Impact of atmospheric release in stable night meteorological conditions; can emergency models predict dispersion

Energy Technology Data Exchange (ETDEWEB)

Connan, O.; Hebert, D.; Solier, L.; Voiseux, C.; Lamotte, M.; Laguionie, P.; Maro, D.; Thomas, L. [IRSN/PRP-ENV/SERIS/LRC (France)

2014-07-01

Atmospheric dispersion of pollutant or radionuclides in stratified meteorological condition, i.e. especially when weather conditions are very stable, mainly at night, is still poorly understood and not well apprehended by the operational atmospheric dispersion models. However, correctly predicting the dispersion of a radioactive plume, and estimating the radiological consequences for the population, following an unplanned atmospheric release of radionuclides are crucial steps in an emergency response. To better understand dispersion in these special weather conditions, IRSN performed a series of 22 air sampling campaigns between 2010 and 2013 in the vicinity of the La Hague nuclear reprocessing plant (AREVA - NC, France), at distances between 200 m and 3000 m from the facility. Krypton-85 ({sup 85}Kr), a b-and g-emitting radionuclide, released during the reprocessing of spent nuclear fuel was used as a non-reactive tracer of radioactive plumes. Experimental campaigns were realized in stability class stable or very stable (E or F according to Pasquill classification) 18 times, and in neutral conditions (D according to Pasquill classification) 4 times. During each campaign, Krypton-85 real time measurement were made to find the plume around the plant, and then integrated samples (30 min) were collected in bag perpendicularly to the assumed wind direction axis. After measurement by gamma spectrometry, we have, when it was possible, estimate the point of impact and the width of the plume. The objective was to estimate the horizontal dispersion (width) of the plume at ground level in function of the distance and be able to calculate atmospheric transfer coefficients. In a second step, objective was to conclude on the use of common model and on their uncertainties. The results will be presented in terms of impact on the near-field. They will be compared with data obtained in previous years in neutral atmospheric conditions, and finally the results will be confronted with

Are there long-term benefits in following stable heart failure patients in a heart failure clinic?

DEFF Research Database (Denmark)

Leetmaa, Tina; Villadsen, Henrik; Mikkelsen, Kirsten

2008-01-01

Objectives and Design. This study describes the long-term outcome of 163 patients with stable mild to moderate heart failure (NYHA II-III), who already were enrolled in a heart failure clinic and now were randomized to continued follow-up in the heart failure (HF) clinic or else to usual care (UC...

Stable isotopes to detect food-conditioned bears and to evaluate human-bear management

Science.gov (United States)

Hopkins, John B.; Koch, Paul L.; Schwartz, Charles C.; Ferguson, Jake M.; Greenleaf, Schuyler S.; Kalinowski, Steven T.

2012-01-01

We used genetic and stable isotope analysis of hair from free-ranging black bears (Ursus americanus) in Yosemite National Park, California, USA to: 1) identify bears that consume human food, 2) estimate the diets of these bears, and 3) evaluate the Yosemite human–bear management program. Specifically, we analyzed the isotopic composition of hair from bears known a priori to be food-conditioned or non-food-conditioned and used these data to predict whether bears with an unknown management status were food-conditioned (FC) or non-food-conditioned (NFC). We used a stable isotope mixing model to estimate the proportional contribution of natural foods (plants and animals) versus human food in the diets of FC bears. We then used results from both analyses to evaluate proactive (population-level) and reactive (individual-level) human–bear management, and discussed new metrics to evaluate the overall human–bear management program in Yosemite. Our results indicated that 19 out of 145 (13%) unknown bears sampled from 2005 to 2007 were food-conditioned. The proportion of human food in the diets of known FC bears likely declined from 2001–2003 to 2005–2007, suggesting proactive management was successful in reducing the amount of human food available to bears. In contrast, reactive management was not successful in changing the management status of known FC bears to NFC bears, or in reducing the contribution of human food to the diets of FC bears. Nine known FC bears were recaptured on 14 occasions from 2001 to 2007; all bears were classified as FC during subsequent recaptures, and human–bear management did not reduce the amount of human food in the diets of FC bears. Based on our results, we suggest Yosemite continue implementing proactive human–bear management, reevaluate reactive management, and consider removing problem bears (those involved in repeated bear incidents) from the population.

Areal-averaged trace gas emission rates from long-range open-path measurements in stable boundary layer conditions

Directory of Open Access Journals (Sweden)

K. Schäfer

2012-07-01

Full Text Available Measurements of land-surface emission rates of greenhouse and other gases at large spatial scales (10 000 m² are needed to assess the spatial distribution of emissions. This can be readily done using spatial-integrating micro-meteorological methods like flux-gradient methods which were evaluated for determining land-surface emission rates of trace gases under stable boundary layers. Non-intrusive path-integrating measurements are utilized. Successful application of a flux-gradient method requires confidence in the gradients of trace gas concentration and wind, and in the applicability of boundary-layer turbulence theory; consequently the procedures to qualify measurements that can be used to determine the flux is critical. While there is relatively high confidence in flux measurements made under unstable atmospheres with mean winds greater than 1 m s⁻¹, there is greater uncertainty in flux measurements made under free convective or stable conditions. The study of N₂O emissions of flat grassland and NH₃ emissions from a cattle lagoon involves quality-assured determinations of fluxes under low wind, stable or night-time atmospheric conditions when the continuous "steady-state" turbulence of the surface boundary layer breaks down and the layer has intermittent turbulence. Results indicate that following the Monin-Obukhov similarity theory (MOST flux-gradient methods that assume a log-linear profile of the wind speed and concentration gradient incorrectly determine vertical profiles and thus flux in the stable boundary layer. An alternative approach is considered on the basis of turbulent diffusivity, i.e. the measured friction velocity as well as height gradients of horizontal wind speeds and concentrations without MOST correction for stability. It is shown that this is the most accurate of the flux-gradient methods under stable conditions.

Influence of horse stable environment on human airways

Directory of Open Access Journals (Sweden)

Pringle John

2009-05-01

Full Text Available Abstract Background Many people spend considerable amount of time each day in equine stable environments either as employees in the care and training of horses or in leisure activity. However, there are few studies available on how the stable environment affects human airways. This study examined in one horse stable qualitative differences in indoor air during winter and late summer conditions and assessed whether air quality was associated with clinically detectable respiratory signs or alterations to selected biomarkers of inflammation and lung function in stable personnel. Methods The horse stable environment and stable-workers (n = 13 in one stable were investigated three times; first in the winter, second in the interjacent late summer and the third time in the following winter stabling period. The stable measurements included levels of ammonia, hydrogen sulphide, total and respirable dust, airborne horse allergen, microorganisms, endotoxin and glucan. The stable-workers completed a questionnaire on respiratory symptoms, underwent nasal lavage with subsequent analysis of inflammation markers, and performed repeated measurements of pulmonary function. Results Measurements in the horse stable showed low organic dust levels and high horse allergen levels. Increased viable level of fungi in the air indicated a growing source in the stable. Air particle load as well as 1,3-β-glucan was higher at the two winter time-points, whereas endotoxin levels were higher at the summer time-point. Two stable-workers showed signs of bronchial obstruction with increased PEF-variability, increased inflammation biomarkers relating to reported allergy, cold or smoking and reported partly work-related symptoms. Furthermore, two other stable-workers reported work-related airway symptoms, of which one had doctor's diagnosed asthma which was well treated. Conclusion Biomarkers involved in the development of airway diseases have been studied in relation to

Influence of horse stable environment on human airways.

Science.gov (United States)

Elfman, Lena; Riihimäki, Miia; Pringle, John; Wålinder, Robert

2009-05-25

Many people spend considerable amount of time each day in equine stable environments either as employees in the care and training of horses or in leisure activity. However, there are few studies available on how the stable environment affects human airways. This study examined in one horse stable qualitative differences in indoor air during winter and late summer conditions and assessed whether air quality was associated with clinically detectable respiratory signs or alterations to selected biomarkers of inflammation and lung function in stable personnel. The horse stable environment and stable-workers (n = 13) in one stable were investigated three times; first in the winter, second in the interjacent late summer and the third time in the following winter stabling period. The stable measurements included levels of ammonia, hydrogen sulphide, total and respirable dust, airborne horse allergen, microorganisms, endotoxin and glucan. The stable-workers completed a questionnaire on respiratory symptoms, underwent nasal lavage with subsequent analysis of inflammation markers, and performed repeated measurements of pulmonary function. Measurements in the horse stable showed low organic dust levels and high horse allergen levels. Increased viable level of fungi in the air indicated a growing source in the stable. Air particle load as well as 1,3-beta-glucan was higher at the two winter time-points, whereas endotoxin levels were higher at the summer time-point. Two stable-workers showed signs of bronchial obstruction with increased PEF-variability, increased inflammation biomarkers relating to reported allergy, cold or smoking and reported partly work-related symptoms. Furthermore, two other stable-workers reported work-related airway symptoms, of which one had doctor's diagnosed asthma which was well treated. Biomarkers involved in the development of airway diseases have been studied in relation to environmental exposure levels in equine stables. Respirable dust and 1

An energy-stable method for solving the incompressible Navier-Stokes equations with non-slip boundary condition

Science.gov (United States)

Lee, Byungjoon; Min, Chohong

2018-05-01

We introduce a stable method for solving the incompressible Navier-Stokes equations with variable density and viscosity. Our method is stable in the sense that it does not increase the total energy of dynamics that is the sum of kinetic energy and potential energy. Instead of velocity, a new state variable is taken so that the kinetic energy is formulated by the L2 norm of the new variable. Navier-Stokes equations are rephrased with respect to the new variable, and a stable time discretization for the rephrased equations is presented. Taking into consideration the incompressibility in the Marker-And-Cell (MAC) grid, we present a modified Lax-Friedrich method that is L2 stable. Utilizing the discrete integration-by-parts in MAC grid and the modified Lax-Friedrich method, the time discretization is fully discretized. An explicit CFL condition for the stability of the full discretization is given and mathematically proved.

Applications of stable isotopes of 2H, 13C and 15N to clinical problems

International Nuclear Information System (INIS)

Klein, P.D.; Szczepanik, P.A.; Hachey, D.L.

1974-01-01

The function of the Argonne Program is to provide synthetic, analytical instrumental capability in a core facility for the clinical investigator who needs to use 2 H, 13 C, or 15 N labelled compounds for metabolic or clinical research on pregnant women, newborn infants, young children, or for mass screening. To carry out such application development, there were six stages which were recurrent steps in every application. Five fundamental strategies should be adopted to establish the use of stable isotopes in clinical work. The instrument required for measurements was a combined gas chromatograph-mass spectrometer, and its use was schematically illustrated. Some of the successful experiences with compounds labelled by stable isotopes, such as deuterium labelled chenodeoxycholic acid, and respective 13 C and 15 N-labelled glycine were described. Deutrium labelled bile acid enabled easy and safe determination of the size of the bile acid pool and the replacement rate, providing clearer diagnoses for cholestatic liver disease and gallstones. 13 C and 15 N labelled compounds were used in clinical studies, of children with genetic disorders of amino acid metabolism, i.e., non ketotic hyperflycinemia, B 12 -responsive methyl malonic acidemia, and Lesch-Nyhan syndrome. 15 N-labelled glycine was also studied in a child with Lesch-Nyhan syndrome. (Mukohata, S.)

Placebo interventions for all clinical conditions

DEFF Research Database (Denmark)

Hróbjartsson, Asbjørn; Gøtzsche, Peter C

2010-01-01

Placebo interventions are often claimed to substantially improve patient-reported and observer-reported outcomes in many clinical conditions, but most reports on effects of placebos are based on studies that have not randomised patients to placebo or no treatment. Two previous versions of this re...... of this review from 2001 and 2004 found that placebo interventions in general did not have clinically important effects, but that there were possible beneficial effects on patient-reported outcomes, especially pain. Since then several relevant trials have been published.......Placebo interventions are often claimed to substantially improve patient-reported and observer-reported outcomes in many clinical conditions, but most reports on effects of placebos are based on studies that have not randomised patients to placebo or no treatment. Two previous versions...

A full genomic characterization of the development of a stable Small Colony Variant cell-type by a clinical Staphylococcus aureus strain.

Science.gov (United States)

Bui, Long M G; Kidd, Stephen P

2015-12-01

A key to persistent and recurrent Staphylococcus aureus infections is its ability to adapt to diverse and toxic conditions. This ability includes a switch into a biofilm or to the quasi-dormant Small Colony Variant (SCV). The development and molecular attributes of SCVs have been difficult to study due to their rapid reversion to their parental cell-type. We recently described the unique induction of a matrix-embedded and stable SCV cell-type in a clinical S. aureus strain (WCH-SK2) by growing the cells with limiting conditions for a prolonged timeframe. Here we further study their characteristics. They possessed an increased viability in the presence of antibiotics compared to their non-SCV form. Their stability implied that there had been genetic changes; we therefore determined both the genome sequence of WCH-SK2 and its stable SCV form at a single base resolution, employing Single Molecular Real-Time (SMRT) sequencing that enabled the methylome to also be determined. The genetic features of WCH-SK2 have been identified; the SCCmec type, the pathogenicity and genetic islands and virulence factors. The genetic changes that had occurred in the stable SCV form were identified; most notably being in MgrA, a global regulator, and RsbU, a phosphoserine phosphatase within the regulatory pathway of the sigma factor SigB. There was a shift in the methylomes of the non-SCV and stable SCV forms. We have also shown a similar induction of this cell-type in other S. aureus strains and performed a genetic comparison to these and other S. aureus genomes. We additionally map RNAseq data to the WCH-SK2 genome in a transcriptomic analysis of the parental, SCV and stable SCV cells. The results from this study represent the unique identification of a suite of epigenetic, genetic and transcriptional factors that are implicated in the switch in S. aureus to its persistent SCV form. Copyright © 2015 Elsevier B.V. All rights reserved.

Serum adiponectin level in obese and non-obese COPD patients during acute exacerbation and stable conditions

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Magdy Mohammad Omar

2014-04-01

Conclusion: Serum adiponectin was significantly higher in obese and nonobese COPD than controls, the rising is more during exacerbation than stable condition and more in non obese than obese COPD and non significant correlation between changes in adiponectin and ventilatory functions was found.

Neurocognitive function in clinically stable individuals with long-term bipolar I disorder: Comparisons with schizophrenia patients and controls

Directory of Open Access Journals (Sweden)

Pei-Yun Lin

2017-05-01

Full Text Available This study compared the levels of the five domains of neurocognitive function—executive function, attention, memory, verbal comprehension, and perceptual organization—among clinically stable individuals with long-term bipolar I disorder, individuals with long-term schizophrenia, and a group of controls. We recruited a total of 93 clinically stable individuals with bipolar I disorder, 94 individuals with schizophrenia, and 106 controls in this study. Their neurocognitive function was measured using a series of neurocognitive function tests: the Wechsler Adult Intelligence Scale—Third Edition (WAIS-III, Line Cancellation Test, Visual Form Discrimination, Controlled Oral Word Association Test, Wisconsin Card Sorting Test, Continuous Performance Task, and Wechsler Memory Scale—Third Edition. Neurocognitive function was compared among the three groups through a multivariate analysis of variance. The results indicated that when the effect of age was controlled, clinically stable individuals with bipolar I disorder and those with schizophrenia demonstrated poor neurocognitive function on all tests except for the WAIS-III Similarity and Information and the Line Cancellation Test. The individuals with bipolar I disorder had similar levels of neurocognitive function compared with the schizophrenia group, but higher levels of neurocognitive function on the WAIS-III Comprehension, Controlled Oral Word Association Test, and Wechsler Memory Scale—Third Edition Auditory Immediate and Delayed Index and Visual Immediate and Delayed Index. The conclusions of this study suggest that compared with controls, individuals with long-term bipolar I disorder and those with long-term schizophrenia have poorer neurocognitive function, even when clinically stable. Individuals with long-term bipolar I disorder and those with long-term schizophrenia have similar levels of deficits in several domains of neurocognitive function.

Conditional CO2 flux analysis of a managed grassland with the aid of stable isotopes

Science.gov (United States)

Zeeman, M. J.; Tuzson, B.; Emmenegger, L.; Knohl, A.; Buchmann, N.; Eugster, W.

2009-04-01

Short statured managed ecosystems, such as agricultural grasslands, exhibit high temporal changes in carbon dioxide assimilation and respiration fluxes for which measurements of the net CO2 flux, e.g. by using the eddy covariance (EC) method, give only limited insight. We have therefore adopted a recently proposed concept for conditional EC flux analysis of forest to grasslands, in order to identify and quantify daytime sub-canopy respiration fluxes. To validate the concept, high frequency (≈5 Hz) stable carbon isotope analyis of CO2 was used. We made eddy covariance measurements of CO2 and its isotopologues during four days in August 2007, using a novel quantum cascade laser absorption spectrometer, capable of high time resolution stable isotope analysis. The effects of a grass cut during the measurement period could be detected and resulted in a sub-canopy source conditional flux classification, for which the isotope composition of the CO2 could be confirmed to be of a respiration source. However, the conditional flux method did not work for an undisturbed grassland canopy. We attribute this to the flux measurement height that was chosen well above the roughness sublayer, where the natural isotopic tracer (δ13C) of respiration was too well mixed with background air.

Working conditions remain stable in the Netherlands

NARCIS (Netherlands)

Houtman, I.; Hooftman, W.

2008-01-01

Despite significant changes in the national questionnaires on work and health, the quality of work as well as health complaints in the Netherlands appear to be relatively stable. Pace of work seems to be on the increase again and more people are working in excess of their contractual hours.

New Polymorph of Fe3O4 Stable at Core-Mantle Boundary Conditions

Science.gov (United States)

Greenberg, E.; Prakapenka, V. B.

2017-12-01

Magnetite Fe3O4 (and its high-pressure polymorphs) is one of the most studied iron bearing minerals. One reason for the interest in magnetite is that it contains both Fe2+ and Fe3+, which is especially important for understanding the physical and chemical properties of Earth's deep interior. Early studies on magnetite debated the nature of the structural phase transition at 35 GPa [1-4]. This high-pressure structure was shown to be of the CaTi2O4-type [5], but with Fe3+ occupying multiple sites. Furthermore, at pressures above 65 GPa a second structural transition to a Pmma space group was shown to take place [5], similar to that in Fe3-xTixO4 solid solution [6]. Other studies have focused on the P-T stability of Fe3O4. Early studies by Lazor et al. [7] predicted that Fe3O4 might disproportionate into FeO and h-Fe2O3 at 50 GPa. Other studies suggested that the high-pressure phase should be stable up to 100 GPa [3]. A more recent experimental study by Ricolleau and Fei [8] revealed that Fe3O4 is stable at least up to 103 GPa. Thus far, structural studies of Fe3O4 have been limited to pressures below 105 GPa. We have studied Fe3O4 up to pressures of 175 GPa and temperatures above 4000K, using diamond anvil cells in combination with synchrotron x-ray diffraction and an online pulsed laser-heating system to study the stability of Fe3O4 at relevant pressure-temperature conditions. Our results show that Fe3O4 is stable up to at least 176 GPa and 4200 K. We have discovered a new polymorph of Fe3O4 at these high P-T conditions. This new phase is stable in the pressure range of at least 100Journal of Physics: Condensed Matter 15, 7697 (2003). [4] Xu et al. Pysical Review B 70, 174106 (2004). [5] Greenberg et al. Physical Review B 95, 195150 (2017). [6] Yamanaka et al. American Mineralogist 98, 736 (2013). [7] Lazor et al. Journal of Geophysical Research 109, B05201 (2004). [8] Ricolleau and Fei. American Mineralogist 101, 719 (2016).

A novel condition for stable nonlinear sampled-data models using higher-order discretized approximations with zero dynamics.

Science.gov (United States)

Zeng, Cheng; Liang, Shan; Xiang, Shuwen

2017-05-01

Continuous-time systems are usually modelled by the form of ordinary differential equations arising from physical laws. However, the use of these models in practice and utilizing, analyzing or transmitting these data from such systems must first invariably be discretized. More importantly, for digital control of a continuous-time nonlinear system, a good sampled-data model is required. This paper investigates the new consistency condition which is weaker than the previous similar results presented. Moreover, given the stability of the high-order approximate model with stable zero dynamics, the novel condition presented stabilizes the exact sampled-data model of the nonlinear system for sufficiently small sampling periods. An insightful interpretation of the obtained results can be made in terms of the stable sampling zero dynamics, and the new consistency condition is surprisingly associated with the relative degree of the nonlinear continuous-time system. Our controller design, based on the higher-order approximate discretized model, extends the existing methods which mainly deal with the Euler approximation. Copyright © 2017 ISA. Published by Elsevier Ltd. All rights reserved.

Stable isotopes labelled compounds

International Nuclear Information System (INIS)

1982-09-01

The catalogue on stable isotopes labelled compounds offers deuterium, nitrogen-15, and multiply labelled compounds. It includes: (1) conditions of sale and delivery, (2) the application of stable isotopes, (3) technical information, (4) product specifications, and (5) the complete delivery programme

Prediction of serious complications in patients with seemingly stable febrile neutropenia: validation of the Clinical Index of Stable Febrile Neutropenia in a prospective cohort of patients from the FINITE study.

Science.gov (United States)

Carmona-Bayonas, Alberto; Jiménez-Fonseca, Paula; Virizuela Echaburu, Juan; Antonio, Maite; Font, Carme; Biosca, Mercè; Ramchandani, Avinash; Martínez, Jerónimo; Hernando Cubero, Jorge; Espinosa, Javier; Martínez de Castro, Eva; Ghanem, Ismael; Beato, Carmen; Blasco, Ana; Garrido, Marcelo; Bonilla, Yaiza; Mondéjar, Rebeca; Arcusa Lanza, María Ángeles; Aragón Manrique, Isabel; Manzano, Aránzazu; Sevillano, Elena; Castañón, Eduardo; Cardona, Mercé; Gallardo Martín, Elena; Pérez Armillas, Quionia; Sánchez Lasheras, Fernando; Ayala de la Peña, Francisco

2015-02-10

To validate a prognostic score predicting major complications in patients with solid tumors and seemingly stable episodes of febrile neutropenia (FN). The definition of clinical stability implies the absence of organ dysfunction, abnormalities in vital signs, and major infections. We developed the Clinical Index of Stable Febrile Neutropenia (CISNE), with six explanatory variables associated with serious complications: Eastern Cooperative Oncology Group performance status ≥ 2 (2 points), chronic obstructive pulmonary disease (1 point), chronic cardiovascular disease (1 point), mucositis of grade ≥ 2 (National Cancer Institute Common Toxicity Criteria; 1 point), monocytes < 200 per μL (1 point), and stress-induced hyperglycemia (2 points). We integrated these factors into a score ranging from 0 to 8, which classifies patients into three prognostic classes: low (0 points), intermediate (1 to 2 points), and high risk (≥ 3 points). We present a multicenter validation of CISNE. We prospectively recruited 1,133 patients with seemingly stable FN from 25 hospitals. Complication rates in the training and validation subsets, respectively, were 1.1% and 1.1% in low-, 6.1% and 6.2% in intermediate-, and 32.5% and 36% in high-risk patients; mortality rates within each class were 0% in low-, 1.6% and 0% in intermediate-, and 4.3% and 3.1% in high-risk patients. Areas under the receiver operating characteristic curves in the validation subset were 0.652 (95% CI, 0.598 to 0.703) for Talcott, 0.721 (95% CI, 0.669 to 0.768) for Multinational Association for Supportive Care in Cancer (MASCC), and 0.868 (95% CI, 0.827 to 0.903) for CISNE (P = .002 for comparison between CISNE and MASCC). CISNE is a valid model for accurately classifying patients with cancer with seemingly stable FN episodes. © 2015 by American Society of Clinical Oncology.

Evaluating the consequences of salmon nutrients for riparian organisms: Linking condition metrics to stable isotopes.

Science.gov (United States)

Vizza, Carmella; Sanderson, Beth L; Coe, Holly J; Chaloner, Dominic T

2017-03-01

Stable isotope ratios (δ 13 C and δ 15 N) have been used extensively to trace nutrients from Pacific salmon, but salmon transfer more than carbon and nitrogen to stream ecosystems, such as phosphorus, minerals, proteins, and lipids. To examine the importance of these nutrients, metrics other than isotopes need to be considered, particularly when so few studies have made direct links between these nutrients and how they affect riparian organisms. Our study specifically examined δ 13 C and δ 15 N of riparian organisms from salmon and non-salmon streams in Idaho, USA, at different distances from the streams, and examined whether the quality of riparian plants and the body condition of invertebrates varied with access to these nutrients. Overall, quality and condition metrics did not mirror stable isotope patterns. Most notably, all riparian organisms exhibited elevated δ 15 N in salmon streams, but also with proximity to both stream types suggesting that both salmon and landscape factors may affect δ 15 N. The amount of nitrogen incorporated from Pacific salmon was low for all organisms (1950s. In addition, our results support those of other studies that have cautioned that inferences from natural abundance isotope data, particularly in conjunction with mixing models for salmon-derived nutrient percentage estimates, may be confounded by biogeochemical transformations of nitrogen, physiological processes, and even historical legacies of nitrogen sources. Critically, studies should move beyond simply describing isotopic patterns to focusing on the consequences of salmon-derived nutrients by quantifying the condition and fitness of organisms putatively using those resources.

Clinically stable angina pectoris is not necessarily associated with histologically stable atherosclerotic plaques

NARCIS (Netherlands)

van der Wal, A. C.; Becker, A. E.; Koch, K. T.; Piek, J. J.; Teeling, P.; van der Loos, C. M.; David, G. K.

1996-01-01

OBJECTIVE: To investigate the extent of plaque inflammation in culprit lesions of patients with chronic stable angina. DESIGN: Retrospective study. SETTING: Amsterdam reference centre. SUBJECTS: 89 consecutive patients who underwent directional coronary atherectomy, 58 of whom met the following

Nutritional status of children with clinical conditions.

Science.gov (United States)

Murphy, Alexia J; Hill, Rebecca J; Buntain, Helen; White, Melinda; Brookes, Denise; Davies, Peter S W

2017-06-01

Nutritional status is an important consideration in many pediatric clinical conditions. This paper aimed to examine and compare the nutritional status, represented by body cell mass (BCM), of children with cancer, Crohn's disease (CD), cystic fibrosis (CF) and anorexia nervosa (AN). Anthropometry was measured and BCM was calculated from whole body potassium-40 counting in 259 children being treated for clinical conditions (n = 66 cancer; n = 59 AN; n = 75 CF; n = 59 CD) and 108 healthy children. BCM was adjusted for height (BCMI) and expressed as a Z-score relative to laboratory reference data. The CD (-0.80 ± 1.61; p = 0.0001) and AN (-1.13 ± 0.99; p = 0.0001) groups had significantly lower BMI Z-score than the healthy control (0.13 ± 0.75), cancer (0.50 ± 1.40) and CF groups (-0.09 ± 0.95). The cancer (-1.16 ± 1.60; p = 0.0001), CD (-1.13 ± 1.36; p = 0.0001) and AN (-0.97 ± 1.18; p = 0.0001) groups had significantly reduced BCM compared to the healthy control (0.07 ± 0.93) and CF group (0.31 ± 1.08). According to BCMI Z-score, 42.4% of patients with cancer, 41.7% of the patients with CD, 27.1% of patients with AN, and 4.0% of patients with CF were considered malnourished. This study demonstrates that children undergoing treatment for clinical conditions may have alterations in BCM, independent of BMI. Children with cancer, CD and AN all had a high prevalence of malnutrition. Assessment of body composition, not just body size, is vital to understand nutritional status in children with clinical conditions. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

A stable enol from a 6-substituted benzanthrone and its unexpected behaviour under acidic conditions

Directory of Open Access Journals (Sweden)

Marc Debeaux

2009-06-01

Full Text Available Treatment of benzanthrone (1 with biphenyl-2-yl lithium leads to the surprisingly stable enol 4, which is converted by dehydrogenation into the benzanthrone derivative 7. Under acidic conditions 4 isomerises to the spiro compound 11 and the bicyclo[4.3.1]decane derivative 12. Furthermore, the formation of 7 and the hydrogenated compound 13 is observed. A mechanism for the formation of the reaction products is proposed and supported by DFT calculations.

Clinical verification in homeopathy and allergic conditions.

Science.gov (United States)

Van Wassenhoven, Michel

2013-01-01

The literature on clinical research in allergic conditions treated with homeopathy includes a meta-analysis of randomised controlled trials (RCT) for hay fever with positive conclusions and two positive RCTs in asthma. Cohort surveys using validated Quality of Life questionnaires have shown improvement in asthma in children, general allergic conditions and skin diseases. Economic surveys have shown positive results in eczema, allergy, seasonal allergic rhinitis, asthma, food allergy and chronic allergic rhinitis. This paper reports clinical verification of homeopathic symptoms in all patients and especially in various allergic conditions in my own primary care practice. For preventive treatments in hay fever patients, Arsenicum album was the most effective homeopathic medicine followed by Nux vomica, Pulsatilla pratensis, Gelsemium, Sarsaparilla, Silicea and Natrum muriaticum. For asthma patients, Arsenicum iodatum appeared most effective, followed by Lachesis, Calcarea arsenicosa, Carbo vegetabilis and Silicea. For eczema and urticaria, Mezereum was most effective, followed by Lycopodium, Sepia, Arsenicum iodatum, Calcarea carbonica and Psorinum. The choice of homeopathic medicine depends on the presence of other associated symptoms and 'constitutional' features. Repertories should be updated by including results of such clinical verifications of homeopathic prescribing symptoms. Copyright © 2012 The Faculty of Homeopathy. Published by Elsevier Ltd. All rights reserved.

Periodontal status affects C-reactive protein and lipids in patients with stable heart disease from a tertiary care cardiovascular clinic.

Science.gov (United States)

Flores, Manuela F; Montenegro, Marlon M; Furtado, Mariana V; Polanczyk, Carisi A; Rösing, Cassiano K; Haas, Alex N

2014-04-01

There are scarce data on the impact of the periodontal condition in the control of biomarkers in patients with cardiovascular disease (CVD). The aim of this study is to assess whether periodontal inflammation and tissue breakdown are associated with C-reactive protein (CRP) and lipids in patients with stable heart disease. This cross-sectional study included 93 patients with stable coronary artery disease (57 males; mean age: 63.5 ± 9.8 years) who were in outpatient care for at least 6 months. After applying a structured questionnaire, periodontal examinations were performed by two calibrated periodontists in six sites per tooth at all teeth. Blood samples were collected from patients on the day of periodontal examination to determine levels of CRP, lipids, and glycated hemoglobin. Multiple linear regression models were fitted to evaluate the association among different periodontal and blood parameters controlling for sex, body mass index, glycated hemoglobin, use of oral hypoglycemic drugs, and smoking. Overall, the sample presented high levels of periodontal inflammation and tissue breakdown. Unadjusted mean concentrations of triglycerides (TGs), very-low-density lipoprotein cholesterol, and glucose were significantly higher in individuals with severe periodontitis. When multiple linear regression models were applied, number of teeth with clinical attachment loss ≥6 mm and presence of severe periodontitis were significantly associated with higher CRP concentrations. Bleeding on probing was significantly associated with TGs, total cholesterol, and non-high-density lipoprotein cholesterol. In this sample of patients with stable CVD, current periodontal inflammation and tissue breakdown are associated with cardiovascular inflammatory markers, such as CRP and lipid profile.

Ivabradine in stable coronary artery disease without clinical heart failure

DEFF Research Database (Denmark)

Fox, Kim; Ford, Ian; Steg, Philippe Gabriel

2014-01-01

minute or more. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of ivabradine, added to standard background therapy, in 19,102 patients who had both stable coronary artery disease without clinical heart failure and a heart rate of 70 beats per minute or more (including 12......,049 patients with activity-limiting angina [class ≥II on the Canadian Cardiovascular Society scale, which ranges from I to IV, with higher classes indicating greater limitations on physical activity owing to angina]). We randomly assigned patients to placebo or ivabradine, at a dose of up to 10 mg twice daily......, with the dose adjusted to achieve a target heart rate of 55 to 60 beats per minute. The primary end point was a composite of death from cardiovascular causes or nonfatal myocardial infarction. RESULTS: At 3 months, the mean (±SD) heart rate of the patients was 60.7±9.0 beats per minute in the ivabradine group...

Reactive gas control of non-stable plasma conditions

International Nuclear Information System (INIS)

Bellido-Gonzalez, V.; Daniel, B.; Counsell, J.; Monaghan, D.

2006-01-01

Most industrial plasma processes are dependant upon the control of plasma properties for repeatable and reliable production. The speed of production and range of properties achieved depend on the degree of control. Process control involves all the aspects of the vacuum equipment, substrate preparation, plasma source condition, power supplies, process drift, valves (inputs/outputs), signal and data processing and the user's understanding and ability. In many cases, some of the processes which involve the manufacturing of interesting coating structures, require a precise control of the process in a reactive environment [S.J. Nadel, P. Greene, 'High rate sputtering technology for throughput and quality', International Glass Review, Issue 3, 2001, p. 45. ]. Commonly in these circumstances the plasma is not stable if all the inputs and outputs of the system were to remain constant. The ideal situation is to move a process from set-point A to B in zero time and maintain the monitored signal with a fluctuation equal to zero. In a 'real' process that's not possible but improvements in the time response and energy delivery could be achieved with an appropriate algorithm structure. In this paper an advanced multichannel reactive plasma gas control system is presented. The new controller offers both high-speed gas control combined with a very flexible control structure. The controller uses plasma emission monitoring, target voltage or any process sensor monitoring as the input into a high-speed control algorithm for gas input. The control algorithm and parameters can be tuned to different process requirements in order to optimize response times

[Startup, stable operation and process failure of EBPR system under the low temperature and low dissolved oxygen condition].

Science.gov (United States)

Ma, Juan; Li, Lu; Yu, Xiao-Jun; Wei, Xue-Fen; Liu, Juan-Li

2015-02-01

A sequencing batch reactor (SBR) was started up and operated with alternating anaerobic/oxic (An/O) to perform enhanced biological phosphorus removal (EBPR) under the condition of 13-16 degrees C. The results showed that under the condition of low temperature, the EBPR system was successfully started up in a short time (<6 d). The reactor achieved a high and stable phosphorus removal performance with an influent phosphate concentration of 20 mg x L(-1) and the dissolved oxygen (DO) concentration of 2 mg x L(-1). The effluent phosphate concentration was lower than 0.5 mg x L(-1). It was found that decreasing DO had an influence on the steady operation of EBPR system. As DO concentration of aerobic phase decreased from 2 mg x L(-1) to 1 mg x L(-1), the system could still perform EBPR and the phosphorus removal efficiency was greater than 97.4%. However, the amount of phosphate released during anaerobic phase was observed to decrease slightly compared with that of 2 mg x L(-1) DO condition. Moreover, the phosphorus removal performance of the system deteriorated immediately and the effluent phosphate concentration couldn't meet the national integrated wastewater discharge standard when DO concentration was further lowered to 0.5 mg x L(-1). The experiments of increasing DO to recover phosphorus removal performance of the EBPR suggested the process failure resulted from low DO was not reversible in the short-term. It was also found that the batch tests of anoxic phosphorus uptake using nitrite and nitrate as electron acceptors had an impact on the stable operation of EBPR system, whereas the resulting negative influence could be recovered within 6 cycles. In addition, the mixed liquid suspended solids (MLSS) of the EBPR system remained stable and the sludge volume index (SVI) decreased to a certain extend in a long run, implying long-term low temperature and low DO condition favored the sludge sedimentation.

Characterization of a stable, metronidazole-resistant Clostridium difficile clinical isolate.

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Tarah Lynch

Full Text Available BACKGROUND: Clostridium difficile are gram-positive, spore forming anaerobic bacteria that are the leading cause of healthcare-associated diarrhea, usually associated with antibiotic usage. Metronidazole is currently the first-line treatment for mild to moderate C. difficile diarrhea however recurrence occurs at rates of 15-35%. There are few reports of C. difficile metronidazole resistance in the literature, and when observed, the phenotype has been transient and lost after storage or exposure of the bacteria to freeze/thaw cycles. Owing to the unstable nature of the resistance phenotype in the laboratory, clinical significance and understanding of the resistance mechanisms is lacking. METHODOLOGY/PRINCIPAL FINDINGS: Genotypic and phenotypic characterization was performed on a metronidazole resistant clinical isolate of C. difficile. Whole-genome sequencing was used to identify potential genetic contributions to the phenotypic variation observed with molecular and bacteriological techniques. Phenotypic observations of the metronidazole resistant strain revealed aberrant growth in broth and elongated cell morphology relative to a metronidazole-susceptible, wild type NAP1 strain. Comparative genomic analysis revealed single nucleotide polymorphism (SNP level variation within genes affecting core metabolic pathways such as electron transport, iron utilization and energy production. CONCLUSIONS/SIGNIFICANCE: This is the first characterization of stable, metronidazole resistance in a C. difficile isolate. The study provides an in-depth genomic and phenotypic analysis of this strain and provides a foundation for future studies to elucidate mechanisms conferring metronidazole resistance in C. difficile that have not been previously described.

The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials.

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Peng, Song; Zhao, Min; Wan, Jing; Fang, Qi; Fang, Dong; Li, Kaiyong

2014-12-20

This meta-analysis aimed to evaluate the efficacy of trimetazidine in combination with other anti-anginal drugs versus other anti-anginal drugs in the treatment of stable angina pectoris (SAP). Randomized controlled trials (RCTs) published in English and Chinese were retrieved from computerized databases: Embase, PubMed, and CNKI. Primary outcomes consist of clinical parameters (numbers of weekly angina attacks and nitroglycerin use) and ergometric parameters (time to 1mm ST-segment depression, and total work (in Mets) and exercise duration (in seconds) at peak exercise) in stable angina pectoris treated by trimetazidine or not. The quality of studies was evaluated using Jadad score. Data analysis of 13 studies was performed using Stata 12.0 software. Results showed that treatment of trimetazidine and other anti-anginal drugs was associated with a smaller weekly mean number of angina attacks (WMD=-0.95, 95%CI: -1.30 to -0.61, Z=5.39, Pangina pectoris. Sensitivity analysis was performed. Sub-group analysis showed that treatment duration was not a significant moderator and patients treated within 8 weeks and above 12 weeks had no difference in the outcomes addressed in this meta-analysis. No publish bias was detected. This meta-analysis confirms the efficacy of trimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Relationship between vitamin A deficiency and the thyroid axis in clinically stable patients with liver cirrhosis related to hepatitis C virus.

Science.gov (United States)

El-Eshmawy, Mervat M; Arafa, Mona M; Elzehery, Rasha R; Elhelaly, Rania M; Elrakhawy, Mohamed M; El-Baiomy, Azza A

2016-09-01

Vitamin A deficiency (VAD) and altered thyroid function are commonly encountered in patients with liver cirrhosis. The link between vitamin A metabolism and thyroid function has been previously identified. The aim of this study was to explore the association between VAD and the thyroid axis in clinically stable patients with cirrhosis related to hepatitis C virus (HCV). One hundred and twelve patients with clinically stable HCV-related cirrhosis and 56 healthy controls matched for age, sex, and socioeconomic status were recruited for this study. Vitamin A status, liver function, thyroid-stimulating hormone (TSH), free thyroxine (FT4), free triiodothyronine (FT3), reverse triiodothyronine (rT3), anti-thyroid peroxidase antibodies (anti-TPO), and thyroid volume were evaluated. The prevalence of VAD among patients with HCV-related cirrhosis was 62.5% compared with 5.4% among controls (P vitamin A status: VAD and normal vitamin A. Patients with VAD had significantly lower vitamin A intake and serum albumin and higher serum bilirubin, FT4, FT3, and TSH than patients with normal vitamin A status. Multiple logistic regression analysis revealed that VAD was associated with Child-Pugh score (β = 0.11, P = 0.05) and TSH (β = -1.63, P = 0.02) independently of confounding variables. We conclude that VAD may be linked to central hyperthyroidism in patients with clinically stable HCV-related liver cirrhosis.

Conditions for Stable Chip Breaking and Provision of Machined Surface Quality While Turning with Asymmetric Tool Vibrations

OpenAIRE

Шелег, В. К.; Молочко, В. И.; Данильчик, С. С.

2015-01-01

The paper considers a process of turning structural steel with asymmetric tool vibrations directed along feeding. Asymmetric vibrations characterized by asymmetry coefficient of vibration cycle, their frequency and amplitude are additionally transferred to the tool in the turning process with the purpose to crush chips. Conditions of stable chip breaking and obtaining optimum dimensions of chip elements have been determined in the paper. In order to reduce a negative impact of the vibration a...

Diabetes mellitus and cardiovascular clinical characteristics of Spanish women with stable ischaemic heart disease: Data from the SIRENA study.

Science.gov (United States)

Gámez, José M; Masmiquel, Luis; Ripoll, Tomás; Barrios, Vivencio; Anguita, Manuel

2017-01-01

The relationship between diabetes and the cardiovascular clinical characteristics of Spanish women with stable ischaemic heart disease was studied in a nationwide cross-sectional study. Diabetes was related to a higher burden of risk factors, comorbidity, multivessel disease and coronary surgery. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Incidence of mitral valve prolapse in one hundred clinically stable newborn baby girls: an echocardiographic study.

Science.gov (United States)

Chandraratna, P A; Vlahovich, G; Kong, Y; Wilson, D

1979-09-01

Clinical and echocardiographic examinations were performed on 100 clinically stable, newborn baby girls. Mitral valve prolapse was noted on the echocardiograms of seven babies. Three subjects had systolic clicks, two of whom had systolic murmurs following the click. The four other babies who had echocardiographic evidence of mitral valve prolapse had no abnormal auscultatory signs. Of the 93 babies without evidence of mitral prolapse, 91 had normal echocardiograms and auscultatory features; one was noted to have a murmur consistent with a ventricular septal defect, and another had an eccentric aortic valve on the echocardiogram which was suggestive of a bicuspid aortic valve. Serial studies on our group of subjects will yield useful information regarding the natural history of mitral valve prolapse.

Colon cleansing protocol in children: research conditions vs. clinical practice.

Science.gov (United States)

Elitsur, Yoram; Balfaqih, Yaslam; Preston, Deborah

2018-04-01

 Colon preparation rates are the limiting factor for a successful diagnostic colonoscopy in children. Different colon cleansing protocols have been published for use in children. Unfortunately, the applicability of those published research protocols has not been formally evaluated in routine clinical practice. We investigated the success rate of our previously published colon cleansing protocol as utilized in our clinical practice.  This was a retrospective study. In the clinical practice, the colon cleansing protocol included PEG-3350 at a dose of 2 g/kg/day plus Dulcolax (Bisacodyl, Boehringer Ingelheim, TX USA) 5 mg/day for 2 days. Adequate colon preparation was graded between 1 - 5, as previously described, and grade ≥ 4.0 was considered an adequate preparation. Patients were instructed to complete a questionnaire that included PEG-3350 dose, number of stools per day, consistency of each stool, and side effects (vomiting, abdominal pain). Clinical and endoscopic results were compared between the protocol under research conditions and routine practice.  The success rate of the colon preparation in our clinical practice was similar to the results observed under our research protocol (75 % vs. 73.6 %). Moreover, the total number of stools, stool consistency, and the intubation rate of the terminal ileum were also similar. We concluded, that in our experience, the colon cleansing protocol used under research conditions was effective and appropriate for use in routine clinical practice.  We recommend testing each new protocol under the routine conditions of clinical practice to confirm its applicability for general practitioners.

42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

Science.gov (United States)

2010-10-01

... Condition: Laboratories performing high complexity testing; clinical consultant. The laboratory must have a... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing high complexity testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID...

Angular stable plates in proximal meta-epiphyseal tibial fractures: study of joint restoration and clinical and functional evaluation.

Science.gov (United States)

Giannotti, S; Giovannelli, D; Dell'Osso, G; Bottai, V; Bugelli, G; Celli, F; Citarelli, C; Guido, G

2016-04-01

The tibial plateau fractures involve one of the main weight bearing joints of the human body. The goals of surgical treatment are anatomical reduction, articular surface reconstruction and high primary stability. The aim of this study was to evaluate the clinical and functional outcomes after internal plate fixation of this kind of fractures. From January 2009 to December 2012, we treated 75 cases of tibial plateau fracture with angular stable plates. We used Rasmussen Score and the Knee Society Score for the clinical and functional evaluation. Twenty-five cases that underwent hardware removal had arthroscopic and CT evaluation of the joint. No complications occurred. The clinical and functional evaluation, performed by the KSS and Rasmussen Score, highlighted the high percentage of good-to-excellent results (over 90 %). In every case, the range of motion was good with flexion >90°. Arthroscopy showed the presence of chondral damage in 100 % of patients. In all the cases, we found that X-ray images seem better than the CT images. Angular stable plates allow to obtain a good primary stability, permitting an early joint recovery with an excellent range of motion. Avoiding to perform a knee arthrotomy at the time of fracture reduction could prove to be an advantage in terms of functional recovery. The meniscus on the injured bone should be preserved in order to maintain good function of the joint. X-ray images remain the gold standard in checking the progression of post-traumatic osteoarthritis.

Attributing Climate Conditions for Stable Malaria Transmission to Human Activity in sub-Saharan Africa

Science.gov (United States)

Sheldrake, L.; Mitchell, D.; Allen, M. R.

2015-12-01

Temperature and precipitation limit areas of stable malaria transmission, but the effects of climate change on the disease remain controversial. Previously, studies have not separated the influence of anthropogenic climate change and natural variability, despite being an essential step in the attribution of climate change impacts. Ensembles of 2900 simulations of regional climate in sub-Saharan Africa for the year 2013, one representing realistic conditions and the other how climate might have been in the absence of human influence, were used to force a P.falciparium climate suitability model developed by the Mapping Malaria Risk in Africa project. Strongest signals were detected in areas of unstable transmission, indicating their heightened sensitivity to climatic factors. Evidently, impacts of human-induced climate change were unevenly distributed: the probability of conditions being suitable for stable malaria transmission were substantially reduced (increased) in the Sahel (Greater Horn of Africa (GHOA), particularly in the Ethiopian and Kenyan highlands). The length of the transmission season was correspondingly shortened in the Sahel and extended in the GHOA, by 1 to 2 months, including in Kericho (Kenya), where the role of climate change in driving recent malaria occurrence is hotly contested. Human-induced warming was primarily responsible for positive anomalies in the GHOA, while reduced rainfall caused negative anomalies in the Sahel. The latter was associated with anthropogenic impacts on the West African Monsoon, but uncertainty in the RCM's ability to reproduce precipitation trends in the region weakens confidence in the result. That said, outputs correspond well with broad-scale changes in observed endemicity, implying a potentially important contribution of anthropogenic climate change to the malaria burden during the past century. Results support the health-framing of climate risk and help indicate hotspots of climate vulnerability, providing

42 CFR 493.1415 - Condition: Laboratories performing moderate complexity testing; clinical consultant.

Science.gov (United States)

2010-10-01

... § 493.1415 Condition: Laboratories performing moderate complexity testing; clinical consultant. The laboratory must have a clinical consultant who meets the qualification requirements of § 493.1417 of this... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing moderate...

Results of the 2005-2008 Association of Residents in Radiation Oncology Survey of Chief Residents in the United States: Clinical Training and Resident Working Conditions

International Nuclear Information System (INIS)

Gondi, Vinai; Bernard, Johnny Ray; Jabbari, Siavash; Keam, Jennifer; Amorim Bernstein, Karen L. de; Dad, Luqman K.; Li, Linna; Poppe, Matthew M.; Strauss, Jonathan B.; Chollet, Casey T.

2011-01-01

Purpose: To document clinical training and resident working conditions reported by chief residents during their residency. Methods and Materials: During the academic years 2005 to 2006, 2006 to 2007, and 2007 to 2008, the Association of Residents in Radiation Oncology conducted a nationwide survey of all radiation oncology chief residents in the United States. Chi-square statistics were used to assess changes in clinical training and resident working conditions over time. Results: Surveys were completed by representatives from 55 programs (response rate, 71.4%) in 2005 to 2006, 60 programs (75.9%) in 2006 to 2007, and 74 programs (93.7%) in 2007 to 2008. Nearly all chief residents reported receiving adequate clinical experience in commonly treated disease sites, such as breast and genitourinary malignancies; and commonly performed procedures, such as three-dimensional conformal radiotherapy and intensity-modulated radiotherapy. Clinical experience in extracranial stereotactic radiotherapy increased over time (p < 0.001), whereas clinical experience in endovascular brachytherapy (p <0.001) decreased over time. The distribution of gynecologic and prostate brachytherapy cases remained stable, while clinical case load in breast brachytherapy increased (p = 0.006). A small but significant percentage of residents reported receiving inadequate clinical experience in pediatrics, seeing 10 or fewer pediatric cases during the course of residency. Procedures involving higher capital costs, such as particle beam therapy and intraoperative radiotherapy, and infrequent clinical use, such as head and neck brachytherapy, were limited to a minority of institutions. Most residency programs associated with at least one satellite facility have incorporated resident rotations into their clinical training, and the majority of residents at these programs find them valuable experiences. The majority of residents reported working 60 or fewer hours per week on required clinical duties

Evaluation of vitamin B 12 deficiency in various clinical condition

International Nuclear Information System (INIS)

Baig, J.A.; Alam, J.M.; Kazmi, T.; Waseem, S.; Hussain, A.; Arif, S.; Shaheen, R.; Sultana, I.

2010-01-01

Low levels of vitamin B 12 have been associated with several clinical conditions. However no single symptom or group of symptoms can be made responsible. Reported causes of deficiency among older population are hematologic or neurological, followed by gastrointestinal and possibly vascular symptoms. The present prospective observational study was, hence, initiated to evaluate the underlying clinical condition or symptoms associated with vitamin B12 deficiency. The study was prospective observational and carried out on 121 patients (males, n=63 and females, n=58) for the period from January 1, 2004 to January 24, 2007. Age ranges were between 16 - 70 years, and categorized as > 60 yrs and < 60 years. All blood parameters were analyzed by standardized methods on automated analyzers. The deficiency was found to be more prevalent in males and increased from 52.06% to 58.10% in individuals with vitamin B12 <150 pg/ml. Mal nourishment was noted among the most subjects and weakness and anemia were frequent clinical findings (35.55%, n=43, 14%, n=51). Other clinical conditions were neuropsychiatric. Whereas less frequent findings were paraesthesia and gastrointestinal symptoms. Hypertension was more prevalent in vitamin B12 deficient individuals followed by diabetes, dementia, stroke, ischemic heart disease and Parkinson's disease. (author)

The use of stable isotopes in medicinal chemistry

International Nuclear Information System (INIS)

Halliday, D.; Thompson, G.N.

1988-01-01

Stable isotopes have been employed increasingly as tracers over the last decade both to provide the clinician with the opportunity to broaden, in a quantitative manner, discrete areas of diagnosis and research, and the clinical chemist with definitive methodology for specific analyte analysis. These non-radioactive 'heavy' isotopes contain one or more extra neutrons in the nucleus compared with their more abundant 'lighter' analogues. Impetus in the application of stable isotopes for in vivo studies has come from an increased awareness of the possible harmful effects in the use of radionuclides, and a realisation of several positive advantages conferred by the use of stable isotopes in their own right - certain elements of clinical importance (especially nitrogen) lack a useable radio-nuclide equivalent; use of a 'cocktail' of stable isotopes permits a range of studies to be performed in the same patient simultaneously and, within specific constraints, serial studies can be performed in the same patients. (author)

Uses of stable isotopes

International Nuclear Information System (INIS)

Axente, Damian

1998-01-01

The most important fields of stable isotope use with examples are presented. These are: 1. Isotope dilution analysis: trace analysis, measurements of volumes and masses; 2. Stable isotopes as tracers: transport phenomena, environmental studies, agricultural research, authentication of products and objects, archaeometry, studies of reaction mechanisms, structure and function determination of complex biological entities, studies of metabolism, breath test for diagnostic; 3. Isotope equilibrium effects: measurement of equilibrium effects, investigation of equilibrium conditions, mechanism of drug action, study of natural processes, water cycle, temperature measurements; 4. Stable isotope for advanced nuclear reactors: uranium nitride with 15 N as nuclear fuel, 157 Gd for reactor control. In spite of some difficulties of stable isotope use, particularly related to the analytical techniques, which are slow and expensive, the number of papers reporting on this subject is steadily growing as well as the number of scientific meetings organized by International Isotope Section and IAEA, Gordon Conferences, and regional meeting in Germany, France, etc. Stable isotope application development on large scale is determined by improving their production technologies as well as those of labeled compound and the analytical techniques. (author)

The effect of glaze on the quality of frozen stored Alaska pollack (Theragra chalcogramma fillets under stable and unstable conditions

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Peter Žoldoš

2011-01-01

Full Text Available Frozen fillets (n = 288 of Alaska pollack (Theragra chalcogramma were used to evaluate the effect of glaze on lipid oxidation and microbiological indicators during 6 months of freezing storage under stable (−18 °C and unstable temperature (varying from −5 to −18 °C conditions. The amount of glaze, moisture, fat and protein content were measured. Despite the low fat content in Alaska pollack, a positive effect of glazing and stable freezing conditions of storage on the range of oxidative changes of lipids expressed as thiobarbituric acid reactive substances was found. Total counts of viable cells slightly rose before the end of the storage period in both groups with commercially glazed fish. The average counts of psychrotrophs in each group ( were at the same level, ranging from 9.1 ×103 CFU·g-1 to 1.1 × 104 CFU·g-1. According to the microbiological results fillets stored under unstable conditions were considered to be acceptable, but sensory evaluation showed that at the end of frozen storage they could not be consumed because of rancidity. Based on our results, glaze application ranged from 10 to 15% guarantee of final quality, however, prevention of temperature fluctuation during storage is important to keep the quality of the frozen fillets. This is the first similar study in Alaska pollack.

Limb anomaly and associated conditions: our clinical experience

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Ragavan M

2011-03-01

Full Text Available Munisamy Ragavan1, Uppalu Haripriya1, Janarthanam Sarvavinothini2, Nagaraja Rao3, Ramamoorthy Gokulkrishnan31Department of Pediatric Surgery, 2Department of Anesthesia, 3Department of Pediatrics, Narayana Medical College and Superspeciality Hospital, Nellore, Andhra Pradesh, IndiaAbstract: Limb anomalies are a common clinical problem with a various spectrum of involvement. There are many conditions associated with these anomalies. There is a variable extent of involvement in the form of agenesis, overgrowth, and duplication, and there is no standard classification to describe all these lesions. Studying limb anomalies provides insights into limb development which may be useful for etiologic studies and public health monitoring. We pooled our data for 12 limb anomaly cases presenting from January 2008 to May 2009 and investigated their associated conditions. A descriptive system for the nomenclature and classification of congenital limb malformations suitable for clinical, epidemiological, and experimental use is discussed.Keywords: limb anomaly, phocomelia, amelia 

Methodology for Multileaf Collimator Quality Assurance in clinical conditions

International Nuclear Information System (INIS)

Diaz M, R. M.; Rodriguez Z, M.; Juarez D, A.; Romero R, R.

2013-01-01

Multileaf Collimators (MLCs) have become an important technological advance as part of clinical linear accelerators (linacs) for radiotherapy. Treatment planning and delivery were substantially modified after these devices. However, it was needed to develop Quality Assurance (QA) methodologies related to the performance of these developments. The most common methods for QA of MLC are made in basic conditions that hardly cover all possible difficulties in clinical practice. Diaz et. el. developed a methodology based upon volumetric detectors bidimensional arrays that can be extended to more demanding situations. In this work, the Auril methodology of Diaz et. al. was implemented to the irradiation with the linac gantry in horizontal position. A mathematical procedure was developed to ease the dosimetric centering of the device with the Auril centering tool. System calibration was made as in the typical Auril methodology. Patterns with leaf misplacements in known positions were irradiated. the method allowed the detection of leafs' misplacements with a minimum number of false positives. We concluded that Auril methodology can be applied in clinical conditions. (Author)

Heat storage in forest biomass significantly improves energy balance closure particularly during stable conditions

Science.gov (United States)

Lindroth, A.; Mölder, M.; Lagergren, F.

2009-08-01

Temperature measurements in trunks and branches in a mature ca. 100 years-old mixed pine and spruce forest in central Sweden were used to estimate the heat storage in the tree biomass. The estimated heat flux in the sample trees and data on biomass distributions were used to scale up to stand level biomass heat fluxes. The rate of change of sensible and latent heat storage in the air layer below the level of the flux measurements was estimated from air temperature and humidity profile measurements and soil heat flux was estimated from heat flux plates and soil temperature measurements. The fluxes of sensible and latent heat from the forest were measured with an eddy covariance system in a tower. The analysis was made for a two-month period in summer of 1995. The tree biomass heat flux was the largest of the estimated storage components and varied between 40 and -35 W m-2 on summer days with nice weather. Averaged over two months the diurnal maximum of total heat storage was 45 W m-2 and the minimum was -35 W m-2. The soil heat flux and the sensible heat storage in air were out of phase with the biomass flux and they reached maximum values that were about 75% of the maximum of the tree biomass heat storage. The energy balance closure improved significantly when the total heat storage was added to the turbulent fluxes. The slope of a regression line with sum of fluxes and storage as independent and net radiation as dependent variable, increased from 0.86 to 0.95 for half-hourly data and the scatter was also reduced. The most significant finding was, however, that during nights with strongly stable conditions when the sensible heat flux dropped to nearly zero, the total storage matched the net radiation nearly perfectly. Another interesting result was that the mean energy imbalance started to increase when the Richardson number became more negative than ca. -0.1. In fact, the largest energy deficit occurred at maximum instability. Our conclusion is that eddy

Can common measures of core stability distinguish performance in a shoulder pressing task under stable and unstable conditions?

Science.gov (United States)

Keogh, Justin W L; Aickin, Sam E; Oldham, Anthony R H

2010-02-01

The primary purpose of this study was to determine whether a range of static core stability (CS) measures could distinguish shoulder press performance in unstable vs. stable conditions. Thirty resistance-trained men gave informed consent to participate in this study. One-repetition maximum strength (from 0.90), moderate (0.85 Core stability training (with or without a SB) may therefore only lead to significant improvements in functional dynamic performance if the postures, mode and velocity of contraction performed in training, are similar to the competitive tasks.

Clinical conditions associated withintestinal strongyloidiasis in Rio de Janeiro, Brazil

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Anna Caryna Cabral

2015-06-01

Full Text Available INTRODUCTION: Strongyloides stercoralis is a soil-transmitted helminth that produces an infection that can persist for decades. The relationships between certain clinical conditions and strongyloidiasis remains controversial. This study aims to identify the clinical conditions associated with intestinal strongyloidiasis at a reference center for infectious diseases in Rio de Janeiro, Brazil. METHODS: The clinical conditions that were assessed included HIV/AIDS, HTLV infection, cardiovascular diseases, diabetes, obstructive respiratory diseases, viral hepatitis, tuberculosis, cancer, chronic renal disease, nutritional/metabolic disorders, psychiatric conditions, rheumatic diseases and dermatologic diseases. We compared 167 S. stercoralis-positive and 133 S. stercoralis-negative patients. RESULTS: After controlling for sex (male/female OR = 2.29; 95% (CI: (1.42 - 3.70, rheumatic diseases remained significantly associated with intestinal strongyloidiasis (OR: 4.96; 95% CI: 1.34-18.37 in a multiple logistic regression model. With respect to leukocyte counts, patients with strongyloidiasis presented with significantly higher relative eosinophil (10.32% ± 7.2 vs. 4.23% ± 2.92 and monocyte (8.49% ± 7.25 vs. 5.39% ± 4.31 counts and lower segmented neutrophil (52.85% ± 15.31 vs. 61.32% ± 11.4 and lymphocyte counts (28.11% ± 9.72 vs. 30.90% ± 9.51 than S. stercoralis-negative patients. CONCLUSIONS: Strongyloidiasis should be routinely investigated in hospitalized patients with complex conditions facilitate the treatment of patients who will undergo immunosuppressive therapy. Diagnoses should be determined through the use of appropriate parasitological methods, such as the Baermann-Moraes technique.

The Nature of Stable Insomnia Phenotypes

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Pillai, Vivek; Roth, Thomas; Drake, Christopher L.

2015-01-01

Study Objectives: We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither criterion (i.e., insomnia cases that do not meet quantitative thresholds for onset or maintenance problems). Insomnia cases that exhibited the same symptom profile over a 1-y period were considered to be phenotypes, and were compared in terms of clinical and demographic characteristics. Design: Longitudinal. Setting: Urban, community-based. Participants: Nine hundred fifty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based current insomnia (46.6 ± 12.6 y; 69.4% female). Interventions: None. Measurements and results: At baseline, participants were divided into four symptom profile groups based on quantitative criteria. Follow-up assessment 1 y later revealed that approximately 60% of participants retained the same symptom profile, and were hence judged to be phenotypes. Stability varied significantly by phenotype, such that sleep onset insomnia (SOI) was the least stable (42%), whereas combined insomnia (CI) was the most stable (69%). Baseline symptom groups (cross-sectionally defined) differed significantly across various clinical indices, including daytime impairment, depression, and anxiety. Importantly, however, a comparison of stable phenotypes (longitudinally defined) did not reveal any differences in impairment or comorbid psychopathology. Another interesting finding was that whereas all other insomnia phenotypes showed evidence of an elevated wake drive both at night and during the day, the “neither criterion” phenotype did not; this latter phenotype exhibited significantly higher daytime sleepiness despite subthreshold onset and maintenance difficulties. Conclusions: By adopting a stringent, stability-based definition, this study offers timely and important data on the longitudinal trajectory of specific insomnia phenotypes. With

STATIC BALANCE MEASUREMENTS IN STABLE AND UNSTABLE CONDITIONS DO NOT DISCRIMINATE GROUPS OF YOUNG ADULTS ASSESSED BY THE FUNCTIONAL MOVEMENT SCREEN™ (FMS™).

Science.gov (United States)

Trindade, Matheus A; de Toledo, Aline Martins; Cardoso, Jefferson Rosa; Souza, Igor Eduardo; Dos Santos Mendes, Felipe Augusto; Santana, Luisiane A; Carregaro, Rodrigo Luiz

2017-11-01

The Functional Movement Screen™ (FMS™) has been the focus of recent research related to movement profiling and injury prediction. However, there is a paucity of studies examining the associations between physical performance tasks such as balance and the FMS™ screening system. The purpose of this study was to compare measures of static balance in stable and unstable conditions between different groups divided by FMS™ scores. A secondary purpose was to discern if balance indices discriminate the groups divided by FMS™ scores. Cross-sectional study. Fifty-seven physically active subjects (25 men and 32 women; mean age of 22.9 ± 3.1 yrs) participated. The outcome was unilateral stance balance indices, composed by: Anteroposterior Index; Medial-lateral Index, and Overall Balance Index in stable and unstable conditions, as provided by the Biodex balance platform. Subjects were dichotomized into two groups, according to a FMS™ cut-off score of 14: FMS1 (score > 14) and FMS2 (score ≤ 14). The independent Students t-test was used to verify differences in balance indices between FMS1 and FMS2 groups. A discriminant analysis was applied in order to identify which of the balance indices would adequately discriminate the FMS™ groups. Comparisons between FMS1 and FMS2 groups in the stable and unstable conditions demonstrated a higher unstable Anteroposterior index for FMS2 (p=0.017). No significant differences were found for other comparisons (p>0.05). The indices did not discriminate the FMS™ groups ( p  > 0.05). The balance indices adopted in this study were not useful as a parameter for identification and discrimination of healthy subjects assessed by the FMS™. 2c.

The clinical profile of women with stable ischaemic heart disease in Spain. More effort is needed in secondary prevention. SIRENA study.

Science.gov (United States)

Gámez, J M; Ripoll, T; Barrios, V; Anguita, M; Pedreira, M; Madariaga, I

2016-01-01

Cardiovascular diseases are the leading cause of death for women, especially ischaemic heart disease, which is still considered a man's disease. In Spain, there are various registries on ischaemic heart disease, although none are exclusively for women. The objectives of the SIRENA study were to describe the clinical profile of women with ischaemic heart disease treated in cardiology consultations, to estimate its prevalence of cardiovascular risk factors and understand its clinical management. A multicentre observational study was conducted with a sample of 631 women with stable ischaemic heart disease, consecutively included during cardiology consultations. Forty-one researchers from all over Spain participated in the study. The mean age was 68.5 years. The clinical presentation was in the form of acute coronary syndrome in up to 67.2% of the patients. The prevalence of cardiovascular risk factors was high (77.7% of the patients had hypertension, 40.7% had diabetes and 68% had dyslipidaemia), with 30.7% having uncontrolled hypertension, 78.4% having LDL-cholesterol levels higher than 70mg/dL and 49.2% having HbA1c levels greater than 7%. The considerable majority of the patients underwent optimal medical treatment with antiplatelet agents, beta-blockers, renin-angiotensin-aldosterone system blockers and hypolipidaemic agents. Coronary angiography was performed for 88.3% of the patients, and 63.4% underwent percutaneous coronary intervention. Women with stable ischaemic heart disease in Spain initially present some form of acute coronary syndrome and a high prevalence of inadequately controlled cardiovascular risk factors, despite undergoing optimal medical therapy. A high percentage of these women undergo coronary revascularisation. Increased efforts are required for secondary prevention in women with stable ischaemic heart disease. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

Renin-angiotensin system antagonists and clinical outcomes in stable coronary artery disease without heart failure.

Science.gov (United States)

Sorbets, Emmanuel; Labreuche, Julien; Simon, Tabassome; Delorme, Laurent; Danchin, Nicolas; Amarenco, Pierre; Goto, Shinya; Meune, Christophe; Eagle, Kim A; Bhatt, Deepak L; Steg, Philippe Gabriel

2014-07-01

The aim of this study was to determine whether angiotensin-converting enzyme inhibitor (ACEI) or angiotensin-II receptor blocker (ARB) use is associated with lower rates of cardiovascular events in patients with stable coronary artery disease (CAD) but without heart failure (HF) receiving contemporary medical management. Using data from the Reduction of Atherothrombosis for Continued Health (REACH) registry, we examined, using propensity score approaches, relationships between cardiovascular outcomes and ACEI/ARB use (64.1% users) in 20 909 outpatients with stable CAD and free of HF at baseline. As internal control, we assessed the relation between statin use and outcomes. At 4-year follow-up, the risk of cardiovascular death, MI, or stroke (primary outcome) was similar in ACEI/ARB users compared with non-users (hazard ratio, 1.03; 95% confidence interval [CI], 0.91-1.16; P = 0.66). Similarly, the risk of the primary outcome and cardiovascular hospitalization for atherothrombotic events (secondary outcome) was not reduced in ACEI/ARB users (hazard ratio, 1.08; 95% CI, 1.01-1.16; P = 0.04), nor were the rates of any of its components. Analyses using propensity score matching yielded similar results, as did sensitivity analyses accounting for missing covariates, changes in medications over time, or analysing separately ACEI and ARB use. In contrast, in the same cohort, statin use was associated with lower rates for all outcomes. Use of ACEI/ARB was not associated with better outcomes in stable CAD outpatients without HF. The benefit of ACEI/ARB seen in randomized clinical trials was not replicated in this large contemporary cohort, which questions their value in this specific subset. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2014. For permissions please email: journals.permissions@oup.com.

Concurrent medical conditions among pregnant women - ignore at their peril: report from an antenatal anesthesia clinic.

Science.gov (United States)

Weiniger, Carolyn F; Einav, Sharon; Elchalal, Uriel; Ozerski, Vladislav; Shatalin, Daniel; Ioscovich, Alexander; Ginosar, Yehuda

2018-03-19

Care of pregnant women with concurrent medical conditions can be optimized by multidisciplinary antenatal management. In the current study we describe women with concurrent medical conditions who attended our antenatal anesthesia clinic over a 14-year period, 2002-2015 and, based on the findings, we suggest new policies, strategies and practices to improve antenatal care. In 2002, an antenatal anesthesia clinic was established in Hadassah Medical Center. Each consultation focused on the concurrent medical condition. A written anesthesia strategy according to the medical condition and its anesthesia considerations was discussed and given to the patient. Data regarding clinic visits were recorded. A total of 451 clinic women attended the antenatal anesthesia clinic. Maternal age was 31.7 ± 6.0 years (mean ± SD), with gestational age of pregnancy 33.0 ± 5.4 weeks at the clinic visit. Musculoskeletal conditions (23% of all the women seen) were the most frequent concurrent conditions, followed by anesthesia related concerns 20%, neurologic conditions 19%, and cardiac conditions 15%. Women were provided plans that were deliberated carefully rather than being concocted during labor. A wide range of concurrent medical conditions was seen in the antenatal anesthesia clinic, however fewer women attended the clinic than expected according to known population frequencies of concurrent medical conditions. Women with concurrent medical conditions should have labor and anesthesia plans considered during the nine months of pregnancy, prior to delivery, and hospitals should have a means of obtaining this information in a timely manner. Finally, there is a need to develop additional antenatal anesthesia clinics.

Stable SU(5) monopoles with higher magnetic charge

International Nuclear Information System (INIS)

Miyamoto, S.; Sato, H.; Tomohiro, S.

1985-01-01

Taking into account the electroweak breaking effects, some multiply charged monopoles were shown to be stable by Gardner and Harvey. We give the explicit Ansa$uml: tze for finite-energy, nonsingular solutions of these stable higher-strength monopoles with eg = 1,(3/2),3. We also give the general stability conditions and the detailed behavior of the interaction potentials between two monopoles which produce the stable higher-strength monopoles

The nature of stable insomnia phenotypes.

Science.gov (United States)

Pillai, Vivek; Roth, Thomas; Drake, Christopher L

2015-01-01

We examined the 1-y stability of four insomnia symptom profiles: sleep onset insomnia; sleep maintenance insomnia; combined onset and maintenance insomnia; and neither criterion (i.e., insomnia cases that do not meet quantitative thresholds for onset or maintenance problems). Insomnia cases that exhibited the same symptom profile over a 1-y period were considered to be phenotypes, and were compared in terms of clinical and demographic characteristics. Longitudinal. Urban, community-based. Nine hundred fifty-four adults with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition based current insomnia (46.6 ± 12.6 y; 69.4% female). None. At baseline, participants were divided into four symptom profile groups based on quantitative criteria. Follow-up assessment 1 y later revealed that approximately 60% of participants retained the same symptom profile, and were hence judged to be phenotypes. Stability varied significantly by phenotype, such that sleep onset insomnia (SOI) was the least stable (42%), whereas combined insomnia (CI) was the most stable (69%). Baseline symptom groups (cross-sectionally defined) differed significantly across various clinical indices, including daytime impairment, depression, and anxiety. Importantly, however, a comparison of stable phenotypes (longitudinally defined) did not reveal any differences in impairment or comorbid psychopathology. Another interesting finding was that whereas all other insomnia phenotypes showed evidence of an elevated wake drive both at night and during the day, the 'neither criterion' phenotype did not; this latter phenotype exhibited significantly higher daytime sleepiness despite subthreshold onset and maintenance difficulties. By adopting a stringent, stability-based definition, this study offers timely and important data on the longitudinal trajectory of specific insomnia phenotypes. With the exception of daytime sleepiness, few clinical differences are apparent across stable phenotypes. �

Progress in stable isotope analysis and new possibilities of clinical investigations

International Nuclear Information System (INIS)

Roth, E.

1989-01-01

The use of stable isotopes in medicine rests on three possibilities offered by labelling: identification of an element, a molecule, or a fragment of a molecule along its biological pathway; quantification of biological pools by isotopic dilution; measurement of metabolization rates, and more generally of clearances. Whenever a corporal function experiences a disregulation reflected either by changes in metabolic activity or modifications of the importance of pools of certain molecules, the possibility exists of making use of isotopes in diagnosis. Examples of practical applications of stable isotopes are given and analytical problems that had to be solved are underlined

Gender- and age-related differences in clinical presentation and management of outpatients with stable coronary artery disease.

Science.gov (United States)

Ferrari, Roberto; Abergel, Hélène; Ford, Ian; Fox, Kim M; Greenlaw, Nicola; Steg, Ph Gabriel; Hu, Dayi; Tendera, Michal; Tardif, Jean-Claude

2013-09-10

Contemporary generalizable data on the demographics and management of outpatients with stable coronary artery disease (CAD) in routine clinical practice are sparse. Using the data from the CLARIFY registry we describe gender- and age-related differences in baseline characteristics and management of these patients across broad geographic regions. This international, prospective, observational, longitudinal registry enrolled stable CAD outpatients from 45 countries in Africa, Asia, Australia, Europe, the Middle East, and North, Central, and South America. Baseline data were available for 33280 patients. Mean (SD) age was 64 (10.5) years and 22.5% of patients were female. The prevalence of CAD risk factors was generally higher in women than in men. Women were older (66.6 vs 63.4 years), more frequently diagnosed with diabetes (33% vs 28%), hypertension (79% vs 69%), and higher resting heart rate (69 vs 67 bpm), and were less physically active. Smoking and a history of myocardial infarction were more common in men. Women were more likely to have angina (28% vs 20%), but less likely to have undergone revascularization procedures. CAD was more likely to be asymptomatic in older patients perhaps because of reduced levels of physical activity. Prescription of evidence-based medication for secondary prevention varied with age, with patients ≥ 75 years treated less often with beta blockers, aspirin and angiotensin-converting enzyme inhibitors than patients age groups of outpatients with stable CAD. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Proinsulin is stable at room temperature for 24 hours in EDTA: A clinical laboratory analysis (adAPT 3.

Directory of Open Access Journals (Sweden)

Jane Davidson

Full Text Available Reference laboratories advise immediate separation and freezing of samples for the assay of proinsulin, which limit its practicability for smaller centres. Following the demonstration that insulin and C-peptide are stable in EDTA at room temperature for at least 24hours, we undertook simple stability studies to establish whether the same might apply to proinsulin.Venous blood samples were drawn from six adult women, some fasting, some not, aliquoted and assayed immediately and after storage at either 4°C or ambient temperature for periods from 2h to 24h.There was no significant variation or difference with storage time or storage condition in either individual or group analysis.Proinsulin appears to be stable at room temperature in EDTA for at least 24h. Immediate separation and storage on ice of samples for proinsulin assay is not necessary, which will simplify sample transport, particularly for multicentre trials.

A new condition for assessing the clinical efficiency of a diagnostic test.

Science.gov (United States)

Bokhari, Ehsan; Hubert, Lawrence

2015-09-01

When prediction using a diagnostic test outperforms simple prediction using base rates, the test is said to be "clinically efficient," a term first introduced into the literature by Meehl and Rosen (1955) in Psychological Bulletin. This article provides three equivalent conditions for determining the clinical efficiency of a diagnostic test: (a) Meehl-Rosen (Meehl & Rosen, 1955); (b) Dawes (Dawes, 1962); and (c) the Bokhari-Hubert condition, introduced here for the first time. Clinical efficiency is then generalized to situations where misclassification costs are considered unequal (for example, false negatives are more costly than false positives). As an illustration, the clinical efficiency of an actuarial device for predicting violent and dangerous behavior is examined that was developed as part of the MacArthur Violence Risk Assessment Study. (c) 2015 APA, all rights reserved.

On the Restriction of the Location of Stable Points for Generalized Lotka-Volterra

OpenAIRE

Livesay, Michael Richard

2017-01-01

We develop tools to determine which fixed points in a generalized Lotka-Volterra system are stable, under certain non-degeneracy conditions. We characterize which faces of the boundary of the domain of the Lotka-Volterra system could contain a stable fixed point. Under various relaxed conditions, we show that whenever a face of the boundary contains a stable point there are no other stable points in any strictly larger face of the boundary.

Perfusion index variations in clinically and hemodynamically stable preterm newborns in the first week of life

Directory of Open Access Journals (Sweden)

Farinasso Daniela

2010-01-01

Full Text Available Abstract Background The perfusion index, derived from the pulse oximeter signal, seems to be an accurate predictor for high illness severity in newborns. The aim of this study was to determine the perfusion index values of clinically and hemodynamically stable preterm newborns in the first week of life. Methods Perfusion index recordings were performed on the first, third and seventh day of life on 30 preterm newborns. Their state of health was assessed according to clinical and behaviour evaluation and to the Score for Neonatal Acute Physiology. Results The median(interquartile range perfusion index values were 0.9(0.6 on the first, 1.2(1.0 on the third, and 1.3(0.9 on the seventh day, with a significant increase between the first and the third day. Conclusions Perfusion index proved to be an easily applicable, non-invasive method for monitoring early postnatal changes in peripheral perfusion. Its trend during the first week of life suggests that its clinical application should take age into account. Further studies are needed to obtain reference perfusion index values from a larger sample of preterm newborns, to identify specific gestational age-related cut-off values for illness and to test the role of perfusion index in monitoring critically ill neonates.

Periodontal conditions in vegetarians: a clinical study.

Science.gov (United States)

Staufenbiel, I; Weinspach, K; Förster, G; Geurtsen, W; Günay, H

2013-08-01

Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size. A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients' oral hygiene habits and level of education. For statistical analysis the Mann-Whitney Test (χ(2) for analysis of the questionnaire) was applied (level of significance: Pvegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (Pvegetarians. Furthermore, vegetarians had a higher level of education (PVegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.

Ivabradine in combination with beta-blocker therapy for the treatment of stable angina pectoris in every day clinical practice.

Science.gov (United States)

Koester, Ralf; Kaehler, Jan; Ebelt, Henning; Soeffker, Gerold; Werdan, Karl; Meinertz, Thomas

2010-10-01

The anti-anginal efficacy of the selective I(f) inhibitor ivabradine has been demonstrated in controlled clinical trials. However, there is limited information about the safety and efficacy of a combined treatment of ivabradine with beta-blockers, particularly outside of clinical trials in every day practice. This analysis from the REDUCTION study evaluated the safety and efficacy of a combined therapy of beta-blockers and ivabradine in every day practice. In this multi-center study 4,954 patients with stable angina pectoris were treated with ivabradine in every day routine practice and underwent a clinical follow-up for 4 months. 344 of these patients received a co-medication with beta-blockers. Heart rate (HR), angina pectoris episodes, nitrate consumption, overall efficacy and tolerance were analyzed. After 4 months of treatment with ivabradine HR was reduced by 12.4 ± 11.6 bpm from 84.3 ± 14.6 to 72.0 ± 9.9 bpm, p every day practice.

Magnitude of reactive thrombocytosis and associated clinical conditions in dogs.

Science.gov (United States)

Athanasiou, Labrini V; Polizopoulou, Zoe S; Papavasileiou, Eleftheria G; Mpairamoglou, Efstathios L; Kantere, Maria C; Rousou, Xanthi A

2017-09-09

Previous studies on the underlying causes of thrombocytosis have raised scientific interest in its clinical relevance in dogs. The purpose of this study was: (1) to explore the clinical conditions associated with thrombocytosis; (2) to compare platelet counts among these conditions; and (3) to identify possible interactions with other haematological variables and associated conditions. Medical records of 195 dogs with thrombocytosis (platelet count >500×10 3 /μL) were reviewed for signalment, complete blood count results and definitive diagnosis. The prevalence of thrombocytosis was 6.02%. All cases included had reactive thrombocytosis, with non-neoplastic, non-inflammatory underlying conditions in 48.2%, inflammatory processes in 34.4% and neoplastic processes in 17.4%. Haemoglobin and white blood cell counts were negatively and positively associated with platelet count, respectively. This study revealed that mean platelet count in dogs with neoplasia and a packed cell volume of 35% or below was significantly higher than that for dogs with other disease categories. Therefore, for dogs with marked thrombocytosis and anaemia, it is recommended that neoplasia should be included in the list of differential diagnoses. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Smoking, season, and detection of chlamydia pneumoniae DNA in clinically stable COPD patients

Directory of Open Access Journals (Sweden)

Goldsmith Charles H

2002-07-01

Full Text Available Abstract Background The prevalence and role of Chlamydia pneumoniae in chronic obstructive pulmonary disease (COPD remain unclear. Methods Peripheral blood mononuclear cells were obtained from 100 outpatients with smoking-related, clinically stable COPD, and induced sputum was obtained in 62 patients. Results Patients had mean age (standard deviation of 65.8 (10.7 years, mean forced expiratory volume in one second of 1.34 (0.61 L, and 61 (61.0% were male. C. pneumoniae nucleic acids were detected by nested polymerase chain reaction in 27 (27.0%. Current smoking (odds ratio {OR} = 2.6, 95% confidence interval {CI}: 1.1, 6.6, P = 0.04, season (November to April (OR = 3.6, 95% CI: 1.4, 9.2, P = 0.007, and chronic sputum production (OR = 6.4, 95% CI: 1.8, 23.2, P = 0.005 were associated with detection of C. pneumoniae DNA. Conclusions Prospective studies are needed to examine the role of C. pneumoniae nucleic acid detection in COPD disease symptoms and progression.

Subsurface Conditions Controlling Uranium Incorporation in Iron Oxides: A Redox Stable Sink

International Nuclear Information System (INIS)

Fendorf, Scott

2016-01-01

Toxic metals and radionuclides throughout the U.S. Department of Energy Complex pose a serious threat to ecosystems and to human health. Of particular concern is the redox-sensitive radionuclide uranium, which is classified as a priority pollutant in soils and groundwaters at most DOE sites owing to its large inventory, its health risks, and its mobility with respect to primary waste sources. The goal of this research was to contribute to the long-term mission of the Subsurface Biogeochemistry Program by determining reactions of uranium with iron (hydr)oxides that lead to long-term stabilization of this pervasive contaminant. The research objectives of this project were thus to (1) identify the (bio)geochemical conditions, including those of the solid-phase, promoting uranium incorporation in Fe (hydr)oxides, (2) determine the magnitude of uranium incorporation under a variety of relevant subsurface conditions in order to quantify the importance of this pathway when in competition with reduction or adsorption; (3) identify the mechanism(s) of U(VI/V) incorporation in Fe (hydr)oxides; and (4) determine the stability of these phases under different biogeochemical (inclusive of redox) conditions. Our research demonstrates that redox transformations are capable of achieving U incorporation into goethite at ambient temperatures, and that this transformation occurs within days at U and Fe(II) concentrations that are common in subsurface geochemical environments with natural ferrihydrites - inclusive of those with natural impurities. Increasing Fe(II) or U concentration, or initial pH, made U(VI) reduction to U(IV) a more competitive sequestration pathway in this system, presumably by increasing the relative rate of U reduction. Uranium concentrations commonly found in contaminated subsurface environments are often on the order of 1-10 μM, and groundwater Fe(II) concentrations can reach exceed 1 mM in reduced zones of the subsurface. The redox-driven U(V) incorporation

Subsurface Conditions Controlling Uranium Incorporation in Iron Oxides: A Redox Stable Sink

Energy Technology Data Exchange (ETDEWEB)

Fendorf, Scott [Stanford Univ., CA (United States)

2016-04-05

Toxic metals and radionuclides throughout the U.S. Department of Energy Complex pose a serious threat to ecosystems and to human health. Of particular concern is the redox-sensitive radionuclide uranium, which is classified as a priority pollutant in soils and groundwaters at most DOE sites owing to its large inventory, its health risks, and its mobility with respect to primary waste sources. The goal of this research was to contribute to the long-term mission of the Subsurface Biogeochemistry Program by determining reactions of uranium with iron (hydr)oxides that lead to long-term stabilization of this pervasive contaminant. The research objectives of this project were thus to (1) identify the (bio)geochemical conditions, including those of the solid-phase, promoting uranium incorporation in Fe (hydr)oxides, (2) determine the magnitude of uranium incorporation under a variety of relevant subsurface conditions in order to quantify the importance of this pathway when in competition with reduction or adsorption; (3) identify the mechanism(s) of U(VI/V) incorporation in Fe (hydr)oxides; and (4) determine the stability of these phases under different biogeochemical (inclusive of redox) conditions. Our research demonstrates that redox transformations are capable of achieving U incorporation into goethite at ambient temperatures, and that this transformation occurs within days at U and Fe(II) concentrations that are common in subsurface geochemical environments with natural ferrihydrites—inclusive of those with natural impurities. Increasing Fe(II) or U concentration, or initial pH, made U(VI) reduction to U(IV) a more competitive sequestration pathway in this system, presumably by increasing the relative rate of U reduction. Uranium concentrations commonly found in contaminated subsurface environments are often on the order of 1-10 μM, and groundwater Fe(II) concentrations can reach exceed 1 mM in reduced zones of the subsurface. The redox-driven U(V) incorporation

Development of a setup to enable stable and accurate flow conditions for membrane biofouling studies

KAUST Repository

Bucs, Szilard

2015-07-10

Systematic laboratory studies on membrane biofouling require experimental conditions that are well defined and representative for practice. Hydrodynamics and flow rate variations affect biofilm formation, morphology, and detachment and impacts on membrane performance parameters such as feed channel pressure drop. There is a suite of available monitors to study biofouling, but systems to operate monitors have not been well designed to achieve an accurate, constant water flow required for a reliable determination of biomass accumulation and feed channel pressure drop increase. Studies were done with membrane fouling simulators operated in parallel with manual and automated flow control, with and without dosage of a biodegradable substrate to the feedwater to enhance biofouling rate. High flow rate variations were observed for the manual water flow system (up to ≈9%) compared to the automatic flow control system (<1%). The flow rate variation in the manual system was strongly increased by biofilm accumulation, while the automatic system maintained an accurate and constant water flow in the monitor. The flow rate influences the biofilm accumulation and the impact of accumulated biofilm on membrane performance. The effect of the same amount of accumulated biomass on the pressure drop increase was related to the linear flow velocity. Stable and accurate feedwater flow rates are essential for biofouling studies in well-defined conditions in membrane systems. © 2015 Balaban Desalination Publications. All rights reserved.

Vitamin K: dietary intake and requirements in different clinical conditions

Science.gov (United States)

Purpose of review: Vitamin K is an enzyme cofactor for the carboxylation of vitamin K dependent proteins (VKDP). Functions include coagulation and regulation of calcification. Different clinical conditions may alter vitamin K requirements by affecting vitamin K status and VKDP carboxylation, which a...

MR imaging of stable posttraumatic spinal cord injury

International Nuclear Information System (INIS)

Braun, I.F.; Hoffman, J.C. Jr.; Murphy, C.; Davis, P.C.

1986-01-01

Posttraumatic spinal cord cysts have been thought to be infrequent sequelae of spinal trauma. To evaluate the incidence of spinal cord abnormalities in patients who have previously sustained cord trauma, the authors studied the incidence of these changes in clinically stable patients following injury. Twenty-five patients with a history of previous cord injury and stable neurologic status volunteered for MR imaging studies. Studies performed using a 0.5-T and 1.5-T unit revealed focal kinking of the cord at the trauma site as well as intramedullary hypointense areas on T1-weighted images in most volunteers. There was close clinical correlation between MR imaging findings and experimental pathologic data, which suggests that these lesions are much more prevalent than once thought

Stable convergence and stable limit theorems

CERN Document Server

Häusler, Erich

2015-01-01

The authors present a concise but complete exposition of the mathematical theory of stable convergence and give various applications in different areas of probability theory and mathematical statistics to illustrate the usefulness of this concept. Stable convergence holds in many limit theorems of probability theory and statistics – such as the classical central limit theorem – which are usually formulated in terms of convergence in distribution. Originated by Alfred Rényi, the notion of stable convergence is stronger than the classical weak convergence of probability measures. A variety of methods is described which can be used to establish this stronger stable convergence in many limit theorems which were originally formulated only in terms of weak convergence. Naturally, these stronger limit theorems have new and stronger consequences which should not be missed by neglecting the notion of stable convergence. The presentation will be accessible to researchers and advanced students at the master's level...

Near-field krypton-85 measurements in stable meteorological conditions around the AREVA NC La Hague reprocessing plant: estimation of atmospheric transfer coefficients.

Science.gov (United States)

Connan, O; Solier, L; Hébert, D; Maro, D; Lamotte, M; Voiseux, C; Laguionie, P; Cazimajou, O; Le Cavelier, S; Godinot, C; Morillon, M; Thomas, L; Percot, S

2014-11-01

The aim of this work was to study the near-field dispersion of (85)Kr around the nuclear fuel reprocessing plant at La Hague (AREVA NC La Hague - France) under stable meteorological conditions. Twenty-two (85)Kr night-time experimental campaigns were carried out at distances of up to 4 km from the release source. Although the operational Gaussian models predict for these meteorological conditions a distance to plume touchdown of several kilometers, we almost systematically observed a marked ground signal at distances of 0.5-4 km. The calculated atmospheric transfer coefficients (ATC) show values (1) higher than those observed under neutral conditions, (2) much higher than those proposed by the operational models, and (3) higher than those used in the impact assessments. Copyright © 2014 Elsevier Ltd. All rights reserved.

Clinical characteristics and usage of statins in patients with stable ischemic heart disease referred for angiography or coronary artery bypass grafting

Directory of Open Access Journals (Sweden)

I.V. Shklianka

2017-12-01

Full Text Available The aim – to compare the clinical characteristics and frequency of statins usage in real clinical practice in patients referred to a specialized clinic for angiography or coronary artery bypass grafting. Materials and methods. In a retrospective slice single-center study data from a primary examination of 155 patients with stable ischemic heart disease, consecutively selected for coronary artery bypass grafting surgery, were analyzed. Depending on the inclusion of statins in the list of medicinal prescriptions, patients were retrospectively divided into two groups: those who had been prescribed statins while they were initially referred to a specialized cardiac surgery center for angiography or revascularization (n = 84 and those who were not prescribed statins (n ​​= 71. Results. The studied patients’ cohort was characterized by earlier coronary events, signs of the peripheral artery atherosclerosis and other absolute indications for treatment with statins in vast majority of cases. At the same time, groups of patients who had been and had not been prescribed statins, did not differ by vast majority of demographic, clinical and instrumental characteristics, concomitant diseases and risk factors. No statin therapy was associated with higher levels of total cholesterol and interleukin-6 compared with the group of patients taking statins (total cholesterol, respectively, 4.8 versus 4.2 mmol/l (p = 0.016 and interleukin-6, respectively, 4.4 versus. 3.1 p/ml (p = 0.022. In general, statins were prescribed in 54,2 % of patients, among them high doses – in 17 patients (20.2 %, moderate – 46 patients (54.8 %, low – 21 patients (25 %. Conclusions. The obtained data show the insufficient level of ambulatory statins usage in patients with ischemic heart disease referred for myocardial revascularization and significant discrepancy between clinical characteristics and real statins usage. Therefore, there is a great need to determine the

Starting the universe: Stable violation of the null energy condition and non-standard cosmologies

International Nuclear Information System (INIS)

Creminelli, P.; Luty, M.A.; Nicolis, A.; Senatore, L.

2006-06-01

We present a consistent effective theory that violates the null energy condition (NEC) without developing any instabilities or other pathological features. The model is the ghost condensate with the global shift symmetry softly broken by a potential. We show that this system can drive a cosmological expansion with H-dot > 0. Demanding the absence of instabilities in this model requires H-dot or approx. H 2 . We then construct a general low-energy effective theory that describes scalar fluctuations about an arbitrary FRW background, and argue that the qualitative features found in our model are very general for stable systems that violate the NEC. Violating the NEC allows dramatically non- standard cosmological histories. To illustrate this, we construct an explicit model in which the expansion of our universe originates from an asymptotically flat state in the past, smoothing out the big-bang singularity within control of a low- energy effective theory. This gives an interesting alternative to standard inflation for solving the horizon problem. We also construct models in which the present acceleration has w < -1; a periodic ever-expanding universe; and a model with a smooth 'bounce' connecting a contracting and expanding phase. (author)

Gravity Waves and Wind-Farm Efficiency in Neutral and Stable Conditions

Science.gov (United States)

Allaerts, Dries; Meyers, Johan

2018-02-01

We use large-eddy simulations (LES) to investigate the impact of stable stratification on gravity-wave excitation and energy extraction in a large wind farm. To this end, the development of an equilibrium conventionally neutral boundary layer into a stable boundary layer over a period of 8 h is considered, using two different cooling rates. We find that turbulence decay has considerable influence on the energy extraction at the beginning of the boundary-layer transition, but afterwards, energy extraction is dominated by geometrical and jet effects induced by an inertial oscillation. It is further shown that the inertial oscillation enhances gravity-wave excitation. By comparing LES results with a simple one-dimensional model, we show that this is related to an interplay between wind-farm drag, variations in the Froude number and the dispersive effects of vertically-propagating gravity waves. We further find that the pressure gradients induced by gravity waves lead to significant upstream flow deceleration, reducing the average turbine output compared to a turbine in isolated operation. This leads us to the definition of a non-local wind-farm efficiency, next to a more standard wind-farm wake efficiency, and we show that both can be of the same order of magnitude. Finally, an energy flux analysis is performed to further elucidate the effect of gravity waves on the flow in the wind farm.

Generation of clinical-grade human induced pluripotent stem cells in Xeno-free conditions.

Science.gov (United States)

Wang, Juan; Hao, Jie; Bai, Donghui; Gu, Qi; Han, Weifang; Wang, Lei; Tan, Yuanqing; Li, Xia; Xue, Ke; Han, Pencheng; Liu, Zhengxin; Jia, Yundan; Wu, Jun; Liu, Lei; Wang, Liu; Li, Wei; Liu, Zhonghua; Zhou, Qi

2015-11-12

Human induced pluripotent stem cells (hiPSCs) are considered as one of the most promising seed cell sources in regenerative medicine. Now hiPSC-based clinical trials are underway. To ensure clinical safety, cells used in clinical trials or therapies should be generated under GMP conditions, and with Xeno-free culture media to avoid possible side effects like immune rejection that induced by the Xeno reagents. However, up to now there are no reports for hiPSC lines developed completely under GMP conditions using Xeno-free reagents. Clinical-grade human foreskin fibroblast (HFF) cells used as feeder cells and parental cells of the clinical-grade hiPSCs were isolated from human foreskin tissues and cultured in Xeno-free media. Clinical-grade hiPSCs were derived by integration-free Sendai virus-based reprogramming kit in Xeno-free pluriton™ reprogramming medium or X medium. Neural cells and cardiomyocytes differentiation were conducted following a series of spatial and temporal specific signals induction according to the corresponding lineage development signals. Biological safety evaluation of the clinical-grade HFF cells and hiPSCs were conducted following the guidance of the "Pharmacopoeia of the People's Republic of China, Edition 2010, Volume III". We have successfully derived several integration-free clinical-grade hiPSC lines under GMP-controlled conditions and with Xeno-free reagents culture media in line with the current guidance of international and national evaluation criteria. As for the source of hiPSCs and feeder cells, biological safety evaluation of the HFF cells have been strictly reviewed by the National Institutes for Food and Drug Control (NIFDC). The hiPSC lines are pluripotent and have passed the safety evaluation. Moreover, one of the randomly selected hiPSC lines was capable of differentiating into functional neural cells and cardiomyocytes in Xeno-free culture media. The clinical-grade hiPSC lines therefore could be valuable sources for

Exhaled nitric oxide in stable chronic obstructive pulmonary disease

International Nuclear Information System (INIS)

Beg Mohammed F S; Alzoghaibi, Mohammad A; Habib, Syed S; Abba, Abdullah A

2009-01-01

The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide (FENO) is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease (COPD) and compare it with the results in patients with asthma and a control population. Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naive asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls (56.54+ - 28.01 vs 22.00 + -6.69; P =0.0001) but lower than the subjects with asthma (56.54+ - 28.01 vs 84.78+ - 39.32 P 0.0285). The FENO values in COPD subjects were inversely related to the FEV 1 /FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects. (author)

Utilization of stable isotopes in medicine

International Nuclear Information System (INIS)

1980-11-01

The ten lectures given at this round table are presented together with a discussion. Five lectures, relating to studies in which deuterium oxide was employed as a tracer of body water, dealt with pulmonary water measurements in man and animals, the total water pool in adipose subjects, and liquid compartments in children undergoing hemodyalisis. The heavy water is analysed by infrared spectrometry and a new double spectrodoser is described. Two studies using 13 C as tracer, described the diagnosis of liver troubles and diabetes respectively. A general review of the perspectives of the application of stable isotopes in clinical medicine is followed by a comparison of the use of stable and radioactive isotopes in France [fr

Hemodynamics in the Sturge-Weber syndrome utilizing stable Xe-CT

International Nuclear Information System (INIS)

Okudaira, Yojiro; Bandoh, Kuniaki; Ito, Masanori; Sato, Kiyoshi; Tsuji, Masahiro

1993-01-01

In 4 Sturge-Weber-syndrome child patients with calcified lesions mainly in the occipital lobe, regional cerebral blood flow (rCBF) was determined with stable Xe-CT in the resting state and after iv injection of acetazolamide (AA) and megimide (M), with the purpose of examining factors affecting deterioration of neurologic manifestations and the influence of lobectomy. In the resting state, rCBF of the temporal and occipital areas was significantly lower on the affected than unaffected sides. The side-to-side asymmetry of rCBF in the affected and unaffected sides decreased from the frontal to temporal and occipital areas. It was indistinct after AA injection because cerebral vasoreactivity became higher on the affected side. A low rCBF in association with a high cerebral vasoreactivity on the lesion side suggested that the low rCBF matched the low cerebral metabolism of the brain area affected by leptomeningeal angiomatosis. However, cerebral vasoreactivity to AA depended on clinical presentations. Two patients presented with progressive mental retardation. The other two patients were in clinically stable condition. Cerebral vasoreactivity to AA in the former two cases was poorer on both the affected and unaffected sides than that in the latter two cases. M administration was associated with a significantly decreased rCBF in the area of leptomeningeal angiomatosis and cerebral calcification and with a significantly increased rCBF of the 'pericalcified' area. In one patient undergoing extended occipital lobectomy on the affected side, no decrease in rCBF was noted in the resting state in either affected or unaffected side, and cerebral vasoreactivity to AM on the unaffected side was apparently increased. Both circulatory disturbance and seizure appear to play a role in clinical presentations, as well as their deterioration in Sturge-Weber-Syndrome patients. (N.K.)

Logic Learning Machine creates explicit and stable rules stratifying neuroblastoma patients.

Science.gov (United States)

Cangelosi, Davide; Blengio, Fabiola; Versteeg, Rogier; Eggert, Angelika; Garaventa, Alberto; Gambini, Claudio; Conte, Massimo; Eva, Alessandra; Muselli, Marco; Varesio, Luigi

2013-01-01

Neuroblastoma is the most common pediatric solid tumor. About fifty percent of high risk patients die despite treatment making the exploration of new and more effective strategies for improving stratification mandatory. Hypoxia is a condition of low oxygen tension occurring in poorly vascularized areas of the tumor associated with poor prognosis. We had previously defined a robust gene expression signature measuring the hypoxic component of neuroblastoma tumors (NB-hypo) which is a molecular risk factor. We wanted to develop a prognostic classifier of neuroblastoma patients' outcome blending existing knowledge on clinical and molecular risk factors with the prognostic NB-hypo signature. Furthermore, we were interested in classifiers outputting explicit rules that could be easily translated into the clinical setting. Shadow Clustering (SC) technique, which leads to final models called Logic Learning Machine (LLM), exhibits a good accuracy and promises to fulfill the aims of the work. We utilized this algorithm to classify NB-patients on the bases of the following risk factors: Age at diagnosis, INSS stage, MYCN amplification and NB-hypo. The algorithm generated explicit classification rules in good agreement with existing clinical knowledge. Through an iterative procedure we identified and removed from the dataset those examples which caused instability in the rules. This workflow generated a stable classifier very accurate in predicting good and poor outcome patients. The good performance of the classifier was validated in an independent dataset. NB-hypo was an important component of the rules with a strength similar to that of tumor staging. The novelty of our work is to identify stability, explicit rules and blending of molecular and clinical risk factors as the key features to generate classification rules for NB patients to be conveyed to the clinic and to be used to design new therapies. We derived, through LLM, a set of four stable rules identifying a new

Logic Learning Machine creates explicit and stable rules stratifying neuroblastoma patients

Science.gov (United States)

2013-01-01

Background Neuroblastoma is the most common pediatric solid tumor. About fifty percent of high risk patients die despite treatment making the exploration of new and more effective strategies for improving stratification mandatory. Hypoxia is a condition of low oxygen tension occurring in poorly vascularized areas of the tumor associated with poor prognosis. We had previously defined a robust gene expression signature measuring the hypoxic component of neuroblastoma tumors (NB-hypo) which is a molecular risk factor. We wanted to develop a prognostic classifier of neuroblastoma patients' outcome blending existing knowledge on clinical and molecular risk factors with the prognostic NB-hypo signature. Furthermore, we were interested in classifiers outputting explicit rules that could be easily translated into the clinical setting. Results Shadow Clustering (SC) technique, which leads to final models called Logic Learning Machine (LLM), exhibits a good accuracy and promises to fulfill the aims of the work. We utilized this algorithm to classify NB-patients on the bases of the following risk factors: Age at diagnosis, INSS stage, MYCN amplification and NB-hypo. The algorithm generated explicit classification rules in good agreement with existing clinical knowledge. Through an iterative procedure we identified and removed from the dataset those examples which caused instability in the rules. This workflow generated a stable classifier very accurate in predicting good and poor outcome patients. The good performance of the classifier was validated in an independent dataset. NB-hypo was an important component of the rules with a strength similar to that of tumor staging. Conclusions The novelty of our work is to identify stability, explicit rules and blending of molecular and clinical risk factors as the key features to generate classification rules for NB patients to be conveyed to the clinic and to be used to design new therapies. We derived, through LLM, a set of four

Role of ivabradine in management of stable angina in patients with different clinical profiles

Science.gov (United States)

Kaski, Juan Carlos; Gloekler, Steffen; Ferrari, Roberto; Fox, Kim; Lévy, Bernard I; Komajda, Michel; Vardas, Panos; Camici, Paolo G

2018-01-01

In chronic stable angina, elevated heart rate contributes to the development of symptoms and signs of myocardial ischaemia by increasing myocardial oxygen demand and reducing diastolic perfusion time. Accordingly, heart rate reduction is a well-known strategy for improving both symptoms of myocardial ischaemia and quality of life (QOL). The heart rate-reducing agent ivabradine, a direct and selective inhibitor of the I f current, decreases myocardial oxygen consumption while increasing diastolic time, without affecting myocardial contractility or coronary vasomotor tone. Ivabradine is indicated for treatment of stable angina and chronic heart failure (HF). This review examines available evidence regarding the efficacy and safety of ivabradine in stable angina, when used as monotherapy or in combination with beta-blockers, in particular angina subgroups and in patients with stable angina with left ventricular systolic dysfunction (LVSD) or HF. Trials involving more than 45 000 patients receiving treatment with ivabradine have shown that this agent has antianginal and anti-ischaemic effects, regardless of age, sex, severity of angina, revascularisation status or comorbidities. This heart rate-lowering agent might also improve prognosis, reduce hospitalisation rates and improve QOL in angina patients with chronic HF and LVSD. PMID:29632676

Rationale, design, and baseline characteristics of the CLARIFY registry of outpatients with stable coronary artery disease.

Science.gov (United States)

Sorbets, Emmanuel; Greenlaw, Nicola; Ferrari, Roberto; Ford, Ian; Fox, Kim M; Tardif, Jean-Claude; Tendera, Michal; Steg, Philippe Gabriel

2017-10-01

Despite major advances in prevention and treatment, coronary artery disease (CAD) remains the leading cause of death worldwide. Whereas many sources of data are available on the epidemiology of acute coronary syndromes, fewer datasets reflect the contemporary management and outcomes of stable CAD patients. A worldwide contemporary registry would improve our knowledge about stable CAD. The main objectives are to describe the demographics, clinical profile, contemporary management and outcomes of outpatients with stable CAD; to identify gaps between evidence and treatment; and to investigate long-term prognostic determinants. CLARIFY (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an ongoing international observational longitudinal registry. Stable CAD patients from 45 countries in Europe, Asia, America, Middle East, Australia and Africa were enrolled between November 2009 and June 2010. The inclusion criteria were previous myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischemia or prior revascularization procedure. The main exclusion criteria were serious non-cardiovascular disease, conditions interfering with life expectancy or severe other cardiovascular disease (including advanced heart failure). Follow-up visits were planned annually for up to 5 years, interspersed with 6-month telephone calls. Of the 32,703 patients enrolled, most (77.6%) were male, age (mean ± SD) was 64.2 ± 10.5 years, and 71.0% were receiving treatment for hypertension; mean ± SD resting heart rate was 68.2 ± 10.6 bpm. Patients were enrolled based on a history of myocardial infarction >3 months earlier (57.7%), having at least one stenosis >50% on coronary angiography (61.1%), proven symptomatic myocardial ischemia on non-invasive testing (23.1%), or history of percutaneous coronary intervention or coronary artery bypass graft (69.8%). Baseline characteristics were similar across the four

Comparing the use of SNOMED CT and ICD10 for coding clinical conditions to implement laboratory guidelines.

Science.gov (United States)

Yasini, Mobin; Ebrahiminia, Vahid; Duclos, Catherine; Venot, Alain; Lamy, Jean-Baptiste

2013-01-01

Laboratory medicine is responsible for an important part of hospital expenditure. Providing appropriate decision support to laboratory test requesters at the point of care is one of the main incentives for implementing laboratory guidelines, which can improve medical care. Laboratory guidelines developed by local experts in the Parisian region and two national guidelines for dyslipidemia were analyzed to extract test ordering recommendations. Clinical conditions which can be a trigger to order or not to order laboratory tests were extracted and mapped with ICD10 and SNOMED CT: 43.1% of clinical conditions were matched by ICD10 whereas SNOMED CT covered 80.1% of these conditions. For the non-mapped conditions, the main problem was found to be the ambiguity of the terms used in the guidelines. Ordinal characteristics of some clinical conditions and using terms more specific than SNOMED CT were other causes of mapping failure. Applying consistent and explicit concepts in the development of guidelines would lead to better implementation. By resolving the guideline ambiguity, SNOMED CT is a good choice and covers almost all of the clinical conditions in laboratory guidelines which are needed to implement in a Clinical Decision Support System.

On Nash-Equilibria of Approximation-Stable Games

Science.gov (United States)

Awasthi, Pranjal; Balcan, Maria-Florina; Blum, Avrim; Sheffet, Or; Vempala, Santosh

One reason for wanting to compute an (approximate) Nash equilibrium of a game is to predict how players will play. However, if the game has multiple equilibria that are far apart, or ɛ-equilibria that are far in variation distance from the true Nash equilibrium strategies, then this prediction may not be possible even in principle. Motivated by this consideration, in this paper we define the notion of games that are approximation stable, meaning that all ɛ-approximate equilibria are contained inside a small ball of radius Δ around a true equilibrium, and investigate a number of their properties. Many natural small games such as matching pennies and rock-paper-scissors are indeed approximation stable. We show furthermore there exist 2-player n-by-n approximation-stable games in which the Nash equilibrium and all approximate equilibria have support Ω(log n). On the other hand, we show all (ɛ,Δ) approximation-stable games must have an ɛ-equilibrium of support O(Δ^{2-o(1)}/ɛ2{log n}), yielding an immediate n^{O(Δ^{2-o(1)}/ɛ^2log n)}-time algorithm, improving over the bound of [11] for games satisfying this condition. We in addition give a polynomial-time algorithm for the case that Δ and ɛ are sufficiently close together. We also consider an inverse property, namely that all non-approximate equilibria are far from some true equilibrium, and give an efficient algorithm for games satisfying that condition.

Magnetic resonance imaging of the liver in postpartum stable women with HELLP syndrome

International Nuclear Information System (INIS)

Carvalho, Ana Rita Marinho Ribeiro; Amorim, Melania Maria Ramos de; Katz, Leila; Souza, Alex Sandro Rolland de; Santos, Aleksana Regina Viana Dutra; Lima, Ana Luiza Medeiros Vasconcelos de

2008-01-01

Objectives: To describe magnetic resonance (MR) findings in the liver of stable patients with HELLP syndrome in the puerperium. Methods: A descriptive study was carried out from August 2005 to July 2006, involving a series of 40 postpartum patients admitted to an obstetric intensive therapy unit in IMIP (Instituto Materno Infantil Prof. Fernando Figueira) with diagnosis of HELLP syndrome (complete and partial). Complete HELLP syndrome was defined when all laboratory parameters were present and incomplete when one or more but not all laboratory findings were present. All patients had stable clinical conditions and were evaluated with magnetic resonance of the liver and the main findings were recorded. Results. Average maternal age was 26.8 ± 6.4 years and gestational age at delivery was 34 ± 26.8 weeks. The MR imaging was performed between eight and 96 hours after diagnosis of HELLP syndrome (56 ± 31h). The most frequent findings were ascitis in 20% (n = 8), pleural effusion in 17.5% and hepatic steatosis in 7.5%. The periportal intensity signal was normal in all cases. Cases of liver infarction and sub-capsular or parenchymatous hematoma were not observed. Conclusion: Findings of magnetic resonance imaging of the liver in stable HELLP syndrome postpartum patients were few and unspecific. Severe liver injuries such as parenchymatous or sub-capsular hematoma, entailing life risk were not found. Results do not corroborate the use of magnetic resonance as routine examination for stable patients with HELLP syndrome. (author)

42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

Science.gov (United States)

2010-10-01

..., clinical experience, and outcome requirements for initial approval of transplant centers. 482.80 Section... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements § 482.80 Condition of participation: Data submission, clinical experience, and outcome requirements for initial...

[Geographical differences in clinical characteristics and management of stable outpatients with coronary artery disease: comparison between the Italian and international population included in the Worldwide CLARIFY registry].

Science.gov (United States)

Pozzoli, Massimo; Tavazzi, Luigi

2014-04-01

Limited data are available regarding specific differences among countries in demographic and clinical characteristics and treatment of patients with stable coronary artery disease. CLARIFY is an international, prospective and longitudinal registry including more than 33 000 patients with stable coronary artery disease enrolled in 45 countries worldwide. Data were used to compare the characteristics of patients enrolled in Italy with those enrolled in Europe and in the rest of the world. Baseline data were available for 33 283 patients, 2112 of whom from Italy and 12 614 from the remaining western European countries. Italian patients were found to be older, more frequently smoker, hypertensive and with sedentary habits. In addition, they presented more frequently a history of myocardial infarction, carotid arterial disease and chronic obstructive pulmonary disease. In addition, when compared with patients of both European and international cohorts, more Italian patients had undergone coronary angiography and angioplasty. As far as treatment was concerned, a greater number of Italian patients were taking ivabradine, angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers, nitrates, thienopyridines, while those taking beta-blockers, calcium antagonists and other antianginal medications were fewer. Among ambulatory patients with stable coronary artery disease, there are important geographic differences in terms of risk factors, clinical characteristics, surgical and pharmacological treatment.

Fractional flow reserve-guided management in stable coronary disease and acute myocardial infarction: recent developments

Science.gov (United States)

Berry, Colin; Corcoran, David; Hennigan, Barry; Watkins, Stuart; Layland, Jamie; Oldroyd, Keith G.

2015-01-01

Coronary artery disease (CAD) is a leading global cause of morbidity and mortality, and improvements in the diagnosis and treatment of CAD can reduce the health and economic burden of this condition. Fractional flow reserve (FFR) is an evidence-based diagnostic test of the physiological significance of a coronary artery stenosis. Fractional flow reserve is a pressure-derived index of the maximal achievable myocardial blood flow in the presence of an epicardial coronary stenosis as a ratio to maximum achievable flow if that artery were normal. When compared with standard angiography-guided management, FFR disclosure is impactful on the decision for revascularization and clinical outcomes. In this article, we review recent developments with FFR in patients with stable CAD and recent myocardial infarction. Specifically, we review novel developments in our understanding of CAD pathophysiology, diagnostic applications, prognostic studies, clinical trials, and clinical guidelines. PMID:26038588

Formation of stable uranium(VI) colloidal nanoparticles in conditions relevant to radioactive waste disposal.

Science.gov (United States)

Bots, Pieter; Morris, Katherine; Hibberd, Rosemary; Law, Gareth T W; Mosselmans, J Frederick W; Brown, Andy P; Doutch, James; Smith, Andrew J; Shaw, Samuel

2014-12-09

The favored pathway for disposal of higher activity radioactive wastes is via deep geological disposal. Many geological disposal facility designs include cement in their engineering design. Over the long term, interaction of groundwater with the cement and waste will form a plume of a hyperalkaline leachate (pH 10-13), and the behavior of radionuclides needs to be constrained under these extreme conditions to minimize the environmental hazard from the wastes. For uranium, a key component of many radioactive wastes, thermodynamic modeling predicts that, at high pH, U(VI) solubility will be very low (nM or lower) and controlled by equilibrium with solid phase alkali and alkaline-earth uranates. However, the formation of U(VI) colloids could potentially enhance the mobility of U(VI) under these conditions, and characterizing the potential for formation and medium-term stability of U(VI) colloids is important in underpinning our understanding of U behavior in waste disposal. Reflecting this, we applied conventional geochemical and microscopy techniques combined with synchrotron based in situ and ex situ X-ray techniques (small-angle X-ray scattering and X-ray adsorption spectroscopy (XAS)) to characterize colloidal U(VI) nanoparticles in a synthetic cement leachate (pH > 13) containing 4.2-252 μM U(VI). The results show that in cement leachates with 42 μM U(VI), colloids formed within hours and remained stable for several years. The colloids consisted of 1.5-1.8 nm nanoparticles with a proportion forming 20-60 nm aggregates. Using XAS and electron microscopy, we were able to determine that the colloidal nanoparticles had a clarkeite (sodium-uranate)-type crystallographic structure. The presented results have clear and hitherto unrecognized implications for the mobility of U(VI) in cementitious environments, in particular those associated with the geological disposal of nuclear waste.

High performance dental resin composites with hydrolytically stable monomers.

Science.gov (United States)

Wang, Xiaohong; Huyang, George; Palagummi, Sri Vikram; Liu, Xiaohui; Skrtic, Drago; Beauchamp, Carlos; Bowen, Rafael; Sun, Jirun

2018-02-01

The objectives of this project were to: 1) develop strong and durable dental resin composites by employing new monomers that are hydrolytically stable, and 2) demonstrate that resin composites based on these monomers perform superiorly to the traditional bisphenol A glycidyl dimethacrylate/triethylene glycol dimethacrylate (Bis-GMA/TEGDMA) composites under testing conditions relevant to clinical applications. New resins comprising hydrolytically stable, ether-based monomer, i.e., triethylene glycol divinylbenzyl ether (TEG-DVBE), and urethane dimethacrylate (UDMA) were produced via composition-controlled photo-polymerization. Their composites contained 67.5wt% of micro and 7.5wt% of nano-sized filler. The performances of both copolymers and composites were evaluated by a battery of clinically-relevant assessments: degree of vinyl conversion (DC: FTIR and NIR spectroscopy); refractive index (n: optical microscopy); elastic modulus (E), flexural strength (F) and fracture toughness (K IC ) (universal mechanical testing); Knoop hardness (HK; indentation); water sorption (W sp ) and solubility (W su ) (gravimetry); polymerization shrinkage (S v ; mercury dilatometry) and polymerization stress (tensometer). The experimental UDMA/TEG-DVBE composites were compared with the Bis-GMA/TEGDMA composites containing the identical filler contents, and with the commercial micro hybrid flowable composite. UDMA/TEG-DBVE composites exhibited n, E, W sp , W su and S v equivalent to the controls. They outperformed the controls with respect to F (up to 26.8% increase), K IC (up to 27.7% increase), modulus recovery upon water sorption (full recovery vs. 91.9% recovery), and stress formation (up to 52.7% reduction). In addition, new composites showed up to 27.7% increase in attainable DC compared to the traditional composites. Bis-GMA/TEGDMA controls exceeded the experimental composites with respect to only one property, the composite hardness. Significantly, up to 18.1% lower HK values in

Stable cosmology in chameleon bigravity

Science.gov (United States)

De Felice, Antonio; Mukohyama, Shinji; Oliosi, Michele; Watanabe, Yota

2018-02-01

The recently proposed chameleonic extension of bigravity theory, by including a scalar field dependence in the graviton potential, avoids several fine-tunings found to be necessary in usual massive bigravity. In particular it ensures that the Higuchi bound is satisfied at all scales, that no Vainshtein mechanism is needed to satisfy Solar System experiments, and that the strong coupling scale is always above the scale of cosmological interest all the way up to the early Universe. This paper extends the previous work by presenting a stable example of cosmology in the chameleon bigravity model. We find a set of initial conditions and parameters such that the derived stability conditions on general flat Friedmann background are satisfied at all times. The evolution goes through radiation-dominated, matter-dominated, and de Sitter eras. We argue that the parameter space allowing for such a stable evolution may be large enough to encompass an observationally viable evolution. We also argue that our model satisfies all known constraints due to gravitational wave observations so far and thus can be considered as a unique testing ground of gravitational wave phenomenologies in bimetric theories of gravity.

Localization of microfibrillar-associated protein 4 (MFAP4 in human tissues: clinical evaluation of serum MFAP4 and its association with various cardiovascular conditions.

Directory of Open Access Journals (Sweden)

Helle Wulf-Johansson

Full Text Available Microfibrillar-associated protein 4 (MFAP4 is located in the extracellular matrix (ECM. We sought to identify tissues with high levels of MFAP4 mRNA and MFAP4 protein expression. Moreover, we aimed to evaluate the significance of MFAP4 as a marker of cardiovascular disease (CVD and to correlate MFAP4 with other known ECM markers, such as fibulin-1, osteoprotegerin (OPG, and osteopontin (OPN. Quantitative real-time PCR demonstrated that MFAP4 mRNA was more highly expressed in the heart, lung, and intestine than in other elastic tissues. Immunohistochemical studies demonstrated high levels of MFAP4 protein mainly at sites rich in elastic fibers and within blood vessels in all tissues investigated. The AlphaLISA technique was used to determine serum MFAP4 levels in a clinical cohort of 172 patients consisting of 5 matched groups with varying degrees of CVD: 1: patients with ST elevation myocardial infarction (STEMI, 2: patients with non-STEMI, 3: patients destined for vascular surgery because of various atherosclerotic diseases (stable atherosclerotic disease, 4: apparently healthy individuals with documented coronary artery calcification (CAC-positive, and 5: apparently healthy individuals without signs of coronary artery calcification (CAC-negative. Serum MFAP4 levels were significantly lower in patients with stable atherosclerotic disease than CAC-negative individuals (p<0.05. Furthermore, lower serum MFAP4 levels were present in patients with stable atherosclerotic disease compared with STEMI and non-STEMI patients (p<0.05. In patients with stable atherosclerotic disease, positive correlations between MFAP4 and both fibulin-1 (ρ = 0.50; p = 0.0244 and OPG (ρ = 0.62; p = 0.0014 were found. Together, these results indicate that MFAP4 is mainly located in elastic fibers and is highly expressed in blood vessels. The present study suggests that serum MFAP4 varies in groups of patients with different cardiovascular conditions

Barriers and facilitators to reducing frequent laboratory testing for patients who are stable on warfarin: a mixed methods study of de-implementation in five anticoagulation clinics.

Science.gov (United States)

Barnes, Geoffrey D; Misirliyan, Sevan; Kaatz, Scott; Jackson, Elizabeth A; Haymart, Brian; Kline-Rogers, Eva; Kozlowski, Jay; Krol, Gregory; Froehlich, James B; Sales, Anne

2017-07-14

Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative. Using a mixed-methods approach, we conducted post-implementation semi-structured interviews with a total of eight anticoagulation nurse or pharmacist staff members at five participating clinic sites to assess barriers and facilitators to de-implementing frequent international normalized ratio (INR) laboratory testing among patients with stable warfarin control. Interview guides were based on the Tailored Implementation for Chronic Disease (TICD) framework. Informed by interview themes, a survey was developed and administered to all anticoagulation clinical staff (n = 62) about their self-reported utilization of less frequent INR testing and specific barriers to de-implementing the standard (more frequent) INR testing practice. From the interviews, four themes emerged congruent with TICD domains: (1) staff overestimating their actual use of less frequent INR testing (individual health professional factors), (2) barriers to appropriate patient engagement (incentives and resources), (3) broad support for an electronic medical record flag to identify potentially eligible patients (incentives and resources), and (4) the importance of personalized nurse/pharmacist feedback (individual health professional factors). In the survey (65% response rate), staff report offering less

Medical condition and care of undocumented migrants in ambulatory clinics in Tel Aviv, Israel: assessing unmet needs.

Science.gov (United States)

Mor, Zohar; Raveh, Yuval; Lurie, Ido; Leventhal, Alex; Gamzu, Roni; Davidovitch, Nadav; Benari, Orel; Grotto, Itamar

2017-07-14

Approximately 150,000 undocumented migrants (UM) who are medically uninsured reside in Israel, including ~50,000 originating from the horn of Africa (MHA). Free medical-care is provided by two walk-in clinics in Tel-Aviv. This study aims to compare the medical complaints of UM from different origins, define their community health needs and assess gaps between medical needs and available services. This cross-sectional study included a random sample of 610 UM aged 18-64 years, who were treated in these community clinics between 2008 and 2011. The study compared UM who had complex medical conditions which necessitated referral to more equipped medical settings with UM having mild/simple medical conditions, who were treated at the clinics. MHA were younger, unemployed and more commonly males compared with UM originating from other countries. MHA also had longer referral-delays and visited the clinics less frequently. UM with complex medical conditions were more commonly females, had chronic diseases and demonstrated longer referral-delays than those who had mild/simple medical conditions. The latter more commonly presented with complained of respiratory, muscular and skeletal discomfort. In multivariate analysis, the variables which predicted complex medical conditions included female gender, chronic illnes and self-referral to the clinics. The ambulatory clinics were capable of responding to mild/simple medical conditions. Yet, the health needs of women and migrants suffering from complex medical conditions and chronic diseases necessitated referrals to secondary/tertiary medical settings, while jeopardizing the continuity of care. The health gaps can be addressed by a more holistic social approach, which includes integration of UM in universal health insurance.

Applications of stable isotopes of /sup 2/H, /sup 13/C and /sup 15/N to clinical problems. Experience of a collaborative program at Argonne National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Klein, P D; Szczepanik, P A; Hachey, D L [Argonne National Lab., Evanston, Ill. (USA)

1974-08-01

The function of the Argonne Program is to provide synthetic, analytical instrumental capability in a core facility for the clinical investigator who needs to use /sup 2/H, /sup 13/C, or /sup 15/N labelled compounds for metabolic or clinical research on pregnant women, newborn infants, young children, or for mass screening. To carry out such application development, there were six stages which were recurrent steps in every application. Five fundamental strategies should be adopted to establish the use of stable isotopes in clinical work. The instrument required for measurements was a combined gas chromatograph-mass spectrometer, and its use was schematically illustrated. Some of the successful experiences with compounds labelled by stable isotopes, such as deuterium labelled chenodeoxycholic acid, and respective /sup 13/C and /sup 15/N-labelled glycine were described. Deutrium labelled bile acid enabled easy and safe determination of the size of the bile acid pool and the replacement rate, providing clearer diagnoses for cholestatic liver disease and gallstones. /sup 13/C and /sup 15/N labelled compounds were used in clinical studies, of children with genetic disorders of amino acid metabolism, i.e., non ketotic hyperflycinemia, B/sub 12/-responsive methyl malonic acidemia, and Lesch-Nyhan syndrome. /sup 15/N-labelled glycine was also studied in a child with Lesch-Nyhan syndrome.

Stable black phosphorus quantum dots for alkali PH sensor

Science.gov (United States)

Guo, Weilan; Song, Haizeng; Yan, Shancheng

2018-01-01

Black phosphorus, as a new two-dimensional material has been widely used in sensors, photovoltaic devices, etc. However, thin layered black phosphorus chemically degrades rapidly under ambient and aqueous conditions, which hinders the application of it in the chemical sensors. In this work, stable black phosphorus quantum dots (BPQDs) in solution are successfully synthesized by functionalization with 4-nitrobenzene-diazonium (4-NBD). The stable BPQDs are investigated by TEM, AFM, Raman, and UV-absorption. As a potential application, the stable BPQDs are used as sensors in alkali solution, which exhibit outstanding performance. Our work paves the way towards a new application with BPQDs in solution.

Stable isotope labeling strategy based on coding theory

Energy Technology Data Exchange (ETDEWEB)

Kasai, Takuma; Koshiba, Seizo; Yokoyama, Jun; Kigawa, Takanori, E-mail: kigawa@riken.jp [RIKEN Quantitative Biology Center (QBiC), Laboratory for Biomolecular Structure and Dynamics (Japan)

2015-10-15

We describe a strategy for stable isotope-aided protein nuclear magnetic resonance (NMR) analysis, called stable isotope encoding. The basic idea of this strategy is that amino-acid selective labeling can be considered as “encoding and decoding” processes, in which the information of amino acid type is encoded by the stable isotope labeling ratio of the corresponding residue and it is decoded by analyzing NMR spectra. According to the idea, the strategy can diminish the required number of labelled samples by increasing information content per sample, enabling discrimination of 19 kinds of non-proline amino acids with only three labeled samples. The idea also enables this strategy to combine with information technologies, such as error detection by check digit, to improve the robustness of analyses with low quality data. Stable isotope encoding will facilitate NMR analyses of proteins under non-ideal conditions, such as those in large complex systems, with low-solubility, and in living cells.

Stable isotope labeling strategy based on coding theory

International Nuclear Information System (INIS)

Kasai, Takuma; Koshiba, Seizo; Yokoyama, Jun; Kigawa, Takanori

2015-01-01

We describe a strategy for stable isotope-aided protein nuclear magnetic resonance (NMR) analysis, called stable isotope encoding. The basic idea of this strategy is that amino-acid selective labeling can be considered as “encoding and decoding” processes, in which the information of amino acid type is encoded by the stable isotope labeling ratio of the corresponding residue and it is decoded by analyzing NMR spectra. According to the idea, the strategy can diminish the required number of labelled samples by increasing information content per sample, enabling discrimination of 19 kinds of non-proline amino acids with only three labeled samples. The idea also enables this strategy to combine with information technologies, such as error detection by check digit, to improve the robustness of analyses with low quality data. Stable isotope encoding will facilitate NMR analyses of proteins under non-ideal conditions, such as those in large complex systems, with low-solubility, and in living cells

Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study.

Science.gov (United States)

Hessen, Erik; Eckerström, Marie; Nordlund, Arto; Selseth Almdahl, Ina; Stålhammar, Jacob; Bjerke, Maria; Eckerström, Carl; Göthlin, Mattias; Fladby, Tormod; Reinvang, Ivar; Wallin, Anders

2017-01-01

In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years. Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% ( n = 4) developed dementia. Regression analysis revealed that low levels of Aβ 42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

Directory of Open Access Journals (Sweden)

Erik Hessen

2017-02-01

Full Text Available Background/Aims: In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1 baseline cerebrospinal fluid biomarkers and (2 a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Methods: Eighty-one patients (mean age 61 years were recruited from university memory clinics and followed up for 6 years. Results: Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4 developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Conclusions: Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

Clinical and Biochemical Uses of Stable Iodine Measurements

Energy Technology Data Exchange (ETDEWEB)

Koutras, D. A. [Thyroid Section, Alexandra Hospital, Athens (Greece)

1970-07-01

Iodine and thyroid function are closely linked, since the only known role of iodine is its participation in the synthesis of thyroid hormones. Iodine metabolism may be represented as a metabolic cycle consisting of three main pools: the Plasma Inorganic Iodine (PIl) pool into which dietary iodine goes and from where it is either taken up by the thyroid or excreted by the kidneys, the intrathyroidal iodine pool, where. thyroid hormone synthesis occurs, and finally the peripheral pool of thyroid hormones, of which about 80% are deiodinated and 20% excreted with the faeces. Endemic goitre is usually due to iodine deficiency. There is no renal homeostatic mechanism to keep the PII level constant, and so adaptation to iodine deficiency occurs by increasing the thyroidal iodide clearance rate. Stable iodine measurements are necessary for a complete study of iodine metabolism. Estimates of the serum Protein-Bound Iodine (PBl) are the best index of thyroid function, estimates of the PII and of the urinary iodine are the best indices of iodine nutrition. (author)

Saccharomyces boulardii CNCM I-745 in different clinical conditions.

Science.gov (United States)

Dinleyici, Ener Cagri; Kara, Ates; Ozen, Metehan; Vandenplas, Yvan

2014-11-01

Saccharomyces boulardii is a well-known probiotic worldwide, and there are numerous studies including experimental and clinical trials in children and adults by the use of S. boulardii. The objective of the present report is to provide an update on the evidence for the efficacy of S. boulardii CNCM I-745 in different clinical conditions. Saccharomyces boulardii is one of the best-studied probiotics in acute gastroenteritis (AGE) and is shown to be safe and to reduce the duration of diarrhea and hospitalization by about 1 day. Saccharomyces boulardii is one of the recommended probiotics for AGE in children by European Society of Paediatric Infectious Diseases and European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN). Saccharomyces boulardii is also a recommended probiotic for the prevention of antibiotic-associated diarrhea (AAD), and a recent study showed promising results for the treatment of AAD in children. There is insufficient evidence to recommend the long-term use of S. boulardii in patients with irritable bowel syndrome. Although some clinical studies showed positive effects of S. boulardii on inflammation, there is no clinical evidence that S. boulardii is useful in inflammatory bowel disease. Saccharomyces boulardii could be used in patients needing Helicobacter pylori eradication because the S. boulardii improves compliance, decreases the side effects and moderately increases the eradication rate. There are new promising results (improving feeding tolerance, shorten the course of hyperbilirubinemia), but we do still not recommend the routine use of S. boulardii in newborns. Saccharomyces boulardii CNCM I-745 is a good example for the statement that each probiotic needs to be taxonomically characterized and its efficacy and safety should be documented individually in different clinical settings.

Adaptive Sniping for Volatile and Stable Continuous Double Auction Markets

Science.gov (United States)

Toft, I. E.; Bagnall, A. J.

This paper introduces a new adaptive sniping agent for the Continuous Double Auction. We begin by analysing the performance of the well known Kaplan sniper in two extremes of market conditions. We generate volatile and stable market conditions using the well known Zero Intelligence-Constrained agent and a new zero-intelligence agent Small Increment (SI). ZI-C agents submit random but profitable bids/offers and cause high volatility in prices and individual trader performance. Our new zero-intelligence agent, SI, makes small random adjustments to the outstanding bid/offer and hence is more cautious than ZI-C. We present results for SI in self-play and then analyse Kaplan in volatile and stable markets. We demonstrate that the non-adaptive Kaplan sniper can be configured to suit either market conditions, but no single configuration is performs well across both market types. We believe that in a dynamic auction environment where current or future market conditions cannot be predicted a viable sniping strategy should adapt its behaviour to suit prevailing market conditions. To this end, we propose the Adaptive Sniper (AS) agent for the CDA. AS traders classify sniping opportunities using a statistical model of market activity and adjust their classification thresholds using a Widrow-Hoff adapted search. Our AS agent requires little configuration, and outperforms the original Kaplan sniper in volatile and stable markets, and in a mixed trader type scenario that includes adaptive strategies from the literature.

Immunosuppression Adherence in Stable Kidney Transplant Patients Converted From Immediate- to Prolonged-Release Tacrolimus in Clinical Practice: A Norwegian Study.

Science.gov (United States)

Abedini, Sadollah; Gøransson, Lasse; Cockburn, Elinor; Kilany, Suzanne; Holdaas, Hallvard

2018-02-01

This study investigated medication adherence in kidney transplant patients (KTPs) converted from immediate-release tacrolimus (IR-T) to prolonged-release tacrolimus (PR-T)-based immunosuppression in routine practice. Noninterventional, observational, multicenter study in Norway. Included adult KTPs with stable graft function, converted from IR-T (baseline) to PR-T (1 mg:1 mg) in routine practice. Data were collected at baseline, and months 1, 3, 6, and 12 postconversion. Primary endpoint: adherence using the Basel Assessment of Adherence to Immunosuppressive Medication Scale. Secondary assessments: tacrolimus dose and trough levels (target, 3-7 ng/mL), clinical laboratory parameters (eg, estimated glomerular filtration rate [Modified Diet in Renal Disease]), and adverse events. Ninety-one KTPs (mean ± SD age 47.7 ± 14.3 years) were analyzed. Mean ± SD change in PR-T dose from baseline (4.4 ± 2.4 mg/d) to month 12 was -0.1 ± 0.9 mg/d; mean tacrolimus trough levels remained within target. Overall medication adherence increased from 45.6% at baseline to 58.1% at month 1, but was similar to baseline thereafter; taking and timing adherence followed a similar pattern. Odds ratio (OR) for adherence at month 1 (but not at other time points) was greater versus baseline for overall (OR, 1.71; P = 0.0205), taking (OR, 3.38; P = 0.0004), and timing (OR, 1.77, P = 0.0252) dimensions. Mean ± SD Basel Assessment of Adherence to Immunosuppressive Medication Scale visual analogue scale score at baseline was 96.4 ± 5.5%, and increased postconversion. Estimated glomerular filtration rate remained stable (month 12, 61.6 ± 17.7 mL/min per 1.73 m 2 ), as did other laboratory parameters. Two (2.2%) patients had adverse events considered probably/possibly treatment-related. There was disparity between high, patient-perceived and low, actual adherence. Converting stable KTPs from IR-T to PR-T in routine practice did not impact long-term adherence to immunosuppression; renal

Comparison of ESD and major organ absorbed doses of 5 year old standard guidekines and clinical exposure conditions

Energy Technology Data Exchange (ETDEWEB)

Kang, A Ram; Ahn, Sung Min [Dept. of Radiological Science, The Graduate School, Gachon University, Incheon (Korea, Republic of); Lee, In Ja [Dept. of Radiologic technology, Dongnam health University, Suwon (Korea, Republic of)

2017-09-15

Pediatrics are more sensibility to radiation than adults and because they are organs that are not completely grown, they have a life expectancy that can be adversely affected by exposure. Therefore, the management of exposure dose is more important than the case of adult. The purpose of this study was to determine the suitability of the 10 year old phantom for the 5 year old pediatric's recommendation and the incident surface dose, and to measure the organ absorbed dose. This study is compared the organ absorbed dose and the entrance surface dose in the clinical conditions at 5 and 10 years old pediatric. Clinical 5 year old condition was slightly higher than recommendation condition and 10 year old condition was very high. In addition, recommendation condition ESD was found to be 43% higher than the ESD of the 5 year old group and the ESD of the 10 year old group was 126% higher than that of the 5 year old group. The recommended ESD at 5 years old and the ESD according to clinical imaging conditions were 31.6%. There was no significant difference between the 5 year old recommended exposure conditions and the organ absorbed dose due to clinical exposure conditions, but there was a large difference between the Chest and Pelvic. However, it was found that there was a remarkable difference when comparing the organ absorbed dose by 10 year clinical exposure conditions. Therefore, more detailed standard exposure dose for the recommended dose of pediatric should be studied.

Comparison of ESD and major organ absorbed doses of 5 year old standard guidekines and clinical exposure conditions

International Nuclear Information System (INIS)

Kang, A Ram; Ahn, Sung Min; Lee, In Ja

2017-01-01

Pediatrics are more sensibility to radiation than adults and because they are organs that are not completely grown, they have a life expectancy that can be adversely affected by exposure. Therefore, the management of exposure dose is more important than the case of adult. The purpose of this study was to determine the suitability of the 10 year old phantom for the 5 year old pediatric's recommendation and the incident surface dose, and to measure the organ absorbed dose. This study is compared the organ absorbed dose and the entrance surface dose in the clinical conditions at 5 and 10 years old pediatric. Clinical 5 year old condition was slightly higher than recommendation condition and 10 year old condition was very high. In addition, recommendation condition ESD was found to be 43% higher than the ESD of the 5 year old group and the ESD of the 10 year old group was 126% higher than that of the 5 year old group. The recommended ESD at 5 years old and the ESD according to clinical imaging conditions were 31.6%. There was no significant difference between the 5 year old recommended exposure conditions and the organ absorbed dose due to clinical exposure conditions, but there was a large difference between the Chest and Pelvic. However, it was found that there was a remarkable difference when comparing the organ absorbed dose by 10 year clinical exposure conditions. Therefore, more detailed standard exposure dose for the recommended dose of pediatric should be studied

Study on the flow reduction of forced flow superconducting magnet and its stable operation condition

Energy Technology Data Exchange (ETDEWEB)

Sugimoto, Makoto [Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment

2001-03-01

The forced flow superconducting coil especially made from a Cable-in-Conduit Conductor (CICC) is applied for large-scale devices such as fusion magnets and superconducting magnet energy storage (SMES) because it has high mechanical and electrical performance potential. The flow reduction phenomena caused by AC loss generation due to the pulsed operation was found based on the experimental results of three forced flow superconducting coils. And relation between the AC loss generation and flow reduction was defined from viewpoint of the engineering design and operation of the coils. Also the mechanism of flow reduction was investigated and stable operation condition under the flow reduction was clarified for forced flow superconducting coils. First, experiments of three different large-scale superconducting coils were carried out and experimental database of the flow reduction by AC loss generation was established. It was found experimentally that the flow reduction depends on the AC loss generation (W/m{sup 3}) in all of coils. It means the stable operation condition is defined not only the electro magnetism of superconducting coil but also flow condition. Mechanism of the flow reduction was investigated based on the experimental database. Hydraulics was applied to supercritical helium as a coolant. Also performances of the cryogenic pump by which coolant are supplied to the coil and friction of the superconductor as cooling path is considered for hydraulic estimation. The flow reduction of the coil is clarified and predictable by the equations of continuity, momentum and energy balance. Also total mass flow rate of coolant was discussed. The estimation method in the design phase was developed for total mass flow rate which are required under the flow reduction by AC losses. The friction of the superconductor and performance of cryogenic pump should be required for precise prediction of flow reduction. These values were obtained by the experiment data of coil and

42 CFR 482.82 - Condition of participation: Data submission, clinical experience, and outcome requirements for re...

Science.gov (United States)

2010-10-01

..., clinical experience, and outcome requirements for re-approval of transplant centers. 482.82 Section 482.82... Hospitals Transplant Center Data Submission, Clinical Experience, and Outcome Requirements § 482.82 Condition of participation: Data submission, clinical experience, and outcome requirements for re-approval...

Clinical presentation and management of stable coronary artery disease: insights from the international prospective CLARIFY registry - results from the Greek national cohort.

Science.gov (United States)

Sbarouni, Eftihia; Voudris, Vassilis; Georgiadou, Panagiota; Hamilos, Michalis; Steg, P Gabriel; Fox, Kim M; Greenlaw, Nicola; Ferrari, Roberto; Vardas, Panos E

2014-01-01

Coronary artery disease (CAD) is highly prevalent worldwide, yet there is a paucity of data regarding the clinical characteristics and management of outpatients with stable CAD. In this paper, we report the baseline data of the Greek cohort and we compare our national data with the global results of the entire registry, as well as the results from the western European countries. CLARIFY is an international, prospective, observational, longitudinal registry of outpatients with stable CAD, defined as prior myocardial infarction or revascularization procedure, evidence of coronary stenosis >50%, or chest pain associated with proven myocardial ischemia. A total of 33,283 patients from 45 countries in 4 continents were enrolled between November 2009 and July 2010; of these, 14,726 were from western European countries (Austria, Belgium, Denmark, France, Germany, Greece, Ireland, Italy, Netherlands, Portugal, Spain, Switzerland and the United Kingdom) and 559 patients were enrolled in Greece. Compared to their counterparts in western Europe and the entire cohort, Greeks were younger (p<0.0001, p<0.0001, respectively), more predominantly male (p<0.0039, p<0.0001), with a higher body mass index (p<0.0002, p<0.0001) and a larger waist circumference (p<0.0001, p<0.0001), as well as a higher prevalence of family history of CAD (p<0.0008, 0.0005), hyperlipidemia (p<0.0001, p<0.0001) and smoking (p<0.0001, p<0.0001). Noninvasive testing (p<0.0001, p<0.0001, respectively) and coronary angiography (p<0.0001, 0.0013) along with surgical revascularization (CABG) (p<0.0001, 0.0088) were performed more often in Greece. Antiplatelets, b-blockers and lipid lowering medications were used to an equal extent in Greece as in the other two cohorts. There are substantial differences in demographics, clinical profiles and treatment in patients with stable CAD within the data set, which are also observed for Greek data. Interestingly, these differences are consistent in relation to the global

Stable limits for sums of dependent infinite variance random variables

DEFF Research Database (Denmark)

Bartkiewicz, Katarzyna; Jakubowski, Adam; Mikosch, Thomas

2011-01-01

The aim of this paper is to provide conditions which ensure that the affinely transformed partial sums of a strictly stationary process converge in distribution to an infinite variance stable distribution. Conditions for this convergence to hold are known in the literature. However, most of these...

Stable isotopes

International Nuclear Information System (INIS)

Evans, D.K.

1986-01-01

Seventy-five percent of the world's stable isotope supply comes from one producer, Oak Ridge Nuclear Laboratory (ORNL) in the US. Canadian concern is that foreign needs will be met only after domestic needs, thus creating a shortage of stable isotopes in Canada. This article describes the present situation in Canada (availability and cost) of stable isotopes, the isotope enrichment techniques, and related research programs at Chalk River Nuclear Laboratories (CRNL)

Unconditionally stable methods for simulating multi-component two-phase interface models with Peng-Robinson equation of state and various boundary conditions

KAUST Repository

Kou, Jisheng

2015-03-01

In this paper, we consider multi-component dynamic two-phase interface models, which are formulated by the Cahn-Hilliard system with Peng-Robinson equation of state and various boundary conditions. These models can be derived from the minimum problems of Helmholtz free energy or grand potential in the realistic thermodynamic systems. The resulted Cahn-Hilliard systems with various boundary conditions are fully coupled and strongly nonlinear. A linear transformation is introduced to decouple the relations between different components, and as a result, the models are simplified. From this, we further propose a semi-implicit unconditionally stable time discretization scheme, which allows us to solve the Cahn-Hilliard system by a decoupled way, and thus, our method can significantly reduce the computational cost and memory requirements. The mixed finite element methods are employed for the spatial discretization, and the approximate errors are also analyzed for both space and time. Numerical examples are tested to demonstrate the efficiency of our proposed methods. © 2015 Elsevier B.V.

Stable isotope-resolved metabolomics and applications for drug development

Science.gov (United States)

Fan, Teresa W-M.; Lorkiewicz, Pawel; Sellers, Katherine; Moseley, Hunter N.B.; Higashi, Richard M.; Lane, Andrew N.

2012-01-01

Advances in analytical methodologies, principally nuclear magnetic resonance spectroscopy (NMR) and mass spectrometry (MS), during the last decade have made large-scale analysis of the human metabolome a reality. This is leading to the reawakening of the importance of metabolism in human diseases, particularly cancer. The metabolome is the functional readout of the genome, functional genome, and proteome; it is also an integral partner in molecular regulations for homeostasis. The interrogation of the metabolome, or metabolomics, is now being applied to numerous diseases, largely by metabolite profiling for biomarker discovery, but also in pharmacology and therapeutics. Recent advances in stable isotope tracer-based metabolomic approaches enable unambiguous tracking of individual atoms through compartmentalized metabolic networks directly in human subjects, which promises to decipher the complexity of the human metabolome at an unprecedented pace. This knowledge will revolutionize our understanding of complex human diseases, clinical diagnostics, as well as individualized therapeutics and drug response. In this review, we focus on the use of stable isotope tracers with metabolomics technologies for understanding metabolic network dynamics in both model systems and in clinical applications. Atom-resolved isotope tracing via the two major analytical platforms, NMR and MS, has the power to determine novel metabolic reprogramming in diseases, discover new drug targets, and facilitates ADME studies. We also illustrate new metabolic tracer-based imaging technologies, which enable direct visualization of metabolic processes in vivo. We further outline current practices and future requirements for biochemoinformatics development, which is an integral part of translating stable isotope-resolved metabolomics into clinical reality. PMID:22212615

Which compactifications of D=11 supergravity are stable

International Nuclear Information System (INIS)

Page, D.N.; Pope, C.N.

1984-01-01

We complete the stability analysis of all known Freund-Rubin solutions of eleven-dimensional supergravity by determining the necessary and sufficient conditions for Qsup(pqr) spaces (U(1) bundles over S 2 xS 2 xS 2 ) to be stable. (orig.)

Clinical application of stable xenon CT-CBF studies without denitrogenation

Energy Technology Data Exchange (ETDEWEB)

Touho, Hajime; Karasawa, Jun; Shishido, Hisashi; Yamada, Keisuke [Osaka Neurological Institute, Toyonaka (Japan)

1990-08-01

Noninvasive and simplified methods for estimating regional cerebral blood flow (CBF) and regional partition coefficient ({lambda}) using the inhalation of stable xenon (Xe{sup s}) and computed tomographic (CT) scanning are described. Thirty percent Xe{sup s} in 70% oxygen was inhaled for 240 seconds and exhaled for 160 seconds during serial CT scanning without denitrogenation in 26 patients with cerebrovascular diseases and four volunteer controls. During the investigation, the end-tidal Xe{sup s} concentration was continuously monitored with a thermoconductivity analyzer to determine the build-up range (A value) and build-up rate constant (K value) of the artery by the curve fitting method. Calculated A and K values were corrected by the following formulae reported previously: for patients aged 0-20 years, A{sub e} = 0.75A{sub a} + 2.15, K{sub e} = 0.67K{sub a} + 0.69; 21-40 years, A{sub e} = 0.56A{sub a} + 3.24, K{sub e} = 0.38K{sub a} + 1.12; 41-60 years, A{sub e} = 0.91A{sub a} + 1.95, K{sub e} = 0.38K{sub a} + 1.32; over 61 years, A{sub e} = 0.52A{sub a} + 3.81, K{sub e} = 0.31K{sub a} + 1.55 (A{sub e} and K{sub e} were calculated with end-tidal Xe{sup s} concentration, A{sub a} and K{sub a} were calculated by direct sampling of arterial blood). A CBF map (f map) and {lambda} map made with corrected A and K values demonstrated reliable distribution. The CBF was high in the gray matter, low in the white matter, and much lower in the infarcted area. {lambda} was high in the white matter, low in the gray matter, and much lower in the infarcted area. Eight patients were examined with and without denitrogenation. Both the f map and {lambda} map with denitrogenation were compatible with those without denitrogenation. Xe{sup s} CT-CBF studies without denitrogenation are useful in clinical neurosurgery and outpatients for estimating regional cerebral circulation. (author).

Cardiac Remote Conditioning and Clinical Relevance: All Together Now!

Directory of Open Access Journals (Sweden)

Kristin Luther

2015-12-01

mechanisms related to cardioprotection, and in the last five to ten years, it has become clear that the mechanisms are similar, whether induced by ischemic or non-ischemic stimuli. Taking together much of the data in the literature, we propose that all of these cardioprotective “conditioning” phenomena represent activation from different entry points of a cardiac conditioning network that converges upon specific mediators and effectors of myocardial cell survival, including NF-кB, Stat3/5, protein kinase C, bradykinin, and the mitoKATP channel. Nervous system pathways may represent a novel mechanism for initiating conditioning of the heart and other organs. IPC and RIPC have proven difficult to translate clinically, as they have associated risks and cannot be used in some patients. Because of this, the use of neural and nociceptive stimuli is emerging as a potential non-ischemic and non-traumatic means to initiate cardiac conditioning. Clinical relevance is underscored by the demonstration of postconditioning with one of these modalities, supporting the conclusion that the development of pharmaceuticals and electroceuticals for this purpose is an area ripe for clinical development.

Stable Isotope Data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Tissue samples (skin, bone, blood, muscle) are analyzed for stable carbon, stable nitrogen, and stable sulfur analysis. Many samples are used in their entirety for...

stableGP

Data.gov (United States)

National Aeronautics and Space Administration — The code in the stableGP package implements Gaussian process calculations using efficient and numerically stable algorithms. Description of the algorithms is in the...

Energy stable and high-order-accurate finite difference methods on staggered grids

Science.gov (United States)

O'Reilly, Ossian; Lundquist, Tomas; Dunham, Eric M.; Nordström, Jan

2017-10-01

For wave propagation over distances of many wavelengths, high-order finite difference methods on staggered grids are widely used due to their excellent dispersion properties. However, the enforcement of boundary conditions in a stable manner and treatment of interface problems with discontinuous coefficients usually pose many challenges. In this work, we construct a provably stable and high-order-accurate finite difference method on staggered grids that can be applied to a broad class of boundary and interface problems. The staggered grid difference operators are in summation-by-parts form and when combined with a weak enforcement of the boundary conditions, lead to an energy stable method on multiblock grids. The general applicability of the method is demonstrated by simulating an explosive acoustic source, generating waves reflecting against a free surface and material discontinuity.

The effect of two different housing conditions on the welfare of young horses stabled for the first time

NARCIS (Netherlands)

Visser, E.K.; Ellis, A.D.; Reenen, van C.G.

2008-01-01

The effect of stabling for the first time on the behaviour and welfare of young and naïve horses has not yet been studied in detail. In this study we examined the effect of two typical housing systems on their subsequent behavioural and physiological responses upon first time stabling. Thirty-six

Stable-carbon isotope variability in tree foliage and wood

International Nuclear Information System (INIS)

Leavitt, S.W.; Long, A.

1986-01-01

This study documents variation of stable-carbon isotope ratios ( 13 C/ 12 C) in trees of genera Juniperus and Pinus under field conditions. Results are from cellulose analysis on leaves, twigs, and wood from a number of localities in the southwestern US. Substantial variability, typically 1-3%, exists among leaves, within wood (radially, vertically, circumferentially), and between individuals at a site. These results may help guide sampling in tracer-type studies with stable-carbon isotope ratios and aid in the interpretation of isotopic results from such studies

Increasing atmospheric CO2 overrides the historical legacy of multiple stable biome states in Africa.

Science.gov (United States)

Moncrieff, Glenn R; Scheiter, Simon; Bond, William J; Higgins, Steven I

2014-02-01

The dominant vegetation over much of the global land surface is not predetermined by contemporary climate, but also influenced by past environmental conditions. This confounds attempts to predict current and future biome distributions, because even a perfect model would project multiple possible biomes without knowledge of the historical vegetation state. Here we compare the distribution of tree- and grass-dominated biomes across Africa simulated using a dynamic global vegetation model (DGVM). We explicitly evaluate where and under what conditions multiple stable biome states are possible for current and projected future climates. Our simulation results show that multiple stable biomes states are possible for vast areas of tropical and subtropical Africa under current conditions. Widespread loss of the potential for multiple stable biomes states is projected in the 21st Century, driven by increasing atmospheric CO2 . Many sites where currently both tree-dominated and grass-dominated biomes are possible become deterministically tree-dominated. Regions with multiple stable biome states are widespread and require consideration when attempting to predict future vegetation changes. Testing for behaviour characteristic of systems with multiple stable equilibria, such as hysteresis and dependence on historical conditions, and the resulting uncertainty in simulated vegetation, will lead to improved projections of global change impacts. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

Limiting stable states of high-Tc superconductors in the alternating current modes

International Nuclear Information System (INIS)

Romanovskii, V.R.; Watanabe, K.; Awaji, S.

2014-01-01

The limiting current-carrying capacity of high-T c superconductor and superconducting tape has been studied in the alternating current states. The features that are responsible for their stable formation have been investigated under the conduction-cooled conditions when the operating peak values of the electric field and the current may essentially exceed the corresponding critical values of superconductor. Besides, it has been proved that these peak values are higher than the values of the electric field and the current, which lead to the thermal runaway phenomenon when the current instability onset occurs in the operating modes with direct current. As a result, the stable extremely high heat generation exists in these operating states, which can be called as overloaded states. The limiting stable peak values of charged currents and stability conditions have been determined taking into account the flux creep states of superconductors. The analysis performed has revealed that there exist characteristic times defining the corresponding time windows in the stable development of overloaded states of the alternating current. In order to explain their existence, the basic thermo-electrodynamics mechanisms have been formulated, which have allowed to explain the high stable values of the temperature and the induced electric field before the onset of alternating current instability. In general, it has been shown that the high-T c superconductors may stably operate in the overloaded alternating current states even under the not intensive cooling conditions at a very high level of heat generation, which is not considered in the existing theory of losses. (authors)

1-Dodecanethiol based highly stable self-assembled monolayers for germanium passivation

International Nuclear Information System (INIS)

Cai, Qi; Xu, Baojian; Ye, Lin; Di, Zengfeng; Huang, Shanluo; Du, Xiaowei; Zhang, Jishen; Jin, Qinghui; Zhao, Jianlong

2015-01-01

Highlights: • A simple and effective approach for higly stable germanium passivation. • 1-Dodecanethiol self-assembled monolayers for germanium oxidation resistance. • The influence factors of germanium passivation were systematically studied. • The stability of the passivated Ge was more than 10 days even in water conditions. - Abstract: As a typical semiconductor material, germanium has the potential to replace silicon for future-generation microelectronics, due to its better electrical properties. However, the lack of stable surface state has limited its extensive use for several decades. In this work, we demonstrated highly stable self-assembled monolayers (SAMs) on Ge surface to prevent oxidization for further applications. After the pretreatment in hydrochloric acid, the oxide-free and Cl-terminated Ge could be further coated with 1-dodecanethiol (NDM) SAMs. The influence factors including reaction time, solvent component and reaction temperature were optimized to obtain stable passivated monolayer for oxidation resistance. Contact angle analysis, atomic force microscopy, ellipsometer and X-ray photoelectron spectroscopy were performed to characterize the functionalized Ge surface respectively. Meanwhile, the reaction mechanism and stability of thiols SAMs on Ge (1 1 1) surface were investigated. Finally, highly stable passivated NDM SAMs on Ge surface could be formed through immersing oxide-free Ge in mixture solvent (water/ethanol, v/v = 1:1) at appropriately elevated temperature (∼80 °C) for 24 h. And the corresponding optimized passivated Ge surface was stable for more than 10 days even in water condition, which was much longer than the data reported and paved the way for the future practical applications of Ge.

1-Dodecanethiol based highly stable self-assembled monolayers for germanium passivation

Energy Technology Data Exchange (ETDEWEB)

Cai, Qi [State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); University of Chinese Academy of Sciences, No. 19A, Yuquan Road, Beijing 100049 (China); Xu, Baojian, E-mail: xbj@mail.sim.ac.cn [State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); Shanghai Internet of Things Co., LTD, No. 1455, Pingcheng Road, Shanghai 201899 (China); Ye, Lin [State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); University of Chinese Academy of Sciences, No. 19A, Yuquan Road, Beijing 100049 (China); Di, Zengfeng [State Key Laboratory of Functional Materials for Informatics, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); Huang, Shanluo; Du, Xiaowei [State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); University of Chinese Academy of Sciences, No. 19A, Yuquan Road, Beijing 100049 (China); Zhang, Jishen; Jin, Qinghui [State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China); Zhao, Jianlong, E-mail: jlzhao@mail.sim.ac.cn [State Key Laboratory of Transducer Technology, Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences, No. 865, Changning Road, Shanghai 200050 (China)

2015-10-30

Highlights: • A simple and effective approach for higly stable germanium passivation. • 1-Dodecanethiol self-assembled monolayers for germanium oxidation resistance. • The influence factors of germanium passivation were systematically studied. • The stability of the passivated Ge was more than 10 days even in water conditions. - Abstract: As a typical semiconductor material, germanium has the potential to replace silicon for future-generation microelectronics, due to its better electrical properties. However, the lack of stable surface state has limited its extensive use for several decades. In this work, we demonstrated highly stable self-assembled monolayers (SAMs) on Ge surface to prevent oxidization for further applications. After the pretreatment in hydrochloric acid, the oxide-free and Cl-terminated Ge could be further coated with 1-dodecanethiol (NDM) SAMs. The influence factors including reaction time, solvent component and reaction temperature were optimized to obtain stable passivated monolayer for oxidation resistance. Contact angle analysis, atomic force microscopy, ellipsometer and X-ray photoelectron spectroscopy were performed to characterize the functionalized Ge surface respectively. Meanwhile, the reaction mechanism and stability of thiols SAMs on Ge (1 1 1) surface were investigated. Finally, highly stable passivated NDM SAMs on Ge surface could be formed through immersing oxide-free Ge in mixture solvent (water/ethanol, v/v = 1:1) at appropriately elevated temperature (∼80 °C) for 24 h. And the corresponding optimized passivated Ge surface was stable for more than 10 days even in water condition, which was much longer than the data reported and paved the way for the future practical applications of Ge.

The simplifying role of pure and stable sets in induced possibilities and necessities

International Nuclear Information System (INIS)

Tsiporkova, E.

1996-01-01

The behaviour of upper and lower (conditional) possibilities and necessities induced by a multivalued mapping is investigated in case pure and stable sets with respect to this multivalued mapping are involved. It is obtained that the upper and lower possibilities (resp. necessities) and the upper and lower conditional possibilities (resp. necessities) of a pure set with respect to the original (non-restricted) mapping coincide. Simplified expressions for the lower conditional possibilities and necessities induced by a multivalued mapping are established in case of a restricting set that is pure with respect to this multivalued mapping. Moreover, if the multivalued mapping involved is non-void and surjective then the interaction of stable sets with the upper and lower (conditional) possibilities and necessities is also studied

High precision and stable structures for particle detectors

CERN Document Server

Da Mota Silva, S; Hauviller, Claude

1999-01-01

The central detectors used in High Energy Physics Experiments require the use of light and stable structures capable of supporting delicate and precise radiation detection elements. These structures need to be highly stable under environmental conditions where external vibrations, high radiation levels, temperature and humidity gradients should be taken into account. Their main design drivers are high dimension and dynamic stability, high stiffness to mass ratio and large radiation length. For most applications, these constraints lead us to choose Carbon Fiber Reinforced Plastics ( CFRP) as structural element. The construction of light and stable structures with CFRP for these applications can be achieved by careful design engineering and further confirmation at the prototyping phase. However, the experimental environment can influence their characteristics and behavior. In this case, theuse of adaptive structures could become a solution for this problem. We are studying structures in CFRP with bonded piezoel...

Uptake of radionuclides and stable elements from paddy soil to rice: a review

International Nuclear Information System (INIS)

Uchida, S.; Tagami, K.; Shang, Z.R.; Choi, Y.H.

2009-01-01

The critical paths for radionuclides and the critical foods in Asian countries differ from those in Western countries because agricultural products and diets are different. Consequently, safety assessments for Asian countries must consider rice as a critical food. As most rice is produced under flooded conditions, the uptake of radionuclides by rice is affected by soil conditions. In this report, we summarize radionuclide and stable element soil-to-plant transfer factors (TFs) for rice. Field observation results for fallout 137 Cs and stable Cs TFs indicated that while fallout 137 Cs had higher TF than stable Cs over several decades, the GM (geometric mean) values were similar with the GM of TF value for 137 Cs being 3.6 x 10 -3 and that for stable Cs being 2.5 x 10 -3 . Although there are some limitations to the use of TF for stable elements under some circumstances, these values can be used to evaluate long-term transfer of long-lived radionuclides in the environment. The compiled data showed that TF values were higher in brown rice than in white rice because distribution patterns for elements were different in the bran and white parts of rice grains.

Application of 13C and 15N stable isotope probing to characterize RDX degrading microbial communities under different electron-accepting conditions

International Nuclear Information System (INIS)

Cho, Kun-Ching; Lee, Do Gyun; Fuller, Mark E.; Hatzinger, Paul B.; Condee, Charles W.; Chu, Kung-Hui

2015-01-01

Highlights: • SIP characterized RDX-degrading communities under different e-accepting conditions. • Dominant RDX degradation pathways differed under different e-accepting conditions. • More complete detoxification of RDX occurred under methanogenic and sulfate-reducing conditions than under manganese(IV) and iron(III)-reducing conditions. - Abstract: This study identified microorganisms capable of using the explosive hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) or its metabolites as carbon and/or nitrogen sources under different electron-accepting conditions using 13 C and 15 N stable isotope probing (SIP). Mesocosms were constructed using groundwater and aquifer solids from an RDX-contaminated aquifer. The mesocosms received succinate as a carbon source and one of four electron acceptors (nitrate, manganese(IV), iron(III), or sulfate) or no additional electron acceptor (to stimulate methanogenesis). When RDX degradation was observed, subsamples from each mesocosm were removed and amended with 13 C 3 - or ring- 15 N 3 -, nitro- 15 N 3 -, or fully-labeled 15 N 6 -RDX, followed by additional incubation and isolation of labeled nucleic acids. A total of fifteen 16S rRNA sequences, clustering in α- and γ-Proteobacteria, Clostridia, and Actinobacteria, were detected in the 13 C-DNA fractions. A total of twenty seven sequences were derived from different 15 N-DNA fractions, with the sequences clustered in α- and γ-Proteobacteria, and Clostridia. Interestingly, sequences identified as Desulfosporosinus sp. (in the Clostridia) were not only observed to incorporate the labeled 13 C or 15 N from labeled RDX, but also were detected under each of the different electron-accepting conditions. The data suggest that 13 C- and 15 N-SIP can be used to characterize microbial communities involved in RDX biodegradation, and that the dominant pathway of RDX biodegradation may differ under different electron-accepting conditions

Design of partially optically stable reflector systems and prisms

Science.gov (United States)

Tsai, Chuang-Yu

2010-09-01

The characteristics and design method of the total optically stable (TOS) reflector systems/prisms were introduced in an early paper (Tsai and Lin in Appl. Opt. 47:4158-4163, 2008), where only two types of TOS reflector system exist, namely preservation or retroreflection. In this paper, we introduce the partially optically stable (POS) reflector system, which is only optically stable about a specific directional vector; nevertheless, the exiting light ray is not restricted to preservation or retroreflection. The proposed paper also presents an analytic method for the design of POS reflector systems comprised of multiple reflectors. Furthermore, it is shown that a POS prism can be obtained by adding two refracting flat boundary surfaces with specific conditions at the entrance and exit positions of the light ray in an optical system with multiple reflectors.

Does transcutaneous electrical nerve stimulation (TENS have a clinically relevant analgesic effect on different pain conditions? A literature review

Directory of Open Access Journals (Sweden)

Asami Naka

2013-07-01

Full Text Available Transcutaneous electric nerve stimulation (TENS is a standard therapy used in different painful conditions such as low back pain, diabetic polyneuropathy or arthrosis. However, literature reviews focusing on the effects and the clinical implication of this method in various painful conditions are yet scarce. The purpose of this literature research was to determine, whether TENS provides an analgesic effect on common painful conditions in clinical practice. Literature research was performed using three data bases (Pubmed, Embase, Cochrane Database, focusing on papers published in the space of time from 2007 to 2012. Papers were evaluated from two reviewers independently concerning the clinical outcome, taking account for the level of external evidence according to the German Cochrane levels of evidence (Ia – IV. 133 papers of varying methodological quality dealing with different painful conditions were selected in total. A clinically relevant analgesic effect was described in 90 painful conditions (67%. In 30 painful states (22%, the outcome was inconclusive due to the study design. No significant analgesic effect of TENS was observed in 15 painful conditions (11%. The vast majority of the papers were classified as Cochrane evidence level Ib (n = 64; 48%, followed by level Ia (n = 23; 17%, level III (n = 18; 14%, level IV (n = 15; 11%, level IIb (n = 10; 8% and level IIa (n = 3; 2%. Most of the studies revealed an analgesic effect in various painful conditions, confirming the usefulness of TENS in clinical practice.

A servo-controlled canine model of stable severe ischemic left ventricular failure.

Science.gov (United States)

Wagner, Richard L; Hood, William B; Howland, Peter A

2009-12-01

Reversible left ventricular failure was produced in conscious dogs by compromise of the coronary circulation. In animals with prior left anterior descending coronary artery occlusion, mean left atrial pressure (LAP) was incorporated into an automatic feedback control system used to inflate a balloon cuff on the circumflex (Cfx) coronary artery. The system could produce stable increases in LAP to 15-20 mm Hg. The dominating system transfer function was the ratio of LAP to balloon volume (BV), which was characterized by a fixed delay (5 s), with LAP/BV = (8e(-jomegatau ))/(0.02 + jomega). The system was stabilized by a phase lead network to reduce oscillations of LAP. A total of seven experiments were conducted in three dogs, and testing of inotropic agents was possible in three experiments under stable conditions with the pump off after an hour or more of operation. Problems encountered were 0.003-0.008 Hz oscillations in LAP in three experiments, which could usually be controlled by reducing the system gain. Late stage ventricular fibrillation occurred in all three animals, but defibrillation was easily accomplished after deflating the Cfx balloon. This system produces reversible left ventricular failure solely due to ischemia, thus closely simulating clinical heart failure due to coronary insufficiency.

Extraversion, Neuroticism, and Verbal Conditioning of Affective Self-Disclosures

Science.gov (United States)

Hekmat, Hamid

1971-01-01

Subjects were assigned to four experimental groups: neurotic extraverts, stable extraverts, neurotic introverts, stable introverts, and a control group. Results indicated that introversion, and not neuroticism, facilitated conditioning processes. Neuroticism, however, did not interact on the conditioning of affective self disclosures. Introverted…

Plaque disruption by coronary computed tomographic angiography in stable patients vs. acute coronary syndrome: a feasibility study.

Science.gov (United States)

Bilolikar, Abhay N; Goldstein, James A; Madder, Ryan D; Chinnaiyan, Kavitha M

2016-03-01

This study was designed to determine whether coronary CT angiography (CTA) can detect features of plaque disruption in clinically stable patients and to compare lesion prevalence and features between stable patients and those with acute coronary syndrome (ACS). We retrospectively identified patients undergoing CTA, followed by invasive coronary angiography (ICA) within 60 days. Quantitative 3-vessel CTA lesion analysis was performed on all plaques ≥25% stenosis to assess total plaque volume, low attenuation plaque (LAP, disruption, including ulceration and intra-plaque dye penetration (IDP). ICA was employed as a reference standard for disruption. A total of 145 (94 ACS and 51 stable) patients were identified. By CTA, plaque disruption was evident in 77.7% of ACS cases. Although more common among those with ACS, CTA also detected plaque disruption in 37.3% of clinically stable patients (P disruption as determined by CTA. Though the prevalence of plaque disruption is less than patients with ACS, these findings support the concept that some clinically stable patients may harbour 'silent' disrupted plaques. These findings may have implications for detection of 'at risk' plaques and patients. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

Kinetics of Quality Changes of Pangasius Fillets at Stable and Dynamic Temperatures, Simulating Downstream Cold Chain Conditions

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Nga Mai

2017-01-01

Full Text Available This study was about the quality changes of Pangasius fillets during storage under simulated temperature conditions of downstream cold chain. Sensory, chemical, and microbiological analyses were conducted over storage time and bacterial growth was modelled. Sensory quality index (QI, at five stable (1, 4, 9, 15, and 19 ± 1°C and three dynamic temperatures, progressed faster at higher temperatures, especially with sooner temperature abuses. Total volatile basic nitrogen remained under the acceptable limit throughout all the storage conditions. Total viable psychrotrophic counts (TVC were around 5.68 ± 0.24 log CFU g−1 at the beginning and exceeded the limit of 6 log CFU g−1 after 216, 96, 36, 16, and 7 h at 1, 4, 9, 15, and 19 ± 1°C, respectively. Meanwhile, Pseudomonas counts started at 3.81 ± 0.53 log CFU g−1 and reached 4.60–6.36 log CFU g−1 by the time of TVC rejection. Since lower shelf lives were given by TVC rather than QI, it should be appropriate to base the product shelf life on the TVC acceptable limit. Kinetics models based on the Baranyi and Roberts and square root models, developed for TVC and Pseudomonas spp., gave acceptable bacterial estimations at dynamic temperatures, with over 80% of observed counts within the acceptable simulation zone, revealing promising model applicability as a supporting tool for cold chain management. However, further improvement and validation of the models are needed.

Private prayer associations with depression, anxiety and other health conditions: an analytical review of clinical studies.

Science.gov (United States)

Anderson, James W; Nunnelley, Paige A

2016-09-01

To critically analyze appropriate clinical studies to assess the relationship between health conditions and the frequency of private prayer. Private prayer is defined as individuals praying for themselves. Using PubMed and other search engines, we identified over 300 articles reporting relationships between prayer and health conditions. We identified 41 observational clinical studies that evaluated the relationship between private prayer and health conditions. Prayer scores of 5 to 1 were assigned to studies, with 5 being private prayer for health and 1 being prayer in combination with meditation or Bible study. Frequency scores ranged from 3 to 1 with 3 being twice daily or more and 0 when frequency was not assessed. Studies were ranked from 8 to 1 based on the sum of Prayer and Frequency Scores. Twenty-one studies had Prayer-Frequency scores of 5 to 8, indicating that they evaluated private prayer (praying for one's own health) of suitable frequency in association with health conditions. Nine of 11 studies indicated that private prayer was associated with a significantly lower prevalence of depression (P value, prayer in four studies (P value, P prayer (P prayer did not have a significant effect on physical health or blood pressure. The reported observational studies suggest that frequent private prayer is associated with a significant benefit for depression, optimism, coping, and other mental health conditions such as anxiety. Controlled clinical trials are required to critically assess the associations of private prayer and health conditions.

Clinical and ultrasonographic findings of some ocular conditions in sheep and goats

Directory of Open Access Journals (Sweden)

O. El-Tookhy

2013-01-01

Full Text Available This study was carried out to describe the ultrasonographic findings in relation to the clinical symptoms of some common ocular conditions in sheep and goats. Fifty animals (32 goats and 18 sheep with different ocular problems were examined. Ultrasonographic examination was performed using a B-mode ocular ultrasound unit, and the structure of the globe was evaluated at a depth of 4-6 cm. Early cases (n=35, 70% showed varying ocular conditions; hypopyon, (n=8, 16%, stromal abscesses, (n=4, 8%, and anterior uveitis (n=23, 46%. Hypopyon appeared clinically as a white or yellowish material in the anterior chamber, and ultrasonographically as a hyperechoic mass in the anterior chamber. Severe iridocyclitis was noticed in acute cases of infectious keratoconjunctivitis (IKC accompanied by blepharospasm, photophobia, excessive tearing and eyelid margin crust formation. Ultrasonographically, the pupil appeared constricted with increased hyperechoic thickening of the ciliary body. In chronic cases of IKC, corneal pigmentation (n=5, 10% and cataract (n=10, 20% were seen. Ultrasonographically the type and degree of cataract were diagnosed. The present study provides an inside view of the inner ocular structures during the course of certain eye diseases where ophthalmoscopic examination is not possible. Our findings, although preliminary, are relevant for the more complete diagnosis of certain external ocular conditions in sheep and goat herds.

A Compact Unconditionally Stable Method for Time-Domain Maxwell's Equations

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Zhuo Su

2013-01-01

Full Text Available Higher order unconditionally stable methods are effective ways for simulating field behaviors of electromagnetic problems since they are free of Courant-Friedrich-Levy conditions. The development of accurate schemes with less computational expenditure is desirable. A compact fourth-order split-step unconditionally-stable finite-difference time-domain method (C4OSS-FDTD is proposed in this paper. This method is based on a four-step splitting form in time which is constructed by symmetric operator and uniform splitting. The introduction of spatial compact operator can further improve its performance. Analyses of stability and numerical dispersion are carried out. Compared with noncompact counterpart, the proposed method has reduced computational expenditure while keeping the same level of accuracy. Comparisons with other compact unconditionally-stable methods are provided. Numerical dispersion and anisotropy errors are shown to be lower than those of previous compact unconditionally-stable methods.

Residual Negative Symptoms Differentiate Cognitive Performance in Clinically Stable Patients with Schizophrenia and Bipolar Disorder

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Rajeev Krishnadas

2014-01-01

Full Text Available Cognitive deficits in various domains have been shown in patients with bipolar disorder and schizophrenia. The purpose of the present study was to examine if residual psychopathology explained the difference in cognitive function between clinically stable patients with schizophrenia and bipolar disorder. We compared the performance on tests of attention, visual and verbal memory, and executive function of 25 patients with schizophrenia in remission and 25 euthymic bipolar disorder patients with that of 25 healthy controls. Mediation analysis was used to see if residual psychopathology could explain the difference in cognitive function between the patient groups. Both patient groups performed significantly worse than healthy controls on most cognitive tests. Patients with bipolar disorder displayed cognitive deficits that were milder but qualitatively similar to those of patients with schizophrenia. Residual negative symptoms mediated the difference in performance on cognitive tests between the two groups. Neither residual general psychotic symptoms nor greater antipsychotic doses explained this relationship. The shared variance explained by the residual negative and cognitive deficits that the difference between patient groups may be explained by greater frontal cortical neurophysiological deficits in patients with schizophrenia, compared to bipolar disorder. Further longitudinal work may provide insight into pathophysiological mechanisms that underlie these deficits.

Benefit from autologous stem cell transplantation in primary refractory myeloma? Different outcomes in progressive versus stable disease

Science.gov (United States)

Rosiñol, Laura; García-Sanz, Ramón; Lahuerta, Juan José; Hernández-García, Miguel; Granell, Miquel; de la Rubia, Javier; Oriol, Albert; Hernández-Ruiz, Belén; Rayón, Consuelo; Navarro, Isabel; García-Ruiz, Juan Carlos; Besalduch, Joan; Gardella, Santiago; Jiménez, Javier López; Díaz-Mediavilla, Joaquín; Alegre, Adrián; Miguel, Jesús San; Bladé, Joan

2012-01-01

Background Several studies of autologous stem cell transplantation in primary refractory myeloma have produced encouraging results. However, the outcome of primary refractory patients with stable disease has not been analyzed separately from the outcome of patients with progressive disease. Design and Methods In the Spanish Myeloma Group 2000 trial, 80 patients with primary refractory myeloma (49 with stable disease and 31 with progressive disease), i.e. who were refractory to initial chemotherapy, were scheduled for tandem transplants (double autologous transplant or a single autologous transplant followed by an allogeneic transplant). Patients with primary refractory disease included those who never achieved a minimal response (≥25% M-protein decrease) or better. Responses were assessed using the European Bone Marrow Transplant criteria. Results There were no significant differences in the rates of partial response or better between patients with stable or progressive disease. However, 38% of the patients with stable disease at the time of transplantation remained in a stable condition or achieved a minimal response after transplantation versus 7% in the group with progressive disease (P=0.0017) and the rate of early progression after transplantation was significantly higher among the group with progressive disease at the time of transplantation (22% versus 2%; P=0.0043). After a median follow-up of 6.6 years, the median survival after first transplant of the whole series was 2.3 years. Progression-free and overall survival from the first transplant were shorter in patients with progressive disease (0.6 versus 2.3 years, P=0.00004 and 1.1 versus 6 years, P=0.00002, respectively). Conclusions Our results show that patients with progressive refractory myeloma do not benefit from autologous transplantation, while patients with stable disease have an outcome comparable to those with chemosensitive disease. (ClinicalTrials.gov:NCT00560053) PMID:22058223

Comfort level of post graduate residents working in different clinical domains in managing common ophthalmic conditions

International Nuclear Information System (INIS)

Jaffar, S.; Tayyab, A.; Shah, S.S.; Naseem, S.; Ghazanfar, H.

2016-01-01

Background: Ophthalmological conditions are frequently encountered in almost all clinical specialties. Assessing the adequacy of ophthalmology teaching in undergraduate medical education is important in order to diagnose and manage different ophthalmological conditions. The objective of this study was to determine the comfort level of post graduate residents working in different clinical domains in managing common ophthalmic conditions. Methods: A cross sectional survey involving 277 post graduate residents was carried out over a period of six months in both private and public tertiary care hospital. A questionnaire containing two sections and 17 variables in total were distributed among Medical Residents of different specialties except ophthalmology residents. Participants of the study were selected through consecutive non probability sampling. Results: Mean hours of classroom based ophthalmology instruction during during undergraduate program was 59.38 hours (55.9) and mean hours of clinical based ophthalmology instruction during undergraduate program was 62.73 hours (60.8) 54 percentage were either not comfortable or somewhat comfortable in managing common ophthalmic condition. Conclusion: Teaching hours in under graduate program meet or exceed requisite criteria. However graduating doctors generally feel that the time spent does not provide them with the comfort and skill level required to care for patients with ocular presentations. (author)

Pellagra-like condition is xeroderma pigmentosum/Cockayne syndrome complex and niacin confers clinical benefit.

Science.gov (United States)

Hijazi, H; Salih, M A; Hamad, M H A; Hassan, H H; Salih, S B M; Mohamed, K A; Mukhtar, M M; Karrar, Z A; Ansari, S; Ibrahim, N; Alkuraya, F S

2015-01-01

An extremely rare pellagra-like condition has been described, which was partially responsive to niacin and associated with a multisystem involvement. The condition was proposed to represent a novel autosomal recessive entity but the underlying mutation remained unknown for almost three decades. The objective of this study was to identify the causal mutation in the pellagra-like condition and investigate the mechanism by which niacin confers clinical benefit. Autozygosity mapping and exome sequencing were used to identify the causal mutation, and comet assay on patient fibroblasts before and after niacin treatment to assess its effect on DNA damage. We identified a single disease locus that harbors a novel mutation in ERCC5, thus confirming that the condition is in fact xeroderma pigmentosum/Cockayne syndrome (XP/CS) complex. Importantly, we also show that the previously described dermatological response to niacin is consistent with a dramatic protective effect against ultraviolet-induced DNA damage in patient fibroblasts conferred by niacin treatment. Our findings show the power of exome sequencing in reassigning previously described novel clinical entities, and suggest a mechanism for the dermatological response to niacin in patients with XP/CS complex. This raises interesting possibilities about the potential therapeutic use of niacin in XP. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term behaviour of concrete under saline conditions for long-term stable sealing structures; Langzeitverhalten von Beton unter salinaren Bedingungen fuer langzeitstabile Verschlussbauwerke

Energy Technology Data Exchange (ETDEWEB)

Dahlhaus, Frank; Haucke, Joerg [Technische Univ. Bergakademie Freiberg (Germany). Inst. fuer Bergbau und Spezialtiefbau

2012-03-15

The authors of the contribution under consideration examine the long-term behaviour of concrete under saline conditions and in particular the suitability of the dam construction materials salt concrete and brine concrete for the use as a part of a sealing system of long-term stable geotechnical sealing structures. The long-term stability of the building material mainly is determined by the corrosion of the cement paste phases. The specific shrinkage behaviour of the construction material is analyzed experimentally in order to verify the expected cracks. The mechanisms of cracking in the salt concrete and brine concrete are analyzed by means of a mesomechanical approach in numerical finite-element calculations.

Discrete Green's Theorem, Green's Functions and Stable Radiative FDTD Boundary Conditions

NARCIS (Netherlands)

Arnold, J.M.; Hon, de B.P.

2007-01-01

We propose a radiative boundary condition for the discrete-grid formulation of Helmholtz’ equation, based on rational approximation in the frequency domain of a Green’s function for the discretised system. This boundary condition is free from instabilities.

On The Roman Domination Stable Graphs

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Hajian Majid

2017-11-01

Full Text Available A Roman dominating function (or just RDF on a graph G = (V,E is a function f : V → {0, 1, 2} satisfying the condition that every vertex u for which f(u = 0 is adjacent to at least one vertex v for which f(v = 2. The weight of an RDF f is the value f(V (G = Pu2V (G f(u. The Roman domination number of a graph G, denoted by R(G, is the minimum weight of a Roman dominating function on G. A graph G is Roman domination stable if the Roman domination number of G remains unchanged under removal of any vertex. In this paper we present upper bounds for the Roman domination number in the class of Roman domination stable graphs, improving bounds posed in [V. Samodivkin, Roman domination in graphs: the class RUV R, Discrete Math. Algorithms Appl. 8 (2016 1650049].

Danish evidence-based clinical guideline for use of nutritional support in pulmonary rehabilitation of undernourished patients with stable COPD

DEFF Research Database (Denmark)

Beck, Anne Marie; Iepsen, Ulrik Winning; Topperup, Randi

2015-01-01

Background and aims Disease-related under-nutrition is a common problem in individuals with COPD. The rationale for nutritional support in pulmonary rehabilitation therefore seems obvious. However there is limited evidence regarding the patient-relevant outcomes i.e. activities of daily living (ADL......) or quality of life. Therefore the topic was included in The Danish Health and Medicines Authority's development of an evidence-based clinical guideline for rehabilitation of patients with stable COPD. Methods The methods were specified by The Danish Health and Medicines Authority as part of a standardized...... studies had been published. There were evidence of moderate quality that nutritional support for undernourished patients with COPD lead to a weight gain of 1.7 kg (95% confidence interval: 1.3 to 2.2 kg), but the effect was quantified as a mean change from baseline, which is less reliable. There were...

Surgical site infections in women and their association with clinical conditions

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Maria Zélia de Araújo Madeira

2014-07-01

Full Text Available Introduction Surgical site infections (SSIs can affect body tissues, cavities, or organs manipulated in surgery and constitute 14% to 16% of all infections. This study aimed to determine the incidence of SSIs in women following their discharge from a gynecology outpatient clinic, to survey different types of SSIs among women, and to verify the association of SSIs with comorbidities and clinical conditions. Methods Data were collected via analytical observation with a cross-sectional design, and the study was conducted in 1,026 women who underwent gynecological surgery in a teaching hospital in the municipality of Teresina, in the northeast Brazilian State of Piauí, from June 2011 to March 2013. Results The incidence of SSIs after discharge was 5.8% among the women in the outpatient clinic. The most prevalent surgery among the patients was hysterectomy, while the most prevalent type of SSI was superficial incisional. Comorbidities in women with SSIs included cancer, diabetes mellitus, and hypertension. Conclusions Surveillance of SSIs during the post-discharge period is critical for infection prevention and control. It is worth reflecting on the planning of surgical procedures for patients who have risk factors for the development of SSIs.

Recognition and Evaluation of Clinical Section Headings in Clinical Documents Using Token-Based Formulation with Conditional Random Fields

Directory of Open Access Journals (Sweden)

Hong-Jie Dai

2015-01-01

Full Text Available Electronic health record (EHR is a digital data format that collects electronic health information about an individual patient or population. To enhance the meaningful use of EHRs, information extraction techniques have been developed to recognize clinical concepts mentioned in EHRs. Nevertheless, the clinical judgment of an EHR cannot be known solely based on the recognized concepts without considering its contextual information. In order to improve the readability and accessibility of EHRs, this work developed a section heading recognition system for clinical documents. In contrast to formulating the section heading recognition task as a sentence classification problem, this work proposed a token-based formulation with the conditional random field (CRF model. A standard section heading recognition corpus was compiled by annotators with clinical experience to evaluate the performance and compare it with sentence classification and dictionary-based approaches. The results of the experiments showed that the proposed method achieved a satisfactory F-score of 0.942, which outperformed the sentence-based approach and the best dictionary-based system by 0.087 and 0.096, respectively. One important advantage of our formulation over the sentence-based approach is that it presented an integrated solution without the need to develop additional heuristics rules for isolating the headings from the surrounding section contents.

Antibiotic therapy for stable non-CF bronchiectasis in adults

DEFF Research Database (Denmark)

Fjaellegaard, Katrine; Sin, Melda Dönmez; Browatzki, Andrea

2017-01-01

To provide an update on efficacy and safety of antibiotic treatments for stable non-cystic fibrosis (CF) bronchiectasis (BE). Systematic review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines was done. Twenty-six studies (1.898 patients) fulfilled......, exacerbations and QoL, whereas studies on aztreonam revealed no significant clinical improvements in the outcomes of interest, including exacerbation rate. Adverse events, including bronchospasm, have been reported in association with tobramycin and aztreonam. Several antibiotic treatment regimens have been...... shown to improve QoL and exacerbation rate, whereas findings regarding sputum production, lung function and admissions have been conflicting. Evidence-based treatment algorithms for antibiotic treatment of stable non-CF BE will have to await large-scale, long-term controlled studies....

Gaussian Plume Model Parameters for Ground-Level and Elevated Sources Derived from the Atmospheric Diffusion Equation in the Neutral and Stable Conditions

International Nuclear Information System (INIS)

Essa, K.S.M.

2009-01-01

The analytical solution of the atmospheric diffusion equation for a point source gives the ground-level concentration profiles. It depends on the wind speed ua nd vertical dispersion coefficient σ z expressed by Pasquill power laws. Both σ z and u are functions of downwind distance, stability and source elevation, while for the ground-level emission u is constant. In the neutral and stable conditions, the Gaussian plume model and finite difference numerical methods with wind speed in power law and the vertical dispersion coefficient in exponential law are estimated. This work shows that the estimated ground-level concentrations of the Gaussian model for high-level source and numerical finite difference method are very match fit to the observed ground-level concentrations of the Gaussian model

Meta-analysis of acupuncture therapy for the treatment of stable angina pectoris.

Science.gov (United States)

Zhang, Ze; Chen, Min; Zhang, Li; Zhang, Zhe; Wu, Wensheng; Liu, Jun; Yan, Jun; Yang, Guanlin

2015-01-01

Angina pectoris is a common symptom imperiling patients' life quality. The aim of this study is to evaluate the efficacy and safety of acupuncture for stable angina pectoris. Clinical randomized-controlled trials (RCTs) comparing the efficacy of acupuncture to conventional drugs in patients with stable angina pectoris were searched using the following database of PubMed, Medline, Wanfang and CNKI. Overall odds ratio (ORs) and weighted mean difference (MD) with their 95% confidence intervals (CI) were calculated by using fixed- or random-effect models depending on the heterogeneity of the included trials. Total 8 RCTs, including 640 angina pectoris cases with 372 patients received acupuncture therapy and 268 patients received conventional drugs, were included. Overall, our result showed that acupuncture significantly increased the clinical curative effects in the relief of angina symptoms (OR=2.89, 95% CI=1.87-4.47, Pacupuncture therapy was superior to conventional drugs. Although there was no significant difference in overall effective rate relating reduction of nitroglycerin between two groups (OR=2.13, 95% CI=0.90-5.07, P=0.09), a significant reduction on nitroglycerin consumption in acupuncture group was found (MD=-0.44, 95% CI=-0.64, -0.24, Pacupuncture therapy than for traditional medicines (MD=2.44, 95% CI=1.64-3.24, Pacupuncture therapy were found. Acupuncture may be an effective therapy for stable angina pectoris. More clinical trials are needed to systematically assess the role of acupuncture in angina pectoris.

IOM and DHHS meeting on making clinical practice guidelines appropriate for patients with multiple chronic conditions.

Science.gov (United States)

Goodman, Richard A; Boyd, Cynthia; Tinetti, Mary E; Von Kohorn, Isabelle; Parekh, Anand K; McGinnis, J Michael

2014-01-01

The increasing prevalence of Americans with multiple (2 or more) chronic conditions raises concerns about the appropriateness and applicability of clinical practice guidelines for patient management. Most guidelines clinicians currently rely on have been designed with a single chronic condition in mind, and many such guidelines are inattentive to issues related to comorbidities. In response to the need for guideline developers to address comorbidities in guidelines, the Department of Health and Human Services convened a meeting in May 2012 in partnership with the Institute of Medicine to identify principles and action options. Eleven principles to improve guidelines' attentiveness to the population with multiple chronic conditions were identified during the meeting. They are grouped into 3 interrelated categories: (1) principles intended to improve the stakeholder technical process for developing guidelines; (2) principles intended to strengthen content of guidelines in terms of multiple chronic conditions; and (3) principles intended to increase focus on patient-centered care. This meeting built upon previously recommended actions by identifying additional principles and options for government, guideline developers, and others to use in strengthening the applicability of clinical practice guidelines to the growing population of people with multiple chronic conditions. The suggested principles are helping professional societies to improve guidelines' attentiveness to persons with multiple chronic conditions.

Clinical Classification of Diseases and Conditions of Mammary Glands in Children and Adolescents

Directory of Open Access Journals (Sweden)

Marina L. Travina

2016-01-01

Full Text Available The article describes the proposed current clinical classification of breast diseases and pathology in childhood and adolescence. The classification is based on the analysis of data obtained from the examination and follow-up monitoring of 6,126 children for up to 8 years. The clinical classification is recommended for widespread use in the work of primary care physicians who conduct follow-up monitoring. The use of this classification creates groups for referral to specialists for further examination and further treatment and follow-up monitoring. The classification is based on the separation of physiological (normal conditions and pathological processes, as well as on temporary deviations from normal development (temporary conditions not leading to pathological processes and anomalies in development of mammary glands and nipple-areolar complex. If any abnormalities are suspected, a patient shall be sent to a mammologist for further examination and US scanning. Control of growth and development of mammary glands in childhood and adolescence ensures early detection of abnormalities and allows necessary remedial measures to protect reproductive health.

Profiling B-type natriuretic peptide in a stable heart failure population: a valuable adjunct to care.

LENUS (Irish Health Repository)

Jan, A

2012-02-01

AIM: To examine the prognostic importance of absolute values and change in values of BNP in patients with stable heart failure (HF). METHODS: Five-hundred and fifty-nine patients attending a disease management programme were categorized into tertiles of BNP (group 1; <\\/= 95 pg\\/ml, group 2; 96-249 pg\\/ml and group 3; >\\/= 250 pg\\/ml). A change in BNP between two stable visits was recorded. Patients were followed up for 1 year for death and a composite morbidity measure of HF hospitalization, all-cause hospitalization, unscheduled visits for clinical deterioration(UC) of HF using survival analysis. RESULTS: The risk of the combined morbidity outcome increased with increasing tertiles of BNP (Log rank = 17.8 (2), p < 0.001). Furthermore, a 50 and 25% increase in BNP predicted morbidity in stable HF patients with an initial BNP > 200 pg\\/ml (p = 0.02) and > 450 pg\\/ml (p = 0.03), respectively. CONCLUSION: In a stable community HF population, an elevated BNP or an increase in BNP predicts an adverse prognosis thereby potentially identifying a population in need of closer clinical follow-up.

Entropy Stable Summation-by-Parts Formulations for Compressible Computational Fluid Dynamics

KAUST Repository

Carpenter, M.H.; Fisher, T.C.; Nielsen, E.J.; Parsani, Matteo; Svä rd, M.; Yamaleev, N.

2016-01-01

that ensure conservation, accuracy and preserve the interior entropy estimates. Nonlinearly stable solid wall boundary conditions are also available. Existing SBP operators that lack a stability proof (e.g. weighted essentially nonoscillatory) may be combined

Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions.

Science.gov (United States)

Courtney, Carol A; Clark, Jeffrey D; Duncombe, Alison M; O'Hearn, Michael A

2011-11-01

Chronic lower quadrant injuries constitute a significant percentage of the musculoskeletal cases seen by clinicians. While impairments may vary, pain is often the factor that compels the patient to seek medical attention. Traumatic injury from sport is one cause of progressive chronic joint pain, particularly in the lower quarter. Recent studies have demonstrated the presence of peripheral and central sensitization mechanisms in different lower quadrant pain syndromes, such as lumbar spine related leg pain, osteoarthritis of the knee, and following acute injuries such as lateral ankle sprain and anterior cruciate ligament rupture. Proper management of lower quarter conditions should include assessment of balance and gait as increasing pain and chronicity may lead to altered gait patterns and falls. In addition, quantitative sensory testing may provide insight into pain mechanisms which affect management and prognosis of musculoskeletal conditions. Studies have demonstrated analgesic effects and modulation of spinal excitability with use of manual therapy techniques, with clinical outcomes of improved gait and functional ability. This paper will discuss the evidence which supports the use of manual therapy for lower quarter musculoskeletal dysfunction.

A highly stable microchannel heat sink for convective boiling

International Nuclear Information System (INIS)

Lu, Chun Ting; Pan Chin

2009-01-01

To develop a highly stable two-phase microchannel heat sink, we experimented with convective boiling in diverging, parallel microchannels with different distributions of laser-etched artificial nucleation sites. Each microchannel had a mean hydraulic diameter of 120 µm. The two-phase flow visualization and the magnitudes of pressure drop and inlet temperature oscillations under boiling conditions demonstrated clearly the merits of using artificial nucleation sites to further stabilize the flow boiling in diverging, parallel microchannels. The stability map showed the plane of subcooling number versus phase change number. It illustrated that diverging, parallel microchannels with artificial nucleation cavities have a much wider stable region than parallel microchannels with uniform cross-sections or diverging, parallel microchannels without artificial nucleation cavities. In addition, the results revealed that the design with cavities distributed uniformly along the downstream half of the channel presented the best stability performance among the three distributions of nucleation sites. This particular design can be regarded as a highly stable microchannel heat sink for convective boiling

Biomarkers of systemic inflammation and depression and fatigue in moderate clinically stable COPD

Directory of Open Access Journals (Sweden)

Singh Dave

2011-01-01

Full Text Available Abstract Introduction COPD is an inflammatory disease with major co-morbidities. It has recently been suggested that depression may be the result of systemic inflammation. We aimed to explore the association between systemic inflammation and symptoms of depression and fatigue in patients with mainly moderate and clinically stable COPD using a range of inflammatory biomarkers, 2 depression and 2 fatigue scales. Method We assessed 120 patients with moderate COPD (FEV1% 52, men 62%, age 66. Depression was assessed using the BASDEC and CES-D scales. Fatigue was assessed using the Manchester COPD-fatigue scale (MCFS and the Borg scale before and after 6MWT. We measured systemic TNF-α, CRP, TNF-α-R1, TNF-α-R2 and IL-6. Results A multivariate linear model of all biomarkers showed that TNF-α only had a positive correlation with BASDEC depression score (p = 0.007. TNF-α remained positively correlated with depression (p = 0.024 after further adjusting for TNF-α-R1, TNF-α-R2, 6MWD, FEV1%, and pack-years. Even after adding the MCFS score, body mass and body composition to the model TNF-α was still associated with the BASDEC score (p = 0.044. Furthermore, patients with higher TNF-α level (> 3 pg/ml, n = 7 had higher mean CES-D depression score than the rest of the sample (p = 0.03. Borg fatigue score at baseline were weakly correlated with TNF-α and CRP, and with TNF-α only after 6MWT. Patients with higher TNF-α had more fatigue after 6MWD (p = 0.054. Conclusion This study indicates a possible association between TNF-α and two frequent and major co-morbidities in COPD; i.e., depression and fatigue.

Stable measures of number sense accuracy in math learning disability: Is it time to proceed from basic science to clinical application?

Science.gov (United States)

Júlio-Costa, Annelise; Starling-Alves, Isabella; Lopes-Silva, Júlia Beatriz; Wood, Guilherme; Haase, Vitor Geraldi

2015-12-01

Math learning disability (MLD) or developmental dyscalculia is a highly prevalent and persistent difficulty in learning arithmetic that may be explained by different cognitive mechanisms. The accuracy of the number sense has been implicated by some evidence as a core deficit in MLD. However, research on this topic has been mainly conducted in demographically selected samples, using arbitrary cut-off scores to characterize MLD. The clinical relevance of the association between number sense and MLD remains to be investigated. In this study, we aimed at assessing the stability of a number sense accuracy measure (w) across five experimental sessions, in two clinically defined cases of MLD. Stable measures of number sense accuracy estimate are required to clinically characterize subtypes of MLD and to make theoretical inferences regarding the underlying cognitive mechanisms. G. A. was a 10-year-old boy with MLD in the context of dyslexia and phonological processing impairment and his performance remained steadily in the typical scores range. The performance of H. V., a 9-year-old girl with MLD associated with number sense inaccuracy, remained consistently impaired across measurements, with a nonsignificant tendency to worsen. Qualitatively, H. V.'s performance was also characterized by greater variability across sessions. Concomitant clinical observations suggested that H. V.'s difficulties could be aggravated by developing symptoms of mathematics anxiety. Results in these two cases are in line with the hypotheses that at least two reliable patterns of cognitive impairment may underlie math learning difficulties in MLD, one related to number sense inaccuracy and the other to phonological processing impairment. Additionally, it indicates the need for more translational research in order to examine the usefulness and validity of theoretical advances in numerical cognition to the clinical neuropsychological practice with MLD. © 2015 The Institute of Psychology, Chinese

Influence of culture conditions for clinically isolated non-albicans Candida biofilm formation.

Science.gov (United States)

Tan, Yulong; Leonhard, Matthias; Ma, Su; Schneider-Stickler, Berit

2016-11-01

Non-albicans Candida species have been isolated in increasing numbers in patients. Moreover, they are adept at forming biofilms. This study analyzed biofilm formation of clinically isolated non-albicans Candida, including Candida tropicalis, Candida krusei and Candida parapsilosis under the influence of different growth media (RPMI 1640, YPD and BHI) and several culture variables (inoculum concentration, incubation period and feeding conditions). The results showed that culture conditions strongly influenced non-albicans Candida species biofilm formation. YPD and BHI resulted in larger amount of biofilm formation with higher metabolic activity of biofilms. Furthermore, the growth media seems to have varying effects on adhesion and biofilm development. Growth conditions may also influence biofilm formation, which was enhanced when starting the culture with a larger inoculum, longer incubation period and using a fed-batch system. Therefore, the potential influences of external environmental factors should be considered when studying the non-albicans Candida biofilms in vitro. Copyright © 2016 Elsevier B.V. All rights reserved.

Permafrost hydrology in changing climatic conditions: seasonal variability of stable isotope composition in rivers in discontinuous permafrost

International Nuclear Information System (INIS)

Streletskiy, Dmitry A; Shiklomanov, Nikolay I; Nyland, Kelsey E; Tananaev, Nikita I; Opel, Thomas; Streletskaya, Irina D; Tokarev, Igor’; Shiklomanov, Alexandr I

2015-01-01

Role of changing climatic conditions on permafrost degradation and hydrology was investigated in the transition zone between the tundra and forest ecotones at the boundary of continuous and discontinuous permafrost of the lower Yenisei River. Three watersheds of various sizes were chosen to represent the characteristics of the regional landscape conditions. Samples of river flow, precipitation, snow cover, and permafrost ground ice were collected over the watersheds to determine isotopic composition of potential sources of water in a river flow over a two year period. Increases in air temperature over the last forty years have resulted in permafrost degradation and a decrease in the seasonal frost which is evident from soil temperature measurements, permafrost and active-layer monitoring, and analysis of satellite imagery. The lowering of the permafrost table has led to an increased storage capacity of permafrost affected soils and a higher contribution of ground water to river discharge during winter months. A progressive decrease in the thickness of the layer of seasonal freezing allows more water storage and pathways for water during the winter low period making winter discharge dependent on the timing and amount of late summer precipitation. There is a substantial seasonal variability of stable isotopic composition of river flow. Spring flooding corresponds to the isotopic composition of snow cover prior to the snowmelt. Isotopic composition of river flow during the summer period follows the variability of precipitation in smaller creeks, while the water flow of larger watersheds is influenced by the secondary evaporation of water temporarily stored in thermokarst lakes and bogs. Late summer precipitation determines the isotopic composition of texture ice within the active layer in tundra landscapes and the seasonal freezing layer in forested landscapes as well as the composition of the water flow during winter months. (letter)

Do planetary seasons play a role in attaining stable climates?

Science.gov (United States)

Olsen, Kasper Wibeck; Bohr, Jakob

2018-05-01

A simple phenomenological account for planetary climate instabilities is presented. The description is based on the standard model where the balance of incoming stellar radiation and outward thermal radiation is described by the effective planet temperature. Often, it is found to have three different points, or temperatures, where the influx of radiation is balanced with the out-flux, even with conserved boundary conditions. Two of these points are relatively long-term stable, namely the point corresponding to a cold climate and the point corresponding to a hot climate. In a classical sense these points are equilibrium balance points. The hypothesis promoted in this paper is the possibility that the intermediate third point can become long-term stable by being driven dynamically. The initially unstable point is made relatively stable over a long period by the presence of seasonal climate variations.

One-dimensional stable distributions

CERN Document Server

Zolotarev, V M

1986-01-01

This is the first book specifically devoted to a systematic exposition of the essential facts known about the properties of stable distributions. In addition to its main focus on the analytic properties of stable laws, the book also includes examples of the occurrence of stable distributions in applied problems and a chapter on the problem of statistical estimation of the parameters determining stable laws. A valuable feature of the book is the author's use of several formally different ways of expressing characteristic functions corresponding to these laws.

Bi-stable optical actuator

Science.gov (United States)

Holdener, Fred R.; Boyd, Robert D.

2000-01-01

The present invention is a bi-stable optical actuator device that is depowered in both stable positions. A bearing is used to transfer motion and smoothly transition from one state to another. The optical actuator device may be maintained in a stable position either by gravity or a restraining device.

The effects of surface condition on abdominal muscle activity during single-legged hold exercise.

Science.gov (United States)

Ha, Sung-min; Oh, Jae-seop; Jeon, In-cheol; Kwon, Oh-yun

2015-02-01

To treat low-back pain, various spinal stability exercises are commonly used to improve trunk muscle function and strength. Because human movement for normal daily activity occurs in multi-dimensions, the importance of exercise in multi-dimensions or on unstable surfaces has been emphasized. Recently, a motorized rotating platform (MRP) for facilitating multi-dimensions dynamic movement was introduced for clinical use. However, the abdominal muscle activity with this device has not been reported. The purpose of this study was to compare the abdominal muscle activity (rectus abdominis, external and internal oblique muscles) during an active single-leg-hold (SLH) exercise on a floor (stable surface), foam roll, and motorized rotating platform (MRP). Thirteen healthy male subjects participated in this study. Using electromyography, the abdominal muscle activity was measured while the subjects performed SLH exercises on floor (stable surface), foam roll, and MRP. There were significant differences in the abdominal muscle activities among conditions (P.05) (Fig. 2). After the Bonferroni correction, however, no significant differences among conditions remained, except for differences in both side IO muscle activity between the floor and foam roll conditions (padjexercises on a foam roll and MRP is more effective increased activities of both side of RA and IO, and Rt. EO compared to floor condition. However, there were no significant differences in abdominal muscles activity in the multiple comparison between conditions (mean difference were smaller than the standard deviation in the abdominal muscle activities) (padj>0.017), except for differences in both side IO muscle activity between the floor (stable surface) and foam roll (padj<0.017) (effect size: 0.79/0.62 (non-supporting/supporting leg) for foam-roll versus floor). Copyright © 2014 Elsevier Ltd. All rights reserved.

The effect of stable bedding materials on dust levels, microbial air contamination and equine respiratory health.

Science.gov (United States)

Kwiatkowska-Stenzel, Agnieszka; Witkowska, Dorota; Sowińska, Janina; Stopyra, Artur

2017-12-01

The choice of bedding material affects the quality of air in a stable and, consequently, the respiratory health of horses and humans. The risk of respiratory problems can be mitigated by improving the quality of air in the stable. The choice of bedding material is particularly important in cold climate conditions where horses are kept indoors throughout the year. This study examined the impact of three bedding materials: straw (S), peat with shavings (PS), and crushed wood pellets (CWP). The investigated factors were air contamination, including dust contamination and microbial (bacterial and fungal) contamination, and the condition of the equine respiratory tract. The condition of the respiratory tract was evaluated based on the results of arterial blood biochemistry tests and endoscopic evaluations of the upper respiratory tract. Mechanical dust contamination was lowest for PS (1.09mg/m 3 ) and highest for CWP (4.07mg/m 3 ). Bacterial contamination (in CFU - colony forming units) was highest for PS (5.14log 10 CFU/m 3 ) and lowest for CWP (4.81log 10 CFU/m 3 ). Fungal air contamination was lowest for CWP (4.54log 10 CFU/m 3 ) and highest for S (4.82log 10 CFU/m 3 ) and PS (4.88log 10 CFU/m 3 ). An analysis of physiological indicators revealed that all horses were clinically healthy regardless of the type of applied bedding. The type of bedding material did not exert a clear influence on arterial blood biochemistry or the results of endoscopic evaluations of the respiratory tract; however, the use of alternative for straw bedding materials improved endoscopy results. Copyright © 2017 Elsevier Ltd. All rights reserved.

Stable glomerular filtration rate in normotensive IDDM patients with stable microalbuminuria. A 5-year prospective study

DEFF Research Database (Denmark)

Mathiesen, E R; Feldt-Rasmussen, B; Hommel, E

1997-01-01

patients with persistent microalbuminuria (mean urinary albumin excretion [UAE] 84 mg/24 h [range 30-300]) were followed prospectively for 5 years of clinical examinations that included the measurement of GFR (51Cr-labeled EDTA clearance) at least once a year. The mean GFR at baseline was 120 +/- 18 ml x....... Out of 40 patients, 14 progressed to diabetic nephropathy (UAE > 300 mg/24 h). These patients had a significant reduction in GFR (mean -2.2 +/- 3.8 ml x min-1 x year-1; P = 0.05), while GFR remained stable in the remaining 26 patients with nonprogressive microalbuminuria (change in GFR 0.5 +/- 2.1 ml...

Remarks on stable and quasi-stable k-strings at large N

International Nuclear Information System (INIS)

Armoni, A.; Shifman, M.

2003-01-01

We discuss k-strings in the large-N Yang-Mills theory and its supersymmetric extension. Whereas the tension of the bona fide (stable) QCD string is expected to depend only on the N-ality of the representation, tensions that depend on specific representation R are often reported in the lattice literature. In particular, adjoint strings are discussed and found in certain simulations. We clarify this issue by systematically exploiting the notion of the quasi-stable strings which becomes well-defined at large N. The quasi-stable strings with representation-dependent tensions decay, but the decay rate (per unit length per unit time) is suppressed as Λ 2 F(N) where F(N) falls off as a function of N. It can be determined on the case-by-case basis. The quasi-stable strings eventually decay into stable strings whose tension indeed depends only on the N-ality. We also briefly review large-N arguments showing why the Casimir formula for the string tension cannot be correct, and present additional arguments in favor of the sine formula. Finally, we comment on the relevance of our estimates to Euclidean lattice measurements

Evolutionary Stable Strategy

Indian Academy of Sciences (India)

Home; Journals; Resonance – Journal of Science Education; Volume 21; Issue 9. Evolutionary Stable Strategy: Application of Nash Equilibrium in Biology. General Article Volume 21 Issue 9 September 2016 pp 803- ... Keywords. Evolutionary game theory, evolutionary stable state, conflict, cooperation, biological games.

Polyelectrolyte brushes: a novel stable lubrication system in aqueous conditions.

Science.gov (United States)

Kobayashi, Motoyasu; Terada, Masami; Takahara, Atsushi

2012-01-01

Surface-initiated controlled radical copolymerizations of 2-dimethylaminoethyl methacrylate (DMAEMA), 2-(methacryloyloxy)ethyl phosphorylcholine (MPC), 2-(methacryloyloxy)ethyltrimethylammonium chloride) (MTAC), and 3-sulfopropyl methacrylate potassium salt (SPMK) were carried out on a silicon wafer and glass ball to prepare polyelectrolyte brushes with excellent water wettability. The frictional coefficient of the polymer brushes was recorded on a ball-on-plate type tribometer by linear reciprocating motion of the brush specimen at a selected velocity of 1.5 x 10(-3) m s-1 under a normal load of 0.49 N applied to the stationary glass ball (d = 10 mm) at 298 K. The poly(DMAEMA-co-MPC) brush partially cross-linked by bis(2-iodoethoxy)ethane maintained a relatively low friction coefficient around 0.13 under humid air (RH > 75%) even after 200 friction cycles. The poly(SPMK) brush revealed an extremely low friction coefficient around 0.01 even after 450 friction cycles. We supposed that the abrasion of the brush was prevented owing to the good affinity of the poly(SPMK) brush for water forming a water lubrication layer, and electrostatic repulsive interactions among the brushes bearing sulfonic acid groups. Furthermore, the poly(SPMK-co-MTAC) brush with a chemically cross-linked structure showed a stable low friction coefficient in water even after 1400 friction cycles under a normal load of 139 MPa, indicating that the cross-linking structure improved the wear resistance of the brush layer.

Entropy Stable Summation-by-Parts Formulations for Compressible Computational Fluid Dynamics

KAUST Repository

Carpenter, M.H.

2016-11-09

A systematic approach based on a diagonal-norm summation-by-parts (SBP) framework is presented for implementing entropy stable (SS) formulations of any order for the compressible Navier–Stokes equations (NSE). These SS formulations discretely conserve mass, momentum, energy and satisfy a mathematical entropy equality for smooth problems. They are also valid for discontinuous flows provided sufficient dissipation is added at shocks and discontinuities to satisfy an entropy inequality. Admissible SBP operators include all centred diagonal-norm finite-difference (FD) operators and Legendre spectral collocation-finite element methods (LSC-FEM). Entropy stable multiblock FD and FEM operators follows immediately via nonlinear coupling operators that ensure conservation, accuracy and preserve the interior entropy estimates. Nonlinearly stable solid wall boundary conditions are also available. Existing SBP operators that lack a stability proof (e.g. weighted essentially nonoscillatory) may be combined with an entropy stable operator using a comparison technique to guarantee nonlinear stability of the pair. All capabilities extend naturally to a curvilinear form of the NSE provided that the coordinate mappings satisfy a geometric conservation law constraint. Examples are presented that demonstrate the robustness of current state-of-the-art entropy stable SBP formulations.

Feather conditions and clinical scores as indicators of broilers welfare at the slaughterhouse.

Science.gov (United States)

Saraiva, S; Saraiva, C; Stilwell, G

2016-08-01

The objective of this study was to evaluate the welfare of 64 different broiler farms on the basis of feather conditions and clinical scores measures collected at the slaughterhouse. A 3-point scale (0, 1 or 2) was used to classify dirty feathers, footpad dermatitis and hock burns measures, and a 2-point scale (present or absent) was used to classify breast burns, breast blisters and breast ulcer measures. Flocks were allocated into three body weight (BW) classes (A, B, C): class A (light) ≥1.43 and ≤1.68kg, class B (medium) ≥1.69 and ≤1.93kg; class C (heavy) ≥1.94 and ≤2.41kg. The absence of hock burns was more common in class A, while mild hock burns was more common in class B flocks. Breast ulcer was observed in class C flocks. The association observed for mild hock burns, breast burns and severe footpad dermatitis can indicate a simultaneous occurrence of these painful lesions. Very dirty feathers and severe footpad dermatitis relationship suggest litter humidity to be the common underlying cause. In conclusion, it was shown that clinical indicators can be used at the slaughterhouse to identify welfare problems. In the studied flocks, footpad dermatitis, feather conditions and hock burns were the main restrictions for good welfare and should be considered significant welfare indicators of the on-farm rearing conditions. Copyright © 2016 Elsevier Ltd. All rights reserved.

The repellency of lemongrass oil against stable flies, tested using video tracking

Science.gov (United States)

Baldacchino, Frédéric; Tramut, Coline; Salem, Ali; Liénard, Emmanuel; Delétré, Emilie; Franc, Michel; Martin, Thibaud; Duvallet, Gérard; Jay-Robert, Pierre

2013-01-01

Lemongrass oil (Cymbopogon citratus) is an effective repellent against mosquitoes (Diptera: Culicidae) and house flies (Diptera: Muscidae). In this study, its effectiveness was assessed on stable flies (Diptera: Muscidae) in laboratory conditions. First, we demonstrated that lemongrass oil is an active substance for antennal olfactory receptor cells of Stomoxys calcitrans as indicated by a significant increase in the electroantennogram responses to increasing doses of lemongrass oil. Feeding-choice tests in a flight cage with stable flies having access to two blood-soaked sanitary pads, one of which was treated with lemongrass oil, showed that stable flies (n = 24) spent significantly more time in the untreated zone (median value = 218.4 s) than in the treated zone (median value = 63.7 s). No stable flies fed on the treated pad, whereas nine fed on the untreated pad. These results suggest that lemongrass oil could be used as an effective repellent against stable flies. Additional studies to confirm its spatial repellent and feeding deterrent effects are warranted. PMID:23759542

Comparison of different culture conditions for human mesenchymal stromal cells for clinical stem cell therapy

DEFF Research Database (Denmark)

Haack-Sorensen, M.; Friis, T.; Bindslev, L.

2008-01-01

OBJECTIVE: Mesenchymal stromal cells (MSCs) from adult bone marrow (BM) are considered potential candidates for therapeutic neovascularization in cardiovascular disease. When implementing results from animal trials in clinical treatment, it is essential to isolate and expand the MSCs under...... conditions following good manufacturing practice (GMP). The aims of the study were first to establish culture conditions following GMP quality demands for human MSC expansion and differentiation for use in clinical trials, and second to compare these MSCs with MSCs derived from culture in four media commonly...... analysis showed that the plastic-adherent MSCs cultured in EMEA medium or in the other four media were identically negative for the haematopoietic surface markers CD45 and CD34 and positive for CD105, CD73, CD90, CD166 and CD13, which in combined expression is characteristic of MSCs. MSC stimulation...

Quantifying and isolating stable soil organic carbon using long-term bare fallow experiment

DEFF Research Database (Denmark)

Barré, P; Eglin, T; Christensen, Bent Tolstrup

2010-01-01

. We analyzed data from six bare fallow experiments of long-duration (>30 yrs), covering a range of soil types and climate conditions, and sited at Askov (Denmark), Grignon and Versailles (France), Kursk (Russia), Rothamsted (UK), and Ultuna (Sweden). A conceptual three pool model dividing soil C...... into a labile pool (turnover time of a several years), an intermediate pool (turnover time of a several decades) and a stable pool (turnover time of a several centuries or more) fits well with the long term C decline observed in the bare fallow soils. The estimate of stable C ranged from 2.7 g C kg−1...... at Rothamsted to 6.8 g C kg−1 at Grignon. The uncertainty associated with estimates of the stable pool was large due to the short duration of the fallow treatments relative to the turnover time of stable soil C. At Versailles, where there is least uncertainty associated with the determination of a stable pool...

Stratifying a Risk for an Increased Variation of Airway Caliber among the Clinically Stable Asthma

Directory of Open Access Journals (Sweden)

Atsushi Hayata

2013-01-01

Conclusions: These results indicate that ACQ, %FEV1 and FENO can stratify the risk for increased variation in airway caliber among patients with stable asthma. This may help identify subjects in whom further monitoring of lung function fluctuations is indicated.

Predictors for major cardiovascular outcomes in stable ischaemic heart disease (PREMAC)

DEFF Research Database (Denmark)

Winkel, Per; Jakobsen, Janus Christian; Hilden, Jørgen

2017-01-01

The purpose of the predictors for major cardiovascular outcomes in stable ischaemic Heart disease (PREMAC) study is exploratory and hypothesis generating. We want to identify biochemical quantities which—conditionally on the values of available standard demographic, anamnestic, and biochemical data...

The Importance of Conditional Probability in Diagnostic Reasoning and Clinical Decision Making: A Primer for the Eye Care Practitioner.

Science.gov (United States)

Sanfilippo, Paul G; Hewitt, Alex W; Mackey, David A

2017-04-01

To outline and detail the importance of conditional probability in clinical decision making and discuss the various diagnostic measures eye care practitioners should be aware of in order to improve the scope of their clinical practice. We conducted a review of the importance of conditional probability in diagnostic testing for the eye care practitioner. Eye care practitioners use diagnostic tests on a daily basis to assist in clinical decision making and optimizing patient care and management. These tests provide probabilistic information that can enable the clinician to increase (or decrease) their level of certainty about the presence of a particular condition. While an understanding of the characteristics of diagnostic tests are essential to facilitate proper interpretation of test results and disease risk, many practitioners either confuse or misinterpret these measures. In the interests of their patients, practitioners should be aware of the basic concepts associated with diagnostic testing and the simple mathematical rule that underpins them. Importantly, the practitioner needs to recognize that the prevalence of a disease in the population greatly determines the clinical value of a diagnostic test.

Development of a microprocessor-controlled coulometric system for stable ph control

NARCIS (Netherlands)

Bergveld, Piet; van der Schoot, B.H.

1983-01-01

The coulometric pH control system utilizes a programmable coulostat for controlling the pH of a certain volume of unbuffered solution. Based on theoretical considerations, conditions are established which guarantee stable operation with maximum suppression of disturbances from the dissolution of

Bayesian Modeling of Air Pollution Extremes Using Nested Multivariate Max-Stable Processes

KAUST Repository

Vettori, Sabrina; Huser, Raphaë l; Genton, Marc G.

2018-01-01

Capturing the potentially strong dependence among the peak concentrations of multiple air pollutants across a spatial region is crucial for assessing the related public health risks. In order to investigate the multivariate spatial dependence properties of air pollution extremes, we introduce a new class of multivariate max-stable processes. Our proposed model admits a hierarchical tree-based formulation, in which the data are conditionally independent given some latent nested $\\alpha$-stable random factors. The hierarchical structure facilitates Bayesian inference and offers a convenient and interpretable characterization. We fit this nested multivariate max-stable model to the maxima of air pollution concentrations and temperatures recorded at a number of sites in the Los Angeles area, showing that the proposed model succeeds in capturing their complex tail dependence structure.

Bayesian Modeling of Air Pollution Extremes Using Nested Multivariate Max-Stable Processes

KAUST Repository

Vettori, Sabrina

2018-03-18

Capturing the potentially strong dependence among the peak concentrations of multiple air pollutants across a spatial region is crucial for assessing the related public health risks. In order to investigate the multivariate spatial dependence properties of air pollution extremes, we introduce a new class of multivariate max-stable processes. Our proposed model admits a hierarchical tree-based formulation, in which the data are conditionally independent given some latent nested $\\\\alpha$-stable random factors. The hierarchical structure facilitates Bayesian inference and offers a convenient and interpretable characterization. We fit this nested multivariate max-stable model to the maxima of air pollution concentrations and temperatures recorded at a number of sites in the Los Angeles area, showing that the proposed model succeeds in capturing their complex tail dependence structure.

Amyloid-β Plaques in Clinical Alzheimer’s Disease Brain Incorporate Stable Isotope Tracer In Vivo and Exhibit Nanoscale Heterogeneity

Science.gov (United States)

Wildburger, Norelle C.; Gyngard, Frank; Guillermier, Christelle; Patterson, Bruce W.; Elbert, Donald; Mawuenyega, Kwasi G.; Schneider, Theresa; Green, Karen; Roth, Robyn; Schmidt, Robert E.; Cairns, Nigel J.; Benzinger, Tammie L. S.; Steinhauser, Matthew L.; Bateman, Randall J.

2018-01-01

Alzheimer’s disease (AD) is a neurodegenerative disorder with clinical manifestations of progressive memory decline and loss of executive function and language. AD affects an estimated 5.3 million Americans alone and is the most common form of age-related dementia with a rapidly growing prevalence among the aging population—those 65 years of age or older. AD is characterized by accumulation of aggregated amyloid-beta (Aβ) in the brain, which leads to one of the pathological hallmarks of AD—Aβ plaques. As a result, Aβ plaques have been extensively studied after being first described over a century ago. Advances in brain imaging and quantitative measures of Aβ in biological fluids have yielded insight into the time course of plaque development decades before and after AD symptom onset. However, despite the fundamental role of Aβ plaques in AD, in vivo measures of individual plaque growth, growth distribution, and dynamics are still lacking. To address this question, we combined stable isotope labeling kinetics (SILK) and nanoscale secondary ion mass spectrometry (NanoSIMS) imaging in an approach termed SILK–SIMS to resolve plaque dynamics in three human AD brains. In human AD brain, plaques exhibit incorporation of a stable isotope tracer. Tracer enrichment was highly variable between plaques and the spatial distribution asymmetric with both quiescent and active nanometer sub-regions of tracer incorporation. These data reveal that Aβ plaques are dynamic structures with deposition rates over days indicating a highly active process. Here, we report the first, direct quantitative measures of in vivo deposition into plaques in human AD brain. Our SILK–SIMS studies will provide invaluable information on plaque dynamics in the normal and diseased brain and offer many new avenues for investigation into pathological mechanisms of the disease, with implications for therapeutic development. PMID:29623063

Amyloid-β Plaques in Clinical Alzheimer’s Disease Brain Incorporate Stable Isotope Tracer In Vivo and Exhibit Nanoscale Heterogeneity

Directory of Open Access Journals (Sweden)

Norelle C. Wildburger

2018-03-01

Full Text Available Alzheimer’s disease (AD is a neurodegenerative disorder with clinical manifestations of progressive memory decline and loss of executive function and language. AD affects an estimated 5.3 million Americans alone and is the most common form of age-related dementia with a rapidly growing prevalence among the aging population—those 65 years of age or older. AD is characterized by accumulation of aggregated amyloid-beta (Aβ in the brain, which leads to one of the pathological hallmarks of AD—Aβ plaques. As a result, Aβ plaques have been extensively studied after being first described over a century ago. Advances in brain imaging and quantitative measures of Aβ in biological fluids have yielded insight into the time course of plaque development decades before and after AD symptom onset. However, despite the fundamental role of Aβ plaques in AD, in vivo measures of individual plaque growth, growth distribution, and dynamics are still lacking. To address this question, we combined stable isotope labeling kinetics (SILK and nanoscale secondary ion mass spectrometry (NanoSIMS imaging in an approach termed SILK–SIMS to resolve plaque dynamics in three human AD brains. In human AD brain, plaques exhibit incorporation of a stable isotope tracer. Tracer enrichment was highly variable between plaques and the spatial distribution asymmetric with both quiescent and active nanometer sub-regions of tracer incorporation. These data reveal that Aβ plaques are dynamic structures with deposition rates over days indicating a highly active process. Here, we report the first, direct quantitative measures of in vivo deposition into plaques in human AD brain. Our SILK–SIMS studies will provide invaluable information on plaque dynamics in the normal and diseased brain and offer many new avenues for investigation into pathological mechanisms of the disease, with implications for therapeutic development.

Immunosuppression Adherence in Stable Kidney Transplant Patients Converted From Immediate- to Prolonged-Release Tacrolimus in Clinical Practice: A Norwegian Study

Directory of Open Access Journals (Sweden)

Sadollah Abedini, MD, PhD

2018-02-01

Conclusions. There was disparity between high, patient-perceived and low, actual adherence. Converting stable KTPs from IR-T to PR-T in routine practice did not impact long-term adherence to immunosuppression; renal function remained stable.

Stable Boundary Layer Issues

OpenAIRE

Steeneveld, G.J.

2012-01-01

Understanding and prediction of the stable atmospheric boundary layer is a challenging task. Many physical processes are relevant in the stable boundary layer, i.e. turbulence, radiation, land surface coupling, orographic turbulent and gravity wave drag, and land surface heterogeneity. The development of robust stable boundary layer parameterizations for use in NWP and climate models is hampered by the multiplicity of processes and their unknown interactions. As a result, these models suffer ...

Stable coronary syndromes: pathophysiology, diagnostic advances and therapeutic need

Science.gov (United States)

Corcoran, David

2018-01-01

The diagnostic management of patients with angina pectoris typically centres on the detection of obstructive epicardial CAD, which aligns with evidence-based treatment options that include medical therapy and myocardial revascularisation. This clinical paradigm fails to account for the considerable proportion (approximately one-third) of patients with angina in whom obstructive CAD is excluded. This common scenario presents a diagnostic conundrum whereby angina occurs but there is no obstructive CAD (ischaemia and no obstructive coronary artery disease—INOCA). We review new insights into the pathophysiology of angina whereby myocardial ischaemia results from a deficient supply of oxygenated blood to the myocardium, due to various combinations of focal or diffuse epicardial disease (macrovascular), microvascular dysfunction or both. Macrovascular disease may be due to the presence of obstructive CAD secondary to atherosclerosis, or may be dynamic due to a functional disorder (eg, coronary artery spasm, myocardial bridging). Pathophysiology of coronary microvascular disease may involve anatomical abnormalities resulting in increased coronary resistance, or functional abnormalities resulting in abnormal vasomotor tone. We consider novel clinical diagnostic techniques enabling new insights into the causes of angina and appraise the need for improved therapeutic options for patients with INOCA. We conclude that the taxonomy of stable CAD could improve to better reflect the heterogeneous pathophysiology of the coronary circulation. We propose the term ‘stable coronary syndromes’ (SCS), which aligns with the well-established terminology for ‘acute coronary syndromes’. SCS subtends a clinically relevant classification that more fully encompasses the different diseases of the epicardial and microvascular coronary circulation. PMID:29030424

Trust and memory: organizational strategies, institutional conditions and trust negotiations in specialty clinics for Alzheimer's disease.

Science.gov (United States)

Beard, Renée L

2008-03-01

Clinicians aim to establish trust during medical encounters because, without it, health consumers may not seek medical care, consider their diagnoses legitimate, or adhere to treatment regimens. This paper examines the identification and treatment of memory loss within two specialty clinics to understand how cultural dynamics, such as organizational ethos and work practices, influence the social fabric of cognitive evaluations. Ethnographic data suggest important historical and cultural differences in the approaches to Alzheimer's disease (AD). Organizational routines, however, support a common goal, that of moving individuals from "potential patients" to patients, and ultimately research subjects, through establishing trust. Although the processes through which trust is potentially achieved, or the social conditions of trust, were similar at the sites, the object of trust was different. Whereas one clinic encouraged trust in collective medical expertise, the other focused on trust in specific clinicians. These conditions affect the clinical consequences of trust, particularly how and when the diagnosis is delivered, use of the AD label and other terminology, and the level of standardization. The individual consequences include perceptions of patients and depictions of the prognosis. Whether cognitive impairment is viewed as a scientific puzzle to be solved or is seen as a chronic illness significantly shapes the organizational processes of clinical evaluation. Alzheimer's disease, as a cultural object, is a particularly salient exemplar of the clinical negotiation of ambiguous diagnostic categorizations and the unpredictable patient in daily biomedical practice.

Top-down influences on ambiguous perception: the role of stable and transient states of the observer

Science.gov (United States)

Scocchia, Lisa; Valsecchi, Matteo; Triesch, Jochen

2014-01-01

The world as it appears to the viewer is the result of a complex process of inference performed by the brain. The validity of this apparently counter-intuitive assertion becomes evident whenever we face noisy, feeble or ambiguous visual stimulation: in these conditions, the state of the observer may play a decisive role in determining what is currently perceived. On this background, ambiguous perception and its amenability to top-down influences can be employed as an empirical paradigm to explore the principles of perception. Here we offer an overview of both classical and recent contributions on how stable and transient states of the observer can impact ambiguous perception. As to the influence of the stable states of the observer, we show that what is currently perceived can be influenced (1) by cognitive and affective aspects, such as meaning, prior knowledge, motivation, and emotional content and (2) by individual differences, such as gender, handedness, genetic inheritance, clinical conditions, and personality traits and by (3) learning and conditioning. As to the impact of transient states of the observer, we outline the effects of (4) attention and (5) voluntary control, which have attracted much empirical work along the history of ambiguous perception. In the huge literature on the topic we trace a difference between the observer's ability to control dominance (i.e., the maintenance of a specific percept in visual awareness) and reversal rate (i.e., the switching between two alternative percepts). Other transient states of the observer that have more recently drawn researchers' attention regard (6) the effects of imagery and visual working memory. (7) Furthermore, we describe the transient effects of prior history of perceptual dominance. (8) Finally, we address the currently available computational models of ambiguous perception and how they can take into account the crucial share played by the state of the observer in perceiving ambiguous displays. PMID

Stable isogeometric analysis of trimmed geometries

Science.gov (United States)

Marussig, Benjamin; Zechner, Jürgen; Beer, Gernot; Fries, Thomas-Peter

2017-04-01

We explore extended B-splines as a stable basis for isogeometric analysis with trimmed parameter spaces. The stabilization is accomplished by an appropriate substitution of B-splines that may lead to ill-conditioned system matrices. The construction for non-uniform knot vectors is presented. The properties of extended B-splines are examined in the context of interpolation, potential, and linear elasticity problems and excellent results are attained. The analysis is performed by an isogeometric boundary element formulation using collocation. It is argued that extended B-splines provide a flexible and simple stabilization scheme which ideally suits the isogeometric paradigm.

Wall-crossing between stable and co-stable ADHM data

Science.gov (United States)

Ohkawa, Ryo

2018-06-01

We prove formula between Nekrasov partition functions defined from stable and co-stable ADHM data for the plane following method by Nakajima and Yoshioka (Kyoto J Math 51(2):263-335, 2011) based on the theory of wall-crossing formula developed by Mochizuki (Donaldson type invariants for algebraic surfaces: transition of moduli stacks, Lecture notes in mathematics, vol 1972, Springer, Berlin, 2009). This formula is similar to conjectures by Ito et al. [J High Energy Phys 2013(5):045, 2013, (4.1), (4.2)] for A1 singularity.

Initial conditions for chaotic inflation

International Nuclear Information System (INIS)

Brandenberger, R.; Kung, J.; Feldman, H.

1991-01-01

In contrast to many other inflationary Universe models, chaotic inflation does not depend on fine tuning initial conditions. Within the context of linear perturbation theory, it is shown that chaotic inflation is stable towards both metric and matter perturbations. Neglecting gravitational perturbations, it is shown that chaotic inflation is an attractor in initial condition space. (orig.)

Meniscectomy versus meniscal repair: 10 years radiological and clinical results in vertical lesions in stable knee.

Science.gov (United States)

Lutz, C; Dalmay, F; Ehkirch, F P; Cucurulo, T; Laporte, C; Le Henaff, G; Potel, J F; Pujol, N; Rochcongar, G; Salledechou, E; Seil, R; Gunepin, F-X; Sonnery-Cottet, B

2015-12-01

Surgical management of meniscal lesion consists of either a meniscectomy or meniscal repair. Although repair offers immediate recovery after surgery, it is also associated with higher rates of revision. A meniscectomy, on the other hand is known to be associated with an early onset of osteoarthritis. The present study compared clinical and radiological results at 10 years between meniscectomy and meniscal repair in isolated vertical lesion in an otherwise stable knee. The hypothesis was that repair shows functional and radiological benefit over meniscectomy. A multi-centric retrospective comparative study of 32 patients (24 male, 8 female). Mean follow-up was 10.6 years (range, 10-13 years). There were 10 meniscal repairs (group R) and 22 meniscectomies (group M), in 17 right and 15 left knees. Mean age at surgery was 33.45±12.3 years (range, 9-47 years). There were 28 medial and 4 lateral meniscal lesions; 26 were in the red-red zone and 6 in red-white zone. Functional score: KOOS score was significantly higher in group R than M on almost all parameters: 98±4.69 versus 77.38±21.97 for symptoms (P=0.0043), 96.89±7.20 versus 78.57±18.9 for pain (P=0.0052), 99.89±0.33 versus 80.88±19.6 for daily life activities (P=0.0002), 96.11±9.83 versus 54.05±32.85 for sport and leisure (P=0.0005), but 91±16.87 versus 68.15±37.7 for quality of life (P=0.1048). Radiology score: in group R, 7 patients had no features of osteoarthritis, and 2 had grade 1 osteoarthritis. In group M, 5 patients had grade 1 osteoarthritis, 10 grade 2, 3 grade 3 and 3 grade 4. Mean quantitative score was 0 (mean, 0.22±0.44) in-group R and 2 (mean, 2.19±0.98) in group M (P<0.0001). At more than 10year's follow-up, functional scores were significantly better with meniscal repair than meniscectomy on all parameters of the KOOS scale except quality of life. Functional and radiological scores correlated closely. These results show that meniscal repair for vertical lesions in stable knees

Stable pelagic vertebrate community structure through extreme Paleogene greenhouse conditions

Science.gov (United States)

Sibert, E. C.; Friedman, M.; Hull, P. M.; Hunt, G.; Norris, R. D.

2016-02-01

The species composition (structure) and energy transfer (function) of an ecosystem is reflected by the presence and type of consumers that it supports. Here we use ichthyoliths, microfossil fish teeth and shark denticles, to assess the ecological variability of the pelagic fish community structure and composition from the Late Cretaceous to the middle Eocene from a drill core in the South Pacific gyre (DSDP Site 596). We find that the overall vertebrate community structure, as measured by the relative abundance of sharks to ray-finned fishes, has a punctuated change at the Cretaceous/Paleogene mass extinction. The vertebrate community structure remained stable throughout the Paleogene despite a five-fold increase in overall abundance of ichthyoliths during the extreme greenhouse of the Early Eocene. Further, we use a novel system to quantify the morphological variation in fish teeth. We find that the morphospace occupied by the tooth assemblage is conserved throughout the interval, with a slight expansion following the Cretaceous-Paleogene mass extinction, and the evolution of a distinct morphotype-group around the Paleocene-Eocene boundary. While there are elevated rates of morphotype origination and extinction following the Cretaceous-Paleogene mass extinction, the extreme greenhouse warming of the Early Eocene and associated increase in fish production produce near-zero origination and extinction rates. The relative stability in composition of the pelagic vertebrate community during intervals of extreme climate change and across large ranges of total fish accumulation, suggests that pelagic ecosystem structure is robust to climate events, and that the overall structure of the pelagic fish community may be decoupled from both climate and ecosystem function.

Stable propagation of an electron beam in gas

International Nuclear Information System (INIS)

Lee, E.P.; Chambers, F.W.; Lodestro, L.L.; Yu, S.S.

1977-01-01

Conditions for the stable propagation of a pinched electron beam in low pressure gas (p approximately 0.1 to 100 torr) are described. The observed window of good propagation around p approximately 2 torr air is interpreted as the quenching of the two-stream mode by sufficiently high plasma density and collision frequency, and the simultaneous suppression of the resistive hose mode by sufficiently rapid generation of electrical conductivity from breakdown ionization

Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

Directory of Open Access Journals (Sweden)

Jing Wu

Full Text Available OBJECTIVES: To compare health-related quality of life (HRQoL between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411 and the general population recruited from 3 Physical Examination Centers (n = 549 was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ. Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females, stable angina patients (68.1 ± 12 years, 50.4% females had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05, SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05, and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05. The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6. Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms

Osteoprotegerin independently predicts mortality in patients with stable coronary artery disease: the CLARICOR trial

DEFF Research Database (Denmark)

Bjerre, Mette; Hilden, Jørgen; Kastrup, Jens

2014-01-01

OBJECTIVES: To elucidate the prognostic power of serum osteoprotegerin (OPG) in patients with stable coronary artery disease (CAD). METHODS: Serum OPG levels were measured in the CLARICOR trial cohort of 4063 patients with stable CAD on blood samples drawn at randomization. The follow-up was 2...... predictor for all-cause mortality. Importantly, OPG remained an independent predictor of mortality even after adjustment for both clinical and conventional cardiovascular risk markers (HR 2.5 [95% CI 1.6-3.9, p power as to all...

Relationship between oral clinical conditions and daily performances

Directory of Open Access Journals (Sweden)

Andréa Silveira Gomes

2009-03-01

Full Text Available The aim of this study was to assess the impact of oral status on the daily performances of civil servants from the Public Works and Waste Management Department of the city of Porto Alegre, located in Southern Brazil. A cross-sectional study was conducted on a representative sample composed of 276 civil servants with ages ranging from 35 to 44 years. The Oral Impacts on Daily Performances index developed was employed to measure impacts caused by oral clinical conditions. Oral examinations were performed after the interviews. Multinomial Logistic Regression Analysis was used. After adjusting for sex and educational level, the results showed that the subjects with high DMFT scores were 5.8 times (95% CI = 2.1-16.1 more likely to have high impacts on their everyday life than those with low DMFT scores. Subjects that presented some coronal caries were 4.3 times (95% CI = 1.9-9.8 more likely to have high impacts on their everyday life than those with no coronal caries. Dental status assessed through the DMFT index and coronal caries are important indicators of impacts on the everyday life of the studied population.

One-Year stable perovskite solar cells by 2D/3D interface engineering

Science.gov (United States)

Grancini, G.; Roldán-Carmona, C.; Zimmermann, I.; Mosconi, E.; Lee, X.; Martineau, D.; Narbey, S.; Oswald, F.; de Angelis, F.; Graetzel, M.; Nazeeruddin, Mohammad Khaja

2017-06-01

Despite the impressive photovoltaic performances with power conversion efficiency beyond 22%, perovskite solar cells are poorly stable under operation, failing by far the market requirements. Various technological approaches have been proposed to overcome the instability problem, which, while delivering appreciable incremental improvements, are still far from a market-proof solution. Here we show one-year stable perovskite devices by engineering an ultra-stable 2D/3D (HOOC(CH2)4NH3)2PbI4/CH3NH3PbI3 perovskite junction. The 2D/3D forms an exceptional gradually-organized multi-dimensional interface that yields up to 12.9% efficiency in a carbon-based architecture, and 14.6% in standard mesoporous solar cells. To demonstrate the up-scale potential of our technology, we fabricate 10 × 10 cm2 solar modules by a fully printable industrial-scale process, delivering 11.2% efficiency stable for >10,000 h with zero loss in performances measured under controlled standard conditions. This innovative stable and low-cost architecture will enable the timely commercialization of perovskite solar cells.

Construction of stable explicit finite-difference schemes for Schroedinger type differential equations

Science.gov (United States)

Mickens, Ronald E.

1989-01-01

A family of conditionally stable, forward Euler finite difference equations can be constructed for the simplest equation of Schroedinger type, namely u sub t - iu sub xx. Generalization of this result to physically realistic Schroedinger type equations is presented.

Angina Pectoris (Stable Angina)

Science.gov (United States)

... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Angina Pectoris (Stable Angina) Updated:Aug 21,2017 You may have heard the term “angina pectoris” or “stable angina” in your doctor’s office, ...

Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Przemyslaw Kardas

2007-05-01

Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

Neuro-ophthalmological conditions: Study of the clinical care pathway.

Science.gov (United States)

Layat, I; Challe, G; LeHoang, P; Bodaghi, B; Touitou, V

2017-06-01

Neuro-ophthalmologic conditions require specialized multidisciplinary management, both medical and surgical, for patients affected by visual loss due to nervous system disease. The primary goal of this study is to define the specificity of neuro-ophthalmology within the realm of visual health. The secondary goal is to review clinical care pathways by studying the organization of management, in terms of accessibility to care and personalization of the care pathway. A field study was carried out from February to June 2015, within the ophthalmology service of the Pitié-Salpêtrière University Medical Center in Paris. A 30-minute interview with the patient before or after his or her neuro-ophthalmology consultation was performed, to describe the clinical care pathway. The medical records of interviewed patients were also analyzed. Seventeen care pathways (10 women and 7 men) were reviewed. The mean age at appearance of visual involvement was 44.5 years (±8.4 years). If we exclude 3 patients over 66 years and retired, 35.71% were active, 35.71% were disabled, and 28.57% were on sick leave. Ten patients (58.82%) met the criteria for admission to long-term care. The first step had been carried out by local private practitioners. The first physician seen was the general medicine physician (59%), then the private ophthalmologist on an emergency basis (17%). On average, patients went through 8 steps during their care pathway (from 6 to 10 steps) and 14 medical departments were involved. The study showed collaboration with the other services of the University Hospital Department of Vision and Disabilities (notably with the Fondation Rothschild, the Quinze-Vingts National Ophthalmology Hospital, and the Fondation Sainte-Marie). In addition to rehabilitation services, health care professionals participating in the outpatient care of the patients included an orthoptist (11.7%), a psychologist (11.7%), and an optician specializing in low vision for visual aids. Finally

Normal modified stable processes

DEFF Research Database (Denmark)

Barndorff-Nielsen, Ole Eiler; Shephard, N.

2002-01-01

Gaussian (NGIG) laws. The wider framework thus established provides, in particular, for added flexibility in the modelling of the dynamics of financial time series, of importance especially as regards OU based stochastic volatility models for equities. In the special case of the tempered stable OU process......This paper discusses two classes of distributions, and stochastic processes derived from them: modified stable (MS) laws and normal modified stable (NMS) laws. This extends corresponding results for the generalised inverse Gaussian (GIG) and generalised hyperbolic (GH) or normal generalised inverse...

Crystal engineering of stable temozolomide cocrystals.

Science.gov (United States)

Babu, N Jagadeesh; Sanphui, Palash; Nangia, Ashwini

2012-10-01

The antitumor prodrug temozolomide (TMZ) decomposes in aqueous medium of pH≥7 but is relatively stable under acidic conditions. Pure TMZ is obtained as a white powder but turns pink and then brown, which is indicative of chemical degradation. Pharmaceutical cocrystals of TMZ were engineered with safe coformers such as oxalic acid, succinic acid, salicylic acid, d,l-malic acid, and d,l-tartaric acid, to stabilize the drug as a cocrystal. All cocrystals were characterized by powder X-ray diffraction (PXRD), single crystal X-ray diffraction, and FT-IR as well as FT-Raman spectroscopy. Temozolomide cocrystals with organic acids (pK(a) 2-6) were found to be more stable than the reference drug under physiological conditions. The half-life (T(1/2)) of TMZ-oxalic and TMZ-salicylic acid measured by UV/Vis spectroscopy in pH 7 buffer is two times longer than that of TMZ (3.5 h and 3.6 h vs. 1.7 h); TMZ-succinic acid, TMZ-tartaric acid, and TMZ-malic acid also exhibited a longer half-life (2.3, 2.5, and 2.8 h, respectively). Stability studies at 40 °C and 75 % relative humidity (ICH conditions) showed that hydrolytic degradation of temozolomide in the solid state started after one week, as determined by PXRD, whereas its cocrystals with succinic acid and oxalic acid were intact at 28 weeks, thus confirming the greater stability of cocrystals compared to the reference drug. The intrinsic dissolution rate (IDR) profile of TMZ-oxalic acid and TMZ-succinic acid cocrystals in buffer of pH 7 is comparable to that of temozolomide. Among the temozolomide cocrystals examined, those with succinic acid and oxalic acid exhibited both an improved stability and a comparable dissolution rate to the reference drug. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The stable Cr isotopic compositions of chondrites and silicate planetary reservoirs

Science.gov (United States)

Schoenberg, Ronny; Merdian, Alexandra; Holmden, Chris; Kleinhanns, Ilka C.; Haßler, Kathrin; Wille, Martin; Reitter, Elmar

2016-06-01

The depletion of chromium in Earth's mantle (∼2700 ppm) in comparison to chondrites (∼4400 ppm) indicates significant incorporation of chromium into the core during our planet's metal-silicate differentiation, assuming that there was no significant escape of the moderately volatile element chromium during the accretionary phase of Earth. Stable Cr isotope compositions - expressed as the ‰-difference in 53Cr/52Cr from the terrestrial reference material SRM979 (δ53/52CrSRM979 values) - of planetary silicate reservoirs might thus yield information about the conditions of planetary metal segregation processes when compared to chondrites. The stable Cr isotopic compositions of 7 carbonaceous chondrites, 11 ordinary chondrites, 5 HED achondrites and 2 martian meteorites determined by a double spike MC-ICP-MS method are within uncertainties indistinguishable from each other and from the previously determined δ53/52CrSRM979 value of -0.124 ± 0.101‰ for the igneous silicate Earth. Extensive quality tests support the accuracy of the stable Cr isotope determinations of various meteorites and terrestrial silicates reported here. The uniformity in stable Cr isotope compositions of samples from planetary silicate mantles and undifferentiated meteorites indicates that metal-silicate differentiation of Earth, Mars and the HED parent body did not cause measurable stable Cr isotope fractionation between these two reservoirs. Our results also imply that the accretionary disc, at least in the inner solar system, was homogeneous in its stable Cr isotopic composition and that potential volatility loss of chromium during accretion of the terrestrial planets was not accompanied by measurable stable isotopic fractionation. Small but reproducible variations in δ53/52CrSRM979 values of terrestrial magmatic rocks point to natural stable Cr isotope variations within Earth's silicate reservoirs. Further and more detailed studies are required to investigate whether silicate

Quantum evolutionary stable strategies of 2-player, 2-strategy symmetric games

International Nuclear Information System (INIS)

Sun, Z.W.

2009-01-01

Quantum evolutionary stable strategies (ESSs) of games are considered as stable solutions to population games on molecular level. The distributive diagram of 2-player, 2-strategy (2 x 2) symmetric games is brought out to get a convenient way of looking for their quantum ESSs. It is found that transpositions, related to the parameters in classical payoff and those of initial quantum states, may occur when games are quantized. Conditions for transpositions are given in two tables. One can easily find quantum ESSs of a 2 x 2 symmetric game according to its transposition. This paper also draws an overall outline of NEs and ESSs of this kind of game.

Rivaroxaban with or without aspirin in patients with stable coronary artery disease

DEFF Research Database (Denmark)

Connolly, Stuart J; Eikelboom, John W; Bosch, Jackie

2018-01-01

, or cardiovascular death. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. FINDINGS: Between March 12, 2013, and May 10, 2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824 patients had stable coronary artery disease from 558 centres...

Highly Stable and Active Catalyst for Sabatier Reactions

Science.gov (United States)

Hu, Jianli; Brooks, Kriston P.

2012-01-01

Highly active Ru/TiO2 catalysts for Sabatier reaction have been developed. The catalysts have shown to be stable under repeated shutting down/startup conditions. When the Ru/TiO2 catalyst is coated on the engineered substrate Fe-CrAlY felt, activity enhancement is more than doubled when compared with an identically prepared engineered catalyst made from commercial Degussa catalyst. Also, bimetallic Ru-Rh/TiO2 catalysts show high activity at high throughput.

Demographics and co-occurring conditions in a clinic-based cohort with Down syndrome in the United Arab Emirates.

Science.gov (United States)

Corder, Jennifer Price; Al Ahbabi, Fatima Jaber Sehmi; Al Dhaheri, Hind Saif; Chedid, Fares

2017-09-01

The majority of studies describing demographics and co-occurring conditions in cohorts with Down syndrome come from regions outside of the Middle East, mainly from Europe and North America. This paper describes demographics and co-occurring conditions in a hospital-based cohort of individuals with Down syndrome living in the Middle Eastern country of the United Arab Emirates (UAE). The first dedicated Down syndrome clinic in the UAE was established in 2012 at Tawam Hospital in Al Ain. This paper describes a clinic-based cohort of 221 participants over 4 years from the Gulf Down Syndrome Registry, a new Down syndrome database and contact registry created at Tawam Hospital. Key demographic findings include mean maternal age of 37 years, among the highest described in the literature. Sixty-two percent of mothers are >35 years. Over 90% of mothers received post-natal diagnosis of Down syndrome. High sex ratio, parental consanguinity, and large family size also characterize the group. The spectrum of many co-occurring conditions mirrors that of previously described populations, with some notable differences. Cardiovascular malformations are well represented, however, atrioventricular canal is not the most common. Genitourinary conditions are common, as evidenced by 12% of males with hypospadias and 15% with undescended testes. Glucose-6-phosphate dehydrogenase deficiency, alpha thalassemia trait, hypovitaminosis D, and dental caries are common in our cohort. This study describes a large hospital-based group with Down syndrome presenting to a new dedicated Down syndrome clinic in the UAE, highlighting unique demographic and co-occurring conditions found in that population. © 2017 Wiley Periodicals, Inc.

Ultrasound-Guided Drainage of Supralevator Hematoma in a Hemodynamically Stable Patient.

Science.gov (United States)

Mukhopadhyay, Debjani; Jennings, Paul E; Banerjee, Mamta; Gada, Ruta

2015-12-01

Paravaginal hematomas can be life-threatening. In patients with intact vaginal walls and perineum, they may pose a diagnostic and therapeutic challenge. Supralevator hematomas are much less common than infralevator hematomas. We present a case of puerperal hemorrhagic shock after a normal vaginal delivery in a low-risk parous woman resulting from an occult supralevator hematoma. Because the woman was hemodynamically unstable initially, she underwent a vaginal surgical drainage. A week later, the supravaginal hematoma reformed. At this time the patient was hemodynamically stable, and ultrasound-guided drainage was performed, which resulted in complete resolution of the hematoma within 10 days. In a clinically stable puerperal patient, ultrasound-guided drainage of a supralevator hematoma resulted in rapid and complete resolution of symptoms.

Stable Boundary Layer Issues

NARCIS (Netherlands)

Steeneveld, G.J.

2012-01-01

Understanding and prediction of the stable atmospheric boundary layer is a challenging task. Many physical processes are relevant in the stable boundary layer, i.e. turbulence, radiation, land surface coupling, orographic turbulent and gravity wave drag, and land surface heterogeneity. The

Stable de Sitter vacua in four-dimensional supergravity originating from five dimensions

International Nuclear Information System (INIS)

Oegetbil, O.

2008-01-01

The five-dimensional stable de Sitter ground states in N=2 supergravity obtained by gauging SO(1,1) symmetry of the real symmetric scalar manifold (in particular, a generic Jordan family manifold of the vector multiplets) simultaneously with a subgroup R s of the R-symmetry group descend to four-dimensional de Sitter ground states under certain conditions. First, the holomorphic section in four dimensions has to be chosen carefully by using the symplectic freedom in four dimensions; second, a group contraction is necessary to bring the potential into a desired form. Under these conditions, stable de Sitter vacua can be obtained in dimensionally reduced theories (from 5D to 4D) if the semidirect product of SO(1,1) with R (1,1) together with a simultaneous R s is gauged. We review the stable de Sitter vacua in four dimensions found in earlier literature for N=2 Yang-Mills Einstein supergravity with the SO(2,1)xR s gauge group in a symplectic basis that comes naturally after dimensional reduction. Although this particular gauge group does not descend directly from five dimensions, we show that its contraction does. Hence, two different theories overlap in certain limits. Examples of stable de Sitter vacua are given for the cases: (i) R s =U(1) R , (ii) R s =SU(2) R , and (iii) N=2 Yang-Mills/Einstein supergravity theory coupled to a universal hypermultiplet. We conclude with a discussion regarding the extension of our results to supergravity theories with more general homogeneous scalar manifolds.

Shelf-stable food through high dose irradiation

International Nuclear Information System (INIS)

Placek, V.; Svobodova, V.; Bartonicek, B.; Rosmus, J.; Camra, M.

2004-01-01

Irradiation of food with high doses (radappertization) is a way, how to prepare shelf-stable ready-to-eat food. The radappertization process requires that the food be heated at first to an internal temperature of at least 75 deg. C to inactivate autolytic enzyme, which could cause the spoilage during storage without refrigeration. In order to prevent radiation induced changes in sensory properties (off flavors, odors, undesirable color change, etc.) the food was vacuum packed and irradiated in frozen state at -30 deg. C or less to a minimum dose of 35 kGy. Such products have characteristics of fresh food prepared for eating even if they are stored for long time under tropical conditions. The wholesomeness (safety for consumption) has been confirmed during 40 years of testing. Within the NRI Rez 10 kinds of shelf-stable meat products have been prepared. The meat was cooked, vacuum packed in SiO x -containing pouch, freezed in liquid nitrogen and irradiated with electron beam accelerator. The microbial, chemical, and organoleptic properties have been tested

Shelf-stable food through high dose irradiation

Energy Technology Data Exchange (ETDEWEB)

Placek, V. E-mail: pla@ujv.cz; Svobodova, V.; Bartonicek, B.; Rosmus, J.; Camra, M

2004-10-01

Irradiation of food with high doses (radappertization) is a way, how to prepare shelf-stable ready-to-eat food. The radappertization process requires that the food be heated at first to an internal temperature of at least 75 deg. C to inactivate autolytic enzyme, which could cause the spoilage during storage without refrigeration. In order to prevent radiation induced changes in sensory properties (off flavors, odors, undesirable color change, etc.) the food was vacuum packed and irradiated in frozen state at -30 deg. C or less to a minimum dose of 35 kGy. Such products have characteristics of fresh food prepared for eating even if they are stored for long time under tropical conditions. The wholesomeness (safety for consumption) has been confirmed during 40 years of testing. Within the NRI Rez 10 kinds of shelf-stable meat products have been prepared. The meat was cooked, vacuum packed in SiO{sub x}-containing pouch, freezed in liquid nitrogen and irradiated with electron beam accelerator. The microbial, chemical, and organoleptic properties have been tested.

CONDITIONS FOR STABLE CHIP BREAKING AND PROVISION OF MACHINED SURFACE QUALITY WHILE TURNING WITH ASYMMETRIC TOOL VIBRATIONS

Directory of Open Access Journals (Sweden)

V. K. Sheleh

2015-01-01

Full Text Available The paper considers a process of turning structural steel with asymmetric tool vibrations directed along feeding. Asymmetric vibrations characterized by asymmetry coefficient of vibration cycle, their frequency and amplitude are additionally transferred to the tool in the turning process with the purpose to crush chips. Conditions of stable chip breaking and obtaining optimum dimensions of chip elements have been determined in the paper. In order to reduce a negative impact of the vibration amplitude on a cutting process and quality of the machined surfaces machining must be carried out with its minimum value. In this case certain ratio of the tool vibration frequency to the work-piece rotation speed has been ensured in the paper. A formula has been obtained for calculation of this ratio with due account of the expected length of chip elements and coefficient of vibration cycle asymmetry.Influence of the asymmetric coefficient of the tool vibration cycle on roughness of the machined surfaces and cutting tool wear has been determined in the paper. According to the results pertaining to machining of work-pieces made of 45 and ШХ15 steel the paper presents mathematical relationships of machined surface roughness with cutting modes and asymmetry coefficient of tool vibration cycle. Tool feeding being one of the cutting modes exerts the most significant impact on the roughness value and increase of the tool feeding entails increase in roughness. Reduction in coefficient of vibration cycle asymmetry contributes to surface roughness reduction. However, the cutting tool wear occurs more intensive. Coefficient of the vibration cycle asymmetry must be increased in order to reduce wear rate. Therefore, the choice of the coefficient of the vibration cycle asymmetry is based on the parameters of surface roughness which must be obtained after machining and intensity of tool wear rate.The paper considers a process of turning structural steel with asymmetric

Magnetic resonance imaging of the liver in postpartum stable women with HELLP syndrome; Ressonancia magnetica hepatica em puerperas estaveis com sindrome HELLP

Energy Technology Data Exchange (ETDEWEB)

Carvalho, Ana Rita Marinho Ribeiro; Amorim, Melania Maria Ramos de; Katz, Leila; Souza, Alex Sandro Rolland de; Santos, Aleksana Regina Viana Dutra; Lima, Ana Luiza Medeiros Vasconcelos de [Instituto Materno Infantil Prof. Fernando Figueira, Recife, PE (Brazil). Centro de Atencao a Mulher. Unidade de Terapia Intensiva Obstetrica

2008-09-15

Objectives: To describe magnetic resonance (MR) findings in the liver of stable patients with HELLP syndrome in the puerperium. Methods: A descriptive study was carried out from August 2005 to July 2006, involving a series of 40 postpartum patients admitted to an obstetric intensive therapy unit in IMIP (Instituto Materno Infantil Prof. Fernando Figueira) with diagnosis of HELLP syndrome (complete and partial). Complete HELLP syndrome was defined when all laboratory parameters were present and incomplete when one or more but not all laboratory findings were present. All patients had stable clinical conditions and were evaluated with magnetic resonance of the liver and the main findings were recorded. Results. Average maternal age was 26.8 {+-} 6.4 years and gestational age at delivery was 34 {+-} 26.8 weeks. The MR imaging was performed between eight and 96 hours after diagnosis of HELLP syndrome (56 {+-} 31h). The most frequent findings were ascitis in 20% (n = 8), pleural effusion in 17.5% and hepatic steatosis in 7.5%. The periportal intensity signal was normal in all cases. Cases of liver infarction and sub-capsular or parenchymatous hematoma were not observed. Conclusion: Findings of magnetic resonance imaging of the liver in stable HELLP syndrome postpartum patients were few and unspecific. Severe liver injuries such as parenchymatous or sub-capsular hematoma, entailing life risk were not found. Results do not corroborate the use of magnetic resonance as routine examination for stable patients with HELLP syndrome. (author)

Structure of acid-stable carmine.

Science.gov (United States)

Sugimoto, Naoki; Kawasaki, Yoko; Sato, Kyoko; Aoki, Hiromitsu; Ichi, Takahito; Koda, Takatoshi; Yamazaki, Takeshi; Maitani, Tamio

2002-02-01

Acid-stable carmine has recently been distributed in the U.S. market because of its good acid stability, but it is not permitted in Japan. We analyzed and determined the structure of the major pigment in acid-stable carmine, in order to establish an analytical method for it. Carminic acid was transformed into a different type of pigment, named acid-stable carmine, through amination when heated in ammonia solution. The features of the structure were clarified using a model compound, purpurin, in which the orientation of hydroxyl groups on the A ring of the anthraquinone skeleton is the same as that of carminic acid. By spectroscopic means and the synthesis of acid-stable carmine and purpurin derivatives, the structure of the major pigment in acid-stable carmine was established as 4-aminocarminic acid, a novel compound.

PRIORITY DIRECTIONS OF PROVISION OF STABLE LAND USE

Directory of Open Access Journals (Sweden)

L. Hun’ko

2016-10-01

Full Text Available The conditions of stable land use are highlighted in this article. The question of the territory of agricultural enterprises is considered as well. The characteristic of the type of land use is given here. The recommendations are shown on the formation of ecologically safe types of land use. In the terms of new land relations is important to resolve the issue of land use regulation to with stand landscapes against adverse natural and anthropogenic influences. The main instrument of the state, which aims to provide an ecologically permissible and economically effective land use, land use is as an important component of land relations. Planning should include a system of legal, technical, economic and environmental activities that will ensure the preservation, restoration and rational use of land and other natural resources for the benefit of the whole society. Keywords: land use, land management, stable development, landscape, soil erosion, protection of land.

Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice

DEFF Research Database (Denmark)

De Backer, Ole; Biasco, Luigi; Lønborg, Jacob

2016-01-01

AIMS: Our aim was to investigate the strength of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) in daily practice. METHODS AND RESULTS: For this study, 3,512 patients with stable CAD and at least one 50-89% coronary stenosis...... were identified; those patients thought to require PCI (n=1,716) were selected. Of these, 962 (56%) were treated based on angiography (XA) alone, whereas 754 patients (44%) had an FFR-guided treatment. In the latter group, 321 patients (43%) were reallocated to another treatment, predominantly medical...... treatment. After propensity score matching, the number of indicated lesions was 957 in the XA-guided group and 947 in the FFR-guided group. FFR guidance resulted in PCI deferral in 462 lesions (48.8%). In a seven-day landmark analysis, the rate of periprocedural myocardial infarction (MI) was less than half...

Applications of stable isotopes

International Nuclear Information System (INIS)

Letolle, R.; Mariotti, A.; Bariac, T.

1991-06-01

This report reviews the historical background and the properties of stable isotopes, the methods used for their measurement (mass spectrometry and others), the present technics for isotope enrichment and separation, and at last the various present and foreseeable application (in nuclear energy, physical and chemical research, materials industry and research; tracing in industrial, medical and agronomical tests; the use of natural isotope variations for environmental studies, agronomy, natural resources appraising: water, minerals, energy). Some new possibilities in the use of stable isotope are offered. A last chapter gives the present state and forecast development of stable isotope uses in France and Europe

Biomedical research applications of electromagnetically separated enriched stable isotopes

International Nuclear Information System (INIS)

Lambrecht, R.M.

1982-01-01

The current and projected annual requirements through 1985 for stable isotopes enriched by electromagnetic separation methods were reviewed for applications in various types of biomedical research: (1) medical radiosotope production, labeled compounds, and potential radiopharmaceuticals; (2) nutrition, food science, and pharmacology; (3) metallobiochemistry and environmental toxicology; (4) nuclear magnetic resonance, electron paramagnetic resonance, and Moessbauer spectroscopy in biochemical, biophysical, and biomedical research; and (5) miscellaneous advances in radioactive and non-radioactive tracer technology. Radioisotopes available from commercial sources or routinely used in clinical nuclear medicine were excluded. Priorities and summaries are based on statements in the references and from answers to a survey conducted in the fall of 1981. Current requirements for enriched stable isotopes in biomedical research are not being satisfied. Severe shortages exist for 26 Mg, 43 Ca, 70 Zn, 76 Se, 78 Se, 102 Pd, 111 Cd, 113 Cd, and 190 Os. Many interesting and potentially important investigations in biomedical research require small quantities of specific elements at high isotopic enrichments

Do stable non-ST-segment elevation acute coronary syndromes require admission to coronary care units?

Science.gov (United States)

van Diepen, Sean; Lin, Meng; Bakal, Jeffrey A; McAlister, Finlay A; Kaul, Padma; Katz, Jason N; Fordyce, Christopher B; Southern, Danielle A; Graham, Michelle M; Wilton, Stephen B; Newby, L Kristin; Granger, Christopher B; Ezekowitz, Justin A

2016-05-01

Clinical practice guidelines recommend admitting patients with stable non-ST-segment elevation acute coronary syndrome (NSTE ACS) to telemetry units, yet up to two-thirds of patients are admitted to higher-acuity critical care units (CCUs). The outcomes of patients with stable NSTE ACS initially admitted to a CCU vs a cardiology ward with telemetry have not been described. We used population-based data of 7,869 patients hospitalized with NSTE ACS admitted to hospitals in Alberta, Canada, between April 1, 2007, and March 31, 2013. We compared outcomes among patients initially admitted to a CCU (n=5,141) with those admitted to cardiology telemetry wards (n=2,728). Patients admitted to cardiology telemetry wards were older (median 69 vs 65years, PST-segment myocardial infarction or unstable angina. There were no differences in clinical outcomes observed between patients with NSTE ACS initially admitted to a ward or a CCU. These findings suggest that stable NSTE ACS may be managed appropriately on telemetry wards and presents an opportunity to reduce hospital costs and critical care capacity strain. Copyright © 2016 Elsevier Inc. All rights reserved.

On the Hitting Probability of Max-Stable Processes

OpenAIRE

Hofmann, Martin

2012-01-01

The probability that a max-stable process {\\eta} in C[0, 1] with identical marginal distribution function F hits x \\in R with 0 < F (x) < 1 is the hitting probability of x. We show that the hitting probability is always positive, unless the components of {\\eta} are completely dependent. Moreover, we consider the event that the paths of standard MSP hit some x \\in R twice and we give a sufficient condition for a positive probability of this event.

Danish stable schools for experiential common learning in groups of organic dairy farmers

DEFF Research Database (Denmark)

Waarst, M.; Nissen, T.B; Østergaard, I.

2007-01-01

in phasing out antibiotics from their herds through promotion of animal health. One way of reaching this goal was to form participatory focused farmer groups in an FFS approach, which was adapted to Danish conditions and named "stable schools." Four stable schools were established and went through a 1-yr......The farmer field school (FFS) is a concept for farmers' learning, knowledge exchange, and empowerment that has been developed and used in developing countries. In Denmark, a research project focusing on explicit non-antibiotic strategies involves farmers who have actively expressed an interest...

Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

LENUS (Irish Health Repository)

Cooke, John

2012-01-31

Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?

LENUS (Irish Health Repository)

Cooke, John

2009-04-01

Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall\\'s tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.

Predictive factors for functional outcome and failure in angular stable osteosynthesis of the proximal humerus.

LENUS (Irish Health Repository)

Hardeman, Francois

2012-02-01

Angular stable osteosynthesis has become the gold standard in the operative treatment of proximal humeral fractures. The aim of this article is to determine the indications for osteosynthesis versus primary arthroplasty based on clinical and radiological parameters.

Effects of different centrifugation conditions on clinical chemistry and Immunology test results

Directory of Open Access Journals (Sweden)

Nesic Predrag

2011-05-01

Full Text Available Abstract Background The effect of centrifugation time of heparinized blood samples on clinical chemistry and immunology results has rarely been studied. WHO guideline proposed a 15 min centrifugation time without citing any scientific publications. The centrifugation time has a considerable impact on the turn-around-time. Methods We investigated 74 parameters in samples from 44 patients on a Roche Cobas 6000 system, to see whether there was a statistical significant difference in the test results among specimens centrifuged at 2180 g for 15 min, at 2180 g for 10 min or at 1870 g for 7 min, respectively. Two tubes with different plasma separators (both Greiner Bio-One were used for each centrifugation condition. Statistical comparisons were made by Deming fit. Results Tubes with different separators showed identical results in all parameters. Likewise, excellent correlations were found among tubes to which different centrifugation conditions were applied. Fifty percent of the slopes lay between 0.99 and 1.01. Only 3.6 percent of the statistical tests results fell outside the significance level of p Conclusion A centrifugation time of either 7 or 10 min provided identical test results compared to the time of 15 min as proposed by WHO under the conditions used in our study.

There is no non-zero stable fixed point for dense networks in the homogeneous Kuramoto model

International Nuclear Information System (INIS)

Taylor, Richard

2012-01-01

This paper is concerned with the existence of multiple stable fixed point solutions of the homogeneous Kuramoto model. We develop a necessary condition for the existence of stable fixed points for the general network Kuramoto model. This condition is applied to show that for sufficiently dense n-node networks, with node degrees at least 0.9395(n−1), the homogeneous (equal frequencies) model has only one stable fixed point solution over the full space of phase angles in the range −π to π. This is the zero fixed point solution defined by all phase angle differences being zero. This result, together with existing research, proves a conjecture of Verwoerd and Mason (2007 Proc. of the American Control Conf. pp 4613–8) that for the complete network and the homogeneous model, the zero fixed point has a basin of attraction consisting of the entire space minus a set of measure zero. The necessary conditions are also tested to see how close to sufficiency they might be by applying them to a class of regular degree networks studied by Wiley et al (2006 Chaos 16 015103). (paper)

The Effect of Weight Loss in Obese Patients with Chronic Stable Plaque-Type Psoriasis

Directory of Open Access Journals (Sweden)

Wanjarus Roongpisuthipong

2013-01-01

Full Text Available Background. Chronic plaque psoriasis is frequently associated with obesity. The effect of a low-calorie diet on psoriasis has not been investigated. Objective. The objective was to investigate whether moderate weight loss increases the therapeutic response to topical treatment in obese patients with chronic stable plaque-type psoriasis. Material and Method. A 24-week clinical trial was conducted in 10 patients. The efficacy of a low-calorie diet with topical treatment was compared with baseline in obese patients with chronic stable plaque-type psoriasis. The primary measure of clinical response was the Psoriasis Area and Severity Index at weeks 12 and 24. Results. At week 12, the mean reduction in body weight was 9.6 percent. There was an improvement from baseline of 50 percent or more in the Psoriasis Area and Severity Index in 50 percent of the patients. The responses as measured by improvements in the Psoriasis Area and Severity Index were paralleled by improvements in global assessments by the physician and the patients and in the Dermatology Life Quality Index. Conclusion. Obese patients with chronic stable plaque-type psoriasis increase their response to a low-calorie diet. Lifestyle modifications, including a low-calorie diet, may supplement the pharmacologic treatment of obese psoriasis patients.

Premature and stable critical heat flux for downward flow in a narrow rectangular channel

International Nuclear Information System (INIS)

Lee, Juhyung; Chang, Soon Heung; Jeong, Yong Hoon; Jo, Daeseong

2014-01-01

It has been recommended that RRs and MTRs be designed to have sufficient margins for CHF and the onset of FI as well, since unstable flow could leads to premature CHF under very low wall heat flux in comparison to stable CHF. Even the fact and previous studies, however, the understanding of relationship among FI, premature CHF and stable CHF is not sufficient to date. In this regards, subcooled flow boiling in a vertical rectangular channel was experimentally investigated to enhance the understanding of the CHF and the effect of the two-phase flow instability on it under low pressure conditions, especially for downward flow which was adopted for Jordan Research and Training Reactor (JRTR) and Kijang research reactor (KJRR) to achieve easier fuel and irradiation rig loading. In this study, CHF for downward flow of water under low pressure in narrow rectangular channel was experimentally investigated. For conditions such as downward flow, narrow rectangular channel and low pressure, it has been deduced from literature that flow instability could largely influence on triggering CHF at lower heat flux, i. e. premature CHF. Total 54 CHF data, which includes premature and stable data was obtained for various fluid conditions and system configurations including inlet stiffness. The upper and lower boundaries of CHF were newly proposed based on the experiment

Synovitis in dogs with stable stifle joints and incipient cranial cruciate ligament rupture: a cross-sectional study.

Science.gov (United States)

Bleedorn, Jason A; Greuel, Erin N; Manley, Paul A; Schaefer, Susan L; Markel, Mark D; Holzman, Gerianne; Muir, Peter

2011-07-01

To evaluate stifle joints of dogs for synovitis, before development of joint instability and cranial cruciate ligament rupture (CrCLR). Cross-sectional study. Dogs (n = 16) with CrCLR and stable contralateral stifles; 10 control dogs with intact CrCL. Arthritis and tibial translation were graded radiographically. Synovitis severity and cruciate pathology were assessed arthroscopically. Presence of inflammatory cells in synovial membrane biopsies was scored histologically. CrCLR stifle pairs and control stifles were compared. Radiographic evidence of arthritis, cranial tibial translation, and arthroscopic synovitis were increased in unstable stifles, when compared with stable contralateral stifles in CrCLR dogs (P < .05). Arthroscopic synovitis in both joints of CrCLR dogs was increased compared with controls, was correlated with radiographic arthritis (S(R) = 0.71, P < .05), and was present in all stable contralateral stifles. Arthroscopically, 75% of stable stifle joints had CrCL fiber disruption, which correlated with severity of synovitis (S(R) = 0.56, P < .05). Histologic evidence of synovitis was identified in all CrCLR dogs, but was only significantly correlated with arthroscopic observations in stable stifles (r(2) = 0.57, P < .005). Synovitis is an early feature of the CrCLR arthropathy in dogs before development of joint instability clinically. Severity of synovitis is correlated with radiographic arthritis in joints with minimal to no clinically detectable CrCL damage. © Copyright 2011 by The American College of Veterinary Surgeons.

Experimental and numerical study of atmospheric turbulence and dispersion in stable conditions and in near field at a complex site

International Nuclear Information System (INIS)

Wei, Xiao

2016-01-01

An experimental program has been designed in order to study pollutants dispersion at a complex site with a focus on stable conditions, which are still challenging for numerical modelling. This experimental program is being conducted at the SIRTA site in a southern suburb of Paris and consists in measuring, in near field, the turbulence and the pollutants dispersion. The aim of this program is to characterize the fine structure of turbulence and associated dispersion through high temporal and spatial resolution measurements. Then, these measurements allow to validate and improve the performance of CFD simulation for turbulence and dispersion in a heterogeneous field. The instrumental set up includes 12 ultrasonic anemometers measuring continuously wind velocity and temperature at 10 Hz, and 6 photo-ionization detectors (PIDs) measuring gas concentration at 50 Hz during tracer tests. Intensive observations periods (IOPs) with gas releases have been performed since March 2012. First of all, a detailed study of flow on the site is made, because it must be characterised and properly simulated before attempting to simulate the pollutants dispersion. This study is based on two years of continuous measurements and on measurements performed during IOPs. Turbulence strong anisotropy in the surface layer is characterized by calculating variances, integral length scales and power spectra of the three wind velocity components. Propagation of turbulent structures between sensors has been characterized with velocity correlations. Energy spectra show several slopes in different frequency regions. Also, data analyses show impact of terrain heterogeneity on the measurements. The forest to the north of the experimental field modifies wind velocity and direction for a large northerly sector. It induces a strong directional wind shear and a wind deceleration below the forest height. Numerical simulations are carried out using the CFD code, Code-Saturne, in RANS mode with a standard k

Conditions and consequences of medical futility--from a literature review to a clinical model.

Science.gov (United States)

Löfmark, R; Nilstun, T

2002-04-01

To present an analysis of "futility" that is useful in the clinical setting. Literature review. According to Medline more than 750 articles have been published about medical futility. Three criteria (language, time period, and the authors expressed their own opinions) singled out 43 of them. The authors' opinions about futility were analysed using the scheme: "If certain conditions are satisfied, then a particular measure is futile" and "If a particular measure is futile, then certain moral consequences are implied". Regarding conditions, most authors stated that judgments about futility should be made by physicians. The measure was usually some kind of medical treatment, and the goals related to quality of life, physiological improvement, or prolongation of life. The probability of success in reaching the goal was in most cases described in semiquantitative terms. Regarding consequences, the authors stated that health care professionals may (sometimes ought or should) withhold or withdraw a futile measure, most often after a dialogue with the patient (29 articles), but sometimes without informing the patient (nine articles), or with one-way information (four articles). Over time more and more articles recommend that the patient should be involved in joint decision making. Based on this literature review a clinical model was developed. The model, requiring that conditions and consequences should be made explicit, may, in "futility situations", facilitate both the collection of the necessary information and make the moral implications visible. It also makes communication about measures considered to be futile possible without using such ambiguous terms as "futile".

Experimental investigation of concentration and stable isotopes signals during organic contaminants back diffusion

DEFF Research Database (Denmark)

Jin, Biao; Nika, Chrysanthi-Elisabeth; Rolle, Massimo

2017-01-01

-dichloroethene (cis-DCE) as model contaminant and we investigated its back diffusion from an impermeable source into a permeable saturated layer, in which advection-dominated flow conditions were established. We used concentration and stable chlorine isotope measurements to investigate the plumes originated by cis...... and stable isotope gradients in the flow-through setup. In particular, steep concentration and stable isotope gradients were observed at the outlet. Lateral isotope gradients corresponding to chlorine isotope fractionation up to 20‰ were induced by cis-DCE back diffusion and subsequent advection......-dominated transport in all flow-through experiments. A numerical modeling approach, tracking individually all chlorine isotopologues, based on the accurate parameterization of local dispersion, as well as on the values of aqueous diffusion coefficients and diffusion-induced isotope fractionation from a previous study...

Stable carbon isotopic composition of tree rings from a pine tree from Augustów Wilderness, Poland, as a temperature and local environment conditions indicator.

Science.gov (United States)

Pawelczyk, Slawomira; Pazdur, Anna; Halas, Stanislaw

2004-06-01

Tree rings can be used as archives of climatic and environmental data with annual resolution. Tree rings widths, maximum late wood density and other parameters as stable composition in tree rings can be used for the reconstruction of past climatic and environmental changes. Stable carbon isotope ratios in tree rings may provide valuable information on past climatic conditions. 13C/12C ratios of plant organic matter can reflect corresponding 13C/12C ratio of atmospheric CO2 during formation of the rings. Investigations of isotopic carbon composition in tree rings from in the ecologically clean the Augustów Wilderness region in the north-eastern part of Poland (22 degrees 58'E, 53 degrees 51'N) (nowadays a sanctuary) were undertaken. Series of delta13C in alpha-cellulose and in wholewood were acquired. Those measurements constituted a part of more complex investigations of carbon isotope composition in tree rings including the measurements of radiocarbon concentration and tree ring widths. This article presents preliminary results. It is argued that contrary to the tree ring widths and delta13C in wholewood that do not reveal significant correlation with temperature, the variation of delta13C in the latewood alpha-cellulose is correlated with combined July and August temperatures. Copyright 2004 Taylor and Francis Ltd.

Clinical-scale investigation of stable isotopes in human blood: delta13C and delta15N from 406 patients at the Johns Hopkins Medical Institutions.

Science.gov (United States)

Kraft, Rebecca A; Jahren, A Hope; Saudek, Christopher D

2008-11-01

Objective chemical biomarkers are needed in clinical studies of diet-related diseases to supplement subjective self-reporting methods. We report on several critical experiments for the development of clinically legitimate dietary stable isotope biomarkers within human blood. Our examination of human blood revealed the following: (1) Within blood clot and serum from anonymous individuals (201 males, 205 females) we observed: mean serum delta13C = -19.1 +/- 0.8 per thousand (standard deviation, SD); clot, -19.3 +/- 0.8 per thousand (SD); range = -15.8 per thousand to -23.4 per thousand. Highly statistically significant differences are observed between clot and serum, males and females for both clot and serum. For 15N (n = 206), mean serum = +8.8 +/- 0.5 per thousand (SD); clot +7.4 +/- 0.4 per thousand (SD); range = +6.3 per thousand to +10.5 per thousand. Blood serum is enriched in 15N relative to blood clot by +1.4 per thousand on average, which may reflect differing protein amino acid content. Serum nitrogen is statistically significantly different for males and females, however, clot shows no statistical difference. (2) Relative to clot, capillary blood is marginally different for 13C, but not 15N. Clot 13C is not significantly different from serum; however, it is depleted in 15N by 1.5 per thousand relative to serum. (3) We assessed the effect of blood additives (sodium fluoride and polymerized acrylamide resin) and laboratory process (autoclaving, freeze drying) commonly used to preserve or prepare venous blood. On average, no alteration in delta13C or delta15N is detected compared with unadulterated blood from the same individual. (4) Storage of blood with and without the additives described above for a period of up to 115 days exhibits statistically significant differences for 13C and 15N for sodium fluoride. However, storage for unadulterated blood and blood preserved with polymerized acrylamide resin does not change the delta13C or delta15N isotopic

Metal Stable Isotope Tagging: Renaissance of Radioimmunoassay for Multiplex and Absolute Quantification of Biomolecules.

Science.gov (United States)

Liu, Rui; Zhang, Shixi; Wei, Chao; Xing, Zhi; Zhang, Sichun; Zhang, Xinrong

2016-05-17

The unambiguous quantification of biomolecules is of great significance in fundamental biological research as well as practical clinical diagnosis. Due to the lack of a detectable moiety, the direct and highly sensitive quantification of biomolecules is often a "mission impossible". Consequently, tagging strategies to introduce detectable moieties for labeling target biomolecules were invented, which had a long and significant impact on studies of biomolecules in the past decades. For instance, immunoassays have been developed with radioisotope tagging by Yalow and Berson in the late 1950s. The later languishment of this technology can be almost exclusively ascribed to the use of radioactive isotopes, which led to the development of nonradioactive tagging strategy-based assays such as enzyme-linked immunosorbent assay, fluorescent immunoassay, and chemiluminescent and electrochemiluminescent immunoassay. Despite great success, these strategies suffered from drawbacks such as limited spectral window capacity for multiplex detection and inability to provide absolute quantification of biomolecules. After recalling the sequences of tagging strategies, an apparent question is why not use stable isotopes from the start? A reasonable explanation is the lack of reliable means for accurate and precise quantification of stable isotopes at that time. The situation has changed greatly at present, since several atomic mass spectrometric measures for metal stable isotopes have been developed. Among the newly developed techniques, inductively coupled plasma mass spectrometry is an ideal technique to determine metal stable isotope-tagged biomolecules, for its high sensitivity, wide dynamic linear range, and more importantly multiplex and absolute quantification ability. Since the first published report by our group, metal stable isotope tagging has become a revolutionary technique and gained great success in biomolecule quantification. An exciting research highlight in this area

Radappertization of ready-to-eat shelf-stable, traditional Indian bread - Methi Paratha

International Nuclear Information System (INIS)

Bhoir, Shraddha A.; Muppalla, Shobita R.; Kanatt, Sweetie R.; Chawla, S.P.; Sharma, Arun

2015-01-01

Shelf-stable ready-to-eat (RTE) Methi Paratha (flavored Indian unleavened flat bread) was developed using combination of hurdles including radiation processing. The Methi Paratha was prepared using dough containing wheat flour, dried fenugreek leaves and spices. The samples were vacuum packed in multi-layered pouches and irradiated at 25 kGy in frozen conditions. Samples were evaluated for microbiological counts, lipid peroxidation and sensory attributes during storage under ambient conditions. Samples were found to be devoid of any viable microorganism throughout the storage period of 180 days. The thiobarbituric acid reactive substances (TBARS) value which indicates lipid peroxidation of samples did not show any significant increase with time. The Methi Paratha was found to be acceptable by the evaluating panelists. - Highlights: • Shelf-stable ready-to-eat (RTE) Methi Paratha (flavored Indian unleavened flat bread) was developed. • A combination of hurdles irradiation, vacuum-packaging and natural antioxidants was used. • Methi Paratha was microbiologically safe and sensorialy acceptable for 180 days

A stable wireless energy transmission system for gastrointestinal microsystems.

Science.gov (United States)

Xin, W H; Yan, G Z; Wang, W X

2010-01-01

A wireless energy transmission system using a Helmholtz primary coil outside and a 3-dimensional secondary coil inside the body is introduced. It is designed to transmit stable power to a gastrointestinal microsystem regardless of its position and orientation when working in the gastric tract. Up to 310 mW of usable DC power can be delivered under worst-case geometrical conditions. Measured data of the system performance are presented and evaluated.

Clinical, cardiopulmonary and haemocytological effects of xylazine in goats after acute exposure to different environmental temperature and humidity conditions

Directory of Open Access Journals (Sweden)

E.G.M. Mogoa

2000-07-01

Full Text Available This study was carried out to assess the influence of xylazine administration on clinical, cardiopulmonary and haemocytological variables after acute exposure to different environmental conditions. Xylazine hydrochloride was administered intravenously at 0.1 mg/kg body mass to 6 clinically healthy, castrated male goats. All animals were exposed for 60 min to 3 sets of climatic conditions: 14 °C, 33% relative humidity; 24 °C, 55% RH, and 34 °C, 65% RH. The variables that were measured for a period of 60 min after xylazine administration were sedation, analgesia, salivation, urination, ventilation rate, heart-rate, mean arterial blood pressure, oesophageal temperature, haematocrit, mean corpuscular volume and mean corpuscular haemoglobin concentration. Xylazine induced sedation, analgesia, salivation and urination independently of the 3 environmental conditions. Environment had no influence on the onset, duration and recovery from sedation. In the 14 °C environment, xylazine resulted in a significant decrease in ventilation and heart-rate from baseline values. Significant changes in mean arterial blood pressure, haemoglobin concentration, mean corpuscular volume, haematocrit and red cell count were observed in the 3 environments. Total plasma protein was significantly altered at 24 °C and 34 °C. Acute exposure of goats to different environmental conditions had no significant influence on the clinical, cardiopulmonary and haemocytological variables. Physiological changes induced by xylazine were therefore independent of the environment.

Clinical vocabulary as a boundary object in multidisciplinary care management of multiple chemical sensitivity, a complex and chronic condition.

Science.gov (United States)

Sampalli, Tara; Shepherd, Michael; Duffy, Jack

2011-04-14

Research has shown that accurate and timely communication between multidisciplinary clinicians involved in the care of complex and chronic health conditions is often challenging. The domain knowledge for these conditions is heterogeneous, with poorly categorized, unstructured, and inconsistent clinical vocabulary. The potential of boundary object as a technique to bridge communication gaps is explored in this study. A standardized and controlled clinical vocabulary was developed as a boundary object in the domain of a complex and chronic health condition, namely, multiple chemical sensitivity, to improve communication among multidisciplinary clinicians. A convenience sample of 100 patients with a diagnosis of multiple chemical sensitivity, nine multidisciplinary clinicians involved in the care of patients with multiple chemical sensitivity, and 36 clinicians in the community participated in the study. Eighty-two percent of the multidisciplinary and inconsistent vocabulary was standardized using the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED(®) CT as a reference terminology. Over 80% of the multidisciplinary clinicians agreed on the overall usefulness of having a controlled vocabulary as a boundary object. Over 65% of clinicians in the community agreed on the overall usefulness of the vocabulary. The results from this study are promising and will be further evaluated in the domain of another complex chronic condition, ie, chronic pain. The study was conducted as a preliminary analysis for developing a boundary object in a heterogeneous domain of knowledge.

Prevalence of airflow obstruction in patients with stable systolic heart failure

DEFF Research Database (Denmark)

Dalsgaard, Morten; Plesner, Louis Lind; Schou, Morten

2017-01-01

Background: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in heart failure (HF). However, routine use of spirometry in outpatient HF clinics is not implemented. The aim of the present study was to determine the prevalence of both airflow obstruction and non...... failure clinics were examined with spirometry at their first visit and after optimal medical treatment for HF was achieved. airflow obstruction was classified and graded according to the GOLD 2011 revision. Results: Baseline spirometry was performed in 593 included patients and 71 (12%) had a clinical......%) had mild disease (GOLD I) and 180 (30%) patients had moderate to very severe disease (GOLD II-IV). No difference in spirometric variables was observed following up titration of medication. Conclusion: In stable patients with HF airflow obstruction is frequent and severely underdiagnosed. Spirometry...

Population Games, Stable Games, and Passivity

Directory of Open Access Journals (Sweden)

Michael J. Fox

2013-10-01

Full Text Available The class of “stable games”, introduced by Hofbauer and Sandholm in 2009, has the attractive property of admitting global convergence to equilibria under many evolutionary dynamics. We show that stable games can be identified as a special case of the feedback-system-theoretic notion of a “passive” dynamical system. Motivated by this observation, we develop a notion of passivity for evolutionary dynamics that complements the definition of the class of stable games. Since interconnections of passive dynamical systems exhibit stable behavior, we can make conclusions about passive evolutionary dynamics coupled with stable games. We show how established evolutionary dynamics qualify as passive dynamical systems. Moreover, we exploit the flexibility of the definition of passive dynamical systems to analyze generalizations of stable games and evolutionary dynamics that include forecasting heuristics as well as certain games with memory.

Ferroelectric nanostructure having switchable multi-stable vortex states

Science.gov (United States)

Naumov, Ivan I [Fayetteville, AR; Bellaiche, Laurent M [Fayetteville, AR; Prosandeev, Sergey A [Fayetteville, AR; Ponomareva, Inna V [Fayetteville, AR; Kornev, Igor A [Fayetteville, AR

2009-09-22

A ferroelectric nanostructure formed as a low dimensional nano-scale ferroelectric material having at least one vortex ring of polarization generating an ordered toroid moment switchable between multi-stable states. A stress-free ferroelectric nanodot under open-circuit-like electrical boundary conditions maintains such a vortex structure for their local dipoles when subject to a transverse inhomogeneous static electric field controlling the direction of the macroscopic toroidal moment. Stress is also capable of controlling the vortex's chirality, because of the electromechanical coupling that exists in ferroelectric nanodots.

Analyzing the movement of an invasive weevil (Polydrusus sericeus) using stable Isotopes

Science.gov (United States)

Joanne Lund; Paula Marquardt; William Jr. Mattson

2010-01-01

To better understand the response of insect populations to increasing CO2 and O3, we used ratios of stable carbon isotopes (d 13C) to trace the movement of an invasive insect in mixed tree communities grown under different air quality conditions. Polydrusus sericeus is a non-native...

The study on clinical conditions and skin dose of upper-gastrointestinal x-ray fluoroscopy

International Nuclear Information System (INIS)

Kim, Sung Chul; Ahn, Sung Min; Jang, Sang Sup

2007-01-01

This study examined present conditions of upper-gastrointestinal X-ray fluoroscopy and patient skin dose. The authors elected 21 equipment to check the X-ray equipment and exposure factor of fluoroscopy and spot exposure in university hospitals, hospitals, and clinics where perform upper-gastrointestinal X-ray fluoroscopy more than five times every day in Incheon areas. The amount of patient's skin dose during upper-gastrointestinal X-ray fluoroscopy was measured by ionization chamber

STABLE STATIONARY STATES OF NON-LOCAL INTERACTION EQUATIONS

KAUST Repository

FELLNER, KLEMENS

2010-12-01

In this paper, we are interested in the large-time behaviour of a solution to a non-local interaction equation, where a density of particles/individuals evolves subject to an interaction potential and an external potential. It is known that for regular interaction potentials, stable stationary states of these equations are generically finite sums of Dirac masses. For a finite sum of Dirac masses, we give (i) a condition to be a stationary state, (ii) two necessary conditions of linear stability w.r.t. shifts and reallocations of individual Dirac masses, and (iii) show that these linear stability conditions imply local non-linear stability. Finally, we show that for regular repulsive interaction potential Wε converging to a singular repulsive interaction potential W, the Dirac-type stationary states ρ̄ ε approximate weakly a unique stationary state ρ̄ ∈ L∞. We illustrate our results with numerical examples. © 2010 World Scientific Publishing Company.

Stable piecewise polynomial vector fields

Directory of Open Access Journals (Sweden)

Claudio Pessoa

2012-09-01

Full Text Available Let $N={y>0}$ and $S={y<0}$ be the semi-planes of $mathbb{R}^2$ having as common boundary the line $D={y=0}$. Let $X$ and $Y$ be polynomial vector fields defined in $N$ and $S$, respectively, leading to a discontinuous piecewise polynomial vector field $Z=(X,Y$. This work pursues the stability and the transition analysis of solutions of $Z$ between $N$ and $S$, started by Filippov (1988 and Kozlova (1984 and reformulated by Sotomayor-Teixeira (1995 in terms of the regularization method. This method consists in analyzing a one parameter family of continuous vector fields $Z_{epsilon}$, defined by averaging $X$ and $Y$. This family approaches $Z$ when the parameter goes to zero. The results of Sotomayor-Teixeira and Sotomayor-Machado (2002 providing conditions on $(X,Y$ for the regularized vector fields to be structurally stable on planar compact connected regions are extended to discontinuous piecewise polynomial vector fields on $mathbb{R}^2$. Pertinent genericity results for vector fields satisfying the above stability conditions are also extended to the present case. A procedure for the study of discontinuous piecewise vector fields at infinity through a compactification is proposed here.

Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

DEFF Research Database (Denmark)

Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe

2015-01-01

The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11......,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST......-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p clinical...

Development of new technology for the use of stable isotopic tracers in the study of human health and disease

International Nuclear Information System (INIS)

Hacyey, D.L.; Klein, P.D.; Szczepanik, P.A.; Niu, W.; Stellaard, F.; Tserng, K.Y.

1977-01-01

This program has five major aspects: first, the development of analytical instrumentation of requisite sensitivity, stability, and simplicity to conduct stable isotope measurements in a routine manner; second, the development of appropriately labeled compounds for metabolic investigations, initially through custom syntheses but eventually through commercial sources; third, development of analytical methodology to isolate, purify, and determine the isotopic content of specific organic compounds reflecting metabolic processes or disease states; fourth, collaborative development of clinical applications and testing on a routine basis, through a network of clinical centers around the country; and finally, the collection and dissemination of stable isotope information on an international scale through survey publications and conferences

Large-eddy simulation of stable atmospheric boundary layers to develop better turbulence closures for climate and weather models

Science.gov (United States)

Bou-Zeid, Elie; Huang, Jing; Golaz, Jean-Christophe

2011-11-01

A disconnect remains between our improved physical understanding of boundary layers stabilized by buoyancy and how we parameterize them in coarse atmospheric models. Most operational climate models require excessive turbulence mixing in such conditions to prevent decoupling of the atmospheric component from the land component, but the performance of such a model is unlikely to be satisfactory under weakly and moderately stable conditions. Using Large-eddy simulation, we revisit some of the basic challenges in parameterizing stable atmospheric boundary layers: eddy-viscosity closure is found to be more reliable due to an improved alignment of vertical Reynolds stresses and mean strains under stable conditions, but the dependence of the magnitude of the eddy viscosity on stability is not well represented by several models tested here. Thus, we propose a new closure that reproduces the different stability regimes better. Subsequently, tests of this model in the GFDL's single-column model (SCM) are found to yield good agreement with LES results in idealized steady-stability cases, as well as in cases with gradual and sharp changes of stability with time.

Stable or unstable tear of the anterior cruciate ligament of the knee: an MR diagnosis?

Energy Technology Data Exchange (ETDEWEB)

Dyck, Pieter van; Gielen, Jan L.; Parizel, Paul M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Edegem (Belgium); Vanhoenacker, Filip M. [University Hospital Antwerp and University of Antwerp, Department of Radiology, Edegem (Belgium); AZ St-Maarten Duffel/Mechelen, Department of Radiology, Duffel (Belgium); Wouters, Kristien [University Hospital Antwerp and University of Antwerp, Department of Scientific Coordination and Biostatistics, Edegem (Belgium); Dossche, Lieven [University Hospital Antwerp and University of Antwerp, Department of Orthopedics, Edegem (Belgium)

2012-03-15

To determine the usefulness of magnetic resonance (MR) imaging to distinguish stable from unstable tears of the anterior cruciate ligament (ACL) of the knee. MR images of 97 patients with surgically confirmed ACL tear were retrospectively reviewed. According to arthroscopic and clinical examination, these patients had 36 stable and 61 unstable (9 partial and 52 complete) ACL tears. MR images were interpreted by two blinded reviewers and scored with respect to previously reported primary and secondary MR signs of ACL injury. Based on a comprehensive assessment of all the MR findings, ACLs were categorized as being stable or unstable. MR accuracy was calculated considering only primary MR signs and considering both primary and secondary MR signs of ACL injury, separately. Accuracy of each individual primary and secondary MR sign was calculated. Considering only primary MR signs, sensitivity, specificity, and accuracy of MR were 77, 92, and 82%, respectively. Considering both primary and secondary MR signs, sensitivity, specificity, and accuracy of MR were 59, 81, and 67%, respectively. Of all MR signs, discontinuity and abnormal orientation had highest test accuracy (79 and 87%, respectively). Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL were only seen in unstable ACLs (specificity 100%), but these secondary findings had low sensitivity (23%). Bone contusion around the lateral knee compartment was seen in both unstable and stable ACLs (accuracy 64%). Previously reported MR imaging signs do not allow accurate distinction between clinically stable and unstable ACL injuries. Anterior tibial translation, uncovering of the posterior horn of the lateral meniscus, and hyperbuckled PCL, if present, are helpful signs in the diagnosis of an unstable tear. The presence of bone marrow edema around the lateral knee compartment is not predictive of ACL insufficiency. (orig.)

Stable isotope signatures of gases liberated from fluid inclusions in bedrock at Olkiluoto

International Nuclear Information System (INIS)

Eichinger, F.; Meier, D.; Haemmerli, J.; Diamond, L.

2010-12-01

Fluid inclusions in quartzes of the Olkiluoto bedrock contain gaseous N 2 , CO 2 , H 2 , CH 4 , and higher hydrocarbons in varying proportions. Stable carbon and hydrogen isotope signatures of the gas phases give valuable information on their origin and the formation conditions. In previous studies, a method to liberate and quantify the gases trapped in fluid inclusions was developed. It allowed determining the carbon isotope signatures of liberated CO 2 , CH 4 and higher hydrocarbons (HHC), but no hydrogen isotope data were acquired. The method was advanced and, in this study, also stable hydrogen isotopes of CH 4 and H 2 liberated from fluid inclusions could be analysed. The stable carbon signatures of methane and higher hydrocarbons, as well as the hydrogen isotope signatures of methane indicate a predominant thermogenic provenance for those gases. (orig.)

New robust stable MPC using linear matrix inequalities

Directory of Open Access Journals (Sweden)

M.A. Rodrigues

2000-03-01

Full Text Available This paper addresses the stability of Model Predictive Control (MPC with output feedback. The proposed controller uses a new state-space formulation of the system, and the control problem is presented as an LMI optimization problem. The stability condition for the closed loop is included as a Lyapunov inequality. The resulting optimization problem becomes nonlinear with the inclusion of the stabilizing condition. A suboptimal solution is developed and the problem reduces to a pair of coupled LMI problems. An iterative solution that converges to a stable output feedback gain is proposed. A polytopic set of process models can be considered. A simulation example is included in the paper and shows that the proposed strategy eliminates the usual practice of enforcing robustness by detuning the MP controller.

Asymptotically stable fourth-order accurate schemes for the diffusion equation on complex shapes

International Nuclear Information System (INIS)

Abarbanel, S.; Ditkowski, A.

1997-01-01

An algorithm which solves the multidimensional diffusion equation on complex shapes to fourth-order accuracy and is asymptotically stable in time is presented. This bounded-error result is achieved by constructing, on a rectangular grid, a differentiation matrix whose symmetric part is negative definite. The differentiation matrix accounts for the Dirichlet boundary condition by imposing penalty-like terms. Numerical examples in 2-D show that the method is effective even where standard schemes, stable by traditional definitions, fail. The ability of the paradigm to be applied to arbitrary geometric domains is an important feature of the algorithm. 5 refs., 14 figs

Stable electron beams from laser wakefield acceleration with few-terawatt driver using a supersonic air jet

Science.gov (United States)

Boháček, K.; Kozlová, M.; Nejdl, J.; Chaulagain, U.; Horný, V.; Krůs, M.; Ta Phuoc, K.

2018-03-01

The generation of stable electron beams produced by the laser wakefield acceleration mechanism with a few-terawatt laser system (600 mJ, 50 fs) in a supersonic synthetic air jet is reported and the requirements necessary to build such a stable electron source are experimentally investigated in conditions near the bubble regime threshold. The resulting electron beams have stable energies of (17.4 ± 1.1) MeV and an energy spread of (13.5 ± 1.5) MeV (FWHM), which has been achieved by optimizing the properties of the supersonic gas jet target for the given laser system. Due to the availability of few-terawatt laser systems in many laboratories around the world these stable electron beams open possibilities for applications of this type of particle source.

Design of ultra-stable insulin analogues for the developing world

Directory of Open Access Journals (Sweden)

Michael A Weiss

2013-01-01

Full Text Available The engineering of insulin analogues illustrates the application of structure-based protein design to clinical medicine. Such design has traditionally been based on structures of wild-type insulin hexamers in an effort to optimize the pharmacokinetic (PK and pharmacodynamic properties of the hormone. Rapid-acting insulin analogues (in chronological order of their clinical introduction, Humalog ® [Eli Lilly & Co.], Novolog ® [Novo-Nordisk], and Apidra ® [Sanofi-Aventis] exploit the targeted destabilization of subunit interfaces to facilitate capillary absorption. Conversely, long-acting insulin analogues exploit the stability of the insulin hexamer and its higher-order self-assembly within the subcutaneous depot to enhance basal glycemic control. Current products either operate through isoelectric precipitation (insulin glargine, the active component of Lantus ® ; Sanofi-Aventis or employ an albumin-binding acyl tether (insulin detemir, the active component of Levemir ® ; Novo-Nordisk. Such molecular engineering has often encountered a trade-off between PK goals and product stability. Given the global dimensions of the diabetes pandemic and complexity of an associated cold chain of insulin distribution, we envisage that concurrent engineering of ultra-stable protein analogue formulations would benefit the developing world, especially for patients exposed to high temperatures with inconsistent access to refrigeration. We review the principal mechanisms of insulin degradation above room temperature and novel molecular approaches toward the design of ultra-stable rapid-acting and basal formulations.

Evaluation of accelerated stability test conditions for medicated chewing gums.

Science.gov (United States)

Maggi, Lauretta; Conte, Ubaldo; Nhamias, Alain; Grenier, Pascal; Vergnault, Guy

2013-10-01

The overall stability of medicated chewing gums is investigated under different storage conditions. Active substances with different chemical stabilities in solid state are chosen as model drugs. The dosage form is a three layer tablet obtained by direct compression. The gum core contains the active ingredient while the external layers are formulated to prevent gum adhesion to the punches of the tableting machine. Two accelerated test conditions (40°C/75% RH and 30°C/65% RH) are performed for 6 months. Furthermore, a long-term stability test at room conditions is conducted to verify the predictability of the results obtained from the stress tests. Some drugs are stable in all the conditions tested, but other drugs, generally considered stable in solid dosage forms, have shown relevant stability problems particularly when stress test conditions are applied to this particular semi-solid dosage forms. For less stable drugs, the stress conditions of 40°C/75% RH are not always predictable of chewing gum stability at room temperature and may produce false negative; intermediate conditions, 30°C/65% RH, are more predictive for this purpose, the results of drug content found after 6 months at intermediate stress conditions and 12 months at room conditions are generally comparable. But the results obtained show that only long-term conditions stability tests gave consistent results. During aging, the semi solid nature of the gum base itself, may also influence the drug delivery rate during chewing and great attention should be given also to the dissolution stability.

Stable isotope (δ"1"3C and δ"1"5N) based interpretation of organic matter source and paleoenvironmental conditions in Al-Azraq basin, Jordan

International Nuclear Information System (INIS)

Ahmad, Khaldoun; Davies, Caroline

2017-01-01

This study examines the stable isotopes of carbon and nitrogen from cored lacustrine sediments of the Al-Azraq, an arid lake basin on the Jordan Plateau. Lacustrine sediments contain valuable records of paleoenvironmental conditions, recording local and regional responses to environmental change. Previous paleo-reconstructions on the Jordan Plateau are based on archaeology, pollen, mineralogy, and stratigraphy. The application of organic geochemistry analyses to these lake sediments identifies multiple sources of organic matter, biological production, and contributes to understanding the paleoenvironments of the Al-Azraq basin during the mid-Pleistocene period. Organic carbon concentration (Corg) provides an overview of the organic matter distribution. Carbon isotopic composition (δ13Corg) and nitrogen isotopic composition (δ15N) are indicators of organic matter sources and paleoproductivity. Magnetic susceptibility (MGSUS) measured the concentration of ferromagnetic minerals and indicated aeolian inputs. Organic geochemistry differentiated five paleoenvironmental zones with specific sources of organic matter, both aquatic and terrestrial. It identified a long period of climate wetter than the present, punctuated by a short intense period of aridity. Diagenesis plays an important role in the decomposition of organic matter and studies indicate this degradation can alter the isotopic signals of organic matter. Analyses of the isotopic signals and statistical analyses demonstrate diagenesis is not a factor in the Al-Azraq sediments in all but Zone 4 of the paleoenvironmental zones. This Zone is defined by less negative carbon isotopic composition and the presence of thick primary gypsum layers, in addition to the influx of high peaks of aeolian sediment as reflected in the magnetic susceptibility data. Stable isotope geochemistry provides detailed information on the paleoenvironments of lake sediments, and is applicable to typically challenging arid basin sediments

Comparison of pore water samplers and cryogenic distillation under laboratory and field conditions for soil water stable isotope analysis.

Science.gov (United States)

Thoma, Michael; Frentress, Jay; Tagliavini, Massimo; Scandellari, Francesca

2018-02-15

We used pore water samplers (PWS) to sample for isotope analysis (1) only water, (2) soil under laboratory conditions, and (3) soil in the field comparing the results with cryogenic extraction (CE). In (1) and (2), no significant differences between source and water extracted with PWS were detected with a mean absolute difference (MAD) always lower than 2 ‰ for δ 2 H and 1 ‰ for δ 18 O. In (2), CE water was more enriched than PWS-extracted water, with a MAD respect to source water of roughly 8 ‰ for δ 2 H and 4 ‰ for δ 18 O. In (3), PWS water was enriched relative to CE water by 3 ‰ for δ 2 H and 0.9 ‰ for δ 18 O. The latter result may be due to the distinct water portions sampled by the two methods. Large pores, easily sampled by PWS, likely retain recent, and enriched, summer precipitation while small pores, only sampled by CE, possibly retain isotopically depleted water from previous winter precipitation or irrigation inputs. Accuracy and precision were greater for PWS relative to CE. PWS is therefore suggested as viable tool to extract soil water for stable isotope analysis, particularly for soils used in this study (sandy and silty loams).

Stable long-term pulmonary function after fludarabine, antithymocyte globulin and i.v. BU for reduced-intensity conditioning allogeneic SCT.

Science.gov (United States)

Dirou, S; Malard, F; Chambellan, A; Chevallier, P; Germaud, P; Guillaume, T; Delaunay, J; Moreau, P; Delasalle, B; Lemarchand, P; Mohty, M

2014-05-01

Lung function decline is a well-recognized complication following allogeneic SCT (allo-SCT). Reduced-intensity conditioning (RIC) and in vivo T-cell depletion by administration of antithymocyte globulin (ATG) may have a protective role in the occurrence of late pulmonary complications. This retrospective study reported the evolution of lung function parameters within the first 2 years after allo-SCT in a population receiving the same RIC regimen that included fludarabine and i.v. BU in combination with low-dose ATG. The median follow-up was 35.2 months. With a median age of 59 years at the time of transplant, at 2 years, the cumulative incidences of non-relapse mortality was as low as 9.7%. The cumulative incidence of relapse was 33%. At 2 years, the cumulative incidences of extensive chronic GVHD (cGVHD) and of pulmonary cGVHD were 23.1% and 1.9%, respectively. The cumulative incidences of airflow obstruction and restrictive pattern were 3.8% and 9.6%, respectively. Moreover, forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio remained stable from baseline up to 2 years post transplantation (P=0.26, P=0.27 and P=0.07, respectively). These results correspond favorably with the results obtained with other RIC regimens not incorporating ATG, and suggest that ATG may have a protective pulmonary role after allo-SCT.

Stable multiple-layer stationary solutions of a semilinear parabolic equation in two-dimensional domains

Directory of Open Access Journals (Sweden)

Arnaldo Simal do Nascimento

1997-12-01

Full Text Available We use $Gamma$--convergence to prove existence of stable multiple--layer stationary solutions (stable patterns to the reaction--diffusion equation. $$ eqalign{ {partial v_varepsilon over partial t} =& varepsilon^2, hbox{div}, (k_1(xabla v_varepsilon + k_2(x(v_varepsilon -alpha(Beta-v_varepsilon (v_varepsilon -gamma_varepsilon(x,,hbox{ in }Omegaimes{Bbb R}^+ cr &v_varepsilon(x,0 = v_0 quad {partial v_varepsilon over partial widehat{n}} = 0,, quadhbox{ for } xin partialOmega,, t >0,.} $$ Given nested simple closed curves in ${Bbb R}^2$, we give sufficient conditions on their curvature so that the reaction--diffusion problem possesses a family of stable patterns. In particular, we extend to two-dimensional domains and to a spatially inhomogeneous source term, a previous result by Yanagida and Miyata.

Spatial-Frequency Azimuthally Stable Cartography of Biological Polycrystalline Networks

Directory of Open Access Journals (Sweden)

V. A. Ushenko

2013-01-01

Full Text Available A new azimuthally stable polarimetric technique processing microscopic images of optically anisotropic structures of biological tissues histological sections is proposed. It has been used as a generalized model of phase anisotropy definition of biological tissues by using superposition of Mueller matrices of linear birefringence and optical activity. The matrix element M44 has been chosen as the main information parameter, whose value is independent of the rotation angle of both sample and probing beam polarization plane. For the first time, the technique of concerted spatial-frequency filtration has been used in order to separate the manifestation of linear birefringence and optical activity. Thereupon, the method of azimuthally stable spatial-frequency cartography of biological tissues histological sections has been elaborated. As the analyzing tool, complex statistic, correlation, and fractal analysis of coordinate distributions of M44 element has been performed. The possibility of using the biopsy of the uterine wall tissue in order to differentiate benign (fibromyoma and malignant (adenocarcinoma conditions has been estimated.

Difference in serum magnesium level among patients with stable chronic obstructive pulmonary disease (COPD) and exacerbated COPD

Science.gov (United States)

Sanowara, R.; Keliat, E. N.; Abidin, A.

2018-03-01

Stable COPD is marked with various degrees of inflammation throughout large and small airways also in the alveoli which cause mucus hypersecretion, narrowing of the airway, and alveoli damage. Exacerbation is an episode of elevated inflammation. The relation between inflammation response and magnesium has been observed with the increase of proinflammation cytokines in magnesium deficiency. A cross-sectional study of 34 patients who came to RSUP H. Adam Malik (17 stable COPD patients and 17 acute exacerbated COPD patients) was conducted to examine serum magnesium level and spirometry in stable condition. Mean serum magnesium level for stable COPD patients group was 2.09 ± 0.11 mEq/L. It was higher than in the exacerbated COPD patients group 1.69 ± 0.27 mEq/L. Mann–Whitney statistical analysis showed a significant difference in magnesium level between stable COPD and exacerbated COPD groups (p<0.05).

Stable particles

International Nuclear Information System (INIS)

Samios, N.P.

1993-01-01

I have been asked to review the subject of stable particles, essentially the particles that eventually comprised the meson and baryon octets. with a few more additions -- with an emphasis on the contributions made by experiments utilizing the bubble chamber technique. In this activity, much work had been done by the photographic emulsion technique and cloud chambers-exposed to cosmic rays as well as accelerator based beams. In fact, many if not most of the stable particles were found by these latter two techniques, however, the forte of the bubble chamber (coupled with the newer and more powerful accelerators) was to verify, and reinforce with large statistics, the existence of these states, to find some of the more difficult ones, mainly neutrals and further to elucidate their properties, i.e., spin, parity, lifetimes, decay parameters, etc

[Verrucous pastern dermatitis syndrome in heavy draught horses. Part II: Clinical findings].

Science.gov (United States)

Geburek, F; Deegen, E; Hewicker-Trautwein, M; Ohnesorge, B

2005-07-01

In the present field study the skin of the feet of 37 heavy draught horses of different breeds showing verrucous pastern dermatitis was examined clinically. Included were the degree of severity of the disease and the prevalence of anatomically normal structures associated with the skin: fetlock tufts of hair ("feathering"), ergots, chestnuts, bulges in the pastern region, cannon circumference. Each horse was examined for Chorioptes sp. skin mites. Information was also collected on the development of the skin alterations and housing conditions and feeding. These individual data were correlated with the clinical degree of severity of verrucous pastern dermatitis, which was evaluated using a numerical code (scoring system). In addition, punch biopsies were taken from the diseased skin of the feet and from healthy skin of the neck for comparative patho-histological examination (see Part III). Verrucous pastern dermatitis is a chronic disease which can be divided into four groups: scaling (group I), hyperkeratotic and hyperplastic plaque-like lesions (group II), tuberous skin masses (group III), and verrucous skin lesions with rugged surfaces (group IV). No correlation was found between the clinical degree of severity of the skin lesions and sex, breed, amount of work, use of stallions for breeding, grooming condition of the hair, white markings in the foot region, or Chorioptes sp. infestation. In regard to feeding it was found that the amount of maize and oats fed had some influence on the clinical degree of severity. Statistical analysis revealed a significant correlation between the clinical degree of severity and the age, the grooming condition of the hooves, and the mean cannon circumference. The prevalence of fetlock tufts of hair, chestnuts, ergots, and anatomically normal bulges in the pastern region also increased significantly with the clinical degree of severity. Furthermore the study revealed that the clinical degree of severity depended on the hygienic

Stable configurations in social networks

Science.gov (United States)

Bronski, Jared C.; DeVille, Lee; Ferguson, Timothy; Livesay, Michael

2018-06-01

We present and analyze a model of opinion formation on an arbitrary network whose dynamics comes from a global energy function. We study the global and local minimizers of this energy, which we call stable opinion configurations, and describe the global minimizers under certain assumptions on the friendship graph. We show a surprising result that the number of stable configurations is not necessarily monotone in the strength of connection in the social network, i.e. the model sometimes supports more stable configurations when the interpersonal connections are made stronger.

Development of Stable Isotope Technology

International Nuclear Information System (INIS)

Jeong, Do Young; Kim, Cheol Jung; Han, Jae Min

2009-03-01

KAERI has obtained an advanced technology with singular originality for laser stable isotope separation. Objectives for this project are to get production technology of Tl-203 stable isotope used for medical application and are to establish the foundation of the pilot system, while we are taking aim at 'Laser Isotope Separation Technology to make resistance to the nuclear proliferation'. And we will contribute to ensuring a nuclear transparency in the world society by taking part in a practical group of NSG and being collaboration with various international groups related to stable isotope separation technology

Electropolishing of Stainless Steel Implants for Stable Functional Osteosynthesis

Directory of Open Access Journals (Sweden)

Omel’chuk, A.О.

2016-01-01

Full Text Available A new method for the electropolishing stainless steel for stable functional osteosynthesis has been developed. The polishing of implants was carried out in solutions, based on the ternary system H2SO4—H3PO4—H2O with stepwise decreasing the current density and increasing the orthophosphoric acid concentration. The optimal polishing conditions (current density, solution composition, temperature and duration have been determined. The developed method improves the quality and mechanical properties of the surface.

Calcium stable isotope geochemistry

Energy Technology Data Exchange (ETDEWEB)

Gausonne, Nikolaus [Muenster Univ. (Germany). Inst. fuer Mineralogie; Schmitt, Anne-Desiree [Strasbourg Univ. (France). LHyGeS/EOST; Heuser, Alexander [Bonn Univ. (Germany). Steinmann-Inst. fuer Geologie, Mineralogie und Palaeontologie; Wombacher, Frank [Koeln Univ. (Germany). Inst. fuer Geologie und Mineralogie; Dietzel, Martin [Technische Univ. Graz (Austria). Inst. fuer Angewandte Geowissenschaften; Tipper, Edward [Cambridge Univ. (United Kingdom). Dept. of Earth Sciences; Schiller, Martin [Copenhagen Univ. (Denmark). Natural History Museum of Denmark

2016-08-01

This book provides an overview of the fundamentals and reference values for Ca stable isotope research, as well as current analytical methodologies including detailed instructions for sample preparation and isotope analysis. As such, it introduces readers to the different fields of application, including low-temperature mineral precipitation and biomineralisation, Earth surface processes and global cycling, high-temperature processes and cosmochemistry, and lastly human studies and biomedical applications. The current state of the art in these major areas is discussed, and open questions and possible future directions are identified. In terms of its depth and coverage, the current work extends and complements the previous reviews of Ca stable isotope geochemistry, addressing the needs of graduate students and advanced researchers who want to familiarize themselves with Ca stable isotope research.

Calcium stable isotope geochemistry

International Nuclear Information System (INIS)

Gausonne, Nikolaus; Schmitt, Anne-Desiree; Heuser, Alexander; Wombacher, Frank; Dietzel, Martin; Tipper, Edward; Schiller, Martin

2016-01-01

This book provides an overview of the fundamentals and reference values for Ca stable isotope research, as well as current analytical methodologies including detailed instructions for sample preparation and isotope analysis. As such, it introduces readers to the different fields of application, including low-temperature mineral precipitation and biomineralisation, Earth surface processes and global cycling, high-temperature processes and cosmochemistry, and lastly human studies and biomedical applications. The current state of the art in these major areas is discussed, and open questions and possible future directions are identified. In terms of its depth and coverage, the current work extends and complements the previous reviews of Ca stable isotope geochemistry, addressing the needs of graduate students and advanced researchers who want to familiarize themselves with Ca stable isotope research.

Stable Control of Firing Rate Mean and Variance by Dual Homeostatic Mechanisms.

Science.gov (United States)

Cannon, Jonathan; Miller, Paul

2017-12-01

Homeostatic processes that provide negative feedback to regulate neuronal firing rates are essential for normal brain function. Indeed, multiple parameters of individual neurons, including the scale of afferent synapse strengths and the densities of specific ion channels, have been observed to change on homeostatic time scales to oppose the effects of chronic changes in synaptic input. This raises the question of whether these processes are controlled by a single slow feedback variable or multiple slow variables. A single homeostatic process providing negative feedback to a neuron's firing rate naturally maintains a stable homeostatic equilibrium with a characteristic mean firing rate; but the conditions under which multiple slow feedbacks produce a stable homeostatic equilibrium have not yet been explored. Here we study a highly general model of homeostatic firing rate control in which two slow variables provide negative feedback to drive a firing rate toward two different target rates. Using dynamical systems techniques, we show that such a control system can be used to stably maintain a neuron's characteristic firing rate mean and variance in the face of perturbations, and we derive conditions under which this happens. We also derive expressions that clarify the relationship between the homeostatic firing rate targets and the resulting stable firing rate mean and variance. We provide specific examples of neuronal systems that can be effectively regulated by dual homeostasis. One of these examples is a recurrent excitatory network, which a dual feedback system can robustly tune to serve as an integrator.

Study of the influence of stable cadmium on the transfer of zinc-65 in an ecosystem irrigated by submersion (irrigated rice field)

International Nuclear Information System (INIS)

Myttenaere, C.; Merlini, M.; Dabin, P.; Mousny, J.M.; Pozzi, G.; Bittel, R.

1975-01-01

Irrigation water contains varying amounts of stable cadmium from industrial disposal. The presence of this element is capable of modifying the transfer of and affecting the mechanisms of absorption of zinc-65, a radionuclide which is discharged into water by nuclear power stations. This type of interaction between a nuclear contaminant and a conventional contaminant was studied in a rice-field irrigated by submersion. This ecosystem was reproduced under controlled 'mini-rice-field' conditions: the water was enriched in stable zinc (1 ppm) and in stable cadmium (2,5x10 -3 ; 50x10 -3 ppm) so as to reproduce the actual conditions; the stable zinc was traced by means of zinc-65. Fish (20 Carassius auratus L.) were introduced into each compartment of the ecosystem. Samples of irrigation water and surface water were taken during cultivation, and at the end of cultivation the content of stable zinc, radioactive zinc and stable cadmium was determined in each component of the ecosystem. The results show the important influence of a conventional contaminant on the transfer of a radionuclide and justify the use of the term 'associate contaminant' to describe it. (author)

Stability of serum, plasma and urine osmolality in different storage conditions: Relevance of temperature and centrifugation.

Science.gov (United States)

Sureda-Vives, Macià; Morell-Garcia, Daniel; Rubio-Alaejos, Ana; Valiña, Laura; Robles, Juan; Bauça, Josep Miquel

2017-09-01

Osmolality reflects the concentration of all dissolved particles in a body fluid, and its measurement is routinely performed in clinical laboratories for the differential diagnosis of disorders related with the hydrolytic balance regulation, the renal function and in small-molecule poisonings. The aim of the study was to assess the stability of serum, plasma and urine osmolality through time and under different common storage conditions, including delayed centrifugation. Blood and urine samples were collected, and classified into different groups according to several preanalytical variables: serum or plasma lithium-heparin tubes; spun or unspun; stored at room temperature (RT), at 4°C or frozen at -21°C. Aliquots from each group were assayed over time, for up to 14days. Statistical differences were based on three different international performance criteria. Whole blood stability was higher in the presence of anticoagulant. Serum osmolality was stable for 2days at RT and 8days at 4°C, while plasma was less stable when refrigerated. Urine stability was 5days at RT, 4days at 4°C and >14days when frozen. Osmolality may be of great interest for the management of several conditions, such as in case of a delay in the clinical suspicion, or in case of problems in sample collection or processing. The ability to obtain reliable results for samples kept up to 14days also offers the possibility to retrospectively assess baseline values for patients which may require it. Copyright © 2017. Published by Elsevier Inc.

Acute phase protein concentrations in serum and milk from healthy cows, cows with clinical mastitis and cows with extramammary inflammatory conditions

NARCIS (Netherlands)

Nielsen, B.H.; Jacobsen, S.; Andersen, P.H.; Niewold, T.A.; Heegaard, P.M.H.

2004-01-01

The concentrations of the two acute phase proteins, serum amyloid A and haptoglobin, in serum and milk were compared in 10 cows with clinical mastitis, 11 cows with extramammary inflammatory conditions and 10 clinically healthy control cows. The concentrations of both acute phase proteins were

Distribution and behavior of radionuclides and stable elements in Lake Obuchi

International Nuclear Information System (INIS)

Ueda, Shinji; Hasegawa, Hidenao; Hisamatsu, Shun'ichi; Inaba, Jiro

2000-01-01

Distribution and behavior of radionuclides and related stable elements in the lake water of brackish Lake Obuchi were investigated by field observations. Concentrations of 238 U and stable elements were measured at various points in the lake, and compiled to obtain the elemental distributions and variation characteristics. The concentrations of 238 U in the lake water were higher in areas nearer to the Pacific Ocean, and correlated well with those of Na, K, Ca, Mg and Sr (r = 0.86 to 0.92). These observations implied that 238 U in the lake originated from seawater. The bottom layer water was reductive during July and September (stratified period) in deep areas (> 3 m). In this condition, concentrations of PO 4 3- -P, NH 4 + -N, Fe and Mn in the water increased. Concentration ratios of 238 U to those of Na strongly suggested the following conclusions. The concentrations of 238 U in the turn-over period were represented by a simple mixture of seawater and fresh water. However, in the stratified period, part of the 238 U was lost from the seawater near the bottom of the lake due to the reductive condition. (author)

A stable penalty method for the compressible Navier-Stokes equations: II: One-dimensional domain decomposition schemes

DEFF Research Database (Denmark)

Hesthaven, Jan

1997-01-01

This paper presents asymptotically stable schemes for patching of nonoverlapping subdomains when approximating the compressible Navier-Stokes equations given on conservation form. The scheme is a natural extension of a previously proposed scheme for enforcing open boundary conditions and as a res......This paper presents asymptotically stable schemes for patching of nonoverlapping subdomains when approximating the compressible Navier-Stokes equations given on conservation form. The scheme is a natural extension of a previously proposed scheme for enforcing open boundary conditions...... and as a result the patching of subdomains is local in space. The scheme is studied in detail for Burgers's equation and developed for the compressible Navier-Stokes equations in general curvilinear coordinates. The versatility of the proposed scheme for the compressible Navier-Stokes equations is illustrated...

Nonmyeloablative and reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation: a clinical review.

Science.gov (United States)

Pollack, Seth M; O'Connor, Thomas P; Hashash, Jana; Tabbara, Imad A

2009-12-01

Allogeneic hematopoietic stem cell transplantation provides many patients, with hematological and malignant diseases, hope of remission and in some cases cure. Because the toxicities of this approach are severe, its use has been limited to younger healthier patients. Nonmyeloablative and reduced intensity conditioning regimens depend more on donor cellular immune effects and less on the cytotoxic effects of the conditioning regimen to eradicate the underlying disease. This approach is based on the induction of host tolerance to donor cells followed by the administration of scheduled donor T-lymphocytes infusions. Accumulated clinical data have been encouraging, and prospective studies are underway to compare this approach to conventional myeloablative allogeneic stem cell transplantation with regard to outcome, durability of responses, effects on the immune system, and the consequences of late complications such as chronic graft-versus-host disease.

Unpredictably Stable

DEFF Research Database (Denmark)

Failla, Virgilio; Melillo, Francesca; Reichstein, Toke

2014-01-01

Is entrepreneurship a more stable career choice for high employment turnover individuals? We find that a transition to entrepreneurship induces a shift towards stayer behavior and identify job matching, job satisfaction and lock-in effects as main drivers. These findings have major implications...

Synthesis and spectroscopic studies of stable aqueous dispersion of silver nanoparticles.

Science.gov (United States)

El-Shishtawy, Reda M; Asiri, Abdullah M; Al-Otaibi, Maha M

2011-09-01

A facile approach for the synthesis of stable aqueous dispersion of silver nanoparticles (AgNPs) using glucose as the reducing agent in water/micelles system, in which cetyltrimethylammonium bromide (CTAB) was used as capping agent (stabilizer) is described. The evolution of plasmon band of AgNPs was monitored under different conditions such as (a) concentration of sodium hydroxide, (b) concentration of glucose, (c) concentration of silver nitrate (d) concentration of CTAB, and (e) reaction time. AgNPs were characterized by UV-visible spectroscopy, transmission electron microscopy (TEM), fluorescence spectroscopy and FT-IR spectroscopy. The results revealed an easy and viable strategy for obtaining stable aqueous dispersion of AgNPs with well controlled shape and size below 30 nm in diameter. Copyright © 2011 Elsevier B.V. All rights reserved.

Stable multi-domain spectral penalty methods for fractional partial differential equations

Science.gov (United States)

Xu, Qinwu; Hesthaven, Jan S.

2014-01-01

We propose stable multi-domain spectral penalty methods suitable for solving fractional partial differential equations with fractional derivatives of any order. First, a high order discretization is proposed to approximate fractional derivatives of any order on any given grids based on orthogonal polynomials. The approximation order is analyzed and verified through numerical examples. Based on the discrete fractional derivative, we introduce stable multi-domain spectral penalty methods for solving fractional advection and diffusion equations. The equations are discretized in each sub-domain separately and the global schemes are obtained by weakly imposed boundary and interface conditions through a penalty term. Stability of the schemes are analyzed and numerical examples based on both uniform and nonuniform grids are considered to highlight the flexibility and high accuracy of the proposed schemes.

A varying-coefficient method for analyzing longitudinal clinical trials data with nonignorable dropout

Science.gov (United States)

Forster, Jeri E.; MaWhinney, Samantha; Ball, Erika L.; Fairclough, Diane

2011-01-01

Dropout is common in longitudinal clinical trials and when the probability of dropout depends on unobserved outcomes even after conditioning on available data, it is considered missing not at random and therefore nonignorable. To address this problem, mixture models can be used to account for the relationship between a longitudinal outcome and dropout. We propose a Natural Spline Varying-coefficient mixture model (NSV), which is a straightforward extension of the parametric Conditional Linear Model (CLM). We assume that the outcome follows a varying-coefficient model conditional on a continuous dropout distribution. Natural cubic B-splines are used to allow the regression coefficients to semiparametrically depend on dropout and inference is therefore more robust. Additionally, this method is computationally stable and relatively simple to implement. We conduct simulation studies to evaluate performance and compare methodologies in settings where the longitudinal trajectories are linear and dropout time is observed for all individuals. Performance is assessed under conditions where model assumptions are both met and violated. In addition, we compare the NSV to the CLM and a standard random-effects model using an HIV/AIDS clinical trial with probable nonignorable dropout. The simulation studies suggest that the NSV is an improvement over the CLM when dropout has a nonlinear dependence on the outcome. PMID:22101223

Leaching of plasticizers from polyvinylchloride perfusion lines by different lipid emulsions for premature infants under clinical conditions.

Science.gov (United States)

Faessler, David; McCombie, Gregor; Biedermann, Maurus; Felder, Florian; Subotic, Ulrike

2017-03-30

Plasticizers migrate from polyvinylchloride (PVC) infusion systems into lipid emulsions. The aim of this study was to investigate the leaching of different plasticizers from PVC perfusion lines by a selection of lipid emulsions under clinical conditions. Seven PVC perfusion lines with an equal length of 150cm and three internal diameters were perfused with three lipid emulsions: Intralipid ® 20%, ClinOleic ® 20% and SMOFlipid ® 20%, mimicking clinical conditions. The concentrations of the plasticizers were measured directly in the emulsions by gas chromatography - mass spectrometry. Of the four plasticizers examined in this study, di (2-ethylhexyl) phthalate (DEHP) leached the most and was found, on average, at 46.5μg/ml in the emulsions - around one order of magnitude higher than the other plasticizers. This study demonstrates that the leaching of DEHP by lipid emulsions in conditions of total parenteral nutrition is many times higher than should be accepted and higher when compared to the other plasticizers. There was no significant difference in leaching of plasticizers in relation to the type of lipid emulsion. The influence of tube diameter on the leaching rate of plasticizers should be taken into account especially in particular exposed patients. Copyright © 2017 Elsevier B.V. All rights reserved.

A stable murine-based RD114 retroviral packaging line efficiently transduces human hematopoietic cells.

Science.gov (United States)

Ward, Maureen; Sattler, Rose; Grossman, I Robert; Bell, Anthony J; Skerrett, Donna; Baxi, Laxmi; Bank, Arthur

2003-11-01

Several barriers exist to high-efficiency transfer of therapeutic genes into human hematopoietic stem cells (HSCs) using complex oncoretroviral vectors. Human clinical trials to date have used Moloney leukemia virus-based amphotropic and gibbon ape leukemia virus-based envelopes in stable retroviral packaging lines. However, retroviruses pseudotyped with these envelopes have low titers due to the inability to concentrate viral supernatants efficiently by centrifugation without damaging the virus and low transduction efficiencies because of low-level expression of viral target receptors on human HSC. The RD114 envelope from the feline endogenous virus has been shown to transduce human CD34+ cells using transient packaging systems and to be concentrated to high titers by centrifugation. Stable packaging systems have potential advantages over transient systems because greater and more reproducible viral productions can be attained. We have, therefore, constructed and tested a stable RD114-expressing packaging line capable of high-level transduction of human CD34+ cells. Viral particles from this cell line were concentrated up to 100-fold (up to 10(7) viral particles/ml) by ultracentrifugation. Human hematopoietic progenitors from cord blood and sickle cell CD34+ cells were efficiently transduced with a Neo(R)-containing vector after a single exposure to concentrated RD114-pseudotyped virus produced from this cell line. Up to 78% of progenitors from transduced cord blood CD34+ cells and 51% of progenitors from sickle cell CD34+ cells expressed the NeoR gene. We also show transfer of a human beta-globin gene into progenitor cells from CD34+ cells from sickle cell patients with this new RD114 stable packaging system. The results indicate that this packaging line may eventually be useful in human clinical trials of globin gene therapy.

Large pneumothorax in blunt chest trauma: Is a chest drain always necessary in stable patients? A case report

Directory of Open Access Journals (Sweden)

Baig M. Idris

2016-01-01

Conclusion: Blunt traumatic large pneumothorax in a clinically stable patient can be managed conservatively. Current recommendations for tube placement may need to be reevaluated. This may reduce morbidity associated with chest tube thoracostomy.

Periodic orbits from Δ-modulation of stable linear systems

OpenAIRE

Xia, X.; Zinober, A.

2004-01-01

The �-modulated control of a single input, discrete time, linear stable system is investigated. The modulation direction is given by cTx where c �Rn/{0} is a given, otherwise arbitrary, vector. We obtain necessary and sufficient conditions for the existence of periodic points of a finite order. Some concrete results about the existence of a certain order of periodic points are also derived. We also study the relationship between certain polyhedra and the periodicity of the �-modulated orb...

Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus.

Science.gov (United States)

Busato, Ivana Maria Saes; Ignácio, Sérgio Aparecido; Brancher, João Armando; Moysés, Simone Tetu; Azevedo-Alanis, Luciana Reis

2012-02-01

To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate (P = 0.00) and logistic regression (P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia (P = 0.00) and OHQoL, and caries experience (P = 0.03) and OHQoL. DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. © 2011 John Wiley & Sons A/S.

Clinical condition and comorbidity as determinants for blood culture positivity in patients with skin and soft-tissue infections

NARCIS (Netherlands)

van Daalen, F. V.; Kallen, M. C.; van den Bosch, C. M. A.; Hulscher, M. E. J. L.; Geerlings, S. E.; Prins, J. M.

2017-01-01

The utility of performing blood cultures in patients with a suspected skin infection is debated. We investigated the association between blood culture positivity rates and patients' clinical condition, including acute disease severity and comorbidity. We performed a retrospective study, including

Reconsidering the Gatekeeper Paradigm for Percutaneous Coronary Intervention in Stable Coronary Disease Management.

Science.gov (United States)

Schulman-Marcus, Joshua; Weintraub, William S; Boden, William E

2017-10-15

Major randomized clinical trials over the last decade support the role of optimal medical therapy for the initial management approach for patients with stable coronary artery disease (CAD), whereas percutaneous coronary intervention (PCI) ought to be reserved for patients with persistent symptoms despite optimal medical therapy. Likewise, several studies have continued to demonstrate the superiority of coronary artery bypass grafting surgery over PCI in many patients with extensive multivessel CAD, especially those with diabetes. Nevertheless, the decision-making paradigm for patients with stable CAD often continues to propagate the upfront use of "ad hoc PCI" and disadvantages alternative therapeutic approaches. In our editorial, we discuss how multiple systemic and interpersonal factors continue to favor early revascularization with PCI in stable patients. We discuss whether the interventional cardiologist can be an unbiased "gatekeeper" for the use of PCI or whether other physicians should also be involved with the patient in decision-making. Finally, we offer suggestions that can redefine the gatekeeper role to facilitate an evidence-based approach that embraces shared decision-making. Copyright © 2017 Elsevier Inc. All rights reserved.

Associations of prepartum body condition score with occurrence of clinical endometritis and resumption of postpartum ovarian activity in dairy cattle.

Science.gov (United States)

Kadivar, Ali; Ahmadi, Mohammad Rahim; Vatankhah, Mahmood

2014-01-01

This study was performed to investigate the effect of periparturient body condition score on the occurrence of clinical endometritis and postpartum resumption of ovarian activity in dairy cows. Eighty-seven lactating Holstein cows, fed with a total mixed ration diet, were included into the study. Body condition scoring (using a 5-point scale with quarter-point divisions) was performed by the same investigator using the visual technique every 2 weeks, from 2 weeks before until 6 weeks after calving. Palpation of the reproductive tract and ultrasonographic assessment of ovaries for detection of corpus luteum using a rectal linear probe was also performed at 2, 4, and 6 weeks after calving. Cows with clinical endometritis had significantly lower body condition score (BCS) than normal cows at all weeks pre- and postcalving, and cows that did not ovulate until 45 days after calving had a significantly lower BCS pre- and postpartum. Cows that did not ovulate until 45 days after calving also lost more BCS from 2 weeks before to 4 weeks after calving. Besides, first ovulation after calving take occurred later in cows with clinical endometritis compared to normal cows (P < 0.05). In conclusion, low BCS is a risk factor for postpartum endometritis and delayed cyclicity in dairy cows. BCS loss from dry-off to early lactation and occurrence of clinical endometritis can significantly affect postpartum ovarian activity.

Caffeine Citrate Dosing Adjustments to Assure Stable Caffeine Concentrations in Preterm Neonates.

Science.gov (United States)

Koch, Gilbert; Datta, Alexandre N; Jost, Kerstin; Schulzke, Sven M; van den Anker, John; Pfister, Marc

2017-12-01

To identify dosing strategies that will assure stable caffeine concentrations in preterm neonates despite changing caffeine clearance during the first 8 weeks of life. A 3-step simulation approach was used to compute caffeine doses that would achieve stable caffeine concentrations in the first 8 weeks after birth: (1) a mathematical weight change model was developed based on published weight distribution data; (2) a pharmacokinetic model was developed based on published models that accounts for individual body weight, postnatal, and gestational age on caffeine clearance and volume of distribution; and (3) caffeine concentrations were simulated for different dosing regimens. A standard dosing regimen of caffeine citrate (using a 20 mg/kg loading dose and 5 mg/kg/day maintenance dose) is associated with a maximal trough caffeine concentration of 15 mg/L after 1 week of treatment. However, trough concentrations subsequently exhibit a clinically relevant decrease because of increasing clearance. Model-based simulations indicate that an adjusted maintenance dose of 6 mg/kg/day in the second week, 7 mg/kg/day in the third to fourth week and 8 mg/kg/day in the fifth to eighth week assures stable caffeine concentrations with a target trough concentration of 15 mg/L. To assure stable caffeine concentrations during the first 8 weeks of life, the caffeine citrate maintenance dose needs to be increased by 1 mg/kg every 1-2 weeks. These simple adjustments are expected to maintain exposure to stable caffeine concentrations throughout this important developmental period and might enhance both the short- and long-term beneficial effects of caffeine treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

First Successful Pre-Distribution of Stable Iodine Tablets Under Japan's New Policy After the Fukushima Daiichi Nuclear Accident.

Science.gov (United States)

Ojino, Mayo; Yoshida, Sumito; Nagata, Takashi; Ishii, Masami; Akashi, Makoto

2017-06-01

Stable iodine tablets are effective in reducing internal exposure to radioactive iodine, which poses a risk for thyroid cancer and other conditions. After the Fukushima Daiichi nuclear power plant accident, the Japanese government shifted its policy on stable iodine tablet distribution from "after-the-fact" to "before-the-fact" and instructed local governments to pre-distribute stable iodine tablets to residents living within a 5-km radius of nuclear facilities. The nation's first pre-distribution of stable iodine tablets was carried out in June and July of 2014 in Kagoshima Prefecture. Health surveys were conducted so that the medication would not be handed out to people with the possibility of side effects. Of the 4715 inhabitants in the area, 132 were found to require a physician's judgment, mostly to exclude risks of side effects. This was considered important to prevent the misuse of the tablets in the event of a disaster. The importance of collective and individualized risk communication between physicians and inhabitants at the community health level was apparent through this study. Involvement of physicians through the regional Sendai City Medical Association was an important component of the pre-distribution. Physicians of the Sendai City Medical Association were successfully educated by using the Guidebook on Distributing and Administering Stable Iodine Tablets prepared by the Japan Medical Association and Japan Medical Association Research Institute with the collaboration of the National Institute of Radiological Sciences and the Japanese government. Thus, the physicians managed to make decisions on the dispensing of stable iodine tablets according to the health conditions of the inhabitants. All physicians nationwide should be provided continuing medical education on stable iodine tablets. (Disaster Med Public Health Preparedness. 2017;11:365-369).

Acute phase protein concentrations in serum and milk from healthy cows, cows with clinical mastitis and cows with extramammary inflammatory conditions

DEFF Research Database (Denmark)

Nielsen, B.H.; Jacobsen, S.; Andersen, P.H.

2004-01-01

The concentrations of the two acute phase proteins, serum amyloid A and haptoglobin, in serum and milk were compared in 10 cows with clinical mastitis, 11 cows with extramammary inflammatory conditions and 10 clinically healthy control cows. The concentrations of both acute phase proteins were...... higher in the serum and milk of the cows with mastitis than in the cows in the other two groups. Four of the cows with extramammary inflammatory conditions had serum amyloid A concentrations in serum above 100 mug/ml, but negligible concentrations in milk, indicating that a pathogen must be present...

Stable rotating dipole solitons in nonlocal media

DEFF Research Database (Denmark)

Lopez-Aguayo, Servando; Skupin, Stefan; Desyatnikov, Anton S.

2006-01-01

We present the first example of stable rotating two-soliton bound states in nonlinear optical media with nonlocal response. We show that, in contrast to media with local response, nonlocality opens possibilities to generate stable azimuthons.......We present the first example of stable rotating two-soliton bound states in nonlinear optical media with nonlocal response. We show that, in contrast to media with local response, nonlocality opens possibilities to generate stable azimuthons....

Stable and high order accurate difference methods for the elastic wave equation in discontinuous media

KAUST Repository

Duru, Kenneth; Virta, Kristoffer

2014-01-01

to be discontinuous. The key feature is the highly accurate and provably stable treatment of interfaces where media discontinuities arise. We discretize in space using high order accurate finite difference schemes that satisfy the summation by parts rule. Conditions

Development of Stable Solidification Method for Insoluble Ferrocyanides-13170

Energy Technology Data Exchange (ETDEWEB)

Ikarashi, Yuki; Masud, Rana Syed; Mimura, Hitoshi [Dept. of Quantum Science and Energy Engineering, Graduate School of Engineering, Tohoku University, Aramaki-Aza-Aoba6-6-01-2, Sendai, 980-8579 (Japan); Ishizaki, Eiji; Matsukura, Minoru [UNION SHOWA K.K. 17-20, Mita 2-chome, Minato-ku, Tokyo 108-0073 (Japan)

2013-07-01

The development of stable solidification method of insoluble ferrocyanides sludge is an important subject for the safety decontamination in Fukushima NPP-1. By using the excellent immobilizing properties of zeolites such as gas trapping ability and self-sintering properties, the stable solidification of insoluble ferrocyanides was accomplished. The immobilization ratio of Cs for K{sub 2}[CoFe(CN){sub 6}].nH{sub 2}O saturated with Cs{sup +} ions (Cs{sub 2}[CoFe(CN){sub 6}].nH{sub 2}O) was estimated to be less than 0.1% above 1,000 deg. C; the adsorbed Cs{sup +} ions are completely volatilized. In contrast, the novel stable solid form was produced by the press-sintering of the mixture of Cs{sub 2}[CoFe(CN){sub 6}].nH{sub 2}O and zeolites at higher temperature of 1,000 deg. C and 1,100 deg. C; Cs volatilization and cyanide release were completely depressed. The immobilization ratio of Cs, under the mixing conditions of Cs{sub 2}[CoFe(CN){sub 6}].nH{sub 2}O:CP= 1:1 and calcining temperature: 1,000 deg. C, was estimated to be nearly 100%. As for the kinds of zeolites, natural mordenite (NM), clinoptilolite (CP) and Chabazite tended to have higher immobilization ratio compared to zeolite A. This may be due to the difference in the phase transformation between natural zeolites and synthetic zeolite A. In the case of the composites (K{sub 2-X}Ni{sub X/2}[NiFe(CN){sub 6}].nH{sub 2}O loaded natural mordenite), relatively high immobilization ratio of Cs was also obtained. This method using zeolite matrices can be applied to the stable solidification of the solid wastes of insoluble ferrocyanides sludge. (authors)

Very early feeding in stable small for gestational age preterm infants: a randomized clinical trial.

Science.gov (United States)

Arnon, Shmuel; Sulam, Daniella; Konikoff, Fred; Regev, Rivka H; Litmanovitz, Ita; Naftali, Timna

2013-01-01

To examine the effect of initiating very early feeding on time-to-reach full feeding in stable, small for gestational age (SGA) preterm infants. Preterm infants with gestational age below 37 weeks and birth weight below the 10(th) percentile were randomly allocated to a very early (within 24 hours of birth) feeding regimen or delayed (after 24 hours of birth) feeding. All infants had in utero evidence of absent or reverse diastolic flow. Infants unable to start early feeding were excluded. Time-to-reach full feeding, feeding progression, and related morbidity were compared. Electrogastrography (EGG) was used to measure pre- and postprandial gastric motility on the second and seventh day after feeding initiation. Sixty infants were included in the study, 30 in each group. Infants included in the very early feeding regimen achieved full enteral feeding sooner than controls (98±80-157 vs. 172±123-261 hours of age, respectively; p= 0.004) and were discharged home earlier (p=0.04). No necrotizing enterocolitis (NEC) was documented in both study groups. Gastric motility was improved at day seven after feeding initiation in both study groups, with no difference between groups. Stable SGA preterm infants on a very early feeding regimen achieved full enteral feeding and were discharged home significantly earlier than those on a delayed regimen, with no excess morbidity. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

Economic Outcomes of First-Line Regimen Switching Among Stable Patients with HIV.

Science.gov (United States)

Rosenblatt, Lisa; Buikema, Ami R; Seare, Jerry; Bengtson, Lindsay G S; Johnson, Jonathan; Cao, Feng; Villasis-Keever, Angelina

2017-07-01

Although switching of antiretroviral therapy (ART) is a valid approach for addressing treatment failure in patients with human immunodeficiency virus (HIV), ART changes among those who are well maintained on their current regimens may lead to the development of new side effects or resistance. To examine the effect of first-line regimen switching on subsequent health care utilization and cost among stable HIV patients. This was a retrospective claims data study of adult patients with HIV who initiated ART between 2007 and 2013 and had been treated with their initial regimens for at least 6 continuous months. Those with evidence of pregnancy or HIV-2 were excluded. Patients who underwent an ART change were assigned to a switcher cohort; a nonswitcher cohort was then generated by matching up to 20 nonswitchers for each switcher, with replacement. The index date was the date of the first ART change for switchers and was the claim date closest to the corresponding switcher's switch date for nonswitchers. Patient characteristics at baseline and post-index annualized health care utilization and costs were analyzed descriptively and with multivariable models. Analyses were performed in the full population and among patients designated as virologically stable (had undetectable viral ribonucleic acid [RNA] for 90 days pre-index) and virologically and clinically stable (had undetectable viral RNA and no apparent clinical reason for switching ART). The study population consisted of 6,983 individuals, which included 927 switchers (168 virologically stable; 55 virologically+clinically stable), who were matched with replacement with 18,511 nonswitcher comparators. The switcher cohort was 88.8% male (mean age 43.8 years). Mean preindex and follow-up treatment durations for switchers and nonswitchers were 1.8 years and 1.5 years, respectively; demographic characteristics, pre-index treatment duration, and follow-up duration were similar between cohorts. Significantly more

Stable isotopes determination in some Romanian fruit juices.

Science.gov (United States)

Magdas, Dana Alina; Puscas, Romulus

2011-09-01

The characterisation of 45 Romanian single-strength fruit juices (apples, pears, plums and grapes) collected from different Transylvanian areas by means of stable isotope approach are presented and discussed in this study. We measured (2)H/(1)H, (18)O/(16)O ratios from water juice and (13)C/(12)C from pulp and compared these results with those already reported in the literature for single-strength juices, in order to see how the geographical and climatic conditions of Transylvania and the meteorological peculiarities of the year 2010 influence the isotopic composition of the investigated fruit juices. The δ(13)C mean values that we found for apple pulp picked up from different Transylvanian areas show slight differences, probably due to the environmental conditions of the plants. No significant correlation either between the variety of apple or the geographical origin and δ(13)C value was established.

Effects of different centrifugation conditions on clinical chemistry and Immunology test results.

Science.gov (United States)

Minder, Elisabeth I; Schibli, Adrian; Mahrer, Dagmar; Nesic, Predrag; Plüer, Kathrin

2011-05-10

The effect of centrifugation time of heparinized blood samples on clinical chemistry and immunology results has rarely been studied. WHO guideline proposed a 15 min centrifugation time without citing any scientific publications. The centrifugation time has a considerable impact on the turn-around-time. We investigated 74 parameters in samples from 44 patients on a Roche Cobas 6000 system, to see whether there was a statistical significant difference in the test results among specimens centrifuged at 2180 g for 15 min, at 2180 g for 10 min or at 1870 g for 7 min, respectively. Two tubes with different plasma separators (both Greiner Bio-One) were used for each centrifugation condition. Statistical comparisons were made by Deming fit. Tubes with different separators showed identical results in all parameters. Likewise, excellent correlations were found among tubes to which different centrifugation conditions were applied. Fifty percent of the slopes lay between 0.99 and 1.01. Only 3.6 percent of the statistical tests results fell outside the significance level of p < 0.05, which was less than the expected 5%. This suggests that the outliers are the result of random variation and the large number of statistical tests performed. Further, we found that our data are sufficient not to miss a biased test (beta error) with a probability of 0.10 to 0.05 in most parameters. A centrifugation time of either 7 or 10 min provided identical test results compared to the time of 15 min as proposed by WHO under the conditions used in our study.

Tempered stable laws as random walk limits

OpenAIRE

Chakrabarty, Arijit; Meerschaert, Mark M.

2010-01-01

Stable laws can be tempered by modifying the L\\'evy measure to cool the probability of large jumps. Tempered stable laws retain their signature power law behavior at infinity, and infinite divisibility. This paper develops random walk models that converge to a tempered stable law under a triangular array scheme. Since tempered stable laws and processes are useful in statistical physics, these random walk models can provide a basic physical model for the underlying physical phenomena.

An Interactive Platform to Visualize Data-Driven Clinical Pathways for the Management of Multiple Chronic Conditions.

Science.gov (United States)

Zhang, Yiye; Padman, Rema

2017-01-01

Patients with multiple chronic conditions (MCC) pose an increasingly complex health management challenge worldwide, particularly due to the significant gap in our understanding of how to provide coordinated care. Drawing on our prior research on learning data-driven clinical pathways from actual practice data, this paper describes a prototype, interactive platform for visualizing the pathways of MCC to support shared decision making. Created using Python web framework, JavaScript library and our clinical pathway learning algorithm, the visualization platform allows clinicians and patients to learn the dominant patterns of co-progression of multiple clinical events from their own data, and interactively explore and interpret the pathways. We demonstrate functionalities of the platform using a cluster of 36 patients, identified from a dataset of 1,084 patients, who are diagnosed with at least chronic kidney disease, hypertension, and diabetes. Future evaluation studies will explore the use of this platform to better understand and manage MCC.

Modelling Conditions and Health Care Processes in Electronic Health Records: An Application to Severe Mental Illness with the Clinical Practice Research Datalink.

Science.gov (United States)

Olier, Ivan; Springate, David A; Ashcroft, Darren M; Doran, Tim; Reeves, David; Planner, Claire; Reilly, Siobhan; Kontopantelis, Evangelos

2016-01-01

The use of Electronic Health Records databases for medical research has become mainstream. In the UK, increasing use of Primary Care Databases is largely driven by almost complete computerisation and uniform standards within the National Health Service. Electronic Health Records research often begins with the development of a list of clinical codes with which to identify cases with a specific condition. We present a methodology and accompanying Stata and R commands (pcdsearch/Rpcdsearch) to help researchers in this task. We present severe mental illness as an example. We used the Clinical Practice Research Datalink, a UK Primary Care Database in which clinical information is largely organised using Read codes, a hierarchical clinical coding system. Pcdsearch is used to identify potentially relevant clinical codes and/or product codes from word-stubs and code-stubs suggested by clinicians. The returned code-lists are reviewed and codes relevant to the condition of interest are selected. The final code-list is then used to identify patients. We identified 270 Read codes linked to SMI and used them to identify cases in the database. We observed that our approach identified cases that would have been missed with a simpler approach using SMI registers defined within the UK Quality and Outcomes Framework. We described a framework for researchers of Electronic Health Records databases, for identifying patients with a particular condition or matching certain clinical criteria. The method is invariant to coding system or database and can be used with SNOMED CT, ICD or other medical classification code-lists.

Dynamical damping terms for symmetry-seeking shift conditions

International Nuclear Information System (INIS)

Alic, Daniela; Rezzolla, Luciano; Hinder, Ian; Moesta, Philipp

2010-01-01

Suitable gauge conditions are fundamental for stable and accurate numerical-relativity simulations of inspiralling compact binaries. A number of well-studied conditions have been developed over the last decade for both the lapse and the shift and these have been successfully used both in vacuum and non-vacuum spacetimes when simulating binaries with comparable masses. At the same time, recent evidence has emerged that the standard 'Gamma-driver' shift condition requires a careful and non-trivial tuning of its parameters to ensure long-term stable evolutions of unequal-mass binaries. We present a novel gauge condition in which the damping constant is promoted to be a dynamical variable and the solution of an evolution equation. We show that this choice removes the need for special tuning and provides a shift damping term which is free of instabilities in our simulations and dynamically adapts to the individual positions and masses of the binary black-hole system. Our gauge condition also reduces the variations in the coordinate size of the apparent horizon of the larger black hole and could therefore be useful when simulating binaries with very small mass ratios.

Effect of Different Carbon Substrates on Nitrate Stable Isotope Fractionation During Microbial Denitrification

DEFF Research Database (Denmark)

Wunderlich, Anja; Meckenstock, Rainer; Einsiedl, Florian

2012-01-01

-labeled water and 18O-labeled nitrite were added to the microcosm experiments to study the effect of putative backward reactions of nitrite to nitrate on the stable isotope fractionation. We found no evidence for a reverse reaction. Significant variations of the stable isotope enrichment factor ε were observed......In batch experiments, we studied the isotope fractionation in N and O of dissolved nitrate during dentrification. Denitrifying strains Thauera aromatica and “Aromatoleum aromaticum strain EbN1” were grown under strictly anaerobic conditions with acetate, benzoate, and toluene as carbon sources. 18O...... of nitrate transport across the cell wall compared to the kinetics of the intracellular nitrate reduction step of microbial denitrification....

Electronic apex locator: A comprehensive literature review — Part II: Effect of different clinical and technical conditions on electronic apex locator′s accuracy

Directory of Open Access Journals (Sweden)

Hamid Razavian

2014-01-01

Full Text Available Introduction: To investigate the effects of different clinical and technical conditions on the accuracy of electronic apex locators (EALs. Materials and Methods: "Tooth apex," "dental instrument," "odontometry," "electronic medical," and "electronic apex locator" were searched as primary identifiers via Medline/PubMed, Cochrane library, and Scopus data base up to 30 July 2013. Original articles that fulfilled the inclusion criteria were selected and reviewed. Results: Out of 402 relevant studies, 183 were selected based on the inclusion criteria. In this part, 75 studies are presented. Pulp vitality conditions and root resorption, types of files and irrigating materials do not affect an EAL′s accuracy; however, the file size and foramen diameter can affect its accuracy. Conclusions: Various clinical conditions such as the file size and foramen diameter may affect EALs′ accuracy. However, more randomized clinical trials are needed for definitive conclusion.

Changes of stable isotopes carbon-13 and nitrogen-15 in different tissues of cattle

International Nuclear Information System (INIS)

Sun Fengmei; Yu Hongxia; Wu Wei; Yang Shuming

2009-01-01

Stable isotope analysis is a potential tool for tracing food origin. The stable carbon and nitrogen isotope composition in different tissues of two varieties of cattle under the same culture condition were investigated. δ 13 C and δ 15 N values of different defatted muscle and crude fat, cattle tail hair, blood, liver and feed were determined by isotope ratio mass spectrometry, and statistical analysis was carried out. The results showed that stable isotopes of carbon and nitrogen composition was not affected by cattle variety; the δ 13 C values between different defatted muscle, blood, liver and cattle hair were not significantly different, but δ 15 N value in the liver was much higher than other muscle and the δ 13 C values didn't show difference among all the crude fat samples. So these results indicated that isotope fractionation in the various tissue was discrepant. (authors)

Comparison of imaging strategies with conditional versus immediate contrast-enhanced computed tomography in patients with clinical suspicion of acute appendicitis

International Nuclear Information System (INIS)

Atema, J.J.; Gans, S.L.; Boermeester, M.A.; Randen, A. van; Stoker, J.; Lameris, W.; Es, H.W. van; Heesewijk, J.P.M. van; Ramshorst, B. van; Bouma, W.H.; Hove, W. ten; Keulen, E.M. van; Dijkgraaf, M.G.W.; Bossuyt, P.M.M.

2015-01-01

To compare the diagnostic accuracy of conditional computed tomography (CT), i.e. CT when initial ultrasound findings are negative or inconclusive, and immediate CT for patients with suspected appendicitis. Data were collected within a prospective diagnostic accuracy study on imaging in adults with acute abdominal pain. All patients underwent ultrasound and CT, read by different observers who were blinded from the other modality. Only patients with clinical suspicion of appendicitis were included. An expert panel assigned a final diagnosis to each patient after 6 months of follow-up (clinical reference standard). A total of 422 patients were included with final diagnosis appendicitis in 251 (60 %). For 199 patients (47 %), ultrasound findings were inconclusive or negative. Conditional CT imaging correctly identified 241 of 251 (96 %) appendicitis cases (95 %CI, 92 % to 98 %), versus 238 (95 %) with immediate CT (95 %CI, 91 % to 97 %). The specificity of conditional CT imaging was lower: 77 % (95 %CI, 70 % to 83 %) versus 87 % for immediate CT (95 %CI, 81 % to 91 %). A conditional CT strategy correctly identifies as many patients with appendicitis as an immediate CT strategy, and can halve the number of CTs needed. However, conditional CT imaging results in more false positives. (orig.)

Comparison of imaging strategies with conditional versus immediate contrast-enhanced computed tomography in patients with clinical suspicion of acute appendicitis

Energy Technology Data Exchange (ETDEWEB)

Atema, J.J.; Gans, S.L.; Boermeester, M.A. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Randen, A. van; Stoker, J. [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Lameris, W. [Academic Medical Centre, Department of Surgery (G4-142), Amsterdam (Netherlands); Spaarne Hospital, Department of Surgery, Hoofddorp (Netherlands); Es, H.W. van; Heesewijk, J.P.M. van [St Antonius Hospital, Department of Radiology, Nieuwegein (Netherlands); Ramshorst, B. van [St Antonius Hospital, Department of Surgery, Nieuwegein (Netherlands); Bouma, W.H. [Gelre Hospital, Department of Surgery, Apeldoorn (Netherlands); Hove, W. ten [Gelre Hospital, Department of Radiology, Apeldoorn (Netherlands); Keulen, E.M. van [Tergooi Hospital, Department of Radiology, Hilversum (Netherlands); Dijkgraaf, M.G.W. [Academic Medical Centre, Clinical Research Unit, Amsterdam (Netherlands); Bossuyt, P.M.M. [Academic Medical Center, Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Amsterdam (Netherlands)

2015-08-15

To compare the diagnostic accuracy of conditional computed tomography (CT), i.e. CT when initial ultrasound findings are negative or inconclusive, and immediate CT for patients with suspected appendicitis. Data were collected within a prospective diagnostic accuracy study on imaging in adults with acute abdominal pain. All patients underwent ultrasound and CT, read by different observers who were blinded from the other modality. Only patients with clinical suspicion of appendicitis were included. An expert panel assigned a final diagnosis to each patient after 6 months of follow-up (clinical reference standard). A total of 422 patients were included with final diagnosis appendicitis in 251 (60 %). For 199 patients (47 %), ultrasound findings were inconclusive or negative. Conditional CT imaging correctly identified 241 of 251 (96 %) appendicitis cases (95 %CI, 92 % to 98 %), versus 238 (95 %) with immediate CT (95 %CI, 91 % to 97 %). The specificity of conditional CT imaging was lower: 77 % (95 %CI, 70 % to 83 %) versus 87 % for immediate CT (95 %CI, 81 % to 91 %). A conditional CT strategy correctly identifies as many patients with appendicitis as an immediate CT strategy, and can halve the number of CTs needed. However, conditional CT imaging results in more false positives. (orig.)

Doppler wind lidar using a MOPA semiconductor laser at stable single-frequency operation

DEFF Research Database (Denmark)

Rodrigo, Peter John; Pedersen, Christian

2009-01-01

for the tapered amplifier section. The specified maximum current values are 0.7 A and 4.0 A for Idfb and Iamp. Although the MOPA-SL has been proven capable of producing single-frequency CW output beam, stable operation at this spectral condition has also been known to highly depend on the drive currents...

Producing air-stable monolayers of phosphorene and their defect engineering.

Science.gov (United States)

Pei, Jiajie; Gai, Xin; Yang, Jiong; Wang, Xibin; Yu, Zongfu; Choi, Duk-Yong; Luther-Davies, Barry; Lu, Yuerui

2016-01-22

It has been a long-standing challenge to produce air-stable few- or monolayer samples of phosphorene because thin phosphorene films degrade rapidly in ambient conditions. Here we demonstrate a new highly controllable method for fabricating high quality, air-stable phosphorene films with a designated number of layers ranging from a few down to monolayer. Our approach involves the use of oxygen plasma dry etching to thin down thick-exfoliated phosphorene flakes, layer by layer with atomic precision. Moreover, in a stabilized phosphorene monolayer, we were able to precisely engineer defects for the first time, which led to efficient emission of photons at new frequencies in the near infrared at room temperature. In addition, we demonstrate the use of an electrostatic gate to tune the photon emission from the defects in a monolayer phosphorene. This could lead to new electronic and optoelectronic devices, such as electrically tunable, broadband near infrared lighting devices operating at room temperature.

Energy conditions and stability in general relativity

International Nuclear Information System (INIS)

Hall, G.S.

1982-01-01

The dominant energy condition in general relativity theory, which says that every observer measures a nonnegative local energy density and a nonspacelike local energy flow, is examined in connection with the types of energy-momentum tensor it permits. The condition that the energy-momentum tensor be ''stable'' in obeying the dominant energy conditions is then defined in terms of a suitable topology on the set of energy-momentum tensors on space-time and the consequences are evaluated and discussed. (author)

Modification of elastic stable intramedullary nailing with a 3rd nail in a femoral spiral fracture model - results of biomechanical testing and a prospective clinical study.

Science.gov (United States)

Kaiser, Martin M; Stratmann, Christine; Zachert, Gregor; Schulze-Hessing, Maaike; Gros, Nina; Eggert, Rebecca; Rapp, Marion

2014-01-08

Elastic stable intramedullary nailing (ESIN) is the standard treatment for displaced diaphyseal femoral fractures in children. However, high complication rates (10-50%) are reported in complex fractures. This biomechanical study compares the stiffness with a 3rd nail implanted to that in the classical 2C-shaped configuration and presents the application into clinical practice. For each of the 3 configurations of ESIN-osteosynthesis with titanium nails eight composite femoral grafts (Sawbones®) with an identical spiral fracture were used: 2C configuration (2C-shaped nails, 2 × 3.5 mm), 3CM configuration (3rd nail from medial) and 3CL configuration (3rd nail from lateral). Each group underwent biomechanical testing in 4-point bending, internal/external rotation and axial compression. 2C and 3CM configurations showed no significant differences in this spiroid type fracture model. 3CL had a significantly higher stiffness during anterior-posterior bending, internal rotation and 9° compression than 2C, and was stiffer in the lateral-medial direction than 3CM. The 3CL was less stable during p-a bending and external rotation than both the others. As biomechanical testing showed a higher stability for the 3CL configuration in two (a-p corresponding to recurvation and 9° compression to shortening) of three directions associated with the most important clinical problems, we added a 3rd nail in ESIN-osteosynthesis for femoral fractures. 11 boys and 6 girls (2.5-15 years) were treated with modified ESIN of whom 12 were '3CL'; due to the individual character of the fractures 4 patients were treated with '3CM' (third nail from medial) and as an exception 1 adolescent with 4 nails and one boy with plate osteosynthesis. No additional stabilizations or re-operations were necessary. All patients achieved full points in the Harris-Score at follow-up; no limb length discrepancy occurred. The 3CL configuration provided a significantly higher stiffness than 2C and 3CM configurations

Temperature and Humidity Control in Livestock Stables

DEFF Research Database (Denmark)

Hansen, Michael; Andersen, Palle; Nielsen, Kirsten M.

2010-01-01

The paper describes temperature and humidity control of a livestock stable. It is important to have a correct air flow pattern in the livestock stable in order to achieve proper temperature and humidity control as well as to avoid draught. In the investigated livestock stable the air flow...

Inertial Measures of Motion for Clinical Biomechanics: Comparative Assessment of Accuracy under Controlled Conditions - Effect of Velocity

Science.gov (United States)

Lebel, Karina; Boissy, Patrick; Hamel, Mathieu; Duval, Christian

2013-01-01

Background Inertial measurement of motion with Attitude and Heading Reference Systems (AHRS) is emerging as an alternative to 3D motion capture systems in biomechanics. The objectives of this study are: 1) to describe the absolute and relative accuracy of multiple units of commercially available AHRS under various types of motion; and 2) to evaluate the effect of motion velocity on the accuracy of these measurements. Methods The criterion validity of accuracy was established under controlled conditions using an instrumented Gimbal table. AHRS modules were carefully attached to the center plate of the Gimbal table and put through experimental static and dynamic conditions. Static and absolute accuracy was assessed by comparing the AHRS orientation measurement to those obtained using an optical gold standard. Relative accuracy was assessed by measuring the variation in relative orientation between modules during trials. Findings Evaluated AHRS systems demonstrated good absolute static accuracy (mean error < 0.5o) and clinically acceptable absolute accuracy under condition of slow motions (mean error between 0.5o and 3.1o). In slow motions, relative accuracy varied from 2o to 7o depending on the type of AHRS and the type of rotation. Absolute and relative accuracy were significantly affected (p<0.05) by velocity during sustained motions. The extent of that effect varied across AHRS. Interpretation Absolute and relative accuracy of AHRS are affected by environmental magnetic perturbations and conditions of motions. Relative accuracy of AHRS is mostly affected by the ability of all modules to locate the same global reference coordinate system at all time. Conclusions Existing AHRS systems can be considered for use in clinical biomechanics under constrained conditions of use. While their individual capacity to track absolute motion is relatively consistent, the use of multiple AHRS modules to compute relative motion between rigid bodies needs to be optimized according to

Continuous Covariate Imbalance and Conditional Power for Clinical Trial Interim Analyses

Science.gov (United States)

Ciolino, Jody D.; Martin, Renee' H.; Zhao, Wenle; Jauch, Edward C.; Hill, Michael D.; Palesch, Yuko Y.

2014-01-01

Oftentimes valid statistical analyses for clinical trials involve adjustment for known influential covariates, regardless of imbalance observed in these covariates at baseline across treatment groups. Thus, it must be the case that valid interim analyses also properly adjust for these covariates. There are situations, however, in which covariate adjustment is not possible, not planned, or simply carries less merit as it makes inferences less generalizable and less intuitive. In this case, covariate imbalance between treatment groups can have a substantial effect on both interim and final primary outcome analyses. This paper illustrates the effect of influential continuous baseline covariate imbalance on unadjusted conditional power (CP), and thus, on trial decisions based on futility stopping bounds. The robustness of the relationship is illustrated for normal, skewed, and bimodal continuous baseline covariates that are related to a normally distributed primary outcome. Results suggest that unadjusted CP calculations in the presence of influential covariate imbalance require careful interpretation and evaluation. PMID:24607294

The Myopic Stable Set for Social Environments

NARCIS (Netherlands)

Demuynck, Thomas; Herings, P. Jean-Jacques; Saulle, Riccardo; Seel, Christian

2017-01-01

We introduce a new solution concept for models of coalition formation, called the myopic stable set. The myopic stable set is defined for a very general class of social environments and allows for an infinite state space. We show that the myopic stable set exists and is non-empty. Under minor

Stable isotope analysis in primatology: a critical review.

Science.gov (United States)

Sandberg, Paul A; Loudon, James E; Sponheimer, Matt

2012-11-01

Stable isotope analysis has become an important tool in ecology over the last 25 years. A wealth of ecological information is stored in animal tissues in the relative abundances of the stable isotopes of several elements, particularly carbon and nitrogen, because these isotopes navigate through ecological processes in predictable ways. Stable carbon and nitrogen isotopes have been measured in most primate taxonomic groups and have yielded information about dietary content, dietary variability, and habitat use. Stable isotopes have recently proven useful for addressing more fine-grained questions about niche dynamics and anthropogenic effects on feeding ecology. Here, we discuss stable carbon and nitrogen isotope systematics and critically review the published stable carbon and nitrogen isotope data for modern primates with a focus on the problems and prospects for future stable isotope applications in primatology. © 2012 Wiley Periodicals, Inc.

Recent developments in application of stable isotope analysis on agro-product authenticity and traceability.

Science.gov (United States)

Zhao, Yan; Zhang, Bin; Chen, Gang; Chen, Ailiang; Yang, Shuming; Ye, Zhihua

2014-02-15

With the globalisation of agro-product markets and convenient transportation of food across countries and continents, the potential for distribution of mis-labelled products increases accordingly, highlighting the need for measures to identify the origin of food. High quality food with identified geographic origin is a concern not only for consumers, but also for agriculture farmers, retailers and administrative authorities. Currently, stable isotope ratio analysis in combination with other chemical methods gradually becomes a promising approach for agro-product authenticity and traceability. In the last five years, a growing number of research papers have been published on tracing agro-products by stable isotope ratio analysis and techniques combining with other instruments. In these reports, the global variety of stable isotope compositions has been investigated, including light elements such as C, N, H, O and S, and heavy isotopes variation such as Sr and B. Several factors also have been considered, including the latitude, altitude, evaporation and climate conditions. In the present paper, an overview is provided on the authenticity and traceability of the agro-products from both animal and plant sources by stable isotope ratio analysis. Copyright © 2013 Elsevier Ltd. All rights reserved.

Entropy Stability and the No-Slip Wall Boundary Condition

KAUST Repository

Svä rd, Magnus; Carpenter, Mark H.; Parsani, Matteo

2018-01-01

We present an entropy stable numerical scheme subject to no-slip wall boundary conditions. To enforce entropy stability only the no-penetration boundary condition and a temperature condition are needed at a wall, and this leads to an L bound on the conservative variables. In this article, we take the next step and design a finite difference scheme that also bounds the velocity gradients. This necessitates the use of the full no-slip conditions.

Entropy Stability and the No-Slip Wall Boundary Condition

KAUST Repository

Svärd, Magnus

2018-01-18

We present an entropy stable numerical scheme subject to no-slip wall boundary conditions. To enforce entropy stability only the no-penetration boundary condition and a temperature condition are needed at a wall, and this leads to an L bound on the conservative variables. In this article, we take the next step and design a finite difference scheme that also bounds the velocity gradients. This necessitates the use of the full no-slip conditions.

Stable cycling in discrete-time genetic models.

OpenAIRE

Hastings, A

1981-01-01

Examples of stable cycling are discussed for two-locus, two-allele, deterministic, discrete-time models with constant fitnesses. The cases that cycle were found by using numerical techniques to search for stable Hopf bifurcations. One consequence of the results is that apparent cases of directional selection may be due to stable cycling.

Stable cycling in discrete-time genetic models.

Science.gov (United States)

Hastings, A

1981-11-01

Examples of stable cycling are discussed for two-locus, two-allele, deterministic, discrete-time models with constant fitnesses. The cases that cycle were found by using numerical techniques to search for stable Hopf bifurcations. One consequence of the results is that apparent cases of directional selection may be due to stable cycling.

Local Search Approaches in Stable Matching Problems

Directory of Open Access Journals (Sweden)

Toby Walsh

2013-10-01

Full Text Available The stable marriage (SM problem has a wide variety of practical applications, ranging from matching resident doctors to hospitals, to matching students to schools or, more generally, to any two-sided market. In the classical formulation, n men and n women express their preferences (via a strict total order over the members of the other sex. Solving an SM problem means finding a stable marriage where stability is an envy-free notion: no man and woman who are not married to each other would both prefer each other to their partners or to being single. We consider both the classical stable marriage problem and one of its useful variations (denoted SMTI (Stable Marriage with Ties and Incomplete lists where the men and women express their preferences in the form of an incomplete preference list with ties over a subset of the members of the other sex. Matchings are permitted only with people who appear in these preference lists, and we try to find a stable matching that marries as many people as possible. Whilst the SM problem is polynomial to solve, the SMTI problem is NP-hard. We propose to tackle both problems via a local search approach, which exploits properties of the problems to reduce the size of the neighborhood and to make local moves efficiently. We empirically evaluate our algorithm for SM problems by measuring its runtime behavior and its ability to sample the lattice of all possible stable marriages. We evaluate our algorithm for SMTI problems in terms of both its runtime behavior and its ability to find a maximum cardinality stable marriage. Experimental results suggest that for SM problems, the number of steps of our algorithm grows only as O(n log(n, and that it samples very well the set of all stable marriages. It is thus a fair and efficient approach to generate stable marriages. Furthermore, our approach for SMTI problems is able to solve large problems, quickly returning stable matchings of large and often optimal size, despite the

Experimental and numerical study of atmospheric turbulence and dispersion in stable conditions and in near field at a complex site

International Nuclear Information System (INIS)

Wei, Xiao

2016-01-01

An experimental program has been designed in order to study pollutants dispersion at a complex site with a focus on stable conditions, which are still challenging for numerical modelling. This experimental program is being conducted at the SIRTA site in a southern suburb of Paris and consists in measuring, in near field, the turbulence and the pollutants dispersion. The aim of this program is to characterize the fine structure of turbulence and associated dispersion through high temporal and spatial resolution measurements. Then, these measurements allow to validate and improve the performance of CFD simulation for turbulence and dispersion in a heterogeneous field. The instrumental set up includes 12 ultrasonic anemometers measuring continuously wind velocity and temperature at 10 Hz, and 6 photo-ionization detectors (PIDs) measuring gas concentration at 50 Hz during tracer tests. Intensive observations periods (IOPs) with gas releases have been performed since March 2012.First of all, a detailed study of flow on the site is made, because it must be characterised and properly simulated before attempting to simulate the pollutants dispersion. This study is based on two years of continuous measurements and on measurements performed during IOPs. Turbulence strong anisotropy in the surface layer is characterized by calculating variances, integral length scales and power spectra of the three wind velocity components. Propagation of turbulent structures between sensors has been characterized with velocity correlations. Energy spectra show several slopes in different frequency regions. Also, data analyses show impact of terrain heterogeneity on the measurements. The forest to the north of experimental field modifies wind velocity and direction for a large northerly sector. It induces a strong directional wind shear and a wind deceleration below the forest height. Numerical simulations are carried out using the CFD code Code-Saturne in RANS mode with a standard κ

Stable beams

CERN Multimedia

2015-01-01

Stable beams: two simple words that carry so much meaning at CERN. When LHC page one switched from "squeeze" to "stable beams" at 10.40 a.m. on Wednesday, 3 June, it triggered scenes of jubilation in control rooms around the CERN sites, as the LHC experiments started to record physics data for the first time in 27 months. This is what CERN is here for, and it’s great to be back in business after such a long period of preparation for the next stage in the LHC adventure.   I’ve said it before, but I’ll say it again. This was a great achievement, and testimony to the hard and dedicated work of so many people in the global CERN community. I could start to list the teams that have contributed, but that would be a mistake. Instead, I’d simply like to say that an achievement as impressive as running the LHC – a machine of superlatives in every respect – takes the combined effort and enthusiasm of everyone ...

Stable isotope research pool inventory

International Nuclear Information System (INIS)

1980-12-01

This report contains a listing of electromagnetically separated stable isotopes which are available for distribution within the United States for non-destructive research use from the Oak Ridge National Laboratory on a loan basis. This inventory includes all samples of stable isotopes in the Materials Research Collection and does not designate whether a sample is out on loan or in reprocessing

An algebraic method for constructing stable and consistent autoregressive filters

International Nuclear Information System (INIS)

Harlim, John; Hong, Hoon; Robbins, Jacob L.

2015-01-01

In this paper, we introduce an algebraic method to construct stable and consistent univariate autoregressive (AR) models of low order for filtering and predicting nonlinear turbulent signals with memory depth. By stable, we refer to the classical stability condition for the AR model. By consistent, we refer to the classical consistency constraints of Adams–Bashforth methods of order-two. One attractive feature of this algebraic method is that the model parameters can be obtained without directly knowing any training data set as opposed to many standard, regression-based parameterization methods. It takes only long-time average statistics as inputs. The proposed method provides a discretization time step interval which guarantees the existence of stable and consistent AR model and simultaneously produces the parameters for the AR models. In our numerical examples with two chaotic time series with different characteristics of decaying time scales, we find that the proposed AR models produce significantly more accurate short-term predictive skill and comparable filtering skill relative to the linear regression-based AR models. These encouraging results are robust across wide ranges of discretization times, observation times, and observation noise variances. Finally, we also find that the proposed model produces an improved short-time prediction relative to the linear regression-based AR-models in forecasting a data set that characterizes the variability of the Madden–Julian Oscillation, a dominant tropical atmospheric wave pattern

42 CFR 485.638 - Conditions of participation: Clinical records.

Science.gov (United States)

2010-10-01

... participation: Clinical records. (a) Standard: Records system—(1) The CAH maintains a clinical records system in..., readily accessible, and systematically organized. (4) For each patient receiving health care services, the CAH maintains a record that includes, as applicable— (i) Identification and social data, evidence of...

Diagnosis and incidence risk of clinical canine monocytic ehrlichiosis under field conditions in Southern Europe.

Science.gov (United States)

René-Martellet, Magalie; Lebert, Isabelle; Chêne, Jeanne; Massot, Raphaël; Leon, Marta; Leal, Ana; Badavelli, Stefania; Chalvet-Monfray, Karine; Ducrot, Christian; Abrial, David; Chabanne, Luc; Halos, Lénaïg

2015-01-06

Canine Monocytic Ehrlichiosis (CME), due to the bacterium Ehrlichia canis and transmitted by the brown dog tick Rhipicephalus sanguineus, is a major tick-borne disease in southern Europe. In this area, infections with other vector-borne pathogens (VBP) are also described and result in similar clinical expression. The aim of the present study was to evaluate the incidence risk of clinical CME in those endemic areas and to assess the potential involvement of other VBP in the occurrence of clinical and/or biological signs evocative of the disease. The study was conducted from April to November 2011 in veterinary clinics across Italy, Spain and Portugal. Sick animals were included when fitting at least three clinical and/or biological criteria compatible with ehrlichiosis. Serological tests (SNAP®4Dx, SNAP®Leish tests, Idexx, USA) and diagnostic PCR for E. canis, Anaplasma platys, Anaplasma phagocytophilum, Babesia spp, Hepatozoon canis and Leishmania infantum detection were performed to identify the etiological agents. Ehrlichiosis was considered when three clinical and/or biological suggestive signs were associated with at least one positive paraclinical test (serology or PCR). The annual incidence risk was calculated and data were geo-referenced for map construction. The probabilities of CME and other vector-borne diseases when facing clinical and/or biological signs suggestive of CME were then evaluated. A total of 366 dogs from 78 veterinary clinics were enrolled in the survey. Among them, 99 (27%) were confirmed CME cases, which allowed an estimation of the average annual incidence risk of CME amongst the investigated dog population to be 0.08%. Maps showed an increasing gradient of CME incidence risk from northern towards southern areas, in particular in Italy. It also suggested the existence of hot-spots of infections by VBP in Portugal. In addition, the detection of other VBP in the samples was common and the study demonstrated that a dog with clinical signs

Representation and properties of a class of conditionally Gaussian processes

DEFF Research Database (Denmark)

Barndorff-Nielsen, Ole Eiler; Pedersen, Jan

2009-01-01

It is shown that the class of conditionally Gaussian processes with independent increments is stable under marginalisation and conditioning. Moreover, in general such processes can be represented as integrals of a time changed Brownian motion where the time change and the integrand are jointly in...

Effectiveness and risks of stable iodine prophylaxis

International Nuclear Information System (INIS)

Waight, P.J.

1995-01-01

The factors upon which the efficacy of stable iodine prophylaxis depends are reviewed, with particular reference to the dose of stable iodine, the timing of the dose, the influence of dietary iodine and the impact of the other prospective actions. The risks of stable iodine ingestion are estimated, and their application to the principle of Justification in outlined. (Author)

Forensic Stable Isotope Biogeochemistry

Science.gov (United States)

Cerling, Thure E.; Barnette, Janet E.; Bowen, Gabriel J.; Chesson, Lesley A.; Ehleringer, James R.; Remien, Christopher H.; Shea, Patrick; Tipple, Brett J.; West, Jason B.

2016-06-01

Stable isotopes are being used for forensic science studies, with applications to both natural and manufactured products. In this review we discuss how scientific evidence can be used in the legal context and where the scientific progress of hypothesis revisions can be in tension with the legal expectations of widely used methods for measurements. Although this review is written in the context of US law, many of the considerations of scientific reproducibility and acceptance of relevant scientific data span other legal systems that might apply different legal principles and therefore reach different conclusions. Stable isotopes are used in legal situations for comparing samples for authenticity or evidentiary considerations, in understanding trade patterns of illegal materials, and in understanding the origins of unknown decedents. Isotope evidence is particularly useful when considered in the broad framework of physiochemical processes and in recognizing regional to global patterns found in many materials, including foods and food products, drugs, and humans. Stable isotopes considered in the larger spatial context add an important dimension to forensic science.

Opposite effects of training in rats with stable and progressive pulmonary hypertension.

Science.gov (United States)

Handoko, M L; de Man, F S; Happé, C M; Schalij, I; Musters, R J P; Westerhof, N; Postmus, P E; Paulus, W J; van der Laarse, W J; Vonk-Noordegraaf, A

2009-07-07

Exercise training in pulmonary arterial hypertension (PH) is a promising adjunct to medical treatment. However, it is still unclear whether training is beneficial for all PH patients. We hypothesized that right ventricular adaptation plays a pivotal role in the response to training. Two different dosages of monocrotaline were used in rats to model stable PH with preserved cardiac output and progressive PH developing right heart failure. Two weeks after injection, PH was confirmed by echocardiography, and treadmill training was initiated. Rats were trained for 4 weeks unless manifest right heart failure developed earlier. At the end of the study protocol, all rats were functionally assessed by endurance testing, echocardiography, and invasive pressure measurements. Lungs and hearts were further analyzed in quantitative histomorphologic analyses. In stable PH, exercise training was well tolerated and markedly increased exercise endurance (from 25+/-3.9 to 62+/-3.9 minutes; Ptraining worsened survival (hazard ratio, 2.7; 95% confidence interval, 1.1 to 14.2) and increased pulmonary vascular remodeling. In addition, training induced widespread leukocyte infiltration into the right ventricle (from 135+/-14 to 276+/-18 leukocytes per 1 mm(2); Ptraining was found to be beneficial in stable PH but detrimental in progressive PH. Future studies are necessary to address the clinical implications of our findings.

Ballooning stable high beta tokamak equilibria

International Nuclear Information System (INIS)

Tuda, Takashi; Azumi, Masafumi; Kurita, Gen-ichi; Takizuka, Tomonori; Takeda, Tatsuoki

1981-04-01

The second stable regime of ballooning modes is numerically studied by using the two-dimensional tokamak transport code with the ballooning stability code. Using the simple FCT heating scheme, we find that the plasma can locally enter this second stable regime. And we obtained equilibria with fairly high beta (β -- 23%) stable against ballooning modes in a whole plasma region, by taking into account of finite thermal diffusion due to unstable ballooning modes. These results show that a tokamak fusion reactor can operate in a high beta state, which is economically favourable. (author)

Use of the natural abundance of stable isotopes in animal physiology

International Nuclear Information System (INIS)

Koyama, Takeo

1987-01-01

Recent studies on the natural abundance (δ-value) of stable isotopes in animals are reviewed. The δ 13 C value of livestock varies among different portions of the body and depending on living conditions, etc. Typically, however, it is about 1 percent larger than that of the feed used. The value of δ 15 N of the blood, milk and droppings is reported to be larger than that of the feed while that of urine is smaller with the decrease showing changes through the day. Natural δ 13 C and δ 15 N of animals are known to vary among the various organs and tissues. Investigations on cattle and two types musseks have shown that δ 13 C and δ 15 N have no significant relations with their age. The isotopic ratio of stable isotopes in animals is largely dependent on that of the feed used. Study results are cited on the changes in isotopic ratio of carbon and nitrogen along the digestion process of ruminants. Discussion is made on the causes for the changes in isotopic ratio during the metabolic process. Measurement of natural abundance of stable isotopes can be used as a tool for determining the eating habits of ungulate animals raised on grazing lands. (Nogami, K.)

Evolutionarily stable learning schedules and cumulative culture in discrete generation models.

Science.gov (United States)

Aoki, Kenichi; Wakano, Joe Yuichiro; Lehmann, Laurent

2012-06-01

Individual learning (e.g., trial-and-error) and social learning (e.g., imitation) are alternative ways of acquiring and expressing the appropriate phenotype in an environment. The optimal choice between using individual learning and/or social learning may be dictated by the life-stage or age of an organism. Of special interest is a learning schedule in which social learning precedes individual learning, because such a schedule is apparently a necessary condition for cumulative culture. Assuming two obligatory learning stages per discrete generation, we obtain the evolutionarily stable learning schedules for the three situations where the environment is constant, fluctuates between generations, or fluctuates within generations. During each learning stage, we assume that an organism may target the optimal phenotype in the current environment by individual learning, and/or the mature phenotype of the previous generation by oblique social learning. In the absence of exogenous costs to learning, the evolutionarily stable learning schedules are predicted to be either pure social learning followed by pure individual learning ("bang-bang" control) or pure individual learning at both stages ("flat" control). Moreover, we find for each situation that the evolutionarily stable learning schedule is also the one that optimizes the learned phenotype at equilibrium. Copyright © 2012 Elsevier Inc. All rights reserved.

CYTOLOGY PULMONARY IN HORSES (EQUUS CABALLUS MAINTAINED THE FIELD OR STABLED

Directory of Open Access Journals (Sweden)

W. F. Fortes Júnior

2016-11-01

Full Text Available Tracheobronchial secretion was collected by endoscopy (Welch-AllynÒ, 200cm long and 9mm diameter, from equines with different ages, races and sex, for posterior cytological analysis. Thirty-six equines were divided into two groups (Group I = stabled, n = 18; Group II = field regimen, n = 18. Animals of Group I (age = 3.5 years were lodged in the Tarumã´s Jockey Club in Curitiba, Parana State. The equines of Group II always were maintained at field condition (never were stabled, in the farm located in Jacarezinho, Paraná State. Following endoscopic exams, tracheobronchial secretion smears were stained by Pappenhein´s method and submitted to cytological analysis. Group I had higher frequency of tracheal discharge than Group II. The cytological analysis showed more presence of macrophages (58.8%, foamy cells (2.3%, body giant cells (0.2%, neutrophils (4.57%, eosinophils (0.7% and Curshmann´s spirals (0.04% on 3 of the 18 animals. The cytological analysis of Group II showed higher frequency of ciliated epithelial cells than Group I, and no Curshmann´s spirals were observed. In conclusion, data showed that horses stabled had more cytological alterations than the animals maintained at field, therefore more tracheobronchial complications. Thus, the care of place where horse are stabled have influence on development of respiratory diseases, may predispose to affections as Chronic Obstructive Pulmonary Disease and Exercise-Induced Pulmonary Hemorrhage, as well athletic horses may be never reach their full respiratory potential.

Could clinical symptoms of the gastrointestinal tract disguise a life threatening condition?

International Nuclear Information System (INIS)

Rajzak, E.; Kostalova, L.; Kovacs, L.; Bereczkova, E.; Rajzak, R.

2016-01-01

In paediatric practice encountering symptoms such as nausea, vomiting, lack of appetite, diarrhoea, abdominal pain are generally associated with and credited to maladies of the gastrointestinal tract. This paper focuses on a case study of a nine-year-old boy tracing the causal background of his deteriorating condition. Within a period of two months he was admitted twice for ambulatory treatment of nausea and vomiting. First he was hospitalized for impaired digestion, however upon symptomatic treatment and rehydration he quickly recovered. Two months following his first hospitalization, he was yet again admitted for aggravated albeit similar and additional symptoms such as fatigue, weight loss, emotional instability and an excessive use of salt. Given the thoroughly assessed anamnesis and study of his clinical symptoms along with the laboratory results, our team’s assumption of Addison’s disease had been confirmed. (author)

An Unconditionally Stable Method for Solving the Acoustic Wave Equation

Directory of Open Access Journals (Sweden)

Zhi-Kai Fu

2015-01-01

Full Text Available An unconditionally stable method for solving the time-domain acoustic wave equation using Associated Hermit orthogonal functions is proposed. The second-order time derivatives in acoustic wave equation are expanded by these orthogonal basis functions. By applying Galerkin temporal testing procedure, the time variable can be eliminated from the calculations. The restriction of Courant-Friedrichs-Levy (CFL condition in selecting time step for analyzing thin layer can be avoided. Numerical results show the accuracy and the efficiency of the proposed method.

Thermal and electrodynamical formation mechanisms of overloaded AC states and charging rate influence on their stable dynamics

International Nuclear Information System (INIS)

Romanovskii, V.; Watanabe, K.; Awaji, S.

2013-01-01

Highlights: •Overloaded AC states are investigated to understand the mechanisms of there formation. •There exist characteristic time windows defining the existence of stable overloaded AC states. •Limiting values of the electric field, current and temperature are higher than the quench ones. -- Abstract: The macroscopic thermal and electrodynamical phenomena occurring in high-T c superconductors during overloaded AC states are theoretically investigated to understand the basic physical mechanisms, which are characteristic for the stable formation of the operating modes when the peak current exceeds the critical current of a superconductor during AC modes. It is shown that there exist characteristic time windows defining the existence of stable overloaded AC states. They identify the stability boundary of the overloaded AC states. Therefore, there is the maximum allowable value of a peak current of stable overloaded AC regimes at the given charging rate, cooling conditions and properties of a superconductor and a matrix. The results obtained prove that the limiting peak current is higher than the corresponding quench current defining the stability margin of DC states. It monotonically increases with the charging rate. Besides, in the stable overloaded AC states, the peak values of the electric field and temperature may be also noticeably higher than the corresponding quench values. They depend on the peak current and charging rate at the given cooling conditions. As a result, high-T c superconducting tapes can stably work under intensive AC modes without instability onset when the peak of applied currents may significantly exceed not only the critical current but also the corresponding values of DC-quench currents

Stable Isotopic Analysis on Water Utilization of Two Xerophytic Shrubs in a Revegetated Desert Area: Tengger Desert, China

OpenAIRE

Lei Huang; Zhishan Zhang

2015-01-01

Stable isotope studies on stable isotope ratios of hydrogen and oxygen in water within plants provide new information on water sources and water use patterns under natural conditions. In this study, the sources of water uptake for two typical xerophytic shrubs, Caragana korshinskii and Artemisia ordosica, were determined at four different-aged revegetated sites (1956, 1964, 1981, and 1987) in the Tengger Desert, a revegetated desert area in China. Samples from precipitation, soil water at dif...

Temperature factor for magnetic instability conditions of type – II superconductors

International Nuclear Information System (INIS)

Romanovskii, V.

2014-01-01

Highlights: • Electrodynamics and thermal diffusion phenomena in superconductors have the fission-chain-reaction nature. • There exist nontrivial relations between stability conditions, allowable losses and stable superconductor’s overheating. • The magnetic stability conditions are direct consequence of the states when the heat releases exceeds the critical energy. • The critical energy of magnetic instability depends on the nature of an external disturbance. • The non-isothermal magnetic instability conditions of the critical state are formulated. - Abstract: The macroscopic development of interrelated electrodynamics and thermal states taking place both before and after instability onset in type-II superconductors are studied using the critical state and the flux creep concepts. The physical mechanisms of the non-isothermal formation of the critical state are discussed solving the set of unsteady thermo-electrodynamics equations taking into consideration the unknown moving penetration boundary of the magnetic flux. To make it, the numerical method, which allows to study diffusion phenomena with unknown moving phase-two boundary, is developed. The corresponding non-isothermal flux jump criteria are written. It is proved for the first time that, first, the diffusion phenomena in superconductors have the fission-chain-reaction nature, second, the stability conditions, losses in superconductor and its stable overheating before instability onset are mutually dependent. The results are compared with those following from the existing magnetic instability theory, which does not take into consideration the stable temperature increase of superconductor before the instability onset. It is shown that errors of isothermal approximation are significant for modes closed to adiabatic ones. Therefore, the well-known adiabatic flux jump criterion limits the range of possible stable superconducting states since a correct determination of their stability states must

Generation of a severe convective ionospheric storm under stable Rayleigh–Taylor conditions: triggering by meteors?

Directory of Open Access Journals (Sweden)

M. C. Kelley

2016-02-01

Full Text Available Here we report on four events detected using the Jicamarca Radio Observatory (JRO over an 18-year period, in which huge convective ionospheric storms (CISs occur in a stable ionosphere. We argue that these rare events could be initiated by meteor-induced electric fields. The meteor-induced electric fields map to the bottomside of the F region, causing radar echoes and a localized CIS. If and when a localized disturbance reaches 500 km, we argue that it becomes two-dimensionally turbulent and cascades structure to both large and small scales. This leads to long-lasting structure and, almost certainly, to scintillations over a huge range of latitudes some ±15° wide and to 3 m irregularities, which backscatter the VHF radar waves. These structures located at high altitudes are supported by vortices shed by the upwelling bubble in a vortex street.

Developing Partnerships in the Provision of Youth Mental Health Services and Clinical Education: A School-Based Cognitive Behavioral Intervention Targeting Anxiety Symptoms in Children.

Science.gov (United States)

Waters, Allison M; Groth, Trisha A; Sanders, Mary; O'Brien, Rosanne; Zimmer-Gembeck, Melanie J

2015-11-01

Clinical scientists are calling for strong partnerships in the provision of evidence-based treatments for child mental health problems in real-world contexts. In the present study, we describe the implementation of a cognitive-behavioral intervention (CBI) to address grade 5 children's anxiety symptoms. The CBI arose from a long-standing partnership between University and Education Department stakeholders. The partnership integrates school-based, evidence-informed treatment delivery with clinical education, and also supports a school-based psychology clinic to provide assessment and treatment services to children attending schools within the catchment area and clinical training for university graduate students. Children in the active condition (N=74) completed the CBI during regular class time, while children in the control condition (N=77) received the standard classroom curriculum. Children's anxiety and depressive symptoms, threat interpretation biases (perceived danger and coping ability), and perceptions of their social skills were assessed before and after condition. Children in the active condition reported significant improvements in self-reported anxiety symptoms, and perceptions of their social skills and coping ability, whereas no significant differences were observed for children in the control condition from pre- to post-assessment. For a subset of children assessed 12 months after the CBI (n=76), symptom improvement remained stable over time and estimates of danger and coping ability showed even greater improvement. Results demonstrate the value of strong stakeholder partnerships in innovative youth mental health services, positive child outcomes, and clinical education. Copyright © 2015. Published by Elsevier Ltd.

Advanced condition monitoring program for turbine system

International Nuclear Information System (INIS)

Ono, Shigetoshi

2015-01-01

It is important for utilities to achieve a stable operation in nuclear power plants. To achieve it, plant anomalies that affect a stable operation must be found out and eliminated. Therefore, the advanced condition monitoring program was developed. In this program, a sophisticated heat balance model based on the actual plant data is adopted to identify plant anomalies at an incipient stage and the symptoms of plant anomalies are found by heat balance changes from the model calculation. The model calculation results have shown precise prediction for actual plant parameters. Moreover, this program has the diagnostic engine that helps operators derive the cause of plant anomalies. By using this monitoring program, the component reliability in the turbine system can be periodically monitored and assessed, and as a result the stable operation of nuclear power plants can be achieved. (author)

On the Effect of Planetary Stable Isotope Compositions on Growth and Survival of Terrestrial Organisms.

Directory of Open Access Journals (Sweden)

Xueshu Xie

Full Text Available Isotopic compositions of reactants affect the rates of chemical and biochemical reactions. Usually it is assumed that heavy stable isotope enrichment leads to progressively slower reactions. Yet the effect of stable isotopes may be nonlinear, as exemplified by the "isotopic resonance" phenomenon. Since the isotopic compositions of other planets of Solar system, including Mars and Venus, are markedly different from terrestrial (e.g., deuterium content is ≈5 and ≈100 times higher, respectively, it is far from certain that terrestrial life will thrive in these isotopic conditions. Here we found that Martian deuterium content negatively affected survival of shrimp in semi-closed biosphere on a year-long time scale. Moreover, the bacterium Escherichia coli grows slower at Martian isotopic compositions and even slower at Venus's compositions. Thus, the biological impact of varying stable isotope compositions needs to be taken into account when planning interplanetary missions.

[Individualized restorative designs and clinical evaluation for dental implants in the anterior esthetic zone with inappropriate conditions].

Science.gov (United States)

Dai, Wen-yong; Zhou, Guo-xing; Zhang, Xiao-zhen; Zhao, Yi; Wang, Jie; Yang, Yi; Zhu, Zhi-jun; Tang, Chun-bo

2014-08-01

To offer individualized restorative strategies for patients receiving dental implants in the anterior esthetic zone but with inappropriate available conditions and evaluate the clinical outcomes. Forty-six patients with 58 implants were recruited for the study in accordance with the criteria and received individualized implant prostheses in the anterior esthetic zone. The patients were followed up for 3-24 months, and the clinical outcomes were evaluated by pink and white esthetic scores (PES/WES). The patients were from 18 to 69 years old, and followed up for 12.6 months in average. According to the third month follow-up esthetic scores, for PES, 1.72% of the patients got low scores, 44.83% got medium scores and 53.45% got high scores; For WES, 0% got low scores, 20.69% got medium scores and 79.31% got high scores. No implant failure or peri-implantitis occurred. Individualized restorative designs for implants in the esthetic zone can effectively improve the appearance of the prostheses which originally have no appropriate available space. Close follow-up and monitoring of the peri-implant soft tissue and proper oral hygiene instructions are important to ensure the conditions of the prostheses.

Narrative meaning making is associated with sudden gains in psychotherapy clients' mental health under routine clinical conditions.

Science.gov (United States)

Adler, Jonathan M; Harmeling, Luke H; Walder-Biesanz, Ilana

2013-10-01

The present study had two aims: (a) to replicate previous findings regarding the characteristics of sudden gains (SGs) in psychotherapy under routine clinical conditions and (b) to examine whether clients' narrative meaning-making processes were associated with SGs in mental health. 54 psychotherapy clients completed the Systemic Therapy Inventory of Change (Pinsof et al., 2009) and wrote private narratives prior to beginning treatment and between every session for 12 assessment points over the course of psychotherapy for a variety of presenting problems. Clients' narratives were coded using existing systems (Adler, 2012; A. M. Hayes, Feldman, & Goldfried, 2006) to assess their content in eight themes: processing, avoidance, coherence, positive self, negative self, agency, hope, and hopelessness. The prevalence, magnitude, and timing of SGs in mental health observed in the present study were similar to those observed in prior research. Two narrative meaning-making processes-processing and coherence-were significantly associated with SGs in mental health. The present study significantly extends prior research on SGs, replicating the characteristics of these gains in routine clinical conditions with a measure of general functioning and identifying two narrative meaning-making processes that are associated with SGs in mental health.

Amino acid stable isotope applications to deep-sea corals: A molecular geochemistry approach to reconstructing past ocean conditions

Science.gov (United States)

McMahon, K.; McCarthy, M. D.; Guilderson, T. P.; Sherwood, O.; Williams, B.; Larsen, T.; Glynn, D. S.

2017-12-01

Future climate change is predicted to alter ocean productivity, food web dynamics, biogeochemical cycling, and the efficacy of the biological pump. Proteinaceous deep-sea corals act as "living sediment traps," providing long-term, high-resolution records of exported surface ocean production and a window into past changes in ocean condition as a historical context for potential future changes. Here, we present recent work developing the application of compound-specific stable isotope analysis of individual amino acids to proteinaceous deep-sea corals to reconstruct past changes in phytoplankton community composition and biogeochemical cycling. We present new calibrations for molecular isotope comparisons between metabolically active coral polyp tissue and bioarchival proteinaceous skeleton. We then applied these techniques to deep-sea corals from the North Pacific Subtropical Gyre (NPSG) to reconstruct centennial to millennial time scale changes in phytoplankton community composition and biogeochemical cycling as a function of regional climate change. This work suggests that the NPSG has undergone multiple major phytoplankton regime shifts over the last millennium between prokaryotic and eukaryotic phytoplankton communities and associated sources of nitrogen fueling production. The most recent regime, which started around the end of the Little Ice Age and the onset of the Industrial era, is unprecedented in the last 1000 years and resulted in a 30-50% increase in diazotrophic cyanobacteria contribution to export production and an associated 17-27% increase in N2-fixation in the NPSG over last century. By offering the first direct phylogenetic context for long-term shifts in isotopic records of exported particulate organic matter, our data represent a major step forward in understanding the evolution of marine plankton community dynamics, food web architecture, biogeochemical cycling, and the climate feedback loops through the biological pump.

The use of stable isotopes for studies on the physiology of plants

International Nuclear Information System (INIS)

Moyse, Alexis.

1982-01-01

The use of the stable isotopes 15 N, 18 O, 13 C for studies on the physiology of plants especially of plants grown under natural environment conditions is reviewed. Analysis of isotopic discrimination give estimates of the various patterns of carbon and nitrogen nutrition and of the rate of water circulation. The method can also be used for paleoclimatology and for the detection of frauds in food products [fr

ROBUST MPC FOR STABLE LINEAR SYSTEMS

Directory of Open Access Journals (Sweden)

M.A. Rodrigues

2002-03-01

Full Text Available In this paper, a new model predictive controller (MPC, which is robust for a class of model uncertainties, is developed. Systems with stable dynamics and time-invariant model uncertainty are treated. The development herein proposed is focused on real industrial systems where the controller is part of an on-line optimization scheme and works in the output-tracking mode. In addition, the system has a time-varying number of degrees of freedom since some of the manipulated inputs may become constrained. Moreover, the number of controlled outputs may also vary during system operation. Consequently, the actual system may show operating conditions with a number of controlled outputs larger than the number of available manipulated inputs. The proposed controller uses a state-space model, which is aimed at the representation of the output-predicted trajectory. Based on this model, a cost function is proposed whereby the output error is integrated along an infinite prediction horizon. It is considered the case of multiple operating points, where the controller stabilizes a set of models corresponding to different operating conditions for the system. It is shown that closed-loop stability is guaranteed by the feasibility of a linear matrix optimization problem.

Tukey max-stable processes for spatial extremes

KAUST Repository

Xu, Ganggang

2016-09-21

We propose a new type of max-stable process that we call the Tukey max-stable process for spatial extremes. It brings additional flexibility to modeling dependence structures among spatial extremes. The statistical properties of the Tukey max-stable process are demonstrated theoretically and numerically. Simulation studies and an application to Swiss rainfall data indicate the effectiveness of the proposed process. © 2016 Elsevier B.V.

About some Regge-like relations for (stable) black holes

International Nuclear Information System (INIS)

Recami, E.; Tonin Zanchin, V.

1991-08-01

Within a purely classical formulation of ''strong gravity'', we associated hadron constituents (and even hadrons themselves) with suitable stationary, axisymmetric solutions of certain new Einstein-type equations supposed to describe the strong field inside hadrons. Such equations are nothing but Einstein equations - with cosmological term - suitably scaled down. As a consequence, the cosmological constant Λ and the masses M result in our theory to be scaled up and transformed into a ''hadronic constant'' and into ''strong masses'', respectively. Due to the unusual range of Λ and M values considered, we met a series of solutions of the Kerr-Newman-de Sitter (KNdS) type with such interesting properties that it is worth studying them - from our particular point of view - also in the case of ordinary gravity. This is the aim of the present work. The requirement that those solutions be stable, i.e., that their temperature (or surface gravity) be vanishingly small, implies the coincidence of at least two of their (in general, three) horizons. Imposing the stability condition of a certain horizon does yield (once chosen the values of J, q and Λ) mass and radius of the associated black-hole. In the case of ordinary Einstein equations and for stable black-holes of the KNdS type, we get in particular Regge-like relations among mass M, angular momentum J, charge q and cosmological constant Λ. For instance, with the standard definitions Q 2 is identical to Gq 2 /(4πε 0 c 4 ); a is identical to J/(Mc); m is identical to GM/c 2 , in the case Λ = 0 in which m 2 = a 2 + Q 2 and if q is negligible we find m 2 = J. When considering, for simplicity, Λ > 0 and J = 0 (and q still negligible), then we obtain m 2 = 1/(9Λ). In the most general case, the condition, for instance, of ''triple coincidence'' among the three horizons yields for modul Λa 2 2 = 2/(9Λ); m 2 = 8(a 2 + Q 2 )/9. Another interesting point is that - with few exceptions - all such relations (among M

Combined strategies for improving production of a thermo-alkali stable laccase in Pichia pastoris

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Jiayi Wang

2017-07-01

Conclusions: The productivity of the thermo-alkali stable laccase from B. licheniformis expressed in P. pastoris was significantly improved through the combination of site-directed mutagenesis and optimization of the cultivation process. The mutant enzyme retains good stability under high temperature and alkaline conditions, and is a good candidate for industrial application in dye decolorization.

Ca2Cr0.5Ga1.5O5—An extremely redox-stable brownmillerite phase

International Nuclear Information System (INIS)

Luo, Kun; Amano Patino, Midori; Hayward, Michael A.

2015-01-01

Investigation of the Ca 2 Cr x Ga 2−x O 5 compositional series reveals a maximum chromium solubility of 25%. The most chromium rich composition, Ca 2 Cr 0.5 Ga 1.5 O 5 , adopts a brownmillerite-type anion deficient perovskite structure described in space group Pnma (a=5.368 Å, b=14.547 Å, c=5.593 Å). Neutron powder diffraction data reveals rigorous B-site cation order, with all of the tetrahedral coordination sites occupied exclusively by gallium and the octahedral coordination sites occupied by gallium or chromium. Annealing studies reveals Ca 2 Cr 0.5 Ga 1.5 O 5 is stable in both oxidizing (100% O 2 ) and reducing (5% H 2 in N 2 ) conditions up to 800 °C, suggesting it could find application as a stable host lattice for fuel cell electrodes or electrolytes with suitable doping to enhance catalytic behaviour and/or anionic conductivity. - Graphical abstract: Ca 2 Cr 0.5 Ga 1.5 O 5 , adopts a brownmillerite-type anion deficient perovskite structure yet it is stable in both oxidizing (100% O 2 ) and reducing (5% H 2 in N 2 ) conditions up to 800 °C. - Highlights: • Anion deficient oxide stable to both oxidation and reduction up to 800 °C. • Cation-ordered brownmillerite structure determined by powder neutron diffraction. • Low solubility of Cr 3+ in framework due to spherical d 3 electron configuration

Chance and stability stable distributions and their applications

CERN Document Server

Uchaikin, Vladimir V

1999-01-01

An introduction to the theory of stable distributions and their applications. It contains a modern outlook on the mathematical aspects of the theory. The authors explain numerous peculiarities of stable distributions and describe the principle concept of probability theory and function analysis. A significant part of the book is devoted to applications of stable distributions. Another notable feature is the material on the interconnection of stable laws with fractals, chaos and anomalous transport processes.

Topical tazarotene vs. coal tar in stable plaque psoriasis

Energy Technology Data Exchange (ETDEWEB)

Kumar, U.; Kaur, I.; Dogra, S.; De, D.; Kumar, B. [Postgraduate Institute of Medical Education & Research, Chandigarh (India)

2010-07-15

The efficacy of topical tazarotene has not previously been compared with the conventional topical treatment of crude coal tar (CCT) in stable plaque psoriasis. In this nonblinded side-to-side comparison study, patients with chronic stable plaque psoriasis, who had bilaterally symmetrical plaques on the limbs, applied 0.1% tazarotene gel on the right side and 5% CCT ointment on the left side once daily for 12 weeks followed by an 8-week treatment-free follow up period. Severity of psoriatic lesions and response to treatment was evaluated by scoring erythema, scaling and induration (ESI). Of 30 patients recruited, 27 could be assessed. In the per-protocol analysis, the mean percentage reduction in ESI score at the end of the treatment period was 74.15% {+-} 9.43 and 77.37% {+-} 10.93 with tazarotene and CCT, respectively (P {gt} 0.05). A reduction in ESI score of {gt} 75% was seen in 11 (40.74%) and 16 (59.26%) patients with tazarotene and CCT, respectively, at the end of 12 weeks. Side-effects were seen in 48.14% of patients treated with tazarotene, but in no patient treated with CCT. Tazarotene 0.1% gel has comparable clinical efficacy to CCT 5% ointment. CCT ointment remains a cost-effective therapy for plaque psoriasis.

Stable isotopic analysis of fossil chironomids as an approach to environmental reconstruction: state of development and future challenges

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Oliver Heiri

2012-10-01

Full Text Available Remains of chironomid larvae, especially their strongly sclerotized head capsules, can be found abundantly and well preserved in most lake sediment records. These remains mainly consist of chitin and proteins and, since their chemical composition does not seem to be strongly affected by decompositional processes, they can be used to develop palaeoenvironmental reconstructions based on their stable isotopic composition. Here we review available stable isotope studies based on fossil chironomids and indicate future research necessary to further develop this still relatively new research approach. Efforts to produce stable isotope records based on fossil chironomids have mainly examined the elements H, N, C, and O. They have focussed on (1 developing the methodology for preparing samples for isotopic analysis, (2 laboratory studies cultivating chironomid larvae under controlled conditions to determine the factors affecting their stable isotopic composition, (3 ecosystem-scale studies relating stable isotopic measurements of fossil chironomid assemblages to environmental conditions, and (4 developing first down-core records describing past changes in the stable isotopic composition of chironomid assemblages. These studies have shown that chemical sample pretreatment may affect the isotopic composition for some elements. Laboratory runs suggest that the diet of the larvae influences their stable isotopic composition for H, N, C and O, whereas stable isotopes in the ambient water also strongly influence their oxygen and to a lesser extent hydrogen isotopic composition. These experiments also indicate only minor offsets between the nitrogen and carbon isotopic composition of chironomid soft tissue and the fossilizing head capsules, whereas for hydrogen and oxygen this offset remains to be explored. Though few datasets have been published, the available ecosystem studies and developed down-core sediment records indicate that stable isotopes in

Is synaesthesia really stable – or does it gradually consolidate?

DEFF Research Database (Denmark)

Sørensen, Thomas Alrik

Synaesthesia is a condition describing a perceptual variation where experience an additional concurrent following an inducer stimulus (Grossenbacher & Lovelace, 2001); some may experience that weekdays or letters have a specific colour, or that a number has a certain size or relate to a particular...... is that the associations are stable over time. However, here we present the case of AR, a colour-grapheme synaesthete who clearly demonstrate synaesthesia, but also a gradual consolidation over time (Sørensen, Nordfang, & Ásgeirsson, accepted). Also, AR does not demonstrate some of the typical modulations of attention...

Structure of stable degeneration of K3 surfaces into pairs of rational elliptic surfaces

Science.gov (United States)

Kimura, Yusuke

2018-03-01

F-theory/heterotic duality is formulated in the stable degeneration limit of a K3 fibration on the F-theory side. In this note, we analyze the structure of the stable degeneration limit. We discuss whether stable degeneration exists for pairs of rational elliptic surfaces. We demonstrate that, when two rational elliptic surfaces have an identical complex structure, stable degeneration always exists. We provide an equation that systematically describes the stable degeneration of a K3 surface into a pair of isomorphic rational elliptic surfaces. When two rational elliptic surfaces have different complex structures, whether their sum glued along a smooth fiber admits deformation to a K3 surface can be determined by studying the structure of the K3 lattice. We investigate the lattice theoretic condition to determine whether a deformation to a K3 surface exists for pairs of extremal rational elliptic surfaces. In addition, we discuss the configurations of singular fibers under stable degeneration. The sum of two isomorphic rational elliptic surfaces glued together admits a deformation to a K3 surface, the singular fibers of which are twice that of the rational elliptic surface. For special situations, singular fibers of the resulting K3 surface collide and they are enhanced to a fiber of another type. Some K3 surfaces become attractive in these situations. We determine the complex structures and the Weierstrass forms of these attractive K3 surfaces. We also deduce the gauge groups in F-theory compactifications on these attractive K3 surfaces times a K3. E 6, E 7, E 8, SU(5), and SO(10) gauge groups arise in these compactifications.

French days on stable isotopes

International Nuclear Information System (INIS)

2000-01-01

These first French days on stable isotopes took place in parallel with the 1. French days of environmental chemistry. Both conferences had common plenary sessions. The conference covers all aspects of the use of stable isotopes in the following domains: medicine, biology, environment, tracer techniques, agronomy, food industry, geology, petroleum geochemistry, cosmo-geochemistry, archaeology, bio-geochemistry, hydrology, climatology, nuclear and particle physics, astrophysics, isotope separations etc.. Abstracts available on CD-Rom only. (J.S.)

Pharmaceuticals labelled with stable isotopes

International Nuclear Information System (INIS)

Krumbiegel, P.

1986-11-01

The relatively new field of pharmaceuticals labelled with stable isotopes is reviewed. Scientific, juridical, and ethical questions are discussed concerning the application of these pharmaceuticals in human medicine. 13 C, 15 N, and 2 H are the stable isotopes mainly utilized in metabolic function tests. Methodical contributions are given to the application of 2 H, 13 C, and 15 N pharmaceuticals showing new aspects and different states of development in the field under discussion. (author)

The Dependence of Chimera States on Initial Conditions

International Nuclear Information System (INIS)

Feng Yue-E; Li Hai-Hong

2015-01-01

A chimera state consisting of both coherent and incoherent groups is a fascinating spatial pattern in non-locally coupled identical oscillators. It is thought that random initial conditions hardly evolve to chimera states. In this work, we study the dependence of chimera states on initial conditions. We show that random initial conditions may lead to chimera states and the chance of realizing chimera states becomes increasing when the model parameters are moving away from the boundary of their stable regime. (paper)

Development of a Safety Management Web Tool for Horse Stables.

Science.gov (United States)

Leppälä, Jarkko; Kolstrup, Christina Lunner; Pinzke, Stefan; Rautiainen, Risto; Saastamoinen, Markku; Särkijärvi, Susanna

2015-11-12

Managing a horse stable involves risks, which can have serious consequences for the stable, employees, clients, visitors and horses. Existing industrial or farm production risk management tools are not directly applicable to horse stables and they need to be adapted for use by managers of different types of stables. As a part of the InnoEquine project, an innovative web tool, InnoHorse, was developed to support horse stable managers in business, safety, pasture and manure management. A literature review, empirical horse stable case studies, expert panel workshops and stakeholder interviews were carried out to support the design. The InnoHorse web tool includes a safety section containing a horse stable safety map, stable safety checklists, and examples of good practices in stable safety, horse handling and rescue planning. This new horse stable safety management tool can also help in organizing work processes in horse stables in general.

Standard test method for determination of resistance to stable crack extension under low-constraint conditions

CERN Document Server

American Society for Testing and Materials. Philadelphia

2006-01-01

1.1 This standard covers the determination of the resistance to stable crack extension in metallic materials in terms of the critical crack-tip-opening angle (CTOAc), ψc and/or the crack-opening displacement (COD), δ5 resistance curve (1). This method applies specifically to fatigue pre-cracked specimens that exhibit low constraint (crack-length-to-thickness and un-cracked ligament-to-thickness ratios greater than or equal to 4) and that are tested under slowly increasing remote applied displacement. The recommended specimens are the compact-tension, C(T), and middle-crack-tension, M(T), specimens. The fracture resistance determined in accordance with this standard is measured as ψc (critical CTOA value) and/or δ5 (critical COD resistance curve) as a function of crack extension. Both fracture resistance parameters are characterized using either a single-specimen or multiple-specimen procedures. These fracture quantities are determined under the opening mode (Mode I) of loading. Influences of environment a...

Behavioural hyperventilation as a novel clinical condition associated with central sleep apnoea: a report of three cases.

Science.gov (United States)

Pevernagie, Dirk; Mariman, An; Vandenbussche, Nele; Tobback, Els; Overeem, Sebastiaan; Delesie, Liesbeth; Janssen, Hennie; Vogelaers, Dirk

2012-12-01

Central sleep apnoea (CSA) is a disorder characterised by repetitive episodes of decreased ventilation due to complete or partial reduction in the central neural outflow to the respiratory muscles. Hyperventilation plays a prime role in the pathogenesis of CSA. Chronic heart failure and dwelling at high altitude are classical conditions in which CSA is induced by hyperventilation. Hyperventilation syndrome (HVS) is a prevalent behavioural condition in which minute ventilation exceeds metabolic demands, resulting in haemodynamic and chemical changes that produce characteristic dysphoric symptoms. HVS is frequently caused by anxiety disorders and panic attacks. Until now, medical literature has focussed primarily on daytime symptoms of behavioural hyperventilation. It is currently unknown how this condition may affect sleep. Three cases are reported in which behavioural hyperventilation was associated with occurrence of significant central sleep apnoea, which was not present during normal tidal breathing in steady sleep. Therefore, behavioural hyperventilation should be added to the list of known clinical conditions associated with CSA. Copyright © 2012 Elsevier B.V. All rights reserved.

Conservative Management for Stable High Ankle Injuries in Professional Football Players.

Science.gov (United States)

Knapik, Derrick M; Trem, Anthony; Sheehan, Joseph; Salata, Michael J; Voos, James E

High ankle "syndesmosis" injuries are common in American football players relative to the general population. At the professional level, syndesmotic sprains represent a challenging and unique injury lacking a standardized rehabilitation protocol during conservative management. PubMed, Biosis Preview, SPORTDiscus, PEDro, and EMBASE databases were searched using the terms syndesmotic injuries, American football, conservative management, and rehabilitation. Clinical review. Level 3. When compared with lateral ankle sprains, syndesmosis injuries result in significantly prolonged recovery times and games lost. For stable syndesmotic injuries, conservative management features a brief period of immobilization and protected weightbearing followed by progressive strengthening exercises and running, and athletes can expect to return to competition in 2 to 6 weeks. Further research investigating the efficacy of dry needling and blood flow restriction therapy is necessary to evaluate the benefit of these techniques in the rehabilitation process. Successful conservative management of stable syndesmotic injuries in professional American football athletes requires a thorough understanding of the anatomy, injury mechanisms, diagnosis, and rehabilitation strategies utilized in elite athletes.

Reproducibility over a 1-month period of 1H-MR spectroscopic imaging NAA/Cr ratios in clinically stable multiple sclerosis patients.

Science.gov (United States)

Mostert, J P; Blaauw, Y; Koch, M W; Kuiper, A J; Hoogduin, J M; De Keyser, J

2008-08-01

N-acetylaspartate/creatine (NAA/Cr) ratios, assessed with proton magnetic resonance spectroscopy, are increasingly used as a surrogate marker for axonal dysfunction and degeneration in multiple sclerosis (MS). The purpose of this study was to test short-time reproducibility of NAA/Cr ratios in patients with clinically stable MS. In 35 MS patients we analysed NAA/Cr ratios obtained with (1)H-MR spectroscopic imaging at the centrum semiovale either with lateral ventricles partially included (group 1; n=15) or more cranially with no ventricles included (group 2; n=20). To test short-term reproducibility of the NAA/Cr measurements, patients were scanned twice 4 weeks apart. We determined mean NAA/Cr and Cho/Cr ratios of 12 grey matter and 24 white matter voxels. Mean NAA/Cr ratios of both the white and grey matter did not change after 4 weeks. Overall 4-week reproducibility of the NAA/Cr ratio, expressed as coefficient of variation, was 4.8% for grey matter and 3.5% for white matter. Reproducibility of cranial scanning of the ventricles was slightly better than with cerebrospinal fluid included. Our study shows good short-term reproducibility of NAA/Cr ratio measurements in the centrum semiovale, which supports the reliability of this technique for longitudinal studies.

Tempered stable distributions stochastic models for multiscale processes

CERN Document Server

Grabchak, Michael

2015-01-01

This brief is concerned with tempered stable distributions and their associated Levy processes. It is a good text for researchers interested in learning about tempered stable distributions.  A tempered stable distribution is one which takes a stable distribution and modifies its tails to make them lighter. The motivation for this class comes from the fact that infinite variance stable distributions appear to provide a good fit to data in a variety of situations, but the extremely heavy tails of these models are not realistic for most real world applications. The idea of using distributions that modify the tails of stable models to make them lighter seems to have originated in the influential paper of Mantegna and Stanley (1994). Since then, these distributions have been extended and generalized in a variety of ways. They have been applied to a wide variety of areas including mathematical finance, biostatistics,computer science, and physics.

Continuous quality improvement in daily clinical practice: a proof of concept study.

Directory of Open Access Journals (Sweden)

Jonathan A Lorch

Full Text Available Continuous Quality Improvement (CQI is an iterative process of: planning to improve a product or process, plan implementation, analyzing and comparing results against those expected, and corrective action on differences between actual and expected results. It is little used in clinical medicine. Anemia, a complex problem in End Stage Renal Disease patients, served to test the ability of an unique electronic medical record (EMR optimized for daily care to empower CQI in practice. We used data collected during daily care, stored in the EMR, and organized to display temporal relationships between clinical, laboratory, and therapeutic events. Our aims were optimal hemoglobin with minimum epoetin, and maintaining stable hemoglobin and epoetin. The study was done on 250 patients treated by maintenance hemodialysis (HD, receiving epoetin prior to February 1, 2010 and followed to July 31, 2011. Repleting iron, ensuring iron sufficiency, slow epoetin reduction, and decision support tools enabling data display over long periods in patient-centered reports were key elements. Epoetin dose, adjusted 6-8 weekly, was based on current clinical conditions and past responses. Hemoglobin increased by months 1-2; epoetin decreased from month 4. By months 16-18, epoetin had decreased 42% to 9,720 units/week while hemoglobin increased 8% to 123.6 g/L. Hemoglobin and epoetin were stable from month 7 onward. New epoetin orders decreased 83%. Transferrin saturation increased after the study start. Individual patient hemoglobin variation decreased by 23%, range by 27%. Mortality, 11.78 per 100 patient years, was 42% less than United States dialysis patient mortality. Allowable epoetin charges decreased by $15.33 per treatment and were $22.88 less than current Medicare allowance. The study validates the hypothesis that an EMR optimized for daily patient care can empower CQI in clinical medicine and serve to monitor medical care quality and cost.

Hemodynamics in the Sturge-Weber syndrome utilizing stable Xe-CT; With special reference to the perfusion reserve and the epileptic focus activated by megimide

Energy Technology Data Exchange (ETDEWEB)

Okudaira, Yojiro; Bandoh, Kuniaki; Ito, Masanori; Sato, Kiyoshi; Tsuji, Masahiro (Juntendo Univ., Tokyo (Japan). School of Medicine)

1993-02-01

In 4 Sturge-Weber-syndrome child patients with calcified lesions mainly in the occipital lobe, regional cerebral blood flow (rCBF) was determined with stable Xe-CT in the resting state and after iv injection of acetazolamide (AA) and megimide (M), with the purpose of examining factors affecting deterioration of neurologic manifestations and the influence of lobectomy. In the resting state, rCBF of the temporal and occipital areas was significantly lower on the affected than unaffected sides. The side-to-side asymmetry of rCBF in the affected and unaffected sides decreased from the frontal to temporal and occipital areas. It was indistinct after AA injection because cerebral vasoreactivity became higher on the affected side. A low rCBF in association with a high cerebral vasoreactivity on the lesion side suggested that the low rCBF matched the low cerebral metabolism of the brain area affected by leptomeningeal angiomatosis. However, cerebral vasoreactivity to AA depended on clinical presentations. Two patients presented with progressive mental retardation. The other two patients were in clinically stable condition. Cerebral vasoreactivity to AA in the former two cases was poorer on both the affected and unaffected sides than that in the latter two cases. M administration was associated with a significantly decreased rCBF in the area of leptomeningeal angiomatosis and cerebral calcification and with a significantly increased rCBF of the 'pericalcified' area. In one patient undergoing extended occipital lobectomy on the affected side, no decrease in rCBF was noted in the resting state in either affected or unaffected side, and cerebral vasoreactivity to AM on the unaffected side was apparently increased. Both circulatory disturbance and seizure appear to play a role in clinical presentations, as well as their deterioration in Sturge-Weber-Syndrome patients. (N.K.).

Stable Chimeras and Independently Synchronizable Clusters

Science.gov (United States)

Cho, Young Sul; Nishikawa, Takashi; Motter, Adilson E.

2017-08-01

Cluster synchronization is a phenomenon in which a network self-organizes into a pattern of synchronized sets. It has been shown that diverse patterns of stable cluster synchronization can be captured by symmetries of the network. Here, we establish a theoretical basis to divide an arbitrary pattern of symmetry clusters into independently synchronizable cluster sets, in which the synchronization stability of the individual clusters in each set is decoupled from that in all the other sets. Using this framework, we suggest a new approach to find permanently stable chimera states by capturing two or more symmetry clusters—at least one stable and one unstable—that compose the entire fully symmetric network.

Stable isotopes in Lithuanian bioarcheological material

Science.gov (United States)

Skipityte, Raminta; Jankauskas, Rimantas; Remeikis, Vidmantas

2015-04-01

Investigation of bioarcheological material of ancient human populations allows us to understand the subsistence behavior associated with various adaptations to the environment. Feeding habits are essential to the survival and growth of ancient populations. Stable isotope analysis is accepted tool in paleodiet (Schutkowski et al, 1999) and paleoenvironmental (Zernitskaya et al, 2014) studies. However, stable isotopes can be useful not only in investigating human feeding habits but also in describing social and cultural structure of the past populations (Le Huray and Schutkowski, 2005). Only few stable isotope investigations have been performed before in Lithuanian region suggesting a quite uniform diet between males and females and protein intake from freshwater fish and animal protein. Previously, stable isotope analysis has only been used to study a Stone Age population however, more recently studies have been conducted on Iron Age and Late medieval samples (Jacobs et al, 2009). Anyway, there was a need for more precise examination. Stable isotope analysis were performed on human bone collagen and apatite samples in this study. Data represented various ages (from 5-7th cent. to 18th cent.). Stable carbon and nitrogen isotope analysis on medieval populations indicated that individuals in studied sites in Lithuania were almost exclusively consuming C3 plants, C3 fed terrestrial animals, and some freshwater resources. Current investigation demonstrated social differences between elites and country people and is promising in paleodietary and daily life reconstruction. Acknowledgement I thank prof. dr. G. Grupe, Director of the Anthropological and Palaeoanatomical State Collection in Munich for providing the opportunity to work in her laboratory. The part of this work was funded by DAAD. Antanaitis-Jacobs, Indre, et al. "Diet in early Lithuanian prehistory and the new stable isotope evidence." Archaeologia Baltica 12 (2009): 12-30. Le Huray, Jonathan D., and Holger

Stable isotope research pool inventory

International Nuclear Information System (INIS)

1984-03-01

This report contains a listing of electromagnetically separated stable isotopes which are available at the Oak Ridge National Laboratory for distribution for nondestructive research use on a loan basis. This inventory includes all samples of stable isotopes in the Research Materials Collection and does not designate whether a sample is out on loan or is in reprocessing. For some of the high abundance naturally occurring isotopes, larger amounts can be made available; for example, Ca-40 and Fe-56

Evaluation of Clinical and Pathological Response after Two Cycles ...

African Journals Online (AJOL)

Results: The clinical response rate was 83%; 11 patients (11.2%) had a complete clinical remission (cCR); 71 had a partial remission (72.4%); 13 had stable disease (13.3%), and 3 had progressive disease (3.1%). Seven patients had complete pathological response. Conclusion: Neoadjuvant chemotherapy can achieve a ...

Selective and Stable Ethylbenzene Dehydrogenation to Styrene over Nanodiamonds under Oxygen-lean Conditions.

Science.gov (United States)

Diao, Jiangyong; Feng, Zhenbao; Huang, Rui; Liu, Hongyang; Hamid, Sharifah Bee Abd; Su, Dang Sheng

2016-04-07

For the first time, significant improvement of the catalytic performance of nanodiamonds was achieved for the dehydrogenation of ethylbenzene to styrene under oxygen-lean conditions. We demonstrated that the combination of direct dehydrogenation and oxidative dehydrogenation indeed occurred on the nanodiamond surface throughout the reaction system. It was found that the active sp(2)-sp(3) hybridized nanostructure was well maintained after the long-term test and the active ketonic carbonyl groups could be generated in situ. A high reactivity with 40% ethylbenzene conversion and 92% styrene selectivity was obtained over the nanodiamond catalyst under oxygen-lean conditions even after a 240 h test, demonstrating the potential of this procedure for application as a promising industrial process for the ethylbenzene dehydrogenation to styrene without steam protection. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents.

Science.gov (United States)

Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe; Aquino, Melissa; Stone, Gregg W; Sartori, Samantha; Steg, Philippe Gabriel; Wijns, William; Smits, Pieter C; Jeger, Raban V; Leon, Martin B; Windecker, Stephan; Serruys, Patrick W; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Kandzari, David; Dangas, George D; Mastoris, Ioannis; Von Birgelen, Clemens; Galatius, Soren; Kimura, Takeshi; Mikhail, Ghada; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Valgimigli, Marco; Kastrati, Adnan; Chieffo, Alaide; Mehran, Roxana

2015-09-15

The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p clinical presentations. After multivariable adjustment, STEMI was independently associated with greater risk of 3-year mortality (hazard ratio [HR] 3.45; 95% confidence interval [CI] 1.99 to 5.98; p clinical spectrum of CAD, STEMI was associated with a greater risk of long-term mortality. Conversely, the adjusted risk of mortality between UAP or NSTEMI and SAP was similar. New-generation DESs provide improved long-term clinical outcomes irrespective of the clinical presentation in women. Published by Elsevier Inc.

Use of stable isotopes of water (d and o-18) in hydrological studies in the Jonkershoek valley

CSIR Research Space (South Africa)

Midgley, JJ

1994-04-01

Full Text Available Stable isotopes of water in rainfall and streams in the Jonkershoek Valley were used to determine the relative contribution of new water (i.e. rain) during storm flow conditions. Significant differences between rain and stream isotopic signatures...

A method comparison of total and HMW adiponectin: HMW/total adiponectin ratio varies versus total adiponectin, independent of clinical condition.

Science.gov (United States)

van Andel, Merel; Drent, Madeleine L; van Herwaarden, Antonius E; Ackermans, Mariëtte T; Heijboer, Annemieke C

2017-02-01

Total and high-molecular-weight (HMW) adiponectin have been associated with endocrine and cardiovascular pathology. As no gold standard is available, the discussion about biological relevance of isoforms is complicated. In our study we perform a method comparison between two commercially available assays measuring HMW and total adiponectin, in various patient groups, thus contributing further to this discussion. We determined levels of HMW and total adiponectin using assays by Lumipulse® and Millipore® respectively, in 126 patients with different clinical characteristics (n=29 healthy volunteers, n=22 dialysis patients, n=25 elderly with body mass index (BMI) LUMIPULSE ∗0.5-0.9=total adiponectin MILLIPORE , albeit with significant deviation from linearity (p<0.001). Pearson's correlation was R=0.987 (p=0.000). No significant differences between patient groups were observed (p=0.190). The HMW/total adiponectin ratio varies with total adiponectin concentration independent of clinical conditions studied. Our results imply that total and HMW adiponectin have similar utility when assessing adiponectin levels in blood, as the ratio is independent of clinical condition. Copyright © 2016 Elsevier B.V. All rights reserved.

Metabolic studies in man using stable isotopes

International Nuclear Information System (INIS)

Faust, H.; Jung, K.; Krumbiegel, P.

1993-01-01

In this project, stable isotope compounds and stable isotope pharmaceuticals were used (with emphasis on the application of 15 N) to study several aspects of nitrogen metabolism in man. Of the many methods available, the 15 N stable isotope tracer technique holds a special position because the methodology for application and nitrogen isotope analysis is proven and reliable. Valid routine methods using 15 N analysis by emission spectrometry have been demonstrated. Several methods for the preparation of biological material were developed during our participation in the Coordinated Research Programme. In these studies, direct procedures (i.e. use of diluted urine as a samples without chemical preparation) or rapid isolation methods were favoured. Within the scope of the Analytical Quality Control Service (AQCS) enriched stable isotope reference materials for medical and biological studies were prepared and are now available through the International Atomic Energy Agency. The materials are of special importance as the increasing application of stable isotopes as tracers in medical, biological and agricultural studies has focused interest on reliable measurements of biological material of different origin. 24 refs

[Moisture sources of Guangzhou during the freezing disaster period in 2008 indicated by the stable isotopes of precipitation].

Science.gov (United States)

Liao, Cong-Yun; Zhong, Wei; Ma, Qiao-Hong; Xue, Ji-Bin; Yin, Huan-Ling; Long, Kun

2012-04-01

From April 2007 to June 2008, stable isotope samples of all single precipitations were collected at the intervals of 5-30 min. We choose five single precipitations in Guangzhou city that happened during the freezing disaster event (from Jan. 10 to Feb. 2, 2008) in South China, aiming to investigate the variation of stable isotopes under the extremely climatic conditions and its controlling factors. The results show that the values of deltaD and delta18O in precipitations drop significantly during this freezing disaster. The analyses of the d-excess and LMWL indicate the abnormal oceanic moisture sources. Air mass trajectory tracking shows the moisture sources were characterized by the mixture of inland and marine water vapors during the freezing disaster peak period, while the long-distance oceanic moisture sources is the dominate one. Changes of stable isotope in single rain event during the freezing disaster shows three different trends, i. e, Up trend, V-shaped trend and W-shaped trend, which may be resulted from the re-evaporation, re-condensation and the related precipitation types in association with the different vapor sources and precipitation conditions.

Stable isotope research pool inventory

International Nuclear Information System (INIS)

1982-01-01

This report contains a listing of electromagnetically separated stable isotopes which are available for distribution within the United States for nondestructive research use from the Oak Ridge National Laboratory on a loan basis. This inventory includes all samples of stable isotopes in the Material Research Collection and does not designate whether a sample is out on loan or in reprocessing. For some of the high abundance naturally occurring isotopes, larger amounts can be made available; for example, Ca-40 and Fe-56

Exact simulation of max-stable processes.

Science.gov (United States)

Dombry, Clément; Engelke, Sebastian; Oesting, Marco

2016-06-01

Max-stable processes play an important role as models for spatial extreme events. Their complex structure as the pointwise maximum over an infinite number of random functions makes their simulation difficult. Algorithms based on finite approximations are often inexact and computationally inefficient. We present a new algorithm for exact simulation of a max-stable process at a finite number of locations. It relies on the idea of simulating only the extremal functions, that is, those functions in the construction of a max-stable process that effectively contribute to the pointwise maximum. We further generalize the algorithm by Dieker & Mikosch (2015) for Brown-Resnick processes and use it for exact simulation via the spectral measure. We study the complexity of both algorithms, prove that our new approach via extremal functions is always more efficient, and provide closed-form expressions for their implementation that cover most popular models for max-stable processes and multivariate extreme value distributions. For simulation on dense grids, an adaptive design of the extremal function algorithm is proposed.

Thermodynamic calculation of the regions of stable existance of niobium nitride phases

International Nuclear Information System (INIS)

Chernyaev, V.V.; Mitrofanov, B.V.; Moiseev, G.K.; 6030000SU)

1987-01-01

Conditions of formation and stable existence of Nb 2 N and NbN niobium nitrides and the general picture of phase transformations in Nb-N system were determined in wide range of temperatures 1400-4000 K and pressures 10 -9 -10 MPa in result of thermodynamic analysis of Nb-N system using the program, realizing algorithm of total potential minimization. The sufficient nitrogen excess is necessary for formation of Nb 2 N and NbN especially. The temperature stability region and the temperature of NbN and Nb 2 N decomposition is shifted to high temperature region with pressure growth. Pressure region where niobium nitrides are stable, is shifted to high pressure region. The obtained calculation data correspond satisfactorily with experimental publication results. This testifies to possibility of using results of thermodynamic calculations for construction of p-T-diagrams of Nb-N system state

A protocol of histone modification-based mechanistic study of acupuncture in patients with stable angina pectoris.

Science.gov (United States)

Wang, Ning; Lu, Sheng-Feng; Chen, Hui; Wang, Jian-Fei; Fu, Shu-Ping; Hu, Chen-Jun; Yang, Yi; Liang, Fan-Rong; Zhu, Bing-Mei

2015-04-30

Angina pectoris (Angina) is a medical condition related to myocardial ischemia. Although acupuncture has been widely accepted as a clinical approach for angina, there is no sufficient evidence of its effectiveness against this syndrome, and its mechanisms have not yet been well elucidated. We develop this protocol to confirm the clinical efficacy of electro-acupuncture on stable angina pectoris by needling on acupoint Neiguan (PC6). Furthermore, we employ high-throughput sequencing technology to investigate the gene expression profiling and determine involvement of histone modifications in the regulation of genes after electro-acupuncture treatment. A randomized, controlled, double-blinded (assessor and patients) trial will be carried out. Sixty participants will be randomly assigned to two acupuncture treatment groups and one control group in a 1:1:1 ratio. Participants in acupuncture groups will receive 12 sessions of electro-acupuncture treatment across 4 weeks, followed by a 12-week randomization period. The acupuncture groups are divided into Neiguan (PC6) on Pericardium Meridian of Hand-jueyin or a non-acupoint. The primary clinical measure of effect is the frequency of angina attacks between these groups for four weeks after randomization. RNAs are extracted from peripheral neutrophils collected from all participants on day 0, day 30, and week 16, and are processed to RNA-Seq. We then investigate profiles of histone modifications by ChIP-Seq, for H3 Lysine 4 (H3K4me) and acetylation of H3 Lysine 27 (H3K27ac), in the presence or absence of acupuncture treatment. This study determines the efficacy and mechanisms of electro-acupuncture on stable angina pectoris. We focus on effectiveness of acupuncture on alleviating symptoms of myocardial ischemia and the gene regulation and the chromatin remodeling marks, including H3K4me1, H3K4me2, and H3K27ac, which could be key factors for regulating gene expressions caused by electro-acupuncture treatment at Neiguan. This

Safety profile of the intravenous administration of brain-targeted stable nucleic acid lipid particles

Directory of Open Access Journals (Sweden)

Mariana Conceição

2016-03-01

Full Text Available In a clinical setting, where multiple administrations of the therapeutic agent are usually required to improve the therapeutic outcome, it is crucial to assess the immunogenicity of the administered nanoparticles. In this data work, we investigated the safety profile of the repeated intravenous administration of brain-targeted stable nucleic acid lipid particles (RVG-9r-targeted SNALPs. To evaluate local activation of the immune system, we performed analysis of mouse tissue homogenates and sections from cerebellum. To investigate peripheral activation of the immune system, we used serum of mice that were intravenously injected with RVG-9r-targeted SNALPs. These data are related and were discussed in the accompanying research article entitled “Intravenous administration of brain-targeted stable nucleic acid lipid particles alleviates Machado–Joseph disease neurological phenotype” (Conceição et al., in press [1].

Extravasation injury of balanced electrolyte solution simulates the clinical condition of necrotizing fasciitis: A case report

Directory of Open Access Journals (Sweden)

Carmine D'Acunto

2015-10-01

Full Text Available Extravasation injury (EI is an iatrogenic condition that occurs preferentially in neonatal and pediatric patients when the injection of fluid substances by intravenous access is required and it accidentally leaks into the adjacent tissues or in spaces outside of vascular compartment. Different types and amount of substances once undergoing extravasation can affect the EI differently [1]. In some instances immediate measures such as saline washout, local antidotes, enzymatic debridement and surgical interventions can be required in order to prevent the occurrence of a growing injury avoiding the progression of the EI to a medical emergency [6]. Here we report an unusual case of a preterm 2-month-old male patient in which the extravasation of balanced electrolyte solution on the upper right arm resulted in the development of full-thickness skin necrosis appearing as the clinical condition of necrotizing fasciitis. The management of necrotic tissue was performed using escharectomy as well as autograft skin under conditions of general anesthesia.

Russian ElectroKhimPribor integrated plant - producer and supplier of enriched stable isotopes

International Nuclear Information System (INIS)

Tatarinov, A.N.; Polyakov, L.A.

1997-01-01

Russian ElectroKhimPribor Integrated Plant, as well as ORNL, is a leading production which manufactures and supplied to the world market such specific products as stable isotopes. More than 200 isotopes of 44 elements can be obtained at its electromagnetic separator. Changes being underway for a few last years in Russia affected production and distribution of stable isotopes. There arose a necessity in a new approach to handling work in this field so as to create favourable conditions for both producers and customers. As a result, positive changes in calutron operation at ElectroKhimPribor has been reached; quality management system covering all stages of production has been set up; large and attractive stock of isotopes has been created; prospective scientific isotope-based developments are taken into account when planning separation F campaigns; executing the contracts is guaranteed; business philosophy has been changed to meet maximum of customer needs. For more than forty years ElectroKhimPribor have had no claim from customers as to quality of products or implementing contracts. Supplying enriched stable isotopes virtually to all the world's leading customers, ElectroKhimPribor cooperates successfully with Canadian company Trace Science since 1996

Clinical heterogeneity among people with high functioning autism spectrum conditions: evidence favouring a continuous severity gradient

Directory of Open Access Journals (Sweden)

Woodbury-Smith Marc

2008-02-01

Full Text Available Abstract Background Autism Spectrum Conditions (ASCs are characterized by a high degree of clinical heterogeneity, but the extent to which this variation represents a severity gradient versus discrete phenotypes is unclear. This issue has complicated genetic studies seeking to investigate the genetic basis of the high hereditability observed clinically in those with an ASC. The aim of this study was to examine the possible clustering of symptoms associated with ASCs to determine whether the observed distribution of symptom type and severity supported either a severity or a symptom subgroup model to account for the phenotypic variation observed within the ASCs. Methods We investigated the responses of a group of adults with higher functioning ASCs on the fifty clinical features examined in the Autism Spectrum Quotient, a screening questionnaire used in the diagnosis of higher functioning ASCs. In contrast to previous studies we have used this instrument with no a priori assumptions about any underlying factor structure of constituent items. The responses obtained were analyzed using complete linkage hierarchical cluster analysis. For the members of each cluster identified the mean score on each Autism Spectrum Quotient question was calculated. Results Autism Spectrum Quotient responses from a total of 333 individuals between the ages of 16.6 and 78.0 years were entered into the hierarchical cluster analysis. The four cluster solution was the one that generated the largest number of clusters that did not also include very small cluster sizes, defined as a membership comprising 10 individuals or fewer. Examination of these clusters demonstrated that they varied in total Autism Spectrum Quotient but that the profiles across the symptoms comprising the Autism Spectrum Quotient did not differ independently of this severity factor. Conclusion These results are consistent with a unitary spectrum model, suggesting that the clinical heterogeneity observed

Measuring the Influence of Galilean Loupe System on Near Visual Acuity of Dentists under Simulated Clinical Conditions

Directory of Open Access Journals (Sweden)

Iris Urlić

2016-01-01

Full Text Available Aim: The purpose of this study was to compare near visual acuity of dentists without optical aids (VSC with near visual acuity of those using the Galilean telescope system (VGA2 with magnification of x 2.5, and the distance of 350 mm in simulated clinical conditions. Methods: The study included 46 dentists (visual acuity 1.0 without correction. A visual acuity testing was carried out using a miniaturized Snellen visual acuity chart which was placed in the cavity of molar teeth mounted in a phantom head in simulated clinical conditions. Near visual acuity for the vicinity was examined: 1 without correction at a distance of 300-400 mm (VSC; 2 with Galilean loupes with magnification of x2.5, focal length of 350mm. Results: The distributions of near visual acuity recorded using VSC and VGA2, 5 systems were compared by the Wilcoxon Signed Rank test. The results obtained by Wilcoxon Signed Rank test pointed to a statistically significant difference in the distribution of recorded visual acuity between the VSC and VGA2 optical systems (W = - 403.5; p <0.001. Conclusion: If using the VGA2, 5 systems, higher values of the near visual acuity were recorded and subsequently compared to near visual acuity without magnifying aids (VSC.

Gynaecomastia in two men on stable antiretroviral therapy who commenced treatment for tuberculosis.

Science.gov (United States)

Kratz, Jeremy D; El-Shazly, Ahmad Y; Mambuque, Santos G; Demetria, Elpidio; Veldkamp, Peter; Anderson, Timothy S

2016-12-01

Gynaecomastia is a common clinical presentation that varies from benign presentations in stages of human development to hormonal pathology, mainly due to hepatic dysfunction, malignancy, and adverse pharmacologic effects. We describe the development of significant bilateral gynaecomastia after starting treatment for pulmonary tuberculosis (TB) in two males with WHO stage III Human Immunodeficiency Virus (HIV) infection on stable antiretroviral regimens. Emerging reports suggest that distinct hepatic impairment in efavirenz metabolism modulates oestrogenic activity, which may be potentiated by anti-tuberculosis therapy. Clinical application includes early recognition of efavirenz-induced gynaecomastia, especially after commencing tuberculosis treatment. To avoid decreased adherence resulting from the distressing side effect of gynecomastia, transition to an alternative ART regimen over the course of tuberculosis treatment should be considered.

Keratin decomposition by trogid beetles: evidence from a feeding experiment and stable isotope analysis

Science.gov (United States)

Sugiura, Shinji; Ikeda, Hiroshi

2014-03-01

The decomposition of vertebrate carcasses is an important ecosystem function. Soft tissues of dead vertebrates are rapidly decomposed by diverse animals. However, decomposition of hard tissues such as hairs and feathers is much slower because only a few animals can digest keratin, a protein that is concentrated in hairs and feathers. Although beetles of the family Trogidae are considered keratin feeders, their ecological function has rarely been explored. Here, we investigated the keratin-decomposition function of trogid beetles in heron-breeding colonies where keratin was frequently supplied as feathers. Three trogid species were collected from the colonies and observed feeding on heron feathers under laboratory conditions. We also measured the nitrogen (δ15N) and carbon (δ13C) stable isotope ratios of two trogid species that were maintained on a constant diet (feathers from one heron individual) during 70 days under laboratory conditions. We compared the isotopic signatures of the trogids with the feathers to investigate isotopic shifts from the feathers to the consumers for δ15N and δ13C. We used mixing models (MixSIR and SIAR) to estimate the main diets of individual field-collected trogid beetles. The analysis indicated that heron feathers were more important as food for trogid beetles than were soft tissues under field conditions. Together, the feeding experiment and stable isotope analysis provided strong evidence of keratin decomposition by trogid beetles.

Stable isotope mass spectrometry in petroleum exploration

International Nuclear Information System (INIS)

Mathur, Manju

1997-01-01

The stable isotope mass spectrometry plays an important role to evaluate the stable isotopic composition of hydrocarbons. The isotopic ratios of certain elements in petroleum samples reflect certain characteristics which are useful for petroleum exploration

Conditional Risk of Relapse in Surveillance for Clinical Stage I Testicular Cancer.

Science.gov (United States)

Nayan, Madhur; Jewett, Michael A S; Hosni, Ali; Anson-Cartwright, Lynn; Bedard, Philippe L; Moore, Malcolm; Hansen, Aaron R; Chung, Peter; Warde, Padraig; Sweet, Joan; O'Malley, Martin; Atenafu, Eshetu G; Hamilton, Robert J

2017-01-01

Patients on surveillance for clinical stage I (CSI) testicular cancer are counseled regarding their baseline risk of relapse. The conditional risk of relapse (cRR), which provides prognostic information on patients who have survived for a period of time without relapse, have not been determined for CSI testicular cancer. To determine cRR in CSI testicular cancer. We reviewed 1239 patients with CSI testicular cancer managed with surveillance at a tertiary academic centre between 1980 and 2014. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: cRR estimates were calculated using the Kaplan-Meier method. We stratified patients according to validated risk factors for relapse. We used linear regression to determine cRR trends over time. At orchiectomy, the risk of relapse within 5 yr was 42.4%, 17.3%, 20.3%, and 12.2% among patients with high-risk nonseminomatous germ cell tumor (NSGCT), low-risk NSGCT, seminoma with tumor size ≥3cm, and seminoma with tumor size testicular cancer is very low. Consideration should be given to adapting surveillance protocols to individualized risk of relapse based on cRR as opposed to static protocols based on baseline factors. This strategy could reduce the intensity of follow-up for the majority of patients. Our study is the first to provide data on the future risk of relapse during surveillance for clinical stage I testicular cancer, given a patient has been without relapse for a specified period of time. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Clinical application of domestica manufactured BHP6601 SPECT

International Nuclear Information System (INIS)

Zhang Shuwen; Tian Jiahe; Liu Zilai; He Yijie; Shao Mingzhe; Zhang Jinming

2005-01-01

Clinical imaging of 150 patients with varying demand is carried out with BHP6601 SPECT manufactured locally, and the results are compared with that obtained by an E. CAM system manufactured by Siemens. The results show that BHP6601 had an acceptable and stable performance from a technical point of view. It offers a sufficient ability for organ imaging of clinical requirement. (authors)

Radio- and stable-manganese distributions in female and male of Haliotis discus at the pre-spawning stage

International Nuclear Information System (INIS)

Ikuta, Kunio; Nakahara, Motokazu.

1986-01-01

Distribution of 54 Mn in female and male tissues of black abalones was examined at the prespawning stage, and compared with that of stable-Mn. The ripeness of gonads was somewhat lower than fully developed condition, but a number of matured ovum and spermatozoon existed in the gonads. Distribution rates of 54 Mn to conch were much less than those of stable-Mn and equal to both sexes; whereas in stable-Mn, the rate of the male is significantly higher than that of the female. It is inferred that two or more inner layer with organic matrices of conch were inactive to receive 54 Mn, and that the radioactivity of conch resulted from the adsorption of 54 Mn on its outermost rough surface mainly composed of conchiolin. The difference of the absolute amount percents for conchs between 54 Mn and stable-Mn could be reasonably explained as the difference between exposure durations to the nuclides. When exposed to 54 Mn, only in gonad, the intersexual difference was recognized with higher level in the ovary than in the spermary. (author)

Ruptured Abdominal Aortic Aneurysm: Prediction of Mortality From Clinical Presentation and Glasgow Aneurysm Score.

Science.gov (United States)

Weingarten, Toby N; Thompson, Lauren T; Licatino, Lauren K; Bailey, Christopher H; Schroeder, Darrell R; Sprung, Juraj

2016-04-01

To examine association of presenting clinical acuity and Glasgow Aneurysm Score (GAS) with perioperative and 1-year mortality. Retrospective chart review. Major tertiary care facility. Patients with ruptured abdominal aortic aneurysm (rAAA) from 2003 through 2013. Emergency repair of rAAA. The authors reviewed outcomes after stable versus unstable presentation and by GAS. Unstable presentation included hypotension, cardiac arrest, loss of consciousness, and preoperative tracheal intubation. In total, 125 patients (40 stable) underwent repair. Perioperative mortality rates were 41% and 12% in unstable and stable patients, respectively (pClinical presentation and GAS identified patients with rAAA who were likely to have a poor surgical outcome. GAS≥96 was associated with poor long-term survival, but>20% of these patients survived 1 year. Thus, neither clinical presentation nor GAS provided reliable guidance for decisions regarding futility of surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Stable isotope ratios in freshwater mussel shells as high resolution recorders of riverine environmental variation

Science.gov (United States)

Kukolich, S.; Kendall, C.; Dettman, D. L.

2017-12-01

The geochemical record stored in growth increments of freshwater mussel shells reveals annual to sub-annual changes in environmental conditions during the lifetime of the organism. The carbon, nitrogen, and oxygen stable isotope composition of aragonite shells responds to changes in water chemistry, temperature, streamflow, turbidity, growth rate, size, age, and reproduction. The goals of this study are to determine how stable isotopes can be used to reconstruct the conditions in which the mussels lived and to illuminate any vital effects that might obscure the isotopic record of those conditions. Previous research has suggested that annual δ13C values decrease in older freshwater mussel shells due to lower growth rates and greater incorporation of dietary carbon into the shell with increasing age. However, a high-resolution, seasonal investigation of δ13C, δ15N, and δ18O as they relate to organism age has not yet been attempted in freshwater mussels. A total of 28 Unionid mussels of three different species were collected live in 2011 in the Tennessee River near Paducah, Kentucky, USA. In this study, we analyzed the shell nacre and external organic layers for stable carbon, nitrogen, and oxygen isotope ratios, focusing on growth bands formed between 2006 and 2011. We present a time series of shell δ13C, δ18O, and δ15N values with monthly resolution. We also compare the shell-derived geochemical time series to a time series of the δ13C and δ15N of particulate organic matter, δ13C of DIC, δ18OWater, and water temperature in which the mussels lived. Results show that environmental factors such as water temperature and primary productivity dominate shell chemistry while animal age has little or no effect.

The clinical impact and preventability of ventilator-associated conditions in critically ill patients who are mechanically ventilated.

Science.gov (United States)

Muscedere, John; Sinuff, Tasnim; Heyland, Daren K; Dodek, Peter M; Keenan, Sean P; Wood, Gordon; Jiang, Xuran; Day, Andrew G; Laporta, Denny; Klompas, Michael

2013-11-01

Ventilator-associated conditions (VACs) and infection-related ventilator-associated complications (iVACs) are the Centers for Disease Control and Prevention's new surveillance paradigms for patients who are mechanically ventilated. Little is known regarding the clinical impact and preventability of VACs and iVACs and their relationship to ventilator-associated pneumonia (VAP). We evaluated these using data from a large, multicenter, quality-improvement initiative. We retrospectively applied definitions for VAC and iVAC to data from a prospective time series study in which VAP clinical practice guidelines were implemented in 11 North American ICUs. Each ICU enrolled 30 consecutive patients mechanically ventilated > 48 h during each of four study periods. Data on clinical outcomes and concordance with prevention recommendations were collected. VAC, iVAC, and VAP rates over time, the agreement (κ statistic) between definitions, associated morbidity/mortality, and independent risk factors for each were determined. Of 1,320 patients, 139 (10.5%) developed a VAC, 65 (4.9%) developed an iVAC, and 148 (11.2%) developed VAP. The agreement between VAP and VAC was 0.18, and between VAP and iVAC it was 0.19. Patients who developed a VAC or iVAC had significantly more ventilator days, hospital days, and antibiotic days and higher hospital mortality than patients who had neither of these conditions. Increased concordance with VAP prevention guidelines during the study was associated with decreased VAP and VAC rates but no change in iVAC rates. VACs and iVACs are associated with significant morbidity and mortality. Although the agreement between VAC, iVAC, and VAP is poor, a higher adoption of measures to prevent VAP was associated with lower VAP and VAC rates.

The medical effects of radioactive fall-out: role of stable end-products

International Nuclear Information System (INIS)

Burrows, B.A.; Cardarelli, J.C.; Boling, E.A.; Sinex, F.M.

1980-01-01

To summarize, from preliminary observations on the possible effects of radioactive fall-out, it may be inferred that in addition to the secondary products of ionizing irradiation per se, the stable end-products of the transmutation of certain radionuclides may adversely influence cellular metabolism, including mutagenesis. The discussion of the possible role of intracellular barium as an end-product of 137Cs decay is offered as an example of an unpredictable number of broad ecological, as well as the more limited medical, effects that may be of both clinical and climatological significance

Comparison of everolimus- and paclitaxel-eluting stents in patients with acute and stable coronary syndromes: pooled results from the SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) Trials.

Science.gov (United States)

Planer, David; Smits, Pieter C; Kereiakes, Dean J; Kedhi, Elvin; Fahy, Martin; Xu, Ke; Serruys, Patrick W; Stone, Gregg W

2011-10-01

This study sought to compare the clinical outcomes of everolimus-eluting stents (EES) versus paclitaxel-eluting stents (PES) in patients with acute coronary syndromes (ACS) and stable coronary artery disease (CAD). Although randomized trials have shown superiority of EES to PES, the safety and efficacy of EES in ACS is unknown. We performed a patient-level pooled analysis from the prospective, randomized SPIRIT (Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) II, III, IV, and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) trials in which 2,381 patients with ACS and 4,404 patients with stable CAD were randomized to EES or to PES. Kaplan-Meier estimates of death, myocardial infarction (MI), ischemia-driven target lesion revascularization, and stent thrombosis were assessed at 2 years and stratified by clinical presentation (ACS vs. stable CAD). At 2 years, patients with ACS compared with stable CAD had higher rates of death (3.2% vs. 2.4%, hazard ratio [HR]: 1.37 [95% confidence interval (CI): 1.02 to 1.85], p = 0.04) and MI (4.9% vs. 3.4%, HR: 1.45 [95% CI: 1.14 to 1.85], p = 0.02). In patients with ACS, EES versus PES reduced the rate of death or MI (6.6% vs. 9.3%, HR: 0.70 [95% CI: 0.52 to 0.94], p = 0.02), stent thrombosis (0.7% vs. 2.9%, HR: 0.25 [95% CI: 0.12 to 0.52], p = 0.0002), and ischemia-driven target lesion revascularization (4.7% vs. 6.2%, HR: 0.69 [95% CI: 0.48 to 0.99], p = 0.04). In patients with stable CAD, EES reduced the rate of death or MI (4.5% vs. 7.1%, HR: 0.62 [95% CI: 0.48 to 0.80], p = 0.0002), stent thrombosis (0.7% vs. 1.8%, HR: 0.34 [95% CI: 0.19 to 0.62], p = 0.0002), and ischemia-driven target lesion revascularization (3.9% vs. 6.9%, HR: 0.55 [95% CI: 0.42 to 0.73], p SPIRIT II]; NCT00180310; SPIRIT III: A Clinical Evaluation of the Investigational Device XIENCE V Everolimus Eluting Coronary Stent System [EECSS] in the

Clinical Research Nursing: Development of a Residency Program
.

Science.gov (United States)

Showalter, Brandi L; Cline, Debbie; Yungclas, Jan; Frentz, Kelly; Stafford, Susan R; Maresh, Kelly J

2017-10-01

Clinical research nurses are essential in the coordination of clinical trials and the management of research participants. Without a stable, knowledgeable research nurse workforce, the conduct of research is affected. A research nurse residency is a novel approach to preparing new graduate nurses for the oncology research nurse role. This article will describe the development and content of the research nurse residency and how this approach is being used to address a need for clinical research nurses to support burgeoning clinical trials at a National Cancer Institute-designated comprehensive cancer center.
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Economic evaluation of trimetazidine in the management of chronic stable angina in Greece

OpenAIRE

Kourlaba, Georgia; Gourzoulidis, George; Andrikopoulos, George; Tsioufis, Konstantinos; Beletsi, Alexandra; Maniadakis, Nikos

2016-01-01

Background To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. Methods A Markov model with 3-month cycles and 1-year time horizon was developed to assess the comparators. The analysis was conducted from a third-party payer perspective. The clinical inputs and utili...

Multiple stable states of a periodically driven electron spin in a quantum dot using circularly polarized light

Science.gov (United States)

Korenev, V. L.

2011-06-01

The periodical modulation of circularly polarized light with a frequency close to the electron spin resonance frequency induces a sharp change of the single electron spin orientation. Hyperfine interaction provides a feedback, thus fixing the precession frequency of the electron spin in the external and the Overhauser field near the modulation frequency. The nuclear polarization is bidirectional and the electron-nuclear spin system (ENSS) possesses a few stable states. The same physics underlie the frequency-locking effect for two-color and mode-locked excitations. However, the pulsed excitation with mode-locked laser brings about the multitudes of stable states in ENSS in a quantum dot. The resulting precession frequencies of the electron spin differ in these states by the multiple of the modulation frequency. Under such conditions ENSS represents a digital frequency converter with more than 100 stable channels.

Digital Clinical Communication for Families and Caregivers of Children or Young People With Short- or Long-Term Conditions: Rapid Review.

Science.gov (United States)

Armoiry, Xavier; Sturt, Jackie; Phelps, Emma Elizabeth; Walker, Clare-Louise; Court, Rachel; Taggart, Frances; Sutcliffe, Paul; Griffiths, Frances; Atherton, Helen

2018-01-05

The communication relationship between parents of children or young people with health conditions and health professionals is an important part of treatment, but it is unclear how far the use of digital clinical communication tools may affect this relationship. The objective of our study was to describe, assess the feasibility of, and explore the impact of digital clinical communication between families or caregivers and health professionals. We searched the literature using 5 electronic databases. We considered all types of study design published in the English language from January 2009 to August 2015. The population of interest included families and caregivers of children and young people aged less than 26 years with any type of health condition. The intervention was any technology permitting 2-way communication. We included 31 articles. The main designs were randomized controlled trials (RCTs; n=10), cross-sectional studies (n=9), pre- and postintervention uncontrolled (pre/post) studies (n=7), and qualitative interview studies (n=2); 6 had mixed-methods designs. In the majority of cases, we considered the quality rating to be fair. Many different types of health condition were represented. A breadth of digital communication tools were included: videoconferencing or videoconsultation (n=14), and Web messaging or emails (n=12). Health care professionals were mainly therapists or cognitive behavioral therapists (n=10), physicians (n=8), and nurses (n=6). Studies were very heterogeneous in terms of outcomes. Interventions were mainly evaluated using satisfaction or acceptance, or outcomes relating to feasibility. Clinical outcomes were rarely used. The RCTs showed that digital clinical communication had no impact in comparison with standard care. Uncontrolled pre/post studies showed good rates of satisfaction or acceptance. Some economic studies suggested that digital clinical communication may save costs. This rapid review showed an emerging body of literature on

A stable partitioned FSI algorithm for incompressible flow and deforming beams

International Nuclear Information System (INIS)

Li, L.; Henshaw, W.D.; Banks, J.W.; Schwendeman, D.W.; Main, A.

2016-01-01

An added-mass partitioned (AMP) algorithm is described for solving fluid–structure interaction (FSI) problems coupling incompressible flows with thin elastic structures undergoing finite deformations. The new AMP scheme is fully second-order accurate and stable, without sub-time-step iterations, even for very light structures when added-mass effects are strong. The fluid, governed by the incompressible Navier–Stokes equations, is solved in velocity-pressure form using a fractional-step method; large deformations are treated with a mixed Eulerian-Lagrangian approach on deforming composite grids. The motion of the thin structure is governed by a generalized Euler–Bernoulli beam model, and these equations are solved in a Lagrangian frame using two approaches, one based on finite differences and the other on finite elements. The key AMP interface condition is a generalized Robin (mixed) condition on the fluid pressure. This condition, which is derived at a continuous level, has no adjustable parameters and is applied at the discrete level to couple the partitioned domain solvers. Special treatment of the AMP condition is required to couple the finite-element beam solver with the finite-difference-based fluid solver, and two coupling approaches are described. A normal-mode stability analysis is performed for a linearized model problem involving a beam separating two fluid domains, and it is shown that the AMP scheme is stable independent of the ratio of the mass of the fluid to that of the structure. A traditional partitioned (TP) scheme using a Dirichlet–Neumann coupling for the same model problem is shown to be unconditionally unstable if the added mass of the fluid is too large. A series of benchmark problems of increasing complexity are considered to illustrate the behavior of the AMP algorithm, and to compare the behavior with that of the TP scheme. The results of all these benchmark problems verify the stability and accuracy of the AMP scheme. Results for

A stable partitioned FSI algorithm for incompressible flow and deforming beams

Energy Technology Data Exchange (ETDEWEB)

Li, L., E-mail: lil19@rpi.edu [Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180 (United States); Henshaw, W.D., E-mail: henshw@rpi.edu [Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180 (United States); Banks, J.W., E-mail: banksj3@rpi.edu [Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180 (United States); Schwendeman, D.W., E-mail: schwed@rpi.edu [Department of Mathematical Sciences, Rensselaer Polytechnic Institute, Troy, NY 12180 (United States); Main, A., E-mail: amain8511@gmail.com [Department of Civil and Environmental Engineering, Duke University, Durham, NC 27708 (United States)

2016-05-01

An added-mass partitioned (AMP) algorithm is described for solving fluid–structure interaction (FSI) problems coupling incompressible flows with thin elastic structures undergoing finite deformations. The new AMP scheme is fully second-order accurate and stable, without sub-time-step iterations, even for very light structures when added-mass effects are strong. The fluid, governed by the incompressible Navier–Stokes equations, is solved in velocity-pressure form using a fractional-step method; large deformations are treated with a mixed Eulerian-Lagrangian approach on deforming composite grids. The motion of the thin structure is governed by a generalized Euler–Bernoulli beam model, and these equations are solved in a Lagrangian frame using two approaches, one based on finite differences and the other on finite elements. The key AMP interface condition is a generalized Robin (mixed) condition on the fluid pressure. This condition, which is derived at a continuous level, has no adjustable parameters and is applied at the discrete level to couple the partitioned domain solvers. Special treatment of the AMP condition is required to couple the finite-element beam solver with the finite-difference-based fluid solver, and two coupling approaches are described. A normal-mode stability analysis is performed for a linearized model problem involving a beam separating two fluid domains, and it is shown that the AMP scheme is stable independent of the ratio of the mass of the fluid to that of the structure. A traditional partitioned (TP) scheme using a Dirichlet–Neumann coupling for the same model problem is shown to be unconditionally unstable if the added mass of the fluid is too large. A series of benchmark problems of increasing complexity are considered to illustrate the behavior of the AMP algorithm, and to compare the behavior with that of the TP scheme. The results of all these benchmark problems verify the stability and accuracy of the AMP scheme. Results for

Quantification of long-term wastewater fluxes at the surface water/groundwater-interface: an integrative model perspective using stable isotopes and acesulfame.

Science.gov (United States)

Engelhardt, I; Barth, J A C; Bol, R; Schulz, M; Ternes, T A; Schüth, C; van Geldern, R

2014-01-01

The suitability of acesulfame to trace wastewater-related surface water fluxes from streams into the hyporheic and riparian zones over long-term periods was investigated. The transport behavior of acesulfame was compared with the transport of water stable isotopes (δ(18)O or δ(2)H). A calibrated model based on a joint inversion of temperature, acesulfame, and piezometric pressure heads was employed in a model validation using data sets of acesulfame and water stable isotopes collected over 5months in a stream and groundwater. The spatial distribution of fresh water within the groundwater resulting from surface water infiltration was estimated by computing groundwater ages and compared with the predicted acesulfame plume obtained after 153day simulation time. Both, surface water ratios calculated with a mixing equation from water stable isotopes and simulated acesulfame mass fluxes, were investigated for their ability to estimate the contribution of wastewater-related surface water inflow within groundwater. The results of this study point to limitations for the application of acesulfame to trace surface water-groundwater interactions properly. Acesulfame completely missed the wastewater-related surface water volumes that still remained in the hyporheic zone under stream-gaining conditions. In contrast, under stream-losing conditions, which developed after periods of stagnating hydraulic exchange, acesulfame based predictions lead to an overestimation of the surface water volume of up to 25% in the riparian zone. If slow seepage velocities prevail a proportion of acesulfame might be stored in smaller pores, while when released under fast flowing water conditions it will travel further downstream with the groundwater flow direction. Therefore, under such conditions acesulfame can be a less-ideal tracer in the hyporheic and riparian zones and additional monitoring with other environmental tracers such as water stable isotopes is highly recommended. © 2013 Elsevier

Multi-stable perception balances stability and sensitivity

Directory of Open Access Journals (Sweden)

Alexander ePastukhov

2013-03-01

Full Text Available We report that multi-stable perception operates in a consistent, dynamical regime, balancing the conflicting goals of stability and sensitivity. When a multi-stable visual display is viewed continuously, its phenomenal appearance reverses spontaneously at irregular intervals. We characterized the perceptual dynamics of individual observers in terms of four statistical measures: the distribution of dominance times (mean and variance and the novel, subtle dependence on prior history (correlation and time-constant.The dynamics of multi-stable perception is known to reflect several stabilizing and destabilizing factors. Phenomenologically, its main aspects are captured by a simplistic computational model with competition, adaptation, and noise. We identified small parameter volumes (~3% of the possible volume in which the model reproduced both dominance distribution and history-dependence of each observer. For 21 of 24 data sets, the identified volumes clustered tightly (~15% of the possible volume, revealing a consistent `operating regime' of multi-stable perception. The `operating regime' turned out to be marginally stable or, equivalently, near the brink of an oscillatory instability. The chance probability of the observed clustering was <0.02.To understand the functional significance of this empirical `operating regime', we compared it to the theoretical `sweet spot' of the model. We computed this `sweet spot' as the intersection of the parameter volumes in which the model produced stable perceptual outcomes and in which it was sensitive to input modulations. Remarkably, the empirical `operating regime' proved to be largely coextensive with the theoretical `sweet spot'. This demonstrated that perceptual dynamics was not merely consistent but also functionally optimized (in that it balances stability with sensitivity. Our results imply that multi-stable perception is not a laboratory curiosity, but reflects a functional optimization of perceptual

Stable solid state reference electrodes for high temperature water chemistry

International Nuclear Information System (INIS)

Jayaweera, P.; Millett, P.J.

1995-01-01

A solid state electrode capable of providing a stable reference potential under a wide range of temperatures and chemical conditions has been demonstrated. The electrode consists of a zirconia or yttria-stabilized zirconia tube packed with an inorganic polymer electrolyte and a silver/silver chloride sensing element. The sensing element is maintained near room temperature by a passive cooling heat sink. The electrode stability was demonstrated by testing it in high temperature (280 C) aqueous solutions over extended periods of time. This reference electrode is useful in many applications, particularly for monitoring the chemistry in nuclear and fossil power plants

Analysing Stable Time Series

National Research Council Canada - National Science Library

Adler, Robert

1997-01-01

We describe how to take a stable, ARMA, time series through the various stages of model identification, parameter estimation, and diagnostic checking, and accompany the discussion with a goodly number...

Tukey max-stable processes for spatial extremes

KAUST Repository

Xu, Ganggang; Genton, Marc G.

2016-01-01

We propose a new type of max-stable process that we call the Tukey max-stable process for spatial extremes. It brings additional flexibility to modeling dependence structures among spatial extremes. The statistical properties of the Tukey max

Living conditions in the districts of Oslo and poisonings by substances of abuse treated at casualty clinic level.

Science.gov (United States)

Akopian, Maja; Vallersnes, Odd Martin; Jacobsen, Dag; Ekeberg, Øivind; Brekke, Mette

2015-11-17

Use of and acute poisoning by substances of abuse represent a major health problem and are often linked to social destitution. We describe associations between place of residence, living conditions and the incidence of poisoning by substances of abuse in Oslo. All patients who were 12 years of age or older and resident in Oslo and who were treated for acute poisoning by substances of abuse at the Oslo Accident and Emergency Outpatient Clinic (OAEOC) were included prospectively for a continuous period of one year, from October 2011 to September 2012. The 15 districts of Oslo were categorised into three groups of living conditions, from the best (I) to the poorest (III) living conditions, based on the City of Oslo's living conditions index. Homeless people were grouped separately. The incidence of poisoning by substances of abuse treated in the OAEOC was estimated. Of a total of 1,560 poisonings by substances of abuse, 1,094 cases (70%) affected men. The median age was 41 years. The most frequent toxic agents were ethanol, with 915 cases (59%), and heroin, with 249 cases (16%). The incidence of poisoning by substances of abuse treated in the OAEOC per year per 1,000 inhabitants amounted to 1.75 in living conditions group I, to 2.76 in living conditions group II and 3.41 in living conditions group III. Living conditions group III had a significantly higher incidence than living conditions group II (p < 0.001), and living conditions group II had a significantly higher incidence than living conditions group I (p < 0.001). The incidence of acute poisoning by substances of abuse was higher, the poorer the living conditions in the district.

Stable Low Cloud Phase II: Nocturnal Event Study

Science.gov (United States)

Bauman, William H., III; Barrett, Joe, III

2007-01-01

This report describes the work done by the Applied Meteorology Unit (AMU) in developing a database of nights that experienced rapid (formation in a stable atmosphere, resulting in ceilings at the Shuttle Landing Facility (TTS) that violated Space Shuttle Flight Rules (FR). This work is the second phase of a similar AMU task that examined the same phenomena during the day. In the first phase of this work, the meteorological conditions favoring the rapid formation of low ceilings include the presence of any inversion below 8000 ft, high relative humidity (RH) beneath the inversion and a clockwise turning of the winds from the surface to the middle troposphere (-15000 ft). The AMU compared and contrasted the atmospheric and thermodynamic conditions between nights with rapid low ceiling formation and nights with low ceilings resulting from other mechanisms. The AMU found that there was little to discern between the rapidly-forming ceiling nights and other low ceiling nights at TTS. When a rapid development occurred, the average RH below the inversions was 87% while non-events had an average RH of 79%. One key parameter appeared to be the vertical wind profile in the Cape Canaveral, FL radiosonde (XMR) sounding. Eighty-three percent of the rapid development events had veering winds with height from the surface to the middle troposphere (-15,000 ft) while 61% of the non-events had veering winds with height. Veering winds indicate a warm-advection regime, which supports large-scale rising motion and ultimately cloud formation in a moist environment. However, only six of the nights (out of 86 events examined) with low cloud ceilings had an occurrence of rapidly developing ceilings. Since only 7% rapid development events were observed in this dataset, it is likely that rapid low cloud development is not a common occurrence during the night, or at least not as common as during the day. In the AMU work on the daytime rapid low cloud development (Case and Wheeler 2005), nearly

Freedom: a transient fission-product release model for radioactive and stable species

International Nuclear Information System (INIS)

Macdonald, L.D.; Lewis, B.J.; Iglesias, F.C.

1989-05-01

A microstructure-dependent fission-gas release and swelling model (FREEDOM) has been developed for UO 2 fuel. The model describes the transient release behaviour for both the radioactive and stable fission-product species. The model can be applied over the full range of operating conditions, as well as for accident conditions that result in high fuel temperatures. The model accounts for lattice diffusion and grain-boundary sweeping of fusion products to the grain boundaries, where the fission gases accumulate in grain-face bubbles as a result of vacancy diffusion. Release of fission-gas to the free void of the fuel element occurs through the interlinkage of bubbles and cracks on the grain boundaries. This treatment also accounts for radioactive chain decay and neutron-induced transmutation effects. These phenomena are described by mass balance equations which are numerically solved using a moving-boundary, finite-element method with mesh refinement. The effects of grain-face bubbles on fuel swelling and fuel thermal conductivity are included in the ELESIM fuel performance code. FREEDOM has an accuracy of better than 1% when assessed against an analytic solution for diffusional release. The code is being evaluated against a fuel performance database for stable gas release, and against sweep-gas and in-cell fission-product release experiments at Chalk River for active species

Computerized respiratory sounds: a comparison between patients with stable and exacerbated COPD.

Science.gov (United States)

Jácome, Cristina; Oliveira, Ana; Marques, Alda

2017-09-01

Diagnosis of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is often challenging as it relies on patients' clinical presentation. Computerized respiratory sounds (CRS), namely crackles and wheezes, may have the potential to contribute for the objective diagnosis/monitoring of an AECOPD. This study explored if CRS differ during stable and exacerbation periods in patients with COPD. 13 patients with stable COPD and 14 with AECOPD were enrolled. CRS were recorded simultaneously at trachea, anterior, lateral and posterior chest locations using seven stethoscopes. Airflow (0.4-0.6l/s) was recorded with a pneumotachograph. Breathing phases were detected using airflow signals; crackles and wheezes with validated algorithms. At trachea, anterior and lateral chest, no significant differences were found between the two groups in the number of inspiratory/expiratory crackles or inspiratory wheeze occupation rate. At posterior chest, the number of crackles (median 2.97-3.17 vs. 0.83-1.2, P < 0.001) and wheeze occupation rate (median 3.28%-3.8% vs. 1.12%-1.77%, P = 0.014-0.016) during both inspiration and expiration were significantly higher in patients with AECOPD than in stable patients. During expiration, wheeze occupation rate was also significantly higher in patients with AECOPD at trachea (median 3.12% vs. 0.79%, P < 0.001) and anterior chest (median 3.55% vs. 1.28%, P < 0.001). Crackles and wheezes are more frequent in patients with AECOPD than in stable patients, particularly at posterior chest. These findings suggest that these CRS can contribute to the objective diagnosis/monitoring of AECOPD, which is especially valuable considering that they can be obtained by integrating computerized techniques with pulmonary auscultation, a noninvasive method that is a component of patients' physical examination. © 2015 John Wiley & Sons Ltd.

Stable isotope studies

International Nuclear Information System (INIS)

Ishida, T.

1992-01-01

The research has been in four general areas: (1) correlation of isotope effects with molecular forces and molecular structures, (2) correlation of zero-point energy and its isotope effects with molecular structure and molecular forces, (3) vapor pressure isotope effects, and (4) fractionation of stable isotopes. 73 refs, 38 figs, 29 tabs

Deficient conditioned pain modulation after spinal cord injury correlates with clinical spontaneous pain measures.

Science.gov (United States)

Albu, Sergiu; Gómez-Soriano, Julio; Avila-Martin, Gerardo; Taylor, Julian

2015-02-01

The contribution of endogenous pain modulation dysfunction to clinical and sensory measures of neuropathic pain (NP) has not been fully explored. Habituation, temporal summation, and heterotopic noxious conditioning stimulus-induced modulation of tonic heat pain intensity were examined in healthy noninjured subjects (n = 10), and above the level of spinal cord injury (SCI) in individuals without (SCI-noNP, n = 10) and with NP (SCI-NP, n = 10). Thermoalgesic thresholds, Cz/AFz contact heat evoked potentials (CHEPs), and phasic or tonic (30 seconds) heat pain intensity were assessed within the C6 dermatome. Although habituation to tonic heat pain intensity (0-10) was reported by the noninjured (10 s: 3.5 ± 0.3 vs 30 s: 2.2 ± 0.5 numerical rating scale; P = 0.003), loss of habituation was identified in both the SCI-noNP (3.8 ± 0.3 vs 3.6 ± 0.5) and SCI-NP group (4.2 ± 0.4 vs 4.9 ± 0.8). Significant temporal summation of tonic heat pain intensity was not observed in the 3 groups. Inhibition of tonic heat pain intensity induced by heterotopic noxious conditioning stimulus was identified in the noninjured (-29.7% ± 9.7%) and SCI-noNP groups (-19.6% ± 7.0%), but not in subjects with SCI-NP (+1.1% ± 8.0%; P pain modulation response correlated positively with Cz/AFz CHEP amplitude (ρ = 0.8; P = 0.015) and evoked heat pain intensity (ρ = 0.8; P = 0.007) in the SCI-NP group. Stepwise regression analysis revealed that the mean conditioned pain modulation (R = 0.72) correlated with pain severity and pressing spontaneous pain in the SCI-NP group. Comprehensive assessment of sensory dysfunction above the level of injury with tonic thermal test and conditioning stimuli revealed less-efficient endogenous pain modulation in subjects with SCI-NP.

Wideband quin-stable energy harvesting via combined nonlinearity

Directory of Open Access Journals (Sweden)

Chen Wang

2017-04-01

Full Text Available In this work, we propose a wideband quintuple-well potential piezoelectric-based vibration energy harvester using a combined nonlinearity: the magnetic nonlinearity induced by magnetic force and the piecewise-linearity produced by mechanical impact. With extra stable states compared to other multi-stable harvesters, the quin-stable harvester can distribute its potential energy more uniformly, which provides shallower potential wells and results in lower excitation threshold for interwell motion. The mathematical model of this quin-stable harvester is derived and its equivalent piecewise-nonlinear restoring force is measured in the experiment and identified as piecewise polynomials. Numerical simulations and experimental verifications are performed in different levels of sinusoid excitation ranging from 1 to 25 Hz. The results demonstrate that, with lower potential barriers compared with tri-stable counterpart, the quin-stable arrangement can escape potential wells more easily for doing high-energy interwell motion over a wider band of frequencies. Moreover, by utilizing the mechanical stoppers, this harvester can produce significant output voltage under small tip deflections, which results in a high power density and is especially suitable for a compact MEMS approach.

Analysis of growth and tissue replacement rates by stable sulfur isotope turnover.

Science.gov (United States)

Arneson, L. S.; Macko, S. A.; Macavoy, S. E.

2003-12-01

Stable isotope analysis has become a powerful tool to study animal ecology. Analysis of stable isotope ratios of elements such as carbon, nitrogen, sulfur, hydrogen, oxygen and others have been used to trace migratory routes, reconstruct dietary sources and determine the physiological condition of individual animals. The isotopes most commonly used are carbon, due to differential carbon fractionation in C3 and C4 plants, and nitrogen, due to the approximately 3% enrichment in 15N per trophic level. Although all cells express sulfur-containing compounds, such as cysteine, methionine, and coenzyme A, the turnover rate of sulfur in tissues has not been examined in most studies, owing to the difficulty in determining the δ 34S signature. In this study, we have assessed the rate of sulfur isotopic turnover in mouse tissues following a diet change from terrestrial (7%) to marine (19%) source. Turnover models reflecting both growth rate and metabolic tissue replacement will be developed for blood, liver, fat and muscle tissues.

Foresight and awareness of incipient changes in a patient' clinical conditions--Perspectives of intensive care nurses.

Science.gov (United States)

Kvande, Monica; Delmar, Charlotte; Lykkeslet, Else; Storli, Sissel Lisa

2015-10-01

The aim of this study was to explore the phenomenon of becoming aware of incipient changes in patient condition from the perspectives and experiences of intensive care nurses. This study involved close observations of and in-depth interviews with 11 experienced intensive care nurses. The text was analysed using a hermeneutic phenomenological method that was inspired by van Manen. This study was undertaken at two different high-technology intensive care units (ICUs) in Norwegian university hospitals. Nurses formed images of individual patients composed of signs (of changes in a patient's condition) that were sensory, measurable, and manifested as the mood of the nurse. The signs may be viewed as separate from and opposed to one another, but they are tightly interwoven and interact with one another. Care situations are powerful stimuli for the patient, and it is of great importance for nurses to become aware of signs in these situations. Nurses also ascribe that following the patient over time is important for becoming aware of signs. An awareness of incipient changes in patient clinical condition requires understanding the ever-changing dynamics of patient condition and dialogic images composed of signs. Care situations and the following of patients through shifts are essential in enabling nurses to detect these signs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Sense of Humor, Stable Affect, and Psychological Well-Being

Directory of Open Access Journals (Sweden)

Arnie Cann

2014-08-01

Full Text Available A good sense of humor has been implicated as a quality that could contribute to psychological well-being. The mechanisms through which sense of humor might operate include helping to reappraise threats, serving as a character strength, or facilitating happiness. The current research attempts to integrate these possibilities by examining whether a good sense of humor might operate globally by helping to maintain a more stable positive affect. Stable positive affect has been shown to facilitate more effective problem solving and to build resilience. However, not all humor is adaptive humor, so we also examine the roles that different styles of humor use might play. Individual differences in humor styles were used to predict stable levels of affect. Then, in a longitudinal design, humor styles and stable affect were used to predict subsequent resilience and psychological health. The results indicated that stable affect was related to resilience and psychological well-being, and that a sense of humor that involves self-enhancing humor, humor based on maintaining a humorous perspective about one’s experiences, was positively related to stable positive affect, negatively related to stable negative affect, and was mediated through stable affect in influencing resilience, well-being and distress. Thus, while a good sense of humor can lead to greater resilience and better psychological health, the current results, focusing on stable affect, find only self-enhancing humor provides reliable benefits.

Does the gestation age of newborn babies influence the ultrasonic assessment of hip condition?

Directory of Open Access Journals (Sweden)

Simić Slavica

2009-01-01

Full Text Available Introduction. Ultrasound represents a method of examination of hips of newborn babies capable of defining hip condition and distinguishing stable and unstable hips based on morphological elements. It is accepted in a large number of countries as a method of examination of high risk newborns, or as a method of systematic screening. Objective. The objective of this study was to investigate correlation between ultrasonically estimated hip maturity and respective gestation maturity both in premature and term-born babies, and to investigate the influence of different delivery types on hips condition. Methods. In our study 2045 patients, 1141 males and 904 females, were examined in at the Institute of Neonatology over a period of 5 years. The average age was 34.04 gestation weeks. There were significantly more premature (1698 or 83.03% than term-born babies (347 or 16.97%. Ultrasound hip examination, as a screening method, was carried out according to Graf. It was followed by clinical examination. Results were analyzed by appropriate statistical methods (χ2-test, one-way ANOVA, multifactor ANOVA. Results. The overall frequency of unstable hips was 3.2%, 1.88% in males and 4.87% in females (p<0.05. 96.8% babies had stable hips, out of which 35.21% were mature and 61.59% immature. In the study of the breech presentation, out of 183 babies, unstable hips were found in 1.58% of male cases, and in 10.23% of female cases. Conclusion. Clinical screening of developmental dysplasia of the hip is insufficient for early diagnosis and decision about the treatment of premature babies. The high frequency of unstable hip type IIc (risky and IId (decentralized in premature babies requires early diagnosis and therapy. Wide swaddling for prematures should be applied up to eight months of age. Gentle manipulation is necessary while nursing and conducting physiotherapy of a premature baby.

Detonation of Meta-stable Clusters

Energy Technology Data Exchange (ETDEWEB)

Kuhl, Allen; Kuhl, Allen L.; Fried, Laurence E.; Howard, W. Michael; Seizew, Michael R.; Bell, John B.; Beckner, Vincent; Grcar, Joseph F.

2008-05-31

We consider the energy accumulation in meta-stable clusters. This energy can be much larger than the typical chemical bond energy (~;;1 ev/atom). For example, polymeric nitrogen can accumulate 4 ev/atom in the N8 (fcc) structure, while helium can accumulate 9 ev/atom in the excited triplet state He2* . They release their energy by cluster fission: N8 -> 4N2 and He2* -> 2He. We study the locus of states in thermodynamic state space for the detonation of such meta-stable clusters. In particular, the equilibrium isentrope, starting at the Chapman-Jouguet state, and expanding down to 1 atmosphere was calculated with the Cheetah code. Large detonation pressures (3 and 16 Mbar), temperatures (12 and 34 kilo-K) and velocities (20 and 43 km/s) are a consequence of the large heats of detonation (6.6 and 50 kilo-cal/g) for nitrogen and helium clusters respectively. If such meta-stable clusters could be synthesized, they offer the potential for large increases in the energy density of materials.

Stable carbon isotope fractionation during the biodegradation of lambda-cyhalothrin.

Science.gov (United States)

Shen, Xiaoli; Xu, Zemin; Zhang, Xichang; Yang, Fangxing

2015-11-01

In this study, the microbial degradation of lambda-cyhalothrin in soil was investigated using compound-specific stable isotope analysis. The results revealed that lambda-cyhalothrin was biodegraded in soil under laboratory conditions. The half-lives of lambda-cyhalothrin were determined to be 49 and 161 days in non-sterile and sterile soils spiked with 2mg/kg lambda-cyhalothrin and 84 and 154 days in non-sterile and sterile soils spiked with 10mg/kg lambda-cyhalothrin, respectively. The biodegradation of lambda-cyhalothrin resulted in carbon isotope fractionation, which shifted from -29.0‰ to -26.5‰ in soil spiked with 2mg/kg lambda-cyhalothrin, and to -27.5‰ with 10mg/kg lambda-cyhalothrin. A relationship was established between the stable carbon isotope fraction and the residual concentrations of lambda-cyhalothrin by the Rayleigh equation in which the carbon isotope enrichment factor ε of the microbial degradation of lambda-cyhalothrin in the soil was calculated as -2.53‰. This study provides an approach to quantitatively evaluate the biodegradation of lambda-cyhalothrin in soil in field studies. Copyright © 2015 Elsevier B.V. All rights reserved.

Perspective: Highly stable vapor-deposited glasses

Science.gov (United States)

Ediger, M. D.

2017-12-01

This article describes recent progress in understanding highly stable glasses prepared by physical vapor deposition and provides perspective on further research directions for the field. For a given molecule, vapor-deposited glasses can have higher density and lower enthalpy than any glass that can be prepared by the more traditional route of cooling a liquid, and such glasses also exhibit greatly enhanced kinetic stability. Because vapor-deposited glasses can approach the bottom of the amorphous part of the potential energy landscape, they provide insights into the properties expected for the "ideal glass." Connections between vapor-deposited glasses, liquid-cooled glasses, and deeply supercooled liquids are explored. The generality of stable glass formation for organic molecules is discussed along with the prospects for stable glasses of other types of materials.

Effects of euthanasia method on stable-carbon and stable-nitrogen isotope analysis for an ectothermic vertebrate.

Science.gov (United States)

Atwood, Meredith A

2013-04-30

Stable isotope analysis is a critical tool for understanding ecological food webs; however, results can be sensitive to sample preparation methods. To limit the possibility of sample contamination, freezing is commonly used to euthanize invertebrates and preserve non-lethal samples from vertebrates. For destructive sampling of vertebrates, more humane euthanasia methods are preferred to freezing and it is essential to evaluate how these euthanasia methods affect stable isotope results. Stable isotope ratios and elemental composition of carbon and nitrogen were used to evaluate whether the euthanasia method compromised the integrity of the sample for analysis. Specifically, the stable isotope and C:N ratios were compared for larval wood frogs (Rana sylvatica  =  Lithobates sylvaticus), an ectothermic vertebrate, that had been euthanized by freezing with four different humane euthanasia methods: CO2, benzocaine, MS-222 (tricaine methanesulfonate), and 70% ethanol. The euthanasia method was not related to the δ(13)C or δ(15)N values and the comparisons revealed no differences between freezing and any of the other treatments. However, there were slight (non-significant) differences in the isotope ratios of benzocaine and CO2 when each was compared with freezing. The elemental composition was altered by the euthanasia method employed. The percentage nitrogen was higher in CO2 treatments than in freezing, and similar (non-significant) trends were seen for ethanol treatments relative to freezing. The resulting C:N ratios were higher for benzocaine treatments than for both CO2 and ethanol. Similar (non-significant) trends suggested that the C:N ratios were also higher for animals euthanized by freezing than for both CO2 and ethanol euthanasia methods. The euthanasia method had a larger effect on elemental composition than stable isotope ratios. The percentage nitrogen and the subsequent C:N ratios were most affected by the CO2 and ethanol euthanasia methods, whereas

Characterization of the sedimentary organic matter preserved in Messel oil shale by bulk geochemistry and stable isotopes

NARCIS (Netherlands)

Bauersachs, T.; Schouten, S.; Schwark, L.

2014-01-01

We investigated a 150 m thick drill core section of Messel oil shale using bulk geochemical and stable isotope techniques in order to determine the organic matter sources and the environmental conditions that prevailed during the deposition of the lacustrine sequence. High Corg values (on average

Treatment of waste salt from the advanced spent fuel conditioning process (II) : optimum immobilization condition

International Nuclear Information System (INIS)

Kim, Jeong Guk; Lee, Jae Hee; Yoo, Jae Hyung; Kim, Joon Hyung

2004-01-01

Since zeolite is known to be stable at a high temperature, it has been reported as a promising immobilization matrix for waste salt. The crystal structure of dehydrated zeolite A breaks down above 1060 K, resulting in the formation of an amorphous solid and re-crystallization to beta-Cristobalite. This structural degradation depends on the existence of chlorides. When contacted to HCl, zeolite 4A is not stable even at 473 K. The optimum consolidation condition for LiCl salt waste from the oxide fuel reduction process based on the electrochemical method (Advanced spent fuel Conditioning Process; ACP) has been studied using zeolite A since 2001. Actually the constituents of waste salt are water-soluble. And, alkali halides are known to be readily radiolyzed to yield interstitial halogens and metal colloids. For disposal in a geological repository, the waste salt must meet the acceptance criteria. For a waste form containing chloride salt, two of the more important criteria are leach resistance and waste form durability. In this work, we prepared some samples with different mixing ratios of LiCl salt to zeolite A, and then compared some characteristics such as thermal stability, salt occlusion, free chloride content, leach resistance, mixing effect, etc

Quantification of long-term wastewater fluxes at the surface water/groundwater-interface: An integrative model perspective using stable isotopes and acesulfame

Energy Technology Data Exchange (ETDEWEB)

Engelhardt, I., E-mail: i.engelhardt@fz-juelich.de [Forschungszentrum Jülich, Institute of Bio- and Geosciences, Agrosphere — IBG-3 (Germany); Technical University of Darmstadt, Institute of Applied Geosciences (Germany); Barth, J.A.C. [GeoZentrum Nordbayern, University of Erlangen-Nuremberg (Germany); Bol, R. [Forschungszentrum Jülich, Institute of Bio- and Geosciences, Agrosphere — IBG-3 (Germany); Schulz, M.; Ternes, T.A. [Federal Institute of Hydrology (BfG) (Germany); Schüth, C. [Technical University of Darmstadt, Institute of Applied Geosciences (Germany); van Geldern, R. [GeoZentrum Nordbayern, University of Erlangen-Nuremberg (Germany)

2014-01-01

The suitability of acesulfame to trace wastewater-related surface water fluxes from streams into the hyporheic and riparian zones over long-term periods was investigated. The transport behavior of acesulfame was compared with the transport of water stable isotopes (δ{sup 18}O or δ{sup 2}H). A calibrated model based on a joint inversion of temperature, acesulfame, and piezometric pressure heads was employed in a model validation using data sets of acesulfame and water stable isotopes collected over 5 months in a stream and groundwater. The spatial distribution of fresh water within the groundwater resulting from surface water infiltration was estimated by computing groundwater ages and compared with the predicted acesulfame plume obtained after 153 day simulation time. Both, surface water ratios calculated with a mixing equation from water stable isotopes and simulated acesulfame mass fluxes, were investigated for their ability to estimate the contribution of wastewater-related surface water inflow within groundwater. The results of this study point to limitations for the application of acesulfame to trace surface water–groundwater interactions properly. Acesulfame completely missed the wastewater-related surface water volumes that still remained in the hyporheic zone under stream-gaining conditions. In contrast, under stream-losing conditions, which developed after periods of stagnating hydraulic exchange, acesulfame based predictions lead to an overestimation of the surface water volume of up to 25% in the riparian zone. If slow seepage velocities prevail a proportion of acesulfame might be stored in smaller pores, while when released under fast flowing water conditions it will travel further downstream with the groundwater flow direction. Therefore, under such conditions acesulfame can be a less-ideal tracer in the hyporheic and riparian zones and additional monitoring with other environmental tracers such as water stable isotopes is highly recommended

Suitability of biocompost as a bedding material for stabled horses: respiratory hygiene and management practicalities.

Science.gov (United States)

Seedorf, J; Schröder, M; Köhler, L; Hartung, J

2007-03-01

Bedding material in stables has an important influence on air hygiene and information on the suitability of biocompost and wood shavings is incomplete. To compare the suitability and benefit of biocompost and wood shavings as bedding in horse stables and to determine key air factors for the evaluation of the potential impact of these materials on respiratory health. The study was conducted in a naturally ventilated stable with 4 horses. Air hygiene parameters were measured 24 h/day for 7 days with each bedding type: ammonia (NH3), inhalable and respirable dust, endotoxins, colony forming units (CFU) of total mesophilic bacteria, fungi, actinomycetes and thermophilic actinomycetes. Both bedding materials were analysed for general chemical composition, particle size distribution and natural microbial content. The animals' behaviour was monitored by video cameras, and their health and cleanliness status determined by clinical and visual examination. Concentrations of NH3, dust, endoxins and fungi were significantly higher during the monitoring period with wood shavings than with biocompost. In contrast concentrations of mesophilic bacteria, mesophilic actinomycetes and thermophilic actinomycetes microbial pollutants were highest with biocompost. The water content of bulk biocompost was considerably higher than that of wood shavings. Particles market.

Myocardial perfusion SPECT in stable angina;Place de la scintigraphie myocardique dans l'angor stable

Energy Technology Data Exchange (ETDEWEB)

Jau, P.; Jacob, T. [HP Clairval, Service de medecine nucleaire, 13 - Marseille (France); Lecorff, G.; Bouvier, J.L.; Novella, P.; Bechet, V.; Pelet, V. [HP Clairval, Service de cardiologie, 13 - Marseille (France)

2010-03-15

We study the precise contribution of myocardial scintigraphy in the therapeutic management of stable coronary artery disease. Until recently, treatment was focused on revascularization, often by coronary angioplasty.Recent studies have challenged this practice by showing the absence of superiority of angioplasty compared to optimal medical therapy.The problem now is to define for each stable coronary artery disease, and individually, the best of both treatment options. In this spirit, the functional approach to coronary artery disease by myocardial perfusion scintigraphy is most interesting.The diagnostic performance, including sensitivity and negative predictive value, and the prognostic value of the technique are clearly established. Recent studies show that a therapeutic decision based on a functional approach to the patient is valid.We need to know this development in cardiology for best position in the multidisciplinary discussions, myocardial scintigraphy as a functional approach to stable coronary artery disease. (N.C.)

Stable Tetraquarks

Energy Technology Data Exchange (ETDEWEB)

Quigg, Chris [Fermilab

2018-04-13

For very heavy quarks, relations derived from heavy-quark symmetry imply novel narrow doubly heavy tetraquark states containing two heavy quarks and two light antiquarks. We predict that double-beauty states will be stable against strong decays, whereas the double-charm states and mixed beauty+charm states will dissociate into pairs of heavy-light mesons. Observing a new double-beauty state through its weak decays would establish the existence of tetraquarks and illuminate the role of heavy color-antitriplet diquarks as hadron constituents.

Stable isotopes as tracers for radionuclides

International Nuclear Information System (INIS)

Giussani, A.; Bartolo, D. de; Cantone, M.C.; Zilker, T.; Greim, H.; Roth, P.; Werner, E.

2000-01-01

The assessment of internal dose after incorporation of radionuclides requires as input data the knowledge of the uptake into the systemic circulation, the distribution and retention in selected organs, the excretion pathways. Realistic biokinetic models are needed for reliable estimates, correct interpretation of bioassay measurements, appropriate decision-making in radiological emergencies. For many radionuclides, however, the biokinetic models currently recommended are often generic, with very few specific parameters, due to the lack of experimental human data. The use of stable isotopes as tracers enables to determine important biokinetic parameters such as the fractional uptake, the clearance from the transfer compartment, the excretion patterns under experimentally controlled conditions. The subjects investigated are not exposed to any radiation risk, so this technique enables to obtain biokinetic information also for sensitive groups of the population, such as children or pregnant women, and to determine age- and gender-specific model parameters. Sophisticated analytical method, able to discriminate and quantitate different isotopes of the same element in complex matrices such as biological fluids, have to be purposely developed and optimized. Activation analysis and mass spectrometry are the most proper techniques of choice. Experiments were conducted with molybdenum, tellurium, ruthenium and zirconium. Activation analysis with protons, thermal ionization mass spectrometry and inductively coupled mass spectrometry were employed for the determination of stable isotopes of these elements in blood plasma and urine samples. Several deviations from the predictions of the ICRP models were observed. For example, modifications to the current model for molybdenum have been suggested on the basis of these results. The dose coefficients to the target regions calculated with this proposed model are even of one order of magnitude different than the ICRP estimates

Development of stable isotope manufacturing in Russia

International Nuclear Information System (INIS)

Pokidychev, A.; Pokidycheva, M.

1999-01-01

For the past 25 years, Russia has relied heavily on the electromagnetic separation process for the production of middle and heavy mass stable isotopes. The separation of most light isotopes had been centered in Georgia which, after the collapse of the USSR, left Russia without this capability. In the mid-1970s, development of centrifuge technology for the separation of stable isotopes was begun. Alternative techniques such as laser separation, physical-chemical methods, and ion cyclotron resonance have also been investigated. Economic considerations have played a major role in the development and current status of the stable isotope enrichment capabilities of Russia

Radappertization of ready-to-eat shelf-stable, traditional Indian bread - Methi Paratha

Science.gov (United States)

Bhoir, Shraddha A.; Muppalla, Shobita R.; Kanatt, Sweetie R.; Chawla, S. P.; Sharma, Arun

2015-06-01

Shelf-stable ready-to-eat (RTE) Methi Paratha (flavored Indian unleavened flat bread) was developed using combination of hurdles including radiation processing. The Methi Paratha was prepared using dough containing wheat flour, dried fenugreek leaves and spices. The samples were vacuum packed in multi-layered pouches and irradiated at 25 kGy in frozen conditions. Samples were evaluated for microbiological counts, lipid peroxidation and sensory attributes during storage under ambient conditions. Samples were found to be devoid of any viable microorganism throughout the storage period of 180 days. The thiobarbituric acid reactive substances (TBARS) value which indicates lipid peroxidation of samples did not show any significant increase with time. The Methi Paratha was found to be acceptable by the evaluating panelists.

Economic and clinical aspects of intravenous versus oral busulfan in adult patients for conditioning prior to HSCT.

Science.gov (United States)

Berger, Karin; Schopohl, Dorothee; Rieger, Christina; Ostermann, Helmut

2015-12-01

Busulfan (BU) used as cytoreductive conditioning prior to hematopoietic stem cell transplantation (HSCT) is available as intravenous (IV) and oral (O) preparation. IV-BU has clinical advantages associated with relevant incremental costs. The aim was to determine the economic impact of IV-BU versus O-BU in adult HSCT recipients from a German health care providers' perspective. A budget-impact model (BIM) including costs and risks for oral mucositis (OM), infection with OM, and hepatic sinusoidal obstruction syndrome (SOS) was developed. Model inputs are literature data comparing clinical effects of IV-BU versus O-BU and German cost data (conditioning therapy, treatment of OM, infections, SOS without/with multiorgan failure) from literature and tariff lists. Base case calculations resulted the following: total costs of adverse events were €86,434 with O-BU and €44,376 with IV-BU for ten patients each. Considering costs of adverse events and drugs, about €5840 for ten patients receiving IV-BU are saved. Sensitivity analyses were conducted in several ways. Cost savings range between €4910 and €12,640 per ten patients for all adverse events and €2070 or €1140 per ten patients considering SOS only. Drug treatment of SOS and treatment of multiorgan failure during severe SOS are major cost drivers. Worst case scenario calculations (assuming -25% risk of all adverse events for O-BU and +25% for IV-BU) yield up to €27,570 per ten patients with IV-BU. Considering costs of adverse events and drugs, IV-BU is the dominant alternative from a German providers' perspective. For more comprehensive economic evaluations, additional epidemiological data, evidence on clinical outcomes, patient-reported outcomes, and treatment patterns are needed.

Stable isotope distribution in precipitation in Romania and its relevance for palaeoclimatic studies

Science.gov (United States)

Perşoiu, Aurel; Nagavciuc, Viorica; Bădăluţă, Carmen

2014-05-01

A surge of recent studies in Romania have targeted various aspects of palaeoclimate (based on stable isotopes in ice, speleothems, tree rings), mineral water origin, wine and other juices provenance. However, while much needed, these studies lack a stable isotope in precipitation background, with only two LMWL's being published so far. In this paper we discuss the links between the stable isotopic composition of precipitation (δ18O and δ2H), climate (air temperature, precipitation amount and large scale circulation) and their relevance for the palaeocllimatic interpretation of stable isotope values in cave ice, cryogenic calcite and tree rings from different sites in Romania. Most of the precipitation in Romania is delivered by the Westerlies, bringing moisture from the North Atlantic; however, their influence is greatly reduced in the eastern half of the country where local evaporative sources play an important role in the precipitation balance. The SW is dominated by water masses from the Mediterranean Sea, while the SE corner clearly draws most of the moisture from the Black Sea and strongly depleted North Atlantic vapor masses. In 2012, Romania experienced the worst draught in 60 years, possibly due to a northward shift of the jest stream associated to blocking conditions in summer, which led to a more northern penetration of the Mediterranean-derived air masses, as well increased precipitation of re-evaporated waters. We have further analyzed cave drip water (δ18O and δ2H), cryogenic cave calcite (δ18O and δ13C) and tree rings (δ18O and δ13C) from selected sites across NW Romania, where the water isotopes in precipitation showed the best (and easiest to understand, given the climatic conditions in 2012) correlation with climatic parameters. Our results that 1) δ18O and δ2H in cave ice are a good proxy for late summer through early winter air temperature; 2) δ13C in cryogenic cave calcite are possible indicators of soil humidity and 3) δ18O in pine

Liquid phase mass production of air-stable black phosphorus/phospholipids nanocomposite with ultralow tunneling barrier

Science.gov (United States)

Zhang, Qiankun; Liu, Yinan; Lai, Jiawei; Qi, Shaomian; An, Chunhua; Lu, Yao; Duan, Xuexin; Pang, Wei; Zhang, Daihua; Sun, Dong; Chen, Jian-Hao; Liu, Jing

2018-04-01

Few-layer black phosphorus (FLBP), a recently discovered two-dimensional semiconductor, has attracted substantial attention in the scientific and technical communities due to its great potential in electronic and optoelectronic applications. However, reactivity of FLBP flakes with ambient species limits its direct applications. Among various methods to passivate FLBP in ambient environment, nanocomposites mixing FLBP flakes with stable matrix may be one of the most promising approaches for industry applications. Here, we report a simple one-step procedure to mass produce air-stable FLBP/phospholipids nanocomposite in liquid phase. The resultant nanocomposite is found to have ultralow tunneling barrier for charge carriers which can be described by an Efros-Shklovskii variable range hopping mechanism. Devices made from such mass-produced FLBP/phospholipids nanocomposite show highly stable electrical conductivity and opto-electrical response in ambient conditions, indicating its promising applications in both electronic and optoelectronic applications. This method could also be generalized to the mass production of nanocomposites consisting of other air-sensitive 2D materials, such as FeSe, NbSe2, WTe2, etc.

Stable and selective self-assembly of α-lipoic acid on Ge(001) for biomolecule immobilization

Science.gov (United States)

Kazmierczak, M.; Flesch, J.; Mitzloff, J.; Capellini, G.; Klesse, W. M.; Skibitzki, O.; You, C.; Bettenhausen, M.; Witzigmann, B.; Piehler, J.; Schroeder, T.; Guha, S.

2018-05-01

We demonstrate a novel method for the stable and selective surface functionalization of germanium (Ge) embedded in silicon dioxide. The Ge(001) surface is functionalized using α-lipoic acid (ALA), which can potentially be utilized for the immobilization of a wide range of biomolecules. We present a detailed pH-dependence study to establish the effect of the incubation pH value on the adsorption layer of the ALA molecules. A threshold pH value for functionalization is identified, dividing the examined pH range into two regions. Below a pH value of 7, the formation of a disordered ALA multilayer is observed, whereas a stable well-ordered ALA mono- to bi-layer on Ge(001) is achieved at higher pH values. Furthermore, we analyze the stability of the ALA layer under ambient conditions, revealing the most stable functionalized Ge(001) surface to effectively resist oxidation for up to one week. Our established functionalization method paves the way towards the successful immobilization of biomolecules in future Ge-based biosensors.

[Current Treatment of Stable Angina].

Science.gov (United States)

Toggweiler, Stefan; Jamshidi, Peiman; Cuculi, Florim

2015-06-17

Current therapy for stable angina includes surgical and percutaneous revascularization, which has been improved tremendously over the last decades. Smoking cessation and regular exercise are the cornerstone for prevention of further cerebrovascular events. Medical treatment includes treatment of cardiovascular risk factors and antithrombotic management, which can be a challenge in some patients. Owing to the fact the coronary revascularization is readily accessible these days in many industrialized countries, the importance of antianginal therapy has decreased over the past years. This article presents a contemporary overview of the management of patients with stable angina in the year 2015.

Preprocedural High-Sensitivity Cardiac Troponin T and Clinical Outcomes in Patients With Stable Coronary Artery Disease Undergoing Elective Percutaneous Coronary Intervention.

Science.gov (United States)

Zanchin, Thomas; Räber, Lorenz; Koskinas, Konstantinos C; Piccolo, Raffaele; Jüni, Peter; Pilgrim, Thomas; Stortecky, Stefan; Khattab, Ahmed A; Wenaweser, Peter; Bloechlinger, Stefan; Moschovitis, Aris; Frenk, Andre; Moro, Christina; Meier, Bernhard; Fiedler, Georg M; Heg, Dik; Windecker, Stephan

2016-06-01

Cardiac troponin detected by new-generation, highly sensitive assays predicts clinical outcomes among patients with stable coronary artery disease (SCAD) treated medically. The prognostic value of baseline high-sensitivity cardiac troponin T (hs-cTnT) elevation in SCAD patients undergoing elective percutaneous coronary interventions is not well established. This study assessed the association of preprocedural levels of hs-cTnT with 1-year clinical outcomes among SCAD patients undergoing percutaneous coronary intervention. Between 2010 and 2014, 6974 consecutive patients were prospectively enrolled in the Bern Percutaneous Coronary Interventions Registry. Among patients with SCAD (n=2029), 527 (26%) had elevated preprocedural hs-cTnT above the upper reference limit of 14 ng/L. The primary end point, mortality within 1 year, occurred in 20 patients (1.4%) with normal hs-cTnT versus 39 patients (7.7%) with elevated baseline hs-cTnT (P<0.001). Patients with elevated hs-cTnT had increased risks of all-cause (hazard ratio 5.73; 95% confidence intervals 3.34-9.83; P<0.001) and cardiac mortality (hazard ratio 4.68; 95% confidence interval 2.12-10.31; P<0.001). Preprocedural hs-TnT elevation remained an independent predictor of 1-year mortality after adjustment for relevant risk factors, including age, sex, and renal failure (adjusted hazard ratio 2.08; 95% confidence interval 1.10-3.92; P=0.024). A graded mortality risk was observed across higher tertiles of elevated preprocedural hs-cTnT, but not among patients with hs-cTnT below the upper reference limit. Preprocedural elevation of hs-cTnT is observed in one fourth of SCAD patients undergoing elective percutaneous coronary intervention. Increased levels of preprocedural hs-cTnT are proportionally related to the risk of death and emerged as independent predictors of all-cause mortality within 1 year. URL: http://www.clinicaltrials.gov. Unique identifier: NCT02241291. © 2016 American Heart Association, Inc.

Reexamining the Efficacy and Value of Percutaneous Coronary Intervention for Patients With Stable Ischemic Heart Disease

Science.gov (United States)

Weintraub, William S.; Boden, William E.

2017-01-01

Percutaneous coronary intervention (PCI) continues to be performed frequently for patients with stable ischemic heart disease, despite uncertain efficacy. Individual randomized trial data and meta-analyses have not demonstrated that PCI in addition to optimal medical therapy reduces the incidence of death or myocardial infarction in patients with stable disease. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) Trial did not show benefit for cardiovascular outcomes or mortality but did find a modest improvement in quality of life that did not persist at 3 years. Long-term follow-up from COURAGE (up to 15 years) found no differences in mortality, consistent with other published literature. How PCI could reduce long-term mortality or prevent myocardial infarction is not clear because sites of future plaque rupture leading to myocardial infarction are unpredictable and PCI can only treat localized anatomic segments of obstructive atherosclerosis. In addition, PCI is expensive, and the value to society of PCI for stable disease has not been demonstrated. The ISCHEMIA trial will assess the role of PCI for stable ischemic heart disease using newer technology and in patients with greater ischemic burden than in COURAGE. After nearly a decade, the COURAGE trial and other studies have given us pause to critically reexamine the role of PCI for patients with stable ischemic heart disease. Until further research can show that PCI can reduce cardiovascular events in these patients, a first-line strategy of optimal medical therapy is known to be safe, effective, and noninferior to PCI, and our practice should more closely follow this strategy. PMID:27380178

Stable isotopes and biomarkers in microbial ecology

NARCIS (Netherlands)

Boschker, H.T.S.; Middelburg, J.J.

2002-01-01

The use of biomarkers in combination with stable isotope analysis is a new approach in microbial ecology and a number of papers on a variety of subjects have appeared. We will first discuss the techniques for analysing stable isotopes in biomarkers, primarily gas chromatography-combustion-isotope

Prospective Analysis of Behavioral Economic Predictors of Stable Moderation Drinking Among Problem Drinkers Attempting Natural Recovery.

Science.gov (United States)

Tucker, Jalie A; Cheong, JeeWon; Chandler, Susan D; Lambert, Brice H; Pietrzak, Brittney; Kwok, Heather; Davies, Susan L

2016-12-01

As interventions have expanded beyond clinical treatment to include brief interventions for persons with less severe alcohol problems, predicting who can achieve stable moderation drinking has gained importance. Recent behavioral economic (BE) research on natural recovery has shown that active problem drinkers who allocate their monetary expenditures on alcohol and saving for the future over longer time horizons tend to have better subsequent recovery outcomes, including maintenance of stable moderation drinking. This study compared the predictive utility of this money-based "Alcohol-Savings Discretionary Expenditure" (ASDE) index with multiple BE analogue measures of behavioral impulsivity and self-control, which have seldom been investigated together, to predict outcomes of natural recovery attempts. Community-dwelling problem drinkers, enrolled shortly after stopping abusive drinking without treatment, were followed prospectively for up to a year (N = 175 [75.4% male], M age = 50.65 years). They completed baseline assessments of preresolution drinking practices and problems, analogue behavioral choice tasks (Delay Discounting, Melioration-Maximization, and Alcohol Purchase Tasks), and a Timeline Followback interview including expenditures on alcohol compared to voluntary savings (ASDE index) during the preresolution year. Multinomial logistic regression models showed that, among the BE measures, only the ASDE index predicted stable moderation drinking compared to stable abstinence or unstable resolutions involving relapse. As hypothesized, stable moderation was associated with more balanced preresolution allocations to drinking and savings (odds ratio = 1.77, 95% confidence interval = 1.02 to 3.08, p < 0.05), suggesting it is associated with longer-term behavior regulation processes than abstinence. The ASDE's unique predictive utility may rest on its comprehensive representation of contextual elements to support this patterning of behavioral