WorldWideScience

Sample records for clinically stable condition

  1. The brains of very preterm newborns in clinically stable condition may be hyperoxygenated

    DEFF Research Database (Denmark)

    Sorensen, Line Caroe; Greisen, Gorm

    2009-01-01

    near-infrared spectroscopy in clinical steady state on the first day of life (median age: 19.2 hours). The mean gestational ages and birth weights in the 2 groups were 29.1 +/- 2.6 weeks versus 39.7 +/- 1.3 weeks and 1307 +/- 437 g versus 3484 +/- 346 g, respectively. Three preterm infants needed......OBJECTIVE: The objective was to compare cerebral oxygenation in preterm newborns with that in healthy term newborns. METHODS: Forty-six preterm newborns with gestational ages of weeks and 25 healthy term newborns were included. The cerebral tissue oxygenation index (c-TOI) was measured by using...... mechanical ventilation and 11 received inotropic drugs. Later, 3 preterm infants developed intraventricular hemorrhage and 2 infants died. All term infants were healthy newborns recruited in the maternity ward. RESULTS: There was a significant difference in c-TOI (preterm: 78.6% [95% confidence interval: 76.9%-80...

  2. Applications of stable isotopes in clinical pharmacology

    NARCIS (Netherlands)

    Schellekens, Reinout C A; Stellaard, Frans; Woerdenbag, Herman J; Frijlink, Henderik W; Kosterink, Jos G W

    2011-01-01

    This review aims to present an overview of the application of stable isotope technology in clinical pharmacology. Three main categories of stable isotope technology can be distinguished in clinical pharmacology. Firstly, it is applied in the assessment of drug pharmacology to determine the pharmacok

  3. Applications of stable isotopes in clinical pharmacology

    NARCIS (Netherlands)

    Schellekens, Reinout C A; Stellaard, Frans; Woerdenbag, Herman J; Frijlink, Henderik W; Kosterink, Jos G W

    2011-01-01

    This review aims to present an overview of the application of stable isotope technology in clinical pharmacology. Three main categories of stable isotope technology can be distinguished in clinical pharmacology. Firstly, it is applied in the assessment of drug pharmacology to determine the

  4. Exchange Rings Satisfying the n-Stable Range Condition, I

    Institute of Scientific and Technical Information of China (English)

    Huanyin Chen; Fu-an Li

    2002-01-01

    We give some necessary and sufficient conditions on an exchange ring R, under which R satisfies the n-stable range condition. We also prove that every simple separative exchange ring with finite stable range must have stable range one.

  5. Exchange Rings Satisfying the n-Stable Range Condition, Ⅱ

    Institute of Scientific and Technical Information of China (English)

    Huanyin Chen; Fu-an Li

    2003-01-01

    This is a continuation of the paper [14]. It is shown that any finite subdirect product of exchange rings satisfying the n-stable range condition is still an exchange ring satisfying the n-stable range condition. Furthermore, we give necessary and sufficient conditions on matrices over an exchange ring R, under which R satisfies the n-stable range condition. This generalizes the corresponding results for unit-regular rings and the stable range one condition.

  6. 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. Notwiths

  7. Surveillance and recipients care in stable condition

    Institute of Scientific and Technical Information of China (English)

    John J. Curtis

    2011-01-01

    @@ For decades now, transplant physicians, during follow-up of successfully transplanted renal failure patients, have ordered frequent checks of the serum creatinine and urinalysis.1 These remain commonplace tools. Blood pressure measurement is preformed on every clinic visit along with a check of body weight and a check for edema.

  8. Highly stable superhydrophobic surfaces under flow conditions

    Science.gov (United States)

    Lee, Moonchan; Yim, Changyong; Jeon, Sangmin

    2015-01-01

    We synthesized hydrophobic anodic aluminum oxide nanostructures with pore diameters of 35, 50, 65, and 80 nm directly on quartz crystal microresonators, and the stability of the resulting superhydrophobicity was investigated under flow conditions by measuring changes in the resonance frequency and dissipation factor. When the quartz substrates were immersed in water, their hydrophobic surfaces did not wet due to the presence of an air interlayer. The air interlayer was gradually replaced by water over time, which caused decreases in the resonance frequency (i.e., increases in mass) and increases in the dissipation factor (i.e., increases in viscous damping). Although the water contact angles of the nanostructures increased with increasing pore size, the stability of their superhydrophobicity increased with decreasing pore size under both static conditions (without flow) and dynamic conditions (with flow); this increase can be attributed to an increase in the solid surface area that interacts with the air layer above the nanopores as the pore size decreases. Further, the effects of increasing the flow rate on the stability of the superhydrophobicity were quantitatively determined.

  9. Stable working conditions with decline in work disability

    NARCIS (Netherlands)

    Hooftman, W.; Houtman, I.

    2012-01-01

    The quality of work in the Netherlands remains quite stable, with a small increase in exposure to time pressure. Despite the stable working conditions, fewer workers feel that protective measures are needed. Changes in work disability regulations have led to far fewer workers dropping out of employm

  10. Biosensors engineered from conditionally stable ligand-binding domains

    Energy Technology Data Exchange (ETDEWEB)

    Church, George M.; Feng, Justin; Mandell, Daniel J.; Baker, David; Fields, Stanley; Jester, Benjamin Ward; Tinberg, Christine Elaine

    2017-09-19

    Disclosed is a biosensor engineered to conditionally respond to the presence of specific small molecules, the biosensors including conditionally stable ligand-binding domains (LBDs) which respond to the presence of specific small molecules, wherein readout of binding is provided by reporter genes or transcription factors (TFs) fused to the LBDs.

  11. Stable field emission from W tips in poor vacuum conditions

    NARCIS (Netherlands)

    Tondare, V.N.; van Druten, N.J.; Hagen, C.W.; Kruit, P.

    2003-01-01

    We report a stable field emission (FE) current from sharp tungsten (W) tips in relatively poor vacuum (up to 10-2 mbar) conditions. We use small tip-anode spacing to keep the extraction voltage low. A simple current regulator circuit, with a bandwidth of ~1.6 kHz, was designed, which controls the vo

  12. The impact of guideline compliant medical therapy on clinical outcome in patients with stable angina: findings from the Euro Heart Survey of stable angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    AIMS: The European Society of Cardiology published guidelines for the management of stable angina in 1997, with the objective of promoting an evidence-based approach to the condition. This study focuses on the impact of guideline compliant medical treatment on clinical outcome in patients with stabl

  13. Estimating Variances of Horizontal Wind Fluctuations in Stable Conditions

    Science.gov (United States)

    Luhar, Ashok K.

    2010-05-01

    Information concerning the average wind speed and the variances of lateral and longitudinal wind velocity fluctuations is required by dispersion models to characterise turbulence in the atmospheric boundary layer. When the winds are weak, the scalar average wind speed and the vector average wind speed need to be clearly distinguished and both lateral and longitudinal wind velocity fluctuations assume equal importance in dispersion calculations. We examine commonly-used methods of estimating these variances from wind-speed and wind-direction statistics measured separately, for example, by a cup anemometer and a wind vane, and evaluate the implied relationship between the scalar and vector wind speeds, using measurements taken under low-wind stable conditions. We highlight several inconsistencies inherent in the existing formulations and show that the widely-used assumption that the lateral velocity variance is equal to the longitudinal velocity variance is not necessarily true. We derive improved relations for the two variances, and although data under stable stratification are considered for comparison, our analysis is applicable more generally.

  14. Ivabradine in stable coronary artery disease without clinical heart failure

    DEFF Research Database (Denmark)

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

    2014-01-01

    BACKGROUND: An elevated heart rate is an established marker of cardiovascular risk. Previous analyses have suggested that ivabradine, a heart-rate-reducing agent, may improve outcomes in patients with stable coronary artery disease, left ventricular dysfunction, and a heart rate of 70 beats per...... 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...

  15. Gender differences in the management and clinical outcome of stable angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    BACKGROUND: We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. METHODS AND RESULTS: The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angi

  16. Stable overload conditions of high-temperature superconductors at alternating current injection

    Science.gov (United States)

    Romanovskii, V. R.

    2015-01-01

    The stability of alternating current injected into a high-temperature superconductor or into a current-carrying element on its basis is studied under weak cooling. The stability conditions of the current varying with time by a sinusoidal law are studied versus its frequency. It is shown that before unstable states set in, the peak values of the electric field intensity, current, and temperature in the superconductor are higher than the values determining a thermal electrodynamic stability boundary of the current permanently flowing through the superconductor—the so-called thermal quench current. It is found that ultimate stable alternating currents cause high stable thermal losses in superconductors; these losses being not considered in the modern theory of losses. Such stable conditions can be referred to as overload conditions. Analysis shows that there are characteristic times determining the time intervals within which alternating current is stable under overload conditions. Main thermoelectrodynamic mechanisms behind the existence of these intervals are formulated. They explain why the superconductor stable overheating and induced electric field reach high values before the injected alternating current becomes unstable. The existence of overload conditions considerably extends the application area of high-temperature superconductors.

  17. Linear stable unity-feedback system - Necessary and sufficient conditions for stability under nonlinear plant perturbations

    Science.gov (United States)

    Desoer, C. A.; Kabuli, M. G.

    1989-01-01

    The authors consider a linear (not necessarily time-invariant) stable unity-feedback system, where the plant and the compensator have normalized right-coprime factorizations. They study two cases of nonlinear plant perturbations (additive and feedback), with four subcases resulting from: (1) allowing exogenous input to Delta P or not; 2) allowing the observation of the output of Delta P or not. The plant perturbation Delta P is not required to be stable. Using the factorization approach, the authors obtain necessary and sufficient conditions for all cases in terms of two pairs of nonlinear pseudostate maps. Simple physical considerations explain the form of these necessary and sufficient conditions. Finally, the authors obtain the characterization of all perturbations Delta P for which the perturbed system remains stable.

  18. Entropy Stable Wall Boundary Conditions for the Compressible Navier-Stokes Equations

    Science.gov (United States)

    Parsani, Matteo; Carpenter, Mark H.; Nielsen, Eric J.

    2014-01-01

    Non-linear entropy stability and a summation-by-parts framework are used to derive entropy stable wall boundary conditions for the compressible Navier-Stokes equations. A semi-discrete entropy estimate for the entire domain is achieved when the new boundary conditions are coupled with an entropy stable discrete interior operator. The data at the boundary are weakly imposed using a penalty flux approach and a simultaneous-approximation-term penalty technique. Although discontinuous spectral collocation operators are used herein for the purpose of demonstrating their robustness and efficacy, the new boundary conditions are compatible with any diagonal norm summation-by-parts spatial operator, including finite element, finite volume, finite difference, discontinuous Galerkin, and flux reconstruction schemes. The proposed boundary treatment is tested for three-dimensional subsonic and supersonic flows. The numerical computations corroborate the non-linear stability (entropy stability) and accuracy of the boundary conditions.

  19. Entropy Stable Wall Boundary Conditions for the Three-Dimensional Compressible Navier-Stokes Equations

    Science.gov (United States)

    Parsani, Matteo; Carpenter, Mark H.; Nielsen, Eric J.

    2015-01-01

    Non-linear entropy stability and a summation-by-parts framework are used to derive entropy stable wall boundary conditions for the three-dimensional compressible Navier-Stokes equations. A semi-discrete entropy estimate for the entire domain is achieved when the new boundary conditions are coupled with an entropy stable discrete interior operator. The data at the boundary are weakly imposed using a penalty flux approach and a simultaneous-approximation-term penalty technique. Although discontinuous spectral collocation operators on unstructured grids are used herein for the purpose of demonstrating their robustness and efficacy, the new boundary conditions are compatible with any diagonal norm summation-by-parts spatial operator, including finite element, finite difference, finite volume, discontinuous Galerkin, and flux reconstruction/correction procedure via reconstruction schemes. The proposed boundary treatment is tested for three-dimensional subsonic and supersonic flows. The numerical computations corroborate the non-linear stability (entropy stability) and accuracy of the boundary conditions.

  20. 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 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....

  1. 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 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....

  2. Framework conditions facilitating paediatric clinical research

    Directory of Open Access Journals (Sweden)

    Alfarez Deborah

    2011-02-01

    Full Text Available Abstract The use of unlicensed and "off-label" medicines in children is widespread. Between 50-80% of the medicines currently administered to children have neither been tested nor authorized for their use in the paediatric population which represents approximately 25% of the whole European population. On 26 January 2007, entered into force the European Regulation of Paediatric Medicines. It aims at the quality of research into medicines for children but without subjecting the paediatric population to unnecessary clinical trial. This article addresses ethical and legal issues arising from the regulation and makes recommendations for the framework conditions facilitating the development of clinical research with children.

  3. Entropy stable wall boundary conditions for the compressible Navier-Stokes equations

    CERN Document Server

    Parsani, Matteo; Nielsen, Eric J

    2014-01-01

    Non-linear entropy stability and a summation-by-parts framework are used to derive entropy stable wall boundary conditions for the compressible Navier-Stokes equations. A semi-discrete entropy estimate for the entire domain is achieved when the new boundary conditions are coupled with an entropy stable discrete interior operator. The data at the boundary are weakly imposed using a penalty flux approach and a simultaneous-approximation-term penalty technique. Although discontinuous spectral collocation operators are used herein for the purpose of demonstrating their robustness and efficacy, the new boundary conditions are compatible with any diagonal norm summation-by-parts spatial operator, including finite element, finite volume, finite difference, discontinuous Galerkin, and flux reconstruction schemes. The proposed boundary treatment is tested for three-dimensional subsonic and supersonic flows. The numerical computations corroborate the non-linear stability (entropy stability) and accuracy of the boundary...

  4. Study of Solids and Gas Distribution in Spouted Bed Operated In Stable and Unstable Conditions

    Directory of Open Access Journals (Sweden)

    Alwan, G. M.,

    2014-02-01

    Full Text Available A spouted bed is a special case of fluidization. It is an effective means of contacting gas with coarse solid particles. Spouted beds should be designed and operated to overcome performance instability and improves the uniform distribution of particles. Steady-state measurements were carried out in the 0.152 m ID cylindrical spouted bed made of Plexiglas that used 60° conical shape spout-air bed. The evaluation of solid and gas holdup in the two regions of spouted bed at stable and an unstable condition was performed using optical probe. The comparison of the radial profiles at the two conditions showed that the variation was in the spout region. The annulus region had similar profiles in both the condition as it acts as a loose packed bed, moving slowly downward. Stable bed was obtained at low gas velocity of 0.74 m/s and instability of spouting was observed at high gas velocity of 1.4 m/s. The beads can fluidize homogenously at stable conditions, while pulsation of the bed was appeared at unstable spout. Different flow regimes and characteristics can be obtained with minor variations in geometry or operating conditions.

  5. A Convective-like Energy-Stable Open Boundary Condition for Simulations of Incompressible Flows

    CERN Document Server

    Dong, Suchuan

    2015-01-01

    We present a new energy-stable open boundary condition, and an associated numerical algorithm, for simulating incompressible flows with outflow/open boundaries. This open boundary condition ensures the energy stability of the system, even when strong vortices or backflows occur at the outflow boundary. Under certain situations it can be reduced to a form that can be analogized to the usual convective boundary condition. One prominent feature of this boundary condition is that it provides a control over the velocity on the outflow/open boundary. This is not available with the other energy-stable open boundary conditions from previous works. Our numerical algorithm treats the proposed open boundary condition based on a rotational velocity-correction type strategy. It gives rise to a Robin-type condition for the discrete pressure and a Robin-type condition for the discrete velocity on the outflow/open boundary, respectively at the pressure and the velocity sub-steps. We present extensive numerical experiments on...

  6. Conditional Sampling for Max-Stable Processes with a Mixed Moving Maxima Representation

    CERN Document Server

    Oesting, Marco

    2012-01-01

    This paper deals with the question of conditional sampling and prediction for the class of stationary max-stable processes which allow for a mixed moving maxima representation. We develop an exact procedure for conditional sampling using the Poisson point process structure of such processes. For explicit calculations we restrict ourselves to the one-dimensional case and use a finite number of shape functions satisfying some regularity conditions. For more general shape functions approximation techniques are presented. Our algorithm is applied to the Gaussian extreme value process and the Brown- Resnick process. Finally, we compare our computational results to other approaches.

  7. Clinical Practice Guidelines for Convulsive Condition Management

    Directory of Open Access Journals (Sweden)

    Victor Rene Navarro Machado

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Convulsive Condition Management. It has been redefined as the occurrence of two or more successive convulsions without conscience recuperation between them; or the occurrence of convulsive uninterrupted activity for more than 5 minutes, including focal crisis. This document includes a review and update of conceptual, etiological and classification aspects for diagnosis and treatment, stressing the various therapy trends. It includes assessment guidelines focused on the most important aspects to be accomplished.

  8. Remote ischemic conditioning: Current clinical perspectives.

    Science.gov (United States)

    Le Page, Sophie; Prunier, Fabrice

    2015-08-01

    Remote ischemic conditioning (RIC) constitutes a promising method in which a tissue or organ is exposed to intermittent ischemia/reperfusion periods enabling it to provide protection to a distant target organ. RIC has been tested in various clinical settings through its simple application by means of intermittent inflation of a blood pressure cuff placed on a limb, primarily evaluating its potential abilities to decrease myocardial injury biomarkers. Its use on other organs, such as the kidneys or brain, has recently been a topic of research. To date, no study has yet been powerful enough to reach a conclusion on the potential benefit of RIC on clinical outcomes. The future role of RIC in the clinical arena could be clarified by the large phase III trials currently underway targeting major outcomes as primary endpoints.

  9. Gender differences in the management and clinical outcome of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Sendon, Jose L. Lopez;

    2006-01-01

    Background- We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. Methods and Results- The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable...... angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were......, 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions- Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less...

  10. Return to work after thoracic organ transplantation in a clinically-stable population.

    Science.gov (United States)

    Petrucci, Lucia; Ricotti, Susanna; Michelini, Ilaria; Vitulo, Patrizio; Oggionni, Tiberio; Cascina, Alessandro; D'Armini, Andrea M; Goggi, Claudio; Campana, Carlo; Viganò, Mario; Dalla-Toffola, Elena; Tinelli, Carmine; Klersy, Catherine

    2007-11-01

    To evaluate the rate of return to work after transplantation and its determinants in a clinically-stable population of patients transplanted and followed-up at a single institution in Italy. 151 thoracic organ transplant recipients (72 lung, 79 heart) were examined. Patients were asked about daily activities, level of education, employment and clinical condition. A six-minute walking test was performed with measurement of dyspnoea using the Borg scale. Quality of Life was evaluated with the SF-36 and GHQ questionnaires. Before transplantation 131 patients (87%), (70 heart and 61 lung) worked. After transplantation, 51 patients (39%) went back to work and 3 more started working. We found that younger age, a better quality of life (mainly in the mental domain), having had an occupation previously (particularly as an entrepreneur/freelancer), and having been off work for less than 24 months, were independent predictors of return to work. Considering their good, objective and subjective, functional status, some patients who could have returned to work, chose not to. Identifying factors which affect return to work might help health professionals to adopt the best course of treatment and psychological support in order to fulfil this goal; however, return to work should not be considered as the only expression of a patient's real psychophysical condition.

  11. 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.

  12. On plasma edge ideal MHD stability/instability condition in Mercier stable magnetic hill configurations

    Science.gov (United States)

    Shchepetov, S. V.

    2016-11-01

    The stability of peeling modes in zero net current stellarator plasma is studied in high poloidal mode number m \\gg 1 approximation. The vacuum region solution is taken into account. Under these conditions in Mercier stable magnetic hill plasmas internal peeling modes are stable. External peeling modes can be unstable, but several limitations on them are found. It is shown that an analytically derived pressure gradient threshold is in reasonable agreement with the experimental observations and numerical calculations. The threshold decreases with increasing poloidal mode number m. It is shown, however, that higher modes may be stabilized due to finite ion Larmor radius effects. For the sake of definiteness, we have investigated peeling mode behavior in Mercier unstable plasma. It is shown that both external and internal peeling modes can be unstable in this regime. However, external and internal peeling modes in this case are definitely different.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    N. Buchmann

    2009-04-01

    Full Text Available 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.

  15. 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.

  16. 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

  17. Mechanism of diamond-to-graphite transformation at diamond-stable conditions

    Institute of Scientific and Technical Information of China (English)

    ZANG ChuangYi; CHEN XiaoZhou; HU Qiang; MA HongAn; JIAXiaoPeng

    2009-01-01

    The diamond-to-graphite transformation at diamond-stable conditions is studied by temperature gradient method (TGM) under high pressure and high temperature (HPHT), although it is unreasonable from the view of thermodynamic considerations. It is found that, at diamond-stable conditions, for example, at 5.5 GPa and 1550 K, with fine diamond grits as carbon source and NiMnCo alloy as metal solvent assisted, not only large diamond crystals, but metastable regrown graphite crystals would be grown by layer growth mechanism, and the abundance of carbon source in the higher temperature region is indispensable for the presence of metastable regrown graphite crystals. From this transformation, it is concluded that, with metal solvent assisted, although the mechanism of crystal growth could be understood by the macro-mechanism of solubility difference between diamond and graphite in metal solvents, from the point of micro-mechanism, the minimum growth units for diamond or graphite crystals should be at atomic level and unrelated to the kinds of carbon source (diamond or graphite), which could be accumulated free-selectively on the graphite with sp2Tr or diamond crystals with sp3 bond structure.

  18. Identification of an emulsifier and conditions for preparing stable nanoemulsions containing the antioxidant astaxanthin.

    Science.gov (United States)

    Kim, D-M; Hyun, S-S; Yun, P; Lee, C-H; Byun, S-Y

    2012-02-01

    In this study, oil-in-water nanoemulsions of astaxanthin were prepared by high-pressure homogenization. The influence of emulsifying conditions including emulsifier type, concentration, passing time, astaxanthin concentration and coantioxidants were optimized. The stabilities of nanoemulsions were measured using zetasizer, FF-SEM, TEM, colorimeter and particle size analyzer. The mean diameter of the dispersed particles containing astaxanthin ranged from 160 to 190 nm. The size distribution was unimodal and extended from 100 to 200 nm. The nanoemulsions prepared with glyceryl citrate/lactate/linoleate/oleate (glyceryl ester) had smaller particle size and narrower size distribution than the emulsion prepared with hydrogenated lecithin. Stable incorporation of astaxanthin in nanoemulsion was performed and checked using HPLC, FF-SEM and TEM. The nanoemulsion was not significantly affected during storage under light and thermal condition for one month indicating that the nanoemulsion had a zeta potential of less than -41 mV, indicating a stable colloid. © 2011 The Authors. ICS © 2011 Society of Cosmetic Scientists and the Société Française de Cosmétologie.

  19. A behavioral and cognitive profile of clinically stable HIV-infected children

    NARCIS (Netherlands)

    Nozyce, ML; Lee, SS; Wiznia, A; Nachman, S; Mofenson, LM; Smith, ME; Yogev, R; McIntosh, K; Stanley, K; Pelton, S

    2006-01-01

    OBJECTIVE. The purpose of this research was to characterize behavioral and cognitive profiles of clinically and immunologically stable antiretroviral-experienced HIV-infected children. METHODS. Two hundred seventy-four previously treated HIV-infected children aged 2 to 17 years were assessed for beh

  20. Clinical course of isolated stable angina due to coronary heart disease

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Voko, Zoltan; Kirwan, Bridget-Anne; de Brouwer, Sophie; Dunselman, Peter H. J. M.; Lubsen, Jacobus

    2007-01-01

    Aims To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascutarization (isolated angina). Methods and results Of 7665 patients in a trial comparing long-acting nifedipine with placebo, 2170 (28%) had isol

  1. High-pressure phase of brucite stable at Earth's mantle transition zone and lower mantle conditions

    Science.gov (United States)

    Hermann, Andreas; Mookherjee, Mainak

    2016-12-01

    We investigate the high-pressure phase diagram of the hydrous mineral brucite, Mg(OH)2, using structure search algorithms and ab initio simulations. We predict a high-pressure phase stable at pressure and temperature conditions found in cold subducting slabs in Earth’s mantle transition zone and lower mantle. This prediction implies that brucite can play a much more important role in water transport and storage in Earth’s interior than hitherto thought. The predicted high-pressure phase, stable in calculations between 20 and 35 GPa and up to 800 K, features MgO6 octahedral units arranged in the anatase–TiO2 structure. Our findings suggest that brucite will transform from a layered to a compact 3D network structure before eventual decomposition into periclase and ice. We show that the high-pressure phase has unique spectroscopic fingerprints that should allow for straightforward detection in experiments. The phase also has distinct elastic properties that might make its direct detection in the deep Earth possible with geophysical methods.

  2. Unsteady Pressure Measurements around Rotor of an Axial Flow Fan under Stable and Unstable Operating Conditions

    Science.gov (United States)

    Shin, You Hwan; Kim, Kwang Ho; Kang, Chang Sik

    This study presents some measurement results on the unsteady pressure fields around rotor under stable and unstable operating conditions of an axial flow fan. The unsteady static pressure of rotor passage was measured by using high frequency pressure transducers mounted on the casing wall. The measurements on the unsteady total pressure at rotor inlet and outlet were also conducted with specially designed high frequency total pressure probe. Double Phase-Locked Ensemble Averaging Technique was used for analysis of pressure fluctuations around the rotor at rotating stall onset point. From the results, the unsteady pressure fields during stable and unstable operations of the axial fan were investigated and compared with each other. Particularly one period of rotating stall could be divided into two regions, stalled flow and unstalled flow region respectively. Furthermore the former could be also classified into two zones, bubbled and disturbed region by their features. The flow characteristics for each zone were described in detail and the static and total pressure fields were also analyzed in terms of the pressure distribution along pressure side and suction side on the blade tip profile.

  3. Force Outputs during Squats Performed Using a Rotational Inertia Device under Stable versus Unstable Conditions with Different Loads.

    Directory of Open Access Journals (Sweden)

    Jairo Vázquez-Guerrero

    Full Text Available The purpose of the study was to compare the force outputs achieved during a squat exercise using a rotational inertia device in stable versus unstable conditions with different loads and in concentric and eccentric phases. Thirteen male athletes (mean ± SD: age 23.7 ± 3.0 years, height 1.80 ± 0.08 m, body mass 77.4 ± 7.9 kg were assessed while squatting, performing one set of three repetitions with four different loads under stable and unstable conditions at maximum concentric effort. Overall, there were no significant differences between the stable and unstable conditions at each of the loads for any of the dependent variables. Mean force showed significant differences between some of the loads in stable and unstable conditions (P < 0.010 and peak force output differed between all loads for each condition (P < 0.045. Mean force outputs were greater in the concentric than in the eccentric phase under both conditions and with all loads (P < 0.001. There were no significant differences in peak force between concentric and eccentric phases at any load in either stable or unstable conditions. In conclusion, squatting with a rotational inertia device allowed the generation of similar force outputs under stable and unstable conditions at each of the four loads. The study also provides empirical evidence of the different force outputs achieved by adjusting load conditions on the rotational inertia device when performing squats, especially in the case of peak force. Concentric force outputs were significantly higher than eccentric outputs, except for peak force under both conditions. These findings support the use of the rotational inertia device to train the squatting exercise under unstable conditions for strength and conditioning trainers. The device could also be included in injury prevention programs for muscle lesions and ankle and knee joint injuries.

  4. 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.

  5. 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

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

    Directory of Open Access Journals (Sweden)

    A. Lindroth

    2009-08-01

    Full Text Available 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

  7. 42 CFR 493.1225 - Condition: Clinical cytogenetics.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Clinical cytogenetics. 493.1225 Section... Testing § 493.1225 Condition: Clinical cytogenetics. If the laboratory provides services in the specialty of Clinical cytogenetics, the laboratory must meet the requirements specified in §§ 493.1230...

  8. Systemic signs of neutrophil mobilization during clinically stable periods and during exacerbations in smokers with obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Andelid K

    2015-06-01

    concentrations were associated with growth of bacteria in sputum. Among patients with low transcutaneous oxygen saturation during exacerbations, PaO2 (partial oxygen pressure correlated with concentrations of MPO and NE protein and neutrophils in a negative manner.Conclusion: There are signs of systemic neutrophil mobilization during clinically stable periods and even more so during exacerbations in chronic obstructive pulmonary disease. In this condition, MPO and NE may share a cellular origin, but its location remains uncertain. Factors other than local bacteria, including hypoxemia, may be important for driving systemic signs of neutrophil mobilization.Keywords: C-reactive protein, COPD, elastase, infection, myeloperoxidase, oxygen

  9. Detection and manipulation of live antigen-expressing cells using conditionally stable nanobodies

    Science.gov (United States)

    Tang, Jonathan CY; Drokhlyansky, Eugene; Etemad, Behzad; Rudolph, Stephanie; Guo, Binggege; Wang, Sui; Ellis, Emily G; Li, Jonathan Z; Cepko, Constance L

    2016-01-01

    The ability to detect and/or manipulate specific cell populations based upon the presence of intracellular protein epitopes would enable many types of studies and applications. Protein binders such as nanobodies (Nbs) can target untagged proteins (antigens) in the intracellular environment. However, genetically expressed protein binders are stable regardless of antigen expression, complicating their use for applications that require cell-specificity. Here, we created a conditional system in which the stability of an Nb depends upon an antigen of interest. We identified Nb framework mutations that can be used to rapidly create destabilized Nbs. Fusion of destabilized Nbs to various proteins enabled applications in living cells, such as optogenetic control of neural activity in specific cell types in the mouse brain, and detection of HIV-infected human cells by flow cytometry. These approaches are generalizable to other protein binders, and enable the rapid generation of single-polypeptide sensors and effectors active in cells expressing specific intracellular epitopes. DOI: http://dx.doi.org/10.7554/eLife.15312.001 PMID:27205882

  10. 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.

  11. 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

  12. Stable feature selection for clinical prediction: exploiting ICD tree structure using Tree-Lasso.

    Science.gov (United States)

    Kamkar, Iman; Gupta, Sunil Kumar; Phung, Dinh; Venkatesh, Svetha

    2015-02-01

    Modern healthcare is getting reshaped by growing Electronic Medical Records (EMR). Recently, these records have been shown of great value towards building clinical prediction models. In EMR data, patients' diseases and hospital interventions are captured through a set of diagnoses and procedures codes. These codes are usually represented in a tree form (e.g. ICD-10 tree) and the codes within a tree branch may be highly correlated. These codes can be used as features to build a prediction model and an appropriate feature selection can inform a clinician about important risk factors for a disease. Traditional feature selection methods (e.g. Information Gain, T-test, etc.) consider each variable independently and usually end up having a long feature list. Recently, Lasso and related l1-penalty based feature selection methods have become popular due to their joint feature selection property. However, Lasso is known to have problems of selecting one feature of many correlated features randomly. This hinders the clinicians to arrive at a stable feature set, which is crucial for clinical decision making process. In this paper, we solve this problem by using a recently proposed Tree-Lasso model. Since, the stability behavior of Tree-Lasso is not well understood, we study the stability behavior of Tree-Lasso and compare it with other feature selection methods. Using a synthetic and two real-world datasets (Cancer and Acute Myocardial Infarction), we show that Tree-Lasso based feature selection is significantly more stable than Lasso and comparable to other methods e.g. Information Gain, ReliefF and T-test. We further show that, using different types of classifiers such as logistic regression, naive Bayes, support vector machines, decision trees and Random Forest, the classification performance of Tree-Lasso is comparable to Lasso and better than other methods. Our result has implications in identifying stable risk factors for many healthcare problems and therefore can

  13. Electroencephalographic sleep in clinically stable schizophrenic patients: two-weeks versus six-weeks neuroleptic-free.

    Science.gov (United States)

    Nofzinger, E A; van Kammen, D P; Gilbertson, M W; Gurklis, J A; Peters, J L

    EEG sleep studies in schizophrenic patients are influenced by alterations in clinical state and medication status. The current study defines longitudinal alterations in electroencephalographic (EEG) sleep for 10 healthy men who were schizophrenic patients who remained relatively clinically stable during a double-blind neuroleptic withdrawal study. Clinical assessments and EEG sleep studies were performed at baseline on haloperidol, and then at 2-week and 6-week drug-free periods. Sleep continuity and rapid eye movement (REM) sleep measures declined not only between the haloperidol baseline and 2-week drug-free conditions, but continued to decline from 2-week to 6-weeks neuroleptic-free. Alterations in EEG sleep from the 2-week to 6-week haloperidol-free assessments did not correlate with changes in clinical symptoms suggesting effects related to drug-withdrawal or subclinical state changes. These results show that despite relative clinical stability over time, the EEG sleep of schizophrenic patients continues to change following withdrawal of a neuroleptic and is dependent on the duration of the drug-free interval.

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

    DEFF Research Database (Denmark)

    Al-shair, Khaled; Kolsum, Umme; Dockry, Rachel

    2011-01-01

    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 clini...... and clinically stable COPD using a range of inflammatory biomarkers, 2 depression and 2 fatigue scales.......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...

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

    Science.gov (United States)

    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.

  16. Heat stable antimicrobial activity of Burkholderia gladioli OR1 against clinical drug resistant isolates

    Science.gov (United States)

    Bharti, Pratibha; Anand, Vivek; Chander, Jagdish; Singh, Inder Pal; Singh, Tej Vir; Tewari, Rupinder

    2012-01-01

    Background & objectives: Drug resistant microbes are a serious challenge to human health. During the search for novel antibiotics/inhibitors from the agricultural soil, a bacterial colony was found to inhibit the growth of clinical isolates including Staphylococcus (resistant to amikacin, ciprofloxacin, clindamycin, clinafloxacin, erythromycin, gentamicin and methicillin) and Candida (resistant to fluconazole and itraconazole). The culture was identified as Burkholderia gladioli and produced at least five different antimicrobial compounds which were highly stable at high temperature (121°C) and in the broad pH range (3.0-11.0). We report here the antimicrobial activity of B. gladioli against drug resistant bacterial pathogens. Methods: The bacterial culture was identified using morphological, biochemical and 16S rRNA gene sequencing techniques. The antimicrobial activity of the identified organism against a range of microbial pathogens was checked by Kirby-Bauer's disc diffusion method. The antimicrobial compounds in the cell free supernatant were chloroform-extracted and separated by thin layer chromatography (TLC). Results: B. gladioli OR1 exhibited broad spectrum antimicrobial activity against drug resistant clinical isolates belonging to various genera of bacteria (Staphylococcus, Enterobacter, Enterococcus, Acinetobacter and Citrobacter) and a fungus (Candida). Based on TLC profile and bioautography studies, the chloroform extract of B. gladioli OR1 consisted of at least three anti-staphylococcal and two anti-Candida metabolites. The antimicrobial activity was heat stable (121°C/20 min) as well as pH stable (3.0-11.0). Interpretation & conclusions: The bacterial soil isolate, B. gladioli OR1 possessed the ability to kill various drug resistant bacteria and a fungus. This organism produced many antimicrobial metabolites which might have the potential to be used as antibiotics in future. PMID:22771597

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Long-term clinical variation of NT-proBNP in stable chronic heart failure patients

    DEFF Research Database (Denmark)

    Schou, Morten; Gustafsson, Finn; Kjaer, Andreas;

    2007-01-01

    AIMS: Here, the aim is to assess long-term clinical variation (CV) of N-terminal pro-brain natriuretic peptide (NT-proBNP) in stable chronic heart failure (CHF) patients. The proposed use of NT-proBNP for monitoring of CHF patients will require accurate information about long-term CV of the peptide...... months after the second follow-up were included. A total of 78 patients fulfilled the criteria, and year-to-year CV was calculated to 30% (median) (range: 0-111%) (% changes range: -87 to 397%). Log transformation of NT-proBNP (skewed to the right) reduced the year-to-year CV to 4.7% (range: 0......-22%) (% changes range: -18 to 38%). CONCLUSION: Long-term CV of plasma concentrations of NT-proBNP in stable CHF patients is 30%, but the variation is substantial. Therefore, high long-term CV of NT-proBNP does not necessarily carry prognostic significance within the subsequent 12 months. Plasma concentrations...

  19. 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.

  20. 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.

  1. Turbulent dispersion of pollutants in urban-type canopies under stable stratification conditions

    Science.gov (United States)

    Shen, Zhi; Cui, Guixiang; Zhang, Zhaoshun

    2017-05-01

    Large eddy simulation is performed for the dispersion of a passive scalar in the turbulent boundary layer over an urban-like roughness surface under neutral and stable stratification. Square arrays of cubical obstacles are used to model the urban canopy with a ground level point source located in front of the obstacle. We design cases for varying building intervals to investigate the relationship between flow patterns and dispersion processes for different plan area densities λp . It has been found (Shen et al. 2015) that flow patterns in a three-dimensional urban canopy can be classified into five basic regimes in neutral stratification: isolated roughness, external wake interference, internal wake interference, skimming flow and streets network. This classification still holds in the presence of moderately stable stratification. In area with large λp , the material released from the point source tends to be trapped by the leeward recirculation and is well-mixed inside the canopy. The mean concentration level within roughness canopies is high due to the reduced advection velocity. In area with small λp , the great part of the material is entrained into the horseshoe vortex wrapping around the obstacle and carried downwind. The material is concentrated in the lower region of the canopy with a relatively higher temporal fluctuation. In the presence of stable stratification, the spread of the plume is reduced and the temporal fluctuation is suppressed as well. For area of large λp , the advective part of the scalar flux is responsible for carrying the material at ground level aloft into the urban canopy layer.

  2. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Immediate and long-term clinical outcome after spinal cord stimulation for refractory stable angina pectoris.

    Science.gov (United States)

    Di Pede, Francesco; Lanza, Gaetano Antonio; Zuin, Guerrino; Alfieri, Ottavio; Rapati, Massimo; Romanò, Massimo; Circo, Antonio; Cardano, Paola; Bellocci, Fulvio; Santini, Massimo; Maseri, Attilio

    2003-04-15

    The treatment of patients with angina pectoris refractory to medical therapy and unsuitable for revascularization procedures has yet not been well standardized. Previous retrospective studies and small prospective studies have suggested beneficial effects of spinal cord stimulation (SCS) in these patients. We created a Prospective Italian Registry of SCS to evaluate the short- and long-term clinical outcome of patients who underwent SCS device implantation because of severe refractory angina pectoris. Overall, 104 patients were enrolled in the registry (70 men, aged 68 +/- 17 years), most of whom (83%) had severe coronary artery disease. Average follow-up was 13.2 +/- 8 months. Overall, 17 patients (16%) died, 8 (8%) due to cardiac death. Among clinical variables, only age was found to be significantly associated both with total mortality (p = 0.04) and cardiac mortality (p = 0.02) on Cox regression analysis. A significant improvement of anginal symptoms (> or =50% reduction of weekly anginal episodes, compared with baseline) occurred in 73% of patients, and Canadian Cardiovascular Society angina class improved by > or =1 class in 80% and by > or =2 classes in 42% of patients, with a relevant reduction in the rate of hospital admission and days spent in the hospital because of angina (p <0.0001 for both). No life-threatening or clinically serious complications were observed. The most frequent side effect consisted of superficial infections, either at the site of puncture of electrode insertion or of the abdominal pocket, which occurred in 6 patients. In conclusion, our prospective data point out that SCS can be performed safely and is associated with a sustained improvement of anginal symptoms in a relevant number of patients with refractory stable angina pectoris.

  5. Stable isotope records of inland California megafauna - new insights into Pleistocene paleoecology and paleoenvironmental conditions

    Science.gov (United States)

    Trayler, R. B.; Dundas, R. G.; Van De Water, P. K.; Fox-Dobbs, K.

    2012-12-01

    Paleodietary studies of California megafauna have focused primarily on the coastal late Pleistocene Rancho La Brea tar seeps (RLB) in Los Angeles, while other sites remain understudied. We examined two Pleistocene fossil localities from inland California (San Joaquin Valley) and report δ13C and δ18O values measured from tooth enamel of mammalian megafauna at both sites. The late Pleistocene McKittrick tar seeps in Kern County has a similar fauna to RLB. The middle Irvingtonian (~700,000 year old) Fairmead Landfill site, near Chowchilla, contains a megafaunal assemblage dominated by Equus, Camelops and Mammuthus. We used stable isotope values measured in carnivore and herbivore tooth enamel to investigate paleodietary and paleoecological patterns at both sites. δ13C values of tooth enamel is controlled by diet and can be used to investigate resource usage and partitioning among and between taxa. In large mammals δ18O ratios are controlled by drinking water, and by proxy, climate. Ontogenetic serial tooth δ18O and δ13C reveal seasonal trends in resource usage, from which we can infer patterns of forage availability. We sampled 85 individuals from 16 taxa; Arctodus, Bison, Camelops, Canis, Capromeryx, Cervus, Equus, Hemiauchenia, Homotherium, Mammut, Mammuthus, Miracinonyx, Panthera, Platygonus, Smilodon and Tetrameryx. Faunal δ13C differ significantly (pdiets trending towards forested habitats, while canids exhibit generalist diets. We serially sampled multiple teeth from both sites to investigate seasonality and temporal resource usage among megafauna. Equus from both localities showed little variation in δ13C, while at McKittrick Camelops diet included variable amounts of C4 resources throughout a seasonal cycle. We also report the first ever serial sampled Tetrameryx tooth; δ13C variation throughout the tooth is low suggesting a stable diet. Comparing similarly aged inland McKittrick and coastal RLB faunas reveal significant differences (p<0.001). Bison

  6. How Stable are Temperaments in the Clinical Setting: A Pilot Study

    Science.gov (United States)

    Karam, Elie G.; El Khoury, Elaine; Itani, Lynn

    2016-01-01

    Background An essential point in evaluating the utility of measuring temperaments is the stability of the instrument used especially in the presence of mental disorders. One of the most commonly used instruments in the clinical setting is the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A). To our knowledge, the TEMPS-A’s stability in an outpatient adult clinical setting has not been evaluated. Objective: To assess the stability of the effect of temperament, time and clinical intervention. Methods: A sample of 89 adult outpatients was assessed at baseline and follow-up on their TEMPS-A scores. Diagnoses of mental disorders were reached through clinical interviews, and the severity of the conditions was clinically assessed at baseline and follow-up on a Likert scale. Changes in scores were examined in terms of z-scores, and possible predictors of the change in scores were assessed. Results: Eighty-nine percent of all subjects’ temperaments scores did not change or changed less than one z-score, and specifically: 84.2% in the case of depressive, 89.9% for cyclothymic, 92.1% for hyperthymic, 92.2% for irritable, and 86.5% for anxious temperaments. For all of the five temperaments, age, gender, time difference between baseline and follow up, number of diagnoses, and percent improvement were not significantly associated with the change in temperament scores. Limitations: Well-established severity measures would add to the validity of any future findings. Conclusion: Shifts in temperament scores between baseline and follow-up were minor, thus proving the stability of temperaments and the TEMPS-A scale in a clinical setting. PMID:27733865

  7. 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...

  8. Quality of care at retail clinics for 3 common conditions.

    Science.gov (United States)

    Shrank, William H; Krumme, Alexis A; Tong, Angela Y; Spettell, Claire M; Matlin, Olga S; Sussman, Andrew; Brennan, Troyen A; Choudhry, Niteesh K

    2014-10-01

    Evaluation of quality of care across retail clinics in a geographically diverse population has not been undertaken to date. We sought to evaluate and compare the quality of care for otitis media, pharyngitis, and urinary tract infection received in retail medical clinics in CVS pharmacies ("MinuteClinics" [MCs]), ambulatory care facilities (ACFs), and emergency departments (EDs). We used 14 measures constructed from RAND Corporation's Quality Assurance Tools and guidelines from the American Academy of Pediatrics, the American Academy of Family Physicians, and the Infectious Diseases Society of America. Our cohort was drawn from Aetna medical and prescription claims, 2009-2012. Members were matched on visit date, condition, and propensity score. Generalized estimating equations were used to compare quality across clinic type, overall, and by index condition. We matched 75,886 episodes of care, of which 20,153 were eligible for at least 1 quality measure. MCs performed better than EDs and ACFs in 7 measures. In a multivariable model, MCs performed better than ACFs and EDs across all quality measures ([OR 0.42; 95% CI, 0.40-0.45; P < .0001; ACF vs MC] [OR 0.29; 95% CI, 0.27-0.31; P < .0001; ED vs MC]). Results for each condition were significant at P < .0001. Quality of care for these conditions based on widely accepted objective measures was superior in MinuteClinics compared with ACFs and EDs.

  9. Parameterization of gaseous dry deposition in atmospheric chemistry models: Sensitivity to aerodynamic resistance formulations under statically stable conditions

    Science.gov (United States)

    Toyota, Kenjiro; Dastoor, Ashu P.; Ryzhkov, Andrei

    2016-12-01

    Turbulence controls the vertical transfer of momentum, heat and trace constituents in the atmospheric boundary layer. In the lowest 10% of this layer lies the surface boundary layer (SBL) where the vertical fluxes of transferred quantities have been successfully parameterized using the Monin-Obukhov similarity theory in weather forecast, climate and atmospheric chemistry models. However, there is a large degree of empiricism in the stability-correction parameterizations used to formulate eddy diffusivity and aerodynamic resistance particularly under strongly stable ambient conditions. Although the influence of uncertainties in stability-correction parameterizations on eddy diffusivity is actively studied in boundary-layer meteorological modeling, its impact on dry deposition in atmospheric chemistry modeling is not well characterized. In this study, we address this gap by providing the mathematical basis for the relationship between the formulations of vertical surface flux used in meteorological and atmospheric chemistry modeling communities, and by examining the sensitivity of the modeled dry deposition velocities in statically stable SBL to the choice of stability-correction parameterizations used in three operational and/or research environmental models (GEM/GEM-MACH, ECMWF IFS and CMAQ-MM5). Aerodynamic resistances (ra) calculated by the three sets of parameterizations are notably different from each other and are also different from those calculated by a "z-less" scaling formulation under strongly stable conditions (the bulk Richardson number > 0.2). Furthermore, we show that many atmospheric chemistry models calculate ra using formulations which are inconsistent with the derivation of micro-meteorological parameters. Finally, practical implications of the differences in stability-correction algorithms are discussed for the computations of dry deposition velocities of SO2, O3 and reactive bromine compounds for specific cases of stable SBL.

  10. Immunological evaluation of the new stable ultrasound contrast agent LK565: a phase one clinical trial

    Directory of Open Access Journals (Sweden)

    Wild P

    2004-09-01

    Full Text Available Abstract Background Ultrasound contrast agents (UCAs allow the enhancement of vascular definition, thereby providing more diagnostic information. LK565 is a new second-generation UCA based on synthetic polymers of aspartic acid which is eliminated from the blood stream via phagocytosis. LK565 forms very stable air-filled microspheres and is capable of repeated passage through the pulmonary capillary bed after peripheral intravenous injection. This characteristic allows examination of the cardiac function or extracardiac vessel abnormalities up to 15 minutes. Methods A phase one clinical study was conducted on 15 healthy volunteers to identify the development of an undesirable immune response. Phagocytosis capacity, TNF-α secretion, and MHC class II upregulation of monocytes was monitored, as well as microsphere specific antibody development (IgM, IgG. Furthermore, the kinetics of the activation surface markers CD69, CD25, CD71, and CD11b on leukocytes were analyzed. Results Due to LK565-metabolism the administration of the UCA led to saturation of phagocytes which was reversible after 24 hrs. Compared to positive controls neither significant TNF-α elevation, neither MHC class II and activation surface markers upregulation, nor specific antibody development was detectable. Conclusion The administration of LK565 provides a comfortable duration of signal enhancement, esp. in echocardiography, without causing a major activation cascade or triggering an adaptive immune response. To minimize the risk of undesirable adverse events such as anaphylactoid reactions, immunological studies should be included in clinical trials for new UCAs. The use of LK565 as another new ultrasound contrast agent should be encouraged as a safe means to provide additional diagnostic information.

  11. 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.

  12. 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.

  13. A Low-Frequency and Refinement Stable Impedance Boundary Condition EFIE

    CERN Document Server

    Dely, Alexandre; Cools, Kristof

    2016-01-01

    In this contribution, a discretisation of the IBC EFIE is introduced that (i) yields the correct solution at arbitrarily small frequencies, (ii) requires for its solution a number of matrix vector products bounded as the frequency tends to zero and as the mesh density increases. The low frequency stabilisation is based on a projector-based discrete Helmholtz splitting, rescaling, and recombination that depends on the low frequency behaviour of both the EFIE operator and the surface impedance condition. The dense mesh stabilisation is a modifcation of the Perfect Electric Conductor operator preconditioning approach taking into account the effect on the singular value spectrum of the IBC term.

  14. Clinical Practice Guidelines for Transfusion of Patients in Critical Condition.

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Transfusion of Patients in Critical Condition. We stress transfusion criteria (blood cells, platelets, granulocyte concentrations, plasma and cryoprecipitate, doses, diagnosis and treatment of post-transfusion reactions. It includes assessment guidelines focused on the most important aspects to be accomplished.

  15. A Comparison of Management Conditions in Japan's Dental Clinics and Medical Clinics

    Directory of Open Access Journals (Sweden)

    Koichi Kawabuchi

    2015-08-01

    Full Text Available In recent years, national medical expenditures have continued to increase in Japan, and have now reached 39 trillion yen. In contrast, dental clinic expenditures have been slow to grow over the past few years, totaling 2.7132 trillion yen. At the same time, the number of dentists continues to increase, with a total of 102,551 dentists in 2012, surpassing the 100,544 physicians at medical clinics. Objective: Given this, we compared management conditions at dental clinics and medical clinics over time to determine whether management conditions of dental clinics are really as harsh as often claimed. Methods: we used the relevant data provided in the Central Social Insurance Medical Council's Survey on Economic Conditions in Health Care for statistics, which depicts management conditions at clinics, and analyzed the causes. Results: Annual fluctuations in the revenue/expense gap (revenue less expense show that the gap for dentists far undercut that for physicians at medical clinics. The main reason for this decline in revenue is that the number of dental patients declined more that the unit price rose compared to the medical clinic. Conclusion: We determined that management conditions are harsh for dental clinics.DOI: 10.14693/jdi.v22i2.507

  16. 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.

  17. Sexual dysfunction in clinically stable patients with bipolar disorder receiving lithium.

    Science.gov (United States)

    Grover, Sandeep; Ghosh, Abhishek; Sarkar, Siddharth; Chakrabarti, Subho; Avasthi, Ajit

    2014-08-01

    There is limited data on the prevalence of sexual dysfunction in patients with bipolar disorder receiving lithium. This study aimed to evaluate the prevalence of sexual dysfunction in patients with bipolar disorder receiving lithium and to study the correlates of sexual dysfunction. One hundred clinically stable patients with bipolar disorder (Global Assessment for Functioning score of >70, Hamilton Depression Rating Scale score of ≤7 and Young Mania Rating Scale score of ≤7, and no change in medications at least in the last 3 months) receiving lithium were evaluated on Arizona Sexual Experience Scale and Brief Adherence Rating Scale. The mean age of study sample was 44.3 years. The mean Hamilton Depression Rating Scale score was 1.06 (SD, 1.7) and the mean Young Mania Rating Scale score was 0.1 (SD, 0.5) and the mean Global Assessment for Functioning scale score was 84 (SD, 6.0). The mean duration of lithium use was approximately 119.62 (SD, 99.6) months, and the mean dose of lithium was 799.5 (SD, 251.4) mg/d. Of the 100 patients, approximately one third of the patients (n = 37) were found to have sexual dysfunction as per Arizona Sexual Experience Scale. Compared with those without sexual dysfunction, those with sexual dysfunction were older (t value = 3; P = 0.003). Those with sexual dysfunction had lower level of functioning (Global level of functioning score of 81.7 vs 85.5; t value = 3.2; P = 0.002), higher number of other adverse effects with lithium (total number of other adverse effects, 2.9 vs 1.4; t value = 4.2; P lithium experience sexual dysfunction, and it is associated with poor medication adherence.

  18. A stable lipase from Candida lipolytica: cultivation conditions and crude enzyme characteristics.

    Science.gov (United States)

    Pereira-Meirelles, F V; Rocha-Leão, M H; Sant Anna, G L

    1997-01-01

    Although lipases have been intensively studied, some aspects of enzyme production like substrate uptake, catabolite repression, and enzyme stability under long storage periods are seldom discussed in the literature. This work deals with the production of lipase by a new selected strain of Candida lipolytica. Concerning nutrition, it was observed that inorganic nitrogen sources were not as effective as peptone, and that oleic acid or triacylglycerides (TAG) were essential carbon sources. Repression by glucose and stimulation by oleic acid and long chain TAG (triolein and olive oil) were observed. Extracellular lipase activity was only observed at high levels at late stationary phase, whereas intracellular lipase levels were constant and almost undetectable during the cultivation period, suggesting that the produced enzyme was attached to the cell wall, mainly at the beginning of cultivation. The crude lipase produced by this yeast strain shows the following optima conditions: pH 8.0-10.0, temperature of 55 degrees C. Moreover, this preparation maintains its full activity for at least 370 d at 5 degrees C.

  19. A Simple Method for the Size Controlled Synthesis of Stable Oligomeric Clusters of Gold Nanoparticles under Ambient Conditions.

    Science.gov (United States)

    Lawrence, Marlon; Testen, Anze; Koklic, Tilen; Smithies, Oliver

    2016-02-05

    Reducing dilute aqueous HAuCl4 with sodium thiocyanate (NaSCN) under alkaline conditions produces 2 to 3 nm diameter nanoparticles. Stable grape-like oligomeric clusters of these yellow nanoparticles of narrow size distribution are synthesized under ambient conditions via two methods. The delay-time method controls the number of subunits in the oligoclusters by varying the time between the addition of HAuCl₄ to alkaline solution and the subsequent addition of reducing agent, NaSCN. The yellow oligoclusters produced range in size from ~3 to ~25 nm. This size range can be further extended by an add-on method utilizing hydroxylated gold chloride (Na(+)[Au(OH₄-x)Clx](-)) to auto-catalytically increase the number of subunits in the as-synthesized oligocluster nanoparticles, providing a total range of 3 nm to 70 nm. The crude oligocluster preparations display narrow size distributions and do not require further fractionation for most purposes. The oligoclusters formed can be concentrated >300 fold without aggregation and the crude reaction mixtures remain stable for weeks without further processing. Because these oligomeric clusters can be concentrated before derivatization they allow expensive derivatizing agents to be used economically. In addition, we present two models by which predictions of particle size can be made with great accuracy.

  20. Plastic and stable electrophysiological properties of adult avian forebrain song-control neurons across changing breeding conditions.

    Science.gov (United States)

    Meitzen, John; Weaver, Adam L; Brenowitz, Eliot A; Perkel, David J

    2009-05-20

    Steroid sex hormones drive changes in the nervous system and behavior in many animal taxa, but integrating the former with the latter remains challenging. One useful model system for meeting this challenge is seasonally breeding songbirds. In these species, plasma testosterone levels rise and fall across the seasons, altering song behavior and causing dramatic growth and regression of the song-control system, a discrete set of nuclei that control song behavior. Whereas the cellular mechanisms underlying changes in nucleus volume have been studied as a model for neural growth and degeneration, it is unknown whether these changes in neural structure are accompanied by changes in electrophysiological properties other than spontaneous firing rate. Here we test the hypothesis that passive and active neuronal properties in the forebrain song-control nuclei HVC and RA change across breeding conditions. We exposed adult male Gambel's white-crowned sparrows to either short-day photoperiod or long-day photoperiod and systemic testosterone to simulate nonbreeding and breeding conditions, respectively. We made whole-cell recordings from RA and HVC neurons in acute brain slices. We found that RA projection neuron membrane time constant, capacitance, and evoked and spontaneous firing rates were all increased in the breeding condition; the measured electrophysiological properties of HVC interneurons and projection neurons were stable across breeding conditions. This combination of plastic and stable intrinsic properties could directly impact the song-control system's motor control across seasons, underlying changes in song stereotypy. These results provide a valuable framework for integrating how steroid hormones modulate cellular physiology to change behavior.

  1. Clinical conditions and memory complaints in outpatient elderly

    Directory of Open Access Journals (Sweden)

    Regina Miksian Magaldi

    Full Text Available Abstract Memory complaints are common in elderly, and may be associated with many clinical problems. Objective: To identify clinical conditions and possible factors related to memory complaints in elderly outpatients presenting at a tertiary unit. Methods: Patients with memory complaints and normal cognitive screening tests were submitted to clinical and laboratorial testing. Radiological evaluation was performed as needed for diagnosis. Results: One hundred and seventy-seven subjects were initially evaluated, 12 were excluded because of poor and inconsistent memory complaints. Of the remainder, seventeen had criteria for dementia diagnosis. Ninety-two (55.4% had one or more comorbid conditions possibly related to their complaints. Major depression was present in 26.0%. Sixteen patients (9.6% had vitamin B12 deficiency, 8 were in use of inappropriate medications, and 7 (4.2% had hypothyroidism. Other conditions diagnosed were: generalized anxiety disorder, obstructive sleep apnea syndrome, hyperparathyroidism, normal pressure hydrocephalus. Three patients had severe hearing loss (in 22 with hearing complaints; one had severe visual impairment (in 22 with visual complaints. Conclusions: Comprehensive evaluation was able to identify treatable conditions possibly related to memory complaints.

  2. Characteristics of stable chronic obstructive pulmonary disease patients in the pulmonology clinics of seven Asian cities

    Directory of Open Access Journals (Sweden)

    Oh YM

    2013-01-01

    Full Text Available Yeon-Mok Oh,1 Arvind B Bhome,2 Watchara Boonsawat,3 Kirthi Dias Gunasekera,4 Dushantha Madegedara,5 Luisito Idolor,6 Camilo Roa,6 Woo Jin Kim,7 Han-Pin Kuo,8 Chun-Hua Wang,8 Le Thi Tuyet Lan,9 Li-Cher Loh,10 Choo-Khoon Ong,10 Alan Ng,11 Masaharu Nishimura,12 Hironi Makita,12 Edwin K Silverman,13 Jae Seung Lee,1 Ting Yang,14 Yingxiang Lin,14 Chen Wang,14 Sang-Do Lee1  1Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea; 2Department of Pulmonary and Critical Care, "Friends of the Breathless" Foundation, Pune, India; 3Department of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Central Chest Clinic, Colombo and National Hospital of Sri Lanka; 5Respiratory Disease Treatment Unit and Teaching Hospital Kandy, Sri Lanka; 6Section of Respiratory Services and Physical Therapy and Rehabilitation Lung Center of the Philippines, Quezon City, Philippines; 7Department of Internal Medicine, Kangwon National University, Kang Won, Korea; 8Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan; 9Respiratory Care Center, University Medical Center Ho Chi Minh City, Vietnam; 10Department of Medicine, Penang Medical College, Penang, Malaysia; 11Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore; 12Division of Respiratory Medicine, Department of Internal Medicine, Hokkaido University Hospital, Sapporo, Japan; 13Channing Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; 14Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, ChinaAll authors made an equal contribution to this studyBackground and objectives: Chronic obstructive pulmonary disease (COPD is responsible for significant morbidity and mortality worldwide. We evaluated the characteristics of stable COPD patients in

  3. A stable high-order finite difference scheme for the compressible Navier Stokes equations: No-slip wall boundary conditions

    Science.gov (United States)

    Svärd, Magnus; Nordström, Jan

    2008-05-01

    A stable wall boundary procedure is derived for the discretized compressible Navier-Stokes equations. The procedure leads to an energy estimate for the linearized equations. We discretize the equations using high-order accurate finite difference summation-by-parts (SBP) operators. The boundary conditions are imposed weakly with penalty terms. We prove linear stability for the scheme including the wall boundary conditions. The penalty imposition of the boundary conditions is tested for the flow around a circular cylinder at Ma=0.1 and Re=100. We demonstrate the robustness of the SBP-SAT technique by imposing incompatible initial data and show the behavior of the boundary condition implementation. Using the errors at the wall we show that higher convergence rates are obtained for the high-order schemes. We compute the vortex shedding from a circular cylinder and obtain good agreement with previously published (computational and experimental) results for lift, drag and the Strouhal number. We use our results to compare the computational time for a given for a accuracy and show the superior efficiency of the 5th-order scheme.

  4. Stable isotope signatures and element stoichiometry of Fucus vesiculosus as indicators for environmental conditions in the Kiel Bight, Baltic Sea

    Science.gov (United States)

    Winde, Vera; Mahler, Annika; Voss, Maren; Böttcher, Michael E.

    2014-05-01

    In the frame of the BMBF project BIOACID II we aim for an understanding of the natural distribution and variation of isotopic composition and C-N-S stoichiometry in Fucus vesiculosus growing around the coast line of the Kiel fjord (part of the Kiel bight). Environmental conditions (aquatic chemistry, temperature, salinity) were monitored, too. Some changes in aquatic chemistry are related to stress factors like human activity (e.g., waste input) and further factors leading to specific changes in the composition of Fucus vesiculosus. Sampling was carried out at different stations at the west and east coast of the Kiel Fjord. For each sampling station the aquatic chemistry (TA, pH, salinity, d13C(DIC), main and trace elements and nutrients) as well as the composition of the Fucus organic tissues (stoichiometry and stable isotope composition of carbon, nitrogen) are analysed. The Fucus tissue was sampled in three size classes (small, medium, large). It is shown, that Fucus vesiculosus indicates clear differences in the N contents and stable isotopes between the west and the east site of the Kiel Fjord. Stable nitrogen isotope signatures in Fucus vesiculosus, are useful proxies to identify the influence factors in the Fucus habitat. From the data it is obtained that the influence of human activity (wastewater treatment plant, harbour), small stream and drainage channels, which flow from the near coastal area into the bight, leads to different Fucus vesiculosus compositions. In future work, it is intended to extend the investigation to trace element signatures to further estimate environmental impacts.

  5. Clinical conditions associated withintestinal strongyloidiasis in Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    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.

  6. Efficacy of entomopathogenic fungi (Ascomycetes: Hypocreales) against adult Haematobia irritans (Diptera: Muscidae) under stable conditions in the Mexican dry tropics.

    Science.gov (United States)

    Galindo-Velasco, E; Lezama-Gutiérrez, R; Cruz-Vázquez, C; Pescador-Rubio, A; Angel-Sahagún, C A; Ojeda-Chi, M M; Rodríguez-Vivas, R I; Contreras-Lara, D

    2015-04-30

    The purpose of this paper is to evaluate the effect of five strains of Metarhizium anisopliae (Ma) and three strains of Isaria fumosorosea (Ifr) at a concentration of 1×10(8)colony-forming units/ml applied by spraying onto bovines with controlled infestation of Haematobia irritans under stable conditions in the Mexican dry tropics. Four experiments were performed, in each of which three treatments (two fungal strains and one control) were evaluated with eight repetitions for each one, by carrying out a single application of the aqueous suspension of each strain. The animals were isolated in individual cages and direct counts of the infestation were carried out for 13 days. It was observed that strains Ma2, Ma6, Ma10, Ma14, and Ma34 caused 94-100% reduction in infestation between days 12 and 13 post-treatment, while strains Ifr19, Ifr11, and Ifr12 reduced infestation from 90% to 98% up to day 13 post-application. There was an effect in the generation of horn flies from the excrement of bovines that were treated with different strains, reducing the reproduction of subsequent generations. It was concluded that the strains of M. anisopliae and I. fumosorosea evaluated in this study can be used as biocontrol agents in infestations of H. irritans in stabled bovines.

  7. ASH1 mRNP-core factors form stable complexes in absence of cargo RNA at physiological conditions.

    Science.gov (United States)

    Edelmann, Franziska T; Niedner, Annika; Niessing, Dierk

    2015-01-01

    Asymmetric ASH1 mRNA transport during mitosis of budding yeast constitutes one of the best-studied examples of mRNA localization. Recently, 2 studies used in vitro motility assays to prove that motile ASH1 mRNA-transport complexes can be reconstituted entirely from recombinant factors. Both studies, however, differed in their conclusions on whether cargo RNA itself is required for particle assembly and thus activation of directional transport. Here we provide direct evidence that stable complexes do assemble in absence of RNA at physiologic conditions and even at ionic strengths above cellular levels. These results directly confirm the previous notion that the ASH1 transport machinery is not activated by the cargo RNA itself, but rather through protein-protein interactions.

  8. Local flux-profile relationships of wind speed and temperature in a canopy layer in atmospheric stable conditions

    Science.gov (United States)

    Zhang, G.; Leclerc, M. Y.; Karipot, A.

    2010-11-01

    The particularities of the physics of the canopy layer pose challenges to the determination and use of traditional universal functions so helpful in the atmospheric surface layer. Progress toward "universal-like functions" such as those provided by Monin-Obukhov similarity theory for the canopy layer has been modest. One of the challenges lies in that the assumptions underlying Monin-Obukhov similarity theory do not hold within a canopy layer. This paper thus examines the local flux-profile relations for wind (Φm) and for temperature (Φh). It uses three different stability parameters, i.e., h/L(h) at tree top, local z/L(z), and the local bulk Richardson number (Ri), within a tall forest canopy in nighttime stable (indicated by h/L(h) > 0) conditions. Results suggest that the in-canopy Φm can be described using the local Richardson number Ri. Furthermore, Φm is found to increase linearly with Ri in the upper canopy layer for |Ri| 1, |Φm| decreases with |Ri| in a power function, a result consistent for all levels of measurements within the canopy. When both local Φh and local Ri are positive, i.e., the local downward turbulent heat flux is consistent with the local temperature gradient, the local Φh increases with the local Ri when Ri 1. The relationship between local Φh and Ri disappears when counter-gradient heat transfer occurs in strongly stable conditions. A self-correlation analysis is used to examine the influence of self-correlation and the physical meaning of these relationships.

  9. Physiological and pathological clinical conditions and light scattering in brain

    Science.gov (United States)

    Kurata, Tsuyoshi; Iwata, Sachiko; Tsuda, Kennosuke; Kinoshita, Masahiro; Saikusa, Mamoru; Hara, Naoko; Oda, Motoki; Ohmae, Etsuko; Araki, Yuko; Sugioka, Takashi; Takashima, Sachio; Iwata, Osuke

    2016-08-01

    MRI of preterm infants at term commonly reveals subtle brain lesions such as diffuse white matter injury, which are linked with later cognitive impairments. The timing and mechanism of such injury remains unclear. The reduced scattering coefficient of near-infrared light (μs’) has been shown to correlate linearly with gestational age in neonates. To identify clinical variables associated with brain μs’, 60 preterm and full-term infants were studied within 7 days of birth. Dependence of μs’ obtained from the frontal head on clinical variables was assessed. In the univariate analysis, smaller μs’ was associated with antenatal glucocorticoid, emergency Caesarean section, requirement for mechanical ventilation, smaller gestational age, smaller body sizes, low 1- and 5-minute Apgar scores, higher cord blood pH and PO2, and higher blood HCO3‑ at the time of study. Multivariate analysis revealed that smaller gestational age, requirement for mechanical ventilation, and higher HCO3‑ at the time of study were correlated with smaller μs’. Brain μs’ depended on variables associated with physiological maturation and pathological conditions of the brain. Further longitudinal studies may help identify pathological events and clinical conditions responsible for subtle brain injury and subsequent cognitive impairments following preterm birth.

  10. Restriction of the referral of patients with stable angina for CT coronary angiography by clinical evaluation and calcium score: impact on clinical decision making.

    Science.gov (United States)

    Dharampal, Anoeshka S; Rossi, Alexia; Dedic, Admir; Cademartiri, Filippo; Papadopoulou, Stella L; Weustink, Annick C; Ferket, Bart S; Boersma, Eric; Meijboom, Willem B; Galema, Tjebbe W; Nieman, Koen; de Feyter, Pim J; Krestin, Gabriel P

    2013-10-01

    To investigate the value of the calcium score (CaSc) plus clinical evaluation to restrict referral for CT coronary angiography (CTCA) by reducing the number of patients with an intermediate probability of coronary artery disease (CAD). We retrospectively included 1,975 symptomatic stable patients who underwent clinical evaluation and CaSc calculation and CTCA or invasive coronary coronary angiography (ICA). The outcome was obstructive CAD (≥50 % diameter narrowing) assessed by ICA or CTCA in the absence of ICA. We investigated two models: (1) clinical evaluation consisting of chest pain typicality, gender, age, risk factors and ECG and (2) clinical evaluation with CaSc. Discrimination of the two models was compared. The stepwise reclassification of patients with an intermediate probability of CAD (10-90 %) after clinical evaluation followed by clinical evaluation with CaSc was assessed by clinical net reclassification improvement (NRI). Discrimination of CAD was significantly improved by adding CaSc to the clinical evaluation (AUC: 0.80 vs. 0.89, P < 0.001). CaSc and CTCA could be avoided in 9 % using model 1 and an additional 29 % of CTCAs could be avoided using model 2. Clinical NRI was 57 %. CaSc plus clinical evaluation may be useful in restricting further referral for CTCA by 38 % in symptomatic stable patients with suspected CAD. • CT calcium scores (CaSc) could proiritise referrals for CT coronary angiography (CTCA) • CaSc provides an incremental discriminatory value of CAD compared with clinical evaluation • Risk stratification is better when clinical evaluation is combined with CaSc • Appropriate use of clinical evaluation and CaSc helps avoid unnecessary CTCA referrals.

  11. 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.

  12. Cardioprotection by remote ischemic conditioning: Mechanisms and clinical evidences

    Institute of Scientific and Technical Information of China (English)

    Alberto; Aimo; Chiara; Borrelli; Alberto; Giannoni; Luigi; Emilio; Pastormerlo; Andrea; Barison; Gianluca; Mirizzi; Michele; Emdin; Claudio; Passino

    2015-01-01

    In remote ischemic conditioning(RIC), several cycles of ischemia and reperfusion render distant organ and tissues more resistant to the ischemia-reperfusion injury. The intermittent ischemia can be applied before the ischemic insult in the target site(remote ischemic preconditioning), during the ischemic insult(remote ischemic perconditioning) or at the onset of reperfusion(remote ischemic postconditioning). The mechanisms of RIC have not been completely defined yet; however, these mechanisms must be represented by the release of humoral mediators and/or the activation of a neural reflex. RIC has been discovered in the heart, and has been arising great enthusiasm in the cardiovascular field. Its efficacy has been evaluated in many clinical trials, which provided controversial results. Our incomplete comprehension of the mechanisms underlying the RIC could be impairing the design of clinical trials and the interpretation of their results. In the present review we summarize current knowledge about RIC pathophysiology and the data about its cardioprotective efficacy.

  13. The reasons for triple therapy in stable COPD patients in Japanese clinical practice

    Directory of Open Access Journals (Sweden)

    Miyazaki M

    2015-06-01

    Full Text Available Masaki Miyazaki,1 Hidetoshi Nakamura,1,2 Saeko Takahashi,1 Shotaro Chubachi,1 Mamoru Sasaki,1 Mizuha Haraguchi,1 Hideki Terai,1 Makoto Ishii,1 Koichi Fukunaga,1 Sadatomo Tasaka,1 Kenzo Soejima,1 Koichiro Asano,3 Tomoko Betsuyaku1 On behalf of the Keio COPD Comorbidity Research (K-CCR group 1Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, 2Department of Respiratory Medicine, Saitama Medical University, Saitama, 3Division of Pulmonary Medicine, Department of Medicine, Tokai University School of Medicine, Kanagawa, Japan Background: Triple combination therapy involving long-acting muscarinic antagonists long-acting β2 agonists, and inhaled corticosteroids has recently become an option for maintenance treatment of COPD. Some add-on clinical trials have reported the benefits of these combinations. However, the process to step up to triple therapy varies for individual cases.Methods: Keio University and affiliated hospitals conducted an observational COPD cohort study, recruiting patients diagnosed as having COPD by pulmonary physicians and those referred for investigation of possible COPD. Their prescription history and clinical course were retrospectively analyzed based on the physicians’ medical records and patient questionnaires. This study was registered with UMIN (UMIN000003470, April 10, 2010.Results: A total of 95 of the 445 COPD patients (21% were treated with inhaled corticosteroids/long-acting β2 agonists/long-acting muscarinic antagonists as maintenance therapy, including 12 in COPD Grade I, 31 in Grade II, 38 in Grade III, and 14 in Grade IV, based on the Global Initiative for Chronic Obstructive Lung Disease spirometric grading. For more than half of the patients on triple therapy, the treatment had been intensified due to unsatisfactory improvement of symptoms, and 32% were treated with triple therapy due to comorbid asthma. In contrast, there were COPD patients whose therapy was

  14. Salt—Water Dynamics in Soils:I.Salt—Water Dynamics in Unsaturated Soils Under Stable Evaporation Condition

    Institute of Scientific and Technical Information of China (English)

    YOUWEN-RUI; MENGFAN-HUA; 等

    1992-01-01

    A long term simulation test on salt-water dynamics in unsaturated soils with different groundwater depths and soil texture profiles under stable evaporation condition was conducted.Salinity sensors and tensiometers were used to monitor salt and water variation in soils.The experiment revealed that in the process of fresh groundwater moving upwards by capillary rise in the column,the salts in subsoil were brought upwards and accumulated in the surface soil,and consequently the salinization of surface soil took place.The rate of salt accumulation is determined mainly by the volume of capillary water flow and the conditions of salts contained in the soil profile.Water flux in soils decreased obviously when groundwater depths fell below 1.5m.When there was an interbedded clay layer 30cm in thickness in the silty loam soil profile or a clay layer 100cm in thickness at the top layer,the water flux was 3-5 times less than in the soil profile of homogeneous silty loam soil.Therefore,the rate of salt accumulation was decreased and the effect of variation of groundwater depth on the water flux in soils was weakened comparatively.If there was precipitation or irrigation supplying water to the soil,the groundwater could rarely take a direct part in the process of salt accumulation in surface soil,especially,in soil profiles with an interbedded stratum or a clayey surface soil layer.

  15. Computational design of a pH stable enzyme: understanding molecular mechanism of penicillin acylase's adaptation to alkaline conditions.

    Directory of Open Access Journals (Sweden)

    Dmitry Suplatov

    Full Text Available Protein stability provides advantageous development of novel properties and can be crucial in affording tolerance to mutations that introduce functionally preferential phenotypes. Consequently, understanding the determining factors for protein stability is important for the study of structure-function relationship and design of novel protein functions. Thermal stability has been extensively studied in connection with practical application of biocatalysts. However, little work has been done to explore the mechanism of pH-dependent inactivation. In this study, bioinformatic analysis of the Ntn-hydrolase superfamily was performed to identify functionally important subfamily-specific positions in protein structures. Furthermore, the involvement of these positions in pH-induced inactivation was studied. The conformational mobility of penicillin acylase in Escherichia coli was analyzed through molecular modeling in neutral and alkaline conditions. Two functionally important subfamily-specific residues, Gluβ482 and Aspβ484, were found. Ionization of these residues at alkaline pH promoted the collapse of a buried network of stabilizing interactions that consequently disrupted the functional protein conformation. The subfamily-specific position Aspβ484 was selected as a hotspot for mutation to engineer enzyme variant tolerant to alkaline medium. The corresponding Dβ484N mutant was produced and showed 9-fold increase in stability at alkaline conditions. Bioinformatic analysis of subfamily-specific positions can be further explored to study mechanisms of protein inactivation and to design more stable variants for the engineering of homologous Ntn-hydrolases with improved catalytic properties.

  16. Operating conditions for the generation of stable anode spot plasma in front of a positively biased electrode

    Energy Technology Data Exchange (ETDEWEB)

    Park, Yeong-Shin; Lee, Yuna; Dang, Jeong-Jeung [Department of Nuclear Engineering, Seoul National University, Seoul 151-744 (Korea, Republic of); Chung, Kyoung-Jae, E-mail: jkjlsh1@snu.ac.kr [Center for Advance Research in Fusion Reactor Engineering, Seoul National University, Seoul 151-744 (Korea, Republic of); Hwang, Y. S. [Department of Nuclear Engineering, Seoul National University, Seoul 151-744 (Korea, Republic of); Center for Advance Research in Fusion Reactor Engineering, Seoul National University, Seoul 151-744 (Korea, Republic of)

    2014-02-15

    Stability of an anode spot plasma, which is an additional high density plasma generated in front of a positively biased electrode immersed in ambient plasma, is a critical issue for its utilization to various types of ion sources. In this study, operating conditions for the generation of stable anode spot plasmas are experimentally investigated. Diagnostics of the bias current flowing into the positively biased electrode and the properties of ambient plasma reveal that unstable nature of the anode spot is deeply associated with the reduction of double layer potential between the anode spot plasma and the ambient plasma. It is found that stability of the anode spot plasma can be improved with increasing the ionization rate in ambient plasma so as to compensate the loss of electrons across the double layer or with enlarging the area of the biased electrode to prevent electron accumulation inside the anode spot. The results obtained from the present study give the guideline for operating conditions of anode spot plasmas as an ion source with high brightness.

  17. Local flux-profile relationships of wind speed and temperature in a canopy layer in atmospheric stable conditions

    Directory of Open Access Journals (Sweden)

    G. Zhang

    2010-11-01

    Full Text Available The particularities of the physics of the canopy layer pose challenges to the determination and use of traditional universal functions so helpful in the atmospheric surface layer. Progress toward "universal-like functions" such as those provided by Monin-Obukhov similarity theory for the canopy layer has been modest. One of the challenges lies in that the assumptions underlying Monin-Obukhov similarity theory do not hold within a canopy layer. This paper thus examines the local flux-profile relations for wind (Φm and for temperature (Φh. It uses three different stability parameters, i.e., h/L(h at tree top, local z/L(z, and the local bulk Richardson number (Ri, within a tall forest canopy in nighttime stable (indicated by h/L(h > 0 conditions. Results suggest that the in-canopy Φm can be described using the local Richardson number Ri. Furthermore, Φm is found to increase linearly with Ri in the upper canopy layer for |Ri| < 1. When local |Ri| > 1, |Φm| decreases with |Ri| in a power function, a result consistent for all levels of measurements within the canopy. When both local Φh and local Ri are positive, i.e., the local downward turbulent heat flux is consistent with the local temperature gradient, the local Φh increases with the local Ri when Ri < 1. However, Φh does not change with Ri (or much more scattered when Ri > 1. The relationship between local Φh and Ri disappears when counter-gradient heat transfer occurs in strongly stable conditions. A self-correlation analysis is used to examine the influence of self-correlation and the physical meaning of these relationships.

  18. Characterization of serological neo-epitope biomarkers reflecting collagen remodeling in clinically stable chronic obstructive pulmonary disease

    DEFF Research Database (Denmark)

    Sand, Jannie M B; Martinez, Gerd; Midjord, Anne-Kirsten

    2016-01-01

    OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is characterized by chronic inflammation that leads to excessive remodeling of the lung extracellular matrix (ECM), resulting in release of protein fragments (neo-epitopes) to the blood. Serological markers assessing this have previously been...... associated with exacerbations of COPD. However, characterization of these in individuals with clinically stable COPD is lacking. The aim of this study was to characterize the collagen remodeling in stable COPD by the serological assessment of neo-epitopes. DESIGN AND METHODS: Sixty-eight subjects...... with clinically stable COPD were included into the study at baseline, and 27 came back for a four weeks follow-up visit. Serum and plasma levels of neo-epitopes were assessed for the evaluation of collagen type III (C3M), IV (C4M, C4Ma3, P4NP 7S), and VI (C6M, Pro-C6) remodeling. RESULTS: C3M, C4M, C4Ma3, P4NP 7S...

  19. The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: The Euro Heart Survey of Stable Angina set out to prospectively study the presentation and management of patients with stable angina as first seen by a cardiologist in Europe, with particular reference to adherence to existing guidelines and regional variability in patient presentation and ini

  20. Simulation of large particle transport near the surface under stable conditions: comparison with the Hanford tracer experiments

    Science.gov (United States)

    Kim, Eugene; Larson, Timothy

    A plume model is presented describing the downwind transport of large particles (1-100 μm) under stable conditions. The model includes both vertical variations in wind speed and turbulence intensity as well as an algorithm for particle deposition at the surface. Model predictions compare favorably with the Hanford single and dual tracer experiments of crosswind integrated concentration (for particles: relative bias=-0.02 and 0.16, normalized mean square error=0.61 and 0.14, for the single and dual tracer experiments, respectively), whereas the US EPA's fugitive dust model consistently overestimates the observed concentrations at downwind distances beyond several hundred meters (for particles: relative bias=0.31 and 2.26, mean square error=0.42 and 1.71, respectively). For either plume model, the measured ratio of particle to gas concentration is consistently overestimated when using the deposition velocity algorithm of Sehmel and Hodgson (1978. DOE Report PNL-SA-6721, Pacific Northwest Laboratories, Richland, WA). In contrast, these same ratios are predicted with relatively little bias when using the algorithm of Kim et al. (2000. Atmospheric Environment 34 (15), 2387-2397).

  1. 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 2-

  2. Four hundred or more participants needed for stable contingency table estimates of clinical prediction rule performance

    DEFF Research Database (Denmark)

    Kent, Peter; Boyle, Eleanor; Keating, Jennifer L

    2017-01-01

    OBJECTIVE: To quantify variability in the results of statistical analyses based on contingency tables and discuss the implications for the choice of sample size for studies that derive clinical prediction rules. STUDY DESIGN AND SETTING: An analysis of three pre-existing sets of large cohort data...

  3. Precedent fluctuation of serum hs-CRP to albumin ratios and mortality risk of clinically stable hemodialysis patients.

    Directory of Open Access Journals (Sweden)

    Jyh-Chang Hwang

    Full Text Available A high sensitivity C-reactive protein to albumin ratio (hs-CRP/Alb predicts mortality risk in patients with acute kidney injury. However, it varies dynamically. This study was conducted to evaluate whether a variation of this marker was associated with long-term outcome in clinically stable hemodialysis (HD patients.hs-CRP/Alb was checked bimonthly in 284 clinically stable HD outpatients throughout all of 2008. Based on the "slope" of trend equation derived from 5-6 hs-CRP/alb ratios for each patient, the total number of patients was divided into quartiles--Group 1: β≦ -0.13, n = 71; group 2: β>-0.13≦0.003; n = 71, group 3: β>0.003≦0.20; and group 4: β>0.20, n = 71. The observation period was from January 1, 2009 to August 31, 2012.Group 1+4 showed a worse long-term survival (p = 0.04 and a longer 5-year hospitalization stay than Group 2+3 (38.7±44.4 vs. 16.7±22.4 days, p<0.001. Group 1+4 were associated with older age (OR = 1.03, 95% CI = 1.01-1.05 and a high prevalence of congestive heart failure (OR = 2.02, 95% CI = 1.00-4.11. Standard deviation (SD of hs-CRP/Alb was associated with male sex (β = 0.17, p = 0.003, higher Davies co-morbidity score (β = 0.16, p = 0.03, and baseline hs-CRP (β = 0.39, p<0.001. Patients with lower baseline and stable trend of hs-CRP/Alb had a better prognosis. By multivariate Cox proportional methods, SD of hs-CRP/alb (HR: 1.05, 95% CI: 1.01-1.08 rather than baseline hs-CRP/Alb was an independent predictive factor for long-term mortality after adjusting for sex and HD vintage.Clinically stable HD patients with a fluctuating variation of hs-CRP/Alb are characterized by old age, and more co-morbidity, and they tend to have longer subsequent hospitalization stay and higher mortality risk.

  4. Management of stable coronary artery disease: from evidence to clinical practice

    Directory of Open Access Journals (Sweden)

    Riccardo Gerloni

    2017-06-01

    Full Text Available Ischemic heart disease, the leading cause of death, is extremely diffuse among patients hospitalized in Internal Medicine ward so that Internist should be able to manage correctly this disease. The following review revises the most recent literature and offers a practical clinical guide to be confident on this topic. After having emphasized that clinical overview remains essential, it briefly mentions advantages and limits of different investigations, reminds readers of possible alternative etiopathogeneses of ischemic heart disease (cardiac syndrome X, reports the most appropriate medical therapy, and gives the opportunity to understand appropriateness of specialist strategies such as coronary artery by-pass grafting and percutaneous coronary intervention. Finally, it illustrates a rational and evidence-based follow-up of these patients, considering that only a small part of them should be followed by a Cardiologist. The aim of a correct management of ischemic heart disease remains to reduce mortality and improve the quality of life.

  5. Adding Complex Terrain and Stable Atmospheric Condition Capability to the Simulator for On/Offshore Wind Farm Applications (SOWFA) (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Churchfield, M. J.

    2013-06-01

    This presentation describes changes made to NREL's OpenFOAM-based wind plant aerodynamics solver so that it can compute the stably stratified atmospheric boundary layer and flow over terrain. Background about the flow solver, the Simulator for Off/Onshore Wind Farm Applications (SOWFA) is given, followed by details of the stable stratification/complex terrain modifications to SOWFA, along with some preliminary results calculations of a stable atmospheric boundary layer and flow over a simple set of hills.

  6. The preferential growth of branched GDGT source microorganisms under aerobic conditions in peat revealed by stable isotope probing experiments

    Science.gov (United States)

    Huguet, Arnaud; Meador, Travis B.; Laggoun-Défarge, Fatima; Könneke, Martin; Derenne, Sylvie; Hinrichs, Kai-Uwe

    2016-04-01

    Branched glycerol dialkyl glycerol tetraether (brGDGTs) membrane lipids are widely distributed in aquatic and terrestrial environments and are being increasingly used as temperature proxies. Nevertheless, little is known regarding the microorganisms that produce these lipids, which are found in especially high abundance in the anaerobic horizons of peat bogs. We initiated stable isotope probing incubations of peat samples from a Sphagnum-dominated peatland (Jura Mountains, France) to measure the incorporation of (D)-D2O and 13C-labeled dissolved inorganic carbon (DIC) into brGDGTs, and thus gauge the activity, growth, and turnover times of their source organisms. Peat samples were collected from two adjacent sites with contrasting humidity levels (hereafter called "fen" and "bog" sites). For each site, samples from the surficial aerobic layer (acrotelm) and deeper anaerobic layer (catotelm) were collected and were incubated under both anaerobic and aerobic conditions for the acrotelm samples and only anaerobic conditions for the catotelm. The incubations were performed at 12 ° C, consistent with the mean summer air temperature at the sampling site. After two months of incubation, there was no incorporation of 13C label in brGDGTs for samples incubated under either aerobic or anaerobic conditions, showing that brGDGT-producing bacteria are heterotrophic microorganisms, as previously observed in organo-mineral soils (Weijers et al., 2011). Similarly, little to no deuterium incorporation was observed for brGDGTs isolated from anaerobically-incubated deep samples. In contrast, in the aerobic incubations of acrotelm samples from bog and fen, the weighted average δD of brGDGT core lipids (CLs) increased by up to 3332‰ and 933‰ after two months, respectively, indicating that fresh brGDGT CLs were biosynthesized at the peat surface. D incorporation into brGDGT CLs converted to production rates ranging from 30-106 ng cm-3y-1 in the aerobic acrotelm from bog and fen

  7. How Stable Is Stable?

    Science.gov (United States)

    Baehr, Marie

    1994-01-01

    Provides a problem where students are asked to find the point at which a soda can floating in some liquid changes its equilibrium between stable and unstable as the soda is removed from the can. Requires use of Newton's first law, center of mass, Archimedes' principle, stable and unstable equilibrium, and buoyant force position. (MVL)

  8. Vitamin D-mediated calcium absorption in patients with clinically stable Crohn's disease: a pilot study.

    Science.gov (United States)

    Kumari, Meena; Khazai, Natasha B; Ziegler, Thomas R; Nanes, Mark S; Abrams, Steven A; Tangpricha, Vin

    2010-08-01

    Vitamin D is the critical hormone for intestinal absorption of calcium. Optimal calcium absorption is important for proper mineralization of bone in the prevention of osteoporosis and osteoporotic fractures, among other important functions. Diseases associated with gut inflammation, such as Crohn's disease (CD), may impair calcium absorption. This pilot study evaluated vitamin D- dependent calcium absorption in subjects with CD. Male subjects with CD (n=4) and healthy age-matched controls (n=5) were studied. All subjects had fractional calcium absorption (FCA; by the dual calcium isotope method), serum 25-hydroxyvitamin D, serum calcium and 24 h urinary calcium excretion measurements at baseline. The FCA in response to vitamin D therapy was re-assessed following administration of oral calcitriol 0.25 mcg twice daily for 1 wk, followed by oral calcitriol 0.50 mcg twice daily for 1 wk. Serum calcium and 24 h urinary calcium determinations were re-assessed after each increasing dose of calcitriol as safety measures. There was no significant difference in calcium FCA at baseline or after increasing doses of calcitriol between the CD and controls. FCA in the control and CD group was approximately 35% at baseline, which increased to 60% after calcitriol therapy. No subject developed hypercalcemia or hypercalciuria. Our results suggest that CD patients have a normal response to vitamin D in enhancing the efficacy of calcium absorption. This suggests that stable CD patients can follow calcium and vitamin D guidelines of non-CD adults. Other factors independent of vitamin D status may impair intestinal calcium absorption in CD, including the degree and location of inflammation, presence of surgical resection and/or use of glucocorticoids.

  9. 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.

  10. Obesity induction in hamster that mimics the human clinical condition.

    Science.gov (United States)

    Jordania da Silva, Vivian; Dias, Sílvia Regina Costa; Maioli, Tatiani Uceli; Serafim, Luciana Ribeiro; Furtado, Luis Fernando Viana; Quintão Silva, Maria da Gloria; Faria, Ana Maria Caetano de; Rabelo, Élida Mara Leite

    2017-08-05

    Although obesity is well established in hamsters, studies using diets with high levels of simple carbohydrate associated with lipids are necessary to assess the impact of this type of food in the body. In this study a high sugar and butter diet (HSB) and high temperature were employed towards this end. Obesity was successfully induced at a temperature of 30.3°C to 30.9°C after 38 days feeding the animals an HSB diet. It was shown that although diet is important for the induction of obesity, temperature is also essential because at a temperature slightly below the one required, obesity was not induced, even when the animals were fed for a longer period (150 days).The obese clinical condition was accompanied by biochemical and hematological changes, as increased cholesterol and triglyceride levels and increased leukocyte numbers, similar to alterations observed in obese humans. Furthermore, it was demonstrated that increasing the intake of simple carbohydrates associated with lipids provided evidence of inflammation in obese animals.

  11. Use of Chest Computed Tomography in Stable Patients with Blunt Thoracic Trauma: Clinical and Forensic Perspective

    Directory of Open Access Journals (Sweden)

    Makbule Ergin

    2011-01-01

    fractures were the most common injury. Thorax computed tomography was significantly superior to chest radiography in detecting pneumothorax , hemothorax and lung contusion. Eightyone life threatening lesions were detected and 50 (61%; pneumothorax 13, hemothorax 24, lung contusion 9,and pneumomediastinum 4 of these lesions could not be detected with plain chest radiography. The clinical management [in 15 patients (30%], and the forensic assesment was changed [in 14 (28%] patients were changed.  Conclusion:We concluded that using Computed Tomography of the thorax in thoracic travmas prive meticulous assesment in management of patients and forens icissues.

  12. Source identification of N2O produced during simulated wastewater treatment under different oxygen conditions using stable isotopic analysis

    Directory of Open Access Journals (Sweden)

    T Azzaya

    2014-12-01

    Full Text Available Nitrous oxide (N2O, a potent greenhouse gas which is important in climate change, is predicted to be the most dominant ozone depleting substance. It is mainly produced by oxidation of hydroxylamine (NH2OH or reduction of nitrite (NO2- during microbiological processes such as nitrification and denitrification. Wastewater treatment plant (WWTP is one of the anthropogenic N2O sources because inorganic and organic nitrogen compounds are converted to nitrate (NO3-, in the case of standard system or N2 (in the case of advanced system by bacterial nitrification and denitrification in WWTP. We investigated the N2O production mechanisms during batch experiments that simulate wastewater treatment with activated sludge under various dissolved oxygen (DO concentrations by stable isotope analysis. About 125mL of water was sampled from 30L incubation chamber for several times during the incubation, and concentration and isotopomer ratios of N2O and N-containing species were measured using gas chromatography/isotope ratio mass spectrometry (GC/IRMS. Ammonium (NH4+ consumption was accompanied by increment of nitrite (NO2-, and at the same time dissolved N2O concentration gradually increased to 4850 and 5650 nmol kg-1, respectively, during the four-hour incubation when DO concentrations were 0.2 and 0.5 mg L-1. Observed low SP values (0.2-8.9‰ at DO-0.2 mg L-1, -5.3-6.3‰ at DO-0.5 mg L-1, -1.0-8.3‰ at DO-0.8 mg L-1 in N2O and relationship of nitrogen isotope ratios between N2O and its potential substrates (NH4+, NO3- suggested that N2O produced under the aerobic condition derived mainly from NO2- reduction by ammonia-oxidizing bacteria (nitrifier–denitrification.DOI: http://doi.dx.org/10.5564/mjc.v15i0.313Mongolian Journal of Chemistry  15 (41, 2014, p4-10  

  13. ATLAS experiment first 900 GeV Collision Events in Stable-Beam Conditions with Inner Detector Fully Powered, December 6, 2009

    CERN Multimedia

    the ATLAS experiment; Neal Hartman; Phil Owen; Joao Pequenao

    2009-01-01

    On Sunday morning, December 6th, 2009, the LHC achieved for the first time 900 GeV collisions under stable-beam conditions. This allowed ATLAS to fully ramp the high voltage of the inner most pixel and silicon-strip tracking detectors.

  14. Passing through the renal clearance barrier: toward ultrasmall sizes with stable ligands for potential clinical applications

    Directory of Open Access Journals (Sweden)

    Zhang XD

    2014-04-01

    Full Text Available Xiao-Dong Zhang,1 Jiang Yang,2 Sha-Sha Song,1 Wei Long,1 Jie Chen,1 Xiu Shen,1 Hao Wang,1 Yuan-Ming Sun,1 Pei-Xun Liu,1 Saijun Fan11Tianjin Key Laboratory of Molecular Nuclear Medicine, Institute of Radiation Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, People's Republic of China; 2Department of Biological Systems Engineering, University of Wisconsin-Madison, Madison, WI, USAAbstract: The use of nanoparticles holds promise for medical applications, such as X-ray imaging, photothermal therapy and radiotherapy. However, the in vivo toxicity of inorganic nanoparticles raises some concern regarding undesirable side effects which prevent their further medical application. Ultrasmall sub-5.5 nm particles can pass through the barrier for renal clearance, minimizing their toxicity. In this letter we address some recent interesting work regarding in vivo toxicity and renal clearance, and discuss the possible strategy of utilizing ultrasmall nanomaterials. We propose that small hydrodynamic sized nanoclusters can achieve both nontoxic and therapeutic clinical features.Keywords: in vivo clearance, gold nanoparticles, small size

  15. Clinical outcomes of new toric trifocal diffractive intraocular lens in patients with cataract and stable keratoconus

    Science.gov (United States)

    Farideh, Doroodgar; Azad, Sanginabadi; Feizollah, Niazi; Sana, Niazi; Cyrus, Alinia; Mohammad, Ghoreishi; Alireza, Baradaran-rafii

    2017-01-01

    Abstract Purpose: To evaluate the clinical results of toric trifocal diffractive intraocular lens in eyes with cataract and mild keratoconus. Methods: Five keratoconus patients (10 eyes) that had bilateral AT LISA 939 implantation were selected and had followed in 3-time horizons of 1, 3, and 6 months. Patients were 46 to 65 years old age, corneal astigmatism of (2.00 D at 6.75 D) and cataract that all of them needed cataract surgery. The distance, intermediate and near visual acuities, defocus curve, ocular aberrations, contrast sensitivity, were measured as effectiveness criteria. Results: Average of binocular uncorrected distance visual acuity (UDVA) improved from 0.72 log MAR ± 0.11 (SD) to 0.04 ± 0.04 (P < 0.05) log MAR, average of uncorrected binocular intermediate visual acuity (UIVA) (80 cm) improved from 0.52 ± 0.07 log MAR to 0.14 ± 0.04 (P < 0.05) log MAR, and average of binocular uncorrected near visual acuity (UNVA) improved from 0.48 ± 0.09 log MAR to 0.02 ± 0.07 (P < 0.05) log MAR at 6 months, respectively. Contrast sensitivity testing showed acceptable results, the binocular defocus curve corroborate were in appropriate good visual acuity even at the intermediate distances, by a gentle slope less than log MAR 0.2 at −1.5 D, with regard to the best distance visual acuity at the 0 D defocus. Conclusions: Trifocal AT LISA 939MP IOLs provided appropriate distances, near and intermediate of the visual results. Prediction of the refractive results and optical performances were good. PMID:28328814

  16. Magnetic resonance imaging of clinically stable late pregnancy bleeding: beyond ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Masselli, Gabriele; Gualdi, Gianfranco [Sapienza University, Radiology Dea Department, Umberto I Hospital, Rome (Italy); Brunelli, Roberto; Perrone, Giuseppina [Sapienza University, Department of Gynecology and Obstetrics, Umberto I Hospital, Rome (Italy); Parasassi, Tiziana [Institute of Neurobiology and Molecular Medicine, National Research Council, Rome (Italy)

    2011-09-15

    To compare the accuracy of magnetic resonance (MRI) and colour Doppler-ultrasound (US) in the diagnosis of late pregnancy bleeding and to assess the accuracy of the different MR sequences in visualizing the origin of haemorrhage. 42 patients in the third trimester of pregnancy underwent to US and MRI for the evaluation of painless vaginal bleeding. Multiplanar HASTE, True Fisp, 3D T1 GRE and sagittal DWI sequences were acquired. Two radiologists, blinded to the results of US, reviewed each case, resolving by consensus any discrepancy. Reference standards were surgical and pathological findings. The reference standards identified 22 placenta previa, 11 placental abruptions (1 coincident with a placental chorioangioma), 1 thrombohaematoma and 1 fibroma with haemorrhagic degeneration. MRI identified correctly all these condition with an interobserver agreement of 0.955. DWI and T1 weighted sequences were statistically superior to Haste and True Fisp sequences in detecting the cause of bleeding (p <.001). US had 6 false negatives and 2 false positive results, its diagnostic accuracy resulting lower than MRI (p =.001). MRI accurately evaluates pregnancy bleeding with an excellent interobserver agreement and can grant new and additional data when US is negative. (orig.)

  17. Angular-stable locking plate fixation of tibial plateau fractures-clinical and radiological midterm results in 101 patients

    Directory of Open Access Journals (Sweden)

    Sven Mardian

    2015-01-01

    Full Text Available Background: Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fixation. Materials and Methods: 101 patients were retrospectively studied using functional (ROM; KSS; VAS, radiographic (osteoarthritis score, loss of reduction and quality of life (WOMAC; Lysholm scores. There were 46 males and 55 females. The average of patients was 51 years (range 22-77 years. Study groups were assigned according to the AO fracture classification. Results: Mean followup was 57 ± 30 months. Fracture type distribution revealed a significantly (P < 0.001 increased number of type B- (62.4% compared to C-fractures. Functional assessment showed a significantly better total KSS (84.1 ± 15.6 vs. 74.7 ± 18.0; P = 0.01 as well as ROM (active: 124°±17° vs. 116°±15°, P = 0.014; passive: 126°±18° vs. 118 ± 14°, P = 0.017 in the B-fracture group. VAS was found to be markedly higher (P = 0.0039 following type C-fractures. Rating osteoarthritis secondary to a tibial plateau fracture as a function of injury severity (r = 0.485; P < 0.001 and relating the loss of reduction to the grade of evolving osteoarthritis (r = 0.643;P < 0.001 a positive correlation was found. Quality of life showed significantly improved results for Lysholm score (P = 0.004 following B-fractures with low overall values for the WOMAC score. Conclusion: Presented data provide sufficient evidence that anatomic restoration of tibial plateau fractures with angular stable plate fixation result in decreased loss of reduction and declined incidence of posttraumatic osteoarthritis, thereby providing acceptable mid to long term outcome.

  18. Dew Formation, Eddy-Correlation Latent Heat Fluxes, and the Surface Energy Imbalance at Cabauw During Stable Conditions

    NARCIS (Netherlands)

    De Roode, S.R.; Bosveld, F.C.; Kroon, P.S.

    2010-01-01

    Observations collected between 2000 and 2008 at the Cabauw meteorological measurement platform in the Netherlands were conditionally sampled to select nights with stably stratified atmospheric conditions, clear skies and weak horizontal wind speeds (<3ms−1). For these conditions the eddy-correlation

  19. Dew Formation, Eddy-Correlation Latent Heat Fluxes, and the Surface Energy Imbalance at Cabauw During Stable Conditions

    NARCIS (Netherlands)

    De Roode, S.R.; Bosveld, F.C.; Kroon, P.S.

    2010-01-01

    Observations collected between 2000 and 2008 at the Cabauw meteorological measurement platform in the Netherlands were conditionally sampled to select nights with stably stratified atmospheric conditions, clear skies and weak horizontal wind speeds (<3ms−1). For these conditions the eddy-correlation

  20. Acute bag-valve breathing maneuvers plus manual chest compression is safe during stable septic shock: a randomized clinical trial.

    Science.gov (United States)

    Blattner, Clarissa Netto; Santos, Rafael Saldanha Dos; Dias, Fernando Suparregui; Dias, Alexandre Simões; Mestriner, Régis Gemerasca; Vieira, Silvia Regina Rios

    2017-01-01

    To evaluate the effects of bag-valve breathing maneuvers combined with standard manual chest compression techniques on safety, hemodynamics and oxygenation in stable septic shock patients. A parallel, assessor-blinded, randomized trial of two groups. A computer-generated list of random numbers was prepared by an independent researcher to allocate treatments. The Intensive Care Unit at Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul. Fifty-two subjects were assessed for eligibility, and 32 were included. All included subjects (n = 32) received the allocated intervention (n = 19 for the Experimental Group and n = 13 for the Control Group). Twenty minutes of bag-valve breathing maneuvers combined with manual chest compression techniques (Experimental Group) or chest compression, as routinely used at our intensive care unit (Control Group). Follow-up was performed immediately after and at 30 minutes after the intervention. Mean artery pressure. All included subjects completed the trial (N = 32). We found no relevant effects on mean artery pressure (p = 0.17), heart rate (p = 0.50) or mean pulmonary artery pressure (p = 0.89) after adjusting for subject age and weight. Both groups were identical regarding oxygen consumption after the data adjustment (p = 0.84). Peripheral oxygen saturation tended to increase over time in both groups (p = 0.05), and there was no significant association between cardiac output and venous oxygen saturation (p = 0.813). No clinical deterioration was observed. A single session of bag-valve breathing maneuvers combined with manual chest compression is hemodynamically safe for stable septic-shocked subjects over the short-term.

  1. Stable carbon isotope fractionation of six strongly fractionating microorganisms is not affected by growth temperature under laboratory conditions

    Science.gov (United States)

    Penger, Jörn; Conrad, Ralf; Blaser, Martin

    2014-09-01

    Temperature is the major driving force for many biological as well as chemical reactions and may impact the fractionation of stable carbon isotopes. Thus, a good correlation between temperature and fractionation is observed in many chemical systems that are controlled by an equilibrium isotope effect. In contrast, biological systems that are usually controlled by a kinetic isotope effect are less well studied with respect to temperature effects and have shown contrasting results. We studied three different biological pathways (methylotrophic methanogenesis, hydrogenotrophic methanogenesis, acetogenesis by the acetyl-CoA pathway) which are characterized by very strong carbon isotope enrichment factors (-50‰ to -83‰). The microorganisms (Methanosarcina barkeri, Methanosarcina acetivorans, Methanolobus zinderi, Methanothermobacter marburgensis, Methanothermobacter thermoautotrophicus, Thermoanaerobacter kivui) exhibiting these pathways were grown at different temperatures ranging between 25 and 68 °C, and the fractionation factors were determined from 13C/12C isotope discrimination during substrate depletion and product formation. Our experiments showed that the fractionation factors were different for the different metabolic pathways but were not much affected by the different growth temperatures. Slight variations were well within the standard errors of replication and regression analysis. Our results showed that temperature had no significant effect on the fractionation of stable carbon isotopes during anaerobic microbial metabolism with relatively strong isotope fractionation.

  2. 42 CFR 485.721 - Condition of participation: Clinical records.

    Science.gov (United States)

    2010-10-01

    ... efficient processing of clinical records (reviewing, indexing, filing, and prompt retrieval). ... contain the following general categories of data: (1) Documented evidence of the assessment of the needs...) Identification data and consent forms. (3) Medical history. (4) Report of physical examinations, if any....

  3. A pressure correction scheme for generalized form of energy-stable open boundary conditions for incompressible flows

    CERN Document Server

    Dong, Suchuan

    2014-01-01

    We present a generalized form of open boundary conditions, and an associated numerical algorithm, for simulating incompressible flows involving open or outflow boundaries. The generalized form represents a family of open boundary conditions, which all ensure the energy stability of the system, even in situations where strong vortices or backflows occur at the open/outflow boundaries. Our numerical algorithm for treating these open boundary conditions is based on a rotational pressure correction-type strategy, with a formulation suitable for $C^0$ spectral-element spatial discretizations. We have introduced a discrete equation and associated boundary conditions for an auxiliary variable. The algorithm contains constructions that prevent a numerical locking at the open/outflow boundary. In addition, we have also developed a scheme with a provable unconditional stability for a sub-class of the open boundary conditions. Extensive numerical experiments have been presented to demonstrate the performance of our meth...

  4. Renewal effect on conditioning and its clinical implications

    Directory of Open Access Journals (Sweden)

    Lopez Seal, María Florencia

    2010-06-01

    Full Text Available Renewal effect refers to the reappearance of a conditioned response by a context change between extinction and testing. This phenomenon holds relevance at a theoretical level since it shows that, in extinction, learning does not go under. Also at an applied level, because psychological treatments that relay on extinction processes are done generally at a different context than that where they are put to test and therefore the response can reappear due to the renewal effect. This article reviews the procedures among which the effects of both classic and instrumental conditioning were studied as well as those treatments that prevent them from occurring

  5. Studies on Influence of Seasonality on Clinical Conditions of Small ...

    African Journals Online (AJOL)

    SH

    Non-infectious conditions such as dystocia (13.92%) and fractures (9.71%) were ... as well as prophylactic treatment (7.77%) were reported most in early dry season respectively. ... Materials and Methods ... Percentage. Abscesses. 4. 0. 4. 1.94. Amputation. 1. 0. 1. 0.49. Anaemia. 1. 0. 1 ..... and horse, Ninth Edition, Bailliere.

  6. Factors controlling stable isotope composition of precipitation in arid conditions: an observation network in the Tianshan Mountains, central Asia

    Directory of Open Access Journals (Sweden)

    Shengjie Wang

    2016-02-01

    Full Text Available Approximately one-third of the Earth's arid areas are distributed across central Asia. The stable isotope composition of precipitation in this region is affected by its aridity, therefore subject to high evaporation and low precipitation amount. To investigate the factors controlling stable water isotopes in precipitation in arid central Asia, an observation network was established around the Tianshan Mountains in 2012. Based on the 1052 event-based precipitation samples collected at 23 stations during 2012–2013, the spatial distribution and seasonal variation of δD and δ18O in precipitation were investigated. The values of δD and δ18O are relatively more enriched in the rainfall dominant summer months (from April to October and depleted in the drier winter months (from November to March with low D-excess due to subcloud evaporation observed at many of the driest low elevation stations. The local meteoric water line (LMWL was calculated to be δD=7.36δ18O – 0.50 (r2=0.97, p<0.01 based on the event-based samples, and δD=7.60δ18O+2.66 (r2=0.98, p<0.01 based on the monthly precipitation-weighted values. In winter, the data indicate an isotopic rain shadow effect whereby rainout leads to depletion of precipitation in the most arid region to the south of the Tianshan Mountains. The values of δ18O significantly correlate with air temperature for each station, and the best-fit equation is established as δ18O=0.78T – 16.01 (r2=0.73, p<0.01. Using daily air temperature and precipitation derived from a 0.5° (latitude×0.5° (longitude gridded data set, an isoscape of δ18O in precipitation was produced based on this observed temperature effect.

  7. HIGH-SPEED, CLINICAL-SCALE MICROFLUIDIC GENERATION OF STABLE PHASE-CHANGE DROPLETS FOR GAS EMBOLOTHERAPY

    Science.gov (United States)

    Bardin, David; Martz, Thomas D.; Sheeran, Paul S.; Shih, Roger; Dayton, Paul A.; Lee, Abraham P.

    2013-01-01

    In this study we report on a microfluidic device and droplet formation regime capable of generating clinical-scale quantities of droplet emulsions suitable in size and functionality for in vivo therapeutics. By increasing the capillary number – based on the flow rate of the continuous outer phase – in our flow-focusing device, we examine three modes of droplet breakup: geometry-controlled, dripping, and jetting. Operation of our device in the dripping regime results in the generation of highly monodisperse liquid perfluoropentane droplets in the appropriate 3–6 µm range at rates exceeding 105 droplets per second. Based on experimental results relating droplet diameter and the ratio of the continuous and dispersed phase flow rates, we derive a power series equation, valid in the dripping regime, to predict droplet size by Dd ≅ 27(QC/QD)−5/12. The volatile droplets in this study are stable for weeks at room temperature yet undergo rapid liquid-to-gas phase transition, and volume expansion, above a uniform thermal activation threshold. The opportunity exists to potentiate locoregional cancer therapies such as thermal ablation and percutaneous ethanol injection using thermal or acoustic vaporization of these monodisperse phase-change droplets to intentionally occlude the vessels of a cancer. PMID:22011845

  8. The conditions and course of clinically induced phonological change.

    Science.gov (United States)

    Gierut, J A

    1992-10-01

    This two-part study continued the evaluation of minimal pair treatment in phonological change (Gierut, 1989, 1990, 1991a; Gierut & Neumann, 1992). Three linguistic variables relevant to change were experimentally manipulated within an alternating treatments design to determine specifically the interplay of a maximal number of feature distinctions, feature class, and relationship of treated phonemes to a child's grammar in inducing sound change. The conditions of treatment that were shown to facilitate optimal phonological change in previous research were again experimentally replicated. Specifically, minimal pairs comparing two phonemes previously unknown to a child that also differed by maximal and major class features were found to be the preferred context motivating change. Important individual differences emerged and underscored the role of a child's pretreatment grammar in phonological change. These differences contributed to descriptions of possible courses of change followed by children with phonological disorders and bear upon the predictability of change and the effectiveness of treatments that may condition change.

  9. Conditions for homogeneous preparation of stable monomeric and oligomeric forms of activated Vip3A toxin from Bacillus thuringiensis.

    Science.gov (United States)

    Kunthic, Thittaya; Surya, Wahyu; Promdonkoy, Boonhiang; Torres, Jaume; Boonserm, Panadda

    2016-07-29

    Bacillus thuringiensis vegetative insecticidal proteins like Vip3A have been used for crop protection and to delay resistance to existing insecticidal Cry toxins. However, little is known about Vip3A's behavior or its mechanism of action, and a structural model is required. Herein, in an effort to facilitate future crystallization and functional studies, we have used the orthogonal biophysical techniques of light scattering and sedimentation to analyze the aggregation behavior and stability of trypsin-activated Vip3A toxin in solution. Both scattering and sedimentation data suggest that at pH 10 the toxin is monomeric and adopts an elongated shape, but after overnight incubation aggregation was observed at all pH values tested (5-12). The narrowest size distribution was observed at pH 7, but it was consistent with large oligomers of ~50 nm on average. The addition of β-D-glucopyranoside (OG) helped in achieving preparations that were stable and with a narrower particle size distribution. In this case, scattering was consistent with a 4-nm monomeric globular Vip3A form. After OG dialysis, 40-nm particles were detected, with a molecular weight consistent with homotetramers. Therefore, OG is proposed as the detergent of choice to obtain a Vip3A crystal for structural studies, either before (monomers) or after dialysis (tetramers).

  10. Boundary-layer flow and power output in large wind farms during transition from neutral to stable conditions

    Science.gov (United States)

    Allaerts, Dries; Meyers, Johan

    2016-11-01

    In wind farms, power deficits are directly related to ambient turbulence levels. Power deficits will therefore increase during the transition from a daytime, conventionally neutral boundary layer (CNBL) to the stable boundary layer (SBL) at night. Besides turbulent decay, a multitude of effects occurs during this transition. For instance, low-level jets may cause strong winds at high elevations, while the velocity near the surface generally decreases. Consequently, Coriolis forces induce a change in wind direction, which alters the apparent wind-farm layout in streamwise direction. In this study, we perform LES of a large onshore wind farm in the late-afternoon transition from an equilibrium CNBL to a surface-cooled SBL. The results of two different cooling rates are compared with the wind-farm performance in the CNBL. The power output decrease during the transition, with faster decrease for stronger surface cooling. However, the initial decrease is dominated by the reduction in wind speed, and the relative power deficits do not increase. Further, considerable wake deflection occurs, and a spatially heterogeneous distribution of temperature and heat flux is observed. The authors acknowledge support from the European Research Council (FP7-Ideas, Grant No. 306471).

  11. Growth conditions influence melanization of Brazilian clinical Sporothrix schenckii isolates.

    Science.gov (United States)

    Almeida-Paes, Rodrigo; Frases, Susana; Fialho Monteiro, Paulo Cezar; Gutierrez-Galhardo, Maria Clara; Zancopé-Oliveira, Rosely Maria; Nosanchuk, Joshua D

    2009-04-01

    Sporothrix schenckii is known to produce DHN melanin on both conidial and yeast cells, however little information is available regarding the factors inducing fungal melanization. We evaluated whether culture conditions influenced melanization of 25 Brazilian S. schenckii strains and one control strain (ATCC 10212). Tested conditions included different media, pH, temperature, incubation time, glucose concentrations, and presence or absence of tricyclazole or L-DOPA. Melanization was reduced on Sabouraud compared to defined chemical medium. The majority of strains produced small amounts of melanin at 37 degrees C and none melanized at basic pH. Increased glucose concentrations did not inhibit melanization, rather increasing glucose enhanced pigment production in 27% of strains. Melanin synthesis was also enhanced by the addition of L-DOPA and its addition to medium with tricyclazole, an inhibitor of melanin synthesis, resulted in fungal melanization, including hyphal melanin production. Our results suggest that different S. schenckii strains have distinct control of melanization and that this fungus can use phenolic compounds to enhance melanization in vitro.

  12. Growth conditions influence melanization of Brazilian clinical Sporothrix schenckii isolates

    Science.gov (United States)

    Almeida-Paes, Rodrigo; Frases, Susana; Monteiro, Paulo Cezar Fialho; Gutierrez-Galhardo, Maria Clara; Zancopé-Oliveira, Rosely Maria; Nosanchuk, Joshua D.

    2009-01-01

    Sporothrix schenckii is known to produce DHN melanin on both conidial and yeast cells, however little information is available regarding the factors inducing fungal melanization. We evaluated whether culture conditions influenced melanization of 25 Brazilian S. schenckii strains and one control strain (ATCC 10212). Tested conditions included different media, pH, temperature, incubation time, glucose concentrations, and presence or absence of tricyclazole or L-DOPA. Melanization was reduced on Sabouraud compared to defined chemical medium. The majority of strains produced small amounts of melanin at 37°C and none melanized at basic pH. Increased glucose concentrations did not inhibit melanization, rather increasing glucose enhanced pigment production in 27% of strains. Melanin synthesis was also enhanced by the addition of L-DOPA and its addition to medium with tricyclazole, an inhibitor of melanin synthesis, resulted in fungal melanization, including hyphal melanin production. Our results suggest that different S. schenckii strains have distinct control of melanization and that this fungus can use phenolic compounds to enhance melanization in vitro. PMID:19328867

  13. Stable-isotope analysis of a combined nitrification- denitrification sustained by thermophilic methanotrophs under low-oxygen conditions

    NARCIS (Netherlands)

    Pel, R.; Oldenhuis, R.; Brand, W.; Vos, A.; Gottschal, J.C.; Zwart, K.B.

    1997-01-01

    To simulate growth conditions experienced by microbiota at O-2- limited interfaces of organic matter in compost, an experimental system capable of maintaining dual limitations of oxygen and carbon for extended periods, i.e., a pO(2)-auxostat, has been used. N-15 tracer studies on thermophilic (53

  14. Toward stable nickel catalysts for aqueous phase reforming of biomass-derived feedstock under reducing and alkaline conditions

    NARCIS (Netherlands)

    Haasterecht, van T.; Ludding, C.C.I.; Jong, de K.P.; Bitter, J.H.

    2014-01-01

    Nickel nanoparticles supported on carbon nanofibers (CNF) can be stabilized in aqueous phase processes at elevated temperatures and pressures by tuning the reaction conditions to control Ni oxidation and leaching. As a showcase, Ni/CNF was used for the production of hydrogen via aqueous phase

  15. Monthly continuous erythropoietin receptor activator treatment maintains stable hemoglobin levels in routine clinical management of hemodialysis patients.

    Science.gov (United States)

    Weinreich, Thomas; Leistikow, Frank; Hartmann, Hagen-Georg; Vollgraf, Günter; Dellanna, Frank

    2012-01-01

    Once-monthly administration of CERA, a continuous erythropoietin receptor activator, has shown equivalent efficacy to shorter-acting erythropoiesis-stimulating agents (ESAs) that require more frequent dosing, but data on routine use of once-monthly CERA in hemodialysis patients are lacking. Study on Efficacy, Safety and Applicability of Mircera (SESAM) was a prospective, multicenter, noninterventional trial with a duration of up to 9 months (month 0-5 "titration phase"; month 6-8 "evaluation phase") to test the stability of Hb control in hemodialysis patients under routine conditions. Patient selection, Hb targets and CERA dosing were at the discretion of the local nephrologist. 918 patients from 92 German nephrology centers were included. Ninety-three percent were on ESA treatment prior to study entry. The mean number of CERA dose changes during the study was 1.9 ± 1.9 per patient. Mean Hb level was 11.4 ± 1.2 g/dL at baseline and 11.7 ± 1.4 g/dL at the end of the 8-month study. During the evaluation phase (months 6-8), 15.6%, 40.3%, and 66.0% of patients had stable Hb (i.e., at least two values) in the ranges 11-12, 10-12, and 10-13 g/dL, respectively. The mean intra-individual fluctuation in Hb was 1.4 ± 0.7 g/dL during the study (0.5 ± 0.4 g/dL during the 3-month evaluation phase). More than 90% of patients, and > 80% of physicians, rated CERA therapy as "very good" or "good" throughout the study. Four patients (0.4%) discontinued prematurely due to adverse drug reactions. Once-monthly CERA therapy maintains stable Hb values with low intra-individual variability and few dose adaptations in hemodialysis patients when administered entirely according to local practice, and the regimen was well-tolerated.

  16. [The most common conditions in a neurology specialty clinic].

    Science.gov (United States)

    Trevisol-Bittencourt, P C; Ferreira, M A; Marasciulo, A C; Collares, C F

    2001-06-01

    To present the most frequent diagnosis among patients referred for neurological evaluation to estimate their labour capacities at the unit of National Institute of Social Security (INSS), Florianópolis-SC, southern Brazil. Review of all medical records of 108 patients evaluated between October 97 and May 98. The sample was submitted to judicious medico-legal assessment to define their final diagnosis. Neurological evaluation disclosed as the commonest disorders, in decreasing order of frequency: epilepsy, rheumatic diseases, psychiatric illnesses, neurological disorders related to chronic alcoholism, head trauma syndrome and cerebrovascular diseases. Neurological disorders may be responsible for important disability among workers in our society. However, the potential for social rehabilitation, often underestimated, must be considered. Moreover, diverse non-neurological conditions used to be sent for neurological evaluation.

  17. An NMR Study of the Bortezomib Degradation under Clinical Use Conditions

    Directory of Open Access Journals (Sweden)

    Adele Bolognese

    2009-01-01

    Full Text Available The (R-3-methyl-1-((S-3-phenyl-2-(pyrazine-2-carboxamidopropanamidobutyl-boronic acid, bortezomib (BTZ, which binds the 20S proteasome subunit and causes a large inhibition of its activity, is a peptidomimetic boronic drug mainly used for the treatment of multiple myeloma. Commercial BTZ, stabilized as mannitol derivative, has been investigated under the common conditions of the clinical use because it is suspected to be easily degradable in the region of its boronic moiety. Commercial BTZ samples, reconstituted according to the reported commercial instructions and stored at 4∘C, were analyzed by high-field nuclear magnetic resonance spectroscopy in comparison with identical samples bubbled with air and argon, respectively. All the samples remained unchanged for a week. After a month, the air filled samples showed the presence of two main degradation products (6% of starting material, the N-(1-(1-hydroxy-3-methylbutylamino-1-oxo-3-phenylpropan-2-yl pyrazine-2-carboxamide (BTZ1; 5%, determined from NMR integration and the (S-N-(1-(3-methylbutanamido-1-oxo-3-phenylpropan-2-ylpyrazine-2-carboxamide (BTZ2; 1%, determined from NMR integration, identified on the basis of their chemical and spectroscopic properties. The BTZ1 and BTZ2 finding suggests that, under the common condition of use and at 4∘C, commercial BTZ-mannitol is stable for a week, and that, in time, it undergoes slow oxidative deboronation which partially inactivates the product. Low temperature and scarce contact with air decrease the degradation process.

  18. Stability of clinical outcome measures in rheumatoid arthritis patients with stable disease defined on the basis of the EULAR response criteria

    DEFF Research Database (Denmark)

    Madsen, Ole Rintek

    2016-01-01

    Natural variation also known as measurement error is assessed in individuals in "steady state." The study aimed to examine inter-visit variations in clinical outcome measures in rheumatoid arthritis (RA) patients with stable disease defined on the basis of the EULAR response criteria. Two hundred...

  19. Development of stable walking robot for accident condition monitoring on uneven floors in a nuclear power plant

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jong Seog; Jang, You Hyun [Central Research Institute of Korea Hydro and Nuclear Power Company, Daejeon (Korea, Republic of)

    2017-04-15

    Even though the potential for an accident in nuclear power plants is very low, multiple emergency plans are necessary because the impact of such an accident to the public is enormous. One of these emergency plans involves a robotic system for investigating accidents under conditions of high radiation and contaminated air. To develop a robot suitable for operation in a nuclear power plant, we focused on eliminating the three major obstacles that challenge robots in such conditions: the disconnection of radio communication, falling on uneven floors, and loss of localization. To solve the radio problem, a Wi-Fi extender was used in radio shadow areas. To reinforce the walking, we developed two- and four-leg convertible walking, a floor adaptive foot, a roly-poly defensive falling design, and automatic standing recovery after falling methods were developed. To allow the robot to determine its location in the containment building, a bar code landmark reading method was chosen. When a severe accident occurs, this robot will be useful for accident condition monitoring. We also anticipate the robot can serve as a workman aid in a high radiation area during normal operations.

  20. Trapping of xenon gas in closed inner spaces of carbon nanomaterials for stable gas storage under high-vacuum condition

    Science.gov (United States)

    Kobayashi, Keita; Yasuda, Hidehiro

    2017-01-01

    Xe gas can be trapped in the closed inner spaces of glassy carbon derived from C60 fullerene by thermal coalescence of C60 in Xe atmosphere and in cap-opened carbon nanotubes (CNTs) covered with an ionic liquid by soaking Xe-adsorbing CNTs in an ionic liquid. The trapped Xe gas is detected by energy dispersive X-ray spectrometry using a spectrometer mounted on an analytical transmission electron microscope. The closed inner spaces store gas molecules even under high-vacuum condition (˜10-5 Pa).

  1. A Conditionally Stable Scheme for a Transient Flow of a Non-Newtonian Fluid Saturating a Porous Medium

    KAUST Repository

    El-Amin, Mohamed

    2012-06-02

    The problem of thermal dispersion effects on unsteady free convection from an isothermal horizontal circular cylinder to a non-Newtonian fluid saturating a porous medium is examined numerically. The Darcy-Brinkman-Forchheimer model is employed to describe the flow field. The thermal diffusivity coefficient has been assumed to be the sum of the molecular diffusivity and the dynamic diffusivity due to mechanical dispersion. The simultaneous development of the momentum and thermal boundary layers are obtained by using finite difference method. The stability conditions are determined for each difference equation. Using an explicit finite difference scheme, solutions at each time-step have been found and then stepped forward in time until reaching steady state solution. Velocity and temperature profiles are shown graphically. It is found that as time approaches infinity, the values of friction factor and heat transfer coefficient approach the steady state values.

  2. Highly fluorescence-stable blue CdZnS/ZnS quantum dots against degradable environmental conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ki-Heon; Lee, Jeong-Hoon; Kang, Hee-Don; Han, Chang-Yeol [Department of Materials Science and Engineering, Hongik University, Seoul 121-791 (Korea, Republic of); Bae, Seung Muk [Kunsan National University Center For Research Facilities, Kunsan National University, Gunsan, Jeonbuk 573-701 (Korea, Republic of); Lee, Yangjin; Hwang, Jun Yeon [Institute of Advanced Composite Materials, Korea Institute of Science and Technology, Jeonbuk 565-905 (Korea, Republic of); Yang, Heesun, E-mail: hyang@hongik.ac.kr [Department of Materials Science and Engineering, Hongik University, Seoul 121-791 (Korea, Republic of)

    2014-10-15

    Graphical abstract: Blue-emitting CdZnS/ZnS alloy QDs exhibited the excellent fluorescent stability against a thorough purification cycle, long-term UV illumination, and hydrophobic-to-hydrophilic ligand exchange. - Highlights: • Highly efficient, color-pure blue CdZnS/ZnS QDs are synthesized. • Fluorescent properties of the QDs remain unchanged against various degradable conditions. • Closely-packed solid QD film is compared with QD solution in PL QY and emission decay dynamics. - Abstract: We report on synthesis of highly efficient, color-pure blue CdZnS/ZnS quantum dots (QDs) and their excellent fluorescent stability against degradable environmental conditions. The CdZnS/ZnS QDs finely emission-tunable in the range of 440–461 nm exhibit high photoluminescence (PL) quantum yields (QYs) of 81–92% along with an exceptionally narrow spectral bandwidth of 19 nm. These QDs are subjected to various post-treatments of a thorough purification cycle, long-term UV illumination, and hydrophobic-to-hydrophilic ligand exchange, each of which is usually detrimental to QD fluorescence. As a result, no noticeable deterioration in the fluorescent properties is observed, indicative of the insensitiveness of our CdZnS/ZnS QDs to the above degradable processes. Furthermore, PL properties of a solid film of multiple QD layers are assessed and compared with those of a diluted QD solution, showing an unprecedentedly small QY reduction of solid QD film versus QD solution. The above promising results are justified mainly by emphasizing the role of a thick ZnS shell present in CdZnS/ZnS QDs.

  3. Clinical significance of microembolus detection by transcranial Doppler sonography in cardiovascular clinical conditions.

    Science.gov (United States)

    Hudorović, Narcis

    2006-01-01

    Transcranial Doppler can detect microembolic signals, which are characterized by unidirectional high intensity increase, short duration, and random occurrence, producing a "whistling" sound. Microembolic signals have been proven to represent solid or gaseous particles within the blood flow. Microemboli have been detected in a number of clinical cardiovascular settings: carotid artery stenosis, aortic arch plaques, atrial fibrillation, myocardial infarction, prosthetic heart valves, patent foramen ovale, valvular stenosis, during invasive procedures (angiography, percutaneous transluminal angioplasty) and surgery (carotid, cardiopulmonary bypass). Despite numerous studies performed so far, clinical significance of microembolic signals is still unclear. This article provides an overview of the development and current state of technical and clinical aspects of microembolus detection.

  4. 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...

  5. Challenges of clinical trial design when there is lack of clinical equipoise: use of a response-conditional crossover design.

    Science.gov (United States)

    Deng, Chunqin; Hanna, Kim; Bril, Vera; Dalakas, Marinos C; Donofrio, Peter; van Doorn, Pieter A; Hartung, Hans-Peter; Merkies, Ingemar S J

    2012-02-01

    Clinical equipoise is widely accepted as the basis of ethics in clinical research and requires investigators to be uncertain of the relative therapeutic merits of trial comparators. When clinical equipoise is in question, innovative trial designs are needed to reduce ethical tension while satisfying regulators' requirements. We report a novel response-conditional crossover study design used in a Phase 3, randomized, double-blind, placebo-controlled clinical trial of intravenous 10% caprylate-chromatography purified immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy. During the initial 24-week period, patients crossed over to the alternative treatment at the first sign of deterioration or if they failed to improve or were unable to maintain improvement at any time after 6 weeks. This trial design addressed concerns about lack of equipoise raised by physicians interested in trial participation and proved acceptable to regulatory authorities. The trial design may be applicable to other studies where clinical equipoise is in question.

  6. Critical appraisal of clinical prediction rules that aim to optimize treatment selection for musculoskeletal conditions

    NARCIS (Netherlands)

    T.R. Stanton (Tasha); M.J. Hancock (Mark J.); C. Maher (Chris); B.W. Koes (Bart)

    2010-01-01

    textabstractBackground. Clinical prediction rules (CPRs) for treatment selection in musculoskeletal conditions have become increasingly popular. Purpose. The purposes of this review are: (1) to critically appraise studies evaluating CPRs and (2) to consider the clinical utility and stage of developm

  7. Influence of sludge retention time at constant food to microorganisms ratio on membrane bioreactor performances under stable and unstable state conditions.

    Science.gov (United States)

    Villain, Maud; Marrot, Benoît

    2013-01-01

    Food to microorganisms ratio (F/M) and sludge retention time (SRT) are known to affect in different ways biomass growth, bioactivities and foulants characteristics. Thus the aim of this study was to dissociate the effects of SRT from those of F/M ratio on lab-scale membrane bioreactors performances during stable and unstable state. Two acclimations were stabilized at a SRT of either 20 or 50 d with a constant F/M ratio of 0.2 kg(COD)kg(MLVSS)(-1) d(-1). During stable state, a higher N-NH(4)(+) removal rate (78%) was obtained at SRT of 50 d as an easier autotroph development was observed. Soluble microbial products (SMPs) release was double at 50 d with a majority of polysaccharides (49% of total SMP). The unstable conditions consisted in F/M ratio changes and operation without air and nutrient. Autotrophs were highly affected by the tested disturbances and SMP retention on membrane surface exhibited consistent changes during the performed stresses.

  8. Modélisation du transport des isotopes stables de l'eau (18O et D) dans le cas d'un sol nu en conditions naturelles

    OpenAIRE

    Melayah, A.; Bruckler, L; Bariac, T.

    1996-01-01

    Nous proposons dans ce travail un modèle mécaniste de prévision du comportement des isotopes stables de l'eau (18O et 2H) dans le système sol atmosphère soumis à des conditions climatiques quelconques. Les principales caractéristiques du modèle sont le couplage entre les flux dans le sol et dans l'atmosphère par l'intermédiaire du bilan d'énergie à la surface du sol et de la convection turbulente dans les basses couches atmosphériques, la prise en compte simultanée des flux isotopiques diffus...

  9. DNA stable-isotope probing of oil sands tailings pond enrichment cultures reveals different key players for toluene degradation under methanogenic and sulfidogenic conditions.

    Science.gov (United States)

    Laban, Nidal Abu; Dao, Anh; Foght, Julia

    2015-05-01

    Oil sands tailings ponds are anaerobic repositories of fluid wastes produced by extraction of bitumen from oil sands ores. Diverse indigenous microbiota biodegrade hydrocarbons (including toluene) in situ, producing methane, carbon dioxide and/or hydrogen sulfide, depending on electron acceptor availability. Stable-isotope probing of cultures enriched from tailings associated specific taxa and functional genes to (13)C6- and (12)C7-toluene degradation under methanogenic and sulfate-reducing conditions. Total DNA was subjected to isopycnic ultracentrifugation followed by gradient fraction analysis using terminal restriction fragment length polymorphism (T-RFLP) and construction of 16S rRNA, benzylsuccinate synthase (bssA) and dissimilatory sulfite reductase (dsrB) gene clone libraries. T-RFLP analysis plus sequencing and in silico digestion of cloned taxonomic and functional genes revealed that Clostridiales, particularly Desulfosporosinus (136 bp T-RF) contained bssA genes and were key toluene degraders during methanogenesis dominated by Methanosaeta. Deltaproteobacterial Desulfobulbaceae (157 bp T-RF) became dominant under sulfidogenic conditions, likely because the Desulfosporosinus T-RF 136 apparently lacks dsrB and therefore, unlike its close relatives, is presumed incapable of dissimilatory sulfate reduction. We infer incomplete oxidation of toluene by Desulfosporosinus in syntrophic association with Methanosaeta under methanogenic conditions, and complete toluene oxidation by Desulfobulbaceae during sulfate reduction. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Myocardial ischemic conditioning: Physiological aspects and clinical applications in cardiac surgery.

    Science.gov (United States)

    Bousselmi, Radhouane; Lebbi, Mohamed Anis; Ferjani, Mustapha

    2014-04-01

    Ischemia-reperfusion is a major determinant of myocardial impairment in patients undergoing cardiac surgery. The main goal of research in cardioprotection is to develop effective techniques to avoid ischemia-reperfusion lesions. Myocardial ischemic conditioning is a powerful endogenous cardioprotective phenomenon. First described in animals in 1986, myocardial ischemic conditioning consists of applying increased tolerance of the myocardium to sustained ischemia by exposing it to brief episodes of ischemia-reperfusion. Several studies have sought to demonstrate its effective cardioprotective action in humans and to understand its underlying mechanisms. Myocardial ischemic conditioning has two forms: ischemic preconditioning (IPC) when the conditioning stimulus is applied before the index ischemia and ischemic postconditioning when the conditioning stimulus is applied after it. The cardioprotective action of ischemic conditioning was reproduced by applying the ischemia-reperfusion stimulus to organs remote from the heart. This non-invasive manner of applying ischemic conditioning has led to its application in clinical settings. Clinical trials for the different forms of ischemic conditioning were mainly developed in cardiac surgery. Many studies suggest that this phenomenon can represent an interesting adjuvant to classical cardioprotection during on-pump cardiac surgery. Ischemic conditioning was also tested in interventional cardiology with interesting results. Finally, advances made in the understanding of mechanisms that underlie the cardioprotective action of ischemic conditioning have paved the way to a new form of myocardial conditioning which is pharmacological conditioning.

  11. High-intensity Statin Treatments in Clinically Stable Patients on Aspirin Monotherapy 12 Months After Drug-eluting Stent Implantation: A Randomized Study.

    Science.gov (United States)

    Im, Eui; Cho, Yun-Hyeong; Suh, Yongsung; Cho, Deok-Kyu; Her, Ae-Young; Kim, Yong Hoon; Lee, Kyounghoon; Kang, Woong Chol; Yun, Kyeong Ho; Yoo, Sang-Yong; Cheong, Sang-Sig; Shin, Dong-Ho; Ahn, Chul-Min; Kim, Jung-Sun; Kim, Byeong-Keuk; Ko, Young-Guk; Choi, Donghoon; Jang, Yangsoo; Hong, Myeong-Ki

    2017-07-14

    Current guidelines on the treatment of blood cholesterol recommend continuous maintenance of high-intensity statin treatment in drug-eluting stent (DES)-treated patients. However, high-intensity statin treatment is frequently underused in clinical practice after stabilization of DES-treated patients. Currently, the impact of continuous high-intensity statin treatment on the incidence of late adverse events in these patients is unknown. We investigated whether high-intensity statin treatment reduces late adverse events in clinically stable patients on aspirin monotherapy 12 months after DES implantation. Clinically stable patients who underwent DES implantation 12 months previously and received aspirin monotherapy were randomly assigned to receive either high-intensity (40mg atorvastatin, n = 1000) or low-intensity (20mg pravastatin, n = 1000) statin treatment. The primary endpoint was adverse clinical events at 12-month follow-up (a composite of all death, myocardial infarction, revascularization, stent thrombosis, stroke, renal deterioration, intervention for peripheral artery disease, and admission for cardiac events). The primary endpoint at 12-month follow-up occurred in 25 patients (2.5%) receiving high-intensity statin treatment and in 40 patients (4.1%) receiving low-intensity statin treatment (HR, 0.58; 95%CI, 0.36-0.92; P = .018). This difference was mainly driven by a lower rate of cardiac death (0 vs 0.4%, P = .025) and nontarget vessel myocardial infarction (0.1 vs 0.7%, P = .033) in the high-intensity statin treatment group. Among clinically stable DES-treated patients on aspirin monotherapy, high-intensity statin treatment significantly reduced late adverse events compared with low-intensity statin treatment. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01557075. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  12. Clinical and radiographic results of arthroscopic partial lateral meniscectomies in stable knees with a minimum follow up of 20 years

    OpenAIRE

    Hulet, Christophe; Menetrey, Jacques; Beaufils, Philippe; Chambat, Pierre; DJIAN, Patrick; Hardy, Philippe; POTEL, Jean-François; Servien, Elvire; Seil, Romain; SOCIETE FRANCAISE D'ARTHROSCOPIE - SFA

    2015-01-01

    Purpose The purpose of this retrospective multicentric study was to evaluate the long-term effects of lateral meniscectomy and to identify those patients who are at the most risk of developing osteoarthritis (OA). Methods Eighty-nine arthroscopic partial lateral meniscectomies in stable knees with a mean follow-up of 22 ± 3 years were included. The following influencing factors were analyzed: age, sex, body mass index (BMI), physical activity, alignment, the types of meniscal lesions, the ext...

  13. The International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of xenocorneal transplantation.

    Science.gov (United States)

    Kim, Mee Kum; Choi, Hyuk Jin; Kwon, Ivo; Pierson, Richard N; Cooper, David K C; Soulillou, Jean-Paul; O'Connell, Philip J; Vabres, Bertrand; Maeda, Naoyuki; Hara, Hidetaka; Scobie, Linda; Gianello, Pierre; Takeuchi, Yasuhiro; Yamada, Kazuhiko; Hwang, Eung-Soo; Kim, Sang Joon; Park, Chung-Gyu

    2014-01-01

    To develop an international consensus regarding the appropriate conditions for undertaking clinical trials in xenocorneal transplantation, here we review specific ethical, logistical, scientific, and regulatory issues regarding xenocorneal transplantation, and propose guidelines for conduct of clinical xenocorneal transplantation trials. These proposed guidelines are modeled on the published consensus statement of the International Xenotransplantation Association regarding recommended guidelines for conduct of clinical islet xenotransplantation. It is expected that this initial consensus statement will be revised over time in response to scientific advances in the field, and changes in the regulatory framework based on accumulating clinical experience.

  14. Clinical and immunological correction of DOCK8 deficiency by allogeneic hematopoietic stem cell transplantation following a reduced toxicity conditioning regimen.

    Science.gov (United States)

    Boztug, Heidrun; Karitnig-Weiß, Cäcilia; Ausserer, Bernd; Renner, Ellen D; Albert, Michael H; Sawalle-Belohradsky, Julie; Belohradsky, Bernd H; Mann, Georg; Horcher, Ernst; Rümmele-Waibel, Alexandra; Geyeregger, Rene; Lakatos, Karoly; Peters, Christina; Lawitschka, Anita; Matthes-Martin, Susanne

    2012-10-01

    Dedicator of cytokinesis 8 protein (DOCK8) deficiency is a combined immunodeficiency disorder characterized by an expanding clinical picture with typical features of recurrent respiratory or gastrointestinal tract infections, atopic eczema, food allergies, chronic viral infections of the skin, and blood eosinophilia often accompanied by elevated serum IgE levels. The only definitive treatment option is allogeneic hematopoietic stem cell transplantation (HSCT). We report a patient with early severe manifestation of DOCK8 deficiency, who underwent unrelated allogeneic HSCT at the age of 3 years following a reduced toxicity conditioning regimen. The transplant course was complicated by pulmonary aspergilloma pretransplantation, adenovirus (ADV) reactivation, and cytomegalovirus (CMV) pneumonitis 4 weeks after transplantation. With antifungal and antiviral treatment the patient recovered. Seven months after transplantation the patient is in excellent clinical condition. Eczematous rash, chronic viral skin infections, and food allergies have subsided, associated with normalization of IgE levels and absolute numbers of eosinophils. Chimerism analysis shows stable full donor chimerism. DOCK8 deficiency can be successfully cured by allogeneic HSCT. This treatment option should be considered early after diagnosis, as opportunistic infections and malignancies that occur more frequently during the natural course of the disease are associated with higher morbidity and mortality.

  15. Comparison of conditional bias-adjusted estimators for interim analysis in clinical trials with survival data.

    Science.gov (United States)

    Shimura, Masashi; Gosho, Masahiko; Hirakawa, Akihiro

    2017-02-17

    Group sequential designs are widely used in clinical trials to determine whether a trial should be terminated early. In such trials, maximum likelihood estimates are often used to describe the difference in efficacy between the experimental and reference treatments; however, these are well known for displaying conditional and unconditional biases. Established bias-adjusted estimators include the conditional mean-adjusted estimator (CMAE), conditional median unbiased estimator, conditional uniformly minimum variance unbiased estimator (CUMVUE), and weighted estimator. However, their performances have been inadequately investigated. In this study, we review the characteristics of these bias-adjusted estimators and compare their conditional bias, overall bias, and conditional mean-squared errors in clinical trials with survival endpoints through simulation studies. The coverage probabilities of the confidence intervals for the four estimators are also evaluated. We find that the CMAE reduced conditional bias and showed relatively small conditional mean-squared errors when the trials terminated at the interim analysis. The conditional coverage probability of the conditional median unbiased estimator was well below the nominal value. In trials that did not terminate early, the CUMVUE performed with less bias and an acceptable conditional coverage probability than was observed for the other estimators. In conclusion, when planning an interim analysis, we recommend using the CUMVUE for trials that do not terminate early and the CMAE for those that terminate early. Copyright © 2017 John Wiley & Sons, Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Kun-Ching; Lee, Do Gyun [Zachry Department of Civil Engineering, Texas A& M University, College Station, TX 77843-3136 (United States); Fuller, Mark E.; Hatzinger, Paul B.; Condee, Charles W. [CB& I Federal Services, Lawrenceville, NJ (United States); Chu, Kung-Hui, E-mail: kchu@civil.tamu.edu [Zachry Department of Civil Engineering, Texas A& M University, College Station, TX 77843-3136 (United States)

    2015-10-30

    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 {sup 13}C and {sup 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 {sup 13}C{sub 3}- or ring-{sup 15}N{sub 3}-, nitro-{sup 15}N{sub 3}-, or fully-labeled {sup 15}N{sub 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 {sup 13}C-DNA fractions. A total of twenty seven sequences were derived from different {sup 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 {sup 13}C or {sup 15}N from labeled RDX, but also were detected under each of the different electron-accepting conditions. The data suggest that {sup 13}C- and {sup 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

  17. [Method for direct generation data for formatted case report forms based on requirement for data authenticity in actual clinical conditions].

    Science.gov (United States)

    Shao, Ming-Yi; Liu, Bao-Yan; He, Li-Yun; Zhang, Run-Shun

    2013-04-01

    Data authenticity is the basic requirement of clinical studies. In actual clinical conditions how to establish formatted case report forms (CRF) in line with the requirement for data authenticity is the key to ensure clinical data quality. On the basis of the characteristics of clinical data in actual clinical conditions, we determined elements for establishing formatted case report forms by comparing differences in data characteristics of CRFs in traditional clinical studies and in actual clinical conditions, and then generated formatted case report forms in line with the requirement for data authenticity in actual clinical conditions. The data of formatted CRFs generated in this study could not only meet the requirement for data authenticity of clinical studies in actual clinical conditions, but also comply with data management practices for clinical studies, thus it is deemed as a progress in technical methods.

  18. 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.

  19. Using a Clinical Knowledge Base to Assess Comorbidity Interrelatedness Among Patients with Multiple Chronic Conditions

    Science.gov (United States)

    Zulman, Donna M.; Martins, Susana B.; Liu, Yan; Tu, Samson W.; Hoffman, Brian B.; Asch, Steven M.; Goldstein, Mary K.

    2015-01-01

    Decision support tools increasingly integrate clinical knowledge such as medication indications and contraindications with electronic health record (EHR) data to support clinical care and patient safety. The availability of this encoded information and patient data provides an opportunity to develop measures of clinical decision complexity that may be of value for quality improvement and research efforts. We investigated the feasibility of using encoded clinical knowledge and EHR data to develop a measure of comorbidity interrelatedness (the degree to which patients’ co-occurring conditions interact to generate clinical complexity). Using a common clinical scenario—decisions about blood pressure medications in patients with hypertension—we quantified comorbidity interrelatedness by calculating the number of indications and contraindications to blood pressure medications that are generated by patients’ comorbidities (e.g., diabetes, gout, depression). We examined properties of comorbidity interrelatedness using data from a decision support system for hypertension in the Veterans Affairs Health Care System. PMID:26958279

  20. The empathic brain and its dysfunction in psychiatric populations: implications for intervention across different clinical conditions

    Directory of Open Access Journals (Sweden)

    Moriguchi Yoshiya

    2007-11-01

    Full Text Available Abstract Empathy is a concept central to psychiatry, psychotherapy and clinical psychology. The construct of empathy involves not only the affective experience of the other person's actual or inferred emotional state but also some minimal recognition and understanding of another's emotional state. It is proposed, in the light of multiple levels of analysis including social psychology, cognitive neuroscience and clinical neuropsychology, a model of empathy that involves both bottom-up and top-down information processing underpinned by parallel and distributed computational mechanisms. The predictive validity of this model is explored with reference to clinical conditions. As many psychiatric conditions are associated with deficits or even lack of empathy, we discuss a limited number of these disorders including psychopathy/antisocial personality disorders, borderline and narcissistic personality disorders, autistic spectrum disorders, and alexithymia. We argue that future clinical investigations of empathy disorders can only be informative if behavioral, dispositional and biological factors are combined.

  1. 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

    Energy Technology Data Exchange (ETDEWEB)

    Gondi, Vinai, E-mail: gondi@humonc.wisc.edu [Department of Radiation Oncology, University of Wisconsin Comprehensive Cancer Center, Madison, Wisconsin (United States); Bernard, Johnny Ray [Mayo Clinic Jacksonville, Jacksonville, Florida (United States); Jabbari, Siavash [University of California San Francisco, San Francisco, California (United States); Keam, Jennifer [Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Amorim Bernstein, Karen L. de [Albert Einstein College of Medicine, Bronx, New York (United States); Dad, Luqman K. [SUNY Roswell Park Cancer Institute, Buffalo, New York (United States); Li, Linna [Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Poppe, Matthew M. [University of Utah Huntsman Cancer Hospital (United States); Strauss, Jonathan B. [Northwestern University Feinberg School of Medicine, Chicago, Illinois (United States); Chollet, Casey T. [Loyola University Medical Center, Maywood, Illinois (United States)

    2011-11-15

    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

  2. Fossil gastropods from the Indian Upper Siwaliks and their stable carbon and oxygen isotope values indicate presence of cold climatic conditions in the Early Pleistocene.

    Science.gov (United States)

    Singh Kotla, Simran

    2016-04-01

    The Early Pleistocene in general is characterized by widespread glaciations in the Northern Hemisphere. Early to Middle Pleistocene freshwater Pinjor Formation (Upper Siwalik) exposed all along the Himalayan Foothills preserves a diverse faunal and floral assemblage. We carried out paleontological (gastropods) and stable isotope (carbon and oxygen isotope) studies of a 6 m thick swamp/pond deposit (that represents ~ 12,000 yrs) of Pinjor Formation, exposed near the Village Nadah, Panchkula (Haryana) and dated to ~ 1.8 Ma (Azzaroli and Napoleon,1982). We have identified four gastropod species in the assemblage, Lymnae sp., Gyraulus sp., Viviparous bengalensis and Hippeutis complantus. The first two are widespread throughout the globe. Lymnae can exist in temperature range of 19 to 24 ° C and occur in Palearctic and Neoartic regions (animalbase.org). Gyraulus occur in Holoarctic region with temperature ranging from 17.8 to 30 ° C (animalbase.org, theaquariumwiki.com), whereas Viviparous bengalensis typically exists in the Oriental region suggesting an overall warm and humid condition (Moore,1997). Hippeutis complantus on the other hand exists in palearctic regions upto 63 ° N (Aplinarska and Cisewka 2006) under cold (6 ° to 23.3 ° C) and dry climatic conditions (Spyra., 2014).The powdered gastropod shell samples were analyzed using Continues Flow Isotope Ratio Mass Spectrometer (CF-IRMS) at the Wadia Institute of Himalayan Geology, Dehradun, India. The δ13C values of gastropod shells fall between -2.56‰ and 6.14‰ VPDB and suggest the dominance of C4 vegetation. The δ18O value of gastropod shell fall between -0.64‰ and -7.80‰ VPDB, suggesting fluctuation of climate between warm and cold conditions . Presence of Hippeutis complantus may suggest the extension of palearctic region up to Panchkula (Haryana, India) in the Early Pleistocene which presently lies in the Oriental Province. Therefore, our results indicate that the overall climatic condition

  3. 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.

  4. A Double Blind Randomized Clinical Trial of Remote Ischemic Conditioning in Live Donor Renal Transplantation

    OpenAIRE

    Nicholson, Michael L; Pattenden, Clare J.; Barlow, Adam D.; Hunter, James P.; Lee, Gwyn; Hosgood, Sarah A.

    2015-01-01

    Abstract Ischemic conditioning involves the delivery of short cycles of reversible ischemic injury in order to induce protection against subsequent more prolonged ischemia. This randomized controlled trial was designed to determine the safety and efficacy of remote ischemic conditioning (RC) in live donor kidney transplantation. This prospective randomized clinical trial, 80 patients undergoing live donor kidney transplantation were randomly assigned in a 1:1 ratio to either RC or to a contro...

  5. SELDI-TOF-MS determination of hepcidin in clinical samples using stable isotope labelled hepcidin as an internal standard

    Directory of Open Access Journals (Sweden)

    Johnson Philip J

    2008-10-01

    Full Text Available Abstract Background Hepcidin is a 25-residue peptide hormone crucial to iron homeostasis. It is essential to measure the concentration of hepcidin in cells, tissues and body fluids to understand its mechanisms and roles in physiology and pathophysiology. With a mass of 2791 Da hepcidin is readily detectable by mass spectrometry and LC-ESI, MALDI and SELDI have been used to estimate systemic hepcidin concentrations by analysing serum or urine. However, peak heights in mass spectra may not always reflect concentrations in samples due to competition during binding steps and variations in ionisation efficiency. Thus the purpose of this study was to develop a robust assay for measuring hepcidin using a stable isotope labelled hepcidin spiking approach in conjunction with SELDI-TOF-MS. Results We synthesised and re-folded hepcidin labelled with 13C/15N phenylalanine at position 9 to generate an internal standard for mass spectrometry experiments. This labelled hepcidin is 10 Daltons heavier than the endogenous peptides and does not overlap with the isotopic envelope of the endogenous hepcidin or other common peaks in human serum or urine mass spectra and can be distinguished in low resolution mass spectrometers. We report the validation of adding labelled hepcidin into serum followed by SELDI analysis to generate an improved assay for hepcidin. Conclusion We demonstrate that without utilising a spiking approach the hepcidin peak height in SELDI spectra gives a good indication of hepcidin concentration. However, a stable isotope labelled hepcidin spiking approach provides a more robust assay, measures the absolute concentration of hepcidin and should facilitate inter-laboratory hepcidin comparisons.

  6. Determining Carbon and Oxygen Stable Isotope Systematics in Brines at Elevated p/T Conditions to Enhance Monitoring of CO2 Induced Processes in Carbon Storage Reservoirs

    Science.gov (United States)

    Becker, V.; Myrttinen, A.; Mayer, B.; Barth, J. A.

    2012-12-01

    Stable carbon isotope ratios (δ13C) are a powerful tool for inferring carbon sources and mixing ratios of injected and baseline CO2 in storage reservoirs. Furthermore, CO2 releasing and consuming processes can be deduced if the isotopic compositions of end-members are known. At low CO2 pressures (pCO2), oxygen isotope ratios (δ18O) of CO2 usually assume the δ18O of the water plus a temperature-dependent isotope fractionation factor. However, at very high CO2 pressures as they occur in CO2 storage reservoirs, the δ18O of the injected CO2 may in fact change the δ18O of the reservoir brine. Hence, changing δ18O of brine constitutes an additional tracer for reservoir-internal carbon dynamics and allows the determination of the amount of free phase CO2 present in the reservoir (Johnson et al. 2011). Further systematic research to quantify carbon and oxygen isotope fractionation between the involved inorganic carbon species (CO2, H2CO3, HCO3-, CO32-, carbonate minerals) and kinetic and equilibrium isotope effects during gas-water-rock interactions is necessary because p/T conditions and salinities in CO2 storage reservoirs may exceed the boundary conditions of typical environmental isotope applications, thereby limiting the accuracy of stable isotope monitoring approaches in deep saline formations (Becker et al. 2011). In doing so, it is crucial to compare isotopic patterns observed in laboratory experiments with artificial brines to similar experiments with original fluids from representative field sites to account for reactions of dissolved inorganic carbon (DIC) with minor brine components. In the CO2ISO-LABEL project, funded by the German Ministry for Education and Research, multiple series of laboratory experiments are conducted to determine the influence of pressure, temperature and brine composition on the δ13C of DIC and the δ18O of brines in water-CO2-rock reactions with special focus placed on kinetics and stable oxygen and carbon isotope fractionation

  7. A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks

    Directory of Open Access Journals (Sweden)

    McInnes Elizabeth

    2012-02-01

    Full Text Available Abstract Background Clinical networks have been established to improve health outcomes and processes of care by implementing a range of innovations and undertaking projects based on perceived local need. Limited research exists on the necessary conditions required to bring about successful network outcomes and what characterises network success from the perspective of those involved in network initiatives. This qualitative study identified stakeholder views on i the conditions for effective clinical networks; and ii desirable outcomes of successful clinical networks. Methods Twenty-seven participants were interviewed using face-to-face audio-recorded semi-structured interviews. Transcribed data were coded and analysed to generate themes relating to the study aims. Results Five key factors represented as sub-themes were identified as important conditions for the establishment of successful clinical networks under the main theme of effective network structure, organisation and governance. These were: building relationships; effective leadership; strategic evidence-based workplans; adequate resources; and ability to implement and evaluate network initiatives. Two major themes encapsulated views on desirable outcomes of successful clinical networks: connecting and engaging which represented the outcomes of interdisciplinary and consumer collaboration and, partnerships with state health and local health services, and changing the landscape of care, which represented the importance of outcomes associated with improving services, care and patient health outcomes and implementing evidence-based practice. Conclusions This study provides new knowledge on the conditions needed to establish successful clinical networks and on desirable outcomes arising from network projects and initiatives that are considered to be valuable by those working in or associated with clinical networks. This provides health services with information on what needs to be in place

  8. Effects of stable aqueous fullerene nanocrystal (nC60) on Daphnia magna:Evaluation of hop frequency and accumulations under different conditions

    Institute of Scientific and Technical Information of China (English)

    Xianji Tao; Yiliang He; Bo Zhang; Yongsheng Chen; Joseph B. Hughes

    2011-01-01

    We investigated the effects of environmental factors and properties of water-stable crystal fullerene (nC60) on the uptake of nC60 by Daphnia magna based on known accumulation in our laboratory. This study was performed for seven days using different environmental factors including temperature, pH, water hardness, concentration (density of particle), and particle size. Results demonstrated that body burden of C60 increased with time in all experiments. Body burden of C60 increased with increasing concentration and particle size, and uptake of particles >100 nm reached their maximums more quickly than those <100 nm. Under high hardness in aqueous systems with lower pH and high temperature, uptake was higher than those under opposite conditions. Uptake in all batch tests reached balance within five days. Both nC60 properties and environmental factors influenced uptake of nC60 by D.magna in an aqueous system. Additionally, environmental factors may have affected accumulation by changing nC60 properties, which are critical to understand the accumulation of fullerenes in aqueous systems.

  9. Clinical FDG PET CT in the Investigation of Suspected Inflammatory and Infective Conditions

    DEFF Research Database (Denmark)

    Lorenz, Eleanor; Wig, Surabhi; Prakash, Vineet

    PURPOSE          F18 FDG PET CT is an established molecular imaging technique most commonly used in the diagnosis and staging of oncological conditions. A rapidly growing clinical application of PET CT is in the investigation of inflammatory and infectious diseases. A review of PET CT scans perfo...

  10. Epidemiology of Autism Spectrum Disorder in Portugal: Prevalence, Clinical Characterization, and Medical Conditions

    Science.gov (United States)

    Oliveira, Guiomar; Ataide, Assuncao; Marques, Carla; Miguel, Teresa S.; Coutinho, Ana Margarida; Mota-Vieira, Luisa; Goncalves, Esmeralda; Lopes, Nazare Mendes; Rodrigues, Vitor; Carmona da Mota, Henrique; Vicente, Astrid Moura

    2007-01-01

    The objective of this study was to estimate the prevalence of autistic spectrum disorder (ASD) and identify its clinical characterization, and medical conditions in a paediatric population in Portugal. A school survey was conducted in elementary schools, targeting 332 808 school-aged children in the mainland and 10 910 in the Azores islands.…

  11. Magnetic resonance imaging-conditional devices: Luxury or real clinical need?

    Science.gov (United States)

    Mavrogeni, Sophie I; Poulos, George; Kolovou, Genovefa; Theodorakis, George

    2017-01-10

    Although the risk of MRI scanning on patients with conventional devices is lower than initially thought, the patient's safety can only be guaranteed when using MRI-conditional devices. The most important modifications in MRI-conditional devices include a) Reduction in ferromagnetic components to reduce magnetic attraction and susceptibility artifacts; b) Replacement of the reed switch by a Hall sensor in order to avoid unpredictable reed switch behavior; c) Lead coil design to minimize lead heating and electrical current induction; d) Filter circuitry to prevent damage to the internal power supply; and e) Dedicated pacemaker programming to prevent inappropriate pacemaker inhibition and competing rhythms. Although many companies claim to have MRI-conditional devices, adoption in clinical practice is limited because a) Not all companies have MRI-conditional devices approved for both 1.5 and 3T; b) Not all companies offer the option of unlimited MRI scanning (without an exclusion zone in the thorax); c) Certain companies allow only a 30-min MRI scanning and only in afebrile patients; and d) Despite having MRI-conditional pacemakers, certain companies do not have MRI-conditional defibrillators and CRT systems. It is clear that this new technology opens the door for MRI to a growing number of patients; however, the widespread adoption of MRI-conditional devices will depend on real-life issues, such as cost, clinical indications for such a device and the permanent education of health care professionals.

  12. Stable distributions

    CERN Document Server

    Janson, Svante

    2011-01-01

    We give some explicit calculations for stable distributions and convergence to them, mainly based on less explicit results in Feller (1971). The main purpose is to provide ourselves with easy reference to explicit formulas. (There are no new results.)

  13. 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...... used for MSC cultivation in animal studies simulating clinical stem cell therapy. MATERIAL AND METHODS: Human mononuclear cells (MNCs) were isolated from BM aspirates by density gradient centrifugation and cultivated in a GMP-accepted medium (EMEA medium) or in one of four other media. RESULTS: FACS...... 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...

  14. 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.

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

    Science.gov (United States)

    Dai, Hong-Jie; Syed-Abdul, Shabbir; Chen, Chih-Wei; Wu, Chieh-Chen

    2015-01-01

    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. PMID:26380302

  16. HIV, Vascular and Aging Injuries in the Brain of Clinically Stable HIV-Infected Adults: A 1H MRS Study

    Science.gov (United States)

    Cysique, Lucette A.; Moffat, Kirsten; Moore, Danielle M.; Lane, Tammy A.; Davies, Nicholas W. S.; Carr, Andrew; Brew, Bruce J.; Rae, Caroline

    2013-01-01

    Background Cardiovascular disease (CVD) and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND) in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear. Methods 92 HIV− infected (HIV+) adults stable on combined antiretroviral therapy (cART) and 30 age-comparable HIV-negative (HIV−) subjects underwent 1H Magnetic Resonance Spectroscopy (MRS) of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury), caudate nucleus (targeting HIV neurochemical injury), and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes). All also underwent standard neuropsychological (NP) testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF) neuroinflammation biomarkers were obtained in 38 HIV+ individuals. Results Relative to HIV− individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA) (pHIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal white matter. Conclusions In chronically HIV+ adults with long-term viral suppression, current CVD risk, past CVD and age are independent factors for neuronal injury and inflammation. This suggests a tripartite model of HIV, CVD and age likely driven by

  17. Effects of dietary fat and saturated fat content on liver fat and markers of oxidative stress in overweight/obese men and women under weight-stable conditions.

    Science.gov (United States)

    Marina, Anna; von Frankenberg, Anize Delfino; Suvag, Seda; Callahan, Holly S; Kratz, Mario; Richards, Todd L; Utzschneider, Kristina M

    2014-10-28

    Dietary fat and oxidative stress are hypothesized to contribute to non-alcoholic fatty liver disease and progression to steatohepatitis. To determine the effects of dietary fat content on hepatic triglyceride, body fat distribution and markers of inflammation and oxidative stress, overweight/obese subjects with normal glucose tolerance consumed a control diet (CONT: 35% fat/12% saturated fat/47% carbohydrate) for ten days, followed by four weeks on a low fat (LFD (n = 10): 20% fat/8% saturated fat/62% carbohydrate) or high fat diet (HFD (n = 10): 55% fat/25% saturated fat/27% carbohydrate). Hepatic triglyceride content was quantified by MRS and abdominal fat distribution by MRI. Fasting biomarkers of inflammation (plasma hsCRP, IL-6, IL-12, TNFα, IFN-γ) and oxidative stress (urinary F2-α isoprostanes) were measured. Body weight remained stable. Compared to the CONT, hepatic triglyceride decreased on the LFD (mean (95% CI): change -2.13% (-3.74%, -0.52%)), but did not change on the HFD and there was no significant difference between the LFD and HFD. Intra-abdominal fat did not change significantly on either diet, but subcutaneous abdominal fat increased on the HFD. There were no significant changes in fasting metabolic markers, inflammatory markers and urinary F2-α isoprostanes. We conclude that in otherwise healthy overweight/obese adults under weight-neutral conditions, a diet low in fat and saturated fat has modest effects to decrease liver fat and may be beneficial. On the other hand, a diet very high in fat and saturated fat had no effect on hepatic triglyceride or markers of metabolism, inflammation and oxidative stress.

  18. HIV, vascular and aging injuries in the brain of clinically stable HIV-infected adults: a (1H MRS study.

    Directory of Open Access Journals (Sweden)

    Lucette A Cysique

    Full Text Available BACKGROUND: Cardiovascular disease (CVD and premature aging have been hypothesized as new risk factors for HIV associated neurocognitive disorders (HAND in adults with virally-suppressed HIV infection. Moreover, their significance and relation to more classical HAND biomarkers remain unclear. METHODS: 92 HIV- infected (HIV+ adults stable on combined antiretroviral therapy (cART and 30 age-comparable HIV-negative (HIV- subjects underwent (1H Magnetic Resonance Spectroscopy (MRS of the frontal white matter (targeting HIV, normal aging or CVD-related neurochemical injury, caudate nucleus (targeting HIV neurochemical injury, and posterior cingulate cortex (targeting normal/pathological aging, CVD-related neurochemical changes. All also underwent standard neuropsychological (NP testing. CVD risk scores were calculated. HIV disease biomarkers were collected and cerebrospinal fluid (CSF neuroinflammation biomarkers were obtained in 38 HIV+ individuals. RESULTS: Relative to HIV- individuals, HIV+ individuals presented mild MRS alterations: in the frontal white matter: lower N-Acetyl-Aspartate (NAA (p<.04 and higher myo-inositol (mIo (p<.04; in the caudate: lower NAA (p = .01; and in the posterior cingulate cortex: higher mIo (p<.008- also significant when Holm-Sidak corrected and higher Choline/NAA (p<.04. Regression models showed that an HIV*age interaction was associated with lower frontal white matter NAA. CVD risk factors were associated with lower posterior cingulate cortex and caudate NAA in both groups. Past acute CVD events in the HIV+ group were associated with increased mIo in the posterior cingulate cortex. HIV duration was associated with lower caudate NAA; greater CNS cART penetration was associated with lower mIo in the posterior cingulate cortex and the degree of immune recovery on cART was associated with higher NAA in the frontal white matter. CSF neopterin was associated with higher mIo in the posterior cingulate cortex and frontal

  19. Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: a collaborative meta-analysis of contemporary randomized clinical trials.

    Science.gov (United States)

    Stergiopoulos, Kathleen; Boden, William E; Hartigan, Pamela; Möbius-Winkler, Sven; Hambrecht, Rainer; Hueb, Whady; Hardison, Regina M; Abbott, J Dawn; Brown, David L

    2014-02-01

    Myocardial ischemia in patients with stable coronary artery disease (CAD) has been repeatedly associated with impaired survival. However, it is unclear if revascularization with percutaneous coronary intervention (PCI) to relieve ischemia improves outcomes compared with medical therapy (MT). The objective of this study was to compare the effect of PCI and MT with MT alone exclusively in patients with stable CAD and objectively documented myocardial ischemia on clinical outcomes. MEDLINE, Cochrane, and PubMed databases from 1970 to November 2012. Unpublished data were obtained from investigators. Randomized clinical trials of PCI and MT vs MT alone for stable coronary artery disease in which stents and statins were used in more than 50% of patients. For studies in which myocardial ischemia diagnosed by stress testing or fractional flow reserve was required for enrollment, descriptive and quantitative data were extracted from the published report. For studies in which myocardial ischemia was not a requirement for enrollment, authors provided data for only those patients with ischemia determined by stress testing prior to randomization. The outcomes analyzed included death from any cause, nonfatal myocardial infarction (MI), unplanned revascularization, and angina. Summary odds ratios (ORs) were obtained using a random-effects model. Heterogeneity was assessed using the Q statistic and I2. In 5 trials enrolling 5286 patients, myocardial ischemia was diagnosed in 4064 patients by exercise stress testing, nuclear or echocardiographic stress imaging, or fractional flow reserve. Follow-up ranged from 231 days to 5 years (median, 5 years). The respective event rates for PCI with MT vs MT alone for death were 6.5% and 7.3% (OR, 0.90 [95% CI, 0.71-1.16); for nonfatal MI, 9.2% and 7.6% (OR, 1.24 [95% CI, 0.99-1.56]); for unplanned revascularization, 18.3% and 28.4% (OR, 0.64 [95% CI, 0.35-1.17); and for angina, 20.3% and 23.3% (OR, 0.91 [95% CI, 0.57-1.44]). In patients with

  20. Seasonal variations of cave conditions and drip water stable isotopes from a monitoring study of Raccoon Mountain Caverns, Tennessee, and its implications in interpreting speleothem record

    Science.gov (United States)

    Holtzclaw, C. L.; Gordon, R. D.; Feng, W.; Allard, J.

    2015-12-01

    A two-year monitoring study at Raccoon Mountain Caverns near Chattanooga, Tennessee was carried out in an attempt to establish quantitative relationships between climate signals and drip water stable isotopes for interpreting speleothem paleoclimate records from the cave. Eight field trips were made from Jan. 2014 to Jun. 2015, during which cave meteorological conditions (RH, temperature and cave air CO2 concentration) and drip rate were measured for 5 sites inside the cave. 63 cave drip and pool water samples were collected and analyzed for oxygen and hydrogen isotope compositions (δ18O and δD values). Cave air temperature varied throughout the study period, the temporal variations ranged at different sites from 2 to 8.4 °C (the greatest variation was observed at sites that are closer to the entrance or surface). These are significantly less than outside temperatures range of 24 °C, but more than observed in other monitored caves. Elevated cave-air CO2 concentration (3200 ppm) and slow drip rate during the summer indicated slowed or stalled growth of calcite. The overall range of δ18O values were -7.1‰ to -4.5‰. A δD vs δ18O diagram yields a slope of 6.1, which falls within the normal range of 6-8 for local Meteoric Water Line. The value is slightly above Global Meteoric Water Line, indicating lack of evaporative effect. Throughout the study period, the δ18O values varied from 0.6 ‰ at some sites to 1.9‰ at others. The largest changes were likely due to the close proximity of collection sites to the surface precipitation. Spatially, for samples collected at each cave trip, different sites displayed variations of δ18O values from 0‰ to 1.7‰. The difference could be attributed to different type of drip sites with varying types of flow paths rainwater takes to the drip sites. The significant seasonal shift of drip water δ18O values and growth conditions indicate importance of consideration of seasonality in interpreting speleothem δ18O record

  1. Cardiac magnetic resonance and computed tomography angiography for clinical imaging of stable coronary artery disease. Diagnostic classification and risk stratification

    Science.gov (United States)

    Korosoglou, Grigorios; Giusca, Sorin; Gitsioudis, Gitsios; Erbel, Christian; Katus, Hugo A.

    2014-01-01

    Despite advances in the pharmacologic and interventional treatment of coronary artery disease (CAD), atherosclerosis remains the leading cause of death in Western societies. X-ray coronary angiography has been the modality of choice for diagnosing the presence and extent of CAD. However, this technique is invasive and provides limited information on the composition of atherosclerotic plaque. Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) have emerged as promising non-invasive techniques for the clinical imaging of CAD. Hereby, CCTA allows for visualization of coronary calcification, lumen narrowing and atherosclerotic plaque composition. In this regard, data from the CONFIRM Registry recently demonstrated that both atherosclerotic plaque burden and lumen narrowing exhibit incremental value for the prediction of future cardiac events. However, due to technical limitations with CCTA, resulting in false positive or negative results in the presence of severe calcification or motion artifacts, this technique cannot entirely replace invasive angiography at the present time. CMR on the other hand, provides accurate assessment of the myocardial function due to its high spatial and temporal resolution and intrinsic blood-to-tissue contrast. Hereby, regional wall motion and perfusion abnormalities, during dobutamine or vasodilator stress, precede the development of ST-segment depression and anginal symptoms enabling the detection of functionally significant CAD. While CT generally offers better spatial resolution, the versatility of CMR can provide information on myocardial function, perfusion, and viability, all without ionizing radiation for the patients. Technical developments with these 2 non-invasive imaging tools and their current implementation in the clinical imaging of CAD will be presented and discussed herein. PMID:25147526

  2. Adding Complex Terrain and Stable Atmospheric Condition Capability to the OpenFOAM-based Flow Solver of the Simulator for On/Offshore Wind Farm Applications (SOWFA): Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Churchfield, M. J.; Sang, L.; Moriarty, P. J.

    2013-09-01

    This paper describes changes made to NREL's OpenFOAM-based wind plant aerodynamics solver such that it can compute the stably stratified atmospheric boundary layer and flow over terrain. Background about the flow solver, the Simulator for Off/Onshore Wind Farm Applications (SOWFA) is given, followed by details of the stable stratification/complex terrain modifications to SOWFA, along with somepreliminary results calculations of a stable atmospheric boundary layer and flow over a simply set of hills.

  3. Preclinical and clinical examinations of Salvia miltiorrhiza and its tanshinones in ischemic conditions

    Directory of Open Access Journals (Sweden)

    Lien Eric

    2006-11-01

    Full Text Available Abstract Salvia miltiorrhiza (Labiatae, Laminaceae, danshen, is an annual sage mainly found in China and neighboring countries. The crude drug (dried root and its preparations are currently used in China to treat patients suffering from heart attack, angina pectoris, stroke and some other conditions. The use of S. miltiorrhiza has been increasing in the management of stroke. Pharmacological examinations showed that the plant and its active ingredients, tanshinones and salvianolic acids, have anticoagulant, vasodilatory, increased blood flow, anti-inflammatory, free radical scavenging, mitochondrial protective and other activities. This review discusses the pharmacology, medicinal chemistry and clinical studies published, especially in China, for danshen and tanshinone preparations. Clinical examinations are evaluated in terms of S. miltiorrhiza preparation, dose, double blinding, control, clinical assessments of outcomes and other parameters. Meta-analyses of S. miltiorrhiza are also discussed.

  4. 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...

  5. 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.

  6. 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.

  7. 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

  8. Stable compactifications

    Energy Technology Data Exchange (ETDEWEB)

    Accetta, F.S.; Gleiser, M.; Holman, R.; Kolb, E.W.

    1986-03-01

    We show that compactifications of theories with extra dimensions are unstable if due to monopole configurations of an antisymmetric tensor field balanced against one-loop Casimir corrections. In the case of ten dimensional supergravity, it is possible, at least for a portion of the phase space, to achieve a stable compactification without fine-tuning by including the contribution of fermionic condensates to the monopole configurations. 23 refs., 2 figs.

  9. Cross-cultural adaptation and clinical validation of the Neonatal Skin Condition Score to Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    Juliana Machado Schardosim

    2014-10-01

    Full Text Available OBJECTIVE: to describe the process of cross-cultural adaptation and clinical validation of the Neonatal Skin Condition Score.METHODS: this methodological cross-cultural adaptation study included five steps: initial translation, synthesis of the initial translation, back translation, review by an Committee of Specialists and testing of the pre-final version, and an observational cross-sectional study with analysis of the psychometric properties using the Adjusted Kappa, Intraclass Correlation Coefficient, and Bland-Altman Method statistical tests. A total of 38 professionals were randomly recruited to review the clarity of the adapted instrument, and 47 newborns hospitalized in the Neonatology Unit of the Clinical Hospital of Porto Alegre were selected by convenience for the clinical validation of the instrument.RESULTS: the adapted scale showed approximately 85% clarity. The statistical tests showed moderate to strong intra and interobserver item to item reliability and from strong to very strong in the total score, with a variation of less than 2 points among the scores assigned by the nurses to the patients.CONCLUSIONS: the scale was adapted and validated to Brazilian Portuguese. The psychometric properties of the Brazilian version of the Neonatal Skin Condition Score instrument were similar to the validation results of the original scale.

  10. Mobile farm clinic outreach to address health conditions among Latino migrant farmworkers in Georgia.

    Science.gov (United States)

    Luque, John S; Reyes-Ortiz, Carlos; Marella, Prasen; Bowers, Angelica; Panchal, Viral; Anderson, Lisa; Charles, Simone

    2012-01-01

    Agricultural labor involves exposure to many occupational hazards, some of which can lead to chronic health conditions. The purpose of this study was to conduct an occupational health needs assessment of illnesses and work-related injuries among a Latino migrant farmworker population (recruited to harvest Vidalia onions) in South Georgia. Study data included survey responses from 100 farmworkers attending mobile farm clinics in 2010 at their worker housing residences, supplemented by medical diagnoses data from the same clinics collected over 3 years (2009-2011) for 1161 farmworkers at six different farms. From the survey, the main health problems reported were hypertension (25%), eye problems (12%), musculoskeletal problems (11%), diabetes (10%), and depression (7%). In multivariate analyses, depression scores were associated with having a history of musculoskeletal problems (p = .002). According to the mobile farm clinic data, the most common medical diagnoses included back pain (11.8%), hypertension (11.4%), musculoskeletal problems (11.3%), gastrointestinal disorders (8.6%), eye problems (7.2%), dermatitis or rash (7.0%), and tinea or fungal skin infections (5.6%). The study identified eye and musculoskeletal problems as the major occupational health conditions for this population of farmworkers.

  11. Three Decades of Comprehensive Geriatric Assessment: Evidence Coming From Different Healthcare Settings and Specific Clinical Conditions.

    Science.gov (United States)

    Pilotto, Alberto; Cella, Alberto; Pilotto, Andrea; Daragjati, Julia; Veronese, Nicola; Musacchio, Clarissa; Mello, Anna Maria; Logroscino, Giancarlo; Padovani, Alessandro; Prete, Camilla; Panza, Francesco

    2017-02-01

    Comprehensive geriatric assessment (CGA) is a multidisciplinary diagnostic and treatment process that identifies medical, psychosocial, and functional capabilities of older adults to develop a coordinated plan to maximize overall health with aging. Specific criteria used by CGA programs to evaluate patients include age, medical comorbidities, psychosocial problems, previous or predicted high healthcare utilization, change in living situation, and specific geriatric conditions. However, no universal criteria have been agreed upon to readily identify patients who are likely to benefit from CGA. Evidence from randomized controlled trials and large systematic reviews and meta-analyses suggested that the healthcare setting may modify the effectiveness of CGA programs. Home CGA programs and CGA performed in the hospital were shown to be consistently beneficial for several health outcomes. In contrast, the data are conflicting for posthospital discharge CGA programs, outpatient CGA consultation, and CGA-based inpatient geriatric consultation services. The effectiveness of CGA programs may be modified also by particular settings or specific clinical conditions, with tailored CGA programs in older frail patients evaluated for preoperative assessment, admitted or discharged from emergency departments and orthogeriatric units or with cancer and cognitive impairment. CGA is capable of effectively exploring multiple domains in older age, being the multidimensional and multidisciplinary tool of choice to determine the clinical profile, the pathologic risk and the residual skills as well as the short- and long-term prognosis to facilitate the clinical decision making on the personalized care plan of older persons.

  12. Clinical compliance of viewing conditions in radiology reporting environments against current guidelines and standards

    Science.gov (United States)

    Daly, S.; Rainford, L.; Butler, M. L.

    2014-03-01

    Several studies have demonstrated the importance of environmental conditions in the radiology reporting environment, with many indicating that incorrect parameters could lead to error and misinterpretation. Literature is available with recommendations as to the levels that should be achieved in clinical practice, but evidence of adherence to these guidelines in radiology reporting environments is absent. This study audited the reporting environments of four teleradiologist and eight hospital based radiology reporting areas. This audit aimed to quantify adherence to guidelines and identify differences in the locations with respect to layout and design, monitor distance and angle as well as the ambient factors of the reporting environments. In line with international recommendations, an audit tool was designed to enquire in relation to the layout and design of reporting environments, monitor angle and distances used by radiologists when reporting, as well as the ambient factors such as noise, light and temperature. The review of conditions were carried out by the same independent auditor for consistency. The results obtained were compared against international standards and current research. Each radiology environment was given an overall compliance score to establish whether or not their environments were in line with recommended guidelines. Poor compliance to international recommendations and standards among radiology reporting environments was identified. Teleradiology reporting environments demonstrated greater compliance than hospital environments. The findings of this study identified a need for greater awareness of environmental and perceptual issues in the clinical setting. Further work involving a larger number of clinical centres is recommended.

  13. Towards the fourth GEWEX atmospheric boundary layer model intercomparison study (GABLS4): exploration of very stable conditions over an Antarctic ice shelf

    NARCIS (Netherlands)

    Vihma, T.; Kilpeläinen, T.; Rontu, L.; Anderson, P.S.; Orr, A.; Phillips, T.; Finkele, K.; Rodrigo, I.; Holtslag, A.A.M.; Svensson, G.

    2012-01-01

    Numerical weather prediction and climate models continue to have large errors for stable boundary layers (SBL). To understand and to improve on this, so far three atmospheric boundary layer model inter-comparison studies have been organised within the Global Energy and Water Cycle Experiment (GEWEX)

  14. 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.

  15. Clinical evaluation of efficacy and safety of cyclosporine (Imusporin in renal transplant patients with stable graft function maintained on neoral or bioral

    Directory of Open Access Journals (Sweden)

    Mrigank S Jha

    2007-01-01

    Full Text Available Objective: Previous pharmacokinetic studies have demonstrated bioequivalence of Imusporin (microemulsion preparation of cyclosporine, Cipla to the innovator product Neoral (Novartis, Switzerland. This study was done to evaluate the clinical efficacy and safety of Imusporin in patients who have already undergone renal transplant and have stable graft function maintained on cyclosporine preparation other than Imusporin. Materials and Methods: Twenty-two renal allograft recipients (mean age of 31.77 years, range 18-53 years, with stable graft function, previously on Neoral or Bioral were switched over to Imusporin after recording their relevant baseline clinical and biochemical parameters. These were repeated on 1, 4, 7, 15, 30 and 90 days after the start of therapy. Change in dosage required to maintain C2 levels at each visit were analyzed by paired sample t -test. Safety of the drug was assessed by the type and severity of adverse events developed during the therapy. Cost analysis was done assuming an average maintenance immunosuppression dose of 150 mg/day of cyclosporine. Results: Twenty-one patients completed the study. One patient was lost to follow-up. Mean C2 value before switchover was 894 ± 208 ng/ml, which was not significantly different from the mean values of C2 after switchover therapy ( P >0.30. Change in dosage required to maintain C2 levels was not significantly different from the baseline dose of 2.34 mg/ kg body weight ( P >0.1. No patient developed graft rejection after switchover therapy at a median follow-up of 16 months (14-18 months. Mean baseline SCr was similar to SCr at day 90 (1.38 vs. 1.37 mg/dl, P =0.930. No severe adverse events were reported. Mild side-effects included headache (4, somnolence (2, dry mouth (5 and generalized fatigue (6. Use of Imusporin (Cipla, India results in an annual savings of Rs. 19892 over Neoral (Novartis, Switzerland and Rs. 2263 over Bioral (Panacea Biotech, India. Conclusions: Imusporin

  16. conditions

    Directory of Open Access Journals (Sweden)

    M. Venkatesulu

    1996-01-01

    Full Text Available Solutions of initial value problems associated with a pair of ordinary differential systems (L1,L2 defined on two adjacent intervals I1 and I2 and satisfying certain interface-spatial conditions at the common end (interface point are studied.

  17. Relationship between Capillary Refill Time at Triage and Abnormal Clinical Condition: A Prospective Study.

    Science.gov (United States)

    Sansone, Claudia M; Prendin, Fabiano; Giordano, Greta; Casati, Paola; Destrebecq, Anne; Terzoni, Stefano

    2017-01-01

    Capillary refill time has been studied in literature as a perfusion indicator. Two pilot studies have proposed possible reference values in healthy adults. No data exist regarding capillary refill time as an indicator of abnormal clinical conditions in adults, which might be of help for triage nurses. We wanted to assess if any relationships existed, between altered capillary refill time and abnormal clinical conditions in the emergency department. We investigated relations between capillary refill time and vital signs recorded in triage and blood tests, by analyzing the clinical records. Mortality at 24 hours, 7 days and over 14 days was investigated by calling the patients after discharge. Observational, single-center study on a sample of consecutive patients aged ≥ 18 years in the Emergency Department of a major Milan hospital, from June to October 2014. Multivariate logistic regression was used to investigate the impact of clinical variables on capillary refill time. 1001 patients were enrolled, aged 59 ± 21 (473 aged 65 or more). Longer refill times were found in patients admitted to hospital units after medical consultations in the emergency department compared to those discharged or sent to outpatients. In elderly patients, statistically significant association was found between increased capillary refill time and sepsis (sensitivity 100%, specificity 83.33%, area under the receiver operating characteristics curve 65.95% CI 47-83), oxygen saturation, mean blood pressure, and lactates. In persons aged 45 to 64, altered refill times were associated with abnormal values of glicemia, platelets, and urea. Capillary refill time can be used by nurses at triage as a complementary parameter to normal vital signs. This is one of the few studies investigating refill time in adult patients.

  18. 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

  19. CLINICAL EFFICACY OF CRUX SYRUP IN THE MANAGEMENT OF COUGH DUE TO VARIOUS ETIOLOGICAL CONDITIONS

    Directory of Open Access Journals (Sweden)

    Patel Girish

    2013-10-01

    Full Text Available Cough associated with acute and chronic respiratory conditions is common in patients of all ages. The objective of this study was to determine the clinical efficacy of CRUX syrup, a proprietary mixture of herbal ingredients in the management of cough of various etiological conditions in open label, uncontrolled, prospective cohort study. 55 Patients aged 9 - 64 years with cough of more than 1 day but less than 14 days duration was recruited. They were prescribed dose of CRUX syrup according to severity of cough for three days. Treatment results were assessed on the basis of Investigator’s evaluation. At the end of three days prescribed treatment, evaluator’s assessment shown that 29 % patient gave excellent, 55 % patient gave good, 11 % patient gave fair and 5 % patient gave poor response to treatment. The results demonstrate that CRUX treatment has significant decrease in the frequency and severity of cough without any significant side effect in patients of all ages.

  20. Impact of Clinical Guideline Recommendations on the Application of Coronary Computed Tomographic Angiography in Patients with Suspected Stable Coronary Artery Disease

    Science.gov (United States)

    Zhou, Jia; Yang, Jun-Jie; Yang, Xia; Chen, Zhi-Ye; He, Bai; Du, Luo-Shan; Chen, Yun-Dai

    2016-01-01

    Background: Coronary computed tomographic angiography (CCTA) has been widely used in patients who are at intermediate risk for having stable coronary artery disease (SCAD), and 2013 European Society of Cardiology Guidelines on the Management of SCAD (2013G) recommended the appropriate application of CCTA. However, 2013G has not been subjected to systematic analyses for subsequent impact on clinical practice. Methods: A total of 5320 patients suspected with SCAD were enrolled and scheduled for CCTA from March 2013 to September 2014. For each patient, pretest probability of SCAD was calculated according to updated Diamond-Forrester model (UDFM). Appropriate CCTA or appropriate stress test was determined as described in the 2013G. A generalized estimating equation model was used to determine the trends in the half-monthly rate of appropriate CCTA. Results: Overall, only 61.37% of patients received appropriate CCTA, and there was insignificant change over time (P = 0.8701). The application of CCTA in patients who should have had a stress test accounted for most of the inappropriate CCTA before (22.29%) or after (19.98%) the publication of the 2013G. In all patients or any subgroup, no significant change in the adjusted half-monthly rate of appropriate CCTA was found after the publication of the 2013G (odds ratio, 1.002; 95% confidence interval, 0.982–1.021; P = 0.8678). Conclusions: These findings suggest that the 2013G have not, to date, been fully incorporated into clinical practice, and the clinical utilization of CCTA remains unreasonable to some extent. PMID:26830982

  1. A COMPARATIVE CLINICAL EVALUATION OF INTUBATING CONDITIONS AND HAEMODYNAMIC EFFECTS AFTER ADMINISTRATION OF SUCCINYL CHOLINE & ROCURONIUM BROMIDE

    Directory of Open Access Journals (Sweden)

    Abhishek

    2015-04-01

    Full Text Available BACKGROUND: Rapid and safe endotracheal intubation is of paramount importance in practice of general anesthesia . Succinylcholine chloride , a depolarizing muscl e relaxant due to its quick onset of action and excellent intubating conditions has remained a muscle relaxant of choice . Rocuronium was proved to be safe alternative to Succinylcholine for endotracheal intubation . AIMS : Study was conducted to evaluate & c ompare the onset time , clinical duration and intubating condition of Succinylcholine and Rocuronium Bromide and Haemodynamic changes caused by these agents . METHODS & MATERIALS : 80 patients were randomly divided into two groups . Group - 1 , Succinylcholine ( 1 . 5mg/kg and group - 2 Rocuronium Bromide ( 0 . 6mg/kg . After 60 sec of administration of muscle relaxant , intubating conditions were judged according to scoring system by Cooper et al . 1 Onset time and duration of action was noted . Hemodynamic parameters ( H eart rate , Systolic Blood Pressure , Diastolic Blood Pressure , Mean Atrial pressure and SPO 2 were monitored before intubation , during intubation and just after intubation at 1 , 2 and 5 minutes . RESULTS : The mean onset time and duration of action was signi ficantly longer for Rocuronium ( 95 . 15±9 . 47 seconds than Succinylcholine ( 59 . 80±14 . 30 seconds and Rocuronium ( 42 . 60±13 . 15 minutes than Succinylcholine ( 5 . 10±2 . 35 minutes . Intubating conditions was excellent in 35 ( 87% and good in 5 ( 12 . 5% patients in su ccinylcholine whereas , in Rocuronium produced excellent intubation in only 23 ( 57 . 5% patients and good intubation in 14 ( 35% patients . The heart rate increased significantly after induction ( maximum at 1 minute with both Rocuronium ( 98 . 75±15 . 53 and Succi nylcholine ( 112 . 75±15 . 89 . But it gradually declined towards normal and change in heart rate with either drug was not significant at 5 minutes . The mean blood pressure increased significantly after induction

  2. Efficacy of ozonized olive oil in the management of oral lesions and conditions: A clinical trial

    Directory of Open Access Journals (Sweden)

    Tarun Kumar

    2016-01-01

    Full Text Available The oral cavity is an open ecosystem that shows a dynamic balance between the entrance of microorganisms (bacterial, viral or fungal, colonization modalities, nutritional balance, and host defenses against their removal. The oral lesions including aphthous ulcerations, herpes labialis, oral candidiasis, oral lichen planus, and angular cheilitis some of the common entities encountered in the clinical practice. A variety of treatment options is available in the literature for all of these lesions and conditions. Topical ozone therapy is a minimally invasive technique that can be used for these conditions without any side effects. Aim and Objectives: To evaluate the efficacy of ozonized olive oil in the treatment of oral lesions and conditions. Materials and Methods: A longitudinal study was carried out on 50 patients (aphthous ulcerations, herpes labialis, oral candidiasis, oral lichen planus, and angular cheilitis. The ozonized olive oil was applied twice daily until the lesion regresses for a maximum of 6 months. Results: All the lesions regress in patients with aphthous ulcerations, herpes labialis, oral candidiasis and angular cheilitis or showed improvement in the signs and symptoms in oral lichen planus patients. No toxicity or side effect was observed in any of the patients. Conclusion: Ozone therapy though requires a gaseous form to be more effective, but topical form can also bring out the positive results without any toxicity or side effect. Hence, it can be considered as a minimally invasive therapy for the oral infective and immunological conditions.

  3. Efficacy of ozonized olive oil in the management of oral lesions and conditions: A clinical trial

    Science.gov (United States)

    Kumar, Tarun; Arora, Neha; Puri, Gagan; Aravinda, Konidena; Dixit, Avani; Jatti, Deepa

    2016-01-01

    The oral cavity is an open ecosystem that shows a dynamic balance between the entrance of microorganisms (bacterial, viral or fungal), colonization modalities, nutritional balance, and host defenses against their removal. The oral lesions including aphthous ulcerations, herpes labialis, oral candidiasis, oral lichen planus, and angular cheilitis some of the common entities encountered in the clinical practice. A variety of treatment options is available in the literature for all of these lesions and conditions. Topical ozone therapy is a minimally invasive technique that can be used for these conditions without any side effects. Aim and Objectives: To evaluate the efficacy of ozonized olive oil in the treatment of oral lesions and conditions. Materials and Methods: A longitudinal study was carried out on 50 patients (aphthous ulcerations, herpes labialis, oral candidiasis, oral lichen planus, and angular cheilitis). The ozonized olive oil was applied twice daily until the lesion regresses for a maximum of 6 months. Results: All the lesions regress in patients with aphthous ulcerations, herpes labialis, oral candidiasis and angular cheilitis or showed improvement in the signs and symptoms in oral lichen planus patients. No toxicity or side effect was observed in any of the patients. Conclusion: Ozone therapy though requires a gaseous form to be more effective, but topical form can also bring out the positive results without any toxicity or side effect. Hence, it can be considered as a minimally invasive therapy for the oral infective and immunological conditions. PMID:27041901

  4. Clinical Observation of the Clinical Effects of Inhaling Glucocorticoid in Treatment of Stable COPD%吸入糖皮质激素在稳定期COPD中的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    孙茹

    2013-01-01

    Objective:To observed the clinical effects of inhaling glucocorticoid in treatment of stable COPD. Method:To analyze the clinical effects of the on the basis of conventional treatment of inhaling budesonide(Observation group)or the basis of conventional treatment(Control group)for treatment of 80 patients with stable COPD in our hospital from April 2010 to June 2012. Result:After treatment,the lung function,dyspnea score,quality of life score and 6-MWD in the observation group were significantly better than those in the control group. Conclusion:The inhaling glucocorticoid in treatment of stable COPD is efficacy. It is worthy to be popularized.%  目的:观察吸入糖皮质激素治疗稳定期COPD中的临床疗效。方法:选择本院2010年4月-2012年6月收治的80例稳定期COPD患者,随机分为观察组和对照组,观察组40例,在常规治疗的基础上给予吸入布地奈德,对照组40例行常规治疗,比较分析两组疗效。结果:治疗后,观察组患者肺功能、呼吸困难评分、生活质量评分和6-MWD情况都显著地优于对照组患者。结论:吸入糖皮质激素治疗稳定期COPD疗效可靠,值得临床推广。

  5. 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 ...

  6. Thermodynamically Stable Pickering Emulsions

    NARCIS (Netherlands)

    Sacanna, S.; Kegel, W.K.; Philipse, A.P.

    2007-01-01

    We show that under appropriate conditions, mixtures of oil, water, and nanoparticles form thermodynamically stable oil-in-water emulsions with monodisperse droplet diameters in the range of 30–150 nm. This observation challenges current wisdom that so-called Pickering emulsions are at most metastabl

  7. Nutritional condition of school age children. Clinic, anthropo-medical and alimentary assessment

    Directory of Open Access Journals (Sweden)

    Alina Esther González Hermida

    2011-04-01

    Full Text Available Background: the study of children´s growth in an appropriate indicator of children health condition and should be used as one of the basis in the practice of preventive medicine. Objective: to determine the nutritional al condition of children of third and sixth grade of elementary schools of Health Area V of Cienfuegos Municipality. Methods: descriptive, observational, cross-sectional and relational study of 445 school age children from 4 elementary schools. A clinic assessment was carried out along with an anthropo-medical evaluation. A qualitative survey was developed to assess the frequency of consumption of different alimentary groups. Results: the relation weight/height in the two genders presents a prevalence of normal weight; undernourishment is more common among females, overweight is more usual among boys and obesity can be found in both genders. The variable weight/age showed one bad-nutrition (for defect among females, there was a prevalence of bad-nutrition for excess in both genders. There were no children with height under the third percentile, with prevalence of boys and girls tall and very tall. Bronchial asthma was the most common disease. Conclusions: Food consumption in general, taking into account frequency and kind of food, is not the appropriate. There is a relation between positive clinical findings and the anthropometric assessment of weight/height.

  8. OPERANT CONDITIONING OF SPINAL REFLEXES:FROM BASIC SCIENCE TO CLINICAL THERAPY

    Directory of Open Access Journals (Sweden)

    Aiko K. Thompson

    2014-03-01

    Full Text Available New appreciation of the adaptive capabilities of the nervous system, recent recognition that most spinal cord injuries are incomplete, and progress in enabling regeneration are generating growing interest in novel rehabilitation therapies. Here we review the 35-year evolution of one promising new approach, operant conditioning of spinal reflexes. This work began in the late 1970’s as basic science; its purpose was to develop and exploit a uniquely accessible model for studying the acquisition and maintenance of a simple behavior in the mammalian CNS. The model was developed first in monkeys and then in rats, mice, and humans. Studies with it showed that the ostensibly simple behavior (i.e., a larger or smaller reflex rests on a complex hierarchy of brain and spinal cord plasticity; and current investigations are delineating this plasticity and its interactions with the plasticity that supports other behaviors. In the last decade, the possible therapeutic uses of reflex conditioning have come under study, first in rats and then in humans. The initial results are very exciting, and they are spurring further studies. At the same time, the original basic science purpose and the new clinical purpose are enabling and illuminating each other in unexpected ways. The long course and current state of this work illustrate the practical importance of basic research and the valuable synergy that can develop between basic science questions and clinical needs.

  9. Surgical site infections in women and their association with clinical conditions

    Directory of Open Access Journals (Sweden)

    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.

  10. Engaging Stakeholders to Inform Clinical Practice Guidelines That Address Multiple Chronic Conditions.

    Science.gov (United States)

    Bennett, Wendy L; Robbins, Craig W; Bayliss, Elizabeth A; Wilson, Renee; Tabano, Heather; Mularski, Richard A; Chan, Wiley V; Puhan, Milo; Yu, Tsung; Leff, Bruce; Li, Tianjing; Dickersin, Kay; Glover, Carol; Maslow, Katie; Armacost, Karen; Mintz, Suzanne; Boyd, Cynthia M

    2017-08-01

    Having more than one chronic condition is common and is associated with greater health care utilization, higher medication burden and complexity of treatment. However, clinical practice guidelines (CPGs) do not routinely address the balance between harms and benefits of treatments for people with multiple chronic conditions (MCCs). To partner with the Kaiser Permanente Integrated Cardiovascular Health (ICVH) program to engage multiple stakeholders in a mixed-methods approach in order to: 1) identify two high-priority clinical questions related to MCCs, and 2) understand patients' and family caregivers' perceptions of meaningful outcomes to inform benefit/harm assessments for these two high-priority questions. These clinical questions and outcomes will be used to inform CPG recommendations for people with MCCs. DESIGN AND PARTICIPANTS: The ICVH program provided 130 topics rank-ordered by the potential for finding evidence that would change clinical recommendations regarding the topic. We used a modified Delphi method to identify and reword topics into questions relevant to people with MCCs. We used two sets of focus groups (n = 27) to elicit patient and caregiver perspectives on two important research questions and relevant patient-important outcomes on benefit/harm balance for people with MCCs. Co-investigators, patients and caregivers identified "optimal blood pressure goals" and "diabetes medication management" as important clinical topics for CPGs related to people with MCCs. Stakeholders identified a list of relevant outcomes to be addressed in future CPG development including 1) physical function and energy, 2) emotional health and well-being, 3) avoidance of treatment burden, side effects and risks, 4) interaction with providers and health care system, and 5) prevention of adverse long-term health outcomes. Through the application of a mixed-methods process, we identified the questions regarding optimal blood pressure goals and diabetes medication management

  11. 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.

  12. ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    M. A. Demidova

    2012-01-01

    Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

  13. Challenges of clinical trial design when there is lack of clinical equipoise: Use of a response-conditional crossover design

    NARCIS (Netherlands)

    C. Deng (Chunqin); K. Hanna (Kim); V. Bril (Vera); M.C. Dalakas (Marinos); P. Donofrio (Peter); P.A. van Doorn (Pieter); H.P. Hartung; I.S.J. Merkies (Ingemar)

    2012-01-01

    textabstractClinical equipoise is widely accepted as the basis of ethics in clinical research and requires investigators to be uncertain of the relative therapeutic merits of trial comparators. When clinical equipoise is in question, innovative trial designs are needed to reduce ethical tension whil

  14. 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

  15. 400 years of summer climatic conditions in the N Carpathian Mts. (eastern Europe) based on O and C stable isotopes in Pinus Cembra L tree rings

    Science.gov (United States)

    Nagavciuc, Viorica; Popa, Ionel; Kern, Zoltán; Persoiu, Aurel

    2016-04-01

    For a better understanding of how the climate is changing and how the environment responds to these changes, it is necessary to understand how the climate has varied in the past. Romania's virgin forests have a great potential to obtain long tree-ring chronologies with annual resolution; but so far, only a few studies resulted in quantitative paleoclimatic reconstructions. In this context, the aim of this study is 1) to calibrate the relationship between the stable isotopes of oxygen and carbon in tree rings and the main climatic parameters and determine the potential of Pinus cembra (Cǎlimani Mts., N Romania, Eastern Europe) for paleoclimatic reconstructions; 2) to provide the first palaeoclimatic reconstitution in Romania based on the isotopic composition of oxygen and carbon in tree ring cellulose, and 3) to test the hypothesis that nearby sulphur mines have not altered the climatic signal recorded by the stable isotopic composition of tree rings, contrary to the similar signal recorded by TRW. For this study, we have analysed wood samples of Swiss stone pine (Pinus cembra L.) from living and dead trees from Cǎlimani Mts., NE Romania, aged between 1600 and 2012 AD. The isotopic composition of oxygen and carbon from the cellulose was analysed at the Institute for Geological and Geochemical Research, Budapest, Hungary, using a high-temperature pyrolysis system (Thermo Quest TC-EA) coupled to an isotope ratio mass spectrometer (Thermo Finningan Delta V) following a ring by ring (i.e., non-pooled) approach. The average level of δ18O and δ13C in cellulose for the period 1600-2012 was 28.83‰ and -22.63 ‰. The tree ring cellulose δ18O and δ13C values showed a strong positive correlation with maximum air temperature (r = 0.6 for δ18O and r = 0.5 for δ13C), mean temperature (r = 0.6 for δ18O and r = 0.45 for δ13C), and sunshine duration (r = 0.69 for δ18O) and negatively correlated with precipitation amount (r = -0.5 for δ18O and r = 0.3 for δ13C) and

  16. Pulse treatment with the proteasome inhibitor bortezomib inhibits osteoclast resorptive activity in clinically relevant conditions

    DEFF Research Database (Denmark)

    Boissy, P; Levin Andersen, Thomas; Lund, T

    2008-01-01

    Myeloma bone disease is due to bone degradation by osteoclasts, and absence of repair by bone forming osteoblasts. Recent observations suggest that the anti-myeloma drug bortezomib, a proteasome inhibitor, stimulates bone formation and may inhibit bone resorption. Here, we tested bortezomib...... on cultured osteoclasts in conditions mimicking the pulse treatment used in the clinic, thereby avoiding continuous proteasome inhibition and unselective toxicity. A 3h pulse with 25nM bortezomib followed by a 3-day culture in its absence markedly inhibited osteoclast activity as evaluated through bone...... resorption, TRAcP release, and RANKL-induced NF-kappaB translocation into nuclei, an event dependent on proteasomes and critical for osteoclast function. The effect on TRAcP was maximal during the first 24h post-pulse, and then tended to subside. Importantly, applying this pulse treatment to cultured myeloma...

  17. Informed conditioning on clinical covariates increases power in case-control association studies.

    Science.gov (United States)

    Zaitlen, Noah; Lindström, Sara; Pasaniuc, Bogdan; Cornelis, Marilyn; Genovese, Giulio; Pollack, Samuela; Barton, Anne; Bickeböller, Heike; Bowden, Donald W; Eyre, Steve; Freedman, Barry I; Friedman, David J; Field, John K; Groop, Leif; Haugen, Aage; Heinrich, Joachim; Henderson, Brian E; Hicks, Pamela J; Hocking, Lynne J; Kolonel, Laurence N; Landi, Maria Teresa; Langefeld, Carl D; Le Marchand, Loic; Meister, Michael; Morgan, Ann W; Raji, Olaide Y; Risch, Angela; Rosenberger, Albert; Scherf, David; Steer, Sophia; Walshaw, Martin; Waters, Kevin M; Wilson, Anthony G; Wordsworth, Paul; Zienolddiny, Shanbeh; Tchetgen, Eric Tchetgen; Haiman, Christopher; Hunter, David J; Plenge, Robert M; Worthington, Jane; Christiani, David C; Schaumberg, Debra A; Chasman, Daniel I; Altshuler, David; Voight, Benjamin; Kraft, Peter; Patterson, Nick; Price, Alkes L

    2012-01-01

    Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI), smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low-BMI cases are larger than those estimated from high-BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals on the basis of phenotype (case-control ascertainment) or phenotype and clinical covariates (case-control-covariate ascertainment). While current approaches improve power in studies with random ascertainment, they often lose power under case-control ascertainment and fail to capture available power increases under case-control-covariate ascertainment. We show that an informed conditioning approach, based on the liability threshold model with parameters informed by external epidemiological information, fully accounts for disease prevalence and non-random ascertainment of phenotype as well as covariates and provides a substantial increase in power while maintaining a properly controlled false-positive rate. Our method outperforms standard case-control association tests with or without covariates, tests of gene x covariate interaction, and previously proposed tests for dealing with covariates in ascertained data, with especially large improvements in the case of case-control-covariate ascertainment. We investigate empirical case-control studies of type 2 diabetes, prostate cancer, lung cancer, breast cancer, rheumatoid arthritis, age-related macular degeneration, and end-stage kidney disease over a total of 89,726 samples. In these datasets, informed conditioning outperforms logistic regression for 115 of the 157 known associated variants investigated (P-value = 1 × 10(-9)). The improvement varied across diseases with a 16% median increase in χ(2) test statistics and a

  18. [Working conditions in outpatient clinics adjacent to private pharmacies in Mexico City: perspective of physicians].

    Science.gov (United States)

    Díaz-Portillo, Sandra P; Reyes-Morales, Hortensia; Cuadra-Hernández, Silvia Magali; Idrovo, Álvaro J; Nigenda, Gustavo; Dreser, Anahí

    2017-05-01

    To analyse the working conditions of physicians in outpatient clinics adjacent to pharmacies (CAFs) and their organizational elements from their own perspective. We carried out an exploratory qualitative study. Semi-structured interviews were conducted with 32 CAF physicians in Mexico City. A directed content analysis technique was used based on previously built and emerging codes which were related to the experience of the subjects in their work. Respondents perceive that work in CAFs does not meet professional expectations due to low pay, informality in the recruitment process and the absence of minimum labour guarantees. This prevents them from enjoying the benefits associated with formal employment, and sustains their desire to work in CAF only temporarily. They believe that economic incentives related to number of consultations, procedures and sales attained by the pharmacy allow them to increase their income without influencing their prescriptive behaviour. They express that the monitoring systems and pressure exerted on CAFs seek to affect their autonomy, pushing them to enhance the sales of medicines in the pharmacy. Physicians working in CAFs face a difficult employment situation. The managerial elements used to induce prescription and enhance pharmacy sales create a work environment that generates challenges for regulation and underlines the need to monitor the services provided at these clinics and the possible risk for users. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. Clinical Implications of Word Recognition Differences in Earphone and Aided Conditions.

    Science.gov (United States)

    McRackan, Theodore R; Ahlstrom, Jayne B; Clinkscales, William B; Meyer, Ted A; Dubno, Judy R

    2016-12-01

    To compare word recognition scores for adults with hearing loss measured using earphones and in the sound field without and with hearing aids (HA). Independent review of presurgical audiological data from an active middle ear implant (MEI) FDA clinical trial. Multicenter prospective FDA clinical trial. Ninety-four adult HA users. Preoperative earphone, aided word recognition scores, and speech intelligibility index. We performed an independent review of presurgical audiological data from an MEI FDA trial and compared unaided and aided word recognition scores with participants' HAs fit according to the NAL-R algorithm. For 52 participants (55.3%), differences in scores between earphone and aided conditions were >10%; for 33 participants (35.1%), earphone scores were higher by 10% or more than aided scores. These participants had significantly higher pure-tone thresholds at 250, 500, and 1000 Hz, higher pure-tone averages, higher speech recognition thresholds (and higher earphone speech levels [p = 0.002]). No significant correlation was observed between word recognition scores measured with earphones and with hearing aids (r = 0.14; p = 0.16), whereas a moderately high positive correlation was observed between unaided and aided word recognition (r = 0.68; p word recognition scores measured with earphones to predict aided word recognition or hearing aid benefit. Rather, these results provide evidence supporting the measurement of aided word recognition in patients who are considering hearing aids.

  20. The prevalence of refractive conditions in Puerto Rican adults attending an eye clinic system.

    Science.gov (United States)

    Rodriguez, Neisha M; Romero, Angel F

    2014-01-01

    To determine the prevalence of refractive conditions in the adult population that visited primary care optometry clinics in Puerto Rico. A retrospective cross-sectional study of patients examined at the Inter American University of Puerto Rico School of Optometry Eye Institute Clinics between 2004 and 2010. Subjects considered had best corrected visual acuity by standardized subjective refraction of 20/40 or better. The refractive errors were classified by the spherical equivalent (SE): sphere+½ cylinder. Myopia was classified as a SE>-0.50D, hyperopia as a SE>+0.50 D, and emmetropia as a SE between -0.50 and +0.50, both included. Astigmatism equal or higher than 0.25 D in minus cylinder form was used. Patients with documented history of cataract extraction (pseudophakia or aphakia), amblyopia, refractive surgery or other corneal/ocular surgery were excluded from the study. A total of 784 randomly selected subjects older than 40 years of age were selected. The estimated prevalence (95%, confidence interval) among all subjects was hyperopia 51.5% (48.0-55.0), emmetropia 33.8% (30.5-37.2), myopia 14.7% (12.1-17.2) and astigmatism 69.6% (68.8-73.3). Hyperopia was more common in females than males although the difference was not statistically significant. The mean spherical equivalent values was hyperopic until 70 y/o and decreased slightly as the population ages. Hyperopia is the most common refractive error and its prevalence and seems to increase among the aging population who visited the clinics. Further programs and studies must be developed to address the refractive errors needs of the adult Puerto Rican population. Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  1. Clinical implications of word recognition differences in earphone and aided conditions

    Science.gov (United States)

    McRackan, Theodore R.; Ahlstrom, Jayne B.; Clinkscales, William B.; Meyer, Ted A.; Dubno, Judy R

    2017-01-01

    Objective To compare word recognition scores for adults with hearing loss measured using earphones and in the sound field without and with hearing aids (HA) Study design Independent review of pre-surgical audiological data from an active middle ear implant (MEI) FDA clinical trial Setting Multicenter prospective FDA clinical trial Patients Ninety-four adult HA users Interventions/Main outcomes measured Pre-operative earphone, unaided and aided pure tone thresholds, word recognition scores, and speech intelligibility index. Results We performed an independent review of pre-surgical audiological data from a MEI FDA trial and compared unaided and aided word recognition scores with participants’ HAs fit according to the NAL-R algorithm. For 52 participants (55.3%), differences in scores between earphone and aided conditions were >10%; for 33 participants (35.1%), earphone scores were higher by 10% or more than aided scores. These participants had significantly higher pure tone thresholds at 250 Hz, 500 Hz, and 1000 Hz), higher pure tone averages, higher speech recognition thresholds, (and higher earphone speech levels (p=0.002). No significant correlation was observed between word recognition scores measured with earphones and with hearing aids (r=.14; p=0.16), whereas a moderately high positive correlation was observed between unaided and aided word recognition (r=0.68; p<0.001). Conclusion Results of the these analyses do not support the common clinical practice of using word recognition scores measured with earphones to predict aided word recognition or hearing aid benefit. Rather, these results provide evidence supporting the measurement of aided word recognition in patients who are considering hearing aids. PMID:27631832

  2. Lumbar spinal imaging in radicular pain and related conditions. Understanding diagnostic images in a clinical context

    Energy Technology Data Exchange (ETDEWEB)

    Wilmink, Jan T. [University Hospital Maastricht (Netherlands). Dept. Radiology

    2010-07-01

    There is general agreement that lumbosacral nerve root compression is a prime factor in the pathogenesis of sciatica and neurogenic claudication, although humoral and vascular factors certainly play a role as well. This book focuses on imaging of the various ways in which nerve root compression can come about, and assessing which anatomic features are reliably associated with the occurrence of radicular pain, as opposed to morphologic findings which are probably coincidental. After a discussion of the nature of radicular pain and related symptoms, spinal imaging techniques and options are reviewed, with emphasis on the role of MR myelography in assessing the condition of the intradural nerve roots. A chapter on normal topographic, sectional, and functional (dynamic) radiologic anatomy is followed by a presentation on pathologic anatomy, addressing the various mechanisms of nerve root compression. In the chapter on pre- and postoperative imaging, features which may help to predict the evolution of the symptoms are discussed, with an eye to selecting candidates for surgical treatment. This is followed by a discussion of the role and limitations of imaging studies in various adverse postoperative conditions. In illustrations involving patient studies, imaging features are linked where possible to the clinical symptoms and history of the individuals involved. (orig.)

  3. A Double Blind Randomized Clinical Trial of Remote Ischemic Conditioning in Live Donor Renal Transplantation.

    Science.gov (United States)

    Nicholson, Michael L; Pattenden, Clare J; Barlow, Adam D; Hunter, James P; Lee, Gwyn; Hosgood, Sarah A

    2015-08-01

    Ischemic conditioning involves the delivery of short cycles of reversible ischemic injury in order to induce protection against subsequent more prolonged ischemia. This randomized controlled trial was designed to determine the safety and efficacy of remote ischemic conditioning (RC) in live donor kidney transplantation.This prospective randomized clinical trial, 80 patients undergoing live donor kidney transplantation were randomly assigned in a 1:1 ratio to either RC or to a control group. RC consisted of cycles of lower limb ischemia induced by an arterial tourniquet cuff placed around the patient's thigh. In the RC treatment group, the cuff was inflated to 200 mm Hg or systolic pressure +25 mm Hg for 4 cycles of 5 min ischemia followed by 5 min reperfusion. In the control group, the blood pressure cuff was inflated to 25 mm Hg. Patients and medical staff were blinded to treatment allocation. The primary end-point was renal function measured by estimated glomerular filtration rate (eGFR) at 1 and 3 months posttransplant.Donor and recipient demographics were similar in both groups (P protocol described here, did not improve renal function after live donor kidney transplantation.

  4. Phases of stable representations of quivers

    CERN Document Server

    Engenhorst, Magnus

    2015-01-01

    We consider stable representations of non-Dynkin quivers with respect to a central charge. On one condition the existence of a stable representation with self-extensions implies the existence of infinitely many stables without self-extensions. In this case the phases of the stable representations approach one or two limit points. In particular, the phases are not dense in two arcs.

  5. Integration of an optical coherence tomography (OCT) system into an examination incubator to facilitate in vivo imaging of cardiovascular development in higher vertebrate embryos under stable physiological conditions

    DEFF Research Database (Denmark)

    Happel, Christoph M.; Thrane, Lars; Thommes, Jan

    2011-01-01

    High-resolution in vivo imaging of higher vertebrate embryos over short or long time periods under constant physiological conditions is a technically challenging task for researchers working on cardiovascular development. In chick embryos, for example, various studies have shown that without...... significance, should be documented under physiological conditions. However, previous studies were mostly carried out outside of an incubator or under suboptimal environmental conditions. Here we present, to the best of our knowledge, the first detailed description of an optical coherence tomography (OCT......) system integrated into an examination incubator to facilitate real-time in vivo imaging of cardiovascular development under physiological environmental conditions. We demonstrate the suitability of this OCT examination incubator unit for use in cardiovascular development studies by examples of proof...

  6. 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 thermal test and conditioning stimuli revealed less-efficient endogenous pain modulation in subjects with SCI-NP.

  7. 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

    ,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...

  8. 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.

  9. 26 CFR 1.28-1 - Credit for clinical testing expenses for certain drugs for rare diseases or conditions.

    Science.gov (United States)

    2010-04-01

    ... muscular dystrophies; Huntington's disease, a hereditary chorea; myoclonus; Tourette's syndrome; and... drugs for rare diseases or conditions. 1.28-1 Section 1.28-1 Internal Revenue INTERNAL REVENUE SERVICE... clinical testing expenses for certain drugs for rare diseases or conditions. (a) General rule. Section 28...

  10. The Clinical Effects of Stable Period COPD by Inhaled Corticosteroids%吸入糖皮质激素治疗稳定期COPD疗效研究

    Institute of Scientific and Technical Information of China (English)

    郭宝明

    2014-01-01

    目的:探讨对稳定期慢性阻塞性肺疾病(COPD)患者吸入糖皮质激素治疗的临床效果。方法:选取86例COPD患者作为研究对象,按随机数字表法分为观察组和对照组各43例。对照组采用常规治疗,观察组在常规治疗的前提下吸入糖皮质激素治疗。比较两组患者的临床疗效。结果:观察组的总有效率为95.35%(41/43),高于对照组的76.74%(33/43),差异有统计学意义(P0.05)。结论:对稳定期COPD患者进行吸入糖皮质激素治疗,能有效改善患者的肺功能,不会明显增加不良反应的发生,安全有效,有利于提高患者的生活质量。%Objective:To explore the clinical effects of stable period COPD by Inhaled corticosteroids. Method:86 patients with COPD were randomly divided into the observation group(n=43)and the control group(n=43). The control group was treated by conventional treatment,on the basis of conventional treatment,the observation group was treated inhaled corticosteroids. The clinical effects of the two groups was compared.Result:The total effective rate of the observation group(95.35%)were higher than the control goup(76.74%)(P0.05).Conclusion:It can improve the lung function for the patients with COPD by inhaled corticosteroids. It has significant effect and it can improve the quality of life for the patients with COPD.

  11. Romidepsin for the treatment of relapsed/refractory peripheral T cell lymphoma: prolonged stable disease provides clinical benefits for patients in the pivotal trial

    Directory of Open Access Journals (Sweden)

    Francine Foss

    2016-03-01

    Full Text Available Abstract Background Achievement of durable responses in patients with relapsed/refractory peripheral T cell lymphoma (PTCL is challenging with current therapies, and there are few data regarding the potential benefits of continuing treatment in patients with the best response of stable disease (SD. Histone deacetylase inhibitors are a novel class of drugs with activity in T cell malignancies. Romidepsin was approved by the US Food and Drug Administration for the treatment of relapsed/refractory PTCL based on a pivotal trial demonstrating an objective response rate of 25 % (33/130, including 15 % with confirmed/unconfirmed complete response and a median duration of response of 28 months. Our objective was to further study the clinical benefits of romidepsin in patients that had the best response of SD. Methods Patients with PTCL relapsed/refractory to ≥1 prior therapy were treated with the approved dose of 14 mg/m2 romidepsin on days 1, 8, and 15 of six 28-day cycles; patients with SD or response after cycle 6 were allowed to continue on study until progression. By protocol amendment, patients treated for ≥12 cycles could receive maintenance dosing twice per cycle; after cycle 24, dosing could be further reduced to once per cycle in those who had received maintenance dosing for ≥6 months. Results Of the 32 patients (25 % with the best response of SD, 22 had SD for ≥90 days (SD90; cycle 4 response assessment. The longest SD was >3 years in a patient who received maintenance dosing of 14 mg/m2 on days 1 and 15 beginning in cycle 13. Patients with the best response of SD90 or partial response achieved similar overall and progression-free survival. Prolonged dosing of romidepsin was well tolerated. Conclusions We concluded that patients who achieve SD may consider continuing treatment because the clinical benefits of romidepsin may extend beyond objective responses. Trial registration NCT00426764

  12. Alternative assessment of nano-TiO{sub 2} sedimentation under different conditions based on sedimentation efficiency at quasi-stable state

    Energy Technology Data Exchange (ETDEWEB)

    He, Guang’an; Chen, Rui; Lu, Shushen [Sun Yat-sen University, School of Chemistry and Chemical Engineering (China); Jiang, Chengchun [Shenzhen Polytechnic, School of Civil and Environmental Engineering (China); Liu, Hong, E-mail: liuhong@cigit.ac.cn [Sun Yat-sen University, School of Chemistry and Chemical Engineering (China); Wang, Chuan [Chinese Academy of Sciences, Chongqing Institute of Green and Intelligent Technology (China)

    2015-11-15

    The predictable significant increase in manufacture and use of engineered nanoparticles (ENPs) will cause their inevitable release into environment, and the potential harmful effects of ENPs have been confirmed. As representative ENPs, sedimentation behavior of nano-titanium dioxide (n-TiO{sub 2}) should be better understood to control its environmental risk. In this study, an experimental methodology was established to set the sampling area and sampling time of n-TiO{sub 2} sedimentation. In addition, we defined a quasi-stable state and a precise index, i.e., sedimentation efficiency (SE) at this state, to describe the n-TiO{sub 2} sedimentation behavior. Both alternative concentration determination and conventional size measurement were applied to evaluate the sedimentation behavior of n-TiO{sub 2} with fulvic acid. Results showed that the sedimentation behavior described by SE was more precise and in disagreement with those predicted by particle size. Moreover, sedimentation experiments with salicylic acid (SA), under an electric field and different water temperatures or with sulfosalicylic acid under light irradiation were also performed. When the total organic carbon concentration of SA, the voltage of working electrodes, and water temperature increased, or the wavelength of light source decreased, the SE of n-TiO{sub 2} increased and n-TiO{sub 2} showed a tendency to settle in water. These findings might be important for deepening the understanding of n-TiO{sub 2} environmental behavior and exploring sedimentation behavior of other ENPs.

  13. Adding complex terrain and stable atmospheric condition capability to the OpenFOAM-based flow solver of the simulator for on/offshore wind farm applications (SOWFA

    Directory of Open Access Journals (Sweden)

    Churchfield Matthew J.

    2014-01-01

    Full Text Available The National Renewable Energy Laboratory's Simulator for On/Offshore Wind Farm Applications contains an OpenFOAM-based flow solver for performing large-eddy simulation of flow through wind plants. The solver computes the atmospheric boundary layer flow and models turbines with actuator lines. Until recently, the solver was limited to flows over flat terrain and could only use the standard Smagorinsky subgrid-scale model. In this work, we present our improvements to the flow solver that enable us to 1 use any OpenFOAM-standard subgrid-scale model and 2 simulate flow over complex terrain. We used the flow solver to compute a stably stratified atmospheric boundary layer using both the standard and the Lagrangian-averaged scale-independent dynamic Smagorinsky models. Surprisingly, the results using the standard Smagorinsky model compare well to other researchers' results of the same case, although it is often said that the standard Smagorinsky model is too dissipative for accurate stable stratification calculations. The scale-independent dynamic subgrid-scale model produced poor results, probably due to the spikes in model constant with values as high as 4.6. We applied a simple bounding of the model constant to remove these spikes, which caused the model to produce results much more in line with other researchers' results. We also computed flow over a simple hilly terrain and performed some basic qualitative analysis to verify the proper operation of the terrain-local surface stress model we employed.

  14. Horner Syndrome in Children: A Clinical Condition with Serious Underlying Disease.

    Science.gov (United States)

    Barrea, Christophe; Vigouroux, Tiphaine; Karam, Joe; Milet, Ariane; Vaessen, Sandrine; Misson, Jean-Paul

    2016-08-01

    Aim Horner syndrome corresponds to the clinical triad of miosis, ptosis, and facial anhidrosis. These symptoms are related to injury of the oculosympathetic chain. In children, Horner syndrome is classified as congenital or acquired. While the diagnosis is made through clinical examination, there is some debate regarding the use of imaging modalities and the extent of anatomical coverage required. Methods Here, we describe two cases of children with acute Horner syndrome. We then review the literature about the different etiology and discuss the interest of some investigations. Results Case 1: An 8-month-old girl without personal or familial history, has presented a right acquired Horner syndrome without additional signs. Frontal chest radiography and ultrasonography of the neck and the abdomen was first achieved and returned normal. The cerebral and cervical magnetic resonance imaging (MRI) with angiographic sequences performed in a second time was also normal. Finally, an enhanced thoracic computed tomography (CT)-scan demonstrated a mass at the right pulmonary apex. Case 2: A 9-year-old boy without personal or familial history has presented an acute headache with loss of consciousness during a basketball competition. Upon waking up, the child has right hemiplegia, aphasia, and left Horner syndrome. The cerebral CT scan realized in the first line was normal. The MRI with angiographic sequences demonstrated M1 left carotid dissection with homolateral white matter infarction. Conclusion Imaging studies seem critical in delineating the nature and extent of any underlying pathology along the oculosympathetic pathway in children presenting a Horner syndrome. In these patients, a history of trauma or surgery may reduce the need for extensive systemic evaluation. Without such anamnesis, a decision to proceed with further evaluation is made with consideration of the relative incidence of tumor, especially neuroblastoma, or other treatable lesions. In this

  15. Improving the external validity of clinical trials: the case of multiple chronic conditions

    Directory of Open Access Journals (Sweden)

    Martin Fortin

    2013-12-01

    Full Text Available The U.S. Department of Health and Human Services vision and strategic framework on multiple chronic conditions (MCCs incorporates recommendations designed to facilitate research that will improve our knowledge about interventions and systems that will benefit individuals with MCCs (or multimorbidity. The evidence base supporting the management of patients with MCCs will be built both through intervention trials specifically designed to address multimorbidity and identification of MCCs in participants across the clinical trial range. This article specifically focuses on issues relating to external validity with specific reference to trials involving patients with MCCs. The exclusion of such patients from clinical trials has been well documented. Randomized control trials (RCTs are considered the “gold standard” of evidence, but may have drawbacks in relation to external validity, particularly in relation to multimorbidity. It may, therefore, be necessary to consider a broader range of research methods that can provide converging evidence on intervention effects to address MCCs. Approaches can also be taken to increase the usefulness of RCTs in general for providing evidence to inform multimorbidity management. Additional improvements to RCTs would include better reporting of inclusion and exclusion criteria and participant characteristics in relation to MCCs. New trials should be considered in terms of how they will add to the existing evidence base and should inform how interventions may work in different settings and patient groups. Research on treatments and interventions for patients with MCCs is badly needed. It is important that this research includes patient-centered measures and that generalizability issues be explicitly addressed.

  16. Highly active and stable ion-exchanged Fe-Ferrierite catalyst for N2O decomposition under nitric acid tail gas conditions

    NARCIS (Netherlands)

    Melian Cabrera, Ignacio; Mentruit, C; Pieterse, JAZ; van den Brink, RW; Mul, G; Kapteijn, F; Moulijn, JA

    2005-01-01

    This communication reports on the excellent performance and durability of a wet ion-exchanged Fe-Ferrierite catalysts for N2O decomposition under conditions of nitric acid plants, especially in the presence of water (0.5% vol) and at a high space time W/F-0(N2O) = 900 kg(cat) s mol(-1). In contrast

  17. Highly active and stable ion-exchanged Fe–Ferrierite catalyst for N2O decomposition under nitric acid tail gas conditions

    NARCIS (Netherlands)

    Melián-Cabrera, I.; Mentruit, C.; Pieterse, J.A.Z.; Brink, R.W. van den; Mul, G.; Kapteijn, F.; Moulijn, J.A.

    2005-01-01

    This communication reports on the excellent performance and durability of a wet ion-exchanged Fe–Ferrierite catalysts for N2O decomposition under conditions of nitric acid plants, especially in the presence of water (0.5% vol) and at a high space time W/F0(N2O) = 900 kgcat s mol-1. In contrast to io

  18. Informed Conditioning on Clinical Covariates Increases Power in Case-Control Association Studies

    Science.gov (United States)

    Zaitlen, Noah; Lindström, Sara; Pasaniuc, Bogdan; Cornelis, Marilyn; Genovese, Giulio; Pollack, Samuela; Barton, Anne; Bickeböller, Heike; Bowden, Donald W.; Eyre, Steve; Freedman, Barry I.; Friedman, David J.; Field, John K.; Groop, Leif; Haugen, Aage; Heinrich, Joachim; Henderson, Brian E.; Hicks, Pamela J.; Hocking, Lynne J.; Kolonel, Laurence N.; Landi, Maria Teresa; Langefeld, Carl D.; Le Marchand, Loic; Meister, Michael; Morgan, Ann W.; Raji, Olaide Y.; Risch, Angela; Rosenberger, Albert; Scherf, David; Steer, Sophia; Walshaw, Martin; Waters, Kevin M.; Wilson, Anthony G.; Wordsworth, Paul; Zienolddiny, Shanbeh; Tchetgen, Eric Tchetgen; Haiman, Christopher; Hunter, David J.; Plenge, Robert M.; Worthington, Jane; Christiani, David C.; Schaumberg, Debra A.; Chasman, Daniel I.; Altshuler, David; Voight, Benjamin; Kraft, Peter; Patterson, Nick; Price, Alkes L.

    2012-01-01

    Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI), smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low–BMI cases are larger than those estimated from high–BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals on the basis of phenotype (case-control ascertainment) or phenotype and clinical covariates (case-control-covariate ascertainment). While current approaches improve power in studies with random ascertainment, they often lose power under case-control ascertainment and fail to capture available power increases under case-control-covariate ascertainment. We show that an informed conditioning approach, based on the liability threshold model with parameters informed by external epidemiological information, fully accounts for disease prevalence and non-random ascertainment of phenotype as well as covariates and provides a substantial increase in power while maintaining a properly controlled false-positive rate. Our method outperforms standard case-control association tests with or without covariates, tests of gene x covariate interaction, and previously proposed tests for dealing with covariates in ascertained data, with especially large improvements in the case of case-control-covariate ascertainment. We investigate empirical case-control studies of type 2 diabetes, prostate cancer, lung cancer, breast cancer, rheumatoid arthritis, age-related macular degeneration, and end-stage kidney disease over a total of 89,726 samples. In these datasets, informed conditioning outperforms logistic regression for 115 of the 157 known associated variants investigated (P-value = 1×10−9). The improvement varied across diseases with a 16% median increase in χ2 test statistics and a

  19. Informed conditioning on clinical covariates increases power in case-control association studies.

    Directory of Open Access Journals (Sweden)

    Noah Zaitlen

    Full Text Available Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI, smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low-BMI cases are larger than those estimated from high-BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals on the basis of phenotype (case-control ascertainment or phenotype and clinical covariates (case-control-covariate ascertainment. While current approaches improve power in studies with random ascertainment, they often lose power under case-control ascertainment and fail to capture available power increases under case-control-covariate ascertainment. We show that an informed conditioning approach, based on the liability threshold model with parameters informed by external epidemiological information, fully accounts for disease prevalence and non-random ascertainment of phenotype as well as covariates and provides a substantial increase in power while maintaining a properly controlled false-positive rate. Our method outperforms standard case-control association tests with or without covariates, tests of gene x covariate interaction, and previously proposed tests for dealing with covariates in ascertained data, with especially large improvements in the case of case-control-covariate ascertainment. We investigate empirical case-control studies of type 2 diabetes, prostate cancer, lung cancer, breast cancer, rheumatoid arthritis, age-related macular degeneration, and end-stage kidney disease over a total of 89,726 samples. In these datasets, informed conditioning outperforms logistic regression for 115 of the 157 known associated variants investigated (P-value = 1 × 10(-9. The improvement varied across diseases with a 16% median increase in χ(2 test statistics

  20. Stable oxygen isotopic composition of corals from the Gulf of Guinea as indicators of periods of extreme precipitation conditions in the sub-Sahara

    Science.gov (United States)

    Swart, Peter K.; White, Kathy S.; Enfield, David; Dodge, Richard E.; Milne, Peter

    1998-11-01

    Stable oxygen isotopic analyses of scleractinian coral skeletons from the Gulf of Guinea in the eastern Atlantic reveal that the corals from this region can be used to identify periods of severe drought and above average precipitation in sub-Sahara Africa. Data presented in this paper show an inverse correlation between precipitation in the Sahel and the δ18O values of a coral skeletons of the species Siderastrea spp. collected from the island of Principe in the Gulf of Guinea. This is opposite to the correlation expected, as previous work has suggested that higher sea surface temperatures occur in the Gulf of Guinea during periods of low rainfall in the Sahel. Such an association would lead to a positive correlation between Sahel precipitation and skeletal δ18O. The explanation for the observed inverse correlation is that the salinity of the Gulf of Guinea is strongly influenced by the outflow from the Niger and Congo rivers. These periods of high freshwater input also correlate with periods of higher rainfall in the sub-Sahara and therefore affect the δ18O values of the coral skeleton. The correlation between δ18O values of the coral skeleton and temperature in the northern subtropical Atlantic Ocean (r = -0.34), the magnitude of the dipole (r = -0.45), and the latitudinal position of the intertropical convergence zone (r = -0.37) illustrate that the δ18O values in the coral skeleton reflect climate dynamics of the region that affect the precipitation patterns in sub-Sahara Africa.

  1. Increased calcium absorption from synthetic stable amorphous calcium carbonate: Double-blind randomized crossover clinical trial in post-menopausal women

    Science.gov (United States)

    Calcium supplementation is a widely recognized strategy for achieving adequate calcium intake. We designed this blinded, randomized, crossover interventional trial to compare the bioavailability of a new stable synthetic amorphous calcium carbonate (ACC) with that of crystalline calcium carbonate (C...

  2. 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

  3. Preventative and Therapeutic Probiotic Use in Allergic Skin Conditions: Experimental and Clinical Findings

    Directory of Open Access Journals (Sweden)

    Öner Özdemir

    2013-01-01

    Full Text Available Probiotics are ingested live microbes that can modify intestinal microbial populations in a way that benefits the host. The interest in probiotic preventative/therapeutic potential in allergic diseases stemmed from the fact that probiotics have been shown to improve intestinal dysbiosis and permeability and to reduce inflammatory cytokines in human and murine experimental models. Enhanced presence of probiotic bacteria in the intestinal microbiota is found to correlate with protection against allergy. Therefore, many studies have been recently designed to examine the efficacy of probiotics, but the literature on the allergic skin disorders is still very scarce. Here, our objective is to summarize and evaluate the available knowledge from randomized or nonrandomized controlled trials of probiotic use in allergic skin conditions. Clinical improvement especially in IgE-sensitized eczema and experimental models such as atopic dermatitis-like lesions (trinitrochlorobenzene and picryl chloride sensitizations and allergic contact dermatitis (dinitrofluorobenzene sensitization has been reported. Although there is a very promising evidence to recommend the addition of probiotics into foods, probiotics do not have a proven role in the prevention or the therapy of allergic skin disorders. Thus, being aware of possible measures, such as probiotics use, to prevent/heal atopic diseases is essential for the practicing allergy specialist.

  4. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

    Science.gov (United States)

    CALDAS, Waleska; CONTI, Ana Cláudia de Castro Ferreira; JANSON, Guilherme; Paulo César Rodrigues, CONTI

    2016-01-01

    ABSTRACT The relationship between Temporomandibular Disorders (TMD) and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. Objectives The aim of this article is to present the most commonly occlusal changes secondary to TMD. Methods The clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented. Conclusions All plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy. PMID:27556214

  5. Occlusal changes secondary to temporomandibular joint conditions: a critical review and implications for clinical practice

    Directory of Open Access Journals (Sweden)

    Waleska CALDAS

    Full Text Available ABSTRACT The relationship between Temporomandibular Disorders (TMD and malocclusion is an extremely critical issue in dentistry. Contrary to the old concept that malocclusion causes TMD, occlusal changes, especially those observed as sudden, may be secondary and reflect joint or muscle disorders due to the obvious connection between these structures and the dental occlusion. Objectives The aim of this article is to present the most commonly occlusal changes secondary to TMD. Methods The clinical presentation of these conditions is discussed. Details regarding diagnosis, treatment, and follow-up of patients presenting TMD prior or during treatment are also presented. Conclusions All plans for irreversible therapy should be preceded by a meticulous analysis of TMD signs and symptoms in such a way that patients are not submitted to irreversible treatment, based on an untrue occlusal relationship, secondary to articular and/or muscular disorders. When present, TMD symptoms must always be controlled to reestablish a “normal” occlusion and allow proper treatment strategy.

  6. Takotsubo syndrome (stress cardiomyopathy): an intriguing clinical condition in search of its identity.

    Science.gov (United States)

    Pelliccia, Francesco; Greco, Cesare; Vitale, Cristiana; Rosano, Giuseppe; Gaudio, Carlo; Kaski, Juan Carlos

    2014-08-01

    Takotsubo syndrome is a relatively frequent clinical entity presenting typically as an acute coronary syndrome in the absence of obstructive coronary artery disease and characterized angiographically by transient left ventricular systolic dysfunction, sparing the basal segments of the left ventricle ("apical ballooning"). Takotsubo syndrome characteristically affects peri- or postmenopausal women, albeit recent series show that men also are at risk. Takotsubo syndrome is characteristically triggered by severe emotional or physical stress, which suggests a pathogenic role for increased sympathetic activity leading to myocardial perfusion abnormalities and ventricular dysfunction. The reasons why severe emotional and physical stress result in the development of takotsubo syndrome in certain individuals but not others is still a matter of speculation, but strongly suggests the existence of predisposing factors/mechanisms in certain subjects. The present article reviews the different factors that can play a role in the development of takotsubo syndrome in different patients. We propose that triggers (ie, emotional stressors, physical stressors, iatrogenic stressors, and neurologic triggers), pathogenic mechanisms (ie, increased catecholamine levels, coronary vasomotor abnormalities leading to myocardial ischemia), and predisposing factors (ie, cardiovascular risk factors, endothelial dysfunction, comorbidities) all interact in a complex fashion and possibly differently in different patients to cause takotsubo syndrome. Identifying these factors may help in preventing and managing the condition more effectively.

  7. Gingival Condition in Children Aged From 6 to 12 Years Old: Clinical and Microbiological Aspects

    Directory of Open Access Journals (Sweden)

    Ane Stella Salgado XAVIER

    2007-03-01

    Full Text Available Objective: The aim of this study was to evaluate the gingival condition and the occurrence of periodontopathogens in 93 children aged from 6 to 12 years old in Araçatuba, Brazil. Method: Clinical examination was performed in accordance to Schour and Massler (1947 while the subgingival plaque samples were obtained though sterilized paper point that were placed into health and inflamed gingival crevice of tooth 54 or 14, 61 or 11, 26, 75 or 35, 82 or 42 and 46, where they were kept for 60 seconds and tranferred to tubes containing 5 ml of thioglicolate broth. Microorganisms were isolated on blood agar and CVE an agar after incubation under anaerobiosis, at 37ºC, for 10 days. The identification of the isolates was based on their morphological, cellular and biochemical features. Results: 91.40% shows gingivitis while 70.97% presented mild gingivitis. Only 8.6% didn’t presented gingivitis. It was verified that the most of children presented mild gengivitis and was had some periodontopathogens. Conclusion: The gingivitis deteriored with age and only F. nucleatum was related with the deterioration of gengival status.

  8. The Condition of Thyroid and Fetoplacental Systems in Pregnant Women with Clinically Euthyroid Goiter

    Directory of Open Access Journals (Sweden)

    V N Petrova

    2007-03-01

    Full Text Available The aim is to study a condition of thyroid and fetoplacental systems at pregnant women with clinically euthyroid goiter. Materials and methods: 116 pregnant women have been included in the basic group with clinically euthyroid goiter. The control group was made by 60 pregnant women with physiologically proceeding pregnancy, not having anamnestic and the clinical data on diseases of the thyroid. Inspection included: definition of concentration thyroid-stimulating hormone (TSH and free thyroxine (fT4 by a radio-immunologic method, sets “RIA-gnost” (France and the maintenance of antibodies to thyroid peroxydase (anti-TPO by a method hard phase immune-enzyme analysis; ultrasonic assessment of a thyroid with the help of device SONOACE 8800 “GAIA MT”; ultrasonic fetometry, placentography, measurement of amniotic fluid volume, doppler ultrasound examination of the blood flow, an estimation of a functional condition of a fetus on parameters of its biophysical profile (BP and cardiotocography (CTG, carried out on device “Oxford Sonicaid Team S8000”. Results: At studying hormonal function thyroid systems at 25 pregnant (21.6% with euthyroid goiter in the third trimester of pregnancy a level fT4 norms were lower and had values from 4.5 up to 6.9 ng/ml, therefore an average level fT4 at pregnant women of the basic group was authentically lower, than in control (8.26 ± 0.30 and 10.71 ± 0.52 ng/ml, accordingly. At the retrospective analysis it is established, that only at 5 of 116 (4.3% pregnant women with a goiter were not complications pregnancy, at the others — 111 (95.7% took place a combination various obstetric complications: an anemia — at 72 (62.0%, threat noncarrying of pregnancy — at 75 (64.6 %, an early toxicosis — at 45 (38.6%, a gestosis — at 47 (40.5% which frequency authentically is higher, than in control group: 20.0%, 25.0%, 16.6%. 20.0%, accordingly, р < 0.05. Average Estimation CTG at patients of the basic group is

  9. Retrospective study of disease incidence and other clinical conditions diagnosed in owned dogs in Delta State, Nigeria

    Directory of Open Access Journals (Sweden)

    Kundu F. Shima

    2015-12-01

    Full Text Available In Nigeria, knowledge on the epidemiology of diseases of dogs is limited. A retrospective study of data from clinical records of six veterinary clinics was undertaken to determine the incidence of disease in owned dogs in Delta State, Nigeria from 2012 to 2014. Association between the diagnosed diseases and the studied variables was explored using Chi-Squared test statistics. This study revealed that most of the conditions presented to the veterinary clinics were preventable. Thirty-one (31 clinical conditions were diagnosed from 571 cases recorded, involving nonspecific (21.6%, infectious (70.9%; P=0.001 and non-infectious (7.5% diseases. The most occurring clinical conditions comprised helminthoses (21.4%, mange (10.5%, parvovirosis (8.4%, babesiosis (7.9%, septicemia (7.2%, gastroenteritis (7.0%, myiasis (7.0%, trauma (6.3%, poisoning (6.0%, ectoparasitism (3.7%, ascites (2.5%, dermatitis (2.3%, aural hematoma (1.2%, and orchitis (1.1%. Disease incidence was highest in Alsatian (40.3%, mixed/cross (33.1%, Rottweiler (7.0% and toy breeds (4.6%. Details on the least occurring diseases and the association between disease and the studied variables are given. The outcomes demonstrate the prevalence of the clinical conditions diagnosed, inadequate husbandry and veterinary care accorded to owned dogs in the State. Education of dog owners on preventive measures is paramount in alleviating some of these health problems.

  10. 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.

  11. Safety and pharmacokinetics of lisdexamfetamine dimesylate in adults with clinically stable schizophrenia: a randomized, double-blind, placebo-controlled trial of ascending multiple doses.

    Science.gov (United States)

    Martin, Patrick; Dirks, Bryan; Gertsik, Lev; Walling, David; Stevenson, Annette; Corcoran, Mary; Raychaudhuri, Aparna; Ermer, James

    2014-12-01

    To assess the safety and pharmacokinetics of lisdexamfetamine dimesylate (LDX), a d-amphetamine prodrug, this double-blind study enrolled adults with clinically stable schizophrenia who were adherent (≥12 weeks) to antipsychotic pharmacotherapy. The participants received placebo or ascending LDX doses (50, 70, 100, 150, 200, and 250 mg) daily for 5 days at each dose (dose periods, 1-6; days, 1-5). Of the 31 enrolled participants, 27 completed the study (placebo, n = 6; LDX, n = 21). Treatment-emergent adverse events (AEs) were reported by 4 participants receiving placebo and by 23 participants receiving LDX (all doses) with no serious AEs while on active treatment. For all periods, the mean postdose change on day 5 (up to 12 hours postdose) in systolic and diastolic blood pressure and pulse, respectively, ranged from -4.62 to 8.05 mm Hg, -3.67 to 4.43 mm Hg, and -3.57 to 14.43 beats per minute for placebo and -3.83 to 11.25 mm Hg, -1.55 to 5.80 mm Hg, and -0.36 to 21.26 beats per minute for LDX. With ascending LDX dose, the mean (SD) maximum plasma concentration for LDX-derived d-amphetamine ranged from 51.68 (10.28) to 266.27 (56.55) ng/mL. The area under the plasma concentration-time curve for 24 hours ranged from 801.8 (170.2) to 4397.9 (1085.9) ng[BULLET OPERATOR]h/mL. The d-amphetamine maximum plasma concentration and area under the plasma concentration-time curve increased linearly with ascending LDX dose. Antipsychotic agents did not markedly affect d-amphetamine pharmacokinetics. Over a wide range of ascending doses, LDX safety profile in adults with schizophrenia was consistent with previous findings with no unexpected treatment-emergent AEs. Pulse tended to increase with LDX dose; overall, blood pressure did not increase with LDX dose. Consistent with previous studies, pharmacokinetic parameters increased linearly with increasing LDX dose.

  12. An atmospheric dispersion model for linear sources in calm wind, stable conditions; Un modello di dispersione atmosferica per sorgenti lineari in condizioni di vento debole

    Energy Technology Data Exchange (ETDEWEB)

    Cirillo, M. C. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente; Buratti, D. [Rome Univ. La Sapienza, Rome (Italy). Facolta' di Scienze Statistiche; Metallo, M. C.; Poli, A.A. [ESA s.a.s., Bracciano, RM (Italy)

    1999-07-01

    In this report a dispersion model is proposed that provides an estimate of concentration of gaseous pollutants emitted by an highway, or in general by a line source, in presence of low wind speed. This aim was pursued because available models have not a satisfactory behaviour in such conditions, which is critical for dispersion of gaseous pollutants. This lack is due to difficulty of simulating dispersion turbulent component which is determined by fluctuation of wind speed and wind direction, and in presence of calm conditions it assumes values comparable with transport component. The proposed model overcomes this difficulty, as it is shown by sensitivity analysis and comparison with experimental data. The capability of simulating dispersion eve in critical conditions, like the presence of low level inversion, and the absence of source geometrical approximations make the model a tool that, properly used, may contribute to the efficient planning and management of environmental resources. [Italian] In questo rapporto viene proposto un modello per la stima delle concentrazioni di inquinanti aeriformi emessi da un'arteria stradale, o in generale da una sorgente lineare, in presenza di vento debole. Questo scopo e' stato perseguito in quanto in questa condizione, nonostante la dispersione degli inquinanti risulti fortemente problematica, i modelli disponibili in letteratura non hanno un comportamento soddisfacente. Questa mancanca e' attribuibile alla difficolta' di simulare la componente turbolenta della dispersione, dovuta alla fluttuazione della direzione e della velocita' del vento che, in presenza di vento debole, assume valori confrontabili alla componente di trasporto. Il modello qui di seguito proposto supera questa difficolta', come dimostrano l'analisi di sensibilita' e il confronto con un caso reale; la capacita' di simulare la dispersione anche in condizioni fisicamente critiche quali la presenza di inversione a

  13. Comparison between National Institute for Health and Care Excellence (NICE) and European Society of Cardiology (ESC) guidelines for the diagnosis and management of stable angina: implications for clinical practice.

    Science.gov (United States)

    Archbold, R Andrew

    2016-01-01

    Cardiologists in the UK use clinical practice guidelines from the National Institute for Health and Care Excellence (NICE) and from the European Society of Cardiology (ESC) to aid clinical decision-making. This review compares their recommendations regarding stable angina. NICE's diagnostic algorithm changed clinical practice in the UK, with most cardiologists moving from the exercise ECG towards newer, more accurate imaging modalities such as CT and MRI for diagnostic testing in patients with a low or medium probability of coronary artery disease (CAD), and directly to invasive coronary angiography in patients with a high probability of CAD. ESC guidelines are based around stress imaging for most patient groups. Both guidelines stress the importance of optimal medical therapy for patients with stable angina. NICE recommends coronary artery bypass graft surgery to improve prognosis for patients with left main stem and/or proximal 3-vessel disease, whereas the ESC also includes proximal left anterior descending artery disease among its indications for revascularisation to improve prognosis, particularly if there is evidence of myocardial ischaemia. The relation between disease complexity and 5-year clinical outcomes after revascularisation in patients with left main stem and/or 3-vessel CAD has been integrated into ESC guidance through the use of the SYNTAX score to aid treatment selection in this group of patients. Patients with stable angina who have disease involving the proximal left anterior descending artery are less likely to undergo myocardial revascularisation if they are managed according to NICE's guidance compared with the ESC's guidance.

  14. An amorphous CoSe film behaves as an active and stable full water-splitting electrocatalyst under strongly alkaline conditions.

    Science.gov (United States)

    Liu, Tingting; Liu, Qian; Asiri, Abdullah M; Luo, Yonglan; Sun, Xuping

    2015-12-01

    It is attractive but still remains a big challenge to develop non-noble metal bifunctional electrocatalysts efficient for both oxygen evolution reaction (OER) and hydrogen evolution reaction (HER) under alkaline conditions. Herein, an amorphous CoSe film electrodeposited on a Ti mesh (a-CoSe/Ti) is demonstrated to exhibit high electrocatalytic activity and stability for both reactions in 1.0 M KOH. It needs overpotentials of 292 and 121 mV to drive 10 mA cm(-2) for OER and HER, respectively. The two-electrode alkaline water electrolyzer affords a water-splitting current of 10 mA cm(-2) at a cell voltage of 1.65 V. This work offers an attractive cost-effective catalytic material toward full water splitting applications.

  15. Grapes from the geographical areas of the Black Sea: Agroclimatic growing conditions and evaluation of stable isotopes compositions in scientific study

    Directory of Open Access Journals (Sweden)

    Kolesnov Alexander

    2016-01-01

    Full Text Available The report considers the agroclimatic conditions in the Black Sea districts of cultivation and processing of grapes - the Black Sea Lowland, the Crimean Peninsula and the South-west coastal areas of the Greater Caucasus. The IRMS/SIRA techniques - Flash combustion (FC-IRMS/SIRA & Isotopic equilibration (EQ-IRMS/SIRA - were first applied for the evaluation of carbon and oxygen isotopes ratios in the components of grapes from the Crimean Peninsula. The 13C/12C ratios were studied by the FC-IRMS/SIRA in carbohydrates and organic acids in authentic samples of 8 grape varieties from the 2015 harvest. The EQ-IRMS/SIRA was applied to measure the 18O/16O ratios in intracellular water of grapes. The measured δ13CVPDB value ranges from − 25.01 to − 21.01‰ (for carbohydrates, and from − 25.09 to − 21.30‰ (for organic acids. To evaluate the extent of biological isotope fractionation the 18O/16O ratios were measured in ground water and water of atmospheric precipitates from the Crimean Peninsula. Compared to ground (δ18OVSMOW from − 10.85 to − 8.14‰ and atmospheric (average δ18OVSMOW− 2.85‰ waters, the intracellular water of Crimean grape varieties is found to be enriched with 18O isotope. The δ18OVSMOW value of the grape intracellular water varies from 2.34 to 5.29‰ according to agroclimatic conditions of the season in 2015.

  16. Secondary protective seal of root canal fillings performed under simulated clinical conditions

    Directory of Open Access Journals (Sweden)

    Matthias Johannes Roggendorf

    2011-07-01

    Full Text Available Objective: This study evaluated sealing properties of root canal fillings with an additional composite barrier. The null hypothesis tested was that different sealers and different methods of sealer removal did not influence microleakage. Material and methods: Eighty extracted human molars with fully mature apices had root canal prepared to size 60 taper .02 and divided into eight groups: three experimental groups for each sealer and negative/positive control (n = 10 each. Teeth of experimental groups were mounted into the molar region of a training puppet to simulate clinical conditions. Root canals were filled with AH Plus or GuttaFlow and gutta-percha. Excess sealer was removed with: ethanol-moistened foam pellet only, additional preparation with a water-cooled diamond bur or additional etch-and-rinse procedure (37% phosphoric acid gel. All procedures were carried out until clean as judged by the naked eye. In all groups except the positive control Syntac was applied to the access cavity. Tetric flow was applied in two increments of 1 mm each. A dye penetration test was carried out by centrifugation for 3 min at 30 G within 5% methylene blue dye. Statistical evaluation was carried out with PASW 18.0 (α = 0.05. Results: Although the two sealers had different chemical composition, sealer exhibited no influence on the results, whereas technique of sealer removal did (Two-way-ANOVA, p < 0.001. Groups with “foam pellet” or “bur preparation” showed significantly more leakage than groups with “etch-and rinse” (SNK, p < 0.05. Conclusion: Applying an etch-and-rinse procedure prior to Syntac may be beneficial for the adhesive seal over root canal fillings.

  17. Effects of roasting conditions on the changes of stable carbon isotope ratios (δ13 C) in sesame oil and usefulness of δ13 c to differentiate blended sesame oil from corn oil.

    Science.gov (United States)

    Seol, Nam Gyu; Jang, Eun Yeong; Kim, Mi-Ja; Lee, Jaehwan

    2012-12-01

    Differentiating blended sesame oils from authentic sesame oil (SO) is a critical step in protecting consumer rights. Stable carbon isotope ratios (δ(13) C), color, fluorescence intensity, and fatty acid profiles were analyzed in SO prepared from sesame seeds with different roasting conditions and in corn oil blended with SO. Sesame seeds were roasted at 175, 200, 225, or 250 °C for 15 or 30 min at each temperature. SO was mixed with corn oil at varying ratios. Roasting conditions ranging from175 to 250 °C at the 30 min time point did not result in significant changes in δ(13) C (P > 0.05). Values of δ(13) C in corn oil and SO from sesame seeds roasted at 250 °C for 15 min were -17.55 and -32.13 ‰, respectively. Fatty acid ratios, including (O + L)/(P × Ln) and (L × L)/O, where O, L, P, and Ln were oleic, linoleic, palmitic, and linolenic acids, respectively, showed good discriminating abilities among the SO blended with corn oil. Therefore, using different combinations of stable carbon isotope ratios and some fatty acid ratios can allow successful differentiation of authentic SO from SO blended with corn oil. © 2012 Institute of Food Technologists®

  18. Conditional expression of type I interferon-induced bovine Mx1 GTPase in a stable transgenic vero cell line interferes with replication of vesicular stomatitis virus.

    Science.gov (United States)

    Baise, Etienne; Pire, Grégory; Leroy, Michaël; Gérardin, Joël; Goris, Nesya; De Clercq, Kris; Kerkhofs, Pierre; Desmecht, Daniel

    2004-09-01

    In some vertebrate species, type I interferon(IFN)-induced Mx gene expression has been shown to confer resistance to some single-stranded RNA (ssRNA) viruses in vitro. Because the bovine species is subject to an exceptionally wide array of infections caused by such viruses, it is anticipated that an antiviral allele should have been retained by evolution at the bovine Mx locus. The identification of such allele may help in evaluating the real significance of the Mx genotype for disease resistance in vivo, in deciphering host-virus molecular interactions involved, or in improving innate disease resistance of livestock through marker-assisted selection. We validated a double transgenic Vero cell clone in which the bovine Mx1 reference allele is placed under control of the human cytomegalovirus (CMV) enhancer-promoter sequence containing elements from the bacterial tetracycline resistance operon to regulate transcription. In the selected clone, transgene repression was very tight, and derepression by doxycycline led to homogeneous 48-h duration expression of physiologic levels of bovine Mx1. Expression of the transgene caused a dramatic decrease in cytopathic efficiency and a 500-5000-fold yield reduction of the Indiana and New Jersey serotypes of vesicular stomatitis virus (VSV). To our knowledge, the transgenic clone developed here is the first ever reported that allows conditional expression of an Mx protein, thus providing a valuable tool for studying functions of Mx proteins in general and that of bovine Mx1 in particular. This latter may henceforward be included in the group of Mx proteins with authenticated anti-VSV activity, which offers new research avenues into the field of host-virus interactions.

  19. Conditions for stable parapatric coexistence between Boophilus decoloratus and B. microplus ticks: a simulation study using the competitive Lotka-Volterra model.

    Science.gov (United States)

    Zeman, Petr; Lynen, Godelieve

    2010-12-01

    The autochthonous tick Boophilus decoloratus, and the invasive species Bo. microplus, the tick most threatening the livestock industry in Africa, show complex interactions in their interspecific rivalry. This study was conducted to specify the conditions under which the two competitors can co-exist in equilibrium, and to provide insight into their climate-dependant parapatric distribution in Tanzania. A model of the Lotka-Volterra type was used, taking into account population dispersal and interactions of various kinds. If the model allowed for immunity-mediated competition on cattle, reproductive interference, and an external mortality factor, it explained fairly well the field observation that the borderline between these ticks loosely follows the 22-23°C isotherm and the 58 mm isohyet (i.e. ~700 mm of annual rainfall total). Simulations fully compatible with the pattern of real co-existing populations of Bo. decoloratus and Bo. microplus, characterized by a pronounced population density trough and mutual exclusion of the two ticks on cattle in an intermediary zone between their distributional ranges, were, however, achieved only if the model also implemented a hypothetical factor responsible for some mortality upon encounter of one tick with the other, interpretable as an interaction through a shared pathogen(s). This study also demonstrated the importance of non-cattle hosts, enabling the autochthon to avoid competition with Bo. microplus, for the behaviour of the modelled system. The simulations indicate that a substantial reduction of wildlife habitats and consequently of Bo. decoloratus refugia, may accelerate the replacement of Bo. decoloratus with Bo. microplus much faster than climatic changes might do.

  20. In-soil radon anomalies as precursors of earthquakes: a case study in the SE slope of Mt. Etna in a period of quite stable weather conditions.

    Science.gov (United States)

    Vizzini, Fabio; Brai, Maria

    2012-11-01

    In-soil radon concentrations as well as climatic parameters (temperature, atmospheric pressure and relative humidity) were collected in St. Venerina (Eastern Sicily - Italy) from March 19th to May 22nd 2009, close to an active fault system called Timpe Fault System (TFS), which is strictly linked to the geodynamics of Mt. Etna. During the monitoring period no drastic climatic variations were observed and, on the other hand, important seismic events were recorded close to the monitoring site. A seismic swarm composed of 5 earthquakes was observed in the Milo area on March 25th (M(max) = 2.7) at just 5.1 km from the site, and on May 13th an earthquake of 3.6 magnitude was recorded in the territory of St. Venerina, at just 3.2 km from the site; the earthquake was felt by the population and reported by all local and regional media. The in-soil radon concentrations have shown anomalous increases possibly linked to the earthquakes recorded, but certainly not attributable to local meteorology. To verify this assumption the average radon concentration and the standard deviation (σ) have been calculated and the regions of ±1.5σ and ±2σ deviation from the average concentration have been investigated. Moreover, to further minimise the contribution of the meteorological parameters on the in-soil radon fluctuations, a multiple regressions method has been used. To distinguish those earthquakes which could generate in-soil radon anomalies as precursors, the Dobrovolsky radius has been applied. The results obtained suggests that a clear correlation between earthquakes and in-soil radon increases exist, and that the detection of the in-soil radon anomalies becomes surely simpler in particular favourable conditions: weather stability, earthquakes within the Dobrovolsky radius and close to the monitoring area. Moreover, the absence of large variations of the climatic parameters, which could generate incoherent noise components to the radon signal, has made the radon fluctuations

  1. Compression Maps and Stable Relations

    CERN Document Server

    Price, Kenneth L

    2011-01-01

    Balanced relations were defined by G. Abrams to extend the convolution product used in the construction of incidence rings. We define stable relations,which form a class between balanced relations and preorders. We also define a compression map to be a surjective function between two sets which preserves order, preserves off-diagonal relations, and has the additional property every transitive triple is the image of a transitive triple. We show a compression map preserves the balanced and stable properties but the compression of a preorder may be stable and not transitive. We also cover an example of a stable relation which is not the compression of a preorder. In our main theorem we provide necessary and sufficient conditions for a finite stable relation to be the compression of a preorder.

  2. 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.

  3. How stable are the 'stable ancient shields'?

    Science.gov (United States)

    Viola, Giulio; Mattila, Jussi

    2014-05-01

    "Archean cratons are relatively flat, stable regions of the crust that have remained undeformed since the Precambrian, forming the ancient cores of the continents" (King, EPSL, 2005). While this type of statement is supported by a wealth of constraints in the case of episodes of thoroughgoing ductile deformation affecting shield regions of Archean and also Peleoproterozoic age, a growing amount of research indicates that shields are not nearly as structurally stable within the broad field of environmental conditions leading to brittle deformation. In fact, old crystalline basements usually present compelling evidence of long brittle deformation histories, often very complex and challenging to unfold. Recent structural and geochronological studies point to a significant mechanical instability of the shield areas, wherein large volumes of 'stable' rocks actually can become saturated with fractures and brittle faults soon after regional cooling exhumes them to below c. 300-350° C. How cold, rigid and therefore strong shields respond to applied stresses remains, however, still poorly investigated and understood. This in turn precludes a better definition of the shallow rheological properties of large, old crystalline blocks. In particular, we do not yet have good constraints on the mechanisms of mechanical reactivation that control the partial (if not total) accommodation of new deformational episodes by preexisting structures, which remains a key to untangle brittle histories lasting several hundred Myr. In our analysis, we use the Svecofennian Shield (SS) as an example of a supposedly 'stable' region with Archean nucleii and Paleoproterozoic cratonic areas to show how it is possible to unravel the details of brittle histories spanning more than 1.5 Gyr. New structural and geochronological results from Finland are integrated with a review of existing data from Sweden to explore how the effects of far-field stresses are partitioned within a shield, which was growing

  4. 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...

  5. 42 CFR 482.80 - Condition of participation: Data submission, clinical experience, and outcome requirements for...

    Science.gov (United States)

    2010-10-01

    ... center. (3) A pancreas transplant center is not required to comply with the clinical experience... pancreas transplants performed at the center. (4) A center that is requesting initial Medicare approval...

  6. Conditionally unbiased estimation in phase II/III clinical trials with early stopping for futility

    OpenAIRE

    Kimani, Peter K.; Todd, Susan; Stallard, Nigel

    2013-01-01

    Seamless phase II/III clinical trials combine traditional phases II and III into a single trial that is conducted in two stages, with stage 1 used to answer phase II objectives such as treatment selection and stage 2 used for the confirmatory analysis, which is a phase III objective. Although seamless phase II/III clinical trials are efficient because the confirmatory analysis includes phase II data from stage 1, inference can pose statistical challenges. In this paper, we consider point esti...

  7. Trace element and stable isotope data from a flowstone in a natural cave of the mining district of SW Sardinia (Italy: evidence for Zn2+-induced aragonite precipitation in comparatively wet climatic conditions

    Directory of Open Access Journals (Sweden)

    Caddeo Guglielmo Angelo

    2011-07-01

    Full Text Available A speleothem from Crovassa Azzurra, a mine cave in SW Sardinia (Italy, has been analysed for mineralogy, minor and traceelements and stable isotopes. It is composed of layers of primary calcite and aragonite, with a region of secondary calcite. The primarycarbonate is strikingly rich in Zn and Pb, presumably as the result of transport in solution from overlying Pb-Zn deposits. Immediatelybelow the transition between calcite and aragonite, concentrations of Zn, Cd and P increase. At the transition between aragonite andPb-rich aragonite, concentrations of Pb and P increase. Stable isotopes do not indicate an evolution toward drier periods for thesetwo transitions, conversely to what is normally observed in calcite-aragonite speleothems. On the contrary the combined observationof increase in P and metals derived from oxidation of sulphides and the variation of isotopic composition of aragonite and calcitesuggests that in this mine cave aragonite was deposited with increasing flowrate and thus more humid conditions. In addition, theeffect of Zn2+ or Pb2+ in inhibiting precipitation of calcite appears to have been more important than that of Mg2+.

  8. CLINICAL PATTERN OF ACNE VULGARIS AND ITS ASSOCIATED CONDITIONS IN THE EASTERN PROVINCE OF KINGDOM OF SAUDI ARABIA: A HOSPITAL-BASED CLINICAL STUDY

    OpenAIRE

    Al-Ameer, Ali M.; Al-Akloby, Omar M.

    2002-01-01

    Objective: This study aims to review the clinical pattern of acne vulgaris cases referred to one hospital in the Eastern Province. Methods: Two hundred cases diagnosed in the Dermatology Department at King Fahad Hospital of the University (KFHU), Al-Khobar, Saudi Arabia were studied Results: Inflammatory acne was the predominant type observed in both males and females (76% and, 79%, respectively). Seborrhea (greasy skin) was the most frequently associated condition 22 (11%) followed by dandru...

  9. Effect of Dynamic Platform Lateral Step-Up versus Stable Platform Lateral Step-Up Weight Bearing Exercise in Hip Abductor Strengthening on Healthy Male Volunteers - Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jagatheesan Alagesan

    2011-07-01

    Full Text Available Objective & Background: To determine the effect of the dynamic platform lateral step-up and stable platform lateral step-up weight bearing standing exercise in strengthening of hip abductor. Many researchers have reported that strengthening of hip muscles as important component especially hip abductors in lower extremity rehabilitation program. Study Design: Single blinded randomized comparative clinical trial. Methodology: Sixty five healthy college going male subjects (Age group of 18 – 24 years volunteered for this study. They were randomly assigned to one of the 2 groups. One group received the dynamic platform lateral step-up and the other received stable platform lateral step-up weight bearing standing exercise. The strength measurements were recorded using hand held dynamometer. Results: The results indicate that both groups had a positive effect on the outcome measures. The strength of hip abductors in dynamic platform group improved from a mean value (SD of 19.47(3.59 to 26.93(3.19 and in stable platform group from 19.07(2.32 to 22.67(2.46. Significant difference is also observed between the two groups at p value .05. Conclusion: The study shows that dynamic platform lateral step-up exercise is more beneficial than stable platform lateral step-up weight bearing standing exercise in improving hip abductor muscle strength.

  10. 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.

  11. Babinski-Nageotte's syndrome and Hemimedullary (Reinhold's) syndrome are clinically and morphologically distinct conditions.

    Science.gov (United States)

    Krasnianski, Michael; Neudecker, Stephan; Schluter, Andreas; Zierz, Stephan

    2003-08-01

    A hemimedullary infarction, in which medial and lateral medullary lesions occur simultaneously, is a rare cerebrovascular disease. It has been suggested that the Babinski-Nageotte's syndrome is the classical brainstem syndrome that corresponds to hemimedullary lesion. In this study we compare clinical symptoms and magnetic resonance imaging (MRI) data of two patients exhibiting classical Babinski-Nageotte's syndrome according to the original description with symptoms and MRI data of a patient with clinically complete hemimedullary lesion. Our study shows that Babinski-Nageotte's syndrome is neither clinically nor on MRI identical with hemimedullary lesion. Hypoglossal palsy, an invariable symptom of hemimedullary syndrome, is not part of the Babinski-Nageotte's syndrome according to the original description. Consistent with the original historical report, Babinski- Nageotte's syndrome is a lateral "Wallenbergian" medullary lesion with a spreading of the lesion to the more basal localised pyramidal tract. The clinical features of the hemimedullary syndrome, described in 1894 by Reinhold, and the MRI appearances in our patient with this syndrome are clearly different from other classical brainstem syndromes and should be called Reinhold's syndrome.

  12. On Boolean Stable Laws

    CERN Document Server

    Arizmendi, Octavio

    2012-01-01

    We determine which Boolean stable law is freely infinitely divisible and which is not. Some positive Boolean stable laws and a mixture of them have completely monotonic densities and they are both freely and classically infinitely divisible. Freely infinitely divisible Boolean stable laws and the corresponding free stable laws are non trivial examples whose free divisibility indicators are infinity.

  13. Diagnosis and management of stable chronic obstructive pulmonary disease: a clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society.

    Science.gov (United States)

    Qaseem, Amir; Wilt, Timothy J; Weinberger, Steven E; Hanania, Nicola A; Criner, Gerard; van der Molen, Thys; Marciniuk, Darcy D; Denberg, Tom; Schünemann, Holger; Wedzicha, Wisia; MacDonald, Roderick; Shekelle, Paul

    2011-08-02

    This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and management of stable chronic obstructive pulmonary disease (COPD) and is intended for clinicians who manage patients with COPD. This guideline addresses the value of history and physical examination for predicting airflow obstruction; the value of spirometry for screening or diagnosis of COPD; and COPD management strategies, specifically evaluation of various inhaled therapies (anticholinergics, long-acting β-agonists, and corticosteroids), pulmonary rehabilitation programs, and supplemental oxygen therapy. This guideline is based on a targeted literature update from March 2007 to December 2009 to evaluate the evidence and update the 2007 ACP clinical practice guideline on diagnosis and management of stable COPD. RECOMMENDATION 1: ACP, ACCP, ATS, and ERS recommend that spirometry should be obtained to diagnose airflow obstruction in patients with respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). Spirometry should not be used to screen for airflow obstruction in individuals without respiratory symptoms (Grade: strong recommendation, moderate-quality evidence). RECOMMENDATION 2: For stable COPD patients with respiratory symptoms and FEV(1) between 60% and 80% predicted, ACP, ACCP, ATS, and ERS suggest that treatment with inhaled bronchodilators may be used (Grade: weak recommendation, low-quality evidence). RECOMMENDATION 3: For stable COPD patients with respiratory symptoms and FEV(1) 50% predicted. (Grade: weak recommendation, moderate-quality evidence). RECOMMENDATION 7: ACP, ACCP, ATS, and ERS recommend that clinicians should prescribe continuous oxygen therapy in patients with COPD who have severe resting hypoxemia (Pao(2) ≤55 mm Hg or Spo(2)

  14. Clinically Relevant Growth Conditions Alter Acinetobacter baumannii Antibiotic Susceptibility and Promote Identification of Novel Antibacterial Agents.

    Directory of Open Access Journals (Sweden)

    Jennifer M Colquhoun

    Full Text Available Biological processes that govern bacterial proliferation and survival in the host-environment(s are likely to be vastly different from those that are required for viability in nutrient-rich laboratory media. Consequently, growth-based antimicrobial screens performed in conditions modeling aspects of bacterial disease states have the potential to identify new classes of antimicrobials that would be missed by screens performed in conventional laboratory media. Accordingly, we performed screens of the Selleck library of 853 FDA approved drugs for agents that exhibit antimicrobial activity toward the Gram-negative bacterial pathogen Acinetobacter baumannii during growth in human serum, lung surfactant, and/or the organism in the biofilm state and compared those results to that of conventional laboratory medium. Results revealed that a total of 90 compounds representing 73 antibiotics and 17 agents that were developed for alternative therapeutic indications displayed antimicrobial properties toward the test strain in at least one screening condition. Of the active library antibiotics only four agents, rifampin, rifaximin, ciprofloxacin and tetracycline, exhibited antimicrobial activity toward the organism during all screening conditions, whereas the remainder were inactive in ≥ 1 condition; 56 antibiotics were inactive during serum growth, 25 and 38 were inactive toward lung surfactant grown and biofilm-associated cells, respectively, suggesting that subsets of antibiotics may outperform others in differing infection settings. Moreover, 9 antibiotics that are predominantly used for the treatment Gram-positive pathogens and 10 non-antibiotics lacked detectable antimicrobial activity toward A. baumannii grown in conventional medium but were active during ≥ 1 alternative growth condition(s. Such agents may represent promising anti-Acinetobacter agents that would have likely been overlooked by antimicrobial whole cell screening assays performed in

  15. Informed Conditioning on Clinical Covariates Increases Power in Case-Control Association Studies

    OpenAIRE

    Zaitlen, Noah; Lindstroem, Sara; Pasaniuc, Bogdan; Cornelis, Marilyn; Genovese, Giulio; Pollack, Samuela; Barton, Anne; Bickeboeller, Heike; Donald W. Bowden; Eyre, Steve; Barry I Freedman; Friedman, David J.; Field, John K.; Groop, Leif; Haugen, Aage

    2012-01-01

    Genetic case-control association studies often include data on clinical covariates, such as body mass index (BMI), smoking status, or age, that may modify the underlying genetic risk of case or control samples. For example, in type 2 diabetes, odds ratios for established variants estimated from low-BMI cases are larger than those estimated from high-BMI cases. An unanswered question is how to use this information to maximize statistical power in case-control studies that ascertain individuals...

  16. A review on experimental and clinical genetic associations studies on fear conditioning, extinction and cognitive-behavioral treatment.

    Science.gov (United States)

    Lonsdorf, T B; Kalisch, R

    2011-09-20

    Fear conditioning and extinction represent basic forms of associative learning with considerable clinical relevance and have been implicated in the pathogenesis of anxiety disorders. There is considerable inter-individual variation in the ability to acquire and extinguish conditioned fear reactions and the study of genetic variants has recently become a focus of research. In this review, we give an overview of the existing genetic association studies on human fear conditioning and extinction in healthy individuals and of related studies on cognitive-behavioral treatment (CBT) and exposure, as well as pathology development after trauma. Variation in the serotonin transporter (5HTT) and the catechol-o-methyltransferase (COMT) genes has consistently been associated with effects in pre-clinical and clinical studies. Interesting new findings, which however require further replication, have been reported for genetic variation in the dopamine transporter (DAT1) and the pituitary adenylate cyclase 1 receptor (ADCYAP1R1) genes, whereas the current picture is inconsistent for variation in the brain-derived neurotrophic factor (BDNF) gene. We end with a discussion of the findings and their limitations, as well as future directions that we hope will aid the field to develop further.

  17. 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.

  18. The effect of electronic health records on the use of clinical care guidelines for patients with medically complex conditions.

    Science.gov (United States)

    Fricton, James; Rindal, D Brad; Rush, William; Flottemesch, Thomas; Vazquez, Gabriela; Thoele, Merry Jo; Durand, Emily; Enstad, Chris; Rhodus, Nelson

    2011-10-01

    The emergence of health information technology provides an opportunity for health care providers to improve the quality and safety of dental care, particularly for patients with medically complex conditions. The authors randomized each of 15 dental clinics (HealthPartners, Bloomington, Minn.) to one of three groups to evaluate the impact of two clinical decision support (CDS) approaches during an 18-month study period. In the first approach--provider activation through electronic dental records (EDRs)--a flashing alert was generated at the dental visit to identify patients with medically complex conditions and to direct the dental care provider to Web-based personalized care guidelines. In the second approach--patient activation through personal health records--a secure e-mail was generated or a letter was mailed to patients before dental visits encouraging them to ask their dental care provider to review the care guidelines specific to their medical conditions. The authors evaluated the rate of reviewing care guidelines among 102 providers. Participants in the provider and patient activation groups increased their use of the system during the first six months, which had a generalized effect of increasing use of the guidelines for all patients, even if they were not part of the study (P electronic alerts. The study results demonstrated that review of clinical care guidelines for patients with medically complex conditions can be improved with CDS systems that involve the use of electronic health records. As the U.S. population ages, dentists must be vigilant in adapting care for patients with medically complex conditions to ensure therapeutic safety and effectiveness. Expanded use of CDS via EDRs can help dental care providers achieve this objective.

  19. Low high-density lipoprotein cholesterol is a residual risk factor associated with long-term clinical outcomes in diabetic patients with stable coronary artery disease who achieve optimal control of low-density lipoprotein cholesterol.

    Science.gov (United States)

    Ogita, Manabu; Miyauchi, Katsumi; Miyazaki, Tadashi; Naito, Ryo; Konishi, Hirokazu; Tsuboi, Shuta; Dohi, Tomotaka; Kasai, Takatoshi; Yokoyama, Takayuki; Okazaki, Shinya; Kurata, Takeshi; Daida, Hiroyuki

    2014-01-01

    Diabetes mellitus is recognized an independent risk factor for coronary artery disease (CAD) and mortality. Clinical trials have shown that statins significantly reduce cardiovascular events in diabetic patients. However, residual cardiovascular risk persists despite the achievement of target low-density lipoprotein cholesterol (LDL-C) levels with statin. High-density lipoprotein cholesterol (HDL-C) is an established coronary risk factor that is independent of LDL-C levels. We evaluated the impact of HDL-C on long-term mortality in diabetic patients with stable CAD who achieved optimal LDL-C. We enrolled 438 consecutive diabetic patients who were scheduled for percutaneous coronary intervention between 2004 and 2007 at our institution. We identified 165 patients who achieved target LDL-C diabetic patients with low-HDL-C who achieved optimal LDL-C (6.9 vs 17.9 %, log-rank P = 0.030). Multivariate Cox regression analysis showed that HDL-C is significantly associated with clinical outcomes (adjusted hazard ratio for MACE 1.33, 95 % confidence interval 1.01-1.75, P = 0.042). Low HDL-C is a residual risk factor that is significantly associated with long-term clinical outcomes among diabetic patients with stable CAD who achieve optimal LDL-C levels.

  20. Cardiac tamponade as the first clinical sign of gastric adenocarcinoma: a rare condition.

    Science.gov (United States)

    Arısoy, Arif; Memiç, Kadriye; Karavelioğlu, Yusuf; Sen, Fatma

    2014-06-01

    Cardiac tamponade originating from a primary gastric cancer (GC) is a rare condition. Patients are generally asymptomatic until the disease is advanced. We report a rare patient with cardiac tamponade as the first manifestation of primary GC. A 46-year-old male was admitted with progressive dyspnea. Cardiac tamponade was diagnosed on two-dimensional ultrasonographic echocardiography. Pericardiocentesis yielded 1500 ml of bloody fluid. Pericardial cytologic examination was positive for malignant cells. The patient underwent abdominal computed tomography scan, which showed thickening of the gastric wall and several mesenteric lymph nodes. Endoscopic examination of the stomach disclosed malignant ulcer along the lesser curvature, and the biopsy showed diffuse type adenocarcinoma. Chemotherapy was initiated by the Oncology Department, and he had no pericardial effusion after six courses of systemic chemotherapy. In conclusion, this is a rare condition and difficult to diagnosis early. Thus, physicians should be aware of malignancy of the stomach when patients present with unexplained cardiac manifestations.

  1. Resveratrol in prevention and treatment of common clinical conditions of aging.

    Science.gov (United States)

    Markus, M Andrea; Morris, Brian J

    2008-01-01

    Resveratrol is a potent member of the class of natural, plant-derived chemicals known as polyphenols. These help explain in part why a diet high in fruit and vegetables confers health benefits and are associated with reduced risk of common complex conditions such as cardiovascular disease, cancer, diabetes, and Alzheimer's disease. We present the latest molecular findings that account for the beneficial actions of resveratrol. The intracellular pathways activated are crucial for anti-oxidant defence, regulation of the cell cycle, mitochondrial energy production, vascular tone, oncogene suppression, and many other phenomena which if unchecked lead to morbidity and mortality from onset and progression of these various diseases. While a healthy diet and lifestyle is strongly recommended in prevention of such conditions, the future bodes well for the use of resveratrol and analogues of higher potency than the natural form for treatment of diseases that afflict humans, particularly as they age.

  2. Clinical studies on health conditions of medical diagnostic X-ray workers

    Energy Technology Data Exchange (ETDEWEB)

    Liu Liqun

    1984-10-01

    The results of investigations on general health conditions of 2484 medical X-ray workers and 1718 controls were reported. It was shown that the incidences of neurasthenic syndrome, loss of appetite, baldness etc. in X-ray workers were statistically higher than those in controls. Chronic rhinitis, pharyngitis, and paranasal sinusitis also occurred more frequently in the former group. The blood pressure, pulse rate, capillary resistance and past medical history showed no significant difference between these two groups. (Author).

  3. Over-the-balloon placement of the Gore Hybrid Vascular Graft in challenging clinical conditions

    Directory of Open Access Journals (Sweden)

    Scott S. Berman, MD, MHA, FACS

    2016-09-01

    Full Text Available This report describes a useful technique for deployment of the Gore Hybrid Vascular Graft (W. L. Gore and Associates, Flagstaff, Ariz in difficult clinical situations that create challenges in obtaining vascular control before introducing the nitinol-reinforced section of the graft. In both arterial and venous applications, introducing the Gore Hybrid Vascular Graft over a balloon allows concurrent vascular control by inflation of the balloon and easier introduction of the device into the recipient vessel by creating a smoother transition between the leading edge of the graft and the guidewire. Examples of both arterial and venous applications of this novel technique are presented.

  4. Clinical course of brain stroke in the persons exposed to ionizing radiation under the production conditions

    Energy Technology Data Exchange (ETDEWEB)

    Bouchmanov, A. [State Research Center of Russia, Moscow (Russian Federation). Inst. of Biophysics

    2000-05-01

    The purpose was to study the risk factors and clinical course of brain strokes in professionally exposed workers being employed in plutonium production in comparison with a control group. The method and materials of study -clinical supervision and clinical database creation on 162 cases of brain stroke (128 males and 34 females) developed among professionally exposed workers. Age of patient varied from 21 to 68 years (in average -51.6 y.). The control group consisted of patients with the same diagnosis, worked on the same enterprise, but non-exposed to radiation. Data on the totally accumulated dose of external gamma radiation were received on the base of the individual dosimeters (from 0.1 cSv to 52 cSv, in average about 13 cSv); the plutonium-239 body content was estimated accordingly to the level of urine radionuclide excretion (from 0.4 kBq to 1.6 kBq, in average about 0.33 kBq). Muscle's hypertinsion and pathological great-toe reflexes in paretic legs and hands, hemianopsia, impressive and ataxic aphasia prevailed in the patients with ischemic brain strokes in system of internal carotid artery, exposed to radiation. The changes of muscle's tension, ataxia and nystagmus were marked more often in the professionals with ischemic brain strokes in system of vertebrobasilar artery. The illness proceeded more easy and with smaller frequency of frustration of consciousness and algesthesia, irrespective of a type ischemic brain strokes in the people exposed to ionizing radiation, than in patients of non-irradiated group. It was found that the arterial hypertension appeared to be the main risk factor for the brain stroke in both groups of patients (in 81.48% and 91.15% of cases). There was no marked differences in significance of risk factors and in main clinical parameters of various types of ischemic brain strokes among the patients professionally exposed to radiation in comparison with a control group. (author)

  5. [Clinical aspects and the course of psychopathologic conditions simulating vertebrogenic pathology].

    Science.gov (United States)

    Ostroglazov, V G; Lisina, M A

    1989-01-01

    The study of clinical picture and the course of unclear pathological states simulating the vertebral pathology suggested that the major signs were centered around the primary general and muscular sensory disorders. These served as a basis for development of more complicated psychosensory and psychomotor disorders and creation of an interpretative hypochondriac++ delirium system. Domination of psychomotor disorders led to a high incidence of social and labor dysadaptation of the patients. Thus, the study of this unclear mental pathology has a major theoretic, clinico-psychopathological and also practical medico-social importance.

  6. Temporal dynamics of relief in avoidance conditioning and fear extinction: Experimental validation and clinical relevance.

    Science.gov (United States)

    Vervliet, Bram; Lange, Iris; Milad, Mohammed R

    2017-09-01

    The learning principles that guide the acquisition and extinction of avoidance are not fully understood. We developed a novel paradigm to study the temporal dynamics of relief, a putative reinforcer of avoidance, and the recovery of fear and avoidance following extinction. During conditioning, the avoidance action canceled the aversive unconditional stimulus (US), without terminating the predictive conditional stimulus (CS). Relief pleasantness was rated after fixed CS offsets, when US omission occured. Avoidance was effective to one CS, but not to another, to track stimulus-specific avoidance learning. Fear was extinguished under response prevention in a separate context. Recovery tests took place 24 h later, in both contexts and with a monetary cost added to the avoidance action. We found that avoidance gradually became stimulus-specific during conditioning, but hardly recovered during delayed testing. Across all phases, initial omissions of the aversive US triggered relief that gradually declined over consecutive omissions, in line with a theoretical prediction error signal. Participants that scored low on distress tolerance, however, displayed sustained levels of relief over continuous omissions. We propose that such forms of sustained relief may produce over-reinforcement of foregoing avoidance actions and promote the development of pathological avoidance. The current paradigm represents an efficacious tool to study the temporal dynamics of relief across avoidance learning and fear extinction and to characterize relief dysregulations in relation to psychopathology. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Stable lepton mass matrices

    CERN Document Server

    Domcke, Valerie

    2016-01-01

    We study natural lepton mass matrices, obtained assuming the stability of physical flavour observables with respect to the variations of individual matrix elements. We identify all four possible stable neutrino textures from algebraic conditions on their entries. Two of them turn out to be uniquely associated to specific neutrino mass patterns. We then concentrate on the semi-degenerate pattern, corresponding to an overall neutrino mass scale within the reach of future experiments. In this context we show that i) the neutrino and charged lepton mixings and mass matrices are largely constrained by the requirement of stability, ii) naturalness considerations give a mild preference for the Majorana phase most relevant for neutrinoless double-beta decay, $\\alpha \\sim \\pi/2$, and iii) SU(5) unification allows to extend the implications of stability to the down quark sector. The above considerations would benefit from an experimental determination of the PMNS ratio $|U_{32}/U_{31}|$, i.e. of the Dirac phase $\\delta...

  8. Patient-tailored dose reduction of TNF-alpha blocking agents in ankylosing spondylitis patients with stable low disease activity in daily clinical practice

    NARCIS (Netherlands)

    Arends, S.; van der Veer, E.; Kamps, F. B. S.; Houtman, P. M.; Bos, R.; Bootsma, H.; Brouwer, E.; Spoorenberg, A.

    2015-01-01

    Objective Tumour necrosis factor-alpha (TNF-alpha) blocking agents are very, effective in controlling systemic inflammation and improving clinical assessments in ankylosing spondylitis (AS). In view of potential side effects and high costs of long-term treatment, our aim was to investigate whether d

  9. Non-progressive cerebellar ataxia and previous undetermined acute cerebellar injury: a mysterious clinical condition

    Directory of Open Access Journals (Sweden)

    Wladimir Bocca Vieira de Rezende Pinto

    2015-01-01

    Full Text Available Cerebellar ataxias represent a wide group of neurological diseases secondary to dysfunctions of cerebellum or its associated pathways, rarely coursing with acute-onset acquired etiologies and chronic non-progressive presentation. We evaluated patients with acquired non-progressive cerebellar ataxia that presented previous acute or subacute onset. Clinical and neuroimaging characterization of adult patients with acquired non-progressive ataxia were performed. Five patients were identified with the phenotype of acquired non-progressive ataxia. Most patients presented with a juvenile to adult-onset acute to subacute appendicular and truncal cerebellar ataxia with mild to moderate cerebellar or olivopontocerebellar atrophy. Establishing the etiology of the acute triggering events of such ataxias is complex. Non-progressive ataxia in adults must be distinguished from hereditary ataxias.

  10. Non-progressive cerebellar ataxia and previous undetermined acute cerebellar injury: a mysterious clinical condition

    Directory of Open Access Journals (Sweden)

    Wladimir Bocca Vieira de Rezende Pinto

    2015-10-01

    Full Text Available Cerebellar ataxias represent a wide group of neurological diseases secondary to dysfunctions of cerebellum or its associated pathways, rarely coursing with acute-onset acquired etiologies and chronic non-progressive presentation. We evaluated patients with acquired non-progressive cerebellar ataxia that presented previous acute or subacute onset. Clinical and neuroimaging characterization of adult patients with acquired non-progressive ataxia were performed. Five patients were identified with the phenotype of acquired non-progressive ataxia. Most patients presented with a juvenile to adult-onset acute to subacute appendicular and truncal cerebellar ataxia with mild to moderate cerebellar or olivopontocerebellar atrophy. Establishing the etiology of the acute triggering events of such ataxias is complex. Non-progressive ataxia in adults must be distinguished from hereditary ataxias.

  11. Miscellaneous conditions of the shoulder: Anatomical, clinical, and pictorial review emphasizing potential pitfalls in imaging diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Farid, Nikdokht [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); Bruce, Dean [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States); University of Alberta, Edmonton, Alberta (Canada); Chung, Christine B. [University of California San Diego, Department of Radiology, 200 West Arbor Drive, San Diego, CA 92103 (United States); VA Healthcare System San Diego, Department of Radiology, 3350 La Jolla Village Drive, La Jolla, CA 92161 (United States)], E-mail: cbchung@ucsd.edu

    2008-10-15

    The purpose of this article is to review the key imaging findings in major categories of pathology affecting the shoulder joint including hydroxyapatite deposition disease, rotator cuff interval pathology, acromioclavicular joint pathology, glenohumeral osteoarthrosis, and synovial inflammatory processes, with specific emphasis on findings that have associated pitfalls in imaging diagnosis. The pathophysiology and clinical manifestations of the above mentioned categories of pathology will be reviewed, followed in each section by a detailed pictorial review of the key imaging findings in each category including plain film, computed tomography, and magnetic resonance imaging findings as applicable. Imaging challenges that relate to both diagnosis and characterization will be addressed with each type of pathology. The goal is that after reading this article, the reader will be able to recognize the key imaging findings in major categories of pathology affecting the shoulder joint and will become familiar with the potential pitfalls in their imaging diagnosis.

  12. NONTUBERCULOUS MYCOBACTERIOSES: EPIDEMIOLOGY, CLINIC AND POSSIBILITIES OF LABORATORY DIAGNOSTICS IN MODERN CONDITIONS

    Directory of Open Access Journals (Sweden)

    Shevchenko OS

    2017-03-01

    Full Text Available Introduction. Today there are more than 150 species of nontuberculous mycobacteria (NTMB known, of which 99 were registered in Europe. Due to the similar clinical picture with tuberculosis, mycobacterioses are difficult to diagnose and often occur with TB as a mixed infection. Also, there are cases of NTMB detection in the sputum of persons previously suffered with tuberculosis, which can lead to a false diagnosis of recurrent disease. Currently, the role of atypical mycobacteria in human pathology is increasing. Atypical mycobacteria are characterized by a wide spectrum of sustainability and potential pathogenicity to humans and animals. It is generally accepted that the reservoir of infection are animals and the environment (water, soil. NTMB presence in water can lead to the erroneous diagnosis of mycobacteriosis due to laboratory contamination of samples with nontuberculous mycobacteria from the outside. Moreover recently it has been found the possibility of transferring NTMB from person to person on the background of existing lung disease. For many types of infections reservoir still has not been found. Aim of this work was to study identified in the Kharkiv region cases of non-tuberculous mycobacterioses, features of their clinical manifestations and laboratory diagnostic options. Materials and Methods. We examined 32 patients (25 men and 7 women, residents of Kharkiv and Kharkiv region, Ukraine, who were diagnosed with "non-tuberculous mycobacteriosis of lungs" during 2014-2016. Patients were examined with routine diagnostic algorithm for TB. Nontuberculous mycobacteriosis was diagnosed on the basis of NTMB growth in BACTEC system, after which the diagnosis was verified by the following criteria: 1. Smear: the absence of formation of Cord-factor (in the smear NTMB are located scattering; 2. Negative immunoassay (ID-test; 3. Negative GeneXpert MTB/RIF Then non-tuberculous mycobacteria were identificated by investigation on solid media

  13. Endothelial cell preservation at hypothermic to normothermic conditions using clinical and experimental organ preservation solutions.

    Science.gov (United States)

    Post, Ivo C J H; de Boon, Wadim M I; Heger, Michal; van Wijk, Albert C W A; Kroon, Jeffrey; van Buul, Jaap D; van Gulik, Thomas M

    2013-10-15

    Endothelial barrier function is pivotal for the outcome of organ transplantation. Since hypothermic preservation (gold standard) is associated with cold-induced endothelial damage, endothelial barrier function may benefit from organ preservation at warmer temperatures. We therefore assessed endothelial barrier integrity and viability as function of preservation temperature and perfusion solution, and hypothesized that endothelial cell preservation at subnormothermic conditions using metabolism-supporting solutions constitute optimal preservation conditions. Human umbilical vein endothelial cells (HUVEC) were preserved at 4-37°C for up to 20 h using Ringer's lactate, histidine-tryptophan-ketoglutarate solution, University of Wisconsin (UW) solution, Polysol, or endothelial cell growth medium (ECGM). Following preservation, the monolayer integrity, metabolic capacity, and ATP content were determined as positive parameters of endothelial cell viability. As negative parameters, apoptosis, necrosis, and cell activation were assayed. A viability index was devised on the basis of these parameters. HUVEC viability and barrier integrity was compromised at 4°C regardless of the preservation solution. At temperatures above 20°C, the cells' metabolic demands outweighed the preservation solutions' supporting capacity. Only UW maintained HUVEC viability up to 20°C. Despite high intracellular ATP content, none of the solutions were capable of sufficiently preserving HUVEC above 20°C except for ECGM. Optimal HUVEC preservation is achieved with UW up to 20°C. Only ECGM maintains HUVEC viability at temperatures above 20°C. © 2013 Elsevier Inc. All rights reserved.

  14. Extreme sensory processing patterns and their relation with clinical conditions among individuals with major affective disorders.

    Science.gov (United States)

    Engel-Yeger, Batya; Muzio, Caterina; Rinosi, Giorgio; Solano, Paola; Geoffroy, Pierre Alexis; Pompili, Maurizio; Amore, Mario; Serafini, Gianluca

    2016-02-28

    Previous studies highlighted the involvement of sensory perception in emotional processes. However, the role of extreme sensory processing patterns expressed in hyper- or hyposensitivity was not thoroughly considered. The present study, in real life conditions, examined the unique sensory processing patterns of individuals with major affective disorders and their relationship with psychiatric symptomatology. The sample consisted of 105 participants with major affective conditions ranging in age from 20 to 84 years (mean=56.7±14.6). All participants completed the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A), the second version of the Beck Depression Inventory (BDI-II), and Adolescent/Adult Sensory Profile (AASP). Sensory sensitivity/avoiding hypersensitivity patterns and low registration (a hyposensitivity pattern) were prevalent among our sample as compared to normative data. About seventy percent of the sample showed lower seeking tendency. Stepwise regression analyses revealed that depression and anxious/cyclothymic affective temperaments were predicted by sensory sensory/avoiding. Anxious and irritable affective temperaments were predicted by low registration. Hyperthymic affective temperament and lower severity of depression were predicted by sensation seeking. Hyposensitivity or hypersensitivity may be "trait" markers of individuals with major affective disorders. Interventions should refer to the individual unique sensory profiles and their behavioral and functional impact in the context of real life.

  15. Resveratrol in prevention and treatment of common clinical conditions of aging

    Directory of Open Access Journals (Sweden)

    M Andrea Markus

    2008-06-01

    Full Text Available M Andrea Markus, Brian J MorrisSchool of Medical Sciences and Bosch Institute, The University of Sydney, Sydney, NSW, AustraliaAbstract: Resveratrol is a potent member of the class of natural, plant-derived chemicals known as polyphenols. These help explain in part why a diet high in fruit and vegetables confers health benefits and are associated with reduced risk of common complex conditions such as cardiovascular disease, cancer, diabetes, and Alzheimer’s disease. We present the latest molecular findings that account for the beneficial actions of resveratrol. The intracellular pathways activated are crucial for anti-oxidant defence, regulation of the cell cycle, mitochondrial energy production, vascular tone, oncogene suppression, and many other phenomena which if unchecked lead to morbidity and mortality from onset and progression of these various diseases. While a healthy diet and lifestyle is strongly recommended in prevention of such conditions, the future bodes well for the use of resveratrol and analogues of higher potency than the natural form for treatment of diseases that afflict humans, particularly as they age.Keywords: resveratrol, longevity, SIRT, wine, aging, cancer

  16. RADIOACTIVE IRON ABSORPTION IN CLINICAL CONDITIONS: NORMAL, PREGNANCY, ANEMIA, AND HEMOCHROMATOSIS.

    Science.gov (United States)

    Balfour, W M; Hahn, P F; Bale, W F; Pommerenke, W T; Whipple, G H

    1942-07-01

    Radio iron is a tool which makes iron absorption studies quite accurate in dogs and reasonably satisfactory in human beings. This method is vastly superior to others previously used. Normal human pregnancy without significant anemia may show active radio iron absorption-16 to 27 per cent of iron intake. The pregnant woman as a rule shows 2 to 10 times the normal absorption of radio iron. Diseased states in which iron stores are known to be very abundant-pernicious anemia, hemochromatosis, familial icterus, and Mediterranean anemia -show very little absorption, probably less than normal. This is in spite of a severe anemia in all conditions except hemochromatosis. Chronic infections in spite of anemia show no utilization of radio iron, whether it may be absorbed or not. Leukemia shows little utilization of radio iron in red cells in spite of absorption (autopsy), probably because of white cells choking the red marrow. Polycythemia shows very low values for iron absorption as do normal persons. Two pregnant women showed only normal iron absorption. We believe that reserve stores of iron in the body, rather than anemia, control iron absorption. This control is exerted upon the gastro-intestinal mucosa which can refuse or accept iron under various conditions.

  17. Development of a novel ozone- and photo-stable HyPer5 red fluorescent dye for array CGH and microarray gene expression analysis with consistent performance irrespective of environmental conditions

    Directory of Open Access Journals (Sweden)

    Kille Peter

    2008-11-01

    Full Text Available Abstract Background Array-based comparative genomic hybridization (CGH and gene expression profiling have become vital techniques for identifying molecular defects underlying genetic diseases. Regardless of the microarray platform, cyanine dyes (Cy3 and Cy5 are one of the most widely used fluorescent dye pairs for microarray analysis owing to their brightness and ease of incorporation, enabling high level of assay sensitivity. However, combining both dyes on arrays can become problematic during summer months when ozone levels rise to near 25 parts per billion (ppb. Under such conditions, Cy5 is known to rapidly degrade leading to loss of signal from either "homebrew" or commercial arrays. Cy5 can also suffer disproportionately from dye photobleaching resulting in distortion of (Cy5/Cy3 ratios used in copy number analysis. Our laboratory has been active in fluorescent dye research to find a suitable alternative to Cy5 that is stable to ozone and resistant to photo-bleaching. Here, we report on the development of such a dye, called HyPer5, and describe its' exceptional ozone and photostable properties on microarrays. Results Our results show HyPer5 signal to be stable to high ozone levels. Repeated exposure of mouse arrays hybridized with HyPer5-labeled cDNA to 300 ppb ozone at 5, 10 and 15 minute intervals resulted in no signal loss from the dye. In comparison, Cy5 arrays showed a dramatic 80% decrease in total signal during the same interval. Photobleaching experiments show HyPer5 to be resistant to light induced damage with 3- fold improvement in dye stability over Cy5. In high resolution array CGH experiments, HyPer5 is demonstrated to detect chromosomal aberrations at loci 2p21-16.3 and 15q26.3-26.2 from three patient sample using bacterial artificial chromosome (BAC arrays. The photostability of HyPer5 is further documented by repeat array scanning without loss of detection. Additionally, HyPer5 arrays are shown to preserve sensitivity and

  18. Hadamard Factorization of Stable Polynomials

    Science.gov (United States)

    Loredo-Villalobos, Carlos Arturo; Aguirre-Hernández, Baltazar

    2011-11-01

    The stable (Hurwitz) polynomials are important in the study of differential equations systems and control theory (see [7] and [19]). A property of these polynomials is related to Hadamard product. Consider two polynomials p,q ∈ R[x]:p(x) = anxn+an-1xn-1+...+a1x+a0q(x) = bmx m+bm-1xm-1+...+b1x+b0the Hadamard product (p × q) is defined as (p×q)(x) = akbkxk+ak-1bk-1xk-1+...+a1b1x+a0b0where k = min(m,n). Some results (see [16]) shows that if p,q ∈R[x] are stable polynomials then (p×q) is stable, also, i.e. the Hadamard product is closed; however, the reciprocal is not always true, that is, not all stable polynomial has a factorization into two stable polynomials the same degree n, if n> 4 (see [15]).In this work we will give some conditions to Hadamard factorization existence for stable polynomials.

  19. Clarithromycin for stable coronary heart disease increases all-cause and cardiovascular mortality and cerebrovascular morbidity over 10years in the CLARICOR randomised, blinded clinical trial

    DEFF Research Database (Denmark)

    Winkel, Per; Hilden, Jørgen; Hansen, Jørgen Fischer

    2015-01-01

    to increased cardiovascular mortality outside hospital in patients not on statin (HR: 2.36, 95% CI: 1.60-3.50). During the last 4years, cardiovascular death outside hospital was lower in the clarithromycin group (HR: 0.64, 95% CI: 0.46-0.88). CONCLUSION: Clarithromycin increased mortality due to cardiovascular......BACKGROUND: The CLARICOR trial reported that clarithromycin compared with placebo increased all-cause mortality in patients with stable coronary heart disease. This study investigates the effects of clarithromycin versus placebo during 10years follow up. METHODS: The CLARICOR trial is a randomised......-cause mortality (hazard ratio (HR): 1.10, 95% confidence interval (CI): 1.00-1.21) and cerebrovascular disease during 10years (HR: 1.19, 95% CI: 1.02-1.38). The increased mortality and morbidity were restricted to patients not on statin at entry (HR: 1.16, 95% CI: 1.04-1.31, and HR: 1.25, 95% CI: 1...

  20. The experiences of patients with Duchenne muscular dystrophy in facing and learning about their clinical conditions

    Directory of Open Access Journals (Sweden)

    Haruo Fujino

    2016-10-01

    Full Text Available Patients experience extreme difficulty when facing an intractable genetic disease. Herein, we examine the experiences of patients with Duchenne muscular dystrophy in facing and learning about their disease. A total of seven patients with Duchenne muscular dystrophy (age range: 20–48 participated. We conducted in-depth interviews with them about how they learned of their disease and how their feelings regarding the disease changed over time. Transcribed data were analysed using thematic analysis. The following themes emerged from this analysis: “experiences before receiving the diagnosis,” “experiences when they learned of their condition and progression of the disease,” “supports,” and “desired explanations.” Anxiety and worry were most pronounced when they had to transition to using wheelchairs or respirators due to disease progression; indeed, such transitions affect the patients psychological adjustment. In such times, support from significant others in their lives helped patients adjust.

  1. 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...

  2. Angina Pectoris (Stable Angina)

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Angina Pectoris (Stable Angina) Updated:Sep 19,2016 You may have heard the term “angina pectoris” or “stable angina” in your doctor’s office, but ...

  3. 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.

  4. Association of remote ischemic peri-conditioning with reduced incidence of clinical heart failure after primary percutaneous coronary intervention.

    Science.gov (United States)

    Ladejobi, Adetola; Wayne, Max; Martin-Gill, Christian; Guyette, Francis X; Althouse, Andrew D; Sharbaugh, Michael S; Reis, Steven E; Callaway, Clifton W; Kellum, John A; Smith, A J Conrad; Toma, Catalin; Olafiranye, Oladipupo

    2017-03-01

    Clinical heart failure (HF) occurs frequently after ST-segment elevation myocardial infarction (STEMI), and is associated with increased mortality. We assessed the impact of remote ischemic peri-conditioning (RIPC) during inter-facility air medical transport of STEMI patients on clinical HF following primary percutaneous coronary intervention (pPCI). Data from Acute Coronary Treatment and Intervention Outcomes Network Registry®-Get With the Guidelines™ (ACTION Registry-GWTG) from two PCI-hospitals that are utilizing RIPC during inter-facility helicopter transport of STEMI patients for pPCI between March, 2013 and September, 2015 were used for this study. The analyses were limited to inter-facility STEMI patients transported by helicopter with LVEF <55% after pPCI. The outcome measures were occurrence of clinical HF and serum level of brain-type natriuretic peptide (BNP). Out of the 150 STEMI patients in this analysis, 92 patients received RIPC and 58 did not. The RIPC and non-RIPC groups were generally similar in demographic and clinical characteristics except for lower incidence of cardiac arrest in the RIPC group (3/92 [3.3%] versus 13/58 [22.4%], p=0.002). STEMI patients who received RIPC were less likely to have in-hospital clinical HF compared to patients who did not receive RIPC (3/92 [3.3%] versus 7/58 [12.1%]; adjusted OR=0.22, 95% CI 0.05-0.92, p=0.038) after adjusting for baseline differences. In subgroup analysis, RIPC was associated with lower BNP (123 [interquartile range, 17.0-310] versus 319 [interquartile range, 106-552], p=0.029). RIPC applied during inter-facility air transport of STEMI patients for pPCI is associated with reduced incidence of clinical HF and serum BNP. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Multilocus sequence typing of Cronobacter sakazakii and Cronobacter malonaticus reveals stable clonal structures with clinical significance which do not correlate with biotypes

    Directory of Open Access Journals (Sweden)

    Manning Georgina

    2009-10-01

    Full Text Available Abstract Background The Cronobacter genus (Enterobacter sakazakii has come to prominence due to its association with infant infections, and the ingestion of contaminated reconstituted infant formula. C. sakazakii and C. malonaticus are closely related, and are defined according their biotype. Due to the ubiquitous nature of the organism, and the high severity of infection for the immunocompromised, a multilocus sequence typing (MLST scheme has been developed for the fast and reliable identification and discrimination of C. sakazakii and C. malonaticus strains. It was applied to 60 strains of C. sakazakii and 16 strains of C. malonaticus, including the index strains used to define the biotypes. The strains were from clinical and non-clinical sources between 1951 and 2008 in USA, Canada, Europe, New Zealand and the Far East. Results This scheme uses 7 loci; atpD, fusA, glnS, gltB, gyrB, infB, and pps. There were 12 sequence types (ST identified in C. sakazakii, and 3 in C. malonaticus. A third (22/60 of C. sakazakii strains were in ST4, which had almost equal numbers of clinical and infant formula isolates from 1951 to 2008. ST8 may represent a particularly virulent grouping of C. sakazakii as 7/8 strains were clinical in origin which had been isolated between 1977 - 2006, from four countries. C. malonaticus divided into three STs. The previous Cronobacter biotyping scheme did not clearly correspond with STs nor with species. Conclusion In conclusion, MLST is a more robust means of identifying and discriminating between C. sakazakii and C. malonaticus than biotyping. The MLST database for these organisms is available online at http://pubmlst.org/cronobacter/.

  6. Finding generically stable measures

    CERN Document Server

    Simon, Pierre

    2010-01-01

    We discuss two constructions for obtaining generically stable Keisler measures in an NIP theory. First, we show how to symmetrize an arbitrary invariant measure to obtain a generically stable one from it. Next, we show that suitable sigma-additive probability measures give rise to generically stable measures. Also included is a proof that generically stable measures over o-minimal theories and the p-adics are smooth.

  7. A clinical study of root surface conditioning with an EDTA gel. II. Surgical periodontal treatment.

    Science.gov (United States)

    Blomlöf, L; Jonsson, B; Blomlöf, J; Lindskog, S

    2000-12-01

    The objective of the present trial was to assess the effect of an EDTA gel applied during surgical periodontal therapy on probing depth reduction and periodontal attachment gain, allowing for the influence on healing of smoking as well as postsurgical oral hygiene. For comparison, citric acid treatment and control surgery only were included. The investigation was performed in one study center involving one clinical investigator and 68 patients. The patients were selected from a consecutive referral material on a voluntary basis. No statistically significant differences between treatment groups concerning attachment gain or pocket depth reduction could be seen after 3 and 6 months. A subgroup of the sample--21 patients who scored zero on the bleeding index at 3 and 6 months postsurgery and did not smoke--had a borderline significantly higher attachment gain in response to experimental treatment as well as a significant pocket depth reduction 6 months postsurgery when controlling for age, gender, Plaque Index at baseline, and treatment in multiple regression analyses. However, this was true not only for EDTA treatment but for citric acid and control treatment as well.

  8. A clinical study of the relationship between crowding of teeth, plaque and gingival condition.

    Science.gov (United States)

    Ingervall, B; Jacobsson, U; Nyman, S

    1977-08-01

    A clinical trial was undertaken to assess whether crowded teeth were more likely to accumulate plaque and develop gingivitis than non-crowded teeth. A tooth was considered crowded if it was displaced by 2 mm and/or rotated 15 degrees or more from the normal position in the arch. The material consisted of 50 dental students aged 21 to 32 years. An initial examination comprised assessment of Plaque Index, Gingival Index and pocket depths. After this examination the subjects refrained from using interdental cleaning aids but continued with their normal toothbrushing for 40 days. After re-examination they were instructed in the effective use of dental floss. A final examination was carried out after 140 days. At the start of the trial no difference was found in regard to the Plaque Index between crowded and non-crowded teeth. The Gingival Index for growded front teeth, but not for crowded premolars, was somewhat higher than for the corresponding controls. The cessation of interdental cleaning resulted in a similar increase in plaque accumulation and gingival inflammation in both non-crowded and crowded teeth. The use of dental floss for approximal tooth cleaning resulted in a similar decrease in the Plaque- and Gingival Indices for both types of teeth. The results demonstrate that in a group of young adults, crowding of teeth (1) did not favour plaque accumulation on approximal tooth surfaces and (2) influenced the degree of gingival inflammation only to a minor extent.

  9. Association between clinical condition and F-waves changes in the acute phase of stroke

    Directory of Open Access Journals (Sweden)

    Gustavo José Luvizutto

    Full Text Available ABSTRACT Objective To relate F-waves with clinical and laboratory exams in the acute phase of stroke. Methods Inclusion criteria for this cross-sectional study were: hemiplegia, absence of previous cranial trauma, myopathy, diabetes, alcoholism or other known causes of peripheral neuropathy, and normal sensory and motor conduction. The National Institutes of Health Stroke Scale (NIHSS score, glycemia, glucosilate hemoglobin, and CPK were obtained at admission by routine blood exams. After hospital admission, the F-wave latencies and persistence were obtained from the deep peroneal nerve using symmetrical techniques. Results Evaluation of 20 individuals – mean age 66 years, 50% male and 85% Caucasian – showed association of F-wave persistence with glycemia (r = 0.71; p < 0.001 and NIHSS categorized (NIHSS 1-7 = 65.0 x NIHSS 9-23 = 100; p = 0.004. Multivariate analysis found only association of F-wave persistence with glycemia β = 0.59 (0.44–0.74; p < 0.001. Conclusion The increase in the persistence of F-waves are associated with hyperglycemia in the acute phase of stroke.

  10. Stable canonical rules

    NARCIS (Netherlands)

    Iemhoff, R.; Bezhanishvili, N.; Bezhanishvili, Guram

    2016-01-01

    We introduce stable canonical rules and prove that each normal modal multi-conclusion consequence relation is axiomatizable by stable canonical rules. We apply these results to construct finite refutation patterns for modal formulas, and prove that each normal modal logic is axiomatizable by stable

  11. The effect of environmental conditions on biofilm formation of Burkholderia pseudomallei clinical isolates.

    Directory of Open Access Journals (Sweden)

    Nur Siti K Ramli

    Full Text Available Burkholderia pseudomallei, a Gram-negative saprophytic bacterium, is the causative agent of the potentially fatal melioidosis disease in humans. In this study, environmental parameters including temperature, nutrient content, pH and the presence of glucose were shown to play a role in in vitro biofilm formation by 28 B. pseudomallei clinical isolates, including four isolates with large colony variants (LCVs and small colony variants (SCVs morphotypes. Enhanced biofilm formation was observed when the isolates were tested in LB medium, at 30 °C, at pH 7.2, and in the presence of as little as 2 mM glucose respectively. It was also shown that all SVCs displayed significantly greater capacity to form biofilms than the corresponding LCVs when cultured in LB at 37 °C. In addition, octanoyl-homoserine lactone (C(8-HSL, a quorum sensing molecule, was identified by mass spectrometry analysis in bacterial isolates referred to as LCV CTH, LCV VIT, SCV TOM, SCV CTH, 1 and 3, and the presence of other AHL's with higher masses; decanoyl-homoserine lactone (C(10-HSL and dodecanoyl-homoserine lactone (C(12-HSL were also found in all tested strain in this study. Last but not least, we had successfully acquired two Bacillus sp. soil isolates, termed KW and SA respectively, which possessed strong AHLs degradation activity. Biofilm formation of B. pseudomallei isolates was significantly decreased after treated with culture supernatants of KW and SA strains, demonstrating that AHLs may play a role in B. pseudomallei biofilm formation.

  12. Comparison study of judged clinical skills competence from standard setting ratings generated under different administration conditions.

    Science.gov (United States)

    Roberts, William L; Boulet, John; Sandella, Jeanne

    2017-02-21

    When the safety of the public is at stake, it is particularly relevant for licensing and credentialing exam agencies to use defensible standard setting methods to categorize candidates into competence categories (e.g., pass/fail). The aim of this study was to gather evidence to support change to the Comprehensive Osteopathic Medical Licensing-USA Level 2-Performance Evaluation standard setting design and administrative process. Twenty-two video recordings of candidates assessed for clinical competence were randomly selected from the 2014-2015 Humanistic domain test score distribution ranging from the highest to lowest quintile of performance. Nineteen panelists convened at the same site to receive training and practice prior to generating judgments of qualified or not qualified performance to each of the twenty videos. At the end of training, one panel remained onsite to complete their judgments and the second panel was released and given 1 week to observe the same twenty videos and complete their judgments offsite. The two one-sided test procedure established equivalence between panel group means at the 0.05 confidence level, controlling for rater errors within each panel group. From a practical cost-effective and administrative resource perspective, results from this study suggest it is possible to diverge from typical panel groups, who are sequestered the entire time onsite, to larger numbers of panelists who can make their judgments offsite with little impact on judged samples of qualified performance. Standard setting designs having panelists train together and then allowing those to provide judgments yields equivalent ratings and, ultimately, similar cut scores.

  13. The effect the design solutions adopted for a pilot vortex burner with central admission of medium have on setting up the conditions for stable combustion of air-fuel mixture

    Science.gov (United States)

    Dvoinishnikov, V. A.; Khokhlov, D. A.

    2015-04-01

    The effect the design and operating parameters of a pilot vortex burner have on the swirl jet formation and on the jet characteristics is studied. The flow characteristics were studied by mathematically modeling the flow using the ANSYS CFX software package. The performed investigations made it possible to determine the extent to which the swirl parameter n, the ratios of channel diameters m and flow rates of medium in the channels in case of using a two-channel swirl burner design, and the constriction ratio K cnst influence the flow aerodynamic pattern, including the back flow zone and its characteristics. The region of m and n values at which the aerodynamic conditions necessary for maintaining stable combustion are set up is determined. Matters concerned with performance efficiency of the axial swirling apparatus are considered. A correlation for determining the flow swirling loss factor is presented. It is shown that pressure loss in an annular channel with a swirling device depends not only on the blade setting angle, but also on the ratio of annular channel diameters.

  14. Initial Experience of the Feasibility of Single-Incision Laparoscopic Appendectomy in Different Clinical Conditions

    Directory of Open Access Journals (Sweden)

    Jyrki Kössi

    2010-01-01

    Full Text Available Introduction. Single-incision laparoscopic surgery (SILS is a new technique developed for performing operations without a visible scar. Preliminary studies have reported the use of the technique mainly in cholecystectomy and appendectomy. We evaluated the feasibility of the technique in various appendicitis conditions including children, fertile women and obese patients. Materials and Methods. SILS technique was used in a random sample of patients hospitalised for suspected appendicitis. The ordinary diagnostic laparoscopy was performed and the appendix was removed if needed. The ligation of appendix was performed by thread loop, absorbable clip or endoscopic stapler. The details regarding the recovery of patients were collected prospectively. Results. Ten SILS procedures were performed without conversions or complications. The patient series included uncomplicated and complicated appendicitis patients. The mean age of the patients was 37 years (range 13–63, mean BMI was 26 (range 18–31, mean operative time was 40 minutes (range 18–31, and mean postoperative stay was 2 days (range 1–5. Conclusions. SILS technique is feasible for obese patients, uncomplicated and complicated appendicitis as well as for exploratory laparoscopy. Most common methods to ligate appendix are feasible with SILS technique. The true benefit of the technique should be assessed by randomised controlled trials.

  15. Price elasticity and medication use: cost sharing across multiple clinical conditions.

    Science.gov (United States)

    Gatwood, Justin; Gibson, Teresa B; Chernew, Michael E; Farr, Amanda M; Vogtmann, Emily; Fendrick, A Mark

    2014-11-01

    To address the impact that out-of-pocket prices may have on medication use, it is vital to understand how the demand for medications may be affected when patients are faced with changes in the price to acquire treatment and how price responsiveness differs across medication classes.  To examine the impact of cost-sharing changes on the demand for 8 classes of prescription medications. This was a retrospective database analysis of 11,550,363 commercially insured enrollees within the 2005-2009 MarketScan Database. Patient cost sharing, expressed as a price index for each medication class, was the main explanatory variable to examine the price elasticity of demand. Negative binomial fixed effect models were estimated to examine medication fills. The elasticity estimates reflect how use changes over time as a function of changes in copayments. Model estimates revealed that price elasticity of demand ranged from -0.015 to -0.157 within the 8 categories of medications (P  less than  0.01 for 7 of 8 categories). The price elasticity of demand for smoking deterrents was largest (-0.157, P  less than  0.0001), while demand for antiplatelet agents was not responsive to price (P  greater than 0.05). The price elasticity of demand varied considerably by medication class, suggesting that the influence of cost sharing on medication use may be related to characteristics inherent to each medication class or underlying condition.

  16. 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 <0.01). Conversely, no differences in crude mortality rates were observed between 1 and 3 years across 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 <0.01), whereas no differences were observed between UAP or NSTEMI and SAP (HR 0.99; 95% CI 0.73 to 1.34; p = 0.94). In women with ACS, use of new-generation DES was associated with reduced risk of major adverse cardiac events (HR 0.58; 95% CI 0.34 to 0.98). The magnitude and direction of the effect with new-generation DES was uniform between women with or without ACS (pinteraction = 0.66). In conclusion, in women across the 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.

  17. Trends in Risk Factors and Treatments in Patients With Stable Ischemic Heart Disease Seen at Cardiology Clinics Between 2006 and 2014.

    Science.gov (United States)

    Cordero, Alberto; Galve, Enrique; Bertomeu-Martínez, Vicente; Bueno, Héctor; Fácila, Lorenzo; Alegría, Eduardo; Cequier, Ángel; Ruiz, Emilio; González-Juanatey, José Ramón

    2016-04-01

    Chronic ischemic heart disease is the most prevalent of all cardiovascular diseases. Patients are at high risk of complications. In recent decades, changes may have occurred in the clinical characteristics of the disease, its treatment and control of risk factors. A direct comparison of 2 national registries of patients with chronic ischemic heart disease carried out in 2006 (n=1583) and 2014 (n=1110). We observed statistically significant differences between the 2 registries, with a higher percentage of men and smokers in the 2014 registry, but a lower prevalence of diabetes mellitus and hypertension. Heart failure and stroke were more prevalent in the 2006 registry. Patients in the 2014 registry had better results for lipid profile, blood glucose, creatinine, and glomerular filtration rate. We observed higher use of recommended drugs for secondary prevention and an increased percentage of patients receiving optimal medical therapy, from 32.5% to 49.5% (Pfactors (improved dyslipidemia, heart rate, and blood glucose in patients with diabetes) but worse blood pressure control. The clinical profile of patients with chronic ischemic heart disease is similar in the 2 registries. There has been an improvement in patients' medical therapy and dyslipidemia control, blood glucose, and heart rate, but there is still much room for improvement in the control of other cardiovascular risk factors. Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  18. Various clinical conditions can mimic Crimean-Congo hemorrhagic fever in pediatric patients in endemic regions.

    Science.gov (United States)

    Kara, Soner S; Kara, Duygu; Fettah, Ali

    2016-01-01

    Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease with high mortality. Many disorders can mimic CCHF. It is important to recognize the condition and to perform differential diagnosis in endemic countries. Twenty-one children aged 18 years or less with a preliminary diagnosis of CCHF were retrospectively evaluated. Real-time PCR and a confirmatory indirect immunofluorescence assay for negative results were performed. The diagnoses determined that 9 patients had (42.9%) CCHF; 7 patients had (33.3%) viral upper respiratory tract infections (URTI); 2 patients had (9.5%) brucellosis; 1 patients had (4.7%) periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome episode; 1 patient had (4.7%) cerebral palsy, diabetes insipidus, acute gastroenteritis, and hypernatremic dehydration; and 1 patient had (4.7%) cellulitis after a tick bite. The mean age of patients with CCHF was greater than that of the other patients (116.1±53.6 vs. 94.1±52.1 months, p=0.02). Seventeen (81%) of the children included had a history of tick bites, 2 (9.5%) had a history of contact with a patient with CCHF, and 2 (9.5%) had no exposure, but were living in an endemic region. Three patients had an underlying disorder: cerebral palsy and diabetes insipidus, epilepsy, or PFAPA. All of the children experienced fever. Other frequent symptoms were malaise, diarrhea, vomiting, and abdominal pain, but none of these differed statistically between the patient groups. CCHF patients had a longer mean duration of symptoms (10.56±1.42 vs. 6.75±3.62 days, p=0.008) and a longer mean length of hospitalization (8.00±2.08 vs. 3.58±1.56 days, pnon-infectious causes may resemble CCHF. Although they are not pathognomonic, some indicators, including a longer symptom duration and hospitalization, cytopenia, elevated liver enzymes, creatine kinase and prolonged coagulation parameters, were found to be in favor of CCHF.

  19. Efficacy and safety in clinical practice of a rilpivirine, tenofovir and emtricitabine single-tablet regimen in virologically suppressed HIV-positive patients on stable antiretroviral therapy

    Directory of Open Access Journals (Sweden)

    Nicola Gianotti

    2015-07-01

    Full Text Available Introduction: Switching to a rilpivirine, tenofovir and emtricitabine (RTE single-tablet regimen (STR has been evaluated in a limited number of virologically suppressed patients. The aim of this study was to describe clinical outcomes in HIV-positive patients switched from a suppressive antiretroviral regimen to RTE STR in routine clinical practice. Methods: In this retrospective study of antiretroviral-treated patients with <50 copies of HIV RNA/mL switched to RTE STR, virological failure (VF was defined as two consecutive measurements of ≥50 copies/mL or a single measurement of ≥50 copies/mL followed by any change in treatment. Treatment failure (TF was defined as VF or discontinuation of the STR for any reason. Univariate mixed-linear models were used to identify differences in laboratory parameters over time. Results and discussion: The analysis involved 307 patients (83% males with a median age of 45.8 years (interquartile range (IQR 39.3–50.9, who were followed up for a median of 7.4 months (IQR 4.6–10.9. VF occurred in three patients (1% switched from a protease inhibitor (PI-based regimen, after a median of 2.6 months (IQR 1.6–3.0, and TF in 34 patients (11% after a median of three months (IQR 1.4–5.8, 24 of whom (71% were receiving a PI-based regimen at baseline. Overall, there was a slight but statistically significant improvement in the mean monthly change from baseline in CD4+ cell counts (p=0.027, the CD4+/CD8+ ratio (p=0.0001, and Hb (p=0.024, alanine amino transferase (ALT (p=0.009, total bilirubin (p<0.0001, indirect bilirubin (p<0.0001, total cholesterol (p<0.0001 and triglyceride (p<0.0001 levels. There was also a slight but statistically significant increase in serum creatinine (p=0.0004, aspartate amino transferase (AST (p=0.001 and liver fibrosis index (FIB-4 (p=0.002, and a decrease in eGFRcreat (p<0.0001 and high-density lipoprotein (HDL cholesterol (p<0.0001 values. The study limitations include its

  20. GeneChaser: Identifying all biological and clinical conditions in which genes of interest are differentially expressed

    Directory of Open Access Journals (Sweden)

    Venkatasubrahmanyam Shivkumar

    2008-12-01

    Full Text Available Abstract Background The amount of gene expression data in the public repositories, such as NCBI Gene Expression Omnibus (GEO has grown exponentially, and provides a gold mine for bioinformaticians, but has not been easily accessible by biologists and clinicians. Results We developed an automated approach to annotate and analyze all GEO data sets, including 1,515 GEO data sets from 231 microarray types across 42 species, and performed 12,658 group versus group comparisons of 24 GEO-specified types. We then built GeneChaser, a web server that enables biologists and clinicians without bioinformatics skills to easily identify biological and clinical conditions in which a gene or set of genes was differentially expressed. GeneChaser displays these conditions in graphs, gives statistical comparisons, allows sort/filter functions and provides access to the original studies. We performed a single gene search for Nanog and a multiple gene search for Nanog, Oct4, Sox2 and LIN28, confirmed their roles in embryonic stem cell development, identified several drugs that regulate their expression, and suggested their potential roles in sex determination, abnormal sperm morphology, malaria infection, and cancer. Conclusion We demonstrated that GeneChaser is a powerful tool to elucidate information on function, transcriptional regulation, drug-response and clinical implications for genes of interest.

  1. AQUEOUS STABLE FREE RADICAL POLYMERIZATION PROCESSES

    Institute of Scientific and Technical Information of China (English)

    Andrea R. Szkurhan; Michael K. Georges

    2004-01-01

    An overview of aqueous polymerizations, which include emulsion, miniemulsion and suspension polymerizations,under stable free radical polymerization (SFRP) conditions is presented. The success of miniemulsion and suspension SFRP polymerizations is contrasted with the difficulties associated with obtaining a stable emulsion polymerization. A recently developed unique microprecipitation technique is referenced as a means of making submicron sized particles that can be used to achieve a stable emulsion SFRP process.

  2. Comprehensive clinical studies in 34 patients with molecularly defined UPD(14)pat and related conditions (Kagami–Ogata syndrome)

    Science.gov (United States)

    Kagami, Masayo; Kurosawa, Kenji; Miyazaki, Osamu; Ishino, Fumitoshi; Matsuoka, Kentaro; Ogata, Tsutomu

    2015-01-01

    Paternal uniparental disomy 14 (UPD(14)pat) and epimutations and microdeletions affecting the maternally derived 14q32.2 imprinted region lead to a unique constellation of clinical features such as facial abnormalities, small bell-shaped thorax with a coat-hanger appearance of the ribs, abdominal wall defects, placentomegaly, and polyhydramnios. In this study, we performed comprehensive clinical studies in patients with UPD(14)pat (n=23), epimutations (n=5), and microdeletions (n=6), and revealed several notable findings. First, a unique facial appearance with full cheeks and a protruding philtrum and distinctive chest roentgenograms with increased coat-hanger angles to the ribs constituted the pathognomonic features from infancy through childhood. Second, birth size was well preserved, with a median birth length of ±0 SD (range, −1.7 to +3.0 SD) and a median birth weight of +2.3 SD (range, +0.1 to +8.8 SD). Third, developmental delay and/or intellectual disability was invariably present, with a median developmental/intellectual quotient of 55 (range, 29–70). Fourth, hepatoblastoma was identified in three infantile patients (8.8%), and histological examination in two patients showed a poorly differentiated embryonal hepatoblastoma with focal macrotrabecular lesions and well-differentiated hepatoblastoma, respectively. These findings suggest the necessity of an adequate support for developmental delay and periodical screening for hepatoblastoma in the affected patients, and some phenotypic overlap between UPD(14)pat and related conditions and Beckwith–Wiedemann syndrome. On the basis of our previous and present studies that have made a significant contribution to the clarification of underlying (epi)genetic factors and the definition of clinical findings, we propose the name ‘Kagami–Ogata syndrome' for UPD(14)pat and related conditions. PMID:25689926

  3. Comprehensive clinical studies in 34 patients with molecularly defined UPD(14)pat and related conditions (Kagami-Ogata syndrome).

    Science.gov (United States)

    Kagami, Masayo; Kurosawa, Kenji; Miyazaki, Osamu; Ishino, Fumitoshi; Matsuoka, Kentaro; Ogata, Tsutomu

    2015-11-01

    Paternal uniparental disomy 14 (UPD(14)pat) and epimutations and microdeletions affecting the maternally derived 14q32.2 imprinted region lead to a unique constellation of clinical features such as facial abnormalities, small bell-shaped thorax with a coat-hanger appearance of the ribs, abdominal wall defects, placentomegaly, and polyhydramnios. In this study, we performed comprehensive clinical studies in patients with UPD(14)pat (n=23), epimutations (n=5), and microdeletions (n=6), and revealed several notable findings. First, a unique facial appearance with full cheeks and a protruding philtrum and distinctive chest roentgenograms with increased coat-hanger angles to the ribs constituted the pathognomonic features from infancy through childhood. Second, birth size was well preserved, with a median birth length of ±0 SD (range, -1.7 to +3.0 SD) and a median birth weight of +2.3 SD (range, +0.1 to +8.8 SD). Third, developmental delay and/or intellectual disability was invariably present, with a median developmental/intellectual quotient of 55 (range, 29-70). Fourth, hepatoblastoma was identified in three infantile patients (8.8%), and histological examination in two patients showed a poorly differentiated embryonal hepatoblastoma with focal macrotrabecular lesions and well-differentiated hepatoblastoma, respectively. These findings suggest the necessity of an adequate support for developmental delay and periodical screening for hepatoblastoma in the affected patients, and some phenotypic overlap between UPD(14)pat and related conditions and Beckwith-Wiedemann syndrome. On the basis of our previous and present studies that have made a significant contribution to the clarification of underlying (epi)genetic factors and the definition of clinical findings, we propose the name 'Kagami-Ogata syndrome' for UPD(14)pat and related conditions.

  4. Inertial measures of motion for clinical biomechanics: comparative assessment of accuracy under controlled conditions - changes in accuracy over time.

    Directory of Open Access Journals (Sweden)

    Karina Lebel

    Full Text Available Interest in 3D inertial motion tracking devices (AHRS has been growing rapidly among the biomechanical community. Although the convenience of such tracking devices seems to open a whole new world of possibilities for evaluation in clinical biomechanics, its limitations haven't been extensively documented. The objectives of this study are: 1 to assess the change in absolute and relative accuracy of multiple units of 3 commercially available AHRS over time; and 2 to identify different sources of errors affecting AHRS accuracy and to document how they may affect the measurements over time.This study used an instrumented Gimbal table on which AHRS modules were carefully attached and put through a series of velocity-controlled sustained motions including 2 minutes motion trials (2MT and 12 minutes multiple dynamic phases motion trials (12MDP. Absolute accuracy was assessed by comparison of the AHRS orientation measurements to those of an optical gold standard. Relative accuracy was evaluated using the variation in relative orientation between modules during the trials.Both absolute and relative accuracy decreased over time during 2MT. 12MDP trials showed a significant decrease in accuracy over multiple phases, but accuracy could be enhanced significantly by resetting the reference point and/or compensating for initial Inertial frame estimation reference for each phase.The variation in AHRS accuracy observed between the different systems and with time can be attributed in part to the dynamic estimation error, but also and foremost, to the ability of AHRS units to locate the same Inertial frame.Mean accuracies obtained under the Gimbal table sustained conditions of motion suggest that AHRS are promising tools for clinical mobility assessment under constrained conditions of use. However, improvement in magnetic compensation and alignment between AHRS modules are desirable in order for AHRS to reach their full potential in capturing clinical outcomes.

  5. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  6. Inadequate control of heart rate in patients with stable angina: results from the European heart survey.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2010-01-01

    AIMS: To examine resting heart rate (HR) in a population presenting with stable angina in relation to prior and subsequent pharmacological treatment, comorbid conditions and clinical outcome. METHODS AND RESULTS: The European Heart Survey was a prospective, observational, cohort study of 3779 patien

  7. Microwave Accelerated Green Synthesis of Stable Silver Nanoparticles with Eucalyptus globulus Leaf Extract and Their Antibacterial and Antibiofilm Activity on Clinical Isolates.

    Directory of Open Access Journals (Sweden)

    Khursheed Ali

    Full Text Available A simple and rapid microwave assisted method of green synthesis of silver nanoparticles (AgNPs was developed using aqueous leaf extract of Eucalyptus globulus(ELE, and their antibacterial and antibiofilm potential investigated. With this aim, the aqueous solutions of ELE and AgNO3(1 mM were mixed (1:4 v/v, and microwave irradiated at 2450 Mhz, for 30 sec. The instant color change of the ELE-AgNO3 mixture from pale yellow to dark brown indicated ELE-AgNPs synthesis. The intensity of peak at 428 nm in UV-Vis spectra, due to the surface plasmon resonance of AgNPs, varied with the amount of ELE, AgNO3 concentration, pH and time of incubation. The biosynthesized ELE-AgNPs were characterized by UV-visible spectroscopy, XRD, TEM, SEM-EDX, FTIR and TGA analyses. The size of ELE-AgNPs was determined to be in range of 1.9-4.3 nm and 5-25 nm, with and without microwave treatment, respectively. SEM exhibited the capping of AgNPs with the ELE constituents, and validated by FTIR analysis. The FTIR data revealed the presence of plant organic constituents and metabolites bound to ELE-AgNPs, which contributes for their stability. The antimicrobial activity of ELE-AgNPs was assessed by growth and biofilm inhibition of extended spectrum β-lactamase (ESBL producing Pseudomonas aeruginosa, Escherichia coli and methicillin-resistant Staphylococcus aureus (MRSA and methicillin-sensitive Staphylococcus aureus (MSSA clinical bacterial isolates. The results demonstrated that S. aureus were more sensitive to ELE-AgNPs than E. coli and P. aeruginosa. MRSA exhibited higher sensitive than MSSA, whereas P. aeruginosa were more sensitive than E. coli to ELE-AgNPs treatment. Also, significant (83 ± 3% and 84 ± 5% biofilm inhibition was observed in case of S. aureus and P. aeruginosa, respectively. The results elucidated environmentally friendly, economical and quick method for production of colloidal bio-functionalized ELE-AgNPs, for effectual clinical applications, as broad

  8. [Evaluation of sleep apnea, detected by 24-hour ECG Holter monitoring analysis in patients with stable coronary artery disease and ischemic heart failure - correlations with clinical data].

    Science.gov (United States)

    Frączek-Jucha, Magdalena; Rostoff, Paweł; Łach, Jacek; Nessler, Jadwiga; Gackowski, Andrzej

    2017-06-23

    Obstructive sleep apnoea (OSA) is frequently undiagnosed in patients with heart failure (HF) and coronary artery disease (CAD). Simple and widely available screening tests are needed to diagnose patients with SA. Measurements of thoracic impedance and heart rate variability during 24-hour ECG Holter (H-EKG) monitoring allows to calculate estimated apnoea-hypopnoea index (eAHI). The aim of the research was to assess prevalence of OSA evaluated with the use of H-EKG and determination of its clinical relevance in patients with CAD and ischeamic HF. The study groups comprised of: 30 consecutive patients with ischeamic HF with reduced LVEF (HFrEF) (group A) and 30 patients with CAD (group B). Control group (C) comprised of 30 patients with arterial hypertension but no CAD nor HF. H-ECG monitoring was performed and eAHI was calculated. On the basis of AHI result group A was subdivided to subgroups A1 (eAHI <15) and A2 (eAHI ≥15). Study groups differed with eAHI values (27,9±19,9 vs. 21,8±17,3 vs. 15,7±12,2; p=0,022). Post hoc analysis revealed that eAHI in group A was higher in comparison to group C (27,9±19,9 vs. 15,7±12,2; p=0,006). SA prevalence was higher in group A compared to group C (70,0% vs. 40,0%; p=0,019). Significant but weak correlation between eAHI and LVEDD was found (r=0,282; p<0,05). Subgroups A1 and A2 did not differ in terms of clinical and demographical parameters, HF symptoms, LVEF and NT-proBNP levels. OSA coexists more frequently with HF than with arterial hypertension Significant but weak correlation between eAHI and LVEDD was demonstrated. However, in patients with symptomatic ischeamic heart failure eAHI ≥15 was not related to NYHA class, lower LVEF and higher NT-proBNP levels.

  9. 噻托溴铵治疗慢性阻塞性肺病稳定期的临床观察%Clinical Observation on Effect of Tiotropium Bromide on Patients with Stable Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    范云峰; 吴鹏

    2014-01-01

    目的:观察吸入噻托溴铵治疗慢性阻塞性肺病(COPD)稳定期的治疗效果。方法将60例稳定期COPD随机分成2组,治疗组给予噻托溴铵吸人,对照组给予常规治疗,比较两组治疗前后肺功能、症状改善,急性加重次数和不良反应。结果治疗组肺功能明显好转,症状明显改善(Pclinical efficacy of inhaled tiotropium bromide in patients with chroic obstrutive pulmonary disease in the stable phase.Methods: Sixty patients with stable COPD were randomly divided into tretment group and control group.The patients in treatment group were received inhaled tiontropium bromide,while the patients in control group were given routine treatment.Before and after the treatment,lung function, symptom develop,times of acute exacerbation and adverse reactions were compared between the two groups. Results As compared with control group FEV1/FVC and FEV1(% predict) in treatment group were significantiy increased,CAT development and the times of acute exacerbation reduced. No significant adverse reaction was found during the treatment. Conclusions :inhaled tiotropium bromide is safe and effective for patient with stable COPD.

  10. 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.

  11. Stable Principal Component Pursuit

    CERN Document Server

    Zhou, Zihan; Wright, John; Candes, Emmanuel; Ma, Yi

    2010-01-01

    In this paper, we study the problem of recovering a low-rank matrix (the principal components) from a high-dimensional data matrix despite both small entry-wise noise and gross sparse errors. Recently, it has been shown that a convex program, named Principal Component Pursuit (PCP), can recover the low-rank matrix when the data matrix is corrupted by gross sparse errors. We further prove that the solution to a related convex program (a relaxed PCP) gives an estimate of the low-rank matrix that is simultaneously stable to small entrywise noise and robust to gross sparse errors. More precisely, our result shows that the proposed convex program recovers the low-rank matrix even though a positive fraction of its entries are arbitrarily corrupted, with an error bound proportional to the noise level. We present simulation results to support our result and demonstrate that the new convex program accurately recovers the principal components (the low-rank matrix) under quite broad conditions. To our knowledge, this is...

  12. Incorporating patient preferences in the management of multiple long-term conditions: is this a role for clinical practice guidelines?

    Directory of Open Access Journals (Sweden)

    Charlotte E. Young

    2015-11-01

    Full Text Available Background: Clinical practice guidelines provide an evidence-based approach to managing single chronic conditions, but their applicability to multiple conditions has been actively debated. Incorporating patient-preference recommendations and involving consumers in guideline development may enhance their applicability, but further understanding is needed. Objectives: To assess guidelines that include recommendations for comorbid conditions to determine the extent to which they incorporate patient-preference recommendations; use consumer-engagement processes during development, and, if so, whether these processes produce more patient-preference recommendations; and meet standard quality criteria, particularly in relation to stakeholder involvement. Design: A review of Australian guidelines published from 2006 to 2014 that incorporated recommendations for managing comorbid conditions in primary care. Document analysis of guidelines examined the presence of patient-preference recommendations and the consumer-engagement processes used. The Appraisal of Guidelines for Research and Evaluation instrument was used to assess guideline quality. Results: Thirteen guidelines were reviewed. Twelve included at least one core patient-preference recommendation. Ten used consumer-engagement processes, including participation in development groups (seven guidelines and reviewing drafts (ten guidelines. More extensive consumer engagement was generally linked to greater incorporation of patient-preference recommendations. Overall quality of guidelines was mixed, particularly in relation to stakeholder involvement. Conclusions: Guidelines do incorporate some patient-preference recommendations, but more explicit acknowledgement is required. Consumer-engagement processes used during guideline development have the potential to assist in identifying patient preferences, but further research is needed. Clarification of the consumer role and investment in consumer training

  13. Late Post-Conditioning with Sevoflurane after Cardiac Surgery--Are Surrogate Markers Associated with Clinical Outcome?

    Directory of Open Access Journals (Sweden)

    John M Bonvini

    Full Text Available In a recent randomized controlled trial our group has demonstrated in 102 patients that late post-conditioning with sevoflurane performed in the intensive care unit after surgery involving extracorporeal circulation reduced damage to cardiomyocytes exposed to ischemia reperfusion injury. On the first post-operative day the sevoflurane patients presented with lower troponin T values when compared with those undergoing propofol sedation. In order to assess possible clinical relevant long-term implications in patients enrolled in this study, we performed the current retrospective analysis focusing on cardiac and non-cardiac events during the first 6 months after surgery.All patients who had successfully completed the late post-conditioning trial were included into this follow-up. Our primary and secondary endpoints were the proportion of patients experiencing cardiac and non-cardiac events, respectively. Additionally, we were interested in assessing therapeutic interventions such as initiation or change of drug therapy, interventional treatment or surgery.Of 102 patients analyzed in the primary study 94 could be included in this follow-up. In the sevoflurane group (with 41 patients 16 (39% experienced one or several cardiac events within 6 months after cardiac surgery, in the propofol group (with 53 patients 19 (36%, p=0.75. Four patients (9% with sevoflurane vs. 7 (13% with propofol sedation had non-cardiac events (p=0.61. While a similar percentage of patients suffered from cardiac and/or non-cardiac events, only 12 patients in the sevoflurane group compared to 20 propofol patients needed a therapeutic intervention (OR: 0.24, 95% CI: 0.04-1.43, p=0.12. A similar result was found for hospital admissions: 2 patients in the sevoflurane group had to be re-admitted to the hospital compared to 8 in the propofol group (OR 0.23, 95% CI: 0.04-1.29, p=0.10.Sevoflurane does not seem to provide protection with regard to the occurrence of cardiac and non

  14. An Overview of Translationally Informed Treatments for Posttraumatic Stress Disorder: Animal Models of Pavlovian Fear Conditioning to Human Clinical Trials.

    Science.gov (United States)

    Bowers, Mallory E; Ressler, Kerry J

    2015-09-01

    Posttraumatic stress disorder manifests after exposure to a traumatic event and is characterized by avoidance/numbing, intrusive symptoms and flashbacks, mood and cognitive disruptions, and hyperarousal/reactivity symptoms. These symptoms reflect dysregulation of the fear system likely caused by poor fear inhibition/extinction, increased generalization, and/or enhanced consolidation or acquisition of fear. These phenotypes can be modeled in animal subjects using Pavlovian fear conditioning, allowing investigation of the underlying neurobiology of normative and pathological fear. Preclinical studies reveal a number of neurotransmitter systems and circuits critical for aversive learning and memory that have informed the development of therapies used in human clinical trials. In this review, we discuss the evidence for a number of established and emerging pharmacotherapies and device-based treatments for posttraumatic stress disorder that have been developed via a bench to bedside translational model.

  15. Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details

    Science.gov (United States)

    Buffel du Vaure, Céline; Dechartres, Agnès; Battin, Constance; Ravaud, Philippe; Boutron, Isabelle

    2016-01-01

    Objectives To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at ClinicalTrials.gov and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions. Design Systematic review of trial registration records. Data sources ClinicalTrials.gov register. Study selection All ongoing RCTs registered from 1 January 2014 to 31 January 2015 that assessed an intervention targeting adults with coronary heart disease (CHD), hypertension, heart failure, stroke/transient ischaemic attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, painful condition, depression and dementia with a target sample size ≥100. Data extraction From the trial registration records, 2 researchers independently recorded the trial characteristics and the number of exclusion criteria and determined whether patients with concomitant chronic conditions were excluded or specifically targeted. Results Among 319 ongoing RCTs, despite the high prevalence of the concomitant chronic conditions, patients with these conditions were excluded in 251 trials (79%). For example, although 91% of patients with CHD had a concomitant chronic condition, 69% of trials targeting such patients excluded patients with concomitant chronic condition(s). When considering the co-occurrence of 2 chronic conditions, 31% of patients with chronic pain also had depression, but 58% of the trials targeting patients with chronic pain excluded patients with depression. Only 37 trials (12%) assessed interventions specifically targeting patients with concomitant chronic conditions; 31 (84%) excluded patients with concomitant chronic condition(s). Conclusions Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions

  16. Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at ClinicalTrials.gov: a systematic review of registration details.

    Science.gov (United States)

    Buffel du Vaure, Céline; Dechartres, Agnès; Battin, Constance; Ravaud, Philippe; Boutron, Isabelle

    2016-09-27

    To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at ClinicalTrials.gov and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions. Systematic review of trial registration records. ClinicalTrials.gov register. All ongoing RCTs registered from 1 January 2014 to 31 January 2015 that assessed an intervention targeting adults with coronary heart disease (CHD), hypertension, heart failure, stroke/transient ischaemic attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, painful condition, depression and dementia with a target sample size ≥100. From the trial registration records, 2 researchers independently recorded the trial characteristics and the number of exclusion criteria and determined whether patients with concomitant chronic conditions were excluded or specifically targeted. Among 319 ongoing RCTs, despite the high prevalence of the concomitant chronic conditions, patients with these conditions were excluded in 251 trials (79%). For example, although 91% of patients with CHD had a concomitant chronic condition, 69% of trials targeting such patients excluded patients with concomitant chronic condition(s). When considering the co-occurrence of 2 chronic conditions, 31% of patients with chronic pain also had depression, but 58% of the trials targeting patients with chronic pain excluded patients with depression. Only 37 trials (12%) assessed interventions specifically targeting patients with concomitant chronic conditions; 31 (84%) excluded patients with concomitant chronic condition(s). Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions excluded patients with concomitant chronic conditions. Published by the BMJ

  17. A Novel Glycinate-based Body Wash: Clinical Investigation Into Ultra-mildness, Effective Conditioning, and Improved Consumer Benefits.

    Science.gov (United States)

    Regan, Jamie; Mollica, Leonel-Maximo; Ananthapadmanabhan, K P

    2013-06-01

    To assess the properties of a novel body wash containing the mild surfactant glycinate. Biochemical and clinical assays. Research laboratories and clinical sites in the United States and Canada. Women 18 to 65 years of age (cleansing efficacy); male and female subjects 26 to 63 years of age with mild or moderate dryness and erythema (leg-controlled application test); subjects 5 to 65 years of age with mild-to-moderate eczema (eczema compatibility); and women 18 to 64 years of age (home use). Assessments across studies included colorimetric dye exclusion to assess skin damage potential (corneosurfametry), efficacy of cosmetic product removal from skin, change from baseline in visual dryness, change from baseline in Eczema Area and Severity Index, and self-perceived eczema attributes and self-reported product preference. The glycinate-based cleanser demonstrated mildness to skin components when evaluated in a corneosurfametry assay. Short-term use under exaggerated wash conditions in subjects with dryness scores <3 and erythema scores <2 (both on a 0-6 scale) indicated an initial reduction in visual dryness. In subjects with eczema, normal use resulted in significant improvements (p<0.05) at Week 4 compared with baseline in skin dryness (change from baseline = -0.73), rash (-0.56), itch (-0.927), tightness (-0.585), and all eczema (-0.756). The glycinate-based body wash removed 56 percent of a long-lasting cosmetic foundation from skin compared with less than 30 percent removed by two competitive products tested. The glycinate-based body wash was preferred over a competitive mild cleansing product overall. The patented glycinate-containing body wash demonstrated better product mildness and patient-preferred attributes and clinical benefits.

  18. Clinical conditions of long-term cure in childhood-onset epilepsy: a 45-year follow-up study.

    Science.gov (United States)

    Sillanpää, Matti; Saarinen, Maiju; Schmidt, Dieter

    2014-08-01

    Clinical conditions of long-term cure in childhood-onset epilepsy, defined as sustained remission off antiepileptic drug (AED) treatment, are not well known. To address that clinically important question, we determined clinical factors predictive of long-term seizure cure in a population-based cohort of 133 patients followed up since their first seizure before the age of 16 years. At the end of the 45-year follow-up (mean=39.8, median=44, range=11-47), 81 (61%) of the 133 patients had entered at least 5-year remission off AEDs, meeting our definition of cure. The 81 patients were seizure-free off AEDs for a mean of 34.4 (median=38, range=6-46) years and 59 (73%) of the 81 patients following the first standard medication until the end of follow-up (mean=36.5, median=39, range=14-46 years). Four independent factors were found to be associated with cure compared with having seizures while on AEDs: seizure frequency less than weekly during the first 12 months of AED treatment (p=0.002), pretreatment seizure frequency less than weekly (p=0.002), higher IQ (>70; p=0.021), and idiopathic or cryptogenic vs. symptomatic etiology (p=0.042). Patients with seizure frequency of less than once a week during early treatment and idiopathic etiology had a ninefold chance to of being cured since the onset of the first adequate antiepileptic therapy until the end of follow-up compared with patients who a symptomatic etiology had at least weekly seizures while on AEDs (RR=8.7, 95% CI=2.0-37.0; pepilepsy.

  19. Associations among body condition score, body weight, somatic cell count, and clinical mastitis in seasonally calving dairy cattle.

    Science.gov (United States)

    Berry, D P; Lee, J M; Macdonald, K A; Stafford, K; Matthews, L; Roche, J R

    2007-02-01

    The objective of this study was to determine if an association existed among body condition score (BCS), body weight (BW), and udder health, as indicated by somatic cell score (SCS) and cases of clinical mastitis (CM). The data consisted of 2,635 lactations from Holstein-Friesian (n = 523) and Jersey (n = 374) cows in a seasonal calving pasture-based research herd between the years 1986 and 2000, inclusive. Increased BCS at calving was associated with reduced SCS in first- and second-parity cows, and greater SCS in cows of third parity or greater. This relationship persisted for most BCS traits throughout lactation. Body weight was positively associated with SCS, although the effect was greater in Jersey cows than in Holstein-Friesians. Increased BCS and BW loss in early lactation were associated with lower SCS and a reduced probability of a high test-day SCC. Body condition score was not significantly related to CM with the exception of a curvilinear relationship between the daily rate of BCS change to nadir and CM in early lactation. Several BW variables were positively associated with a greater likelihood of CM. Nevertheless, most associations with udder health lacked biological significance within the ranges of BCS and BW generally observed on-farm. Results are important in assuring the public that modern dairy systems, where cows are subjected to substantial amounts of BCS mobilization in early lactation, do not unduly compromise cow udder health.

  20. Impact of four training conditions on physician use of a web-based clinical decision support system.

    Science.gov (United States)

    Kealey, Edith; Leckman-Westin, Emily; Finnerty, Molly T

    2013-09-01

    Training has been identified as an important barrier to implementation of clinical decision support systems (CDSSs), but little is known about the effectiveness of different training approaches. Using an observational retrospective cohort design, we examined the impact of four training conditions on physician use of a CDSS: (1) computer lab training with individualized follow-up (CL-FU) (n=40), (2) computer lab training without follow-up (CL) (n=177), (3) lecture demonstration (LD) (n=16), or (4) no training (NT) (n=134). Odds ratios of any use and ongoing use under training conditions were compared to no training over a 2-year follow-up period. CL-FU was associated with the highest percent of active users and odds for any use (90.0%, odds ratio (OR)=10.2, 95% confidence interval (CI): 3.2-32.9) and ongoing use (60.0%, OR=6.1 95% CI: 2.6-13.7), followed by CL (any use=81.4%, OR=5.3, CI: 2.9-9.6; ongoing use=28.8%, OR=1.7, 95% CI: 1.0-3.0). LD was not superior to no training (any use=47%, ongoing use=22.4%). Training format may have differential effects on initial and long-term follow-up of CDSSs use by physicians. Copyright © 2013 Elsevier B.V. All rights reserved.

  1. The effects of body weight, body condition score, sex, and age on serum fructosamine concentrations in clinically healthy cats.

    Science.gov (United States)

    Gilor, Chen; Graves, Thomas K; Lascelles, B Duncan X; Thomson, Andrea E; Simpson, Wendy; Halpern, David S

    2010-09-01

    Serum fructosamine (SF) concentrations depend on plasma glucose concentrations and are used to evaluate glycemic control in animals with diabetes mellitus (DM). Despite the strong association between obesity and DM, the effects of body weight (BW) and body condition on SF concentrations in clinically healthy cats have not been reported. The aim of the study was to evaluate the effects of BW, body condition score (BCS), sex, and age on SF concentrations in healthy cats. BW, BCS, and SF concentrations were determined in 84 clinically healthy client-owned cats (50 neutered males, 33 spayed females, and 1 intact female) of known age. The cats were enrolled prospectively in the study. Mean BW, median BCS, and mean SF concentrations for the 84 cats were 5.4 kg, 5/9, and 268.7 ± 45.5 μmol/L (range 197-399), respectively. BW was weakly but significantly correlated with SF (r=.26; P=.02), whereas BCS was not. Cats weighing >5.4 kg and cats with BCS>5/9 had higher mean SF concentrations compared with cats weighing <5.4 kg and cats with BCS <5/9, respectively. Cats categorized as normal weight to obese by BW (BW ≥ 4.0 kg) had higher mean SF concentrations compared with cats categorized as lean (BW< 4.0 kg). For domestic shorthair cats, the same was true for BCS: cats with BCS ≥ 4/9 had higher mean fructosamine concentrations than those with BCS<4/9. Male cats had significantly higher mean SF concentrations compared with female cats (285.1 ± 45.3 vs 244.5 ± 33.9 μmol/L, P<.001). Age did not affect mean SF concentrations. BW is positively correlated with SF concentration, and lean cats have lower SF concentrations than normal and obese cats. In contrast to previous reports, mean SF concentrations were higher in male cats than in female cats, even when males and females were matched based on BW, BCS, and age. ©2010 American Society for Veterinary Clinical Pathology.

  2. [Clinical trial of a topical preparation containing urea, sunflower oil, evening primrose oil, wheat germ oil and sodium pyruvate, in several hyperkeratotic skin conditions].

    Science.gov (United States)

    Ferrando, J

    1986-01-01

    A topical clinical trial with preparations containing urea and sodium pyruvate has been made. It was used for diverse hyperkeratotic skin conditions (psoriasis, xerosis, pityriasis rubra pilaris, stuccokeratosis, seborrheic dermatitis, stasis dermatitis, pityriasis lichenoides chronica). A month later a clinical improvement was evident in all cases except in pityriasis lichenoides.

  3. 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 highe

  4. Are Problems Prevalent and Stable in Non-Clinical Populations? Problems and Test-Retest Stability of a Patient-Generated Measure, PSYCHLOPS (Psychological Outcome Profiles), in a Non-Clinical Student Sample

    Science.gov (United States)

    Evans, Chris; Ashworth, Mark; Peters, Marilyn

    2010-01-01

    In straightened times counselling must evidence the changes it promotes on reputable measures. Patient-generated measures complement nomothetic measures and may be nearer the ethos of counselling in eliciting individuals' problems. Scores from such measures from non-clinical samples are rarely reported, making their test-retest stability…

  5. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Hack, N.; Tiling, R. [Klinikum Grosshadern (Germany). Dept. of Nuclear Medicine; Jakobs, T.; Nikolaou, K.; Becker, C. [Klinikum Grosshadern (Germany). Dept. of Clinical Radiology; Ziegler, F. von; Knez, A. [Klinikum Grosshadern (Germany). Dept. of Cardiology; Koenig, A.; Klauss, V. [Medizinische Poliklinik-Innenstadt, Univ. of Munich (Germany). Dept. of Cardiology

    2007-07-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting ''obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 {+-} 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  6. [THE CONDITION AND TENDENCIES OF DEVELOPMENT OF CLINICAL AND SANITARY MICROBIOLOGY IN THE RUSSIAN FEDERATION AND PROBLEM OF IMPORT SUBSTITUTION].

    Science.gov (United States)

    Dyatlov, I A; Mironov, A Yu; Shepelin, A P; Aleshkin, V A

    2015-08-01

    The import substitution becomes one of the strategic tasks of national economy as a result of prolongation of economic sanctions concerning the Russian Federation of part of the USA, EU countries, Japan and number of other countries. It is not proper to be limited in import substitution only by goods because in conditions ofsanctions when access toforeign technologies is complicated Russia is needed to substitute foreign technologies by national designs in faster manner One of directions of effective import substitution is localization of production of laboratory equipment and consumables for clinical and sanitary microbiology on the territory ofthe Russian Federation and countries of Customs union. In Russia, in the field ofdiagnostic of dangerous and socially significant infections, all components for import substitution to implement gene diagnostic, immune diagnostic. bio-sensory and biochip approaches, isolation and storage of live microbial cultures, implementation of high-tech methods of diagnostic are available. At the same time, national diagnostic instrument-making industry for microbiology is factually absent. The few devices of national production more than on 50% consist of import components. The microbiological laboratories are to be equipped only with import devices of open type for applying national components. The most perspective national designs to be implemented are multiplex polimerase chain reaction test-systems and biochips on the basis of national plotters and readers. The modern development of diagnostic equipment and diagnostic instruments requires supplement of national collections of bacterial and viral pathogens and working-through of organizational schemes of supplying collections with strains. The presented data concerning justification of nomenclature of laboratory equipment and consumables permits to satisfy in fill scope the needs of clinical and sanitary microbiology in devices, growth mediums, consumables of national production

  7. Engineering Stable Hollow Capsules

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ Scientists at the CAS Institute of Chemistry have been succeeded in fabricating stable hollow capsules by extending covalent layer-by-layer self-assembly(CSA)technique from 2-dimensional to 3-dimensional systems.

  8. Stable Recursive Subhomogeneous Algebras

    CERN Document Server

    Liang, Hutian

    2011-01-01

    In this paper, we introduce stable recursive subhomogeneous algebras (SRSHAs), which is analogous to recursive subhomogeneous algebras (RSHAs) introduced by N. C. Phillips in the studies of free minimal integer actions on compact metric spaces. The difference between the stable version and the none stable version is that the irreducible representations of SRSHAs are infinite dimensional, but the irreducible representations of the RSHAs are finite dimensional. While RSHAs play an important role in the study of free minimal integer actions on compact metric spaces, SRSHAs play an analogous role in the study of free minimal actions by the group of the real numbers on compact metric spaces. In this paper, we show that simple inductive limits of SRSHAs with no dimension growth in which the connecting maps are injective and non-vanishing have topological stable rank one.

  9. [Human papillomavirus infection and its correlates with clinically relevant gynecological and obstetric conditions: A cross-sectional study].

    Science.gov (United States)

    López-Hernández, Daniel; Beltrán-Lagunes, Luis; Brito-Aranda, Leticia; López-Hernández, Maria de la Luz

    2016-08-05

    To analyze the prevalence of human papillomavirus (HPV) infection and the possible epidemiological association with conditions of clinical relevance in women. A cross-sectional study from Mexico City was conducted from January 2012 to December 2014. HPV molecular detection was performed on cervical samples. Data were analyzed with appropriated statistic tests. A total of 1,604 females (median 47, interquartile range 38-54) were analyzed. Global prevalence of infection for any HPV is 9.91% (95% CI 8.6-11.3). An association between infection with 16-HPV and number of abortions (NA) (OR=1.427; 95% CI 1.091-1.866), by univariate regression model (UVRM) was estimated. Moreover, menarche (OR=1.566; 95% CI 1.079-2.272), NA (OR=1.570; 95% CI 1.106-2.227) and number of pregnancies (NP) (OR=0.461; 95% CI 0.260-0.818) have a direct and inverse association with infection by genotype 18 of HPV, respectively. Also, infection with HR-HPV genotypes has an inverse association with NP (OR=0.791; 95% CI 0.707-0.884) by normal labor (OR=0.867; 95% CI 0.767-0.979) and NA (OR=0.715; 95% CI 0.534-0.959) (UVRM), and a direct association with number of sexual partners (OR=1.082; 95% CI 1.015-1.154). Onset of sexual activity has an inverse association with infection by genotype 16- (UVRM: OR=0.814; 95% CI 0.715-0.926; multinomial regression model (MNRM): OR=0.803; 95% CI 0.702-0.918) and HR-HPV (UVRM: OR=0.933; 95% CI 0.889-0.980, and MNRM: OR=0.912; 95% CI 0.867-0.959), all P values were lower than .03. Prevalence of HPV cervical infection is different according to age and it is associated with several medical conditions of clinical relevance in women. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  10. Lower urinary tract symptoms associated with neurological conditions: Observations on a clinical sample of outpatients neurorehabilitation service

    Directory of Open Access Journals (Sweden)

    Fabrizio Torelli

    2015-07-01

    Full Text Available Objectives: The overall aims of this study were to investigate the lower urinary tract symptoms (LUTS associated with neurological conditions and their prevalence and impact on a clinical sample of outpatients of a neurorehabilitation service. Materials and methods: We reviewed the files of 132 patients treated in our neurorehabilitation service from December 2012 to December 2013. Patients were divided into several subgroups based on the neurological diagnosis: Multiple Sclerosis (MS, other demyelinating diseases, Peripheral Neuropathy, neurovascular disorders (ND, neoplastic disease, traumatic brain injury (TBI, Parkinson and Parkinsonism, spinal cord injuries (SCI. Urinary status was based on medical evaluations of history of LUTS, type, degree, onset and duration of symptoms. We tried to analyze prevalence, kind of disorder, timing of presentation (if before or after the neurological onset and eventual persistence of urological disorders (in the main group and in all subgroups. Results: At the time of admission to our rehabilitation service, LUTS were observed in 14 out of 132 cases (11%. A high proportion of these outpatients (64.2% presented bothersome urinary symptoms such as incontinence, frequency and urgency (storage LUTS. The most frequent symptom was urinary urge incontinence (42.8%. This symptom was found to be prevalent in the multiple sclerosis and neurovascular disorders. In 93% the urinary symptoms arose as a result of neurologic conditions and 78.5% did not present a complete recovery of urological symptoms in spite of improved selfreported functional activity limitations. None of these patients performed urological rehabilitation. Conclusions: Neurological disorders are a significant issue in rehabilitation services and it can lead to lower tract dysfunction, which causes LUTS. Storage symptoms are more common, especially urge incontinence. Current literature reports that a further optimization of the rehabilitation potential

  11. Limited Clinical Utility of Remote Ischemic Conditioning in Renal Transplantation: A Meta-Analysis of Randomized Controlled Trials

    Science.gov (United States)

    Wu, Ran; Xin, Hui; Lu, Tian-Ze; Li, Ming-Hao; Song, Kai-Wei; Wang, Min; Zhu, Yun-Peng; Zhu, Meng; Geng, Li-Guo; Gao, Xiao-Fei; Zhou, Liu-Hua; Zhang, Sheng-Li; Zhu, Jia-Geng; Jia, Rui-Peng

    2017-01-01

    Objective We conducted this meta-analysis of randomized controlled trials (RCTs) to investigate whether remote ischemic conditioning (RIC) could improve graft functions in kidney transplantation. Methods PubMed, Web of Science, and Cochrane Library were comprehensively searched to identify all eligible studies by October 5, 2016. The treatment effects were examined with risk ratio (RR) and weighted mean difference with the corresponding 95% confidence intervals (CI). The statistical significance and heterogeneity were assessed with both Z-test and Q-test. Results A total of six RCTs including 651 recipients, were eventually identified. Compared to the controls, RIC could reduce the incidence of delayed graft function (DGF) after kidney transplantation (random-effects model: RR = 0.89; fixed-effect model: RR = 0.84). However, the decrease did not reveal statistical significance. The subgroup analysis by RIC type demonstrated no significant difference among the three interventions in protecting renal allografts against DGF. Furthermore, no significant difference could be observed in the incidence of acute rejection, graft loss, 50% fall in serum creatinine, as well as the estimated glomerular filtration rate and hospital stay between the RIC and Control groups. Conclusions This meta-analysis suggested that RIC might exert renoprotective functions in human kidney transplantation, and further well-designed RCTs with large sample size are warranted to assess its clinical efficacy. PMID:28129389

  12. The clinical and economic potential of hyperbaric oxygen therapy in the treatment of diabetic ulceration and other conditions.

    Science.gov (United States)

    McMillan, Grant; Glover, Mark

    2007-09-01

    Selective use of systemic hyperbaric oxygen therapy (HBOT) is a treatment that deserves further study and analysis. The current situation in the United Kingdom (UK) is discussed in relation to available evidence and practices elsewhere. It would appear that there is increasing evidence that HBOT could benefit many patients and health care budgets through improved clinical efficacy and cost-efficiency in the treatment of specific conditions, notably nonhealing diabetic ulceration of the lower limbs. This is not only disabling, it may lead to amputation. It is also a financial burden to patients and health service providers. In the UK, it is estimated that chronic wound care costs more than pound1 billion a year, with diabetic ulceration accounting for a substantial part of that staggering sum. It has been said repeatedly, and quite correctly, that there is insufficient good-quality evidence upon which a properly informed decision may be made on the contribution HBOT might make to alleviate that situation. It is intriguing that no determined effort is apparent that would seek to settle the issue by encouraging and facilitating appropriately designed and conducted randomized controlled trials to assess the actual effects of this treatment. Indeed, a proposed government research initiative appears to have been cancelled. Is lack of research preventing provision of HBOT?

  13. A randomized, rater-blinded, crossover study comparing the clinical efficacy of Ritalin(®) LA (methylphenidate) treatment in children with attention-deficit hyperactivity disorder under different breakfast conditions over 2 weeks.

    Science.gov (United States)

    Schulz, Eberhard; Fleischhaker, Christian; Hennighausen, Klaus; Heiser, Philip; Haessler, Frank; Linder, Martin; Stollhoff, Kirsten; Warnke, Andreas; Baier, Monika; Klatt, Jan

    2010-11-01

    Several extended-release methylphenidate medications are available for treatment of children with ADHD. Pharmacokinetic investigations suggest that the serum levels of methylphenidate are partially altered when the medication is taken without breakfast. Clinical data comparing different breakfast situations are missing. In this study, different breakfast compositions and their influence on treatment with Ritalin LA are investigated. A total of 150 patients were enrolled in a rater-blinded, randomized crossover trial that compared a minimal breakfast with a standard breakfast in patients under stable treatment with Ritalin LA. Ratings for clinical efficacy were carried out after 1 week by teachers and parents (FBB-ADHS), as well as physicians (CGI). Additionally, a math test was administered to the patients. Of the total patients, 144 finished the trial with a breakfast compliance of 93%. All of the clinical rating scales showed consistently no difference between the two breakfast conditions. Non-inferiority of minimal breakfast versus standard breakfast was shown to be statistically significant (FBB-AHDS(Teacher): 0.97 with minimal breakfast, 1.01 with standard breakfast, P Ritalin LA is not influenced by breakfast and works independently of food intake.

  14. Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine.

    Science.gov (United States)

    Rosano, Giuseppe M C; Vitale, Cristiana; Volterrani, Maurizio

    2016-08-01

    Percutaneous coronary intervention and anti-anginal medications have similar prognostic effectiveness in patients with chronic stable angina. The choice of optimal medical therapy for the management of chronic angina is of pivotal importance in patients with stable ischemic heart disease. The most commonly used anti-anginal agents have demonstrated equivalent efficacy in improving patient reported ischemic symptoms and quantitative exercise parameters. With regards to mortality, beta-blockers are beneficial only in the setting of depressed left ventricular systolic function after a recent myocardial infarction. Recent evidence suggests the lack of any benefit of beta-blockers in patients with preserved systolic function, even in the setting of prior myocardial infarction.Ranolazine is a non-haemodynamic anti-anginal agent. It is effective as adjunctive therapy in patients with chronic stable angina whose symptoms are un-adequately controlled by conventional treatment. The clinical development program of ranolazine has shown that the drug improves exercise performance, decreases angina and use of sublingual nitrates, compared to placebo. Ranolazine is well tolerated with neutral effect on haemodynamics. Besides its role in chronic stable angina, ranolazine has the potential for development in a number of other cardiovascular and non-cardiovascular conditions in the future.

  15. Implementation of NICE Clinical Guideline 95 for assessment of stable chest pain in a rapid access chest pain clinic reduces the mean number of investigations and cost per patient

    Science.gov (United States)

    Lee, Alvin J X; Michail, Michael; Quaderi, Shumonta A; Richardson, James A; Aggarwal, Suneil K; Speechly-Dick, M Elsya

    2015-01-01

    Objective In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using ‘CADScore’ to guide appropriate cardiac investigations for chest pain of recent onset. Implementation of the guideline in the University College London Hospitals NHS Foundation Trust was evaluated to see if it led to a reduction in the average cost of the diagnostic journey per patient and fewer investigations per patient in order to confirm a diagnosis. Methods This was a single centre study at a Tertiary Centre in Central London. The investigative journey for each patient presenting to the Rapid Access Chest Pain Clinic (RACPC) at University College London Hospitals NHS Foundation Trust was recorded. Retrospective analysis on this data was performed. Results Data for 4968 patients presenting to the RACPC from 2004 to 2012 was analysed and a size-matched cohort of 1503 patients preimplementation and postimplementation of the guidelines was compared. The mean cost of investigations postimplementation was £291.83 as compared to £319.54 preimplementation of the guidelines despite higher costs associated with some of the recommended initial investigations. The mean number of tests per patient postguidelines was 0.78 compared to 0.97 for preguidelines. An approximate twofold increase in patients not requiring tests was seen post-CG95 implementation (245 pre-CG95 vs 476 post-CG95). Conclusions The implementation of the NICE guidelines in our trust has reduced the average cost of the investigative journey and the number of investigations required per patient. PMID:25722859

  16. Efficient Methods for Stable Distributions

    Science.gov (United States)

    2007-11-02

    are used, corresponding to the common values used in digital signal processing. Five new functions for discrete/quantized stable distributions were...written. • sgendiscrete generates discrete stable random variates. It works by generating continuous stable random variables using the Chambers- Mallows ...with stable distributions. It allows engineers and scientists to analyze data and work with stable distributions within the common matlab environment

  17. Stable generalized complex structures

    CERN Document Server

    Cavalcanti, Gil R

    2015-01-01

    A stable generalized complex structure is one that is generically symplectic but degenerates along a real codimension two submanifold, where it defines a generalized Calabi-Yau structure. We introduce a Lie algebroid which allows us to view such structures as symplectic forms. This allows us to construct new examples of stable structures, and also to define period maps for their deformations in which the background three-form flux is either fixed or not, proving the unobstructedness of both deformation problems. We then use the same tools to establish local normal forms for the degeneracy locus and for Lagrangian branes. Applying our normal forms to the four-dimensional case, we prove that any compact stable generalized complex 4-manifold has a symplectic completion, in the sense that it can be modified near its degeneracy locus to produce a compact symplectic 4-manifold.

  18. 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.

  19. 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.

  20. Stable Flows over Time

    Directory of Open Access Journals (Sweden)

    Jannik Matuschke

    2013-08-01

    Full Text Available In this paper, the notion of stability is extended to network flows over time. As a useful device in our proofs, we present an elegant preflow-push variant of the Gale-Shapley algorithm that operates directly on the given network and computes stable flows in pseudo-polynomial time, both in the static flow and the flow over time case. We show periodical properties of stable flows over time on networks with an infinite time horizon. Finally, we discuss the influence of storage at vertices, with different results depending on the priority of the corresponding holdover edges.

  1. Clinically significant changes in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation

    DEFF Research Database (Denmark)

    Norup, Anne; Kristensen, Karin Spangsberg; Poulsen, Ingrid;

    2013-01-01

    Objective: To investigate clinically significant change in the emotional condition of relatives of patients with severe traumatic brain injury during sub-acute rehabilitation. Methods: Participants were 62 pairs of relatives and patients. Relatives completed the anxiety and depression scales from...... the Symptom Checklist-90-R (SCL-90-R) when the patients were admitted to sub-acute rehabilitation and at discharge. Improvement in emotional condition was investigated using the following criteria: (i) statistically reliable improvement; and (ii) clinically significant change (CSC). Results: At admission, 53...

  2. 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...

  3. The stable subgroup graph

    Directory of Open Access Journals (Sweden)

    Behnaz Tolue

    2018-07-01

    Full Text Available In this paper we introduce stable subgroup graph associated to the group $G$. It is a graph with vertex set all subgroups of $G$ and two distinct subgroups $H_1$ and $H_2$ are adjacent if $St_{G}(H_1\\cap H_2\

  4. Stable isotope studies

    Energy Technology Data Exchange (ETDEWEB)

    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.

  5. Stable Unhappy Marriages.

    Science.gov (United States)

    Heaton, Tim B.; Albrecht, Stan L.

    1991-01-01

    Examined prevalence and determinants of stable unhappy marriage using data from national survey. Results indicated age, lack of prior marital experience, commitment to marriage as an institution, low social activity, lack of control over one's life, and belief that divorce would detract from happiness were all predictive of stability in unhappy…

  6. 2005 Economy: Stable Development

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ 2005 is the fifth year of China's Tenth Five-Year Plan, it is an important year to implement commitment for entering into WTO as well as a key year for deepening macro-control. With further deepening of macro control and development of regional economy, Chinese economy will operate in a more healthy and stable way.

  7. 2005 Economy: Stable Development

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

      2005 is the fifth year of China's Tenth Five-Year Plan, it is an important year to implement commitment for entering into WTO as well as a key year for deepening macro-control. With further deepening of macro control and development of regional economy, Chinese economy will operate in a more healthy and stable way.……

  8. The Stable Concordance Genus

    OpenAIRE

    Kearney, M. Kate

    2013-01-01

    The concordance genus of a knot is the least genus of any knot in its concordance class. Although difficult to compute, it is a useful invariant that highlights the distinction between the three-genus and four-genus. In this paper we define and discuss the stable concordance genus of a knot, which describes the behavior of the concordance genus under connected sum.

  9. Farsightedly stable networks

    NARCIS (Netherlands)

    Herings, P.J.J.; Mauleon, A.; Vannetelbosch, V.; Carraro, C.

    2015-01-01

    A set of networks G is pairwise farsightedly stable (i) if all possible farsighted pairwise deviations from any network g  G to a network outside G are deterred by the threat of ending worse off or equally well off, (ii) if there exists a farsighted improving path from any network outside the set l

  10. 穴位按压联合艾灸治疗稳定型心绞痛33例临床观察%Clinical observation of stable angina pectoris treated by combination of acupressure and moxibustion

    Institute of Scientific and Technical Information of China (English)

    王秋云; 王玉梅; 郭雅丽

    2012-01-01

    Objective To investigate clinical effect of stable angina pectoris treated by combination of acupressure and moxibustion. Methods 66 cases of stable angina patients were randomly divided into 2 groups. 33 cases in control group received the conventional Western treatment for five weeks; 33 cases in treatment group received combination of acupressure and moxibustion on the basis of the control group 6 times a week for 5 consecutive weeks. The effect of angina, electrocardiogram and traditional Chinese medicine syndrome (chest pain, chest tightness, heart palpitations and shortness of breath) were recorded. Results The total efficiency of angina pectoris, chest pain, chest tightness, heart palpitations and shortness of breath in treatment group were 96. 97% , 96. 97% , 100% , 96.97%, 96.97%. Those of control group were 72.72% , 75.76%, 81.82%, 75.76%, 75.76%. Markedly effective rate of ECG in treatment group (63.63%) was superior to that in control group (39.39%, P<0.05). Conclusion Acupressure combined moxibustion was safe, convenient and effective on treatment of stable angina pectoris.%目的 观察定位按压联合艾灸治疗稳定型心绞痛的临床疗效.方法 将66例稳定型心绞痛患者随机分为2组,对照组33例予西医常规治疗,连续5周;治疗组33例在对照组治疗基础上加穴位按压联合艾灸,每周6次,连续5周.统计2组心绞痛、心电图及中医证候(胸痛、胸闷、心悸及气短)疗效.结果 治疗组心绞痛、胸痛、胸闷、心悸及气短总有效率分别为96.97%、96.97%、100%、96.97%、96.97%,对照组分别为72.72%、75.76%、81.82%、75.76%、75.76%,治疗组均优于对照组(P<0.05).治疗组心电图显效率63.63%,对照组显效率39.39%,2组显效率比较差异有统计学意义(P<0.05),治疗组优于对照组.结论 穴位按压联合艾灸治疗稳定型心绞痛安全方便,疗效确切.

  11. Relationship between the lnspiratory Capacity and Clinical Characters of Stable Chronic Obstructive Pulmonary Disease%慢性阻塞性肺疾病稳定期患者深吸气量临床特征性研究

    Institute of Scientific and Technical Information of China (English)

    刘波; 汪俊; 李可可; 刘晓

    2011-01-01

    目的 探讨深吸气量( inspiratory capacity,IC)与慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者临床特征的相关性.方法 2009年12月- 2010年6月纳入84例稳定期COPD患者,测定6分钟步行试验(6-minute walk test,6MWT)、圣乔治生活问卷评分(St George's respiratory questionnaire,SGRQ)及肺功能检查:第1秒用力呼气容积(forced expirotovy volume in one second,FEV1)、IC、IC与肺总量(total lung capacity,TLC)比值(IC/TLC)等相关指标,并进行相关性分析.结果 6MWT值与FEV1无明显直线相关(r=0.14,P>0.1);6MWT值与FEV1≥60%无明显直线相关(r=0.16,P>0.1);6MWT值与IC值呈正的直线相关(r=0.317,P<0.01);6MWT值与IC/TLC值呈正的直线相关(r=0.274,P<0.01);SGRQ值与FEV1呈负的直线相关(r=-0.307,P<0.01);SGRQ值与IC值无直线相关(r=-0.001,P>0.25);SGRQ值与IC/TLC值无直线相关(r=-0.003,P>0.25).结论 对COPD患者,IC比FEV1更准确地反映患者的运动耐量的程度,FEV1比IC更准确地反映患者呼吸困难的严重程度.%Objective To explore the relationship between the inspiratory capacity (IC) and clinical characters of stable chronic obstructive pulmonary disease (COPD). Methods Between December 2009 and June 2010, 84 patients with stable COPD were enrolled. Lung function (FEV1, IC, IC/TLC) ,6 minute walk-test (6MWT) and St George's respiratory questionnaire (SGRQ) were examined. The relationship among FEV1, IC, IC/TLC, and the results of 6MWT and SGRQ by Pearson correlation analysis. Results There was no linear correlation between 6MWT and FEV1 (r=0. 14,P>0. 1), and 6MWT and FEVl>60% (r=0. 16,P>0. 1). There was positive correlation between 6MWT and IC (r=0. 317,P0. 25), and SGRQ and IC/TLC (r= -0. 003,P>0. 25). Conclusion In stable COPD patients, IC may be more accurate than FEV1 in refection of exercise tolerance while FEV1 may be more sensitive than IC in evaluation of dyspnea.

  12. Stable Imaging for Astronomy (SIA)

    Science.gov (United States)

    Beaulieu, Mathilde; Ottogalli, Sebastien; Preis, Olivier; Bresson, Yves; Rivet, Jean-Pierre; Abe, Lyu; Vakili, Farrokh

    2014-07-01

    One of the most challenging fields of astronomical instrumentation is probably high-contrast imaging since it ultimately combines ultra-high sensitivity at low flux and the ability to cope with photon flux contrasts of several hundreds of millions or even more. These two aspects implicitly require that high-contrast instruments should be highly stable in the sense of the reproducibility of their measurements at different times, but also, continuously stable over time. In most high contrast instruments or experiments, their sensitivity is broken after at most tens of minutes of operation due to uncontrolled and unknown behaviour of the whole experiment regarding the environmental conditions. In this paper, we introduce a general approach of an exhaustive stability study for high-contrast imaging that has been initiated at Lagrange Laboratory, Observatoire de la Côte d'Azur (OCA). On a practical ground, one of the fundamental issues of this study is the metrology, which is the basis of all reproducible measurements. We describe a small experiment designed to understand the behaviour of one of our ultra-precise metrology tools (a commercial sub-nanometric 3-way interferometer) and derive the conditions under which its operation delivers reliable results. The approach will apply to the high-contrast imaging test-bench SPEED, under development at OCA.

  13. Treatment of Dupuytren’s contracture with collagenase clostridium histolyticum under clinical practice conditions: ReDUCTo study

    Directory of Open Access Journals (Sweden)

    Haerle, Max

    2015-08-01

    Full Text Available Background: To date, real-life data on non-surgical correction of Dupuytren’s contracture with collagenase clostridium histolyticum injection (CCH, Xiapex are limited. Methods and results: In an open-label non-interventional study in in Germany (mean age 65.1±9.8 years, 79.3% males, patients were followed up until 1 year after injection. 63 (73.3% received the injection at the MCP joint, and 23 (26.7% at the PIP. The mean grade of contracture in the presently treated finger at baseline was for the MCP joint 32.4°±25.1, for the PIP° 29.2±31.5, and for the DIP° 0.5±2.0. At days 30/360 compared to baseline, the degree of contracture of the MCP joint was reduced by 28.2°±24.6/30.8°±25.0, of the PIP by 20.0°±24.7/8.5°±29.6, and of the DIP by 0.01°±1.9/0.7±2.3. Improvement of hand function at day 30/360 was rated by physicians as very good in 69.5/60.9%, as good in 23.2/28.3%, and as poor in 7.3/8.7%, and none in 0.0/2.2%. No serious adverse drug reactions (SADR occurred. Adverse drug reactions (ADR were noted within injection in 64 patients (74.4%, mostly contusion/swelling, pain, blood blister or other bleeding at the injection site, or ecchymosis. In an overall assessment, at day 30/360, 73.5%/95.7% of the physicians rated tolerability of CCH in their patients as very good, 22.9%/2.2% as good, and 3.6%/2.2% as moderate. On the EQ-5D Visual Analog Scale the mean score improved from 79.5±17.9 to 83.8±15.8 at day 30, and to 85.4±14.1 at day 360. On the Michigan Hand Questionnaire, the total score was 67.5 points at baseline, at day 30 and 75.2 points at day 360.Conclusions: Overall, treatment with CCH under clinical practice conditions was effective and well tolerated. Quality of life and hand function improved substantially. No unknown safety issues were identified during the study.

  14. Qualidade de sono e função pulmonar em adolescentes portadores de anemia falciforme clinicamente estáveis Quality of sleep and pulmonary function in clinically stable adolescents with sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Lisliê Capoulade Nogueira Arrais de Souza

    2007-06-01

    Full Text Available OBJETIVO: Avaliar a qualidade de sono e função pulmonar em adolescentes portadores de anemia falciforme (AF, clinicamente estáveis. MÉTODOS: Estudo trasversal descritivo de 50 pacientes portadores de AF submetidos a polissonografia noturna e espirometria no Hospital Universitário de Brasília. Analisamos dados antropométricos, polissonográficos e de função pulmonar. Dividimos os pacientes em dois grupos segundo a saturação periférica de oxigênio (SpO2 em sono com movimentos oculares rápidos (MOR: SpO2 93%. Realizamos estatística descritiva, teste t de Student, qui-quadrado e correlação de Pearson. RESULTADOS: A média de idade foi de 13,9 ± 2,5 anos. O tempo total de sono e percentagem do sono em MOR estavam diminuídos; dois pacientes (4% não apresentaram sono MOR. Latência de sono MOR, número de despertares, movimentação em sono, mudança de estágio, índice de distúrbios respiratórios e índice de apnéia obstrutiva estavam aumentados. Entre os dois grupos, houve diferenças estatisticamente significativas na maioria das variáveis polissonográficas. A SpO2 em sono MOR correlacionou-se de forma forte e positiva com a SpO2 em vigília, bem como com a SpO2 em sono não-MOR; e correlacionou-se de forma forte e negativa com a percentagem do tempo total de sono em que a SPO2 foi OBJECTIVE: To evaluate quality of sleep and pulmonary function in clinically stable adolescents with sickle cell anemia (SCA. METHODS: A cross-sectional descriptive study involving 50 patients with SCA submitted to nocturnal polysomnography and spirometry at the Brasília University Hospital. Anthropometric, polysomnographic and pulmonary function data were analyzed. Patients were divided into two groups according to oxygen saturation by pulse oximetry (SpO2 during rapid eye movement (REM sleep: SpO2 93%. Descriptive statistics, Student's t-test, chi-square test and Pearson's correlation coefficient were used. RESULTS: Mean age was 13.9 ± 2

  15. Clinical effect of community based exercise therapy on patients with stable COPD%基于社区的运动疗法对COPD稳定期患者的临床效果研究

    Institute of Scientific and Technical Information of China (English)

    来春艳

    2015-01-01

    Objective To study the clinical effect of community based exercise therapy on patients with stable COPD.Methods 60 patients with COPD were enrolled and randomly divided into observation group and control group with 30 cases in each group.According to the personal information,the baseline data of pulmonary function,exercise ability,dyspnea score and anxiety depression score were recorded.The observation group was given community nursing,and the patients were followed up by telephone or on site every 15 days.The control group was not intervened.After 6 months,data of two groups was compared.Results There were no significant differences in baseline values between the two groups (P>0.05).After 6 months,in the observation group,the value of FEV1 was higher than that in control group (P0.05),随访6个月后,观察组FEV1(%)值高于对照组(P<0.01),FEV1/FVC(%)值也高于对照组(P<0.05).观察组6MWD值明显优于对照组(P<0.01),观察组Borg评分低于对照组(P<0.05),观察组焦虑、抑郁评分低于对照组(P<0.05).结论 基于社区的运动疗法有助于提高COPD稳定期患者的肺功能和活动耐力,减轻呼吸困难症状,改善患者心理健康,值得推广.

  16. FUNCTIONAL STATE OF ORGANISM OF INTERN DOCTORS WITH DIFFERENT SUCCESS LEVEL ACTIVITY IN EXTREME CONDITIONS IN THE COURSE OF DAILY DUTY IN CLINIC

    Directory of Open Access Journals (Sweden)

    L.K. Madzigon

    2008-09-01

    Full Text Available In the course of daily duty in clinic, the indeces of functional status, functional reserve of organism and mnestic (operator’s performance ability of intern doctors with different success level activity in extreme conditions were determined twice (in the beginning and at the end of the duty. It is shown that the higher success level activity in extreme conditions of interns, the more tolerance and strength of their body functional system formed in work process and it means the higher professional activity performance. Intern graduates activity preparation in extreme conditions is one of activities of Medical Institutions of Higher Education quality improvement

  17. 26 CFR 1.28-0 - Credit for clinical testing expenses for certain drugs for rare diseases or conditions; table of...

    Science.gov (United States)

    2010-04-01

    ... drugs for rare diseases or conditions; table of contents. 1.28-0 Section 1.28-0 Internal Revenue... Taxable Year § 1.28-0 Credit for clinical testing expenses for certain drugs for rare diseases or... 505(i). (d) Definition and special rules. (1) Definition of “rare disease or condition”. (i)...

  18. Stable local oscillator module.

    Energy Technology Data Exchange (ETDEWEB)

    Brocato, Robert Wesley

    2007-11-01

    This report gives a description of the development of a Stable Local Oscillator (StaLO) multi-chip module (MCM). It is a follow-on report to SAND2006-6414, Stable Local Oscillator Microcircuit. The StaLO accepts a 100MHz input signal and produces output signals at 1.2, 3.3, and 3.6 GHz. The circuit is built as a multi-chip module (MCM), since it makes use of integrated circuit technologies in silicon and lithium niobate as well as discrete passive components. This report describes the development of an MCM-based version of the complete StaLO, fabricated on an alumina thick film hybrid substrate.

  19. Stable charged cosmic strings.

    Science.gov (United States)

    Weigel, H; Quandt, M; Graham, N

    2011-03-11

    We study the quantum stabilization of a cosmic string by a heavy fermion doublet in a reduced version of the standard model. We show that charged strings, obtained by populating fermionic bound state levels, become stable if the electroweak bosons are coupled to a fermion that is less than twice as heavy as the top quark. This result suggests that extraordinarily large fermion masses or unrealistic couplings are not required to bind a cosmic string in the standard model. Numerically we find the most favorable string profile to be a simple trough in the Higgs vacuum expectation value of radius ≈10(-18)  m. The vacuum remains stable in our model, because neutral strings are not energetically favored.

  20. Decomposability for stable processes

    CERN Document Server

    Wang, Yizao; Roy, Parthanil

    2011-01-01

    We characterize all possible independent symmetric $\\alpha$-stable (S$\\alpha$S) components of a non--Gaussian S$\\alpha$S process, $0<\\alpha<2$. In particular, we characterize the independent stationary S$\\alpha$S components of a stationary S$\\alpha$S process. One simple consequence of our characterization is that all stationary components of the S$\\alpha$S moving average processes are trivial. As a main application, we show that the standard Brown--Resnick process has a moving average representation. This complements a result of Kabluchko et al. (2009), who obtained mixed moving average representations for these processes. We also develop a parallel characterization theory for max-stable processes.

  1. 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) 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.

  2. Stable Spirocyclic Meisenheimer Complexes

    Directory of Open Access Journals (Sweden)

    Gonzalo Guirado

    2008-06-01

    Full Text Available Meisenheimer complexes are important intermediates in Nucleophilic Aromatic Substitution Reactions (SNAr. They are formed by the addition of electron rich species to polynitro aromatic compounds or aromatic compounds with strong electron withdrawing groups. It is possible to distinguish two types of Meisenheimer or σ-complexes, the σHcomplex or σX-complex (also named ipso, depending on the aromatic ring position attacked by the nucleophile (a non-substituted or substituted one, respectively. Special examples of σX- or ipso-complexes are formed through intermediate spiro adducts, via intramolecular SNAr. Some of these spirocyclic Meisenheimer complexes, a type of σXcomplex, are exceptionally stable in solution and/or as solids. They can be isolated and characterized using X-ray, and various spectroscopic techniques such as NMR, UV-Vis, IR, and fluorescence. A few of these stable spirocyclic Meisenheimer complexes are zwitterionic and exhibit interesting photophysical and redox properties. We will review recent advances, synthesis and potential applications of these stable spirocyclic Meisenheimer complexes.

  3. Kinetic Stable Delaunay Graphs

    CERN Document Server

    Agarwal, Pankaj K; Guibas, Leonidas J; Kaplan, Haim; Koltun, Vladlen; Rubin, Natan; Sharir, Micha

    2011-01-01

    We consider the problem of maintaining the Euclidean Delaunay triangulation $\\DT$ of a set $P$ of $n$ moving points in the plane, along algebraic trajectories of constant description complexity. Since the best known upper bound on the number of topological changes in the full $\\DT$ is nearly cubic, we seek to maintain a suitable portion of it that is less volatile yet retains many useful properties. We introduce the notion of a stable Delaunay graph, which is a dynamic subgraph of the Delaunay triangulation. The stable Delaunay graph (a) is easy to define, (b) experiences only a nearly quadratic number of discrete changes, (c) is robust under small changes of the norm, and (d) possesses certain useful properties. The stable Delaunay graph ($\\SDG$ in short) is defined in terms of a parameter $\\alpha>0$, and consists of Delaunay edges $pq$ for which the angles at which $p$ and $q$ see their Voronoi edge $e_{pq}$ are at least $\\alpha$. We show that (i) $\\SDG$ always contains at least roughly one third of the Del...

  4. 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.

  5. 42 CFR 482.82 - Condition of participation: Data submission, clinical experience, and outcome requirements for re...

    Science.gov (United States)

    2010-10-01

    ... performed at the center. (3) A pancreas transplant center is not required to comply with the clinical... section for pancreas transplants performed at the center. (4) A center that is approved to...

  6. A Novel Glycinate-based Body Wash: Clinical Investigation Into Ultra-mildness, Effective Conditioning, and Improved Consumer Benefits

    OpenAIRE

    Regan, Jamie; Mollica, Leonel-Maximo; Ananthapadmanabhan, K. P.

    2013-01-01

    Objective: To assess the properties of a novel body wash containing the mild surfactant glycinate. Design: Biochemical and clinical assays. Setting: Research laboratories and clinical sites in the United States and Canada. Participants: Women 18 to 65 years of age (cleansing efficacy); male and female subjects 26 to 63 years of age with mild or moderate dryness and erythema (leg-controlled application test); subjects 5 to 65 years of age with mild-to-moderate eczema (eczema compatibility); an...

  7. A Novel Glycinate-based Body Wash: Clinical Investigation Into Ultra-mildness, Effective Conditioning, and Improved Consumer Benefits

    OpenAIRE

    Regan, Jamie; Mollica, Leonel-Maximo; Ananthapadmanabhan, K. P.

    2013-01-01

    Objective: To assess the properties of a novel body wash containing the mild surfactant glycinate. Design: Biochemical and clinical assays. Setting: Research laboratories and clinical sites in the United States and Canada. Participants: Women 18 to 65 years of age (cleansing efficacy); male and female subjects 26 to 63 years of age with mild or moderate dryness and erythema (leg-controlled application test); subjects 5 to 65 years of age with mild-to-moderate eczema (eczema compatibility); an...

  8. Millon Clinical Multiaxial Inventory (MCMI-III): the inability of the validity conditions to detect random responders.

    Science.gov (United States)

    Charter, Richard A; Lopez, Michael N

    2002-12-01

    The effectiveness of the MCMI-III Validity scale, Scale X, and the Clinical Personality Pattern scales to detect random responding is put to the test. The binomial expansion and Monte Carlo techniques were used. If the examiner is willing to interpret tests of questionable validity, then 50% of the random responders will not be detected. Scale X and the Clinical Personality Pattern scales were useless in detecting random responders.

  9. Influence of body condition on plasma prednisolone and prednisone concentrations in clinically healthy cats after single oral dose administration.

    Science.gov (United States)

    Center, Sharon A; Randolph, John F; Warner, Karen L; Simpson, Kenneth W; Rishniw, Mark

    2013-08-01

    Influence of body condition (over-conditioned vs. normal-conditioned) on plasma glucocorticoid concentrations after single dose oral prednisolone or prednisone in 11 cats (5 normal-conditioned and 6-over-conditioned) was investigated using a two-drug crossover trial (3-week washout interval). Body condition was determined using criterion-referenced bioelectrical impedance together with plasma drug concentrations (prednisolone [active drug] and prednisone [pro-drug]) measured by HPLC. Although interconversion of each drug to the other was confirmed, a single 2mg/kg body weight oral dose of prednisolone produced significantly higher plasma prednisolone concentration (∼4-fold higher AUC) compared to prednisone. Significantly higher plasma drug concentrations in over-conditioned cats (∼2-fold) compared to normal-conditioned cats might explain their perceived increased risk for glucocorticoid associated side effects (hepatic lipidosis, diabetes mellitus). Findings suggest low comparative bioavailability of oral prednisone compared to prednisolone in cats and consideration of lean body mass or ideal body weight for dosing practices.

  10. Practice Patterns for Outpatients With Stable Coronary Artery Disease: A Case Vignette-based Survey Among French Cardiologists

    Directory of Open Access Journals (Sweden)

    Christophe Bauters

    2015-11-01

    Interpretation: When not guided by high-level recommendations, practice patterns for routine clinical situations in stable CAD vary considerably. Future clinical trials should address these clinical interrogations.

  11. Comparison of Clinical Success of Applying a Kind of Fissure Sealant on the Lower Permanent Molar Teeth in Dry and Wet Conditions

    Directory of Open Access Journals (Sweden)

    Tahereh Eskandarian

    2015-09-01

    Full Text Available Statement of the Problem: Fissure sealant therapy is among the most effective methods of preventing dental caries. However, it is lengthy and isolation of the teeth is difficult in this procedure especially in young children. Using new hydrophilic fissure sealant may reduce such problems. Purpose: This study aimed to evaluate the clinical success of a hydrophilic fissure sealant on the lower permanent mo-lar teeth in dry and wet conditions. Materials and Method: This clinical trial assessed 31 patients (mean age 8.13±1.77 years who needed fissure sealant therapy on their first or second mandibular permanent molar. Having performed dental prophylaxis, the teeth were etched and rinsed. Then one of the two was randomly selected and sealed with smartseal & loc in isolated and dry con-ditions; while, the other was wetted on the etched enamel by using a saliva-contaminated micro brush, and was then sealed with the same fissure as the first tooth. Six and 12 months later, two independent observers examined the clinical success of sealant through checking the marginal integrity, marginal discoloration, and anatomical form. Data were analyzed by using SPSS software, version 16. The bivariate Chi-square and Exact Fisher tests were used to compare the clinical success of the two treatment methods. Results: There was a high interpersonal reliability between the two examiners (K= 0.713. After 12 months, 90.3% clinical success was observed in dry conditions and 83.9% in wet conditions for smartseal & loc; however, the differ-ence was not statistically significant (p= 0.0707. Conclusion: According to the results of this study, it seems that using new hydrophilic fissure sealant can reduce tech-nical sensitivities and consequently decreases the apprehensions on saliva contamination of etched enamel during treatment procedures.

  12. Clinical and Economic Burden of Mental Disorders Among Children With Chronic Physical Conditions, United States, 2008–2013

    OpenAIRE

    Suryavanshi, Manasi S.; Yang, Yi

    2016-01-01

    Introduction The prevalence of chronic physical and mental disorders is increasing among children and adolescents in the United States. In this study, we investigated the association between mental health disorders and chronic physical conditions among children, and we assessed whether having mental disorders is associated with increased health care costs for children with chronic physical conditions, using Medical Expenditure Panel Survey data from 2008 through 2013. Methods Children aged 5 ...

  13. Evaluating the Referring Physician's Clinical History and Indication as a Means for Communicating Chronic Conditions That Are Pertinent at the Point of Radiologic Interpretation.

    Science.gov (United States)

    Obara, Piotr; Sevenster, Merlijn; Travis, Adam; Qian, Yuechen; Westin, Charles; Chang, Paul J

    2015-06-01

    The clinical history and indication (CHI) provided with a radiological examination are critical components of a quality interpretation by the radiologist. A patient's chronic conditions offer the context in which acute symptoms and findings can be interpreted more accurately. Seven pertinent (potentially diagnosis altering) chronic conditions, which are fairly prevalent at our institution, were selected. We analyze if and how in 140 CHIs there was mention of a patient's previously reported chronic condition and if and how the condition was subsequently described in the radiology report using a four-item scheme (Mention/Specialization, Generalization, Common comorbidity, No mention). In 40.7% of CHIs, the condition was rated Mention/Specialization. Therefore, we reject our first hypothesis that the CHI is a reliable source for obtaining pertinent chronic conditions (≥ 90.0%). Non-oncological conditions were significantly more likely rated No mention in the CHI than oncological conditions (58.7 versus 8.3%, P radiology report (χ(2) test, P radiology department to the care chain.

  14. 国内专科护士研究现状%The research condition of clinical nurce specialist/internal

    Institute of Scientific and Technical Information of China (English)

    肖江琴; 冯蕾; 李萍

    2008-01-01

    For the past few years,clinical nurse specialist developed quickly in the internal.This article review that current clinical nurse specialist will revolve the question and expect its future from its origin,applied fielded in the nation and practice meaning.%近年来国内专科护士发展迅速,从专科护士的起源、国内的应用领域、实施的意义,综述了当前专科护士发展中待解决的问题及展望今后专科护士的发展.

  15. 23价肺炎球菌多糖疫苗接种对稳定期COPD患者的影响%Clinical observation of 23-valent pneumococcal vaccine in patients with stable chornic obstructive pulmonary disease.

    Institute of Scientific and Technical Information of China (English)

    唐勇; 贾树雅; 苏畅; 方洵; 杜玲

    2011-01-01

    Objective To estimate clinical significance in the application of 23--valent peneurnococcal polysaccharide vaccine in COPD patients. Methods 100 subjects were divided into experimental group and control group randomly. 23-valent pneumococcal vaccines were injected to experimental group. They were observed the side effects for 1 week after vaccination. During 2 years observation, exacerbation frequency, pulmonary infection frequency,hospitalization, mortality, side effect were compared between two group. Results Exacerbation frequency, pulmonary infection frequency, hospitalization and mortality in experimental group were obviously less than control group.Most of side effects of vaccine were local reactions in inject site. They were relieved by local stupe or rest in 1-3 days.Conclusion 23-valent pneumococcal vaccines injection can reduce exacerbation frequency, pulmonary infection frequency, hospitalization, and mortality in stable COPD patients.%目的 评价23价肺炎球菌多糖疫苗(PPSV-23)接种在稳定期慢性阻塞性肺病(COPD)的作用.方法 将100例稳定期COPD患者随机分成干预组和对照组,干预组患者于接种后随访1周观察不良反应.注射疫苗2年内观察病情急性发作、肺部感染、住院次数、死亡率和不良反应,并与对照组进行对比.结果 干预组急性发作次数、肺部感染、住院次数、病死率均低于对照组.接种后不良反应多为局部反应,经热敷或休息1~3d可缓解.结论 PPSV-23可以减少稳定期COPD患者急性发作率、肺部感染率、住院率、死亡率.

  16. Adherence to Treatment, Safety, Tolerance, and Effectiveness of Perindopril/Amlodipine Fixed-Dose Combination in Greek Patients with Hypertension and Stable Coronary Artery Disease: A Pan-Hellenic Prospective Observational Study of Daily Clinical Practice.

    Science.gov (United States)

    Liakos, Charalampos I; Papadopoulos, Dimitrios P; Kotsis, Vasilios T

    2017-05-02

    Initiation of antihypertensive therapy with a two-drug fixed-dose combination (FDC) in a single tablet may be recommended in patients at high risk of cardiovascular events to improve adherence and effectiveness. Preferred combinations include an angiotensin-converting enzyme inhibitor with a dihydropyridine calcium antagonist. This study assessed adherence to and the safety, tolerance, and effectiveness of the perindopril/amlodipine FDC in Greek patients with hypertension and stable coronary artery disease (CAD) over a 4-month period. A total of 1907 patients with hypertension and CAD (59.1% males) who had recently (≤2 weeks) commenced treatment with the perindopril/amlodipine FDC (5/5, 5/10, 10/5, or 10/10 mg) were studied at baseline and at 1 and 4 months. Adherence to treatment was assessed with the Morisky Medication-taking Adherence Scale (MMAS). Seven patients (0.4%) did not attend the scheduled visits. In total, 1607 (84.6%) patients received a constant treatment dose throughout the study. High adherence (MMAS score = 0) was reported by 1592 (83.6%), 1628 (85.7%), and 1477 (77.7%) patients at the second and the third visit and at both visits, respectively. Adverse reactions were reported by only 13 (0.7%) patients, were all minor, and did not result in treatment discontinuation. Office blood pressure (BP) was significantly decreased at the third visit (130.8 ± 8.4/78.2 ± 6.4 mmHg) compared with baseline (156.5 ± 15.0/89.9 ± 9.6 mmHg; p hypertension at baseline showed a reduction in BP of 19.3/9.4, 31.5/13.5, and 47.8/22.2 mmHg, respectively (p hypertension (≥140/90 mmHg) was notably reduced from 90.3% at baseline to 18.5% at the third visit. The perindopril/amlodipine FDC is characterized by high adherence and effectiveness, regardless of previous treatment. Degree of BP reduction was related to baseline BP levels. Clinical trials registration number (Protocol Number): IC4 - 05985 - 011 - GRC.

  17. Diagnosis of stable ischemic heart disease: summary of a clinical practice guideline from the American College of Physicians/American College of Cardiology Foundation/American Heart Association/American Association for Thoracic Surgery/Preventive Cardiovascular Nurses Association/Society of Thoracic Surgeons.

    Science.gov (United States)

    Qaseem, Amir; Fihn, Stephan D; Williams, Sankey; Dallas, Paul; Owens, Douglas K; Shekelle, Paul

    2012-11-20

    The American College of Physicians (ACP) developed this guideline in collaboration with the American College of Cardiology Foundation (ACCF), American Heart Association (AHA), American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, and Society of Thoracic Surgeons to help clinicians diagnose known or suspected stable ischemic heart disease. Literature on this topic published before November 2011 was identified by using MEDLINE, Embase, Cochrane CENTRAL, PsychINFO, AMED, and SCOPUS. Searches were limited to human studies published in English. This guideline grades the evidence and recommendations according to a translation of the ACCF/AHA grading system into ACP's clinical practice guidelines grading system. This guideline includes 28 recommendations that address the following issues: the initial diagnosis of the patient who might have stable ischemic heart disease, cardiac stress testing to assess the risk for death or myocardial infarction in patients diagnosed with stable ischemic heart disease, and coronary angiography for risk assessment.

  18. 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.)

  19. Paleoproxies: Heavy Stable Isotope Perspectives

    Science.gov (United States)

    Nagler, T. F.; Hippler, D.; Siebert, C.; Kramers, J. D.

    2002-12-01

    potential to solve this problem for a given set of samples and thus to model the ocean system more accurately in different scales. Besides all complications some important applications of heavy stable isotopes as paleoproxies already emerge. Pilot studies indicate that Mo isotopes may present a proxy for the extend of anoxic condition in past oceans. On a finer scale the same system appears to provide a measure of (bio)-chemical redox-changes related to diagenesis. The Ca isotope system may complement more classical sea surface temperature proxies in particular environments. Promising results exist for polar waters (N. pachy left), as well as indications on the seasonality under global greenhouse conditions ~110-50 Ma ago. However, the heavily species dependent Ca isotope fractionation can not be interpreted by just adopting concepts and findings from the oxygen system. While a complication to the ease of use as SST proxy, this species dependence offers pathways to unravel different modes of bio-calcifications. Given the complexity of the matter, collaboration of specialists of different fields will be needed to develop successful process-related hypotheses and diagnostic tools.

  20. Dural metastases from disseminated prostate cancer clinically mimicking a benign reactive condition of the dura: case report and review of the literature.

    Science.gov (United States)

    Gunia, S; Ecke, T; Wohlfarth, B; Koch, S; Erbersdobler, A

    2011-01-01

    Dural spread from prostate cancer (PC) is exceedingly uncommon. We report on a 62-year-old man suffering from disseminated PC with osseous metastases who presented with a parietal skull metastasis along with a circumscribed nodular thickening of the adjacent dura. Magnetic resonance imaging findings suggested a benign reactive condition of the dura which, however, histologically turned out to be a dural metastasis. Therefore, the present case report stresses the notion that very rarely, disseminated PC might present with clinically unsuspected dural metastases radiologically mimicking a benign condition.

  1. Lipoprotein cholesterol and triglyceride concentrations associated with dog body condition score; effect of recommended fasting duration on sample concentrations in Japanese private clinics.

    Science.gov (United States)

    Usui, Shiho; Yasuda, Hidemi; Koketsu, Yuzo

    2015-09-01

    The objectives of this study were to survey clinics' guidance about recommended fasting duration (FD) prior to lipoprotein analysis, and to characterize lipoprotein cholesterol and triglyceride concentrations in obese and overweight dogs categorized on the basis of the 5-point body condition score (BCS) scale. A dataset was created from lipoprotein analysis medical records of 1,538 dogs from 75 breeds in 354 clinics from 2012 to 2013. A phone survey was conducted to obtain the clinics' FD. Two-level linear mixed-effects models were applied to the data. Over 50% of the clinics said they recommended fasting for 12 hr or more. Dogs in clinics with FD 12 hr or more had lower chylomicron triglyceride concentrations than those in clinics with FD less than 8 hr (P=0.05). Mean (± SEM) BCS at sampling was 3.7 ± 0.02. Obese and overweight dogs had higher very low density lipoprotein (VLDL) and high density lipoprotein (HDL) cholesterol and triglyceride concentrations than ideal dogs (Plipoprotein cholesterol and triglyceride concentrations (P≥0.07). Across all BCS, as dog age rose from 0 to 8 years old, HDL cholesterol concentrations decreased by 13.5 mg/dl, whereas VLDL triglyceride concentrations increased by 81.7 mg/dl (Plipoprotein lipid concentrations. Obese and overweight dogs were characterized as having high VLDL and HDL cholesterol and triglyceride concentrations.

  2. 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...... in the mammary gland for serum amyloid A to accumulate in milk. The acute phase protein concentrations in milk increased significantly with increasing somatic cell count, suggesting that they may be indicators of the severity of an infection....

  3. Photosynthetic parameters of switchgrass (Panicum virgatum) under low radiation: Influence of stable overexpression of Miscanthus x giganteus PPDK on responses to light and CO₂ under warm and cool growing conditions

    OpenAIRE

    Halter, Mathew; Mitchell, Jackson; Man, David G.J.; Muthukumar, Balasubramaniam; Stewart, C Neal; Nilsen, Erik T.

    2015-01-01

    Background: Switchgrass (Panicum virgatum) is one of the leading candidates to provide lignocellulosic biomass for biofuel production. Switchgrass is capable of relatively high productivity on marginal land or when intercropped with trees. Production of switchgrass is dependent upon light use efficiency at the canopy level. Thus, maintenance of photosynthesis at light limiting and cool conditions ought to elongate the growing season and increase productivity of switchgrass. Photosynthesis und...

  4. Marginally Stable Nuclear Burning

    Science.gov (United States)

    Strohmayer, Tod E.; Altamirano, D.

    2012-01-01

    Thermonuclear X-ray bursts result from unstable nuclear burning of the material accreted on neutron stars in some low mass X-ray binaries (LMXBs). Theory predicts that close to the boundary of stability oscillatory burning can occur. This marginally stable regime has so far been identified in only a small number of sources. We present Rossi X-ray Timing Explorer (RXTE) observations of the bursting, high-inclination LMXB 4U 1323-619 that reveal for the first time in this source the signature of marginally stable burning. The source was observed during two successive RXTE orbits for approximately 5 ksec beginning at 10:14:01 UTC on March 28, 2011. Significant mHz quasi-periodic oscillations (QPO) at a frequency of 8.1 mHz are detected for approximately 1600 s from the beginning of the observation until the occurrence of a thermonuclear X-ray burst at 10:42:22 UTC. The mHz oscillations are not detected following the X-ray burst. The average fractional rms amplitude of the mHz QPOs is 6.4% (3 - 20 keV), and the amplitude increases to about 8% below 10 keV.This phenomenology is strikingly similar to that seen in the LMXB 4U 1636-53. Indeed, the frequency of the mHz QPOs in 4U 1323-619 prior to the X-ray burst is very similar to the transition frequency between mHz QPO and bursts found in 4U 1636-53 by Altamirano et al. (2008). These results strongly suggest that the observed QPOs in 4U 1323-619 are, like those in 4U 1636-53, due to marginally stable nuclear burning. We also explore the dependence of the energy spectrum on the oscillation phase, and we place the present observations within the context of the spectral evolution of the accretion-powered flux from the source.

  5. Association Between Nutritional Status, Inflammatory Condition, and Prognostic Indexes with Postoperative Complications and Clinical Outcome of Patients with Gastrointestinal Neoplasia.

    Science.gov (United States)

    Costa, Milena Damasceno de Souza; Vieira de Melo, Camila Yandara Sousa; Amorim, Ana Carolina Ribeiro de; Cipriano Torres, Dilênia de Oliveira; Dos Santos, Ana Célia Oliveira

    2016-10-01

    The aim of this study is to describe and relate nutritional and inflammatory status and prognostic indexes with postoperative complications and clinical outcome of patients with gastrointestinal malignancies. Twenty-nine patients were evaluated; nutritional assessment was carried out by subjective and objective parameters; albumin, pre-albumin, C-reactive protein (CRP), and alpha-1-acid glycoprotein (AGP) were determined. To assess prognosis, the Glasgow scale, the Prognostic Inflammatory Nutritional Index (PINI), and CRP/albumin ratio were used; the clinical outcomes considered were hospital discharge and death. A high Subjective Global Assessment (SGA) score was associated with the occurrence of postoperative complications: 73% of the patients with postoperative complications had the highest SGA score, but only 6% of those without postoperative complications had the highest SGA score (P 1, and Glasgow score 2. There was a positive correlation between weight loss percentage with serum CRP levels (P = 0.002), CRP/albumin (P = 0.002), PINI (P = 0.002), and Glasgow score (P = 0.000). This study provides evidence that the assessment of the nutritional status and the use of prognostic indexes are good tools for predicting postoperative complications and clinical outcome in patients with gastrointestinal neoplasia.

  6. Osteoarthritis treatment using autologous conditioned serum after placebo: Patient considerations and clinical response in a non-randomized case series

    NARCIS (Netherlands)

    Rutgers, M.; Creemers, L.B.; Yang, K.G.A.; Raijmakers, N.J.H.; Dhert, W.J.A.; Saris, Daniël B.F.

    2015-01-01

    Background and purpose Autologous conditioned serum (ACS) is a disease-modifying drug for treatment of knee osteoarthritis, and modest superiority over placebo was reported in an earlier randomized controlled trial (RCT). We hypothesized that when given the opportunity, placebo-treated patients from

  7. Conditional Survival Analysis of Patients With Locally Advanced Laryngeal Cancer: Construction of a Dynamic Risk Model and Clinical Nomogram

    Science.gov (United States)

    Sheu, Tommy; Vock, David M.; Mohamed, Abdallah S. R.; Gross, Neil; Mulcahy, Collin; Zafereo, Mark; Gunn, G. Brandon; Garden, Adam S.; Sevak, Parag; Phan, Jack; Lewin, Jan S.; Frank, Steven J.; Beadle, Beth M.; Morrison, William H.; Lai, Stephen Y.; Hutcheson, Katherine; Marai, G. Elisabeta; Canahuate, Guadalupe M.; Kies, Merrill; El-Naggar, Adel; Weber, Randal S.; Rosenthal, David I.; Fuller, Clifton D.

    2017-01-01

    Conditional survival (CS), the survival beyond a pre-defined time interval, can identify periods of higher mortality risk for patients with locally advanced laryngeal cancer who face treatment-related toxicity and comorbidities related to alcohol and smoking in the survivorship setting. Using Weibull regression modeling, we analyzed retrospectively abstracted data from 638 records of patients who received radiation to identify prognostic factors for overall survival (OS) and recurrence free survival (RFS) for the first 3 years of survival and for OS conditional upon 3 years of survival. The CS was iteratively calculated, stratifying on variables that were statistically significant on multivariate regression. Predictive nomograms were generated. The median total follow up time was 175 months. The 3- and 6- year actuarial overall survival (OS) was 68% (95% confidence interval [CI] 65–72%) and 49% (CI 45–53%). The 3-year conditional overall survival (COS) at 3 years was 72% (CI 65–74%). Black patients had worse COS over time. Nodal disease was significantly associated with recurrence, but after 3 years, the 3-year conditional RFS converged for all nodal groups. In conclusion, the CS analysis in this patient cohort identified subgroups and time intervals that may represent opportunities for intervention. PMID:28276466

  8. Antibiotics and iron-limiting conditions and their effect on the production and composition of outer membrane vesicles secreted from clinical isolates of extraintestinal pathogenic E. coli.

    Science.gov (United States)

    Chan, Kin W; Shone, Clifford; Hesp, J Richard

    2017-01-01

    The focus of this study was to characterize the effect of clinically relevant stress-inducing conditions on the production and composition of proinflammatory outer membrane vesicles (OMVs) produced from ST131 extraintestinal pathogenic Escherichia coli (ExPEC) clinical isolates. A label-free method (relative normalized spectral index quantification, SINQ) was used to identify changes in the respective OMV proteomes following exposure of the ExPEC strains to antibiotics and low iron. Nanoparticle tracking analysis was used to quantify changes in abundance and size of OMVs produced by the gentamicin-resistant (GenR) and gentamicin-sensitive (GenS) ExPEC strains. Up to a 13.1-fold increase in abundance of particles were detected when the gentamicin-sensitive strain was exposed to a range of gentamicin concentrations. In contrast, no increase was observed for the gentamicin-resistant strain. Iron-limiting conditions had minimal effect on OMV production for either strain. Marked changes in the OMV proteome were observed for both strains including increases in Hsp100/Clp proteins, ATP-dependent ClpP protease, and regulatory proteins. These data provide information on changes in the composition of OMV particles derived from ExPEC strains generated in response to clinically relevant conditions. We show that the levels of the proinflammatory OMVs increase for gentamicin-sensitive ExPEC exposed to the antibiotic. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  9. Stable cosmic vortons.

    Science.gov (United States)

    Garaud, Julien; Radu, Eugen; Volkov, Mikhail S

    2013-10-25

    We present solutions in the gauged U(1)×U(1) model of Witten describing vortons-spinning flux loops stabilized against contraction by the centrifugal force. Vortons were heuristically described many years ago; however, the corresponding field theory solutions were not obtained and so the stability issue remained open. We construct explicitly a family of stationary vortons characterized by their charge and angular momentum. Most of them are unstable and break in pieces when perturbed. However, thick vortons with a small radius preserve their form in the 3+1 nonlinear dynamical evolution. This gives the first ever evidence of stable vortons and impacts several branches of physics where they could potentially exist. These range from cosmology, since vortons could perhaps contribute to dark matter, to QCD and condensed matter physics.

  10. Stable umbral chromospheric structures

    Science.gov (United States)

    Henriques, V. M. J.; Scullion, E.; Mathioudakis, M.; Kiselman, D.; Gallagher, P. T.; Keenan, F. P.

    2015-02-01

    Aims: We seek to understand the morphology of the chromosphere in sunspot umbra. We investigate if the horizontal structures observed in the spectral core of the Ca II H line are ephemeral visuals caused by the shock dynamics of more stable structures, and examine their relationship with observables in the H-alpha line. Methods: Filtergrams in the core of the Ca II H and H-alpha lines as observed with the Swedish 1-m Solar Telescope are employed. We utilise a technique that creates composite images and tracks the flash propagation horizontally. Results: We find 0.̋15 wide horizontal structures, in all of the three target sunspots, for every flash where the seeing is moderate to good. Discrete dark structures are identified that are stable for at least two umbral flashes, as well as systems of structures that live for up to 24 min. We find cases of extremely extended structures with similar stability, with one such structure showing an extent of 5''. Some of these structures have a correspondence in H-alpha, but we were unable to find a one-to-one correspondence for every occurrence. If the dark streaks are formed at the same heights as umbral flashes, there are systems of structures with strong departures from the vertical for all three analysed sunspots. Conclusions: Long-lived Ca II H filamentary horizontal structures are a common and likely ever-present feature in the umbra of sunspots. If the magnetic field in the chromosphere of the umbra is indeed aligned with the structures, then the present theoretical understanding of the typical umbra needs to be revisited. Movies associated to Figs. 3 and 4 are available in electronic form at http://www.aanda.org

  11. Stable superstring relics

    Energy Technology Data Exchange (ETDEWEB)

    Chang, S.; Coriano, C. [Florida Univ., Gainesville, FL (United States). Inst. for Fundamental Theory; Faraggi, A.E. [Florida Univ., Gainesville, FL (United States). Inst. for Fundamental Theory]|[Inst. for Advanced Study, Princeton, NJ (United States). School of Natural Sciences

    1996-05-15

    The authors investigate the cosmological constraints on exotic stable matter states which arise in realistic free fermionic superstring models. These states appear in the superstring models due to a ``Wilson-line`` breaking of the unifying non-Abelian gauge symmetry. In the models that they consider the unifying SO(10) gauge symmetry is broken at the string level to SO(6) x SO(4), SU(5) x U(1) or SU(3) x SU(2) x U(1). The exotic matter states are classified according to the patterns of the SO(10) symmetry breaking. In SO(6) x XO(4) and SU(5) x U(1) type models one obtains fractionally charged states with Q{sub e.m.} = {+-}1/2. In SU(3) x SU(2) x U(1) type models one also obtains states with the regular charges under the Standard Model gauge group but with ``fractional`` charges under the U(1){sub z{prime}} symmetry. These states include down-like color triplets and electroweak doublets, as well as states which are Standard Model singlets. By analyzing the renormalizable and nonrenormalizable terms of the superpotential in a specific superstring model, the authors show that these exotic states can be stable. They investigate the cosmological constraints on the masses and relic density of the exotic states. They propose that, while the abundance and the masses of the fractionally charged states are highly constrained, the Standard Model-like states, and in particular the Standard Model singlet, are good dark matter candidates.

  12. 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.

  13. Non-Hodgkin lymphoma and pre-existing conditions: spectrum, clinical characteristics and outcome in 213 children and adolescents.

    Science.gov (United States)

    Attarbaschi, Andishe; Carraro, Elisa; Abla, Oussama; Barzilai-Birenboim, Shlomit; Bomken, Simon; Brugieres, Laurence; Bubanska, Eva; Burkhardt, Birgit; Chiang, Alan K S; Csoka, Monika; Fedorova, Alina; Jazbec, Janez; Kabickova, Edita; Krenova, Zdenka; Lazic, Jelena; Loeffen, Jan; Mann, Georg; Niggli, Felix; Miakova, Natalia; Osumi, Tomoo; Ronceray, Leila; Uyttebroeck, Anne; Williams, Denise; Woessmann, Wilhelm; Wrobel, Grazyna; Pillon, Marta

    2016-12-01

    Children and adolescents with pre-existing conditions such as DNA repair defects or other primary immunodeficiencies have an increased risk of non-Hodgkin lymphoma. However, large-scale data on patients with non-Hodgkin lymphoma and their entire spectrum of pre-existing conditions are scarce. A retrospective multinational study was conducted by means of questionnaires sent out to the national study groups or centers, by the two largest consortia in childhood non-Hodgkin lymphoma, the European Intergroup for Childhood non-Hodgkin Lymphoma, and the international Berlin-Frankfurt-Münster Study Group. The study identified 213 patients with non-Hodgkin lymphoma and a pre-existing condition. Four subcategories were established: a) cancer predisposition syndromes (n=124, 58%); b) primary immunodeficiencies not further specified (n=27, 13%); c) genetic diseases with no increased cancer risk (n=40, 19%); and d) non-classifiable conditions (n=22, 10%). Seventy-nine of 124 (64%) cancer predispositions were reported in groups with more than 20 patients: ataxia telangiectasia (n=32), Nijmegen breakage syndrome (n=26), constitutional mismatch repair deficiency (n=21). For the 151 patients with a known cancer risk, 5-year event-free survival and overall survival rates were 40%±4% and 51%±4%, respectively. Five-year cumulative incidences of progression/relapse and treatment-related death as a first event were 22%±4% and 24%±4%, respectively. Ten-year incidence of second malignancy was 24%±5% and 7-year overall survival of the 21 patients with a second malignancy was 41%±11%. Patients with non-Hodgkin lymphoma and pre-existing conditions have an inferior survival rate with a large proportion of therapy-related deaths compared to patients with non-Hodgkin lymphoma and no pre-existing conditions. They may require special vigilance when receiving standard or modified/reduced-intensity chemotherapy or when undergoing allogeneic stem cell transplantation. Copyright© Ferrata

  14. 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.

  15. Sociodemographic factors and clinical conditions associated to hospitalization in influenza A (H1N1 2009 virus infected patients in Spain, 2009-2010.

    Directory of Open Access Journals (Sweden)

    Fernando González-Candelas

    Full Text Available The emergence and pandemic spread of a new strain of influenza A (H1N1 virus in 2009 resulted in a serious alarm in clinical and public health services all over the world. One distinguishing feature of this new influenza pandemic was the different profile of hospitalized patients compared to those from traditional seasonal influenza infections. Our goal was to analyze sociodemographic and clinical factors associated to hospitalization following infection by influenza A(H1N1 virus. We report the results of a Spanish nationwide study with laboratory confirmed infection by the new pandemic virus in a case-control design based on hospitalized patients. The main risk factors for hospitalization of influenza A (H1N1 2009 were determined to be obesity (BMI≥40, with an odds-ratio [OR] 14.27, hematological neoplasia (OR 10.71, chronic heart disease, COPD (OR 5.16 and neurological disease, among the clinical conditions, whereas low education level and some ethnic backgrounds (Gypsies and Amerinds were the sociodemographic variables found associated to hospitalization. The presence of any clinical condition of moderate risk almost triples the risk of hospitalization (OR 2.88 and high risk conditions raise this value markedly (OR 6.43. The risk of hospitalization increased proportionally when for two (OR 2.08 or for three or more (OR 4.86 risk factors were simultaneously present in the same patient. These findings should be considered when a new influenza virus appears in the human population.

  16. Characterizing breast conditions at an open-access breast clinic in South Africa: a model that is more than cancer care for a resource-limited setting.

    Science.gov (United States)

    Rayne, Sarah; Lince-Deroche, Naomi; Hendrickson, Cheryl; Shearer, Kate; Moyo, Faith; Michelow, Pam; Rubin, Grace; Benn, Carol; Firnhaber, Cynthia

    2017-01-21

    While most breast-related research focuses on cancer, presentation of symptomatic persons in non-screened environments requires understanding the spectrum of breast diseases so as to plan services in resource-constrained settings. This study presents the variety of breast disease managed at a government, open-access breast clinic in South Africa. We performed a retrospective file review using a systematic random sample of patients 18 years and above presenting for breast care over a 14-month period. We collected demographics, clinical characteristics, management and final diagnoses from the first visit and twelve subsequent months. The final sample contained 365 individuals (97 · 5% women). Most were black, unmarried and South African citizens with a median age of 43 years (IQR 31-55) . Of those reporting their status (24 · 1%) 38 · 6% were HIV-positive. A mass (57 · 0%) and/or pain (28 · 5%) were the most common symptoms. Imaging and breast biopsies were required in 78 and 25% of individuals, respectively. Nearly half of biopsies identified breast cancer (44 · 1% of women ≤40 and 57 · 3% for women >40). Benign conditions (47 · 7%) and no abnormality (18 · 2%) were common final classifications among women. There was no difference between the final classifications of patients who self-referred versus those who were formally referred from another health care provider. Nearly half of the participants (46 · 6%) travelled 20 km or more to attend the clinic. Benign breast conditions far outweighed cancer diagnoses. As breast cancer awareness increases in resource-limited countries, facilities offering breast care require administrative and clinical preparation to manage a range of non-cancer related conditions.

  17. Establishment of stable and clinically representative mouse models of Clostridium difficile infection%具有临床代表性的艰难梭菌感染小鼠稳定模型的构建

    Institute of Scientific and Technical Information of China (English)

    费稼希; 林倩云; 张岩; 曾丽珊; 王浦; 陈烨

    2016-01-01

    Objective To build mouse models of Clostridium difficile infection with clinical representativeness and good stability,and provide suitable tools for researches on the infection of Clostridium difficile.Methods 3 different species of mice (C57BL/6 mice,BALB/c mice and KM mice) were treated with antibiotics and then challenged with different concentrations of Clostridium difficile suspension by garage.The symptom of diarrhea,general situation and pathological changes of colonic tissues were observed.Results After gavage,all the BALB/c mice in the 1010 CFU/mL concentration group developed diarrhea,with a mortality rate of 16.7%.The diarrhea symptoms of mice in other experimental groups varied in severity or even were mild and only seen in some of the mice.The mice with diarrhea had loose or even watery stool,wet tail,weight loss and reduced food intake.Histological examination showed congestion,hemorrhage and neutrophil infiltration of the mucosa in dead mice.Conclusion BALB/c mice which were induced by gavage with five antibiotics for 9 days and intraperitoneal injection with clindamycin,then gavaged with 1010 CFU/mL of Clostridium difficile bacterial suspension are the most stable models for Clostridium difficile associated diarrhea.%目的 构建临床代表性好、稳定性佳的艰难梭菌感染小鼠模型,为艰难梭菌感染相关疾病提供研究工具.方法 选择C57BL/6、BALB/c、昆明小鼠,经抗生素诱导后,分别予以不同浓度(108 CFU/mL~1010 CFU/mL)的临床分离菌株混悬液灌胃,观察不同品系小鼠不同时间点腹泻、全身情况及结肠组织病理学变化.结果 灌菌后,BALB/c小鼠1010 CFU/mL浓度组全部出现腹泻,死亡率为16.7%;其他实验组小鼠腹泻程度差异较大或仅部分出现轻度腹泻.腹泻小鼠表现为稀烂便甚至水样便和湿尾现象,体重减轻,肠道病理显示结肠黏膜充血水肿伴炎性细胞浸润.结论 经5种抗生素灌胃9 d+

  18. A new fenofibrate formulation: results of six single-dose, clinical studies of bioavailability under fed and fasting conditions.

    Science.gov (United States)

    Guivarc'h, Pol-Henri; Vachon, Michael G; Fordyce, Diana

    2004-09-01

    The main drawback of the lipid-lowering agent fenofibrate is low bioavailability when taken orally on an empty stomach. Even the newest marketed formulations, micronized fenofibrate (MF) 200-mg capsules and microcoated fenofibrate (MCF) 160-mg tablets, require administration with meals to increase bioavailability. Insoluble Drug Delivery-Microparticle (IDD-P) fenofibrate 160-mg tablets are a new formulation developed to provide bioavailability independent of food. The aims of this group of studies were to determine the effects of food on the bioavailability of IDD-P fenofibrate and MCF and to compare the bioavailabilities of IDD-P fenofibrate, MF, and MCF under fasting and fed conditions. Six single-dose pharmacokinetic studies were conducted in healthy adult volunteers. The primary end points were the extrapolated area under the curve (AUC) from time 0 to infinity (AUC(0-infinity)), the experimental AUC from time 0 to time t, and the maximum plasma concentration of the active fenofibrate metabolite, fenofibric acid. The bioavailabilities of tested treatments were compared using the 90% CIs of ratios of least squares means (RLSMs) of logarithmically transformed AUC(0-infinity) values; 90% CIs within 80% to 125% were considered to indicate equivalent bioavailability (ie, extent of absorption). One hundred thirteen subjects (87 men, 26 women) received > or =1 study treatment and were evaluable for tolerability, and 99 of them (77 men, 22 women) were evaluable for bioavailability. The RLSMs of IDD-P fenofibrate extent of absorption (AUC(0-infinity)) under fed versus fasting conditions were 104.99%, 118.76%, and 113.56% (high-fat fed) and 111.06% and 110.64% (low-fat fed) in 5 separate comparisons. The corresponding 90% CIs were 95.38% to 115.58%, 113.38% to 124.40%, 107.54% to 119.93%, 106.06% to 116.32%, and 104.75% to 116.86%. All of these CIs were within the 80% to 125% range, suggesting equivalent bioavailability of IDD-P fenofibrate independent of food. The RLSM

  19. First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--Chapter 4: pre-clinical efficacy and complication data required to justify a clinical trial.

    Science.gov (United States)

    Cooper, David K C; Bottino, Rita; Gianello, Pierre; Graham, Melanie; Hawthorne, Wayne J; Kirk, Allan D; Korsgren, Olle; Park, Chung-Gyu; Weber, Collin

    2016-01-01

    In 2009, the International Xenotransplantation Association (IXA) published a consensus document that provided guidelines and "recommendations" (not regulations) for those contemplating clinical trials of porcine islet transplantation. These guidelines included the IXA's opinion on what constituted "rigorous pre-clinical studies using the most relevant animal models" and were based on "non-human primate testing." We now report our discussion following a careful review of the 2009 guidelines as they relate to pre-clinical testing. In summary, we do not believe there is a need to greatly modify the conclusions and recommendations of the original consensus document. Pre-clinical studies should be sufficiently rigorous to provide optimism that a clinical trial is likely to be safe and has a realistic chance of success, but need not be so demanding that success might only be achieved by very prolonged experimentation, as this would not be in the interests of patients whose quality of life might benefit immensely from a successful islet xenotransplant. We believe these guidelines will be of benefit to both investigators planning a clinical trial and to institutions and regulatory authorities considering a proposal for a clinical trial. In addition, we suggest consideration should be given to establishing an IXA Clinical Trial Advisory Committee that would be available to advise (but not regulate) researchers considering initiating a clinical trial of xenotransplantation.

  20. Minor interference of cross-reactive carbohydrates with the diagnosis of respiratory allergy in standard clinical conditions

    DEFF Research Database (Denmark)

    Vidal, Carmen; Sanmartín, Carolina; Armisén, Margarita

    2012-01-01

    Background: Immunoglobulin E (IgE) to N-glycans from plant and invertebrate glycoproteins induces extensive in vitro cross-reactivity. This study investigates the prevalence and diagnostic relevance of IgE to these N-glycans [cross-reactive carbohydrate determinants (CCDs)] in patients with suspi......Background: Immunoglobulin E (IgE) to N-glycans from plant and invertebrate glycoproteins induces extensive in vitro cross-reactivity. This study investigates the prevalence and diagnostic relevance of IgE to these N-glycans [cross-reactive carbohydrate determinants (CCDs)] in patients...... with suspicion of respiratory allergy. Methods: A total of 1,025 adult subjects with symptoms of rhinitis and/or asthma from a reference allergy clinic were studied. Determinations included a structured questionnaire, skin prick tests (SPT), total IgE, a multiallergen IgE test and specific IgE (s...

  1. Evaluation of a Fully Automated Research Prototype for the Immediate Identification of Microorganisms from Positive Blood Cultures under Clinical Conditions

    Directory of Open Access Journals (Sweden)

    Jay M. Hyman

    2016-04-01

    Full Text Available A clinical laboratory evaluation of an intrinsic fluorescence spectroscopy (IFS-based identification system paired to a BacT/Alert Virtuo microbial detection system (bioMéééérieux, Inc., Durham, NC was performed to assess the potential for fully automated identification of positive blood cultures. The prototype IFS system incorporates a novel method combining a simple microbial purification procedure with rapid in situ identification via spectroscopy. Results were available within 15 min of a bottle signaling positive and required no manual intervention. Among cultures positive for organisms contained within the database and producing acceptable spectra, 75 of 88 (85.2% and 79 of 88 (89.8% were correctly identified to the species and genus level, respectively. These results are similar to the performance of existing rapid methods.

  2. INVARIANTS UNDER STABLE EQUIVALENCES OF MORITA TYPE

    Institute of Scientific and Technical Information of China (English)

    Li Fang; Sun Longgang

    2012-01-01

    The aim of this article is to study some invariants of associative algebras under stable equivalences of Morita type.First of all,we show that,if two finite-dimensional selfinjective k-algebras are stably equivalent of Morita type,then their orbit algebras are isomorphic.Secondly,it is verified that the quasitilted property of an algebra is invariant under stable equivalences of Morita type.As an application of this result,it is obtained that if an algebra is of finite representation type,then its tilted property is invariant under stable equivalences of Morita type; the other application to partial tilting modules is given in Section 4. Finally,we prove that when two finite-dimensional k-algebras are stably equivalent of Morita type,their repetitive algebras are also stably equivalent of Morita type under certain conditions.

  3. High-Order Energy Stable WENO Schemes

    Science.gov (United States)

    Yamaleev, Nail K.; Carpenter, Mark H.

    2008-01-01

    A new third-order Energy Stable Weighted Essentially NonOscillatory (ESWENO) finite difference scheme for scalar and vector linear hyperbolic equations with piecewise continuous initial conditions is developed. The new scheme is proven to be stable in the energy norm for both continuous and discontinuous solutions. In contrast to the existing high-resolution shock-capturing schemes, no assumption that the reconstruction should be total variation bounded (TVB) is explicitly required to prove stability of the new scheme. A rigorous truncation error analysis is presented showing that the accuracy of the 3rd-order ESWENO scheme is drastically improved if the tuning parameters of the weight functions satisfy certain criteria. Numerical results show that the new ESWENO scheme is stable and significantly outperforms the conventional third-order WENO finite difference scheme of Jiang and Shu in terms of accuracy, while providing essentially nonoscillatory solutions near strong discontinuities.

  4. Lung infarction following pulmonary embolism. A comparative study on clinical conditions and CT findings to identify predisposing factors

    Energy Technology Data Exchange (ETDEWEB)

    Kirchner, J.; Obermann, A.; Stueckradt, S.; Tueshaus, C. [General Hospital Hagen (Germany). Radiology; Goltz, J.; Kickuth, R. [University Hospital Wuerzburg (Germany). Radiology; Liermann, D. [University Hospital Marienhospital Herne (Germany). Radiology

    2015-06-15

    The aim of this study was to identify factors predisposing to lung infarction in patients with pulmonary embolism (PE). We performed a retrospective analysis on 154 patients with the final diagnosis of PE being examined between January 2009 and December 2012 by means of a Toshiba Aquilion 64 CT scanner. The severity of clinical symptoms was defined by means of a clinical index with 4 classes. The pulmonary clot load was quantified using a modified severity index of PE as proposed by Miller. We correlated several potential predictors of pulmonary infarction such as demographic data, pulmonary clot burden, distance of total vascular obstruction and pleura, the presence of cardiac congestion, signs of chronic bronchitis or emphysema with the occurrence of pulmonary infarction. Computed tomography revealed 78 areas of pulmonary infarction in 45/154 (29.2%) patients. The presence of infarction was significantly higher in the right lung than in the left lung (p < 0.001). We found no correlation between pulmonary infarction and the presence of accompanying malignant diseases (r=-0.069), signs of chronic bronchitis (r=-0.109), cardiac congestion (r=-0.076), the quantified clot burden score (r=0.176), and the severity of symptoms (r=-0.024). Only a very weak negative correlation between the presence of infarction and age (r=-0.199) was seen. However, we could demonstrate a moderate negative correlation between the distance of total vascular occlusion and the occurrence of infarction (r=-0.504). Neither cardiac congestion nor the degree of pulmonary vascular obstruction are main factors predisposing to pulmonary infarction in patients with PE. It seems that a peripheral total vascular obstruction more often results in infarction than even massive central clot burden.

  5. Assessment of accuracy and efficiency of atlas-based autosegmentation for prostate radiotherapy in a variety of clinical conditions

    Energy Technology Data Exchange (ETDEWEB)

    Simmat, I. [Medical Univ. Vienna/AKH Vienna (Austria). Div. of Medical Radiation Physics; Georg, P.; Georg, D.; Goldner, G.; Stock, M. [Medical Univ. Vienna/AKH Vienna (Austria). Div. of Medical Radiation Physics; Medical Univ. Vienna (Austria). Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology; Birkfellner, W. [Medical Univ. Vienna (Austria). Center for Medical Physics and Biomedical Engineering; Medical Univ. Vienna (Austria). Christian Doppler Lab. for Medical Radiation Research for Radiation Oncology

    2012-09-15

    Background and purpose: The goal of the current study was to evaluate the commercially available atlas-based autosegmentation software for clinical use in prostate radiotherapy. The accuracy was benchmarked against interobserver variability. Material and methods: A total of 20 planning computed tomographs (CTs) and 10 cone-beam CTs (CBCTs) were selected for prostate, rectum, and bladder delineation. The images varied regarding to individual (age, body mass index) and setup parameters (contrast agent, rectal balloon, implanted markers). Automatically created contours with ABAS {sup registered} and iPlan {sup registered} were compared to an expert's delineation by calculating the Dice similarity coefficient (DSC) and conformity index. Results: Demo-atlases of both systems showed different results for bladder (DSC{sub ABAS} 0.86 {+-} 0.17, DSC{sub iPlan} 0.51 {+-} 0.30) and prostate (DSC{sub ABAS} 0.71 {+-} 0.14, DSC{sub iPlan} 0.57 {+-} 0.19). Rectum delineation (DSC{sub ABAS} 0.78 {+-} 0.11, DSC{sub iPlan} 0.84 {+-} 0.08) demonstrated differences between the systems but better correlation of the automatically drawn volumes. ABAS {sup registered} was closest to the interobserver benchmark. Autosegmentation with iPlan {sup registered}, ABAS {sup registered} and manual segmentation took 0.5, 4 and 15-20 min, respectively. Automatic contouring on CBCT showed high dependence on image quality (DSC bladder 0.54, rectum 0.42, prostate 0.34). Conclusion: For clinical routine, efforts are still necessary to either redesign algorithms implemented in autosegmentation or to optimize image quality for CBCT to guarantee required accuracy and time savings for adaptive radiotherapy. (orig.)

  6. Stable embeddedness and NIP

    CERN Document Server

    Pillay, Anand

    2010-01-01

    We give sufficient conditions for a predicate P in a complete theory T to be stably embedded: P with its induced 0-definable structure has "finite rank", P has NIP in T and P is 1-stably embedded. This generalizes recent work by Hasson and Onshuus in the case where P is o-minimal in T.

  7. Derivation of vascular endothelial cells from human embryonic stem cells under GMP-compliant conditions: towards clinical studies in ischaemic disease.

    Science.gov (United States)

    Kaupisch, A; Kennedy, L; Stelmanis, V; Tye, B; Kane, N M; Mountford, J C; Courtney, A; Baker, A H

    2012-10-01

    Revascularisation of ischaemic tissue remains an area of substantial unmet clinical need in cardiovascular disease. Strategies to induce therapeutic angiogenesis are therefore attractive. Our recent focus has been on human embryonic stem cell (hESC) strategies since hESC can be maintained in a pluripotent state or differentiated into any desired cell type, including endothelial cells (EC), under defined differentiation culture conditions. We recently published a protocol for non-good manufacturing practice (GMP) feeder- and serum-free hESC-EC-directed monolayer differentiation to vascular EC demonstrating the potential to generate hESC-derived EC in a GMP-compliant manner suitable for use in clinical trials. In this study we modified that laboratory protocol to GMP compliance. EC production was confirmed by flow cytometry, qRT-PCR and production of vascular structures in Matrigel®, yielding approximately 30 % mature VE-cadherin(+)/PECAM-1(+) cells using the GMP-compliant hESC line RC13. In conclusion, we have successfully demonstrated the production of vascular EC under GMP-compliant conditions suitable for clinical evaluation.

  8. Stable isotopes. Applications and production; Les isotopes stables. Applications - production

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, S.; Louvet, P.; Soulie, E. [eds.

    1994-12-31

    This conference presents 46 communications concerning stable isotope production, utilization and application, grouped in 6 sessions and posters. The various themes are: biological applications (pharmacology, medical diagnosis, metabolism and protein studies, toxicity and response studies, labelled compounds), analysis procedures (NMR analysis for macromolecules, tracer studies), nuclear applications (utilization of stable isotopes in nuclear reactors), biological, physical and chemical applications (mass transfer, mobility, crystallography, isotopic exchange), stable isotope production (ion chromatography, ion cyclotron resonance, cryogenic distillation).

  9. Influence of Light Conditions and Light Sources on Clinical Measurement of Natural Teeth Color using VITA Easyshade Advance 4,0(®) Spectrophotometer. Pilot Study.

    Science.gov (United States)

    Posavec, Ivona; Prpić, Vladimir; Zlatarić, Dubravka Knezović

    2016-12-01

    The purpose of this study was to evaluate and compare lightness (L), chroma (C) and hue (h), green-red (a) and blue-yellow (b) character of the color of maxillary right central incisors in different light conditions and light sources. Two examiners who were well trained in digital color evaluation participated in the research. Intraclass correlation coefficients (ICCs) were used to analyze intra- and interobserver reliability. The LCh and L*a*b* values were determined at 08.15 and at 10.00 in the morning under three different light conditions. Tooth color was assessed in 10 subjects using intraoral spectrophotometer VITA Easyshade Advance 4.0(®) set at the central region of the vestibular surface of the measured tooth. Intra- and interobserver ICC values were high for both examiners and ranged from 0.57 to 0.99. Statistically significant differences in LCh and L*a*b* values measured in different time of the day and certain light condition were not found (p>0.05). Statistically significant differences in LCh and L*a*b* values measured under three different light conditions were not found, too (p>0.05). VITA Easyshade Advance 4.0(®) is reliable enough for daily clinical work in order to assess tooth color during the fabrication of esthtic appliances because it is not dependent on light conditions and light sources.

  10. [Clinical psychophysiological markers of maladaptive neuropsychic conditions in polyclinic doctors of old and middle age with professional burnout syndrome].

    Science.gov (United States)

    Parfenov, Iu A

    2012-01-01

    The article presents the actual in modern medicine problem of professional burnout of polyclinic doctors of middle and elderly age. It is shown that the specificity of the polyclinic doctors' activity provokes the formation of professional burnout syndrome, paired with maladaptive neuro-psychic conditions. We studied the prevalence of this syndrome in polyclinic doctors of middle age and older; its specific versions among the middle-aged doctors were defined, where the level of burnout is associated with aggressive tendencies, and the elderly doctors, where professional burnout is associated with the instability of affective response. Pathogenic markers of compensatory redistribution of information saturation of indicators of electroencephalography to the occipital cortex at professional burnout in polyclinic doctors of the elderly age, reflecting the involution processes in prefrontal areas of the cerebral cortex of the brain were identified.

  11. Plaque removal efficacy of powered and manual toothbrushes under supervised and unsupervised conditions: A comparative clinical study

    Directory of Open Access Journals (Sweden)

    S Kallar

    2011-01-01

    Full Text Available The present study was undertaken to determine and compare the efficacy of manual and powered toothbrushes under supervised and unsupervised conditions in 200 school-going children between 6 and 13 years of age. Two hundred school-going children aged between 6 and 13 years were selected. Children were randomly divided into two groups of 100 in each. Group 1 children were given manual brushes, while group 2 children were given powered brushes. The groups were further divided into two subgroups, with supervised brushing in subgroup A and unsupervised brushing in subgroup B. At 3, 6, 9 and 12 weeks, plaque was recorded according to Turseky-Gilmore-Glickman modification of Quingley Hein index and oral hygiene performance index. Data were statistically analyzed. Both brushes significantly reduced the plaque accumulation, though to different degrees. Powered brushes showed significant plaque reduction as compared to the manual brushes. Supervised group of both brushes showed a greater plaque reduction.

  12. Functionalized Magnetic Resonance Contrast Agent Selectively Binds to Glycoprotein IIb/IIIa on Activated Human Platelets under Flow Conditions and Is Detectable at Clinically Relevant Field Strengths

    Directory of Open Access Journals (Sweden)

    Constantin von zur Mühlen

    2008-03-01

    Full Text Available Recent progress in molecular magnetic resonance imaging (MRI provides the opportunity to image cells and cellular receptors using microparticles of iron oxide (MPIOs. However, imaging targets on vessel walls remains challenging owing to the quantity of contrast agents delivered to areas of interest under shear stress conditions. We evaluated ex vivo binding characteristics of a functional MRI contrast agent to ligand-induced binding sites (LIBSs on activated glycoprotein IIb/IIIa receptors of human platelets, which were lining rupture-prone atherosclerotic plaques and could therefore facilitate detection of platelet-mediated pathology in atherothrombotic disease. MPIOs were conjugated to anti-LIBS single-chain antibodies (LIBS-MPIO or control antibodies (control MPIO. Ex vivo binding to human platelet-rich clots in a dose-dependent manner was confirmed on a 3 T clinical MRI scanner and by histology (p < .05 for LIBS-MPIO vs control MPIO. By using a flow chamber setup, significant binding of LIBS-MPIO to a platelet matrix was observed under venous and arterial flow conditions, but not for control MPIO (p < .001. A newly generated MRI contrast agent detects activated human platelets at clinically relevant magnetic field strengths and binds to platelets under venous and arterial flow conditions, conveying high payloads of contrast to specific molecular targets. This may provide the opportunity to identify vulnerable, rupture-prone atherosclerotic plaques via noninvasive MRI.

  13. Psychiatric care in restricted conditions for work migrants, refugees and asylum seekers: experience of the Open Clinic for Work Migrants and Refugees, Israel 2006.

    Science.gov (United States)

    Lurie, Ido

    2009-01-01

    In the last few decades, the State of Israel has become a target for work migrants, refugees, asylum seekers and victims of human trafficking, as part of the trend of world immigration. Immigration is a process of loss and change with significant socio-psychological stress, with possible effects on the immigrants' mental health. The Physicians for Human Rights - Israel (PHR) Association operates a psychiatric clinic as part of the Open Clinic for Work Migrants and Refugees. This article will present major clinical issues regarding psychiatry and immigration in Israel according to the data collected at the clinic. Trauma and stress-related psychopathology was found to have a high prevalence in immigrant patients treated at the clinic; prevalence of PTSD (post-traumatic stress disorder) in immigrants was high (23%) and even higher in refugees (33%). Female immigrants are at higher risk for psychiatric hospitalization. The relative rate of African patients at the clinic is significantly higher than patients from other continents. A significant association was found between psychiatric hospitalization and suicide attempts. Immigrant patients present a combination of psychiatric, socio-economic and general medical conditions, which demands a holistic view of the patient. The evaluation of an immigrant patient must take into account the stress related to immigration, gender, culture of origin and the risk for suicide and hospitalization. Treatment recommendations include awareness of cultural diversities, acquiring information regarding the pre-immigration history, preferably using cultural consultants with background in the immigrants' culture and community. Decision-making about medication and diagnostic evaluation should be as inexpensive as possible. Basic human needs (food, shelter) and family support should be included in the decisions about treatment.

  14. Minor interference of cross-reactive carbohydrates with the diagnosis of respiratory allergy in standard clinical conditions

    DEFF Research Database (Denmark)

    Vidal, Carmen; Sanmartín, Carolina; Armisén, Margarita

    2012-01-01

    Background: Immunoglobulin E (IgE) to N-glycans from plant and invertebrate glycoproteins induces extensive in vitro cross-reactivity. This study investigates the prevalence and diagnostic relevance of IgE to these N-glycans [cross-reactive carbohydrate determinants (CCDs)] in patients with suspi...... mite-allergic patients, CCD sensitization is relatively rare and CCD-sIgE levels are low. Thus, CCDs do not represent a major obstacle for the diagnosis of respiratory allergy in a specialized setting. Hymenoptera stings are associated with CCD sensitization....... with suspicion of respiratory allergy. Methods: A total of 1,025 adult subjects with symptoms of rhinitis and/or asthma from a reference allergy clinic were studied. Determinations included a structured questionnaire, skin prick tests (SPT), total IgE, a multiallergen IgE test and specific IgE (s...... sensitization. Sensitization was more frequent in patients sensitized to pollens than in those sensitized to mites, the most common inhalant allergens in the area. A history of Hymenoptera stings was associated with CCD sensitization and multiallergen IgE test positivity. CCD sensitization was not significantly...

  15. The transition to clinical expert: enhanced decision making for children aged less than 5 years attending the paediatric ED with acute respiratory conditions

    Science.gov (United States)

    Bowen, Leah; Shaw, Alison; Lyttle, Mark D; Purdy, Sarah

    2017-01-01

    Background Rates of unplanned paediatric admissions are persistently high. Many admissions are short-stay events, lasting less than 48 hours. Objective This qualitative research explores factors that influence clinical decision making in the paediatric ED (PED) for children under 5 attending with acute respiratory conditions, focusing on how management decisions adapt with increasing experience. Method Semi-structured interviews were conducted with 15 PED clinicians (doctors, emergency nurse practitioners and registered nurses) with varying levels of experience in paediatric emergency medicine (PEM), emergency medicine or paediatrics. Audio-recorded interviews were transcribed and analysed thematically. Results There were clear differences in decision-making approaches between experienced clinicians and junior staff. The latter were more risk adverse, relying heavily on guidelines, set admission criteria, clinical theory and second opinions. This was particularly true for doctors. ‘Informal’ learning was apparent in accounts from less-experienced doctors and nurses, whereby tacit knowledge and risk management played an increasing role in the development of clinical intuition that permitted rapid assessment and treatment of young patients. Conclusions The emergence of intuition entwined with approaches to risk management and the role of these skills in clinical decision making, carry implications for the development of training programmes for clinicians working in PEM. Enhanced training for such groups to permit development of the supplementary skills described in this study could have the ability to improve care delivery and even reduce paediatric admissions. PMID:27496899

  16. Body Condition Scores and Evaluation of Feeding Habits of Dogs and Cats at a Low Cost Veterinary Clinic and a General Practice

    Directory of Open Access Journals (Sweden)

    Stephanie A. Sapowicz

    2016-01-01

    Full Text Available This study assessed body condition scores (BCS and feeding habits for dogs and cats. Eighty-six cats and 229 dogs (and their owners were enrolled from 2 clinics: a low cost clinic (n=149 and a general practice (n=166. BCS and body weight were recorded. Owners completed a survey which included animal age, sex, and breed; owner demographics; and feeding practices (e.g., diet, rationale for feeding practices. Owners from the low cost clinic had a significantly lower income (P<0.001 and education (P<0.001 compared to those from the general practice. Animals from the low cost clinic were younger (P<0.001 and dogs were less likely to be neutered (P<0.001. Overweight prevalence was 55% overall (P=0.083, with a significantly higher prevalence in the general practice for cats (44% versus 66%; P=0.046, but not for dogs (58% versus 53%; P=0.230. Multivariate analysis showed that only neuter status was significantly associated with BCS (P=0.004. Veterinarians were the most common source of nutritional information, though lack of accurate nutrition knowledge was common among all participants. These findings support the need for enhanced communication about optimal BCS and nutrition regardless of socioeconomic status.

  17. Comparison of CT-Determined Pulmonary Artery Diameter, Aortic Diameter, and Their Ratio in Healthy and Diverse Clinical Conditions.

    Directory of Open Access Journals (Sweden)

    Sang Hoon Lee

    Full Text Available The main pulmonary artery diameter (mPA, aortic diameter (Ao, and the mPA/Ao ratio, easily measured using chest computed tomography (CT, provide information that enables the diagnosis and evaluation of cardiopulmonary diseases. Here, we used CT to determine the sex- and age-specific distribution of normal reference values for mPA, Ao, and mPA/Ao ratio in an adult Korean population.Data from non-contrast, ECG-gated, coronary-calcium-scoring CT images of 2,547 individuals who visited the Health Screening Center of the Severance Hospital were analyzed. Healthy individuals (n = 813 included those who do not have hypertension, diabetes, asthma, obstructive lung disease, ischemic heart disease, stroke, smoking, obesity, and abnormal CT findings. Both mPA and Ao were measured at the level of bifurcation of the main pulmonary artery.The mean mPA and Ao were 25.9 mm and 30.0 mm in healthy participants, respectively, while the mean mPA/Ao ratio was 0.87. Medical conditions associated with a larger mPA were male, obesity, smoking history, hypertension, and diabetes. A larger mPA/Ao ratio was associated with female, the obese, non-smoker, normotensive, and normal serum level of lipids, while a smaller mPA/Ao ratio was associated with older age. In healthy individuals, the 90th percentile sex-specific mPA, Ao, and mPA/Ao ratio were, 31.3 mm (95% CI 29.9-32.2, 36.8 mm (95% CI 35.7-37.5, and 1.05 (95% CI 0.99-1.07 in males, and 29.6 mm (95% CI 29.1-30.2, 34.5 mm (95% CI 34.1-34.9, and 1.03 (95% CI 1.02-1.06 in females, respectively.In the Korean population, the mean mPA reference values in male and female were 26.5 mm and 25.8 mm, respectively, while the mean mPA/Ao ratio was 0.87. These values were influenced by a variety of underlying medical conditions.

  18. Responsiveness of Clinical Outcome Measures

    DEFF Research Database (Denmark)

    Lauridsen, Henrik Hein

    Rating Scale is recommended. The MCID was more or less stable across subgroups for most instruments and increased monotonously with baseline condition severity in PrS and LBP patients only. The clinical question: “how are you now compared to when you started the treatment” seems to be most sensitive...... obtainable by a certain treatment. Chronic LBP patients seem to have a reasonable idea of an acceptable change in pain but overestimate change in functional and psychological /affective domains....

  19. First update of the International Xenotransplantation Association consensus statement on conditions for undertaking clinical trials of porcine islet products in type 1 diabetes--Executive summary.

    Science.gov (United States)

    Hering, Bernhard J; Cozzi, Emanuele; Spizzo, Thomas; Cowan, Peter J; Rayat, Gina R; Cooper, David K C; Denner, Joachim

    2016-01-01

    The International Xenotransplantation Association has updated its original "Consensus Statement on Conditions for Undertaking Clinical Trials of Porcine Islet Products in Type 1 Diabetes," which was published in Xenotransplantation in 2009. This update is timely and important in light of scientific progress and changes in the regulatory framework pertinent to islet xenotransplantation. Except for the chapter on "informed consent," which has remained relevant in its 2009 version, all other chapters included in the initial consensus statement have been revised for inclusion in this update. These chapters will not provide complete revisions of the original chapters; rather, they restate the key points made in 2009, emphasize new and under-appreciated topics not fully addressed in 2009, suggest relevant revisions, and communicate opinions that complement the consensus opinion. Chapter 1 provides an update on national regulatory frameworks addressing xenotransplantation. Chapter 2 a, previously Chapter 2, suggests several important revisions regarding the generation of suitable source pigs from the perspective of the prevention of xenozoonoses. The newly added Chapter 2b discusses conditions for the use of genetically modified source pigs in clinical islet xenotransplantation. Chapter 3 reviews porcine islet product manufacturing and release testing. Chapter 4 revisits the critically important topic of preclinical efficacy and safety data required to justify a clinical trial. The main achievements in the field of transmission of all porcine microorganisms, the rationale for more proportionate recipient monitoring, and response plans are reviewed in Chapter 5. Patient selection criteria and circumstances where trials of islet xenotransplantation would be both medically and ethically justified are examined in Chapter 6 in the context of recent advances in available and emerging alternative therapies for serious and potentially life-threatening complications of diabetes

  20. Effect of infliximab dose increase in rheumatoid arthritis at different trough concentrations: a cohort study in clinical practice conditions

    Directory of Open Access Journals (Sweden)

    Chamaida ePlasencia

    2015-10-01

    Full Text Available BackgroundEvidence supporting treatment intensification in rheumatoid arthritis is limited and controversial. We explored outcomes of infliximab dose increases and accounted for pre-existing trough levels in patients with active rheumatoid arthritis (RA.MethodsThis study was a retrospective study of 42 RA patients who received increased infliximab following an insufficient response (DAS28 > 3.2. Serum concentrations of infliximab and antibodies to infliximab (ATI and DAS28 and EULAR clinical response parameters were recorded for one year. Analyses were performed in three patient groups that were defined by infliximab serum concentration prior to treatment enhancement: No detectable, Low (< 1.1 µg/mL or High (≥ 1.1 µg/mL drug levels. Results No circulating infliximab was detected in 20 patients (47.6 %, but 13 (30.9 % and 9 (21.4 % patients exhibited Low and High levels, respectively. ATI were only detected in patients with No detectable drug levels because the drug interferes with ELISA. DAS28 disease activity globally showed a modest improvement after dose escalation, but this improvement did not persist after 6 and 12 months. Infliximab serum levels increased significantly in the High group (p=0.016, but no increase was achieved in the Low and No detectable groups. The three study groups exhibited similar disease activity over time, and no improvement was observed in the non-responder EULAR rates. ConclusionsThese results suggest that the efficacy of an infliximab dose increase is limited, and the response is independent of the infliximab trough serum concentration that is achieved prior to escalation.

  1. Stable Solution of Nonlinear Age-structuredForest Evolution System

    Institute of Scientific and Technical Information of China (English)

    WANGDing-jiang; ZHAOTing-fang

    2004-01-01

    This paper studies the dynamical behavior of a class of total area dependent nonlinear age-structured forest evolution model. We give the problem of equal value for the forest system, and discuss the stable solution of system. We obtained the necessary and sufficient conditions for there exists the stable solution.

  2. Markov Chain Approximations to Singular Stable-like Processes

    OpenAIRE

    2012-01-01

    We consider the Markov chain approximations for singular stable-like processes. First we obtain properties of some Markov chains. Then we construct the approximating Markov chains and give a necessary condition for weak convergence of these chains to singular stable-like processes.

  3. Comparative evaluation under routine conditions of the nitrate reduction assay, the proportion assay and the MGIT 960 assay for drug susceptibility testing of clinical isolates of Mycobacterium tuberculosis

    Directory of Open Access Journals (Sweden)

    Leila de Souza Fonseca

    2012-02-01

    Full Text Available The performance of the nitrate reductase assay (NRA was compared with the proportion method (PM on Lowenstein-Jensen medium and the BACTEC MGIT960 assay under routine conditions using 160 clinical isolates of Mycobacterium tuberculosis with a high proportion of resistant strains. The mean time to obtain results was 8.8 days and the overall agreements between NRA and PM and NRA and M960 were 95% and 94%, respectively. NRA was easy to perform and represents a useful tool for the rapid screening of drug-resistant M. tuberculosis strains in low-resource countries.

  4. [Dynamics of tumour necrosis factor-alpha and clinical signs of osteoarthrosis during the treatment with alflutop in combination with peloid applications under conditions of health resort].

    Science.gov (United States)

    Maganev, V A; Davletshin, R A; Davletshina, G K; Iapparov, G S

    2011-01-01

    The objective of the present work was to develop indications for the combined treatment of patients presenting with osteoarthrosis including the use of peloid applications and intramuscular injections of alflutop. The study was based at Yakty-Kul' health resort and included 94 patients at the age from 40 to 59 years. The proposed method was shown to have beneficial effect on the patients' clinical conditions. In addition, the treatment caused a decrease in the level of tumour necrosis factor-alpha (TNF-alpha) that turned out to be related to the articular index.

  5. On stable compact minimal submanifolds

    CERN Document Server

    Torralbo, Francisco

    2010-01-01

    Stable compact minimal submanifolds of the product of a sphere and any Riemannian manifold are classified whenever the dimension of the sphere is at least three. The complete classification of the stable compact minimal submanifolds of the product of two spheres is obtained. Also, it is proved that the only stable compact minimal surfaces of the product of a 2-sphere and any Riemann surface are the complex ones.

  6. De-identifying Swedish clinical text - refinement of a gold standard and experiments with Conditional random fields

    Directory of Open Access Journals (Sweden)

    Dalianis Hercules

    2010-04-01

    Full Text Available Abstract Background In order to perform research on the information contained in Electronic Patient Records (EPRs, access to the data itself is needed. This is often very difficult due to confidentiality regulations. The data sets need to be fully de-identified before they can be distributed to researchers. De-identification is a difficult task where the definitions of annotation classes are not self-evident. Results We present work on the creation of two refined variants of a manually annotated Gold standard for de-identification, one created automatically, and one created through discussions among the annotators. The data is a subset from the Stockholm EPR Corpus, a data set available within our research group. These are used for the training and evaluation of an automatic system based on the Conditional Random Fields algorithm. Evaluating with four-fold cross-validation on sets of around 4-6 000 annotation instances, we obtained very promising results for both Gold Standards: F-score around 0.80 for a number of experiments, with higher results for certain annotation classes. Moreover, 49 false positives that were verified true positives were found by the system but missed by the annotators. Conclusions Our intention is to make this Gold standard, The Stockholm EPR PHI Corpus, available to other research groups in the future. Despite being slightly more time-consuming we believe the manual consensus gold standard is the most valuable for further research. We also propose a set of annotation classes to be used for similar de-identification tasks.

  7. Towards clinical molecular diagnosis of inherited cardiac conditions: a comparison of bench-top genome DNA sequencers.

    Directory of Open Access Journals (Sweden)

    Xinzhong Li

    Full Text Available Molecular genetic testing is recommended for diagnosis of inherited cardiac disease, to guide prognosis and treatment, but access is often limited by cost and availability. Recently introduced high-throughput bench-top DNA sequencing platforms have the potential to overcome these limitations.We evaluated two next-generation sequencing (NGS platforms for molecular diagnostics. The protein-coding regions of six genes associated with inherited arrhythmia syndromes were amplified from 15 human samples using parallelised multiplex PCR (Access Array, Fluidigm, and sequenced on the MiSeq (Illumina and Ion Torrent PGM (Life Technologies. Overall, 97.9% of the target was sequenced adequately for variant calling on the MiSeq, and 96.8% on the Ion Torrent PGM. Regions missed tended to be of high GC-content, and most were problematic for both platforms. Variant calling was assessed using 107 variants detected using Sanger sequencing: within adequately sequenced regions, variant calling on both platforms was highly accurate (Sensitivity: MiSeq 100%, PGM 99.1%. Positive predictive value: MiSeq 95.9%, PGM 95.5%. At the time of the study the Ion Torrent PGM had a lower capital cost and individual runs were cheaper and faster. The MiSeq had a higher capacity (requiring fewer runs, with reduced hands-on time and simpler laboratory workflows. Both provide significant cost and time savings over conventional methods, even allowing for adjunct Sanger sequencing to validate findings and sequence exons missed by NGS.MiSeq and Ion Torrent PGM both provide accurate variant detection as part of a PCR-based molecular diagnostic workflow, and provide alternative platforms for molecular diagnosis of inherited cardiac conditions. Though there were performance differences at this throughput, platforms differed primarily in terms of cost, scalability, protocol stability and ease of use. Compared with current molecular genetic diagnostic tests for inherited cardiac arrhythmias

  8. The pancreas is altered by in utero androgen exposure: implications for clinical conditions such as polycystic ovary syndrome (PCOS.

    Directory of Open Access Journals (Sweden)

    Mick Rae

    Full Text Available Using an ovine model of polycystic ovary syndrome (PCOS, (pregnant ewes injected with testosterone propionate (TP (100 mg twice weekly from day (d62 to d102 of d147 gestation (maternal injection - MI-TP, we previously reported female offspring with normal glucose tolerance but hyperinsulinemia. We therefore examined insulin signalling and pancreatic morphology in these offspring using quantitative (Q RT-PCR and western blotting. In addition the fetal pancreatic responses to MI-TP, and androgenic and estrogenic contributions to such responses (direct fetal injection (FI of TP (20 mg or diethylstilbestrol (DES (20 mg at d62 and d82 gestation were assessed at d90 gestation. Fetal plasma was assayed for insulin, testosterone and estradiol, pancreatic tissue was cultured, and expression of key β-cell developmental genes was assessed by QRT-PCR. In female d62MI-TP offspring insulin signalling was unaltered but there was a pancreatic phenotype with increased numbers of β-cells (P<0.05. The fetal pancreas expressed androgen receptors in islets and genes involved in β-cell development and function (PDX1, IGF1R, INSR and INS were up-regulated in female fetuses after d62MI-TP treatment (P<0.05-0.01. In addition the d62MI-TP pancreas showed increased insulin secretion under euglycaemic conditions (P<0.05 in vitro. The same effects were not seen in the male fetal pancreas or when MI-TP was started at d30, before the male programming window. As d62MI-TP increased both fetal plasma testosterone (P<0.05 and estradiol concentrations (P<0.05 we assessed the relative contribution of androgens and estrogens. FI-TP (commencing d62 (not FI-DES treatment caused elevated basal insulin secretion in vitro and the genes altered by d62MI-TP treatment were similarly altered by FI-TP but not FI-DES. In conclusion, androgen over-exposure alters fetal pancreatic development and β-cell numbers in offspring. These data suggest that that there may be a primary pancreatic

  9. Advanced thermally stable jet fuels

    Energy Technology Data Exchange (ETDEWEB)

    Schobert, H.H.

    1999-01-31

    The Pennsylvania State University program in advanced thermally stable coal-based jet fuels has five broad objectives: (1) Development of mechanisms of degradation and solids formation; (2) Quantitative measurement of growth of sub-micrometer and micrometer-sized particles suspended in fuels during thermal stressing; (3) Characterization of carbonaceous deposits by various instrumental and microscopic methods; (4) Elucidation of the role of additives in retarding the formation of carbonaceous solids; (5) Assessment of the potential of production of high yields of cycloalkanes by direct liquefaction of coal. Future high-Mach aircraft will place severe thermal demands on jet fuels, requiring the development of novel, hybrid fuel mixtures capable of withstanding temperatures in the range of 400--500 C. In the new aircraft, jet fuel will serve as both an energy source and a heat sink for cooling the airframe, engine, and system components. The ultimate development of such advanced fuels requires a thorough understanding of the thermal decomposition behavior of jet fuels under supercritical conditions. Considering that jet fuels consist of hundreds of compounds, this task must begin with a study of the thermal degradation behavior of select model compounds under supercritical conditions. The research performed by The Pennsylvania State University was focused on five major tasks that reflect the objectives stated above: Task 1: Investigation of the Quantitative Degradation of Fuels; Task 2: Investigation of Incipient Deposition; Task 3: Characterization of Solid Gums, Sediments, and Carbonaceous Deposits; Task 4: Coal-Based Fuel Stabilization Studies; and Task 5: Exploratory Studies on the Direct Conversion of Coal to High Quality Jet Fuels. The major findings of each of these tasks are presented in this executive summary. A description of the sub-tasks performed under each of these tasks and the findings of those studies are provided in the remainder of this volume

  10. Stable Isogeometric Analysis of Trimmed Geometries

    OpenAIRE

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

    2016-01-01

    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 isogeometri...

  11. Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil

    Directory of Open Access Journals (Sweden)

    Julia Ampuero

    2009-11-01

    Full Text Available The positivities of two methods for the diagnosis of localised cutaneous leishmaniasis (CL were estimated in 280 patients enrolled in a clinical trial. The trial was conducted in an endemic area of Leishmania (Viannia braziliensis and trial participants were patients with skin ulcers and positive leishmanin skin tests. Patients underwent aspirative skin punctures of the ulcerated lesions and lymph nodes for in vitro cultures, which were processed under field conditions at the local health centre. Skin lesion biopsies were tested at a reference laboratory using kinetoplastid DNA (kDNA-PCR to detect DNA. The median time required to obtain a positive culture from the skin samples was seven days and the contamination rate of the samples was 1.8%. The positivities of the cultures from skin lesions, kDNA-PCR and the combination of the two methods were 78.2% (95% CI: 73-82.6%, 89.3% (95% CI: 85.1-92.4% and 97.1% (95% CI: 94.5-98.5%. We conclude that parasite culture is a feasible method for the detection of Leishmania in field conditions and that the combination of culture and PCR has a potential role for the diagnosis of CL in candidates for clinical trials.

  12. Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil.

    Science.gov (United States)

    Ampuero, Julia; Rios, Alexandre Pereira; Carranza-Tamayo, César Omar; Romero, Gustavo Adolfo Sierra

    2009-11-01

    The positivities of two methods for the diagnosis of localised cutaneous leishmaniasis (CL) were estimated in 280 patients enrolled in a clinical trial. The trial was conducted in an endemic area of Leishmania (Viannia) braziliensis and trial participants were patients with skin ulcers and positive leishmanin skin tests. Patients underwent aspirative skin punctures of the ulcerated lesions and lymph nodes for in vitro cultures, which were processed under field conditions at the local health centre. Skin lesion biopsies were tested at a reference laboratory using kinetoplastid DNA (kDNA)-PCR to detect DNA. The median time required to obtain a positive culture from the skin samples was seven days and the contamination rate of the samples was 1.8%. The positivities of the cultures from skin lesions, kDNA-PCR and the combination of the two methods were 78.2% (95% CI: 73-82.6%), 89.3% (95% CI: 85.1-92.4%) and 97.1% (95% CI: 94.5-98.5%). We conclude that parasite culture is a feasible method for the detection of Leishmania in field conditions and that the combination of culture and PCR has a potential role for the diagnosis of CL in candidates for clinical trials.

  13. Hydrolytically stable titanium-45

    DEFF Research Database (Denmark)

    Severin, Gregory; Fonslet, Jesper; Zhuravlev, Fedor

    2014-01-01

    Introduction Titanium-45, a candidate PET isotope, is under-employed largely because of the challenging aqueous chemistry of Ti(IV). The propensity for hydrolysis of Ti(IV) compounds makes radio-labeling difficult and excludes 45Ti from use in bio-conjugate chemistry. This is unfortunate because...... metal-based chemotherapeutics such as cisplatin. The aim of our work has been to produce the radioactive analogue of one of these Ti(IV)-salan compounds, Ti-salan-dipic [2], which has hydro-lytic stability on the order of weeks. Not only will this allow us to shed some light on the still un......-known mechanism of antiproliferative action of titanium-based chemotherapeutics, but it will also make progress toward bioconjugate 45Ti PET tracers. In the current abstract, we present some of the methods we are using to separate 45Ti from irradiated Sc, and subsequent labeling conditions. Material and Methods...

  14. 弹性髓内针治疗儿童桡骨颈骨折的临床应用研究%Clinical application of elastic stable intramedullary nail in treatment of radial neck fractures

    Institute of Scientific and Technical Information of China (English)

    李兵; 张军; 张亚军

    2014-01-01

    目的探讨弹性髓内针治疗桡骨颈骨折疗效。方法我院于2006年5月至2009年9月应用弹性髓内针治疗23例桡骨颈骨折患者,其中男性17例,女性6例,年龄6~13岁,平均9.3岁。摔伤21例,绞伤2例。按 Judet 分型,其中Ⅱ型3例、Ⅲ型16例、Ⅳ型4例。合并肘关节其他部位损伤3例,其中肘关节内侧副韧带损伤2例,肱骨内上髁骨折1例。结果术后随访6~38个月,平均17.5个月。根据 Métaizeau 术后 X 线片评价标准,优18例、良3例、中2例,优良率达91%。功能评价采用 Métaizeau 功能评价标准,优16例、良6例、一般1例,优良率达96%。其中2例桡骨头骺变形膨大,1例出现关节周围异常钙化。结论弹性髓内针治疗桡骨颈骨折操作简便,效果满意。%Background Radial neck fractures account for 5%-10% in elbow joint fractures and most of them are slightly displaced or non-displaced types.Satisfactory therapeutic results can be achieved by conservative treatment.As to severe displaced radial neck fractures,it is controversial in selection of therapeutic methods and curative effect clinically.To explore clinical therapeutic effect of radial neck fractures with elastic intramedullary nail and accumulate experience for diagnosis and treatment,23 cases of radial neck fracture were treated with elastic intramedullary nail from May 2006 to September 2009 in our hospital.Methods From May 2006 to September 2009,23 cases of radial neck fracture were admitted into our hospital and treated with elastic intramedullary nail,including 1 7 male and 6 female,aged from 6 to 13,and the average age was 9.3 years.Traumatic mechanisms were classified as fallen injuries with 21 cases and wringer injuries with 2 cases.Twenty cases were in right elbow and 3 cases were in left elbow.Operation time from injury ranged from 1 to 5 days,and averaged in 2.3 days.There were 3 cases of associated injuries on other parts of the elbow joint,including 2 cases of medial

  15. Improvement of skin condition in striae distensae: development, characterization and clinical efficacy of a cosmetic product containing Punica granatum seed oil and Croton lechleri resin extract

    Science.gov (United States)

    Bogdan, Cătălina; Iurian, Sonia; Tomuta, Ioan; Moldovan, Mirela

    2017-01-01

    Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract) and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae. PMID:28280300

  16. Impact of Denture Cleaning Method and Overnight Storage Condition on Denture Biofilm Mass and Composition: A Cross-Over Randomized Clinical Trial.

    Directory of Open Access Journals (Sweden)

    Joke Duyck

    Full Text Available Appropriate oral hygiene is required to maintain oral health in denture wearers. This study aims to compare the role of denture cleaning methods in combination with overnight storage conditions on biofilm mass and composition on acrylic removable dentures.In a cross-over randomized controlled trial in 13 older people, 4 conditions with 2 different mechanical cleaning methods and 2 overnight storage conditions were considered: (i brushing and immersion in water without a cleansing tablet, (ii brushing and immersion in water with a cleansing tablet, (iii ultrasonic cleaning and immersion in water without a cleansing tablet, and (iv ultrasonic cleaning and immersion in water with a cleansing tablet. Each test condition was performed for 5 consecutive days, preceded by a 2-days wash-out period. Biofilm samples were taken at baseline (control and at the end of each test period from a standardized region. Total and individual levels of selected oral bacteria (n = 20, and of Candida albicans were identified using the Polymerase Chain Reaction (PCR technique. Denture biofilm coverage was scored using an analogue denture plaque score. Paired t-tests and Wilcoxon-signed rank tests were used to compare the test conditions. The level of significance was set at α< 5%.Overnight denture storage in water with a cleansing tablet significantly reduced the total bacterial count (p<0.01. The difference in total bacterial level between the two mechanical cleaning methods was not statistically significant. No significant effect was observed on the amount of Candida albicans nor on the analogue plaque scores.The use of cleansing tablets during overnight denture storage in addition to mechanical denture cleaning did not affect Candida albicans count, but reduced the total bacterial count on acrylic removable dentures compared to overnight storage in water. This effect was more pronounced when combined with ultrasonic cleaning compared to brushing.Clinical

  17. Clinical analysis of the treatment by inhaling the Symbicort Turbuhaler in stable COPD patients%信必可都保吸入治疗COPD稳定期患者临床分析

    Institute of Scientific and Technical Information of China (English)

    乌日娜; 杨敬平; 徐喜媛

    2011-01-01

    目的 观察信必可都保吸入治疗COPD稳定期患者疗效.方法 2006年~2008年收治的80例慢性阻塞性肺疾病(COPD)稳定期患者随机分为观察组44例和对照组36例,两组均予COPD常规治疗,在此基础上观察组予信必可都保吸入,每次1喷,2次/d;对照组口服茶碱缓释片0.1 g,2次/d,并酌情予沙丁胺醇(万托林)气雾剂,疗程均为12周.观察两组治疗前后肺功能、血气指标及不良反应情况.结果 治疗后观察组肺功能、血气指标改善情况均明显优于对照组(P<0.05),不良反应少 .结论 信必可都保吸入能明显改善COPD稳定期患者肺功能及血气指标.%Objective To observe treatment efficacy by inhaling the Symbicort Turbuhaler in stable COPD patients.Methods Between 2006 and 2008 years,treated 80 chronic obstructive pulmonary disease(COPD) stable patients were randomly divided into two groups of 44 cases and the control group 36 cases,the two groups were given correspondingly COPD conventional treatment,on this basis, the observation group was given by Symbicort Turbuhaler inhalation, each one spray,2 times/d ;the control group was treated with theophylline sustained-release tablets 0.1 g,2 times/d,and,to salbutamol( Ventolin)aerosol,both 12-week course of treatment.At the before and after treatment,we observe the Lung function and blood gas targets situation.Results After treatment, observed group lung function, blood gas targets had been improved significantly than the control group( P < 0.05 ) adverse reactions.Conclusion Symbicort Turbuhaler inhalation can significantly improve lung functionin patients with stable COPD,and arterial blood gas targets.

  18. Nuclear physics and stable isotopes; Physique nucleaire et isotopes stables

    Energy Technology Data Exchange (ETDEWEB)

    Goutte, D. [CEA Centre d`Etudes de Saclay, 91 - Gif-sur-Yvette (France). Dept. d`Astrophysique, de la Physique des Particules, de la Physique Nucleaire et de l`Instrumentation Associee

    1994-12-31

    The aim of this paper is to show that fundamental research in nuclear physics requires utilization of stable isotopes; stable isotopes are essential as target material since a large quantity of nucleus have to be studied in order to appreciate all the complexity of the nuclear structure, but also as a tool, such as beams, for the same purpose. Examples are given with samarium, tin and germanium isotopes. 7 figs.

  19. [Clinical pathomorphology of critical conditions].

    Science.gov (United States)

    Rybakova, M G; Zhidkov, K P; Klechikov, V Z

    2005-01-01

    The authors present a review of clinicopathologic manifestations of the most important syndromes of terminal period. Insufficiency and failure of the heart, lungs, brain, kidneys, and liver as well as multiple organ failure are characterized. Precise definition in the autopsy report of the prevailing syndrome and type of death makes it possible to assess adequacy of intensive care and resuscitation, reveal probable causes of their ineffectiveness and improve treatment protocols in premortal period of the disease.

  20. Nonlinear evaluations of unconditionally stable explicit algorithms

    Institute of Scientific and Technical Information of China (English)

    Shuenn-Yih Chang

    2009-01-01

    Two explicit integration algorithms with unconditional stability for linear elastic systems have been successfully developed for pseudodynamic testing. Their numerical properties in the solution of a linear elastic system have been well explored and their applications to the pseudodynamic testing of a nonlinear system have been shown to be feasible. However, their numerical properties in the solution of a nonlinear system are not apparent. Therefore, the performance of both algorithms for use in the solution of a nonlinear system has been analytically evaluated after introducing an instantaneous degree of nonlinearity. The two algorithms have roughly the same accuracy for a small value of the product of the natural frequency and step size. Meanwhile, the first algorithm is unconditionally stable when the instantaneous degree of nonlinearity is less than or equal to 1, and it becomes conditionally stable when it is greater than 1. The second algorithm is conditionally stable as the instantaneous degree of nonlinearity is less than 1/9, and becomes unstable when it is greater than I. It can have unconditional stability for the range between I/9 and 1. Based on these evaluations, it was concluded that the first algorithm is superior to the second one. Also, both algorithms were found to require commensurate computational efforts, which are much less than needed for the Newmark explicit method in general structural dynamic problems.

  1. Up-to-date Clinical Trials of Hair Regeneration using Conditioned Media of Adipose-Derived Stem Cells in Male and Female Pattern Hair Loss.

    Science.gov (United States)

    Shin, Hyoseung; Won, Chong Hyun; Chung, Woon-Kyung; Park, Byung-Soon

    2017-05-04

    The primary roles of mesenchymal stem cells (MSCs) are to maintain the stem cell niche, facilitate recovery after injury, and ensure healthy aging and the homeostasis of organ and tissues. MSCs have recently emerged as a new therapeutic option for hair loss. Since adipose-derived stem cells (ADSCs) are the most accessible sources of MSCs, ADSC-based hair regeneration is currently under investigation. Besides replacing degenerated cells in affected organs, ADSCs exhibit their beneficial effects through the paracrine actions of various cytokines and growth factors. Several laboratory experiments and animal studies have shown that ADSC-related proteins can stimulate hair growth. In this paper, we introduce our clinical pilot studies using conditioned media of ADSCs for pattern hair loss in men and women. We also discuss practical therapeutic challenges and the direction of future research. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  2. Participation-engagement: a philosophically based heuristic for prioritizing clinical interventions in the treatment of comorbid, complex, and chronic psychiatric conditions.

    Science.gov (United States)

    Shahar, Golan; Davidson, Larry

    2009-01-01

    We propose Participation-Engagement (PAR-EN) as a philosophically based heuristic for prioritizing interventions in comorbid, complex, and chronic psychiatric conditions. Drawing from 1) the sociologist Talcott Parsons, 2) the continental-philosophical tradition, and 3) our own previous work (Davidson & Shahar, 2009; Shahar, 2004, 2006), we argue that participation in personally meaningful life goals represents a hallmark of mental health. Symptoms and vulnerabilities that impede such participation should therefore be targeted vigorously, whereas others which do not pose such imminent threats should assume a secondary focus, if at all. Winnicott's (1987) notion of the spontaneous gesture, the importance of daily activities as reflecting patients' participation, and the dialectics of interpersonal relatedness and self-definition, are introduced as guidelines for implementing PAR-EN. Implications for clinical assessment and the therapeutic relationship are discussed.

  3. Preferred extensions as stable models

    CERN Document Server

    Nieves, Juan Carlos; Cortés, Ulises

    2008-01-01

    Given an argumentation framework AF, we introduce a mapping function that constructs a disjunctive logic program P, such that the preferred extensions of AF correspond to the stable models of P, after intersecting each stable model with the relevant atoms. The given mapping function is of polynomial size w.r.t. AF. In particular, we identify that there is a direct relationship between the minimal models of a propositional formula and the preferred extensions of an argumentation framework by working on representing the defeated arguments. Then we show how to infer the preferred extensions of an argumentation framework by using UNSAT algorithms and disjunctive stable model solvers. The relevance of this result is that we define a direct relationship between one of the most satisfactory argumentation semantics and one of the most successful approach of non-monotonic reasoning i.e., logic programming with the stable model semantics.

  4. Vertebral osteomyelitis caused by non-tuberculous mycobacteria: Predisposing conditions and clinical characteristics of six cases and a review of 63 cases in the literature.

    Science.gov (United States)

    Kim, Chung-Jong; Kim, Uh-Jin; Kim, Hong Bin; Park, Sang Won; Oh, Myoung-Don; Park, Kyung-Hwa; Kim, Nam Joong

    2016-07-01

    Background Several case series have reported on clinical and radiographic characteristics of patients with vertebral osteomyelitis (VO) caused by non-tuberculous mycobacteria (NTM). However, only a few patients were included, and systematic reviews are still lacking. The aim of this study was to update and summarise the pre-disposing conditions, clinical and radiographic characteristics of such cases due to NTM. Methods In this study, a systematic review was conducted of the English-language literature from 1961-2014 to investigate the pre-disposing conditions and characteristics of cases of VO due to NTM. Also, six additional cases diagnosed in the study hospitals were described; these cases are included in an analysis of a total of 69 cases of NTM VO. Results The most common species, regardless of the presence of HIV co-infection, was M. avium Complex followed by M. xenopi. Ten cases with HIV infection had a median CD4 lymphocyte count of 320/mm(3) (range = 41-465/mm(3)) at the time of diagnosis of NTM VO. The VO in the cases with HIV infections occurred at an earlier age and more often involved the thoracic spine than in the cases without HIV infection. Pre-disposing trauma or surgery was reported in 14.5% (10/69) of the cases. A variety of immunosuppressive diseases were observed in 49.3% of the patients, including the 10 with HIV infections and corticosteroids were used in 27.5% of the cases. Surgery was performed in 67.6% and improvement was reported in 80.6%. Conclusion NTM should be considered in immunocompromised patients with indolent VO without confirmation of tuberculosis.

  5. A facile method to establish human induced pluripotent stem cells from adult blood cells under feeder-free and xeno-free culture conditions: a clinically compliant approach.

    Science.gov (United States)

    Chou, Bin-Kuan; Gu, Haihui; Gao, Yongxing; Dowey, Sarah N; Wang, Ying; Shi, Jun; Li, Yanxin; Ye, Zhaohui; Cheng, Tao; Cheng, Linzhao

    2015-04-01

    Reprogramming human adult blood mononuclear cells (MNCs) cells by transient plasmid expression is becoming increasingly popular as an attractive method for generating induced pluripotent stem (iPS) cells without the genomic alteration caused by genome-inserting vectors. However, its efficiency is relatively low with adult MNCs compared with cord blood MNCs and other fetal cells and is highly variable among different adult individuals. We report highly efficient iPS cell derivation under clinically compliant conditions via three major improvements. First, we revised a combination of three EBNA1/OriP episomal vectors expressing five transgenes, which increased reprogramming efficiency by ≥10-50-fold from our previous vectors. Second, human recombinant vitronectin proteins were used as cell culture substrates, alleviating the need for feeder cells or animal-sourced proteins. Finally, we eliminated the previously critical step of manually picking individual iPS cell clones by pooling newly emerged iPS cell colonies. Pooled cultures were then purified based on the presence of the TRA-1-60 pluripotency surface antigen, resulting in the ability to rapidly expand iPS cells for subsequent applications. These new improvements permit a consistent and reliable method to generate human iPS cells with minimal clonal variations from blood MNCs, including previously difficult samples such as those from patients with paroxysmal nocturnal hemoglobinuria. In addition, this method of efficiently generating iPS cells under feeder-free and xeno-free conditions allows for the establishment of clinically compliant iPS cell lines for future therapeutic applications. ©AlphaMed Press.

  6. Preferred extensions as stable models

    OpenAIRE

    2008-01-01

    Given an argumentation framework AF, we introduce a mapping function that constructs a disjunctive logic program P, such that the preferred extensions of AF correspond to the stable models of P, after intersecting each stable model with the relevant atoms. The given mapping function is of polynomial size w.r.t. AF. In particular, we identify that there is a direct relationship between the minimal models of a propositional formula and the preferred extensions of an argumentation framework by w...

  7. Diagnosis and Management of Stable Chronic Obstructive Pulmonary Disease : A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society

    NARCIS (Netherlands)

    Qaseem, Amir; Wilt, Timothy J.; Weinberger, Steven E.; Hanania, Nicola A.; Criner, Gerard; van der Molen, Thys; Marciniuk, Darcy D.; Denberg, Tom; Schuenemann, Holger; Wedzicha, Wisia; MacDonald, Roderick; Shekelle, Paul

    2011-01-01

    Description: This guideline is an official statement of the American College of Physicians (ACP), American College of Chest Physicians (ACCP), American Thoracic Society (ATS), and European Respiratory Society (ERS). It represents an update of the 2007 ACP clinical practice guideline on diagnosis and

  8. A Numerical Handling of the Boundary Conditions Imposed by the Skull on an Inhomogeneous Diffusion-Reaction Model of Glioblastoma Invasion Into the Brain: Clinical Validation Aspects

    Directory of Open Access Journals (Sweden)

    Georgios S Stamatakos

    2017-01-01

    Full Text Available A novel explicit triscale reaction-diffusion numerical model of glioblastoma multiforme tumor growth is presented. The model incorporates the handling of Neumann boundary conditions imposed by the cranium and takes into account both the inhomogeneous nature of human brain and the complexity of the skull geometry. The finite-difference time-domain method is adopted. To demonstrate the workflow of a possible clinical validation procedure, a clinical case/scenario is addressed. A good agreement of the in silico calculated value of the doubling time (ie, the time for tumor volume to double with the value of the same quantity based on tomographic imaging data has been observed. A theoretical exploration suggests that a rough but still quite informative value of the doubling time may be calculated based on a homogeneous brain model. The model could serve as the main component of a continuous mathematics-based glioblastoma oncosimulator aiming at supporting the clinician in the optimal patient-individualized design of treatment using the patient’s multiscale data and experimenting in silico (ie, on the computer.

  9. Use of Condition-Specific Patient-Reported Outcome Measures in Clinical Trials among Patients with Wrist Osteoarthritis: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Steven M. McPhail

    2012-01-01

    Full Text Available Background. This paper aimed to identify condition-specific patient-reported outcome measures used in clinical trials among people with wrist osteoarthritis and summarise empirical peer-reviewed evidence supporting their reliability, validity, and responsiveness to change. Methods. A systematic review of randomised controlled trials among people with wrist osteoarthritis was undertaken. Studies reporting reliability, validity, or responsiveness were identified using a systematic reverse citation trail audit procedure. Psychometric properties of the instruments were examined against predefined criteria and summarised. Results. Thirteen clinical trials met inclusion criteria. The most common patient-reported outcome was the disabilities of the arm, shoulder, and hand questionnaire (DASH. The DASH, the Michigan Hand Outcomes Questionnaire (MHQ, the Patient Evaluation Measure (PEM, and the Patient-Reported Wrist Evaluation (PRWE had evidence supporting their reliability, validity, and responsiveness. A post-hoc review of excluded studies revealed the AUSCAN Osteoarthritis Hand Index as another suitable instrument that had favourable reliability, validity, and responsiveness. Conclusions. The DASH, MHQ, and AUSCAN Osteoarthritis Hand Index instruments were supported by the most favourable empirical evidence for validity, reliability, and responsiveness. The PEM and PRWE also had favourable empirical evidence reported for these elements. Further psychometric testing of these instruments among people with wrist osteoarthritis is warranted.

  10. Improvement of skin condition in striae distensae: development, characterization and clinical efficacy of a cosmetic product containing Punica granatum seed oil and Croton lechleri resin extract

    Directory of Open Access Journals (Sweden)

    Bogdan C

    2017-02-01

    Full Text Available Cătălina Bogdan,1 Sonia Iurian,2 Ioan Tomuta,2 Mirela Moldovan1 1Department of Dermatopharmacy and Cosmetics, 2Department of Pharmaceutical Technology and Biopharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania Abstract: Striae distensae are a frequent skin condition associated with pregnancy, weight change or lack of skin elasticity. The aim of this research was to obtain a topical product containing herbal active ingredients with documented antioxidant and anti-inflammatory activity (Punica granatum seed oil and Croton lechleri resin extract and demonstrate its positive effect on prevention and treatment of striae distensae. First, the cream base formulation was optimized through experimental design. Secondly, the cream containing the two active ingredients was investigated in an interventional nonrandomized clinical trial. The clinical outcome was assessed through biophysical parameters and ultrasonographic evaluation. The state of the skin was evaluated by biophysical measurements and ultrasonography at the beginning of the study and after 3 and 6 weeks. The experimental design was successfully used to set the best ranges for the technological and formulation factors to obtain a cosmetic formulation with optimal characteristics. The study of clinical efficacy on the optimal formulation revealed an increase in the dermis thickness, hydration and elasticity values in both groups after 6 weeks of cream application. The new oil-in-water cream containing P. granatum seed oil and C. lechleri resin extract can be helpful in the prevention or improving of skin changes associated with striae. Keywords: stretch marks, ultrasonography, texture analysis, design of experiments, oil-in-water emulsion

  11. Investigating the condition of medical counseling and some of clinical aspects for fasting in holy month of Ramadan from the perspective of diabetic and hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ahmad Mahmoudian

    2015-06-01

    Full Text Available Introduction: Although fasting has many benefits for health, it can be dangerous for patients. So it is necessary that physicians have adequate information about clinical aspects of fasting and they should advice patients. Therefore in this study we analyses the condition of physicians counseling about fasting from the perspective of patients. Methods:In this descriptive analytical cross-sectional study, patients with diabetes and hypertension who were going to doctors in Isfahan in holy month of Ramadan of 2012 and 2013 completed the questionnaires. A valid self-regulation questionnaire including patient`s satisfaction from the quality of physicians counseling about fasting (In the area of education, evaluation of the patient condition, communication /relationship with patients, caring for diseases in holy Ramadan and the incidence of symptoms in fasting had been used with  = 0.76. The patients completed the questionnaire after visit. The data was analyzed by Independent t-test, chi-square, Regression, one-way ANOVA in the19 spss software. Results: 285 patients, 199(69.8% female and 86(30.2% male, were selected. The mean satisfaction score of counseling was 70.50 ±13.23. The highest score (75.36±14.16 was referred to counseling of physician, and the least score (66.09±18.84 to patient assessment by physician. Mean score of Patients' satisfaction of specialists was higher than of general practitioner (p-value

  12. Transportation conditions for prompt use of ex vivo expanded and freshly harvested clinical-grade bone marrow mesenchymal stromal/stem cells for bone regeneration.

    Science.gov (United States)

    Veronesi, Elena; Murgia, Alba; Caselli, Anna; Grisendi, Giulia; Piccinno, Maria Serena; Rasini, Valeria; Giordano, Rosaria; Montemurro, Tiziana; Bourin, Philippe; Sensebé, Luc; Rojewski, Markus T; Schrezenmeier, Hubert; Layrolle, Pierre; Ginebra, Maria Pau; Panaitescu, Carmen Bunu; Gómez-Barrena, Enrique; Catani, Fabio; Paolucci, Paolo; Burns, Jorge S; Dominici, Massimo

    2014-03-01

    Successful preliminary studies have encouraged a more translational phase for stem cell research. Nevertheless, advances in the culture of human bone marrow-derived mesenchymal stromal/stem cells (hBM-MSC) and osteoconductive qualities of combined biomaterials can be undermined if necessary cell transportation procedures prove unviable. We aimed at evaluating the effect of transportation conditions on cell function, including the ability to form bone in vivo, using procedures suited to clinical application. hBM-MSC expanded in current Good Manufacturing Practice (cGMP) facilities (cGMP-hBM-MSC) to numbers suitable for therapy were transported overnight within syringes and subsequently tested for viability. Scaled-down experiments mimicking shipment for 18 h at 4°C tested the influence of three different clinical-grade transportation buffers (0.9% saline alone or with 4% human serum albumin [HSA] from two independent sources) compared with cell maintenance medium. Cell viability after shipment was >80% in all cases, enabling evaluation of (1) adhesion to plastic flasks and hydroxyapatite tricalcium phosphate osteoconductive biomaterial (HA/β-TCP 3D scaffold); (2) proliferation rate; (3) ex vivo osteogenic differentiation in contexts of 2D monolayers on plastic and 3D HA/β-TCP scaffolds; and (4) in vivo ectopic bone formation after subcutaneous implantation of cells with HA/β-TCP scaffold into NOD/SCID mice. Von Kossa staining was used to assess ex vivo osteogenic differentiation in 3D cultures, providing a quantifiable test of 3D biomineralization ex vivo as a rapid, cost-effective potency assay. Near-equivalent capacities for cell survival, proliferation, and osteogenic differentiation were found for all transportation buffers. Moreover, cGMP-hBM-MSC transported from a production facility under clinical-grade conditions of 4% HSA in 0.9% saline to a destination 18 h away showed prompt adhesion to HA/β-TCP 3D scaffold and subsequent in vivo bone formation

  13. Generation of a stable packaging cell line producing high-titer PPT-deleted integration-deficient lentiviral vectors

    Directory of Open Access Journals (Sweden)

    Peirong Hu

    2015-01-01

    Full Text Available The risk of insertional mutagenesis inherent to all integrating exogenous expression cassettes was the impetus for the development of various integration-defective lentiviral vector (IDLV systems. These systems were successfully employed in a plethora of preclinical applications, underscoring their clinical potential. However, current production of IDLVs by transient plasmid transfection is not optimal for large-scale production of clinical grade vectors. Here, we describe the development of the first tetracycline-inducible stable IDLV packaging cell line comprising the D64E integrase mutant and the VSV-G envelope protein. A conditional self-inactivating (cSIN vector and a novel polypurine tract (PPT-deleted vector were incorporated into the newly developed stable packaging cell line by transduction and stable transfection, respectively. High-titer (∼107 infectious units (IU/ml cSIN vectors were routinely generated. Furthermore, screening of single-cell clones stably transfected with PPT-deleted vector DNA resulted in the identification of highly efficient producer cell lines generating IDLV titers higher than 108 IU/mL, which upon concentration increased to 1010 IU/ml. IDLVs generated by stable producer lines efficiently transduce CNS tissues of rodents. Overall, the availability of high-titer IDLV lentivirus packaging cell line described here will significantly facilitate IDLV-based basic science research, as well as preclinical and clinical applications.

  14. Generation of a stable packaging cell line producing high-titer PPT-deleted integration-deficient lentiviral vectors.

    Science.gov (United States)

    Hu, Peirong; Li, Yedda; Sands, Mark S; McCown, Thomas; Kafri, Tal

    2015-01-01

    The risk of insertional mutagenesis inherent to all integrating exogenous expression cassettes was the impetus for the development of various integration-defective lentiviral vector (IDLV) systems. These systems were successfully employed in a plethora of preclinical applications, underscoring their clinical potential. However, current production of IDLVs by transient plasmid transfection is not optimal for large-scale production of clinical grade vectors. Here, we describe the development of the first tetracycline-inducible stable IDLV packaging cell line comprising the D64E integrase mutant and the VSV-G envelope protein. A conditional self-inactivating (cSIN) vector and a novel polypurine tract (PPT)-deleted vector were incorporated into the newly developed stable packaging cell line by transduction and stable transfection, respectively. High-titer (~10(7) infectious units (IU)/ml) cSIN vectors were routinely generated. Furthermore, screening of single-cell clones stably transfected with PPT-deleted vector DNA resulted in the identification of highly efficient producer cell lines generating IDLV titers higher than 10(8) IU/mL, which upon concentration increased to 10(10) IU/ml. IDLVs generated by stable producer lines efficiently transduce CNS tissues of rodents. Overall, the availability of high-titer IDLV lentivirus packaging cell line described here will significantly facilitate IDLV-based basic science research, as well as preclinical and clinical applications.

  15. Ageing, exposure to pollution, and interactions between climate change and local seasons as oxidant conditions predicting incident hematologic malignancy at KINSHASA University clinics, Democratic Republic of CONGO (DRC).

    Science.gov (United States)

    Nkanga, Mireille Solange Nganga; Longo-Mbenza, Benjamin; Adeniyi, Oladele Vincent; Ngwidiwo, Jacques Bikaula; Katawandja, Antoine Lufimbo; Kazadi, Paul Roger Beia; Nzonzila, Alain Nganga

    2017-08-23

    The global burden of hematologic malignancy (HM) is rapidly rising with aging, exposure to polluted environments, and global and local climate variability all being well-established conditions of oxidative stress. However, there is currently no information on the extent and predictors of HM at Kinshasa University Clinics (KUC), DR Congo (DRC). This study evaluated the impact of bio-clinical factors, exposure to polluted environments, and interactions between global climate changes (EL Nino and La Nina) and local climate (dry and rainy seasons) on the incidence of HM. This hospital-based prospective cohort study was conducted at Kinshasa University Clinics in DR Congo. A total of 105 black African adult patients with anaemia between 2009 and 2016 were included. HM was confirmed by morphological typing according to the French-American-British (FAB) Classification System. Gender, age, exposure to traffic pollution and garages/stations, global climate variability (El Nino and La Nina), and local climate (dry and rainy seasons) were potential independent variables to predict incident HM using Cox regression analysis and Kaplan Meier curves. Out of the total 105 patients, 63 experienced incident HM, with an incidence rate of 60%. After adjusting for gender, HIV/AIDS, and other bio-clinical factors, the most significant independent predictors of HM were age ≥ 55 years (HR = 2.4; 95% CI 1.4-4.3; P = 0.003), exposure to pollution and garages or stations (HR = 4.9; 95% CI 2-12.1; P types included acute myeloid leukaemia (28.6% n = 18), multiple myeloma (22.2% n = 14), myelodysplastic syndromes (15.9% n = 10), chronic myeloid leukaemia (15.9% n = 10), chronic lymphoid leukaemia (9.5% n = 6), and acute lymphoid leukaemia (7.9% n = 5). After adjusting for confounders using Cox regression analysis, age ≥ 55 years, exposure to pollution, combined local dry season + La Nina and combined local dry season + El Nino were the most significant predictors of

  16. 模拟场景下临床路径对提高院前创伤救治质量的研究%Effect of clinical pathway on promoting pre-hospital trauma care under clinical simulations condition

    Institute of Scientific and Technical Information of China (English)

    付卫林; 张军根; 袁轶俊; 唐春福; 张燕军; 张志伟

    2015-01-01

    Objective To explore the effect of clinical pathway on promoting pre-hospital trauma care under clinical simulations condition. Methods The traumatic mimic patients and pre-hospital clinical pathway were designed and the traditional traumaic treatment and clinical pathway treatment were used on simulated patients. Results After training, the percentage of locale assessment, life-threatening bleeding assessment, airway assessment, breathing assessment, circula-tion assessment, rapidly trauma assessment and communication with teammates and assistants were significantly increased (χ2=80.81, 88.17, 66.78, 55.54, 74.67, 84.41, 64.07, 74.67,P<0.05). The scores of control bleeding, dressing, cervi-cal spine immobilization, airway management were also significantly improved (t=-42.97,-35.37,-54.34,-88.75,-52.28, P<0.05). Moreover, the time of locale treatment, assessment, control bleeding and dressing, cervical spine immobiliza-tion, fracture fixation were significantly shortened than that of before training (t=4.88,12.81,6.63,3.92,4.58,P<0.05). Conclusion The clinical pathway under clinical simulations condition can improve the quality of trauma assessment, re-duce time of treatment, improve the efficiency and the quality of treatment.%目的:探讨在模拟场景下临床路径对提高院前创伤救治质量的有效程度。方法设计创伤的模拟病例场景和创伤的院前临床路径,以传统的创伤救治和临床路径的救治方式分别对模拟病例进行救治。结果培训后进行现场评估、显性大出血评估、气道评估、呼吸评估、循环评估、快速查体评估、救治沟通、协助救治的急救小组比例较培训前有明显提高(χ2分别=80.81、88.17、66.78、55.54、74.67、84.41、64.07、74.67,P均<0.05)。止血、包扎、长骨固定、颈椎固定、气道管理等各单项技能操作的成绩也较培训前明显提高(t分别=-42.97、-35.37、-54.34、-88.75、-52.28,P均<0.05

  17. Stable Boundary Layer Education (STABLE) Final Campaign Summary

    Energy Technology Data Exchange (ETDEWEB)

    Turner, David D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-03-01

    The properties of, and the processes that occur in, the nocturnal stable boundary layer are not well understood, making it difficult to represent adequately in numerical models. The nocturnal boundary layer often is characterized by a temperature inversion and, in the Southern Great Plains region, a low-level jet. To advance our understanding of the nocturnal stable boundary layer, high temporal and vertical resolution data on the temperature and wind properties are needed, along with both large-eddy simulation and cloud-resolving modeling.

  18. On the existence of stable seasonally varying Arctic sea ice

    CERN Document Server

    Moon, W

    2012-01-01

    Within the framework lower order thermodynamic theories for the climatic evolution of Arctic sea ice we isolate the conditions required for the existence of stable seasonally-varying ice states. This is done by constructing a two-season model from the continuously evolving theory of Eisenman and Wettlaufer (2009) and showing that the necessary and sufficient condition for stable seasonally-varying states resides in the relaxation of the constant annual average short-wave radiative forcing. This forcing is examined within the scenario of greenhouse gas warming, as a function of which stability conditions are discerned.

  19. Stable Degeneracies for Ising Models

    Science.gov (United States)

    Knauf, Andreas

    2016-10-01

    We introduce and consider the notion of stable degeneracies of translation invariant energy functions, taken at spin configurations of a finite Ising model. By this term we mean the lack of injectivity that cannot be lifted by changing the interaction. We show that besides the symmetry-induced degeneracies, related to spin flip, translation and reflection, there exist additional stable degeneracies, due to more subtle symmetries. One such symmetry is the one of the Singer group of a finite projective plane. Others are described by combinatorial relations akin to trace identities. Our results resemble traits of the length spectrum for closed geodesics on a Riemannian surface of constant negative curvature. There, stable degeneracy is defined w.r.t. Teichmüller space as parameter space.

  20. Stable clocks and general relativity

    CERN Document Server

    Will, C M

    1995-01-01

    We survey the role of stable clocks in general relativity. Clock comparisons have provided important tests of the Einstein Equivalence Principle, which underlies metric gravity. These include tests of the isotropy of clock comparisons (verification of local Lorentz invariance) and tests of the homogeneity of clock comparisons (verification of local position invariance). Comparisons of atomic clocks with gravitational clocks test the Strong Equivalence Principle by bounding cosmological variations in Newton's constant. Stable clocks also play a role in the search for gravitational radiation: comparision of atomic clocks with the binary pulsar's orbital clock has verified gravitational-wave damping, and phase-sensitive detection of waves from inspiralling compact binaries using laser interferometric gravitational observatories will facilitate extraction of useful source information from the data. Stable clocks together with general relativity have found important practical applications in navigational systems s...

  1. Skin-whitening and skin-condition-improving effects of topical oxidized glutathione: a double-blind and placebo-controlled clinical trial in healthy women

    Directory of Open Access Journals (Sweden)

    Watanabe F

    2014-10-01

    Full Text Available Fumiko Watanabe,1 Erika Hashizume,1 Gertrude P Chan,2 Ayako Kamimura11Healthcare Products Development Center, KYOWA HAKKO BIO CO., LTD., Tsukuba, Ibaraki, Japan; 2Clinical Trial Management and Testing Associates, Inc., Filinvest Corporate City, Alabang, Muntinlupa City, PhilippinesPurpose: Glutathione is a tripeptide consisting of cysteine, glycine, and glutamate and functions as a major antioxidant. It is synthesized endogenously in humans. Glutathione protects thiol protein groups from oxidation and is involved in cellular detoxification for maintenance of the cell environment. Reduced glutathione (GSH has a skin-whitening effect in humans through its tyrosinase inhibitory activity, but in the case of oxidized glutathione (GSSG this effect is unclear. We examined the skin-whitening and skin-condition effects of topical GSSG in healthy women.Subjects and methods: The subjects were 30 healthy adult women aged 30 to 50 years. The study design was a randomized, double-blind, matched-pair, placebo-controlled clinical trial. Subjects applied GSSG 2% (weight/weight [w/w] lotion to one side of the face and a placebo lotion to the other side twice daily for 10 weeks. We objectively measured changes in melanin index values, moisture content of the stratum corneum, smoothness, wrinkle formation, and elasticity of the skin. The principal investigator and each subject also used subjective scores to investigate skin whitening, wrinkle reduction, and smoothness. Analysis of variance was used to evaluate differences between groups.Results: The skin melanin index was significantly lower with GSSG treatment than with placebo from the early weeks after the start of the trial through to the end of the study period (at 10 weeks, P<0.001. In addition, in the latter half of the study period GSSG-treated sites had significant increases in moisture content of the stratum corneum, suppression of wrinkle formation, and improvement in skin smoothness. There were no

  2. 256层ICT探测冠状动脉钙化在不稳定心绞痛与稳定心绞痛患者中的对比%Detection of Coronary Artery Calcification Score and Compare it in Patients Diagnosed Clinically as Stable and Unstable Angina by 256 ICT

    Institute of Scientific and Technical Information of China (English)

    朱大光

    2013-01-01

    目的:探讨256层ICT在探测冠状动脉钙化积分中的意义。方法:采用256层ICT对2组患者进行冠状动脉钙化积分扫描,钙化积分由工作站软件自动获得,132例患者分为2组,55例稳定心绞痛,77不例稳定心绞痛。结果:不稳定心绞痛患者的钙化积分要显著大于稳定心绞痛患者(p<0.05),不稳定心绞痛患者的血管钙化数目要明显多于稳定心绞痛组。结论:不稳定心绞痛患者的钙化更明显,因此预测冠状动脉情况冠状动脉钙化积分可以作为重要指标。%Objective:To detect Coronary calcification score and compare it in patients diagnosed clinically of having stable and unsta -ble angina and they being more prone for cardiovascular risk .Methods:Coronary artery calcification was scanned and its scores ( CACS) were measured through 256-slice ICT in 132 patients diagnosed of having stable and unstable angina .(55 stable and 77 unstable angi-na).the result were analyzed statistically by 2-grouped test.Also some associated risk factors were also taken into concideraton (HTN, total cholesterol ,Triglycerides etc ) .Results:The calcification scores in patients with unstable angina were comparatively more than those with patients having stable angina (p<0.05).Also it found that 3-vesssel calcification was more significant with unstable angina ,where as 1-vesssel calcification was more significant with stable angina cases .Conclusion:Coronary artery calcification scores is of great value in predicting cardiovascular enets .

  3. Stable complex solitary waves of Sasa Satsuma equation

    Indian Academy of Sciences (India)

    Sasanka Ghosh

    2001-11-01

    Existence of a new class of complex solitary waves is shown for Sasa Satsuma equation. These solitary waves are found to be stable in a certain domain of the parameter and become chaotic if the parameter exceeds the value 2.4. Significantly, the complex solitary waves propagate at higher bit rate over the most stable solitons under the same conditions of the input parameters.

  4. Organismal effects of pesticide exposure on meadow voles (Microtus pennsylvanicus) living in golf course ecosystems: developmental instability, clinical hematology, body condition, and blood parasitology.

    Science.gov (United States)

    Knopper, Loren D; Mineau, Pierre

    2004-06-01

    This is the second of two articles reporting the results of a nonlethal biomonitoring study that quantified the effects of pesticide exposure on meadow voles (Microtus pennsylvanicus) living in golf course ecosystems of the Ottawa/Gatineau region (ON and PQ, Canada, respectively). In the present article, we describe results of measurements regarding developmental instability (e.g., fluctuating asymmetry), congenital birth defects (e.g., skeletal terata), clinical hematology (e.g., differential counts), general body condition (e.g., body mass-length relationships), and blood parasite load (Trypanosoma sp. and Bartonella spp.). Voles were captured during the year 2001 to 2003 at six golf courses and two reference sites. Once voles were fully sedated using isoflurane, blood was collected, radiographs taken, and morphometric measurements recorded. Three animals from each course were euthanized to determine body burdens of historically used organochlorine (OC) and metal-based pesticides. Exposure to in-use pesticides was determined from detailed golf course pesticide-use records. None of the endpoints measured was significantly related to body burdens of OC pesticides and metals historically used, nor did any endpoint significantly vary among capture sites in relation to total pesticide application to the capture site or to the number of days since the last application of pesticide. Based on these findings, it appears that voles from golf courses were no less healthy than their conspecifics from reference sites.

  5. Monitoring of stable glaucoma patients

    NARCIS (Netherlands)

    K.M. Holtzer-Goor (Kim); N.S. Klazinga (Niek); M.A. Koopmanschap (Marc); H.G. Lemij (Hans); T. Plochg; E. van Sprundel (Esther)

    2010-01-01

    textabstractA high workload for ophthalmologists and long waiting lists for patients challenge the organization of ophthalmic care. Tasks that require less specialized skills, like the monitoring of stable (well controlled) glaucoma patients could be substituted from ophthalmologists to other profes

  6. Bayesian stable isotope mixing models

    Science.gov (United States)

    In this paper we review recent advances in Stable Isotope Mixing Models (SIMMs) and place them into an over-arching Bayesian statistical framework which allows for several useful extensions. SIMMs are used to quantify the proportional contributions of various sources to a mixtur...

  7. Stable Networks and Convex Payoffs

    NARCIS (Netherlands)

    Gilles, R.P.; Sarangi, S.

    2005-01-01

    Recently a variety of link-based stability concepts have emerged in the literature on game theoretic models of social network formation.We investigate two basic formation properties that establish equivalence between some well known types of stable networks and their natural extensions.These propert

  8. Clinical Observation of 170 Cases of Suhuangzhike Capsule in the Treatment of Stable Chronic Obstructive Pulmonary Disease%苏黄止咳胶囊治疗慢性阻塞性肺病稳定期170例疗效观察

    Institute of Scientific and Technical Information of China (English)

    徐泰; 孙辉

    2015-01-01

    目的:探讨苏黄止咳胶囊治疗慢性阻塞性肺病(COPD)稳定期提高生存质量的临