12: 349 -54. [36] Olsen AK. The pig as a model in

  3. [First open heart surgery in hypothermia in Croatia performed in 1957]. (United States)

    Hromadko, Miroslav; Fatović-Ferencić, Stella


    In Zagreb, at the Surgical Department of University Hospital "Dr Ozren Novosel", today "Merkur" the first operation in hypothermia was performed on October 25th, 1957, on the patient with pulmonary valve stenosis. It allowed total circulatory interruption to do the operation in the open heart successfully, and this was the first such operation not only in Croatia but in the broader context of former Yugoslavia.

  4. Prevention and correction of hypocalaemia during systematic hypothermia in patients with aneurismal subarachnoid hemorrhages

    Directory of Open Access Journals (Sweden)

    Dudukina S.


    Full Text Available The effectiveness of hypothermia as a method of neuroprotection in brain damage has been proved in many studies, but a large number of complications requires development of further protocols of its management. The article presents experience of treatment of aneurismal subarachnoid hemorrhage under conditions of preventive hypothermia. 84 patients were examined. In 56 of them the efficacy of developed method on prevention and correction of hypocalaemia developed as a result of cold diuresis has been proposed. It has been found that decrease in plasma potassium occurs in parallel with decrease in body temperature regardless the technique of potassium chloride injection. Introduction of potassium chloride solution in physiological dose of 0.2 mmol/kg prevents hypocalaemia development during preventive hypothermia. Injection of potassium chloride in the physiological dose of 0.2 mmol/kg/h and after beginning of patient’s rewarming – 0.8 mmol/kg within the period of one postsurgery day prevents the development of postoperative hypocalaemia in the postoperative period; and after patient’s rewarming– 0.8. mmol/kg within the period of one postoperative day prevents development of postoperative cardiac complications in the perioperative period by 20%.

  5. Underlying Mechanism of Aconitum Lizhong Acting on Experimental Hypothermia with Indigestion in Rats: Role of Ghrelin

    Directory of Open Access Journals (Sweden)

    Xin Zhao


    Full Text Available This study is aimed to investigate the Aconitum Lizhong pill (ALZ pharmacological actions on hypothermia with indigestion, especially the ghrelin roles. The littermate-matched rats were randomly divided into four groups. Control did sham operation or standard diet, Model carried out interscapular brown adipose (IBA removal with standard diet, Fat-diet did IBA removal with fat-diet, and ALZ did IBA removal and fat-diet with 4.536 g/kg/d ALZ. The potency of adaptive thermogenesis, ghrelin levels in plasma or gastric mucosa, thyroid hormones and metabolite in sera, expression of ghrelin mRNA, and protein in gastric mucous membrane were determined. ALZ relieved the hypothermia processes with indigestion, via inhibiting ghrelin expression and increasing ghrelin secretion; the dynamics from the therapy is supported with the energy changes as less body weight loss, less plasma lipid decrease, more plasma T3 or T4 increase with TSH decrease, and more compensation of thermogenic AUC decrease. Ghrelin played key roles in the actions of ALZ on the hypothermia with indigestion. The pharmacological mechanisms of ALZ involved the homeostasis of ghrelin expression and secretion.

  6. Potential role of the gut microbiota in synthetic torpor and therapeutic hypothermia. (United States)

    Sisa, Claudia; Turroni, Silvia; Amici, Roberto; Brigidi, Patrizia; Candela, Marco; Cerri, Matteo


    Therapeutic hypothermia is today used in several clinical settings, among them the gut related diseases that are influenced by ischemia/reperfusion injury. This perspective paved the way to the study of hibernation physiology, in natural hibernators, highlighting an unexpected importance of the gut microbial ecosystem in hibernation and torpor. In natural hibernators, intestinal microbes adaptively reorganize their structural configuration during torpor, and maintain a mutualistic configuration regardless of long periods of fasting and cold temperatures. This allows the gut microbiome to provide the host with metabolites, which are essential to keep the host immunological and metabolic homeostasis during hibernation. The emerging role of the gut microbiota in the hibernation process suggests the importance of maintaining a mutualistic gut microbiota configuration in the application of therapeutic hypothermia as well as in the development of new strategy such as the use of synthetic torpor in humans. The possible utilization of tailored probiotics to mold the gut ecosystem during therapeutic hypothermia can also be taken into consideration as new therapeutic strategy.

  7. Chloroplast avoidance movement reduces photodamage in plants. (United States)

    Kasahara, Masahiro; Kagawa, Takatoshi; Oikawa, Kazusato; Suetsugu, Noriyuki; Miyao, Mitsue; Wada, Masamitsu

    When plants are exposed to light levels higher than those required for photosynthesis, reactive oxygen species are generated in the chloroplasts and cause photodamage. This can occur even under natural growth conditions. To mitigate photodamage, plants have developed several protective mechanisms. One is chloroplast avoidance movement, in which chloroplasts move from the cell surface to the side walls of cells under high light conditions, although experimental support is still awaited. Here, using different classes of mutant defective in chloroplast avoidance movement, we show that these mutants are more susceptible to damage in high light than wild-type plants. Damage of the photosynthetic apparatus and subsequent bleaching of leaf colour and necrosis occur faster under high light conditions in the mutants than in wild-type plants. We conclude that chloroplast avoidance movement actually decreases the amount of light absorption by chloroplasts, and might therefore be important to the survival of plants under natural growth conditions.

  8. Airborne Collision Avoidance System X (United States)


    avoidance system on behalf of the Federal Aviation Adminis- tration (FAA). The current Traffic Alert and Collision Avoidance System II (TCAS II...transformations to the National Airspace System are being imple- mented through the FAA’s Next-Genera- tion Air Transportation System (NextGen). With the goal...weighted states to provide a single, optimal action. If a collision avoidance This work is sponsored by the Federal Aviation Administration under Air

  9. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    Directory of Open Access Journals (Sweden)

    de Haan Timo R


    Full Text Available Abstract Background In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage necessitating newborn resuscitation occurs in at least 200 of the 180–185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with therapeutic hypothermia. During hypothermia neonates receive sedative, analgesic, anti-epileptic and antibiotic drugs. So far little information is available how the pharmacokinetics (PK and pharmacodynamics (PD of these drugs are influenced by post resuscitation multi organ failure and the metabolic effects of the cooling treatment itself. As a result, evidence based dosing guidelines are lacking. This multicenter observational cohort study was designed to answer the question how hypothermia influences the distribution, metabolism and elimination of commonly used drugs in neonatal intensive care. Methods/Design Multicenter cohort study. All term neonates treated with hypothermia for Hypoxic Ischemic Encephalopathy (HIE resulting from perinatal asphyxia in all ten Dutch Neonatal Intensive Care Units (NICUs will be eligible for this study. During hypothermia and rewarming blood samples will be taken from indwelling catheters to investigate blood concentrations of several antibiotics, analgesics, sedatives and anti-epileptic drugs. For each individual drug the population PK will be characterized using Nonlinear Mixed Effects Modelling (NONMEM. It will be investigated how clearance and volume of distribution are influenced by hypothermia also taking maturation of neonate into account. Similarly, integrated PK-PD models will be developed relating the time course of drug concentration to pharmacodynamic parameters such as successful seizure treatment; pain assessment and infection clearance. Discussion On basis of the derived population PK-PD models dosing guidelines will be developed for the application of drugs during neonatal hypothermia treatment. The

  10. Stimulus conflict triggers behavioral avoidance. (United States)

    Dignath, David; Eder, Andreas B


    According to a recent extension of the conflict-monitoring theory, conflict between two competing response tendencies is registered as an aversive event and triggers a motivation to avoid the source of conflict. In the present study, we tested this assumption. Over five experiments, we examined whether conflict is associated with an avoidance motivation and whether stimulus conflict or response conflict triggers an avoidance tendency. Participants first performed a color Stroop task. In a subsequent motivation test, participants responded to Stroop stimuli with approach- and avoidance-related lever movements. These results showed that Stroop-conflict stimuli increased the frequency of avoidance responses in a free-choice motivation test, and also increased the speed of avoidance relative to approach responses in a forced-choice test. High and low proportions of response conflict in the Stroop task had no effect on avoidance in the motivation test. Avoidance of conflict was, however, obtained even with new conflict stimuli that had not been presented before in a Stroop task, and when the Stroop task was replaced with an unrelated filler task. Taken together, these results suggest that stimulus conflict is sufficient to trigger avoidance.

  11. Mild hypothermia, but not propofol, is neuroprotective in organotypic hippocampal cultures. (United States)

    Feiner, John R; Bickler, Philip E; Estrada, Sergio; Donohoe, Paul H; Fahlman, Christian S; Schuyler, Jennifer A


    The neuroprotective potency of anesthetics such as propofol compared to mild hypothermia remains undefined. Therefore, we determined whether propofol at two clinically relevant concentrations is as effective as mild hypothermia in preventing delayed neuron death in hippocampal slice cultures (HSC). Survival of neurons was assessed 2 and 3 days after 1 h oxygen and glucose deprivation (OGD) either at 37 degrees C (with or without 10 or 100 microM propofol) or at an average temperature of 35 degrees C during OGD (mild hypothermia). Cell death in CA1, CA3, and dentate neurons in each slice was measured with propidium iodide fluorescence. Mild hypothermia eliminated death in CA1, CA3, and dentate neurons but propofol protected dentate neurons only at a concentration of 10 microM; the more ischemia vulnerable CA1 and CA3 neurons were not protected by either 10 microM or 100 microM propofol. In slice cultures, the toxicity of 100 muM N-methyl-D-aspartate (NMDA), 500 microM glutamate, and 20 microM alpha-amino-5-methyl-4-isoxazole propionic acid (AMPA) was not reduced by 100 microM propofol. Because propofol neuroprotection may involve gamma-aminobutyric acid (GABA)-mediated indirect inhibition of glutamate receptors (GluRs), the effects of propofol on GluR activity (calcium influx induced by GluR agonists) were studied in CA1 neurons in HSC, in isolated CA1 neurons, and in cortical brain slices. Propofol (100 and 200 microM, approximate burst suppression concentrations) decreased glutamate-mediated [Ca2+]i increases (Delta[Ca2+]i) responses by 25%-35% in isolated CA1 neurons and reduced glutamate and NMDA Delta[Ca2+]i in acute and cultured hippocampal slices by 35%-50%. In both CA1 neurons and cortical slices, blocking GABAA receptors with picrotoxin reduced the inhibition of GluRs substantially. We conclude that mild hypothermia, but not propofol, protects CA1 and CA3 neurons in hippocampal slice cultures subjected to oxygen and glucose deprivation. Propofol was not

  12. Allergen avoidance: does it work? (United States)

    Woodcock, A; Custovic, A


    The first recorded example of allergen avoidance in the treatment of allergic disorders dates from the 16th century. The Italian physician Gerolamo Cardano (1501-1576) was invited to Scotland by John Hamilton, Archbishop of St Andrews (and brother of the Regent), to give advice on the treatment of his asthma. Cardano recommended that the Archbishop should get rid of his feather bedding, which was followed by a 'miraculous' remission of otherwise troublesome symptoms. The first controlled attempts to treat asthma by environmental manipulation date to the beginning of 20th century. In 1925, the Leopold brothers treated patients with asthma and other allergic disorders by moving them into a dust free room. Storm van Leeuwen created a 'climate' chamber in The Netherlands in 1927 and demonstrated that asthmatic patients improved when moved from their homes into the chamber. One year later, Dekker observed that measures aimed at reducing the amount of dust in bedrooms had a beneficial effect on asthma symptoms in patients allergic to house dust. Van Leeuwen wrote: 'In our endeavours to find the cause of the attack ... we utilised the known fact that the environment of the asthmatic patient is, as a rule, of primary importance in determining the intensity and frequency of his attacks'. Nowadays, more than ever, it is essential to address the environmental influences on the increasing prevalence of asthma and allergic disorders.

  13. Chemical avoidance responses of fishes. (United States)

    Tierney, Keith B


    The hydrosphere is a repository for all of our waste and mistakes, be they sewage, garbage, process-affected waters, runoff, and gases. For fish living in environments receiving undesirable inputs, moving away seems an obvious way to avoid harm. While this should occur, there are numerous examples where it will not. The inability to avoid harmful environments may lead to sensory impairments that in turn limit the ability to avoid other dangers or locate benefits. For avoidance to occur, the danger must first be perceived, which may not happen if the fish is 'blinded' in some capacity. Second, the danger must be recognized for what it is, which may also not happen if the fish is cognitively confused or impaired. Third, it is possible that the fish may not be able to leave the area, or worse, learns to prefer a toxic environment. Concerning generating regulations around avoidance, there are two possibilities: that an avoidance threshold be used to set guidelines for effluent release with the intention of driving fishes away; the second is to set a contaminant concentration that would not affect the avoidance or attraction responses to other cues. With the complexities of the modern world in which we release diverse pollutants, from light to municipal effluents full of 1000s of chemicals, to the diversity present in ecosystems, it is impossible to have avoidance data on every stimulus-species combination. Nevertheless, we may be able to use existing avoidance response data to predict the likelihood of avoidance of untested stimuli. Where we cannot, this review includes a framework that can be used to direct new research. This review is intended to collate existing avoidance response data, provide a framework for making decisions in the absence of data, and suggest studies that would facilitate the prediction of risk to fish health in environments receiving intentional and unintentional human-based chemical inputs.

  14. Research on Double Collision Avoidance Mechanism of Ships at Sea

    Directory of Open Access Journals (Sweden)

    XiuYing Bi


    Full Text Available When power driven vessels encounter at sea, they need to avoid collision. The definition of right vessel may mislead ships officers think his or her direct navigating has absolute power with this special ship. This paper will define DCPA symbols; give the cause and the method of double collision avoidance mechanism of ships at sea.

  15. White matter apoptosis is increased by delayed hypothermia and rewarming in a neonatal piglet model of hypoxic ischemic encephalopathy. (United States)

    Wang, B; Armstrong, J S; Reyes, M; Kulikowicz, E; Lee, J-H; Spicer, D; Bhalala, U; Yang, Z-J; Koehler, R C; Martin, L J; Lee, J K


    Therapeutic hypothermia is widely used to treat neonatal hypoxic ischemic (HI) brain injuries. However, potentially deleterious effects of delaying the induction of hypothermia and of rewarming on white matter injury remain unclear. We used a piglet model of HI to assess the effects of delayed hypothermia and rewarming on white matter apoptosis. Piglets underwent HI injury or sham surgery followed by normothermic or hypothermic recovery at 2h. Hypothermic groups were divided into those with no rewarming, slow rewarming at 0.5°C/h, or rapid rewarming at 4°C/h. Apoptotic cells in the subcortical white matter of the motor gyrus, corpus callosum, lateral olfactory tract, and internal capsule at 29h were identified morphologically and counted by hematoxylin & eosin staining. Cell death was verified by terminal deoxynucleotidyl transferase (TdT) dUTP nick end labeling (TUNEL) assay. White matter neurons were also counted, and apoptotic cells were immunophenotyped with the oligodendrocyte marker 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase). Hypothermia, slow rewarming, and rapid rewarming increased apoptosis in the subcortical white matter relative to normothermia (ppiglets had more apoptosis in the lateral olfactory tract than those that were rewarmed (ppiglets had more apoptosis than shams after normothermia, slow rewarming, and rapid rewarming (ppiglet model of HI; in some regions these temperature effects are independent of HI. Vulnerable cells include myelinating oligodendrocytes. This study identifies a deleterious effect of therapeutic hypothermia in the developing brain.

  16. Short term outcome of therapeutic hypothermia in term infants with moderate to severe hypoxic ischaemic encephalopathy; the Sungai Buloh experience. (United States)

    See, K C; Jamal, S J Syed; Chiam, M L


    This analysis is a case-series to document the outcome of term newborns with hypoxic ischaemic encephalopathy (HIE), enrolled into total body hypothermia therapy, in a tertiary neonatal unit in Malaysia. The method used to achieve total body hypothermia is a novel method using just environmental temperature, without the need of expensive equipment. A total of 17 babies were eligible to be included in this study, from the 1st of January 2010 to the 31st of December 2010. 14 out of 15 babies who had Stage 2 HIE had no neurological deficit at follow-up. All Stage 3 HIE babies passed away. Allowing for the small sample size, we can conclude that total body hypothermia therapy is feasible and is a safe treatment modality for HIE Stage 2 babies in a Malaysian setting, by manipulating environmental temperature to achieve therapeutic hypothermia. Further work is needed to determine the long-term outcome of passive cooling total body hypothermia in Stage 2 HIE babies in Malaysia.

  17. Mild hypothermia alleviates brain oedema and blood-brain barrier disruption by attenuating tight junction and adherens junction breakdown in a swine model of cardiopulmonary resuscitation (United States)

    Li, Jiebin; Li, Chunsheng; Yuan, Wei; Wu, Junyuan; Li, Jie; Li, Zhenhua; Zhao, Yongzhen


    Mild hypothermia improves survival and neurological recovery after cardiac arrest (CA) and cardiopulmonary resuscitation (CPR). However, the mechanism underlying this phenomenon is not fully elucidated. The aim of this study was to determine whether mild hypothermia alleviates early blood–brain barrier (BBB) disruption. We investigated the effects of mild hypothermia on neurologic outcome, survival rate, brain water content, BBB permeability and changes in tight junctions (TJs) and adherens junctions (AJs) after CA and CPR. Pigs were subjected to 8 min of untreated ventricular fibrillation followed by CPR. Mild hypothermia (33°C) was intravascularly induced and maintained at this temperature for 12 h, followed by active rewarming. Mild hypothermia significantly reduced cortical water content, decreased BBB permeability and attenuated TJ ultrastructural and basement membrane breakdown in brain cortical microvessels. Mild hypothermia also attenuated the CPR-induced decreases in TJ (occludin, claudin-5, ZO-1) and AJ (VE-cadherin) protein and mRNA expression. Furthermore, mild hypothermia decreased the CA- and CPR-induced increases in matrix metalloproteinase-9 (MMP-9) and vascular endothelial growth factor (VEGF) expression and increased angiogenin-1 (Ang-1) expression. Our findings suggest that mild hypothermia attenuates the CA- and resuscitation-induced early brain oedema and BBB disruption, and this improvement might be at least partially associated with attenuation of the breakdown of TJ and AJ, suppression of MMP-9 and VEGF expression, and upregulation of Ang-1 expression. PMID:28355299

  18. Pattern Avoidance in Ternary Trees

    CERN Document Server

    Gabriel, Nathan; Pudwell, Lara; Tay, Samuel


    This paper considers the enumeration of ternary trees (i.e. rooted ordered trees in which each vertex has 0 or 3 children) avoiding a contiguous ternary tree pattern. We begin by finding recurrence relations for several simple tree patterns; then, for more complex trees, we compute generating functions by extending a known algorithm for pattern-avoiding binary trees. Next, we present an alternate one-dimensional notation for trees which we use to find bijections that explain why certain pairs of tree patterns yield the same avoidance generating function. Finally, we compare our bijections to known "replacement rules" for binary trees and generalize these bijections to a larger class of trees.

  19. Neuroprotective effects of bloodletting atJing points combined with mild induced hypothermia in acute severe traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    Yue Tu; Xiao-mei Miao; Tai-long Yi; Xu-yi Chen; Hong-tao Sun; Shi-xiang Cheng; Sai Zhang


    Bloodletting atJing points has been used to treat coma in traditional Chinese medicine. Mild induced hypothermia has also been shown to have neuroprotective effects. However, the therapeutic effects of bloodletting atJing points and mild induced hypothermia alone are limited. Therefore, we investigated whether combined treatment might have clinical effectiveness for the treatment of acute severe trau-matic brain injury. Using a rat model of traumatic brain injury, combined treatment substantially alleviated cerebral edema and blood-brain barrier dysfunction. Furthermore, neurological function was ameliorated, and cellular necrosis and the inlfammatory response were lessened. These ifndings suggest that the combined effects of bloodletting atJing points (20 µL, twice a day, for 2 days) and mild induced hypothermia (6 hours) are better than their individual effects alone. Their combined application may have marked neuroprotective effects in the clinical treatment of acute severe traumatic brain injury.

  20. Controle ácido-básico na hipotermia The acid-base management in hypothermia

    Directory of Open Access Journals (Sweden)

    Walter José Gomes


    Full Text Available O emprego da hipotermia profunda tem se constituído, atualmente, numa Importante estratégia para melhoria da qualidade técnica e resultados em cirurgia cardiovascular. A hipotermia reduz os danos teciduais induzidos pela isquemia por diminuir o metabolismo e preservar os fosfatos energéticos. A regulação do pH tecidual durante a hipotermia é fundamental para a manutenção da homeostasia celular, já que a hipotermia induz alterações desse pH pela mudança provocada na constante de dissociação da água. A questão do melhor manuseio dos gases sangüíneos durante a hipotermia induzida tem sido objeto de controvérsia. Duas abordagens têm sido preconizadas para o manejo das alterações iónicas durante a hipotermia. A regulção pH-stat envolve a manutenção do pH constante de 7,40 em todas as temperaturas com ajustes da PaCO2 e a regulação α-stat permite a variação do pH sangüíneo, que aumenta conforme a diminuição da temperatura e o conteúdo total corpóreo de CO2 é mantido constante. Nesta presente revisão a relação entre pH sangüíneo e intracelular e as alterações iónicas induzidas pela hipotermia são discutidas.Deep hypothermia is a usefull tool to improve technical results in cardiovascular surgery and is nowadays the major strategy used to reduce ischemic injury. Hypothermia reduces metabolism and preserves cellular stores of high-energy phosphates. The regulation of tissue pH during hypothermia is important for cellular homeostasis. Furthermore, hypothermia has important effects on pH by altering the dissociation constant of water and various metabolics intermediates and the question of optimal blood gas management during deliberate hypothermia has been subject of much controversy. Two approaches have been advocated for pH management during hypothermia, the first termed pH strategy, where blood pH is maintained constant at 7,40 at all temperatures with PaCO2 adjustment, and in the second type of

  1. Intracranial Pressure Elevation 24 Hours after Ischemic Stroke in Aged Rats is Prevented by Early, Short Hypothermia Treatment

    Directory of Open Access Journals (Sweden)

    Lucy Anne Murtha


    Full Text Available Stroke is predominantly a senescent disease, yet most preclinical studies investigate treatment in young animals. We recently demonstrated that short-duration hypothermia-treatment completely prevented the dramatic intracranial pressure (ICP rise seen post-stroke in young rats. Here, our aim was to investigate whether a similar ICP rise occurs in aged rats and to determine whether short-duration hypothermia is an effective treatment in aged animals. Experimental Middle Cerebral Artery occlusion (MCAo - 3 hour occlusion was performed on male Wistar rats aged 19-20 months. At one hour after stroke-onset, rats were randomized to 2.5 hours hypothermia-treatment (32.5 °C or normothermia (37 °C. ICP was monitored at baseline, for 3.5 hours post-occlusion, and at 24 hours post-stroke. Infarct and edema volumes were calculated from histology. Baseline pre-stroke ICP was 11.2 ± 3.3 mmHg across all animals. Twenty-four hours post-stroke, ICP was significantly higher in normothermic animals compared to hypothermia-treated animals (27.4 ± 18.2 mmHg vs. 8.0 ± 5.0 mmHg, p = 0.03. Infarct and edema volumes were not significantly different between groups. These data demonstrate ICP may also increase 24 hours post-stroke in aged rats, and that short-duration hypothermia treatment has a profound and sustained preventative effect. These findings may have important implications for the use of hypothermia in clinical trials of aged stroke patients.

  2. Neuromorphic UAS Collision Avoidance Project (United States)

    National Aeronautics and Space Administration — Using biologically-inspired neuromorphic optic flow algorithms is a novel approach in collision avoidance for UAS. Traditional computer vision algorithms rely on...

  3. Things to Avoid When Breastfeeding (United States)

    ... need to avoid fish that are high in mercury, namely, shark, swordfish, king mackerel, and tilefish. When you do eat fish, it’s important to eat varieties that contain less mercury, such as canned light tuna, shrimp, salmon, pollock, ...

  4. Avoiding Gluten Cross-Contamination (United States)

    ... Avoiding Gluten Cross-Contamination Reviewed by Sharon Denny, MS, RDN Published April 22, 2014 Print Email You might not think twice about the pot you use to boil water, the plate you put your food on or even the ...

  5. Vision-based obstacle avoidance (United States)

    Galbraith, John


    A method for allowing a robot to avoid objects along a programmed path: first, a field of view for an electronic imager of the robot is established along a path where the electronic imager obtains the object location information within the field of view; second, a population coded control signal is then derived from the object location information and is transmitted to the robot; finally, the robot then responds to the control signal and avoids the detected object.

  6. Scandinavian clinical practice guidelines for therapeutic hypothermia and post-resuscitation care after cardiac arrest

    DEFF Research Database (Denmark)

    Castrén, M; Silfvast, T; Rubertsson, S;


    studies MTH has been proven to be safe, with few complications and improved survival, and is recommended by the International Liaison of Committee on Resuscitation. The aim of this paper is to recommend clinical practice guidelines for MTH treatment after cardiac arrest from the Scandinavian Society...... of Anaesthesiology and Intensive Care Medicine (SSAI). METHODS: Relevant studies were identified after two consensus meetings of the SSAI Task Force on Therapeutic Hypothermia (SSAITFTH) and via literature search of the Cochrane Central Register of Controlled Trials and Medline. Evidence was assessed and consensus...

  7. Efficacy of external warming in attenuation of hypothermia in surgical patients

    Directory of Open Access Journals (Sweden)

    Zeba Snježana


    Full Text Available Background/Aim. Hypothermia in surgical patients can be the consequence of long duration of surgical intervention, general anaesthesia and low temperature in operating room. Postoperative hypothermia contributes to a number of postoperative complications such as arrhythmia, myocardial ischemia, hypertension, bleeding, wound infection, coagulopathy, and prolonged effect of muscle relaxants. External heating procedures are used to prevent this condition. The aim of this study was to evaluate the efficiency of external warming system in alleviation of cold stress and hypothermia in patients who underwent major surgical procedures. Methods. The study was conducted in the Military Medical Academy in Belgrade. A total of 30 patients of both genders underwent abdominal surgical procedures, randomly divided into two equal groups: the one was externally warmed using warm air mattress (W, while in the control group (C surgical procedure was performed in regular conditions, without additional warming. Oesophageal temperature (Te was used as indicator of changes in core temperature, during surgery and awakening postoperative period, and temperature of control sites on the right hand (Th and the right foot (Tf reflected the changes in skin temperatures during surgery. Te and skin temperatures were monitored during the intraoperative period, with continuous measurement of Te during the following 90 minutes of the postoperative period. Heart rates and blood pressures were monitored continuously during the intraoperative and awakening period. Results. In the W group, the average Te, Tf and Th did not change significantly during the intraoperative as well as the postoperative period. In the controls, the average Te significantly decreased during the intraoperative period (from 35.61 ± 0.35ºC at 0 minute to 33.86 ± 0.51ºC at 120th minute. Compared to the W group, Te in the C group was significantly lower in all the observed periods. Average values of Tf and

  8. How does a cyclist avoid obstacles? (United States)

    Miyadait, Masayuki; Uetake, Teruo; Shimoda, Masahiro


    The purpose of this research is to examine the ways bicycles swerve off sidewalks onto roads under various conditions. Seven students, five males and two females participated in an experiment on a road with a 100-cm wide sidewalk. Footage of each participant on a bicycle evading obstacles such as a utility pole and pedestrian were taken with a video camera, while a front-wheel view of the path taken by the bicycle was recorded simultaneously with a digital camera. Twelve experimental conditions were used for each participant, consisting of all the combinations of (1) three obstacle types, (2) the side (left or right) to which the bicycle went to avoid the obstacle, and (3) two weather conditions. Based on the two recorded scenes, the path was then analyzed from the viewpoint of how the bicycle swerved to avoid hitting the obstacle. We found that the conditions of riding a bicycle with an umbrella caused a larger swerve to avoid the obstacle than those conditions when the rider did not have an umbrella. In particular, the condition in which the obstacle was a pedestrian who also had an umbrella caused the largest swerve. Furthermore, the distance required to become aligned with the sidewalk when the obstacle was a pedestrian walking toward the cyclist was longer than that for other obstacles. The swerve width data showed interesting results, including a tendency for swerve width to be wider when the obstacle was a utility pole compared with other obstacles.

  9. Hipotermia terapêutica em pacientes pós-parada cardiorrespiratória: mecanismos de ação e desenvolvimento de protocolo assistencial Mild therapeutic hypothermia after cardiac arrest: mechanism of action and protocol development

    Directory of Open Access Journals (Sweden)

    Tatiana Helena Rech


    Full Text Available A parada cardiorrespiratória é um evento de alta mortalidade. A isquemia cerebral difusa relacionada ao hipofluxo cerebral frequentemente leva à injúria neurológica grave e ao desenvolvimento de estado vegetativo persistente. A hipotermia terapêutica representa um importante avanço no tratamento da encefalopatia anóxica pós-parada cardíaca. Seus efeitos neuroprotetores têm sido amplamente demonstrados em várias situações de isquemia neuronal. Apesar de ser um procedimento associado com redução de mortalidade nesses pacientes, a hipotermia ainda é um tratamento subutilizado no manejo da síndrome pós-ressuscitação. Nosso objetivo é revisar aspectos referentes aos mecanismos de ação da hipotermia e seus efeitos em pacientes críticos reanimados pós- parada cardiorrespiratória e propor um protocolo assistencial simples, que possa ser implantado em qualquer unidade de terapia intensiva.Cardiac arrest is a high mortality event and the associated brain ischemia frequently causes severe neurological damage and persistent vegetative state. Therapeutic hypothermia is an important tool for the treatment of post-anoxic coma after cardiopulmonary resuscitation. It has been shown to reduce mortality and to improve neurological outcomes after cardiac arrest. Nevertheless, hypothermia is underused in critical care units. This manuscript aims to review the hypothermia mechanism of action in cardiac arrest survivors and to propose a simple protocol, feasible to be implemented in any critical care unit.

  10. Approach/avoidance in dreams. (United States)

    Malcolm-Smith, Susan; Koopowitz, Sheri; Pantelis, Eleni; Solms, Mark


    The influential threat simulation theory (TST) asserts that dreaming yields adaptive advantage by providing a virtual environment in which threat-avoidance may be safely rehearsed. We have previously found the incidence of biologically threatening dreams to be around 20%, with successful threat avoidance occurring in approximately one-fifth of such dreams. TST asserts that threat avoidance is over-represented relative to other possible dream contents. To begin assessing this issue, we contrasted the incidence of 'avoidance' dreams with that of their opposite: 'approach' dreams. Because TST states that the threat-avoidance function is only fully activated in ecologically valid (biologically threatening) contexts, we also performed this contrast for populations living in both high- and low-threat environments. We find that 'approach' dreams are significantly more prevalent across both contexts. We suggest these results are more consistent with the view that dreaming is generated by reward-seeking systems than by fear-conditioning systems, although reward-seeking is clearly not the only factor determining the content of dreams.

  11. Automated analysis of background EEG and reactivity during therapeutic hypothermia in comatose patients after cardiac arrest. (United States)

    Noirhomme, Quentin; Lehembre, Rémy; Lugo, Zulay Del Rosario; Lesenfants, Damien; Luxen, André; Laureys, Steven; Oddo, Mauro; Rossetti, Andrea O


    Visual analysis of electroencephalography (EEG) background and reactivity during therapeutic hypothermia provides important outcome information, but is time-consuming and not always consistent between reviewers. Automated EEG analysis may help quantify the brain damage. Forty-six comatose patients in therapeutic hypothermia, after cardiac arrest, were included in the study. EEG background was quantified with burst-suppression ratio (BSR) and approximate entropy, both used to monitor anesthesia. Reactivity was detected through change in the power spectrum of signal before and after stimulation. Automatic results obtained almost perfect agreement (discontinuity) to substantial agreement (background reactivity) with a visual score from EEG-certified neurologists. Burst-suppression ratio was more suited to distinguish continuous EEG background from burst-suppression than approximate entropy in this specific population. Automatic EEG background and reactivity measures were significantly related to good and poor outcome. We conclude that quantitative EEG measurements can provide promising information regarding current state of the patient and clinical outcome, but further work is needed before routine application in a clinical setting.

  12. Promotion of Viral IRES-Mediated Translation Initiation under Mild Hypothermia.

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    Maria Licursi

    Full Text Available Internal ribosome entry site (IRES-mediated translation is an essential replication step for certain viruses. As IRES-mediated translation is regulated differently from cap-dependent translation under various cellular conditions, we sought to investigate whether temperature influences efficiency of viral IRES-mediated translation initiation by using bicistronic reporter constructs containing an IRES element of encephalomyocarditis virus (EMCV, foot-and-mouth disease virus (FMDV, hepatitis C virus (HCV, human rhinovirus (HRV or poliovirus (PV. Under mild hypothermic conditions (30 and 35°C, we observed increases in the efficiency of translation initiation by HCV and HRV IRES elements compared to translation initiation at 37°C. The promotion of HRV IRES activity was observed as early as 2 hours after exposure to mild hypothermia. We also confirmed the promotion of translation initiation by HRV IRES under mild hypothermia in multiple cell lines. The expression levels and locations of polypyrimidine tract-binding protein (PTB and upstream of N-Ras (unr, the IRES trans-acting factors (ITAFs of HCV and HRV IRES elements, were not modulated by the temperature shift from 37°C to 30°C. Taken together, this study demonstrates that efficiency of translation initiation by some viral IRES elements is temperature dependent.

  13. Nitric oxide in the nucleus raphe magnus modulates cutaneous blood flow in rats during hypothermia

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    Masoumeh Kourosh Arami


    Full Text Available Objective(s: Nucleus Raphe Magnus (NRM that is involved in the regulation of body temperature contains nitric oxide (NO synthase. Considering the effect of NO on skin blood flow control, in this study, we assessed its thermoregulatory role within the raphe magnus. Materials and Methods: To this end, tail blood flow of male Wistar rats was measured by laser doppler following the induction of hypothermia. Results: Intra-NRM injection of SNP (exogenous NO donor, 0.1- 0.2 μl, 0.2 nM increased the blood flow. Similarly, unilateral microinjection of glutamate (0.1- 0.2 μl, 2.3 nM into the nucleus increased the blood flow. This effectof L-glutamate was reduced by prior intra NRM administrationof NO synthase inhibitor NG-methyl-L-arginine or NG-nitro-L-argininemethyl ester (L-NAME, 0.1 µl, 100 nM. Conclusion: It is concluded that NO modulates the thermoregulatory response of NRM to hypothermia and may interactwith excitatory amino acids in central skin blood flow regulation.

  14. Mild Hypothermia Protects Pigs’ Gastric Mucosa After Cardiopulmonary Resuscitation via Inhibiting Interleukin 6 (IL-6) Production (United States)

    Wang, Yan; Song, Jian; Liu, Yuhong; Li, Yaqiang; Liu, Zhengxin


    Background The purpose of this study was to determine the effect of mild hypothermia therapy on gastric mucosa after cardiopulmonary resuscitation (CPR) and the underlying mechanism. Material/Methods Ventricular fibrillation was induced in pigs. After CPR, the surviving pigs were divided into mild hypothermia-treated and control groups. The changes in vital signs and hemodynamic parameters were monitored before cardiac arrest and at intervals of 0.5, 1, 2, 4, 6, 12, and 24 h after restoration of spontaneous circulation. Serum IL-6 was determined at the same time, and gastroscopy was performed. The pathologic changes were noted, and the expression of IL-6 was determined by hematoxylin and eosin (HE) staining and immunohistochemistry under light. Results The heart rate, mean arterial blood pressure, and cardiac output in both groups did not differ significantly. The gastric mucosa ulcer index evaluated by gastroscopy 2 h and 24 h after restoration of spontaneous circulation (ROSC) in the mild hypothermic group was lower than that the control group (Pgastric mucosa in the mild hypothermic group 6–24 h after ROSC was lower than that in the control group (Pgastric mucosa IL-6 expression 0.5–4 h and 6, 12, and 24 h after ROSC was lower in the mild hypothermic group than in the control group (Pgastric mucosa after ROSC via inhibiting IL-6 production and relieving the inflammatory reaction. PMID:27694796

  15. Promotion of Viral IRES-Mediated Translation Initiation under Mild Hypothermia (United States)

    Licursi, Maria; Carmona-Martinez, Ricardo A.; Razavi, Seyd; Hirasawa, Kensuke


    Internal ribosome entry site (IRES)-mediated translation is an essential replication step for certain viruses. As IRES-mediated translation is regulated differently from cap-dependent translation under various cellular conditions, we sought to investigate whether temperature influences efficiency of viral IRES-mediated translation initiation by using bicistronic reporter constructs containing an IRES element of encephalomyocarditis virus (EMCV), foot-and-mouth disease virus (FMDV), hepatitis C virus (HCV), human rhinovirus (HRV) or poliovirus (PV). Under mild hypothermic conditions (30 and 35°C), we observed increases in the efficiency of translation initiation by HCV and HRV IRES elements compared to translation initiation at 37°C. The promotion of HRV IRES activity was observed as early as 2 hours after exposure to mild hypothermia. We also confirmed the promotion of translation initiation by HRV IRES under mild hypothermia in multiple cell lines. The expression levels and locations of polypyrimidine tract-binding protein (PTB) and upstream of N-Ras (unr), the IRES trans-acting factors (ITAFs) of HCV and HRV IRES elements, were not modulated by the temperature shift from 37°C to 30°C. Taken together, this study demonstrates that efficiency of translation initiation by some viral IRES elements is temperature dependent. PMID:25951166

  16. Hypoxia-induced hypothermia mediated by the glutamatergic transmission in the lateral preoptic area. (United States)

    Osaka, T


    Hypoxia evokes a regulated decrease in the body core temperature, which response is mediated, at least in part, by noradrenaline (NA) and nitric oxide (NO) in the rostromedial preoptic area (POA) of the hypothalamus. In the accompanying paper, it was shown that glutamatergic activation of the lateral POA also evokes hypothermic responses. Here, I tested the hypothesis that the glutamatergic transmission in the lateral POA is critically involved in the neural mechanism of hypoxia-induced hypothermia. Hypoxic ventilation (10% O(2)-90% N(2), 5 min) as well as a single microinjection of NA (50 pmol) or the NO donor sodium nitroprusside (8.4 nmol) into the rostromedial POA evoked an increase in the tail skin temperature and a decrease in the colonic temperature in urethane-chloralose-anesthetized, neuromuscularly blocked, artificially ventilated rats. All of these responses were greatly attenuated by pretreatment with multiple microinjections of kynurenic acid (10 nmol, four locations), a nonselective glutamate receptor antagonist, but not by those with saline solution, in the bilateral rostral and central parts of the lateral POA. These results suggest that the NA- and NO-sensitive structure in the rostromedial POA activated the glutamatergic transmission in the lateral POA to mediate hypoxia-induced hypothermia.

  17. Preventing hypothermia in elective arthroscopic shoulder surgery patients: a protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Duff Jed


    Full Text Available Abstract Background Patients having arthroscopic shoulder surgery frequently experience periods of inadvertent hypothermia. This common perioperative problem has been linked to adverse patient outcomes such as myocardial ischaemia, surgical site infection and coagulopathy. International perioperative guidelines recommend patient warming, using a forced air warming device, and the use of warmed intraoperative irrigation solutions for the prevention of hypothermia in at-risk patient groups. This trial will investigate the effect of these interventions on patients’ temperature, thermal comfort, and total recovery time. Method/Design The trial will employ a randomised 2 x 2 factorial design. Eligible patients will be stratified by anaesthetist and block randomised into one of four groups: Group one will receive preoperative warming with a forced air warming device; group two will receive warmed intraoperative irrigation solutions; group three will receive both preoperative warming and warmed intraoperative irrigation solutions; and group four will receive neither intervention. Participants in all four groups will receive active intraoperative warming with a forced air warming device. The primary outcome measures are postoperative temperature, thermal comfort, and total recovery time. Primary outcomes will undergo a two-way analysis of variance controlling for covariants such as operating room ambient temperature and volume of intraoperative irrigation solution. Discussion This trial is designed to confirm the effectiveness of these interventions at maintaining perioperative normothermia and to evaluate if this translates into improved patient outcomes. Australian New Zealand Clinical Trials Registry number ACTRN12610000591055

  18. Neuroprognostication of hypoxic-ischaemic coma in the therapeutic hypothermia era. (United States)

    Greer, David M; Rosenthal, Eric S; Wu, Ona


    Neurological prognostication after cardiac arrest has always been challenging, and has become even more so since the advent of therapeutic hypothermia (TH) in the early 2000s. Studies in this field are prone to substantial biases--most importantly, the self-fulfilling prophecy of early withdrawal of life-sustaining therapies--and physicians must be aware of these limitations when evaluating individual patients. TH mandates sedation and prolongs drug metabolism, and delayed neuronal recovery is possible after cardiac arrest with or without hypothermia treatment; thus, the clinician must allow an adequate observation period to assess for delayed recovery. Exciting advances have been made in clinical evaluation, electrophysiology, chemical biomarkers and neuroimaging, providing insights into the underlying pathophysiological mechanisms of injury, as well as prognosis. Some clinical features, such as pupillary reactivity, continue to provide robust information about prognosis, and EEG patterns, such as reactivity and continuity, seem promising as prognostic indicators. Evoked potential information is likely to remain a reliable prognostic tool in TH-treated patients, whereas traditional serum biomarkers, such as neuron-specific enolase, may be less reliable. Advanced neuroimaging techniques, particularly those utilizing MRI, hold great promise for the future. Clinicians should continue to use all the available tools to provide accurate prognostic advice to patients after cardiac arrest.

  19. Rapid Assessment of Avoidable Blindness in India.

    Directory of Open Access Journals (Sweden)

    John Neena

    Full Text Available BACKGROUND: Rapid assessment of avoidable blindness provides valid estimates in a short period of time to assess the magnitude and causes of avoidable blindness. The study determined magnitude and causes of avoidable blindness in India in 2007 among the 50+ population. METHODS AND FINDINGS: Sixteen randomly selected districts where blindness surveys were undertaken 7 to 10 years earlier were identified for a follow up survey. Stratified cluster sampling was used and 25 clusters (20 rural and 5 urban were randomly picked in each district.. After a random start, 100 individuals aged 50+ were enumerated and examined sequentially in each cluster. All those with presenting vision = 50 years were enumerated, and 94.7% examined. Based on presenting vision,, 4.4% (95% Confidence Interval[CI]: 4.1,4.8 were severely visually impaired (vision<6/60 to 3/60 in the better eye and 3.6% (95% CI: 3.3,3.9 were blind (vision<3/60 in the better eye. Prevalence of low vision (<6/18 to 6/60 in the better eye was 16.8% (95% CI: 16.0,17.5. Prevalence of blindness and severe visual impairment (<6/60 in the better eye was higher among rural residents (8.2%; 95% CI: 7.9,8.6 compared to urban (7.1%; 95% CI: 5.0, 9.2, among females (9.2%; 95% CI: 8.6,9.8 compared to males (6.5%; 95% CI: 6.0,7.1 and people above 70 years (20.6%; 95% CI: 19.1,22.0 compared to people aged 50-54 years (1.3%; 95% CI: 1.1,1.6. Of all blindness, 88.2% was avoidable. of which 81.9% was due to cataract and 7.1% to uncorrected refractive errors/uncorrected aphakia. CONCLUSIONS: Cataract and refractive errors are major causes of blindness and low vision and control strategies should prioritize them. Most blindness and low vision burden is avoidable.

  20. Motive to Avoid Success, Locus of Control, and Reinforcement Avoidance. (United States)

    Katovsky, Walter

    Subjects were four groups of 12 college women, high or low in motive to avoid success (MAS) and locus of control (LC), were reinforced for response A on a fixed partial reinforcement schedule on three concept learning tasks, one task consisting of combined reward and punishment, another of reward only, and one of punishment only. Response B was…

  1. Hipotermia acidental em um país tropical Accidental hypothermia cases in a tropical country

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    Valdir Golin


    Full Text Available OBJETIVOS: Estudar a presença, forma de apresentação e as conseqüências da hipotermia em nosso meio. MÉTODOS: Estudo prospectivo em hipotérmicos atendidos no Serviço de Emergência de Clínica Médica da Santa Casa de São Paulo, com 212 pacientes com hipotermia leve, moderada e grave, entre 1987 a 2001, a maioria constituída por alcoólatras crônicos e moradores de rua. Foram analisados os resultados quanto ao sexo, faixa etária, temperatura central, eletrocardiograma, comorbidades e mortalidade. RESULTADOS: A hipotermia predominou no sexo masculino em 75,9%. Quanto à faixa etária prevaleceu a idade entre 30 e 59 anos. Em 70,3% dos pacientes a temperatura central foi inferior a 32ºC, sendo que em 26,4% destes, a temperatura foi menor que 28ºC. A associação com quadros infecciosos ocorreu em 76,8% dos casos. Os pacientes com hipotermia leve responderam melhor à terapêutica (96,8% quando comparados com os hipotérmicos moderados (72,1% e graves (87,5%. A onda de Osborn esteve presente em 42,6% dos pacientes. A mortalidade geral foi de 38,2%. CONCLUSÕES: A hipotermia acidental em serviços de emergência de país tropical é fato inegável. O socorrista deve estar atento e treinado para o reconhecimento desta doença de alta morbidade e mortalidade. A mortalidade aumenta com a presença de doenças associadas, particularmente processos infecciosos, desnutrição e alcoolismo crônico.OBJECTIVE: This paper has by objective to study the hypothermia's presence, presentation form and consequences in our environment. METHODS: A prospective study in hypothermic patients assisted in the Medical Clinic Emergency Service of Santa Casa of São Paulo, with 212 patients with mild, moderate and serious hypothermia from 1987 to 2001, the most part of them constituted by chronic alcoholics and homeless. The results were analyzed in reference to sex, age group, central temperature, electrocardiogram, co-morbidity and mortality. RESULTS: The

  2. L-NAME (N omega-nitro-L-arginine methyl ester), a nitric-oxide synthase inhibitor, and WIN 55212-2 [4,5-dihydro-2-methyl-4(4-morpholinylmethyl)-1-(1-naphthalenyl-carbonyl)-6H-pyrrolo[3,2,1ij]quinolin-6-one], a cannabinoid agonist, interact to evoke synergistic hypothermia. (United States)

    Rawls, S M; Tallarida, R J; Gray, A M; Geller, Ellen B; Adler, Martin W


    Cannabinoids evoke profound hypothermia in rats by activating central CB(1) receptors. Nitric oxide (NO), a prominent second messenger in central and peripheral neurons, also plays a crucial role in thermoregulation, with previous studies suggesting pyretic and antipyretic functions. Dense nitric-oxide synthase (NOS) staining and CB(1) receptor immunoreactivity have been detected in regions of the hypothalamus that regulate body temperature, suggesting that intimate NO-cannabinoid associations may exist in the central nervous system. The present study investigated the effect of N(omega)-nitro-L-arginine methyl ester (L-NAME), a NO synthase inhibitor, on the hypothermic response to WIN 55212-2 [4,5-dihydro-2-methyl-4(4-morpholinylmethyl)-1-(1-naphthalenylcarbonyl)-6H-pyrrolo[3,2,1ij]quinolin-6-one], a selective cannabinoid agonist, in rats. WIN 55212-2 (1-5 mg/kg, i.m.) produced dose-dependent hypothermia that peaked 45 to 90 min post-injection. L-NAME (10-100 mg/kg, i.m.) by itself did not significantly alter body temperature. However, a nonhypothermic dose of L-NAME (50 mg/kg) potentiated the hypothermia caused by WIN 55212-2 (0.5-5 mg/kg). The augmentation was strongly synergistic, indicated by a 2.5-fold increase in the relative potency of WIN 55212-2. The inactive enantiomer of WIN 55212-2, WIN 55212-3 [S-(-)-[2,3-dihydro-5-methyl-3-[(morpholinyl)methyl]pyrrolo[1,2,3-de]-1,4-benzoxazinyl]-(1-napthanlenyl) methanone mesylate] (5 mg/kg, i.m.), did not produce hypothermia in the absence or presence of L-NAME (50 mg/kg), confirming that cannabinoid receptors mediated the synergy. The present data are the first evidence that drug combinations of NOS blockers and cannabinoid agonists produce synergistic hypothermia. Thus, NO and cannabinoid systems may interact to induce superadditive hypothermia.

  3. C5a receptor (CD88) inhibition improves hypothermia-induced neuroprotection in an in vitro ischemic model. (United States)

    Thundyil, John; Pavlovski, Dale; Hsieh, Yu-Hsuan; Gelderblom, Mathias; Magnus, Tim; Fairlie, David P; Arumugam, Thiruma V


    The concept of 'salvageble penumbra' has prompted both scientists and physicians to explore various neuroprotective approaches that could be beneficial during stroke therapy. Unfortunately, most of them have proved ineffective in targeting multiple cellular death cascades incited within the ischemic penumbra. Hypothermia has been shown to be capable of addressing this problem to some extent. Although many studies have shown that hypothermia targets several cellular processes, its effects on innate immune receptor-mediated apoptotic death still remain unclear. Moreover, whether inhibiting the signaling of innate immune receptors like complement anaphylatoxin C5a receptor (CD88) plays a role in this hypothermic neuroprotection still need to be deciphered. Using various types of ischemic insults in different neuronal cells, we confirm that hypothermia does indeed attenuate apoptotic neuronal cell death in vitro and this effect can be further enhanced by pharmacologically blocking or knocking out CD88. Thus, our study raises a promising therapeutic possibility of adding CD88 antagonists along with hypothermia to improve stroke outcomes.

  4. Excitatory amino acid changes in the brains of rhesus monkeys following selective cerebral deep hypothermia and blood flow occlusion

    Institute of Scientific and Technical Information of China (English)

    Jun Pu; Xiaoqun Niu; Jizong Zhao


    Selective cerebral deep hypothermia and blood flow occlusion can enhance brain tolerance to ischemia and hypoxia and reduce cardiopulmonary complications in monkeys. Excitotoxicity induced by the release of a large amount of excitatory amino acids after cerebral ischemia is the major mechanism underlying ischemic brain injury and nerve cell death. In the present study, we used selective cerebral deep hypothermia and blood flow occlusion to block the bilateral common carotid arteries and/or bilateral vertebral arteries in rhesus monkey, followed by reperfusion using Ringer's solution at 4°C. Microdialysis and transmission electron microscope results showed that selective cerebral deep hypothermia and blood flow occlusion inhibited the release of glutamic acid into the extracellular fluid in the brain frontal lobe and relieved pathological injury in terms of the ultrastructure of brain tissues after severe cerebral ischemia. These findings indicate that cerebral deep hypothermia and blood flow occlusion can inhibit cytotoxic effects and attenuate ischemic/ hypoxic brain injury through decreasing the release of excitatory amino acids, such as glutamic acid.

  5. Fos-like immunoreactivity in Siberian hamster brain during initiation of torpor-like hypothermia induced by 2DG. (United States)

    Park, Jin Ho; Dark, John


    Systemic 2-deoxy-d-glucose (2DG) produces pronounced torpor-like hypothermia (notSiberian hamster. Siberian hamsters are heterothermic, naturally undergoing photoperiod-dependent torpor during winter-like photoperiods. Fos was used to identify neural structures activated during the initiation of torpor-like hypothermia induced by 2DG treatment. The Fos-like immunoreactivity (Fos-li) in the area postrema and nucleus of the solitary tract that predominantly characterizes other 2DG-induced responses was absent during 2DG-induced torpor in the present experiment. Fos-li was seen in a number of forebrain and hindbrain sites during entry into hypothermia, but the densest Fos-li was found in the parvocellular portion of the paraventricular nucleus. Fos-li in the medial nucleus of the amygdala and the dorsal lateral septum also distinguished 2DG-induced torpor from other 2DG-induced behaviors. The possible involvement of neuropeptide Y pathways during 2DG-induced expression of reversible hypothermia is discussed.

  6. Mild hypothermia combined with neural stem cell transplantation for hypoxic-ischemic encephalopathy:neuroprotective effects of combined therapy

    Institute of Scientific and Technical Information of China (English)

    Lin Wang; Feng Jiang; Qifeng Li; Xiaoguang He; Jie Ma


    Neural stem cell transplantation is a useful treatment for ischemic stroke, but apoptosis often occurs in the hypoxic-ischemic environment of the brain after cell transplantation. In this study, we determined if mild hypothermia (27-28°C) can increase the survival rate of neural stem cells (1.0 × 105 /μL) transplanted into neonatal mice with hypoxic-ischemic encephalopathy. Long-term effects on neurological functioning of the mice were also examined. After mild hy-pothermia combined with neural stem cell transplantation, we observed decreased expression levels of inflammatory factor nuclear factor-kappa B and apoptotic factor caspase-3, reduced cerebral infarct volumes, increased survival rate of transplanted cells, and marked improvements in neurological function. Thus, the neuroprotective effects of mild hypothermia combined with neural stem cell transplantation are superior to those of monotherapy. Moreover, our ifndings suggest that the neuroprotective effects of mild hypothermia combined with neural stem cell transplantation on hypoxic-ischemic encephalopathy are achieved by anti-inlfammatory and an-ti-apoptotic mechanisms.

  7. Wireless vehicular networks for car collision avoidance

    CERN Document Server


    Wireless Vehicular Networks for Car Collision Avoidance focuses on the development of the ITS (Intelligent Transportation Systems) in order to minimize vehicular accidents. The book presents and analyses a range of concrete accident scenarios while examining the causes of vehicular collision and proposing countermeasures based on wireless vehicular networks. The book also describes the vehicular network standards and quality of service mechanisms focusing on improving critical dissemination of safety information. With recommendations on techniques and protocols to consider when improving road safety policies in order to minimize crashes and collision risks.

  8. Avoiding plagiarism in academic writing. (United States)

    Anderson, Irene

    Plagiarism means taking the work of another and presenting it as one's own, resulting in potential upset for the original author and disrepute for the professions involved. This article aims to explore the issue of plagiarism and some mechanisms for detection and avoidance.

  9. Avoiding unfavourable outcomes in liposuction

    Directory of Open Access Journals (Sweden)

    Atul Khanna


    Full Text Available The origin of liposuction can be traced to an adverse event by Dujarrier in 1921 when he used a uterine curette to remove fat from the knees of a ballerina ending in an amputation secondary to damage of the femoral artery. The history of liposuction since then has been one of avoiding complications and optimising outcome. After this adverse event, liposuction was abandoned until the 1960′s when Schrudde revived the practice using small stab incisions and sharp curettage with the secondary suction to aspirate the freed tissue. This technique was associated with a high incidence of complications especially seroma and skin necrosis. Illouz then replaced the curette with a blunt cannula connected to vacuum pump thus avoiding the complications of a sharp curette. Despite the presence of various techniques for liposuction, suction assisted liposuction (SAL is still the standard technique of liposuction. This article aims to discuss literature regarding the various aspects of liposuction (SAL and to highlight the salient points in the literature and in the senior author′s experience in order to avoid unfavourable outcomes in liposuction. A literature review on avoiding complication is in liposuction including some of the seminal papers on liposuction. Liposuction is generally a safe procedure with reproducible outcome. Just like any surgical procedure it should be treated with the utmost care. Illouz published 10 commandments for liposuction in 1989 and we review these commandments to demonstrate how liposuction has evolved.

  10. Multiobjective Optimization Based Vessel Collision Avoidance Strategy Optimization

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    Qingyang Xu


    Full Text Available The vessel collision accidents cause a great loss of lives and property. In order to reduce the human fault and greatly improve the safety of marine traffic, collision avoidance strategy optimization is proposed to achieve this. In the paper, a multiobjective optimization algorithm NSGA-II is adopted to search for the optimal collision avoidance strategy considering the safety as well as economy elements of collision avoidance. Ship domain and Arena are used to evaluate the collision risk in the simulation. Based on the optimization, an optimal rudder angle is recommended to navigator for collision avoidance. In the simulation example, a crossing encounter situation is simulated, and the NSGA-II searches for the optimal collision avoidance operation under the Convention on the International Regulations for Preventing Collisions at Sea (COLREGS. The simulation studies exhibit the validity of the method.

  11. Influence of hypothermia, barbiturate therapy, and intracranial pressure monitoring on morbidity and mortality after near-drowning. (United States)

    Bohn, D J; Biggar, W D; Smith, C R; Conn, A W; Barker, G A


    We retrospectively evaluated the clinical and pathologic effects of hypothermia and high-dose barbiturate therapy on hypoxic/ischemic cerebral injury after near-drowning in children. Of 40 near-drowned patients admitted to the ICU, 13 died, seven had permanent cerebral damage, and 20 survived. Twenty-four patients (group 1) were treated with a regime of hyperventilation, hypothermia, and high-dose phenobarbitone while intracranial pressure (ICP) was continuously monitored. Of ten who died in this group, three were diagnosed as having cerebral death shortly after admission; autopsy revealed severe cerebral edema with herniation. The remaining seven nonsurvivors had severe cerebral hypoxia without raised ICP and had the features of severe adult respiratory distress syndrome and hypoxic/ischemic damage to other organs. Six of these seven patients developed septicemia which was invariably associated with a profound neutropenia. Sixteen patients (group 2) were treated with a similar protocol but without hypothermia. Three of these patients died but only one developed septicemia. Neutropenia after resuscitation from near-drowning seemed to indicate a poor prognosis; the mean polymorphonuclear leukocyte count in nonsurvivors (1.9 +/- 0.5 X 10(9) cell/L) was significantly (p less than .01) lower than that in survivors (6.4 +/- 1.1 X 10(9) cell/L). Hypothermia was associated with a decreased number of circulating PMNs but did not increase the number of neurologically intact survivors. Similarly, although barbiturates may control ICP, their use did not improve outcome. Because severe cerebral edema and herniation after near-drowning is usually associated with irreversible brain damage, measures to control brain swelling such as hypothermia and barbiturates will be of little benefit.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Hypothermia on admission: a risk factor for death in newborns referred to the Pernambuco Institute of Mother and Child Health. (United States)

    da Mota Silveira, Suzana Maria; Gonçalves de Mello, Maria Júlia; de Arruda Vidal, Suely; de Frias, Paulo Germano; Cattaneo, Adriano


    The objective of this study was to determine the mortality risk related to hypothermia at the moment of admission and other factors such as clinical and geographical related to the transportation of the newborns admitted to the Instituto Materno Infantil de Pernambuco IMIP from 8 March to 11 June 2000. A prospective study involving 320 newborns arriving from home or health centres was carried out. Babies that were dead on arrival or subsequently transferred to other units were excluded. The risk of death was determined according to exposure to hypothermia and other types of exposure, using logistical regression. The risk of death was higher (RR = 3.09; CI = 2.15-4.43) in the group exposed to moderate hypothermia (temperature between 32.5 degrees C and 35.99 degrees C) than in the non-exposed group (temperature equal to or greater than 36.00 degrees C). The relative risk of death was also higher for newborns with a weight of less than 2500 g, that were less than 1 day old, respiratory distress syndrome, premature babies or with congenital malformations, that had used oxygen and/or intravenous infusion during transit, that came from the interior and that had travelled more than 150 km. In the final result of the multivariate analysis, sepsis ('adjusted' RO = 6.23; 95% CI = 5.66-6.80), respiratory distress syndrome ('adjusted' RO = 5.28; 95% CI = 5.03-5.59), moderate hypothermia ('adjusted' RO = 3.49, 95% CI = 3.18-3.81), and distance undertaken greater than 50 km ('adjusted' RO = 2.39; 95% CI = 2.14-2.63) remained. Hypothermia on admission showed itself to be an important and independent risk factor for neonatal death.

  13. Summary of avoidable cancers in the Nordic countries

    DEFF Research Database (Denmark)

    Olsen, J H; Andersen, A; Dreyer, L


    An overview is given of the most important known causes of cancer in the five Nordic countries and the resulting number of cancers that are potentially avoidable. The main causes include active and passive smoking, alcohol consumption, exposure to asbestos and other occupational carcinogens, solar...

  14. Hypothermia postpones DNA damage repair in irradiated cells and protects against cell killing

    Energy Technology Data Exchange (ETDEWEB)

    Baird, Brandon J.; Dickey, Jennifer S.; Nakamura, Asako J.; Redon, Christophe E.; Parekh, Palak [Laboratory of Molecular Pharmacology, CCR, NCI, Bethesda, MD 20892 (United States); Griko, Yuri V. [Radiation and Space Biotechnology Branch, NASA Ames Research Center, Moffett Field, CA 94035 (United States); Aziz, Khaled; Georgakilas, Alexandros G. [Biology Department, East Carolina University, Greenville, NC 27858 (United States); Bonner, William M. [Laboratory of Molecular Pharmacology, CCR, NCI, Bethesda, MD 20892 (United States); Martin, Olga A., E-mail: [Laboratory of Molecular Pharmacology, CCR, NCI, Bethesda, MD 20892 (United States)


    Hibernation is an established strategy used by some homeothermic organisms to survive cold environments. In true hibernation, the core body temperature of an animal may drop to below 0 {sup o}C and metabolic activity almost cease. The phenomenon of hibernation in humans is receiving renewed interest since several cases of victims exhibiting core body temperatures as low as 13.7 {sup o}C have been revived with minimal lasting deficits. In addition, local cooling during radiotherapy has resulted in normal tissue protection. The experiments described in this paper were prompted by the results of a very limited pilot study, which showed a suppressed DNA repair response of mouse lymphocytes collected from animals subjected to 7-Gy total body irradiation under hypothermic (13 {sup o}C) conditions, compared to normothermic controls. Here we report that human BJ-hTERT cells exhibited a pronounced radioprotective effect on clonogenic survival when cooled to 13 {sup o}C during and 12 h after irradiation. Mild hypothermia at 20 and 30 {sup o}C also resulted in some radioprotection. The neutral comet assay revealed an apparent lack on double strand break (DSB) rejoining at 13 {sup o}C. Extension of the mouse lymphocyte study to ex vivo-irradiated human lymphocytes confirmed lower levels of induced phosphorylated H2AX ({gamma}-H2AX) and persistence of the lesions at hypothermia compared to the normal temperature. Parallel studies of radiation-induced oxidatively clustered DNA lesions (OCDLs) revealed partial repair at 13 {sup o}C compared to the rapid repair at 37 {sup o}C. For both {gamma}-H2AX foci and OCDLs, the return of lymphocytes to 37 {sup o}C resulted in the resumption of normal repair kinetics. These results, as well as observations made by others and reviewed in this study, have implications for understanding the radiobiology and protective mechanisms underlying hypothermia and potential opportunities for exploitation in terms of protecting normal tissues against

  15. Hepatic confinement of newly produced erythrocytes caused by low-temperature exposure in Xenopus laevis. (United States)

    Maekawa, Shun; Iemura, Hitomi; Kuramochi, Yuko; Nogawa-Kosaka, Nami; Nishikawa, Hironori; Okui, Takehito; Aizawa, Youichi; Kato, Takashi


    Diminished erythrocyte count and erythropoiesis have been reported during hypothermia in some ectothermic animals. In this study, the African clawed frog, Xenopus laevis, was used to investigate the cause of hypothermia-induced anemia. We developed a new model of hypothermia at 5°C and monitored blood cell count and erythropoiesis on several days. Erythrocyte count declined by 30% on the first day following cold exposure (5°C) and mRNA expression of hemeoxygenase-1 was enhanced 10-fold; accumulation of iron as a result of heme degradation was observed in the liver. One day after low-temperature exposure, erythropoietin mRNA expression was elevated in the liver and lung compared with that at normal temperature (22°C) by qRT-PCR analysis. Examination of liver sections (i.e. the erythropoietic organ) showed an increase in o-dianisidine-positive erythrocytes in the hepatic sinusoid 5 days after the onset of low-temperature exposure compared with normal liver. Peripheral erythrocyte count remained low, indicating that newly produced erythrocytes did not migrate from the liver to the circulation during hypothermia. In conclusion, this study reveals hypothermic anemia as being associated with hepatic erythrocyte destruction; prolonged anemia during low-temperature exposure is concomitant with newly produced erythrocytes being confined to the liver and may lead to new insights into vertebrate hematopoiesis.

  16. Radioprotective effect of mild hypothermia versus amifostine on acute radiation injury in mice%亚低温与氨磷汀对辐照后小鼠辐射防护作用的比较

    Institute of Scientific and Technical Information of China (English)

    王新钢; 李曙芳; 王永丽; 黄立群; 岳娟; 安全; 闻建华


    不影响小鼠的健康状况,亚低温在机体早期抗氧化及调整细胞周期方面有更好的防护效果,而氨磷汀能更快地提高骨髓有核细胞数。%Objective Amifostine, as a pan-cell radioprotective agent , has gained a clinical application in radiotherapy and chemotherapy , but may cause quite a few adverse reactions .This study aims to compare the effects of mild hypothermia and amifostine on radiation-induced injury in mice . Methods A total of 175 BALB/C male mice were randomly divided into 5 groups of equal num-ber:normal control, mild hypothermia alone, irradiation alone, amifostine, and mild hypothermia.The animals in the irradiation a-lone, mild hypothermia, and amifostine groups were exposed to whole body irradiation of 60Coγray at 6 Gy, those in the mild hypother-mia group treated with mild hypothermia for 6 hours immediately after irradiation , those in the mild hypothermia alone group intervened with mild hypothermia for 6 hours after sham irradiation , and those in the amifostine group injected intraperitoneally with amifostine at 0.5 hour before irradiation .Then, we observed histopathological changes in the bone marrow , counted the nucleated cells in the bone marrow at 1, 3, 7, 14, 21, and 28 days after irradiation , measured the content of malondiadehyde ( MDA) and the activity of superoxide dismutase enzyme ( SOD) and glutathione peroxidase enzyme ( GSH-px) in the serum, and detected the cell cycle in the bone marrow at 6 and 24 hours after irradiation . Results There were no statistically significant differences between the normal control and mild hypother-mia alone groups ( P>0.05) .The numbers of nucleated cells were markedly lower in the mild hypothermia than in the amifostine group at 3 days ([25±1] vs [79±6]×107, P0.05 ) . Conclusion Mild hypothermia does not affect the health of mice and plays a better role than amifostine in protecting the body against oxidation and adjusting the bone marrow cell cycle in the

  17. Obstacle Avoidance Through Visual Teleoperation

    Directory of Open Access Journals (Sweden)

    Muhammad Usman Keerio


    Full Text Available This paper presents a novel controlling approach forHumanoid Robot to work safely in critical situations like badlight environment using Visual Teleoperation. In this regardmodeling environments for Humanoid Teleoperation Systemis developed. Here virtual reality modeling environmentincludes development of virtual Humanoid BHR-2, andvirtual objects like table etc. The main goal of this work is toenhance our visual teleoperation system for BHR-2 in orderto avoid any collision during real time operation. SoftwareMaya is used for modeling and simulations. Maya plug-insin VC++ provides efficient modeling rule, real timeinteraction, and time saving rendering approach in a virtualenvironment. In this paper the validity of proposed scheme isshown by conducting experiments using offline step overtrajectory to avoid obstacle in bad light environment.

  18. Consumer Privacy and Marketing Avoidance


    Il-Horn Hann; Kai-Lung Hui; Sang-Yong Tom Lee; Ivan Png


    We introduce consumer avoidance into analytical marketing research. We show that consumer efforts to conceal themselves and to deflect marketing have a crucial impact on sellers¡¯ marketing strategy. Under reasonable conditions, seller marketing is a strategic complement with consumer concealment. Hence, consumer measures to conceal themselves from marketing will increase its cost-effectiveness and lead sellers to market more. Policies that encourage consumers to conceal their identities woul...

  19. Effect of ultra-fast mild hypothermia using total liquid ventilation on hemodynamics and respiratory mechanics. (United States)

    Sage, Michaël; Nadeau, Mathieu; Kohlhauer, Matthias; Praud, Jean-Paul; Tissier, Renaud; Robert, Raymond; Walti, Hervé; Micheau, Philippe


    Ultra-fast cooling for mild therapeutic hypothermia (MTH) has several potential applications, including prevention of post-cardiac arrest syndrome. Ultra-fast MTH by total liquid ventilation (TLV) entails the sudden filling of the lungs with a cold perfluorocarbon liquid and its subsequent use to perform TLV. The present physiological study was aimed at assessing whether pulmonary and systemic hemodynamics as well as lung mechanics are significantly altered during this procedure. Pulmonary and systemic arterial pressures, cardiac output as well as airway resistance and respiratory system compliance were measured during ultra-fast MTH by TLV followed by rewarming and normothermia in six healthy juvenile lambs. Results show that none of the studied variables were altered upon varying the perfluorocarbon temperature from 12 to 41 °C. It is concluded that ultra-fast MTH by TLV does not have any deleterious effect on hemodynamics or lung mechanics in healthy juvenile lambs.

  20. The ability of different thermal aids to reduce hypothermia in neonatal piglets

    DEFF Research Database (Denmark)

    Pedersen, Lene Juul; Larsen, Mona Lilian Vestbjerg; Malmkvist, Jens


    different combinations of flooring (solid vs. slatted) and treatments: control, with no additional thermal aids on a solid floor (n = 26) or a slatted floor (n = 26); built-in floor heating (n = 31) or floor heating as a radiant floor plate on solid floor (FloorPlate; n = 19); radiant heater above a solid......We investigated whether hypothermia in newborn piglets could be reduced by applying different thermal aids. The experiment was performed on 150 newborn piglets from 24 sows. Right after birth, the piglets were moved to a wire mesh cage for the first 2 h of life where they experienced 1 of 7...... floor (RadiantC; n = 22) or a slatted floor (RadiantSlat; n = 18); and provision of straw on a solid floor (Straw; n = 8). Piglets’ rectal temperature was measured both continuously and manually every 10 min for the first 2 h after birth using a thermal sensor inserted in the rectum of the piglets...

  1. Mild to moderate hypothermia: the hope for improving outcome of severe head injured patients

    Institute of Scientific and Technical Information of China (English)


    @@Traumatic brain injury (TBI) is a major public health problem throughout the worl d. More than 400000 patients with TBI in the United States of America and more than a million patients with TBI in China are admitted to hospital every ye ar. Head trauma is also No.1 killer of young people in the developed countries as well a s in some developing countries. Unfortunately, the outcome of patients with seve re TBI is still poor all over the world. The mortality of severe TBI patients (G CS 3-8) in majority of hospitals is over 30% and very severe TBI patients (GCS 3-5) is over 80% with only 15% functional recovery.1,2 However, recent ad vance in cerebral protection by mild (35-33℃) to moderate hypothermia (32-30 ℃) is certainly encouraging, which brings neurosurgeons the hope to improve the outcome of severe head injured patients.

  2. Automatic control system of brain temperature by air-surface cooling for therapeutic hypothermia. (United States)

    Utsuki, T


    An automatic control system of brain temperature by air-surface cooling was developed for therapeutic hypothermia, which is increasingly recommended for hypoxic-ischemic encephalopathy after cardiac arrest and neonatal asphyxia in several guidelines pertinent to resuscitation. Currently, water-surface cooling is the most widespread cooling method in therapeutic hypothermia. However, it requires large electric power for precise control and also needs water-cooling blankets which have potential for compression of patients by its own weight and for water leakage in ICU. Air-surface cooling does not have such problems and is more suitable for clinical use than water-surface cooling, because air has lower specific heat and density as well as the impossibility of the contamination in ICU by its leakage. In the present system, brain temperature of patients is automatically controlled by suitable adjustment of the temperature of the air blowing into the cooling blankets. This adjustment is carried out by the regulation of mixing cool and warm air using proportional control valves. The computer in the developed control apparatus suitably calculates the air temperature and rotation angle of the valves every sampling time on the basis of the optimal-adaptive control algorithm. Thus, the proposed system actualizes automatic control of brain temperature by the inputting only the clinically desired temperature of brain. The control performance of the suggested system was verified by the examination using the mannequin in substitution for an adult patient. In the result, the control error of the head temperature of the mannequin was 0.12 °C on average in spite of the lack of the production capacity of warm air after the re-warming period. Thus, this system serves as a model for the clinically applied system.

  3. Effects of anesthesia-induced modest hypothermia on cellular radiation sensitivity

    Institute of Scientific and Technical Information of China (English)

    XIANG; Yingsong(项莺松); TANG; Gusheng(唐古生); XU; Xiongfei(许熊飞); YANG; Rujun(杨如俊); CAI; Jianming(蔡建明); ZHANG; Minghui(张明辉); CAO; Xuetao(曹雪涛)


    To assess the mechanisms of modest hypothermia(MH) and its effects on cellular radiation response, a model of anesthesia-induced modest hypothermia(AIMH) in the adult mice and a model of pure MH in the newborn mice were established. The survival rate of lethally irradiated mice was increased to 72% through AIMH before irradiation. Both apoptosis and necrosis of human fetal bone marrow CD34+ hematopoietic stem cells cultured under MH were significantly decreased as detected by MTT and flow cytometry, with three-color labeled by PE-CD34+/ FITC-AnnexinV /7AAD. The survival and proliferation of mouse bone marrow MNC treated with MH after irradiation were also increased. The MH exerted similar protective effects on the leukemia cell lines A20, HL60, K562 to the normal bone marrow cells, but it enhanced the radiation sensitivity of leukemia cell line FBL3 and mouse melanoma B16F10. No effects have been found on the radiation sensitivity of those cells treated with MH before irradiation. The results also showed that MH mediated the effects on radiation sensitivity, in addition to increasing the oxygen tension. These results show different effects of MH on different cells:(i) AIMH exerts a protective effect on the normal hematopoietic stem cells, some leukemia cell lines A20, HL60, K562, and some neoplasma 3LL, LOVO. And MH exhibits a synthetic effect with anesthetic.(ii) MH enhances the radiation sensitivity of another leukemia and neoplasma cell lines FBL3, B16F10 and CT26. Therefore, AIMH has a potential to enhance the effects of radiation-therapy and decrease side effects on some tumors.

  4. Spectral analysis-based risk score enables early prediction of mortality and cerebral performance in patients undergoing therapeutic hypothermia for ventricular fibrillation and comatose status



    Background: Early prognosis in comatose survivors after cardiac arrest due to ventricular fibrillation (VF) is unreliable, especially in patients undergoing mild hypothermia. We aimed at developing a reliable risk-score to enable early prediction of cerebral performance and survival. Methods: Sixty-one out of 239 consecutive patients undergoing mild hypothermia after cardiac arrest, with eventual return of spontaneous circulation (ROSC), and comatose status on admission fulfilled the inclu...

  5. Mild therapeutic hypothermia in patients resuscitated from out-of-hospital cardiac arrest: A meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Pedro A Villablanca


    Full Text Available Aims: Guidelines recommend mild therapeutic hypothermia (MTH for survivors of out-of-hospital cardiac arrest (OHCA. However, there is little literature demonstrating a survival benefit. We performed a meta-analysis of randomized controlled trials (RCTs assessing the efficacy of MTH in patients successfully resuscitated from OHCA. Materials and Methods: Electronic databases were searched for RCT involving MTH in survivors of OHCA, and the results were put through a meta-analysis. The primary endpoint was all-cause mortality, and the secondary endpoint was favorable neurological function. Odds ratios (ORs and 95% confidence intervals (CIs were computed using the Mantel-Haenszel method. A fixed-effect model was used and, if heterogeneity (I2 was >40, effects were analyzed using a random model. Results: Six RCT (n = 1400 patients were included. Overall survival was 50.7%, and favorable neurological recovery was 45.5%. Pooled data demonstrated no significant all-cause mortality (OR, 0.81; 95% CI 0.55-1.21 or neurological recovery (OR, 0.77; 95% CI 0.47-1.24. No evidence of publication bias was observed. Conclusion: This meta-analysis demonstrated that MTH did not confer benefit on overall survival rate and neurological recovery in patients resuscitated from OHCA.

  6. Mild hypothermia attenuates changes in respiratory system mechanics and modifies cytokine concentration in bronchoalveolar lavage fluid during low lung volume ventilation. (United States)

    Dostál, P; Senkeřík, M; Pařízková, R; Bareš, D; Zivný, P; Zivná, H; Cerný, V


    Hypothermia was shown to attenuate ventilator-induced lung injury due to large tidal volumes. It is unclear if the protective effect of hypothermia is maintained under less injurious mechanical ventilation in animals without previous lung injury. Tracheostomized rats were randomly allocated to non-ventilated group (group C) or ventilated groups of normothermia (group N) and mild hypothermia (group H). After two hours of mechanical ventilation with inspiratory fraction of oxygen 1.0, respiratory rate 60 min(-1), tidal volume 10 ml x kg(-1), positive end-expiratory pressure (PEEP) 2 cm H2O or immediately after tracheostomy in non-ventilated animals inspiratory pressures were recorded, rats were sacrificed, pressure-volume (PV) curve of respiratory system constructed, bronchoalveolar lavage (BAL) fluid and aortic blood samples obtained. Group N animals exhibited a higher rise in peak inspiratory pressures in comparison to group H animals. Shift of the PV curve to right, higher total protein and interleukin-6 levels in BAL fluid were observed in normothermia animals in comparison with hypothermia animals and non-ventilated controls. Tumor necrosis factor-alpha was lower in the hypothermia group in comparison with normothermia and non-ventilated groups. Mild hypothermia attenuated changes in respiratory system mechanics and modified cytokine concentration in bronchoalveolar lavage fluid during low lung volume ventilation in animals without previous lung injury.

  7. Jam avoidance with autonomous systems

    CERN Document Server

    Tordeux, Antoine


    Many car-following models are developed for jam avoidance in highways. Two mechanisms are used to improve the stability: feedback control with autonomous models and increasing of the interaction within cooperative ones. In this paper, we compare the linear autonomous and collective optimal velocity (OV) models. We observe that the stability is significantly increased by adding predecessors in interaction with collective models. Yet autonomous and collective approaches are close when the speed difference term is taking into account. Within the linear OV models tested, the autonomous models including speed difference are sufficient to maximise the stability.

  8. Critical temperature ranges of hypothermia-induced platelet activation: possible implications for cooling patients in cardiac surgery. (United States)

    Straub, Andreas; Breuer, Melanie; Wendel, Hans P; Peter, Karlheinz; Dietz, Klaus; Ziemer, Gerhard


    Cooling of the patient is routinely applied in cardiac surgery to protect organs against ischemia. Hypothermia induces activation of platelets, but the effects of temperatures such as used during cardiac surgery are not well described. To investigate this in an in-vitro study heparinized whole blood was incubated at different temperatures (37 degrees C, 34.5 degrees C, 32 degrees C, 29.5 degrees C, 27 degrees C, 24.5 degrees C, 22 degrees C, 19.5 degrees C and 17 degrees C). The effect of these temperatures on aggregation, P-selectin expression, GP IIb/IIIa activation and platelet microparticle (PMP) formation of unstimulated and ADP-stimulated platelets of 36 subjects was evaluated in flow cytometry. A four-parametric logistic model was fitted to depict the temperature effect on platelet parameters. Lower temperatures increased aggregates, P-selectin expression, and GP IIb/IIIa activation. The number of PMPs decreases with hypothermia. Additional experiments revealed a slight influence of heparin on platelet P-selectin expression but excluded an effect of this anticoagulant on the other evaluated parameters. Threshold temperatures, which mark 5% changes of platelet parameters compared to values at 37 degrees C, were calculated. On ADP-stimulated platelets the thresholds for P-selectin expression and GP IIb/IIa activation are 34.0 degrees C and 36.4 degrees C, respectively, and lie in the temperature range routinely applied in cardiac surgery. Hypothermia-induced platelet activation may develop in most patients undergoing cardiac surgery, possibly resulting in thromboembolic events, coagulation defects, and proinflammatory leukocyte bridging by P-selectin bearing platelets and PMPs. These findings suggest that pharmacological protection of platelets against hypothermia-induced damage may be beneficial during cardiac surgery.

  9. Avoidable cancers in the Nordic countries. Radiation

    DEFF Research Database (Denmark)

    Winther, J F; Ulbak, Kaare; Dreyer, L;


    Exposure to solar and ionizing radiation increases the risk for cancer in humans. Some 5% of solar radiation is within the ultraviolet spectrum and may cause both malignant melanoma and non-melanocytic skin cancer; the latter is regarded as a benign disease and is accordingly not included in our......, it was estimated that the exposure of the Nordic populations to natural sources of ionizing radiation other than radon and to medical sources will each give rise to an annual total of 2120 cancers at various sites. For all types of ionizing radiation, the annual total will be 4420 cancer cases, or 3.9% of all...... estimation of avoidable cancers. Under the assumption that the rate of occurrence of malignant melanoma of the buttocks of both men and women and of the scalp of women would apply to all parts of the body in people completely unexposed to solar radiation, it was estimated that approximately 95% of all...

  10. Collision Avoidance of Trains Using Arm7

    Directory of Open Access Journals (Sweden)

    Dr. K. R. R. Mohan Rao


    Full Text Available Railways are the popular mode of Transport in almost all major cities of the World. Railways are the most widely used and comfortable modes of transportation system. The major cause for railway accidents is collision of trains on the same track. The main aim of this anti collision system is to identify collision points and to report these error cases to main control room nearer to the station as well as grid control station. Majority of accidents occurred due to improper communication among the network between drivers and control room, due to wrong signaling, worst atmospheric condition, immediate change of route. The train driver doesn’t get proper information in time leading to hazardous situations. So this system by using zigbee protocol provides communication in between trains, which provide information or track id of one train to another train to avoid collision.

  11. The Effectiveness of Local Hypothermia and Peritoneal Lavage-Dialysis in the Treatment of Patients with Acute Destructive Pancreatitis

    Directory of Open Access Journals (Sweden)

    Veniamin I. Shaposhnikov, PhD, ScD


    Full Text Available The aim of this study was to improve the principles of the pathogenetic therapy of acute pancreatitis and assess the effectiveness of local hypothermia of the pancreas, as well as peritoneal lavage-dialysis in the treatment of acute destructive pancreatitis. A total of 5889 patients with acute pancreatitis (AP were examined. The leading role played by the lesions of the pancreatic lymphatic system in the development of destructive processes was noted. In experiments done on eight dogs, the first day of experimental acute pancreatitis showed necrosis of the lumbar retroperitoneal lymph nodes with a violation of lymph drainage from the pancreas before the retroperitoneal fat necrosis was initiated. The effectiveness of local hypothermia of the pancreas was experimentally demonstrated. In 32 patients with AP, the perioperative local hypothermia of the pancreas for 20-25 minutes was followed by the reduction of the alpha-amylase activity in the peripheral blood and in the portal system, as well as a significant reduction in the edema of the pancreas, that delayed the progression of the destructive lesions. An effective method of performing lavage-dialysis of the omental bursa, by using a transversely perforated tube with a pollution control device in the lumen, was developed.

  12. Effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury

    Institute of Scientific and Technical Information of China (English)

    WANG Qiong; LI Ai-lin; ZHI Da-shi; HUANG Hui-ling


    Objective:To study the effect of mild hypothermia on glucose metabolism and glycerol of brain tissue in patients with severe traumatic brain injury (STBI) using clinical microdialysis.Methods: Thirty-one patients with STBI ( GCS ≤8) were randomly divided into hypothermic group (Group A) and control group (Group B). Microdialysis catheters were inserted into the cerebral cortex of perilesional and normal brain tissue. All samples were analyzed using CMA microdialysis analyzer.Results: In comparison with the control group, lactate/glucose ratio ( L/G) , lactate/pyruvate ratio ( L/P) and glycerol (Gly) in perilensional tissue were significantly decreased; L/P in normal brain tissue was significantly decreased. In control group, L/G, L/P and Gly in perilensional tissue were higher than that in normal brain tissue. In the hypothermic group, L/P in perilensional tissue was higher than that in relative normal brain.Conclusions: Mild hypothermia protects brain tissues by decreasing L/G, L/P and Gly in perilensional tissue and L/P in "normal brain" tissues. The energy crisis and membrane phospholipid degradation in perilensional tissue are easier to happen after traumatic brain injury, and mild hypothermia protects brain better in perilensional tissue than in normal brain tissue.

  13. Serotonin and dopamine protect from hypothermia/rewarming damage through the CBS/H2S pathway.

    Directory of Open Access Journals (Sweden)

    Fatemeh Talaei

    Full Text Available Biogenic amines have been demonstrated to protect cells from apoptotic cell death. Herein we show for the first time that serotonin and dopamine increase H(2S production by the endogenous enzyme cystathionine-β-synthase (CBS and protect cells against hypothermia/rewarming induced reactive oxygen species (ROS formation and apoptosis. Treatment with both compounds doubled CBS expression through mammalian target of rapamycin (mTOR and increased H(2S production in cultured rat smooth muscle cells. In addition, serotonin and dopamine treatment significantly reduced ROS formation. The beneficial effect of both compounds was minimized by inhibition of their re-uptake and by pharmacological inhibition of CBS or its down-regulation by siRNA. Exogenous administration of H(2S and activation of CBS by Prydoxal 5'-phosphate also protected cells from hypothermic damage. Finally, serotonin and dopamine pretreatment of rat lung, kidney, liver and heart prior to 24 h of hypothermia at 3°C followed by 30 min of rewarming at 37°C upregulated the expression of CBS, strongly reduced caspase activity and maintained the physiological pH compared to untreated tissues. Thus, dopamine and serotonin protect cells against hypothermia/rewarming induced damage by increasing H(2S production mediated through CBS. Our data identify a novel molecular link between biogenic amines and the H(2S pathway, which may profoundly affect our understanding of the biological effects of monoamine neurotransmitters.

  14. Observation of efficacy of heating liquid combining brain surgery paste towel in prevented hypothermia in Choledochoscope auxiliary stone art%加温液体和脑科手术粘帖巾联合运用预防胆道镜辅助取石术中低体温的效果观察

    Institute of Scientific and Technical Information of China (English)

    刘华云; 李梦; 李雪玲; 张维


    postoperative 10 min, and faster heart rate, higher blood pressure, higher blood glucose, compared with the control group were obvious difference (P < 0.05); patients of the observation group were less blood loss, postoperative anesthesia revival time were shorter and chill incidence were lower, compared with the control group were obvious difference (P < 0.01). Conclusion Heating liquid combining brain surgery paste towel are used on choledochoscope auxiliary stone art. It can be as far as possible avoiding the occurrence of complications that are caused by intraoperative hypothermia, decreasing intraoperative adverse impact, surgery patients can safety smoothly pass the surgery recovery.

  15. Electrocardiographic changes during induced therapeutic hypothermia in comatose survivors after cardiac arrest

    Institute of Scientific and Technical Information of China (English)

    Pablo; Salinas; Esteban; Lopez-de-Sa; Laura; Pena-Conde; Ana; Viana-Tejedor; Juan; Ramon; Rey-Blas; Eduardo; Armada; Jose; Luis; Lopez-Sendon


    AIM: To assess the safety of therapeutic hypothermia(TH) concerning arrhythmias we analyzed serial electrocardiograms(ECG) during TH.METHODS: All patients recovered from a cardiac arrest with Glasgow < 9 at admission were treated with induced mild TH to 32-34℃. TH was obtained with cool fluid infusion or a specific intravascular device. Twelvelead ECG before,during,and after TH,as well as ECG telemetry data was recorded in all patients. From a total of 54 patients admitted with cardiac arrest during the study period,47 patients had the 3 ECG and telemetry data available. ECG analysis was blinded and performed with manual caliper by two independent cardiologists from blinded copies of original ECG,recorded at 25 mm/s and 10 mm/m V. Coronary care unit staff analyzed ECG telemetry for rhythm disturbances. Variables measured in ECG were rhythm,RR,PR,QT and corrected QT(QTc by Bazett formula,measured in lead v2) intervals,QRS duration,presence of Osborn’s J wave and U wave,as well as ST segment displacement and T wave amplitude in leads Ⅱ,v2 and v5.RESULTS: Heart rate went down an average of 19 bpm during hypothermia and increased again 16 bpm with rewarming(P < 0.0005,both). There was a nonsignificant prolongation of the PR interval during TH and a significant decrease with rewarming(P = 0.041). QRS duration significantly prolonged(P = 0.041) with TH and shortened back(P < 0.005) with rewarming. QTc interval presented a mean prolongation of 58 ms(P < 0.005) during TH and a significant shortening with rewarming of 22.2 ms(P = 0.017). Osborn or J wave was found in 21.3% of the patients. New arrhythmias occurred in 38.3% of the patients. Most frequent arrhythmia was non-sustained ventricular tachycardia(19.1%),followed by severe bradycardia or paced rhythm(10.6%),accelerated nodal rhythm(8.5%) and atrial fibrillation(6.4%). No life threatening arrhythmias(sustained ventricular tachycardia,polymorphic ventricular tachycardia or ventricular fibrillation) occurred

  16. Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model.

    Directory of Open Access Journals (Sweden)

    K Horst

    Full Text Available Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma.Male pigs (35 ± 5kg were mechanically ventilated and monitored over the study period of 48 h. Combined trauma included tibia fracture, lung contusion, liver laceration and pressure-controlled hemorrhagic shock (MAP < 30 ± 5 mmHg for 90 min. After resuscitation, hypothermia (33°C was induced for a period of 12 h (HT-T group with subsequent re-warming over a period of 10 h. The NT-T group was kept normothermic. Systemic and local (fracture hematoma cytokine levels (IL-6, -8, -10 and alarmins (HMGB1, HSP70 were measured via ELISA.Severe signs of shock as well as systemic and local increases of pro-inflammatory mediators were observed in both trauma groups. In general the local increase of pro- and anti-inflammatory mediator levels was significantly higher and prolonged compared to systemic concentrations. Induction of hypothermia resulted in a significantly prolonged elevation of both systemic and local HMGB1 levels at 48 h compared to the NT-T group. Correspondingly, local IL-6 levels demonstrated a significantly prolonged increase in the HT-T group at 48 h.A prolonged inflammatory response might reduce the well-described protective effects on organ and immune function observed in the early phase after hypothermia induction. Furthermore, local immune response also seems to be affected. Future studies should aim to investigate the use of therapeutic hypothermia at different degrees and duration of application.

  17. Mild hypothermia effects on intercellular adhesion molecule-1 and serum interleukin-6 expression in brain tissues of a rat focal ischemia model

    Institute of Scientific and Technical Information of China (English)

    Shengqi Fu; Lei Yang; Shuling Zhang; Shilong Sun; Xingai Mao


    BACKGROUND: Previous studies have confirmed the neuroprotective effect of mild hypothermia on ischemic brain injury.OBJECTIVE: To investigate the effects of mild hypothermia on intercellular adhesion molecule-1 expression and serum interleukin-6 levels in ischemic brain tissues of focal brain ischemia rats, and to explore the neuroprotective effects of mild hypothermia on ischemic brain injury.DESIGN, TIME AND SETTING: A randomized, controlled, neurobiological experiment was performed at the Central Laboratory, First Affiliated Hospital, Xinxiang Medical College, China from February to July 2006.MATERIALS: Thirty healthy, adult, Sprague Dawley rats were used to establish middle cerebral artery occlusion models using the suture method. The immunohistochemistry (streptavidin-biotin-peroxidase complex method) kit was purchased from Boster, China. Interleukin-6 radioimmunoassay was supplied by Institute of Radioimmunity, Technology Development Center, General Hospital of Chinese PLA. METHODS: The rats were equally and randomly assigned into mild hypothermia and control groups, and middle cerebral artery occlusion models were established. The rectal temperature was maintained at (37 ± 0.5)℃ in the control group. In the mild hypothermia group, the rectal temperature was maintained at (33±1)℃.MAIN OUTCOME MEASURES: At 12 hours after model establishment, the ischemic brain hemispheres were coronally sliced at the level of the optic chiasm. The number of intercellular adhesion molecule- 1 -positive vessels per high-power field was observed with an optical microscope. Serum interleukin-6 levels were measured by radioimmunoassay.RESULTS: Compared with the control group, intercellular adhesion molecule-I and serum interleukin-6 expressions were significantly decreased in ischemic brain tissues of the mild hypothermia group (P < 0.01).CONCLUSION: Mild hypothermia exhibits a neuroprotective effect by reducing serum interleukin-6 and intercellular adhesion molecule- 1

  18. Long-Term Effects of Induced Hypothermia on Local and Systemic Inflammation - Results from a Porcine Long-Term Trauma Model (United States)

    Horst, K.; Eschbach, D.; Pfeifer, R.; Relja, B.; Sassen, M.; Steinfeldt, T.; Wulf, H.; Vogt, N.; Frink, M.; Ruchholtz, S.; Pape, H. C.; Hildebrand, F.


    Background Hypothermia has been discussed as playing a role in improving the early phase of systemic inflammation. However, information on the impact of hypothermia on the local inflammatory response is sparse. We therefore investigated the kinetics of local and systemic inflammation in the late posttraumatic phase after induction of hypothermia in an established porcine long-term model of combined trauma. Materials & Methods Male pigs (35 ± 5kg) were mechanically ventilated and monitored over the study period of 48 h. Combined trauma included tibia fracture, lung contusion, liver laceration and pressure-controlled hemorrhagic shock (MAP < 30 ± 5 mmHg for 90 min). After resuscitation, hypothermia (33°C) was induced for a period of 12 h (HT-T group) with subsequent re-warming over a period of 10 h. The NT-T group was kept normothermic. Systemic and local (fracture hematoma) cytokine levels (IL-6, -8, -10) and alarmins (HMGB1, HSP70) were measured via ELISA. Results Severe signs of shock as well as systemic and local increases of pro-inflammatory mediators were observed in both trauma groups. In general the local increase of pro- and anti-inflammatory mediator levels was significantly higher and prolonged compared to systemic concentrations. Induction of hypothermia resulted in a significantly prolonged elevation of both systemic and local HMGB1 levels at 48 h compared to the NT-T group. Correspondingly, local IL-6 levels demonstrated a significantly prolonged increase in the HT-T group at 48 h. Conclusion A prolonged inflammatory response might reduce the well-described protective effects on organ and immune function observed in the early phase after hypothermia induction. Furthermore, local immune response also seems to be affected. Future studies should aim to investigate the use of therapeutic hypothermia at different degrees and duration of application. PMID:27144532

  19. All About PID - Testing and Avoidance in the Field

    Energy Technology Data Exchange (ETDEWEB)

    Hacke, Peter; Johnston, Steve


    Potential-induced degradation can cause significant power loss in modules if the appropriate precautions are not taken. In the first part of a new series in PV Tech Power on module failure, Peter Hacke and Steve Johnston assess the current state-of-the-art in detecting, avoiding and mitigating the worst effects of PID.

  20. Secondary Physical Education Avoidance and Gender: Problems and Antidotes (United States)

    Ryan, Thomas; Poirier, Yves


    Our goal was to locate and evaluate the barriers that impact and cause females to avoid secondary elective physical education courses. We sought to find answers to stop the further decline of female enrolment in secondary physical education by looking into curricula, program and instructional variables. Anecdotal evidence informed this study which…

  1. Avoidant/Restrictive Food Intake Disorder (United States)

    ... for the Professional Version Eating Disorders Definition of Eating Disorders Anorexia Nervosa Avoidant/Restrictive Food Intake Disorder Binge Eating ... about what they eat. Eating Disorders Definition of Eating Disorders Anorexia Nervosa Avoidant/Restrictive Food Intake Disorder Binge Eating ...

  2. Influence of mild hypothermia on vascular endothelial growth factor and infarct volume in brain tissues after cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    Fei Ye; Gangming Xi; Biyong Qin; Shifeng Wang; Chengyan Li


    BACKGROUND: It has been demonstrated that mild hypothermia has obvious protective effect on both whole and local cerebral ischemia. However, the definite mechanism is still unclear for the brain protection of mild hypothermia on cerebral edema, inhibiting inflammatory reaction, stabilizing blood brain barrier, etc.OBJECTIVE: To investigate the effect of mild hypothermia on the expression of vascular endothelial growth factor and the infarct volume after cerebral ischemia in rats, and analyze the brain protective mechanism of mild hypothermia.DESIGN: A randomized grouping and controlled animal trial.SETTING: Department of Neurology, People's Hospital of Yunyang Medical College.MATERIALS: Twenty adult male SD rats of clean degree, weighing (250±30) g, were provided by the animal experimental center, School of Medicine, Wuhan University. The kits for SP immunohistochemistry were purchased from Beijing Zhongshan Golden Bridge Biotechnology Co., Ltd.METHODS: The experiments were carried out in the laboratory of Department of Neurology, Renmen Hospital of Wuhan University from May to July 2005. ① The 20 rats were divided randomly into normal temperature group (n =10) and mild hypothermia group (n =10). Models of permanent middle cerebral artery occlusion were established with modified nylon suture embolization. The rats were assessed with the Longa standards: O point for without nerve dysfunction; 1 for mild neurological deficit (fore claws could no extend completely); 2 for moderate neurological deficit (circling towards the affected side); 3 for severe neurological deficit (tilting towards the affected side); 4 for coma and unconscious; 1 -3 points represented that models were successfully established. The rats of the normal temperature group were fed at room temperature, and those in the mild hypothermia group were induced by hypothermia from 2 hours postoperatively, and the rectal temperature was kept at 34-35 ℃ for 72 hours. ② Measurement of infarct volume

  3. Obstacle avoidance sonar for submarines (United States)

    Dugas, Albert C.; Webman, Kenneth M.


    The Advanced Mine Detection Sonar (AMDS) system was designed to operate in poor environments with high biological and/or shallow-water boundary conditions. It provides increased capability for active detection of volume, close-tethered, and bottom mines, as well as submarine and surface target active/passive detection for ASW and collision avoidance. It also provides bottom topography mapping capability for precise submarine navigation in uncharted littoral waters. It accomplishes this by using advanced processing techniques with extremely narrow beamwidths. The receive array consists of 36 modules arranged in a 15-ft-diameter semicircle at the bottom of the submarine sonar dome to form a chin-mounted array. Each module consists of 40 piezoelectric rubber elements. The modules provide the necessary signal conditioning to the element data prior to signal transmission (uplink) through the hull. The elements are amplified, filtered, converted to digital signals by an A/D converter, and multiplexed prior to uplink to the inboard receiver. Each module also has a downlink over which it receives synchronization and mode/gain control. Uplink and downlink transmission is done using fiberoptic telemetry. AMDS was installed on the USS Asheville. The high-frequency chin array for Virginia class submarines is based on the Asheville design.

  4. Main Complications of Mild Induced Hypothermia after Cardiac Arrest: A Review Article

    Directory of Open Access Journals (Sweden)

    Hassan Soleimanpour


    Full Text Available The aim of the present study is to assess the complications of mild induced hypothermia (MIH in patients with cardiac arrest. Presently, based on the guidelines of the American heart Association, MIH following successful cardiopulmonary resuscitation (CPR in unconscious adult patients due to ventricular fibrillation (VF with out-of-hospital cardiac arrest (OOHCA is essential and required. However, MIH could be associated with complications in Patients with cardiac arrest. Studies conducted on the precautions and care following cardiac arrest and MIH were included. Valid scientific data bases were used for data collection. The obtained results from different studies revealed that mild MIH could be associated with numerous complications and the knowledge and awareness of the medical staff from the complications is required to guarantee successful therapeutic approaches in MIH following cardiac arrest which is a novel medical facility with different styles and complications. Overall, further future studies are required to improve the quality of MIH, to increase survival and to decrease complications rates.

  5. Pavlovian inhibitory conditioning and tolerance to pentobarbital-induced hypothermia in rats. (United States)

    Hinson, R E; Siegel, S


    In this experiment we investigated inhibitory Pavlovian conditioning in the development of tolerance to pentobarbital-induced hypothermia. During an initial phase, one group of rats (discrimination group) received training in which, on alternate days, one conditional stimulus (CS+) was associated with administration of 30 mg/kg pentobarbital, and a different conditional stimulus (CS-) was associated with administration of physiological saline. During the phase, control groups received either exposure to both CSs but not the drug or to the drug but no CSs or to neither the CSs nor the drug. Subsequently, half the rats in each group received injections of pentobarbital in the presence of one of the CSs and the remaining half in the presence of the other CS. Rats from the discrimination group injected with pentobarbital in the presence of CS+ displayed the most tolerance (i.e., smallest drug effect), whereas rats from the discrimination group injected with pentobarbital in the presence of CS- displayed the least tolerance (i.e., greatest drug effect). The attenuation of tolerance seen in rats of the discrimination group injected in the presence of CS- provides evidence of inhibitory Pavlovian conditioning. Additional evidence of inhibitory conditioning was provided by the fact that CS2 enhanced the hypothermic effects of pentobarbital in the discrimination group, whereas CS1 attenuated these effects. Implications of the results for the nature of inhibitory conditioning are discussed.

  6. Developing sustainable global health technologies: insight from an initiative to address neonatal hypothermia. (United States)

    Gupta, Rajesh; Patel, Rajan; Murty, Naganand; Panicker, Rahul; Chen, Jane


    Relative to drugs, diagnostics, and vaccines, efforts to develop other global health technologies, such as medical devices, are limited and often focus on the short-term goal of prototype development instead of the long-term goal of a sustainable business model. To develop a medical device to address neonatal hypothermia for use in resource-limited settings, we turned to principles of design theory: (1) define the problem with consideration of appropriate integration into relevant health policies, (2) identify the users of the technology and the scenarios in which the technology would be used, and (3) use a highly iterative product design and development process that incorporates the perspective of the user of the technology at the outset and addresses scalability. In contrast to our initial idea, to create a single device, the process guided us to create two separate devices, both strikingly different from current solutions. We offer insights from our initial experience that may be helpful to others engaging in global health technology development.

  7. Remote Postconditioning Alone and Combined with Hypothermia Improved Postresuscitation Cardiac and Neurological Outcomes in Swine. (United States)

    Xu, Jiefeng; Huang, Zeng; Ye, Sen; Wang, Moli; Fang, Ya; Li, Zilong


    Objective. Previously, we demonstrated that remote ischemic postconditioning (RIpostC) improved postresuscitation myocardial and cerebral functions in rat. Here, we investigated the effects of RIpostC alone and combined with therapeutic hypothermia (TH) on cardiac and neurological outcomes after CPR in swine. Methods. Twenty-one pigs were subjected to 10 mins of VF and then 5 mins of CPR. The animals were randomized to receive RIpostC alone, or its combination with TH, or sham control. RIpostC was induced by 4 cycles of limb ischemia followed by reperfusion. TH was implemented by surface cooling to reach a temperature of 32-34°C. Results. During 72 hrs after resuscitation, lower level of cardiac troponin I and greater stroke volume and global ejection fraction were observed in animals that received RIpostC when compared to the control. RIpostC also decreased serum levels of neuron-specific enolase and S100B and increased neurologic alertness score after resuscitation. The combination of RIpostC and TH resulted in greater improvement in cardiac and neurological outcomes than RIpostC alone. Conclusion. RIpostC was conducive to improving postresuscitation myocardial and cerebral functions and reducing their organ injuries. Its combination with TH further enhanced its protective effects.

  8. Remote Postconditioning Alone and Combined with Hypothermia Improved Postresuscitation Cardiac and Neurological Outcomes in Swine

    Directory of Open Access Journals (Sweden)

    Jiefeng Xu


    Full Text Available Objective. Previously, we demonstrated that remote ischemic postconditioning (RIpostC improved postresuscitation myocardial and cerebral functions in rat. Here, we investigated the effects of RIpostC alone and combined with therapeutic hypothermia (TH on cardiac and neurological outcomes after CPR in swine. Methods. Twenty-one pigs were subjected to 10 mins of VF and then 5 mins of CPR. The animals were randomized to receive RIpostC alone, or its combination with TH, or sham control. RIpostC was induced by 4 cycles of limb ischemia followed by reperfusion. TH was implemented by surface cooling to reach a temperature of 32–34°C. Results. During 72 hrs after resuscitation, lower level of cardiac troponin I and greater stroke volume and global ejection fraction were observed in animals that received RIpostC when compared to the control. RIpostC also decreased serum levels of neuron-specific enolase and S100B and increased neurologic alertness score after resuscitation. The combination of RIpostC and TH resulted in greater improvement in cardiac and neurological outcomes than RIpostC alone. Conclusion. RIpostC was conducive to improving postresuscitation myocardial and cerebral functions and reducing their organ injuries. Its combination with TH further enhanced its protective effects.

  9. 5′-Adenosine Monophosphate-Induced Hypothermia Attenuates Brain Ischemia/Reperfusion Injury in a Rat Model by Inhibiting the Inflammatory Response

    Directory of Open Access Journals (Sweden)

    Yi-Feng Miao


    Full Text Available Hypothermia treatment is a promising therapeutic strategy for brain injury. We previously demonstrated that 5′-adenosine monophosphate (5′-AMP, a ribonucleic acid nucleotide, produces reversible deep hypothermia in rats when the ambient temperature is appropriately controlled. Thus, we hypothesized that 5′-AMP-induced hypothermia (AIH may attenuate brain ischemia/reperfusion injury. Transient cerebral ischemia was induced by using the middle cerebral artery occlusion (MCAO model in rats. Rats that underwent AIH treatment exhibited a significant reduction in neutrophil elastase infiltration into neuronal cells and matrix metalloproteinase 9 (MMP-9, interleukin-1 receptor (IL-1R, tumor necrosis factor receptor (TNFR, and Toll-like receptor (TLR protein expression in the infarcted area compared to euthermic controls. AIH treatment also decreased the number of terminal deoxynucleotidyl transferase dUTP nick end labeling- (TUNEL- positive neuronal cells. The overall infarct volume was significantly smaller in AIH-treated rats, and neurological function was improved. By contrast, rats with ischemic brain injury that were administered 5′-AMP without inducing hypothermia had ischemia/reperfusion injuries similar to those in euthermic controls. Thus, the neuroprotective effects of AIH were primarily related to hypothermia.

  10. Evolution of Apparent Diffusion Coefficient and Fractional Anisotropy in the Cerebrum of Asphyxiated Newborns Treated with Hypothermia over the First Month of Life

    Directory of Open Access Journals (Sweden)

    Saskia Kwan


    Full Text Available The objective of this study was to assess the evolution of diffusion-weighted imaging (DWI and diffusion-tensor imaging (DTI over the first month of life in asphyxiated newborns treated with hypothermia and to compare it with that of healthy newborns. Asphyxiated newborns treated with hypothermia were enrolled prospectively; and the presence and extent of brain injury were scored on each MRI. Apparent diffusion coefficient (ADC and fractional anisotropy (FA values were measured in the basal ganglia, in the white matter and in the cortical grey matter. Sixty-one asphyxiated newborns treated with hypothermia had a total of 126 ADC and FA maps. Asphyxiated newborns developing brain injury eventually had significantly decreased ADC values on days 2-3 of life and decreased FA values around day 10 and 1 month of life compared with those not developing brain injury. Despite hypothermia treatment, asphyxiated newborns may develop brain injury that still can be detected with advanced neuroimaging techniques such as DWI and DTI as early as days 2-3 of life. A study of ADC and FA values over time may aid in the understanding of how brain injury develops in these newborns despite hypothermia treatment.

  11. Study of the effects of mild hypothermia on cerebral PO2, PCO2 and pH and body temperature in patients with acute severe head injury

    Institute of Scientific and Technical Information of China (English)

    JIA Jun; LIN Yuan-quan; LIU Wen-feng; ZHONG Tian-an; ZHANG Jun; YE Yu; XU Yi-qun


    Objective: To study the effects of mild hypothermia on cerebral oxygen partial pressure, carbon dioxide partial pressure, pH and body temperature (PbrO2, PbrCO2, pHbr and BT) in patients with acute severe head injury.Methods: Thirty-eight patients with acute severe head injury were treated with mild hypothermia, meantime PbrO2, PbrCO2, pHbr and BT were monitored in order to study the changes of PbrO2, PbrCO2, pHbr and BT.Results: In patients with acute head injury, mild hypothermia obviously increased PbrO2, decreased PbrCO2 and CO2 accumulation and acidosis in brain tissue. BT was 1℃-1.5℃ higher than rectal temperature(RT) after injury. The BT and RT were decreased when the patients were treated with mild hypothermia, but at the same time the difference between BT and RT was increased.Conclusions: In patients with acute severe head injury the direct monitoring of PbrO2, PbrCO2, pHbr and BT was safe and reliable, and is helpful in estimating prognosis and mild hypothermia therapy.

  12. Generalization of socially transmitted and instructed avoidance

    Directory of Open Access Journals (Sweden)

    Gemma eCameron


    Full Text Available Excessive avoidance behavior, in which an instrumental action prevents an upcoming aversive event, is a defining feature of anxiety disorders. Left unchecked, both fear and avoidance of potentially threatening stimuli may generalize to perceptually related stimuli and situations. The behavioral consequences of generalization mean that aversive learning experiences with specific threats may lead people to infer that classes of related stimuli are threatening, potentially dangerous, and need to be avoided, despite differences in physical form. Little is known about avoidance generalization in humans and the learning pathways by which it may be transmitted. In the present study, we compared two pathways to avoidance, instructions and social observation, on subsequent generalization of avoidance behavior, fear expectancy and physiological arousal. Participants first learned that one cue was a danger cue (conditioned stimulus, CS+ and another was a safety cue (CS-. Groups then were either instructed that a simple avoidance response in the presence of the CS+ cancelled upcoming shock presentations (instructed-learning group or observed a short movie showing a demonstrator performing the avoidance response to prevent shock (observational-learning group. During generalization testing, danger and safety cues were presented along with generalization stimuli that parametrically varied in perceptual similarity to the CS+. Reinstatement of fear and avoidance was also tested. Findings demonstrate, for the first time, generalization of socially transmitted and instructed avoidance: both groups showed comparable generalization gradients in fear expectancy, avoidance behavior and arousal. Return of fear was evident, suggesting that generalized avoidance remains persistent following extinction testing. The utility of the present paradigm for research on avoidance generalization is discussed.

  13. YUCCA auxin biosynthetic genes are required for Arabidopsis shade avoidance

    Directory of Open Access Journals (Sweden)

    Patricia Müller-Moulé


    Full Text Available Plants respond to neighbor shade by increasing stem and petiole elongation. Shade, sensed by phytochrome photoreceptors, causes stabilization of PHYTOCHROME INTERACTING FACTOR proteins and subsequent induction of YUCCA auxin biosynthetic genes. To investigate the role of YUCCA genes in phytochrome-mediated elongation, we examined auxin signaling kinetics after an end-of-day far-red (EOD-FR light treatment, and found that an auxin responsive reporter is rapidly induced within 2 hours of far-red exposure. YUCCA2, 5, 8, and 9 are all induced with similar kinetics suggesting that they could act redundantly to control shade-mediated elongation. To test this hypothesis we constructed a yucca2, 5, 8, 9 quadruple mutant and found that the hypocotyl and petiole EOD-FR and shade avoidance responses are completely disrupted. This work shows that YUCCA auxin biosynthetic genes are essential for detectable shade avoidance and that YUCCA genes are important for petiole shade avoidance.

  14. YUCCA auxin biosynthetic genes are required for Arabidopsis shade avoidance (United States)

    Müller-Moulé, Patricia; Nozue, Kazunari; Pytlak, Melissa L.; Palmer, Christine M.; Covington, Michael F.; Wallace, Andreah D.; Harmer, Stacey L.


    Plants respond to neighbor shade by increasing stem and petiole elongation. Shade, sensed by phytochrome photoreceptors, causes stabilization of PHYTOCHROME INTERACTING FACTOR proteins and subsequent induction of YUCCA auxin biosynthetic genes. To investigate the role of YUCCA genes in phytochrome-mediated elongation, we examined auxin signaling kinetics after an end-of-day far-red (EOD-FR) light treatment, and found that an auxin responsive reporter is rapidly induced within 2 hours of far-red exposure. YUCCA2, 5, 8, and 9 are all induced with similar kinetics suggesting that they could act redundantly to control shade-mediated elongation. To test this hypothesis we constructed a yucca2, 5, 8, 9 quadruple mutant and found that the hypocotyl and petiole EOD-FR and shade avoidance responses are completely disrupted. This work shows that YUCCA auxin biosynthetic genes are essential for detectable shade avoidance and that YUCCA genes are important for petiole shade avoidance. PMID:27761349

  15. Electrophysiological functional recovery in a rat model of spinal cord hemisection injury following bone marrow-derived mesenchymal stem cell transplantation under hypothermia

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Jianjun Zhang


    Following successful establishment of a rat model of spinal cord hemisection injury by resecting right spinal cord tissues, bone marrow stem cells were transplanted into the spinal cord lesions via the caudal vein while maintaining rectal temperature at 34 ± 0.5°C for 6 hours (mild hypothermia). Hematoxylin-eosin staining showed that astrocytes gathered around the injury site and formed scars at 4 weeks post-transplantation. Compared with rats transplanted with bone marrow stem cells under normal temperature, rats transplanted with bone marrow stem cells under hypothermia showed increased numbers of proliferating cells (bromodeoxyuridine-positive cells), better recovery of somatosensory-evoked and motor-evoked potentials, greater Basso, Beattie, and Bresnahan locomotor rating scores, and an increased degree of angle in the incline plate test. These findings suggested that hypothermia combined with bone marrow mesenchymal stem cells transplantation effectively promoted electrical conduction and nerve functional repair in a rat model of spinal cord hemisection injury.

  16. Brief Rewarming Blunts Hypothermia-Induced Alterations in Sensation, Motor Drive and Cognition (United States)

    Brazaitis, Marius; Paulauskas, Henrikas; Skurvydas, Albertas; Budde, Henning; Daniuseviciute, Laura; Eimantas, Nerijus


    hypothermia-induced alterations in neural drive transmission (4.3 ± 0.5 vs. 3.4 ± 0.8 mV H-reflex and 4.9 ± 0.2 vs. 4.4 ± 0.4 mV V-wave, P < 0.05), which increased central fatigue during a 2-min maximum load (P < 0.05). Furthermore, only in brief warm water rewarming cerebral alterations were restored to the control level and it was indicated by shortened reaction times (P < 0.05). Conclusions: Brief rewarming in warm water rather than the same duration rewarming in thermoneutral environment blunted the hypothermia-induced alterations for sensation, motor drive, and cognition, despite the fact that rectal and deep muscle temperature remained lowered. PMID:27990123

  17. Association of serum lactate with outcome after out-of-hospital cardiac arrest treated with therapeutic hypothermia (United States)

    Novain, Michaël; Cattet, Florian; Plattier, Rémi; Nefzaoui, Mohamed; Hyvernat, Hervé; Raguin, Olivier; Kaidomar, Michel; Kerever, Sébastien; Ichai, Carole


    Aims Lactate reflects hypoxic insult in many conditions and is considered as a prognosis factor. But, after cardiac arrest, its interest is still debated. Our study aimed to assess the prognosis value of lactate in out-of-hospital cardiac arrest patients treated with therapeutic hypothermia. Methods This retrospective observational study included out-of-hospital cardiac arrest patients treated with therapeutic hypothermia in four ICUs. Lactate levels were compared at different times during the first 24 hours according to outcome at ICU discharge and to the type of death (multiorgan or neurologic failure). Results Two hundred and seventy-two patients were included, 89 good outcome and 183 poor outcome. In the latter group, 171 patients died, from multiorgan failure in 30% and neurologic failure in 70%. Lactate levels were higher in the poor compared to the good outcome patients at admission (5.4 (3.3–9.4) vs. 2.2 (1.5–3.6) mmol/L; padmission (7.9 (3.9–12.0) vs. 5.2 (3.3–8.8) mmol/L; p<0.01), H12 (4.9 (2.1–8.9) vs. 2.2 (1.4–3.4) mmol/L; p<0.01) and H24 (3.3 (1.8–5.5) vs. 1.4 (1.1–2.5) mmol/L; p<0.01). Initial lactate levels showed an increasing proportion of poor outcome from the first to fourth quartile. Conclusions After out-of-hospital cardiac arrest treated with therapeutic hypothermia, lactate levels during the first 24 hours seem linked with ICU outcome. Patients dying from multiorgan failure exhibit higher initial lactate concentrations than patients succumbing from neurological failure. PMID:28282398

  18. Study on changes of partial pressure of brain tissue oxygen and brain temperature in acute phase of severe head injury during mild hypothermia therapy

    Institute of Scientific and Technical Information of China (English)

    朱岩湘; 姚杰; 卢尚坤; 章更生; 周关仁


    Objective: To study the changes of partial pressure of brain tissue oxygen (PbtO2) and brain temperature in acute phase of severe head injury during mild hypothermia therapy and the clinical significance.Methods: One hundred and sixteen patients with severe head injury were selected and divided into a mild hypothermia group (n=58), and a control group (n=58) according to odd and even numbers of hospitalization. While mild hypothermia therapy was performed PbtO2 and brain temperature were monitored for 1-7 days (mean=86 hours), simultaneously, the intracranial pressure, rectum temperature, cerebral perfusion pressure, PaO2 and PaCO2 were also monitored. The patients were followed up for 6 months and the prognosis was evaluated with GOS (Glasgow outcome scale).Results: The mean value of PbtO2 within 24 hour monitoring in the 116 patients was 13.7 mm Hg±4.94 mm Hg, lower than the normal value (16 mm Hg±40 mm Hg) The time of PbtO2 recovering to the normal value in the mild hypothermia group was shortened by 10±4.15 hours compared with the control group (P<0.05). The survival rate of the mild hypothermia group was 60.43%, higher than that of the control group (46.55%). After the recovery of the brain temperature, PbtO2 increased with the rise of the brain temperature. Conclusions: Mild hypothermia can improve the survival rate of severe head injury. The technique of monitoring PbtO2 and the brain temperature is safe and reliable, and has important clinical significance in judging disease condition and instructing clinical therapy.

  19. Mild hypothermia combined with a scaffold of NgR-silenced neural stem cells/Schwann cells to treat spinal cord injur y

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Jinhua Liang; Jianjun Zhang; Shuhong Liu; Wenwen Sun


    Because the inhibition of Nogo proteins can promote neurite growth and nerve cell differenti-ation, a cell-scaffold complex seeded with Nogo receptor (NgR)-silenced neural stem cells and Schwann cells may be able to improve the microenvironment for spinal cord injury repair. Previ-ous studies have found that mild hypothermia helps to attenuate secondary damage in the spinal cord and exerts a neuroprotective effect. Here, we constructed a cell-scaffold complex consisting of a poly(D,L-lactide-co-glycolic acid) (PLGA) scaffold seeded with NgR-silenced neural stem cells and Schwann cells, and determined the effects of mild hypothermia combined with the cell-scaffold complexes on the spinal cord hemi-transection injury in the T9 segment in rats. Compared with the PLGA group and the NgR-silencing cells+PLGA group, hindlimb motor function and nerve electrophysiological function were clearly improved, pathological changes in the injured spinal cord were attenuated, and the number of surviving cells and nerve ifbers were increased in the group treated with the NgR-silenced cell scaffold+mild hypothermia at 34°C for 6 hours. Furthermore, fewer pathological changes to the injured spinal cord and more surviv-ing cells and nerve ifbers were found after mild hypothermia therapy than in injuries not treated with mild hypothermia. These experimental results indicate that mild hypothermia combined with NgR gene-silenced cells in a PLGA scaffold may be an effective therapy for treating spinal cord injury.

  20. Immediate hypothermia reduces cardiac troponin I after hypoxic-ischemic encephalopathy in newborn pigs. (United States)

    Liu, Xun; Tooley, James; Løberg, Else M; Suleiman, M Saadeh; Thoresen, Marianne


    Neonatal hypoxic-ischemic encephalopathy (HIE) is a clinically defined neurological condition after lack of oxygen and often associated with cardiac dysfunction in term infants. Therapeutic hypothermia (HT) after birth is neuroprotective in infants with HIE. However, it is not known whether HT is also cardioprotective. Four newborn pigs were used in the pilot study and a further 18 newborn pigs [randomly assigned to 72 h normothermia (NT) or 24 h HT followed by 48 h NT] were subjected to global HIE insults. Serum cTnI was measured before and post the HIE insult. Blood pressure, inotropic support, blood gases, and heart rate (HR) were recorded throughout. Cardiac pathology was assessed from histological sections. Cooling reduced serum cTnI levels significantly in HT pigs by 6 h (NT, 1.36 ± 0.67; HT, 0.34 ± 0.23 ng/mL; p = 0.0009). After rewarming, from 24 to 30 h postinsult, HR and cTnI increased in the HT group; from HR[24 h] = 117 ± 22 to HR[30 h] = 218 ± 32 beats/min (p = 0.0002) and from cTnI[24 h] = 0.23 ± 0.12 to cTnI[30 h] = 0.65 ± 0.53 ng/mL, (p = 0.05). There were fewer ischemic lesions on cardiac examination (37%) in the HT group compared with the NT group (70%). HT (24 h) pigs did not have the postinsult cTnI increase seen in NT-treated pigs. There was a trend that HT improved cardiac pathology in this 3-d survival model.

  1. Effect of Therapeutic Hypothermia on Survival and Neurologic Outcome in the Elderly. (United States)

    Bosson, Nichole E; Kaji, Amy H; Koenig, William J; Niemann, James T


    Old age is considered a negative prognostic factor after out-of-hospital cardiac arrest (OHCA). The purpose of this study was to assess the benefit of therapeutic hypothermia (TH) on survival and neurologic outcome in the elderly. This is a retrospective study of patients treated for OHCA from April 2011 to August 2013 in a regional cardiac system. Patients with return of spontaneous circulation (ROSC) are directed to designated cardiac receiving centers with established TH protocols. The decision to initiate TH is determined by the treating physician. All patients 65 years or older were identified. Patients were excluded if awake and responsive in the emergency department, died before hospital admission, or had preexisting coma. The adjusted odds ratio for survival with good neurologic outcome (defined as cerebral performance category [CPC] 1 or 2) was calculated for patients who received TH compared to a reference group without TH. There were 1612 patients, of whom 552 (34%) received TH. Median age was 78 (inter-quartile range [IQR] 71-85); 56% was male. 493 (31%) patients survived to hospital discharge, 266 (17%) with CPC of 1 or 2. Of 1292 patients considered for TH, 192 (25%) of 552 patients who received TH survived to hospital discharge and 97 (18%) with good neurologic outcome compared to 150 (20%) and 57 (8%), respectively, without TH. The adjusted odds ratio for survival with good neurologic outcome for TH was 2.0 (95% CI 1.3-3.3). TH is associated with improved neurologic outcome in the elderly population.

  2. Detection And Avoidance Of Obstacles By Helicopters (United States)

    Cheng, Victor H. L.; Sridhar, Banavar


    Report discusses problems relevant to control subsystems enabling helicopters on nap-of-the-Earth flight paths to detect and avoid obstacles automatically. Indicates similarities between this and obstacle-avoidance problem of industrial mobile robots. Two approaches extend two-dimensional obstacle-avoidance concept to three dimensions. First involves direct search of three-dimensional range-map data for indications of openings between obstacles. Second involves compression of data into two-dimensional map for path search.

  3. Mobile Robot Collision Avoidance in Human Environments


    Lingqi Zeng; Gary M. Bone


    Collision avoidance is a fundamental requirement for mobile robots. Avoiding moving obstacles (also termed dynamic obstacles) with unpredictable direction changes, such as humans, is more challenging than avoiding moving obstacles whose motion can be predicted. Precise information on the future moving directions of humans is unobtainable for use in navigation algorithms. Furthermore, humans should be able to pursue their activities unhindered and without worrying about the robots around them....

  4. A case of transient hypothermia after trans-lamina terminalis and third ventricle clipping of an extremely high-position basilar tip aneurysm

    Directory of Open Access Journals (Sweden)

    Toshikazu Hidaka


    Full Text Available Reports on the trans-lamina terminalis and trans-third ventricular approach are rare. The risk associated with this approach is unknown. After an unsuccessful endovascular surgery, we performed direct surgical clipping via the third ventricle on a 78-year-old woman presenting with an extremely high-positioned, ruptured basilar tip aneurysm. She experienced transient hypothermia for 5 days, and it was considered that this was due to hypothalamic dysfunction. It is necessary to recognize that there is the potential for hypothermia after surgery via the lamina terminalis and third ventricle, even though the mechanisms of hypothalamic thermoregulation are still unclear.

  5. Who Avoids Cancer Information? Examining a Psychological Process Leading to Cancer Information Avoidance. (United States)

    Chae, Jiyoung


    Although cancer information avoidance (CIA) is detrimental to public health, predictors of CIA have not been fully investigated. Based on uncertainty management theory, this study viewed CIA as a response to uncertainty related to the distress associated with cancer information and illustrated the psychological process leading to CIA. Given the current information context, it was hypothesized that cancer information overload (CIO), accompanied by confusion and stress about cancer information, causes CIA. As trait anxiety is a strong predictor of CIO, it was also hypothesized that trait anxiety has an indirect effect on CIA through CIO. Study 1 tested this relationship in a U.S. sample (N = 384); the results showed that CIO was positively associated with CIA and that trait anxiety indirectly influenced CIA through CIO. Whereas Study 1 tested the relationship with cross-sectional data in the general cancer context, Study 2 replicated Study 1 with 3-wave longitudinal data in the context of a specific cancer (i.e., stomach cancer) in South Korea (N = 1,130 at Wave 1, 813 at Wave 2, and 582 at Wave 3). Trait anxiety at Wave 1 predicted CIO at Wave 2, which in turn increased CIA at Wave 3, suggesting that some people are inherently inclined to avoid cancer information due to their trait anxiety, which results in confusion about cancer information.

  6. Management of Sigmoid Volvulus Avoiding Sigmoid Resection (United States)

    Katsikogiannis, Nikolaos; Machairiotis, Nikolaos; Zarogoulidis, Paul; Sarika, Eirini; Stylianaki, Aikaterini; Zisoglou, Maria; Zervas, Vasilis; Bareka, Metaxia; Christofis, Christos; Iordanidis, Alkis


    Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic percussion tones and no bowel sounds. She was diagnosed with acute sigmoid volvulus. Although urgent resective surgery seems to be the appropriate treatment for those who present with acute abdominal pain, intestinal perforation or ischemic necrosis of the intestinal mucosa, the first therapeutic choice for clinically stable patients in good general condition is considered, by many institutions, to be endoscopic decompression. Controversy exists on the decision of the time, the type of definitive treatment, the strategy and the most appropriate surgical technique, especially for teenagers for whom sigmoid resection can be avoided. PMID:22754489

  7. Management of Sigmoid Volvulus Avoiding Sigmoid Resection

    Directory of Open Access Journals (Sweden)

    Nikolaos Katsikogiannis


    Full Text Available Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic percussion tones and no bowel sounds. She was diagnosed with acute sigmoid volvulus. Although urgent resective surgery seems to be the appropriate treatment for those who present with acute abdominal pain, intestinal perforation or ischemic necrosis of the intestinal mucosa, the first therapeutic choice for clinically stable patients in good general condition is considered, by many institutions, to be endoscopic decompression. Controversy exists on the decision of the time, the type of definitive treatment, the strategy and the most appropriate surgical technique, especially for teenagers for whom sigmoid resection can be avoided.

  8. Can low metallicity binaries avoid merging?

    CERN Document Server

    de Mink, S E; Pols, O R


    Rapid mass transfer in a binary system can drive the accreting star out of thermal equilibrium, causing it to expand. This can lead to a contact system, strong mass loss from the system and possibly merging of the two stars. In low metallicity stars the timescale for heat transport is shorter due to the lower opacity. The accreting star can therefore restore thermal equilibrium more quickly and possibly avoid contact. We investigate the effect of accretion onto main sequence stars with radiative envelopes with different metallicities. We find that a low metallicity (Z<0.001), 4 solar mass star can endure a 10 to 30 times higher accretion rate before it reaches a certain radius than a star at solar metallicity. This could imply that up to two times fewer systems come into contact during rapid mass transfer when we compare low metallicity. This factor is uncertain due to the unknown distribution of binary parameters and the dependence of the mass transfer timescale on metallicity. In a forthcoming paper we w...

  9. Oxidative stress is enhanced by hypothermia imposed on cerulein-induced pancreatitis in rats Aumento do estresse oxidativo após hipotermia em ratos com pancreatite induzida por ceruleína

    Directory of Open Access Journals (Sweden)

    Wellington Andraus


    Full Text Available BACKGROUND: Hypothermia is a frequent event in severe acute pancreatitis (AP and its real effects on the normal pancreas have not been well demonstrated. Moreover, neither have its effects on the outcome of acute pancreatitis been fully investigated. One hypothesis is that oxidative stress may be implicated in lesions caused or treated by hypothermia. AIM OF THE STUDY: To investigate the effect of hypothermia in cerulein-induced acute pancreatitis (CIAP in rats and the role played by oxidative stress in this process. METHODS: Male Wistar rats were divided into hypothermic and normothermic groups. Hypothermia was induced with a cold mattress and rectal temperature was kept at 30ºC for one hour. Acute pancreatitis was induced with 2 doses of cerulein (20 ìg/kg administered at a one-hour interval. Serum amylase, pancreas vascular permeability by Evan's blue method, pancreas wet-to-dry weight ratio and histopathology were analyzed in each group. RESULTS: When compared with normothermic rats, hypothermic animals, with cerulein-induced acute pancreatitis, showed higher levels of pancreatic vascular permeability (p BACKGROUND: Hipotermia é um evento freqüente em episódios de pancreatite aguda, contudo seu efeito real sobre pâncreas normal ainda não esta bem demonstrado. Além do mais, o efeito da hipotermia no decorrer da pancreatite aguda também não está completamente esclarecido. Uma das hipóteses sobre as causas das lesões causadas ou tratadas por hipotermia aventa a implicação de estresse oxidativo. OBJETIVOS: Investigar o efeito da hipotermia em ratos com pancreatite aguda induzida por ceruleína e o papel do estresse oxidativo neste processo. MÉTODOS: Ratos Wistar machos foram divididos em grupos hipotérmicos e normotérmicos. Hipotermia foi induzida com uma bolsa gelada de forma que a temperatura retal permanecesse em 30ºC por uma hora. Pancreatite aguda foi induzida com duas aplicações de ceruleína (20 ìg/kg administradas

  10. Aesthetic rhinoplasty: Avoiding unfavourable results

    Directory of Open Access Journals (Sweden)

    Kulwant S Bhangoo


    Full Text Available Rhinoplasty is one of the most challenging surgical procedures in plastic surgery. It is not surprising that a significant number of patients end up with unfavourable outcomes. Many of these unfavourable outcomes could be the result of poor judgment and wrong decision making. Most frequently, the unfavourable outcome is the result of errors in surgical technique. In this paper, unfavourable outcomes resulting from errors in surgical technique are discussed under the heading of each operative step. Poor placement of intra-nasal incision can result in internal valve obstruction. Bad columellar scars can result from errors during open rhinoplasty. Unfavourable results associated with skeletonisation are mentioned. Tip plasty, being the most difficult part of rhinoplasty, can result in lack of tip projection, asymmetry and deformities associated with placement of tip grafts. Over-resection of the lower lateral cartilages during tip plasty can also result in pinched nose, alar collapse causing external valve obstruction and other alar rim deformities. Humpectomy can result in open roof deformity, inverted V deformity and over-resection resulting in saddle nose. The so-called poly beak deformity is also a preventable unfavourable outcome when dealing with a large dorsal hump. Complications resulting from osteotomies include narrowing of nasal airway, open roof deformity, inverted V deformity and asymmetry of the bony wall resulting from incomplete or green stick fractures. Judicious use of grafts can be very rewarding. By the same token, grafts also carry with them the risk of complications. Allografts can result in recurrent infection, atrophy of the overlying skin and extrusion resulting in crippling deformities. Autografts are recommended by the author. Unfavourable results from autografts include displacement of graft, visibility of the graft edges, asymmetry, warping, and resorption.

  11. 47 CFR 74.604 - Interference avoidance. (United States)


    ... 47 Telecommunication 4 2010-10-01 2010-10-01 false Interference avoidance. 74.604 Section 74.604 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST RADIO SERVICES EXPERIMENTAL RADIO... Stations § 74.604 Interference avoidance. (a) (b) Where two or more licensees are assigned a common...

  12. Avoidable deaths in Greenland 1968-1985

    DEFF Research Database (Denmark)

    Bjerregaard, Peter; Juel, K


    The concept of avoidable deaths suggests that certain deaths ought not occur in a given society because it is possible to prevent or treat the disease or condition. A list of avoidable deaths is time and community specific as it reflects the socioeconomic conditions, professional medical capacity...


    Directory of Open Access Journals (Sweden)

    Mauricio Palacios


    Full Text Available Colombia Médica publishes 64% of the original research articles submitted to editorial process, which highlights the rigor of the editorial review system; while at the same time, generating a reflection on the causes for rejecting material submitted for publication as an input for the Journal’s collaborators.The review of the file of articles rejected by the Journal leads us to arbitrarily discriminating the causes for rejecting scientific documents into two groups: A first group we will call «lost causes», which centers on the lack of ethical evaluation, research design flaws, and plagiarism. And the second group, «manuscripts with avoidable rejection», which includes deficiencies in following the editorial guidelines for authors, inadequate writing, and delays by authors in submitting answers to observations raised during an initial evaluation. Documents classifying in the latter group could have had an opportunity with a bit of joint effort between the authors and the editorial board; and in all cases, by correcting errors and seeking support from, among others, expert consultants, these could, potentially, be revived by submitting them to a journal with a lower impact than that in which they were rejected.Among the reasons for the lost causes, we find that faults in the structure of institutional research take up considerable space. Institutions considering scientific production as one of their assets, must invest on the conformation and growth of an ethics committee on research that reasonably provides researchers with social, environmental, and ethical reflection elements to enrich research proposals. With bioethics foundations, Colombian and international norms do not consider other forms of ethical evaluation of the projects, and; consequently, neither does the Editorial Committee. Furthermore, anyone seeking to conduct clinical trials must register the entity in any of the international data bases that permit inputting the


    Directory of Open Access Journals (Sweden)

    Mauricio Palacios


    Full Text Available Colombia Médica publishes 64% of the original research articles submitted to editorial process, which highlights the rigor of the editorial review system; while at the same time, generating a reflection on the causes for rejecting material submitted for publication as an input for the Journal’s collaborators. The review of the file of articles rejected by the Journal leads us to arbitrarily discriminating the causes for rejecting scientific documents into two groups: A first group we will call «lost causes», which centers on the lack of ethical evaluation, research design flaws, and plagiarism. And the second group, «manuscripts with avoidable rejection», which includes deficiencies in following the editorial guidelines for authors, inadequate writing, and delays by authors in submitting answers to observations raised during an initial evaluation. Documents classifying in the latter group could have had an opportunity with a bit of joint effort between the authors and the editorial board; and in all cases, by correcting errors and seeking support from, among others, expert consultants, these could, potentially, be revived by submitting them to a journal with a lower impact than that in which they were rejected. Among the reasons for the lost causes, we find that faults in the structure of institutional research take up considerable space. Institutions considering scientific production as one of their assets, must invest on the conformation and growth of an ethics committee on research that reasonably provides researchers with social, environmental, and ethical reflection elements to enrich research proposals. With bioethics foundations, Colombian and international norms do not consider other forms of ethical evaluation of the projects, and; consequently, neither does the Editorial Committee. Furthermore, anyone seeking to conduct clinical trials must register the entity in any of the international data bases that permit inputting the

  15. A new method to avoid PPP in data evaluation

    Institute of Scientific and Technical Information of China (English)

    Chen Zhen-Peng; Sun Ye-Ying


    The Peelle Pertinent Puzzle (PPP) has been studied systematically. The results obtained by using several proposed methods to deal with a sample of 6Li(n, t) are compared with each other. The cause of PPP occurrence has been found.error according to the relative extent of discrepancy'. The method is able to produce the best result and should be used to avoid the PPP at first.

  16. The clinical efficacy and prognosis of hemisphere skull bone flap decompression and mild hypothermia treatment for severe craniocerebral trauma

    Directory of Open Access Journals (Sweden)

    YANG Hua-tang


    Full Text Available In this study, 1626 patients with severe craniocerebral trauma were assessed by Glasgow Coma Scale (GCS, 886 patients of 3-5 score and 740 of 6-8 score. Patients were divided into 2 groups. Ninety hundred and eleven patients (496 of 3-5 score and 415 of 6-8 score underwent hemisphere calvarial bone flap decompression with auxiliary mild hypothermia (experiment group, and 715 patients (390 of 3-5 score and 325 of 6-8 score underwent traditional frontal, temporal, parietal large traumatic craniotomy (control group. After operation the treatment of 2 groups was basically the same. Compared with control group, the intracranial pressure of experiment group on the 1st, 3rd, 5th and 7th days after surgery decreased significantly (P < 0.05, for all; the consciousness recovery time was significantly shorter (P < 0.05, for all; the prognosis after 3 months was better (P < 0.05, for all. Hemisphere calvarial bone flap decompression with auxiliary mild hypothermia treatment could significantly reduce the morbidity and mortality, and improve the quality of life and prognosis of patients with severe craniocerebral trauma.

  17. Induction of therapeutic hypothermia by pharmacological modulation of temperature-sensitive TRP channels: theoretical framework and practical considerations. (United States)

    Feketa, Viktor V; Marrelli, Sean P


    Therapeutic hypothermia has emerged as a remarkably effective method of neuroprotection from ischemia and is being increasingly used in clinics. Accordingly, it is also a subject of considerable attention from a basic scientific research perspective. One of the fundamental problems, with which current studies are concerned, is the optimal method of inducing hypothermia. This review seeks to provide a broad theoretical framework for approaching this problem, and to discuss how a novel promising strategy of pharmacological modulation of the thermosensitive ion channels fits into this framework. Various physical, anatomical, physiological and molecular aspects of thermoregulation, which provide the foundation for this text, have been comprehensively reviewed and will not be discussed exhaustively here. Instead, the first part of the current review, which may be helpful for a broader readership outside of thermoregulation research, will build on this existing knowledge to outline possible opportunities and research directions aimed at controlling body temperature. The second part, aimed at a more specialist audience, will highlight the conceptual advantages and practical limitations of novel molecular agents targeting thermosensitive Transient Receptor Potential (TRP) channels in achieving this goal. Two particularly promising members of this channel family, namely TRP melastatin 8 (TRPM8) and TRP vanilloid 1 (TRPV1), will be discussed in greater detail.

  18. Hypothermia During Cardiopulmonary Bypass Increases Need for Inotropic Support but Does Not Impact Inflammation in Children Undergoing Surgical Ventricular Septal Defect Closure. (United States)

    Schmitt, Katharina Rose Luise; Fedarava, Katsiaryna; Justus, Georgia; Redlin, Mathias; Böttcher, Wolfgang; Delmo Walter, Eva Maria; Hetzer, Roland; Berger, Felix; Miera, Oliver


    Minimizing the systemic inflammatory response caused by cardiopulmonary bypass is a major concern. It has been suggested that the perfusion temperature affects the inflammatory response. The aim of this prospective study was to compare the effects of moderate hypothermia (32°C) and normothermia (36°C) during cardiopulmonary bypass on markers of the inflammatory response and clinical outcomes (time on ventilator) after surgical closure of ventricular septal defects. During surgical closure of ventricular septal defects under cardiopulmonary bypass, 20 children (median age 4.9 months, range 2.3-38 months; median weight 7.2 kg, range 5.2-11.7 kg) were randomized to a perfusion temperature of either 32°C (Group 1, n = 10) or 36°C (Group 2, n = 10). The clinical data and blood samples were collected before cardiopulmonary bypass, directly after aortic cross-clamp release, and 4 and 24 h after weaning from cardiopulmonary bypass. Time on ventilation as primary outcome did not differ between the two groups. Other clinical outcome parameters like fluid balance or length of stay in the intensive care were also similar in the two groups. Compared with Group 2, Group 1 needed significantly higher and longer inotropic support (P bypass temperature does not influence time on ventilation or inflammatory marker release. However, in the present study, with a small patient cohort, patients operated under hypothermic bypass needed higher and longer inotropic support. The use of hypothermic cardiopulmonary bypass in infants and children should be approached with care.

  19. Data on pharmacological applications and hypothermia protection against in vitro oxygen-glucose-deprivation-related neurodegeneration of adult rat CA1 region

    Directory of Open Access Journals (Sweden)

    Pınar Öz


    Here, the use CA1sp width measurements on Nissl-stained hippocampal slices is introduced as a valid and affordable method for detecting the level of neurodegeneration and neuroprotection on hippocampal slices. The protective effect of hypothermia was found to be more pronounced compared to other agents.

  20. A recommended early goal-directed management guideline for the prevention of hypothermia-related transfusion, morbidity, and mortality in severely injured trauma patients. (United States)

    Perlman, Ryan; Callum, Jeannie; Laflamme, Claude; Tien, Homer; Nascimento, Barto; Beckett, Andrew; Alam, Asim


    Hypothermia is present in up to two-thirds of patients with severe injury, although it is often disregarded during the initial resuscitation. Studies have revealed that hypothermia is associated with mortality in a large percentage of trauma cases when the patient's temperature is below 32 °C. Risk factors include the severity of injury, wet clothing, low transport unit temperature, use of anesthesia, and prolonged surgery. Fortunately, associated coagulation disorders have been shown to completely resolve with aggressive warming. Selected passive and active warming techniques can be applied in damage control resuscitation. While treatment guidelines exist for acidosis and bleeding, there is no evidence-based approach to managing hypothermia in trauma patients. We synthesized a goal-directed algorithm for warming the severely injured patient that can be directly incorporated into current Advanced Trauma Life Support guidelines. This involves the early use of warming blankets and removal of wet clothing in the prehospital phase followed by aggressive rewarming on arrival at the hospital if the patient's injuries require damage control therapy. Future research in hypothermia management should concentrate on applying this treatment algorithm and should evaluate its influence on patient outcomes. This treatment strategy may help to reduce blood loss and improve morbidity and mortality in this population of patients.

  1. Gap junction modifier rotigaptide decreases the susceptibility to ventricular arrhythmia by enhancing conduction velocity and suppressing discordant alternans during therapeutic hypothermia in isolated rabbit hearts

    DEFF Research Database (Denmark)

    Hsieh, Yu-Cheng; Lin, Jiunn-Cherng; Hung, Chen-Ying


    ) and 30°C (P = .042). Rotigaptide did not change connexin43 expressions and distributions during hypothermia. CONCLUSION: Rotigaptide protects the hearts against ventricular arrhythmias by increasing ventricular CV, delaying the onset of SDA, and reducing repolarization heterogeneity during TH. Enhancing...

  2. Therapeutic hypothermia for the treatment of acute myocardial infarction-combined analysis of the RAPID MI-ICE and the CHILL-MI trials. (United States)

    Erlinge, David; Götberg, Matthias; Noc, Marko; Lang, Irene; Holzer, Michael; Clemmensen, Peter; Jensen, Ulf; Metzler, Bernhard; James, Stefan; Bøtker, Hans Erik; Omerovic, Elmir; Koul, Sasha; Engblom, Henrik; Carlsson, Marcus; Arheden, Håkan; Östlund, Ollie; Wallentin, Lars; Klos, Bradley; Harnek, Jan; Olivecrona, Göran K


    In the randomized rapid intravascular cooling in myocardial infarction as adjunctive to percutaneous coronary intervention (RAPID MI-ICE) and rapid endovascular catheter core cooling combined with cold saline as an adjunct to percutaneous coronary intervention for the treatment of acute myocardial infarction CHILL-MI studies, hypothermia was rapidly induced in conscious patients with ST-elevation myocardial infarction (STEMI) by a combination of cold saline and endovascular cooling. Twenty patients in RAPID MI-ICE and 120 in CHILL-MI with large STEMIs, scheduled for primary percutaneous coronary intervention (PCI) within myocardial infarct size (IS) as a percentage of myocardium at risk (IS/MaR) assessed by cardiac magnetic resonance imaging at 4±2 days. Patients randomized to hypothermia treatment achieved a mean core body temperature of 34.7°C before reperfusion. Although significance was not achieved in CHILL-MI, in the pooled analysis IS/MaR was reduced in the hypothermia group, relative reduction (RR) 15% (40.5, 28.0-57.6 vs. 46.6, 36.8-63.8, p=0.046, median, interquartile range [IQR]). IS/MaR was predominantly reduced in early anterior STEMI (0-4h) in the hypothermia group, RR=31% (40.5, 28.8-51.9 vs. 59.0, 45.0-67.8, p=0.01, median, IQR). There was no mortality in either group. The incidence of heart failure was reduced in the hypothermia group (2 vs. 11, p=0.009). Patients with large MaR (>30% of the left ventricle) exhibited significantly reduced IS/MaR in the hypothermia group (40.5, 27.0-57.6 vs. 55.1, 41.1-64.4, median, IQR; hypothermia n=42 vs. control n=37, p=0.03), while patients with MaRmyocardial IS and reduction in heart failure by 1-3 hours with endovascular cooling in association with primary PCI of acute STEMI predominantly in patients with large area of myocardium at risk. ( id NCT00417638 and NCT01379261).

  3. Foods to Avoid or Limit during Pregnancy (United States)

    ... report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... more. Stony Point, NY 10980 Close X Home > Pregnancy > Nutrition, weight & fitness > Foods to avoid or limit during ...

  4. GSA IT Reform Cost Savings/Avoidance (United States)

    General Services Administration — GSA IT provides data related to Agency IT initiatives that save or avoid expenditures. This data is provided as a requirement of OMB's Integrated Data Collection...

  5. Active Collision Avoidance for Planetary Landers Project (United States)

    National Aeronautics and Space Administration — Advancements in radar technology have resulted in commercial, automotive collision avoidance radars. These radar systems typically use 37GHz or 77GHz interferometry...

  6. Avoid the Consequences of High Blood Pressure (United States)

    ... Thromboembolism Aortic Aneurysm More Avoid the Consequences of High Blood Pressure Infographic Updated:Oct 31,2016 View a downloadable version of this infographic High Blood Pressure • Home • Get the Facts About HBP • Know Your ...

  7. Your Adolescent: Anxiety and Avoidant Disorders (United States)

    ... other times, it develops into panic attacks and phobias. Identifying the Signs Anxiety disorders vary from teenager ... may begin to avoid normal activities and routines. Phobias Many fears of younger children are mild, passing, ...

  8. USAID IT Reform Cost Savings/Avoidance (United States)

    US Agency for International Development — The Office of the Chief Information Officer in the Management Bureau of USAID launched initiatives designed for IT cost savings and avoidance. This dataset includes...

  9. 6 Tips to Avoid Medication Mistakes (United States)

    ... For Consumers Consumer Updates 6 Tips to Avoid Medication Mistakes Share Tweet Linkedin Pin it More sharing ... dietary supplements you use. back to top Computerized Medication Box FDA has cleared for marketing the Electronic ...

  10. Dual Eligibles and Potentially Avoidable Hospitalizations (United States)

    U.S. Department of Health & Human Services — About 25 percent of the hospitalizations for dual eligible beneficiaries in 2005 were potentially avoidable. Medicare and Medicaid spending for those potentially...

  11. Dopamine treatment attenuates acute kidney injury in a rat model of deep hypothermia and rewarming - The role of renal H2S-producing enzymes. (United States)

    Dugbartey, George J; Talaei, Fatemeh; Houwertjes, Martin C; Goris, Maaike; Epema, Anne H; Bouma, Hjalmar R; Henning, Robert H


    Hypothermia and rewarming produces organ injury through the production of reactive oxygen species. We previously found that dopamine prevents hypothermia and rewarming-induced apoptosis in cultured cells through increased expression of the H2S-producing enzyme cystathionine β-Synthase (CBS). Here, we investigate whether dopamine protects the kidney in deep body cooling and explore the role of H2S-producing enzymes in an in vivo rat model of deep hypothermia and rewarming. In anesthetized Wistar rats, body temperature was decreased to 15°C for 3h, followed by rewarming for 1h. Rats (n≥5 per group) were treated throughout the procedure with vehicle or dopamine infusion, and in the presence or absence of a non-specific inhibitor of H2S-producing enzymes, amino-oxyacetic acid (AOAA). Kidney damage and renal expression of three H2S-producing enzymes (CBS, CSE and 3-MST) was quantified and serum H2S level measured. Hypothermia and rewarming induced renal damage, evidenced by increased serum creatinine, renal reactive oxygen species production, KIM-1 expression and influx of immune cells, which was accompanied by substantially lowered renal expression of CBS, CSE, and 3-MST and lowered serum H2S levels. Infusion of dopamine fully attenuated renal damage and maintained expression of H2S-producing enzymes, while normalizing serum H2S. AOAA further decreased the expression of H2S-producing enzymes and serum H2S level, and aggravated renal damage. Hence, dopamine preserves renal integrity during deep hypothermia and rewarming likely by maintaining the expression of renal H2S-producing enzymes and serum H2S.

  12. The vigilance-avoidance model of avoidant recognition: An ERP study under threat priming. (United States)

    Zhai, Jing; Chen, Xu; Ma, Jianling; Yang, Qingqing; Liu, Ying


    Our study examined attachment-related electrophysiological differences in recognition using event-related potentials (ERPs) measured during a study-test paradigm after threat priming. We identified ERP correlates of recognition by comparing the ERPs of attachment-related positive and negative images between avoidant and secure attachment orientations. Our results revealed that the distribution of early old/new effects was broader in avoidant individuals than in secure individuals, and an early parietal old/new effect was observed in avoidant individuals, which reflected their implicit memory. The late old/new effect was found only in secure individuals when evoked by negative pictures, and was not observed in avoidant individuals. The results suggest that avoidant individuals adopt the "vigilance-avoidance" dual-process model to recognize both positive and negative attachment-related stimuli and carry out preferential familiarity matching at the automatic level and avoidant retrieval at the controlled-processing level.

  13. Information Dilemmas and Blame-Avoidance Strategies

    DEFF Research Database (Denmark)

    Erik, Baekkeskov; Rubin, Olivier


    from day one about 2009 H1N1 flu. To explore why, this article links crisis information dilemmas to blame avoidance concepts from democratic political theories. We argue that greater Chinese transparency about infectious disease response reflects evolution in blame avoidance, from heavy reliance...... in place public health specialists and institutions as responsible for H1N1 information and responses, thereby insulating the top-tier leadership....

  14. Mobile Robot Collision Avoidance in Human Environments

    Directory of Open Access Journals (Sweden)

    Lingqi Zeng


    Full Text Available Collision avoidance is a fundamental requirement for mobile robots. Avoiding moving obstacles (also termed dynamic obstacles with unpredictable direction changes, such as humans, is more challenging than avoiding moving obstacles whose motion can be predicted. Precise information on the future moving directions of humans is unobtainable for use in navigation algorithms. Furthermore, humans should be able to pursue their activities unhindered and without worrying about the robots around them. In this paper, both active and critical regions are used to deal with the uncertainty of human motion. A procedure is introduced to calculate the region sizes based on worst‐case avoidance conditions. Next, a novel virtual force field‐based mobile robot navigation algorithm (termed QVFF is presented. This algorithm may be used with both holonomic and nonholonomic robots. It incorporates improved virtual force functions for avoiding moving obstacles and its stability is proven using a piecewise continuous Lyapunov function. Simulation and experimental results are provided for a human walking towards the robot and blocking the path to a goal location. Next, the proposed algorithm is compared with five state‐of‐the‐art navigation algorithms for an environment with one human walking with an unpredictable change in direction. Finally, avoidance results are presented for an environment containing three walking humans. The QVFF algorithm consistently generated collision‐free paths to the goal.

  15. Anesthesia-Induced Hypothermia Attenuates Early-Phase Blood-Brain Barrier Disruption but Not Infarct Volume following Cerebral Ischemia. (United States)

    Liu, Yu-Cheng; Lee, Yu-Da; Wang, Hwai-Lee; Liao, Kate Hsiurong; Chen, Kuen-Bao; Poon, Kin-Shing; Pan, Yu-Ling; Lai, Ted Weita


    Blood-brain barrier (BBB) disruption is thought to facilitate the development of cerebral infarction after a stroke. In a typical stroke model (such as the one used in this study), the early phase of BBB disruption reaches a peak 6 h post-ischemia and largely recovers after 8-24 h, whereas the late phase of BBB disruption begins 48-58 h post-ischemia. Because cerebral infarct develops within 24 h after the onset of ischemia, and several therapeutic agents have been shown to reduce the infarct volume when administered at 6 h post-ischemia, we hypothesized that attenuating BBB disruption at its peak (6 h post-ischemia) can also decrease the infarct volume measured at 24 h. We used a mouse stroke model obtained by combining 120 min of distal middle cerebral arterial occlusion (dMCAo) with ipsilateral common carotid arterial occlusion (CCAo). This model produced the most reliable BBB disruption and cerebral infarction compared to other models characterized by a shorter duration of ischemia or obtained with dMCAO or CCAo alone. The BBB permeability was measured by quantifying Evans blue dye (EBD) extravasation, as this tracer has been shown to be more sensitive for the detection of early-phase BBB disruption compared to other intravascular tracers that are more appropriate for detecting late-phase BBB disruption. We showed that a 1 h-long treatment with isoflurane-anesthesia induced marked hypothermia and attenuated the peak of BBB disruption when administered 6 h after the onset of dMCAo/CCAo-induced ischemia. We also demonstrated that the inhibitory effect of isoflurane was hypothermia-dependent because the same treatment had no effect on ischemic BBB disruption when the mouse body temperature was maintained at 37°C. Importantly, inhibiting the peak of BBB disruption by hypothermia had no effect on the volume of brain infarct 24 h post-ischemia. In conclusion, inhibiting the peak of BBB disruption is not an effective neuroprotective strategy, especially in comparison

  16. Ultrastructural observation of effect of moderate hypothermia on axonal damage in an animal model of diffuse axonal injury

    Institute of Scientific and Technical Information of China (English)

    孙晓川; 唐文渊; 郑履平


    Objective: To investigate the effect of moderate hypothermia on responses of axonal cytoskeleton to axonal injury in the acute stage of injury. Methods: Of fifteen adult guinea pigs, twelve animals were subjected to stretch injury to the right optic nerves and divided into the normothermic group (n=6) in which the animal's core temperature was maintained at 36.0-37.5℃ and the hypothermia group (n=6) in which the core temperature was reduced to 32.0-32.5℃ after stretch injury. Remaining three animals sustained no injury to the right optic nerves and served as control group. Half of injured animals (n=3) of either normothermic group or hypothermic group were killed at either 2 hours or 4 hours after injury. The ultrastructural changes of axonal cytoskeleton of the right optic nerve fibers from the animals were examined under a transmission electron microscope and analyzed by quantitative analysis with a computer image analysis system. Results: At 2 hours after stretch injury, there was a significant reduction in the mean number of microtubules (P<0.001), and a significant increase in the mean intermicrotubule spacing (P<0.05 or P<0.01) in axons of all sizes in normothermic animals. The mean number of neurofilaments also decreased statistically (P<0.01) in large and medium subgroups of axons in the same experimental group at 2 hours. By 4 hours, the large subgroup of axons in normothermic animals still demonstrated a significant decline in the mean number of microtubules (P<0.01) and an increase in the mean intermicrotubule spacing (P<0.05), while the medium and small subgroups of axons displayed a significant increase in the mean number of neurofilaments (P<0.05) and reduction in the mean interneurofilament spacing (P<0.05). On the contrary, either the mean number of microtubules and the mean intermicrotubule spacing, or the mean number of neurofilaments and interneurofilament spacing in axons of all sizes in hypothermic stretch-injured animals was not

  17. Geoengineering to Avoid Overshoot: An Uncertainty Analysis (United States)

    Tanaka, K.


    Geoengineering (or climate engineering) using stratospheric sulfur injections (Crutzen, 2006) has been called for research in case of an urgent need for stopping global warming when other mitigation efforts were exhausted. Although there are a number of concerns over this idea (e.g. Robock, 2008), it is still useful to consider geoengineering as a possible method to limit warming caused by overshoot. Overshoot is a feature accompanied by low stabilizations scenarios aiming for a stringent target (Rao et al., 2008) in which total radiative forcing temporarily exceeds the target before reaching there. Scenarios achieving a 50% emission reduction by 2050 produces overshoot. Overshoot could cause sustained warming for decades due to the inertia of the climate system. If stratospheric sulfur injections were to be used as a "last resort" to avoid overshoot, what would be the suitable start-year and injection profile of such an intervention? Wigley (2006) examined climate response to combined mitigation/geoengineering scenarios with the intent to avert overshoot. Wigley's analysis demonstrated a basic potential of such a combined mitigation/geoengineering approach to avoid temperature overshoot - however it considered only simplistic sulfur injection profiles (all started in 2010), just one mitigation scenario, and did not examine the sensitivity of the climate response to any underlying uncertainties. This study builds upon Wigley's premise of the combined mitigation/geoengineering approach and brings associated uncertainty into the analysis. First, this study addresses the question as to how much geoengineering intervention would be needed to avoid overshoot by considering associated uncertainty? Then, would a geoengineering intervention of such a magnitude including uncertainty be permissible in considering all the other side effects? This study begins from the supposition that geoengineering could be employed to cap warming at 2.0°C since preindustrial. A few

  18. İşçilerin Haklarını Kullanmaktan Kaçınmaları: Nedenleri ve Çözüm Yaklaşımları (Workers Avoidance of Using Their Rights: The Causes and Solution Approaches

    Directory of Open Access Journals (Sweden)

    Barış SEÇER


    Full Text Available Through the legislation which regulates the working life, workers have a lot of statutory rights. But it doesn’t mean that the workers exercises this rights certainly. In spite of the legal sanctions, workers can avoid to exercise their rights. Because rights have a dimension which shaped by the worker’s subjective consideration. Workers make an cost/benefit assessment about exercising rights. These assessments affected by some factors such as personality characteristics, job and employer related factors, unemployment and job insecurity. The main aim of this study is explaining the process of exercising rights of workers and the factors which affects these process. In this study, trade unions and workplace committees which can provide the exercising these rights are discussed. On the other hand, discrimination and employment security regulations, and social responsibility practices are also addressed.


    Energy Technology Data Exchange (ETDEWEB)



    In today's globalized economy, we cannot live without imported products. Most people do not realize how thin the safety net of regulation and inspection really is. Less than three percent of imported products receive any form of government inspection prior to sale. Avoid flea markets, street vendors and deep discount stores. The sellers of counterfeit wares know where to market their products. They look for individuals who are hungry for a brand name item but do not want to pay a brand name price for it. The internet provides anonymity to the sellers of counterfeit products. Unlike Europe, U.S. law does not hold internet-marketing organizations, responsible for the quality of the products sold on their websites. These organizations will remove an individual vendor when a sufficient number of complaints are lodged, but they will not take responsibility for the counterfeit products you may have purchased. EBay has a number of counterfeit product guides to help you avoid being a victim of the sellers of these products. Ten percent of all medications taken worldwide are counterfeit. If you do buy medications on-line, be sure that the National Association of Boards of Pharmacy Verified Internet Pharmacy Practice Sites (VIPPS) recommends the pharmacy you choose to use. Inspect all medication purchases and report any change in color, shape, imprinting or odor to your pharmacist. If you take generic medications these attributes may change from one manufacturer to another. Your pharmacist should inform you of any changes when you refill your prescription. If they do not, get clarification prior to taking the medication. Please note that the Federal Drug Administration (FDA) does not regulate supplements. The FDA only steps in when a specific supplement proves to cause physical harm or contains a regulated ingredient. Due to counterfeiting, Underwriters Laboratories (UL) changed their label design three times since 1996. The new gold label should be attached to the cord


    Directory of Open Access Journals (Sweden)

    Indah Dwi Pratama


    Full Text Available One factor that can interfere with the absorption rate of viewers on television advertisement is advertising avoidance which shows the difference between the number of viewers who watch advertisement programs and the number of viewers who watch television programs. The factors that affect advertising avoidance include the demography of the viewers (gender, age, area of residence, and social economic status, or SES, advertising attributes (the television stations, order of ads, genre of the program, and advertising sector, and competition (DayPart. The study attempted to measure the level of advertising avoidance in Indonesia and its relation to various factors that influence it by using the secondary data generated by Nielsen Audience Measurement Indonesia through Television Audience Measurement (TAM. The methods utilized consisted of the t-test independent sample, one way ANOVA, Tukey, Kruskal Wallis, and Dunn Bonferoni. The result showed that the level of advertising avoidance in Indonesia reached by 23%, with relatively similar results to the other studies in various countries. The hypothesis test results also showed a significant relationship between the advertising avoidance and demographic variables, advertising attributes, and competitions affecting this avoidance. On one hand, the findings of the study are expected to be useful for the advertisers to plan their advertisements on television so that they become more effective and efficient. On the other hand, television stations can utilize these findings as a development strategy to expand their audience segmentation and to accommodate the needs of the advertisers more optimally.Keywords: advertising avoidance, television advertisement, TAM, ANOVA, Tukey

  1. Drug-induced mild therapeutic hypothermia obtained by administration of a transient receptor potential vanilloid type 1 agonist

    DEFF Research Database (Denmark)

    Fosgerau, Keld; Weber, Uno J; Gotfredsen, Jacob W


    the feasibility of using a transient receptor potential vanilloid type 1 (TRPV1) agonist for obtaining drug-induced sustainable mild hypothermia. Methods First, we screened a heterogeneous group of TRPV1 agonists and secondly we tested the hypothermic properties of a selected candidate by dose-response studies....... Finally we tested the hypothermic properties in a large animal. The screening was in conscious rats, the dose-response experiments in conscious rats and in cynomologus monkeys, and the finally we tested the hypothermic properties in conscious young cattle (calves with a body weight as an adult human......). The investigated TRPV1 agonists were administered by continuous intravenous infusion. Results  Screening: Dihydrocapsaicin (DHC), a component of chili pepper, displayed a desirable hypothermic profile with regards to the duration, depth and control in conscious rats. Dose-response experiments: In both rats...

  2. Retraction: Selective cerebro-myocardial perfusion under mild hypothermia during primary repair for aortic coarctation with ventricular septal defect. (United States)


    The following article from Artificial Organs, "Selective Cerebro-Myocardial Perfusion Under Mild Hypothermia During Primary Repair for Aortic Coarctation With Ventricular Septal Defect" by Huiwen Chen, Haifa Hong, Zhongqun Zhu and Jinfen Liu, published online on 2 November 2012 in Wiley Online Library (, has been retracted by agreement between the authors, the journal Editor-in-Chief, Paul S. Malchesky, the International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc. The retraction has been agreed due to simultaneous publication of a substantially similar article, "Continuous Cerebral and Myocardial Perfusion During One-Stage Repair for Aortic Coarctation With Ventricular Septal Defect", by Huiwen Chen, Haifa Hong, Zhongqun Zhu and Jinfen Liu, in Pediatric Cardiology 7 November 2012 [Epub ahead of print].

  3. The application of hypothermia therapy on cardiogenic shock%亚低温在心源性休克中的运用

    Institute of Scientific and Technical Information of China (English)

    杨小刚; 罗来邦; 洪华章


    目的:探讨亚低温对于心源性休克患者血流动力学及生存率影响。方法选择心源性休克病人90例,分成亚低温组和对照组。亚低温组给予亚低温治疗:用冰毯或经血液净化管路输入冷置换液把目标温度设置为33℃左右。同时经股动脉置入脉搏指示持续心排监测(Pulse indicator Continuous Cardiac Output,PICCO)导管,接仪器监测血流动力学参数。分别记录患者降温前血压(0h)、降温后8、16、24h心指数(cardiac output index,CI),心率(heart rate,HR),血管外周阻力等变化(system vascular resistance index,SVRI);观察病人2个月内存活率。对照组给予目前常规治疗,其他治疗同亚低温组。结果两组均通过调整血管活性药物控制血压,血压无明显差异。病人心率在亚低温组稍显降低,但统计学无差异。心脏指数亚低温组增高, P<0.05,有统计学差异。两温组外周阻力没有明显差异。亚低温组应用去甲肾上腺素量较低,P<0.05有统计学差异。结论亚低温对于心源性休克患者能增加心输出量,减少血管活性药物的使用。%Objective To evaluate the effect of hypothermia therapy on cardiac hemodynamics and survival rate of patients with cardiogenic shock. Methods 90 patients with cardiogenic shock were divided into hypothermia group and the control group. Hypothermia group was treated with hypothermia therapy:Set the temperature to 33°C with ice-cold blanket or injecting displace-ment fluid through blood purification line,place PICCO via femoral artery catheter,connect the monitoring instrument to observe hemodynamic parameters,record the cardiac output index,heart rate,system vascular resistance index(SVRI) before cooling,8,16, 24 hours after cooling blood pressure respectively,observe the patient survival rate after two month. Control group were given con-ventional treatments,other are equivalent to hypothermia group

  4. Sarcosine attenuates toluene-induced motor incoordination, memory impairment, and hypothermia but not brain stimulation reward enhancement in mice

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Ming-Huan [Department of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan (China); Institute of Neuroscience, National Changchi University, Taipei, Taiwan (China); Chung, Shiang-Sheng [Department of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan (China); Department of Pharmacy, Yuli Veterans Hospital, Hualien, Taiwan (China); Stoker, Astrid K.; Markou, Athina [Department of Psychiatry, School of Medicine, University of California San Diego, La Jolla, CA (United States); Chen, Hwei-Hsien, E-mail: [Department of Pharmacology and Toxicology, Tzu Chi University, Hualien, Taiwan (China); Division of Mental Health and Addiction Medicine, Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County, Taiwan (China)


    Toluene, a widely used and commonly abused organic solvent, produces various behavioral disturbances, including motor incoordination and cognitive impairment. Toluene alters the function of a large number of receptors and ion channels. Blockade of N-methyl-D-aspartate (NMDA) receptors has been suggested to play a critical role in toluene-induced behavioral manifestations. The present study determined the effects of various toluene doses on motor coordination, recognition memory, body temperature, and intracranial self-stimulation (ICSS) thresholds in mice. Additionally, the effects of sarcosine on the behavioral and physiological effects induced by toluene were evaluated. Sarcosine may reverse toluene-induced behavioral manifestations by acting as an NMDA receptor co-agonist and by inhibiting the effects of the type I glycine transporter (GlyT1). Mice were treated with toluene alone or combined with sarcosine pretreatment and assessed for rotarod performance, object recognition memory, rectal temperature, and ICSS thresholds. Toluene dose-dependently induced motor incoordination, recognition memory impairment, and hypothermia and lowered ICSS thresholds. Sarcosine pretreatment reversed toluene-induced changes in rotarod performance, novel object recognition, and rectal temperature but not ICSS thresholds. These findings suggest that the sarcosine-induced potentiation of NMDA receptors may reverse motor incoordination, memory impairment, and hypothermia but not the enhancement of brain stimulation reward function associated with toluene exposure. Sarcosine may be a promising compound to prevent acute toluene intoxications by occupational or intentional exposure. -- Highlights: ► Toluene induces impairments in Rotarod test and novel object recognition test. ► Toluene lowers rectal temperature and ICSS thresholds in mice. ► Sarcosine reverses toluene-induced changes in motor, memory and body temperature. ► Sarcosine pretreatment does not affect toluene

  5. Brain tissue partial pressure of oxygen predicts the outcome of severe traumatic brain injury under mild hypothermia treatment

    Directory of Open Access Journals (Sweden)

    Sun H


    Full Text Available Hongtao Sun,1,* Maohua Zheng,2,* Yanmin Wang,1 Yunfeng Diao,1 Wanyong Zhao,1 Zhengjun Wei1 1Sixth Department of Neurosurgery, Affiliated Hospital of Logistics University of People’s Armed Police Force, Tianjin, 2Department of Neurosurgery, The First Hospital of Lanzhou University, Lanzhou, People’s Republic of China *These authors contributed equally to this work Objective: The aim of this study was to investigate the clinical significance and changes of brain tissue partial pressure of oxygen (PbtO2 in the course of mild hypothermia treatment (MHT for treating severe traumatic brain injury (sTBI. Methods: There were 68 cases with sTBI undergoing MHT. PbtO2, intracranial pressure (ICP, jugular venous oxygen saturation (SjvO2, and cerebral perfusion pressure (CPP were continuously monitored, and clinical outcomes were evaluated using the Glasgow Outcome Scale score. Results: Of 68 patients with sTBI, PbtO2, SjvO2, and CPP were obviously increased, but decreased ICP level was observed throughout the MHT. PbtO2 and ICP were negatively linearly correlated, while there was a positive linear correlation between PbtO2 and SjvO2. Monitoring CPP and SjvO2 was performed under normal circumstances, and a large proportion of patients were detected with low PbtO2. Decreased PbtO2 was also found after MHT. Conclusion: Continuous PbtO2 monitoring could be introduced to evaluate the condition of regional cerebral oxygen metabolism, thereby guiding the clinical treatment and predicting the outcome. Keywords: severe traumatic brain injury, hypothermia, brain tissue partial pressure of oxygen, therapy

  6. Mild hypothermia during global cardiac ischemia opens a window of opportunity to develop heart donation after cardiac death. (United States)

    Stadelmann, Mathieu; Dornbierer, Monika; Clément, David; Gahl, Brigitta; Dick, Florian; Carrel, Thierry P; Tevaearai, Hendrik T; Longnus, Sarah


    Although heart donation after cardiac death (DCD) could greatly improve graft availability, concerns regarding warm ischemic damage typically preclude transplantation. Improving tolerance to warm ischemia may thus open a window of opportunity for DCD hearts. We investigated the hypothesis that, compared with normothermia, mild hypothermia (32° C) initiated after ischemic onset improves cardiac functional recovery upon reperfusion. Isolated, working hearts from adult, male Wistar rats underwent global, no-flow ischemia, and reperfusion (n = 28). After ischemic onset, temperature was maintained at either 37° C for 20 or 30 min or reduced to 32° C for 40, 50, or 60 min. Recovery was measured after 60-min reperfusion. Following normothermic ischemia, recovery of rate-pressure product (RPP; per cent of preischemic value) was almost complete after 20-min ischemia (97 ± 9%), whereas no recovery was detectable after 30-min ischemia. After mildly hypothermic ischemia (32° C), RPP also recovered well after 40 min (86 ± 4%). Markers of metabolism and necrosis were similar in 37° C/20 min and 32° C/40 min groups. Simple reduction in cardiac temperature by a few degrees after the onset of global ischemia dramatically prolongs the interval during which the heart remains resistant to functional deterioration. Preservation of hemodynamic function is associated with improved metabolic recovery and reduced necrosis. The application of mild hypothermia may be a simple first step towards development of clinical protocols for DCD heart recovery.

  7. Effects of xenon and hypothermia on cerebrovascular pressure reactivity in newborn global hypoxic-ischemic pig model. (United States)

    Chakkarapani, Elavazhagan; Dingley, John; Aquilina, Kristian; Osredkar, Damjan; Liu, Xun; Thoresen, Marianne


    Autoregulation of cerebral perfusion is impaired in hypoxic-ischemic encephalopathy. We investigated whether cerebrovascular pressure reactivity (PRx), an element of cerebral autoregulation that is calculated as a moving correlation coefficient between averages of intracranial and mean arterial blood pressure (MABP) with values between -1 and +1, is impaired during and after a hypoxic-ischemic insult (HI) in newborn pigs. Associations between end-tidal CO2, seizures, neuropathology, and PRx were investigated. The effect of hypothermia (HT) and Xenon (Xe) on PRx was studied. Pigs were randomized to Sham, and after HI to normothermia (NT), HT, Xe or xenon hypothermia (XeHT). We defined PRx >0.2 as peak and negative PRx as preserved. Neuropathology scores after 72 hours of survival was grouped as 'severe' or 'mild.' Secondary PRx peak during recovery, predictive of severe neuropathology and associated with insult severity (P=0.05), was delayed in HT (11.5 hours) than in NT (6.5 hours) groups. Seizures were associated with impaired PRx in NT pigs (P=0.0002), but not in the HT/XeHT pigs. PRx was preserved during normocapnia and impaired during hypocapnia. Xenon abolished the secondary PRx peak, increased (mean (95% confidence interval (CI)) MABP (6.5 (3.8, 9.4) mm Hg) and cerebral perfusion pressure (5.9 (2.9, 8.9) mm Hg) and preserved the PRx (regression coefficient, -0.098 (95% CI (-0.18, -0.01)), independent of the insult severity.

  8. Is avoiding an aversive outcome rewarding? Neural substrates of avoidance learning in the human brain. (United States)

    Kim, Hackjin; Shimojo, Shinsuke; O'Doherty, John P


    Avoidance learning poses a challenge for reinforcement-based theories of instrumental conditioning, because once an aversive outcome is successfully avoided an individual may no longer experience extrinsic reinforcement for their behavior. One possible account for this is to propose that avoiding an aversive outcome is in itself a reward, and thus avoidance behavior is positively reinforced on each trial when the aversive outcome is successfully avoided. In the present study we aimed to test this possibility by determining whether avoidance of an aversive outcome recruits the same neural circuitry as that elicited by a reward itself. We scanned 16 human participants with functional MRI while they performed an instrumental choice task, in which on each trial they chose from one of two actions in order to either win money or else avoid losing money. Neural activity in a region previously implicated in encoding stimulus reward value, the medial orbitofrontal cortex, was found to increase, not only following receipt of reward, but also following successful avoidance of an aversive outcome. This neural signal may itself act as an intrinsic reward, thereby serving to reinforce actions during instrumental avoidance.

  9. Cod avoidance by area regulations in Kattegat

    DEFF Research Database (Denmark)

    Eliasen, Søren Qvist


    presents two initiatives for cod avoidance in Kattegat; a fisher initiative sharing information about cod bycatch which could lead to real time closures in areas with high bycatch of juveniles, for vessels with low cod quota to avoid catch of all cod, and a Danish Swedish Government initiative of permanent......The article examines the experiences of two initiatives of cod avoidance by area regulations in the Kattegat in the light of the upcoming discard ban in EU fisheries. The first section highlights elements of the discard ban in the reformed EU Common Fisheries Policy (CFP). The second section...... and temporary area closures in Kattegat. The third section discusses the lessons learned in the light of implementation of the discard ban. The fourth section sums up the lessons learned; Regional measures of implementation of the discard ban should include all vessels with quota in the region to be regarded...

  10. Avoiding barriers in control of mowing robot

    Institute of Scientific and Technical Information of China (English)

    QIU Bai-jing; QIAN Guo-hong; XIANG Zhong-ping; LI Zuo-peng


    Due to complicated barriers,it is difficult to track the path of the mowing robot and to avoid barriers.In order to solve the problem,a method based on distance-measuring sensors and fuzzy control inputs was proposed.Its track was composed of beelines and was easy to tail.The fuzzy control inputs were based on the front barrier distance and the difference between the left and right barrier distance measured by ultrasonic sensors;the output was the direction angle.The infrared sensors around the robot improved its safety in avoiding barriers.The result of the method was feasible,agile,and stable.The distance between the robot and the barriers could be changed by altering the inputs and outputs of fuzzy control and the length of the beelines.The disposed sensors can fulfill the need of the robot in avoiding barriers.

  11. Engaging Math-Avoidant College Students

    Directory of Open Access Journals (Sweden)

    M. Paul Latiolais


    Full Text Available This paper is an informal, personal account of how we, as two college teachers, became interested in math anxiety, decided to explore it amongst students at our institution in order to inform our teaching, and became convinced that the massive problem is math avoidance. We tried discussion groups, but few students attended, although those that did made useful suggestions. Thus informed, we designed an innovative course, Confronting College Mathematics as a Humanities course with the possibility of credit toward the math requirement, but it was undersubscribed in its first offering and had to be canceled. How can we get college students who avoid math to break through the barrier of math avoidance? We have now begun to explore a new approach: Second Life, where students can engage math—and quantitative literacy—virtually, and anonymously.

  12. Learning processes underlying avoidance of negative outcomes. (United States)

    Andreatta, Marta; Michelmann, Sebastian; Pauli, Paul; Hewig, Johannes


    Successful avoidance of a threatening event may negatively reinforce the behavior due to activation of brain structures involved in reward processing. Here, we further investigated the learning-related properties of avoidance using feedback-related negativity (FRN). The FRN is modulated by violations of an intended outcome (prediction error, PE), that is, the bigger the difference between intended and actual outcome, the larger the FRN amplitude is. Twenty-eight participants underwent an operant conditioning paradigm, in which a behavior (button press) allowed them to avoid a painful electric shock. During two learning blocks, participants could avoid an electric shock in 80% of the trials by pressing one button (avoidance button), or by not pressing another button (punishment button). After learning, participants underwent two test blocks, which were identical to the learning ones except that no shocks were delivered. Participants pressed the avoidance button more often than the punishment button. Importantly, response frequency increased throughout the learning blocks but it did not decrease during the test blocks, indicating impaired extinction and/or habit formation. In line with a PE account, FRN amplitude to negative feedback after correct responses (i.e., unexpected punishment) was significantly larger than to positive feedback (i.e., expected omission of punishment), and it increased throughout the blocks. Highly anxious individuals showed equal FRN amplitudes to negative and positive feedback, suggesting impaired discrimination. These results confirm the role of negative reinforcement in motivating behavior and learning, and reveal important differences between high and low anxious individuals in the processing of prediction errors.

  13. Low-Cost Avoidance Behaviors Are Resistant To Fear Extinction In Humans

    Directory of Open Access Journals (Sweden)

    Bram eVervliet


    Full Text Available Elevated levels of fear and avoidance are core symptoms across the anxiety disorders. It has long been known that fear serves to motivate avoidance. Consequently, fear extinction has been the primary focus in pre-clinical anxiety research for decades, under the implicit assumption that removing the motivator of avoidance (fear would automatically mitigate the avoidance behaviors as well. Although this assumption has intuitive appeal, it has received little scientific scrutiny. The scarce evidence from animal studies is mixed, while the assumption remains untested in humans. The current study applied an avoidance conditioning protocol in humans to investigate the effects of fear extinction on the persistence of low-cost avoidance. Online danger-safety ratings and skin conductance responses documented the dynamics of conditioned fear across avoidance and extinction phases. Anxiety- and avoidance-related questionnaires explored individual differences in rates of avoidance. Participants first learned to click a button during a predictive danger signal, in order to cancel an upcoming aversive electrical shock (avoidance conditioning. Next, fear extinction was induced by presenting the signal in the absence of shocks while button-clicks were prevented (by removing the button in Experiment 1, or by instructing not to click the button in Experiment 2. Most importantly, post-extinction availaibility of the button caused a significant return of avoidant button-clicks. In addition, trait-anxiety levels correlated positively with rates of avoidance during a predictive safety signal, and with the rate of pre- to post-extinction decrease during this signal. Fear measures gradually decreased during avoidance conditioning, as participants learned that button-clicks effectively canceled the shock. Preventing button-clicks elicited a sharp increase in fear, which subsequently extinguished. Fear remained low during avoidance testing, but danger-safety ratings

  14. Low-Cost Avoidance Behaviors are Resistant to Fear Extinction in Humans. (United States)

    Vervliet, Bram; Indekeu, Ellen


    Elevated levels of fear and avoidance are core symptoms across the anxiety disorders. It has long been known that fear serves to motivate avoidance. Consequently, fear extinction has been the primary focus in pre-clinical anxiety research for decades, under the implicit assumption that removing the motivator of avoidance (fear) would automatically mitigate the avoidance behaviors as well. Although this assumption has intuitive appeal, it has received little scientific scrutiny. The scarce evidence from animal studies is mixed, while the assumption remains untested in humans. The current study applied an avoidance conditioning protocol in humans to investigate the effects of fear extinction on the persistence of low-cost avoidance. Online danger-safety ratings and skin conductance responses documented the dynamics of conditioned fear across avoidance and extinction phases. Anxiety- and avoidance-related questionnaires explored individual differences in rates of avoidance. Participants first learned to click a button during a predictive danger signal, in order to cancel an upcoming aversive electrical shock (avoidance conditioning). Next, fear extinction was induced by presenting the signal in the absence of shocks while button-clicks were prevented (by removing the button in Experiment 1, or by instructing not to click the button in Experiment 2). Most importantly, post-extinction availability of the button caused a significant return of avoidant button-clicks. In addition, trait-anxiety levels correlated positively with rates of avoidance during a predictive safety signal, and with the rate of pre- to post-extinction decrease during this signal. Fear measures gradually decreased during avoidance conditioning, as participants learned that button-clicks effectively canceled the shock. Preventing button-clicks elicited a sharp increase in fear, which subsequently extinguished. Fear remained low during avoidance testing, but danger-safety ratings increased again when

  15. [Chances of avoiding amputation in an arteritis patient with gangrene]. (United States)

    Natali, J; Firouz-Abadie, H; Maraval, M; Kieffer, E


    During the period 1970-1974, restorative surgery was carried out 324 times in patients with gangrene or severe ischaemia caused by arteritis of the lower limbs. In 67 percent of the cases major excision surgery, such as amputation at the thigh or of the whole leg, was avoided and the support was retained. In 61 cases (19 percent) amputation was necessary either immediately or within a few weeks or months. Death occurred in 47 patients (14 percent) either in the operative period or in the 3 following years.

  16. Avoided by association: acquisition, extinction, and renewal of avoidance tendencies toward conditioned fear stimuli

    NARCIS (Netherlands)

    A.M. Krypotos; M. Effting; I. Arnaudova; M. Kindt; T. Beckers


    Traditional theoretical models hold that avoidance reflects the interplay of Pavlovian and instrumental learning. Here we suggest that avoidance tendencies to intrinsically neutral cues may be established by mere Pavlovian association. Following fear conditioning, in which pictures of one object wer

  17. Development of a Measure of Experiential Avoidance: The Multidimensional Experiential Avoidance Questionnaire (United States)

    Gamez, Wakiza; Chmielewski, Michael; Kotov, Roman; Ruggero, Camilo; Watson, David


    Experiential avoidance (EA) has been conceptualized as the tendency to avoid negative internal experiences and is an important concept in numerous conceptualizations of psychopathology as well as theories of psychotherapy. Existing measures of EA have either been narrowly defined or demonstrated unsatisfactory internal consistency and/or evidence…

  18. Reasonable Avoidability, Responsibility and Lifestyle Diseases

    DEFF Research Database (Denmark)

    Andersen, Martin Marchman


    In “Health, Luck and Justice” Shlomi Segall argues for a luck egalitarian approach to justice in health care. As the basis for a just distribution he suggests a principle of Reasonable Avoidability, which he takes to imply that we do not have justice-based reasons to treat diseases brought about ...

  19. Organising European technical documentation to avoid duplication. (United States)

    Donawa, Maria


    The development of comprehensive accurate and well-organised technical documentation that demonstrates compliance with regulatory requirements is a resource-intensive, but critically important activity for medical device manufacturers. This article discusses guidance documents and method of organising technical documentation that may help avoid costly and time-consuming duplication.

  20. The Netherlands Bird Avoidance Model, Final Report

    NARCIS (Netherlands)

    Shamoun-Baranes, J.; Bouten, W.; Sierdsema, H.; van Belle, J.; van Gasteren, J.R.; van Loon, E.E.


    The NL-BAM was developed as a web-based decision support tool to be used by the bird hazard avoidance experts in the ecology unit of the Royal Netherlands Air Force. The NL-BAM will be used together with the ROBIN 4 radar system to provide BirdTAMS, for real time warnings and flight planning and to

  1. An Examination of Avoided Costs in Utah

    Energy Technology Data Exchange (ETDEWEB)

    Bolinger, Mark; Wiser, Ryan


    The Utah Wind Working Group (UWWG) believes there are currently opportunities to encourage wind power development in the state by seeking changes to the avoided cost tariff paid to qualifying facilities (QFs). These opportunities have arisen as a result of a recent renegotiation of Pacificorp's Schedule 37 tariff for wind QFs under 3 MW, as well as an ongoing examination of Pacificorp's Schedule 38 tariff for wind QFs larger than 3 MW. It is expected that decisions made regarding Schedule 38 will also impact Schedule 37. Through the Laboratory Technical Assistance Program (Lab TAP), the UWWG has requested (through the Utah Energy Office) that LBNL provide technical assistance in determining whether an alternative method of calculating avoided costs that has been officially adopted in Idaho would lead to higher QF payments in Utah, and to discuss the pros and cons of this method relative to the methodology recently adopted under Schedule 37 in Utah. To accomplish this scope of work, I begin by summarizing the current method of calculating avoided costs in Utah (per Schedule 37) and Idaho (the ''surrogate avoided resource'' or SAR method). I then compare the two methods both qualitatively and quantitatively. Next I present Pacificorp's four main objections to the use of the SAR method, and discuss the reasonableness of each objection. Finally, I conclude with a few other potential considerations that might add value to wind QFs in Utah.

  2. Avoidance Motivation and Conservation of Energy

    NARCIS (Netherlands)

    Roskes, Marieke; Elliot, Andrew J.; Nijstad, Bernard A.; De Dreu, Carsten K. W.


    Compared to approach motivation, avoidance motivation evokes vigilance, attention to detail, systematic information processing, and the recruitment of cognitive resources. From a conservation of energy perspective it follows that people would be reluctant to engage in the kind of effortful cognitive

  3. [Avoidance of patient-prosthesis mismatch]. (United States)

    Sakamoto, Y; Hashimoto, K


    To minimize the incidence of patient-prosthesis mismatch (PPM), we have routinely adopted aortic root enlargement to avoid PPM for patients with small aortic annulus. The aim of this study was to review our strategy of avoiding PPM. The Carpentier-Edwards Perimount (CEP) valves were implanted in 53 patients who were mostly aged over 65 and the St. Jude Medical (SJM) mechanical valves were used in 128 patients aged under 65. A standard 21-mm SJM valve was used in only 3 patients and no 19-mm valves were employed. However, 19-mm CEP valves were used in 12 patients with a small body surface area (1.43 +/- 0.14 m2). Of these, 26 patients (14.4%) who had a small aortic annulus and 24 patients aged under 65 underwent aortic root enlargement. No patient receiving an SJM valve had an projected indexed effective orifice area (EOAI) small annulus, the first choice for avoiding PPM is aortic annular enlargement, which may be avoided by high performance mechanical valves with larger EOA.

  4. Teaching Preschool Children to Avoid Poison Hazards (United States)

    Dancho, Kelly A.; Thompson, Rachel H.; Rhoades, Melissa M.


    We evaluated the effectiveness of group safety training and in situ feedback and response interruption to teach preschool children to avoid consuming potentially hazardous substances. Three children ingested ambiguous substances during a baited baseline assessment condition and continued to ingest these substances following group safety training.…

  5. Avoidable costs of comprehensive case management. (United States)

    Issel, L M; Anderson, R A


    Comprehensive case management has become an industry standard and its pervasiveness raises questions about the ubiquitous need for this service. Analyzed from the perspective of transaction cost analysis and access, we argue that in some cases comprehensive case management is an avoidable cost incurred because of system problems that limit access to otherwise eligible clients. Implications are discussed.


    Institute of Scientific and Technical Information of China (English)



    Use of Sexist language is one of the serious yet often-neglected mistakes in the English writing and speaking of Chineselearners of English. Sexist language in English can be classifiedinto two categories : ambiguity of referent and stereotyping. Thispaper focuses on some common sexist language in the Englishwriting and speaking of Chinese learners of English and givessome suggestions about how to avoid them.

  7. Simple Obstacle Avoidance Algorithm for Rehabilitation Robots

    NARCIS (Netherlands)

    Stuyt, F.H.A.; Römer, G.R.B.; Stuyt, H.J.A.


    The efficiency of a rehabilitation robot is improved by offering record-and-replay to operate the robot. While automatically moving to a stored target (replay) collisions of the robot with obstacles in its work space must be avoided. A simple, though effective, generic and deterministic algorithm fo

  8. Doppler micro sense and avoid radar (United States)

    Gorwara, Ashok; Molchanov, Pavlo; Asmolova, Olga


    There is a need for small Sense and Avoid (SAA) systems for small and micro Unmanned Aerial Systems (UAS) to avoid collisions with obstacles and other aircraft. The proposed SAA systems will give drones the ability to "see" close up and give them the agility to maneuver through tight areas. Doppler radar is proposed for use in this sense and avoid system because in contrast to optical or infrared (IR) systems Doppler can work in more harsh conditions such as at dusk, and in rain and snow. And in contrast to ultrasound based systems, Doppler can better sense small sized obstacles such as wires and it can provide a sensing range from a few inches to several miles. An SAA systems comprised of Doppler radar modules and an array of directional antennas that are distributed around the perimeter of the drone can cover the entire sky. These modules are designed so that they can provide the direction to the obstacle and simultaneously generate an alarm signal if the obstacle enters within the SAA system's adjustable "Protection Border". The alarm signal alerts the drone's autopilot to automatically initiate an avoidance maneuver. A series of Doppler radar modules with different ranges, angles of view and transmitting power have been designed for drones of different sizes and applications. The proposed Doppler radar micro SAA system has simple circuitry, works from a 5 volt source and has low power consumption. It is light weight, inexpensive and it can be used for a variety of small unmanned aircraft.

  9. Oscillations in two-person avoidance control

    CERN Document Server

    Kish, Lazar


    Social interaction dynamics are a special type of group interactions that play a large part in our everyday lives. They dictate how and with whom a certain individual will interact. One of such interactions can be termed "avoidance control". This everyday situation occurs when two fast-walking persons suddenly realize that they are on a frontal collision course and begin maneuvering to avoid collision. If the two walkers' initial maneuverings are in the same direction that can lead to oscillations that lengthen time required to reach a stable avoidance trajectory. We introduce a dynamical model with a feedback loop to understand the origin and properties of this oscillation. For the emergence of the oscillatory behavior, two conditions must be satisfied: i) the persons must initiate the avoidance maneuver in the same direction; ii) the time delays in the feedback loop must reverse the phase of the players' positions at the oscillation frequency. The oscillation can be terminated at any time if one of the walk...

  10. Reducing avoidable pressure ulcers in the community. (United States)

    Parnham, Alison; Pankhurst, Sarah; Dabell, Wendy


    The elimination of avoidable pressure ulcers remains a challenge in healthcare provision, represents an increasing financial burden on resources and continues to affect patients' quality of life. Many pressure ulcers are deemed to be avoidable and there are several factors that can influence this, including the development of a care delivery system and a service delivery strategy that incorporate a comprehensive structure, a meticulous process and measurable outcomes. Nottingham CityCare developed a strategy to reduce avoidable pressure ulcers. The implementation of the strategy in an inner city community setting is discussed. The importance of eliminating pressure ulcers is explored, and the barriers to care delivery are reviewed, demonstrating how a new culture in clinical practice can ensure the elimination of avoidable pressure ulcers. The challenges within the implementation process are reflected on and the implementation of the SSKIN (Surface, Skin inspection, Keep your patient moving, Incontinence and moisture, Nutrition and hydration) phenomenon is reviewed in relation to care delivery, record-keeping and evaluation.

  11. Hydrofluoric acid on dentin should be avoided.

    NARCIS (Netherlands)

    Loomans, B.A.C.; Mine, A.; Roeters, F.J.M.; Opdam, N.J.M.; Munck, J. De; Huysmans, M.C.D.N.J.M.; Meerbeek, B. Van


    Hydrofluoric acid can be used for intra-oral repair of restorations. Contamination of tooth substrate with hydrofluoric acid cannot always be avoided. OBJECTIVES: To investigate the bonding effectiveness to hydrofluoric acid contaminated dentin by, micro-tensile bond strength testing, SEM and TEM. M

  12. Measuring Patients’ Attachment Avoidance in Psychotherapy: Development of the Attachment Avoidance in Therapy Scale (AATS

    Directory of Open Access Journals (Sweden)

    András Láng


    Full Text Available A new scale measuring patient-therapist attachment avoidance was developed. Attachment Avoidance in Therapy Scale is a new measure based on the Bartholomew model of adult attachment (Bartholomew & Horowitz, 1991 and the Experience in Close Relationships Scale (Brennan, Clark, & Shaver, 1998 to measure patients’ attachment avoidance towards therapists. With 112 patient-therapist dyads participating in the study, validation of a preliminary scale – measuring both attachment anxiety and attachment avoidance in therapy – took place using therapists’ evaluations of patients’ relational behavior and patients’ self-reports about their attitude toward psychotherapy. Analysis of the data revealed six underlying scales. Results showed all six scales to be reliable. Validation of scales measuring attachment anxiety failed. The importance of Attachment Avoidance in Therapy Scale and its subscales is discussed.

  13. Bursting neurons and ultrasound avoidance in crickets

    Directory of Open Access Journals (Sweden)

    Gary eMarsat


    Full Text Available Decision making in invertebrates often relies on simple neural circuits composed of only a few identified neurons. The relative simplicity of these circuits makes it possible to identify the key computation and neural properties underlying decisions. In this review, we summarize recent research on the neural basis of ultrasound avoidance in crickets, a response that allows escape from echolocating bats. The key neural property shaping behavioral output is high-frequency bursting of an identified interneuron, AN2, which carries information about ultrasound stimuli from receptor neurons to the brain. AN2's spike train consists of clusters of spikes –bursts– that may be interspersed with isolated, non-burst spikes. AN2 firing is necessary and sufficient to trigger avoidance steering but only high-rate firing, such as occurs in bursts, evokes this response. AN2 bursts are therefore at the core of the computation involved in deciding whether or not to steer away from ultrasound. Bursts in AN2 are triggered by synaptic input from nearly synchronous bursts in ultrasound receptors. Thus the population response at the very first stage of sensory processing –the auditory receptor- already differentiates the features of the stimulus that will trigger a behavioral response from those that will not. Adaptation, both intrinsic to AN2 and within ultrasound receptors, scales the burst-generating features according to the stimulus statistics, thus filtering out background noise and ensuring that bursts occur selectively in response to salient peaks in ultrasound intensity. Furthermore AN2’s sensitivity to ultrasound varies adaptively with predation pressure, through both developmental and evolutionary mechanisms. We discuss how this key relationship between bursting and the triggering of avoidance behavior is also observed in other invertebrate systems such as the avoidance of looming visual stimuli in locusts or heat avoidance in beetles.

  14. Bursting neurons and ultrasound avoidance in crickets. (United States)

    Marsat, Gary; Pollack, Gerald S


    Decision making in invertebrates often relies on simple neural circuits composed of only a few identified neurons. The relative simplicity of these circuits makes it possible to identify the key computation and neural properties underlying decisions. In this review, we summarize recent research on the neural basis of ultrasound avoidance in crickets, a response that allows escape from echolocating bats. The key neural property shaping behavioral output is high-frequency bursting of an identified interneuron, AN2, which carries information about ultrasound stimuli from receptor neurons to the brain. AN2's spike train consists of clusters of spikes - bursts - that may be interspersed with isolated, non-burst spikes. AN2 firing is necessary and sufficient to trigger avoidance steering but only high-rate firing, such as occurs in bursts, evokes this response. AN2 bursts are therefore at the core of the computation involved in deciding whether or not to steer away from ultrasound. Bursts in AN2 are triggered by synaptic input from nearly synchronous bursts in ultrasound receptors. Thus the population response at the very first stage of sensory processing - the auditory receptor - already differentiates the features of the stimulus that will trigger a behavioral response from those that will not. Adaptation, both intrinsic to AN2 and within ultrasound receptors, scales the burst-generating features according to the stimulus statistics, thus filtering out background noise and ensuring that bursts occur selectively in response to salient peaks in ultrasound intensity. Furthermore AN2's sensitivity to ultrasound varies adaptively with predation pressure, through both developmental and evolutionary mechanisms. We discuss how this key relationship between bursting and the triggering of avoidance behavior is also observed in other invertebrate systems such as the avoidance of looming visual stimuli in locusts or heat avoidance in beetles.

  15. Vehicle routing under time-dependant travel times: The impact of congestion avoidance

    NARCIS (Netherlands)

    Kok, A.L.; Hans, E.W.; Schutten, J.M.J.


    Daily traffic congestion forms a major problem for businesses such as logistic service providers and distribution firms. It causes late arrivals at customers and additional costs for hiring the truck drivers. Such costs caused by traffic congestion can be reduced by taking into account and avoiding

  16. Calpain expression changes in response to hypothermia after traumatic brain injury%颅脑外伤后亚低温治疗对Calpain表达的影响

    Institute of Scientific and Technical Information of China (English)

    万杰清; 贾锋; 毛青; 江基尧


    Objective To determine the effect of hypothermia on gene transcription and protein expression of calpain after traumatic brain injury (TBI). Methods Twenty-seven rats were randomly divided into three groups, ie, normal control group, normothermia TBI group and hypothermia TBI group. All rats with TBI were suffered from a lateral fluid percussion injury (FPI) at the right parietal lobe. Hy-pothermia intervention [rectal temperature for (32 ± 0.5) ℃] was performed for four hours immediately after TBI in hypothermia TBI group. Fluorescence PCR and Western blot were utilized to semi-quantify gene transcription and protein expression of ealpain and immunofluorescence used to observe protein dis-tribution of Calpain. Results Compared with normothermia TBi group and normal control group, hypo-thermia TBI group showed increased calpain gene transcription at 12 and 24 hours respectively after FPI (P <0.05). However, the increase of ealpain protein expression in hypothermia TBI group was inhibited more significantly by hypothermia at 6,12,24 and 72 hours after TBI, compared with normothermia TBI group (P < 0.05). Conclusion Neuroproteetion of hypothermia after TBI may somewhat be related to the decrease of calpain protein expression after its gene transcription.%目的 探讨亚低温治疗对颅脑外伤后Calpain基因和蛋白表达的影响.方法 将27只SD大鼠按随机数字表法分为正常对照组、常温脑损伤组和亚低温脑损伤组.脑损伤组分别接受右顶部侧方中度液压损伤打击,其中亚低温组在伤后即刻接受持续4 h的亚低温治疗[肛温(32±0.5)℃].在伤后6,12,24和72 h四个时间点分别通过荧光PCR、Western blot定量检测各组打击伤灶周围皮层钙蛋白酶Calpain基因转录和蛋白分子表达的水平,同时运用免疫荧光观察Calpain蛋白分布情况.结果 与常温组比较,亚低温使颅脑外伤后12 h及24 h Calpain基因的转录较正常对照和同时间点常

  17. Exposure to creosote bush phenolic resin causes avoidance in the leaf-cutting ant Acromyrmex lobicornis (Formicidae: Attini La exposición a la resina fenólica de jarilla causa deterrencia en la hormiga cortadora de hojas Acromyrmex lobicornis (Formicidae: Attini

    Directory of Open Access Journals (Sweden)



    Full Text Available We focused our study on the effects of Larrea cuneifolia phenolic resin on leaf-cutting ants from two populations (Sierra de las Quijadas National Park and San Roque of Acromyrmex lobicornis in San Luis, Argentina. We conducted two bioassays of food choice (field and laboratory to compare the effects of phenolic resin on ant workers from these two populations. Results of the field experiment indicated that there were no differences in preference for either leaves treated with resin or untreated leaves among colonies from both localities. However, results of the laboratory experiments with individual ants indicated a significant effect of population and treatment on the time spent in different treatments. While leaf-cutting individual workers from Quijadas preferred the phenolic resin, workers from San Roque avoided it. These results evidence that ants respond according to time of exposure to chemicals from plants (presence or absence and that the effects of resin among a population can be observed and measured on individual ant workers, even in the absence of fungus garden influences in the nest.Este estudio se ha centrado en los efectos que produce la resina fenólica de Larrea cuneifolia sobre dos poblaciones distintas (Parque Nacional de Sierra de las Quijadas y la localidad de San Roque de Acromyrmex lobicornis en San Luis, Argentina. Se disenaron dos tipos de bioensayos (a campo y en laboratorio para comparar los efectos de la resina fenólica sobre las hormigas obreras de estas dos poblaciones. Los resultados de los experimentos de elección de la oferta alimentaria en el campo, indicaron que no hubo ninguna diferencia de preferencia entre las colonias, ni por las hojas tratadas con resina ni por las hojas sin tratar para ambas localidades. Sin embargo, los resultados de los experimentos de laboratorio con las hormigas obreras individualmente indicaron efectos significativos entre las poblaciones y entre los tratamientos. Mientras que las

  18. BUCKLE: A Model of Unobserved Cause Learning (United States)

    Luhmann, Christian C.; Ahn, Woo-kyoung


    Dealing with alternative causes is necessary to avoid making inaccurate causal inferences from covariation data. However, information about alternative causes is frequently unavailable, rendering them unobserved. The current article reviews the way in which current learning models deal, or could deal, with unobserved causes. A new model of causal…

  19. Investigation of oxyhemoglobin and carboxyhemoglobin ratios in right and left cardiac blood for diagnosis of fatal hypothermia and death by fire. (United States)

    Kanto-Nishimaki, Yuko; Saito, Haruka; Watanabe-Aoyagi, Miwako; Toda, Ritsuko; Iwadate, Kimiharu


    Few large-scale investigations have looked at the oxyhemoglobin ratio (%O2-Hb) or the carboxyhemoglobin ratio (%CO-Hb) in fatal hypothermia and death by fire as applicable to forensic medicine. We therefore retrospectively examined right and left cardiac blood samples for both %O2-Hb and %CO-Hb in 690 forensic autopsy cases. We therefore sought to establish reference values for the above forensic diagnoses, to compare %O2-Hb in fatal hypothermia with or without cardiopulmonary resuscitation (CPR), and to compare the relationship between %CO-Hb and smoking history. All %O2-Hb and %CO-Hb data were obtained during or immediately after autopsies using a portable CO-oximeter. Death by carbon monoxide (CO) intoxication and death by fire were excluded from the analysis involving smoking history. In fatal hypothermia, %O2-Hb in the left cardiac blood was significantly higher than that in the right cardiac blood, providing important evidence for fatal hypothermia. Furthermore, %O2-Hb in the left cardiac blood increases with CPR but that in the right cardiac blood increases in parallel. No correlation was observed between rectal temperature and %O2-Hb in the right and left cardiac blood, indicating that it is unlikely that postmortem cooling increases %O2-Hb in cardiac blood. %CO-Hb in smokers was significantly higher than that in non-smokers, although the number of cigarettes smoked did not appear to be significant. When assessing death by fire, we identified that %CO-Hb of >10% was a reliable marker of antemortem CO inhalation, regardless of smoking history.

  20. Contribution of hypothermia and CB1 receptor activation to protective effects of TAK-937, a cannabinoid receptor agonist, in rat transient MCAO model.

    Directory of Open Access Journals (Sweden)

    Noriko Suzuki

    Full Text Available BACKGROUND: Cannabinoid (CB receptor agonists are expected to alleviate ischemic brain damage by modulating neurotransmission and neuroinflammatory responses via CB(1 and CB(2 receptors, respectively. In a previous study, TAK-937, a novel potent and selective CB(1 and CB(2 receptor agonist, was shown to exert significant cerebroprotective effects accompanied by hypothermia after transient middle cerebral artery occlusion (MCAO in rats. Sustained hypothermia itself induces significant neuroprotective effects. In the present studies, we examined the relative contribution of hypothermia and CB(1 receptor activation to the cerebroprotective effects of TAK-937. METHODOLOGY/PRINCIPAL FINDINGS: Using a multichannel brain temperature controlling system we developed, the brain temperature of freely moving rats was telemetrically monitored and maintained between 37 and 38°C during intravenous infusion of TAK-937 (100 µg/kg/h or vehicle for 24 h after 2 h MCAO. AM251, a selective CB(1 receptor antagonist, was administered intraperitoneally at 30 mg/kg 30 min before starting intravenous infusion of TAK-937 (100 µg/kg/h for 24 h. Rats were sacrificed and their brains were isolated 26 h after MCAO in both experiments. When the hypothermic effect of TAK-937 was completely reversed by a brain temperature controlling system, the infarct-reducing effect of TAK-937 was attenuated in part, but remained significant. On the other hand, concomitant AM251 treatment with TAK-937 completely abolished the hypothermic and infarct-reducing effects of TAK-937. CONCLUSIONS/SIGNIFICANCE: We conclude that the cerebroprotective effects of TAK-937 were at least in part mediated by induction of hypothermia, and mainly mediated by CB(1 receptor activation.

  1. Preventing Hypothermia: Comparison of Current Devices Used by the U.S. Army with an In Vitro Warmed Crystalloid Fluid Model (United States)


    normal thermogenesis [7]. Viscous bronchorrhea, decreased ciliary motility, non-cardiogenic pulmonary edema , and decreased renal blood flow by 50...metabolic derangement [22]. Hypothermia by itself presents treatment challenges. Combined with a shock state and hypovolemia, it can be a disastrous event...through Soldier innovation , such as the human remains pouch (Fig 2). This device has been used alone, and in combination with the space blanket and wool

  2. The effect of hypothermia on the expression of neurotrophin mRNA in the hippocampus following transient cerebral ischemia in the rat. (United States)

    Boris-Möller, F; Kamme, F; Wieloch, T


    The expression of the mRNAs of nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin 3 (NT3) and the neurotrophin receptor, TrkB, was studied in the rat hippocampus by in situ hybridization following normothermic (37 degreesC) and protective hypothermic (33 degreesC) transient cerebral ischemia of 15 min duration. In the resistant dentate gyrus, normothermic ischemia transiently induced NGF mRNA at around 8 h of recovery, while the NT3 mRNA levels were depressed over at least a 24-h recovery period. The levels of BDNF and TrkB were transiently and markedly elevated with a maximal expression at 24 h of recovery. Intraischemic hypothermia reduced the induction of NGF mRNA, while the increase of BDNF mRNA expression occurred earlier during recovery, and the post-ischemic NT3 mRNA depression was not affected. Also, the expression of TrkB mRNA was enhanced, and occurred concomitantly with the elevation of BDNF mRNA. In contrast, there were no changes in neurotrophin and TrkB mRNA in the CA3 and CA1 regions. The expression of BDNF mRNA at 24 h after normothermic ischemia, was attenuated by intraischemic hypothermia. We conclude that, the expressions of NGF, BDNF, NT3 or TrkB mRNA in ischemia-sensitive hippocampal subregions are not increased by protective hypothermia. In contrast, hypothermia induces neurotrophin mRNA alterations in the ischemia-resistant dentate gyrus that may convey protection to sensitive regions.

  3. 局部深低温对脊髓损伤大鼠神经再生和硫酸软骨素蛋白多糖mRNA表达的影响%Effects of Regional Profound Hypothermia on Axon Regeneration and Chondroitin Sulfate Proteoglycans' mRNA Expression in Rats with Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    许晓宇; 成惠林


    eviated demyelinating condition was observed in rats received RH, in addition, the SCI+Hypothermia group got a higher BBB score compared with the SCI group ( <0.05). Conclusion The regional profound hypothermia could promote the recovery of locomotors' function after SCI, which may be caused by the downregulation of CSPGs.

  4. Predictive value of the amplitude integrated EEG in infants with hypoxic ischaemic encephalopathy: data from a randomised trial of therapeutic hypothermia. (United States)

    Azzopardi, Denis


    The amplitude integrated EEG (aEEG) is reputed to be one of the best predictors of neurological outcome following hypoxic ischaemic encephalopathy in term newborns and was used to select infants into trials of neuroprotection with hypothermia, but its predictive value and the effect of moderate hypothermia on the aEEG have not previously been examined in a randomised study. The positive predictive value (PPV) of the aEEG recorded within 6 h of birth for death or disability at 18 months of age was determined in 314 infants born after 35 weeks gestation who were randomised to receive standard care with or without cooling for 72 h. The aEEG was classified according to voltage and by pattern. The PPV of a severely abnormal aEEG assessed by the voltage and pattern methods was 0.63 and 0.59 respectively in non-cooled infants and 0.55 and 0.51 in cooled infants (p>0.05). Although the differences in PPV between cooled and non-cooled groups were not significant, they are consistent with observational studies showing a lower PPV in infants treated with hypothermia, probably due to a neuroprotective effect of cooling.

  5. Plasma levels of liver-specific miR-122 is massively increased in a porcine cardiogenic shock model and attenuated by hypothermia. (United States)

    Andersson, Patrik; Gidlöf, Olof; Braun, Oscar O; Götberg, Matthias; van der Pals, Jesper; Olde, Björn; Erlinge, David


    Tissue-specific circulating micro-RNAs (miRNAs) are released into the blood after organ injury. In an ischemic porcine cardiogenic shock model, we investigated the release pattern of cardiac-specific miR-208b and liver-specific miR-122 and assessed the effect of therapeutic hypothermia on their respective plasma levels. Pigs were anesthetized, and cardiogenic shock was induced by inflation of a percutaneous coronary intervention balloon in the proximal left anterior descending artery for 40 min followed by reperfusion. After fulfillment of the predefined shock criteria, the pigs were randomized to hypothermia (33°C, n = 6) or normothermia (38°C, n = 6). Circulating miRNAs were extracted from plasma and measured with quantitative real-time polymerase chain reaction (PCR). Tissue specificity was assessed by miRNA extraction from porcine tissues followed by quantitative real-time PCR. In vitro, the release of miR-122 from a cultured hepatocyte cell line exposed to either hypoxia or acidosis was assessed by real-time PCR. miR-122 was found to be highly liver specific, whereas miR-208b was expressed exclusively in the heart. In the control group, ischemic cardiogenic shock induced a 460,000-fold and a 63,000-fold increase in plasma levels of miR-122 (P cardiogenic shock and that therapeutic hypothermia significantly reduces the levels of miR-122.

  6. Disseminated mycotic infection caused by Colletotrichum acutatum in a Kemp's ridley sea turtle (Lepidochelys kempi). (United States)

    Manire, Charles A; Rhinehart, Howard L; Sutton, Deanna A; Thompson, Elizabeth H; Rinaldi, Michael G; Buck, John D; Jacobson, Elliott


    Colletotrichum acutatum is a cosmopolitan plant pathogen with a wide host range. While the organism's phytopathogenic potential has been well documented, it has never been reported as an etiologic agent of disease in either animals or humans. In this case, a juvenile Kemp's ridley sea turtle, Lepidochelys kempi, probably with immune compromise following cold stunning (extended hypothermia), developed a disseminated mycotic infection in the lungs and kidneys. Prophylactic treatment with oral itraconazole did not prevent or cure the infection. This report of a Colletotrichum acutatum infection in an animal extends the range of disease caused by this organism beyond that of a phytopathogen.

  7. Neuroprotection by Radical Avoidance: Search for Suitable Agents

    Directory of Open Access Journals (Sweden)

    Rüdiger Hardeland


    Full Text Available Neurodegeneration is frequently associated with damage by free radicals. However, increases in reactive oxygen and nitrogen species, which may ultimately lead to neuronal cell death, do not necessarily reflect its primary cause, but can be a consequence of otherwise induced cellular dysfunction. Detrimental processes which promote free radical formation are initiated, e.g., by disturbances in calcium homeostasis, mitochondrial malfunction, and an age-related decline in the circadian oscillator system. Free radicals generated at high rates under pathophysiological conditions are insufficiently detoxified by scavengers. Interventions at the primary causes of dysfunction, which avoid secondary rises in radical formation, may be more efficient. The aim of such approaches should be to prevent calcium overload, to reduce mitochondrial electron dissipation, to support electron transport capacity, and to avoid circadian perturbations. l-Theanine and several amphiphilic nitrones are capable of counteracting excitotoxicity and/or mitochondrial radical formation. Resveratrol seems to promote mitochondrial biogenesis. Mitochondrial effects of leptin include attenuation of electron leakage. Melatonin combines all the requirements mentioned, additionally regulates anti- and pro-oxidant enzymes and is, with few exceptions, very well tolerated. In this review, the perspectives, problems and limits of drugs are compared which may be suitable for reducing the formation of free radicals.

  8. Converging evidence of social avoidant behavior in schizophrenia from two approach-avoidance tasks. (United States)

    de la Asuncion, Javier; Docx, Lise; Sabbe, Bernard; Morrens, Manuel; de Bruijn, Ellen R A


    Many people with schizophrenia suffer from social impairments characterized by active social avoidance, which is related to social phobia common in schizophrenia, while motivational impairments can also result in passive social withdrawal. Although social avoidance is frequently reported in this population, this is the first study to directly compare approach-avoidance tendencies in schizophrenia patients (N = 37) and healthy controls (N = 29). Participants performed two tasks: a computerized approach-avoidance task (AAT) to assess response tendencies toward images of happy and angry faces with direct or averted gaze and a one-to-one personal space test (PST) to gauge more naturalistic approach-avoidance behaviors toward a real person bearing a neutral expression. The AAT results showed that both groups showed faster avoidance responses to angry faces and faster approach responses to happy faces with a direct gaze. Happy faces with averted gaze, however, resulted in faster avoidance responses in the patient group only. On the PST, the patients approached the experimenter less than healthy controls did. This measure of interpersonal distance was positively related to positive symptom severity. Delusions of reference and increased sensitivity to social rejection may explain the patients' avoidance tendencies in response to pictures of happy faces with averted gaze and in the presence of an actual person. The current findings demonstrate the importance of others adopting positive and unambiguous attitudes when interacting with schizophrenia patients to minimize behavioral avoidance patterns, which is particularly relevant for relatives and clinicians whose interactions with the patients are crucial to facilitating treatment and promoting healthy social relationships.

  9. Information Dilemmas and Blame-Avoidance Strategies

    DEFF Research Database (Denmark)

    Erik, Baekkeskov; Rubin, Olivier


    China and other authoritarian states notoriously keep mum about disasters. Yet two recent but dissimilar Chinese responses to infectious disease epidemics show that authoritarian crisis management can shift from secrecy to openness. China maintained prolonged secrecy during 2003 SARS, yet was open...... from day one about 2009 H1N1 flu. To explore why, this article links crisis information dilemmas to blame avoidance concepts from democratic political theories. We argue that greater Chinese transparency about infectious disease response reflects evolution in blame avoidance, from heavy reliance...... on information control to insulating leaders by using technical experts and agencies as “lightning rods.” In 2003, the Chinese strategy of information containment and secrecy backfired, and the Chinese leadership eventually received blame at home and internationally for crisis mismanagement. In 2009, China put...

  10. How to avoid deferred-compensation troubles. (United States)

    Freeman, Todd I


    Executive compensation packages have long included stock options and deferred compensation plans in order to compete for talent. Last year, Congress passed a law in response to the Enron debacle, in which executives were perceived to be protecting their deferred compensation at the expense of employees, creditors, and investors. The new law is designed to protect companies and their shareholders from being raided by the very executives that guided the company to financial ruin. Physicians who are part owners of medical practices need to know about the changes in the law regarding deferred compensation and how to avoid costly tax penalties. This article discusses how the changes affect medical practices as well as steps physician-owned clinics can take to avoid the risk of penalty, such as freezing deferred compensation and creating a new deferred compensation plan.

  11. Optical Flow based Robot Obstacle Avoidance

    Directory of Open Access Journals (Sweden)

    Kahlouche Souhila


    Full Text Available In this paper we try to develop an algorithm for visual obstacle avoidance of autonomous mobile robot. The input of the algorithm is an image sequence grabbed by an embedded camera on the B21r robot in motion. Then, the optical flow information is extracted from the image sequence in order to be used in the navigation algorithm. The optical flow provides very important information about the robot environment, like: the obstacles disposition, the robot heading, the time to collision and the depth. The strategy consists in balancing the amount of left and right side flow to avoid obstacles, this technique allows robot navigation without any collision with obstacles. The robustness of the algorithm will be showed by some examples.

  12. Construction dispute research conceptualisation, avoidance and resolution

    CERN Document Server


    There are three specific purposes of Construction Dispute Research. First, this volume aims to summarise studies on construction dispute. Second, apart from the theoretical constructs, where appropriate empirical tests are also included. This approach serves to go beyond the commonly used anecdotal approach for the subject matters. Third, it is the sincere hope of the authors that this book will help shaping research agenda of construction dispute.  The studies are mostly framed from a management perspective drawing on methods and concepts in contract law, economics, psychology and management science.   The book has twenty chapters that are arranged in four parts covering conceptualisation, avoidance, negotiation and mediation. Part 1 is devoted for dispute conceptualisation. A building is only as strong as its foundation. Thus it is no better start to study construction dispute by conceptualisation. The theme of Part 2 is dispute avoidance. The conventional wisdom of ‘prevention is better than cure’ se...

  13. Airborne Collision Detection and Avoidance for Small UAS Sense and Avoid Systems (United States)

    Sahawneh, Laith Rasmi

    The increasing demand to integrate unmanned aircraft systems (UAS) into the national airspace is motivated by the rapid growth of the UAS industry, especially small UAS weighing less than 55 pounds. Their use however has been limited by the Federal Aviation Administration regulations due to collision risk they pose, safety and regulatory concerns. Therefore, before civil aviation authorities can approve routine UAS flight operations, UAS must be equipped with sense-and-avoid technology comparable to the see-and-avoid requirements for manned aircraft. The sense-and-avoid problem includes several important aspects including regulatory and system-level requirements, design specifications and performance standards, intruder detecting and tracking, collision risk assessment, and finally path planning and collision avoidance. In this dissertation, our primary focus is on developing an collision detection, risk assessment and avoidance framework that is computationally affordable and suitable to run on-board small UAS. To begin with, we address the minimum sensing range for the sense-and-avoid (SAA) system. We present an approximate close form analytical solution to compute the minimum sensing range to safely avoid an imminent collision. The approach is then demonstrated using a radar sensor prototype that achieves the required minimum sensing range. In the area of collision risk assessment and collision prediction, we present two approaches to estimate the collision risk of an encounter scenario. The first is a deterministic approach similar to those been developed for Traffic Alert and Collision Avoidance (TCAS) in manned aviation. We extend the approach to account for uncertainties of state estimates by deriving an analytic expression to propagate the error variance using Taylor series approximation. To address unanticipated intruders maneuvers, we propose an innovative probabilistic approach to quantify likely intruder trajectories and estimate the probability of

  14. Potentially Avoidable Peripartum Hysterectomies in Denmark

    DEFF Research Database (Denmark)

    Colmorn, Lotte Berdiin; Krebs, Lone; Langhoff-Roos, Jens


    to minimize the number of unnecessary peripartum hysterectomies, obstetricians and anesthesiologists should investigate individual cases by structured clinical audit, and disseminate and discuss the results for educational purposes. An international collaboration is warranted to strengthen our recommendations......OBJECTIVE: To audit the clinical management preceding peripartum hysterectomy and evaluate if peripartum hysterectomies are potentially avoidable and by which means. MATERIAL AND METHODS: We developed a structured audit form based on explicit criteria for the minimal mandatory management...

  15. Robot maps, robot moves, robot avoids


    Farrugia, Claire; Duca, Edward


    Robotics is a cornerstone for this century’s innovations. From robot nurses to your own personal assistant, most robots need to know: ‘where is it?’ ‘Where should it go?’ And ‘how to get there?’ Without answers to these questions a robot cannot do much.

  16. Acute carbon dioxide avoidance in Caenorhabditis elegans


    Hallem, Elissa A.; Sternberg, Paul W.


    Carbon dioxide is produced as a by-product of cellular respiration by all aerobic organisms and thus serves for many animals as an important indicator of food, mates, and predators. However, whether free-living terrestrial nematodes such as Caenorhabditis elegans respond to CO2 was unclear. We have demonstrated that adult C. elegans display an acute avoidance response upon exposure to CO2 that is characterized by the cessation of forward movement and the rapid initiation of backward movement....

  17. Knowing and avoiding plagiarism during scientific writing. (United States)

    Kumar, P Mohan; Priya, N Swapna; Musalaiah, Svvs; Nagasree, M


    Plagiarism has become more common in both dental and medical communities. Most of the writers do not know that plagiarism is a serious problem. Plagiarism can range from simple dishonesty (minor copy paste/any discrepancy) to a more serious problem (major discrepancy/duplication of manuscript) when the authors do cut-copy-paste from the original source without giving adequate credit to the main source. When we search databases like PubMed/MedLine there is a lot of information regarding plagiarism. However, it is still a current topic of interest to all the researchers to know how to avoid plagiarism. It's time to every young researcher to know ethical guidelines while writing any scientific publications. By using one's own ideas, we can write the paper completely without looking at the original source. Specific words from the source can be added by using quotations and citing them which can help in not only supporting your work and amplifying ideas but also avoids plagiarism. It is compulsory to all the authors, reviewers and editors of all the scientific journals to know about the plagiarism and how to avoid it by following ethical guidelines and use of plagiarism detection software while scientific writing.

  18. Traffic jam driving with NMV avoidance (United States)

    Milanés, Vicente; Alonso, Luciano; Villagrá, Jorge; Godoy, Jorge; de Pedro, Teresa; Oria, Juan P.


    In recent years, the development of advanced driver assistance systems (ADAS) - mainly based on lidar and cameras - has considerably improved the safety of driving in urban environments. These systems provide warning signals for the driver in the case that any unexpected traffic circumstance is detected. The next step is to develop systems capable not only of warning the driver but also of taking over control of the car to avoid a potential collision. In the present communication, a system capable of autonomously avoiding collisions in traffic jam situations is presented. First, a perception system was developed for urban situations—in which not only vehicles have to be considered, but also pedestrians and other non-motor-vehicles (NMV). It comprises a differential global positioning system (DGPS) and wireless communication for vehicle detection, and an ultrasound sensor for NMV detection. Then, the vehicle's actuators - brake and throttle pedals - were modified to permit autonomous control. Finally, a fuzzy logic controller was implemented capable of analyzing the information provided by the perception system and of sending control commands to the vehicle's actuators so as to avoid accidents. The feasibility of the integrated system was tested by mounting it in a commercial vehicle, with the results being encouraging.

  19. Urban water restrictions: Attitudes and avoidance (United States)

    Cooper, Bethany; Burton, Michael; Crase, Lin


    In most urban cities across Australia, water restrictions remain the dominant policy mechanism to restrict urban water consumption. The extensive adoption of water restrictions as a means to limit demand, over several years, means that Australian urban water prices have consistently not reflected the opportunity cost of water. Given the generally strong political support for water restrictions and the likelihood that they will persist for some time, there is value in understanding households' attitudes in this context. More specifically, identifying the welfare gains associated with avoiding urban water restrictions entirely would be a nontrivial contribution to our knowledge and offer insights into the benefits of alternative policy responses. This paper describes the results from a contingent valuation study that investigates consumers' willingness to pay to avoid urban water restrictions. Importantly, the research also investigates the influence of cognitive and exogenous dimensions on the utility gain associated with avoiding water restrictions. The results provide insights into the impact of the current policy mechanism on economic welfare.

  20. Acute carbon dioxide avoidance in Caenorhabditis elegans. (United States)

    Hallem, Elissa A; Sternberg, Paul W


    Carbon dioxide is produced as a by-product of cellular respiration by all aerobic organisms and thus serves for many animals as an important indicator of food, mates, and predators. However, whether free-living terrestrial nematodes such as Caenorhabditis elegans respond to CO2 was unclear. We have demonstrated that adult C. elegans display an acute avoidance response upon exposure to CO2 that is characterized by the cessation of forward movement and the rapid initiation of backward movement. This response is mediated by a cGMP signaling pathway that includes the cGMP-gated heteromeric channel TAX-2/TAX-4. CO2 avoidance is modulated by multiple signaling molecules, including the neuropeptide Y receptor NPR-1 and the calcineurin subunits TAX-6 and CNB-1. Nutritional status also modulates CO2 responsiveness via the insulin and TGFbeta signaling pathways. CO2 response is mediated by a neural circuit that includes the BAG neurons, a pair of sensory neurons of previously unknown function. TAX-2/TAX-4 function in the BAG neurons to mediate acute CO2 avoidance. Our results demonstrate that C. elegans senses and responds to CO2 using multiple signaling pathways and a neural network that includes the BAG neurons and that this response is modulated by the physiological state of the worm.

  1. Granting silence to avoid wireless collisions

    KAUST Repository

    Choi, Jung Il


    We describe grant-to-send, a novel collision avoidance algorithm for wireless mesh networks. Rather than announce packets it intends to send, a node using grant-to-send announces packets it expects to hear others send. We present evidence that inverting collision avoidance in this way greatly improves wireless mesh performance. Evaluating four protocols from 802.11 meshes and 802.15.4 sensor networks, we find that grant-to-send matches or outperforms CSMA and RTS/CTS in all cases. For example, in a 4-hop UDP flow, grantto- send can achieve 96% of the theoretical maximum throughput while maintaining a 99.9% packet delivery ratio. Grant-tosend is also general enough to replace protocol-specific collision avoidance mechanisms common to sensor network protocols. Grant-to-send is simple. For example, incorporating it into 802.11 requires only 11 lines of driver code and no hardware changes. Furthermore, as it reuses existing 802.11 mechanisms, grant-to-send inter-operates with current networks and can be incrementally deployed. © 2010 IEEE.

  2. Implementation and conduct of therapeutic hypothermia for perinatal asphyxial encephalopathy in the UK--analysis of national data.

    Directory of Open Access Journals (Sweden)

    Denis Azzopardi

    Full Text Available BACKGROUND: Delay in implementing new treatments into clinical practice results in considerable health and economic opportunity costs. Data from the UK TOBY Cooling Register provides the opportunity to examine how one new effective therapy for newborn infants suspected of suffering asphyxial encephalopathy--therapeutic hypothermia- was implemented in the UK. METHODOLOGY/PRINCIPAL FINDINGS: We analysed returned data forms from inception of the Register in December 2006 to the end of July 2011. Data forms were received for 1384 (67% of the 2069 infants registered. The monthly rate of notifications increased from median {IQR} 18 {15-31} to 33 {30-39} after the announcement of the results of the recent TOBY trial, and to 50 {36-55} after their publication. This rate further increased to 70 {64-83} following official endorsement of the therapy, and is now close to the expected numbers of eligible infants. Cooling was started at 3.3 {1.5-5.5} hours after birth and the time taken to achieve the target 33-34 °C rectal temperature was 1 {0-3} hours. The rectal temperature was in the target range in 83% of measurements. From 2006 to 2011 there was evidence of extension of treatment to slightly less severely affected infants. 278 of 1362 (20% infants died at 2.9 {1.4-4.1} days of age. The rates of death fell slightly over the period of the Register and, at two years of age cerebral palsy was diagnosed in 22% of infants; half of these were spastic bilateral. Factors independently associated with adverse outcome were clinical seizures prior to cooling (p<0.001 and severely abnormal amplitude integrated EEG (p<0.001. CONCLUSIONS/SIGNIFICANCE: Therapeutic hypothermia was implemented appropriately within the UK, with significant benefit to patients and the health economy. This may be due in part to participation by neonatal units in clinical trials, the establishment of the national Register, and its endorsement by advisory bodies.

  3. 中度低温减轻内毒素性急性肺损伤大鼠肺炎症反应%Moderate Hypothermia Attenuates Lung Inflammation in Lipopolysaccharide-Induced Acute Lung Injury in Rats

    Institute of Scientific and Technical Information of China (English)

    吴长毅; 曾因明; 顾卫东; 丁浩中; 陈肖; 张焰


    Objective To investigate the role of moderate hypothermia in the lung inflammation of rat acute lung injury induced by lipopolysaccharide( LPS). Methods A rat model of acute lung injury (ALI) was established by intra-tracheal instillation of lipopolysaccharide (1.5 mg/kg, 0.5 ml) at 16 h after LPS (1.0 mg/kg) intraperitoneal administration. Thirty-four male Sprague Dawley rats were randomly divided into four groups: control group, receiving saline only;LPS group, receiving LPS; hypothermia group, treated with hypothermia without LPS; LPS + hypothermia group, treated with LPS and cooled to 32.5℃~ 33.0℃ as PaO2/FiO2 was below 300 mmHg. Hemodynamics and blood gases were recorded every hour throughout the study. Rats were killed 4 h after ALI, and lung lavage was performed to measure the tumor necrosis factor α (TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) concentrations in bronchoalveolar lavage fluid (BALF) by using enzyme-linked immunosorbent assay (ELISA). Results PaO2/FiO2 was significantly decreased and PaCO2 was increased in the LPS group as compared to their baseline values( P 《 0.01 ). Treatment with hypothermia inhibited the increase in PaCO2 ( P 《 0.05) but had no effect on PaO2/FiO2 in the presence of LPS. The administration of LPS significantly increased the concentrations of TNF-α, IL-6 and IL-10 in BALE as compared to the control experiment( P 《0.05, P 《 0.01 ). Moderate hypothermia reduced the expressions of TNF-α and IL-6( P 《 0.01 ) but had no effect on the production of IL-10( P 》 0.05). Conclusion Moderate hypothermia significantly inhibits proinflammatory cytokine expressions in lipopolysaccharide-induced acute lung injury.

  4. See-and-Avoid Collision Avoidance Using ADS-B Signal and Radar Sensing Project (United States)

    National Aeronautics and Space Administration — IAI proposes an innovative collision avoidance radar and communication technology to detect and track both cooperative and non-cooperative targets. The system...

  5. Effect of mild hypothermia on partial pressure of oxygen in brain tissue and brain temperature in patients with severe head injury

    Institute of Scientific and Technical Information of China (English)

    张赛; 只达石; 林欣; 尚彦国; 牛玉德


    Objective: To study the changes of partial pressure of oxygen in brain tissue (PbtO2) and brain temperature (BT) in patients in acute phase of severe head injury, and to study the effect of mild hypothermia on PbtO2 and BT.   Methods: The PbtO2 and the BT of 18 patients with severe head injury were monitored, and the patients were treated with mild hypothermia within 20 hours after injury. The rectal temperature (RT) of the patients was kept on 31.5-34.9℃ for 1-7 days (57.7 hours±28.4 hours averagely), simultaneously, the indexes of PbtO2 and BT were monitored for 1-5 days (with an average of 54.8 hours±27.0 hours). According to Glasgow Outcome Scale (GOS), the prognosis of the patients was evaluated at 6 months after injury.   Results: Within 24 hours after severe head injury, the PbtO2 was significantly lower (9.6 mm Hg±6.8 mm Hg, 1 mm Hg=0.133 kPa) than the normal value (16-40 mm Hg). After treatment of mild hypothermia, the mean PbtO2 increased to 28.7 mm Hg±8.8 mm Hg during the first 24 hours, and the PbtO2 was still maintained within the range of normal value at 3 days after injury. The BT was higher than the RT in the patients in acute phase of severe head injury, and the difference between the BT and the RT significantly increased after treatment of mild hypothermia. Hyperventilation (the partial pressure of carbon dioxide in artery (PaCO2)≈25 mm Hg) decreased the high intracranial pressure (ICP) and significantly decreased the PbtO2.   Conclusions: This study demonstrates that PptO2 and BT monitoring is a safe, reliable and sensitive diagnostic method to follow cerebral oxygenation. It might become an important tool in our treatment regime for patients in the acute phase of severe head injury requiring hypothermia and hyperventilation.

  6. Preventable avoidable mortality: evolution of socioeconomic inequalities in urban areas in Spain, 1996-2003. (United States)

    Nolasco, Andreu; Melchor, Inmaculada; Pina, José A; Pereyra-Zamora, Pamela; Moncho, Joaquin; Tamayo, Nayara; García-Senchermes, Carmen; Zurriaga, Oscar; Martínez-Beneito, Miguel A


    This study describes the inequalities in preventable avoidable mortality in relation to socioeconomic levels and analyses their evolution during the period 1996-2003 in the cities of Alicante, Castellon and Valencia. Four causes of preventable avoidable mortality were analysed according to sex: malignant tumour of the trachea, bronchus and lung, cirrhosis and other chronic diseases of the liver, motor vehicle accidents and AIDS, which had caused the death of non-institutionalised residents in the three cities during the period 1996-2003. The different census tracts were grouped into three socioeconomic levels. In general, socioeconomic inequalities in preventable avoidable mortality remain constant in time, except the ones caused by AIDS in Valencia, where they increase for men. Some census tracts in the three cities where the study was carried out were found to have significantly higher preventable mortality rates, and therefore require intervention.

  7. Avoiding unseen obstacles: Subcortical vision is not sufficient to maintain normal obstacle avoidance behaviour during reaching. (United States)

    Ross, Alasdair I; Schenk, Thomas; Billino, Jutta; Macleod, Mary J; Hesse, Constanze


    Previous research found that a patient with cortical blindness (homonymous hemianopia) was able to successfully avoid an obstacle placed in his blind field, despite reporting no conscious awareness of it [Striemer, C. L., Chapman, C. S., & Goodale, M. A., 2009, PNAS, 106(37), 15996-16001]. This finding led to the suggestion that dorsal stream areas, that are assumed to mediate obstacle avoidance behaviour, may obtain their visual input primarily from subcortical pathways. Hence, it was suggested that normal obstacle avoidance behaviour can proceed without input from the primary visual cortex. Here we tried to replicate this finding in a group of patients (N = 6) that suffered from highly circumscribed lesions in the occipital lobe (including V1) that spared the subcortical structures that have been associated with action-blindsight. We also tested if obstacle avoidance behaviour differs depending on whether obstacles are placed only in the blind field or in both the blind and intact visual field of the patients simultaneously. As expected, all patients successfully avoided obstacles placed in their intact visual field. However, none of them showed reliable avoidance behaviour - as indicated by adjustments in the hand trajectory in response to obstacle position - for obstacles placed in their blind visual field. The effects were not dependent on whether one or two obstacles were present. These findings suggest that behaviour in complex visuomotor tasks relies on visual input from occipital areas.

  8. Differences in avoidable mortality between migrants and the native Dutch in the Netherlands

    Directory of Open Access Journals (Sweden)

    Bos V


    Full Text Available Abstract Background The quality of the healthcare system and its role in influencing mortality of migrant groups can be explored by examining ethnic variations in 'avoidable' mortality. This study investigates the association between the level of mortality from 'avoidable' causes and ethnic origin in the Netherlands and identifies social factors that contribute to this association. Methods Data were obtained from cause of death and population registries in the period 1995–2000. We compared mortality rates for selected 'avoidable' conditions for Turkish, Moroccan, Surinamese and Antillean/Aruban groups to native Dutch. Results We found slightly elevated risk in total 'avoidable' mortality for migrant populations (RR = 1.13. Higher risks of death among migrants were observed from almost all infectious diseases (most RR > 3.00 and several chronic conditions including asthma, diabetes and cerebro-vascular disorders (most RR > 1.70. Migrant women experienced a higher risk of death from maternity-related conditions (RR = 3.37. Surinamese and Antillean/Aruban population had a higher mortality risk (RR = 1.65 and 1.31 respectively, while Turkish and Moroccans experienced a lower risk of death (RR = 0.93 and 0.77 respectively from all 'avoidable' conditions compared to native Dutch. Control for demographic and socioeconomic factors explained a substantial part of ethnic differences in 'avoidable' mortality. Conclusion Compared to the native Dutch population, total 'avoidable' mortality was slightly elevated for all migrants combined. Mortality risks varied greatly by cause of death and ethnic origin. The substantial differences in mortality for a few 'avoidable' conditions suggest opportunities for quality improvement within specific areas of the healthcare system targeted to disadvantaged groups.

  9. The influence of mastery-avoidance goals on performance improvement

    NARCIS (Netherlands)

    Van Yperen, Nico W.; Elliot, Andrew J.; Anseel, Frederik


    Two experiments focused on examining the influence of mastery-avoidance goals on performance improvement, and more specifically, on mastery-avoidance goals grounded in an intrapersonal standard. That is, herein, mastery-avoidance goals entail striving to avoid doing worse than one has done before. B

  10. Exploring the Relationship between Experiential Avoidance, Alcohol Use Disorders, and Alcohol-Related Problems among First-Year College Students (United States)

    Levin, Michael E.; Lillis, Jason; Seeley, John; Hayes, Steven C.; Pistorello, Jacqueline; Biglan, Anthony


    Objective: This study explored the relationship of experiential avoidance (eg, the tendency to avoid, suppress, or otherwise control internal experiences even when doing so causes behavioral harm) to alcohol use disorders and alcohol-related problems. Participants: Cross-sectional data were collected from 240 undergraduate college students in…

  11. Life threatening central nervous system manifestations and hypothermia due to maneb intoxication in a child: a case report. (United States)

    de Tollenaer, S M; Buysse, Cmp; van den Anker, J N; Touw, D J; de Hoog, M


    Maneb, manganese ethylene-bis-dithiocarbamate, is a fungicide pesticide used in the agriculture and bulb flower culture sector. Toxicological effects for humans have been reported in literature and are diverse. They vary from allergic reactions (dermatitis, conjunctivitis, and bronchitis), central nervous system effects (muscarinic, nicotinic, central and extrapyramidal) and renal toxicity (acute renal failure).A 7-year old girl was admitted to the pediatric intensive care unit because of status epilepticus. Physical examination showed respiratory insufficiency, convulsions, and severe hypothermia (32.5 degrees C). The patient was intubated and her convulsions were successfully treated with benzodiazepines. Except for a combined metabolic and respiratory acidosis and hyperglycemia, diagnostic investigations on admission (full blood count, electrolytes, liver and renal functions, cerebrospinal fluid investigation, toxicology screening of blood and urine for barbiturates and benzodiazepines, blood culture, herpes PCR, and a CT scan of the brain) were normal. Within 24 hours, there was a complete recovery of all neurological signs. Within 72 hours, the patient was discharged from the hospital. Liquid chromatography-mass spectrometric investigation of her blood showed amounts of maneb, which can explain all symptoms and signs. However, effects of this magnitude on the central nervous system have not previously been reported in humans.

  12. Evaluation of hypothermia on the in vitro metabolism and binding and in vivo disposition of midazolam in rats. (United States)

    Miyamoto, Hirotaka; Matsueda, Satoshi; Moritsuka, Akihiro; Shimokawa, Kenta; Hirata, Haruna; Nakashima, Mikiro; Sasaki, Hitoshi; Fumoto, Shintaro; Nishida, Koyo


    The effect of hypothermia on the in vivo pharmacokinetics of midazolam was evaluated, with a focus on altered metabolism in the liver and binding to serum proteins. Rat primary hepatocytes were incubated with midazolam (which is metabolized mainly by CYP3A2) at 37, 32 or 28 °C. The Michaelis-Menten constant (Km) and maximum velocity (Vmax) of midazolam were estimated using the Michaelis-Menten equation. The Km of CYP3A2 midazolam remained unchanged, but the Vmax decreased at 28 °C. In rats, whose temperature was maintained at 37, 32 or 28 °C by a heat lamp or ice pack, the plasma concentrations of midazolam were higher, whereas those in the brain and liver were unchanged at 28 °C. The tissue/plasma concentration ratios were, however, increased significantly. The unbound fraction of midazolam in serum at 28 °C was half that at 37 °C. These pharmacokinetic changes associated with hypothermic conditions were due to reductions in CYP3A2 activity and protein binding.

  13. The global cost of eliminating avoidable blindness

    Directory of Open Access Journals (Sweden)

    Kirsten L Armstrong


    Full Text Available Aims : To complete an initial estimate of the global cost of eliminating avoidable blindness, including the investment required to build ongoing primary and secondary health care systems, as well as to eliminate the ′backlog′ of avoidable blindness. This analysis also seeks to understand and articulate where key data limitations lie. Materials and Methods : Data were collected in line with a global estimation approach, including separate costing frameworks for the primary and secondary care sectors, and the treatment of backlog. Results : The global direct health cost to eliminate avoidable blindness over a 10-year period from 2011 to 2020 is estimated at $632 billion per year (2009 US$. As countries already spend $592 billion per annum on eye health, this represents additional investment of $397.8 billion over 10 years, which is $40 billion per year or $5.80 per person for each year between 2010 and 2020. This is concentrated in high-income nations, which require 68% of the investment but comprise 16% of the world′s inhabitants. For all other regions, the additional investment required is $127 billion. Conclusions : This costing estimate has identified that low- and middle-income countries require less than half the additional investment compared with high-income nations. Low- and middle-income countries comprise the greater investment proportion in secondary care whereas high-income countries require the majority of investment into the primary sector. However, there is a need to improve sector data. Investment in better data will have positive flow-on effects for the eye health sector.

  14. Tax Anti-avoidance Through Transfer Pricing

    DEFF Research Database (Denmark)

    Rossing, Christian Plesner; Riise Johansen, Thomas; Pearson, Thomas C.


    This paper examines the case of Starbucks’ UK branch, which became subject to massive public criticism over alleged tax avoidance. Despite Starbucks arguing that its transfer pricing practices were in full compliance with regulatory requirements, public pressure for higher corporate tax payments...... led Starbucks to increase its UK tax payment on transfer pricing income beyond regulatory requirements. This case study suggests that MNE tax behavior on international transfer pricing is not strictly a matter of compliance with formal tax regulation. We demonstrate the way an MNE attempts to re...


    Directory of Open Access Journals (Sweden)

    Stoian Ciprian-Dumitru


    Full Text Available Worldwide crisis has made multinational companies that are engaged in corporate social responsibility actions to manage their businesses through the lens of various tax avoidance practices. The content of this paper is important due to the fact that tries to identify the impact in case of companies active in corporate social responsibility actions versus their tax structures orientation. Corporate social responsibility literature did not paid enough attention on the impact of the tax avoidance practices of companies. Tax, as a concept, brings in itself an important corporate financial impact with subsequent effects for the life of multiple citizens in countries where private entities are operating. Even though companies are usually expressing their ethical and responsible conduct in respect of the social environment, there are many cases when the business practices were not aligned with the declared corporate behavior. This paper seeks firstly to examine whether companies engaged in tax avoidance practices (ex. offshore tax havens consider that continue to act socially responsible. Secondly, the paper examines the influence on attending the stakeholders’ goals for those companies practicing tax avoidance and its implications on corporate social responsibility actions. Moreover, the paper focuses also on the aspects described before from the perspective of the corporate entities operating in Romania. This paper’s intention is to use and to develop the results of previous research carried out by Lutz Preus (University of London and, subsequently, by Senators Levin, Coleman and Obama in their “Stop Tax Haven Abuse Bill”. The implications and the objectives of this material are to highlight, to identify and to spot clearly the relations and the influences of the tax haven practices of corporations versus their undertaken social responsibility actions. Moreover, this paper brings a fresh perspective of this topic from the

  16. Avoiding Lawsuits for Wage and Hour Violations. (United States)

    Silberman, Cherie L


    Due to the highly technical language in the wage and hour laws and regulations, employers often find that they have unknowingly violated the Fair Labor Standards Act (FLSA). This can occur because employers have improperly classified an employee as exempt or because employers do not realize that certain time should be paid in full. Improperly classifying employees as exempt or failing to compensate nonexempt employees for all time worked can lead to costly lawsuits, audits, or enforcement actions by the Wage and Hour Division of the Department of Labor. This article discusses the most common FLSA exemptions and provides best practices to avoid liability under the FLSA.

  17. Conflict Avoidance by Descent Behind the Intruder

    Directory of Open Access Journals (Sweden)

    Tone Magister


    Full Text Available The paramount priorities for safe implementation of a singlepilot manned cockpit concept and the futuristic concept of asingle pilot acting as a supervisor for a fully automated aircraftflying on incessantly self-optimised trajectories are eliminationsof the risk of mid-air collisions and of conflicts resulting fromthe lack of safe airborne separations. Avoidance procedureswith initiation of descent behind the intruder for conflict resolutionbetween a pair of aircraft where one of them is in the vicinityof the top of its descent represents merely one little piece ofthis giant puzzle.

  18. Contact Dermatitis, Patch Testing, and Allergen Avoidance. (United States)

    Burkemper, Nicole M


    In patients presenting with a complaint of rash, contact dermatitis is often the underlying diagnosis making it an entity with which health care providers should be familiar. Contact dermatitis can be divided into irritant contact dermatitis and allergic contact dermatitis. In a patient suspected of having allergic contact dermatitis, patch testing can be done to identify specific allergens. Education focused on allergen avoidance and safe products is an integral part of treatment for the contact dermatitis patient. Knowledge of the most common allergens is helpful for clinicians to be able to provide this education.

  19. Guide to the collision avoidance rules

    CERN Document Server

    Cockcroft, A N


    A Guide to the Collision Avoidance Rules is the essential reference to the safe operation of all vessels at sea. Published continuously since 1965, this respected and expert guide is the classic text for all who need to, practically and legally, understand and comply with the Rules. This sixth edition incorporates all of the amendments to the International Regulations for Preventing Collisions at Sea which came into force in November 2003.The books sets out all of the Rules with clear explanation of their meaning, and gives detailed examples of how the rules have been used in practice

  20. Avoiding plagiarism: guidance for nursing students. (United States)

    Price, Bob

    The pressures of study, diversity of source materials, past assumptions relating to good writing practice, ambiguous writing guidance on best practice and students' insecurity about their reasoning ability, can lead to plagiarism. With the use of source checking software, there is an increased chance that plagiarised work will be identified and investigated, and penalties given. In extreme cases, plagiarised work may be reported to the Nursing and Midwifery Council and professional as well as academic penalties may apply. This article provides information on how students can avoid plagiarism when preparing their coursework for submission.

  1. The relationship between 'theory of mind' and attachment-related anxiety and avoidance in Italian adolescents. (United States)

    Hünefeldt, Thomas; Laghi, Fiorenzo; Ortu, Francesca; Belardinelli, Marta Olivetti


    This study examined the relationship between 'theory of mind' and attachment-related anxiety and avoidance in adolescence. The "Reading the Mind in the Eyes" test and the "Experiences in Close Relationships - Relationship Structures" questionnaires were administered to 402 14-19 year-old adolescents. Contrary to expectations, anxiety but not avoidance with mother was associated with less accurate mindreading, and this effect was stronger in younger than in older adolescents. Results might be explained in terms of the inconsistency of caregiver behavior that is supposed to cause anxious strategies, and thus illustrate the need to consider not only the effects, but also the causes of different types of insecure strategies.

  2. Human-inspired lighting the intention control in robot systems with of glare avoidance%Human-inspired lighting the intention control in robot systems with of glare avoidance

    Institute of Scientific and Technical Information of China (English)

    Chen Shengyong; Guan Qiu; Liu Sheng; Bi Dexue


    This paper presents some human-inspired strategies for lighting control in a robot system for best scene interpretation, where the main intention is to avoid possible glares or highlights occurring in images. It firstly compares the characteristics of human eyes and robot eyes. Then some evaluation criteria are addressed to assess the lighting conditions. A bio-inspired method is adopted to avoid the visual glare which is caused by either direct illumination from large light sources or indirect illumination reflected by smooth surfaces. Appropriate methods are proposed to optimize the pose and optical parameters of the light source and the vision camera.

  3. Underactuated spacecraft formation reconfiguration with collision avoidance (United States)

    Huang, Xu; Yan, Ye; Zhou, Yang


    Underactuated collision-free controllers are proposed in this paper for multiple spacecraft formation reconfiguration in circular orbits with the loss of either the radial or in-track thrust. A nonlinear dynamical model of underactuated formation flying is introduced, which is then linearized about circular orbits for controllability and feasibility analyses on underactuated formation reconfiguration. By using the inherent dynamics coupling of system states, reduced-order sliding mode controllers are then designed for either case to indirectly stabilize the system trajectories to the desired formations. In consideration of the collision-avoidance requirement, the artificial potential function method is then employed to design novel underactuated collision-avoidance maneuvers. Rigorous proof substantiates the capabilities of such maneuvers in preventing collisions even in the absence of radial or in-track thrust. Furthermore, a Lyapunov-based analysis ensures the asymptotic stability of the overall closed-loop system. Numerical simulations are performed in a J2-perturbed environment to verify the validity of the proposed underactuated control schemes for collision-free reconfiguration.

  4. Shape optimization of self-avoiding curves (United States)

    Walker, Shawn W.


    This paper presents a softened notion of proximity (or self-avoidance) for curves. We then derive a sensitivity result, based on shape differential calculus, for the proximity. This is combined with a gradient-based optimization approach to compute three-dimensional, parameterized curves that minimize the sum of an elastic (bending) energy and a proximity energy that maintains self-avoidance by a penalization technique. Minimizers are computed by a sequential-quadratic-programming (SQP) method where the bending energy and proximity energy are approximated by a finite element method. We then apply this method to two problems. First, we simulate adsorbed polymer strands that are constrained to be bound to a surface and be (locally) inextensible. This is a basic model of semi-flexible polymers adsorbed onto a surface (a current topic in material science). Several examples of minimizing curve shapes on a variety of surfaces are shown. An advantage of the method is that it can be much faster than using molecular dynamics for simulating polymer strands on surfaces. Second, we apply our proximity penalization to the computation of ideal knots. We present a heuristic scheme, utilizing the SQP method above, for minimizing rope-length and apply it in the case of the trefoil knot. Applications of this method could be for generating good initial guesses to a more accurate (but expensive) knot-tightening algorithm.

  5. Honey bees selectively avoid difficult choices. (United States)

    Perry, Clint J; Barron, Andrew B


    Human decision-making strategies are strongly influenced by an awareness of certainty or uncertainty (a form of metacognition) to increase the chances of making a right choice. Humans seek more information and defer choosing when they realize they have insufficient information to make an accurate decision, but whether animals are aware of uncertainty is currently highly contentious. To explore this issue, we examined how honey bees (Apis mellifera) responded to a visual discrimination task that varied in difficulty between trials. Free-flying bees were rewarded for a correct choice, punished for an incorrect choice, or could avoid choosing by exiting the trial (opting out). Bees opted out more often on difficult trials, and opting out improved their proportion of successful trials. Bees could also transfer the concept of opting out to a novel task. Our data show that bees selectively avoid difficult tasks they lack the information to solve. This finding has been considered as evidence that nonhuman animals can assess the certainty of a predicted outcome, and bees' performance was comparable to that of primates in a similar paradigm. We discuss whether these behavioral results prove bees react to uncertainty or whether associative mechanisms can explain such findings. To better frame metacognition as an issue for neurobiological investigation, we propose a neurobiological hypothesis of uncertainty monitoring based on the known circuitry of the honey bee brain.

  6. Convective Weather Avoidance with Uncertain Weather Forecasts (United States)

    Karahan, Sinan; Windhorst, Robert D.


    Convective weather events have a disruptive impact on air traffic both in terminal area and in en-route airspaces. In order to make sure that the national air transportation system is safe and efficient, it is essential to respond to convective weather events effectively. Traffic flow control initiatives in response to convective weather include ground delay, airborne delay, miles-in-trail restrictions as well as tactical and strategic rerouting. The rerouting initiatives can potentially increase traffic density and complexity in regions neighboring the convective weather activity. There is a need to perform rerouting in an intelligent and efficient way such that the disruptive effects of rerouting are minimized. An important area of research is to study the interaction of in-flight rerouting with traffic congestion or complexity and developing methods that quantitatively measure this interaction. Furthermore, it is necessary to find rerouting solutions that account for uncertainties in weather forecasts. These are important steps toward managing complexity during rerouting operations, and the paper is motivated by these research questions. An automated system is developed for rerouting air traffic in order to avoid convective weather regions during the 20- minute - 2-hour time horizon. Such a system is envisioned to work in concert with separation assurance (0 - 20-minute time horizon), and longer term air traffic management (2-hours and beyond) to provide a more comprehensive solution to complexity and safety management. In this study, weather is dynamic and uncertain; it is represented as regions of airspace that pilots are likely to avoid. Algorithms are implemented in an air traffic simulation environment to support the research study. The algorithms used are deterministic but periodically revise reroutes to account for weather forecast updates. In contrast to previous studies, in this study convective weather is represented as regions of airspace that pilots

  7. Alcohol Detection and Automatic Drunken Drive Avoiding System

    Directory of Open Access Journals (Sweden)

    Prof. P. H. Kulkarni


    Full Text Available The main aim of this project is to design an embedded system for implementing a efficient alcohol detection system that will be useful to avoid accidents. There are many different types of accidents which occur in daily life. Accidents may cause due to many reasons it may be due to brake fail. Most often accidents occur due to over drunken person. Though there are laws to punish drunken drivers they cannot be fully implemented. Because traffic police cannot stand on every road to check each and every car driver whether he/she has drunk or not. This can be a major reason for accidents. So there is a need for a effective system to check drunken drivers. Therefore in order to avoid these accidents we have implemented a prototype project. In our project, Initially we check whether the person has drunken or not by using the MQ3 GAS sensor. In this system, sensor circuit is used to detect whether the alcohol was consumed by driver or not. To this end, we have designed such a system that when alcohol concentration is detected then car will be stopped and the related information will go to nearby location through GSM. This project is based on EMBEDDED C programming using AVR-AT mega 16 microcontroller.

  8. Avoidable cancers in the Nordic countries. Exogenous hormones

    DEFF Research Database (Denmark)

    Winther, J F; Dreyer, L; Tryggvadottir, L


    The well-described influence of several aspects of reproductive life on the risk for cancer in the reproductive organs has raised concern regarding the safety of exogenous hormones, particularly since sex hormones have become one of the most widely used drugs among women in the western world...... of the breast and uterine cervix) and beneficial effects (protection against cancers of the ovary and endometrium), indicate that 95 cases of breast cancer and 40 of cervical cancer will be caused by oral contraceptives annually around 2000 in the Nordic countries, which corresponds to 0.6% of all breast...... years) of hormone replacement therapy among Nordic women aged 40-69 in 1995 was estimated to be 10-11%, which on the basis of an associated relative risk for breast cancer ranging from 1.2-1.5 suggests than an annual total of 260 cases of breast cancer could be avoided in the Nordic countries around...

  9. Avoidable cancers in the Nordic countries. Alcohol consumption

    DEFF Research Database (Denmark)

    Dreyer, L; Winther, J F; Andersen, A


    Alcohol intake is causally associated with cancers of the larynx, oral cavity, pharynx, oesophagus and liver. In all five Nordic countries, alcohol consumption increased substantially between 1965 (6.5 litres per adult per year) and 1975 (10 litres), but remained at about 10 litres between 1975...... if alcohol drinking were eliminated. This corresponds to about 29% of all alcohol-related cancers, i.e. in the oesophagus (37%), oral cavity and pharynx (33%), larynx (29%) and liver (15%). About 2% of all cancers in men and 1% in women in the Nordic countries around the year 2000 will be caused...... and 1985. The daily consumption of men during the period was substantially higher than that of women, and that of both men and women was higher in Denmark than in the other Nordic countries. In about 2000, an annual total of almost 1,300 cancer cases (1,000 in men and 300 in women) would be avoided...

  10. The first rapid assessment of avoidable blindness (RAAB in Thailand.

    Directory of Open Access Journals (Sweden)

    Saichin Isipradit

    Full Text Available BACKGROUND: The majority of vision loss is preventable or treatable. Population surveys are crucial for planning, implementation, and monitoring policies and interventions to eliminate avoidable blindness and visual impairments. This is the first rapid assessment of avoidable blindness (RAAB study in Thailand. METHODS: A cross-sectional study of a population in Thailand age 50 years old or over aimed to assess the prevalence and causes of blindness and visual impairments. Using the Thailand National Census 2010 as the sampling frame, a stratified four-stage cluster sampling based on a probability proportional to size was conducted in 176 enumeration areas from 11 provinces. Participants received comprehensive eye examination by ophthalmologists. RESULTS: The age and sex adjusted prevalence of blindness (presenting visual acuity (VA <20/400, severe visual impairment (VA <20/200 but ≥20/400, and moderate visual impairment (VA <20/70 but ≥20/200 were 0.6% (95% CI: 0.5-0.8, 1.3% (95% CI: 1.0-1.6, 12.6% (95% CI: 10.8-14.5. There was no significant difference among the four regions of Thailand. Cataract was the main cause of vision loss accounted for 69.7% of blindness. Cataract surgical coverage in persons was 95.1% for cut off VA of 20/400. Refractive errors, diabetic retinopathy, glaucoma, and corneal opacities were responsible for 6.0%, 5.1%, 4.0%, and 2.0% of blindness respectively. CONCLUSION: Thailand is on track to achieve the goal of VISION 2020. However, there is still much room for improvement. Policy refinements and innovative interventions are recommended to alleviate blindness and visual impairments especially regarding the backlog of blinding cataract, management of non-communicative, chronic, age-related eye diseases such as glaucoma, age-related macular degeneration, and diabetic retinopathy, prevention of childhood blindness, and establishment of a robust eye health information system.

  11. DENIS Galaxies in the Zone of Avoidance

    CERN Document Server

    Schröder, A; Mamon, G A; Ruphy, S; Paris-Meudon, Obs.


    We investigated the potential of using DENIS for studies of galaxies behind the obscuration layer of our Milky Way, and mapping the Galactic extinction. As a pilot study, we examined DENIS I-, J-, and K-band images of heavily obscured galaxies from a deep optical (B_J-band) galaxy survey in the Zone of Avoidance. We tried to uncover additional galaxies at latitudes where the Milky Way remains fully opaque, i.e. we conducted a `blind' search at |b| 4-5 mag. Furthermore, we determined the I, J and K magnitudes of galaxies in the low-latitude, nearby, rich cluster Abell 3627 and compared the resulting colour-colour diagram with that of an unobscured cluster.

  12. Avoiding Quantum Chaos in Quantum Computation

    CERN Document Server

    Berman, G P; Izrailev, F M; Tsifrinovich, V I


    We study a one-dimensional chain of nuclear $1/2-$spins in an external time-dependent magnetic field. This model is considered as a possible candidate for experimental realization of quantum computation. According to the general theory of interacting particles, one of the most dangerous effects is quantum chaos which can destroy the stability of quantum operations. According to the standard viewpoint, the threshold for the onset of quantum chaos due to an interaction between spins (qubits) strongly decreases with an increase of the number of qubits. Contrary to this opinion, we show that the presence of a magnetic field gradient helps to avoid quantum chaos which turns out to disappear with an increase of the number of qubits. We give analytical estimates which explain this effect, together with numerical data supporting

  13. Avoiding sexual harassment liability in veterinary practices. (United States)

    Lacroix, C A; Wilson, J F


    Harassment based on gender violates the rule of workplace equality established by Title VII of the Civil Rights Act and enforced by the EEOC. In 1986, the US Supreme Court, in Meritor Savings Bank v Vinson, established the criteria that must be met for a claim of hostile environment sexual harassment to be considered valid. Plaintiffs must show that they were subjected to conduct based on their gender, that it was unwelcome, and that it was severe and pervasive enough to alter their condition of employment, resulting in an abusive working environment. There have been few sexual harassment cases involving veterinary professionals, and it is our goal to help keep the number of filed actions to a minimum. The most effective way to avoid hostile environment sexual harassment claims is to confront the issue openly and to adopt a sexual harassment policy for the practice. When it comes to sexual harassment, an ounce of prevention is unquestionably worth a pound of cure.

  14. Experiential Avoidance and Technological Addictions in Adolescents. (United States)

    García-Oliva, Carlos; Piqueras, José A


    Background and aims This study focuses on the use of popular information and communication technologies (ICTs) by adolescents: the Internet, mobile phones, and video games. The relationship of ICT use and experiential avoidance (EA), a construct that has emerged as underlying and transdiagnostic to a wide variety of psychological problems, including behavioral addictions, is examined. EA refers to a self-regulatory strategy involving efforts to control or escape from negative stimuli such as thoughts, feelings, or sensations that generate strong distress. This strategy, which may be adaptive in the short term, is problematic if it becomes an inflexible pattern. Thus, the aim of this study was to explore whether EA patterns were associated with addictive or problematic use of ICT in adolescents. Methods A total of 317 students of the Spanish southeast between 12 and 18 years old were recruited to complete a questionnaire that included questions about general use of each ICTs, an experiential avoidance questionnaire, a brief inventory of the Big Five personality traits, and specific questionnaires on problematic use of the Internet, mobile phones, and video games. Results Correlation analysis and linear regression showed that EA largely explained results regarding the addictive use of the Internet, mobile phones, and video games, but not in the same way. As regards gender, boys showed a more problematic use of video games than girls. Concerning personality factors, conscientiousness was related to all addictive behaviors. Discussion and conclusions We conclude that EA is an important construct that should be considered in future models that attempt to explain addictive behaviors.

  15. How to avoid overheating during exercise (United States)

    ... risk for heat emergencies , such as: Heat cramps. Muscle cramps, usually in the legs or stomach (caused by ... signs of heat exhaustion: Heavy sweating Tiredness Thirsty Muscle cramps Later signs may include: Weakness Dizziness Headache Nausea ...

  16. Amide proton signals as pH indicator for in vivo MRS and MRI of the brain-Responses to hypercapnia and hypothermia. (United States)

    Watanabe, Takashi; Frahm, Jens; Michaelis, Thomas


    Using proton MRS and MRI of mouse brain at 9.4T, this work provides the first in vivo evidence of pH-dependent concurrent changes of three amide signals and related metabolic responses to hypercapnia and hypothermia. During hypercapnia, amide proton MRS signals of glutamine at 6.8-6.9ppm and 7.6ppm as well as of unspecific compounds at 8.1-8.3ppm increase by at least 50% both at 37°C and 22°C. These changes reflect a reduced proton exchange with water. They are strongly correlated with intracellular pH which ranges from 6.75±0.10 to 7.13±0.06 as determined from a shift in creatine phosphokinase equilibrium. In MRI, saturation transfer from aliphatic as well as aromatic and/or amide protons alters slightly during hypercapnia and significantly during hypothermia. The asymmetry in magnetization transfer ratios decreased slightly during hypercapnia and hypothermia. Regardless of pH or temperature, saturation transfer from aliphatic protons between -2 and -4ppm frequency offset to water protons is significantly greater than that from aromatic/amide protons at corresponding offsets between +2 and +4ppm. Irradiation of aliphatic compounds at -3.5ppm frequency offset from water predominantly saturates lipids and water associated with myelin. Taken together, the results indicate that, for the B1 power used in this study, dipolar coupling between aliphatic and water protons rather than proton exchange is the dominant factor in Z-spectra and magnetization transfer ratio asymmetry of the brain in vivo.

  17. Early-Stage Hyperoxia Is Associated with Favorable Neurological Outcomes and Survival after Severe Traumatic Brain Injury: A Post-Hoc Analysis of the Brain Hypothermia Study. (United States)

    Fujita, Motoki; Oda, Yasutaka; Yamashita, Susumu; Kaneda, Kotaro; Kaneko, Tadashi; Suehiro, Eiichi; Dohi, Kenji; Kuroda, Yasuhiro; Kobata, Hitoshi; Tsuruta, Ryosuke; Maekawa, Tsuyoshi


    The effects of hyperoxia on the neurological outcomes of patients with severe traumatic brain injury (TBI) are still controversial. We examined whether the partial pressure of arterial oxygen (PaO2) and hyperoxia were associated with neurological outcomes and survival by conducting post-hoc analyses of the Brain Hypothermia (B-HYPO) study, a multi-center randomized controlled trial of mild therapeutic hypothermia for severe TBI. The differences in PaO2 and PaO2/fraction of inspiratory oxygen (P/F) ratio on the 1st day of admission were compared between patients with favorable (n = 64) and unfavorable (n = 65) neurological outcomes and between survivors (n = 90) and deceased patients (n = 39). PaO2 and the P/F ratio were significantly greater in patients with favorable outcomes than in patients with unfavorable neurological outcomes (PaO2: 252 ± 122 vs. 202 ± 87 mm Hg, respectively, p = 0.008; P/F ratio: 455 ± 171 vs. 389 ± 155, respectively, p = 0.022) and in survivors than in deceased patients (PaO2: 242 ± 117 vs. 193 ± 75 mm Hg, respectively, p = 0.005; P/F ratio: 445 ± 171 vs. 370 ± 141, respectively, p = 0.018). Similar tendencies were observed in subgroup analyses in patients with fever control and therapeutic hypothermia, and in patients with an evacuated mass or other lesions (unevacuated lesions). PaO2 was independently associated with survival (odds ratio 1.008, p = 0.037). These results suggested that early-stage hyperoxia might be associated with favorable neurological outcomes and survival following severe TBI.

  18. Monosodium glutamate-induced arcuate nucleus damage affects both natural torpor and 2DG-induced torpor-like hypothermia in Siberian hamsters. (United States)

    Pelz, Kimberly M; Routman, David; Driscoll, Joseph R; Kriegsfeld, Lance J; Dark, John


    Siberian hamsters (Phodopus sungorus) have the ability to express daily torpor and decrease their body temperature to approximately 15 degrees C, providing a significant savings in energy expenditure. Daily torpor in hamsters is cued by winterlike photoperiods and occurs coincident with the annual nadirs in body fat reserves and chronic leptin concentrations. To better understand the neural mechanisms underlying torpor, Siberian hamster pups were postnatally treated with saline or MSG to ablate arcuate nucleus neurons that likely possess leptin receptors. Body temperature was studied telemetrically in cold-acclimated (10 degrees C) male and female hamsters moved to a winterlike photoperiod (10:14-h light-dark cycle) (experiments 1 and 2) or that remained in a summerlike photoperiod (14:10-h light-dark cycle) (experiment 3). In experiment 1, even though other photoperiodic responses persisted, MSG-induced arcuate nucleus ablations prevented the photoperiod-dependent torpor observed in saline-treated Siberian hamsters. MSG-treated hamsters tended to possess greater fat reserves. To determine whether reductions in body fat would increase frequency of photoperiod-induced torpor after MSG treatment, hamsters underwent 2 wk of food restriction (70% of ad libitum) in experiment 2. Although food restriction did increase the frequency of torpor in both MSG- and saline-treated hamsters, it failed to normalize the proportion of MSG-treated hamsters undergoing photoperiod-dependent torpor. In experiment 3, postnatal MSG treatments reduced the proportion of hamsters entering 2DG-induced torpor-like hypothermia by approximately 50% compared with saline-treated hamsters (38 vs. 72%). In those MSG-treated hamsters that did become hypothermic, their minimum temperature during hypothermia was significantly greater than comparable saline-treated hamsters. We conclude that 1) arcuate nucleus mechanisms mediate photoperiod-induced torpor, 2) food-restriction-induced torpor may also be

  19. Optimizing sampling design to deal with mist-net avoidance in Amazonian birds and bats.

    Directory of Open Access Journals (Sweden)

    João Tiago Marques

    Full Text Available Mist netting is a widely used technique to sample bird and bat assemblages. However, captures often decline with time because animals learn and avoid the locations of nets. This avoidance or net shyness can substantially decrease sampling efficiency. We quantified the day-to-day decline in captures of Amazonian birds and bats with mist nets set at the same location for four consecutive days. We also evaluated how net avoidance influences the efficiency of surveys under different logistic scenarios using re-sampling techniques. Net avoidance caused substantial declines in bird and bat captures, although more accentuated in the latter. Most of the decline occurred between the first and second days of netting: 28% in birds and 47% in bats. Captures of commoner species were more affected. The numbers of species detected also declined. Moving nets daily to minimize the avoidance effect increased captures by 30% in birds and 70% in bats. However, moving the location of nets may cause a reduction in netting time and captures. When moving the nets caused the loss of one netting day it was no longer advantageous to move the nets frequently. In bird surveys that could even decrease the number of individuals captured and species detected. Net avoidance can greatly affect sampling efficiency but adjustments in survey design can minimize this. Whenever nets can be moved without losing netting time and the objective is to capture many individuals, they should be moved daily. If the main objective is to survey species present then nets should still be moved for bats, but not for birds. However, if relocating nets causes a significant loss of netting time, moving them to reduce effects of shyness will not improve sampling efficiency in either group. Overall, our findings can improve the design of mist netting sampling strategies in other tropical areas.

  20. Optimizing sampling design to deal with mist-net avoidance in Amazonian birds and bats. (United States)

    Marques, João Tiago; Ramos Pereira, Maria J; Marques, Tiago A; Santos, Carlos David; Santana, Joana; Beja, Pedro; Palmeirim, Jorge M


    Mist netting is a widely used technique to sample bird and bat assemblages. However, captures often decline with time because animals learn and avoid the locations of nets. This avoidance or net shyness can substantially decrease sampling efficiency. We quantified the day-to-day decline in captures of Amazonian birds and bats with mist nets set at the same location for four consecutive days. We also evaluated how net avoidance influences the efficiency of surveys under different logistic scenarios using re-sampling techniques. Net avoidance caused substantial declines in bird and bat captures, although more accentuated in the latter. Most of the decline occurred between the first and second days of netting: 28% in birds and 47% in bats. Captures of commoner species were more affected. The numbers of species detected also declined. Moving nets daily to minimize the avoidance effect increased captures by 30% in birds and 70% in bats. However, moving the location of nets may cause a reduction in netting time and captures. When moving the nets caused the loss of one netting day it was no longer advantageous to move the nets frequently. In bird surveys that could even decrease the number of individuals captured and species detected. Net avoidance can greatly affect sampling efficiency but adjustments in survey design can minimize this. Whenever nets can be moved without losing netting time and the objective is to capture many individuals, they should be moved daily. If the main objective is to survey species present then nets should still be moved for bats, but not for birds. However, if relocating nets causes a significant loss of netting time, moving them to reduce effects of shyness will not improve sampling efficiency in either group. Overall, our findings can improve the design of mist netting sampling strategies in other tropical areas.

  1. Serial plasma choline measurements after cardiac arrest in patients undergoing mild therapeutic hypothermia: a prospective observational pilot trial.

    Directory of Open Access Journals (Sweden)

    Christian Storm

    Full Text Available OBJECTIVE: Choline is related to phospholipid metabolism and is a marker for global ischaemia with a small reference range in healthy volunteers. The aim of our study was to characterize the early kinetics of plasma free choline in patients after cardiac arrest. Additionally, we investigated the potential of plasma free choline to predict neurological outcome. METHODS: Twenty patients admitted to our medical intensive care unit were included in this prospective, observational trial. All patients were enrolled between May 2010 and May 2011. They received post cardiac arrest treatment including mild therapeutic hypothermia which was initiated with a combination of cold fluid and a feedback surface cooling device according to current guidelines. Sixteen blood samples per patient were analysed for plasma free choline levels within the first week after resuscitation. Choline was detected by liquid chromatography-tandem mass spectrometry. RESULTS: Most patients showed elevated choline levels on admission (median 14.8 µmol/L; interquartile range; IQR 9.9-20.1 which subsequently decreased. 48 hours after cardiac arrest choline levels in all patients reached subnormal levels at a median of 4.0 µmol/L (IQR 3-4.9; p = 0.001. Subsequently, choline levels normalized within seven days. There was no significant difference in choline levels when groups were analyzed in relation to neurological outcome. CONCLUSIONS: Our data indicate a choline deficiency in the early postresucitation phase. This could potentially result in impaired cell membrane recovery. The detailed characterization of the early choline time course may aid in planning of choline supplementation trials. In a limited number of patients, choline was not promising as a biomarker for outcome prediction.

  2. 'Crashing' the rugby scrum -- an avoidable cause of cervical spinal injury. Case reports. (United States)

    Scher, A T


    Deliberate crashing of the opposing packs prior to a rugby scrum is an illegal but commonly practised manoeuvre which can lead to abnormal flexion forces being applied to players in the front row, with resultant cervical spine and spinal cord injury. Two cases of cervical spinal cord injury sustained in this manner are presented. The mechanism of injury, the forces involved and preventive measures are discussed.

  3. Fractures of modern high nitrogen stainless steel cemented stems: cause, mechanism, and avoidance in 14 cases. (United States)

    Yates, Piers J; Quraishi, Nasir A; Kop, Allan; Howie, Donald W; Marx, Clare; Swarts, Eric


    We present 14 cases of fracture of modern, high-nitrogen, stainless steel stems. Our clinical and radiological data suggest that heavy patients with small stems and poor proximal support are at risk for fracturing their implants. "Champagne-glass" canals can lead to the use of smaller stems often placed in varus, which can lead to cantilever bending and fatigue failure in the distal half of the stem. Metallurgical assessment of the retrieved high-nitrogen, stainless steel stems reveals microstructural inconsistencies that may contribute to their failure. Based on our findings, careful consideration and attention to technique is required when using stainless steel stems in patients with high body mass index or high weight. Technique is particularly important in femurs with champagne-glass canals.

  4. The role of NTS2 in the development of tolerance to NT69L in mouse models for hypothermia and thermal analgesia


    Smith, Kristin E.; Boules, Mona; Williams, Katrina; Fauq, Abdul H.; Richelson, Elliott


    NT69L is a neurotensin (NT)(8–13) analog that binds the two major NT receptors, NTS1 and NTS2, and elicits similar behavioral effects as endogenous NT. Tolerance develops rapidly to some, but not to all of NT69L's effects, and to date, little is known about the mechanisms responsible for this tolerance. The development of tolerance appears to be more prevalent in behavioral effects mediated by NTS1 than by those mediated by NTS2, including hypothermia and thermal analgesia. However, we hypoth...

  5. The Relation between Youth Fear and Avoidance of Crime in School and Academic Experiences (United States)

    Barrett, Kimberly L.; Jennings, Wesley G.; Lynch, Michael J.


    Despite decades of research analyzing fear of crime among adults, little is known about youth fear of crime in general and youth fear of crime in school, specifically. Moreover, among existing studies most emphasize causes of fear, with little discussion of avoidance or the academic consequences of these feelings and behaviors in school. This…

  6. Brief Report: Avoidance Extinction as Treatment for Compulsive and Ritual Behavior in Autism (United States)

    Wolff, Jason J.; Hupp, Susan C.; Symons, Frank J.


    Treatment options for maladaptive repetitive behaviors associated with autism are limited. This is particularly so for ritual and compulsive forms of repetitive behavior, which commonly interfere with adaptive activities and may cause distress to individuals with autism and their families. The present study assessed an avoidance extinction…

  7. Pregnant Women Should Avoid Zika-Hit Texas Town: CDC (United States)

    ... page: Pregnant Women Should Avoid Zika-Hit Texas Town: CDC ... 15, 2016 THURSDAY, Dec. 15, 2016 (HealthDay News) -- Pregnant women should avoid traveling to a south Texas ...

  8. US Forest Service Aerial Fire Retardant Hydrographic Avoidance Areas: Aquatic (United States)

    US Forest Service, Department of Agriculture — A map services on the www depicting aerial retardant avoidance areas for hydrographic feature data. Aerial retardant avoidance area for hydrographic feature data are...

  9. Performance of humans in concurrent avoidance/positive-reinforcement schedules


    Ruddle, H. V.; Bradshaw, C M; Szabadi, E; Foster, T M


    Performance maintained under concurrent schedules consisting of a variable-interval avoidance component and a variable-interval positive-reinforcement component was studied in three human subjects using points exchangeable for money as the reinforcer. The rate of responding in the avoidance component increased, and the rate of responding in the positive-reinforcement component declined, as a function of the frequency of point-losses avoided in the avoidance component. The performance of all t...

  10. Spectrum-specific damage and solar ultraviolet radiation avoidance in the two-spotted spider mite. (United States)

    Sakai, Yuta; Osakabe, Masahiro


    The spatial distribution of the two-spotted spider mite Tetranychus urticae Koch is biased toward the lower surfaces of leaves as compared with the upper leaf surfaces on their host plants. Because of the deleterious effects of solar ultraviolet (UV) irradiation, we hypothesized T. urticae remains on lower leaf surfaces as an adaptation to avoid solar UV radiation (UVR). We examined the effects of solar UVR components on females and tested whether spatial distribution was associated with solar UVR avoidance. Attenuation of solar UVR using UV opaque film increased fecundity and reduced the movement of females from the upper to the lower leaf surfaces. In contrast, diverting solar UVR to the lower leaf surface using a light reflection sheet caused the mites to move from the lower to the upper leaf surfaces; however, attenuated UV reflection did not, suggesting that they occupy the lower leaf surface to avoid solar UVR. In monochromatic UVR tests, no eggs hatched when placed under 280-300 nm radiation, whereas almost all eggs hatched at 320-360 nm. Adult females, however, did not avoid wavelengths of 280 and 300 nm, but avoided 320-340 nm. We conclude that T. urticae exploit UVA information to avoid ambient UVB radiation.

  11. Neuroimaging the temporal dynamics of human avoidance to sustained threat. (United States)

    Schlund, Michael W; Hudgins, Caleb D; Magee, Sandy; Dymond, Simon


    Many forms of human psychopathology are characterized by sustained negative emotional responses to threat and chronic behavioral avoidance, implicating avoidance as a potential transdiagnostic factor. Evidence from both nonhuman neurophysiological and human neuroimaging studies suggests a distributed frontal-limbic-striatal brain network supports avoidance. However, our understanding of the temporal dynamics of the network to sustained threat that prompts sustained avoidance is limited. To address this issue, 17 adults were given extensive training on a modified free-operant avoidance task in which button pressing avoided money loss during a sustained threat period. Subsequently, subjects underwent functional magnetic resonance imaging while completing the avoidance task. In our regions of interest, we observed phasic, rather than sustained, activation during sustained threat in dorsolateral and inferior frontal regions, anterior and dorsal cingulate, ventral striatum and regions associated with emotion, including the amygdala, insula, substantia nigra and bed nucleus of the stria terminalis complex. Moreover, trait levels of experiential avoidance were negatively correlated with insula, hippocampal and amygdala activation. These findings suggest knowledge that one can consistently avoid aversive outcomes is not associated with decreased threat-related responses and that individuals with greater experiential avoidance exhibit reduced reactivity to initial threat. Implications for understanding brain mechanisms supporting human avoidance and psychological theories of avoidance are discussed.

  12. Social anxiety predicts avoidance behaviour in virtual encounters

    NARCIS (Netherlands)

    Rinck, M.; Rörtgen, T.; Lange, W.G.; Dotsch, R.; Wigboldus, D.H.J.; Becker, E.S.


    Avoidant behaviour is critical in social anxiety and social phobia, being a major factor in the maintenance of anxiety. However, almost all previous studies of social avoidance were restricted to using self-reports for the study of intentional aspects of avoidance. In contrast, the current study use

  13. 14 CFR 121.356 - Collision avoidance system. (United States)


    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Collision avoidance system. 121.356 Section... Collision avoidance system. Effective January 1, 2005, any airplane you operate under this part must be equipped and operated according to the following table: Collision Avoidance Systems If you operate...

  14. Effects of optimism on creativity under approach and avoidance motivation

    NARCIS (Netherlands)

    Icekson, Tamar; Roskes, Marieke; Moran, Simone


    Focusing on avoiding failure or negative outcomes (avoidance motivation) can undermine creativity, due to cognitive (e.g., threat appraisals), affective (e.g., anxiety), and volitional processes (e.g., low intrinsic motivation). This can be problematic for people who are avoidance motivated by natur

  15. 14 CFR 129.18 - Collision avoidance system. (United States)


    ... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Collision avoidance system. 129.18 Section... § 129.18 Collision avoidance system. Effective January 1, 2005, any airplane you, as a foreign air... Avoidance Systems If you operate in the United States any . . . Then you must operate that airplane with:...

  16. 14 CFR 437.65 - Collision avoidance analysis. (United States)


    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Collision avoidance analysis. 437.65..., DEPARTMENT OF TRANSPORTATION LICENSING EXPERIMENTAL PERMITS Safety Requirements § 437.65 Collision avoidance... permittee must obtain a collision avoidance analysis from United States Strategic Command. (b) The...

  17. 14 CFR 417.231 - Collision avoidance analysis. (United States)


    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Collision avoidance analysis. 417.231..., DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH SAFETY Flight Safety Analysis § 417.231 Collision avoidance analysis. (a) General. A flight safety analysis must include a collision avoidance analysis...

  18. 20 CFR 606.23 - Avoidance of tax credit reduction. (United States)


    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Avoidance of tax credit reduction. 606.23... Tax Credit Reduction § 606.23 Avoidance of tax credit reduction. (a) Applicability. Subsection (g) of... receipts and benefit outlays under the law in effect for the year for which avoidance is requested, as...

  19. Avoidance learning : a review of theoretical models and recent developments

    NARCIS (Netherlands)

    Krypotos, Angelos-Miltiadis; Effting, Marieke; Kindt, Merel; Beckers, Tom


    Avoidance is a key characteristic of adaptive and maladaptive fear. Here, we review past and contemporary theories of avoidance learning. Based on the theories, experimental findings and clinical observations reviewed, we distill key principles of how adaptive and maladaptive avoidance behavior is a

  20. 20 CFR 606.24 - Application for avoidance. (United States)


    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Application for avoidance. 606.24 Section 606... Credit Reduction § 606.24 Application for avoidance. (a) Application. (1) The Governor of the State shall... respect to which a State requests avoidance of tax credit reduction. The Governor is required to...

  1. 50 CFR 600.510 - Gear avoidance and disposal. (United States)


    ... 50 Wildlife and Fisheries 8 2010-10-01 2010-10-01 false Gear avoidance and disposal. 600.510 Section 600.510 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND... Gear avoidance and disposal. (a) Vessel and gear avoidance. (1) FFV's arriving on fishing grounds...

  2. 78 FR 35262 - Detection and Avoidance of Counterfeit Electronic Parts (United States)


    ... Defense Acquisition Regulations System Detection and Avoidance of Counterfeit Electronic Parts AGENCY... and the private sector regarding the electronic parts detection and avoidance coverage proposed to be... about the requirements for detection and avoidance of counterfeit electronic parts in DoD contracts....

  3. Effects of vasopressin on active and passive avoidance behavior

    NARCIS (Netherlands)

    Bohus, B.; Ader, R.; Wied, D. de


    Male rats were trained in an active avoidance and/or a “step-through” type of passive avoidance situation. Lysine vasopressin administration resulted in resistance to extinction of active avoidance behavior if it was injected 1 hr prior to the third and final acquisition session; peptide treatment 6

  4. 34 CFR 75.611 - Avoidance of flood hazards. (United States)


    ... 34 Education 1 2010-07-01 2010-07-01 false Avoidance of flood hazards. 75.611 Section 75.611... by a Grantee? Construction § 75.611 Avoidance of flood hazards. In planning the construction, a...) Evaluate flood hazards in connection with the construction; and (b) As far as practicable, avoid...

  5. 47 CFR 51.609 - Determination of avoided retail costs. (United States)


    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Determination of avoided retail costs. 51.609... (CONTINUED) INTERCONNECTION Resale § 51.609 Determination of avoided retail costs. (a) Except as provided in § 51.611, the amount of avoided retail costs shall be determined on the basis of a cost study...

  6. Facilitation and disruption by mescaline and 3,4-dimethoxyphenylethylamine of shock avoidance in rats. (United States)

    Gorelick, D A; Bridger, W H


    The effects of mescaline hydrochloride (4.95-79.2 mg/kg i.p.) and its non-hallucinogenic analogue 3,4-dimethoxyphenylethylamine hydrochloride (DMPEA) (12.5-100 mg/kg i.p.) on shock avoidance in a shuttlebox were studied in male Long-Evans rats trained to high (above 88%, good performers) or low (below 6%, poor performers) stable base-line avoidance rates. In good performers, mescaline and DMPEA caused a dose-dependent decrease in avoidance rate (ED 50's 44.6 and 39.2 mg/kg, respectively) without affecting presession (5-min adaptation period) or intertrial shuttlebox crossings. In poor performers, mescaline caused a dose-dependent increase in avoidance rate (ED 50 = 24.8 mg/kg) and intertrial crossings, without affecting presession crossings. The results suggest that mescaline, but not DMPEA, has dual facilitative and disruptive effects on avoidance behavior at similar dose ranges. The facilitative, but not the disruptive, effect may be related to changes in motor activity.

  7. Approach and avoidance motivation in eating disorders. (United States)

    Harrison, Amy; Treasure, Janet; Smillie, Luke D


    It has been proposed that approach and avoidance processes may be critically involved in the development and maintenance of eating disorders (EDs), including anorexia nervosa (AN) and bulimia nervosa (BN). The Behavioural Inhibition System and Behavioural Activation System Scales (BIS/BAS) and Appetitive Motivation Scale (AMS) questionnaires were administered to 286 participants: 91 healthy controls (HCs), 121 participants with a current ED, either AN (restrictive and binge purge subtypes), or BN and 74 participants recovered from an ED. Individuals with EDs had higher levels of sensitivity to punishment and lower levels of reward reactivity than controls. Individuals in recovery from an ED scored the same as those in the acute group, with the exception of BAS fun seeking, for which they scored significantly higher than those with restricting AN. Discriminant analysis revealed that HCs were maximally separated from those in the acute and recovered ED groups along a dimension reflecting high punishment sensitivity and low reward sensitivity. Classification analysis demonstrated that ED and HC group membership was predicted from reward and punishment sensitivity measures; however recovered participants tended to be misclassified as ED. This study suggests high punishment sensitivity and low reward reactivity/sensitivity might form a personality cluster associated with the risk of developing an ED.

  8. The amygdala: securing pleasure and avoiding pain (United States)

    Fernando, Anushka B. P.; Murray, Jennifer E.; Milton, Amy L.


    The amygdala has traditionally been associated with fear, mediating the impact of negative emotions on memory. However, this view does not fully encapsulate the function of the amygdala, nor the impact that processing in this structure has on the motivational limbic corticostriatal circuitry of which it is an important structure. Here we discuss the interactions between different amygdala nuclei with cortical and striatal regions involved in motivation; interconnections and parallel circuitries that have become increasingly understood in recent years. We review the evidence that the amygdala stores memories that allow initially motivationally neutral stimuli to become associated through pavlovian conditioning with motivationally relevant outcomes which, importantly, can be either appetitive (e.g. food) or aversive (e.g. electric shock). We also consider how different psychological processes supported by the amygdala such as conditioned reinforcement and punishment, conditioned motivation and suppression, and conditioned approach and avoidance behavior, are not only psychologically but also neurobiologically dissociable, being mediated by distinct yet overlapping neural circuits within the limbic corticostriatal circuitry. Clearly the role of the amygdala goes beyond encoding aversive stimuli to also encode the appetitive, requiring an appreciation of the amygdala's mediation of both appetitive and fearful behavior through diverse psychological processes. PMID:24367307

  9. The amygdala: securing pleasure and avoiding pain

    Directory of Open Access Journals (Sweden)

    Anushka B P Fernando


    Full Text Available The amygdala has traditionally been associated with fear, mediating the impact of negative emotions on memory. However, this view does not fully encapsulate the function of the amygdala, nor the impact that processing in this structure has on the motivational limbic corticostriatal circuitry of which it is an important structure. Here we discuss the interactions between different amygdala nuclei with cortical and striatal regions involved in motivation; interconnections and parallel circuitries that have become increasingly understood in recent years. We review the evidence that the amygdala stores memories that allow initially motivationally neutral stimuli to become associated through pavlovian conditioning with motivationally relevant outcomes which, importantly, can be either appetitive (e.g. food or aversive (e.g. electric shock. We also consider how different psychological processes supported by the amygdala such as conditioned reinforcement and punishment, conditioned motivation and suppression, and conditioned approach and avoidance behavior, are not only psychologically but also neurobiologically dissociable, being mediated by distinct yet overlapping neural circuits within the limbic corticostriatal circuitry. Clearly the role of the amygdala goes beyond encoding aversive stimuli to also encode the appetitive, requiring an appreciation of the amygdala’s mediation of both appetitive and fearful behavior through diverse psychological processes.

  10. Aerial vehicles collision avoidance using monocular vision (United States)

    Balashov, Oleg; Muraviev, Vadim; Strotov, Valery


    In this paper image-based collision avoidance algorithm that provides detection of nearby aircraft and distance estimation is presented. The approach requires a vision system with a single moving camera and additional information about carrier's speed and orientation from onboard sensors. The main idea is to create a multi-step approach based on a preliminary detection, regions of interest (ROI) selection, contour segmentation, object matching and localization. The proposed algorithm is able to detect small targets but unlike many other approaches is designed to work with large-scale objects as well. To localize aerial vehicle position the system of equations relating object coordinates in space and observed image is solved. The system solution gives the current position and speed of the detected object in space. Using this information distance and time to collision can be estimated. Experimental research on real video sequences and modeled data is performed. Video database contained different types of aerial vehicles: aircrafts, helicopters, and UAVs. The presented algorithm is able to detect aerial vehicles from several kilometers under regular daylight conditions.

  11. Avoidable cancers in the Nordic countries. Radiation

    DEFF Research Database (Denmark)

    Winther, J F; Ulbak, Kaare; Dreyer, L


    Exposure to solar and ionizing radiation increases the risk for cancer in humans. Some 5% of solar radiation is within the ultraviolet spectrum and may cause both malignant melanoma and non-melanocytic skin cancer; the latter is regarded as a benign disease and is accordingly not included in our...

  12. Effect of quality control circle to reduce intraoperative hypothermia during transurethral resection or prostate for elderly patients%品管圈活动降低经尿道前列腺电切术老年患者术中低体温的效果

    Institute of Scientific and Technical Information of China (English)

    陈艳; 张悦; 陆朝蓉; 黄平


    Objective To explore the effect of quality control circle ( QCC) to prevent intraoperative hypothermia during transurethral resection or prostate ( TURP) of aging patients .Methods We founded QCC team, utilized PDCA, and established ‘To prevent Intraoperative hypothermia during TURP of elderly patients ’ as a theme.Elderly, who met the sampling criteria and implement of TURP from January to October 2013 were assigned, for stock taking, setting goals, analyzing the causes, implementing rectification measures and evaluating the effect .Results Through the QCC , the rates of intraoperative hypothermia ,chills and postoperative agitation (14.3%,13.4%and 8.9%) were significant differences before QCC carried out (41.6%,30.9%and 21.4%) (χ2 =18.694,12.311,6.125,respectively;P<0.05).Each member of QCC was improved in the use of QCC, teamwork, expertise, relationships, the power of executive and the ability to resolve problems . Conclusions To carry out the quality control circle activity in elderly patients with TURP can effectively reduce the intraoperative hypothermia occurs , reduce intraoperative shivering and agitation and other complications , and improve the ability of team members to use QCC problem .%目的:探讨品管圈活动在降低高龄患者前列腺电切术( TURP)中低体温的应用效果。方法成立品管圈活动小组,运用PDCA循环方法,确立“降低高龄患者TURP术中低体温”为活动主题,对2013年1—10月112例行TURP的高龄患者进行现状调查、分析原因、设定目标,制定对策并落实整改措施,进行相关评价。结果通过品管圈活动的良性干预,高龄患者术中低体温、术中寒颤及躁动的发生率分别为14.3%,13.4%,8.92%,均较活动前下降,差异有统计学意义(χ2值分别为18.694,12.311,6.125;P <0.05)。结论开展品管圈活动能有效降低高龄患者TURP术中低体温的发生,减少术中寒颤及躁动

  13. Toxic effects of the easily avoidable phthalates and parabens. (United States)

    Crinnion, Walter J


    Some environmental toxins like DDT and other chlorinated compounds accumulate in the body because of their fat-soluble nature. Other compounds do not stay long in the body, but still cause toxic effects during the time they are present. For serious health problems to arise, exposure to these rapidly-clearing compounds must occur on a daily basis. Two such classes of compounds are the phthalate plasticizers and parabens, both of which are used in many personal care products, some medications, and even foods and food preservation. The phthalates are commonly found in foods and household dust. Even though they have relatively short half-lives in humans, phthalates have been associated with a number of serious health problems, including infertility, testicular dysgenesis, obesity, asthma, and allergies, as well as leiomyomas and breast cancer. Parabens, which can be dermally absorbed, are present in many cosmetic products, including antiperspirants. Their estrogenicity and tissue presence are a cause for concern regarding breast cancer. Fortunately, these compounds are relatively easy to avoid and such steps can result in dramatic reductions of urinary levels of these compounds.

  14. Avoidance learning, Pavlovian conditioning, and the development of phobias. (United States)

    Siddle, D A; Bond, N W


    This paper examines the role of Pavlovian conditioning in the acquisition, maintenance and elimination of human phobias. Because many conceptualizations of human fears and phobias are based on data from studies of avoidance learning in animals, we first review theories of avoidance. Our conclusion is that none of the extant theories provides an adequate account of avoidance learning, and we propose a model of avoidance that involves Pavlovian, but not instrumental learning. We then analyse critically arguments that Pavlovian conditioning plays only a small role in the aetiology of fears. Finally, the paper examines the implications of a conditioning model of avoidance for the study of human fears and phobias.

  15. Velocity of chloroplast avoidance movement is fluence rate dependent. (United States)

    Kagawa, Takatoshi; Wada, Masamitsu


    In Arabidopsis leaves, chloroplast movement is fluence rate dependent. At optimal, lower light fluences, chloroplasts accumulate at the cell surface to maximize photosynthetic potential. Under high fluence rates, chloroplasts avoid incident light to escape photodamage. In this paper, we examine the phenomenon of chloroplast avoidance movement in greater detail and demonstrate a proportional relationship between fluence rate and the velocity of chloroplast avoidance. In addition we show that the amount of light-activated phototropin2, the photoreceptor for the avoidance response, likely plays a role in this phenomenon, as heterozygous mutant plants show a reduced avoidance velocity compared to that of homozygous wild type plants.

  16. Education and smoking: were Vietnam war draft avoiders also more likely to avoid smoking? (United States)

    Grimard, Franque; Parent, Daniel


    We use the Vietnam war draft avoidance behavior documented by Card and Lemieux [Card, D., Lemieux, T., May 2001. Did draft avoidance raise college attendance during the Vietnam war? American Economic Review 91 (2), 97-102] as a quasi experiment to infer causation from education to smoking and find strong evidence that education, whether measured in years of completed schooling or in educational attainment categories, reduces the probability of smoking at the time of the interview, more particularly the probability of smoking regularly. However, while we find that more education substantially increases the probability of never smoking, our instrumental procedure yields imprecise estimates of the effect of education on smoking cessation. Potential mechanisms linking education and smoking are also explored.

  17. Faecal avoidance and selective foraging: do wild mice have the luxury to avoid faeces? (United States)

    Walsh, Patrick T; McCreless, Erin; Pedersen, Amy B


    Host-parasite interactions are a key determinant of the population dynamics of wild animals, and behaviours that reduce parasite transmission and infection may be important for improving host fitness. While antiparasite behaviours have been demonstrated in laboratory animals and domesticated ungulates, whether these behaviours operate in the wild is poorly understood. Therefore, examining antiparasite behaviours in natural populations is crucial for understanding their ecological significance. In this study, we examined whether two wild rodents (white-footed mice, Peromyscus leucopus, and deer mice, Peromyscus maniculatus), selectively foraged away from conspecific faeces or avoided faeces altogether, and whether faecal gastrointestinal parasite status affected their behaviour. We also tested whether wild mice, when nesting, avoided using material that had previously been used by healthy or parasite-infected conspecifics. Our results, in contrast to laboratory mouse studies, suggest that wild mice do not demonstrate faecal avoidance, selective foraging or selective use of nesting material; they preferred being near faeces and did not differentiate between faeces from parasitized and uninfected conspecifics. Behavioural avoidance to reduce parasite infection may still represent an important strategy; however, mice in our study population appeared to favour the opportunity to feed and nest over the risks of coming into contact with faecal-transmitted parasites. Furthermore, the presence of conspecific faeces may actually provide a positive cue of a good foraging or nesting location. Ultimately, balancing the trade-off of performing antiparasite behaviours to reduce infection with missing an important feeding or nesting opportunity may be very different for animals in the wild facing complex and stochastic environments.

  18. Clinical Practice of Steroid Avoidance in Pediatric Kidney Transplantation. (United States)

    Nehus, E; Liu, C; Hooper, D K; Macaluso, M; Kim, M-O


    Steroid-avoidance protocols have recently gained popularity in pediatric kidney transplantation. We investigated the clinical practice of steroid avoidance among 9494 kidney transplant recipients at 124 transplant centers between 2000 and 2012 in the Organ Procurement and Transplantation Network database. The practice of steroid avoidance increased during the study period and demonstrated significant variability among transplant centers. From 2008 to 2012, 39% of transplant centers used steroid avoidance in avoidance in 10-40% of transplant recipients, and 40% of transplant centers used steroid avoidance in >40% of discharged patients. Children receiving steroid avoidance more frequently received induction with lymphocyte-depleting agents. Repeat kidney transplants were the least likely to receive steroid avoidance. Children who received a deceased donor kidney, underwent pretransplant dialysis, were highly sensitized, or had glomerular kidney disease or delayed graft function were also less likely to receive steroid avoidance. The variation in practice between centers remained highly significant (p avoidance among transplant centers remain unexplained and may reflect uncertainty about the safety and efficacy of steroid-avoidance protocols.

  19. Body checking and avoidance in ethnically diverse female college students. (United States)

    White, Emily K; Warren, Cortney S


    Although body checking and avoidance behaviors are common in women with eating disorders, minimal research has examined the nature or correlates of these behaviors in ethnically diverse female college students without eating disorders. Self-identified European American (n=268), Asian American (n=163), Latina (n=146), and African American (n=73) women completed self-report measures of body checking and avoidance, thin-ideal internalization, eating pathology, and clinical impairment. Results indicated that European and Asian American women reported significantly more body checking and avoidance than African American and Latina women. Generally, correlates of body checking and avoidance were consistent across ethnic groups: Regression analyses indicated that type of ethnicity predicted body checking and avoidance; and ethnicity, body checking, and body avoidance predicted eating pathology and clinical impairment. These associations suggest that body checking and avoidance are not benign behaviors in diverse nonclinical women.

  20. Nursing progress on rewarming of critical ill patients with hypothermia%危重病患者亚低温复温的护理进展

    Institute of Scientific and Technical Information of China (English)

    闫雯雯; 徐旸; 罗南; 梁宇杰; 马颖; 乔杉; 苏芬菊; 宋丽华


    This paper aimed to study current situations of domestic and foreign nursing about clinical applications,measures and complications of mild hypothermia rewarming in critical ill patients.Recent nursing research progress was summarized to improve hypothermia rewarming process and operation specification,lower the morbidity and mortality of the patients,improve the quality of their life,reduce the mental burden of patients and their family members,further enhance the clinical nursing work and the quality of nursing care.%本文旨在研究危重病患者临床应用亚低温复温的方法、护理措施及并发症等方面的国内外护理现状,对已有的护理研究进展加以归纳和总结,改善亚低温复温的流程及操作规范,降低患者的致残率与死亡率,提高其生存质量,减轻患者及其家属的精神负担,进一步完善临床护理工作,提高护理质量.

  1. Effect of wet-cold weather transportation conditions on thermoregulation and the development of accidental hypothermia in pullets under tropical conditions. (United States)

    Minka, Ndazo S; Ayo, Joseph O


    The present study examines onboard thermal microclimatic conditions and thermoregulation of pullets exposed to accidental hypothermia during wet-cold weather transportation conditions, and the effect of rewarming on colonic temperature (CT) of the birds immediately after transportation. A total of 2200 pullets were transportation for 5 h in two separate vehicles during the nighttime. The last 3 h of the transportation period was characterized by heavy rainfall. During the precipitation period, each vehicle was covered one fourth way from the top-roof with a tarpaulin. The onboard thermal conditions inside the vehicles during transportation, which comprised ambient temperature and relative humidity were recorded, while humidity ratio and specific enthalpy were calculated. The CT of the birds was recorded before and after transportation. During transportation, onboard thermal heterogeneity was observed inside the vehicles with higher (p transported pullets under tropical conditions and a successful rewarming outcome. In conclusion, transportation of pullets during wet weather at onboard temperature of 18-20 °C induced hypothermia on birds located at the air inlets, which recovered fully after several hours of gradual rewarming.

  2. Evaluation of the protection exerted by Pisum sativum Ferredoxin-NADP(H) Reductase against injury induced by hypothermia on Cos-7 cells. (United States)

    Pucci Molineris, M; Di Venanzio, G; Mamprin, M E; Mediavilla, M G


    Hypothermia is employed as a method to diminish metabolism rates and preserve tissues and cells. However, low temperatures constitute a stress that produces biochemical changes whose extension depends on the duration and degree of cold exposure and is manifested when physiological temperature is restored. For many cellular types, cold induces an oxidative stress that is dependent on the elevation of intracellular iron, damages macromolecules, and is prevented by the addition of iron chelators. Pisum sativum Ferredoxin-NADP(H) Reductase (FNR) has been implicated in protection from injury mediated by intracellular iron increase and successfully used to reduce oxidative damage on bacterial, plant and mammalian systems. In this work, FNR was expressed in Cos-7 cells; then, they were submitted to cold incubation and iron overload to ascertain whether this enzyme was capable of diminishing the harm produced by these challenges. Contrary to expected, FNR was not protective and even exacerbated the damage under certain circumstances. It was also found that the injury induced by hypothermia in Cos-7 cells presented both iron-dependent and iron-independent components of damage when cells were actively dividing but only iron-independent component when cells were in an arrested state. This is in agreement with previous findings which showed that iron-dependent damage is also an energy-dependent process.

  3. Management of Sigmoid Volvulus Avoiding Sigmoid Resection


    Nikolaos Katsikogiannis; Nikolaos Machairiotis; Paul Zarogoulidis; Eirini Sarika; Aikaterini Stylianaki; Maria Zisoglou; Vasilis Zervas; Metaxia Bareka; Christos Christofis; Alkis Iordanidis


    Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic p...

  4. Selective hypothermia: an experimental study on traumatic brain injury in rats Hipotermia seletiva: estudo experimental de traumatismo crânio-encefálico em ratos

    Directory of Open Access Journals (Sweden)

    Amylcar Edemilson Dvilevicius


    Full Text Available OBJECTIVE: To evaluate the efficiency of selective hypothermia in the treatment of the traumatic brain injury in rats. METHOD: After the trauma produced for the model of cortical impact, a small craniectomy in the right frontoparietal region was carried through; after the procedure the animals had been divided in two groups of 15 each. Group A, without treatment with hypothermia (control group and group B, treated with selective hypothermia for a period to 5 to 6 hours. After this time all the animals were sacrificed, their brains had been removed and histopathological analysis was carried through. RESULTS: Comparison between both groups was done using the counting of neurons injured for field. Counting in the control group n=15 had an average of 70.80 neurons injured for field against an average of 21.33 neurons injured for field in group B (submitted to the treatment with hypothermia, with n=15 also. The difference was statiscally significant. CONCLUSION: Based in the quantification of the neurons injured for field, the effectiveness of the treatment with selective hypothermia was demonstrated.OBJETIVO: Avaliar a eficiência da hipotermia seletiva no tratamento do traumatismo crânio-encefálico (TCe em ratos. o trauma foi produzido por um modelo de impacto cortical desenvolvido exclusivamente para o estudo. MÉTODO: Após o TCE produzido pelo modelo de impacto cortical, foi realizada pequena craniectomia na região fronto-parietal direita; após o procedimento os animais foram divididos em dois grupos de 15 cada um. o grupo A, sem tratamento com hipotermia (grupo controle e grupo B, tratado com hipotermia seletiva por período de 5 a 6 horas. depois deste tempo todos os animais foram sacrificados, seus encéfalos foram removidos e realizada a análise anatomopatológica. RESULTADOS: Na comparação entre o grupo tratado com hipotermia e o grupo controle utilizou-se a contagem de neurônios lesados por campo. Tal contagem no grupo A (controle

  5. The TOBY Study. Whole body hypothermia for the treatment of perinatal asphyxial encephalopathy: A randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Thoresen Marianne


    Full Text Available Abstract Background A hypoxic-ischaemic insult occurring around the time of birth may result in an encephalopathic state characterised by the need for resuscitation at birth, neurological depression, seizures and electroencephalographic abnormalities. There is an increasing risk of death or neurodevelopmental abnormalities with more severe encephalopathy. Current management consists of maintaining physiological parameters within the normal range and treating seizures with anticonvulsants. Studies in adult and newborn animals have shown that a reduction of body temperature of 3–4°C after cerebral insults is associated with improved histological and behavioural outcome. Pilot studies in infants with encephalopathy of head cooling combined with mild whole body hypothermia and of moderate whole body cooling to 33.5°C have been reported. No complications were noted but the group sizes were too small to evaluate benefit. Methods/Design TOBY is a multi-centre, prospective, randomised study of term infants after perinatal asphyxia comparing those allocated to "intensive care plus total body cooling for 72 hours" with those allocated to "intensive care without cooling". Full-term infants will be randomised within 6 hours of birth to either a control group with the rectal temperature kept at 37 +/- 0.2°C or to whole body cooling, with rectal temperature kept at 33–34°C for 72 hours. Term infants showing signs of moderate or severe encephalopathy +/- seizures have their eligibility confirmed by cerebral function monitoring. Outcomes will be assessed at 18 months of age using neurological and neurodevelopmental testing methods. Sample size At least 236 infants would be needed to demonstrate a 30% reduction in the relative risk of mortality or serious disability at 18 months. Recruitment was ahead of target by seven months and approvals were obtained allowing recruitment to continue to the end of the planned recruitment phase. 325 infants were

  6. An Avalanche of Ignoring-A Qualitative Study of Health Care Avoidance in Women With Malignant Breast Cancer Wounds

    DEFF Research Database (Denmark)

    Lund-Nielsen, Betina; Midtgaard, Julie; Rørth, Mikael;


    . METHODS:: A qualitative study was conducted based on semistructured interviews. Seventeen women with advanced breast cancer (median age, 69 years; range, 47-90 years) who had avoided medical treatment despite development of malignant wounds participated. Systematic text-condensation analysis was used......BACKGROUND:: A contributing factor to development of malignant wounds is patient-related delay caused by health care avoidance. OBJECTIVE:: The purpose of this study was to describe the experience of health care avoidance in women with advanced breast cancer who have developed malignant wounds....... RESULTS:: The women deliberately avoided health care for a median of 24 months (minimum, 3 months; maximum, 84 months). Despite being aware of the development of a malignant wound from a breast lump, the women avoided health care because of negative health care experiences and extremely burdening life...

  7. Mild Hypothermia Combined with Hydrogen Sulfide Treatment During Resuscitation Reduces Hippocampal Neuron Apoptosis Via NR2A, NR2B, and PI3K-Akt Signaling in a Rat Model of Cerebral Ischemia-Reperfusion Injury. (United States)

    Dai, Hai-Bin; Xu, Miao-Miao; Lv, Jia; Ji, Xiang-Jun; Zhu, Si-Hai; Ma, Ru-Meng; Miao, Xiao-Lei; Duan, Man-Lin


    We investigated whether mild hypothermia combined with sodium hydrosulfide treatment during resuscitation improves neuron survival following cerebral ischemia-reperfusion injury beyond that observed for the individual treatments. Male Sprague-Dawley rats were divided into seven groups (n = 20 for each group). All rats underwent Pulsinelli 4-vessel occlusion. Ischemia was induced for 15 min using ligatures around the common carotid arteries, except for the sham group. Immediately after initiating reperfusion, the mild hypothermia (MH), sodium hydrosulfide (NaHS), hydroxylamine (HA), MH + NaHS, MH + HA, and ischemia-reperfusion (I/R) control groups received an intraperitoneal injection of saline, sodium hydrosulfide, hydroxylamine, sodium hydrosulfide, hydroxylamine, and saline, respectively, and mild hypothermia (32 to 33 °C) was induced in the MH, MH + NaHS, and MH + HA groups for 6 h. The levels of NR2A, NR2B, p-Akt, and p-Gsk-3β in the hippocampus of the MH, NaHS, and MH + NaHS groups were higher than those in the I/R control group, with the highest levels observed in the MH + NaHS group (P sodium hydrosulfide treatment for resuscitation following ischemia-reperfusion injury was more beneficial for reducing hippocampal apoptosis and pathology than that of mild hypothermia or hydrogen sulfide treatment alone.

  8. Role of EEG background activity, seizure burden and MRI in predicting neurodevelopmental outcome in full-term infants with hypoxic-ischaemic encephalopathy in the era of therapeutic hypothermia

    NARCIS (Netherlands)

    Weeke, Lauren C.; Boylan, Geraldine B.; Pressler, Ronit M.; Hallberg, Boubou; Blennow, Mats; Toet, Mona C.; Groenendaal, Floris; de Vries, Linda S.


    Objective: To investigate the role of EEG background activity, electrographic seizure burden, and MRI in predicting neurodevelopmental outcome in infants with hypoxic-ischaemic encephalopathy (HIE) in the era of therapeutic hypothermia. Methods: Twenty-six full-term infants with HIE (September 2011-

  9. Towards better patient care: drugs to avoid. (United States)


    Common sense dictates that one should choose tried and tested drugs with proven, concrete benefits that outweigh their adverse effects. Many new drugs are approved each year, often despite a lack of solid evidence that they are any better than existing treatments. Worse, some are approved despite being less effective or more harmful than current options. Massive promotion is used to ensure that such drugs achieve a positive image in the eyes of healthcare professionals and patients. Renowned "opinion leaders" intervene in their favour at conferences and in specialist media, and their opinions are further propagated by specialists in the field. Finally, campaigns in the lay media are used to highlight the target illness, encouraging patients to request a prescription. New data sometimes show that older, initially promising drugs are less effective or more harmful than first thought. For all these reasons, many drugs that are now present on the market are more harmful than beneficial and should be avoided. Unfortunately, negative assessment data and warnings are often drowned in the flood of promotion and advertising. Front-line healthcare professionals who are determined to act in their patients' best interests can find themselves swimming against a tide of specialist opinion, marketing authorisation, and reimbursement decisions. By leaving drugs that are more harmful than beneficial on the market and contenting themselves with simple half-measures, healthcare authorities are failing in their duty to protect patients. Prescrire, a journal funded solely by its subscribers, does not seek to do the work of health authorities, and does not have the means to do so. Prescrire's goal is simply to help healthcare professionals provide better care. The following text lists the principal drugs that we consider more harmful than beneficial, based on our reviews published between 2010 and 2012 in our French edition. These drugs should not be used. Patients and healthcare

  10. Adolescents' approach-avoidance behaviour in the context of pain. (United States)

    Fisher, Emma; Keogh, Edmund; Eccleston, Christopher


    Adolescents who experience pain often face competing goals and have to choose whether to approach (confront) or avoid pain. This study investigates the decisions adolescents make when their pain conflicts with a valued goal. Adolescents between the ages of 15 and 18 years (N = 170) completed questionnaires on general and pain-specific anxiety, courage, and dispositional avoidance. Adolescents were presented with 16 vignettes (8 high pain intensity, 8 low pain intensity), which described pain conflicting with a goal (eg, doing well at school, seeing friends). Adolescents rated goals for importance and reported how likely they would be to approach or avoid each pain. Adolescents were more likely to avoid and were more fearful of high pain intensity than low pain intensity vignettes. Pain anxiety predicted higher levels of avoidance for both pain intensities. General anxiety was not a significant predictor of avoidance for either pain intensity. Goal importance promoted approach of goals, but only when pain was described as intense. However, pain anxiety predicted avoidance beyond the importance of goals for high pain intensity vignettes. In addition, we compared approach-avoidance of adolescents with and without chronic pain; analyses revealed no differences in approach-avoidance behaviour. We also found that behavioural endurance was predictive of approach and dispositional avoidance predicted higher avoidance, but courage was not predictive of behaviour in this task. We adopt a motivational perspective when interpreting the findings and consider whether the fear-avoidance model should be extended to include the function of avoidance or approach in the pursuit of a desired goal.

  11. Fuzzy Inference Based Obstacle Avoidance Control of Electric Powered Wheelchair Considering Driving Risk (United States)

    Kiso, Atsushi; Murakami, Hiroki; Seki, Hirokazu

    This paper describes a novel obstacle avoidance control scheme of electric powered wheelchairs for realizing the safe driving in various environments. The “electric powered wheelchair” which generates the driving force by electric motors is expected to be widely used as a mobility support system for elderly people and disabled people; however, the driving performance must be further improved because the number of driving accidents caused by elderly operator's narrow sight and joystick operation errors is increasing. This paper proposes a novel obstacle avoidance control scheme based on fuzzy algorithm to prevent driving accidents. The proposed control system determines the driving direction by fuzzy algorithm based on the information of the joystick operation and distance to obstacles measured by ultrasonic sensors. Fuzzy rules to determine the driving direction are designed surely to avoid passers-by and walls considering the human's intent and driving environments. Some driving experiments on the practical situations show the effectiveness of the proposed control system.

  12. Avoid Workplace Injury through Ergonomics | Poster (United States)

    Ergonomics is “the scientific study of people at work,” with the goal of reducing stress and eliminating injuries associated with overused muscles, bad posture, and repeated tasks, according to the Centers for Disease Control and Prevention (CDC). The Occupational Safety and Health Administration (OSHA) states that working ergonomically reduces muscle fatigue, increases productivity, and decreases the number and severity of work-related musculoskeletal disorders (MSDs). MSDs affect the muscles, nerves, and tendons, and are a leading cause of lost workdays due to injury or illness.

  13. Effects of mild hypothermia on the expression of microtubule-associated protein 2 in neurons of the hippocampal dentate gyrus in a rat model of cerebral ischemia/reperfusion

    Institute of Scientific and Technical Information of China (English)

    Qian Yang; Feng Zheng; Jiami Wu


    BACKGROUND: It is widely accepted that mild hypothermia can protect against injury to cerebral ischemia/reperfusion.OBJECTIVE: To observe the effects of mild hypothermia on microtubule-associated protein 2 (MAP2) expression in the hippocampal dentate gyrus in rats following cerebral ischemia/reperfusion. Also, to study neuronal uhrastructural changes in the dentate gyrus to investigate the mechanism of the protection against injury to cerebral ischemia/reperfusion conferred by mild hypothermia.DESIGN, TIME AND SETTING: This randomized grouping, neural cell morphology trial was performed at the Laboratory Animal Center of Yijishan Hospital between March and June 2007.MATERIALS: Eighty-five healthy male Sprague Dawley rats were randomly allocated to three groups: mild hyputhermia (n = 40), normothermia (n = 40), and sham-operated (n = 5).METHODS: Cerebral ischemia/reperfusion injury was induced by the suture method in the mild hypothermia and normothermia groups, with a threading depth of 180.5 mm. In the sham-operated group, the suture was inserted 15 mm, with no vascular ligation, and was followed by reperfusion 2 hours later. In the sham-operated and normothermia groups, the rat rectal temperature was maintained at 36-37℃; in the mild hypothermia group, it was controlled at 32-33 ℃.MAIN OUTCOME MEASURES: The hippocampal dentate gyrus was serially sectioned for hematoxylin-eosin staining and MAP2 immunohistochemistry. Ultrastructural changes and the MAP2 absorbance value of the hippocampal dentate gyrus were examined by transmission electron microscopy.RESULTS: The sham-operated group exhibited approximately normal ultrastmcture of neurons in the bilateral hippocampal dentate gyms. In the normothermia group, ischemic hippocampal dentate gyms neurons were found with markedly fewer normal mitochondria, greatly proliferated rough endoplasmic reticulum, and a swollen and dysmorphic Golgi. In the mild hypothermia group, at each corresponding time point, these

  14. Factors associated with hospitalisations in chronic conditions deemed avoidable: ecological study in the Spanish healthcare system (United States)

    Angulo-Pueyo, Ester; Ridao-López, Manuel; Martínez-Lizaga, Natalia; García-Armesto, Sandra; Peiró, Salvador; Bernal-Delgado, Enrique


    Objectives Potentially avoidable hospitalisations have been used as a proxy for primary care quality. We aimed to analyse the ecological association between contextual and systemic factors featured in the Spanish healthcare system and the variation in potentially avoidable hospitalisations for a number of chronic conditions. Methods A cross-section ecological study based on the linkage of administrative data sources from virtually all healthcare areas (n=202) and autonomous communities (n=16) composing the Spanish National Health System was performed. Potentially avoidable hospitalisations in chronic conditions were defined using the Spanish validation of the Agency for Health Research and Quality (AHRQ) preventable quality indicators. Using 2012 data, the ecological association between potentially avoidable hospitalisations and factors featuring healthcare areas and autonomous communities was tested using multilevel negative binomial regression. Results In 2012, 151 468 admissions were flagged as potentially avoidable in Spain. After adjusting for differences in age, sex and burden of disease, the only variable associated with the outcome was hospitalisation intensity for any cause in previous years (incidence risk ratio 1.19 (95% CI 1.13 to 1.26)). The autonomous community of residence explained a negligible part of the residual unexplained variation (variance 0.01 (SE 0.008)). Primary care supply and activity did not show any association. Conclusions The findings suggest that the variation in potentially avoidable hospitalisations in chronic conditions at the healthcare area level is a reflection of how intensively hospitals are used in a healthcare area for any cause, rather than of primary care characteristics. Whether other non-studied features at the healthcare area level or primary care level could explain the observed variation remains uncertain. PMID:28237952

  15. The effects of pesticide exposure on ultraviolet-B radiation avoidance behavior in tadpoles. (United States)

    Yu, Shuangying; Weir, Scott M; Cobb, George P; Maul, Jonathan D


    Effects of contaminants on behavior may have important consequences on wildlife populations because behaviors such as predation, predator avoidance, reproduction, and social interaction can affect population dynamics. As a common environmental stressor, ultraviolet-B (UVB) radiation causes various deleterious effects and some aquatic organisms actively avoid UVB radiation in water. However, the extent to which environmental contaminants can impair UVB avoidance has not been evaluated, which may cause greater UVB exposure and toxicity. In the present study, we used Xenopus laevis tadpoles to determine if acute exposure to sublethal concentrations of agricultural chemicals can alter tadpole response to UVB radiation. We exposed tadpoles to four pesticides (malathion, endosulfan, α-cypermethrin, and chlorothalonil) for 96 h. At the end of the exposure, tadpoles were transferred to tanks divided into UVB and no-UVB areas. We observed tadpoles for 30 min and recorded time spent in the UVB area. We compared the proportion of time tadpoles spent in the UVB area among different concentrations for each pesticide. There was no significant difference between FETAX control and solvent control tadpoles. When combined, control tadpoles spent less than half of the time in the UVB area indicating that X. laevis tadpoles exhibit UVB avoidance behavior. Tadpoles exposed to 5 μg/L endosulfan spent significantly more time under UVB than control tadpoles. Other pesticides had no effect on tadpole UVB avoidance behavior. Our results suggest that some neurotoxic pesticides can affect UVB avoidance in larval amphibians, which may increase their exposure and subsequently the risk of UVB-induced damage. The present study highlights the importance of examining the interaction between two stressors that co-occur across broad spatial scales and to consider behavioral alteration when evaluating the risk of pesticides to amphibians.

  16. Effects of repeated quetiapine treatment on conditioned avoidance responding in rats. (United States)

    Gao, Jun; Feng, Min; Swalve, Natashia; Davis, Collin; Sui, Nan; Li, Ming


    The present study characterized the behavioral mechanisms of avoidance-disruptive effect of quetiapine in the conditioned avoidance response test under two behavioral testing (2 warning signals vs. 1 warning signal) and two drug administration conditions (subcutaneous vs. intravenous). In Experiments 1 and 2, well-trained adult male Sprague-Dawley rats were tested under the subcutaneous (s.c.) quetiapine treatment (5.0, 15.0, 25.0, 50.0mg/kg) for 7 days in a novel procedure consisting of two conditioned stimuli (CS) (white noise serving as CS1 and pure tone as CS2). Only the highest dose (50.0mg/kg) produced a persistent suppression of the avoidance response without impairing the escape response. The magnitude of suppression of the CS1 avoidance was similar to that of CS2 avoidance. No significant group difference was found in the quetiapine (15.0mg/kg, s.c.) challenge test, indicating a lack of a long-term quetiapine effect. In Experiment 3, well-trained rats were tested under the intravenous (i.v.) quetiapine treatment (3.0, 9.0, 15.0mg/kg) for 5 days and challenged with quetiapine (6.0mg/kg, i.v. followed by 9.0mg/kg, s.c.). Only the white noise was used as the CS. Similar to what was being observed in Experiments 1 and 2, intravenously administered quetiapine dose-dependently suppressed avoidance responding during the drug test days, but did not alter drug sensitivity in the challenge days. Thus, quetiapine does not appear to show a preferential inhibition of the avoidance response to a less salient stimulus; and prior quetiapine treatment (s.c. and i.v.) does not cause a sensitization or tolerance to quetiapine.

  17. Postmortem volumetric CT data analysis of pulmonary air/gas content with regard to the cause of death for investigating terminal respiratory function in forensic autopsy. (United States)

    Sogawa, Nozomi; Michiue, Tomomi; Ishikawa, Takaki; Kawamoto, Osamu; Oritani, Shigeki; Maeda, Hitoshi


    Postmortem CT (PMCT) is useful to investigate air/gas distribution and content in body cavities and viscera. The present study investigated the procedure to estimate total lung air/gas content and aeration ratio as possible indices of terminal respiratory function, using three-dimensional (3-D) PMCT data analysis of forensic autopsy cases without putrefactive gas formation (within 3 days postmortem, n=75), and analyzed the volumetric data with regard to the cause of death. When 3-D bilateral lung images were reconstructed using an image analyzer, combined lung volume was larger in drowning (n=12) than in alcohol/sedative-hypnotic intoxication (n=8) and sudden cardiac death (SCD; n=10), and intermediate in other cases, including mechanical asphyxiation (n=12), fire fatalities due to burns (n=6) and carbon monoxide intoxication (n=7), fatal methamphetamine abuse (n=7), hyperthermia (heatstroke; n=6) and fatal hypothermia (cold exposure; n=7). Air/gas content of the lung as detected using HU interval between -2000 and -400 ('effective' lung aeration areas) and between -2000 and -191 (total lung aeration areas) as well as the ratios to total lung volume ('effective' and total lung aeration ratios, respectively) was higher in mechanical asphyxiation, drowning, fatal burns and hypothermia (cold exposure) than in SCD, and was intermediate in other cases. 'Effective' and total lung aeration ratios may be useful for comparisons between specific causes of death to discriminate between hypothermia (cold exposure) and drug intoxication, and between SCD and other causes of death, respectively. These findings provide interesting insights into potential efficacy of PMCT data analyses of lung volume and CT density as well as lung air/gas content and aeration ratio with regard to the cause of death, as possible indicators of terminal respiratory function, as part of virtual autopsy of the viscera in situ.

  18. Generalisation of fear and avoidance along a semantic continuum. (United States)

    Boyle, Sean; Roche, Bryan; Dymond, Simon; Hermans, Dirk


    Directly conditioned fear and avoidance readily generalises to dissimilar but conceptually related stimuli. Here, for the first time, we examined the conceptual/semantic generalisation of both fear and avoidance using real words (synonyms). Participants were first exposed to a differential fear conditioning procedure in which one word (e.g., "broth"; CS+) was followed with brief electric shock [unconditioned stimulus (US)] and another was not (e.g., "assist"; CS-). Next, an instrumental conditioning phase taught avoidance in the presence the CS+ but not the CS-. During generalisation testing, synonyms of the CS+ (e.g., "soup"; GCS+) and CS- (e.g., "help"; GCS-) were presented in the absence of shock. Conditioned fear and avoidance, measured via skin conductance responses, behavioural avoidance and US expectancy ratings, generalised to the semantically related, but not to the semantically unrelated, synonyms. Findings have implications for how natural language categories and concepts mediate the expansion of fear and avoidance repertoires in clinical contexts.

  19. Excise tax avoidance: the case of state cigarette taxes. (United States)

    DeCicca, Philip; Kenkel, Donald; Liu, Feng


    We conduct an applied welfare economics analysis of cigarette tax avoidance. We develop an extension of the standard formula for the optimal Pigouvian corrective tax to incorporate the possibility that consumers avoid the tax by making purchases in nearby lower tax jurisdictions. To provide a key parameter for our formula, we estimate a structural endogenous switching regression model of border-crossing and cigarette prices. In illustrative calculations, we find that for many states, after taking into account tax avoidance the optimal tax is at least 20% smaller than the standard Pigouvian tax that simply internalizes external costs. Our empirical estimate that tax avoidance strongly responds to the price differential is the main reason for this result. We also use our results to examine the benefits of replacing avoidable state excise taxes with a harder-to-avoid federal excise tax on cigarettes.

  20. Method for Collision Avoidance Motion Coordination of Multiple Mobile Robots Using Central Observation

    Energy Technology Data Exchange (ETDEWEB)

    Ko, N.Y.; Seo, D.J. [Chosun University, Kwangju (Korea)


    This paper presents a new method driving multiple robots to their goal position without collision. Each robot adjusts its motion based on the information on the goal locations, velocity, and position of the robot and the velocity and position of the other robots. To consider the movement of the robots in a work area, we adopt the concept of avoidability measure. The avoidability measure figures the degree of how easily a robot can avoid other robots considering the following factors: the distance from the robot to the other robots, velocity of the robot and the other robots. To implement the concept in moving robot avoidance, relative distance between the robots is derived. Our method combines the relative distance with an artificial potential field method. The proposed method is simulated for several cases. The results show that the proposed method steers robots to open space anticipating the approach of other robots. In contrast, the usual potential field method sometimes fails preventing collision or causes hasty motion, because it initiates avoidance motion later than the proposed method. The proposed method can be used to move robots in a robot soccer team to their appropriate position without collision as fast as possible. (author). 21 refs., 10 figs., 13 tabs.