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Sample records for cps control totals

  1. Resource-aware control and dynamic scheduling in CPS

    NARCIS (Netherlands)

    Heemels, W.P.M.H.

    2015-01-01

    Recent developments in computer and communication technologies are leading to an increasingly networked and wireless world. This raises new challenging questions in the context of control for cyberphysical systems (CPS), especially when the computation, communication, energy and actuation resources

  2. A Simple CPS Transformation of Control-Flow Information

    DEFF Research Database (Denmark)

    Damian, Daniel; Danvy, Olivier

    2002-01-01

    We build on Danvy and Nielsen's first-order program transformation into continuation-passing style (CPS) to design a new CPS transformation of flow information that is simpler and more efficient than what has been presented in previous work. The key to simplicity and efficiency is that our CPS tr...

  3. Total synthesis of a Streptococcus pneumoniae serotype 12F CPS repeating unit hexasaccharide

    Directory of Open Access Journals (Sweden)

    Peter H. Seeberger

    2017-01-01

    Full Text Available The Gram-positive bacterium Streptococcus pneumoniae causes severe disease globally. Vaccines that prevent S. pneumoniae infections induce antibodies against epitopes within the bacterial capsular polysaccharide (CPS. A better immunological understanding of the epitopes that protect from bacterial infection requires defined oligosaccharides obtained by total synthesis. The key to the synthesis of the S. pneumoniae serotype 12F CPS hexasaccharide repeating unit that is not contained in currently used glycoconjugate vaccines is the assembly of the trisaccharide β-D-GalpNAc-(1→4-[α-D-Glcp-(1→3]-β-D-ManpNAcA, in which the branching points are equipped with orthogonal protecting groups. A linear approach relying on the sequential assembly of monosaccharide building blocks proved superior to a convergent [3 + 3] strategy that was not successful due to steric constraints. The synthetic hexasaccharide is the starting point for further immunological investigations.

  4. A Selective CPS Transformation

    DEFF Research Database (Denmark)

    Nielsen, Lasse Riechstein

    2001-01-01

    characterize this involvement as a control effect and we present a selective CPS transformation that makes functions and expressions continuation-passing if they have a control effect, and that leaves the rest of the program in direct style. We formalize this selective CPS transformation with an operational...

  5. Modeling of continuous withdrawal and falling out of CPS control rods accident, using QUABOX/CUBBOX-HYCA code

    International Nuclear Information System (INIS)

    Bubelis, E.; Pabarcius, R.; Tonkunas, A.

    2003-01-01

    At present, at the Ignalina NPP the process of a wider use of the new uranium-erbium fuel of higher saturation and the manual control rods of new design is going on. These actions are directed to reducing the reactor control and protection system (CPS) cooling circuit voiding effect and to improving the technical and economical reactor operation parameters. Continuous withdrawal and falling out of CPS control rods lead to the reactivity and power changes in the reactor core. Therefore, important for safety is the evaluation of the CPS ability to compensate for the resulting excess reactivity in the reactor core, having the changed core loading conditions during such accidents. This article presents the calculation results of the continuous withdrawal and falling out of CPS control rods for the specific reactor core conditions of the Ignalina NPP Unit 2, i.e. during its operation on the maximum allowed power level of 4200 MW. The German code QUABOX/CUBBOX-HYCA with the improved CPS logic was used for the simulation of the above-mentioned transients. (author)

  6. A game-theoretic method for cross-layer stochastic resilient control design in CPS

    Science.gov (United States)

    Shen, Jiajun; Feng, Dongqin

    2018-03-01

    In this paper, the cross-layer security problem of cyber-physical system (CPS) is investigated from the game-theoretic perspective. Physical dynamics of plant is captured by stochastic differential game with cyber-physical influence being considered. The sufficient and necessary condition for the existence of state-feedback equilibrium strategies is given. The attack-defence cyber interactions are formulated by a Stackelberg game intertwined with stochastic differential game in physical layer. The condition such that the Stackelberg equilibrium being unique and the corresponding analytical solutions are both provided. An algorithm is proposed for obtaining hierarchical security strategy by solving coupled games, which ensures the operational normalcy and cyber security of CPS subject to uncertain disturbance and unexpected cyberattacks. Simulation results are given to show the effectiveness and performance of the proposed algorithm.

  7. Study on perception and control layer of mine CPS with mixed logic dynamic approach

    Science.gov (United States)

    Li, Jingzhao; Ren, Ping; Yang, Dayu

    2017-01-01

    Mine inclined roadway transportation system of mine cyber physical system is a hybrid system consisting of a continuous-time system and a discrete-time system, which can be divided into inclined roadway signal subsystem, error-proofing channel subsystems, anti-car subsystems, and frequency control subsystems. First, to ensure stable operation, improve efficiency and production safety, this hybrid system model with n inputs and m outputs is constructed and analyzed in detail, then its steady schedule state to be solved. Second, on the basis of the formal modeling for real-time systems, we use hybrid toolbox for system security verification. Third, the practical application of mine cyber physical system shows that the method for real-time simulation of mine cyber physical system is effective.

  8. An Operational Investigation of the CPS Hierarchy

    DEFF Research Database (Denmark)

    Danvy, Olivier; Yang, Zhe

    1999-01-01

    We explore the hierarchy of control induced by successive transformations into continuation-passing style (CPS) in the presence of “control delimiters ” and “composable continuations ”. Specifically, we investigate the structural operational semantics associated with the CPS hierarchy. To this end......, we characterize an operational notion of continuation semantics. We relate it to the traditional CPS transformation and we use it to account for the control operator shift and the control delimiter reset operationally. We then transcribe the resulting continuation semantics in ML, thus obtaining...

  9. An Operational Investigation of the CPS Hierarchy

    DEFF Research Database (Denmark)

    Danvy, Olivier; Yang, Zhe

    1998-01-01

    We explore the hierarchy of control induced by successive transformations into continuation-passing style (CPS) in the presence of “control delimiters ” and “composable continuations ”. Specifically, we investigate the structural operational semantics associated with the CPS hierarchy. To this end......, we characterize an operational notion of continuation semantics. We relate it to the traditional CPS transformation and we use it to account for the control operator shift and the control delimiter reset operationally. We then transcribe the resulting continuation semantics in ML, thus obtaining...

  10. CA/CPS: A Communications ZEBRA implementation using CPS

    International Nuclear Information System (INIS)

    Roberts, L.A.

    1991-05-01

    CZ/CPS is an implementation of the Communications ZEBRA distributed computing environment utilizing the CPS communications protocol. CZ/CPS is intended for parallelization of high energy physics application programs using the CERN Program Library memory and data structure management features. CZ/CPS provides transparent communication of ZEBRA data structures among cooperative processes using standard interfaces for ZEBRA I/O. Examples of usage in a CPS HBOOK4 and GEANT3 application are provided

  11. CPS Transformation of Flow Information, Part II

    DEFF Research Database (Denmark)

    Damian, D.; Danvy, Olivier

    2003-01-01

    consider the administrative reductions of a Plotkin-style transformation into Continuation-Passing Style (CPS), and how they affect the result of a constraint-based control-flow analysis and, in particular, the least element in the space of solutions. We show that administrative reductions preserve...... the least solution. Preservation of least solutions solves a problem that was left open in Palsberg and Wand's article ‘CPS Transformation of Flow Information.’ Together, Palsberg and Wand's article and the present article show how to map in linear time the least solution of the flow constraints...... of a program into the least solution of the flow constraints of the CPS counterpart of this program, after administrative reductions. Furthermore, we show how to CPS transform control-flow information in one pass....

  12. CPS and the Fermilab farms

    International Nuclear Information System (INIS)

    Fausey, M.R.

    1992-06-01

    Cooperative Processes Software (CPS) is a parallel programming toolkit developed at the Fermi National Accelerator Laboratory. It is the most recent product in an evolution of systems aimed at finding a cost-effective solution to the enormous computing requirements in experimental high energy physics. Parallel programs written with CPS are large-grained, which means that the parallelism occurs at the subroutine level, rather than at the traditional single line of code level. This fits the requirements of high energy physics applications, such as event reconstruction, or detector simulations, quite well. It also satisfies the requirements of applications in many other fields. One example is in the pharmaceutical industry. In the field of computational chemistry, the process of drug design may be accelerated with this approach. CPS programs run as a collection of processes distributed over many computers. CPS currently supports a mixture of heterogeneous UNIX-based workstations which communicate over networks with TCP/IR CPS is most suited for jobs with relatively low I/O requirements compared to CPU. The CPS toolkit supports message passing remote subroutine calls, process synchronization, bulk data transfers, and a mechanism called process queues, by which one process can find another which has reached a particular state. The CPS software supports both batch processing and computer center operations. The system is currently running in production mode on two farms of processors at Fermilab. One farm consists of approximately 90 IBM RS/6000 model 320 workstations, and the other has 85 Silicon Graphics 4D/35 workstations. This paper first briefly describes the history of parallel processing at Fermilab which lead to the development of CPS. Then the CPS software and the CPS Batch queueing system are described. Finally, the experiences of using CPS in production on the Fermilab processor farms are described

  13. CPS and the Fermilab farms

    Energy Technology Data Exchange (ETDEWEB)

    Fausey, M.R.

    1992-06-01

    Cooperative Processes Software (CPS) is a parallel programming toolkit developed at the Fermi National Accelerator Laboratory. It is the most recent product in an evolution of systems aimed at finding a cost-effective solution to the enormous computing requirements in experimental high energy physics. Parallel programs written with CPS are large-grained, which means that the parallelism occurs at the subroutine level, rather than at the traditional single line of code level. This fits the requirements of high energy physics applications, such as event reconstruction, or detector simulations, quite well. It also satisfies the requirements of applications in many other fields. One example is in the pharmaceutical industry. In the field of computational chemistry, the process of drug design may be accelerated with this approach. CPS programs run as a collection of processes distributed over many computers. CPS currently supports a mixture of heterogeneous UNIX-based workstations which communicate over networks with TCP/IR CPS is most suited for jobs with relatively low I/O requirements compared to CPU. The CPS toolkit supports message passing remote subroutine calls, process synchronization, bulk data transfers, and a mechanism called process queues, by which one process can find another which has reached a particular state. The CPS software supports both batch processing and computer center operations. The system is currently running in production mode on two farms of processors at Fermilab. One farm consists of approximately 90 IBM RS/6000 model 320 workstations, and the other has 85 Silicon Graphics 4D/35 workstations. This paper first briefly describes the history of parallel processing at Fermilab which lead to the development of CPS. Then the CPS software and the CPS Batch queueing system are described. Finally, the experiences of using CPS in production on the Fermilab processor farms are described.

  14. A First-Order One-Pass CPS Transformation

    DEFF Research Database (Denmark)

    Danvy, Olivier; Nielsen, Lasse Reichstein

    2001-01-01

    We present a new transformation of λ-terms into continuation-passing style (CPS). This transformation operates in one pass and is both compositional and first-order. Previous CPS transformations only enjoyed two out of the three properties of being first-order, one-pass, and compositional......, but the new transformation enjoys all three properties. It is proved correct directly by structural induction over source terms instead of indirectly with a colon translation, as in Plotkin's original proof. Similarly, it makes it possible to reason about CPS-transformed terms by structural induction over...... source terms, directly.The new CPS transformation connects separately published approaches to the CPS transformation. It has already been used to state a new and simpler correctness proof of a direct-style transformation, and to develop a new and simpler CPS transformation of control-flow information....

  15. A First-Order One-Pass CPS Transformation

    DEFF Research Database (Denmark)

    Danvy, Olivier; Nielsen, Lasse Reichstein

    2003-01-01

    We present a new transformation of λ-terms into continuation-passing style (CPS). This transformation operates in one pass and is both compositional and first-order. Previous CPS transformations only enjoyed two out of the three properties of being first-order, one-pass, and compositional......, but the new transformation enjoys all three properties. It is proved correct directly by structural induction over source terms instead of indirectly with a colon translation, as in Plotkin's original proof. Similarly, it makes it possible to reason about CPS-transformed terms by structural induction over...... source terms, directly.The new CPS transformation connects separately published approaches to the CPS transformation. It has already been used to state a new and simpler correctness proof of a direct-style transformation, and to develop a new and simpler CPS transformation of control-flow information....

  16. Function generation and regulation libraries and their application to the control of the new main power converter (POPS) at the CERN CPS

    International Nuclear Information System (INIS)

    King, Q.; Page, S.T.; Thiesen, H.; Veenstra, M.

    2012-01-01

    Power converter control for the LHC is based on an embedded control computer called a Function Generator/Controller (FGC). Every converter includes an FGC with responsibility for the generation of the reference current as a function of time and the regulation of the circuit current, as well as control of the converter state. With many new converter controls software classes in development it was decided to generalize several key components of the FGC software in the form of C libraries: function generation in libfg, regulation, limits and simulation in libreg and DCCT, ADC and DAC calibration in libcal. These libraries were first used in the software class dedicated to controlling the new 60 MW main power converter (POPS) at the CERN Proton Synchrotron (CPS) where regulation of both magnetic field and circuit current is supported. This paper reports on the functionality provided by each library and in particular libfg and libreg. The libraries are already being used by software classes in development for the next generation FGC for Linac4 converters, as well as the CERN SPS converter controls (MUGEF) and MedAustron converter regulation board. (authors)

  17. Fluid Ability (Gf and Complex Problem Solving (CPS

    Directory of Open Access Journals (Sweden)

    Patrick Kyllonen

    2017-07-01

    Full Text Available Complex problem solving (CPS has emerged over the past several decades as an important construct in education and in the workforce. We examine the relationship between CPS and general fluid ability (Gf both conceptually and empirically. A review of definitions of the two factors, prototypical tasks, and the information processing analyses of performance on those tasks suggest considerable conceptual overlap. We review three definitions of CPS: a general definition emerging from the human problem solving literature; a more specialized definition from the “German School” emphasizing performance in many-variable microworlds, with high domain-knowledge requirements; and a third definition based on performance in Minimal Complex Systems (MCS, with fewer variables and reduced knowledge requirements. We find a correlation of 0.86 between expert ratings of the importance of CPS and Gf across 691 occupations in the O*NET database. We find evidence that employers value both Gf and CPS skills, but CPS skills more highly, even after controlling for the importance of domain knowledge. We suggest that this may be due to CPS requiring not just cognitive ability but additionally skill in applying that ability in domains. We suggest that a fruitful future direction is to explore the importance of domain knowledge in CPS.

  18. BCD/CPS: An event-level GEANT3 parallelization via CPS

    International Nuclear Information System (INIS)

    Roberts, L.A.

    1991-04-01

    BCD/CPS is an implementation of the Bottom Collider Detector GEANT3 simulation for CPS processor ranches. BCD/CPS demonstrates some of the capabilities of event-parallel applications applicable to current SSC detector simulations using the CPS and CZ/CPS communications protocols. Design, implementation and usage of the BCD/CPS simulation are presented along with extensive source listings for novice GEANT3/CPS programmers. 11 refs

  19. Investigation of thermohydraulic parameter variations in operating conditions of Bilibino NPP CPS cooling circuit

    International Nuclear Information System (INIS)

    Baranaev, Yu.D.; Koz'menkova, V.V.; Parafilo, L.M.

    2015-01-01

    In consequence of activities on uncovering the reasons for through faults formation in cooling tubes of reactor control and protection system (CPS) channels of Bilibino-2 reactor the conclusion is made that corrosion failure development takes place against the backdrop of periodic increase of total moisture in reactor space at transient and standby modes at top of cooling tubes of CPS channels. Formation of corrosion defects in cooling tubes of four CPS channels of unit 2 in 2011-2012 is specific factor for this plant unit and do not effect on operation of other plant units. It is pointed out that ingress of moisture into gas system of the reactor is the critical factor providing integrity of structure elements of EhPG-6 reactor core cooling system. This fact agrees nicely with the results obtained during operation AM reactor of the First NPP [ru

  20. An Operational Foundation for Delimited Continuations in the CPS Hierarchy

    DEFF Research Database (Denmark)

    Biernacka, Malgorzata; Biernacki, Dariusz; Danvy, Olivier

    2004-01-01

    We present an abstract machine and a reduction semantics for the lambda-calculus extended with control operators that give access to delimited continuations in the CPS hierarchy. The abstract machine is derived from an evaluator in continuation-passing style (CPS); the reduction semantics (i.......e., a small-step operational semantics with an explicit representation of evaluation contexts) is constructed from the abstract machine; and the control operators are the shift and reset family. We also present new applications of delimited continuations in the CPS hierarchy: finding list prefixes...

  1. An Operational Foundation for Delimited Continuations in the CPS Hierarchy

    DEFF Research Database (Denmark)

    Biernacka, Malgorzata; Biernacki, Dariusz; Danvy, Olivier

    2005-01-01

    We present an abstract machine and a reduction semantics for the lambda-calculus extended with control operators that give access to delimited continuations in the CPS hierarchy. The abstract machine is derived from an evaluator in continuation-passing style (CPS); the reduction semantics (i.......e., a small-step operational semantics with an explicit representation of evaluation contexts) is constructed from the abstract machine; and the control operators are the shift and reset family. We also present new applications of delimited continuations in the CPS hierarchy: finding list prefixes...

  2. A First-Order One-Pass CPS Transformation

    DEFF Research Database (Denmark)

    Danvy, Olivier; Nielsen, Lasse Reichstein

    2002-01-01

    We present a new transformation of call-by-value lambdaterms into continuation-passing style (CPS). This transformation operates in one pass and is both compositional and first-order. Because it operates in one pass, it directly yields compact CPS programs that are comparable to what one would...... write by hand. Because it is compositional, it allows proofs by structural induction. Because it is first-order, reasoning about it does not require the use of a logical relation. This new CPS transformation connects two separate lines of research. It has already been used to state a new and simpler...... correctness proof of a direct-style transformation, and to develop a new and simpler CPS transformation of control-flow information....

  3. CPS Transformation of Beta-Redexes

    DEFF Research Database (Denmark)

    Danvy, Olivier; Nielsen, Lasse

    2005-01-01

    The extra compaction of the most compacting CPS transformation in existence, which is due to Sabry and Felleisen, is generally attributed to (1) making continuations occur first in CPS terms and (2) classifying more redexes as administrative. We show that this extra compaction is actually...... independent of the relative positions of values and continuations and furthermore that it is solely due to a context-sensitive transformation of beta-redexes. We stage the more compact CPS transformation into a first-order uncurrying phase and a context-insensitive CPS transformation. We also define a context......-insensitive CPS transformation that provides the extra compaction. This CPS transformation operates in one pass and is dependently typed....

  4. CPS Transformation of Beta-Redexes

    DEFF Research Database (Denmark)

    Danvy, Olivier; Nielsen, Lasse R.

    2000-01-01

    The extra compaction of the most compacting CPS transformation in existence, which is due to Sabry and Felleisen, is generally attributed to (1) making continuations occur first in CPS terms and (2) classifying more redexes as administrative. We show that this extra compaction is actually...... independent of the relative positions of values and continuations and furthermore that it is solely due to a context-sensitive transformation of beta-redexes. We stage the more compact CPS transformation into a first-order uncurrying phase and a context-insensitive CPS transformation. We also define a context......-insensitive CPS transformation that provides the extra compaction. This CPS transformation operates in one pass and is dependently typed....

  5. Syntactic accidents in program analysis: on the impact of the CPS transformation

    DEFF Research Database (Denmark)

    Damian, Daniel; Danvy, Olivier

    2003-01-01

    We show that a non-duplicating transformation into Continuation-Passing Style (CPS) has no effect on control-flow analysis, a positive effect on binding-time analysis for traditional partial evaluation, and no effect on binding-time analysis for continuation-based partial evaluation: a monovariant...... control-flow analysis yields equivalent results on a direct-style program and on its CPS counterpart, a monovariant binding-time analysis yields less precise results on a direct-style program than on its CPS counterpart, and an enhanced monovariant binding-time analysis yields equivalent results...... on a direct-style program and on its CPS counterpart. Our proof technique amounts to constructing the CPS counterpart of flow information and of binding times. Our results formalize and confirm a folklore theorem about traditional binding-time analysis, namely that CPS has a positive effect on binding times...

  6. Syntactic Accidents in Program Analysis: On the Impact of the CPS Transformation

    DEFF Research Database (Denmark)

    Daniel, Damian; Danvy, Olivier

    2000-01-01

    We show that a non-duplicating transformation into Continuation-Passing Style (CPS) has no effect on control-flow analysis, a positive effect on binding-time analysis for traditional partial evaluation, and no effect on binding-time analysis for continuation-based partial evaluation: a monovariant...... control-flow analysis yields equivalent results on a direct-style program and on its CPS counterpart, a monovariant binding-time analysis yields less precise results on a direct-style program than on its CPS counterpart, and an enhanced monovariant binding-time analysis yields equivalent results...... on a direct-style program and on its CPS counterpart. Our proof technique amounts to constructing the CPS counterpart of flow information and of binding times. Our results formalize and confirm a folklore theorem about traditional binding-time analysis, namely that CPS has a positive effect on binding times...

  7. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...... of parameters of continuations in its output. To this end, we specify the one-pass CPS transformation relationally and we use the proof technique of logical relations....

  8. MMI design of K-CPS for preventing human errors and enhancing convenient operation

    International Nuclear Information System (INIS)

    Sung, Chan Ho; Jung, Yeon Sub; Oh, Eoung Se; Shin, Young Chul; Lee, Yong Kwan

    2001-01-01

    In order to supplement defects of paper procedure, reduce human errors and enhance convenient operation, computer-based procedure system is being developed. CPS (Computerized Procedure System) including human-factor engineering design concept for KNGR (Korean Next Generation Reactor) has been also developed with the same object. K-CPS(KNGR CPS) has higher level of automation than paper procedure. It is fully integrated with control and monitoring systems. Combining statements and relevant components, which changes dynamically according to plant status enhances readability of procedure. This paper shows general design criteria on computer-based procedure system, the MMI design characteristics of K-CPS and the results of suitability evaluation for K-CPS by operator

  9. An Extensional CPS Transform (Preliminary Report)

    DEFF Research Database (Denmark)

    Filinski, Andrzej

    2001-01-01

    We shoe that, in a language wihg general continuation-effects, the syntactic, or intensional, CPS transform is mirrored by a semantic, or extensional, functional term. In other words, form only the observable behavior any direct-style term (possibly containing the usual first-class continuation...... primitives), we can uniformly extract the observable behavior of its CPS counterpart. As a consequence of this result, we show that the computational lambda-calculus is complete for observational equivalence of pure, simply typed lambda-terms in Scheme-like contexts....

  10. Classical realizability in the CPS target language

    DEFF Research Database (Denmark)

    Frey, Jonas

    2016-01-01

    Motivated by considerations about Krivine's classical realizability, we introduce a term calculus for an intuitionistic logic with record types, which we call the CPS target language. We give a reformulation of the constructions of classical realizability in this language, using the categorical...... techniques of realizability triposes and toposes. We argue that the presentation of classical realizability in the CPS target language simplifies calculations in realizability toposes, in particular it admits a nice presentation of conjunction as intersection type which is inspired by Girard's ludics....

  11. On proving syntactic properties of CPS programs

    DEFF Research Database (Denmark)

    Danvy, Olivier; Dzafic, Belmina; Pfenning, Frank

    1999-01-01

    Higher-order program transformations raise new challenges for proving properties of their output, since they resist traditional, first-order proof techniques. In this work, we consider (1) the “one-pass” continuation-passing style (CPS) transformation, which is second-order, and (2) the occurrences...

  12. Role of Ontologies for CPS Implementation in Manufacturing

    Directory of Open Access Journals (Sweden)

    Garetti Marco

    2015-12-01

    Full Text Available Cyber Physical Systems are an evolution of embedded systems featuring a tight combination of collaborating computational elements that control physical entities. CPSs promise a great potential of innovation in many areas including manufacturing and production. This is because we obtain a very powerful, flexible, modular infrastructure allowing easy (re configurability and fast ramp-up of manufacturing applications by building a manufacturing system with modular mechatronic components (for machining, transportation and storage and embedded intelligence, by integrating them into a system, through a network connection. However, when building such kind of architectures, the way to supply the needed domain knowledge to real manufacturing applications arises as a problem to solve. In fact, a CPS based architecture for manufacturing is made of smart but independent manufacturing components without any knowledge of the role they have to play together in the real world of manufacturing applications. Ontologies can supply such kind of knowledge, playing a very important role in CPS for manufacturing. The paper deals with this intriguing theme, also presenting an implementation of this approach in a research project for the open automation of manufacturing systems, in which the power of CPS is complemented by the support of an ontology of the manufacturing domain.

  13. International Conference ML4CPS 2016

    CERN Document Server

    Niggemann, Oliver; Kühnert, Christian

    2017-01-01

    The work presents new approaches to Machine Learning for Cyber Physical Systems, experiences and visions. It contains some selected papers from the international Conference ML4CPS – Machine Learning for Cyber Physical Systems, which was held in Karlsruhe, September 29th, 2016. Cyber Physical Systems are characterized by their ability to adapt and to learn: They analyze their environment and, based on observations, they learn patterns, correlations and predictive models. Typical applications are condition monitoring, predictive maintenance, image processing and diagnosis. Machine Learning is the key technology for these developments. The Editors Prof. Dr.-Ing. Jürgen Beyerer is Professor at the Department for Interactive Real-Time Systems at the Karlsruhe Institute of Technology. In addition he manages the Fraunhofer Institute of Optronics, System Technologies and Image Exploitation IOSB. Prof. Dr. Oliver Niggemann is Professor for Embedded Software Engineering. His research interests are in the field of Di...

  14. Fluid Ability (Gf) and Complex Problem Solving (CPS)

    OpenAIRE

    Patrick Kyllonen; Cristina Anguiano Carrasco; Harrison J. Kell

    2017-01-01

    Complex problem solving (CPS) has emerged over the past several decades as an important construct in education and in the workforce. We examine the relationship between CPS and general fluid ability (Gf) both conceptually and empirically. A review of definitions of the two factors, prototypical tasks, and the information processing analyses of performance on those tasks suggest considerable conceptual overlap. We review three definitions of CPS: a general definition emerging from the human pr...

  15. Reliable CPS design for mitigating semiconductor and battery aging in electric vehicles

    NARCIS (Netherlands)

    Chang, W.; Proebstl, A.; Goswami, D.; Zamani, M.; Chakraborty, S.

    2015-01-01

    Reliability and performance of cyber-physical systems (CPS) in electric vehicles (EVs) are influenced by three design aspects: (i) controller design, (ii) battery usage, i.e., Battery rate capacity and aging effects, (iii) processor aging of the in-vehicle embedded platform. In this paper, we

  16. Verificación del cumplimiento de los criterios CPS de la NERC en el SNI del Ecuador; Verification of the execution of the CPS approachies of NEPC in the national interconnected System of Ecuador

    Directory of Open Access Journals (Sweden)

    Marcelo Arias Castañeda

    2011-02-01

    Full Text Available En este artículo se describe el procedimiento utilizado para la evaluación del controlautomático de la generación en el Sistema Nacional Interconectado (SNI del Ecuador,tomando como marco de referencia los criterios CPS-1 y CPS-2 (Control PerformanceStandars por sus siglas en inglés. de la NERC. El artículo está dividido en secciones queexplican en detalle en qué consisten los criterios CPS de la NERC, cómo se calculan loslímites de estos criterios teniendo en consideración las condiciones específicas del sistemaeléctrico ecuatoriano (sección 2, y cómo se aplican los criterios en la evaluación del controlautomático de la generación en el SNI del Ecuador teniendo en cuenta la interconexión conColombia (sección 3. Además se sugiere el valor mínimo de BIAS a fijar en el sistemaecuatoriano para el cumplimiento del criterio CPS-2. This paper presents an analytic framework for the formulation and evaluation of automaticgeneration control in the Ecuadorian Electrical System (SNI taking like reference mark theapproaches CPS-1 and CPS-2 of NERC. The article is divided in sections that they explain indetail the approaches CPS of NERC, how the limits of these approaches are calculated havingin consideration the specific conditions of the electric Ecuadorian system (section 2, and howthe approaches are applied in the evaluation of the automatic control of the generation in SNIof Ecuador keeping in mind the interconnection with Colombia (section 3. The minimum valueof BIAS is also suggested to fix in the Ecuadorian system for the execution of the approachCPS-2.

  17. Targeting CPS1 in the treatment of Carbamoyl phosphate synthetase 1 (CPS1) deficiency, a urea cycle disorder.

    Science.gov (United States)

    Diez-Fernandez, Carmen; Häberle, Johannes

    2017-04-01

    Carbamoyl phosphate synthetase 1 (CPS1) deficiency (CPS1D) is a rare autosomal recessive urea cycle disorder (UCD), which can lead to life-threatening hyperammonemia. Unless promptly treated, it can result in encephalopathy, coma and death, or intellectual disability in surviving patients. Over recent decades, therapies for CPS1D have barely improved leaving the management of these patients largely unchanged. Additionally, in many cases, current management (protein-restriction and supplementation with citrulline and/or arginine and ammonia scavengers) is insufficient for achieving metabolic stability, highlighting the importance of developing alternative therapeutic approaches. Areas covered: After describing UCDs and CPS1D, we give an overview of the structure- function of CPS1. We then describe current management and potential novel treatments including N-carbamoyl-L-glutamate (NCG), pharmacological chaperones, and gene therapy to treat hyperammonemia. Expert opinion: Probably, the first novel CPS1D therapies to reach the clinics will be the already commercial substance NCG, which is the standard treatment for N-acetylglutamate synthase deficiency and has been proven to rescue specific CPS1D mutations. Pharmacological chaperones and gene therapy are under development too, but these two technologies still have key challenges to be overcome. In addition, current experimental therapies will hopefully add further treatment options.

  18. A hybrid intermediate language between SSA and CPS

    DEFF Research Database (Denmark)

    Torrens, Paulo; Vasconcellos, Cristiano; Gonçalves, Ju

    2017-01-01

    passing style (CPS) lambda calculus has been used as intermediate language for functional language compilers, they are (almost) equivalent and it is possible to draw syntactic translations between them. This short paper aims to present an untyped intermediate language which may be interpreted as both SSA...... and CPS, in order to provide a common language for both imperative and functional compilers, as well to take advantage of optimizations designed for either one of the approaches. Finally, potential variants and research opportunities are discussed....

  19. STRATEGI PEMBELAJARAN CREATIVE PROBLEM SOLVING (CPS BERBASIS EKSPERIMEN UNTUK MENINGKATKAN KEMAMPUAN KOGNITIF DAN KETERAMPILAN BERPIKIR KREATIF

    Directory of Open Access Journals (Sweden)

    Ahmad Busyairi

    2015-09-01

    Full Text Available This study aimed to get an idea related to the development of cognitive abilities and creative thinking skills in problem solving student after being given treatment with CPS-based experimental learning and conventional learning. The method used in this research is a quasi-experimental design with the randomized pretest-posttest control group design. The research sample group of 58 high school students who are divided into two classes (class 29 experimental and 29 control group. The collected data was then analyzed using N-gain calculation, t-test, and the calculation of effect size. The result showed that the students' cognitive abilities for both classes equally increased by the moderate category. For the creative thinking skills of students in problem solving, experimental class increased by categories was increased while the control class with low category. Based on the test results show that the application of learning hypothesis-based experiments CPS can significantly improve the cognitive abilities and skills of creative thinking in solving problems of students compared to the application of conventional learning. In addition, based on the calculation of effect size indicates that the application of experiment-based learning CPS effective in improving cognitive ability and creative thinking skills in problem solving students with moderate category. ABSTRAK Penelitian ini bertujuan untuk mendapatkan gambaran terkait peningkatan kemampuan kognitif dan keterampilan berpikir kreatif dalam pemecahan masalah siswa setelah diberikan perlakuan dengan pembelajaran CPS berbasis eksperimen dan pembelajaran kovensional. Metode yang digunakan dalam penelitian ini adalah metode kuasi eksperimen dengan desain the randomized pretest-posttest control group design. Sampel penelitian sebanyak 58 siswa SMA yang dibagi ke dalam dua kelas (29 kelas eksperimen dan 29 kelas kontrol. Data yang terkumpul kemudian dianalisis dengan menggunakan perhitungan N

  20. Effect of eccentric location of the RBMK CPS displacer graphite block in the shielding sheath

    International Nuclear Information System (INIS)

    Dostov, A.I.

    2001-01-01

    Temperature conditions and accumulation of Wigner energy in the graphite block of the RBMK reactor CPS (control power system) displacer is examined. It is shown, that at eccentric location of the block in the shielding sheath average temperature of the block drops sharply. Due to the design demerit quantity of the stored energy in the block may be so great, that its release will result in melting of the displacer tube. (author)

  1. CPW to CPS transition for feeding UWB antennas

    DEFF Research Database (Denmark)

    Butrym, Alexander; Pivnenko, Sergey

    2004-01-01

    The paper considers a transition (balun) from Coplanar Waveguide (CPW) to Coplanar Stripline (CPS) which is non-resonant and suitable for feeding UWB antennas such as Tapered Slot Antennas (Vivaldi antennas in particular), bow-tie antennas, and other. Some numerical and experimental results...

  2. CPW to CPS transition for feeding UWB antennas

    DEFF Research Database (Denmark)

    Butrym, Alexander; Pivnenko, Sergey

    2006-01-01

    The paper considers a transition (balun) from Coplanar Waveguide (CPW) to Coplanar Stripline (CPS) which is non-resonant and suitable for feeding UWB antennas such as Tapered Slot Antennas (Vivaldi antennas, in particular), bow-tie antennas, and other. Some numerical and experimental results...

  3. SecureCPS: Defending a nanosatellite cyber-physical system

    Science.gov (United States)

    Forbes, Lance; Vu, Huy; Udrea, Bogdan; Hagar, Hamilton; Koutsoukos, Xenofon D.; Yampolskiy, Mark

    2014-06-01

    Recent inexpensive nanosatellite designs employ maneuvering thrusters, much as large satellites have done for decades. However, because a maneuvering nanosatellite can threaten HVAs on-­orbit, it must provide a level of security typically reserved for HVAs. Securing nanosatellites with maneuvering capability is challenging due to extreme cost, size, and power constraints. While still in the design process, our low-­cost SecureCPS architecture promises to dramatically improve security, to include preempting unknown binaries and detecting abnormal behavior. SecureCPS also applies to a broad class of cyber-­physical systems (CPS), such as aircraft, cars, and trains. This paper focuses on Embry-­Riddle's ARAPAIMA nanosatellite architecture, where we assume any off-­the-­shelf component could be compromised by a supply chain attack.1 Based on these assumptions, we have used Vanderbilt's Cyber Physical -­ Attack Description Language (CP-­ADL) to represent realistic attacks, analyze how these attacks propagate in the ARAPAIMA architecture, and how to defeat them using the combination of a low-­cost Root of Trust (RoT) Module, Global InfoTek's Advanced Malware Analysis System (GAMAS), and Anomaly Detection by Machine Learning (ADML).2 Our most recent efforts focus on refining and validating the design of SecureCPS.

  4. CPS Transformation of Flow Information, Part II: Administrative Reductions

    DEFF Research Database (Denmark)

    Damian, Daniel; Danvy, Olivier

    2001-01-01

    the least solution. Preservation of least solutions solves a problem that was left open in Palsberg and Wand's article ‘CPS Transformation of Flow Information.’ Together, Palsberg and Wand's article and the present article show how to map in linear time the least solution of the flow constraints...

  5. Novel Strategies Using Total Gastrodin and Gastrodigenin, or Total Gastrodigenin for Quality Control of Gastrodia elata.

    Science.gov (United States)

    Tang, Chunlan; Wu, Bingchu; Wu, Jinyi; Zhang, Zheng; Yu, Bocheng

    2018-01-29

    Gastrodia elata Blume ( G. elata ), a traditional Chinese medicine, is widely used for treatment of various neuro dysfunctions. However, its quality control is still limited to the determination of gastrodin. In the present study, two novel strategies based on quantitative evaluation of total gastrodin and gastrodigenin with base hydrolysis and total gastrodigenin with base-enzymatic hydrolysis followed by HPLC-FLD were put forward and successfully applied to evaluate the quality of 47 batches of G. elata from eight localities. Meanwhile, a systematic comparison of the novel strategy with the multiple markers and the Pharmacopeia method was performed. The results showed that the parishins category could be completely hydrolyzed to gastrodin by sodium hydroxide solution, and gastrodin could further utterly hydrolyze to gastrodigenin with β-d-glucosidase buffer solution. The contents of total gastrodin and gastrodigenin ranged from 1.311% to 2.034%, and total gastrodigenin from 0.748% to 1.120% at the eight localities. From the comparison, we can conclude that the two novel strategies can comprehensively reveal the characteristics of overall active ingredients in G. elata for quality control. The present study provides a feasible and credible strategy for the quality control of G. elata , suggesting a revision of the latest Chinese Pharmacopoeia or European Pharmacopoeia methods for the modernization of G. elata use.

  6. Quality control of dosimetry in total body irradiation

    International Nuclear Information System (INIS)

    Kallinger, W.

    1986-11-01

    An on-line dose measurement system for the quality control of the treatment of leukemia by means of total body irradiation with Co-60 gamma radiation is introduced. An ionization chamber and 5 diodes arranged on the surface of the patient incorporated with a microprocessor provides useful information and data necessary for the treatment. Following the concerted treatment procedure employing this system, the treatment of leukemia by means of total body irradiation is expected to be improved

  7. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    OpenAIRE

    Su, Xiaoling; Han, Minxiao; Guerrero, Josep M.; Sun, Hai

    2015-01-01

    This paper presents a microgrid stability controller (MSC) in order to provide existing distributed generation units (DGs) the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding...

  8. Cost-effectiveness evaluation of clobetasol propionate shampoo (CPS) maintenance in patients with moderate scalp psoriasis: a Pan-European analysis.

    Science.gov (United States)

    Papp, K; Poulin, Y; Barber, K; Lynde, C; Prinz, J C; Berg, M; Kerrouche, N; Rives, V P

    2012-11-01

    Scalp psoriasis is a difficult to treat and usually chronic manifestation of psoriasis. The CalePso study showed that CPS (Clobex(®) Shampoo) in maintenance therapy of scalp psoriasis (twice weekly) significantly increases the probability of keeping patient under remission during 6 months, compared with vehicle (40.3% relapses vs. 11.6% relapses, ITT). The objective of the study was to assess the cost-effectiveness of a maintenance therapy with CPS vs. its vehicle in nine European countries. A 24-week decision tree model was developed with 4-weekly time steps. The considered population has moderate scalp psoriasis successfully treated with a daily application of CPS up to 4 weeks. Data were taken from the CalePso study and from national experts' recommendations for alternative treatment choices, with their probabilities of success taken from literature to develop country-specific models. Health benefits are measured in disease-free days (DFD). The economic analysis includes drug and physician costs. A probabilistic sensitivity analysis (PrSA) assesses the uncertainty of the model. Depending on the country, the mean total number of DFDs per patient is 21-42% higher with CPS compared with vehicle, and the mean total cost is 11-31% lower. The mean costs per DFD are 30-46% lower with CPS compared with the vehicle. The PrSA showed in 1000 simulations that CPS is more effective vs. vehicle in 100% of the cases and less expensive than its vehicle in 80-99% of the cases. This model suggests that CPS is cost-effective in maintaining the success achieved in moderate scalp psoriasis patients. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

  9. Determination of dilution and quality control of total and anti ...

    African Journals Online (AJOL)

    Objective: To determine the correct dilution and Quality control commercial ELISA of total and anti-measles antibodies for HIV infected pregnant women. Design: A laboratory based study. Setting: The University of Nairobi, Department of Paediatrics laboratory. Subjects: HIV infected pregnant women enrolled and exposed to ...

  10. Isolation and identification of citrus psorosis virus Egyptian isolate (CPsV-EG).

    Science.gov (United States)

    Ghazal, S A; El-Dougdoug, Kh A; Mousa, A A; Fahmy, H; Sofy, A R

    2008-01-01

    Citrus psorosis ophiovirus (CPsV), is considered to be of the most serious and deter mental virus pathogen's citrus species trees in Egypt. CPsV-EG was isolated from infected citrus grapefruit (C. paradisi Macf.) at Agric. Res. Centre (ARC). The grapefruit which used for CPsV-EG isolate was found to be free from CTV, CEVd and Spiroplasma citri where as gave -ve results with DTBIA, tissue print hybridization and Diene's stain respectively. CPsV-EG was detected on the basis of biological indexing by graft inoculation which gave oak leaf pattern (OLP) on Dweet tangor and serological assay by DAS-ELISA using Mab specific CPsV. CPsV-EG was reacted with variable responses on 16 host plants belonging to 6 families. Only 8 host plants are susceptible and showed visible external symptoms which appeared as local, systemic and local followed by systemic infections. CPsV-EG isolate was transmitted from infected citrus to citrus by syringe and grafting and herbaceous plants by forefinger inoculation and syringe. The woody indicators and rootstocks were differed in response to CPsV-EG isolate which appeared as no-response, response, sensitivity and hypersensitivity. The serological characters represented as the antigenic determinants of CPsV-EG isolate related to monoclonal antibodies specific CPsV strain where as appeared precipitation reaction by DAS-ELISA and DTBIA. The partial fragment of RNA3 (coat protein gene) of CPsV-EG (-1140bp and -571bp) was amplified by reverse transcription-polymerase chain reaction (RT-PCR) from grapefruit tissues using two sets primers specific CPsV (CPV3 and CPV4) and (PS66 and PS65) respectively. The virus under study was identified as CPsV-EG isolate according to biological, serological and molecular characters.

  11. The Classroom Performance System (CPS): Effects on student participation, attendance, and achievement in multicultural anatomy and physiology classes at South Texas College

    Science.gov (United States)

    Termos, Mohamad Hani

    2011-12-01

    The Classroom Performance System (CPS) is an instructional technology tool that increases student performance and addresses different learning styles. Instructional technologies are used to promote active learning; however, student embarrassment issue in a multicultural setting is not addressed. This study assessed the effect of the CPS on student participation, attendance, and achievement in multicultural college-level anatomy and physiology classes at South Texas College, where the first spoken language is not English. Quantitative method and quasi-experimental design were employed and comparative statistic methods and pre-post tests were used to collect the data. Participants were college students and sections of study were selected by convenient sampling. Participation was 100% during most of the lectures held and participation rate did not strike above 68% in control group. Attendance was significantly higher in CPS sections than the control group as shown by t-tests. Experimental sections had a higher increase in the pre-post test scores and student averages on lecture exams increased at a higher rate as compared to the control group. Therefore, the CPS increased student participation, attendance, and achievement in multicultural anatomy and physiology classes. The CPS can be studied in other settings where the first spoken language is English or in other programs, such as special education programs. Additionally, other variables can be studied and other methodologies can be employed.

  12. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    DEFF Research Database (Denmark)

    Su, Xiaoling; Han, Minxiao; Guerrero, Josep M.

    2015-01-01

    This paper presents a microgrid stability controller (MSC) in order to provide existing DGs the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics....... The MSC provides fast dynamic response and robustness to the microgrid. When the system is operating in grid-connected mode, it is able to improve the controllability of the exchanged power between the microgrid and the utility grid, while smoothing DG’s output power. When the microgrid is operating...... and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding-mode control (ARTSMC) system for the MSC. It is proved that the ARTSMC system is insensitive to parametric uncertainties and external disturbances...

  13. Japanese style total quality control: A first hand experience

    Science.gov (United States)

    Cook, S. C.

    1991-11-01

    The scope, concepts and practices of Total Quality Control (TQC) as operated in Japan today are described. The following mechanisms and elements are introduced: policy deployment, cross functional management, small group activities, suggestion systems, standardization, the TQC promotion department, and TQC education. It is shown on a practical level, how TQC operates in the research and engineering divisions of the aeroengine and space operation at Ishikawajima Harima Industries in Japan. Japanese style TQC is a well developed, well promoted, well structured, common approach to achieving customer satisfaction through continuous improvements. Furthermore, TQC itself is being continuously improved with the Japanese still refining, extending, and developing TQC.

  14. Microgrid Stability Controller Based on Adaptive Robust Total SMC

    Directory of Open Access Journals (Sweden)

    Xiaoling Su

    2015-03-01

    Full Text Available This paper presents a microgrid stability controller (MSC in order to provide existing distributed generation units (DGs the additional functionality of working in islanding mode without changing their control strategies in grid-connected mode and to enhance the stability of the microgrid. Microgrid operating characteristics and mathematical models of the MSC indicate that the system is inherently nonlinear and time-variable. Therefore, this paper proposes an adaptive robust total sliding-mode control (ARTSMC system for the MSC. It is proved that the ARTSMC system is insensitive to parametric uncertainties and external disturbances. The MSC provides fast dynamic response and robustness to the microgrid. When the system is operating in grid-connected mode, it is able to improve the controllability of the exchanged power between the microgrid and the utility grid, while smoothing the DGs’ output power. When the microgrid is operating in islanded mode, it provides voltage and frequency support, while guaranteeing seamless transition between the two operation modes. Simulation and experimental results show the effectiveness of the proposed approach.

  15. The Classroom Process Scale (CPS): An Approach to the Measurement of Teaching Effectiveness.

    Science.gov (United States)

    Anderson, Lorin W.; Scott, Corinne C.

    The purpose of this presentation is to describe the Classroom Process Scale (CPS) and its usefulness for the assessment of teaching effectiveness. The CPS attempts to ameliorate weaknesses in existing classroom process measures by including a coding of student involvement in learning, objectives being pursued, and methods used to pursue attainment…

  16. Phylogenetic distribution and membrane topology of the LytR-CpsA-Psr protein family

    Directory of Open Access Journals (Sweden)

    Berger-Bächi Brigitte

    2008-12-01

    Full Text Available Abstract Background The bacterial cell wall is the target of many antibiotics and cell envelope constituents are critical to host-pathogen interactions. To combat resistance development and virulence, a detailed knowledge of the individual factors involved is essential. Members of the LytR-CpsA-Psr family of cell envelope-associated attenuators are relevant for β-lactam resistance, biofilm formation, and stress tolerance, and they are suggested to play a role in cell wall maintenance. However, their precise function is still unknown. This study addresses the occurrence as well as sequence-based characteristics of the LytR-CpsA-Psr proteins. Results A comprehensive list of LytR-CpsA-Psr proteins was established, and their phylogenetic distribution and clustering into subgroups was determined. LytR-CpsA-Psr proteins were present in all Gram-positive organisms, except for the cell wall-deficient Mollicutes and one strain of the Clostridiales. In contrast, the majority of Gram-negatives did not contain LytR-CpsA-Psr family members. Despite high sequence divergence, the LytR-CpsA-Psr domains of different subclusters shared a highly similar, predicted mixed a/β-structure, and conserved charged residues. PhoA fusion experiments, using MsrR of Staphylococcus aureus, confirmed membrane topology predictions and extracellular location of its LytR-CpsA-Psr domain. Conclusion The LytR-CpsA-Psr domain is unique to bacteria. The presence of diverse subgroups within the LytR-CpsA-Psr family might indicate functional differences, and could explain variations in phenotypes of respective mutants reported. The identified conserved structural elements and amino acids are likely to be important for the function of the domain and will help to guide future studies of the LytR-CpsA-Psr proteins.

  17. Association Between Maternal Serum Total Oxidant Status Total Antioxidant Status and Preterm Labor: A Prospective - Controlled Clinical Study

    OpenAIRE

    Hakan Kalaycı; Mete Gürol Uğur; Ebru Öztürk; Özcan Balat; Özcan Erel

    2011-01-01

    OBJECTIVE: To measure the levels of individual antioxidant components of pregnants with preterm labor to evaluate their total antioxidant status (TAS), total oxidant status (TOS) and oxidative stress index (OSI). STUDY DESIGN: Prospectively-controlled 31 pregnants with a diagnosis of preterm labor (group Ι) and 32 controls (group ΙΙ) were evaluated for demographic data, general and obstetrical physical examination, obstetrical sonography, and routine laboratory tests. TAS, TOS and OSI leve...

  18. SVM-Based Dynamic Reconfiguration CPS for Manufacturing System in Industry 4.0

    Directory of Open Access Journals (Sweden)

    Hyun-Jun Shin

    2018-01-01

    Full Text Available CPS is potential application in various fields, such as medical, healthcare, energy, transportation, and defense, as well as Industry 4.0 in Germany. Although studies on the equipment aging and prediction of problem have been done by combining CPS with Industry 4.0, such studies were based on small numbers and majority of the papers focused primarily on CPS methodology. Therefore, it is necessary to study active self-protection to enable self-management functions, such as self-healing by applying CPS in shop-floor. In this paper, we have proposed modeling of shop-floor and a dynamic reconfigurable CPS scheme that can predict the occurrence of anomalies and self-protection in the model. For this purpose, SVM was used as a machine learning technology and it was possible to restrain overloading in manufacturing process. In addition, we design CPS framework based on machine learning for Industry 4.0, simulate it, and perform. Simulation results show the simulation model autonomously detects the abnormal situation and it is dynamically reconfigured through self-healing.

  19. Quantitation of stress/rest 201TI SPECT of the legs in the diagnosis of compartment-NT syndromes (CPS)

    International Nuclear Information System (INIS)

    Hayes, A.A.; Bower, G.D.; Pitstock, K.L.; Maguire, K.F.

    1998-01-01

    Full text: Compartment-NT syndrom (CPS) of the legs is considered to have an ischaemic basis related to muscle swelling and pressure increase in a muscle compartment (MC) during isotonic work. We decided to study selected patients where CPS was suspected with exercise 201 TI SPECT of the legs to better define their diagnoses. Eighteen patients with probable CPS reproduced their leg pain(s) during isotonic work, and 100 MBq of 201 TI was given i.v. during continued work and pain. Anterior 300 sec. planar and 360 degree, elliptical SPECT studies were acquired five minutes after stress and again four hours later. Quantitation of whole calf and regional MC uptake was attempted after the first five patients were assessed qualitatively. Ten patients were men and eight were women. The mean age was 30.8 y. Four had localised posterior and three had anterior pain with 11 having mixed and bilateral symptoms. Five patients had had a bone scan in the past and nine had MC pressure studies done within a month of study. Six patients had had previous decompressive surgery and seven patients had surgery after stress/rest studies. Four asymptomatic cardiac patients (''controls'') were imaged after their cardiac 201 TI studies and data used for comparison. Mean age of controls was 33 years. Generally even muscle uptake was seen on stress images with mean washout of 201 TI of 12% (7-23%) being calculated on delayed images of controls. Painful MCs with qualitative reduction in uptake after stress showed a mean increase in 201 TI of 25.7% (6-39%) on delayed imaging. Three patients with dramatic improvement in symptoms after surgery had shown a mean increase of 25.2% in delayed uptake in MCs on pre-operative studies. One patient showed washout of 11 and 15% from posterior MCs and had a poor response to subsequent surgery. Further clinical follow up in a large group of patients will be required to fully identify the place of Stress 201 TI imaging of the legs in this difficult group of

  20. SLAE–CPS: Smart Lean Automation Engine Enabled by Cyber-Physical Systems Technologies

    Science.gov (United States)

    Ma, Jing; Wang, Qiang; Zhao, Zhibiao

    2017-01-01

    In the context of Industry 4.0, the demand for the mass production of highly customized products will lead to complex products and an increasing demand for production system flexibility. Simply implementing lean production-based human-centered production or high automation to improve system flexibility is insufficient. Currently, lean automation (Jidoka) that utilizes cyber-physical systems (CPS) is considered a cost-efficient and effective approach for improving system flexibility under shrinking global economic conditions. Therefore, a smart lean automation engine enabled by CPS technologies (SLAE–CPS), which is based on an analysis of Jidoka functions and the smart capacity of CPS technologies, is proposed in this study to provide an integrated and standardized approach to design and implement a CPS-based smart Jidoka system. A set of comprehensive architecture and standardized key technologies should be presented to achieve the above-mentioned goal. Therefore, a distributed architecture that joins service-oriented architecture, agent, function block (FB), cloud, and Internet of things is proposed to support the flexible configuration, deployment, and performance of SLAE–CPS. Then, several standardized key techniques are proposed under this architecture. The first one is for converting heterogeneous physical data into uniform services for subsequent abnormality analysis and detection. The second one is a set of Jidoka scene rules, which is abstracted based on the analysis of the operator, machine, material, quality, and other factors in different time dimensions. These Jidoka rules can support executive FBs in performing different Jidoka functions. Finally, supported by the integrated and standardized approach of our proposed engine, a case study is conducted to verify the current research results. The proposed SLAE–CPS can serve as an important reference value for combining the benefits of innovative technology and proper methodology. PMID:28657577

  1. SLAE-CPS: Smart Lean Automation Engine Enabled by Cyber-Physical Systems Technologies.

    Science.gov (United States)

    Ma, Jing; Wang, Qiang; Zhao, Zhibiao

    2017-06-28

    In the context of Industry 4.0, the demand for the mass production of highly customized products will lead to complex products and an increasing demand for production system flexibility. Simply implementing lean production-based human-centered production or high automation to improve system flexibility is insufficient. Currently, lean automation (Jidoka) that utilizes cyber-physical systems (CPS) is considered a cost-efficient and effective approach for improving system flexibility under shrinking global economic conditions. Therefore, a smart lean automation engine enabled by CPS technologies (SLAE-CPS), which is based on an analysis of Jidoka functions and the smart capacity of CPS technologies, is proposed in this study to provide an integrated and standardized approach to design and implement a CPS-based smart Jidoka system. A set of comprehensive architecture and standardized key technologies should be presented to achieve the above-mentioned goal. Therefore, a distributed architecture that joins service-oriented architecture, agent, function block (FB), cloud, and Internet of things is proposed to support the flexible configuration, deployment, and performance of SLAE-CPS. Then, several standardized key techniques are proposed under this architecture. The first one is for converting heterogeneous physical data into uniform services for subsequent abnormality analysis and detection. The second one is a set of Jidoka scene rules, which is abstracted based on the analysis of the operator, machine, material, quality, and other factors in different time dimensions. These Jidoka rules can support executive FBs in performing different Jidoka functions. Finally, supported by the integrated and standardized approach of our proposed engine, a case study is conducted to verify the current research results. The proposed SLAE-CPS can serve as an important reference value for combining the benefits of innovative technology and proper methodology.

  2. Renin secretion and total body sodium: Pathways of integrative control

    DEFF Research Database (Denmark)

    Bie, Peter; Damkjaer, Mads

    2009-01-01

    to a spring/shock absorber set-up: Non-adaptive RAAS functions determine the new steady state position while TGF controls the rate of change. Recruitment of renin-secreting cells during sustained stimulation may be essential for chronic adaptation, although details of this afferent arteriolar cell plasticity...

  3. Development of technology for fabrication of lithium CPS on basis of CNT-reinforced carboxylic fabric

    International Nuclear Information System (INIS)

    Tazhibayeva, Irina; Baklanov, Viktor; Ponkratov, Yuriy; Abdullin, Khabibulla; Kulsartov, Timur; Gordienko, Yuriy; Zaurbekova, Zhanna; Lyublinski, Igor; Vertkov, Alexey; Skakov, Mazhyn

    2017-01-01

    Highlights: • Preliminary study of carboxylic fabric wettability with liquid lithium is presented. • Preliminary studies of carboxylic fabric wettability with liquid lithium consist in carrying out of experiments at temperatures 673,773 and 873 К in vacuum during long time. • A scheme of experimental device for manufacturing of lithium CPS and matrix filling procedure with liquid lithium are presented. • The concept of lithium limiter with CPS on basis of CNT-reinforced carboxylic fabric is proposed. - Abstract: The paper describes the analysis of liquid lithium interaction with materials based on carbon, the manufacture technology of capillary-porous system (CPS) matrix on basis of CNT-reinforced carboxylic fabric. Preliminary study of carboxylic fabric wettability with liquid lithium is presented. The development of technology includes: microstructural studies of carboxylic fabric before its CNT-reinforcing; validation of CNT-reinforcing technology; mode validation of CVD-method for CNT synthesize; study of synthesized carbon structures. Preliminary studies of carboxylic fabric wettability with liquid lithium consist in carrying out of experiments at temperatures 673, 773 and 873 К in vacuum during long time. The scheme of experimental device for manufacturing of lithium CPS and matrix filling procedure with liquid lithium are presented. The concept of lithium limiter with CPS on basis of CNT-reinforced carboxylic fabric is proposed.

  4. Development of technology for fabrication of lithium CPS on basis of CNT-reinforced carboxylic fabric

    Energy Technology Data Exchange (ETDEWEB)

    Tazhibayeva, Irina, E-mail: tazhibayeva@ntsc.kz [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan); Baklanov, Viktor; Ponkratov, Yuriy [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan); Abdullin, Khabibulla [Institute of Experimental and Theoretical Physics of Kazakh National University, Almaty (Kazakhstan); Kulsartov, Timur; Gordienko, Yuriy; Zaurbekova, Zhanna [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan); Lyublinski, Igor [JSC «Red Star», Moscow (Russian Federation); NRNU «MEPhI», Moscow (Russian Federation); Vertkov, Alexey [JSC «Red Star», Moscow (Russian Federation); Skakov, Mazhyn [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan)

    2017-04-15

    Highlights: • Preliminary study of carboxylic fabric wettability with liquid lithium is presented. • Preliminary studies of carboxylic fabric wettability with liquid lithium consist in carrying out of experiments at temperatures 673,773 and 873 К in vacuum during long time. • A scheme of experimental device for manufacturing of lithium CPS and matrix filling procedure with liquid lithium are presented. • The concept of lithium limiter with CPS on basis of CNT-reinforced carboxylic fabric is proposed. - Abstract: The paper describes the analysis of liquid lithium interaction with materials based on carbon, the manufacture technology of capillary-porous system (CPS) matrix on basis of CNT-reinforced carboxylic fabric. Preliminary study of carboxylic fabric wettability with liquid lithium is presented. The development of technology includes: microstructural studies of carboxylic fabric before its CNT-reinforcing; validation of CNT-reinforcing technology; mode validation of CVD-method for CNT synthesize; study of synthesized carbon structures. Preliminary studies of carboxylic fabric wettability with liquid lithium consist in carrying out of experiments at temperatures 673, 773 and 873 К in vacuum during long time. The scheme of experimental device for manufacturing of lithium CPS and matrix filling procedure with liquid lithium are presented. The concept of lithium limiter with CPS on basis of CNT-reinforced carboxylic fabric is proposed.

  5. Heterogenic control groups in randomized, controlled, analgesic trials of total hip and knee arthroplasty.

    Science.gov (United States)

    Karlsen, Anders P; Mathiesen, Ole; Dahl, Jørgen B

    2018-03-01

    Postoperative analgesic interventions are often tested adjunct to basic non-opioid analgesics in randomized controlled trials (RCTs). Consequently, treatment in control groups, and possible assay sensitivity, differs between trials. We hypothesized that postoperative opioid requirements and pain intensities vary between different control groups in analgesic trials. Control groups from RCTs investigating analgesic interventions after total hip and knee arthroplasty were categorized based on standardized basic analgesic treatment. Morphine consumption 0 to 24 hours postoperatively, and resting pain scores at 6 and 24 hours for subgroups of basic treatments, were compared with ANOVA. In an additional analysis, we compared pain and opioid requirements in trials where a non-steroidal anti-inflammatory drug (NSAID) was administered as an intervention with trial where NSAID was administered in a control group. We included 171 RCTs employing 28 different control groups with large variability in pain scores and opioid requirements. Four types of control groups (comprising 78 trials) were eligible for subgroup comparisons. These subgroups received "opioid" alone, "NSAID + opioid", "acetaminophen + opioid", or "NSAID + acetaminophen + opioid", respectively. Morphine consumption and pain scores varied substantially between these groups, with no consistent superior efficacy in any subgroup. Additionally, trials administering NSAID as an intervention demonstrated lower pain scores and opioid requirements than trials where NSAID was administered in a control group. Analgesic treatment in RCT control groups varies considerably. Control groups receiving various combinations of opioid, NSAID and acetaminophen did not differ consistently in pain and opioid requirements. Pain and opioid requirements were lower in trials administering NSAID as an intervention compared with trials administering NSAID in a control group.

  6. An Anonymous Access Authentication Scheme Based on Proxy Ring Signature for CPS-WMNs

    Directory of Open Access Journals (Sweden)

    Tianhan Gao

    2017-01-01

    Full Text Available Access security and privacy have become a bottleneck for the popularization of future Cyber-Physical System (CPS networks. Furthermore, users’ need for privacy-preserved access during movement procedure is more urgent. To address the anonymous access authentication issue for CPS Wireless Mesh Network (CPS-WMN, a novel anonymous access authentication scheme based on proxy ring signature is proposed. A hierarchical authentication architecture is presented first. The scheme is then achieved from the aspect of intergroup and intragroup anonymous mutual authentication through proxy ring signature mechanism and certificateless signature mechanism, respectively. We present a formal security proof of the proposed protocol with SVO logic. The simulation and performance analysis demonstrate that the proposed scheme owns higher efficiency and adaptability than the typical one.

  7. A Total Quality-Control Plan with Right-Sized Statistical Quality-Control.

    Science.gov (United States)

    Westgard, James O

    2017-03-01

    A new Clinical Laboratory Improvement Amendments option for risk-based quality-control (QC) plans became effective in January, 2016. Called an Individualized QC Plan, this option requires the laboratory to perform a risk assessment, develop a QC plan, and implement a QC program to monitor ongoing performance of the QC plan. Difficulties in performing a risk assessment may limit validity of an Individualized QC Plan. A better alternative is to develop a Total QC Plan including a right-sized statistical QC procedure to detect medically important errors. Westgard Sigma Rules provides a simple way to select the right control rules and the right number of control measurements. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Streptococcus iniae cpsG alters capsular carbohydrate composition and is a cause of serotype switching in vaccinated fish.

    Science.gov (United States)

    Heath, Candice; Gillen, Christine M; Chrysanthopoulos, Panagiotis; Walker, Mark J; Barnes, Andrew C

    2016-09-25

    Streptococcus iniae causes septicaemia and meningitis in marine and freshwater fish wherever they are farmed in warm-temperate and tropical regions. Although serotype specific, vaccination with bacterins (killed bacterial cultures) is largely successful and vaccine failure occurs only occasionally through emergence of new capsular serotypes. Previously we showed that mutations in vaccine escapes are restricted to a limited repertoire of genes within the 20-gene capsular polysaccharide (cps) operon. cpsG, a putative UDP-galactose 4-epimerase, has three sequence types based on the insertion or deletion of the three amino acids leucine, serine and lysine in the substrate binding site of the protein. To elucidate the role of cpsG in capsular polysaccharide (CPS) biosynthesis and capsular composition, we first prepared isogenic knockout and complemented mutants of cpsG by allelic exchange mutagenesis. Deletion of cpsG resulted in changes to colony morphology and cell buoyant density, and also significantly decreased galactose content relative to glucose in the capsular polysaccharide as determined by GC-MS, consistent with epimerase activity of CpsG. There was also a metabolic penalty of cpsG knockout revealed by slower growth in complex media, and reduced proliferation in whole fish blood. Moreover, whilst antibodies raised in fish against the wild type cross-reacted in whole cell and cps ELISA, they did not cross-opsonise the mutant in a peripheral blood neutrophil opsonisation assay, consistent with reported vaccine escape. We have shown here that mutation in cpsG results in altered CPS composition and this in turn results in poor cross-opsonisation that explains some of the historic vaccination failure on fish farms in Australia. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  9. Diffusive Promotion by Velocity Gradient of Cytoplasmic Streaming (CPS in Nitella Internodal Cells.

    Directory of Open Access Journals (Sweden)

    Kenji Kikuchi

    Full Text Available Cytoplasmic streaming (CPS is well known to assist the movement of nutrients, organelles and genetic material by transporting all of the cytoplasmic contents of a cell. CPS is generated by motility organelles that are driven by motor proteins near a membrane surface, where the CPS has been found to have a flat velocity profile in the flow field according to the sliding theory. There is a consistent mixing of contents inside the cell by CPS if the velocity gradient profile is flattened, which is not assisted by advection diffusion but is only supported by Brownian diffusion. Although the precise flow structure of the cytoplasm has an important role for cellular metabolism, the hydrodynamic mechanism of its convection has not been clarified. We conducted an experiment to visualise the flow of cytoplasm in Nitella cells by injecting tracer fluorescent nanoparticles and using a flow visualisation system in order to understand how the flow profile affects their metabolic system. We determined that the velocity field in the cytosol has an obvious velocity gradient, not a flattened gradient, which suggests that the gradient assists cytosolic mixing by Taylor-Aris dispersion more than by Brownian diffusion.

  10. 77 FR 58510 - Proposed Information Collection; Comment Request; Current Population Survey (CPS), Annual Social...

    Science.gov (United States)

    2012-09-21

    ... various population groups. A prime statistic of interest is the classification of people in poverty and... Information Collection; Comment Request; Current Population Survey (CPS), Annual Social and Economic... conducted this supplement annually for over 50 years. The Census Bureau and the Bureau of Labor Statistics...

  11. Development of the Childbirth Perception Scale (CPS) : Perception of delivery and the first postpartum week

    NARCIS (Netherlands)

    Truijens, Sophie E. M.; Wijnen, Hennie A.; Pommer, Antoinette M.; Oei, S. Guid; Pop, Victor J. M.

    2014-01-01

    Some caregivers suggest a more positive experience of childbirth when giving birth at home. Since properly developed instruments that assess women’s perception of delivery and the early postpartum are missing, the aim of the current study is to develop a Childbirth Perception Scale (CPS). Three

  12. Medium-Chain Chlorinated Paraffins (CPs) Dominate in Australian Sewage Sludge

    NARCIS (Netherlands)

    Brandsma, Sicco H; van Mourik, Louise; O'Brien, Jake W; Eaglesham, Geoff; Leonards, Pim E G; de Boer, Jacob; Gallen, Christie; Mueller, Jochen; Gaus, Caroline; Bogdal, Christian

    2017-01-01

    To simultaneously quantify and profile the complex mixture of short-, median-, and long-chain CPs (SCCPs, MCCPs, and LCCPs) in Australian sewage sludge, we applied and further validated a recently developed novel instrumental technique, using quadrupole time-of-flight high resolution mass

  13. Determination of tritium generation and release parameters at lithium CPS under neutron irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Ponkratov, Yuriy, E-mail: ponkratov@nnc.kz [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan); Baklanov, Viktor; Skakov, Mazhyn; Kulsartov, Timur; Tazhibayeva, Irina; Gordienko, Yuriy; Zaurbekova, Zhanna; Tulubayev, Yevgeniy [Institute of Atomic Energy, National Nuclear Center of RK, Kurchatov (Kazakhstan); Chikhray, Yevgeniy [Institute of Experimental and Theoretical Physics of Kazakh National University, Almaty (Kazakhstan); Lyublinski, Igor [JSC “Star”, Moscow (Russian Federation); NRNU “MEPhI”, Moscow (Russian Federation); Vertkov, Alexey [JSC “Star”, Moscow (Russian Federation)

    2016-11-01

    Highlights: • The main parameters of tritium generation and release from lithium capillary-porous system (CPS) under neutron irradiation at the IVG.1 M research reactor is described in paper. • In the experiments a very small tritium release was fixed likely due to its high solubility in liquid lithium. • If the lithium CPS will be used as a plasma facing material in temperature range up to 773 K under neutron irradiation only helium will release from lithium CPS into a vacuum chamber. - Abstract: This paper describes the main parameters of tritium generation and release from lithium capillary-porous system (CPS) under neutron irradiation at the IVG.1 M research reactor. The experiments were carried out using the method of mass-spectrometric registration of released gases and using a specially constructed ampoule device. Irradiation was carried out at different reactor thermal powers (1, 2 and 6 MW) and sample temperatures from 473 to 773 K. In the experiments a very small tritium release was detected likely due to its high solubility in liquid lithium. It can be caused by formation of lithium tritide during tritium diffusion to the lithium surface.

  14. 76 FR 75869 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Fertility...

    Science.gov (United States)

    2011-12-05

    ... of the first birth. Potential needs for government assistance, such as aid to families with dependent children, child care, and maternal health care for single parent households, can be estimated using CPS... child spacing, and to aid policymakers in their decisions affected by changes in family size and...

  15. MPM4CPS: multi-pardigm modelling for cyber-physical systems

    NARCIS (Netherlands)

    Vangeheluwe, Hans; Ameral, Vasco; Giese, Holger; Broenink, Johannes F.; Schätz, Bernhard; Norta, Alexander; Carreira, Paulo; Lukovic, Ivan; Mayerhofer, Tanja; Wimmer, Manuel; Vellecillo, Antonio

    2016-01-01

    The last decades have seen the emergence of truly complex, designed systems, known as Cyber-Physical Systems (CPS). Engineering such systems requires integrating physical, software, and network aspects. To date, neither a unifying theory nor systematic design methods, techniques and tools exist to

  16. 78 FR 45910 - Proposed Information Collection; Comment Request; Current Population Survey (CPS) Email Address...

    Science.gov (United States)

    2013-07-30

    ... Population Survey (CPS) Email Address Collection Test Supplement AGENCY: U.S. Census Bureau, Commerce. ACTION... request clearance for the collection of data concerning the November 2013 Email Address Collection Test... tool to help increase response rates. We foresee that in the future, we could collect email addresses...

  17. Automated glycan assembly of a S. pneumoniae serotype 3 CPS antigen

    Directory of Open Access Journals (Sweden)

    Markus W. Weishaupt

    2016-07-01

    Full Text Available Vaccines against S. pneumoniae, one of the most prevalent bacterial infections causing severe disease, rely on isolated capsular polysaccharide (CPS that are conjugated to proteins. Such isolates contain a heterogeneous oligosaccharide mixture of different chain lengths and frame shifts. Access to defined synthetic S. pneumoniae CPS structures is desirable. Known syntheses of S. pneumoniae serotype 3 CPS rely on a time-consuming and low-yielding late-stage oxidation step, or use disaccharide building blocks which limits variability. Herein, we report the first iterative automated glycan assembly (AGA of a conjugation-ready S. pneumoniae serotype 3 CPS trisaccharide. This oligosaccharide was assembled using a novel glucuronic acid building block to circumvent the need for a late-stage oxidation. The introduction of a washing step with the activator prior to each glycosylation cycle greatly increased the yields by neutralizing any residual base from deprotection steps in the synthetic cycle. This process improvement is applicable to AGA of many other oligosaccharides.

  18. Implementation of the On-the-fly Encryption for the Linux OS Based on Certified CPS

    Directory of Open Access Journals (Sweden)

    Alexander Mikhailovich Korotin

    2013-02-01

    Full Text Available The article is devoted to tools for on-the-fly encryption and a method to implement such tool for the Linux OS based on a certified CPS.The idea is to modify the existing tool named eCryptfs. Russian cryptographic algorithms will be used in the user and kernel modes.

  19. Blockchain-Oriented Coalition Formation by CPS Resources: Ontological Approach and Case Study

    Directory of Open Access Journals (Sweden)

    Alexey Kashevnik

    2018-05-01

    Full Text Available Cyber-physical systems (CPS, robotics, Internet of Things, information and communication technologies have become more and more popular over the last several years. These topics open new perspectives and scenarios that can automate processes in human life. CPS are aimed at interaction support in information space for physical entities communicated in physical space in real time. At the same time the blockchain technology that becomes popular last years allows to organize immutable distributed database that store all significant information and provide access for CPS participants. The paper proposes an approach that is based on ontology-based context management, publish/subscribe semantic interoperability support, and blockchain techniques. Utilization of these techniques provide possibilities to develop CPS that supports dynamic, distributed, and stable coalition formation of the resources. The case study presented has been implemented for the scenario of heterogeneous mobile robots’ collaboration for the overcoming of obstacles. There are two types of robots and an information service participating in the scenario. Evaluation shows that the proposed approach is applicable for the presented class of scenarios.

  20. Using creative problem solving (CPS) to improve leadership in a non-profit organization

    OpenAIRE

    Sousa, Fernando; Castelão, Paula; Monteiro, Ileana Pardal; Pellissier, René

    2013-01-01

    The purpose of this study was to evaluate the effectiveness of the Creative Problem Solving (CPS) method in improving the leadership process in a non-profit organization. The research was designed around an intervention and structured in three stages (pre-consult, intervention and follow-up), with a team designated by management, in order to bring leadership cohesion to both departments of the organization and also between the board and executive management. The results, expressed in the task...

  1. Analysis mathematical literacy skills in terms of the students’ metacognition on PISA-CPS model

    Science.gov (United States)

    Ovan; Waluya, S. B.; Nugroho, S. E.

    2018-03-01

    This research was aimed to know the effectiveness of PISA-CPS model and desceibe the mathematical literacy skills (KLM) in terms of the students’ metacognition. This study used Mixed Methods approaches with the concurrent embedded desaign. The technique of data analysis on quantitative research done analysis of lesson plan, prerequisite test, test hypotesis 1 and hypotesis test. While qualitative research done data reduction, data presentation, and drawing conclution and data verification. The subject of this study was the students of Grade Eight (VIII) of SMP Islam Sultan Agung 4 Semarang, Central Java. The writer analyzed the data with quantitative and qualitative approaches based on the metacognition of the students in low, medium and high groups. Subsequently, taken the mathematical literacy skills (KLM) from students’ metacognition in low, medium, and high . The results of the study showed that the PISA-CPS model was complete and the students’ mathematical literacy skills in terms of the students’ metacognition taught by the PISA-CPS model was higher than the expository learning. metacognitions’ students classified low hadmathematical literacy skills (KLM) less good, metacognitions’ students classified medium had mathematical literacy skills (KLM) good enough, metacognitions’ students classified high had mathematical literacy skills (KLM) very good. Based onresult analysis got conclusion that the PISA-CPS model was effective toward the students’ mathematical literacy skills (KLM). To increase the students’ mathematical literacy skills (KLM), the teachers need to provide reinforcements in the form of the exercises so that the student’s mathematical literacy was achieved at level 5 and level 6.

  2. Medium-Chain Chlorinated Paraffins (CPs) Dominate in Australian Sewage Sludge.

    Science.gov (United States)

    Brandsma, Sicco H; van Mourik, Louise; O'Brien, Jake W; Eaglesham, Geoff; Leonards, Pim E G; de Boer, Jacob; Gallen, Christie; Mueller, Jochen; Gaus, Caroline; Bogdal, Christian

    2017-03-21

    To simultaneously quantify and profile the complex mixture of short-, median-, and long-chain CPs (SCCPs, MCCPs, and LCCPs) in Australian sewage sludge, we applied and further validated a recently developed novel instrumental technique, using quadrupole time-of-flight high resolution mass spectrometry running in the negative atmospheric pressure chemical ionization mode (APCI-qTOF-HRMS). Without using an analytical column the cleaned extracts were directly injected into the qTOF-HRMS followed by quantification of the CPs by a mathematical algorithm. The recoveries of the four SCCP, MCCP and LCCP-spiked sewage sludge samples ranged from 86 to 123%. This APCI-qTOF-HRMS method is a fast and promising technique for routinely measuring SCCPs, MCCPs, and LCCPs in sewage sludge. Australian sewage sludge was dominated by MCCPs with concentrations ranging from 542 to 3645 ng/g dry weight (dw). Lower SCCPs concentrations (<57-1421 ng/g dw) were detected in the Australian sewage sludge, which were comparable with the LCCPs concentrations (116-960 ng/g dw). This is the first time that CPs were reported in Australian sewage sludge. The results of this study gives a first impression on the distribution of the SCCPs, MCCPs, and LCCPs in Australia wastewater treatment plants (WWTPs).

  3. On the spatial behavior of background plasma in different background pressure in CPS device

    International Nuclear Information System (INIS)

    Samantaray, Subrata; Paikaray, Rita; Sahoo, Gourishankar; Das, Parthasarathi; Ghosh, Joydeep; Sanyasi, Amulya Kumar

    2015-01-01

    Blob formation and transport is a major concern for investigators as it greatly reduces the efficiency of the devices. Initial results from CPS device confirm the role of fast neutrals inside the bulk plasma in the process of blob formation and transport. 2-D simulation of curvature and velocity shear instability in plasma structures suggest that in the presence of background plasma, secondary instability do not grow non-linearly to a high level and stabilizes the flow. Adiabaticity effect also creates a radial barrier for interchange modes. In the absence of background plasma the blob fragments even at the modest level of viscosity. The fast neutrals outside bulk plasma supposed to stabilize the system. The background plasma set up is aimed at creating fast neutrals outside main plasma column, hence; the background plasma set up is done in CPS device. The spatial behavior of plasma column in between electrodes is different for different base pressure in CPS device. The spatial variation of electron temperature of plasma column between electrodes is presented in this communication. Electron temperature is measured from emission spectroscopy data. The maximum electron temperature (line averaged) is ∼ 1.5 eV. (author)

  4. Effect of weed control treatments on total leaf area of plantation black walnut (Juglans nigra)

    Science.gov (United States)

    Jason Cook; Michael R. Saunders

    2013-01-01

    Determining total tree leaf area is necessary for describing tree carbon balance, growth efficiency, and other measures used in tree-level and stand-level physiological growth models. We examined the effects of vegetation control methods on the total leaf area of sapling-size plantation black walnut trees using allometric approaches. We found significant differences in...

  5. Panel summary of cyber-physical systems (CPS) and Internet of Things (IoT) opportunities with information fusion

    Science.gov (United States)

    Blasch, Erik; Kadar, Ivan; Grewe, Lynne L.; Brooks, Richard; Yu, Wei; Kwasinski, Andres; Thomopoulos, Stelios; Salerno, John; Qi, Hairong

    2017-05-01

    During the 2016 SPIE DSS conference, nine panelists were invited to highlight the trends and opportunities in cyber-physical systems (CPS) and Internet of Things (IoT) with information fusion. The world will be ubiquitously outfitted with many sensors to support our daily living thorough the Internet of Things (IoT), manage infrastructure developments with cyber-physical systems (CPS), as well as provide communication through networked information fusion technology over the internet (NIFTI). This paper summarizes the panel discussions on opportunities of information fusion to the growing trends in CPS and IoT. The summary includes the concepts and areas where information supports these CPS/IoT which includes situation awareness, transportation, and smart grids.

  6. Proposta do uso de pool de sangue total como controle interno de qualidade em hematologia

    OpenAIRE

    Schons,Carina Daniele; Tavares,Rejane Giacomelli

    2010-01-01

    INTRODUÇÃO: A confiabilidade dos resultados do laboratório é garantida pela realização do controle de qualidade, que tem como funções básicas análise, pesquisa e prevenção da ocorrência de erros laboratoriais por meio de programas que abrangem tanto o controle interno quanto o externo. OBJETIVO: Propor a padronização de utilização de pool de sangue total como controle interno de qualidade no setor de hematologia. MÉTODO: Foram selecionadas amostras de sangue total, colhidas com ácido etilenod...

  7. Manual instructivo de instalación y control de prótesis totales Instructive manual of installation and control of total prostheses

    Directory of Open Access Journals (Sweden)

    Marcia Hortensia Corona Carpio

    2007-12-01

    Full Text Available Se realizó un estudio de la literatura con el objetivo de describir el paso clínico de instalación y control de prótesis total, durante el período comprendido de enero a mayo del 2005 en la Clínica Estomatológica Provincial Docente de Santiago de Cuba. Se abordaron diversos aspectos, definición de conceptos, así como todo el proceder clínico, instrucciones al paciente y consejo s a los portadores de prótesis. Se enfatizó en el paciente geriátrico, destacándose que precisamente este paso es el indicado para eliminar los defectos evidentes y donde el paciente adquiere el hábito de utilizarlos y el organismo de aceptarlo.A literature study was conducted aimed at describing the clinical step of installation and control of total prosthesis at the Provincial Teaching Dental Clinic of Santiago de Cuba from January to May, 2005. Diverse aspects were dealt with, as well as the definition of concepts, the whole clinical procedure, instructions to the patients and advises to prosthesis wearers. Emphasis was made on the geriatric patient, and it was stressed that this step is the indicated to eliminate the evident defects, and where the patient acquires the habit to use them and the body to accept them.

  8. Controlling total spot power from holographic laser by superimposing a binary phase grating.

    Science.gov (United States)

    Liu, Xiang; Zhang, Jian; Gan, Yu; Wu, Liying

    2011-04-25

    By superimposing a tunable binary phase grating with a conventional computer-generated hologram, the total power of multiple holographic 3D spots can be easily controlled by changing the phase depth of grating with high accuracy to a random power value for real-time optical manipulation without extra power loss. Simulation and experiment results indicate that a resolution of 0.002 can be achieved at a lower time cost for normalized total spot power.

  9. Total antioxidants in plasma of hemodialysed patients and healthy controls measured by two commercial assays

    OpenAIRE

    Ruskovska, Tatjana; Jansen, Eugene

    2012-01-01

    Introduction: As a result of an increased interest in oxidative stress research, in both basic and clinical studies, numerous commercial test kits became available. The aim of this study was to evaluate the results for total antioxidants measured by two commercial assays in a complex clinical condition such as single hemodialysis session in patients on chronic hemodialysis treatment, in comparison to healthy controls. Methods: The level of plasma total antioxidants was measured by BAP ...

  10. Quality control on the accuracy of the total Beta activity index in different sample matrices water

    International Nuclear Information System (INIS)

    Pujol, L.; Pablo, M. A. de; Payeras, J.

    2013-01-01

    The standard ISO/IEC 17025:2005 of general requirements for the technical competence of testing and calibration laboratories, provides that a laboratory shall have quality control procedures for monitoring the validity of tests and calibrations ago. In this paper, the experience of Isotopic Applications Laboratory (CEDEX) in controlling the accuracy rate of total beta activity in samples of drinking water, inland waters and marine waters is presented. (Author)

  11. Tranexamic acid for control of blood loss in bilateral total knee replacement in a single stage

    Directory of Open Access Journals (Sweden)

    Mandeep S Dhillon

    2011-01-01

    Full Text Available Background: Tranexamic acid (TEA reduces blood loss and red cell transfusions in patients undergoing unilateral total knee arthroplasty (TKA. However, there is not much literature regarding the use of TEA in patients undergoing bilateral TKA in a single stage and the protocols for administration of TEA in such patients are ill-defined. Materials and Methods: We carried out a case control study evaluating the effect of TEA on postoperative hemoglobin (Hb, total drain output, and number of blood units transfused in 52 patients undergoing bilateral TKA in a single stage, and compared it with 56 matched controls who did not receive TEA. Two doses of TEA were administered in doses of 10 mg / kg each (slow intravenous (IV infusion, with the first dose given just before tourniquet release of the first knee and the second dose three hours after the first one. Results: A statistically significant reduction in the total drain output and requirement of allogenic blood transfusion in cases who received TEA, as compared to the controls was observed. The postoperative Hb and Hb at the time of discharge were found to be lower in the control group, and this result was found to be statistically significant. Conclusion: TEA administered in patients undergoing single stage bilateral TKA helped reduce total blood loss and decreased allogenic blood transfusion requirements. This might be particularly relevant, where facilities such as autologous reinfusion might not be available.

  12. Patient-Controlled Oral Analgesia for Postoperative Pain Management Following Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Patti Kastanias

    2010-01-01

    Full Text Available PURPOSE: To investigate whether patient-controlled oral analgesia (PCOA used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN-administered oral analgesia.

  13. Scientific Opinion on the essential composition of total diet replacements for weight control

    DEFF Research Database (Denmark)

    Tetens, Inge

    2015-01-01

    or authoritative bodies. Derived from the minimum content of macronutrients, the Panel proposed a minimum energy content of total diet replacements for weight control of 2 510 kJ/day (600 kcal/day). The Panel also advised on potential conditions and restrictions of use for these products....

  14. A randomised, controlled clinical study on total hip arthroplasty using 4 different bearings

    DEFF Research Database (Denmark)

    Borgwardt, Arne; Zerahn, Bo; Fabricius, Sandra D

    2017-01-01

    PURPOSE: To compare 4 different bearings in total hip arthroplasty (THA) in a randomised controlled clinical study on clinical performance. METHODS: 393 patients with osteoarthritis of the hip or avascular necrosis were included and allocated to 1 of the head-and-cup couples zirconia...

  15. A Controlled Study to Assess the Clinical Efficacy of Totally Self-Administered Systematic Desensitization

    Science.gov (United States)

    Rosen, Gerald M.; And Others

    1976-01-01

    Highly anxious self-referred snake phobics received either (a) therapist-administered desensitization, (b) self-administered desensitization with weekly therapist phone calls, (c) totally self-administered desensitization, (d) self-administered double-blind placebo control, or (e) no treatment. Pretreatment to posttreatment measures revealed…

  16. The construction of distant total distributed measuring and controlling system based on RS-232 communication

    International Nuclear Information System (INIS)

    Shi Chengying; Li Tiantuo; Zhu Wenkai; Zhang Quanhu

    1999-01-01

    The author discusses the construction of distant total distributed measuring and controlling system based on RS-232 communication. The merits of this system are simple construction, reliable performance, big communication distance, and wide covering range. The system fits in with application in radiation environment. The author also discusses the system's hardware equipment and communication protocol

  17. The Total Synthesis Problem of linear multivariable control. II - Unity feedback and the design morphism

    Science.gov (United States)

    Sain, M. K.; Antsaklis, P. J.; Gejji, R. R.; Wyman, B. F.; Peczkowski, J. L.

    1981-01-01

    Zames (1981) has observed that there is, in general, no 'separation principle' to guarantee optimality of a division between control law design and filtering of plant uncertainty. Peczkowski and Sain (1978) have solved a model matching problem using transfer functions. Taking into consideration this investigation, Peczkowski et al. (1979) proposed the Total Synthesis Problem (TSP), wherein both the command/output-response and command/control-response are to be synthesized, subject to the plant constraint. The TSP concept can be subdivided into a Nominal Design Problem (NDP), which is not dependent upon specific controller structures, and a Feedback Synthesis Problem (FSP), which is. Gejji (1980) found that NDP was characterized in terms of the plant structural matrices and a single, 'good' transfer function matrix. Sain et al. (1981) have extended this NDP work. The present investigation is concerned with a study of FSP for the unity feedback case. NDP, together with feedback synthesis, is understood as a Total Synthesis Problem.

  18. Blood volume, blood pressure and total body sodium: internal signalling and output control

    DEFF Research Database (Denmark)

    Bie, P

    2009-01-01

    Total body sodium and arterial blood pressure (ABP) are mutually dependent variables regulated by complex control systems. This review addresses the role of ABP in the normal control of sodium excretion (NaEx), and the physiological control of renin secretion. NaEx is a pivotal determinant of ABP......, and under experimental conditions, ABP is a powerful, independent controller of NaEx. Blood volume is a function of dietary salt intake; however, ABP is not, at least not in steady states. A transient increase in ABP after a step-up in sodium intake could provide a causal relationship between ABP...... and the regulation of NaEx via a hypothetical integrative control system. However, recent data show that subtle sodium loading (simulating salty meals) causes robust natriuresis without changes in ABP. Changes in ABP are not necessary for natriuresis. Normal sodium excretion is not regulated by pressure. Plasma...

  19. Interaction of valleys and circulation patterns (CPs on spatial precipitation patterns in southern Germany

    Directory of Open Access Journals (Sweden)

    M. Liu

    2013-11-01

    Full Text Available Topography exerts influence on the spatial precipitation distribution over different scales, known typically at the large scale as the orographic effect, and at the small scale as the wind-drift rainfall (WDR effect. At the intermediate scale (1~10 km, which is characterized by secondary mountain valleys, topography also demonstrates some effect on the precipitation pattern. This paper investigates such intermediate-scale topographic effects on precipitation patterns, focusing on narrow-steep valleys in the complex terrain of southern Germany, based on the daily observations over a 48 yr period (1960~2007 from a high-density rain-gauge network covering two sub-areas, Baden-Wuerttemberg (BW and Bavaria (BY. Precipitation data at the valley and non-valley stations are compared under consideration of the daily general circulation patterns (CPs classified by a fuzzy rule-based algorithm. Scatter plots of precipitation against elevation demonstrate a different behavior of valley stations comparing to non-valley stations. A detailed study of the precipitation time series for selected station triplets, each consisting of a valley station, a mountain station and an open station have been investigated by statistical analysis with the Kolmogorov–Smirnov (KS test supplemented by the One-way analysis of variance (One-way ANOVA and a graphical comparison of the mean precipitation amounts. The results show an interaction of valley orientation and the direction of the CPs at the intermediate scale, i.e. when the valley is shielded from the CP which carries the precipitation, the precipitation amount within the valley is comparable to that on the mountain crest, and both larger than the precipitation at the open station. When the valley is open to the CP, the precipitation within the valley is similar to the open station but much less than that on the mountain. Such phenomenon where the precipitation is "blind" to the valleys at the intermediate scale

  20. Development of a totally computer-controlled triple quadrupole mass spectrometer system

    International Nuclear Information System (INIS)

    Wong, C.M.; Crawford, R.W.; Barton, V.C.; Brand, H.R.; Neufeld, K.W.; Bowman, J.E.

    1983-01-01

    A totally computer-controlled triple quadrupole mass spectrometer (TQMS) is described. It has a number of unique features not available on current commercial instruments, including: complete computer control of source and all ion axial potentials; use of dual computers for data acquisition and data processing; and capability for self-adaptive control of experiments. Furthermore, it has been possible to produce this instrument at a cost significantly below that of commercial instruments. This triple quadrupole mass spectrometer has been constructed using components commercially available from several different manufacturers. The source is a standard Hewlett-Packard 5985B GC/MS source. The two quadrupole analyzers and the quadrupole CAD region contain Balzers QMA 150 rods with Balzers QMG 511 rf controllers for the analyzers and a Balzers QHS-511 controller for the CAD region. The pulsed-positive-ion-negative-ion-chemical ionization (PPINICI) detector is made by Finnigan Corporation. The mechanical and electronics design were developed at LLNL for linking these diverse elements into a functional TQMS as described. The computer design for total control of the system is unique in that two separate LSI-11/23 minicomputers and assorted I/O peripherals and interfaces from several manufacturers are used. The evolution of this design concept from totally computer-controlled instrumentation into future self-adaptive or ''expert'' systems for instrumental analysis is described. Operational characteristics of the instrument and initial results from experiments involving the analysis of the high explosive HMX (1,3,5,7-Tetranitro-1,3,5,7-Tetrazacyclooctane) are presented

  1. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing.

    Science.gov (United States)

    van Jonbergen, H P W; Scholtes, V A B; van Kampen, A; Poolman, R W

    2011-08-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in total knee replacement in the absence of patellar resurfacing. Patients requiring knee replacement for primary osteoarthritis were randomly assigned circumpatellar electrocautery (intervention group) or no electrocautery (control group). The primary outcome measure was the incidence of anterior knee pain. A secondary measure was the standardised clinical and patient-reported outcomes determined by the American Knee Society scores and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. A total of 131 knees received circumpatellar electrocautery and 131 had no electrocautery. The overall incidence of anterior knee pain at follow-up at one year was 26% (20% to 31%), with 19% (12% to 26%) in the intervention group and 32% (24% to 40%) in the control group (p = 0.02). The relative risk reduction from electrocautery was 40% (9% to 61%) and the number needed to treat was 7.7 (4.3 to 41.4). The intervention group had a better mean total WOMAC score at follow-up at one year compared with the control group (16.3 (0 to 77.7) versus 21.6 (0 to 76.7), p = 0.04). The mean post-operative American Knee Society knee scores and function scores were similar in the intervention and control groups (knee score: 92.4 (55 to 100) versus 90.4 (51 to 100), respectively (p = 0.14); function score: 86.5 (15 to 100) versus 84.5 (30 to 100), respectively (p = 0.49)). Our study suggests that in the absence of patellar resurfacing electrocautery around the margin of the patella improves the outcome of total knee replacement.

  2. Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy.

    Science.gov (United States)

    Teixeira, Miguel; Mendonça, Teresa; Rocha, Paula; Rabiço, Rui

    2014-12-01

    This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthesia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient's response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient's response, as well as, a comparison between the switching strategy and the Extended Kalman Kilter (EKF) technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improvement technique is able to produce a better reference tracking. Also, this technique showed a better performance than the (EKF). Based on these results, the switching control strategy with a bank of total system mass control laws proved to be robust enough to be used as an automatic control system for the NMB level.

  3. Development of a microcontroller-based automatic control system for the electrohydraulic total artificial heart.

    Science.gov (United States)

    Kim, H C; Khanwilkar, P S; Bearnson, G B; Olsen, D B

    1997-01-01

    An automatic physiological control system for the actively filled, alternately pumped ventricles of the volumetrically coupled, electrohydraulic total artificial heart (EHTAH) was developed for long-term use. The automatic control system must ensure that the device: 1) maintains a physiological response of cardiac output, 2) compensates for an nonphysiological condition, and 3) is stable, reliable, and operates at a high power efficiency. The developed automatic control system met these requirements both in vitro, in week-long continuous mock circulation tests, and in vivo, in acute open-chested animals (calves). Satisfactory results were also obtained in a series of chronic animal experiments, including 21 days of continuous operation of the fully automatic control mode, and 138 days of operation in a manual mode, in a 159-day calf implant.

  4. Study on the total amount control of atmospheric pollutant based on GIS.

    Science.gov (United States)

    Wang, Jian-Ping; Guo, Xi-Kun

    2005-08-01

    To provide effective environmental management for total amount control of atmospheric pollutants. An atmospheric diffusion model of sulfur dioxide on the surface of the earth was established and tested in Shantou of Guangdong Province on the basis of an overall assessment of regional natural environment, social economic state of development, pollution sources and atmospheric environmental quality. Compared with actual monitoring results in a studied region, simulation values fell within the range of two times of error and were evenly distributed in the two sides of the monitored values. Predicted with the largest emission model method, the largest emission of sulfur dioxide would be 54,279.792 tons per year in 2010. The mathematical model established and revised on the basis of GIS is more rational and suitable for the regional characteristics of total amount control of air pollutants.

  5. Application of the control variate technique to estimation of total sensitivity indices

    International Nuclear Information System (INIS)

    Kucherenko, S.; Delpuech, B.; Iooss, B.; Tarantola, S.

    2015-01-01

    Global sensitivity analysis is widely used in many areas of science, biology, sociology and policy planning. The variance-based methods also known as Sobol' sensitivity indices has become the method of choice among practitioners due to its efficiency and ease of interpretation. For complex practical problems, estimation of Sobol' sensitivity indices generally requires a large number of function evaluations to achieve reasonable convergence. To improve the efficiency of the Monte Carlo estimates for the Sobol' total sensitivity indices we apply the control variate reduction technique and develop a new formula for evaluation of total sensitivity indices. Presented results using well known test functions show the efficiency of the developed technique. - Highlights: • We analyse the efficiency of the Monte Carlo estimates of Sobol' sensitivity indices. • The control variate technique is applied for estimation of total sensitivity indices. • We develop a new formula for evaluation of Sobol' total sensitivity indices. • We present test results demonstrating the high efficiency of the developed formula

  6. Lifetime total and beverage specific - alcohol intake and prostate cancer risk: a case-control study

    Directory of Open Access Journals (Sweden)

    Carruba Giuseppe

    2004-12-01

    Full Text Available Abstract Background We investigated lifetime alcohol consumption and prostate cancer risk in a case-control study conducted in Buffalo, NY (1998–2001. Methods The study included 88 men, aged 45 to 85 years with incident, histologically-confirmed prostate cancer and 272 controls. We conducted extensive in-person interviews regarding lifetime alcohol consumption and other epidemiologic data. Results Prostate cancer risk was not associated with lifetime intake of total and beverage specific ethanol. In addition we found no association with number of drinks per day (average drinks per day over the lifetime or drinks per drinking day (average drinks per day on drinking days only over the lifetime. However, we observed an inverse association with the total number of drinking years. Men in the lowest tertile of total drinking years had a two-fold prostate cancer risk than men in the highest tertile (OR 2.16, 95% CI 0.98–4.78, p for trend Conclusion Our results suggest that alcohol intake distribution across lifetime may play a more important role in prostate cancer etiology than total lifetime consumption.

  7. Feasibility Study of Correcting Circuit Scheme for Automatic Control System of Total Air in Boiler

    Directory of Open Access Journals (Sweden)

    V. I. Nazarov

    2013-01-01

    Full Text Available The paper contains results of investigations on dynamic characteristics automatic control system (ACS for total air consumption (TAC in a boiler with corrections for О2 and СО. From transition process point of view the ACS TAC with correction for СО is considered as the most optimum one as with disturbance attack on fuel expenditure so discharging beyond boiler furnace.

  8. Total reduction of distorted echelle spectrograms - An automatic procedure. [for computer controlled microdensitometer

    Science.gov (United States)

    Peterson, R. C.; Title, A. M.

    1975-01-01

    A total reduction procedure, notable for its use of a computer-controlled microdensitometer for semi-automatically tracing curved spectra, is applied to distorted high-dispersion echelle spectra recorded by an image tube. Microdensitometer specifications are presented and the FORTRAN, TRACEN and SPOTS programs are outlined. The intensity spectrum of the photographic or electrographic plate is plotted on a graphic display. The time requirements are discussed in detail.

  9. Total quality control: the deming management philosophy applied to nuclear power plants

    International Nuclear Information System (INIS)

    Heising, C.D.; Wetherell, D.L.; Melhem, S.A.; Sato, M.

    1987-01-01

    In recent years, a call has come for the development of inherently safe nuclear reactor systems that cannot have large-scale accidents. In the search for the perfect inherently safe reactor system, some are calling for the institution of computerized automated control of reactors eliminating most human operators from the control room. A different approach to the problem of the control of inherently safe reactors is that both future and present nuclear power plants need to institute total quality control (TQC) to plant operations and management. The Deming management philosophy of TQC has been implemented in a wide range of industries - particularly in Japan and the US. Specific attention is given, however, to TQC implementation in the electric power industry as applied to nuclear plants. The Kansai Electric Power Company and Florida Power and Light Company have recently implemented TQC. Statistical quality control methods have been applied to monitor and control reactor variables (for example, to the steam generator water level important to start-up operations of pressurized water reactors)

  10. Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty

    Science.gov (United States)

    Ma, Ting-Ting; Wang, Yu-Hui; Jiang, Yun-Feng; Peng, Cong-Bin; Yan, Chao; Liu, Zi-Gui; Xu, Wei-Xing

    2017-01-01

    Abstract Background: In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA. Methods: We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model. Results: Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P  =  .018) and the length of hospital stay (P  =  .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05). Conclusion: Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient. PMID:28640101

  11. Liposomal bupivacaine versus traditional bupivacaine for pain control after total hip arthroplasty: A meta-analysis.

    Science.gov (United States)

    Ma, Ting-Ting; Wang, Yu-Hui; Jiang, Yun-Feng; Peng, Cong-Bin; Yan, Chao; Liu, Zi-Gui; Xu, Wei-Xing

    2017-06-01

    In the past, the efficacy of local infiltration of liposomal bupivacaine for total hip arthroplasty (THA) patients was in debate. Therefore, this meta-analysis was conducted to determine whether local infiltration of liposomal bupivacaine provides better pain relief after THA. We searched Web of Science, PubMed, Embase, and the Cochrane Library databases to the April 2017. Any studies comparing liposomal bupivacaine and traditional bupivacaine were included in our meta-analysis. The outcomes included visual analog scale (VAS) at 24, 48, and 72 hours, total morphine consumption at 24 hours, and the length of hospital stay. We assessed the pooled data using a random-effect model. Six studies were finally included in this meta-analysis. Our pooled data analysis demonstrated that liposomal bupivacaine was more effective than the traditional bupivacaine in terms of VAS at 24 hours (P  =  .018) and the length of hospital stay (P  =  .000). There was no significant difference in terms of the VAS at 48 and 72 hours and total morphine consumption at 24 hours (P >.05). Compared with the traditional bupivacaine, liposomal bupivacaine shows better pain control at 24 hours and reduces the length of hospital stay after THA. Its economic costs must be assessed in multimodal center randomized controlled trials when being recommended as a long-acting alternative analgesic agent for a THA patient.

  12. Perioperative celecoxib administration for pain management after total knee arthroplasty – A randomized, controlled study

    Directory of Open Access Journals (Sweden)

    Lin Wei-Peng

    2008-06-01

    Full Text Available Abstract Background Non-steroidal anti-inflammatory drugs (NSAIDs are recommended for multimodal postoperative pain management. We evaluated opioid-sparing effects and rehabilitative results after perioperative celecoxib administration for total knee arthroplasty. Methods This was a prospective, randomized, observer-blind control study. Eighty patients that underwent total knee arthroplasty were randomized into two groups of 40 each. The study group received a single 400 mg dose of celecoxib, one hour before surgery, and 200 mg of celecoxib every 12 hours for five days, along with patient-controlled analgesic (PCA morphine. The control group received only PCA morphine for postoperative pain management. Visual analog scale (VAS pain scores, active range of motion (ROM, total opioid use and postoperative nausea/vomiting were analyzed. Results Groups were comparable for age, pre-operative ROM, operation duration and intraoperative blood loss. Resting VAS pain scores improved significantly in the celecoxib group, compared with controls, at 48 hrs (2.13 ± 1.68 vs. 3.43 ± 1.50, p = 0.03 and 72 hrs (1.78 ± 1.66 vs. 3.17 ± 2.01, p = 0.02 after surgery. Active ROM also increased significantly in the patients that received celecoxib, especially in the first 72 hrs [40.8° ± 17.3° vs. 25.8° ± 11.5°, p = 0.01 (day 1; 60.7° ± 18.1° vs. 45.0° ± 17.3°, p = 0.004 (day 2; 77.7° ± 15.1° vs. 64.3° ± 16.9°, p = 0.004 (day 3]. Opioid requirements decreased about 40% (p = 0.03 in the celecoxib group. Although patients suffering from post-operative nausea/vomiting decreased from 43% in control group to 28% in celecoxib group, this was not significant (p = 0.57. There were no differences in blood loss (intra- and postoperative between the groups. Celecoxib resulted in no significant increase in the need for blood transfusions. Conclusion Perioperative celecoxib significantly improved postoperative resting pain scores at 48 and 72 hrs, opioid

  13. Quality control for total evaporation technique by surface/thermal ionization mass spectrometer

    International Nuclear Information System (INIS)

    Kato, Seikou; Inoue, Sinichi; Yamaguchi, Katsuyuki; Tsutaki, Yasuhiro

    2007-01-01

    For the measurement of uranium and plutonium isotopic composition, the surface/thermal ionization mass spectrometry is widely used at the both nuclear facilities and safeguards verification laboratories. The progress of instrument specification makes higher sensitivity. The total evaporation technique is one of the latest measurement techniques by using this progress, in which all of uranium or plutonium on the filament would be evaporated by increasing the filament current. The accuracy and precision of this technique is normally checked by using the certified isotope reference materials measurement. But the fluctuation of ion beam is very different by each filament, depending on the chemical form of evaporation. So, it should be considered how to check the measurement quality of unknown samples which has no certified values. This presentation is focused on the monitoring of ion yields and pattern of isotope ratio fluctuation to attain the traceability between reference material and unknown sample as quality control approach of total evaporation technique. (author)

  14. Strategies to determine and control the contributions of indoor air pollution to total inhalation exposure (STRATEX)

    DEFF Research Database (Denmark)

    Cochet, C.; Fernandes, E.O.; Jantunen, M.

    ECA-IAQ (European Collaborative Action, Urban Air, Indoor Environment and Human Exposure), 2006. Strategies to determine and control the contributions of indoor air pollution to total inhalation exposure (STRATEX), Report No 25. EUR 22503 EN. Luxembourg: Office for Official Publications...... of the European Communities It is now well established that indoor air pollution contributes significantly to the global burden of disease of the population. Therefore, the knowledge of this contribution is essential in view of risk assessment and management. The ECA STRATEX report collates the respective...... information and describes the strategies to determine population exposure to indoor air pollutants. Its major goal is to emphasise the importance of the contribution of indoor air to total air exposure. Taking this contribution into account is a prerequisite for sound risk assessment of air pollution...

  15. Does circumpatellar electrocautery improve the outcome after total knee replacement?: a prospective, randomised, blinded controlled trial.

    Science.gov (United States)

    Baliga, S; McNair, C J; Barnett, K J; MacLeod, J; Humphry, R W; Finlayson, D

    2012-09-01

    The incidence of anterior knee pain following total knee replacement (TKR) is reported to be as high as 49%. The source of the pain is poorly understood but the soft tissues around the patella have been implicated. In theory circumferential electrocautery denervates the patella thereby reducing efferent pain signals. However, there is mixed evidence that this practice translates into improved outcomes. We aimed to investigate the clinical effect of intra-operative circumpatellar electrocautery in patients undergoing TKR using the LCS mobile bearing or Kinemax fixed bearing TKR. A total of 200 patients were randomised to receive either circumpatellar electrocautery (diathermy) or not (control). Patients were assessed by visual analogue scale (VAS) for anterior knee pain and Oxford knee score (OKS) pre-operatively and three months, six months and one year post-operatively. Patients and assessors were blinded. There were 91 patients in the diathermy group and 94 in the control. The mean VAS improvement at one year was 3.9 in both groups (control; -10 to 6, diathermy; -9 to 8, p electrocautery on either VAS anterior knee pain or OKS for patients undergoing LCS and Kinemax TKR.

  16. Total aircraft flight-control system - Balanced open- and closed-loop control with dynamic trim maps

    Science.gov (United States)

    Smith, G. A.; Meyer, G.

    1979-01-01

    The availability of the airborne digital computer has made possible a Total Aircraft Flight Control System (TAFCOS) that uses virtually the complete nonlinear propulsive and aerodynamic data for the aircraft to construct dynamic trim maps that represent an inversion of the aircraft model. The trim maps, in series with the aircraft, provide essentially a linear feed-forward path. Basically, open-loop trajectory control is employed with only a small perturbation feedback signal required to compensate for inaccuracy in the aircraft model and for external disturbances. Simulation results for application to an automatic carrier-landing system are presented. Flight-test results for a STOL aircraft operating automatically over a major portion of its flight regime are presented. The concept promises a more rapid and straightforward design from aerodynamic principles, particularly for highly nonlinear configurations, and requires substantially less digital computer capacity than conventional automatic flight-control system designs.

  17. Control of total voltage in the large distributed RF system of LEP

    CERN Document Server

    Ciapala, Edmond

    1995-01-01

    The LEP RF system is made up of a large number of independent RF units situated around the ring near the interaction points. These have different available RF voltages depending on their type and they may be inactive or unable to provide full voltage for certain periods. The original RF voltage control system was based on local RF unit voltage function generators pre-loaded with individual tables for energy ramping. This was replaced this year by a more flexible global RF voltage control system. A central controller in the main control room has direct access to the units over the LEP TDM system via multiplexers and local serial links. It continuously checks the state of all the units and adjusts their voltages to maintain the desired total voltage under all conditions. This voltage is distributed among the individual units to reduce the adverse effects of RF voltage asymmetry around the machine as far as possible. The central controller is a VME system with 68040 CPU and real time multitasking operating syste...

  18. Driver electronics design and control for a total artificial heart linear motor.

    Science.gov (United States)

    Unthan, Kristin; Cuenca-Navalon, Elena; Pelletier, Benedikt; Finocchiaro, Thomas; Steinseifer, Ulrich

    2018-01-27

    For any implantable device size and efficiency are critical properties. Thus, a linear motor for a Total Artificial Heart was optimized with focus on driver electronics and control strategies. Hardware requirements were defined from power supply and motor setup. Four full bridges were chosen for the power electronics. Shunt resistors were set up for current measurement. Unipolar and bipolar switching for power electronics control were compared regarding current ripple and power losses. Here, unipolar switching showed smaller current ripple and required less power to create the necessary motor forces. Based on calculations for minimal power losses Lorentz force was distributed to the actor's four coils. The distribution was determined as ratio of effective magnetic flux through each coil, which was captured by a force test rig. Static and dynamic measurements under physiological conditions analyzed interaction of control and hardware and all efficiencies were over 89%. In conclusion, the designed electronics, optimized control strategy and applied current distribution create the required motor force and perform optimal under physiological conditions. The developed driver electronics and control offer optimized size and efficiency for any implantable or portable device with multiple independent motor coils. Graphical Abstract ᅟ.

  19. Application of Adaptive Starling-Like Controller to Total Artificial Heart Using Dual Rotary Blood Pumps.

    Science.gov (United States)

    Ng, Boon C; Smith, Peter A; Nestler, Frank; Timms, Daniel; Cohn, William E; Lim, Einly

    2017-03-01

    The successful clinical applicability of rotary left ventricular assist devices (LVADs) has led to research interest in devising a total artificial heart (TAH) using two rotary blood pumps (RBPs). The major challenge when using two separately controlled LVADs for TAH support is the difficulty in maintaining the balance between pulmonary and systemic blood flows. In this study, a starling-like controller (SLC) hybridized with an adaptive mechanism was developed for a dual rotary LVAD TAH. The incorporation of the adaptive mechanism was intended not only to minimize the risk of pulmonary congestion and atrial suction but also to match cardiac demand. A comparative assessment was performed between the proposed adaptive starling-like controller (A-SLC) and a conventional SLC as well as a constant speed controller. The performance of all controllers was evaluated by subjecting them to three simulated scenarios [rest, exercise, head up tilt (HUT)] using a mock circulation loop. The overall results showed that A-SLC was superior in matching pump flow to cardiac demand without causing hemodynamic instabilities. In contrast, improper flow regulation by the SLC resulted in pulmonary congestion during exercise. From resting supine to HUT, overpumping of the RBPs at fixed speed (FS) caused atrial suction, whereas implementation of SLC resulted in insufficient flow. The comparative study signified the potential of the proposed A-SLC for future TAH implementation particularly among outpatients, who are susceptible to variety of clinical scenarios.

  20. Seminal plasma total antioxidant capacity and vitamin- C levels in asthenozoospermia: a case- control study

    Directory of Open Access Journals (Sweden)

    Ali Bidmeshkipour

    2010-03-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Defective sperm function is now recognized as one of the most important causes of male infertility. Seminal plasma possesses a rich source of different enzymatic and non-enzymatic antioxidants such as vitamin C (ascorbic acid that protect spermatozoa against oxidative stress as one of the mediators of infertility causing sperm dysfunction and low sperm quality. The aim of this study was investigation of seminal total antioxidant capacity and determination of vitamin C effects on sperm motility. "n"nMethods: We designed a case-control study with a total subject of 62 males. Sperm parameters were analyzed according to World Health Organization guidelines (WHO, 1999. Total antioxidant capacity and vitamin C level of seminal plasma were measured in the 32 normozoospermic as the control group and 32 asthenospermic men as the case group using FRAP (Ferric Reducing of Antioxidants Powers and RP-HPLC (Reverse Phase High Performance Liquid Chromatography methods, respectively. "n"nResults: Our results indicated that total antioxidant capacity levels in the seminal plasma of asthenospermic men were significantly lower than healthy men (p=0.002. In addition, we found a positive correlation between reduced total

  1. What is the Quality of Online Resources About Pain Control After Total Knee Arthroplasty?

    Science.gov (United States)

    Schairer, William W; Kahlenberg, Cynthia A; Sculco, Peter K; Nwachukwu, Benedict U

    2017-12-01

    With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject. Three authors then independently graded websites and the results averaged. Flesch-Kinkaid reading level was also evaluated. After identifying 166 unique websites, 32 met final inclusion criteria. The overall scores were low-4.7 of 25 total points (18.8%), written at an average 10th grade level. Subgroup scores were 50% for route of administration, 40% for types of analgesia, 23% for opioid-specific items, and 30% for general guidance. Only about half discussed the risks of opioid dependency. The top 3 website total scores ranged from 10.7-12.5 of 25 points. There is a paucity of online information for TKA patients to read about pain control. Most websites provide limited educational content, particularly about opioids. Higher quality information is needed to help patients make decisions with their physicians and to help combat the opioid epidemic. Given the lack of quality information available, there is an opportunity for subspecialty organizations to take a leadership role in such efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Nontypeable pneumococci can be divided into multiple cps types, including one type expressing the novel gene pspK.

    Science.gov (United States)

    Park, In Ho; Kim, Kyung-Hyo; Andrade, Ana Lucia; Briles, David E; McDaniel, Larry S; Nahm, Moon H

    2012-01-01

    Although virulence of Streptococcus pneumoniae is associated with its capsule, some pathogenic S. pneumoniae isolates lack capsules and are serologically nontypeable (NT). We obtained 64 isolates that were identified as NT "pneumococci" (i.e., bacteria satisfying the conventional definition but without the multilocus sequence typing [MLST]-based definition of S. pneumoniae) by the traditional criteria. All 64 were optochin sensitive and had lytA, and 63 had ply. Twelve isolates had cpsA, suggesting the presence of a conventional but defective capsular polysaccharide synthesis (cps) locus. The 52 cpsA-negative isolates could be divided into three null capsule clades (NCC) based on aliC (aliB-like ORF1), aliD (aliB-like ORF2), and our newly discovered gene, pspK, in their cps loci. pspK encodes a protein with a long alpha-helical region containing an LPxTG motif and a YPT motif known to bind human pIgR. There were nine isolates in NCC1 (pspK(+) but negative for aliC and aliD), 32 isolates in NCC2 (aliC(+) aliD(+) but negative for pspK), and 11 in NCC3 (aliD(+) but negative for aliC and pspK). Among 52 cpsA-negative isolates, 41 were identified as S. pneumoniae by MLST analysis. All NCC1 and most NCC2 isolates were S. pneumoniae, whereas all nine NCC3 and two NCC2 isolates were not S. pneumoniae. Several NCC1 and NCC2 isolates from multiple individuals had identical MLST and cps regions, showing that unencapsulated S. pneumoniae can be infectious among humans. Furthermore, NCC1 and NCC2 S. pneumoniae isolates could colonize mice as well as encapsulated S. pneumoniae, although S. pneumoniae with an artificially disrupted cps locus did not. Moreover, an NCC1 isolate with pspK deletion did not colonize mice, suggesting that pspK is critical for colonization. Thus, PspK may provide pneumococci a means of surviving in the nasopharynx without capsule. IMPORTANCE The presence of a capsule is critical for many pathogenic bacteria, including pneumococci. Reflecting the

  3. Integration of virtual control units in the total vehicle simulation; Integration virtueller Steuergeraete in die Gesamtfahrzeugsimulation

    Energy Technology Data Exchange (ETDEWEB)

    Soppa, Andreas; Lund, Christoph [Volkswagen AG, Wolfsburg (Germany)

    2012-11-01

    In this article the simulation of information and energetics of vehicles with model-integration of electronic control units (ECU) in a simulation, based on the coupling of physical and control components of the total vehicle are investigated. For that simplified models of ECU's, simulating the functionally of the real ECU's, were used. The integration of virtual EUC's in models of full vehicles makes it possible to simulate the energetics for different driving cycles in a realistic way. By better simulation results an evaluation of physical components and the amount of functions are possible. In the area of the thermal management of vehicles by this analyses and optimizations of functions become possible. This article shows the advantages of embedding virtual ECU's in simulations of full vehicles. (orig.)

  4. Total hip arthroplasty and perioperative oral carbohydrate treatment: a randomised, double-blind, controlled trial.

    Science.gov (United States)

    Harsten, Andreas; Hjartarson, Hjörtur; Toksvig-Larsen, Sören

    2012-06-01

    Perioperative oral carbohydrate intake is beneficial to general surgery patients. Total hip arthroplasty is a common surgical procedure, and even a moderate improvement in patient outcome could have a significant effect on the resources needed for these patients. However, few studies have focused on the effects of carbohydrate intake on orthopaedic patients. The purpose of this study was to investigate if perioperative oral carbohydrate intake alters the postoperative course for patients undergoing total hip arthroplasty. The primary hypothesis was that pain scores would be lower in patients treated with carbohydrate. A randomised, double-blind, controlled trial. This study was carried out between September 2009 and April 2011 at a district Swedish hospital that specialises in orthopaedic surgery. Sixty ASA physical status I-III patients scheduled for elective total hip arthroplasty were included. Exclusion criteria were obesity, diabetes, prior hip surgery to the same hip, ongoing infection, immunological deficiency or age less than 50 or more than 80 years. Patients were given 400 ml of either an oral 12.5% carbohydrate solution or a placebo beverage (flavoured water) 1.5 h before and 2 h after surgery. Visual analogue scales were used to score six discomfort parameters. Immediately prior to surgery, the carbohydrate-treated patients were less hungry (median score 9.5 vs. 22 mm) and experienced less nausea (0 vs. 1.5 mm) (Phip arthroplasty.

  5. Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma.

    Science.gov (United States)

    Sano, Takeshi; Sasako, Mitsuru; Mizusawa, Junki; Yamamoto, Seiichiro; Katai, Hitoshi; Yoshikawa, Takaki; Nashimoto, Atsushi; Ito, Seiji; Kaji, Masahide; Imamura, Hiroshi; Fukushima, Norimasa; Fujitani, Kazumasa

    2017-02-01

    To clarify the role of splenectomy in total gastrectomy for proximal gastric cancer. Splenectomy in total gastrectomy is associated with increased operative morbidity and mortality, but its survival benefit is unclear. Previous randomized controlled trials were underpowered and inconclusive. We conducted a multiinstitutional randomized controlled trial. Proximal gastric adenocarcinoma of T2-4/N0-2/M0 not invading the greater curvature was eligible. During the operation, surgeons confirmed that R0 resection was possible with negative lavage cytology, and patients were randomly assigned to either splenectomy or spleen preservation. The primary endpoint was overall survival (OS) and the secondary endpoints were relapse-free survival, operative morbidity, operation time, and blood loss. The trial was designed to confirm noninferiority of spleen preservation to splenectomy in OS with a noninferiority margin of the hazard ratio as 1.21 and 1-sided alpha of 5%. Between June 2002 and March 2009, 505 patients (254 splenectomy, 251 spleen preservation) were enrolled from 36 institutions. Splenectomy was associated with higher morbidity and larger blood loss, but the operation time was similar. The 5-year survivals were 75.1% and 76.4% in the splenectomy and spleen preservation groups, respectively. The hazard ratio was 0.88 (90.7%, confidence interval 0.67-1.16) (splenectomy should be avoided as it increases operative morbidity without improving survival.

  6. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    Science.gov (United States)

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  7. Total protein analysis as a reliable loading control for quantitative fluorescent Western blotting.

    Directory of Open Access Journals (Sweden)

    Samantha L Eaton

    Full Text Available Western blotting has been a key technique for determining the relative expression of proteins within complex biological samples since the first publications in 1979. Recent developments in sensitive fluorescent labels, with truly quantifiable linear ranges and greater limits of detection, have allowed biologists to probe tissue specific pathways and processes with higher resolution than ever before. However, the application of quantitative Western blotting (QWB to a range of healthy tissues and those from degenerative models has highlighted a problem with significant consequences for quantitative protein analysis: how can researchers conduct comparative expression analyses when many of the commonly used reference proteins (e.g. loading controls are differentially expressed? Here we demonstrate that common controls, including actin and tubulin, are differentially expressed in tissues from a wide range of animal models of neurodegeneration. We highlight the prevalence of such alterations through examination of published "-omics" data, and demonstrate similar responses in sensitive QWB experiments. For example, QWB analysis of spinal cord from a murine model of Spinal Muscular Atrophy using an Odyssey scanner revealed that beta-actin expression was decreased by 19.3±2% compared to healthy littermate controls. Thus, normalising QWB data to β-actin in these circumstances could result in 'skewing' of all data by ∼20%. We further demonstrate that differential expression of commonly used loading controls was not restricted to the nervous system, but was also detectable across multiple tissues, including bone, fat and internal organs. Moreover, expression of these "control" proteins was not consistent between different portions of the same tissue, highlighting the importance of careful and consistent tissue sampling for QWB experiments. Finally, having illustrated the problem of selecting appropriate single protein loading controls, we demonstrate

  8. Functional exercise after total hip replacement (FEATHER a randomised control trial

    Directory of Open Access Journals (Sweden)

    Monaghan Brenda

    2012-11-01

    Full Text Available Abstract Background Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR. It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life. Methods/design This will be a single blind multi centre randomized control trial with two arms. Seventy subjects post primary total hip arthroplasty will be randomized into either an experimental group (n=35, or to a control group (n=35. The experimental group will attend a functional exercise class twice weekly for a six week period from week 12 to week 18 post surgery. The functional exercise group will follow a circuit based functional exercise class supervised by a chartered Physiotherapist. The control group will receive usual care. The principal investigator (BM will perform blinded outcome assessments on all patients using validated measures for pain, stiffness, and function using the Western Ontario and Mc Master Universities Osteoarthritis index (WOMAC. This is the primary outcome measurement tool. Secondary outcome measurements include Quality of life (SF-36, 6 min walk test, Visual Analogue Scale, and the Berg Balance score. The WOMAC score will be collated on day five post surgery and repeated at week twelve and week eighteen. All other measurements will be taken at week 12 and repeated at week eighteen. In addition a blinded radiologist will measure gluteus medius cross sectional area using real time ultrasound for all subjects at week 12 and at week 18 to determine if the functional exercise programme has any effect on muscle size. Discussion This randomised controlled trial will add to the body of evidence on the relationship between muscle size, functional ability, balance, quality of life and time post surgery in patients following total hip arthroplasty. The CONSORT guidelines will be followed to throughout. Ethical

  9. Cashew consumption reduces total and LDL cholesterol: a randomized, crossover, controlled-feeding trial.

    Science.gov (United States)

    Mah, Eunice; Schulz, Jacqueline A; Kaden, Valerie N; Lawless, Andrea L; Rotor, Jose; Mantilla, Libertie B; Liska, DeAnn J

    2017-05-01

    Background: Cashews are the third most-consumed tree nut in the United States and are abundant with monounsaturated fatty acids and polyunsaturated fatty acids, which are associated with reduced cardiovascular disease risk. Although a qualified Food and Drug Administration health claim exists for nuts and heart health, cashews have been exempt from its use because cashews exceed the disqualifying amount of saturated fatty acids. Approximately one-third of the saturated fat in cashews is stearic acid, which is relatively neutral on blood lipids, thereby suggesting that cashews could have effects that are similar to those of other nuts. However, clinical data on cashews and blood lipids have been limited. Objective: We investigated the effect of reasonable intakes of cashews on serum lipids in adults with or at risk of high LDL cholesterol. Design: In a randomized, crossover, isocaloric, controlled-feeding study, 51 men and women (aged 21-73 y) with a median LDL-cholesterol concentration of 159 mg/dL (95% CI: 146, 165 mg/dL) at screening consumed typical American diets with cashews (28-64 g/d; 50% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 32% of kilocalories from total fat) or potato chips (control; 54% of kilocalories from carbohydrate, 18% of kilocalories from protein, and 29% of kilocalories from total fat) for 28 d with a ≥2-wk washout period. Results: Consumption of the cashew diet resulted in a significantly greater median change from baseline (compared with the control, all P cholesterol [-3.9% (95% CI: -9.3%, 1.7%) compared with 0.8% (95% CI: -1.5%, 4.5%), respectively], LDL cholesterol [-4.8% (95% CI: -12.6%, 3.1%) compared with 1.2% (95% CI: -2.3%, 7.8%), respectively], non-HDL cholesterol [-5.3% (95% CI: -8.6%, 2.1%) compared with 1.7% (95% CI: -0.9%, 5.6%), respectively], and the total-cholesterol:HDL-cholesterol ratio [-0.0% (95% CI: -4.3%, 4.8%) compared with 3.4% (95% CI: 0.6%, 5.2%), respectively]. There were no

  10. The effects of probiotics on total cholesterol: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Lang; Guo, Mao-Juan; Gao, Qing; Yang, Jin-Feng; Yang, Lin; Pang, Xiao-Li; Jiang, Xi-Juan

    2018-02-01

    Probiotics supplements provide a new nonpharmacological alternative to reduce cardiovascular risk factors. The impact of probiotics on the reduction of total cholesterol (TC) remains controversial. We conducted a meta-analysis to showcase the most updated and comprehensive evaluation of the studies. Randomized controlled trials (RCTs) were searched from electronic databases, including PubMed, Embase, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang database dating from January 2007 to January 2017. The curative effects of probiotics on the reduction of TC were assessed using mean difference (MD), as well as their 95% confidence interval (CI). RevMan software (version 5.3) was used to carry out this meta-analysis. Thirty-two RCTs including 1971 patients met the inclusion criteria. Results of this analysis showed that compared with the control group serum TC was significantly reduced in probiotics group [MD = -13.27, 95% CI (-16.74 to 9.80), P  6 weeks: [MD = -22.18, 95% CI (-28.73, -15.63), P probiotics forms and intervention duration might have a significant impact on the results. However, strains and doses of probiotics had no significant influence on curative effects. Available evidence indicates that probiotics supplements can significantly reduce serum TC. Furthermore, higher baseline TC, longer intervention time, and probiotics in capsules form might contribute to a better curative effect.

  11. Plasma and salivary total antioxidant capacity in healthy controls compared with aggressive and chronic periodontitis patients.

    Science.gov (United States)

    Baser, Ulku; Gamsiz-Isik, Hikmet; Cifcibasi, Emine; Ademoglu, Evin; Yalcin, Funda

    2015-07-01

    To evaluate the plasma and salivary total antioxidant capacity (TAOC) in patients with generalized chronic periodontitis (CP), generalized aggressive periodontitis (AgP), and periodontally healthy controls. This cross-sectional study includes of 88 individuals seeking dental treatment at the Faculty of Dentistry, Istanbul University, Istanbul, Turkey between January 2011 and March 2012. Fifteen AgP patients were compared with 21 healthy controls (C1), while 36 CP patients were compared with 16 healthy controls (C2). Clinical periodontal measurements were recorded, and plasma and saliva samples were collected. The TAOC of the plasma and saliva samples were determined using a commercially available colorimetric kit. The plasma TAOC of both AgP and CP patients was significantly lower for C1 and C2. The salivary TAOC of CP patients was significantly lower for C2, but there was no significant difference between AgP patients and C1. Our results demonstrate that severe periodontitis may be associated with a lower plasma antioxidant capacity. The reduced antioxidant capacity in patients with severe periodontitis, especially with aggressive forms may be an important contributing factor to severe tissue destruction.

  12. Quality control related to total quality: why not to nuclear area too?

    International Nuclear Information System (INIS)

    Vasques, R.J.

    1992-01-01

    We're living in a new economical age, where quality, productivity, competence, competitiveness and costumer satisfaction are necessary. We must develop our capacity more and more, daily, for could survive and to excel in this new age. Only through Total Quality Control (TQC) is that we'll go to achieve these requirements. TQC is expanding all over the world and is already, the new universal language. Why not get the TQC's benefits to nuclear area too? We must stay within this reality. With our quality assurance systems turned to TQC, certainly we'll get best results. This is the intention of this paper: to call the nuclear professionals attention to knowledge, application and commitment to TQC's philosophy. (author)

  13. [Operative treatment strategies for multiple trauma patients : early total care versus damage control].

    Science.gov (United States)

    Klüter, T; Lippross, S; Oestern, S; Weuster, M; Seekamp, A

    2013-09-01

    The treatment of multiple trauma patients is a great challenge for an interdisciplinary team. After preclinical care and subsequent treatment in the emergency room the order of the interventions is prioritized depending of the individual risk stratification. For planning the surgery management it is essential to distinguish between absolutely essential operations to prevent life-threatening situations for the patient and interventions with shiftable indications, depending on the general condition of the patient. All interventions need to be done without causing significant secondary damage to prohibit hyperinflammation and systemic inflammatory response syndrome. The challenge consists in determination of the appropriate treatment at the right point in time. In general the early primary intervention, early total care, is differentiated from the damage control concept.

  14. Catechol-O-methyltransferase (COMT) genotype affects cognitive control during total sleep deprivation.

    Science.gov (United States)

    Satterfield, Brieann C; Hinson, John M; Whitney, Paul; Schmidt, Michelle A; Wisor, Jonathan P; Van Dongen, Hans P A

    2018-02-01

    Adaptive decision making is profoundly impaired by total sleep deprivation (TSD). This suggests that TSD impacts fronto-striatal pathways involved in cognitive control, where dopamine is a key neuromodulator. In the prefrontal cortex (PFC), dopamine is catabolized by the enzyme catechol-O-methyltransferase (COMT). A functional polymorphism (Val158Met) influences COMT's enzymatic activity, resulting in markedly different levels of prefrontal dopamine. We investigated the effect of this polymorphism on adaptive decision making during TSD. Sixty-six healthy young adults participated in one of two in-laboratory studies. After a baseline day, subjects were randomized to either a TSD group (n = 32) with 38 h or 62 h of extended wakefulness or a well-rested control group (n = 34) with 10 h nighttime sleep opportunities. Subjects performed a go/no-go reversal learning (GNGr) task at well-rested baseline and again during TSD or equivalent control. During the task, subjects were required to learn stimulus-response relationships from accuracy feedback. The stimulus-response relationships were reversed halfway through the task, which required subjects to learn the new stimulus-response relationships from accuracy feedback. Performance on the GNGr task was quantified by discriminability (d') between go and no-go stimuli before and after the stimulus-response reversal. GNGr performance did not differ between COMT genotypes when subjects were well-rested. However, TSD exposed a significant vulnerability to adaptive decision making impairment in subjects with the Val allele. Our results indicate that sleep deprivation degrades cognitive control through a fronto-striatal, dopaminergic mechanism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Large head metal-on-metal cementless total hip arthroplasty versus 28mm metal-on-polyethylene cementless total hip arthroplasty: design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van Raaij Jos JAM

    2008-10-01

    Full Text Available Abstract Background Osteoarthritis of the hip is successfully treated by total hip arthroplasty with metal-on-polyethylene articulation. Polyethylene wear debris can however lead to osteolysis, aseptic loosening and failure of the implant. Large head metal-on-metal total hip arthroplasty may overcome polyethylene wear induced prosthetic failure, but can increase systemic cobalt and chromium ion concentrations. The objective of this study is to compare two cementless total hip arthroplasties: a conventional 28 mm metal-on-polyethylene articulation and a large head metal-on-metal articulation. We hypothesize that the latter arthroplasties show less bone density loss and higher serum metal ion concentrations. We expect equal functional scores, greater range of motion, fewer dislocations, fewer periprosthetic radiolucencies and increased prosthetic survival with the metal-on-metal articulation. Methods A randomized controlled trial will be conducted. Patients to be included suffer from non-inflammatory degenerative joint disease of the hip, are aged between 18 and 80 and are admitted for primary cementless unilateral total hip arthroplasty. Patients in the metal-on-metal group will receive a cementless titanium alloy acetabular component with a cobalt-chromium liner and a cobalt-chromium femoral head varying from 38 to 60 mm. Patients in the metal-on-polyethylene group will receive a cementless titanium alloy acetabular component with a polyethylene liner and a 28 mm cobalt-chromium femoral head. We will assess acetabular bone mineral density by dual energy x-ray absorptiometry (DEXA, serum ion concentrations of cobalt, chromium and titanium, self reported functional status (Oxford hip score, physician reported functional status and range of motion (Harris hip score, number of dislocations and prosthetic survival. Measurements will take place preoperatively, perioperatively, and postoperatively (6 weeks, 1 year, 5 years and 10 years. Discussion

  16. Laparoscopic versus open total mesorectal excision: a case-control study.

    Science.gov (United States)

    Breukink, S O; Pierie, J P E N; Grond, A J K; Hoff, C; Wiggers, T; Meijerink, W J H J

    2005-09-01

    Because definitive long-term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non-randomised study was to assess the feasibility and short-term outcome of laparoscopic total mesorectal excision (LTME) after 25--30 Gy preoperative radiotherapy and to compare the results with a matched-control group of open TME (OTME). A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short-term radiotherapy. There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group. This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique compared with open surgery.

  17. Interrelationships between lipid peroxidation and total antioxidant status in sedentary controls and unprofessional athletes.

    Science.gov (United States)

    Caimi, Gregorio; Canino, Baldassare; Lo Presti, Rosalia

    2010-01-01

    We examined the thiobarbituric acid-reactive substances (TBARS) as an index of lipid peroxidation, and the total antioxidant status (TAS) in 81 unprofessional athletes subdivided into three subgroups. The first group included 28 subjects who practised endurance sports, the second included 30 subjects who practised mixed sports, the third included 23 subjects who practised power sports. We enrolled also a group of 61 sedentary controls (SC). TBARS were increased and TAS was decreased in the whole group of athletes in comparison with SC; an almost similar behaviour was present also subdividing athletes according to the practised sport. A significant negative correlation between these two parameters emerged in SC but not in the whole group of athletes. Unless for the athletes that practised endurance sports a similar trend was found in athletes that practised mixed and power sports. In conclusion, at rest the symmetrical behaviour between the lipid peroxidation increase and the TAS decrease, observed in sedentary controls, was not evident in unprofessional athletes who practised different sports.

  18. Do Pilates-based exercises following total knee arthroplasty improve postural control and quality of life?

    Science.gov (United States)

    Karaman, Aysenur; Yuksel, Inci; Kinikli, Gizem Irem; Caglar, Omur

    2017-04-01

    The aim of this prospective, randomized, controlled study was to investigate the effects of the addition of Pilates-based exercises to standard exercise programs performed after total knee arthroplasty on quality of life and balance. Forty-six volunteers were divided into two groups. The control group (n = 17) was assigned a standard exercise program after discharge; the study group (n = 17) was assigned Pilates-based exercises along with the standard exercise program. We carried out clinical evaluations of all patients on the day of discharge and after the completion of the 6-week exercise program. We also recorded sociodemographic data, Berg Balance test scores, and Short Form-36 (SF-36) health-related quality of life measurements. When we compared the differences between pre- and post-treatment balance scores of the groups, we found a significant change in favor of the Pilates-based exercise group (13.64 ± 1.45; p Pilates-based exercises group were found to be significant in terms of physical function (p = 0.001), physical role restriction (p = 0.01), and physical component score (p = 0.001). Pilates-based exercises performed along with standard exercise programs were more effective for improving balance and quality of life than standard exercise programs alone.

  19. Stop of loss of cognitive performance during rehabilitation after total hip arthroplasty-prospective controlled study.

    Science.gov (United States)

    Brem, Matthias H; Lehrl, Siegfried; Rein, Anna K; Massute, Sylvia; Schulz-Drost, Stefan; Gelse, Kolja; Schlechtweg, Phillip M; Hennig, Friedrich F; Olk, Alexander; Jacob, Harald J; Gusinde, Johannes

    2010-01-01

    Prolonged hospitalization is known to be associated with a loss of cognitive performance. Does playing video games (VGs) developed to improve cognitive properties delay this loss or even lead to an increase in cognitive performance? We performed a 10-day longitudinal study of patients who received total hip arthroplasty. We compared 16 patients (6 male) aged 66 ± 9 years (mean ± standard deviation) who played Dr. Kawashima's Brain Training: How Old Is Your Brain? (Nintendo; Redmond, Washington) on a Nintendo DS handheld console with 16 control patients (6 male) aged 69 ± 14 years. We measured cognitive performance 1 day preoperation, as well as on days 2 and 9 postoperation. With the daily exercise of a specific VG by the play group, the patients' fluid intelligence (median intelligence quotient 99-106), working memory capacity, and rate of information processing significantly improved over the course of 7 postoperative days. The cognitive performance of the control group did not increase. However, the memory spans of both groups did not systematically change. Exercise with VGs can prevent the loss of cognitive performance during prolonged hospitalization.

  20. Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

    Science.gov (United States)

    Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

    2016-11-01

    Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

  1. Predicting Child Protective Services (CPS) Involvement among Low-Income U.S. Families with Young Children Receiving Nutritional Assistance.

    Science.gov (United States)

    Slack, Kristen S; Font, Sarah; Maguire-Jack, Kathryn; Berger, Lawrence M

    2017-10-11

    This exploratory study examines combinations of income-tested welfare benefits and earnings, as they relate to the likelihood of child maltreatment investigations among low-income families with young children participating in a nutritional assistance program in one U.S. state (Wisconsin). Using a sample of 1065 parents who received the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) benefits in late 2010 and early 2011, we find that relying on either work in the absence of other means-tested welfare benefits, or a combination of work and welfare benefits, reduces the likelihood of CPS involvement compared to parents who rely on welfare benefits in the absence of work. Additionally, we find that housing instability increases the risk of CPS involvement in this population. The findings from this investigation may be useful to programs serving low-income families with young children, as they attempt to identify safety net resources for their clientele.

  2. Exploring the integration of the human as a flexibility factor in CPS enabled manufacturing environments: Methodology and results

    OpenAIRE

    Fantini, P.; Tavola, G.; Taisch, M.; Barbosa, José; Leitão, Paulo; Liu, Y.; Sayed, M.S.; Lohse, N.

    2016-01-01

    Cyber Physical Systems (CPS) are expected to shape the evolution of production towards the fourth industrial revolution named Industry 4.0. The increasing integration of manufacturing processes and the strengthening of the autonomous capabilities of manufacturing systems make investigating the role of humans a primary research objective in view of emerging social and demographic megatrends. Understanding how the employees can be better integrated to enable increased flexibility in manufacturi...

  3. A Personalized QoS Prediction Approach for CPS Service Recommendation Based on Reputation and Location-Aware Collaborative Filtering.

    Science.gov (United States)

    Kuang, Li; Yu, Long; Huang, Lan; Wang, Yin; Ma, Pengju; Li, Chuanbin; Zhu, Yujia

    2018-05-14

    With the rapid development of cyber-physical systems (CPS), building cyber-physical systems with high quality of service (QoS) has become an urgent requirement in both academia and industry. During the procedure of building Cyber-physical systems, it has been found that a large number of functionally equivalent services exist, so it becomes an urgent task to recommend suitable services from the large number of services available in CPS. However, since it is time-consuming, and even impractical, for a single user to invoke all of the services in CPS to experience their QoS, a robust QoS prediction method is needed to predict unknown QoS values. A commonly used method in QoS prediction is collaborative filtering, however, it is hard to deal with the data sparsity and cold start problem, and meanwhile most of the existing methods ignore the data credibility issue. Thence, in order to solve both of these challenging problems, in this paper, we design a framework of QoS prediction for CPS services, and propose a personalized QoS prediction approach based on reputation and location-aware collaborative filtering. Our approach first calculates the reputation of users by using the Dirichlet probability distribution, so as to identify untrusted users and process their unreliable data, and then it digs out the geographic neighborhood in three levels to improve the similarity calculation of users and services. Finally, the data from geographical neighbors of users and services are fused to predict the unknown QoS values. The experiments using real datasets show that our proposed approach outperforms other existing methods in terms of accuracy, efficiency, and robustness.

  4. Patient-controlled oral analgesia for postoperative pain management following total knee replacement.

    Science.gov (United States)

    Kastanias, Patti; Gowans, Sue; Tumber, Paul S; Snaith, Kianda; Robinson, Sandra

    2010-01-01

    To investigate whether patient-controlled oral analgesia (PCOA) used by individuals receiving a total knee replacement could reduce pain, increase patient satisfaction, reduce opioid use and/or reduce opioid side effects when compared with traditional nurse (RN)-administered oral analgesia. Patients who underwent an elective total knee replacement at a quaternary care centre (Toronto Western Hospital, Toronto, Ontario) were randomly assigned to either PCOA or RN-administered short-acting oral opioids on postoperative day 2. Subjects in the RN group called the RN to receive their prescribed short-acting opioid. Subjects in the PCOA group kept a single dose of their prescribed oral opioid at their bedside and took this dose when they felt they needed it, to a maximum of one dose every 2 h. Study outcomes, collected on postoperative day 2, included pain (measured by the Brief Pain Inventory - Short Form), patient satisfaction (measured by the Pain Outcome Questionnaire Satisfaction subscale - component II), opioid use (oral morphine equivalents), opioid side effects (nausea, pruritus and/or constipation) and knee measures (maximum passive knee flexion and pain at maximum passive knee flexion, performed on the operative knee). Study outcomes were analyzed twice. First, for a subset of 73 subjects who remained in their randomly assigned group (PCOA group, n=36; RN group, n=37), randomized analyses were performed. Second, for the larger sample of 88 subjects who were categorized by their actual method of receiving oral opioids (PCOA group, n=41; RN group, n=47), as-treated analyses were performed. There were no differences in study outcomes between the PCOA and RN groups in either analysis. PCOA was not superior to RN administration on study outcomes. However, PCOA did not increase opioid use or pain. PCOA remains an important element in the patient-centred care facility.

  5. Can therapy dogs improve pain and satisfaction after total joint arthroplasty? A randomized controlled trial.

    Science.gov (United States)

    Harper, Carl M; Dong, Yan; Thornhill, Thomas S; Wright, John; Ready, John; Brick, Gregory W; Dyer, George

    2015-01-01

    The use of animals to augment traditional medical therapies was reported as early as the 9th century but to our knowledge has not been studied in an orthopaedic patient population. The purpose of this study was to evaluate the role of animal-assisted therapy using therapy dogs in the postoperative recovery of patients after THA and TKA. We asked: (1) Do therapy dogs have an effect on patients' perception of pain after total joint arthroplasty as measured by the VAS? (3) Do therapy dogs have an effect on patients' satisfaction with their hospital stay after total joint arthroplasty as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS)? A randomized controlled trial of 72 patients undergoing primary unilateral THA or TKA was conducted. Patients were randomized to a 15-minute visitation with a therapy dog before physical therapy or standard postoperative physical therapy regimens. Both groups had similar demographic characteristics. Reduction in pain was assessed using the VAS after each physical therapy session, beginning on postoperative Day 1 and continuing for three consecutive sessions. To ascertain patient satisfaction, the proportion of patients selecting top-category ratings in each subsection of the HCAHPS was compared. Patients in the treatment group had lower VAS scores after each physical therapy session with a final VAS score difference of 2.4 units (animal-assisted therapy VAS, 1.7; SD, 0.97 [95% CI, 1.4-2.0] versus control VAS, 4.1; SD, 0.97 [95% CI, 3.8-4.4], pphysical therapy session. Patients in the treatment group had a higher proportion of top-box HCAHPS scores in the following fields: nursing communication (33 of 36, 92% [95% CI, 78%-98%] versus 69%, 25 of 36 [95% CI, 52%-84%], p=0.035; risk ratio, 1.3 [95% CI of risk ratio, 1.0-1.7]; risk difference, 23% [95% CI of risk difference, 5%-40%]), pain management (34 of 36, 94% [95% CI, 81%-99%], versus 26 of 36, 72% [95% CI, 55%-86%], p=0.024; risk ratio, 1.3 [95

  6. Beyond deficit or compensation: new insights on postural control after long-term total visual loss.

    Science.gov (United States)

    Russo, Maitê M; Lemos, Thiago; Imbiriba, Luís A; Ribeiro, Nathalia L; Vargas, Claudia D

    2017-02-01

    Loss of vision is well known to affect postural control in blind subjects. This effect has classically been framed in terms of deficit or compensation depending on whether body sway increases or decreases in comparison with that of sighted subjects with the eyes open. However, studies have shown that postural responses can be modulated by the context and that changes in postural sway may not necessarily mean a worsened or improved postural control. The goal of our study was to test whether balance is affected by the context in blind subjects. Additional to the quantification of center of pressure (COP) displacement, measurements of body motion (COG) and the correspondent net neuromuscular response (COP-COG) were evaluated in anterior-posterior and medial-lateral directions. Thirty-eight completely blind and thirty-two sighted subjects participated of this study. The volunteers were asked to stand barefoot on a force platform for 60 s in two different conditions: feet apart and feet together. Sighted participants performed the tests with both the eyes open and eyes closed. Results showed that the COP-COG displacements in the blind group were greater than those of the sighted group with eyes open in almost all conditions tested, but not in eyes closed condition. However, the COP and COG results confirmed that the postural responses were context dependent. Together these results suggest that total visual loss does not just lead to a balance deficit or compensation, but to a specific postural signature that might imply in enhancing COP, COG and/or COP-COG in specific postural conditions.

  7. Postoperative Care Navigation for Total Knee Arthroplasty Patients: A Randomized Controlled Trial.

    Science.gov (United States)

    Losina, Elena; Collins, Jamie E; Wright, John; Daigle, Meghan E; Donnell-Fink, Laurel A; Strnad, Doris; Usiskin, Ilana M; Yang, Heidi Y; Lerner, Vladislav; Katz, Jeffrey N

    2016-09-01

    To establish the efficacy of motivational interviewing-based postoperative care navigation in improving functional status after total knee arthroplasty (TKA) and to identify subgroups likely to benefit from the intervention. We conducted a parallel randomized controlled trial in TKA recipients with 2 arms: postoperative care with frequent followup by a care navigator or usual care. The primary outcome was the difference between the arms in Western Ontario and McMaster Universities Osteoarthritis Index function score change, over 6 months postsurgery. We performed a preplanned subgroup analysis of differential efficacy by obesity and exploratory subgroup analyses on sex and pain catastrophizing. We enrolled 308 subjects undergoing TKA for osteoarthritis. Mean ± SD preoperative function score was 41 ± 17 (0-100 scale, where 100 = worst function). At 6 months, subjects in the navigation arm improved by mean ± SD 30 ± 16 points compared to 27 ± 18 points in the usual-care arm (P = 0.148). Participants with moderate to high levels of pain catastrophizing were unlikely to benefit from navigation compared to those with lower levels of pain catastrophizing (P = 0.013 for interaction). Subjects assigned to the navigation intervention did not demonstrate greater functional improvement compared to those in the control group. The negative overall result could be explained by the large effect on functional improvement of TKA itself compared to the smaller, additional benefit from care navigation, as well as by potential differential effects for subjects with moderate to high degrees of pain catastrophizing. Greater focus on developing programs for reducing pain catastrophizing could lead to better functional outcomes following TKA. © 2016, American College of Rheumatology.

  8. The effect of low-dose total body irradiation on tumor control

    International Nuclear Information System (INIS)

    Sakamoto, Kiyohiko; Miyamoto, Miyako; Watabe, Nobuyuki.

    1987-01-01

    Total body irradiation (TBI) is considered to bring about an immunosuppressive effect on an organism, on the basis of data obtained from sublethal doses of TBI. However, there are no data on how low-dose TBI affects an organism. Over the last five years, we have been studying the effects of low-dose TBI on normal or tumor-bearing mice and the immunological background of these effects. In experimental studies, an increase in the TD50 value (the number of cells required for a tumor incidence of 50 %) in mice exposed to 10 rad was recognized and showed a remarkable increase at 6 hours to 15 hours after irradiation. TBI of 10 rad also showed an enhancement effect on tumor cell killing when given 12 hours before local tumor irradiation. In order to clarify the mechanism of this kind of effect, some immunological studies were performed using several immunological procedures, and the results suggested that 10 rad of TBI caused increasing tumor immunity in irradiated mice. Clinical trials in some patients with advanced tumors are now being undertaken on the basis of these experimental data, and the effect of TBI on tumor control appears promising, although it is too early to draw conclusions. (author)

  9. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: External humidifier versus heat and moisture exchanger

    NARCIS (Netherlands)

    Mérol, Jean-Claude; Charpiot, Anne; Langagne, Thibault; Hémar, Patrick; Ackerstaff, Annemieke H.; Hilgers, Frans J. M.

    2012-01-01

    Objectives/Hypothesis: Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Study Design: Randomized controlled trial (RCT). Methods: Fifty-three

  10. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger

    NARCIS (Netherlands)

    Mérol, J.-C.; Charpiot, A.; Langagne, T.; Hémar, P.; Ackerstaff, A.H.; Hilgers, F.J.M.

    2012-01-01

    Objectives/Hypothesis: Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Study Design: Randomized controlled trial (RCT). Methods: Fifty-three

  11. Periacetabular Bone Mineral Density Changes After Resurfacing Hip Arthroplasty Versus Conventional Total Hip Arthroplasty. A Randomized Controlled DEXA Study

    NARCIS (Netherlands)

    Smolders, J.M.H.; Pakvis, D.F.; Hendrickx, B.W.; Verdonschot, Nicolaas Jacobus Joseph; van Susante, J.L.C.

    2013-01-01

    A randomized controlled trial was performed to evaluate acetabular bone mineral density (BMD) changes after hip resurfacing (RHA) versus an established conventional total hip arthroplasty (THA). A total of 71 patients were allocated randomly to receive either an RHA press-fit cobalt–chromium cup (n

  12. Total glucosides of paeony for rheumatoid arthritis: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Luo, Jing; Jin, Di-Er; Yang, Guo-Yan; Zhang, Ying-Ze; Wang, Jian-Ming; Kong, Wei-Ping; Tao, Qing-Wen

    2017-10-01

    Total glucosides of paeony (TGP) is commonly used to treat rheumatoid arthritis (RA) in China. However, clinical practice hasn't been well informed by evidence from appropriately conducted systematic reviews. This PRISMA-compliant systematic review aims at examining the effectiveness and safety of TGP for RA. Randomized controlled trials (RCTs) comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs (DMARDs) for patients with RA were retrieved by searching seven databases. Primary outcomes included disease improvement and disease remission. Secondary outcomes included adverse effects, pain, health-related quality of life, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Data extraction and analyses were conducted according to the Cochrane standards. We assessed risk of bias for each included studies and quality of evidence on pre-specified outcomes. Eight studies enrolling 1209 patients with active RA were included in this systematic review. On the basis of traditional DMARD(s), TGP might be beneficial for patients with RA in improvement of American College of Rheumatology (ACR) 20 response rate, ACR 50 response rate, ACR70 response rate, and in reduction of adverse effects, compared with no treatment. The overall methodological quality of included studies and the quality of evidence for each outcome were limited. Current trials suggested potential benefits of TGP for RA on the basis of traditional DMARD(s). Therefore, TGP may be a good choice for RA as an adjuvant therapy. However, considering the limited methodological quality and strength of evidence, high-quality RCTs are warranted to support the use of TGP for RA. Copyright © 2017. Published by Elsevier Ltd.

  13. Mobile Computerized Procedure System for the Improved Situation Awareness among Field Workers and Main Control Room Operators

    International Nuclear Information System (INIS)

    Lee, Sungjin; Seong, Nokyu; Jung, Yeonsub

    2013-01-01

    This paper explains the technical issues of the mobile CPS (m-CPS) in the conceptual development stage. The proposed m-CPS can be developed with many recent technologies in the various industry fields based on CRI CPS. Performance and stability of CRI CPS have been tested several times until now. It is expected that more human errors can be reduced by the m-CPS through improved situation awareness and human performance tools for local workers and MCR operators. Some considerations as well as mentioned ones will be reflected in the m-CPS development. Human errors can occur during the test and maintenance of the generator, safety injection system and reactor coolant inventory in nuclear power plants (NPPs). Most of human errors have been occurred by the omission of the prevention techniques such as the self-check, the peer-check, the concurrent verification and etc. Another important reason is the insufficient information sharing among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. KHNP central research institute (CRI) expects that the extended application of CPS including the field activity, that is a kind of mobile CPS, can enhance the reduction of human errors

  14. EOS-based cup navigation: Randomised controlled trial in 78 total hip arthroplasties.

    Science.gov (United States)

    Verdier, N; Billaud, A; Masquefa, T; Pallaro, J; Fabre, T; Tournier, C

    2016-06-01

    Minimising the risk of cup implantation outside the safe zone is among the objectives of navigation during total hip arthroplasty (THA). However, given the technical challenges raised by navigation when the patient is lying on the side, many surgeons still use the freehand technique. We conducted a randomised controlled trial to evaluate the new navigation system NAVEOS in the iliac plane, which is easily identified in the lateral decubitus position, with the objective of determining whether NAVEOS navigation decreased the frequency of cup implantation outside the safe zone compared to freehand cup positioning, without increasing the operative time or the frequency of complications. NAVEOS navigation decreases the frequency of cup positioning outside the safe zone compared to freehand positioning. This randomised controlled trial compared cup positioning using NAVEOS navigation versus the freehand technique in patients undergoing primary THA. The safe zone was defined according to Lewinnek as 15±10° of radiological anteversion and 40±10° of radiological inclination. Cup position parameters were measured on computed tomography images obtained 3months after THA. The images were read by two independent observers who were blinded to group assignment. The primary evaluation criterion was cup position within the safe zone. A 1:1 randomisation scheme was used to assign 78 patients (mean age, 68years; age range, 44-91years) to NAVEOS navigation or freehand cup positioning. The two groups were comparable for age, gender distribution, body mass index, and preoperative functional scores. In the NAVEOS group, navigation was discontinued prematurely in 6 patients, because of technical difficulties (n=2) or a marked discrepancy with clinical findings (n=4); however, the intention-to-treat approach was used for the analysis. The proportion of cups in the safe zone was 67% (28/39) in the NAVEOS group and 38% (17/39) in the freehand group (P=0.012). Anteversion was within the

  15. Biochemical Characterization of CPS-1, a Subclass B3 Metallo-β-Lactamase from a Chryseobacterium piscium Soil Isolate

    DEFF Research Database (Denmark)

    Gudeta, Dereje Dadi; Pollini, Simona; Docquier, Jean-Denis

    2016-01-01

    CPS-1 is a subclass B3 metallo-β-lactamase from a Chryseobacterium piscium isolated from soil, showing 68 % amino acid identity to GOB-1 enzyme. CPS-1 was overproduced in Escherichia coli Rosetta (DE3), purified by chromatography and biochemically characterized. This enzyme exhibits a broad spect...... spectrum substrate profile including penicillins, cephalosporins and carbapenems, which overall resembles those of L1, GOB-1 and acquired subclass B3 enzymes AIM-1 and SMB-1....

  16. Telerehabilitation Versus Traditional Care Following Total Hip Replacement: A Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Nelson, Mark; Bourke, Michael; Crossley, Kay; Russell, Trevor

    2017-03-02

    Total hip replacement (THR) is the gold standard treatment for severe hip osteoarthritis. Effectiveness of physical rehabilitation for THR patients following discharge from hospital is supported by evidence; however, barriers such as geographical location and transport can limit access to appropriate health care. One solution to this issue is using an alternative model of care using telerehabilitation technology to deliver rehabilitation programs directly into patients' homes. A telerehabilitation model may also have potential health care cost savings for health care providers. This study aims to determine if a telerehabilitation model of care delivered remotely is as effective as face-to-face rehabilitation in the THR population and cost effective for health care providers and patients. A total of 70 people undergoing THR will be recruited to participate in a randomized, single-blind, controlled noninferiority clinical trial. The trial will compare a technology-based THR rehabilitation program to in-person care. On discharge from hospital, participants randomized to the in-person group will receive usual care, defined as a paper home exercise program (HEP) targeting strengthening exercises for quadriceps, hip abductors, extensors, and flexors; they will be advised to perform their HEP 3 times per day. At 2, 4, and 6 weeks postoperatively, they will receive a 30-minute in-person physiotherapy session with a focus on gait retraining and reviewing and progressing their HEP. The telerehabilitation protocol will involve a program similar in content to the in-person rehabilitation program, except delivery will be directly into the homes of the participants via telerehabilitation technology on an iPad. Outcomes will be evaluated preoperatively, day of discharge from in-patient physiotherapy, 6 weeks and 6 months postoperatively. The primary outcome will be the quality of life subscale of the hip disability and osteoarthritis outcome score, measured at 6 weeks. Both

  17. Integrated Autopilot/Autothrottle Based on a Total Energy Control Concept: Design and Evaluation of Additional Autopilot Modes

    Science.gov (United States)

    Bruce, Kevin R.

    1988-01-01

    An integrated autopilot/autothrottle system was designed using a total energy control design philosophy. This design ensures that the system can differentiate between maneuvers requiring a change in thrust to accomplish a net energy change, and those maneuvers which only require elevator control to redistribute energy. The system design, the development of the system, and a summary of simulation results are defined.

  18. Postoperative Complications of Laparoscopic Total Gastrectomy versus Open Total Gastrectomy for Gastric Cancer in a Meta-Analysis of High-Quality Case-Controlled Studies

    Directory of Open Access Journals (Sweden)

    Mikito Inokuchi

    2016-01-01

    Full Text Available Background. Some meta-analyses of case-controlled studies (CCSs have shown that laparoscopic or laparoscopy-assisted total gastrectomy (LTG had some short-term advantages over open total gastrectomy (OTG. However, postoperative complications differed somewhat among the meta-analyses, and some CCSs included in the meta-analyses had mismatched factors between LTG and OTG. Methods. CCSs comparing postoperative complications between LTG and OTG were identified in PubMed and Embase. Studies matched for patients’ status, tumor stage, and the extents of lymph-node dissection were included. Outcomes of interest, such as anastomotic, other intra-abdominal, wound, and pulmonary complications, were evaluated in a meta-analysis performed using Review Manager version 5.3 software. Result. This meta-analysis included a total of 2,560 patients (LTG, 1,073 patients; OTG, 1,487 patients from 15 CCSs. Wound complications were significantly less frequent in LTG than in OTG (n = 2,430; odds ratio [OR] 0.30, 95% confidence interval [CI] 0.29–0.85, P=0.01, I2 = 0%, and OR 0.46, 95% CI 0.17–0.52, P<0.0001, I2 = 0%. However, the incidence of anastomotic complications was slightly but not significantly higher in LTG than in OTG (n = 2,560; OR 1.44, 95% CI 0.96–2.16, P=0.08, I2 = 0%. Conclusion. LTG was associated with a lower incidence of wound-related postoperative complications than was OTG in this meta-analysis of CCSs; however, some concern remains about anastomotic problems associated with LTG.

  19. Comparison of total disc replacement with lumbar fusion: a meta-analysis of randomized controlled trials

    International Nuclear Information System (INIS)

    Nie, H.

    2015-01-01

    A meta-analysis was performed to evaluate whether a beneficial clinical effect of the Total Disc Replacement (TDR) over lumbar fusion for the treatment of patients with Degenerative Disc Disease (DDD). An electronic search of PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from their inception to 2012 was completed, and we assessed risk bias and retrieved relevant data, and meta-analysis was performed, if appropriate. Oswestry Disability Index (ODI), Visual Analog Score (VAS), patient satisfaction or VAS patient satisfaction, narcotic use, overall success rate, reoperation rate, work status, surgery again, complications and radiographic outcomes were evaluated. Six RCTs were included in this meta-analysis. At 2 years, TDR was demonstrated to be more beneficial for patients compared to lumbar fusion in the following outcomes, including ODI scores (MD: -4.87, 95% CI: -7.77 to -1.97, p=0.001), patient satisfaction (OR:1.91, 95% CI: 1.27 to 2.86, p=0.002) and VAS patient satisfaction (MD:9.10, 95% CI: 3.20 to 14.99, p=0.002), the percentage of using narcotics (OR=0.54, 95%CI: 0.31 to 0.96, p=0.03), overall success rate (OR:1.68, 95% CI: 1.26 to 2.25, p=0.005), the rate of patients to chose the same surgical treatment again (OR:2.38, 95% CI: 1.72 to 3.28, p < 0.001), and complications (OR=0.50, 95% CI: 0.29 to 0.84, p=0.008). Other outcomes, including re-operation rate (OR:0.62, 95% CI: 0.36 to 1.06, p=0.08) and work status (OR=1.05, 95% CI: 0.75 to 1.47, p=0.80), were demonstrated to be no differences between the two groups. In a long-term of follow-up (2 years), TDR shows a significant superiority for the treatment of lumbar DDD compared with fusion. (author)

  20. A randomized, controlled trial comparing local infiltration analgesia with epidural infusion for total knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Karen Vestergaard; Bak, Marie; Christensen, Birgitte Viebæk

    2010-01-01

    There have been few studies describing wound infiltration with additional intraarticular administration of multimodal analgesia for total knee arthroplasty (TKA). In this study, we assessed the efficacy of wound infiltration combined with intraarticular regional analgesia with epidural infusion...

  1. E-cigarette use and smoking reduction or cessation in the 2010/2011 TUS-CPS longitudinal cohort

    OpenAIRE

    Yuyan Shi; John P. Pierce; Martha White; Maya Vijayaraghavan; Wilson Compton; Kevin Conway; Anne M. Hartman; Karen Messer

    2016-01-01

    Abstract Background Electronic cigarettes (e-cigarettes) are heavily marketed and widely perceived as helpful for quitting or reducing smoking intensity. We test whether ever-use of e-cigarettes among early adopters was associated with: 1) increased cigarette smoking cessation; and 2) reduced cigarette consumption. Methods A representative cohort of U.S. smokers (N = 2454) from the 2010 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) was re-interviewed 1 year later. Outcomes...

  2. Insight into the Physical and Dynamical Processes that Control Rapid Increases in Total Flash Rate

    Science.gov (United States)

    Schultz, Christopher J.; Carey, Lawrence D.; Schultz, Elise V.; Blakeslee, Richard J.; Goodman, Steven J.

    2015-01-01

    Rapid increases in total lightning (also termed "lightning jumps") have been observed for many decades. Lightning jumps have been well correlated to severe and hazardous weather occurrence. The main focus of lightning jump work has been on the development of lightning algorithms to be used in real-time assessment of storm intensity. However, in these studies it is typically assumed that the updraft "increases" without direct measurements of the vertical motion, or specification of which updraft characteristic actually increases (e.g., average speed, maximum speed, or convective updraft volume). Therefore, an end-to-end physical and dynamical basis for coupling rapid increases in total flash rate to increases in updraft speed and volume must be understood in order to ultimately relate lightning occurrence to severe storm metrics. Herein, we use polarimetric, multi-Doppler, and lightning mapping array measurements to provide physical context as to why rapid increases in total lightning are closely tied to severe and hazardous weather.

  3. Chooz B1 start-up marked by total computer control

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The start-up of Chooz B1, the first of EdF's latest generation 1450 MWe N4 reactors, marks the first use in a nuclear power plant of a fully computerised control room. Working in partnership with EdF, Sema Group designed and supplied the advanced command and control system for this plant. (Author)

  4. Quality control on the accuracy of the total Beta activity index in different sample matrices water; Control de calidad en la precision del indice de actividad beta total en diferentes matrices de muestras de aguas

    Energy Technology Data Exchange (ETDEWEB)

    Pujol, L.; Pablo, M. A. de; Payeras, J.

    2013-07-01

    The standard ISO/IEC 17025:2005 of general requirements for the technical competence of testing and calibration laboratories, provides that a laboratory shall have quality control procedures for monitoring the validity of tests and calibrations ago. In this paper, the experience of Isotopic Applications Laboratory (CEDEX) in controlling the accuracy rate of total beta activity in samples of drinking water, inland waters and marine waters is presented. (Author)

  5. Functional exercise after total hip replacement (FEATHER): a randomised control trial.

    LENUS (Irish Health Repository)

    Monaghan, Brenda

    2012-11-01

    Prolonged physical impairments in range of movement, postural stability and walking speed are commonly reported following total hip replacement (THR). It is unclear from the current body of evidence what kind of exercises should be performed to maximize patient function and quality of life.

  6. [Case-control study on effect of rivaroxaban on the risk of hidden bleeding after total hip arthroplasty].

    Science.gov (United States)

    Li, Jun; Jing, Jue-Hua; Shi, Zhan-Jun; Zhou, Yun

    2014-01-01

    To investigate the risk of hidden blood loss about applying rivaroxaban after total hip arthroplasty. From October 2009 to May 2012,88 patients with femoral head necrosis were treated with primary total hip arthroplasty. All the patients were divided into Rivaroxaban group(44 cases)and control group(44 cases). There were 25 males and 19 females in the Rivaroxaban group, with an average age of (58.48 +/- 15.19) years old; in the control group,24 patients were male and 20 patients were female, with an average age of (61.11 +/- 13.54) years old. The patients in the Rivaroxaban group took Rivaroxaban orally from the first day after operation with a dose of 10 mg each day, and treatment course was 14 days. The patients in the control group took placebo orally at the same time. Dominant blood loss and transfusion were recorded, blood routine examinations were taken before operation and at 3 days after operation. The total blood loss and hidden blood loss were calculated according to the formula. The mean total blood loss was (1509.56 +/- 325.23) ml and the hidden blood loss was(581.47 +/- 215.01) ml, accounting for (37.88 +/- 10.42)% in the Rivaroxaban group. The mean total blood loss was (1262.30 +/- 397.95) ml and the hidden blood loss was (395.59 +/- 97.33) ml, accounting for (30.62 +/- 0.20)% in the control group. The total blood loss, hidden blood loss and transfusion in the Rivaroxaban group was significantly more than those in control group,b ut there was no significant difference on dominant blood loss between two groups. Rivaroxaban increased the overall bleeding risk of total hip arthroplasty, especially hidden bleeding risk, which should be careful used.

  7. Light-Controlled Swarming and Assembly of Colloidal Particles

    Directory of Open Access Journals (Sweden)

    Jianhua Zhang

    2018-02-01

    Full Text Available Swarms and assemblies are ubiquitous in nature and they can perform complex collective behaviors and cooperative functions that they cannot accomplish individually. In response to light, some colloidal particles (CPs, including light active and passive CPs, can mimic their counterparts in nature and organize into complex structures that exhibit collective functions with remote controllability and high temporospatial precision. In this review, we firstly analyze the structural characteristics of swarms and assemblies of CPs and point out that light-controlled swarming and assembly of CPs are generally achieved by constructing light-responsive interactions between CPs. Then, we summarize in detail the recent advances in light-controlled swarming and assembly of CPs based on the interactions arisen from optical forces, photochemical reactions, photothermal effects, and photoisomerizations, as well as their potential applications. In the end, we also envision some challenges and future prospects of light-controlled swarming and assembly of CPs. With the increasing innovations in mechanisms and control strategies with easy operation, low cost, and arbitrary applicability, light-controlled swarming and assembly of CPs may be employed to manufacture programmable materials and reconfigurable robots for cooperative grasping, collective cargo transportation, and micro- and nanoengineering.

  8. Quality Control of Valerianae Radix by Attenuated Total Reflection Fourier Transform Infrared (ATR-FTIR) Spectroscopy.

    Science.gov (United States)

    Nikzad-Langerodi, Ramin; Arth, Katharina; Klatte-Asselmeyer, Valerie; Bressler, Sabine; Saukel, Johannes; Reznicek, Gottfried; Dobeš, Christoph

    2018-04-01

    (Acetoxy-)valerenic acid and total essential oil content are important quality attributes of pharmacy grade valerian root (Valerianae radix). Traditional analysis of these quantities is time-consuming and necessitates (harmful) solvents. Here we investigated an application of attenuated total reflection Fourier transform infrared spectroscopy for extractionless analysis of these quality attributes on a representative sample comprising 260 wild-crafted individuals covering the Central European taxonomic diversity of the Valeriana officinalis L. s. l. species aggregate with its three major ploidy cytotypes (i.e., di-, tetra- and octoploid). Calibration models were built by orthogonal partial least squares regression for quantitative analysis of (acetoxy-)valerenic acid and total essential oil content. For the latter, we propose a simplistic protocol involving apolar extraction followed by gas chromatography as a reference method for multivariate calibration in order to handle the analysis of samples taken from individual plants. We found good predictive ability of chemometric models for quantification of valerenic acid, acetoxyvalerenic acid, total sesquiterpenoid acid, and essential oil content with a root mean squared error of cross-validation of 0.064, 0.043, and 0.09 and root mean squared error of prediction of 0.066, 0.057, and 0.09 (% content), respectively. Orthogonal partial least squares discriminant analysis revealed good discriminability between the most productive phenotype (i.e., the octoploid cytotype) in terms of sesquiterpenoid acids, and the less productive ones (i.e., di- and tetraploid). All in all, our results demonstrate the application of attenuated total reflection Fourier transform infrared spectroscopy for rapid, extractionless estimation of the most important quality attributes of valerian root and minimally invasive identification of the most productive phenotype in terms of sesquiterpenoid acids. Georg Thieme Verlag KG Stuttgart · New

  9. High-energy coordination polymers (CPs) exhibiting good catalytic effect on the thermal decomposition of ammonium dinitramide

    Science.gov (United States)

    Li, Xin; Han, Jing; Zhang, Sheng; Zhai, Lianjie; Wang, Bozhou; Yang, Qi; Wei, Qing; Xie, Gang; Chen, Sanping; Gao, Shengli

    2017-09-01

    High-energy coordination polymers (CPs) not only exhibit good energetic performances but also have a good catalytic effect on the thermal decomposition of energetic materials. In this contribution, two high-energy CPs Cu2(DNBT)2(CH3OH)(H2O)3·3H2O (1) and [Cu3(DDT)2(H2O)2]n (2) (H2DNBT = 3,3‧-dinitro-5,5‧-bis(1H-1,2,4-triazole and H3DDT = 4,5-bis(1H-tetrazol-5-yl)-2H-1,2,3-triazole) were synthesized and structurally characterized. Furthermore, 1 was thermos-dehydrated to produce Cu2(DNBT)2(CH3OH)(H2O)3 (1a). The thermal decomposition kinetics of 1, 1a and 2 were studied by Kissinger's method and Ozawa's method. Thermal analyses and sensitivity tests show that all compounds exhibit high thermal stability and low sensitivity for external stimuli. Meanwhile, all compounds have large positive enthalpy of formation, which are calculated as being (1067.67 ± 2.62) kJ mol-1 (1), (1464.12 ± 3.12) kJ mol-1 (1a) and (3877.82 ± 2.75) kJ mol-1 (2), respectively. The catalytic effects of 1a and 2 on the thermal decomposition of ammonium dinitramide (ADN) were also investigated.

  10. Postural control in rheumatoid arthritis patients scheduled for total knee arthroplasty

    NARCIS (Netherlands)

    Tjon A Hen, S.S.K.; Bosch, P.V.; Laan, R.F.J.M.; Mulder, T.

    2000-01-01

    Objective: To investigate the use of compensatory visual and attentional control strategies for standing balance in patients with rheumatoid arthritis (RA) with severe knee joint impairment. Design: Experimental 2-group design. Setting: Specialized clinic for orthopedics, rheumatology, and

  11. Transversus abdominis plane block after ambulatory total laparoscopic hysterectomy: randomized controlled trial.

    Science.gov (United States)

    Calle, Gustavo A; López, Claudia C; Sánchez, Enrique; De Los Ríos, José F; Vásquez, Elsa M; Serna, Eduardo; Arango, Adriana M; Castañeda, Juan D; Vásquez, Ricardo A; González, Antonio; Escobar, Alvaro; Almanza, Luis A

    2014-04-01

    To determine if transversus abdominis plane anesthetic blockage (TAP block) diminishes early postoperative pain scores and facilitates ambulatory management following total laparoscopic hysterectomy. Randomized triple blind trial. Gynecological endoscopy unit at a referral center for laparoscopic surgery. A total of 197 patients. Comparison of a treatment group receiving TAP block with bupivacaine 0.25% and placebo group with comparably placed bilateral injection of sterile saline solution. Pain scores at discharge 24, 48 and 72 h after surgery, opioid requirement after procedure. Patients who had TAP block had a significant reduction in their pain score at discharge compared with the placebo group (p = 0.017). There were no significant differences in the pain scores between groups at 24 h (95% CI 1.36-0.133, p = 0.237), 48 h (95% CI 0.689-0.465, p = 0.702) and 72 h (95% CI -0.631 to 0.223, p = 0.347). No differences were found between the groups regarding opioid requirements following the procedure (χ(2)  = 3.62, p = 0.46). Although TAP block after a total laparoscopic hysterectomy reduced the pain score at discharge compared with placebo, its role in this setting is debatable due to the possible lack of clinical significance of the small difference found. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  12. Controlling costs without compromising quality: paying hospitals for total knee replacement.

    Science.gov (United States)

    Pine, Michael; Fry, Donald E; Jones, Barbara L; Meimban, Roger J; Pine, Gregory J

    2010-10-01

    Unit costs of health services are substantially higher in the United States than in any other developed country in the world, without a correspondingly healthier population. An alternative payment structure, especially for high volume, high cost episodes of care (eg, total knee replacement), is needed to reward high quality care and reduce costs. The National Inpatient Sample of administrative claims data was used to measure risk-adjusted mortality, postoperative length-of-stay, costs of routine care, adverse outcome rates, and excess costs of adverse outcomes for total knee replacements performed between 2002 and 2005. Empirically identified inefficient and ineffective hospitals were then removed to create a reference group of high-performance hospitals. Predictive models for outcomes and costs were recalibrated to the reference hospitals and used to compute risk-adjusted outcomes and costs for all hospitals. Per case predicted costs were computed and compared with observed costs. Of the 688 hospitals with acceptable data, 62 failed to meet effectiveness criteria and 210 were identified as inefficient. The remaining 416 high-performance hospitals had 13.4% fewer risk-adjusted adverse outcomes (4.56%-3.95%; P costs ($12,773-$11,512; P costs. A payment system based on the demonstrated performance of effective, efficient hospitals can produce sizable cost savings without jeopardizing quality. In this study, 96% of total excess hospital costs resulted from higher routine costs at inefficient hospitals, whereas only 4% was associated with ineffective care.

  13. Adductor canal block with local infiltrative analgesia compared with local infiltrate analgesia for pain control after total knee arthroplasty

    OpenAIRE

    Xing, Qiujuan; Dai, Weiwei; Zhao, Dongfeng; Wu, Ji; Huang, Chunshui; Zhao, Yun

    2017-01-01

    Abstract Background: This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA). Methods: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TK...

  14. On the controllability and run-away possibility of a totally free piston, pulsed compression reactor

    NARCIS (Netherlands)

    Roestenberg, T.; Glouchenkov, Maxim Joerjevisj; glushenkov, M.J.; Kronberg, Alexandre E.; van der Meer, Theodorus H.

    2010-01-01

    The pulsed compression reactor promises to be a compact, economical and energy efficient alternative to conventional chemical reactors. While its design and operation is similar to that of a free piston internal combustion engine, it does not benefit from any controllability through the load.

  15. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing

    NARCIS (Netherlands)

    Jonbergen, H.P. van; Scholtes, V.A.; Kampen, A. van; Poolman, R.W.

    2011-01-01

    The efficacy of circumpatellar electrocautery in reducing the incidence of post-operative anterior knee pain is unknown. We conducted a single-centre, outcome-assessor and patient-blinded, parallel-group, randomised, controlled trial to compare circumpatellar electrocautery with no electrocautery in

  16. Comparison of natural drainage group and negative drainage groups after total thyroidectomy: prospective randomized controlled study.

    Science.gov (United States)

    Woo, Seung Hoon; Kim, Jin Pyeong; Park, Jung Je; Shim, Hyun Seok; Lee, Sang Ha; Lee, Ho Joong; Won, Seong Jun; Son, Hee Young; Kim, Rock Bum; Son, Young-Ik

    2013-01-01

    The aim of this study was to compare a negative pressure drain with a natural drain in order to determine whether a negative pressure drainage tube causes an increase in the drainage volume. Sixty-two patients who underwent total thyroidectomy for papillary thyroid carcinoma (PTC) were enrolled in the study between March 2010 and August 2010 at Gyeongsang National University Hospital. The patients were prospectively and randomly assigned to two groups, a negative pressure drainage group (n=32) and natural drainage group (n=30). Every 3 hours, the volume of drainage was checked in the two groups until the tube was removed. The amount of drainage during the first 24 hours postoperatively was 41.68 ± 3.93 mL in the negative drain group and 25.3 ± 2.68 mL in the natural drain group (pdrain group was 35.19 ± 4.26 mL and natural drain groups 21.53 ± 2.90 mL (pdrain may increase the amount of drainage during the first 24-48 hours postoperatively. Therefore, it is not necessary to place a closed suction drain when only a total thyroidectomy is done.

  17. Crystallization and preliminary crystallographic analysis of the bacterial capsule assembly-regulating tyrosine phosphatases Wzb of Escherichia coli and Cps4B of Streptococcus pneumoniae

    International Nuclear Information System (INIS)

    Huang, Hexian; Hagelueken, Gregor; Whitfield, Chris; Naismith, James H.

    2009-01-01

    The crystallization is reported of two bacterial tyrosine phosphatases which belong to different enzyme families despite their ability to catalyse identical reactions. Bacterial tyrosine kinases and their cognate phosphatases are key players in the regulation of capsule assembly and thus are important virulence determinants of these bacteria. Examples of the kinase/phosphatase pairing are found in Gram-negative bacteria such as Escherichia coli (Wzc and Wzb) and in Gram-positive bacteria such as Streptococcus pneumoniae (CpsCD and CpsB). Although Wzb and Cps4B are both predicted to dephosphorylate the C-terminal tyrosine cluster of their cognate tyrosine kinase, they appear on the basis of protein sequence to belong to quite different enzyme classes. Recombinant purified proteins Cps4B of S. pneumoniae TIGR4 and Wzb of E. coli K-30 have been crystallized. Wzb crystals belonged to space-group family P3 x 21 and diffracted to 2.7 Å resolution. Crystal form I of Cps4B belonged to space-group family P4 x 2 1 2 and diffracted to 2.8 Å resolution; crystal form II belonged to space group P2 1 2 1 2 1 and diffracted to 1.9 Å resolution

  18. Multivariable polynomial fitting of controlled single-phase nonlinear load of input current total harmonic distortion

    Science.gov (United States)

    Sikora, Roman; Markiewicz, Przemysław; Pabjańczyk, Wiesława

    2018-04-01

    The power systems usually include a number of nonlinear receivers. Nonlinear receivers are the source of disturbances generated to the power system in the form of higher harmonics. The level of these disturbances describes the total harmonic distortion coefficient THD. Its value depends on many factors. One of them are the deformation and change in RMS value of supply voltage. A modern LED luminaire is a nonlinear receiver as well. The paper presents the results of the analysis of the influence of change in RMS value of supply voltage and the level of dimming of the tested luminaire on the value of the current THD. The analysis was made using a mathematical model based on multivariable polynomial fitting.

  19. Multivariable polynomial fitting of controlled single-phase nonlinear load of input current total harmonic distortion

    Directory of Open Access Journals (Sweden)

    Sikora Roman

    2018-04-01

    Full Text Available The power systems usually include a number of nonlinear receivers. Nonlinear receivers are the source of disturbances generated to the power system in the form of higher harmonics. The level of these disturbances describes the total harmonic distortion coefficient THD. Its value depends on many factors. One of them are the deformation and change in RMS value of supply voltage. A modern LED luminaire is a nonlinear receiver as well. The paper presents the results of the analysis of the influence of change in RMS value of supply voltage and the level of dimming of the tested luminaire on the value of the current THD. The analysis was made using a mathematical model based on multivariable polynomial fitting.

  20. Potential Cardiovascular and Total Mortality Benefits of Air Pollution Control in Urban China.

    Science.gov (United States)

    Huang, Chen; Moran, Andrew E; Coxson, Pamela G; Yang, Xueli; Liu, Fangchao; Cao, Jie; Chen, Kai; Wang, Miao; He, Jiang; Goldman, Lee; Zhao, Dong; Kinney, Patrick L; Gu, Dongfeng

    2017-10-24

    Outdoor air pollution ranks fourth among preventable causes of China's burden of disease. We hypothesized that the magnitude of health gains from air quality improvement in urban China could compare with achieving recommended blood pressure or smoking control goals. The Cardiovascular Disease Policy Model-China projected coronary heart disease, stroke, and all-cause deaths in urban Chinese adults 35 to 84 years of age from 2017 to 2030 if recent air quality (particulate matter with aerodynamic diameter ≤2.5 µm, PM 2.5 ) and traditional cardiovascular risk factor trends continue. We projected life-years gained if urban China were to reach 1 of 3 air quality goals: Beijing Olympic Games level (mean PM 2.5 , 55 μg/m 3 ), China Class II standard (35 μg/m 3 ), or World Health Organization standard (10 μg/m 3 ). We compared projected air pollution reduction control benefits with potential benefits of reaching World Health Organization hypertension and tobacco control goals. Mean PM 2.5 reduction to Beijing Olympic levels by 2030 would gain ≈241,000 (95% uncertainty interval, 189 000-293 000) life-years annually. Achieving either the China Class II or World Health Organization PM 2.5 standard would yield greater health benefits (992 000 [95% uncertainty interval, 790 000-1 180 000] or 1 827 000 [95% uncertainty interval, 1 481 00-2 129 000] annual life-years gained, respectively) than World Health Organization-recommended goals of 25% improvement in systolic hypertension control and 30% reduction in smoking combined (928 000 [95% uncertainty interval, 830 000-1 033 000] life-years). Air quality improvement in different scenarios could lead to graded health benefits ranging from 241 000 life-years gained to much greater benefits equal to or greater than the combined benefits of 25% improvement in systolic hypertension control and 30% smoking reduction. © 2017 American Heart Association, Inc.

  1. Effectiveness of Active Packaging on Control of Escherichia Coli O157:H7 and Total Aerobic Bacteria on Iceberg Lettuce.

    Science.gov (United States)

    Lu, Haixia; Zhu, Junli; Li, Jianrong; Chen, Jinru

    2015-06-01

    Contaminated leafy green vegetables have been linked to several outbreaks of human gastrointestinal infections. Antimicrobial interventions that are adoptable by the fresh produce industry for control of pathogen contamination are in great demand. This study was undertaken to evaluate the efficacy of sustained active packaging on control of Escherichia coli O157:H7 and total aerobic bacteria on lettuce. Commercial Iceberg lettuce was inoculated with a 3-strain mixture of E. coli O157:H7 at 10(2) or 10(4) CFU/g. The contaminated lettuce and un-inoculated controls were placed respectively in 5 different active packaging structures. Traditional, nonactive packaging structure was included as controls. Packaged lettuce was stored at 4, 10, or 22 °C for 3 wk and sampled weekly for the population of E. coli O157:H7 and total aerobic bacteria. Results showed that packaging structures with ClO2 generator, CO2 generator, or one of the O2 scavengers effectively controlled the growth of E. coli O157:H7 and total aerobic bacteria under all storage conditions. Packaging structure with the ClO2 generator was most effective and no E. coli O157:H7 was detected in samples packaged in this structure except for those that were inoculated with 4 log CFU/g of E. coli O157:H7 and stored at 22 °C. Packaging structures with an oxygen scavenger and the allyl isothiocyanate generator were mostly ineffective in control of the growth of the bacteria on Iceberg lettuce. The research suggests that some of the packaging structures evaluated in the study can be used to control the presence of foodborne pathogens on leafy green vegetables. © 2015 Institute of Food Technologists®

  2. Scanning with a Total Information Storage and Controlled Data Presentation System

    Energy Technology Data Exchange (ETDEWEB)

    Rejali, A. M.; Gregg, E. C.; Voelker, W. H.; Friedell, H. L. [Case Western Reserve University, Cleveland, OH (United States)

    1969-01-15

    This presentation demonstrates improved clinical results obtained from storing all available information received by the detector or detectors without prior modifications in a permanent memory. Permanently stored information is modified later with a special electronic imaging system with kinescope presentation in black and white or colour. Under carefully controlled circumstances this system permits immediate and innumerable degrees of erase and contrast enhancement or colour coding in fractions of a second. A profile representing the count-rate through any slice in the scanned area may be performed to determine relative distribution of radioisotopes. The advantage of this system and various clinical results in scans of myocardiums, pancreas, cardiac blood pool, placenta, etc. will be presented. (author)

  3. Purex Process Improvements for Pu and NP Control in Total Actinide Recycle Flowsheets

    International Nuclear Information System (INIS)

    Birkett, J.E.; Carrott, M.J.; Crooks, G.; Fox, O.D.; Maher, C.J.; Taylor, R.J.; Woodhead, D.A.

    2006-01-01

    Significant improvements are required in the Purex process to optimise it for Advanced Fuel Cycles. Two key challenges we have identified are, firstly, developing more efficient methods for U/Pu separations especially at elevated Pu concentrations and, secondly, improving recovery, control and routing of Np in a modified Purex process. A series of Purex-like flowsheets for improved Pu separations based on hydroxamic acids and are reported. Purex-like flowsheets have been tested on a glovebox-housed 30-stage miniature centrifugal contactor train. A series of trials have been performed to demonstrate the processing of feeds with varying Pu contents ranging from 7 - 40% by weight. These flowsheets have demonstrated hydroxamic acids are excellent reagents for complexant stripping of Pu being able to achieve high decontamination factors (DF) on both the U and Pu product streams and co - recover Np with Pu. The advantages of a complexant-based approach are shown to be especially relevant when AFC scenarios are considered, where the Pu content of the fuel is expected to b e significantly higher. Recent results towards modifying the Purex process to improve recovery and control of Np in short residence time contactors are reported. Work on the development of chemical and process models to describe the complicated behaviour of Np under primary separation conditions (i.e. the HA extraction contactor) is described. To test the performance of the model a series of experiments were performed including testing of flowsheets on a fume-hood housed miniature centrifugal contactor train. The flowsheet was designed to emulate the conditions of a primar y separations contactor with the Np split between the U-solvent product and aqueous raffinate. In terms of Np routing the process model showed good agreement with flowsheet trial however much further work is required to fully understand this complex system. (authors)

  4. After total knee replacement younger patients demonstrate superior balance control compared to older patients when recovering from a forward fall.

    Science.gov (United States)

    Street, Brian D; Gage, William

    2017-05-01

    National joint replacement registries have reported a substantial growth in younger knee osteoarthritic patients (controlled perturbation have shown age-related differences between younger and older healthy adults, whether similar age-related differences exist among total knee replacement patients is unknown. A total of 59 participants, including 29 unilateral total knee replacement patients (six-months post-surgery) made up the four experimental groups: 1) younger patient (54.3 (SD 7.9) years), 2) younger control (55.2 (SD 4.0) years), 3) older patient (76.9 (SD 4.7) years), and 4) older control (77.7 (SD 4.1) years). Using a tether-release method to perturb balance and simulate a forward fall, center of mass and stepping characteristics were analyzed. Younger patients recovered following the perturbation with a significantly smaller center of mass displacement compared to the older patients (14.85 (SD 0.01) v. 18.13 (SD 0.02) %ht, p=0.02); utilizing a longer (0.43 (SD 0.02) v. 0.39 (SD 0.03) m, pcontrols in center of mass displacement or recovery step characteristics (p>0.05). The younger patients demonstrated superior center of mass control in response to a forward perturbation, suggesting that younger patients would be at a reduced risk of falling when recovering from a forward-directed postural perturbation compared to older patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Utility of the CPS+EG staging system in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer treated with neoadjuvant chemotherapy.

    Science.gov (United States)

    Marmé, Frederik; Lederer, Bianca; Blohmer, Jens-Uwe; Costa, Serban Dan; Denkert, Carsten; Eidtmann, Holger; Gerber, Bernd; Hanusch, Claus; Hilfrich, Jörn; Huober, Jens; Jackisch, Christian; Kümmel, Sherko; Loibl, Sibylle; Paepke, Stefan; Untch, Michael; von Minckwitz, Gunter; Schneeweiss, Andreas

    2016-01-01

    Pathologic complete response after neoadjuvant chemotherapy (NACT) correlates with overall survival (OS) in primary breast cancer. A recently described staging system based on pre-treatment clinical stage (CS), final pathological stage (PS), estrogen receptor (ER) status and nuclear grade (NG) leads to a refined estimation of prognosis in unselected patients. Its performance in luminal type breast cancers has not been determined. This study investigates the clinical utility of this CPS+EG score when restricted to hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) patients and compares the results to a cohort of unselected patients. The CPS+EG score was calculated for 6637 unselected patients and 2454 patients with HR+/HER2- tumours who received anthracycline/taxane-based NACT within 8 prospective German trials. Five-year disease-free survival (DFS) and OS were 75.6% and 84.1% for the unselected cohort and 80.6% and 87.8% for the HR+/HER2- subgroup, respectively. The CPS+EG system distinguished different prognostic groups with 5-year DFS ranging from 0% to 91%. The CPS+EG system leads to an improved categorisation of patients by outcome compared to CS, PS, ER or NG alone. When applying the CPS+EG score to the HR+/HER2- subgroup, a shift to lower scores was observed compared to the overall population, but 5-year DFS and OS for the individual scores were identical to that observed in the overall population. In HR+/HER2- patients, the CPS+EG staging system retains its ability to facilitate a refined stratification of patients according to outcome. It can help to select candidates for post-neoadjuvant clinical trials in luminal breast cancer. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Controllable transmission and total reflection through an impedance-matched acoustic metasurface

    KAUST Repository

    Mei, Jun

    2014-12-02

    A general design paradigm for a novel type of acoustic metasurface is proposed by introducing periodically repeated supercells on a rigid thin plate, where each supercell contains multiple cut-through slits that are filled with materials possessing different refractive indices but the same impedance as that of the host medium. When the wavelength of the incident wave is smaller than the periodicity, the direction of the transmitted wave with nearly unity transmittance can be chosen by engineering the phase discontinuities along the transverse direction. When the wavelength is larger than the periodicity, even though the metasurface is impedance matched to the host medium, most of the incident energy is reflected back and the remaining portion is converted into a surface-bound mode. We show that both the transmitted wave control and the high reflection with the surface mode excitation can be interpreted by a unified analytic model based on mode-coupling theory. Our general design principle not only supplies the functionalities of reflection-type acoustic metasurfaces, but also exhibits unprecedented flexibility and efficiency in various domains of wave manipulation for possible applications in fields like refracting, collimating, focusing or absorbing wave energy.

  7. The Total In-Flight Simulator (TIFS) aerodynamics and systems: Description and analysis. [maneuver control and gust alleviators

    Science.gov (United States)

    Andrisani, D., II; Daughaday, H.; Dittenhauser, J.; Rynaski, E.

    1978-01-01

    The aerodynamics, control system, instrumentation complement and recording system of the USAF Total In/Flight Simulator (TIFS) airplane are described. A control system that would allow the ailerons to be operated collectively, as well as, differentially to entrance the ability of the vehicle to perform the dual function of maneuver load control and gust alleviation is emphasized. Mathematical prediction of the rigid body and the flexible equations of longitudinal motion using the level 2.01 FLEXSTAB program are included along with a definition of the vehicle geometry, the mass and stiffness distribution, the calculated mode frequencies and mode shapes, and the resulting aerodynamic equations of motion of the flexible vehicle. A complete description of the control and instrumentation system of the aircraft is presented, including analysis, ground test and flight data comparisons of the performance and bandwidth of the aerodynamic surface servos. Proposed modification for improved performance of the servos are also presented.

  8. Appropriate control time constant in relation to characteristics of the baroreflex vascular system in 1/R control of the total artificial heart.

    Science.gov (United States)

    Mizuta, Sora; Saito, Itsuro; Isoyama, Takashi; Hara, Shintaro; Yurimoto, Terumi; Li, Xinyang; Murakami, Haruka; Ono, Toshiya; Mabuchi, Kunihiko; Abe, Yusuke

    2017-09-01

    1/R control is a physiological control method of the total artificial heart (TAH) with which long-term survival was obtained with animal experiments. However, 1/R control occasionally diverged in the undulation pump TAH (UPTAH) animal experiment. To improve the control stability of the 1/R control, appropriate control time constant in relation to characteristics of the baroreflex vascular system was investigated with frequency analysis and numerical simulation. In the frequency analysis, data of five goats in which the UPTAH was implanted were analyzed with first Fourier transform technique to examine the vasomotion frequency. The numerical simulation was carried out repeatedly changing baroreflex parameters and control time constant using the elements-expanded Windkessel model. Results of the frequency analysis showed that the 1/R control tended to diverge when very low frequency band that was an indication of the vasomotion frequency was relative high. In numerical simulation, divergence of the 1/R control could be reproduced and the boundary curves between the divergence and convergence of the 1/R control varied depending on the control time constant. These results suggested that the 1/R control tended to be unstable when the TAH recipient had high reflex speed in the baroreflex vascular system. Therefore, the control time constant should be adjusted appropriately with the individual vasomotion frequency.

  9. Evaluation of Total Daily Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the Hospital

    Science.gov (United States)

    2016-05-20

    regular insulin has significantly increased in recent years. These patients are severely insulin resistant requiring high doses of insulin to achieve...on U-500 Insulin Admitted to the Hospital presented at SURF Conference, San Antonio, TX 20 May 201 6 with MDWI 41-108, and has been assigned local...59th CSPG/SGVU) C.201 4 . I 52d PROTOCOL TITLE Evaluation of Total Dai ly Dose and Glycemic Control for Patients on U-500 Insulin Admitted to the

  10. Total antioxidant intake and prostate cancer in the Cancer of the Prostate in Sweden (CAPS) study. A case control study

    International Nuclear Information System (INIS)

    Russnes, Kjell M.; Möller, Elisabeth; Wilson, Kathryn M.; Carlsen, Monica; Blomhoff, Rune; Smeland, Sigbjørn; Adami, Hans-Olov; Grönberg, Henrik; Mucci, Lorelei A.; Bälter, Katarina

    2016-01-01

    The total intake of dietary antioxidants may reduce prostate cancer risk but available data are sparse and the possible role of supplements unclear. We investigated the potential association between total and dietary antioxidant intake and prostate cancer in a Swedish population. We used FFQ data from 1499 cases and 1112 controls in the population based case–control study Cancer of the Prostate in Sweden (CAPS). The ferric reducing antioxidant potential (FRAP) assay was used to assess the total antioxidant capacity (TAC) of diet and supplements. We calculated odds ratios (ORs) for the risk of prostate cancer across quintiles of antioxidant intake from all foods, from fruit and vegetables only, and from dietary supplements using unconditional logistic regression. Coffee comprised 62 % of the dietary antioxidant intake, tea 4 %, berries 4 %, chocolate 2 %, and boiled potatoes 2 %. In total 19 % and 13 % of the population took multivitamins and supplemental Vitamin C respectively, on a regular basis. Antioxidant intake from all foods and from fruits and vegetables separately measured by the FRAP assay was not associated with prostate cancer risk. For antioxidant intake from supplements we found a positive association with total, advanced, localized, high grade and low grade prostate cancer in those above median supplemental TAC intake of users compared to non-users (Adjusted ORs for total prostate cancer: 1.37, 95 % CI 1.08–1.73, advanced: 1.51, 95 % CI 1.11–2.06, localized: 1.36. 95 % CI 1.06–1.76, high grade 1.60, 95 % CI 1.06–2.40, low grade 1.36, 95 % CI 1.03–1.81). A high intake of coffee (≥6 cups/day) was associated with a possible risk reduction of fatal and significantly with reduced risk for high grade prostate cancer, adjusted OR: 0.45 (95 % CI: 0.22–0.90), whereas a high intake of chocolate was positively associated with risk of total, advanced, localized and low grade disease (adjusted OR for total: 1.43, 95 % CI 1.12–1.82, advanced: 1

  11. Use of intravenous tranexamic acid in total knee arthroplasty: a meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    FU De-jie

    2013-04-01

    Full Text Available 【Abstract】 Objective: The effect of tranexamic acid (TA on patients receiving total knee arthroplasty (TKA has been reported in many small clinical trials. But single trials are not sufficient enough to clarify the effectiveness and safety of TA. So, we carried out a meta-analysis of randomized controlled trials to investigate the efficacy and safety of the intravenous use of TA in TKA. Methods: Literatures were retrieved in Cochrane Library, OVID, PubMed, EMBASE, CNKI and Wanfang Data. All the related literatures were checked by two independent investigators and only the high quality randomized con-trolled trials were enrolled. Relevant data were analyzed using RevMan 5.1 to compare the difference of blood loss, transfusion and complications between TA group and con-trol group. Results: There were 353 related literatures and only 22 randomized controlled trials met the inclusion criteria. The use of TA in TKA significantly reduced total blood loss by a mean of 435.41 ml (95% CI 300.62-570.21, P<0.01, post-operative blood loss by a mean of 406.69 ml (95% CI 333.16-480.22, P<0.01. TA also significantly lowered the transfu-sion rate (risk difference 0.30, 95% CI 0.21-0.39, P<0.01 and transfusion volume (mean difference 0.95 unit, 95% CI 0.53-1.37, P<0.01. The risks between TA group and control group in developing deep vein thrombosis and pulmonary embo-lism were not statistically significant. Conclusion: TA is beneficial for patients undergoing TKA, which can significantly reduce total blood loss, post-operative blood loss, transfusion rate, and transfusion volume. Meanwhile TA is recommended to reduce deep vein thrombosis and pulmonary embolism following TKA. Key words: Tranexamic acid; Arthroplasty; Knee; Blood loss, surgical; Meta-analysis

  12. Reachable Sets of Hidden CPS Sensor Attacks : Analysis and Synthesis Tools

    NARCIS (Netherlands)

    Murguia, Carlos; van de Wouw, N.; Ruths, Justin; Dochain, Denis; Henrion, Didier; Peaucelle, Dimitri

    2017-01-01

    For given system dynamics, control structure, and fault/attack detection procedure, we provide mathematical tools–in terms of Linear Matrix Inequalities (LMIs)–for characterizing and minimizing the set of states that sensor attacks can induce in the system while keeping the alarm rate of the

  13. Tobacco Use Supplement to the Current Population Survey (TUS-CPS) Data

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1992-1993, 1995-1996, 1998-1999, 2001-2002, 2003, 2006-2007, 2010-2011, 2014-2015. Centers for Disease Control and Prevention (CDC). State Tobacco Activities...

  14. [The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study].

    Science.gov (United States)

    Karaman, Tugba; Ozsoy, Asker Zeki; Karaman, Serkan; Dogru, Serkan; Tapar, Hakan; Sahin, Aynur; Dogru, Hatice; Suren, Mustafa

    A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group) or with transversus abdominis plane block using 20mL of 0.25% bupivacaine (transversus abdominis plane group). Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24hours. The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD) 0.130 (0.25) vs. 0.094 (0.02) mcg.kg -1 .min -1 ; pplane group soon after surgery; median (range) 6 (2-10) vs. 3 (0-5); pplane group had significantly higher QoR-40 scores 190.5 (175-197) vs. 176.5 (141-187); pplane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  15. Auricular Acupressure for Managing Postoperative Pain and Knee Motion in Patients with Total Knee Replacement: A Randomized Sham Control Study

    Directory of Open Access Journals (Sweden)

    Ling-hua Chang

    2012-01-01

    Full Text Available Background. Postoperative pain management remains a significant challenge for all healthcare providers. A randomized controlled trial was conducted to examine the adjuvant effects of auricular acupressure on relieving postoperative pain and improving the passive range of motion in patients with total knee replacement (TKR. Method. Sixty-two patients who had undergone a TKR were randomly assigned to the acupressure group and the sham control group. The intervention was delivered three times a day for 3 days. A visual analog scale (VAS and the Short-Form McGill Pain Questionnaire were used to assess pain intensity. Pain medication consumption was recorded, and the knee motion was measured using a goniometer. Results. The patients experienced a moderately severe level of pain postoperatively (VAS 58.66 ± 20.35 while being on the routine PCA. No differences were found in pain scores between the groups at all points. However, analgesic drug usage in the acupressure group patients was significantly lower than in the sham control group (<0.05, controlling for BMI, age, and pain score. On the 3rd day after surgery, the passive knee motion in the acupressure group patients was significantly better than in the sham control group patients (<0.05, controlling for BMI. Conclusion. The application of auricular acupressure at specific therapeutic points significantly reduces the opioid analgesia requirement and improves the knee motion in patients with TKR.

  16. Interventions for the prediction and management of chronic postsurgical pain after total knee replacement: systematic review of randomised controlled trials.

    Science.gov (United States)

    Beswick, Andrew D; Wylde, Vikki; Gooberman-Hill, Rachael

    2015-05-12

    Total knee replacement can be a successful operation for pain relief. However, 10-34% of patients experience chronic postsurgical pain. Our aim was to synthesise evidence on the effectiveness of applying predictive models to guide preventive treatment, and for interventions in the management of chronic pain after total knee replacement. We conducted a systematic review of randomised controlled trials using appropriate search strategies in the Cochrane Library, MEDLINE and EMBASE from inception to October 2014. No language restrictions were applied. Adult patients receiving total knee replacement. Predictive models to guide treatment for prevention of chronic pain. Interventions for management of chronic pain. Reporting of specific outcomes was not an eligibility criterion but we sought outcomes relating to pain severity. No studies evaluated the effectiveness of predictive models in guiding treatment and improving outcomes after total knee replacement. One study evaluated an intervention for the management of chronic pain. The trial evaluated the use of a botulinum toxin A injection with antinociceptive and anticholinergic activity in 49 patients with chronic postsurgical pain after knee replacement. A single injection provided meaningful pain relief for about 40 days and the authors acknowledged the need for a large trial with repeated injections. No trials of multidisciplinary interventions or individualised treatments were identified. Our systematic review highlights a lack of evidence about the effectiveness of prediction and management strategies for chronic postsurgical pain after total knee replacement. As a large number of people are affected by chronic pain after total knee replacement, development of an evidence base about care for these patients should be a research priority. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Intra-articular versus intravenous tranexamic acid application in total knee arthroplasty: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Mi, Bobin; Liu, Guohui; Zhou, Wu; Lv, Huijuan; Liu, Yi; Zha, Kun; Wu, Qipeng; Liu, Jing

    2017-07-01

    The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included. Main outcomes of the two methods were collected and analyzed by using Review Manager 5.3. There were 16 randomized controlled trials with 1308 cases met the criteria. Compared with IV TXA, IA TXA had similar blood volume of drainage, hidden blood loss, transfusion rate and complications (P > 0.05). IA TXA had lower total blood loss than IV TXA, and there was significant difference (P  0.05) when compared with IA TXA. Both IA TXA and single dose of IV TXA are effective in reducing total blood loss and postoperative hemoglobin drop without increasing complications of DVT or PE. The current meta-analysis suggests that 1.5 g TXA by IA administration or 1 g TXA by IV administration 10 min before tourniquet deflation is effective and safe in patients undergoing TKA.

  18. Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial.

    Science.gov (United States)

    Kruse, Christine; Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

    2018-01-01

    The two most common surgical approaches to total hip arthroplasty are the posterior approach and lateral approach. The surgical approach may influence cup positioning and restoration of the offset, which may affect the biomechanical properties of the hip joint. The primary aim was to compare cup position between posterior approach and lateral approach. Secondary aims were to compare femoral offset, abductor moment arm and leg length discrepancy between the two approaches. Eighty patients with primary hip osteoarthritis were included in a randomized controlled trial and assigned to total hip arthroplasty using posterior approach or lateral approach. Postoperative radiographs from 38 patients in each group were included in this study for measurement of cup anteversion and inclination. Femoral offset, cup offset, total offset, abductor moment arm and leg length discrepancy were measured on preoperative and postoperative radiographs in 28 patients in each group. We found that mean anteversion was 5° larger in the posterior approach group (95% CI, -8.1 to -1.4; p = 0.006), while mean inclination was 5° less steep (95% CI, 2.7 to 7.2; pcup anteversion but less steep cup inclination in the posterior approach group compared with the lateral approach group. Femoral offset and abductor moment arm were restored after total hip arthroplasty using lateral approach but significantly increased when using posterior approach.

  19. Comparison of topical and intravenous administration of tranexamic acid for blood loss control during total joint replacement: Review of literature

    Directory of Open Access Journals (Sweden)

    Georgi P. Georgiev

    2018-04-01

    Full Text Available Purpose: Many randomised controlled trials and meta-analysis studies have presented the efficacy of tranexamic acid (TXA without an increase of complications. However, questions still remain about the type of administration, optimal dose and secondary outcomes of TXA in total hip arthroplasty and total knee arthroplasty. The aim of this review is to summarise the existing information in literature concerning the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use. Methods: A literature review containing 63 articles from the PubMed data starting from the first description of tranexamic acid until now was made in trying to present the existing information in a simple and effective way. Results: TXA leads to statistically significant reduction of peri and postoperative bleeding and in that way decreases blood transfusion rates and the infection risk. Topical and intravenous (IV use of TXA revealed similar results, with no increase of deep venous thrombosis. Therefore, topical TXA could be a reasonable alternative in patients with contraindications for IV application of TXA. Conclusions: Blood loss control with TXA, a synthetic analogue of the amino acid lysine, may be an excellent and safe alternative to allogeneic blood transfusion after total hip arthroplasty and total knee arthroplasty. Further studies are needed to establish the efficacy of combined IV and topical administration of TXA with regard to diminishing blood loss and reducing hospital stay. The Translational Potential of this Article: This review briefly presents the pharmacological characteristics of TXA, forms, doses, types of application and contraindications for its use with regard to diminishing blood loss and reducing hospital stay for better therapeutic strategies in orthopaedics. Keywords: Arthroplasty, Review, Tranexamic acid

  20. Research report of fiscal 1997. Study on total energy and material control (feasibility study on circulating society); 1997 nendo chosa hokokusho. Total energy and material control ni kansuru chosa (junkangata shakai kochiku kanosei chosa) chosa hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    In order to construct real sustainable global environment and human society in the 21st century called the century of environment, not only the innovation of manufacturing processes technically supporting such the construction but also the conception including the innovation of the whole society from a wide viewpoint are essential. As a total energy and material control system (TEMCOS) concept, the view of an energy-saving circulating society is attempted which minimizes a total energy and material flow in Japan, and the role and issue of manufacturing industry, in particular, material industry are extracted. As one of the targets of such a concept, the conception of an eco-town is also described. Paying attention on some important material industries including a mass material flow and consuming a large amount of energy such as metal, plastics and automobile industries, the study result on a material flow for every industry is arranged, and some effective issues contributing to minimize a material flow and control energy consumption and CO2 emission are extracted. 80 refs., 67 figs., 30 tabs.

  1. Effectiveness of Bupivacaine Liposome Injectable Suspension for Postoperative Pain Control in Total Knee Arthroplasty: A Prospective, Randomized, Double Blind, Controlled Study.

    Science.gov (United States)

    DeClaire, Jeffrey H; Aiello, Paige M; Warritay, Olayinka K; Freeman, Dwight C

    2017-09-01

    We compared the effectiveness of liposomal bupivacaine to ropivacaine, each as part of multimodal pain management, in total knee arthroplasty (TKA) postoperative pain control. This prospective, double blind study randomized 96 TKA patients into a control group (periarticular injection of ropivacaine, ketorolac, morphine, and epinephrine in saline; 100cc) or an experimental group (periarticular injection of bupivacaine, ketorolac, morphine, and epinephrine in saline; 80cc plus 1.3% liposomal bupivacaine 20cc; total injection 100cc). The postoperative use of narcotics, visual analog pain scores, hours to ambulate 100 feet, and length of hospital stay were recorded. There was no significant difference between the two groups (control N = 49, experiment N = 47) in mean narcotic use per hour, total narcotic use during hospital stay, time to ambulate 100 feet, length of hospital stay, or visual analog score for pain postoperatively. There is no benefit in the use of liposomal bupivacaine compared with ropivacaine for postoperative pain control in TKA. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Preliminary evaluation of Community-Led Total Sanitation for the control of Taenia solium cysticercosis in Katete District of Zambia.

    Science.gov (United States)

    Bulaya, Carol; Mwape, Kabemba E; Michelo, Charles; Sikasunge, Chummy S; Makungu, Chitwambi; Gabriel, Sarah; Dorny, Pierre; Phiri, Isaac K

    2015-01-30

    Taenia solium taeniasis/cysticercosis is a zoonotic disease endemic in sub-Saharan Africa. It is associated with poor sanitary practices, free-range pig husbandry and lack of disease awareness in endemic communities. A comparative research was conducted with pre and post-intervention assessments in nine villages to evaluate Community-Led Total Sanitation (CLTS) as an intervention measure for the control of porcine cysticercosis in Katete District in the Eastern Province of Zambia. Blood samples were collected from pigs for circulating antigen detection and a questionnaire focused on the household was administered to a total of 153 respondents whose pigs were examined (64 pre-intervention, 89 post-intervention), in order to obtain information on general demographic characteristics, pig husbandry practices, sanitation practices and associated knowledge and awareness of T. solium infections. The first sampling was conducted prior to the implementation of the CLTS and second sampling eight months after triggering of CLTS in the selected villages. A total of 379 pig serum samples were examined using the B158/B60 Ag-ELISA to detect T. solium cysticercosis, 104 pre-intervention and 275 post-intervention, of which 14 (13.5%) and 45 (16.4%) were positive, respectively. Wald test p-values were computed to assess significant differences in the variables of interest mentioned above for the pre and post CLTS. The research revealed that CLTS as a control measure did not significantly improve T. solium infections in pigs. The research also revealed that the sanitation practices and awareness of cysticercosis did not change. It is recommended that a longer term evaluation be undertaken when the villages have been declared open defaecation free. In addition, the research recommends that health education, mass drug treatment and pig vaccination be incorporated, as an essential component of prevention and control programmes for T. solium infections. Copyright © 2014 Elsevier B

  3. The Relative Effects of Manual Versus Automatic Exposure Control on Radiation Dose to Vital Organs in Total Hip Arthroplasty.

    Science.gov (United States)

    Harper, Katharine D; Li, Shidong; Jennings, Rachel; Amer, Kamil M; Haydel, Christopher; Ali, Sayed

    2018-01-01

    Technologic advances have reduced medical radiation exposure while maintaining image quality. The purpose of this study was to determine the effects of the presence of total hip arthroplasty implants, compared with native hips, on radiation exposure of the most radiosensitive organs when manual and automatic exposure control settings are used. Detection probes were placed at six locations (stomach, sigmoid colon, right pelvic wall, left pelvic wall, pubic symphysis, and anterior pubic skin) in a cadaver. Radiographs were obtained with the use of manual and automatic exposure control protocols, with exposures recorded. A total hip arthroplasty implant was placed in the cadaver, probe positioning was confirmed, and the radiographs were repeated, with exposure values recorded. The control probe placed at the stomach had values ranging from 0.00 mSv to 0.01 mSv in protocols with and without implants. With the manual protocol, exposures in the pelvis ranged from 0.36 mSv to 2.74 mSv in the native hip and from 0.33 mSv to 2.24 mSv after implant placement. The increases in exposure after implant placement, represented as relative risk, were as follows: stomach, 1.000; pubic symphysis, 0.818; left pelvic wall, 1.381; sigmoid colon, 1.550; right pelvic wall, 0.917; and anterior pubic skin, 1.015. With automatic exposure control, exposures in the pelvis ranged from 0.07 mSv to 0.89 mSv in the native hip and from 0.21 mSv to 1.15 mSv after implant placement. With automatic exposure control, the increases in exposure after implant placement, represented as relative risk, were as follows: stomach, 1.000; pubic symphysis, 1.292; left pelvic wall, 1.476; sigmoid colon, 2.182; right pelvic wall, 3.000; and anterior pubic skin, 1.378. The amount of radiation to which patients are exposed as a result of medical procedures or imaging, and whether exposure is associated with an increased risk of malignant transformation, are the subject of ongoing debate. We found that after insertion

  4. Distributed co-simulation of embedded control software with exhaust gas recirculation water handling system using INTO-CPS

    DEFF Research Database (Denmark)

    Pedersen, Nicolai; Lausdahl, Kenneth; Sanchez, Enrique Vidal

    2017-01-01

    properties is often desirable. However, it is non-trivial to be able to combine such different models of different constituent elements. In order to reduce the need for expensive tests on the real system it is advantageous to be able to combine such heterogeneous models in a joint co-simulation in order...

  5. Distributed co-simulation of embedded control software with exhaust gas recirculation water handling system using INTO-CPS

    DEFF Research Database (Denmark)

    Pedersen, Nicolai; Lausdahl, Kenneth; Sanchez, Enrique Vidal

    2017-01-01

    to reduce the overall costs of validation. This paper demonstrates how this can be achieved for a commercial system developed by MAN Diesel & Turbo using a newly developed tool chain based on the Functional Mock-up Interface standard for co-simulation supporting different operating systems. The generality...

  6. Altitude profiles of total chlorinated paraffins in humus and spruce needles from the Alps (MONARPOP)

    Energy Technology Data Exchange (ETDEWEB)

    Iozza, Saverio, E-mail: saverio.iozza@empa.c [Empa, Swiss Federal Laboratories for Materials Testing and Research, Laboratory for Analytical Chemistry, Uberlandstrasse 129, CH-8600 Duebendorf (Switzerland); University of Basel, Department of Chemistry, St. Johanns-Ring 19, CH-4056 Basel (Switzerland); Schmid, Peter, E-mail: peter.schmid@empa.c [Empa, Swiss Federal Laboratories for Materials Testing and Research, Laboratory for Analytical Chemistry, Uberlandstrasse 129, CH-8600 Duebendorf (Switzerland); Oehme, Michael, E-mail: michael.oehme@unibas.c [University of Basel, Department of Chemistry, St. Johanns-Ring 19, CH-4056 Basel (Switzerland); Bassan, Rodolfo [Regional Agency for Environmental Prevention and Protection of Veneto (Italy); Belis, Claudio [Regional Agency for Environmental Protection of Lombardia (Italy); Jakobi, Gert; Kirchner, Manfred; Schramm, Karl-Werner [GSF-National Research Centre for Environment and Health (Germany); Kraeuchi, Norbert [Swiss Federal Institute for Forest, Snow and Landscape Research (Switzerland); Moche, Wolfgang; Offenthaler, Ivo; Weiss, Peter [Federal Environment Agency Ltd. (Austria); Simoncic, Primoz [Slovenian Forestry Institute (Slovenia); Knoth, Wilhelm [Federal Environment Agency (Germany)

    2009-12-15

    Chlorinated paraffins (CPs) are toxic, bioaccumulative, persistent, and ubiquitously present in the environment. CPs were analyzed in humus and needle samples, which were taken within the Monitoring Network in the Alpine Region for Persistent and other Organic Pollutants (MONARPOP) at sampling sites of 7 different altitude profiles in the Alps. Gas chromatography combined with electron ionization tandem mass spectrometry (EI-MS/MS) was used for the determination of total CPs (sum of short, medium and long chain CPs). CPs were found in all samples; the concentrations varied between 7 and 199 ng g{sup -1} dry weight (dw) and within 26 and 460 ng g{sup -1} dw in humus and needle samples, respectively. A clear vertical tendency within the individual altitude profiles could not be ascertained. Within all altitude profiles, elevated concentrations were observed in humus samples taken between 700 and 900 m and between 1300 and 1500 m. In the needle samples no similar correlation could be observed due to higher variation of the data. - For the first time, CP levels of humus and spruce needle samples from the Alps (MONARPOP) were presented including the evaluation of altitude profiles.

  7. Altitude profiles of total chlorinated paraffins in humus and spruce needles from the Alps (MONARPOP).

    Science.gov (United States)

    Iozza, Saverio; Schmid, Peter; Oehme, Michael; Bassan, Rodolfo; Belis, Claudio; Jakobi, Gert; Kirchner, Manfred; Schramm, Karl-Werner; Kräuchi, Norbert; Moche, Wolfgang; Offenthaler, Ivo; Weiss, Peter; Simoncic, Primoz; Knoth, Wilhelm

    2009-12-01

    Chlorinated paraffins (CPs) are toxic, bioaccumulative, persistent, and ubiquitously present in the environment. CPs were analyzed in humus and needle samples, which were taken within the Monitoring Network in the Alpine Region for Persistent and other Organic Pollutants (MONARPOP) at sampling sites of 7 different altitude profiles in the Alps. Gas chromatography combined with electron ionization tandem mass spectrometry (EI-MS/MS) was used for the determination of total CPs (sum of short, medium and long chain CPs). CPs were found in all samples; the concentrations varied between 7 and 199 ng g(-1) dry weight (dw) and within 26 and 460 ng g(-1) dw in humus and needle samples, respectively. A clear vertical tendency within the individual altitude profiles could not be ascertained. Within all altitude profiles, elevated concentrations were observed in humus samples taken between 700 and 900 m and between 1300 and 1500 m. In the needle samples no similar correlation could be observed due to higher variation of the data.

  8. The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Tugba Karaman

    Full Text Available Abstract Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg-1.min-1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min-1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2-10 vs. 3 (0-5; p < 0.001, at 2 h (5 [3-9] vs. 2.5 [0-6]; p < 0.001, at 6 h (4 [2-7] vs. 3[0-6], p < 0.001, at 12 h (3.5 [1-6] vs. 2 [1-5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175-197 vs. 176.5 (141-187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total abdominal hysterectomy.

  9. Effects of extracted soy isoflavones alone on blood total and LDL cholesterol: Meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Kyoko Taku

    2008-07-01

    Full Text Available Kyoko Taku1, Keizo Umegaki1, Yoshiko Ishimi2, Shaw Watanabe31Information Center, National Institute of Health and Nutrition, Tokyo, Japan; 2Nutritional Epidemiology Program, National Institute of Health and Nutrition, Tokyo, Japan; 3Nutritional Education Program, National Institute of Health and Nutrition, Tokyo, JapanAbstract: When provided concurrently with soy protein for 1–3 months, soy isoflavones exert synergistic or additive cholesterol-lowering effects. This meta-analysis was performed to evaluate the effects of extracted soy isoflavones alone (not ingested concurrently with soy protein on total and low density lipoprotein (LDL cholesterol. MEDLINE (1966–2007, EMBASE (1966–2007, CENTRAL (1966–2007, ICHUSHI (1983–2008, and CNKI (1979–2007 were searched for randomized placebo-controlled trials published in English, Japanese, and Chinese, describing the changes in lipid profiles in adult humans resulting from ingestion of extracted soy isoflavones for 1–3 months. Reference lists of relevant systematic reviews and meta-analyses were hand-searched. Meta-analysis of 10 and 9 trials with usable information using REVMAN found that an average of 70 mg soy isoflavones/day (27–132 mg, as the aglycone form alone had a nonsignificant effect on total (0.01 mmol/L [95% CI: –0.12, 0.14]; P = 0.86 and LDL (0.03 mmol/L [95% CI: –0.11, 0.16]; P = 0.71 cholesterol in menopausal women, respectively. It is concluded that ingestion of about 70 mg extracted soy isoflavones/day alone for 1–3 months does not improve total and LDL cholesterol levels in normocholesterolemic menopausal women; further studies are needed to verify the effects of extracted soy isoflavones.Keywords: extracted soy isoflavones, lipid, total cholesterol, LDL cholesterol

  10. A Flexible Job Shop Scheduling Problem with Controllable Processing Times to Optimize Total Cost of Delay and Processing

    Directory of Open Access Journals (Sweden)

    Hadi Mokhtari

    2015-11-01

    Full Text Available In this paper, the flexible job shop scheduling problem with machine flexibility and controllable process times is studied. The main idea is that the processing times of operations may be controlled by consumptions of additional resources. The purpose of this paper to find the best trade-off between processing cost and delay cost in order to minimize the total costs. The proposed model, flexible job shop scheduling with controllable processing times (FJCPT, is formulated as an integer non-linear programming (INLP model and then it is converted into an integer linear programming (ILP model. Due to NP-hardness of FJCPT, conventional analytic optimization methods are not efficient. Hence, in order to solve the problem, a Scatter Search (SS, as an efficient metaheuristic method, is developed. To show the effectiveness of the proposed method, numerical experiments are conducted. The efficiency of the proposed algorithm is compared with that of a genetic algorithm (GA available in the literature for solving FJSP problem. The results showed that the proposed SS provide better solutions than the existing GA.

  11. Landscape controls on total and methyl mercury in the upper Hudson River basin of New York State

    Science.gov (United States)

    Burns, D. A.; Murray, K. R.; Bradley, P. M.; Brigham, M. E.; Aiken, G.; Smith, M.

    2010-12-01

    High levels of mercury (Hg) in aquatic biota have been identified in surface waters of the Adirondack region of New York, and factors such as the prevalence of wetlands, extensive forest cover, and oligotrophic waters promote Hg bioaccumulation in this region. Past research in this region has focused on improved understanding of the Hg cycle in lake ecosystems. In the study described herein, the landscape controls on total Hg and methylmercury (MeHg) concentrations in riverine ecosystems were explored through synoptic surveys of 27 sites in the upper Hudson River basin of the Adirondack region. Stream samples were collected and analyzed for total Hg, MeHg, dissolved organic carbon (DOC), and ultraviolet absorbance at 254 nm (UV254) during spring and summer of 2006-08. Landscape indices including many common land cover, hydrographic, and topographic-based measures were explored as predictors of Hg through multivariate linear regression. Multivariate models that included a wetland or riparian area-based metric, an index for open water area, and in some cases a topographic metric such as the wetness index explained 55 to 65 percent of the variation in MeHg concentrations, and 55 to 80 percent of the variation in total Hg concentrations. An open water index (OWI) was developed that incorporated both the basin area drained by ponded water and the surface area of these ponds. This index was inversely related to concentrations of total Hg and MeHg. This OWI was also inversely related to specific ultra-violet absorbance, consistent with previous studies showing that open water increases the influence of algal-derived carbon on DOC, decreasing aromaticity, which should decrease the ability of the dissolved carbon pool to bind Hg. The OWI was not significant in models for total Hg that also included UV254 as a predictive variable, but the index did remain significant in similar models for MeHg suggesting that biogeochemical factors in addition to decreasing carbon

  12. The effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Tugba Karaman

    2018-05-01

    Full Text Available Background and objectives: A transversus abdominis plane block is a peripheral block method that has been used successfully for pain relief after total abdominal hysterectomy. However, the effects of the combination of the transversus abdominis plane block and general anesthesia on analgesic and anesthetic requirements remain unclear. This randomized placebo-controlled study is aimed to evaluate the effects of transversus abdominis plane block on analgesic and anesthetic consumption during total abdominal hysterectomy under general anesthesia. Methods: Sixty-six women undergoing total abdominal hysterectomy were randomized into two groups to receive general anesthesia alone (control group or with transversus abdominis plane block using 20 mL of 0.25% bupivacaine (transversus abdominis plane group. Intraoperative remifentanil and sevoflurane consumption were recorded. We also evaluated the postoperative pain, nausea, quality of recovery scores and rescue analgesic requirement during postoperative 24 hours. Results: The total remifentanil and sevoflurane consumption is significantly lower in transversus abdominis plane group; respectively mean (SD 0.130 (0.25 vs. 0.094 (0.02 mcg.kg−1.min−1; p < 0.01 and 0.295 (0.05 vs. 0.243 (0.06 mL.min−1; p < 0.01. In the postoperative period, pain scores were significantly reduced in transversus abdominis plane group soon after surgery; median (range 6 (2–10 vs. 3 (0–5; p < 0.001, at 2 h (5 [3–9] vs. 2.5 [0–6]; p < 0.001, at 6 h (4 [2–7] vs. 3[0–6], p < 0.001, at 12 h (3.5 [1–6] vs. 2 [1–5]; p = 0.003. The patients in the transversus abdominis plane group had significantly higher QoR-40 scores 190.5 (175–197 vs. 176.5 (141–187; p < 0.001. Conclusion: Combining transversus abdominis plane block with general anesthesia can provide reduced opioid and anesthetic consumption and can improve postoperative pain and quality of recovery scores in patients undergoing total

  13. Inflammation and post-operative recovery in patients undergoing total knee arthroplasty-secondary analysis of a randomized controlled trial

    DEFF Research Database (Denmark)

    Langkilde, A; Jakobsen, T L; Bandholm, T Q

    2017-01-01

    OBJECTIVE: Reduced function persists for many patients after total knee arthroplasty (TKA). Inflammation is part of osteoarthritis' pathophysiology, and surgery induces a marked inflammatory response. We therefore wanted to explore the role of inflammation in long-term recovery after TKA, and thus...... conducted this secondary analysis of our randomized controlled trial (RCT) of physical rehabilitation ± progressive strength training (PST). We aimed to investigate whether (1) inflammation is associated with functional performance, knee-extension strength, and knee pain before TKA; (2) PST affects...... factor (TNF)-α at baseline; day 1, week 4, 8, and 26 after TKA. RESULTS: At baseline, suPAR (P = 006) was negatively associated with 6MWT. Neither baseline nor surgery-induced inflammation modified the response to rehabilitation ± PST. Only surgery-induced IL-10 was associated with Δ6MWT26 weeks...

  14. Tantalum acetabular augments in one-stage exchange of infected total hip arthroplasty: a case-control study.

    Science.gov (United States)

    Klatte, Till Orla; Kendoff, Daniel; Sabihi, Reza; Kamath, Atul F; Rueger, Johannes M; Gehrke, Thorsten

    2014-07-01

    During the one-stage exchange procedure for periprosthetic joint infection (PJI) after total hip arthroplasty (THA), acetabular defects challenge reconstructive options. Porous tantalum augments are an established tool for addressing acetabular destruction in aseptic cases, but their utility in septic exchange is unknown. This retrospective case-control study presents the initial results of tantalum augmentation during one-stage exchange for PJI. Primary endpoints were rates of re-infection and short-term complications associated with this technique. Study patients had no higher risk of re-infection with equivalent durability at early follow-up with a re-infection rate in both groups of 4%. In conclusion, tantalum augments are a viable option for addressing acetabular defects in one-stage exchange for septic THA. Further study is necessary to assess long-term durability when compared to traditional techniques for acetabular reconstruction. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Is Electrocautery of Patella Useful in Patella Non-Resurfacing Total Knee Arthroplasty?: A Prospective Randomized Controlled Study.

    Science.gov (United States)

    Kwon, Sae Kwang; Nguku, Levis; Han, Chang Dong; Koh, Yong-Gon; Kim, Dong-Wook; Park, Kwan Kyu

    2015-12-01

    There is controversy over the need for electrocauterization of the patella in non-resurfacing total knee arthroplasty (TKA). We investigated whether this procedure is beneficial through a prospective randomized controlled trial. Fifty patients who underwent electrocautery were compared with 50 patients who did not undergo this procedure. We determined cartilage status, preoperative and postoperative American Knee Society (AKS) score, the Western Ontario and McMaster Universities score (WOMAC) and the Patellofemoral (PF) scores for a minimum of 5 years. The two groups did not differ significantly in demographics, intraoperative cartilage status, or preoperative or postoperative outcomes. No complications were detected in either group. We found no benefits of electrocautery of the patella in patellar non-resurfacing TKA up to 5 years. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Effect of an e-Learning Tool on Expectations and Satisfaction Following Total Knee Arthroplasty: A Randomized Controlled Trial.

    Science.gov (United States)

    Culliton, Sharon E; Bryant, Dianne M; MacDonald, Steven J; Hibbert, Kathy M; Chesworth, Bert M

    2018-07-01

    Orthopedic surgeons recognize patient expectations of total knee arthroplasty (TKA) can be managed through education. E-learning is the application of educational technology. The objective of this study was to evaluate whether an e-learning tool could affect whether patients' expectations were met and they were satisfied 1 year following TKA. Patients with osteoarthritis from the London Health Sciences Centre, Canada, were randomly assigned to either a control group (n = 207) receiving standard patient education or an intervention group (n = 209) using the e-learning tool in addition to the standard. We used a web-based system with permuted block sizes, stratified by surgeon and first or second TKA. Preoperative measures were completed following the patients' preadmission clinic visit. Postoperative patient-reported outcome measures were completed at 6 weeks, 3 months, and 1 year after TKA. One year after TKA, risk difference was used to determine between-group differences for patient satisfaction and expectations being met. One year postoperatively, the risk that expectations of patients were not met was 21.8% in the control group and 21.4% in the intervention group for an adjusted risk difference of 1.3% (95% confidence interval, -7.8% to 10.4%, P = .78). The proportion of patients satisfied with their TKA at 1 year postoperative was 78.6% in the intervention and 78.2% in the control groups. There was no between-group difference at 1 year between intervention and control groups for either the risk that expectations of patients were not met or the proportion of patients who were dissatisfied with their TKA. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. E-cigarette use and smoking reduction or cessation in the 2010/2011 TUS-CPS longitudinal cohort

    Directory of Open Access Journals (Sweden)

    Yuyan Shi

    2016-10-01

    Full Text Available Abstract Background Electronic cigarettes (e-cigarettes are heavily marketed and widely perceived as helpful for quitting or reducing smoking intensity. We test whether ever-use of e-cigarettes among early adopters was associated with: 1 increased cigarette smoking cessation; and 2 reduced cigarette consumption. Methods A representative cohort of U.S. smokers (N = 2454 from the 2010 Tobacco Use Supplement to the Current Population Survey (TUS-CPS was re-interviewed 1 year later. Outcomes were smoking cessation for 30+ days and change in cigarette consumption at follow-up. E-cigarettes use was categorized as for cessation purposes or for another reason. Multivariate regression was used to adjust for demographics and baseline cigarette dependence level. Results In 2011, an estimated 12 % of adult U.S. smokers had ever used e-cigarettes, and 41 % of these reported use to help quit smoking. Smokers who had used e-cigarettes for cessation were less likely to be quit for 30+ days at follow-up, compared to never-users who tried to quit (11.1 % vs 21.6 %; ORadj = 0.44, 95 % CI = 0.2–0.8. Among heavier smokers at baseline (15+ cigarettes per day (CPD, ever-use of e-cigarettes was not associated with change in smoking consumption. Lighter smokers (<15 CPD who had ever used e-cigarettes for quitting had stable consumption, while increased consumption was observed among all other lighter smokers, although this difference was not statistically significant. Conclusions Among early adopters, ever-use of first generation e-cigarettes to aid quitting cigarette smoking was not associated with improved cessation or with reduced consumption, even among heavier smokers.

  18. E-cigarette use and smoking reduction or cessation in the 2010/2011 TUS-CPS longitudinal cohort.

    Science.gov (United States)

    Shi, Yuyan; Pierce, John P; White, Martha; Vijayaraghavan, Maya; Compton, Wilson; Conway, Kevin; Hartman, Anne M; Messer, Karen

    2016-10-21

    Electronic cigarettes (e-cigarettes) are heavily marketed and widely perceived as helpful for quitting or reducing smoking intensity. We test whether ever-use of e-cigarettes among early adopters was associated with: 1) increased cigarette smoking cessation; and 2) reduced cigarette consumption. A representative cohort of U.S. smokers (N = 2454) from the 2010 Tobacco Use Supplement to the Current Population Survey (TUS-CPS) was re-interviewed 1 year later. Outcomes were smoking cessation for 30+ days and change in cigarette consumption at follow-up. E-cigarettes use was categorized as for cessation purposes or for another reason. Multivariate regression was used to adjust for demographics and baseline cigarette dependence level. In 2011, an estimated 12 % of adult U.S. smokers had ever used e-cigarettes, and 41 % of these reported use to help quit smoking. Smokers who had used e-cigarettes for cessation were less likely to be quit for 30+ days at follow-up, compared to never-users who tried to quit (11.1 % vs 21.6 %; ORadj = 0.44, 95 % CI = 0.2-0.8). Among heavier smokers at baseline (15+ cigarettes per day (CPD)), ever-use of e-cigarettes was not associated with change in smoking consumption. Lighter smokers (<15 CPD) who had ever used e-cigarettes for quitting had stable consumption, while increased consumption was observed among all other lighter smokers, although this difference was not statistically significant. Among early adopters, ever-use of first generation e-cigarettes to aid quitting cigarette smoking was not associated with improved cessation or with reduced consumption, even among heavier smokers.

  19. Phase variable expression of a single phage receptor in Campylobacter jejuni NCTC12662 influences sensitivity toward several diverse CPS-dependent phages

    DEFF Research Database (Denmark)

    Gencay, Yilmaz Emre; Sørensen, Martine C.H.; Wenzel, Cory Q.

    2018-01-01

    Campylobacter jejuni NCTC12662 is sensitive to infection by many Campylobacter bacteriophages. Here we used this strain to investigate the molecular mechanism behind phage resistance development when exposed to a single phage and demonstrate how phase variable expression of one surface component...... influences phage sensitivity against many diverse C. jejuni phages. When C. jejuni NCTC12662 was exposed to phage F207 overnight, 25% of the bacterial cells were able to grow on a lawn of phage F207, suggesting that resistance develops at a high frequency. One resistant variant, 12662R, was further...... characterized and shown to be an adsorption mutant. Plaque assays using our large phage collection showed that seven out of 36 diverse capsular polysaccharide (CPS)-dependent phages could not infect 12662R, whereas the remaining phages formed plaques on 12662R with reduced efficiencies. Analysis of the CPS...

  20. Randomized controlled trial on postoperative pulmonary humidification after total laryngectomy: external humidifier versus heat and moisture exchanger.

    Science.gov (United States)

    Mérol, Jean-Claude; Charpiot, Anne; Langagne, Thibault; Hémar, Patrick; Ackerstaff, Annemieke H; Hilgers, Frans J M

    2012-02-01

    Assessment of immediate postoperative airway humidification after total laryngectomy (TLE), comparing the use of an external humidifier (EH) with humidification through a heat and moisture exchanger (HME). Randomized controlled trial (RCT). Fifty-three patients were randomized into the standard (control) EH (N = 26) or the experimental HME arm (N = 27). Compliance, pulmonary and sleeping problems, patients' and nursing staff satisfaction, nursing time, and cost-effectiveness were assessed with trial-specific structured questionnaires and tally sheets. In the EH arm data were available for all patients, whereas in the HME arm data were incomplete for four patients. The 24/7 compliance rate in the EH arm was 12% and in the HME arm 87% (77% if the four nonevaluable patients are considered noncompliant). Compliance and patients' satisfaction were significantly better, and the number of coughing episodes, mucus expectoration for clearing the trachea, and sleeping disturbances were significantly less in the HME arm (P humidification by means of an HME over the use of an EH after TLE. This study therefore underlines that HMEs presently can be considered the better option for early postoperative airway humidification after TLE. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  1. Clinical outcome of increased flexion gap after total knee arthroplasty. Can controlled gap imbalance improve knee flexion?

    Science.gov (United States)

    Ismailidis, P; Kuster, M S; Jost, B; Giesinger, K; Behrend, H

    2017-06-01

    Increased range of motion (ROM) while maintaining joint stability is the goal of modern total knee arthroplasty (TKA). A biomechanical study has shown that small increases in flexion gap result in decreased tibiofemoral force beyond 90° flexion. The purpose of this paper was to investigate clinical implications of controlled increased flexion gap. Four hundred and four TKAs were allocated into one of two groups and analysed retrospectively. In the first group (n = 352), flexion gap exceeded extension gap by 2.5 mm, while in the second group (n = 52) flexion gap was equal to the extension gap. The procedures were performed from 2008 to 2012. The patients were reviewed 12 months postoperatively. Objective clinical results were assessed for ROM, mediolateral and sagittal stability. Patient-reported outcome measures were the WOMAC score and the Forgotten Joint Score (FJS-12). After categorizing postoperative flexion into three groups (poor < 90°, satisfactory 91°-119°, good ≥ 120°) significantly more patients in group 1 achieved satisfactory or good ROM (p = 0.006). Group 1 also showed a significantly higher mean FJS-12 (group 1: 73, group 2: 61, p = 0.02). The mean WOMAC score was 11 in the first and 14 in the second group (n.s.). Increase in flexion gap did not influence knee stability. The clinical relevance of this study is that a controlled flexion gap increase of 2.5 mm may have a positive effect on postoperative flexion and patient satisfaction after TKA. Neither knee stability in the coronal and sagittal planes nor complications were influenced by a controlled increase in flexion gap. III.

  2. Weed control in young coffee plantations through post emergence herbicide application onto total area Controle de plantas daninhas em cafezais recém-implantados, com herbicidas aplicados em pós-emergência em área total

    Directory of Open Access Journals (Sweden)

    C.P. Ronchi

    2004-12-01

    at doses recommended for bean crop, these herbicides may be applied to control weeds in coffee and bean intercropping systems by spraying the entire area.Este trabalho foi realizado com o objetivo de investigar, em campo, a eficiência de vários herbicidas aplicados em pós-emergência em área total no controle de plantas daninhas, em cafezais recém-implantados e no consórcio de café e feijão, assim como seus efeitos sobre essas culturas. Mudas de Coffea arabica, cultivar Catuaí Vermelho, com quatro a seis pares de folhas foram transplantadas para o campo e cultivadas segundo práticas agronômicas usuais. O consórcio de café e feijão foi obtido por meio do plantio de três linhas de feijão nas entrelinhas do cafezal. Quando os herbicidas foram aplicados sobre as culturas, as plantas de café estavam com seis a dez pares de folhas, as de feijão com três folíolos e as plantas daninhas no estádio inicial de desenvolvimento. Fluazifop-p-butil e clethodim foram seletivos às plantas de café e controlaram eficientemente Brachiaria plantaginea e Digitaria horizontalis. Plantas daninhas dicotiledôneas (Amaranthus retroflexus, Bidens pilosa, Coronopus didymus, Emilia sonchifolia, Galinsoga parviflora, Ipomoea grandifolia, Lepidium virginicum e Raphanus raphanistrum foram controladas eficientemente por aplicações isoladas de fomesafen, flazasulfuron e oxyfluorfen, com exceção de B. pilosa, C. didymus e R. raphanistrum para o oxyfluorfen. Aplicações seqüenciais com intervalos de sete dias de fomesafen + fluazifop-p-butil ou clethodim, e as duas misturas comerciais de fomesafen + fluazifop-p-butil controlaram simultaneamente ambos os tipos de plantas daninhas. Cyperus rotundus foi controlada apenas por flazasulfuron. Com exceção de fluazifop-p-butil e clethodim todos os demais tratamentos herbicidas provocaram apenas leves injúrias às folhas mais novas das plantas de café. Contudo, o crescimento das plantas não foi prejudicado, de forma que tanto a

  3. Comparison of Customized Cutting Block and Conventional Cutting Instrument in Total Knee Arthroplasty: A Randomized Controlled Trial.

    Science.gov (United States)

    Tammachote, Nattapol; Panichkul, Phonthakorn; Kanitnate, Supakit

    2018-03-01

    Customized cutting block (CCB) was designed to ensure the accurate alignment of knee prostheses during total knee arthroplasty. Given the paucity of CCB efficacy data, we compare CCB with conventional cutting guide using a randomized controlled trial. One hundred eight osteoarthritic knee patients underwent total knee arthroplasty by one experienced surgeon were randomized to receive CCB (n = 54) or conventional cutting instrument (CCI) surgery (n = 54). The primary outcomes were limb alignment, prostheses position, and operative time. The secondary outcomes were hemodynamic alteration after surgery, functional outcomes (modified Western Ontario and McMaster University Osteoarthritis Index) and range of motion at 2 years after surgery. Mean hip-knee-ankle angle in the CCB group was 179.4° ± 1.8° vs 179.1° ± 2.4° in the CCI group, Δ = 0 (95% confidence interval [CI] -0.6 to 1.1, P = .55). Mean operative time was faster in the CCB arm: 93 ± 12 vs 104 ± 12 minutes, Δ = 11 (95% CI -16.7 to -7.2, P < .0001). There were no differences in hemodynamic parameters, mean blood loss (446 [CCB] vs 514 mL [CCI], Δ = -68 [95% CI -138 to 31 mL, P = .21]), postoperative hemoglobin changes, incidence of hypotension (systolic <90 mm Hg), oliguria, and rates of blood transfusion. Functional outcomes and range of motion were also similar. There was no improvement in alignment, hemodynamic changes, blood loss, and knee functional outcomes. CCB reduced surgical time by 11 minutes in our population. CCB cost-effectiveness should be further investigated. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Early Statin Use and the Progression of Alzheimer Disease: A Total Population-Based Case-Control Study.

    Science.gov (United States)

    Lin, Feng-Cheng; Chuang, Yun-Shiuan; Hsieh, Hui-Min; Lee, Tzu-Chi; Chiu, Kuei-Fen; Liu, Ching-Kuan; Wu, Ming-Tsang

    2015-11-01

    The protective effect of statin on Alzheimer disease (AD) is still controversial, probably due to the debate about when to start the use of statin and the lack of any large-scale randomized evidence that actually supports the hypothesis. The purpose of this study was to examine the protective effect of early statin use on mild-to-moderate AD in the total Taiwanese population.This was a total population-based case-control study, using the total population of Taiwanese citizens seen in general medical practice; therefore, the findings can be applied to the general population. The study patients were those with newly diagnosed dementia (ICD-9 290.x) and prescribed any acetylcholinesterase inhibitors (AChEI) from the Taiwan National Health Insurance dataset in 1997 to 2008. The newly diagnosed eligible mild-to-moderate AD patients were traced from the dates of their index dates, which was defined as the first day to receive any AChEI treatment, back to 1 year (exposure period) to categorize them into AD with early statin use and without early statin use. Early statin use was defined as patients using statin before AChEI treatment. Alzheimer disease patients with early statin use were those receiving any statin treatment during the exposure period. Then, we used propensity-score-matched strategy to match these 2 groups as 1:1. The matched study patients were followed-up from their index dates. The primary outcome was the discontinuation of AChEI treatment, indicating AD progression.There were 719 mild-to-moderate AD-paired patients with early statin use and without early statin use for analyses. Alzheimer disease progression was statistically lower in AD patients with early statin use than those without (P = 0.00054). After adjusting for other covariates, mild-to-moderate AD patients with early stain use exhibited a 0.85-risk (95% CI = 0.76-0.95, P = 0.0066) to have AD progression than those without.Early statin use was significantly associated with a reduction in AD

  5. A case-control study to identify risk factors for totally implantable central venous port-related bloodstream infection.

    Science.gov (United States)

    Lee, Guk Jin; Hong, Sook Hee; Roh, Sang Young; Park, Sa Rah; Lee, Myung Ah; Chun, Hoo Geun; Hong, Young Seon; Kang, Jin Hyoung; Kim, Sang Il; Kim, Youn Jeong; Chun, Ho Jong; Oh, Jung Suk

    2014-07-01

    To date, the risk factors for central venous port-related bloodstream infection (CVPBSI) in solid cancer patients have not been fully elucidated. We conducted this study in order to determine the risk factors for CVP-BSI in patients with solid cancer. A total of 1,642 patients with solid cancer received an implantable central venous port for delivery of chemotherapy between October 2008 and December 2011 in a single center. CVP-BSI was diagnosed in 66 patients (4%). We selected a control group of 130 patients, who were individually matched with respect to age, sex, and catheter insertion time. CVP-BSI occurred most frequently between September and November (37.9%). The most common pathogen was gram-positive cocci (n=35, 53.0%), followed by fungus (n=14, 21.2%). Multivariate analysis identified monthly catheter-stay as a risk factor for CVP-BSI (p=0.000), however, its risk was lower in primary gastrointestinal cancer than in other cancer (p=0.002). Initial metastatic disease and long catheter-stay were statistically significant factors affecting catheter life span (p=0.005 and p=0.000). Results of multivariate analysis showed that recent transfusion was a risk factor for mortality in patients with CVP-BSI (p=0.047). In analysis of the results with respect to risk factors, prolonged catheter-stay should be avoided as much as possible. It is necessary to be cautious of CVP-BSI in metastatic solid cancer, especially non-gastrointestinal cancer. In addition, avoidance of unnecessary transfusion is essential in order to reduce the mortality of CVP-BSI. Finally, considering the fact that confounding factors may have affected the results, conduct of a well-designed prospective controlled study is warranted.

  6. Quality of life in cancer survivors 5 years or more after total gastrectomy: a case-control study.

    Science.gov (United States)

    Lee, Seung Soo; Chung, Ho Young; Kwon, Oh Kyoung; Yu, Wansik

    2014-01-01

    This study investigated how total gastrectomy (TG), along with memories of cancer, affect the subjective wellness of survivors long after surgery. Rational approaches for effectively improving the quality of life (QoL) of these survivors were suggested. Between 2008 and 2013, QoL data of gastric cancer patients who underwent a curative TG, were obtained at 5-year postoperative follow-up visits (5-year survivors) and at visits beyond 5 years (long-term survivors). The control groups for these survivor groups were constructed from volunteers who visited our health-examination center for annual medical checkups. The Korean versions of the European Organization for Research and Treatment (EORTC) Quality of Life Questionnaire Core 30 (QLQ-C30) and the gastric cancer specific module, the EORTC QLQ-STO22, were used to assess QoL. Five-year survivors showed worse QoL compared to the control group in role functioning, social functioning, nausea/vomiting, appetite loss, financial difficulties, reflux, eating restrictions, taste, and body image, and better QoL in the emotional and cognitive functioning scales. In long-term survivors, deterioration in QoL were still apparent in financial difficulties, reflux, and eating restrictions, while QoL differences in the remaining scales had diminished. Surviving 5 years after TG does not result in living in a carefree state in terms of QoL. After 5 postoperative years, survivors still need extended care for deteriorated QoL indicators due to symptomatic, behavioral, and financial consequences of surgery. While relevant clinical and institutional approaches are required for corresponding declines in QoL, such efforts must extend beyond 5 postoperative years. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Mediator effect of statistical process control between Total Quality Management (TQM) and business performance in Malaysian Automotive Industry

    Science.gov (United States)

    Ahmad, M. F.; Rasi, R. Z.; Zakuan, N.; Hisyamudin, M. N. N.

    2015-12-01

    In today's highly competitive market, Total Quality Management (TQM) is vital management tool in ensuring a company can success in their business. In order to survive in the global market with intense competition amongst regions and enterprises, the adoption of tools and techniques are essential in improving business performance. There are consistent results between TQM and business performance. However, only few previous studies have examined the mediator effect namely statistical process control (SPC) between TQM and business performance. A mediator is a third variable that changes the association between an independent variable and an outcome variable. This study present research proposed a TQM performance model with mediator effect of SPC with structural equation modelling, which is a more comprehensive model for developing countries, specifically for Malaysia. A questionnaire was prepared and sent to 1500 companies from automotive industry and the related vendors in Malaysia, giving a 21.8 per cent rate. Attempts were made at findings significant impact of mediator between TQM practices and business performance showed that SPC is important tools and techniques in TQM implementation. The result concludes that SPC is partial correlation between and TQM and BP with indirect effect (IE) is 0.25 which can be categorised as high moderator effect.

  8. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials.

    LENUS (Irish Health Repository)

    Abdulkarim, Ali

    2013-02-22

    The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  9. Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Ali Abdulkarim

    2013-03-01

    Full Text Available The optimal method of fixation for primary total hip replacements (THR, particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

  10. Total control of chromium in tanneries - thermal decomposition of filtration cake from enzymatic hydrolysis of chrome shavings.

    Science.gov (United States)

    Kocurek, P; Kolomazník, K; Bařinová, M; Hendrych, J

    2017-04-01

    This paper deals with the problem of chromium recovery from chrome-tanned waste and thus with reducing the environmental impact of the leather industry. Chrome-tanned waste was transformed by alkaline enzymatic hydrolysis promoted by magnesium oxide into practically chromium-free, commercially applicable collagen hydrolysate and filtration cake containing a high portion of chromium. The crude and magnesium-deprived chromium cakes were subjected to a process of thermal decomposition at 650°C under oxygen-free conditions to reduce the amount of this waste and to study the effect of magnesium removal on the resulting products. Oxygen-free conditions were applied in order to prevent the oxidation of trivalent chromium into the hazardous hexavalent form. Thermal decomposition products from both crude and magnesium-deprived chrome cakes were characterized by high chromium content over 50%, which occurred as eskolaite (Cr 2 O 3 ) and magnesiochromite (MgCr 2 O 4 ) crystal phases, respectively. Thermal decomposition decreased the amount of chrome cake dry feed by 90%. Based on the performed experiments, a scheme for the total control of chromium in the leather industry was designed.

  11. La administración financiera y el control total de la calidad: algunos elementos de importancia

    Directory of Open Access Journals (Sweden)

    Mario Kaffury Silva

    2015-05-01

    Full Text Available RESUMEN El presente resumen tiene por objeto analizar la función que cumple el control total de la calidad en la administración financiera. Ha sido uno de los modelos aplicados a nuestro sistema colombiano, buscando mejores canales de comunicación dentro de la empresa, ajustando todo su proceso productivo de la manera más eficiente a los cambios en los gustos de los consumidores y a utilizar mejores sistemas para el avance y el encajonamiento en el mercado de dichas empresas. El esquema institucional de la normalización técnica en Colombia ha mostrado su eficiencia como modelo de concertación y ha contribuido a la formación de profesionales y técnicos en el campo general de la organización. Así, a través del desarrollo del trabajo se pretende ver y comprender la aplicación que ha tenido dicho sistema en los diferentes  campos tanto de contabilidad, costos y servicios.

  12. Methodology to quantify the role of the factors controlling the variation of rivers' total dissolved solids in Jiu Catchment (Romania)

    Science.gov (United States)

    Adina Morosanu, Gabriela; Zaharia, Liliana; Ioana-Toroimac, Gabriela; Belleudy, Philippe

    2017-04-01

    The total dissolved solids (TDS) is a river water quality parameter reflecting its concentration in solute ions. It is sensitive to many physical and anthropogenic features of the watershed. In this context, the objective of this work is to analyze the spatial variation of the TDS and to identify the role of the main controlling factors (e.g. geology, soils, land use) in Jiu River and some of its main tributaries, by using a methodology based on GIS and multivariate analysis. The Jiu watershed (10,000 kmp) is located in south-western Romania and it has a high diversity of physical and anthropogenic features influencing the water flow and its quality. The study is based on TDS measurements performed in August, 2016, during low flow conditions in the Jiu River and its tributaries. To measure in situ the TDS (ppm), an EC/TDS/Temperature Hand-held Tester was used in the 12 measuring points on Jiu River and in another 7 points on some of its tributaries. Across the hydrographic basin, the recorded TDS values ranged from 31 ppm to 607 ppm, while in the case of Jiu River, the TDS varied between 38 ppm at Lonea station (upper Jiu River) and 314 ppm at Išalniča (in the lower course). For each catchment corresponding to the sampling points, the influence of some contiguous features was defined on the basis of the lithology (marls, limestones, erodible bedrocks) and soils (clay textures), as well as the land cover/use influencing the solubility and solid content. This assessment was carried out in GIS through a set of spatial statistics analysis by calculating the percentages of the catchment coverage area for each determinant. In order to identify the contributions of different catchment features on the TDS variability, principal components analysis (PCA) was then applied. The results revealed the major role of the marls and clayey soils in the increase of TDS (on the Amaradia and Gilort rivers and some sections in the middle course of the Jiu River). In contrast

  13. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  14. Randomized Clinical Trial of Periarticular Drug Injection used in combination Patient-Controlled Analgesia versus Patient-Controlled Analgesia Alone in Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    MN Sabran

    2008-11-01

    Full Text Available This is a prospective randomized clinical trial to compare use of a combination of periarticular drug injection with patient- controlled analgesia (PCA to PCA alone in post-total knee arthroplasty (TKA. Thirty patients who were admitted for unilateral total knee arthroplasty were selected randomly into an Injection group or a Standard group. The periarticular injection contained Ropivacaine, Ketorolac and Adrenaline, given intra-operatively. The mean amount of opioid used was 22.87 mmol/L in the Injection group as compared to 39.78 mmol/L in the Standard group (p = 0.026. The Injection group had lower pain score at rest and during exercise (p=0.021, p=0.041, respectively, as well as better return to function (p=0.026 and shorter hospital stay (6.1 days, Injection; 7.5 days, Standard, p=0.027. Overall, the group receiving periarticular drugs injection had less pain, less narcotic usage, earlier return to function, similar experience of adverse effects and shorter hospital stays.

  15. Blood glucose control in healthy subject and patients receiving intravenous glucose infusion or total parenteral nutrition using glucagon-like peptide 1

    DEFF Research Database (Denmark)

    Nauck, Michael A; Walberg, Jörg; Vethacke, Arndt

    2004-01-01

    It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition.......It was the aim of the study to examine whether the insulinotropic gut hormone GLP-1 is able to control or even normalise glycaemia in healthy subjects receiving intravenous glucose infusions and in severely ill patients hyperglycaemic during total parenteral nutrition....

  16. Effect of joint mobilization techniques for primary total knee arthroplasty: Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Xu, Jiao; Zhang, Juan; Wang, Xue-Qiang; Wang, Xuan-Lin; Wu, Ya; Chen, Chan-Cheng; Zhang, Han-Yu; Zhang, Zhi-Wan; Fan, Kai-Yi; Zhu, Qiang; Deng, Zhi-Wei

    2017-12-01

    Total knee arthroplasty (TKA) has become the most preferred procedure by patients for the relief of pain caused by knee osteoarthritis. TKA patients aim a speedy recovery after the surgery. Joint mobilization techniques for rehabilitation have been widely used to relieve pain and improve joint mobility. However, relevant randomized controlled trials showing the curative effect of these techniques remain lacking to date. Accordingly, this study aims to investigate whether joint mobilization techniques are valid for primary TKA. We will manage a single-blind, prospective, randomized, controlled trial of 120 patients with unilateral TKA. Patients will be randomized into an intervention group, a physical modality therapy group, and a usual care group. The intervention group will undergo joint mobilization manipulation treatment once a day and regular training twice a day for a month. The physical modality therapy group will undergo physical therapy once a day and regular training twice a day for a month. The usual care group will perform regular training twice a day for a month. Primary outcome measures will be based on the visual analog scale, the knee joint Hospital for Special Surgery score, range of motion, surrounded degree, and adverse effect. Secondary indicators will include manual muscle testing, 36-Item Short Form Health Survey, Berg Balance Scale function evaluation, Pittsburgh Sleep Quality Index, proprioception, and muscle morphology. We will direct intention-to-treat analysis if a subject withdraws from the trial. The important features of this trial for joint mobilization techniques in primary TKA are randomization procedures, single-blind, large sample size, and standardized protocol. This study aims to investigate whether joint mobilization techniques are effective for early TKA patients. The result of this study may serve as a guide for TKA patients, medical personnel, and healthcare decision makers. It has been registered at http

  17. Periarticular Injection of Liposomal Bupivacaine Offers No Benefit Over Standard Bupivacaine in Total Knee Arthroplasty: A Prospective, Randomized, Controlled Trial.

    Science.gov (United States)

    Alijanipour, Pouya; Tan, Timothy L; Matthews, Christopher N; Viola, Jessica R; Purtill, James J; Rothman, Richard H; Parvizi, Javad; Austin, Matthew S

    2017-02-01

    Periarticular injection of liposomal bupivacaine has been adopted as part of multimodal pain management after total knee arthroplasty (TKA). In this prospective, randomized clinical trial, we enrolled 162 patients undergoing primary TKA in a single institution between January 2014 and May 2015. Eighty-seven patients were randomized to liposomal bupivacaine (experimental group), and 75 patients were randomized to free bupivacaine (control group). All patients received spinal anesthesia and otherwise identical surgical approaches, pain management, and rehabilitation protocols. Outcomes evaluated include the patient-reported visual analog pain scores, narcotic consumption, and narcotic-related side effects (Brief Pain Inventory) within 96 hours after surgery as well as functional outcomes using the Knee Society Score and the Short-Form 12 measured preoperatively and at 4-6 weeks after surgery. There were no statistically significant differences between the groups in terms of postoperative daily pain scores, narcotic consumption (by-day and overall), or narcotic-related side effects. There were no statistically significant differences between the groups in terms of surgical (P = .76) and medical complications or length of hospital stay (P = .35). There were no statistically significant differences in satisfaction between the groups (P = .56) or between the groups in postoperative Knee Society Score (P = .53) and the Short-Form 12 at 4-6 weeks (P = .82, P = .66). As part of multimodal pain management protocol, periarticular injection of liposomal bupivacaine compared with bupivacaine HCl did not result in any clinically or statistically significant improvement of the measured outcomes following TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Effect of Transcutaneous Electric Nerve Stimulation on Pain after Total Knee Arthroplasty: A Blind Randomized Controlled Trial.

    Science.gov (United States)

    Beckwée, David; Bautmans, Ivan; Lefeber, Nina; Lievens, Pierre; Scheerlinck, Thierry; Vaes, Peter

    2018-02-01

    Transcutaneous electric nerve stimulation (TENS) has proven to be effective for postsurgical pain relief. However, there is a lack of well-constructed clinical trials investigating the effect of TENS after total knee arthroplasty (TKA). In addition, previous investigations reported that low- and high-frequency TENSs produced analgesic tolerance after 4 or 5 days of treatment. The aim of this study is to explore the effect of burst TENS on pain during hospitalization after TKA and to investigate whether burst TENS produces analgesic tolerance after 4 or 5 days of treatment. This stratified, triple blind, randomized controlled trial was approved by the University Hospital Brussels. Sixty-eight subjects were screened for eligibility before surgery; 54 were found eligible and 53 were included in the analyses. Patients were allocated to either a burst TENS or sham burst TENS group. TENS was applied daily during continuous passive mobilization. Knee pain intensity, knee range of motion, and analgesic consumption were assessed daily. Patients received burst TENS ( N  = 25) or sham burst TENS ( N  = 28). No significant differences in knee pain intensity were found between the groups ( p  > 0.05). Within the TENS and the sham TENS groups, the difference in knee pain before and after treatment did not evolve over time ( p  > 0.05). This study found no effects of burst TENS compared with sham burst TENS on pain during hospitalization after TKA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  19. Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty: A meta-analysis of randomized control trails.

    Science.gov (United States)

    Cao, Xiuling; Pan, Fang

    2017-09-01

    This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty. A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software. Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: -0.150 to 0.695, P = .207), 24 hours (SMD = -0.056, 95% CI: -0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: -0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = -0.039, 95% CI: -0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: -0.136 to 0.228, P = .618) and 48 hours (SMD = -0.025, 95% CI: -0.207 to 0.157, P = .785). Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block.

  20. Using discrete choice experiments as a decision aid in total knee arthroplasty: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dowsey, Michelle M; Scott, Anthony; Nelson, Elizabeth A; Li, Jinhu; Sundararajan, Vijaya; Nikpour, Mandana; Choong, Peter F M

    2016-08-19

    Osteoarthritis (OA) is a leading cause of disability in developed nations. Total knee arthroplasty (TKA) is a clinically effective treatment for people with end-stage knee OA, and represents one of the highest volume medical interventions globally. However, up to one in three patients remain dissatisfied following TKA. Research indicates that the strongest predictor of patient dissatisfaction following TKA is unmet expectations. This study will use a discrete choice experiment (DCE) provided to patients to improve knowledge of the expected outcomes of TKA. This increased knowledge is based on actual outcome data and is hypothesised to optimise patient expectations of TKA outcomes, thereby increasing their satisfaction and self-reported health outcomes. One hundred and thirty-two people with end-stage OA on the waiting list for TKA will be recruited and randomly allocated to one of two groups using computer-generated block randomisation. A randomised controlled trial (RCT) adhering to SPIRIT and CONSORT guidelines will evaluate the effect of administering a DCE prior to surgery on patient-reported pain and function and satisfaction following TKA. Patients in the intervention arm will complete a survey containing the DCE, compared to the control group who will complete a modified survey that does not contain the DCE activity. The DCE contains information on actual risks of postoperative complications, as well as health status after TKA. The DCE encourages patients to actively make trade-offs between risks and health outcomes to elicit their preferences. Participants in both groups will be required to complete the survey after consenting to have the procedure, but prior to surgery during their routine preadmission appointment at St. Vincent's Hospital, Melbourne, Australia (SVHM). Patients in both the intervention and control groups will also be required to complete a brief patient expectation survey 1 week prior to scheduled TKA. In addition, orthopaedic surgeons

  1. A Cyber Physical Model Based on a Hybrid System for Flexible Load Control in an Active Distribution Network

    Directory of Open Access Journals (Sweden)

    Yun Wang

    2017-02-01

    Full Text Available To strengthen the integration of the primary and secondary systems, a concept of Cyber Physical Systems (CPS is introduced to construct a CPS in Power Systems (Power CPS. The most basic work of the Power CPS is to build an integration model which combines both a continuous process and a discrete process. The advanced form of smart grid, the Active Distribution Network (ADN is a typical example of Power CPS. After designing the Power CPS model architecture and its application in ADN, a Hybrid System based model and control method of Power CPS is proposed in this paper. As an application example, ADN flexible load is modeled and controlled with ADN feeder power control by a control strategy which includes the normal condition and the underpowered condition. In this model and strategy, some factors like load power consumption and load functional demand are considered and optimized. In order to make up some of the deficiencies of centralized control, a distributed control method is presented to reduce model complexity and improve calculation speed. The effectiveness of all the models and methods are demonstrated in the case study.

  2. Stability and alignment do not improve by using patient-specific instrumentation in total knee arthroplasty: a randomized controlled trial.

    Science.gov (United States)

    Kosse, Nienke M; Heesterbeek, Petra J C; Schimmel, Janneke J P; van Hellemondt, Gijs G; Wymenga, Ate B; Defoort, Koen C

    2018-06-01

    The primary aim of the study was to examine stability and alignment after total knee arthroplasty (TKA) using patient-specific instrumentation (PSI) and conventional instrumentation (CI). The hypothesis was that stability and alignment would be better using PSI than CI, 12 months postoperatively. The secondary aim included the evaluation of clinical outcomes after TKA. In this prospective randomized controlled trial, 42 patients with knee osteoarthritis received a Genesis II PS prosthesis with either PSI or CI. Patients visited the hospital preoperatively and postoperatively after 6 weeks and 3 and 12 months. To evaluate stability, varus-valgus laxity was determined in extension and flexion using stress radiographs 12 months postoperatively. Three months postoperatively, a long-leg radiograph and CT scan were obtained to measure hip-knee-ankle (HKA) alignment and component rotation. Furthermore, frontal and sagittal alignment of the components, the Knee Society Score, VAS Pain, VAS Satisfaction, Knee injury and Osteoarthritis Outcome score, Patella score (Kujala), University of California Los Angeles activity score, anterior-posterior laxity, (serious) adverse device-related events, and intraoperative complications were reported. The clinical outcomes were compared using independent t tests or non-parametric alternatives, and repeated measurements ANOVA with a significance level of p stability, HKA angle, and rotational alignment. In four patients, the PSI did not fit correctly on the tibia and/or femur requiring intraoperative modifications. Both groups improved significantly over time on all clinical outcomes, with no significant differences between the groups 12 months postoperatively. The PSI group showed less tibial slope than the patients in the CI group [PSI 2.6° versus CI 4.8° (p = 0.02)]. Finally, the PSI group more frequently received a thinner insert size than the CI group (p = 0.03). Patients operated with PSI did not differ from CI in

  3. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  4. Removal of total suspended solid by natural coagulant derived from cassava peel waste

    Science.gov (United States)

    Mohd-Asharuddin, S.; Othman, N.; Mohd-Zin, N. S.; Tajarudin, H. A.

    2018-04-01

    The present study was aimed to investigate the performance of starch derived from cassava peel waste as primary coagulant and coagulant aid. Comparable study was also conducted using commercially used aluminium sulfate (alum) as primary coagulant. A series of Jar tests were performed using raw water from Sembrong Barat water treatment plant. It was observed that coagulation test using cassava peel starch (CPS) alone had unappreciable removing ability. However, it was found that combination of alum-CPS successfully achieve up to 90.48% of total suspended solid (TSS) removal under optimized working conditions (pH 9, 7.5mg/L : 100 mg/L of alum : CPS dosage, rapid mixing of 200 rpm for 1 minute; 100 rpm for 2 minutes, slow mixing of 25 rpm for 30 minutes and 30 minutes settling time). This remarks the reduction in alum dosage up to 50% compared to coagulation test using alum alone. Therefore this finding suggesting that CPS can be considered as potential source of sustainable and effective coagulant aid for water treatment especially in developing countries.

  5. Sleep Quality Effects Recovery After Total Knee Arthroplasty (TKA)--A Randomized, Double-Blind, Controlled Study.

    Science.gov (United States)

    Gong, Long; Wang, ZhenHu; Fan, Dong

    2015-11-01

    This study examined the effects of sleep quality on early recovery after total knee arthroplasty. A total of 148 patients were randomized 1:1 to receive either zolpidem or placebo for 2 weeks. VAS pain scores (rest, ambulation and night), range of motion (ROM), total amount of opioid analgesics and antiemetics taken, postoperative nausea and vomiting (PONV), sleep efficacy and satisfaction were recorded. It was found that patients taking zolpidem achieved greater improvement in quality of life and reported better satisfaction. Patients in the intervention group had lower pain score and took less antiemetics. Moreover, a significant correlation between sleep quality and ROM was detected. These results demonstrated that improved sleep quality is beneficial to patients' post-TKA recovery. Copyright © 2015. Published by Elsevier Inc.

  6. Radiographic cup position following posterior and lateral approach to total hip arthroplasty. An explorative randomized controlled trial

    DEFF Research Database (Denmark)

    Kruse, Christine; Rosenlund, Signe; Broeng, Leif

    2018-01-01

    The two most common surgical approaches to total hip arthroplasty are the posterior approach and lateral approach. The surgical approach may influence cup positioning and restoration of the offset, which may affect the biomechanical properties of the hip joint. The primary aim was to compare cup...... arthroplasty using posterior approach or lateral approach. Postoperative radiographs from 38 patients in each group were included in this study for measurement of cup anteversion and inclination. Femoral offset, cup offset, total offset, abductor moment arm and leg length discrepancy were measured...... approach group had a larger mean femoral offset of 4.3mm (95% CI, -7.4 to -1.3, p = 0.006), mean total offset of 6.3mm (95% CI, -9.6 to -3; pcup anteversion but less...

  7. Quality Control of Gamma Irradiated Dwarf Mallow (Malva neglecta Wallr.) Based on Color, Organic Acids, Total Phenolics and Antioxidant Parameters.

    Science.gov (United States)

    Pinela, José; Barros, Lillian; Antonio, Amilcar L; Carvalho, Ana Maria; Oliveira, M Beatriz P P; Ferreira, Isabel C F R

    2016-04-08

    This study addresses the effects of gamma irradiation (1, 5 and 8 kGy) on color, organic acids, total phenolics, total flavonoids, and antioxidant activity of dwarf mallow (Malva neglecta Wallr.). Organic acids were analyzed by ultra fast liquid chromatography (UFLC) coupled to a photodiode array (PDA) detector. Total phenolics and flavonoids were measured by the Folin-Ciocalteu and aluminium chloride colorimetric methods, respectively. The antioxidant activity was evaluated based on the DPPH(•) scavenging activity, reducing power, β-carotene bleaching inhibition and thiobarbituric acid reactive substances (TBARS) formation inhibition. Analyses were performed in the non-irradiated and irradiated plant material, as well as in decoctions obtained from the same samples. The total amounts of organic acids and phenolics recorded in decocted extracts were always higher than those found in the plant material or hydromethanolic extracts, respectively. The DPPH(•) scavenging activity and reducing power were also higher in decocted extracts. The assayed irradiation doses affected differently the organic acids profile. The levels of total phenolics and flavonoids were lower in the hydromethanolic extracts prepared from samples irradiated at 1 kGy (dose that induced color changes) and in decocted extracts prepared from those irradiated at 8 kGy. The last samples also showed a lower antioxidant activity. In turn, irradiation at 5 kGy favored the amounts of total phenolics and flavonoids. Overall, this study contributes to the understanding of the effects of irradiation in indicators of dwarf mallow quality, and highlighted the decoctions for its antioxidant properties.

  8. We Need to Talk... Developing Communicating Power Supplies to Monitor & Control Miscellaneous Electric Loads

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Andrew; Lanzisera, Steven; Liao, Anna; Meier, Alan

    2014-08-11

    Plug loads represent 30percent of total electricity use in residential buildings. Significant energy savings would result from an accurate understanding of which miscellaneous electric devices are using energy, at what time, and in what quantity. Commercially available plug load monitoring and control solutions replace or limit the attached device's native controls - forcing the user to adapt to a separate set of controls associated with the monitoring and control hardware. A better solution is integration of these capabilities at the power supply level. In this paper, we demonstrate a method achieving this integration. Our solution allows unobtrusive power monitoring and control while retaining native device control features. Further, our prototype enables intelligent behaviors by allowing devices to respond to the state of one another automatically. The CPS enables energy savings while demonstrating an added level of functionality to the user. If CPS technology became widespread in devices, a combination of automated and human interactive solutions would enable high levels of energy savings in buildings.

  9. Autologous re-transfusion drain compared with no drain in total knee arthroplasty : a randomised controlled trial

    NARCIS (Netherlands)

    Horstmann, Wieger; Kuipers, Bart; Ohanis, David; Slappendel, Robert; Kollen, Boudewijn; Verheyen, Cees

    Background. Post-operative anaemia following total knee arthroplasty is reported to impede functional mobility in the early period following surgery, whereas allogeneic blood transfusions, used to correct low post-operative haemoglobin levels, have concomitant disadvantages. The use of a

  10. A comparison of total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting a clinical randomized case control trial

    International Nuclear Information System (INIS)

    Akhlagh, S.H.; Chohedri, A.H.; Bazojoo, A.; Nemati, M.H.

    2007-01-01

    The aim of this clinical case-control trial was to compare the total amount of blood needed in patients taking autologous or homologous blood transfusion in coronary artery bypass grafting (CABG) surgery. Sixty patients scheduled for CABG were randomly allocated to ANH (Acute Normovulemic Hemodynamic) group (A group) or control group (B group). Hematocrit before operation and 24 hours after the operation were checked. The amount of the total blood needed in each group was measured at the end of the operation. There was no significant difference between the two groups as regards post operational hematocrit. The mean total blood infused to the control and ANH group was 2010 ml and 1815 ml respectively. However there was significant difference between the two groups as regards the total amount of the blood needed during operation. Our randomized, double blinded case control study demonstrated that autologous blood, beside carrying lower risks for hemolytic and nonhemolytic transfusion reactions decrease the total amount of blood needed for CABG. However larger studies with more patients are needed to confirm the results. (author)

  11. The influence of selenium status on body composition, oxidative DNA damage and total antioxidant capacity in newly diagnosed type 2 diabetes mellitus: A case-control study.

    Science.gov (United States)

    Othman, Fatimah Binti; Mohamed, Hamid Jan Bin Jan; Sirajudeen, K N S; Noh, Mohd Fairulnizal B Md; Rajab, Nor Fadilah

    2017-09-01

    Selenium is involved in the complex system of defense against oxidative stress in diabetes through its biological function of selenoproteins and the antioxidant enzyme. A case-control study was carried out to determine the association of plasma selenium with oxidative stress and body composition status presented in Type 2 Diabetes Mellitus (T2DM) patient and healthy control. This study involved 82 newly diagnosed T2DM patients and 82 healthy controls. Plasma selenium status was determined with Graphite Furnace Atomic Absorption Spectrometry. Body Mass Index, total body fat and visceral fat was assessed for body composition using Body Composition Analyzer (TANITA). Oxidative DNA damage and total antioxidant capacity were determined for oxidative stress biomarker status. In age, gender and BMI adjustment, no significant difference of plasma selenium level between T2DM and healthy controls was observed. There was as a significant difference of Oxidative DNA damage and total antioxidant capacity between T2DM patients and healthy controls with tail DNA% 20.62 [95% CI: 19.71,21.49] (T2DM), 17.67 [95% CI: 16.87,18.56] (control); log tail moment 0.41[95% CI: 0.30,0.52] (T2DM), 0.41[95% CI: 0.30,0.52] (control); total antioxidant capacity 0.56 [95% CI: 0.54,0.58] (T2DM), 0.60 [95% CI: 0.57,0.62] (control). Waist circumference, BMI, visceral fat, body fat and oxidative DNA damage in the T2DM group were significantly lower in the first plasma selenium tertile (38.65-80.90μg/L) compared to the second (80.91-98.20μg/L) and the third selenium tertiles (98.21-158.20μg/L). A similar trend, but not statistically significant, was observed in the control group. Copyright © 2016 Elsevier GmbH. All rights reserved.

  12. A Development Method of Mobile Computerized Procedure System for the Cooperation among Field Workers and Main Control Room Operators in Korean Nuclear Power Plants

    International Nuclear Information System (INIS)

    Lee, Sun Jin; Seong, No Kyu; Jung, Yeon Sub

    2014-01-01

    Human errors can occur during the test and maintenance of steam generator, safety injection system and other various systems and devices in nuclear power plants (NPPs). Most of human errors can be improved by the human error prevention techniques such as self-check, peer-check, concurrent verification and etc. Another important technique is to share work information among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. It is expected that the proposed mobile CPS can enhance the reduction of human errors by supporting human error prevention techniques and information sharing. This paper describes the technical issues of the mobile CPS (mobile CPS) in the initial development stage. Based on the design of APR1400, CRI CPS has been developed and operated for SKN 3 and 4 HFE V and V and license test for the MCR operating staff. Therefore the mobile CPS will be developed by upgrading the CRI CPS with improved features

  13. A Development Method of Mobile Computerized Procedure System for the Cooperation among Field Workers and Main Control Room Operators in Korean Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Jin; Seong, No Kyu; Jung, Yeon Sub [KHNP ,Daejeon (Korea, Republic of)

    2014-08-15

    Human errors can occur during the test and maintenance of steam generator, safety injection system and other various systems and devices in nuclear power plants (NPPs). Most of human errors can be improved by the human error prevention techniques such as self-check, peer-check, concurrent verification and etc. Another important technique is to share work information among main control room (MCR) operators and field workers. Various field service automation tools have been developed with recent information technology in many countries. APR1400 computerized procedure system (CPS) has been developed for the MCR operators of Shin-Kori 3 and 4 units. Especially, the concurrent verification support design is applied in the construction project of Shin-Hanul 1 and 2 CPS. It is expected that the proposed mobile CPS can enhance the reduction of human errors by supporting human error prevention techniques and information sharing. This paper describes the technical issues of the mobile CPS (mobile CPS) in the initial development stage. Based on the design of APR1400, CRI CPS has been developed and operated for SKN 3 and 4 HFE V and V and license test for the MCR operating staff. Therefore the mobile CPS will be developed by upgrading the CRI CPS with improved features.

  14. Intraoperative local infiltration analgesia for early analgesia after total hip arthroplasty: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Lunn, Troels H; Husted, Henrik; Solgaard, Søren

    2011-01-01

    : High-volume local infiltration analgesia (LIA) is widely applied as part of a multimodal pain management strategy in total hip arthroplasty (THA). However, methodological problems hinder the exact interpretation of previous trials, and the evidence for LIA in THA remains to be clarified....... Therefore, we evaluated whether intraoperative high-volume LIA, in addition to a multimodal oral analgesic regimen, would further reduce acute postoperative pain after THA....

  15. Ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty: a multicenter randomized controlled study

    Directory of Open Access Journals (Sweden)

    Fen Wang

    2015-02-01

    Full Text Available BACKGROUND AND OBJECTIVES: Postoperative analgesia is crucial for early functional excise after total knee arthroplasty. To investigate the clinical efficacy of ultrasound and nerve stimulator guided continuous femoral nerve block analgesia after total knee arthroplasty. METHODS: 46 patients with ASA grade I-III who underwent total knee arthroplasty received postoperative analgesia from October 2012 to January 2013. In 22 patients, ultrasound and nerve stimulator guided continuous femoral nerve block were performed for analgesia (CFNB group; in 24 patients, epidural analgesia was done (PCEA group. The analgesic effects, side effects, articular recovery and complications were compared between two groups. RESULTS: At 6 h and 12 h after surgery, the knee pain score (VAS score during functional tests after active exercise and after passive excise in CFNB were significantly reduced when compared with PCEA group. The amount of parecoxib used in CFNB patients was significantly reduced when compared with PCEA group. At 48 h after surgery, the muscle strength grade in CFNB group was significantly higher, and the time to ambulatory activity was shorter than those in PCEA group. The incidence of nausea and vomiting in CFNB patients was significantly reduced when compared with PCEA group. CONCLUSION: Ultrasound and nerve stimulator guided continuous femoral nerve block provide better analgesia at 6 h and 12 h, demonstrated by RVAS and PVAS. The amount of parecoxib also reduces, the incidence of nausea and vomiting decreased, the influence on muscle strength is compromised and patients can perform ambulatory activity under this condition.

  16. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  17. TX 2000: total reflection and 45o energy dispersive x-ray fluorescence spectrometer

    International Nuclear Information System (INIS)

    Pasti, F.; Torboli, A.; Valdes, M.

    2000-01-01

    This equipment, developed by Ital Structures, combines two kinds of energy dispersive X-ray fluorescence techniques, the first using total reflection geometry and the second conventional 45 o geometry. The equipment is completely controlled by a PC and to reach the condition of total reflection is very easy because it is enough to load the file with the right position for the corresponding energy. In this apparatus we used an x-ray tube with an alloy anode of Mo/W with a long fine focus at 2200 W. To monochromatize the x-ray beam while choosing, for example, the Mo K alpha or W L alpha or a piece of white spectrum of 33 keV, we use a highly reflective multilayer made of Si/W with 2d = 45.5 A o . The detector used in the equipment is a lithium drifted silicon detector (Si(Li)) with an excellent energy resolution of 135 eV at 5.9 keV and 1000 cps. We developed two programs written in Windows 95, 98 and NT for a 32 bit microprocessor. The first one is called TYACQ32 and has the following functions: first, complete control of the hardware, second automatic alignment of the TX 2000 spectrometer and third acquisition of spectra. The second program is EDXRF32. This is a program to accomplish spectrum and quantitative analysis for TXRF and EDXRF 45 o degrees analysis. (author)

  18. Total energy intake may be more associated with glycemic control compared to each proportion of macronutrients in the korean diabetic population.

    Science.gov (United States)

    Kang, Hye Mi; Kim, Dong-Jun

    2012-08-01

    Major macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans. A total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years) who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%). Dietary intake was assessed by using a 24-recall item questionnaire. High total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002). Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted. Total energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.

  19. Total Energy Intake May Be More Associated with Glycemic Control Compared to Each Proportion of Macronutrients in the Korean Diabetic Population

    Directory of Open Access Journals (Sweden)

    Hye Mi Kang

    2012-08-01

    Full Text Available BackgroundMajor macronutrients for energy intake vary among countries and cultures. Carbohydrates, including rice, are the major component of daily energy intake in Korea. The aim of this study was to examine the association of daily energy intake or each proportion of macronutrients, especially carbohydrates, with glycemic control in diabetic Koreans.MethodsA total of 334 individuals with diabetes (175 men, age 57.4±0.8 years; 159 women, age 60.9±0.9 years who participated in the 2005 Korean National Health and Nutrition Examination Survey were examined. Glycemic control was categorized based on concentration of glycated hemoglobin (HbA1c; HbA1c ≤6.5%; 6.6% to 8.0%; ≥8.1%. Dietary intake was assessed by using a 24-recall item questionnaire.ResultsHigh total energy intake was associated with poor glycemic control (HbA1c ≤6.5%, 1,824±75 kcal; 6.6% to 8.0%, 1,990±57 kcal; ≥8.1%, 2,144±73 kcal; P value for trend=0.002. Each proportion of protein, fat, or carbohydrate was not associated with glycemic control. Even after adjusting for several parameters, the association of daily energy intake with glycemic control still persisted.ConclusionTotal energy intake may be more closely related to glycemic control than each proportionof macronutrients in Korean diabetics.

  20. Japan Meteorological Agency/Meteorological Research Institute-Coupled Prediction System version 2 (JMA/MRI-CPS2): atmosphere-land-ocean-sea ice coupled prediction system for operational seasonal forecasting

    Science.gov (United States)

    Takaya, Yuhei; Hirahara, Shoji; Yasuda, Tamaki; Matsueda, Satoko; Toyoda, Takahiro; Fujii, Yosuke; Sugimoto, Hiroyuki; Matsukawa, Chihiro; Ishikawa, Ichiro; Mori, Hirotoshi; Nagasawa, Ryoji; Kubo, Yutaro; Adachi, Noriyuki; Yamanaka, Goro; Kuragano, Tsurane; Shimpo, Akihiko; Maeda, Shuhei; Ose, Tomoaki

    2018-02-01

    This paper describes the Japan Meteorological Agency/Meteorological Research Institute-Coupled Prediction System version 2 (JMA/MRI-CPS2), which was put into operation in June 2015 for the purpose of performing seasonal predictions. JMA/MRI-CPS2 has various upgrades from its predecessor, JMA/MRI-CPS1, including improved resolution and physics in its atmospheric and oceanic components, introduction of an interactive sea-ice model and realistic initialization of its land component. Verification of extensive re-forecasts covering a 30-year period (1981-2010) demonstrates that JMA/MRI-CPS2 possesses improved seasonal predictive skills for both atmospheric and oceanic interannual variability as well as key coupled variability such as the El Niño-Southern Oscillation (ENSO). For ENSO prediction, the new system better represents the forecast uncertainty and transition/duration of ENSO phases. Our analysis suggests that the enhanced predictive skills are attributable to incremental improvements resulting from all of the changes, as is apparent in the beneficial effects of sea-ice coupling and land initialization on 2-m temperature predictions. JMA/MRI-CPS2 is capable of reasonably representing the seasonal cycle and secular trends of sea ice. The sea-ice coupling remarkably enhances the predictive capability for the Arctic 2-m temperature, indicating the importance of this factor, particularly for seasonal predictions in the Arctic region.

  1. Local anesthetics after total knee arthroplasty: intraarticular or extraarticular administration? A randomized, double-blind, placebo-controlled study

    DEFF Research Database (Denmark)

    Andersen, L.O.; Kristensen, B.B.; Husted, H.

    2008-01-01

    evaluated. PATIENTS AND METHODS: 32 patients undergoing total knee replacement with high-volume (170 mL) 0.2% ropivacaine infiltration analgesia were randomized to receive injection of 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL saline in the extraarticular wound space 24 hours postoperatively...... or to receive 20 mL ropivacaine (0.2%) intraarticularly plus 30 mL ropivacaine (0.2%) in the extraarticular wound space 24 hours postoperatively. Pain intensity at rest and with mobilization was recorded for 4 hours after administration of additional local anesthetics. RESULTS: Intensity of pain at rest, during...

  2. High-volume infiltration analgesia in total knee arthroplasty: a randomized, double-blind, placebo-controlled trial

    DEFF Research Database (Denmark)

    Andersen, L.O.; Husted, H.; Otte, K.S.

    2008-01-01

    with a detailed description of the infiltration technique. METHODS: In a randomized, double-blind, placebo-controlled trial in 12 patients undergoing bilateral knee arthroplasty, saline or high-volume (170 ml) ropivacaine (0.2%) with epinephrine was infiltrated around each knee, with repeated doses administered...

  3. Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: A pilot randomized controlled trial

    NARCIS (Netherlands)

    Oosting, E.; Jans, M.P.; Dronkers, J.J.; Naber, R.H.; Dronkers-Landman, C.M.; Appelman-De Vries, S.M.; Meeteren, N.L. van

    2012-01-01

    Preoperative home-based physical therapy versus usual care to improve functional health of frail older adults scheduled for elective total hip arthroplasty: a pilot randomized controlled trial. Objective: To investigate the feasibility and preliminary effectiveness of a home-based intensive exercise

  4. Economic Impacts of Total Water Use Control in the Heihe River Basin in Northwestern China—An Integrated CGE-BEM Modeling Approach

    Directory of Open Access Journals (Sweden)

    Na Li

    2015-03-01

    Full Text Available This paper develops an integrated modeling approach combined with a top-down dynamic computable general equilibrium (CGE model and a bottom-up bio-economic model (BEM to study the economic impact of a total water use control policy in the Heihe river basin, northwestern China. The integrated CGE-BEM model is regionally disaggregated with a variety of crops and livestock, and includes the responses of farmers and consequent feedback effects in the regional economic system. The results show that under the total water use control scenario, the water use structure is changed and water use efficiency is improved. The total water use control policy has limited negative impact on the regional economic growth with only a slightly lower growth rate of 13.38% compared with a growth rate of 14% by 2020 under a business as usual water use scenario. However, the total water use control policy has significant negative impacts on several sectors, especially agriculture and food processing. It is expected cropping systems will change through a replacement of water-intensive crops with water-efficient crops. Farmers’ incomes will decrease by 3.14%. In order to alleviate farmers’ income loss and deal with water use conflicts across different sectors and regions, the promotion of migration of surplus labor from agriculture to non-agricultural sectors and the improvement of water use efficiency in agriculture are needed.

  5. Plasma total anti-oxidant capacity correlates inversely with the extent of acute appendicitis: a case control study

    Directory of Open Access Journals (Sweden)

    Devay Seda

    2006-03-01

    Full Text Available Abstract Background The role of free oxygen radicals in inflammatory conditions is well known. Free radicals cause lipid peroxidation of cellular membranes resulting in cell death. The purpose of this study was to investigate the levels of total anti-oxidant status (TAS, as a marker of anti-oxidant defense system and malondialdehyde (MDA, as a marker of oxidative stress, in the plasma of patients with acute appendicitis. Methods Fifty-one adult patients with a median age of 31 years who underwent operations with a preoperative diagnosis of acute appendicitis were included in this prospective study. Blood samples for C-reactive protein (CRP, MDA and TAS were collected preoperatively. Groups were compared by using the Mann-Whitney U test. Results There were 27 patients with acute phlagmenous appendicitis and 19 patients with advanced appendicitis (10 gangrenous and 9 perforated appendicitis, while 5 negative explorations were documented. No significant differences in WBC counts and MDA levels between groups were encountered. Plasma CRP was significantly higher in patients with perforated appendicitis, but not in the other groups. In advanced appendicitis group, TAS level was significantly lower than the other groups. On the other hand, plasma TAS level in acute phlagmenous appendicitis group was significantly higher. Conclusion A decrease in plasma total anti-oxidant capacity might be a predictor of the progression of inflammation to the perforation in acute appendicitis.

  6. Classical Example of Total Kinetic and Thermodynamic Control: The Diels-Alder Reaction between DMAD and Bis-furyl Dienes.

    Science.gov (United States)

    Borisova, Kseniya K; Kvyatkovskaya, Elizaveta A; Nikitina, Eugeniya V; Aysin, Rinat R; Novikov, Roman A; Zubkov, Fedor I

    2018-04-20

    A rare example of chemospecificity in the tandem Diels-Alder reaction of activated alkynes and bis-dienes has been revealed. The reaction between bis-furyl dienes and DMAD occurs at 25-80 °C and leads to kinetically controlled "pincer" adducts, 4a,8a-disubstituted 1,4:5,8-diepoxynaphthalenes. On the contrary, only thermodynamically controlled "domino" adducts (2,3-disubstituted 1,4:5,8-diepoxynaphthalenes) are formed in the same reaction at 140 °C. The "pincer" adducts can be transformed to the "domino" adducts at heating. The rate constants for reactions of both types were calculated using dynamic 1 H NMR spectroscopy.

  7. Knee joint biomechanics and neuromuscular control during gait before and after total knee arthroplasty are sex-specific.

    Science.gov (United States)

    Astephen Wilson, Janie L; Dunbar, Michael J; Hubley-Kozey, Cheryl L

    2015-01-01

    The future of total knee arthroplasty (TKA) surgery will involve planning that incorporates more patient-specific characteristics. Despite known biological, morphological, and functional differences between men and women, there has been little investigation into knee joint biomechanical and neuromuscular differences between men and women with osteoarthritis, and none that have examined sex-specific biomechanical and neuromuscular responses to TKA surgery. The objective of this study was to examine sex-associated differences in knee kinematics, kinetics and neuromuscular patterns during gait before and after TKA. Fifty-two patients with end-stage knee OA (28 women, 24 men) underwent gait and neuromuscular analysis within the week prior to and one year after surgery. A number of sex-specific differences were identified which suggest a different manifestation of end-stage knee OA between the sexes. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. The effect of tourniquet use on fixation quality in cemented total knee arthroplasty a prospective randomized clinical controlled RSA trial.

    Science.gov (United States)

    Molt, Mats; Harsten, Andreas; Toksvig-Larsen, Sören

    2014-03-01

    A concern that arises with any change in technique is whether it affects the long-term implant stability. The objective of this study was to evaluate the early migration, measured by radiostereometric analysis (RSA), and the functional outcome of the Triathlon™ cemented knee prosthesis, operated on with or without a tourniquet. During the last decades RSA has emerged as a way to assess prosthetic fixation and long time prognosis. The method has been used extensively in both hip and knee arthroplasty. This was a single centre prospective study including 60 patients randomized into two groups operated on either with or without tourniquet. RSA investigation was done within 2-3 days postoperatively after full weight bearing, and then at 3 months, 1 year and 2 years postoperatively. There were no differences between the groups regarding the translation along or rotation around the three coordinal axes, or in maximum total point motion (MTPM). At 2 years the mean MTPM (SD) was 0.71 mm (0.64) for the tourniquet-group and 0.53 mm (0.21) for the non-tourniquet-group. The tibial tray of the Triathlon™ cemented knee prosthesis showed similar early stability whether operated on with or without tourniquet. Level I. Article focus: A safety study for total knee replacement operated on with or without perioperative tourniquet regarding the prosthetic fixation. Strengths and limitations: Strength of this study is that it is a randomized prospective trial using an objective measuring tool. The sample size of 25-30 patients is reportedly sufficient for the screening of implants using RSA (1-3). Clinical trials NCT01604382, Ethics Committee approval D-nr: 144/20085. © 2013.

  9. Patient-specific guides do not improve accuracy in total knee arthroplasty: a prospective randomized controlled trial.

    Science.gov (United States)

    Victor, Jan; Dujardin, Jan; Vandenneucker, Hilde; Arnout, Nele; Bellemans, Johan

    2014-01-01

    Recently, patient-specific guides (PSGs) have been introduced, claiming a significant improvement in accuracy and reproducibility of component positioning in TKA. Despite intensive marketing by the manufacturers, this claim has not yet been confirmed in a controlled prospective trial. We (1) compared three-planar component alignment and overall coronal mechanical alignment between PSG and conventional instrumentation and (2) logged the need for applying changes in the suggested position of the PSG. In this randomized controlled trial, we enrolled 128 patients. In the PSG cohort, surgical navigation was used as an intraoperative control. When the suggested cut deviated more than 3° from target, the use of PSG was abandoned and marked as an outlier. When cranial-caudal position or size was adapted, the PSG was marked as modified. All patients underwent long-leg standing radiography and CT scan. Deviation of more than 3° from the target in any plane was defined as an outlier. The PSG and conventional cohorts showed similar numbers of outliers in overall coronal alignment (25% versus 28%; p = 0.69), femoral coronal alignment (7% versus 14%) (p = 0.24), and femoral axial alignment (23% versus 17%; p = 0.50). There were more outliers in tibial coronal (15% versus 3%; p = 0.03) and sagittal 21% versus 3%; p = 0.002) alignment in the PSG group than in the conventional group. PSGs were abandoned in 14 patients (22%) and modified in 18 (28%). PSGs do not improve accuracy in TKA and, in our experience, were somewhat impractical in that the procedure needed to be either modified or abandoned with some frequency.

  10. Ultrasound-guided genicular nerve block for pain control after total knee replacement: Preliminary case series and technical note.

    Science.gov (United States)

    González Sotelo, V; Maculé, F; Minguell, J; Bergé, R; Franco, C; Sala-Blanch, X

    2017-12-01

    Total knee arthroplasty (TKA) is an operation with moderate to severe postoperative pain. The Fast-Track models employ local infiltration techniques with anaesthetics at high volumes (100-150ml). We proposed a genicular nerve block with low volume of local anaesthetic. The aim of our study is to evaluate the periarticular distribution of these blocks in a fresh cadaver model and to describe the technique in a preliminary group of patients submitted to TKA. In the anatomical phase, 4 genicular nerves (superior medial, superior lateral, inferior medial and inferior lateral) were blocked with 4ml of local anaesthetic with iodinated contrast and methylene blue in each (16ml in total). It was performed on a fresh cadaver and the distribution of the injected medium was evaluated by means of a CT-scan and coronal anatomical sections on both knees. The clinical phase included 12 patients scheduled for TKA. Ultrasound-guided block of the 4 genicular nerves was performed preoperatively and their clinical efficacy evaluated by assessing pain after the reversal of the spinal block and at 12h after the block. Pain was measured using the numerical scale and the need for rescue analgesia was evaluated. A wide periarticular distribution of contrast was observed by CT-scan, which was later evaluated in the coronal sections. The distribution followed the joint capsule without entering the joint, both in the femur and in the tibia. The pain after the reversal of the subarachnoid block was 2±1, requiring rescue analgesia in 42% of the patients. At 12h, the pain according to the numerical scale was 4±1, 33% required rescue analgesia. The administration of 4ml of local anaesthetic at the level of the 4 genicular nerves of the knee produces a wide periarticular distribution. Our preliminary data in a series of 12 patients undergoing TKA seems to be clinically effective. Nevertheless, extensive case series and comparative studies with local infiltration techniques with anaesthetics are

  11. Knee strength retention and analgesia with continuous perineural fentanyl infusion after total knee replacement: randomized controlled trial.

    Science.gov (United States)

    Mangar, Devanand; Karlnoski, Rachel A; Sprenker, Collin J; Downes, Katheryne L; Taffe, Narrene; Wainwright, Robert; Gustke, Kenneth; Bernasek, Thomas L; Camporesi, Enrico

    2014-04-01

    Despite providing adequate pain relief, a femoral nerve block can induce postoperative muscle weakness after total knee arthoplasty (TKA). Fentanyl has been shown to have peripheral effects but has not been used as a perineural infusate alone after TKA. Sixty patients scheduled for TKA were randomized to one of three blinded groups: a continuous 24 h infusion of either fentanyl 3 μg/ml, ropivacaine 0.1%, or 0.9% normal saline through a femoral nerve sheath catheter at 10 ml/h. The main outcome was maximum voluntary isometric contraction (MVIC) in the quadriceps femoris (knee extension), measured by a handheld dynamometer (Nm/kg). Other variables assessed were preoperative and postoperative visual analog scale (VAS) scores, hamstrings MVIC (knee flexion), active range of motion of the operative knee, distance ambulated, incidence of knee buckling, supplemental morphine usage, postoperative side effects, and serum fentanyl levels. Quadriceps MVIC values were significantly greater in the fentanyl group compared to the group that received ropivacaine (median values, 0.08 vs. 0.03 Nm/kg; p = 0.028). The incidence of postoperative knee buckling upon ambulation was higher in the ropivacaine group compared to the fentanyl group, although not statistically significant (40% vs. 15 %, respectively; p = 0.077). VAS scores while ambulating were not significantly different between the fentanyl group and the ropivacaine group (p = 0.270). Postoperative morphine consumption, nausea and vomiting, and resting VAS scores were similar among the three groups. A continuous perineural infusion of fentanyl produced greater strength retention than ropivacaine post-TKA.

  12. Beyond total treatment effects in randomised controlled trials: Baseline measurement of intermediate outcomes needed to reduce confounding in mediation investigations.

    Science.gov (United States)

    Landau, Sabine; Emsley, Richard; Dunn, Graham

    2018-06-01

    Random allocation avoids confounding bias when estimating the average treatment effect. For continuous outcomes measured at post-treatment as well as prior to randomisation (baseline), analyses based on (A) post-treatment outcome alone, (B) change scores over the treatment phase or (C) conditioning on baseline values (analysis of covariance) provide unbiased estimators of the average treatment effect. The decision to include baseline values of the clinical outcome in the analysis is based on precision arguments, with analysis of covariance known to be most precise. Investigators increasingly carry out explanatory analyses to decompose total treatment effects into components that are mediated by an intermediate continuous outcome and a non-mediated part. Traditional mediation analysis might be performed based on (A) post-treatment values of the intermediate and clinical outcomes alone, (B) respective change scores or (C) conditioning on baseline measures of both intermediate and clinical outcomes. Using causal diagrams and Monte Carlo simulation, we investigated the performance of the three competing mediation approaches. We considered a data generating model that included three possible confounding processes involving baseline variables: The first two processes modelled baseline measures of the clinical variable or the intermediate variable as common causes of post-treatment measures of these two variables. The third process allowed the two baseline variables themselves to be correlated due to past common causes. We compared the analysis models implied by the competing mediation approaches with this data generating model to hypothesise likely biases in estimators, and tested these in a simulation study. We applied the methods to a randomised trial of pragmatic rehabilitation in patients with chronic fatigue syndrome, which examined the role of limiting activities as a mediator. Estimates of causal mediation effects derived by approach (A) will be biased if one of

  13. No difference in terms of radiostereometric analysis between fixed- and mobile-bearing total knee arthroplasty: a randomized, single-blind, controlled trial.

    Science.gov (United States)

    Schotanus, M G M; Pilot, P; Kaptein, B L; Draijer, W F; Tilman, P B J; Vos, R; Kort, N P

    2017-09-01

    A concern that arises with any new prosthesis is whether it will achieve satisfactory long-term implant stability. The gold standard of assessing the quality of fixation in a new or relatively new implant is to undertake a randomized controlled trial using radiostereometric analysis. It was hypothesized that both mobile-bearing total knee arthroplasty and fixed-bearing total knee arthroplasty have comparable migration patterns at 2-year follow-up. This study investigated two types of cemented total knee arthroplasty, the mobile- or fixed-bearing variant from the same family with use of radiostereometric analysis. This prospective, patient-blinded, randomized, controlled trial was designed to investigate early migration of the tibia component after two years of follow-up with use of radiostereometric analysis. A total of 50 patients were randomized to receive a mobile- or fixed-bearing TKA from the same family. Patients were evaluated during 2-year follow-up, including radiostereometric analysis, physical and clinical examination and patient reported outcome measures (PROMs). At two-year follow-up, the mean (±SD) maximum total point motion (MTPM) in the fixed-bearing group was 0.82 (±1.16) versus 0.92 mm (±0.64) in the mobile-bearing group (p = n.s) with the largest migration seen during the first 6 weeks (0.45 ± 0.32 vs. 0.54 ± 0.30). The clinical outcome and PROMs significantly improved within each group, not between both groups. Measuring early micromotion is useful for predicting clinical loosening that can lead to revision. The results of this study demonstrate that early migration of the mobile-bearing is similar to that of the fixed-bearing component at two years and was mainly seen in the first weeks after implantation. Randomized, single-blind, controlled trial, Level I.

  14. Combined versus single application of tranexamic acid in total knee and hip arthroplasty: A meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Peng Zhang, M M; Jifeng Li, M M; Xiao Wang, M M

    2017-07-01

    To compare the efficacy and safety of the combined application of both intravenous and topical tranexamic acid versus the single use of either application in patients with total knee and hip arthroplasty. Potentially relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect and the Cochrane Library. Patients undergoing primary total knee and hip arthroplasty were included in our studies, with an experimental group that received combined intravenous and topical application of tranexamic acid and a control group that received a single application of tranexamic acid or normal saline. The primary outcomes were total blood loss, hemoglobin decline and transfusion requirements. The secondary outcomes were length of stay, operation time and tranexamic acid-related adverse effects, such as superficial infection, deep vein thrombosis or pulmonary embolism. Modified Jadad scores were used to assess the quality of the included randomized controlled trials (RCTs). The data was pooled using RevMan 5.3. After testing for heterogeneity across studies, the data were aggregated using random-effects modeling when appropriate. We have registered the trial at http://www.researchregistry.com. Six RCTs that included 704 patients met the inclusion criteria. The present meta-analysis indicated significant differences existed in the total blood loss (MD = -134.65, 95% CI: -191.66 to -77.64, P tranexamic acid in total knee and hip arthroplasty was associated with significantly reduced total blood loss, postoperative hemoglobin decline, drainage volume, and transfusion requirements. Based on the limitations of current meta-analysis, well-designed, high-quality RCTs with long-term follow-up are still required. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  15. Reducción de costo total de inventario aplicando un modelo de control de inventario del tipo (s,S).

    OpenAIRE

    Matos Quispe, Cesar Anibal; Matos Quispe, Cesar Anibal; Matos Quispe, Cesar Anibal

    2012-01-01

    El presente informe de suficiencia propone un modelo de control de inventario para minimizar los costos totales de inventario, aplicando una política de inventario de tipo (s, S) que es un modelo de control de inventario de clase estocástica. Explica cómo se desarrolla el modelo mediante el uso de la simulación Monte Cario tanto para simular el modelo de inventario, así como también la metodología de optimización para obtener los valores de decisión. Para el modelo de simulación se conside...

  16. Exchanging a few commercial, regularly consumed food items with improved fat quality reduces total cholesterol and LDL-cholesterol: a double-blind, randomised controlled trial.

    Science.gov (United States)

    Ulven, Stine M; Leder, Lena; Elind, Elisabeth; Ottestad, Inger; Christensen, Jacob J; Telle-Hansen, Vibeke H; Skjetne, Anne J; Raael, Ellen; Sheikh, Navida A; Holck, Marianne; Torvik, Kristin; Lamglait, Amandine; Thyholt, Kari; Byfuglien, Marte G; Granlund, Linda; Andersen, Lene F; Holven, Kirsten B

    2016-10-01

    The healthy Nordic diet has been previously shown to have health beneficial effects among subjects at risk of CVD. However, the extent of food changes needed to achieve these effects is less explored. The aim of the present study was to investigate the effects of exchanging a few commercially available, regularly consumed key food items (e.g. spread on bread, fat for cooking, cheese, bread and cereals) with improved fat quality on total cholesterol, LDL-cholesterol and inflammatory markers in a double-blind randomised, controlled trial. In total, 115 moderately hypercholesterolaemic, non-statin-treated adults (25-70 years) were randomly assigned to an experimental diet group (Ex-diet group) or control diet group (C-diet group) for 8 weeks with commercially available food items with different fatty acid composition (replacing SFA with mostly n-6 PUFA). In the Ex-diet group, serum total cholesterol (PLDL-cholesterol (Pcholesterol and LDL-cholesterol, respectively. No difference in change in plasma levels of inflammatory markers (high-sensitive C-reactive protein, IL-6, soluble TNF receptor 1 and interferon-γ) was observed between the groups. In conclusion, exchanging a few regularly consumed food items with improved fat quality reduces total cholesterol, with no negative effect on levels of inflammatory markers. This shows that an exchange of a few commercially available food items was easy and manageable and led to clinically relevant cholesterol reduction, potentially affecting future CVD risk.

  17. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial.

    Science.gov (United States)

    Sierink, Joanne C; Treskes, Kaij; Edwards, Michael J R; Beuker, Benn J A; den Hartog, Dennis; Hohmann, Joachim; Dijkgraaf, Marcel G W; Luitse, Jan S K; Beenen, Ludo F M; Hollmann, Markus W; Goslings, J Carel

    2016-08-13

    Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in patients with trauma. We undertook an international, multicentre, randomised controlled trial at four hospitals in the Netherlands and one in Switzerland. Patients aged 18 years or older with trauma with compromised vital parameters, clinical suspicion of life-threatening injuries, or severe injury were randomly assigned (1:1) by ALEA randomisation to immediate total-body CT scanning or to a standard work-up with conventional imaging supplemented with selective CT scanning. Neither doctors nor patients were masked to treatment allocation. The primary endpoint was in-hospital mortality, analysed in the intention-to-treat population and in subgroups of patients with polytrauma and those with traumatic brain injury. The χ(2) test was used to assess differences in mortality. This trial is registered with ClinicalTrials.gov, number NCT01523626. Between April 22, 2011, and Jan 1, 2014, 5475 patients were assessed for eligibility, 1403 of whom were randomly assigned: 702 to immediate total-body CT scanning and 701 to the standard work-up. 541 patients in the immediate total-body CT scanning group and 542 in the standard work-up group were included in the primary analysis. In-hospital mortality did not differ between groups (total-body CT 86 [16%] of 541 vs standard work-up 85 [16%] of 542; p=0.92). In-hospital mortality also did not differ between groups in subgroup analyses in patients with polytrauma (total-body CT 81 [22%] of 362 vs standard work-up 82 [25%] of 331; p=0.46) and traumatic brain injury (68 [38%] of 178 vs 66 [44%] of 151; p=0.31). Three serious adverse events were reported in patients in the total-body CT group (1%), one in the standard work-up group (<1%), and

  18. Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: A case-controlled cohort study.

    Science.gov (United States)

    Howes, Benjamin H L; Watson, David I; Xu, Chris; Fosh, Beverley; Canepa, Maximiliano; Dean, Nicola R

    2016-09-01

    Patient-reported outcomes and quality of life following mastectomy are not well understood. This study evaluates the quality of life following surgery for breast cancer and compares outcomes following breast-conserving surgery versus total mastectomy with or without reconstruction. A case-controlled cross-sectional study was conducted using the validated BREAST-Q™ questionnaire and a study-specific questionnaire to determine patient's views about surgical outcomes. Questionnaires were completed by patients following breast-conserving surgery and total mastectomy with or without reconstruction and by controls without breast cancer. A one-way ANOVA was used to compare mean BREAST-Q™ scores between groups and post hoc analysis using Tukey's and Kruskal-Wallis tests. BREAST-Q™ questionnaires were completed by 400 women (123 controls, 97 breast conservations, 93 mastectomies without reconstruction, 87 mastectomies with reconstruction). Women who had undergone mastectomy and reconstruction had higher scores in satisfaction with breast and sexual well-being domains compared with women who had breast-conserving surgery, and women who had total mastectomy without reconstruction had the lowest scores in these two domains. There was no difference in psychosocial well-being between the groups. Women who had undergone breast-conserving surgery scored the lowest in the physical well-being chest domain and the majority reported breast asymmetry. Our study suggests that women who undergo total mastectomy and breast reconstruction for cancer achieve a quality-of-life outcome that is at least as good as that following breast-conserving surgery. Furthermore, breast conservation has been found to be associated with lower physical well-being (i.e., more pain and discomfort) in the chest area and poorer sexual well-being outcomes. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. All rights reserved.

  19. Robust fault detection of turbofan engines subject to adaptive controllers via a Total Measurable Fault Information Residual (ToMFIR) technique.

    Science.gov (United States)

    Chen, Wen; Chowdhury, Fahmida N; Djuric, Ana; Yeh, Chih-Ping

    2014-09-01

    This paper provides a new design of robust fault detection for turbofan engines with adaptive controllers. The critical issue is that the adaptive controllers can depress the faulty effects such that the actual system outputs remain the pre-specified values, making it difficult to detect faults/failures. To solve this problem, a Total Measurable Fault Information Residual (ToMFIR) technique with the aid of system transformation is adopted to detect faults in turbofan engines with adaptive controllers. This design is a ToMFIR-redundancy-based robust fault detection. The ToMFIR is first introduced and existing results are also summarized. The Detailed design process of the ToMFIRs is presented and a turbofan engine model is simulated to verify the effectiveness of the proposed ToMFIR-based fault-detection strategy. Copyright © 2013 ISA. Published by Elsevier Ltd. All rights reserved.

  20. Comparison of extended-release epidural morphine with femoral nerve block to patient-controlled epidural analgesia for postoperative pain control of total knee arthroplasty: a case-controlled study.

    Science.gov (United States)

    Sugar, Scott L; Hutson, Larry R; Shannon, Patrick; Thomas, Leslie C; Nossaman, Bobby D

    2011-01-01

    Because newer anticoagulation strategies for total knee replacement present potentially increased risk of neuraxial analgesia, there is movement away from using patient-controlled epidural analgesia (PCEA) for pain control. This concern opens the door for other regional modalities in postoperative analgesia, including the use of extended-release epidural morphine (EREM) combined with a femoral nerve block (FNB). This study was a prospective observational chart review with the use of recent historical controls in patients undergoing unilateral total knee replacement. Outcomes of interest were 0-, 24-, and 48-hour postoperative pain scores using the visual analog scale (VAS); incidence of side effects; and time spent in the postanesthesia care unit (PACU). Postoperative pain scores at 24 and 48 hours in the EREM and FNB group (n  =  14; 2.6 ± 0.6 and 5.0 ± 0.9, respectively) were comparable to the PCEA group (n  =  14; 3.8 ± 0.6 and 4.2 ± 0.9). The PACU time was shorter in the EREM and FNB group (2.4 ± 0.3 hours) compared with PCEA (3.6 ± 0.3 hours, P  =  .02). No statistically significant difference was found in the incidence of side effects between the 2 groups. The VAS scores at 24 and 48 hours indicate that EREM and FNB provide comparable analgesia to PCEA. The trend toward shorter PACU times represents an opportunity for cost-identification analysis. The study data are limited by their observational nature and the small number of patients involved; nevertheless, this study demonstrates a therapeutic equivalence to PCEA that may be more cost effective.

  1. A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR).

    Science.gov (United States)

    Jepson, Paul; Sands, Gina; Beswick, Andrew D; Davis, Edward T; Blom, Ashley W; Sackley, Catherine M

    2016-02-01

    To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement. Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery. Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK. Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre. The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual. The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks. Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use. The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial. © The Author(s) 2015.

  2. Aspect ratio control of Au nanorods via covariation of the total amount of HAuCl{sub 4} and ascorbic acid

    Energy Technology Data Exchange (ETDEWEB)

    Ma, Xiao [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China); Wang, Moo-Chin, E-mail: mcwang@kmu.edu.tw [Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 80708, Taiwan (China); Feng, Jinyang [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China); Zhao, Xiujian, E-mail: opluse@whut.edu.cn [State Key Laboratory of Silicate Materials for Architectures, Wuhan University of Technology, 122 Luoshi Road, Hongshan District, Wuhan 430070, Hubei (China)

    2015-07-15

    Highlights: • The AR value decreased as the total amount of [HAuCl{sub 4}] and [AA] increasing. • The UV–vis absorption spectra showed the peak wavelength of TSPR at around 530 nm. • The wavelength of LSPR had a red-shifted effect. - Abstract: Controlling the aspect ratio (AR) of gold nanorods (GNRs) via covariation of the total concentrations of HAuCl{sub 4} ([HAuCl{sub 4}]) and ascorbic acid ([AA]) has been studied. Characteristics of GNRs were examined by transmission electron microscopy (TEM) and ultraviolet–visible (UV–vis) absorption spectrophotometry. TEM results showed that single crystalline GNRs grew along an elongated growth direction of [100]. TEM results also revealed that the quantity of plate shaped and nearly spherical nanoparticles increased as the total amount of [HAuCl{sub 4}] and [AA] decreased. The AR value measured from TEM images decreased from 4.74 to 2.41 as the total amount of [HAuCl{sub 4}] and [AA] was increased from 0.305 to 2.44 mM. The UV–vis absorption spectra of all samples showed that the wavelength of transverse surface plasmon resonance (TSPR) peak appeared at around 530 nm for all samples. The wavelength of longitudinal surface plasmon resonance (LSPR) peak increased from 640 to 894 nm as the total amount of [HAuCl{sub 4}] and [AA] decreased from 2.44 to 0.305 mM. The wavelength of LSPR peak shows a red-shifted effect except when the total amount of [HAuCl{sub 4}] and [AA] was 0.122 mM.

  3. Early self-managed focal sensorimotor rehabilitative training enhances functional mobility and sensorimotor function in patients following total knee replacement: a controlled clinical trial.

    Science.gov (United States)

    Moutzouri, Maria; Gleeson, Nigel; Coutts, Fiona; Tsepis, Elias; John, Gliatis

    2018-02-01

    To assess the effects of early self-managed focal sensorimotor training compared to functional exercise training after total knee replacement on functional mobility and sensorimotor function. A single-blind controlled clinical trial. University Hospital of Rion, Greece. A total of 52 participants following total knee replacement. The primary outcome was the Timed Up and Go Test and the secondary outcomes were balance, joint position error, the Knee Outcome Survey Activities of Daily Living Scale, and pain. Patients were assessed on three separate occasions (presurgery, 8 weeks post surgery, and 14 weeks post surgery). Participants were randomized to either focal sensorimotor exercise training (experimental group) or functional exercise training (control group). Both groups received a 12-week home-based programme prescribed for 3-5 sessions/week (35-45 minutes). Consistently greater improvements ( F 2,98  = 4.3 to 24.8; P effect size range of 1.3-6.5. Overall, the magnitude of improvements in functional mobility and sensorimotor function endorses using focal sensorimotor training as an effective mode of rehabilitation following knee replacement.

  4. Comparison of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled and prospective cohort trials.

    Science.gov (United States)

    Wang, Hao; Shen, Bin; Zeng, Yi

    2014-12-01

    There has been much debate and controversy about the optimal regimen of tranexamic acid in primary total knee arthroplasty. The purpose of this study was to undertake a meta-analysis to compare the efficacy of topical and intravenous regimen of tranexamic acid in primary total knee arthroplasty. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized controlled trials and prospective cohort studies evaluating the effectiveness of topical and intravenous tranexamic acid during primary total knee arthroplasty were included. The focus of the analysis was on the outcomes of blood loss, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 328 papers identified, six trials were eligible for data extraction and meta-analysis comprising 679 patients (739 knees). We found no statistically significant difference between topical and intravenous administration of tranexamic acid in terms of blood loss, transfusion requirements and thromboembolic complications. Topical tranexamic acid has a similar efficacy to intravenous tranexamic acid in reducing both blood loss and transfusion rate without sacrificing safety in primary total knee arthroplasty. II. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Supervisory control synthesis for a waterway lock

    NARCIS (Netherlands)

    Reijnen, F.F.H.; Goorden, M.A.; van de Mortel - Fronczak, J.M.; Rooda, J.E.

    2017-01-01

    Formal methods help in coping with the growing functionality and complexity, time-to-market and costs in cyber-physical systems (CPSs). Supervisory control synthesis (SCS) is such a method. It can be used to synthesize a controller for a CPS from the uncontrolled system model (plant) and the

  6. Continuous Femoral Nerve Block versus Intravenous Patient Controlled Analgesia for Knee Mobility and Long-Term Pain in Patients Receiving Total Knee Replacement: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Lihua Peng

    2014-01-01

    Full Text Available Objectives. To evaluate the comparative analgesia effectiveness and safety of postoperative continuous femoral nerve block (CFNB with patient controlled intravenous analgesia (PCIA and their impact on knee function and chronic postoperative pain. Methods. Participants were randomly allocated to receive postoperative continuous femoral nerve block (group CFNB or intravenous patient controlled analgesia (group PCIA. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores for knee and incidence of chronic postoperative pain at 3, 6, and 12 months postoperatively were compared. postoperative pain and salvage medication at rest or during mobilization 24 hours, 48 hours, and 7 days postoperatively were also recorded. Results. After discharge from the hospital and rehabilitation of joint function, patients in group CFNB reported significantly improved knee flexion and less incidence of chronic postoperative pain at 3 months and 6 months postoperatively (P<0.05. Analgesic rescue medications were significantly reduced in patients receiving CFNB (P<0.001 and P=0.031, resp.. Conclusion. With standardized rehabilitation therapy, continuous femoral nerve block analgesia reduced the incidence of chronic postoperative pain, improved motility of replaced joints, and reduced the dosages of rescue analgesic medications, suggesting a recovery-enhancing effect of peripheral nerve block analgesia.

  7. Major and minor arsenic compounds accounting for the total urinary excretion of arsenic following intake of blue mussels (Mytilus edulis): A controlled human study

    DEFF Research Database (Denmark)

    Molin, M.; Ydersbond, T.A.; Ulven, S.M.

    2012-01-01

    Blue mussels (Mytilus edulis) accumulate and biotransform arsenic (As) to a larger variety of arsenicals than most seafood. Eight volunteers ingested a test meal consisting of 150g blue mussel (680μg As), followed by 72h with an identical, low As controlled diet and full urine sampling. We provide...... a complete speciation, with individual patterns, of urinary As excretion. Total As (tAs) urinary excretion was 328±47μg, whereof arsenobetaine (AB) and dimethylarsinate (DMA) accounted for 66% and 21%, respectively. Fifteen minor urinary arsenicals were quantified with inductively coupled plasma mass...... spectrometry (ICPMS) coupled to reverse-phase, anion and cation-exchange high performance liquid chromatography (HPLC). Thio-arsenicals and non-thio minor arsenicals (including inorganic As (iAs) and methylarsonate (MA)) contributed 10% and 7% of the total sum of species excretion, respectively, but there were...

  8. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  9. Do state minimum markup/price laws work? Evidence from retail scanner data and TUS-CPS.

    Science.gov (United States)

    Huang, Jidong; Chriqui, Jamie F; DeLong, Hillary; Mirza, Maryam; Diaz, Megan C; Chaloupka, Frank J

    2016-10-01

    Minimum markup/price laws (MPLs) have been proposed as an alternative non-tax pricing strategy to reduce tobacco use and access. However, the empirical evidence on the effectiveness of MPLs in increasing cigarette prices is very limited. This study aims to fill this critical gap by examining the association between MPLs and cigarette prices. State MPLs were compiled from primary legal research databases and were linked to cigarette prices constructed from the Nielsen retail scanner data and the self-reported cigarette prices from the Tobacco Use Supplement to the Current Population Survey. Multivariate regression analyses were conducted to examine the association between MPLs and the major components of MPLs and cigarette prices. The presence of MPLs was associated with higher cigarette prices. In addition, cigarette prices were higher, above and beyond the higher prices resulting from MPLs, in states that prohibit below-cost combination sales; do not allow any distributing party to use trade discounts to reduce the base cost of cigarettes; prohibit distributing parties from meeting the price of a competitor, and prohibit distributing below-cost coupons to the consumer. Moreover, states that had total markup rates >24% were associated with significantly higher cigarette prices. MPLs are an effective way to increase cigarette prices. The impact of MPLs can be further strengthened by imposing greater markup rates and by prohibiting coupon distribution, competitor price matching, and use of below-cost combination sales and trade discounts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Body composition of adult cystic fibrosis patients and control subjects as determined by densitometry, bioelectrical impedance, total-body electrical conductivity, skinfold measurements, and deuterium oxide dilution

    International Nuclear Information System (INIS)

    Newby, M.J.; Keim, N.L.; Brown, D.L.

    1990-01-01

    This study contrasts body compositions (by six methods) of eight cystic fibrosis (CF) subjects with those of eight control subjects matched for age, height, and sex. CF subjects weighed 84% as much as control subjects. Densitometry and two bioelectrical impedance-analysis methods suggested that reduced CF weights were due to less lean tissue (10.7, 9.5, and 10.4 kg). Total-body electrical conductivity (TOBEC) and skinfold-thickness measurements indicated that CF subjects were leaner than control subjects and had less fat (5.4 and 3.6 kg) and less lean (5.2 and 7 kg) tissue. D2O dilution showed a pattern similar to TOBEC (8.3 kg less lean, 2.7 kg less fat tissue). Densitometry estimates of fat (mass and percent) were not correlated (r less than 0.74, p greater than 0.05) with any other method for CF subjects but were correlated with all other methods for control subjects. CF subjects contained less fat and lean tissue than did control subjects. Densitometry by underwater weighing is unsuitable for assessing body composition of CF patients

  11. Transcutaneous Electrical Nerve Stimulation (TENS) for the Control of Pain during Rehabilitation Following Total Knee Arthroplasty (TKA): A Randomized, Blinded, Placebo-Controlled Trial

    Science.gov (United States)

    Rakel, Barbara; Zimmerman, M. Bridget; Geasland, Katharine; Embree, Jennie; Clark, Charles R; Noiseux, Nicolas O; Callaghan, John J; Herr, Keela; Walsh, Deirdre; Sluka, Kathleen A

    2014-01-01

    This study evaluated the efficacy of TENS in reducing pain and hyperalgesia and increasing function following total knee arthroplasty (TKA). We hypothesized participants using TENS during rehabilitation exercises would: 1) report significantly lower pain during range-of-motion (ROM) and fast walking but not at rest; 2) have less hyperalgesia; and, 3) have better function than participants receiving Placebo-TENS or Standard Care. We also hypothesized that change in ROM pain would differ based on psychological characteristics (trait anxiety, pain catastrophizing and depression) and treatment group. This prospective, randomized study used intent-to-treat analyses on 317 subjects after primary, unilateral TKA. Assessors, blinded to treatment allocation, measured pain, function (ROM and gait speed), and hyperalgesia (quantitative sensory tests) postoperatively and 6 weeks after surgery. Analgesic intake, anxiety, depression, and pain catastrophizing were also assessed. TENS participants used it 1–2 times/day at 42 mA (on average) and had less pain postoperatively during active knee extension (p=0.019) and fast walking (p=0.006) than Standard Care participants. TENS and Placebo-TENS were not significantly different. TENS participants who scored low on anxiety and pain catastrophizing had a greater reduction in ROM pain at 6 weeks than those scoring high on these factors (p=0.002 and 0.03). Both TENS and Placebo-TENS participants had less postoperative mechanical hyperalgesia (p=0.03 – 0.01) than Standard Care participants. Supplementing pharmacologic analgesia with TENS during rehabilitation exercises reduces movement pain postoperatively but a placebo influence exists and the effect is gone by 6 weeks. Patients with low anxiety and pain catastrophizing may benefit most from TENS. PMID:25270585

  12. Comparison of group-based outpatient physiotherapy with usual care after total knee replacement: a feasibility study for a randomized controlled trial.

    Science.gov (United States)

    Artz, Neil; Dixon, Samantha; Wylde, Vikki; Marques, Elsa; Beswick, Andrew D; Lenguerrand, Erik; Blom, Ashley W; Gooberman-Hill, Rachael

    2017-04-01

    To evaluate the feasibility of conducting a randomized controlled trial comparing group-based outpatient physiotherapy with usual care in patients following total knee replacement. A feasibility study for a randomized controlled trial. One secondary-care hospital orthopaedic centre, Bristol, UK. A total of 46 participants undergoing primary total knee replacement. The intervention group were offered six group-based exercise sessions after surgery. The usual care group received standard postoperative care. Participants were not blinded to group allocation. Feasibility was assessed by recruitment, reasons for non-participation, attendance, and completion rates of study questionnaires that included the Lower Extremity Functional Scale and Knee Injury and Osteoarthritis Outcome Score. Recruitment rate was 37%. Five patients withdrew or were no longer eligible to participate. Intervention attendance was high (73%) and 84% of group participants reported they were 'very satisfied' with the exercises. Return of study questionnaires at six months was lower in the usual care (75%) than in the intervention group (100%). Mean (standard deviation) Lower Extremity Functional Scale scores at six months were 45.0 (20.8) in the usual care and 57.8 (15.2) in the intervention groups. Recruitment and retention of participants in this feasibility study was good. Group-based physiotherapy was acceptable to participants. Questionnaire return rates were lower in the usual care group, but might be enhanced by telephone follow-up. The Lower Extremity Functional Scale had high responsiveness and completion rates. Using this outcome measure, 256 participants would be required in a full-scale randomized controlled trial.

  13. A randomised, controlled trial of circumpatellar electrocautery in total knee replacement without patellar resurfacing: a concise follow-up at a mean of 3.7 years.

    Science.gov (United States)

    van Jonbergen, H P W; Scholtes, V A B; Poolman, R W

    2014-04-01

    In the absence of patellar resurfacing, we have previously shown that the use of electrocautery around the margin of the patella improved the one-year clinical outcome of total knee replacement (TKR). In this prospective randomised study we compared the mean 3.7 year (1.1 to 4.2) clinical outcomes of 300 TKRs performed with and without electrocautery of the patellar rim: this is an update of a previous report. The overall prevalence of anterior knee pain was 32% (95% confidence intervals [CI] 26 to 39), and 26% (95% CI 18 to 35) in the intervention group compared with 38% (95% CI 29 to 48) in the control group (chi-squared test; p = 0.06). The overall prevalence of anterior knee pain remained unchanged between the one-year and 3.7 year follow-up (chi-squared test; p = 0.12). The mean total Western Ontario McMasters Universities Osteoarthritis Indices and the American Knee Society knee and function scores at 3.7 years' follow-up were similar in the intervention and control groups (repeated measures analysis of variance p = 0.43, p = 0.09 and p = 0.59, respectively). There were no complications. A total of ten patients (intervention group three, control group seven) required secondary patellar resurfacing after the first year. Our study suggests that the improved clinical outcome with electrocautery denervation compared with no electrocautery is not maintained at a mean of 3.7 years' follow-up.

  14. Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty: a prospective randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    van den Akker-Scheek Inge

    2009-09-01

    Full Text Available Abstract Background Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL and those in which the ligament is routinely sacrificed (posterior stabilized. In patients with a functional PCL the decision which design is chosen depends largely on the favour and training of the surgeon. The objective of this study is to determine whether the patient's perceived outcome and speed of recovery differs between a posterior cruciate retaining total knee arthroplasty and a posterior stabilized total knee arthroplasty. Methods/Design A randomized controlled trial will be conducted. Patients who are admitted for primary unilateral TKA due to primary osteoarthrosis are included when the following inclusion criteria are met: non-fixed fixed varus or valgus deformity less than 10 degrees, age between 55 and 85 years, body mass index less than 35 kg/m2 and ASA score (American Society of Anaesthesiologists I or II. Patients are randomized in 2 groups. Patients in the posterior cruciate retaining group will receive a prosthesis with a posterior cut-out for the posterior cruciate ligament and relatively flat topography. In patients allocated to the posterior stabilized group, in which the posterior cruciate ligament is excised, the design may substitute for this function by an intercondylar tibial prominence that articulates with the femur in flexion. Measurements will take place preoperatively and 6 weeks, 3 months, 6 months and 1 year postoperatively. At all measurement points patient's perceived outcome will be assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Secondary outcome measures are quality of life (SF-36 and physician reported functional status and range of motion as determined with the Knee Society Clinical Rating System (KSS. Discussion In the current practice both posterior cruciate retaining and posterior stabilized designs

  15. Synergistic effects of intravenous and intra-articular tranexamic acid on reducing hemoglobin loss in revision total knee arthroplasty: a prospective, randomized, controlled study.

    Science.gov (United States)

    Yuan, Xiangwei; Wang, Jiaxing; Wang, Qiaojie; Zhang, Xianlong

    2018-04-01

    Tranexamic acid decreases blood loss in primary total knee arthroplasty, and no related prospective randomized clinical trials have been conducted to evaluate the effectiveness and safety of tranexamic acid in revision total knee arthroplasty. Thus, we conducted this work to evaluate the synergistic effects of intravenous plus intra-articular tranexamic acid on reducing hemoglobin loss compared with intra-articular tranexamic acid alone in revision total knee arthroplasty. This prospective, controlled study randomized 96 patients undergoing revision total knee arthroplasty into two groups: an intravenous plus intra-articular tranexamic acid group (48 patients who received 20 mg/kg intravenous tranexamic acid and 3.0 g intra-articular tranexamic acid); and an intra-articular tranexamic acid alone group (48 patients who received the same intravenous volume of normal saline and 3.0 g intra-articular tranexamic acid). The primary outcome was hemoglobin loss. Secondary outcomes included the volume of drain output, the percentage of patients who received transfusions, the number of units transfused, and thromboembolic events. The baseline data, preoperative hemoglobin, and tourniquet time were similar in both groups. There was significantly less hemoglobin loss in the intravenous plus intra-articular tranexamic acid group compared with the intra-articular tranexamic acid alone group (2.7 ± 0.6 g/dL and 3.7 ± 0.7 g/dL; p tranexamic acid alone group, the intravenous plus intra-articular tranexamic acid group also had significantly less drain output, fewer patients who received transfusions, and fewer units transfused (all p tranexamic acid alone, combined intravenous plus intra-articular tranexamic acid significantly reduced hemoglobin loss and the need for transfusion without an apparent increase in thromboembolic events in patients who underwent revision total knee arthroplasty. © 2018 AABB.

  16. Total Effective Xenoestrogen Burden in Serum Samples and Risk for Breast Cancer in a Population-Based Multicase–Control Study in Spain

    Science.gov (United States)

    Pastor-Barriuso, Roberto; Fernández, Mariana F.; Castaño-Vinyals, Gemma; Whelan, Denis; Pérez-Gómez, Beatriz; Llorca, Javier; Villanueva, Cristina M.; Guevara, Marcela; Molina-Molina, José-Manuel; Artacho-Cordón, Francisco; Barriuso-Lapresa, Laura; Tusquets, Ignasi; Dierssen-Sotos, Trinidad; Aragonés, Nuria; Olea, Nicolás; Kogevinas, Manolis; Pollán, Marina

    2016-01-01

    Background: Most studies on endocrine-disrupting chemicals and breast cancer have focused on single compounds and have produced inconclusive findings. Objectives: We assessed the combined estrogenic effects of mixtures of xenoestrogens in serum and their relationship to breast cancer risk. Methods: A total of 186 incident pretreatment breast cancer cases and 196 frequency-matched controls were randomly sampled from a large population-based multicase–control study in Spain. The total effective xenoestrogen burden attributable to organohalogenated xenoestrogens (TEXB-α) and endogenous hormones and more polar xenoestrogens (TEXB-β) was determined in serum samples using high-performance liquid chromatography and E-Screen bioassay. Odds ratios for breast cancer comparing tertiles of serum TEXB-α and TEXB-β were estimated using logistic models, and smooth risk trends were obtained using spline models. Results: Cases had higher geometric mean TEXB-α and TEXB-β levels (8.32 and 9.94 Eeq pM/mL, respectively) than controls (2.99 and 5.96 Eeq pM/mL, respectively). The fully adjusted odds ratios for breast cancer (95% confidence intervals) comparing the second and third tertiles of TEXB-α with the first tertile were 1.77 (0.76, 4.10) and 3.45 (1.50, 7.97), respectively, and those for TEXB-β were 2.35 (1.10, 5.03) and 4.01 (1.88, 8.56), respectively. A steady increase in risk was evident across all detected TEXB-α levels and a sigmoidal trend was observed for TEXB-β. Individual xenoestrogens showed weak and opposing associations with breast cancer risk. Conclusions: This is the first study to show a strong positive association between serum total xenoestrogen burden and breast cancer risk, highlighting the importance of evaluating xenoestrogen mixtures, rather than single compounds, when studying hormone-related cancers. Citation: Pastor-Barriuso R, Fernández MF, Castaño-Vinyals G, Whelan D, Pérez-Gómez B, Llorca J, Villanueva CM, Guevara M, Molina-Molina JM

  17. Data set on the effects of conifer control and slash burning on soil carbon, total N, organic matter and extractable micro-nutrients

    Directory of Open Access Journals (Sweden)

    Jonathan D. Bates

    2017-10-01

    Full Text Available Conifer control in sagebrush steppe of the western United States causes various levels of site disturbance influencing vegetation recovery and resource availability. The data set presented in this article include growing season availability of soil micronutrients and levels of total soil carbon, organic matter, and N spanning a six year period following western juniper (Juniperus occidentalis spp. occidentalis reduction by mechanical cutting and prescribed fire of western juniper woodlands in southeast Oregon. These data can be useful to further evaluate the impacts of conifer woodland reduction to soil resources in sagebrush steppe plant communities.

  18. Short-term hypertension management in community is associated with long-term risk of stroke and total death in China: A community controlled trial.

    Science.gov (United States)

    Wang, Zengwu; Hao, Guang; Wang, Xin; Wang, Wen; Chen, Weiwei; Zhu, Manlu

    2016-11-01

    It is not fully clear whether the effect of short-term management in community can reduce the long-term risk of stroke OBJECTIVES:: To evaluate whether short-term hypertension management is associated with long-term incidence of stroke and total death in community health centers in China. Community controlled trail. Six community health centers (4 active, 2 control) in China, patients with hypertension. Patients were treated with normally therapy method. Patients were treated oriented by the Guideline for hypertension management. Two centers (Hebei and Zhejiang) from the Hypertension Control in Community (HCC) Project, which was conducted from 2005 to 2008, were randomly selected for this study. Four thousand hypertensive patients from these centers, who were under management for one year in the baseline, were followed up in 2013. The electronic health record system (2005-2008) was used to identify 2000 hypertensive patients, who were not included in HCC but lived in comparable community health center in the same province, as the control group. All baseline and follow-up data were collected using standardized questionnaires for stroke outcomes. Stroke. Of the 6000 participants, 3787 (63.1%) were eligible for analysis. At the time of follow-up, the average BP was kept in the lower level than that in baseline, and the control rate was 59.3%. After propensity-score matching, 110 strokes (2.0% vs 4.6%) and 141 deaths (1.4% vs 3.8%) were noted in the matched intervention and control groups (1078 pairs), respectively. Patients in the intervention group were less likely to experience a stroke or die than those in the control group (hazard ratio [HR] = 0.40, 95% confidence interval [CI]: 0.26-0.62, P stroke in hypertensive patients.

  19. The Impact of Survey and Response Modes on Current Smoking Prevalence Estimates Using TUS-CPS: 1992-2003

    Directory of Open Access Journals (Sweden)

    Julia Soulakova

    2009-12-01

    Full Text Available This study identified whether survey administration mode (telephone or in-person and respondent type (self or proxy result in discrepant prevalence of current smoking in the adult U.S. population, while controlling for key sociodemographic characteristics and longitudinal changes of smoking prevalence over the 11-year period from 1992-2003. We used a multiple logistic regression analysis with replicate weights to model the current smoking status logit as a function of a number of covariates. The final model included individual- and family-level sociodemographic characteristics, survey attributes, and multiple two-way interactions of survey mode and respondent type with other covariates. The respondent type is a significant predictor of current smoking prevalence and the magnitude of the difference depends on the age, sex, and education of the person whose smoking status is being reported. Furthermore, the survey mode has significant interactions with survey year, sex, and age. We conclude that using an overall unadjusted estimate of the current smoking prevalence may result in underestimating the current smoking rate when conducting proxy or telephone interviews especially for some sub-populations, such as young adults. We propose that estimates could be improved if more detailed information regarding the respondent type and survey administration mode characteristics were considered in addition to commonly used survey year and sociodemographic characteristics. This information is critical given that future surveillance is moving toward more complex designs. Thus, adjustment of estimates should be contemplated when comparing current smoking prevalence results within a given survey series with major changes in methodology over time and between different surveys using various modes and respondent types.

  20. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls

    DEFF Research Database (Denmark)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind

    2017-01-01

    deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. CONCLUSION: The use of a bipolar sealer in a TKA revision setting without......BACKGROUND: Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim......-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. RESULTS: No significant differences were found neither for calculated blood loss, with 1397 (standard...

  1. Does a thrombin-based topical haemostatic agent reduce blood loss and transfusion requirements after total knee revision surgery? A randomized, controlled trial.

    Science.gov (United States)

    Romanò, Carlo L; Monti, Lorenzo; Logoluso, Nicola; Romanò, Delia; Drago, Lorenzo

    2015-11-01

    The aim of the present study was to assess the efficacy of a thrombin-based topical haemostatic in reducing blood requirements after total knee replacement (TKR) revision surgery. This prospective, randomized, controlled study was designed to evaluate the haemostatic efficacy and safety of a thrombin-based topical haemostatic (Floseal) versus standard treatment in patients receiving total knee revision arthroplasty. The decrease in haemoglobin values postsurgery and the blood units transfused were recorded. The decision to transfuse was made by a surgeon blinded to the patient's group allocation. Forty-eight patients were enroled in the study; twenty-four patients each were randomized to the treatment and control groups, respectively. The median decrease in haemoglobin concentration on the first postoperative day was 2.2 g/dL in the treatment group and 2.7 g/dL in the control group. A significant reduction in units of blood transfused was also observed in the treatment group compared with the control group [1.1 ± 1.13 (range 0-4) vs. 1.9 ± 1.41 (range 0-5) blood units; P = 0.04]. No major treatment-related adverse events were recorded in the study. This study shows that a thrombin-based topical haemostatic reduces the need for blood transfusion in TKR revision surgery. A thrombin-based topical haemostatic agent can be an appropriate solution to enhance haemostasis and vessel sealing at the operative site in TKR revision surgery, in order to reduce the need for blood transfusion after surgery. II.

  2. Comparative evaluation of serum and salivary immunoglobulin G and A levels with total serum protein in oral submucous fibrosis patients: A case control study

    Directory of Open Access Journals (Sweden)

    M Kandasamy

    2016-01-01

    Full Text Available Aim and Objective: The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA levels in various stages of oral submucous fibrosis (OSMF patients and relate it to total serum protein (TSP and hemoglobin (Hb levels. Materials and Methods: The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. Results: Serum and salivary IgA and IgG levels were statistically significantly increased (P < 0.001 in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased (P < 0.01 in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased (P < 0.001 in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t -test were used for statistical analysis. Conclusion: The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.

  3. Comparative evaluation of serum and salivary immunoglobulin G and A levels with total serum protein in oral submucous fibrosis patients: A case control study.

    Science.gov (United States)

    Kandasamy, M; Jaisanghar, N; Austin, Ravi David; Srivastava, Kumar Chandan; Anusuya, G Sai; Anisa, N

    2016-10-01

    The objective of this study is to estimate and compare the serum and salivary immunoglobulin G and A (IgG, IgA) levels in various stages of oral submucous fibrosis (OSMF) patients and relate it to total serum protein (TSP) and hemoglobin (Hb) levels. The sample for the present study comprised a total of 20 healthy controls, 20 OSMF patients. About 5 ml of blood and 2 ml of saliva were collected. Quantitative analysis of serum and salivary IgG, IgA was done by turbidometric immunoassay. TSP and Hb were estimated by Biuret and cyanmethemoglobin methods, respectively. Serum and salivary IgA and IgG levels were statistically significantly increased ( P < 0.001) in OSMF patients when compared to controls. Also serum and salivary IgG and IgA levels showed significantly increased ( P < 0.01) in all the three staging of OSMF when compared to control group. Hb levels and TSP levels were significantly decreased ( P < 0.001) in OSMF patients when compared to controls. One-way ANOVA, Pearson's correlation, and unpaired t -test were used for statistical analysis. The elevated levels of IgG and IgA are also in favor of polygammapathy, which are nonspecific and nondiagnostic objective reflections of an underlying disease. Decreased TSP is a result of host response and Hb, acts as an indicator of nutritional status plays an important role. It is also observed from the present study that the severity of OSMF was directly proportional to the estimated elevated levels of the major IgG and IgA. A need is also felt for the knowledge of immunoprofile estimation in etiology and pathogenesis that would prove a great asset in the proper assessment of this condition.

  4. N-Acetylcysteine Supplementation Controls Total Antioxidant Capacity, Creatine Kinase, Lactate, and Tumor Necrotic Factor-Alpha against Oxidative Stress Induced by Graded Exercise in Sedentary Men

    Directory of Open Access Journals (Sweden)

    Donrawee Leelarungrayub

    2011-01-01

    Full Text Available Aim of this study was to evaluate the effects of short-term (7 days N-acetylcysteine (NAC at 1,200 mg daily supplementation on muscle fatigue, maximal oxygen uptake (VO2max, total antioxidant capacity (TAC, lactate, creatine kinase (CK, and tumor necrotic factor-alpha (TNF-α. Twenty-nine sedentary men (13 controls; 16 in the supplement group from a randomized control were included. At before and after supplementation, fatigue index (FI was evaluated in the quadriceps muscle, and performed a graded exercise treadmill test to induce oxidative stress, and as a measure of VO2max. Blood samples were taken before exercise and 20 minutes after it at before and after supplementation, to determine TAC, CK, lactate, and TNF-α levels. Results showed that FI and VO2max increased significantly in the supplement group. After exercise decreased the levels of TAC and increased lactate, CK, and TNF-α of both groups at before supplementation. After supplementation, lactate, CK, and TNF-α levels significantly increased and TAC decreased after exercise in the control group. Whereas the TAC and lactate levels did not change significantly, but CK and TNF-α increased significantly in the supplement group. Therefore, this results showed that NAC improved the muscle fatigue, VO2max, maintained TAC, controlled lactate production, but had no influence on CK and TNF-α.

  5. Patterns of Failure and Local Control After Intraoperative Electron Boost Radiotherapy to the Presacral Space in Combination with Total Mesorectal Excision in Patients with Locally Advanced Rectal Cancer

    International Nuclear Information System (INIS)

    Roeder, Falk; Treiber, Martina; Oertel, Susanne; Dinkel, Julien; Timke, Carmen; Funk, Angela; Garcia-Huttenlocher, Helena; Bischof, Marc; Weitz, Juergen; Harms, Wolfgang; Hensley, Frank W.; Buchler, Markus W.; Debus, Juergen; Krempien, Robert

    2007-01-01

    Purpose: To evaluate local control and patterns of failure in patients treated with intraoperative electron beam radiotherapy (IOERT) after total mesorectal excision (TME), to appraise the effectiveness of intraoperative target definition. Methods and Materials: We analyzed the outcome of 243 patients with rectal cancer treated with IOERT (median dose, 10 Gy) after TME. Eighty-eight patients received neoadjuvant and 122 patients adjuvant external beam radiotherapy (EBRT) (median dose, 41.4 Gy), and in 88% simultaneous chemotherapy was applied. Median follow-up was 59 months. Results: Local failure was observed in 17 patients (7%), resulting in a 5-year local control rate of 92%. Only complete resection and absence of nodal involvement correlated positively with local control. Considering IOERT fields, seven infield recurrences were seen in the presacral space, resulting in a 5-year local control rate of 97%. The remaining local relapses were located as follows: retrovesical/retroprostatic (5), anastomotic site (2), promontorium (1), ileocecal (1), and perineal (1). Conclusion: Intraoperative electron beam radiotherapy as part of a multimodal treatment approach including TME is a highly effective regimen to prevent local failure. The presacral space remains the site of highest risk for local failure, but IOERT can decrease the percentage of relapses in this area

  6. The effect of a single infusion of zoledronic acid on early implant migration in total hip arthroplasty. A randomized, double-blind, controlled trial.

    Science.gov (United States)

    Friedl, Gerald; Radl, Roman; Stihsen, Christoph; Rehak, Peter; Aigner, Reingard; Windhager, Reinhard

    2009-02-01

    Aseptic loosening is the most frequent cause of implant failure in total hip arthroplasty. While a direct link between aseptic loosening and periprosthetic bone loss remains elusive, there is plentiful evidence for a close association with early implant migration. The present trial was primarily designed to evaluate whether a single infusion of 4 mg of zoledronic acid prevented early implant migration in patients with osteonecrosis of the femoral head. Fifty patients were consecutively enrolled to receive either zoledronic acid or saline solution after cementless total hip arthroplasty. Radiographs, biochemical parameters of bone turnover, and the Harris hip-rating score were determined preoperatively and at each follow-up examination at seven weeks, six months, one year, and yearly thereafter. The median follow-up period was 2.8 years. We found a significant subsidence of the stem of up to a mean (and standard deviation) of -1.2 +/- 0.6 mm at two years within the control group, and the cups had a mean medialization of 0.6 +/- 1.0 mm and a mean cranialization of 0.6 +/- 0.8 mm (p < 0.001). Treatment with zoledronic acid effectively minimized the migration of the cups in both the transverse and the vertical direction (mean, 0.15 +/- 0.6 mm and 0.06 +/- 0.6 mm, respectively; p < 0.05), while only a trend to decreased subsidence of the stem was detected. Finally, the Harris hip score rapidly increased over time in both treatment groups, although this increase was significantly more pronounced in the zoledronate-treated group than in the control group (analysis of variance, p = 0.008). A single infusion of zoledronic acid shows promise in improving initial fixation of a cementless implant, which may improve the clinical outcome of total hip arthroplasty in patients with osteonecrosis of the femoral head.

  7. Adductor canal block for post-operative analgesia after simultaneous bilateral total knee replacement: A randomised controlled trial to study the effect of addition of dexmedetomidine to ropivacaine

    Directory of Open Access Journals (Sweden)

    Rakhee Goyal

    2017-01-01

    Full Text Available Background and Aims: Knee replacement surgery causes tremendous post-operative pain and adductor canal block (ACB is used for post-operative analgesia. This is a randomised, controlled, three-arm parallel group study using different doses of dexmedetomidine added to ropiavcaine for ACB. Methods: A total of 150 patients aged 18–75 years, scheduled for simultaneous bilateral total knee replacement, received ultrasound-guided ACB. They were randomised into three groups -Group A received ACB with plain ropivacaine; Groups B and C received ACB with ropivacaine and addition of dexmedetomidine 0.25 μg/kg and 0.50 μg/kg, respectively, on each side of ACB. The primary outcome was the duration of analgesia. Total opioid consumption, success of early ambulation, and level of patient satisfaction were also assessed. Results: The patient characteristics and block success rates were comparable in all groups. Group C patients had longer duration of analgesia (Group C 18.4 h ± 7.4; Group B 14.6 ± 7.1; Group A 10.8 ± 7; P < 0.001; lesser tramadol consumption (Group C 43.8 mg ± 53.2; Group B 76.4 ± 49.6; Group A 93.9 mg ± 58.3; P < 0.001 and lesser pain on movement (P < 0.001. The patients in Group B and C walked more steps than in Group A (P < 0.002. The level of patient satisfaction was highest in Group C (P < 0.001. Conclusions: The addition of dexmedetomidine to ropivacaine resulted in longer duration of analgesia after adductor canal block for simultaneous bilateral total knee replacement surgery.

  8. Effectiveness of an online SUpport PRogramme (SUPR) for older hearing aid users: study protocol for a cluster randomised controlled trial.

    Science.gov (United States)

    Meijerink, Janine Fj; Pronk, Marieke; Paulissen, Bernadette; Witte, Birgit I; Wouden, Bregje van der; Jansen, Vera; Kramer, Sophia E

    2017-06-20

    An educational SUpport PRogramme called SUPR has been developed for hearing aid users (HAUs) and their communication partners (CPs) offering care beyond hearing aid fitting. SUPR teaches its users communication strategies, hearing aid handling skills and personal adjustment to hearing impairment. Using a cluster randomised controlled trial design, 70 Dutch hearing aid dispenser practices were randomised into hearing aid fitting (care as usual, 34 practices) and hearing aid fitting including SUPR (36 practices). The aim was to recruit a total of 569 older (aged 50+ years) first-time (n=258) and experienced (n=311) HAUs and their CPs. SUPR consists of a Practical Support Booklet and online material offered via email over a period of 6-7 months. The booklet provides practical information on hearing aids, advice on communication strategies and home exercises. The online material consists of educational videos on hearing aid functionality and usage, communication strategies and peer testimonials. Finally, noncommittal email contact with the dispenser is offered. Every HAU is asked to assign a CP who is advised to be involved intensively. Effect measurements for HAUs and their CPs will occur at baseline and at 6, 12 and 18 months follow-up via online questionnaires. The primary outcomes for HAUs will be the use of communication strategies as measured by the subscales of the Communication Profile for the Hearing Impaired. A process evaluation will be performed. The study was approved by the Dutch Institutional Review Board of the VU Medical University Center Amsterdam. This intervention could contribute to lowering the hearing impairment burden in our ageing society. The results will be disseminated through peer-reviewed publications and scientific conferences. ISRCTN77340339; Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly

  9. Control chart analysis of data regarding 0.2% yield strength (YS) and percent total circumferential elongation (%TCE) for zircaloy clad tubes for PHWR and BWR fuels

    International Nuclear Information System (INIS)

    Yadav, M.B.; Singh, Hari; Vaidyanathan, S.; Sood, D.D.; Raghavan, S.V.; Bandyopadhyay, A.K.; Kulkarni, P.G.

    1992-01-01

    Zircaloy cladding tubes for PHWR and BWR fuels are manufactured and tested at Nuclear Fuel Complex (NFC), Hyderabad. Atomic Fuels Division is carrying out the quality assurance of the fuels on behalf of Nuclear Power Corporation (NPC). In this paper an attempt has been made to assess whether the quality of the clad tubes has met the requirements specified for the two mechanical properties of the tubes namely 0.2% yield strength and percent total circumferential elongation using control chart technique. For this purpose data for about 100 lots in each case were used. Process means and process standard deviations for these properties and the control limits for the corresponding control charts were estimated. The main findings are: (i) In case of PHWR tubes the production quality level with respect to 0.2% YS is higher, while that in case of %TCE is lower causing rejection of lots. On the other hand in the case of BWR tubes the production quality levels with respect to both the properties are higher than the required one. (ii) With respect to 0.2% YS, in case of BWR tubes a change in the pattern of distribution is detected beyond the lot serial no.47. However in case of PHWR tubes, though the data falls into two groups, no such pattern is seen. A modification in the acceptance/rejection criterion of the lot has been suggested. It is also pointed out that to have a correct picture of the total variation it is necessary to study the within tube variation. (author). 4 figs, 2 tabs

  10. Local tumor control and cosmetic outcome following breast-conserving surgery and radiation up to a total dose of 56 Gy without boost in breast cancer patients

    International Nuclear Information System (INIS)

    Bayerl, A.

    2001-01-01

    Purpose: To evaluate overall survival, local tumor control and cosmetic outcome after breast-conserving surgery followed by radiotherapy without boost irradiation. Patients and Methods: In a retrospective study 270 breast cancer patients were treated with breast conserving surgery combined with a homogenous radiation of the tumor bearing breast up to a total dose of 56 Gy without local boost irradiation. Mean follow-up was 48 months. Local tumor control, side effects, cosmetic results and contentment with treatment were assessed using physical examinations and interviews based on a standardized questionnaire. Results: Cause-specific survival at 5 years after treatment was 88.3%, actuarial disease-free survival at 5 years was 76.1%. Within 23 to 78 months after treatment 12 patients suffered from ipsilateral breast recurrence. The actuarial freedom from local recurrence (single tumor manifestation) was 96.8% at 5 years after treatment, 89% at 10 years. The occurrence of local failures was not significantly correlated to tumor size, margins, grading, nodal status, age or lymphangiosis. 15.6% of the patients developed distant metastases. In all patients treatment was performed without interruption. Side effects were predominantly of mild degree, no severe side effects were detected. 73% of physicians and 81% of patients scored their cosmetic outcome as excellent or good. 93% of patients would again decide in favor of this procedure. Whereas, use of adjuvant chemotherapy as well as subcutaneous reconstruction of breast tissue did not significantly affect breast cosmesis, analysis demonstrated impaired cosmetic results related to a larger breast size. Conclusion: The data of this study show that tumor control achieved by breast conserving surgery in combination with a radiation technique up to a total dose of 56 Gy which omits boost irradiation is within the range of literature data. Side effects of the therapy were tolerable. The treatment displayed a good

  11. Effective therapy to reduce edema after total knee arthroplasty Multi-layer compression therapy or standard therapy with cool pack - a randomized controlled pilot trial

    Science.gov (United States)

    Stocker, Brigitta; Babendererde, Christine; Rohner-Spengler, Manuela; Müller, Urs W; Meichtry, André; Luomajoki, Hannu

    2018-02-01

    Background: After total knee arthroplasty (TKA) efficient control and reduction of postoperative edema is of great importance. Aim: The aim of this pilot study (EKNZ 2014 – 225 DRKS00006271) was to investigate the effectiveness of multi-layer compression therapy (MLCT) to reduce edema in the early period after surgery compared to the standard treatment with Cool Pack. Methods: In this randomized controlled pilot trial, sixteen patients after TKA were randomized into an intervention group (IG) or a control group (CG). Circumferential measurements were used to assess edema. Secondary outcomes were range of motion (ROM), pain (numeric rating scale, NRS) and function as measured with the fast Self Paced Walking Test (fSPWT). Results: Clinically relevant differences in edema reduction between the two groups were found in the early postoperative period and at the six weeks follow up. Six days postoperatively the group time interaction (IE) in favor of the IG were −3.8 cm (95 % CI: −5.1; −2.4) when measured 10 cm proximal to the joint space and −2.7 cm (CI: −4.1; −1.3) when measured 5 cm proximally. We further observed differences in secondary outcomes in favor of the CG. Six days postoperatively the IE for knee flexion was –8.3 ° (CI: −22.0; 5.4) and for the fSPWT it was 12.8 seconds (CI: −16.4; 41.3). Six weeks postoperatively these differences diminished. Conclusions: The findings suggest that MLCT could be an alternative treatment to reduce postoperative edema in patients after total knee arthroplasty. Eventually possible negative effects on early knee flexion and function must be considered.

  12. High Assurance Control of Cyber-Physical Systems with Application to Unmanned Aircraft Systems

    Science.gov (United States)

    Kwon, Cheolhyeon

    With recent progress in the networked embedded control technology, cyber attacks have become one of the major threats to Cyber-Physical Systems (CPSs) due to their close integration of physical processes, computational resources, and communication capabilities. While CPSs have various applications in both military and civilian uses, their on-board automation and communication afford significant advantages over a system without such abilities, but these benefits come at the cost of possible vulnerability to cyber attacks. Traditionally, most cyber security studies in CPSs are mainly based on the computer security perspective, focusing on issues such as the trustworthiness of data flow, without rigorously considering the system's physical processes such as real-time dynamic behaviors. While computer security components are key elements in the hardware/software layer, these methods alone are not sufficient for diagnosing the healthiness of the CPSs' physical behavior. In seeking to address this problem, this research work proposes a control theoretic perspective approach which can accurately represent the interactions between the physical behavior and the logical behavior (computing resources) of the CPS. Then a controls domain aspect is explored extending beyond just the logical process of the CPS to include the underlying physical behavior. This approach will allow the CPS whose physical operations are robust/resilient to the damage caused by cyber attacks, successfully complementing the existing CPS security architecture. It is important to note that traditional fault-tolerant/robust control methods could not be directly applicable to achieve resiliency against malicious cyber attacks which can be designed sophisticatedly to spoof the security/safety monitoring system (note this is different from common faults). Thus, security issues at this layer require different risk management to detect cyber attacks and mitigate their impact within the context of a unified

  13. No Effect of a Bipolar Sealer on Total Blood Loss or Blood Transfusion in Nonseptic Revision Knee Arthroplasty-A Prospective Study With Matched Retrospective Controls.

    Science.gov (United States)

    Nielsen, Christian Skovgaard; Gromov, Kirill; Jans, Øivind; Troelsen, Anders; Husted, Henrik

    2017-01-01

    Postoperative anemia is frequent after revision of total knee arthroplasty (TKA) with reported transfusion rates up to 83%. Despite increased efforts of reducing blood loss and enhancing fast recovery within the fast-track setup, a considerable transfusion rate is still evident. The aim of this study was therefore to evaluate the effect of a bipolar sealer on blood loss and transfusion in revision TKA. In this single-center prospective cohort study with retrospective controls, 51 patients were enrolled in a fast-track setup for revision TKA without the use of a tourniquet. Twenty-five prospectively enrolled patients received treatment with both a bipolar sealer and electrocautery, whereas 26 patients had received treatment with a conventional electrocautery only in the retrospective group. No significant differences were found neither for calculated blood loss, with 1397 (standard deviation, ± 452) mL in the bipolar sealer group vs 1452 (SD, ± 530) mL in the control group (P = .66), nor for blood transfusion rates of 53% and 46% (P = .89), respectively. Four controls were readmitted within 90 days follow-up. The use of a bipolar sealer in a TKA revision setting without the use of a tourniquet did not reduce blood loss or blood transfusion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Perbandingan antara Sevofluran dan Propofol Menggunakan Total Intravenous Anesthesia Target Controlled Infusion terhadap Waktu Pulih Sadar dan Pemulangan Pasien pada Ekstirpasi Fibroadenoma Payudara

    Directory of Open Access Journals (Sweden)

    Arvianto

    2017-04-01

    Full Text Available Total intravenous anesthesia (TIVA with propofol is increasingly used, because it is easy to control, has rapid onset, short duration, minimal adverse effects, and rapid recovery of the psychomotor and cognitive functions. This study was conducted to compare the emergence and discharge time between patients receiving sevoflurane and propofol with TCI. A single blind randomized controlled clinical trial was conducted on 36 female patients aged 18–65 years with American Society of Anesthesiologists (ASA physical status I–II, who underwent breast fibroadenoma extirpation biopsy at the outpatient surgical unit in Dr. Hasan Sadikin General Hospital Bandung. The subjects were randomized and divided into two groups: sevoflurane group receiving inhalation anesthesia with sevoflurane and target controlled infusion (TCI group receiving propofol TCI Schnider’s Effect Concentration (ec. The mergence time and discharge time were recorded for each group and analysis was performed using Mann Whitney test, t-test and chi-square/Fisher’s exact with 95% confidence interval. This study showed that the emergence time in sevoflurane group and TCI group were 7.429±0.763 minutes and 9.356±2.331 minutes, respectively. The result showed that sevoflurane provides shorter emergence time while TIVA with TCI propofol provides shorter discharge time.

  15. Patient-Specific CT-Based Instrumentation versus Conventional Instrumentation in Total Knee Arthroplasty: A Prospective Randomized Controlled Study on Clinical Outcomes and In-Hospital Data

    Directory of Open Access Journals (Sweden)

    Andrzej Kotela

    2015-01-01

    Full Text Available Total knee arthroplasty (TKA is a frequently performed procedure in orthopaedic surgery. Recently, patient-specific instrumentation was introduced to facilitate correct positioning of implants. The aim of this study was to compare the early clinical results of TKA performed with patient-specific CT-based instrumentation and conventional technique. A prospective, randomized controlled trial on 112 patients was performed between January 2011 and December 2011. A group of 112 patients who met the inclusion and exclusion criteria were enrolled in this study and randomly assigned to an experimental or control group. The experimental group comprised 52 patients who received the Signature CT-based implant positioning system, and the control group consisted of 60 patients with conventional instrumentation. Clinical outcomes were evaluated with the KSS scale, WOMAC scale, and VAS scales to assess knee pain severity and patient satisfaction with the surgery. Specified in-hospital data were recorded. Patients were followed up for 12 months. At one year after surgery, there were no statistically significant differences between groups with respect to clinical outcomes and in-hospital data, including operative time, blood loss, hospital length of stay, intraoperative observations, and postoperative complications. Further high-quality investigations of various patient-specific systems and longer follow-up may be helpful in assessing their utility for TKA.

  16. Muscle-invasive bladder cancer treated with external beam radiation: influence of total dose, overall treatment time, and treatment interruption on local control

    International Nuclear Information System (INIS)

    Moonen, L.; Voet, H. van der; Nijs, R. de; Horenblas, S.; Hart, A.A.M.; Bartelink, H.

    1998-01-01

    Purpose: To evaluate and eventually quantify a possible influence of tumor proliferation during the external radiation course on local control in muscle invasive bladder cancer. Methods and Materials: The influence of total dose, overall treatment time, and treatment interruption has retrospectively been analyzed in a series of 379 patients with nonmetastasized, muscle-invasive transitional cell carcinoma of the urinary bladder. All patients received external beam radiotherapy at the Netherlands Cancer Institute between 1977 and 1990. Total dose varied between 50 and 75 Gy with a mean of 60.5 Gy and a median of 60.4 Gy. Overall treatment time varied between 20 and 270 days with a mean of 49 days and a median of 41 days. Number of fractions varied between 17 and 36 with a mean of 27 and a median of 26. Two hundred and forty-four patients had a continuous radiation course, whereas 135 had an intended split course or an unintended treatment interruption. Median follow-up was 22 months for all patients and 82 months for the 30 patients still alive at last follow-up. A stepwise procedure using proportional hazard regression has been used to identify prognostic treatment factors with respect to local recurrence as sole first recurrence. Results: One hundred and thirty-six patients experienced a local recurrence and 120 of these occurred before regional or distant metastases. The actuarial local control rate was 40.3% at 5 years and 32.3% at 10 years. In a multivariate analysis total dose showed a significant association with local control (p 0.0039), however in a markedly nonlinear way. In fact only those patients treated with a dose below 57.5 Gy had a significant higher bladder relapse rate, whereas no difference in relapse rate was found among patients treated with doses above 57.5 Gy. This remained the case even after adjustment for overall treatment time and all significant tumor and patient characteristics. The Normalized Tumor Dose (NTD) (α/β = 10) and NTD (

  17. Analgesic and sedative effects of perioperative gabapentin in total knee arthroplasty A randomized, double-blind, placebo-controlled, dose-finding study

    DEFF Research Database (Denmark)

    Lunn, Troels Haxholdt; Husted, Henrik; Laursen, Mogens Berg

    2015-01-01

    (1:1:1) to either gabapentin 1300 mg/d (group A), gabapentin 900 mg/d (group B), or placebo (group C) daily from 2 hours preoperatively to postoperative day 6 in addition to a standardized multimodal analgesic regime. The primary outcome was pain upon ambulation 24 hours after surgery......Gabapentin has shown acute postoperative analgesic effects, but the optimal dose and procedure-specific benefits vs harm have not been clarified. In this randomized, double-blind, placebo-controlled dose-finding study, 300 opioid-naive patients scheduled for total knee arthroplasty were randomized......, and the secondary outcome was sedation 6 hours after surgery. Other outcomes were overall pain during well-defined mobilizations and at rest and sedation during the first 48 hours and from days 2-6, morphine use, anxiety, depression, sleep quality, and nausea, vomiting, dizziness, concentration difficulty, headache...

  18. Patient directed self management of pain (PaDSMaP compared to treatment as usual following total knee replacement: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Donell Simon

    2012-11-01

    Full Text Available Abstract Background In 2009, 665 patients underwent total knee replacements (TKRs at the Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH, representing nearly 1% of the national total. Pain control following the operation can be poor, and this can cause poor mobilization and potential long-term adverse events. Although high levels of pain are not associated with patient dissatisfaction, brief periods of pain may lead to neuronal remodeling and sensitization. Patient controlled oral analgesia (PCOA may improve pain relief; however, the evidence to date has been inconclusive. Patient directed self management of pain (PaDSMaP is a single center randomized controlled trial, which aims to establish if patient self-medication improves, or is equivalent to, treatment as usual and to create an educational package to allow implementation elsewhere. Methods/design Patients eligible for a TKR will be recruited and randomized in the outpatient clinic. All patients will undergo their operations according to normal clinical practice but will be randomized into two groups. Once oral medication has commenced, one group will have pain relief administered by nursing staff in the usual way (treatment as usual; TAU, whilst the second group will self manage their pain medication (patient directed self management of pain; PaDSMaP. Those recruited for self-medication will undergo a training program to teach the use of oral analgesics according to the World Health Organization (WHO pain cascade and how to complete the study documentation. The primary endpoint of the trial is the visual analogue scale (VAS pain score at 3 days or discharge, whichever is sooner. The follow-up time is 6 weeks with a planned trial period of 3 years. The secondary objectives are satisfaction with the management of patient pain post-operatively whilst an inpatient after primary TKR; overall pain levels and pain on mobilization; satisfaction with pain management information

  19. Local anaesthetic infiltration for peri-operative pain control in total hip and knee replacement: systematic review and meta-analyses of short- and long-term effectiveness.

    Science.gov (United States)

    Marques, Elsa M R; Jones, Hayley E; Elvers, Karen T; Pyke, Mark; Blom, Ashley W; Beswick, Andrew D

    2014-07-05

    Surgical pain is managed with multi-modal anaesthesia in total hip replacement (THR) and total knee replacement (TKR). It is unclear whether including local anaesthetic infiltration before wound closure provides additional pain control. We performed a systematic review of randomised controlled trials of local anaesthetic infiltration in patients receiving THR or TKR. We searched MEDLINE, Embase and Cochrane CENTRAL to December 2012. Two reviewers screened abstracts, extracted data, and contacted authors for unpublished outcomes and data. Outcomes collected were post-operative pain at rest and during activity after 24 and 48 hours, opioid requirement, mobilisation, hospital stay and complications. When feasible, we estimated pooled treatment effects using random effects meta-analyses. In 13 studies including 909 patients undergoing THR, patients receiving local anaesthetic infiltration experienced a greater reduction in pain at 24 hours at rest by standardised mean difference (SMD) -0.61 (95% CI -1.05, -0.16; p = 0.008) and by SMD -0.43 (95% CI -0.78 -0.09; p = 0.014) at 48 hours during activity.In TKR, diverse multi-modal regimens were reported. In 23 studies including 1439 patients undergoing TKR, local anaesthetic infiltration reduced pain on average by SMD -0.40 (95% CI -0.58, -0.22; p SMD -0.27 (95% CI -0.50, -0.05; p = 0.018) at 48 hours during activity, compared with patients receiving no infiltration or placebo. There was evidence of a larger reduction in studies delivering additional local anaesthetic after wound closure. There was no evidence of pain control additional to that provided by femoral nerve block.Patients receiving local anaesthetic infiltration spent on average an estimated 0.83 (95% CI 1.54, 0.12; p = 0.022) and 0.87 (95% CI 1.62, 0.11; p = 0.025) fewer days in hospital after THR and TKR respectively, had reduced opioid consumption, earlier mobilisation, and lower incidence of vomiting.Few studies reported long-term outcomes. Local

  20. Determination of total arsenic and arsenic(III) in phosphate fertilizers by hydride generation atomic absorption spectrometry after ultrasound-assisted extraction based on a control acid media.

    Science.gov (United States)

    Rezende, Helen Cristine; Coelho, Nivia Maria Melo

    2014-01-01

    An ultrasound-assisted extraction procedure was developed for determination of inorganic arsenic (As) in phosphate fertilizer by hydride generation atomic absorption spectrometry. The variables that affect the hydride generation step were optimized, including the reducer, acid, sample flow rate, and concentrations of the acid and reducer. The determination of As(lll) was performed through the simple control of solution pH with a 0.5 M citric acid-sodium citrate buffer solution at pH 4.5, and total As was determined after a pre-reduction reaction with 1.0% (w/v) thiourea. Ultrasound-assisted acid extraction was performed, and the parameters sonication time and acid and Triton X-114 concentrations were optimized using a 23 factorial design and central composite design. LODs for As(lll) and total As were 0.029 and 0.022 microg/L, respectively. The accuracy of the method was confirmed with certified reference materials. The method was successfully applied in the determination of inorganic As in phosphate fertilizer samples.

  1. Acute effect of sorghum flour-containing pasta on plasma total polyphenols, antioxidant capacity and oxidative stress markers in healthy subjects: A randomised controlled trial.

    Science.gov (United States)

    Khan, Imran; Yousif, Adel M; Johnson, Stuart K; Gamlath, Shirani

    2015-06-01

    It has been previously reported that pasta containing wholegrain sorghum flour exhibits high content of polyphenols and antioxidant capacity and hence might enhance antioxidant status and reduce markers of oxidative stress in vivo; however no clinical studies have yet been reported. Therefore, the present study assessed the effect of pasta containing red or white wholegrain sorghum flour on plasma total polyphenols, antioxidant capacity and oxidative stress markers in humans. The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN: 12612000324819). In a randomised crossover design, healthy subjects (n = 20) consumed three test meals of control pasta (CP), 30% red sorghum pasta (RSP) or 30% white sorghum pasta (WSP), 1-2 wk apart. The test meals were consumed as breakfast after an overnight fast. Blood samples were obtained at fasting and 2 h after consumption and analysed for total polyphenols, antioxidant capacity, superoxide dismutase (SOD) activity, protein carbonyl and 8-isoprostanes. Compared to baseline, the 2 h post-prandial levels following the RSP meal of plasma polyphenols, antioxidant capacity and SOD activity were significantly (P pasta containing red wholegrain sorghum flour enhanced antioxidant status and improved markers of oxidative stress in healthy subjects. Copyright © 2014 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. Analgesic effect of ultrasound-guided transversus abdominis plane block after total abdominal hysterectomy: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Røjskjaer, Jesper O; Gade, Erik; Kiel, Louise B; Lind, Morten N; Pedersen, Lars M; Kristensen, Billy B; Rasmussen, Yvonne H; Foss, Nicolai B

    2015-03-01

    To assess the effect of bilateral ultrasound-guided transversus abdominis plane block with ropivacaine compared with placebo as part of a multimodal analgesic regimen. A randomized, double-blind, placebo-controlled trial following the CONSORT criteria. Hvidovre University Hospital. Forty-six women scheduled for total abdominal hysterectomy. Women received either ropivacaine 0.75%, 20 mL (n = 24) or 0.9% saline, 20 mL (n = 24) in the transversus abdominis plane on each side. Primary outcome was the 24-h postoperative morphine consumption. Secondary outcomes were pain scores at rest and during coughing, postoperative nausea and vomiting at 1, 2, 4, 6, 8, and 24 h, and time to first mobilization. There was no difference in the mean 24-h postoperative morphine consumption between the two groups (p = 0.733). The ropivacaine group had significantly lower median pain scores at 1 h (p = 0.008) and 2 h (p = 0.027) postoperatively at rest and at 8 h (p = 0.028) during coughing. There was no significant difference in other secondary outcomes. There was no reduction in 24-h morphine consumption when using an ultrasound-guided transversus abdominis plane block in women undergoing total abdominal hysterectomy. As part of a multimodal regimen the transversus abdominis plane block showed some effect on pain scores at rest only in the early postoperative period. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Maria Giné-Garriga

    Full Text Available Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity.To assess the effectiveness of a Primary Health Care (PHC based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period.Randomized controlled trial.Three hundred and sixty-two (n = 362 inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD; 68.3 (8.8 years; 118 women were randomly allocated to the physical activity program (IG. One hundred and seventy-nine patients (n = 179; 67.2 (9.1 years; 106 women were allocated to the control group (CG. The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources.The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2 was assessed at baseline (month 0, at the end of the intervention (month 3, and at 12 months follow-up after the end of the intervention (month 15.The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5. The CG remained about the same: 18.2 (11.1 (P = .002.Our findings indicate that a 3-month physical activity program linked to community resources is a short-duration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits.ClinicalTrials.gov NCT00714831.

  4. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  5. Volume totalizers analysis of pipelines operated by TRANSPETRO National Operational Control Center; Analise de totalizadores de volume em oleodutos operados pelo Centro Nacional de Controle e Operacao da TRANSPETRO

    Energy Technology Data Exchange (ETDEWEB)

    Aramaki, Thiago Lessa; Montalvao, Antonio Filipe Falcao [Petrobras Transporte S.A. (TRANSPETRO), Rio de Janeiro, RJ (Brazil); Marques, Thais Carrijo [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil)

    2012-07-01

    This paper aims to present the results and methodology in the analysis of differences in volume totals used in systems such as batch tracking and leak detection of pipelines operated by the National Center for Operational Control (CNCO) at TRANSPETRO. In order to optimize this type of analysis, software was developed to acquisition and processing of historical data using the methodology developed. The methodology developed takes into account the particularities encountered in systems operated by TRANSPETRO, more specifically, by CNCO. (author)

  6. Liposomal bupivacaine infiltration versus femoral nerve block for pain control in total knee arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Ma, Jianbing; Zhang, Weijie; Yao, Shuxin

    2016-12-01

    Total knee arthroplasty (TKA) usually results in postoperative pain. The objective of this meta-analysis was to compare the effectiveness and safety of liposomal bupivacaine (LB) infiltration and femoral nerve block (FNB) for pain control in total knee arthroplasty. We systemically searched electronic databases, including Embase (1980-2016.7), MEDLINE (1966-2016.7), PubMed (1966-2016.7), ScienceDirect (1985-2016.7), Web of Science (1950-2016.7) and Cochrane Library for potentially relevant articles. All calculations were conducted using Stata 11.0. One randomized controlled trials (RCTs) and five non-RCTs involving 1289 participants met the inclusion criteria. The result of the meta-analysis revealed that there were no significant differences in terms of postoperative pain scores at POD 0 (SMD = -0.047, 95% CI: -0.276 to 0.182, P = 0.688), POD1 (SMD = -0.038, 95% CI: -0.273 to 0.197, P = 0.749) or POD 2 (SMD = -0.043, 95% CI: -0.192 to 0.107, P = 0.575). Significant differences were found between groups in morphine equivalent consumption at POD 1 (SMD = 0.625, 95% CI: 0.068 to 1.183, P = 0.028) and POD 2 (SMD = 0.410, 95% CI: 0.024 to 0.796, P = 0.037) between groups. There were no significant differences regarding the incidence of adverse effects such as nausea (RD = -0.01, 95% CI: -0.04 to -0.075, P = 0.914) or vomiting (RD = 0.006, 95% CI: -0.049 to 0.062, P = 0.821). Liposomal bupivacaine infiltration provides similar postoperative pain relief to femoral nerve block following total knee arthroplasty. In addition, liposomal bupivacaine infiltration could significantly reduce the consumption of morphine equivalents compared to femoral nerve block without an increased risk of adverse events. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  7. Essential fatty acids for premenstrual syndrome and their effect on prolactin and total cholesterol levels: a randomized, double blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Pinho Neto João S

    2011-01-01

    Full Text Available Abstract Objective To evaluate the effectiveness and safety of polyunsaturated fatty acids for the treatment of the premenstrual syndrome (PMS using a graded symptom scale and to assess the effect of this treatment on basal plasma levels of prolactin and total cholesterol. Methods A randomized, double-blind, placebo-controlled study was conducted with 120 women with PMS divided into three groups and treated with 1 or 2 grams of the medication or placebo. Symptoms were recorded over a 6-month period using the Prospective Record of the Impact and Severity of Menstruation (PRISM calendar. Total cholesterol and prolactin levels were measured. Analysis of variance (ANOVA, Pearson's chi-square test, Wilcoxon's nonparametric signed-rank test for paired samples and the Mann-Whitney nonparametric test for independent samples were used in the statistical analysis. Results There were no differences in age, marital status, schooling or ethnicity between the groups. In the group treated with 1 gram of the medication, a significant reduction was found when the median PRISM score recorded in the luteal phase at baseline (99 was compared with the median score recorded in the 3rd month (58 and in the 6th month of evaluation (35. In the 2-gram group, these differences were even more significant (baseline score: 98; 3rd month: 48; 6th month: 28. In the placebo group, there was a significant reduction at the 3rd but not at the 6th month (baseline: 96.5; 3rd month: 63.5; 6th month: 62. The difference between the phases of the menstrual cycle was greater in the 2-gram group compared to the group treated with 1 gram of the medication. There were no statistically significant differences in prolactin or total cholesterol levels between baseline values and those recorded after six months of treatment. Conclusion The difference between the groups using the medication and the placebo group with respect to the improvement in symptomatology appears to indicate the

  8. Optimising multi-product multi-chance-constraint inventory control system with stochastic period lengths and total discount under fuzzy purchasing price and holding costs

    Science.gov (United States)

    Allah Taleizadeh, Ata; Niaki, Seyed Taghi Akhavan; Aryanezhad, Mir-Bahador

    2010-10-01

    While the usual assumptions in multi-periodic inventory control problems are that the orders are placed at the beginning of each period (periodic review) or depending on the inventory level they can happen at any time (continuous review), in this article, we relax these assumptions and assume that the periods between two replenishments of the products are independent and identically distributed random variables. Furthermore, assuming that the purchasing price are triangular fuzzy variables, the quantities of the orders are of integer-type and that there are space and service level constraints, total discount are considered to purchase products and a combination of back-order and lost-sales are taken into account for the shortages. We show that the model of this problem is a fuzzy mixed-integer nonlinear programming type and in order to solve it, a hybrid meta-heuristic intelligent algorithm is proposed. At the end, a numerical example is given to demonstrate the applicability of the proposed methodology and to compare its performance with one of the existing algorithms in real world inventory control problems.

  9. No difference in joint awareness after mobile- and fixed-bearing total knee arthroplasty: 3-year follow-up of a randomized controlled trial.

    Science.gov (United States)

    Schotanus, M G M; Pilot, P; Vos, R; Kort, N P

    2017-12-01

    To compare the patients ability to forget the artificial knee joint in everyday life who were randomized to be operated for mobile- or fixed-bearing total knee arthroplasty (TKA). This single-center randomized controlled trial evaluated the 3-year follow-up of the cemented mobile- and fixed-bearing TKA from the same brand in a series of 41 patients. Clinical examination was during the pre-, 6-week, 6-month, 1-, 2- and 3-year follow-up containing multiple patient-reported outcome measures (PROMs) including the 12-item Forgotten Joint Score (FJS-12) at 3 years. Effect size was calculated for each PROM at 3-year follow-up to quantify the size of the difference between both bearings. At 3-year follow-up, general linear mixed model analysis showed that there were no significant or clinically relevant differences between the two groups for all outcome measures. Calculated effect sizes were small (awareness was slightly lower in patients operated with the MB TKA with comparable improved clinical outcome and PROMs at 3-year follow-up. Measuring joint awareness with the FJS-12 is useful and provides more stringent information at 3-year follow-up compared to other PROMs and should be the PROM of choice at each follow-up after TKA. Level I, randomized controlled trial.

  10. AQUACEL® Ag Surgical Dressing Reduces Surgical Site Infection and Improves Patient Satisfaction in Minimally Invasive Total Knee Arthroplasty: A Prospective, Randomized, Controlled Study

    Directory of Open Access Journals (Sweden)

    Feng-Chih Kuo

    2017-01-01

    Full Text Available The use of modern surgical dressings to prevent wound complications and surgical site infection (SSI after minimally invasive total knee arthroplasty (MIS-TKA is lacking. In a prospective, randomized, controlled study, 240 patients were randomized to receive either AQUACEL Ag Surgical dressing (study group or a standard dressing (control group after MIS-TKA. The primary outcome was wound complication (SSI and blister. The secondary outcomes were wear time and number of dressing changes in the hospital and patient satisfaction (pain, comfort, and ease of use. In the intention-to-treat analysis, there was a significant reduction in the incidence of superficial SSI (0.8%, 95% CI∶ 0.00–2.48 in the study group compared to 8.3% (95% CI∶ 3.32–13.3 in the control group (p=0.01. There were no differences in blister and deep/organ-space SSIs between the two groups. Multivariate analysis revealed that AQUACEL Ag Surgical dressing was an independent risk factor for reduction of SSI (odds ratio: 0.07, 95% CI: 0.01–0.58, p=0.01. The study group had longer wear time (5.2±0.7 versus 1.7±0.4 days, p<0.0001 and lower number of dressing changes (1.0±0.2 versus 3.6±1.3 times, p<0.0001. Increased patient satisfaction (p<0.0001 was also noted in the study group. AQUACEL Ag Surgical dressing is an ideal dressing to provide wound care efficacy, patient satisfaction, reduction of SSI, and cost-effectiveness following MIS-TKA.

  11. The relationship between three-dimensional knee MRI bone shape and total knee replacement—a case control study: data from the Osteoarthritis Initiative

    Science.gov (United States)

    Barr, Andrew J.; Dube, Bright; Hensor, Elizabeth M. A.; Kingsbury, Sarah R.; Peat, George; Bowes, Mike A.; Sharples, Linda D.

    2016-01-01

    Objective. There is growing understanding of the importance of bone in OA. Our aim was to determine the relationship between 3D MRI bone shape and total knee replacement (TKR). Methods. A nested case-control study within the Osteoarthritis Initiative cohort identified case knees with confirmed TKR for OA and controls that were matched using propensity scores. Active appearance modelling quantification of the bone shape of all knee bones identified vectors between knees having or not having OA. Vectors were scaled such that −1 and +1 represented the mean non-OA and mean OA shapes. Results. Compared to controls (n = 310), TKR cases (n = 310) had a more positive mean baseline 3D bone shape vector, indicating more advanced structural OA, for the femur [mean 0.98 vs −0.11; difference (95% CI) 1.10 (0.88, 1.31)], tibia [mean 0.86 vs −0.07; difference (95% CI) 0.94 (0.72, 1.16)] and patella [mean 0.95 vs 0.03; difference (95% CI) 0.92 (0.65, 1.20)]. Odds ratios (95% CI) for TKR per normalized unit of 3D bone shape vector for the femur, tibia and patella were: 1.85 (1.59, 2.16), 1.64 (1.42, 1.89) and 1.36 (1.22, 1.50), respectively, all P < 0.001. After including Kellgren–Lawrence grade in a multivariable analysis, only the femur 3D shape vector remained significantly associated with TKR [odds ratio 1.24 (1.02, 1.51)]. Conclusion. 3D bone shape was associated with the endpoint of this study, TKR, with femoral shape being most associated. This study contributes to the validation of quantitative MRI bone biomarkers for OA structure-modification trials. PMID:27185958

  12. The Effect of India's Total Sanitation Campaign on Defecation Behaviors and Child Health in Rural Madhya Pradesh: A Cluster Randomized Controlled Trial

    Science.gov (United States)

    Patil, Sumeet R.; Arnold, Benjamin F.; Salvatore, Alicia L.; Briceno, Bertha; Ganguly, Sandipan; Colford, John M.; Gertler, Paul J.

    2014-01-01

    Background Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). Methods and Findings We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May–July 2009), and revisited households 21 months later (February–April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%–26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%–15%; group means: 73% intervention versus 84% control). However, the intervention

  13. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Sumeet R Patil

    2014-08-01

    Full Text Available Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs, defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth.We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009, and revisited households 21 months later (February-April 2011 after the program was delivered. The study enrolled a random sample of 5,209 children <5 years old from 3,039 households that had at least one child <24 months at the beginning of the study. A random subsample of 1,150 children <24 months at enrollment were tested for soil transmitted helminth and protozoan infections in stool. The randomization successfully balanced intervention and control groups, and we estimated differences between groups in an intention to treat analysis. The intervention increased percentage of households in a village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention, decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control. However, the intervention did not improve child health

  14. Proposta do uso de pool de sangue total como controle interno de qualidade em hematologia Proposal for the use of a pool of whole blood as internal quality control in hematology

    Directory of Open Access Journals (Sweden)

    Carina Daniele Schons

    2010-06-01

    Full Text Available INTRODUÇÃO: A confiabilidade dos resultados do laboratório é garantida pela realização do controle de qualidade, que tem como funções básicas análise, pesquisa e prevenção da ocorrência de erros laboratoriais por meio de programas que abrangem tanto o controle interno quanto o externo. OBJETIVO: Propor a padronização de utilização de pool de sangue total como controle interno de qualidade no setor de hematologia. MÉTODO: Foram selecionadas amostras de sangue total, colhidas com ácido etilenodiaminotetracético (EDTA, de mesmos grupo sanguíneo e fator Rh, livres de interferentes, como hemólise, lipemia e icterícia. De um total de 30 ml de sangue total, obtiveram-se três alíquotas de 10 ml cada, às quais foram adicionados, respectivamente, 0 ml (sem adição, 1 ml e 5 ml de glicerol (conservante. As amostras foram avaliadas em contador automático ADVIA® 60. Após determinação dos valores de média e DP, todas as amostras foram avaliadas por um período de 45 dias úteis para confecção do gráfico de Levey-Jennings e verificação da estabilidade da amostra. RESULTADO E CONCLUSÃO: Podemos verificar que o pool de sangue total, preparado de acordo com a metodologia proposta, não apresenta estabilidade necessária para sua utilização, como controle interno alternativo no setor de hematologia.INTRODUCTION: The reliability of laboratory results is ensured by the implementation of quality control, which has basic functions, such as analysis, research and prevention of laboratory errors through programs that encompass both internal and external control. OBJECTIVE: To propose a standard method to use pooled whole blood as internal quality control in the Hematology division. METHOD: The selected whole blood samples were collected with EDTA, belonged to the same blood group and Rh factor and did not present interfering factors, such as hemolysis, lipemia and icterus. From a total of 30 ml of whole blood it was obtained 3

  15. Topical versus intravenous administration of tranexamic acid in primary total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Sammy A. Hanna

    2016-09-01

    Full Text Available Tranexamic acid (TA is widely used by orthopedic surgeons to decrease blood loss and the need for transfusion following total hip arthroplasty (THA. Although both intravenous and topical applications are described in the literature, there remains no consensus regarding the optimal regimen, dosage and method of delivery of TA during THA. In addition, concerns still exist regarding the risk of thromboembolic events with intravenous administration. The purpose of this meta-analysis was to compare the efficacy and safety of topical versus intravenous administration of TA in THA. A systemic review of the electronic databases PubMed, CENTRAL, EMBASE and Google Scholar was undertaken to identify all randomized controlled trials (RCTs comparing the topical and intravenous administration of TA during THA, in terms of total blood loss, rate of blood transfusion and incidence of deep venous thrombosis (DVT and pulmonary embolism (PE post-operatively. A meta-analysis was performed to evaluate and compare the efficacy and safety of both methods of administration. Of 248 potentially relevant papers, three RCTs comprising (482 were eligible for data extraction and metaanalysis. The results showed a slightly higher amount of blood loss [Mean Difference (MD – 46.37, P=0.12, 95% confidence interval (CI – 12.54 to 105.29] and rate of transfusion (Risk Ratio 1.30, P=0.39, 95%CI 0.71 to 2.37 postoperatively in the topical TA group, but both did not reach statistical significance. There were 3 cases (1.2% of DVT/PE in the intravenous group and one case (0.4% in the topical group. Topical TA is an effective and safe method to reduce blood loss and the rate of transfusion following primary THA. It has comparative effectiveness to IV administration with slightly less post-operative thromboembolic complications. Larger and better-designed RCTs are required to establish the optimum dosage and regimen for topical use.

  16. No Exacerbation of Knee Joint Pain and Effusion Following Preoperative Progressive Resistance Training in Patients Scheduled for Total Knee Arthroplasty: Secondary Analyses From a Randomized Controlled Trial.

    Science.gov (United States)

    Skoffer, Birgit; Dalgas, Ulrik; Maribo, Thomas; Søballe, Kjeld; Mechlenburg, Inger

    2017-11-09

    Preoperative progressive resistance training (PRT) is controversial in patients scheduled for total knee arthroplasty (TKA), because of the concern that it may exacerbate knee joint pain and effusion. To examine whether preoperative PRT initiated 5 weeks prior to TKA would exacerbate pain and knee effusion, and would allow a progressively increased training load throughout the training period that would subsequently increase muscle strength. Secondary analyses from a randomized controlled trial. University Hospital and a Regional Hospital. A total of 30 patients who were scheduled for TKA due to osteoarthritis and assigned as the intervention group. Patients underwent unilateral PRT (3 sessions per week). Exercise loading was 12 repetitions maximum (RM) with progression toward 8 RM. The training program consisted of 6 exercises performed unilaterally. Before and after each training session, knee joint pain was rated on an 11-point scale, effusion was assessed by measuring the knee joint circumference, and training load was recorded. The first and last training sessions were initiated by 1 RM testing of unilateral leg press, unilateral knee extension, and unilateral knee flexion. The median pain change score from before to after each training session was 0 at all training sessions. The average increase in knee joint effusion across the 12 training sessions was a mean 0.16 cm ± 0.23 cm. No consistent increase in knee joint effusion after training sessions during the training period was found (P = .21). Training load generally increased, and maximal muscle strength improved as follows: unilateral leg press: 18% ± 30% (P = .03); unilateral knee extension: 81% ± 156% (P knee flexion: 53% ± 57% (P knee joint pain and effusion, despite a substantial progression in loading and increased muscle strength. Concerns for side effects such as pain and effusion after PRT seem unfounded. To be determined. Copyright © 2017. Published by Elsevier Inc.

  17. A 2-year RSA study of the Vanguard CR total knee system: A randomized controlled trial comparing patient-specific positioning guides with conventional technique.

    Science.gov (United States)

    Øhrn, Frank-David; Van Leeuwen, Justin; Tsukanaka, Masako; Röhrl, Stephan M

    2018-05-09

    Background and purpose - There is some concern regarding the revision rate of the Vanguard CR TKA in 1 registry, and the literature is ambiguous about the efficacy of patient-specific positioning guides (PSPGs). The objective of this study was to investigate the stability of the cemented Vanguard CR Total Knee using 2 different surgical techniques. Our hypothesis was that there is no difference in migration when implanting the Vanguard CR with either PSPGs or conventional technique. We hereby present a randomized controlled trial of 2-year follow-up with radiostereometric analysis (RSA). Patients and methods - 40 TKAs were performed between 2011 and 2013 with either PSPGs or the conventional technique and 22 of these were investigated with RSA. Results - The PSPG (8 knees) and the conventional (14 knees) groups had a mean maximum total point motion (MTPM) (95% CI) of 0.83 (0.48-1.18) vs. 0.70 (0.43-0.97) mm, 1.03 (0.60-1.43) vs. 0.86 (0.53-1.19), and 1.46 (1.07-1.85) vs. 0.80 (0.52-1.43) at 3, 12, and 24 months respectively (p = 0.1). 5 implants had either an MTPM >1.6 mm at 12 months and/or a migration of more than 0.2 mm between 1- and 2-year follow-ups. 2 of these also had a peripheral subsidence of more than 0.6 mm at 2 years. Interpretation - 5 implants (3 in the PSPG group) were found to be at risk of later aseptic loosening. The PSPG group continuously migrated between 12 and 24 months. The conventional group had an initial high migration between postoperative and 3 months, but seemed more stable after 1 year. Although the difference was not statistically significant, we think the migration in the PSPG group is of some concern.

  18. A randomised controlled trial of total hip arthroplasty versus resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint.

    Science.gov (United States)

    Achten, Juul; Parsons, Nick R; Edlin, Richard P; Griffin, Damian R; Costa, Matthew L

    2010-01-14

    Hip replacement (arthroplasty) surgery is a highly successful treatment for patients with severe symptomatic arthritis of the hip joint. For older patients, several designs of Total Hip Arthroplasty have shown excellent results in terms of both function and value for money. However, in younger more active patients, there is approximately a 50% failure rate at 25 years for traditional implants. Hip resurfacing is a relatively new arthroplasty technique. In a recent review of the literature on resurfacing arthroplasty it was concluded that the short-term functional results appear promising but some potential early disadvantages were identified, including the risk of femoral neck fracture and collapse of the head of the femur. The aim of the current study is to assess whether there is a difference in functional hip scores at one year post-operation between Total Hip Arthroplasty and Resurfacing Arthroplasty. Secondary aims include assessment of complication rates for both procedures as well cost effectiveness. All patients medically fit for surgery and deemed suitable for a resurfacing arthroplasty are eligible to take part in this study. A randomisation sequence will be produced and administered independently. After consenting, all patients will be clinically reviewed and hip function, quality of life and physical activity level will be assessed through questionnaires. The allocated surgery will then be performed with the preferred technique of the surgeon. Six weeks post-operation hip function will be assessed and complications recorded. Three, six and 12 months post-operation hip function, quality of life and physical activity level will be assessed. Additional information about patients' out-of-pocket expenses will also be collected. Current Controlled Trials ISRCTN33354155. UKCLRN portfolio ID 4093.

  19. Effectiveness of prolonged use of continuous passive motion (CPM as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

    Directory of Open Access Journals (Sweden)

    Geesink Ruud JT

    2006-02-01

    Full Text Available Abstract Background Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA. Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80° of knee flexion at the time of discharge will be randomised over two treatment groups, a usual care group and an experimental group The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days, followed by physical therapy alone (usual care in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation and regaining range of motion (ROM in the knee

  20. Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: Design of a randomised controlled trial [ISRCTN85759656

    Science.gov (United States)

    Lenssen, Anton F; Crijns, Yvonne HF; Waltjé, Eddie MH; Roox, George M; van Steyn, Mike JA; Geesink, Ruud JT; van den Brandt, Piet A; de Bie, Rob A

    2006-01-01

    Background Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. Methods In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM) device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA). Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80° of knee flexion at the time of discharge) will be randomised over two treatment groups, a usual care group and an experimental group The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days), followed by physical therapy alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation) and regaining range of motion (ROM) in the knee. Discussion Because

  1. Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Jebb, Susan A; Astbury, Nerys M; Tearne, Sarah; Nickless, Alecia; Aveyard, Paul

    2017-08-04

    The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care. The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence. This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results

  2. Effectiveness of prolonged use of continuous passive motion (CPM) as an adjunct to physiotherapy following total knee arthroplasty: design of a randomised controlled trial [ISRCTN85759656].

    Science.gov (United States)

    Lenssen, Anton F; Crijns, Yvonne H F; Waltjé, Eddie M H; Roox, George M; van Steyn, Mike J A; Geesink, Ruud J T; van den Brandt, Piet A; de Bie, Rob A

    2006-02-23

    Adequate and intensive rehabilitation is an important requirement for successful Total Knee Arthroplasty. The primary focus of early rehabilitation is ambulation of patients and regaining range of motion in the knee. Although research suggests that Continuous Passive Motion should be implemented in the first rehabilitation phase following surgery, there is substantial debate about the duration of each session and the total period of CPM application and. A Cochrane review on this topic concluded that short-term use of CPM leads to greater short-term range of motion. It also suggested, however, that future research should concentrate on the treatment period during which CPM should be administered. In a randomised controlled trial we intend to investigate the efficacy of prolonged use of a continuous passive motion (CPM) device in the home situation as an adjunct to standardised physical therapy. The experimental treatment is compared to standardised physical therapy, in patients with osteoarthritis of the knee undergoing Total Knee Arthroplasty (TKA). Efficacy will be assessed in terms of faster improvements in range of motion and functional recovery. Seventy patients with knee osteoarthritis undergoing TKA and experiencing early postoperative flexion impairment (less than 80 degrees of knee flexion at the time of discharge) will be randomised over two treatment groups, a usual care group and an experimental group. The experimental group will receive CPM + physiotherapy for 17 consecutive days after surgery, whereas the usual care group will receive the same treatment during the in-hospital phase (i.e. about four days), followed by physical therapy alone (usual care) in the first two weeks after hospital discharge. From 18 days to three months after discharge, both groups will receive standardised PT. The primary focus of rehabilitation will be functional recovery (e.g. ambulation) and regaining range of motion (ROM) in the knee. Because restricted knee ROM affects

  3. A randomised controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study.

    Science.gov (United States)

    Bowrey, David J; Baker, Melanie; Halliday, Vanessa; Thomas, Anne L; Pulikottil-Jacob, Ruth; Smith, Karen; Morris, Tom; Ring, Arne

    2015-11-21

    Poor nutrition in the first months after oesophago-gastric resection is a contributing factor to the reduced quality of life seen in these patients. The aim of this pilot and feasibility study was to ascertain the feasibility of conducting a multi-centre randomised controlled trial to evaluate routine home enteral nutrition in these patients. Patients undergoing oesophagectomy or total gastrectomy were randomised to either six weeks of home feeding through a jejunostomy (intervention), or treatment as usual (control). Intervention comprised overnight feeding, providing 50 % of energy and protein requirements, in addition to usual oral intake. Primary outcome measures were recruitment and retention rates at six weeks and six months. Nutritional intake, nutritional parameters, quality of life and healthcare costs were also collected. Interviews were conducted with a sample of participants, to ascertain patient and carer experiences. Fifty-four of 112 (48 %) eligible patients participated in the study over the 20 months. Study retention at six weeks was 41/54 patients (76 %) and at six months was 36/54 (67 %). At six weeks, participants in the control group had lost on average 3.9 kg more than participants in the intervention group (95 % confidence interval [CI] 1.6 to 6.2). These differences remained evident at three months (mean difference 2.5 kg, 95 % CI -0.5 to 5.6) and at six months (mean difference 2.5 kg, 95 % CI -1.2 to 6.1). The mean values observed in the intervention group for mid arm circumference, mid arm muscle circumference, triceps skin fold thickness and right hand grip strength were greater than for the control group at all post hospital discharge time points. The economic evaluation suggested that it was feasible to collect resource use and EQ-5D data for a full cost-effectiveness analysis. Thematic analysis of 15 interviews identified three main themes related to the intervention and the trial: 1) a positive experience, 2) the reasons for taking

  4. The effect of India's total sanitation campaign on defecation behaviors and child health in rural Madhya Pradesh: a cluster randomized controlled trial.

    Science.gov (United States)

    Patil, Sumeet R; Arnold, Benjamin F; Salvatore, Alicia L; Briceno, Bertha; Ganguly, Sandipan; Colford, John M; Gertler, Paul J

    2014-08-01

    Poor sanitation is thought to be a major cause of enteric infections among young children. However, there are no previously published randomized trials to measure the health impacts of large-scale sanitation programs. India's Total Sanitation Campaign (TSC) is one such program that seeks to end the practice of open defecation by changing social norms and behaviors, and providing technical support and financial subsidies. The objective of this study was to measure the effect of the TSC implemented with capacity building support from the World Bank's Water and Sanitation Program in Madhya Pradesh on availability of individual household latrines (IHLs), defecation behaviors, and child health (diarrhea, highly credible gastrointestinal illness [HCGI], parasitic infections, anemia, growth). We conducted a cluster-randomized, controlled trial in 80 rural villages. Field staff collected baseline measures of sanitation conditions, behaviors, and child health (May-July 2009), and revisited households 21 months later (February-April 2011) after the program was delivered. The study enrolled a random sample of 5,209 children village with improved sanitation facilities as defined by the WHO/UNICEF Joint Monitoring Programme by an average of 19% (95% CI for difference: 12%-26%; group means: 22% control versus 41% intervention), decreased open defecation among adults by an average of 10% (95% CI for difference: 4%-15%; group means: 73% intervention versus 84% control). However, the intervention did not improve child health measured in terms of multiple health outcomes (diarrhea, HCGI, helminth infections, anemia, growth). Limitations of the study included a relatively short follow-up period following implementation, evidence for contamination in ten of the 40 control villages, and bias possible in self-reported outcomes for diarrhea, HCGI, and open defecation behaviors. The intervention led to modest increases in availability of IHLs and even more modest reductions in open

  5. Informed consent: do information pamphlets improve post-operative risk-recall in patients undergoing total thyroidectomy: prospective randomized control study.

    Science.gov (United States)

    Alsaffar, Hussain; Wilson, Lindsay; Kamdar, Dev P; Sultanov, Faizullo; Enepekides, Danny; Higgins, Kevin M

    2016-02-13

    Informed consent consists of basic five elements: voluntarism, capacity, disclosure, understanding, and ultimate decision-making. Physician disclosure, patient understanding, and information retention are all essential in the doctor-patient relationship. This is inclusive of helping patients make and manage their decisions and expectations better and also to deal with any consequences and/or complications that arise. This study investigates whether giving patients procedure-specific handouts pre-operatively as part of the established informed consent process significantly improves overall risk-recall following surgery. These handouts outline the anticipated peri-operative risks and complications associated with total thyroidectomy, as well as the corrective measures to address complications. In addition, the influence of potential confounders affecting risk-recall, such as anxiety and pre-existing memory disturbance, are also examined. Consecutive adult (≥18 years old) patients undergoing total thyroidectomy at a single academic tertiary care referral centre are included. Participants are randomly assigned into either the experimental group (with pamphlets) or the control group by a computerized randomization system (Clinstat). All participants filled out a Hospital Anxiety and Depression Scale (HADS) and they are tested by the physician for short-term memory loss using the Memory Impairment Screen (MIS) exam. All patients are evaluated at one week post-operatively. The written recall questionnaire test is also administered during this clinical encounter. Forty-nine patients are included--25 of them receive verbal consent only, while another 24 patients received both verbal consent and patient education information pamphlets. The overall average of correct answers for each group was 83% and 80% in the control and intervention groups, respectively, with no statistically significant differences. There are also no statistically significant differences between the

  6. Acetabular component positioning in total hip arthroplasty with and without a computer-assisted system: a prospective, randomized and controlled study.

    Science.gov (United States)

    Gurgel, Henrique M C; Croci, Alberto T; Cabrita, Henrique A B A; Vicente, José Ricardo N; Leonhardt, Marcos C; Rodrigues, João Carlos

    2014-01-01

    In a study of the acetabular component in total hip arthroplasty, 20 hips were operated on using imageless navigation and 20 hips were operated on using the conventional method. The correct position of the acetabular component was evaluated with computed tomography, measuring the operative anteversion and the operative inclination and determining the cases inside Lewinnek's safe zone. The results were similar in all the analyses: a mean anteversion of 17.4° in the navigated group and 14.5° in the control group (P=.215); a mean inclination of 41.7° and 42.2° (P=.633); a mean deviation from the desired anteversion (15°) of 5.5° and 6.6° (P=.429); a mean deviation from the desired inclination of 3° and 3.2° (P=.783); and location inside the safe zone of 90% and 80% (P=.661). The acetabular component position's tomography analyses were similar whether using the imageless navigation or performing it conventionally. Published by Elsevier Inc.

  7. Total body irradiation prior to bone marrow transplantation: efficacy and safety of granisetron in the prophylaxis and control of radiation-induced emesis

    International Nuclear Information System (INIS)

    Belkacemi, Yazid; Ozsahin, Mahmut; Pene, Francoise; Rio, Bernard; Sutton, Laurent; Laporte, Jean-Philippe; Touboul, Emmanuel; Gorin, Norbert-Claude; Laugier, Alain

    1996-01-01

    Purpose: Radiation-induced emisis is one of the most disturbing side effects of total body irradiation (TBI). To evaluate the efficacy and to determine the best schedule of granisetron (a selective 5-hydroxytryptamine 3 serotonin receptor antagonist) administration in the prevention of radiation-induced nausea and vomiting, we conducted a trial involving patients receiving single-dose TBI before bone marrow transplantation (BMT). Methods and Materials: Thirty-six patients with non-Hodgkin's lymphoma (n 12), multiple myeloma (n = 8), acute lymphoblastic leukemia (n = 7), acute nonlymphoblastic leukemia (n = 6), and chronic myeloid leukemia (n = 3) referred to our department between March 1992 and February 1994 were enrolled in this study to assess the efficacy of granisetron during single-dose TBI before autologous BMT (n = 26), allogeneic BMT (n = 8), or syngeneic BMT (n 2). The male-to-female ratio was 22:14 (1.57), and the mean age was 41 ± 11 years (range 16-58). Before TBI, conditioning chemotherapy consisted of cyclophosphamide (CY) alone (60 mg/kg per day on 2 successive days) in 24 patients, CY combined with other drugs in 6, and combinations without CY in 6. All patients received single-dose TBI (10 Gy administered to the midplane at L4, and 8 Gy to the lungs). The mean instantaneous and average dose rates were 0.039 ± 0.012 Gy/min (range 0.031-0.058), and 0.025-0.006 Gy/min (range 2.08-3.96), respectively. Granisetron was administered 30-45 min before TBI according to two different modalities: a total dose of 3 mg as a 5-min intravenous (i.v.) infusion (Treatment A, n = 15; 42%) or the same treatment plus 3 mg of granisetron as a 24-h continuous i.v. infusion (total dose: 6 mg, Treatment B, n = 21; 58%). Depending on the BMT teams, hyper diuresis was continued (n = 19, 53%) or suspended (n = 17, 47%) during TBI. Nausea and vomiting were assessed during the TBI session and the following 12 h, and were scored as follows: S1 = no nausea or vomiting; S2

  8. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

    Science.gov (United States)

    Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

    2017-09-01

    Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with

  9. Supporting the Delivery of Total Knee Replacements Care for Both Patients and Their Clinicians With a Mobile App and Web-Based Tool: Randomized Controlled Trial Protocol.

    Science.gov (United States)

    Hussain, M Sazzad; Li, Jane; Brindal, Emily; van Kasteren, Yasmin; Varnfield, Marlien; Reeson, Andrew; Berkovsky, Shlomo; Freyne, Jill

    2017-03-01

    Total knee replacement (TKR) surgeries have increased in recent years. Exercise programs and other interventions following surgery can facilitate the recovery process. With limited clinician contact time, patients with TKR have a substantial burden of self-management and limited communication with their care team, thus often fail to implement an effective rehabilitation plan. We have developed a digital orthopedic rehabilitation platform that comprises a mobile phone app, wearable activity tracker, and clinical Web portal in order to engage patients with self-management tasks for surgical preparation and recovery, thus addressing the challenges of adherence to and completion of TKR rehabilitation. The study will determine the efficacy of the TKR platform in delivering information and assistance to patients in their preparation and recovery from TKR surgery and a Web portal for clinician care teams (ie, surgeons and physiotherapists) to remotely support and monitor patient progress. The study will evaluate the TKR platform through a randomized controlled trial conducted at multiple sites (N=5) in a number of states in Australia with 320 patients undergoing TKR surgery; the trial will run for 13 months for each patient. Participants will be randomized to either a control group or an intervention group, both receiving usual care as provided by their hospital. The intervention group will receive the app and wearable activity tracker. Participants will be assessed at 4 different time points: 4 weeks before surgery, immediately before surgery, 12 weeks after surgery, and 52 weeks after surgery. The primary outcome measure is the Oxford Knee Score. Secondary outcome measures include quality of life (Short-Form Health Survey); depression, anxiety, and stress (Depression, Anxiety, and Stress Scales); self-motivation; self-determination; self-efficacy; and the level of satisfaction with the knee surgery and care delivery. The study will also collect quantitative usage data

  10. Tasimelteon for non-24-hour sleep-wake disorder in totally blind people (SET and RESET): two multicentre, randomised, double-masked, placebo-controlled phase 3 trials.

    Science.gov (United States)

    Lockley, Steven W; Dressman, Marlene A; Licamele, Louis; Xiao, Changfu; Fisher, Dennis M; Flynn-Evans, Erin E; Hull, Joseph T; Torres, Rosarelis; Lavedan, Christian; Polymeropoulos, Mihael H

    2015-10-31

    Most totally blind people have non-24-hour sleep-wake disorder (non-24), a rare circadian rhythm disorder caused by an inability of light to reset their circadian pacemaker. In two consecutive placebo-controlled trials (SET and RESET), we assessed safety and efficacy (in terms of circadian entrainment and maintenance) of once-daily tasimelteon, a novel dual-melatonin receptor agonist. We undertook the placebo-controlled, randomised, double-masked trials in 27 US and six German clinical research centres and sleep centres. We screened totally blind adults (18-75 years of age), who were eligible for the randomisation phase of SET if they had a non-24-hour circadian period (τ) of 24·25 h or longer (95% CI greater than 24·0 and up to 24·9 h), as calculated from measurements of urinary 6-sulphatoxymelatonin rhythms. For SET, we used block randomisation to assign patients (1:1) to receive tasimelteon (20 mg) or placebo every 24 h at a fixed clock time 1 h before target bedtime for 26 weeks. Patients who entered the open-label group receiving tasimelteon in SET or who did not meet the SET inclusion criteria but did meet the RESET inclusion criteria were screened for RESET. A subset of the patients who entered the open-label group before the RESET study and who had eligible τ values were screened for RESET after completing the open-label treatment. In RESET, we withdrew tasimelteon in a randomised manner (1:1) in patients who responded (ie, entrained) after a tasimelteon run-in period. Entrainment was defined as having τ of 24·1 h or less and a 95% CI that included 24·0 h. In SET, the primary endpoint was the proportion of entrained patients, assessed in the intention-to-treat population. The planned step-down primary endpoint assessed the proportion of patients who had a clinical response (entrainment at month 1 or month 7 plus clinical improvement, measured by the Non-24 Clinical Response Scale). In RESET, the primary endpoint was the proportion of non

  11. FY 2000 Development of technologies for optimization control of reducing power loss during the service period. Report on the research and development results of the 'building total cooperation control by micro-internet technologies'; 2000 nendo kadoji denki sonshitsu sakugen saiteki seigyo gijutsu kaihatsu seika hokokusho. Micro internet gijutsu ni yoru biru total kyocho seigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    The research and development project is implemented for development of the energy-saving optimization/control system which continuously monitors/controls all of the energy-consuming appliances in a building for their optimization, and the FY 2000 results are reported. The program for the sensing technologies involves a human tracking system aided by fish-eye images and human region sensing technologies based on the neuro technologies, and introduces an animated image simulation system aided by a personal computer. The researches on the building total cooperation control involve establishment of the system designs for controlling heat sources, based on the thermal loads predicted by the information network system. The researches on the micro-internet technologies involve development of the prototype unit which collects information from indoor environment sensors (e.g., for room temperature, luminous intensity and CO2 concentration), and interface devices which collect information from the sub-systems, e.g., air conditioners and heat sources. These systems are completed. The demonstration and assessment program involves designs of the instrumentation systems and network environments. The designs are completed, and various sensors and monitors are installed. (NEDO)

  12. FY 2000 Development of technologies for optimization control of reducing power loss during the service period. Report on the research and development results of the 'building total cooperation control by micro-internet technologies'; 2000 nendo kadoji denki sonshitsu sakugen saiteki seigyo gijutsu kaihatsu seika hokokusho. Micro internet gijutsu ni yoru biru total kyocho seigyo

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    The research and development project is implemented for development of the energy-saving optimization/control system which continuously monitors/controls all of the energy-consuming appliances in a building for their optimization, and the FY 2000 results are reported. The program for the sensing technologies involves a human tracking system aided by fish-eye images and human region sensing technologies based on the neuro technologies, and introduces an animated image simulation system aided by a personal computer. The researches on the building total cooperation control involve establishment of the system designs for controlling heat sources, based on the thermal loads predicted by the information network system. The researches on the micro-internet technologies involve development of the prototype unit which collects information from indoor environment sensors (e.g., for room temperature, luminous intensity and CO2 concentration), and interface devices which collect information from the sub-systems, e.g., air conditioners and heat sources. These systems are completed. The demonstration and assessment program involves designs of the instrumentation systems and network environments. The designs are completed, and various sensors and monitors are installed. (NEDO)

  13. Control Analysis Of Tobacco Raw Material Supplies Using Eoq Method Economic Order Quantity To Reach Efficiency Total Costs Of Raw Material In Pr. Sukun

    Directory of Open Access Journals (Sweden)

    Wiwik Sudarwati

    2017-07-01

    Full Text Available The raw material inventory control system determines and guarantees the availability of raw material stock in the right quantity quality and timing. The problem in this research is the procurement of raw materials of tobacco. PR. Sukun still often experiences the excess. This is related to the frequency of raw material purchases and the quantity of raw material purchases which can lead to waste of working capital embedded in raw material inventory raw material ordering costs and raw material storage costs. The purpose of this research is to know how to make an efficiency level in procurement of raw material inventory between EOQ method compared with policy of PR. Sukun. The type of research used is analytic descriptive type. Data analysis begins by analyzing raw material quantity comparison total raw material inventory cost and raw material cost between PR Sukun policy with EOQ method. Based on the results of research known that by using EOQ method can be much more efficient compared to policy of PR. Sukun. The quantity and frequency of purchasing raw materials is less but still take into account the safety stock and reorder point so the production process is not disturbed. In addition the cost of purchasing ordering costs and raw materials storage costs less so as to create efficiencies on the cost of raw materials inventory. PR. Sukun in the procurement of raw material inventory should use EOQ method to be more efficient and take into account the safety stock and reorder point to avoid the inventory excess of raw materials.

  14. Incongruence between Women's Survey- & Interview-Determined Decision Control Preferences: A Mixed Methods Study of Decision-Making in Metastatic Breast Cancer.

    Science.gov (United States)

    Ejem, Deborah; Nicholas Dionne-Odom, J; Turkman, Yasemin; Knight, Sara; Willis, Dan; Kaufman, Peter; Bakitas, Marie

    2018-04-30

    Women with metastatic breast cancer (MBC) face numerous, complex treatment and advance care planning (ACP) decisions. Our aim was to develop a better understanding of women with MBC's decision-making preferences overtime and relative to specific types of decisions. Convergent, parallel mixed-methods study. Participants completed the Control Preferences Scale (CPS) and a semi-structured interview of decision-making experiences at enrollment (T1; n=22) and when facing a decision or 3 months later (T2; n=19). We categorized women's decision-making experience descriptions into one of the CPS decisional styles and compared them to their CPS response. We constructed an analytic grid that aligned the interview-determined treatment and ACP decisional preferences with the CPS categories at T1 and T2 and calculated Cohen's kappa coefficient and congruence percentages. Participants (n=22) were White (100%), averaged 62 years, married (54%), retired (45%), and had a bachelor's degree (45%). Congruence between CPS response and interview-determined treatment preferences at T1 was 32% (kappa=0.083) and 33% (kappa=0.120) at T2. Congruence between CPS survey response and interview-determined ACP preferences at T1 was 22.7% (kappa =0.092) at T1 and 11% (kappa = 0.011) at T2. Although women selected a "shared" treatment decision-making style using the CPS validated tool, when interviewed their descriptions generally reflected a passive process in which they followed the oncologists' treatment suggestions. Future research should explore whether the incongruence between stated and actual decision-making style is a function of misinterpreting the CPS choices or a true inconsistency that could lead to adverse consequences such as decisional regret. This article is protected by copyright. All rights reserved.

  15. Total - annual report 2005

    International Nuclear Information System (INIS)

    2006-01-01

    This annual report presents the activities and results of TOTAL S.A., french society on oil and gas. It deals with statistics, the managers, key information on financial data and risk factors, information on the Company, unresolved Staff Comments, employees, major Shareholders, consolidated statements, markets, security, financial risks, defaults dividend arrearages and delinquencies, controls and procedures, code of ethics and financial statements. (A.L.B.)

  16. Immediate total-body CT scanning versus conventional imaging and selective CT scanning in patients with severe trauma (REACT-2): a randomised controlled trial

    NARCIS (Netherlands)

    Sierink, Joanne C.; Treskes, Kaij; Edwards, Michael J. R.; Beuker, Benn J. A.; den Hartog, Dennis; Hohmann, Joachim; Dijkgraaf, Marcel G. W.; Luitse, Jan S. K.; Beenen, Ludo F. M.; Hollmann, Markus W.; Goslings, J. Carel; Saltzherr, T. P.; Schep, N. W. L.; Streekstra, G. J.; van Lieshout, E. M. M.; Patka, P.; Klimek, M.; van Vugt, R.; Tromp, T. J. N.; Brink, M.; Harbers, J. S.; El Moumni, M.; Wendt, K. W.; Bingisser, R.; Ummenhofer, W.; Bless, N.

    2016-01-01

    Published work suggests a survival benefit for patients with trauma who undergo total-body CT scanning during the initial trauma assessment; however, level 1 evidence is absent. We aimed to assess the effect of total-body CT scanning compared with the standard work-up on in-hospital mortality in

  17. Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial

    DEFF Research Database (Denmark)

    Lunn, Troels; Kristensen, Billy Bjarne; Andersen, Lasse

    2011-01-01

    Total knee arthroplasty (TKA) is associated with severe pain and inflammation despite an extensive multimodal analgesic approach, but the effect of high-dose glucocorticoid administration has not been studied.......Total knee arthroplasty (TKA) is associated with severe pain and inflammation despite an extensive multimodal analgesic approach, but the effect of high-dose glucocorticoid administration has not been studied....

  18. The efficiency and safety of local liposomal bupivacaine infiltration for pain control in total hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Zhang, Xin; Yang, Qing; Zhang, Zhi

    2017-12-01

    This meta-analysis aimed to compare the efficiency and safety of local liposomal bupivacaine infiltration and traditional cocktail analgesia for pain management in total hip arthroplasty (THA). PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Participants: patients planned for a THA with a diagnosis of hip osteoarthritis. liposomal bupivacaine was administrated in the experimental groups for pain control. Comparisons: the control groups received local infiltration of traditional analgesics. pain scores, opioids consumption, and postoperative complications among the patients. randomized control trials (RCTs) and non-RCTs. Methodological Index for Non-Randomized Studies scale was used to assess the methodological quality of the included studies. Meta-analysis was conducted by Stata 11.0 software. Systematic review registration number is CRD42017120981. Four articles involving 308 participants were included. Current meta-analysis revealed that there were significant differences regarding postoperative pain score at 12 hours (standard mean difference [SMD] = -0.496, 95% CI: -0.717 to -0.275, P = .000), 24 hours (SMD = -0.537, 95% CI: -0.760 to -0.313, P = .000), and 48 hours (SMD = -0.802, 95% CI: -1.029 to -0.576, P = .000). Liposomal bupivacaine intervention was found to significantly decrease opioid consumption at 12 hours (SMD = -0.544, 95% CI: -0.766 to -0.323, P = .000), 24 hours (SMD = -0.357, 95% CI: -0.577 to -0.138, P = .001), and 48 hours (SMD = -0.370, 95% CI: -0.589 to -0.151, P = .001). Local liposomal bupivacaine infiltration could significantly reduce visual analogue scale (VAS) scores and opioid consumption within the first 48 hours following THA surgery. In addition, there was a decreased risk of nausea and vomiting in liposomal bupivacaine groups. The overall evidence level was low, which means that further research is likely to

  19. Periarticular Liposomal Bupivacaine Injection Versus Intra-Articular Bupivacaine Infusion Catheter for Analgesia After Total Knee Arthroplasty: A Double-Blinded, Randomized Controlled Trial.

    Science.gov (United States)

    Smith, Eric B; Kazarian, Gregory S; Maltenfort, Mitchell G; Lonner, Jess H; Sharkey, Peter F; Good, Robert P

    2017-08-16

    Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104). The primary outcome of this study was cumulative narcotic consumption on postoperative days 0 through 3. Narcotic consumption data were collected retrospectively from in-hospital records while patients were in the hospital. Following discharge, narcotic consumption data were gathered from patient surveys, as were secondary outcomes measures. We did not identify greater narcotic use in the ON-Q* group compared with the Exparel group (p = 0.641). The mean difference between the groups was 0.5 morphine equivalent (95% confidence interval [CI] = -1.7 to +2.8), with the ON-Q* group consuming an average 10.4 morphine equivalents (95% CI = 8.7 to 12.0) compared with 10.9 (95% CI = 9.3 to 12.5) in the Exparel group. There were no significant differences between groups with regard to any of the secondary measures of pain with the exception of pain while walking and pain with physical therapy (p = 0.019 and p = 0.010, respectively), both of which showed an approximately 1-point difference in favor of the ON-Q* group on a visual analog scale (VAS). There were also no differences in the postoperative side effects, including nausea, constipation, or vomiting, or in the rates of study-related complications, patient satisfaction, or length of hospital stay. Exparel did not have superior efficacy compared with the ON-Q* Pain Relief System as reflected by narcotic consumption, our primary outcome. There were small significant

  20. Minimally invasive computer-navigated total hip arthroplasty, following the concept of femur first and combined anteversion: design of a blinded randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Woerner Michael

    2011-08-01

    Full Text Available Abstract Background Impingement can be a serious complication after total hip arthroplasty (THA, and is one of the major causes of postoperative pain, dislocation, aseptic loosening, and implant breakage. Minimally invasive THA and computer-navigated surgery were introduced several years ago. We have developed a novel, computer-assisted operation method for THA following the concept of "femur first"/"combined anteversion", which incorporates various aspects of performing a functional optimization of the cup position, and comprehensively addresses range of motion (ROM as well as cup containment and alignment parameters. Hence, the purpose of this study is to assess whether the artificial joint's ROM can be improved by this computer-assisted operation method. Second, the clinical and radiological outcome will be evaluated. Methods/Design A registered patient- and observer-blinded randomized controlled trial will be conducted. Patients between the ages of 50 and 75 admitted for primary unilateral THA will be included. Patients will be randomly allocated to either receive minimally invasive computer-navigated "femur first" THA or the conventional minimally invasive THA procedure. Self-reported functional status and health-related quality of life (questionnaires will be assessed both preoperatively and postoperatively. Perioperative complications will be registered. Radiographic evaluation will take place up to 6 weeks postoperatively with a computed tomography (CT scan. Component position will be evaluated by an independent external institute on a 3D reconstruction of the femur/pelvis using image-processing software. Postoperative ROM will be calculated by an algorithm which automatically determines bony and prosthetic impingements. Discussion In the past, computer navigation has improved the accuracy of component positioning. So far, there are only few objective data quantifying the risks and benefits of computer navigated THA. Therefore, this

  1. The effectiveness of Patient Controlled Analgesia (PCA morphine-ketamine compared to Patient Controlled Analgesia (PCA morphine to reduce total dose of morphine and Visual Analog Scale (VAS in postoperative laparotomy surgery

    Directory of Open Access Journals (Sweden)

    I Gusti Ngurah Mahaalit Aribawa

    2017-05-01

    Full Text Available Background: Laparotomy may cause moderate to severe after surgery pain, thus adequate pain management is needed. The addition of ketamine in patient controlled analgesia (PCA morphine after surgery can be the option. This study aims to evaluate the effectiveness of PCA morphine-ketamine compared to PCA morphine in patient postoperative laparotomy surgery to reduce total dose of morphine requirement and pain intensity evaluated with visual analog scale (VAS. Methods: This study was a double-blind RCT in 58 patients of ASA I and II, age 18-64 years, underwent an elective laparotomy at Sanglah General Hospital. Patients were divided into 2 groups. Group A, got addition of ketamine (1mg/ml in PCA morphine (1mg/ml and patients in group B received morphine (1mg/ml by PCA. Prior to surgical incision both group were given a bolus ketamine 0,15mg/ kg and ketorolac 0,5mg/kg. The total dose of morphine and VAS were measured at 6, 12, and 24 hours postoperatively. Result: Total dose of morphine in the first 24 hours postoperatively at morphine-ketamine group (5,1±0,8mg is lower than morphine only group (6,5±0,9mg p<0,001. VAS (resting 6 and 12 hour postoperative in morphine-ketamine group (13,4±4,8 mm and (10,7±2,6 mm are lower than morphine (17,9±4,1mm p≤0,05 and (12,8±5,3mm p≤0,05. VAS (moving 6, 12, and 24 hour postoperative morphineketamine group (24,8±5,1mm, (18±5,6mm and (9±5,6mm are lower than morphine (28,7±5,2mm p≤0,05, (23,1±6,0mm p≤0,05, and (12,8±5,3mm p≤0,05. Conclusions: Addition of ketamine in PCA morphine for postoperative laparotomy surgery reduces total morphine requirements in 24 hours compared to PCA morphine alone.

  2. Report on a survey in fiscal 1999. Part 3. Survey on total energy and material control (Survey on feasibility of structuring a circulation type society); 1999 nendo total energy and material control ni kansuru chosa hokokusho. 3. Junkangata shakai kochiku kanosei chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    Structuring a circulation type society indispensably requires effective utilization of energies and resources, to which approaches have been taken by industries independently. An approach upon structuring an industry crossing network may be taken effective for further effective utilization of the energies and resources. The present survey is intended to extract problems therefrom. It is also intended to perform surveys and studies on the following three points: (1) process-linking with different industries aimed at zero wasting in industrial complexes and electric furnaces dispersed adequately nationwide, (2) effective use and cascading utilization of energies and resources, and (3) a circulating type economic system simulation using metallic material industry as the core. It is further intended that problems shall be extracted; the results are compiled as the 'basic technology development for the metallic material circulating type economic system'; technological development themes are extracted; and the draft proposal shall be prepared. The total energy and materials control system (TECOS) activities are aimed at structuring a circulation type industrial structure, in which the following requirements are executed: the process-linking transcending the conventional industrial boundaries is performed; substances included in respective materials and discharges, and energies used in the processes are controlled comprehensively; the energies are utilized at ultra-high efficiency; and minimization of all the discharges is realized. (NEDO)

  3. Report on a survey in fiscal 1999. Part 3. Survey on total energy and material control (Survey on feasibility of structuring a circulation type society); 1999 nendo total energy and material control ni kansuru chosa hokokusho. 3. Junkangata shakai kochiku kanosei chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    Structuring a circulation type society indispensably requires effective utilization of energies and resources, to which approaches have been taken by industries independently. An approach upon structuring an industry crossing network may be taken effective for further effective utilization of the energies and resources. The present survey is intended to extract problems therefrom. It is also intended to perform surveys and studies on the following three points: (1) process-linking with different industries aimed at zero wasting in industrial complexes and electric furnaces dispersed adequately nationwide, (2) effective use and cascading utilization of energies and resources, and (3) a circulating type economic system simulation using metallic material industry as the core. It is further intended that problems shall be extracted; the results are compiled as the 'basic technology development for the metallic material circulating type economic system'; technological development themes are extracted; and the draft proposal shall be prepared. The total energy and materials control system (TECOS) activities are aimed at structuring a circulation type industrial structure, in which the following requirements are executed: the process-linking transcending the conventional industrial boundaries is performed; substances included in respective materials and discharges, and energies used in the processes are controlled comprehensively; the energies are utilized at ultra-high efficiency; and minimization of all the discharges is realized. (NEDO)

  4. Intelligent control schemes applied to Automatic Generation Control

    Directory of Open Access Journals (Sweden)

    Dingguo Chen

    2016-04-01

    Full Text Available Integrating ever increasing amount of renewable generating resources to interconnected power systems has created new challenges to the safety and reliability of today‟s power grids and posed new questions to be answered in the power system modeling, analysis and control. Automatic Generation Control (AGC must be extended to be able to accommodate the control of renewable generating assets. In addition, AGC is mandated to operate in accordance with the NERC‟s Control Performance Standard (CPS criteria, which represent a greater flexibility in relaxing the control of generating resources and yet assuring the stability and reliability of interconnected power systems when each balancing authority operates in full compliance. Enhancements in several aspects to the traditional AGC must be made in order to meet the aforementioned challenges. It is the intention of this paper to provide a systematic, mathematical formulation for AGC as a first attempt in the context of meeting the NERC CPS requirements and integrating renewable generating assets, which has not been seen reported in the literature to the best knowledge of the authors. Furthermore, this paper proposes neural network based predictive control schemes for AGC. The proposed controller is capable of handling complicated nonlinear dynamics in comparison with the conventional Proportional Integral (PI controller which is typically most effective to handle linear dynamics. The neural controller is designed in such a way that it has the capability of controlling the system generation in the relaxed manner so the ACE is controlled to a desired range instead of driving it to zero which would otherwise increase the control effort and cost; and most importantly the resulting system control performance meets the NERC CPS requirements and/or the NERC Balancing Authority’s ACE Limit (BAAL compliance requirements whichever are applicable.

  5. Total Logistic Plant Solutions

    Directory of Open Access Journals (Sweden)

    Dusan Dorcak

    2016-02-01

    Full Text Available The Total Logistics Plant Solutions, plant logistics system - TLPS, based on the philosophy of advanced control processes enables complex coordination of business processes and flows and the management and scheduling of production in the appropriate production plans and planning periods. Main attributes of TLPS is to create a comprehensive, multi-level, enterprise logistics information system, with a certain degree of intelligence, which accepts the latest science and research results in the field of production technology and logistics. Logistic model of company understands as a system of mutually transforming flows of materials, energy, information, finance, which is realized by chain activities and operations

  6. TOTAL annual report 2003

    International Nuclear Information System (INIS)

    2004-01-01

    This 2003 annual report of the Group Total provides economical results and information of the society on the following topics: keys data, the corporate governance (Directors charter, board of directors, audit committee, nomination and remuneration committee, internal control procedures, compensation of directors and executive officers), the corporate social responsibility (environmental stewardship, the future of energy management, the safety enhancement, the human resources, ethics and local development), the investor relations, the management report, the upstream exploration and production, the downstream refining, marketing, trading and shipping, the chemicals and financial and legal information. (A.L.B.)

  7. REVIEW Of COMPUTERIZED PROCEDURE GUIDELINES FOR NUCLEAR POWER PLANT CONTROL ROOMS

    Energy Technology Data Exchange (ETDEWEB)

    David I Gertman; Katya Le Blanc; Ronald L Boring

    2011-09-01

    Computerized procedures (CPs) are recognized as an emerging alternative to paper-based procedures for supporting control room operators in nuclear power plants undergoing life extension and in the concept of operations for advanced reactor designs. CPs potentially reduce operator workload, yield increases in efficiency, and provide for greater resilience. Yet, CPs may also adversely impact human and plant performance if not designed and implemented properly. Therefore, it is important to ensure that existing guidance is sufficient to provide for proper implementation and monitoring of CPs. In this paper, human performance issues were identified based on a review of the behavioral science literature, research on computerized procedures in nuclear and other industries, and a review of industry experience with CPs. The review of human performance issues led to the identification of a number of technical gaps in available guidance sources. To address some of the gaps, we developed 13 supplemental guidelines to support design and safety. This paper presents these guidelines and the case for further research.

  8. Retention of the posterior cruciate ligament versus the posterior stabilized design in total knee arthroplasty : a prospective randomized controlled clinical trial

    NARCIS (Netherlands)

    van den Boom, L.G.H.; Brouwer, R.W.; van den Akker-Scheek, I.; Bulstra, S.K.; van Raaij, J.J.A.M.

    2009-01-01

    Background: Prosthetic design for the use in primary total knee arthroplasty has evolved into designs that preserve the posterior cruciate ligament (PCL) and those in which the ligament is routinely sacrificed (posterior stabilized). In patients with a functional PCL the decision which design is

  9. No positive effect of autologous platelet gel after total knee arthroplasty: A double-blind randomized controlled trial: 102 patients with a 3-month follow-up

    NARCIS (Netherlands)

    J.C. Peerbooms (Joost); G.S. de Wolf (Gideon); J.W. Colaris (Joost); D.J. Bruijn (Danil); J.A.N. Verhaar (Jan)

    2009-01-01

    textabstractBackground and purpose Activated platelets release a cocktail of growth factors, some of which are thought to stimulate repair. We investigated whether the use of autologous platelet gel (PG) in total knee arthroplasty (TKA) would improve wound healing and knee function, and reduce blood

  10. A high-protein diet increases postprandial but not fasting plasma total homocysteine concentrations: a dietary controlled, crossover trial in healthy volunteers

    NARCIS (Netherlands)

    Verhoef, P.; Vliet, van T.; Olthof, M.R.; Katan, M.B.

    2005-01-01

    Background: A high plasma concentration of total homocysteine (tHcy) is associated with increased risk of cardiovascular disease. A high protein intake and hence a high intake of methionine¿the sole dietary precursor of homocysteine¿may raise plasma tHcy concentrations. Objectives: We studied

  11. A high-protein diet increases postprandial but not fasting plasma total homocysteine concentrations: A dietary controlled, crossover trial in healthy volunteers

    NARCIS (Netherlands)

    Verhoef, P.; Vliet, T. van; Olthof, M.R.; Katan, M.B.

    2005-01-01

    Background: A high plasma concentration of total homocysteine (tHcy) is associated with increased risk of cardiovascular disease. A high protein intake and hence a high intake of methionine-the sole dietary precursor of homocysteine-may raise plasma tHcy concentrations. Objectives: We studied

  12. A high-protein diet increases postprandial but not fasting plasma total homocysteine concentrations : A dietary controlled, crossover trial in healthy volunteers

    NARCIS (Netherlands)

    Verhoef, Petra; Van Vliet, Trinette; Olthof, Margreet R.; Katan, Martijn B.

    2005-01-01

    Background: A high plasma concentration of total homocysteine (tHcy) is associated with increased risk of cardiovascular disease. A high protein intake and hence a high intake of methionine-the sole dietary precursor of homocysteine-may raise plasma tHcy concentrations. Objectives: We studied

  13. No positive effect of autologous platelet gel after total knee arthroplasty A double-blind randomized controlled trial: 102 patients with a 3-month follow-up

    NARCIS (Netherlands)

    Peerbooms, J.C.; de Wolf, G.S.; Colaris, J.W.; Bruijn, D.J.; Verhaar, J.A.N.

    2009-01-01

    Background and purpose Activated platelets release a cocktail of growth factors, some of which are thought to stimulate repair. We investigated whether the use of autologous platelet gel (PG) in total knee arthroplasty (TKA) would improve wound healing and knee function, and reduce blood loss and

  14. Randomized controlled trial of total intravenous anesthesia with propofol versus inhalation anesthesia with isoflurane-nitrous oxide: postoperative nausea with vomiting and economic analysis

    NARCIS (Netherlands)

    Visser, K.; Hassink, E. A.; Bonsel, G. J.; Moen, J.; Kalkman, C. J.

    2001-01-01

    To assess the incidence of postoperative nausea and vomiting after total intravenous anesthesia (TIVA) with propofol versus inhalational anesthesia with isoflurane-nitrous oxide, the authors performed a randomized trial in 2,010 unselected surgical patients in a Dutch academic institution. An

  15. Migration and clinical outcome of mobile-bearing versus fixed-bearing single-radius total knee arthroplasty : A randomized controlled trial

    NARCIS (Netherlands)

    Van Hamersveld, Koen T.; Marang-Van De Mheen, Perla J.; Van Der Heide, Huub J.L.; Van Der Linden-Van Der Zwaag, Henrica M.J.; Valstar, E.R.; Nelissen, R.G.H.H.

    2018-01-01

    Background and purpose — Mobile-bearing total knee prostheses (TKPs) were developed in the 1970s in an attempt to increase function and improve implant longevity. However, modern fixed-bearing designs like the single-radius TKP may provide similar advantages. We compared tibial component

  16. Comparison of total oxidant/antioxidant status in unconjugated hyperbilirubinemia of newborn before and after conventional and LED phototherapy: A prospective randomized controlled trial.

    Science.gov (United States)

    Demirel, Gamze; Uras, Nurdan; Celik, Istemi H; Aksoy, Hatice T; Oguz, Serife S; Erdeve, Omer; Erel, Ozcan; Dilmen, Ugur

    2010-10-01

    We evaluated and compared the oxidant and antioxidant status of hyperbilirubinemic infants before and after the two forms of phototherapy: conventional and LED phototherapy, in order to identify the optimal treatment method. Thirty newborns exposed to conventional (Group I) phototherapy and 30 infants exposed to LED phototherapy (Group II) were studied. The serum total antioxidant capacity (TAC) and the total oxidant status (TOS) were assessed by EREL's method. There were no statistically significant differences in TAC or TOS levels between Group I and Group II prior to phototherapy, and no statistically significant difference in TAC levels between the two groups after phototherapy; however, TOS levels were significantly lower in Group II compared to Group I after phototherapy. Oxidative stress index (OSI) increased after conventional phototherapy (p < 0.05) The increase in TOS following conventional phototherapy was not not observed following LED phototherapy. This difference should be considered when using phototherapy.

  17. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  18. Effect of Daikenchuto, a Traditional Japanese Herbal Medicine, after Total Gastrectomy for Gastric Cancer: A Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase II Trial.

    Science.gov (United States)

    Yoshikawa, Kozo; Shimada, Mitsuo; Wakabayashi, Go; Ishida, Koichiro; Kaiho, Takashi; Kitagawa, Yuko; Sakamoto, Junichi; Shiraishi, Norio; Koeda, Keisuke; Mochiki, Erito; Saikawa, Yoshiro; Yamaguchi, Kazuya; Watanabe, Masayuki; Morita, Satoshi; Kitano, Seigo; Saji, Shigetoyo; Kanematsu, Takashi; Kitajima, Masaki

    2015-08-01

    Daikenchuto (DKT) has widely been used to improve abdominal symptoms by being expected to accelerate bowel motility. The purpose of this study is to examine the efficacy and safety of DKT for prevention of ileus and associated gastrointestinal symptoms after total gastrectomy. Two hundred and forty-five gastric cancer patients who underwent total gastrectomy were enrolled. Patients received either DKT (15.0 g/d) or matching placebo from postoperative days 1 to 12. Primary end points were time to first flatus, time to first bowel movement (BM), and frequency of BM. Secondary end points included quality of life, C-reactive protein level, symptoms indicative of a severe gastrointestinal disorder, and incidence of postoperative ileus. A total of 195 patients (DKT, n = 96; placebo, n = 99) were included in the per-protocol set analysis. There were no significant differences between the groups in terms of patient background characteristics. Median time to first BM was shorter in the DKT group than in the placebo group (94.7 hours vs 113.9 hours; p = 0.051). In patients with high medication adherence, median time to first BM was significantly shorter in the DKT group than in the placebo group (93.8 hours vs 115.1 hours; p = 0.014). Significantly fewer patients in the DKT group had ≥2 symptoms of gastrointestinal dysfunction than those in the placebo group on postoperative day 12 (p = 0.026). Administration of DKT during the immediate postoperative period after total gastrectomy appears to promote early recovery of postoperative bowel function. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  19. Role of the judge in defending tobacco control measures in Colombia: total ban on advertising, promotion and sponsorship of tobacco products case

    Directory of Open Access Journals (Sweden)

    Lorena Viviana Calderón Pinzón

    2018-03-01

    Colombia, has established a total ban on all forms of advertising, promotion and sponsorship of tobacco, as a result of the harmonization process between internal rules, mainly related to measures to protect the right to health of the population. In view of the adverse consequences of tobacco consumption and exposure to tobacco smoke and the international obligations set out in the first legally binding public health treaty within the United Nations System: WHO´s FCTC.

  20. Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study

    Directory of Open Access Journals (Sweden)

    Gladys Castaño, PhD

    2003-09-01

    Full Text Available Background: Hypercholesterolemia is a major risk factor for coronary heart disease. Clinical studies have shown that lowering elevated serum cholesterol levels, particularly low-density lipoprotein cholesterol (LDL-C, is beneficial for patients with borderline to mildly elevated serum total cholesterol (TC levels (5.0–6.0 mmol/L. Policosanol is a cholesterol-lowering drug made from purified sugar cane wax. The therapeutic range of policosanol is 5 to 20 mg/d. Objective: This study investigated the efficacy and tolerability of policosanol 5 mg/d in patients with borderline to mildly elevated serum TC levels. Methods: This 14-week, single-center, prospective, double-blind, placebo-controlled, parallel-group, comparative study was conducted in men and women aged 25 to 75 years with a serum TC level ≥4.8 to <6.0 mmol/L. After a 6-week run-in period in which patients were placed on therapeutic lifestyle changes, in particular a cholesterol-lowering diet, patients were randomly assigned to receive policosanol 5-mg tablets or placebo tablets once daily with the evening meal for 8 weeks, and the diet was continued throughout the study. Lipid profile variables, safety indicators, adverse events (AEs, and compliance with study medications were assessed. Results: One hundred patients (71 women, 29 men; mean [SD] age, 52 [10] years entered the study after the dietary run-in period. After 8 weeks of treatment, the mean (SD serum LDL-C level decreased significantly in the policosanol group (P<0.001 vs baseline and placebo from 3.57 (0.30 mmol/L to 2.86 (0.41 mmol/L (change, −19.9%. Significantly more patients in the policosanol group (42 patients [84%] achieved a ≥15% decrease in serum LDL-C than in the placebo group (2 patients [4%] (P<0.001. Also in the policosanol group, the mean (SD serum TC level decreased significantly, from 5.20 (0.22 mmol/L to 4.56 (0.44 mmol/L (P<0.001 vs baseline and placebo (change, −12.3%; the mean (SD triglyceride (TG

  1. Quality of life and nutritional consequences after aboral pouch reconstruction following total gastrectomy for gastric cancer: randomized controlled trial CCG1101.

    Science.gov (United States)

    Ito, Yuichi; Yoshikawa, Takaki; Fujiwara, Michitaka; Kojima, Hiroshi; Matsui, Takanori; Mochizuki, Yoshinari; Cho, Haruhiko; Aoyama, Toru; Ito, Seiji; Misawa, Kazunari; Nakayama, Hiroshi; Morioka, Yuki; Ishiyama, Akiharu; Tanaka, Chie; Morita, Satoshi; Sakamoto, Junichi; Kodera, Yasuhiro

    2016-07-01

    Total gastrectomy has detrimental effects on postoperative nutritional status and quality of life (QOL), but it is often unavoidable in the treatment of gastric cancer. Roux-en-Y (RY) is the most common reconstruction method following total gastrectomy. Trials to explore other means of reconstruction have been conducted but have failed to identify a method that is globally accepted. Aboral pouch reconstruction (AP), in which an anisoperistaltic jejunal pouch is created in the Y limb of the RY reconstruction, is considered effective and technically feasible. A prospective randomized trial was conducted to compare AP with RY. Gastric cancer patients requiring total gastrectomy for R0 resection were randomly assigned during surgery to receive either RY (n = 51) or AP (n = 49). Postoperative QOL as assessed by the EORTC QLQ-C30 and STO22, body composition, and morbidity were compared between the two reconstruction methods. The physical functioning score of the QLQ-C30 was selected as the primary endpoint. The incidences of postoperative complications were similar between the two groups (29 % in the RY group and 27 % in the AP group). No significant difference was observed in the physical functioning score, and the superiority of AP was demonstrated only for the nausea and vomiting score at 12 months (p = 0.041) and the reflux score at 1 month (p = 0.036). No significant differences were observed in body composition or serum biochemistry. Although AP was safely implemented, no increased benefits in nutritional or QOL-related parameters were observed for this method over RY within 12 months postoperatively.

  2. Evaluating the effectiveness of carbon tax for total emission control of carbon dioxide. Systems analysis of a dynamic environmental-economic model

    International Nuclear Information System (INIS)

    Tamura, Hiroyuki; Abe, Makoto; Tomiyama, Shinji; Hatono, Itsuo

    1999-01-01

    This paper deals with how to evaluate the effectiveness of carbon tax (environmental tax) for regulating the carbon dioxide emissions. For this purpose we mainly deal with a primal problem and its dual problem of dynamic linear programming model. The primal problem is formulated by using Leontief type input-output model and the basic idea of commodity stocks. It represents the balance of materials. The dual problem is obtained and interpreted as cash balance. It is clarified in this paper whether the carbon tax is effective to decrease the total amount of carbon dioxide emissions. (author)

  3. Pseudotumour incidence, cobalt levels and clinical outcome after large head metal-on-metal and conventional metal-on-polyethylene total hip arthroplasty MID-TERM RESULTS OF A RANDOMISED CONTROLLED TRIAL

    NARCIS (Netherlands)

    van der Veen, H. C.; Reininga, I. H. F.; Zijlstra, W. P.; Boomsma, M. F.; Bulstra, S. K.; van Raay, J. J. A. M.

    2015-01-01

    We compared the incidence of pseudotumours after large head metal-on-metal (MoM) total hip arthroplasty (THA) with that after conventional metal-on-polyethylene (MoP) THA and assessed the predisposing factors to pseudotumour formation. From a previous randomised controlled trial which compared large

  4. Effects of the daily consumption of protein enriched bread and protein enriched drinking yoghurt on the total protein intake in older adults in a rehabilitation centre: A single blind randomised controlled trial

    NARCIS (Netherlands)

    van Til, A.J.; Naumann, E.; Cox-Claessens, I.J.H.M.; Kremer, S.; Boelsma, E.; van Bokhorst-de van der Schueren, M.A.E.

    2015-01-01

    Objectives: To investigate the effects of protein enriched bread and drinking yoghurt, substituting regular products, on the total protein intake and the distribution of protein intake over the day in older adults.Design: A single blind randomised controlled trial.Setting: Rehabilitation

  5. Effect of the daily consumption of protein enriched bread and protein enriched drinking yoghurt on the total protein intake in older adults in a rehabilitation centre: a single blind randomised controlled trial

    NARCIS (Netherlands)

    Til, van A.J.; Naumann, E.; Cox-Claessens, I.J.H.M.; Kremer, S.; Boelsma, E.; Schueren, van der D.E.

    2015-01-01

    Objectives To investigate the effects of protein enriched bread and drinking yoghurt, substituting regular products, on the total protein intake and the distribution of protein intake over the day in older adults. Design A single blind randomised controlled trial. Setting Rehabilitation centre.

  6. Intraoperative Low-Dose Ketamine Infusion Reduces Acute Postoperative Pain Following Total Knee Replacement Surgery: A Prospective, Randomized Double-Blind Placebo-Controlled Trial

    International Nuclear Information System (INIS)

    Pelin Cengiz, P.; Gokcinar, D.; Karabeyoglu, I.; Topcu, H.; Cicek, G. S.; Gogus, N.

    2014-01-01

    Objective: To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. Study Design: A randomized, double-blind comparative study. Place and Duration of Study: Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Methodology: Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6.25 g/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Results: Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Conclusion: Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects. (author)

  7. Intraoperative low-dose ketamine infusion reduces acute postoperative pain following total knee replacement surgery: a prospective, randomized double-blind placebo-controlled trial.

    Science.gov (United States)

    Cengiz, Pelin; Gokcinar, Derya; Karabeyoglu, Isil; Topcu, Hulya; Cicek, Gizem Selen; Gogus, Nermin

    2014-05-01

    To evaluate the effect of intraoperative low-dose ketamine with general anesthesia on postoperative pain after total knee replacement surgery. A randomized, double-blind comparative study. Ankara Numune Training and Research Hospital, Turkey, from January and June 2011. Sixty adults undergoing total knee arthroplasty were enrolled in this study. The patients were randomly allocated into two groups of equal size to receive either racemic ketamine infusion (6 μg/kg/minute) or the same volume of saline. A visual analogue scale (VAS) was used to measure each patient's level of pain at 1, 3, 6, 12, and 24 hours after surgery. Time to first analgesic request, postoperative morphine consumption and the incidence of side effects were also recorded. Low-dose ketamine infusion prolonged the time to first analgesic request. It also reduced postoperative cumulative morphine consumption at 1, 3, 6, 12, and 24 hours postsurgery (p < 0.001). Postoperative VAS scores were also significantly lower in the ketamine group than placebo, at all observation times. Incidences of side effects were similar in both study groups. Intraoperative continuous low-dose ketamine infusion reduced pain and postoperative analgesic consumption without affecting the incidence of side effects.

  8. Correlation between resting state fMRI total neuronal activity and PET metabolism in healthy controls and patients with disorders of consciousness.

    Science.gov (United States)

    Soddu, Andrea; Gómez, Francisco; Heine, Lizette; Di Perri, Carol; Bahri, Mohamed Ali; Voss, Henning U; Bruno, Marie-Aurélie; Vanhaudenhuyse, Audrey; Phillips, Christophe; Demertzi, Athena; Chatelle, Camille; Schrouff, Jessica; Thibaut, Aurore; Charland-Verville, Vanessa; Noirhomme, Quentin; Salmon, Eric; Tshibanda, Jean-Flory Luaba; Schiff, Nicholas D; Laureys, Steven

    2016-01-01

    The mildly invasive 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) is a well-established imaging technique to measure 'resting state' cerebral metabolism. This technique made it possible to assess changes in metabolic activity in clinical applications, such as the study of severe brain injury and disorders of consciousness. We assessed the possibility of creating functional MRI activity maps, which could estimate the relative levels of activity in FDG-PET cerebral metabolic maps. If no metabolic absolute measures can be extracted, our approach may still be of clinical use in centers without access to FDG-PET. It also overcomes the problem of recognizing individual networks of independent component selection in functional magnetic resonance imaging (fMRI) resting state analysis. We extracted resting state fMRI functional connectivity maps using independent component analysis and combined only components of neuronal origin. To assess neuronality of components a classification based on support vector machine (SVM) was used. We compared the generated maps with the FDG-PET maps in 16 healthy controls, 11 vegetative state/unresponsive wakefulness syndrome patients and four locked-in patients. The results show a significant similarity with ρ = 0.75 ± 0.05 for healthy controls and ρ = 0.58 ± 0.09 for vegetative state/unresponsive wakefulness syndrome patients between the FDG-PET and the fMRI based maps. FDG-PET, fMRI neuronal maps, and the conjunction analysis show decreases in frontoparietal and medial regions in vegetative patients with respect to controls. Subsequent analysis in locked-in syndrome patients produced also consistent maps with healthy controls. The constructed resting state fMRI functional connectivity map points toward the possibility for fMRI resting state to estimate relative levels of activity in a metabolic map.

  9. Cerebral blood flow and metabolism during controlled hypotension with sodium-nitroprusside and general anaesthesia for total hip replacement a.m. Charnley

    International Nuclear Information System (INIS)

    Buenemann, L.; Jensen, K.; Thomsen, L.; Riisager, S.

    1987-01-01

    Cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRo 2 ) were studied during hypotension induced with sodium nitroprusside (SNP) in 10 patients undergoing total hip replacement a.m. Charnley. Cerebral blood flow was measured using an injection of xenon-133 into an arm vein. The decay curve was detected by five scintillation counters placed over each hemisphere and analysed with the Novo 10a cerebrograph. Blood samples were drawn from the radial artery and the jugular venous bulb to calculate the CMRo 2 . In the gropu as a whole, there were significant decreases in mean arterial pressure and in cerebrovascular resistance. There were no significant changes, in either CBF or CMRo 2 in the gropu as a whole, but there were substantial individual differences. In conclusion, the use of SNP-induced hypotension for extracranial surgery should be used only in patients monitored closely. (author)

  10. Isquemia e reperfusão hepática total associada ao estado de choque hemorrágico controlado: efeitos no seqüestro de neutrófilos no pulmão do rato Total hepatic warm ischemia and reperfusion associated with controlled hemorrhagic shock: effects of neutrophil sequestration in lung of rats

    Directory of Open Access Journals (Sweden)

    Mario Mantovani

    2002-02-01

    Full Text Available OBJETIVO: Estudar os efeitos da isquemia e reperfusão hepática total sobre acúmulo de neutrófilos no interstício pulmonar de ratos, em condições de normalidade e submetidos ao estado de choque hemorrágico controlado. MÉTODOS: 32 ratos Wistar, machos, foram divididos em quatro grupos de oito animais cada: grupo Sham, submetido aos procedimentos padrões com um período de 60 minutos de observação; grupo Choque, submetido a choque hemorrágico controlado (PAM = 40 mmHg, 20 min. seguido de reposição volêmica (Ringer lactato + sangue, 3:1 e reperfusão (60 min.; grupo Pringle, submetido a isquemia hepática total (15 min. e reperfusão (60 min.; grupo Total submetido a choque hemorrágico controlado (15 min. seguido de reposição volêmica (Ringer lactato + sangue, 3:1 e reperfusão (60 min.. Após o sacrifício dos animais, procedeu-se à contagem de neutrófilos no interstício pulmonar. RESULTADOS: Os valores encontrados para contagem de neutrófilos no interstício pulmonar indicaram que, os animais dos grupos Pringle, Total e, também, do grupo Choque, não diferiram dos animais do grupo Sham com valores de (Sham 21,08± 14,12; Choque 35,15± 18,74; Pringle 19,78± 15,38; Total 23,90± 16,37 (p=0.253 CONCLUSÃO: Em ratos submetidos a estado de choque hemorrágico controlado associado a isquemia hepática de 15 minutos, seguida de 60 minutos de reperfusão, não ocorreu acúmulo significativo de neutrófilos no interstício pulmonar.OBJECTIVE: The purpose of this experimental work was to study the effects of total hepatic ischemia and reperfusion on the accumulation of neutrophils in the lung of rats, under normal conditions and submitted to controlled hemorrhagic shock state. METHODS: thirty two adult male Wistar rats, were divided into four groups: the Sham group, was submitted to the standard procedures for a period of 60 min. of observation; Shock group, was submitted to controlled hemorrhagic shock (PAM=40 mmHg, 20 min

  11. An initial SPARROW model of land use and in-stream controls on total organic carbon in streams of the conterminous United States

    Science.gov (United States)

    Shih, Jhih-Shyang; Alexander, Richard B.; Smith, Richard A.; Boyer, Elizabeth W.; Shwarz, Grogory E.; Chung, Susie

    2010-01-01

    Watersheds play many important roles in the carbon cycle: (1) they are a site for both terrestrial and aquatic carbon dioxide (CO2) removal through photosynthesis; (2) they transport living and decomposing organic carbon in streams and groundwater; and (3) they store organic carbon for widely varying lengths of time as a function of many biogeochemical factors. Using the U.S. Geological Survey (USGS) Spatially Referenced Regression on Watershed Attributes (SPARROW) model, along with long-term monitoring data on total organic carbon (TOC), this research quantitatively estimates the sources, transport, and fate of the long-term mean annual load of TOC in streams of the conterminous United States. The model simulations use surrogate measures of the major terrestrial and aquatic sources of organic carbon to estimate the long-term mean annual load of TOC in streams. The estimated carbon sources in the model are associated with four land uses (urban, cultivated, forest, and wetlands) and autochthonous fixation of carbon (stream photosynthesis). Stream photosynthesis is determined by reach-level application of an empirical model of stream chlorophyll based on total phosphorus concentration, and a mechanistic model of photosynthetic rate based on chlorophyll, average daily solar irradiance, water column light attenuation, and reach dimensions. It was found that the estimate of in-stream photosynthesis is a major contributor to the mean annual TOC load per unit of drainage area (that is, yield) in large streams, with a median share of about 60 percent of the total mean annual carbon load in streams with mean flows above 500 cubic feet per second. The interquartile range of the model predictions of TOC from in-stream photosynthesis is from 0.1 to 0.4 grams (g) carbon (C) per square meter (m-2) per day (day-1) for the approximately 62,000 stream reaches in the continental United States, which compares favorably with the reported literature range for net carbon fixation by

  12. Social Information Processing of Positive and Negative Hypothetical Events in Children with ADHD and Conduct Problems and Controls

    Science.gov (United States)

    Andrade, Brendan F.; Waschbusch, Daniel A.; Doucet, Amelie; King, Sara; MacKinnon, Maura; McGrath, Patrick J.; Stewart, Sherry H.; Corkum, Penny

    2012-01-01

    Objective: This study examined social information processing (SIP) of events with varied outcomes in children with ADHD and conduct problems (CPs; defined as oppositional defiant disorder [ODD] or conduct disorder [CD]) and controls. Method: Participants were 64 children (46 boys, 18 girls) aged 6 to 12, including 39 with ADHD and 25 controls.…

  13. Efficacy in Deep Vein Thrombosis Prevention With Extended Mechanical Compression Device Therapy and Prophylactic Aspirin Following Total Knee Arthroplasty: A Randomized Control Trial.

    Science.gov (United States)

    Snyder, Mark A; Sympson, Alexandra N; Scheuerman, Christina M; Gregg, Justin L; Hussain, Lala R

    2017-05-01

    Aspirin at 325 mg twice daily is now included as a nationally approved venous thromboembolism (VTE) prophylaxis protocol for low-risk total knee arthroplasty (TKA) patients. The purpose of this study is to examine whether there is a difference in deep vein thrombosis (DVT) occurrence after a limited tourniquet TKA using aspirin-based prophylaxis with or without extended use of mechanical compression device (MCD) therapy. One hundred limited tourniquet TKA patients, whose DVT risk was managed with aspirin 325 mg twice daily for 3 weeks, were randomized to either using an MCD during hospitalization only or extended use at home up to 6 weeks postoperatively. Lower extremity duplex venous ultrasonography (LEDVU) was completed on the second postoperative day, 14 days postoperatively, and at 3 months postoperatively to confirm the absence of DVT after treatment. The DVT rate for the postdischarge MCD therapy group was 0% and 23.1% for the inpatient MCD group (P aspirin for 3 weeks postoperatively, and on MCD therapy for up to 6 weeks postoperatively experienced superior DVT prophylaxis than patients receiving MCD therapy only as an inpatient (P aspirin and extended-use MCD further validates this type of prophylaxis in low DVT risk TKA patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese with metabolic syndrome symptoms: the RESMENA randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Lopez-Legarrea Patricia

    2013-02-01

    Full Text Available Abstract Background Dietary strategies seem to be the most prescribed therapy in order to counteract obesity regarding not only calorie restriction, but also bioactive ingredients and the composition of the consumed foods. Dietary total antioxidant capacity (TAC is gaining importance in order to assess the quality of the diet. Methods Ninety-six obese adults presenting metabolic syndrome (MetS symptoms completed an 8-week intervention trial to evaluate the effects of a novel dietary program with changes in the nutrient distribution and meal frequency and to compare it with a dietary pattern based on the American Heart Association (AHA guidelines. Anthropometric and biochemical parameters were assessed at baseline and at the endpoint of the study, in addition to 48-hours food dietary records. Results Both diets equally (p > 0.05 improved MetS manifestations. Dietary TAC was the component which showed the major influence on body weight (p = 0.034, body mass index (p = 0.026, waist circumference (p = 0.083 and fat mass (p = 0.015 reductions. Transaminases (ALT and AST levels (p = 0.062 and p = 0.004, respectively were associated with lower TAC values. Conclusion RESMENA diet was as effective as AHA pattern for reducing MetS features. Dietary TAC was the most contributing factor involved in body weight and obesity related markers reduction. Trial registration http://www.clinicaltrials.gov; NCT01087086

  15. Improved recovery of regional left ventricular function after PCI of chronic total occlusion in STEMI patients: a cardiovascular magnetic resonance study of the randomized controlled EXPLORE trial.

    Science.gov (United States)

    Elias, Joëlle; van Dongen, Ivo M; Hoebers, Loes P; Ouweneel, Dagmar M; Claessen, Bimmer E P M; Råmunddal, Truls; Laanmets, Peep; Eriksen, Erlend; van der Schaaf, René J; Ioanes, Dan; Nijveldt, Robin; Tijssen, Jan G; Hirsch, Alexander; Henriques, José P S

    2017-07-19

    The Evaluating Xience and left ventricular function in PCI on occlusiOns afteR STEMI (EXPLORE) trial did not show a significant benefit of percutaneous coronary intervention (PCI) of the concurrent chronic total occlusion (CTO) in ST-segment elevation myocardial infarction (STEMI) patients on global left ventricular (LV) systolic function. However a possible treatment effect will be most pronounced in the CTO territory. Therefore, we aimed to study the effect of CTO PCI compared to no-CTO PCI on the recovery of regional LV function, particularly in the CTO territory. Using cardiovascular magnetic resonance (CMR) we studied 180 of the 302 EXPLORE patients with serial CMR (baseline and 4 months follow-up). Segmental wall thickening (SWT) was quantified on cine images by an independent core laboratory. Dysfunctional segments were defined as SWT PCI compared to no-CTO PCI (ΔSWT 17 ± 27% vs 11 ± 23%, p = 0.03). This recovery was most pronounced in the dysfunctional but viable segments(TEI PCI compared with no-CTO PCI is associated with a greater recovery of regional systolic function in the CTO territory, especially in the dysfunctional but viable segments. Further research is needed to evaluate the use of CMR in selecting post-STEMI patients for CTO PCI and the effect of regional LV function recovery on clinical outcome. Trialregister.nl NTR1108 , Date registered NTR: 30-okt-2007.

  16. Intraoperative and postoperative feasibility and safety of total tubeless, tubeless, small-bore tube, and standard percutaneous nephrolithotomy: a systematic review and network meta-analysis of 16 randomized controlled trials.

    Science.gov (United States)

    Lee, Joo Yong; Jeh, Seong Uk; Kim, Man Deuk; Kang, Dong Hyuk; Kwon, Jong Kyou; Ham, Won Sik; Choi, Young Deuk; Cho, Kang Su

    2017-06-27

    Percutaneous nephrolithotomy (PCNL) is performed to treat relatively large renal stones. Recent publications indicate that tubeless and total tubeless (stentless) PCNL is safe in selected patients. We performed a systematic review and network meta-analysis to evaluate the feasibility and safety of different PCNL procedures, including total tubeless, tubeless with stent, small-bore tube, and large-bore tube PCNLs. PubMed, Cochrane Central Register of Controlled Trials, and EMBASE™ databases were searched to identify randomized controlled trials published before December 30, 2013. One researcher examined all titles and abstracts found by the searches. Two investigators independently evaluated the full-text articles to determine whether those met the inclusion criteria. Qualities of included studies were rated with Cochrane's risk-of-bias assessment tool. Sixteen studies were included in the final syntheses including pairwise and network meta-analyses. Operation time, pain scores, and transfusion rates were not significantly different between PCNL procedures. Network meta-analyses demonstrated that for hemoglobin changes, total tubeless PCNL may be superior to standard PCNL (mean difference [MD] 0.65, 95% CI 0.14-1.13) and tubeless PCNLs with stent (MD -1.14, 95% CI -1.65--0.62), and small-bore PCNL may be superior to tubeless PCNL with stent (MD 1.30, 95% CI 0.27-2.26). Network meta-analyses also showed that for length of hospital stay, total tubeless (MD 1.33, 95% CI 0.23-2.43) and tubeless PCNLs with stent (MD 0.99, 95% CI 0.19-1.79) may be superior to standard PCNL. In rank probability tests, small-bore tube and total tubeless PCNLs were superior for operation time, pain scores, and hemoglobin changes. For hemoglobin changes, total tubeless and small-bore PCNLs may be superior to other methods. For hospital stay, total tubeless and tubeless PCNLs with stent may be superior to other procedures.

  17. Effect of zoledronic acid on reducing femoral bone mineral density loss following total hip arthroplasty: A meta-analysis from randomized controlled trails.

    Science.gov (United States)

    Gao, Jian; Gao, Chong; Li, Hui; Wang, Guo-Sheng; Xu, Chang; Ran, Jian

    2017-11-01

    This meta-analysis aimed to assess the efficiency of intravenous administration of zoledronic acid on reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty (THA). A systematic search was performed in Medline (1966-2017.07.31), PubMed (1966-2017.07.31), Embase (1980-2017.07.31), ScienceDirect (1985-2017.07.31) and the Cochrane Library (1966-2017.07.31). Fixed/random effect model was used according to the heterogeneity tested by I 2 statistic. Sensitivity analysis was conducted and publication bias was assessed. Meta-analysis was performed using Stata 11.0 software. Four studies including 185 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of periprosthetic bone mineral density in Gruen zone 1 (SMD = 0.752, 95% CI: 0.454 to 1.051, P = 0.000), 2 (SMD = 0.524, 95% CI: 0.230 to 0.819, P = 0.000), 4 (SMD = 0.400, 95% CI: 0.107 to 0.693, P = 0.008), 6 (SMD = 0.893, 95% CI: 0.588 to 1.198, P = 0.000) and 7 (SMD = 0.988, 95% CI: 0.677 to 1.300, P = 0.000). Intravenous administration of zoledronic acid could significantly reduce periprosthetic bone mineral density loss (Gruen zone 1, 2, 4, 6 and 7) after THA. In addition, no severe adverse events were identified. High-quality RCTs with large sample size were still required. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Use of a total traffic count metric to investigate the impact of roadways on asthma severity: a case-control study

    Directory of Open Access Journals (Sweden)

    deVos Annemarie JBM

    2011-06-01

    Full Text Available Abstract Background This study had two principal objectives: (i to investigate the relationship between asthma severity and proximity to major roadways in Perth, Western Australia; (ii to demonstrate a more accurate method of exposure assessment for traffic pollutants using an innovative GIS-based measure that fully integrates all traffic densities around subject residences. Methods We conducted a spatial case-control study, in which 'cases' were defined as individuals aged under 19 years of age with more severe asthma (defined here as two or more emergency department contacts with asthma in a defined 5-year period versus age- and gender-matched 'controls' with less severe asthma (defined here as one emergency department contact for asthma. Traffic exposures were measured using a GIS-based approach to determine the lengths of the roads falling within a buffer area, and then multiplying them by their respective traffic counts. Results We examined the spatial relationship between emergency department contacts for asthma at three different buffer sizes: 50 metres, 100 metres and 150 metres. No effect was noted for the 50 metre buffer (OR = 1.07; 95% CI: 0.91-1.26, but elevated odds ratios were observed with for crude (unadjusted estimates OR = 1.21 (95% CI: 1.00-1.46 for 100 metre buffers and OR = 1.25 (95% CI: 1.02-1.54 for 150 metre buffers. For adjusted risk estimates, only the 150 metre buffer yielded a statistically significant finding (OR = 1.24; 95% CI:1.00-1.52. Conclusions Our study revealed a significant 24% increase in the risk of experiencing multiple emergency department contacts for asthma for every log-unit of traffic exposure. This study provides support for the hypothesis that traffic related air pollution increases the frequency of health service contacts for asthma. This study used advanced GIS techniques to establish traffic-weighted buffer zones around the geocoded residential location of subjects to provide an accurate

  19. Impulse control disorder and response-inhibition alterations in Parkinson's disease. A rare case of totally absent functionality of the medial-prefrontal cortex and review of literature.

    Science.gov (United States)

    Palermo, Sara; Morese, Rosalba; Zibetti, Maurizio; Dematteis, Francesca; Sirgiovanni, Stefano; Stanziano, Mario; Valentini, Maria Consuelo; Lopiano, Leonardo

    2017-11-01

    This report illustrates a Parkinson's disease (PD) patient with impulse-control disorder (ICD) and selective impairment in response-inhibition abilities as revealed by the performance in a functional magnetic resonance imaging (fMRI) anterior cingulate cortex - sensitive go-nogo task. In line with hypothesis on the role of response-inhibition disabilities in the arising of impulsivity in PD, the patient completely failed the go-nogo task. Moreover, fMRI acquisition revealed absent task-sensitive activity in the anterior cingulate cortex, medial prefrontal, and orbitofrontal cortices for the contrast nogo versus go, which signifying that a hypo-function of this network could be associated with ICD. A fronto-striatal and cingulo-frontal dysfunction may reflect impairment in metacognitive-executive abilities (such as response-inhibition, action monitoring, and error awareness) and promote compulsive repetition of behavior. Response-inhibition tasks may be useful in PD post-diagnostic phase, to better identify individuals at risk of developing ICD with dopaminergic medication.

  20. Controlling photophysical properties of ultrasmall conjugated polymer nanoparticles through polymer chain packing

    KAUST Repository

    Piwonski, Hubert Marek; Michinobu, Tsuyoshi; Habuchi, Satoshi

    2017-01-01

    of the development of Pdots. Here we demonstrate that proper control of the physical interactions between the chains is as critical as the molecular design. The unique design of twisted CPs and fine-tuning of the reprecipitation conditions allow us to fabricate

  1. Total and high molecular weight (HMW) adiponectin levels and measures of glucose and lipid metabolism following pioglitazone treatment in a randomized placebo-controlled study in polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Glintborg, Dorte; Frystyk, Jan; Højlund, Kurt

    2008-01-01

    and controls and examined possible mechanisms for increased insulin sensitivity during pioglitazone treatment. STUDY SUBJECTS: Thirty PCOS patients randomized to pioglitazone, 30 mg/day, or placebo for 16 weeks and 14 weight-matched healthy females were studied. DESIGN: Total and HMW adiponectin levels were...... measured, and euglycaemic hyperinsulinaemic clamps and indirect calorimetry were performed. Delta-values denoted changes during pioglitazone treatment (16 weeks--basal). RESULTS: Pretreatment adiponectin levels were decreased in PCOS patients vs. controls (P ...OBJECTIVE: Recent studies suggested that the effect of adiponectin on insulin-stimulated glucose metabolism is mediated primarily by the high molecular weight (HMW) form of adiponectin. In the present study we evaluated total and HMW adiponectin in polycystic ovary syndrome (PCOS) patients...

  2. One- and multistage total strain and stress-controlled fatigue tests with a steel of type 42 CrMo 4 subject to varied residual and mean stress loading. Final report

    International Nuclear Information System (INIS)

    Macherauch, E.; Schulze, V.

    1995-01-01

    Work under this research project covered tests with the quenched and tempered steel 42 CrMo 4 to which one- and two-stage tension-compression fatigue stresses were applied with varying mean loads, under conditions of nominal stress and total strain control. Shot peening was used to induce various microstructural conditions in the material at the surface and near below. Softening in the material was observed to be a continuous process, and the steel showed no stabilised, cyclic deformation behaviour. The cyclic stress-strain curve measured with equal stress amplitudes and total strain control applied shows higher plastic strain amplitudes than that measured with nominal stresses. The fatigue behaviour under two-stage loading depends on the chosen sequence of loads applied, the testing periods, and the overall testing procedure, so that there is no way of deriving data for two-stage testing procedures from single-stage test results. (orig.) [de

  3. Effects of the daily consumption of protein enriched bread and protein enriched drinking yoghurt on the total protein intake in older adults in a rehabilitation centre: a single blind randomised controlled trial.

    Science.gov (United States)

    van Til, A J; Naumann, E; Cox-Claessens, I J H M; Kremer, S; Boelsma, E; de van der Schueren, M A E

    2015-05-01

    To investigate the effects of protein enriched bread and drinking yoghurt, substituting regular products, on the total protein intake and the distribution of protein intake over the day in older adults. A single blind randomised controlled trial. Rehabilitation centre. Older adults (≥ 55 years) admitted to a rehabilitation centre after hospital discharge (n=34). Participants received a high protein diet (protein enriched bread and protein enriched drinking yoghurt; n=17) or a regular diet (regular bread and regular drinking yoghurt; n=17) for three consecutive weeks. Total protein intake and protein intake per meal, measured twice weekly over a three weeks period (six measurements per participant). Compared with controls, patients who received the protein enriched products had a significantly higher protein intake (115.3 g/d vs 72.5 g/d, Pconsumption of protein enriched products improves protein distribution over the day.

  4. Relationship of nocturnal concentrations of melatonin, gamma-aminobutyric acid and total antioxidants in peripheral blood with insomnia after stroke: study protocol for a prospective non-randomized controlled trial

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Fang Li; Tong Zhang

    2017-01-01

    Melatonin and gamma-aminobutyric acid (GABA) have been shown to regulate sleep. The nocturnal concentrations of melatonin, GABA and total antioxidants may relate to insomnia in stroke patients. In this prospective single-center non-randomized controlled clinical trial performed in the China Rehabilitation Research Center, we analyzed the relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke. Patients during rehabilitation of stroke were recruited and assigned to the insomnia group or non-insomnia group. Simultaneously, persons without stroke or insomnia served as normal controls. Each group contained 25 cases. The primary outcome was nocturnal concentrations of melatonin, GABA and total antioxidants in peripheral blood. The secondary outcomes were Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, Fatigue Severity Scale, Morningness-Eveningness Questionnaire (Chinese version), and National Institute of Health Stroke Scale. The relationship of nocturnal concentrations of melatonin, GABA and total antioxidants with insomnia after stroke was analyzed and showed that they were lower in the insomnia group than in the non-insomnia group. The severity of stroke was higher in the insomnia group than in the non-insomnia group. Correlation analysis demonstrated that the nocturnal concentrations of melatonin and GABA were associated with insomnia after stroke. This trial was regis-tered at ClinicalTrials.gov, identifier: NCT03202121.

  5. Calidad total en el ICESI

    OpenAIRE

    González Zamora, José Hipólito

    2010-01-01

    En primer lugar deseo dar la bienvenida esta reunión al ingeniero Francisco Gensini, director ejecutivo de INCOLDA, quien ha sido fuente constante de inspiración para el trabajo relacionado con Control Total de Calidad (C.T.C.) que se ha venido desarrollando en el ICESI. El ingeniero Gensini ha logrado aglutinar alrededor de INCOLDA al grupo de seis empresas de la región, líderes en el estudio y aplicación de los principios del Control Total de Calidad , es decir Rica Rondo S.A., Banco de Oc...

  6. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  7. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  8. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  9. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  10. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  11. Design of a Quality Control Program for the Measurement of Gross Alpha and Gross Beta Activities (LMPR-CIEMAT); Diseno del Control de Calidad de las Medidas de Actividad Alfa-Beta Total (LMPR-CIEMAT)

    Energy Technology Data Exchange (ETDEWEB)

    Alvarez, A.; Yague, L.; Gasco, C.; Navarro, N.; Higueras, E.; Noguerales, C.

    2010-10-21

    In accordance with international standards, general requirements for testing laboratories have to include a quality system for planning, implementing, and assessing the work performed by the organization and for carrying out required quality assurance and quality control. The purpose of internal laboratory quality control is to monitor performance, identify problems, and initiate corrective actions. This report describes the internal quality control to monitor the gross alpha and beta activities determination. Identification of specific performance indicators, the principles that govern their use and statistical means of evaluation are explained. Finally, calculation of alpha and beta specific activities, uncertainties and detection limits are performed. (Author) 10 refs.

  12. Two novel Pb(II) coordination polymers (CPs) based on 4-(4-oxopyridin-1(4H)-yl) and 3-(4-oxopyridin-1(4H)-yl) phthalic acid: Band gaps, structures, and their photoelectrocatalytic properties in CO2-saturated system

    Science.gov (United States)

    Yan, Zhi Shuo; Long, Ji Ying; Gong, Yun; Lin, Jian Hua

    2018-05-01

    Based on 4-(4-oxopyridin-1(4H)-yl) phthalic acid (H2L1) and 3-(4-oxopyridin-1(4H)-yl) phthalic acid (H2L2), two novel Pb(II) coordination polymers (CPs) formulated as [Pb4Cl4·(L1)2·H2O]n (CP 1), [Pb3Cl4·L2·H2O]n (CP 2) were solvothermally synthesized and characterized by single-crystal X-ray diffraction. The two novel Pb(II) CPs (CPs 1 and 2) possessed different structures. Density functional theory (DFT) calculations revealed the two CPs had different band structures yet the characteristic of semiconductors in common. Their valence band (VB) and conduction band (CB) positions were determined by Mott-Schottky and UV-visible diffuse reflectance analyses. The photoelectrocatalytic performance of the two CPs towards CO2 reduction were tested by photocurrent responses at various applied potentials. And the E =-1.4 V vs SCE (-0.74 V vs NHE) was selected as the required potential according to the regulation of photocurrent responses at various tested potentials in CO2-saturated system. The photoelectrocatalytic performance of CP 2 was superior to that of CP 1 owing to the well-matched CB position of CP 2 and CO2 reduction potentials at the required potential of -1.4 V vs SCE (-0.74 V vs NHE). In addition, the photoelectrolytic experiment were performed 1 h in the CO2-saturated 0.2 M Na2SO4 solution at the required potential of -1.4 V vs SCE (-0.74 V vs NHE) with and without illumination, and we initially demonstrated the influence of visible light in the CO2-saturated photoelectrocatalytic measurement system and the reason of stability in 1 h chronoamperometry.

  13. Validation of the CPS+EG and Neo-Bioscore staging systems after preoperative systemic therapy for breast cancer in a single center in China.

    Science.gov (United States)

    Xu, Ling; Duan, Xuening; Zhou, Bin; Liu, Yinhua; Ye, Jingming; Liu, Zhaorui; Ma, Chao; Zhang, Hong; Zhang, Shuang; Zhang, Lanbo; Zhao, Jianxin; Cheng, Yuanjia

    2018-04-17

    Prognostic assessment after preoperative systemic therapy (PST) plays a vital role in determining treatment in breast cancer patients. Many researchers have sought to develop a system to quantitate residual tumor and its correlation with prognosis after PST. This retrospective study validated the CPS + EG staging system and Neo-Bioscore in a single center in China. Data from patients with non-metastatic primary breast cancer who were treated with PST and surgery from Jan. 2008 to Dec. 2014 at the Breast Disease Center of Peking University First Hospital, China, were reviewed. DFS, DSS and OS were calculated using the K-M curve and AUC. Multivariate analysis was used for a Cox proportional hazards model. All calculations were performed with SAS 9.4. A total of 403 patients were enrolled in this study. The median follow-up period was 45 (range 11-107) months. The five-year DFS, DSS and OS rates were 86.4%, 91.2% and 90.5%, respectively. The CS, PS, CPS + EG staging system and Neo-Bioscore stratified patients according to DFS, DSS, and OS after PST, with all P values < 0.0001. The CPS + EG staging system and Neo-Bioscore stratified prognosis after PST better than CS. HER2-positive patients without trastuzumab treatment had obviously worse DFS and OS than other subgroups with different HER2 statuses that scored a 3 in the Neo-Bioscore system. The CPS + EG staging system and Neo-Bioscore can improve prognostic prediction in non-pCR breast cancer patients after PST and, provided unfavorable prognostic factors such as insufficient treatment are incorporated, will have broader clinical applicability. Copyright © 2018 Elsevier Ltd. All rights reserved.

  14. Conditional protein splicing: a new tool to control protein structure and function in vitro and in vivo.

    Science.gov (United States)

    Mootz, Henning D; Blum, Elyse S; Tyszkiewicz, Amy B; Muir, Tom W

    2003-09-03

    Protein splicing is a naturally occurring process in which an intervening intein domain excises itself out of a precursor polypeptide in an autocatalytic fashion with concomitant linkage of the two flanking extein sequences by a native peptide bond. We have recently reported an engineered split VMA intein whose splicing activity in trans between two polypeptides can be triggered by the small molecule rapamycin. In this report, we show that this conditional protein splicing (CPS) system can be used in mammalian cells. Two model constructs harboring maltose-binding protein (MBP) and a His-tag as exteins were expressed from a constitutive promoter after transient transfection. The splicing product MBP-His was detected by Western blotting and immunoprecipitation in cells treated with rapamycin or a nontoxic analogue thereof. No background splicing in the absence of the small-molecule inducer was observed over a 24-h time course. Product formation could be detected within 10 min of addition of rapamycin, indicating the advantage of the posttranslational nature of CPS for quick responses. The level of protein splicing was dose dependent and could be competitively attenuated with the small molecule ascomycin. In related studies, the geometric flexibility of the CPS components was investigated with a series of purified proteins. The FKBP and FRB domains, which are dimerized by rapamycin and thereby induce the reconstitution of the split intein, were fused to the extein sequences of the split intein halves. CPS was still triggered by rapamycin when FKBP and FRB occupied one or both of the extein positions. This finding suggests yet further applications of CPS in the area of proteomics. In summary, CPS holds great promise to become a powerful new tool to control protein structure and function in vitro and in living cells.

  15. Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada.

    Science.gov (United States)

    Sun, Zhuoyu; Liu, Lin; Wang, Peizhong Peter; Roebothan, Barbara; Zhao, Jin; Dicks, Elizabeth; Cotterchio, Michelle; Buehler, Sharon; Campbell, Peter T; McLaughlin, John R; Parfrey, Patrick S

    2012-03-26

    Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC) risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL) and Ontario (ON), Canada. Incident colorectal cancer cases (n = 1760) were identified from population-based cancer registries in the provinces of ON (1997-2000) and NL (1999-2003). Controls (n = 2481) were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ), personal history questionnaire (PHQ), and food frequency questionnaire (FFQ) were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p-trend = 0.02, 5th versus 1st quintile), whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p-trend = 0.06, 5th versus 1st quintile), carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p-trend = 0.05, 5th versus 1st quintile) and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p-trend = 0.04, 5th versus 1st quintile). Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

  16. Association of total energy intake and macronutrient consumption with colorectal cancer risk: results from a large population-based case-control study in Newfoundland and Labrador and Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Sun Zhuoyu

    2012-03-01

    Full Text Available Abstract Background Diet is regarded as one of the most important environmental factors associated with colorectal cancer (CRC risk. A recent report comprehensively concluded that total energy intake does not have a simple relationship with CRC risk, and that the data were inconsistent for carbohydrate, cholesterol and protein. The objective of this study was to identify the associations of CRC risk with dietary intakes of total energy, protein, fat, carbohydrate, fiber, and alcohol using data from a large case-control study conducted in Newfoundland and Labrador (NL and Ontario (ON, Canada. Methods Incident colorectal cancer cases (n = 1760 were identified from population-based cancer registries in the provinces of ON (1997-2000 and NL (1999-2003. Controls (n = 2481 were a random sample of residents in each province, aged 20-74 years. Family history questionnaire (FHQ, personal history questionnaire (PHQ, and food frequency questionnaire (FFQ were used to collect study data. Logistic regression was used to evaluate the association of intakes of total energy, macronutrients and alcohol with CRC risk. Results Total energy intake was associated with higher risk of CRC (OR: 1.56; 95% CI: 1.21-2.01, p-trend = 0.02, 5th versus 1st quintile, whereas inverse associations emerged for intakes of protein (OR: 0.85, 95%CI: 0.69-1.00, p-trend = 0.06, 5th versus 1st quintile, carbohydrate (OR: 0.81, 95%CI: 0.63-1.00, p-trend = 0.05, 5th versus 1st quintile and total dietary fiber (OR: 0.84, 95% CI:0.67-0.99, p-trend = 0.04, 5th versus 1st quintile. Total fat, alcohol, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, and cholesterol were not associated with CRC risk. Conclusion This study provides further evidence that high energy intake may increase risk of incident CRC, whereas diets high in protein, fiber, and carbohydrate may reduce the risk of the disease.

  17. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  18. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  19. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  20. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  1. Total body water and total body potassium in anorexia nervosa

    Energy Technology Data Exchange (ETDEWEB)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-08-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation.

  2. Total body water and total body potassium in anorexia nervosa

    International Nuclear Information System (INIS)

    Dempsey, D.T.; Crosby, L.O.; Lusk, E.; Oberlander, J.L.; Pertschuk, M.J.; Mullen, J.L.

    1984-01-01

    In the ill hospitalized patient with clinically relevant malnutrition, there is a measurable decrease in the ratio of the total body potassium to total body water (TBK/TBW) and a detectable increase in the ratio of total exchangeable sodium to total exchangeable potassium (Nae/Ke). To evaluate body composition analyses in anorexia nervosa patients with chronic uncomplicated semistarvation, TBK and TBW were measured by whole body K40 counting and deuterium oxide dilution in 10 females with stable anorexia nervosa and 10 age-matched female controls. The ratio of TBK/TBW was significantly (p less than 0.05) higher in anorexia nervosa patients than controls. The close inverse correlation found in published studies between TBK/TBW and Nae/Ke together with our results suggest that in anorexia nervosa, Nae/Ke may be low or normal. A decreased TBK/TBW is not a good indicator of malnutrition in the anorexia nervosa patient. The use of a decreased TBK/TBW ratio or an elevated Nae/Ke ratio as a definition of malnutrition may result in inappropriate nutritional management in the patient with severe nonstressed chronic semistarvation

  3. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  4. Clinical- and cost-effectiveness of the STAR care pathway compared to usual care for patients with chronic pain after total knee replacement: study protocol for a UK randomised controlled trial.

    Science.gov (United States)

    Wylde, Vikki; Bertram, Wendy; Beswick, Andrew D; Blom, Ashley W; Bruce, Julie; Burston, Amanda; Dennis, Jane; Garfield, Kirsty; Howells, Nicholas; Lane, Athene; McCabe, Candy; Moore, Andrew J; Noble, Sian; Peters, Tim J; Price, Andrew; Sanderson, Emily; Toms, Andrew D; Walsh, David A; White, Simon; Gooberman-Hill, Rachael

    2018-02-21

    Approximately 20% of patients experience chronic pain after total knee replacement. There is little evidence for effective interventions for the management of this pain, and current healthcare provision is patchy and inconsistent. Given the complexity of this condition, multimodal and individualised interventions matched to pain characteristics are needed. We have undertaken a comprehensive programme of work to develop a care pathway for patients with chronic pain after total knee replacement. This protocol describes the design of a randomised controlled trial to evaluate the clinical- and cost-effectiveness of a complex intervention care pathway compared with usual care. This is a pragmatic two-armed, open, multi-centred randomised controlled trial conducted within secondary care in the UK. Patients will be screened at 2 months after total knee replacement and 381 patients with chronic pain at 3 months postoperatively will be recruited. Recruitment processes will be optimised through qualitative research during a 6-month internal pilot phase. Patients are randomised using a 2:1 intervention:control allocation ratio. All participants receive usual care as provided by their hospital. The intervention comprises an assessment clinic appointment at 3 months postoperatively with an Extended Scope Practitioner and up to six telephone follow-up calls over 12 months. In the assessment clinic, a standardised protocol is followed to identify potential underlying causes for the chronic pain and enable appropriate onward referrals to existing services for targeted and individualised treatment. Outcomes are assessed by questionnaires at 6 and 12 months after randomisation. The co-primary outcomes are pain severity and pain interference assessed using the Brief Pain Inventory at 12 months after randomisation. Secondary outcomes relate to resource use, function, neuropathic pain, mental well-being, use of pain medications, satisfaction with pain relief, pain frequency, capability

  5. Avoidance of Total Knee Arthroplasty in Early Osteoarthritis of the Knee with Intra-Articular Implantation of Autologous Activated Peripheral Blood Stem Cells versus Hyaluronic Acid: A Randomized Controlled Trial with Differential Effects of Growth Factor Addition

    Directory of Open Access Journals (Sweden)

    Thana Turajane

    2017-01-01

    Full Text Available In this randomized controlled trial, in early osteoarthritis (OA that failed conservative intervention, the need for total knee arthroplasty (TKA and WOMAC scores were evaluated, following a combination of arthroscopic microdrilling mesenchymal cell stimulation (MCS and repeated intra-articular (IA autologous activated peripheral blood stem cells (AAPBSCs with growth factor addition (GFA and hyaluronic acid (HA versus IA-HA alone. Leukapheresis-harvested AAPBSCs were administered as three weekly IA injections combined with HA and GFA (platelet-rich plasma [PRP] and granulocyte colony-stimulating factor [hG-CSF] and MCS in group 1 and in group 2 but without hG-CSF while group 3 received IA-HA alone. Each group of 20 patients was evaluated at baseline and at 1, 6, and, 12 months. At 12 months, all patients in the AAPBSC groups were surgical intervention free compared to three patients needing TKA in group 3 (p<0.033. Total WOMAC scores showed statistically significant improvements at 6 and 12 months for the AAPBSC groups versus controls. There were no notable adverse events. We have shown avoidance of TKA in the AAPBSC groups at 12 months and potent, early, and sustained symptom alleviation through GFA versus HA alone. Differential effects of hG-CSF were noted with an earlier onset of symptom alleviation throughout.

  6. Avoidance of Total Knee Arthroplasty in Early Osteoarthritis of the Knee with Intra-Articular Implantation of Autologous Activated Peripheral Blood Stem Cells versus Hyaluronic Acid: A Randomized Controlled Trial with Differential Effects of Growth Factor Addition

    Science.gov (United States)

    Turajane, Thana; Chaveewanakorn, Ukrit; Fongsarun, Warachaya; Aojanepong, Jongjate

    2017-01-01

    In this randomized controlled trial, in early osteoarthritis (OA) that failed conservative intervention, the need for total knee arthroplasty (TKA) and WOMAC scores were evaluated, following a combination of arthroscopic microdrilling mesenchymal cell stimulation (MCS) and repeated intra-articular (IA) autologous activated peripheral blood stem cells (AAPBSCs) with growth factor addition (GFA) and hyaluronic acid (HA) versus IA-HA alone. Leukapheresis-harvested AAPBSCs were administered as three weekly IA injections combined with HA and GFA (platelet-rich plasma [PRP] and granulocyte colony-stimulating factor [hG-CSF]) and MCS in group 1 and in group 2 but without hG-CSF while group 3 received IA-HA alone. Each group of 20 patients was evaluated at baseline and at 1, 6, and, 12 months. At 12 months, all patients in the AAPBSC groups were surgical intervention free compared to three patients needing TKA in group 3 (p < 0.033). Total WOMAC scores showed statistically significant improvements at 6 and 12 months for the AAPBSC groups versus controls. There were no notable adverse events. We have shown avoidance of TKA in the AAPBSC groups at 12 months and potent, early, and sustained symptom alleviation through GFA versus HA alone. Differential effects of hG-CSF were noted with an earlier onset of symptom alleviation throughout. PMID:29056974

  7. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  8. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  9. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  10. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  11. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  12. Quality control of total alpha and beta activity analysis in water using the Proportional Counter of Gaseous Flux technique; Controle de qualidade das análises de atividades alfa e beta total em água pela técnica do Contador Proporcional de Fluxo Gasoso

    Energy Technology Data Exchange (ETDEWEB)

    Neto, Alberto P.; Bastos, Thiago M.R.; Santos, Thiago O.; Filho, Crescêncio A.S.; França, Elvis J. de, E-mail: albertopereiran@gmail.com, E-mail: thiagomrbastos@gmail.com, E-mail: thiago_cbufpe@yahoo.com.br, E-mail: candrade@cnen.gov.br, E-mail: ejfranca@cnen.gov.br [Centro Regional de Ciências Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil)

    2017-07-01

    The analytical capacity of the CRCN (Centro Regional de Ciências Nucleares do Nordeste) for quantification of total alpha and beta concentrations in water samples using the Proportional Counter of Gaseous Flux is presented. To demonstrate the traceability of the results, the National Intercomparison Program (PNI) samples were used, promoted by the Institute of Radioprotection and Dosimetry (IRD) from which the Regional Nuclear Science Center of the Northeast (CRCN-NE) participates since 2011. The results reported to the PNI demonstrate the analytical capacity of the CRCN to detect the emission of alpha and beta radioactivities in water within the potability standards in analytical detection of quantification in radioactivity by the technique of the Proportional Flow Counter.

  13. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  14. Effects of a tele-prehabilitation program or an in-person prehabilitation program in surgical candidates awaiting total hip or knee arthroplasty: Protocol of a pilot single blind randomized controlled trial.

    Science.gov (United States)

    Doiron-Cadrin, Patrick; Kairy, Dahlia; Vendittoli, Pascal-André; Lowry, Véronique; Poitras, Stéphane; Desmeules, François

    2016-12-15

    The accessibility for total joint arthroplasty often comes up against long wait lists, and may lead to deleterious effects for the awaiting patients. This pilot single blind randomized controlled trial aims to evaluate the impact of a telerehabilitation prehabilitation program before a hip or knee arthroplasty compared to in-person prehabilitation or to usual wait for surgery. Thirty-six patients on a wait list for a total hip or knee arthroplasty will be recruited and randomly assigned to one of three groups. The in-person prehabilitation group (n = 12) will receive a 12-week rehabilitation program (2 sessions/week) including education, exercises of the lower limb and cardiovascular training. Patients in the tele-prehabilitation group (n = 12) will receive the same intervention using a telecommunication software. The control group (n = 12) will be provided with the hospital's usual documentation before surgery. The Lower Extremity Functional Scale (LEFS) will be the primary outcome measure taken at baseline and at 12 weeks. Secondary measures will include self-reported function and quality of life as well as performance tests. A mixed-model, 2-way repeated-measure ANOVA will be used to analyse the effects of the rehabilitation programs. This pilot study is the first to evaluate the feasibility and the impact of a telerehabilitation prehabilitation program for patients awaiting a total joint arthroplasty. The results of this pilot-RCT will set the foundations for further research in the fields of rehabilitation and tele-medicine for patients suffering from lower limb osteoarthritis. ClinicalTrials.gov: NCT02636751.

  15. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  16. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  17. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  18. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  19. Test Case RCM-3 Using CPS

    Science.gov (United States)

    2001-03-01

    influence We observe an important variation of the flame length with the ratio gas / liquid injected (Figure 6 and Figure 7). The flame length increases with...fraction, the flame length increases (Figure 7). This is due to the increase of the oxygen injection speed to obtain the correct amount of oxygen...influence of C, with have made calculation with an arbitrary value for a witch is 10-6 N / m. The flame length decrease with the surface tension

  20. Effect of sepsis on calcium uptake and content in skeletal muscle and regulation in vitro by calcium of total and myofibrillar protein breakdown in control and septic muscle: Results from a preliminary study

    International Nuclear Information System (INIS)

    Benson, D.W.; Hasselgren, P.O.; Hiyama, D.T.; James, J.H.; Li, S.; Rigel, D.F.; Fischer, J.E.

    1989-01-01

    Because high calcium concentration in vitro stimulates muscle proteolysis, calcium has been implicated in the pathogenesis of increased muscle breakdown in different catabolic conditions. Protein breakdown in skeletal muscle is increased during sepsis, but the effect of sepsis on muscle calcium uptake and content is not known. In this study the influence of sepsis, induced in rats by cecal ligation and puncture, on muscle calcium uptake and content was studied. Sixteen hours after cecal ligation and puncture or sham operation, calcium content of the extensor digitorum longus (EDL) and soleus (SOL) muscles was determined with an atomic absorption spectrometer. Calcium uptake was measured in intact SOL muscles incubated in the presence of calcium 45 (45Ca) for between 1 and 120 minutes. Total and myofibrillar protein breakdown was determined in SOL muscles, incubated in the presence of different calcium concentrations (0; 2.5; 5.0 mmol/L), and measured as release into the incubation medium of tyrosine and 3-methylhistidine (3-MH), respectively. Calcium content was increased by 51% (p less than 0.001) during sepsis in SOL and by 10% (p less than 0.05) in EDL muscle. There was no difference in 45Ca uptake between control and septic muscles during the early phase (1 to 5 minutes) of incubation. During more extended incubation (30 to 120 minutes), muscles from septic rats took up significantly more 45Ca than control muscles (p less than 0.05). Tyrosine release by incubated SOL muscles from control and septic rats was increased when calcium was added to the incubation medium, and at a calcium concentration of 2.5 mmol/L, the increase in tyrosine release was greater in septic than in control muscle. Addition of calcium to the incubation medium did not affect 3-MH release in control or septic muscle

  1. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  2. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  3. Reduction of total labor length through the addition of parenteral dextrose solution in induction of labor in nulliparous: results of DEXTRONS prospective randomized controlled trial.

    Science.gov (United States)

    Paré, Josianne; Pasquier, Jean-Charles; Lewin, Antoine; Fraser, William; Bureau, Yves-André

    2017-05-01

    Prolonged labor is a significant cause of maternal and fetal morbidity and very few interventions are known to shorten labor course. Skeletal muscle physiology suggests that glucose supplementation might improve muscle performance in case of prolonged exercise and this situation is analogous to the gravid uterus during delivery. Therefore, it seemed imperative to evaluate the impact of adding carbohydrate supplements on the course of labor. We sought to provide evidence as to whether intravenous glucose supplementation during labor induction in nulliparous women can reduce total duration of active labor. We performed a single-center prospective double-blind randomized controlled trial comparing the use of parental intravenous dextrose 5% with normal saline to normal saline in induced nulliparous women. The study was conducted in a tertiary-level university hospital setting. Participants, caregivers, and those assessing the outcomes were blinded to group assignment. Inclusion criteria were singleton pregnancy at term with cephalic presentation and favorable cervix. Based on blocked randomization, patients were assigned to receive either 250 mL/h of intravenous dextrose 5% with normal saline or 250 mL/h of normal saline for the whole duration of induction, labor, and delivery. The primary outcome studied was the total length of active labor. Secondary outcomes included duration of the active phase of second stage of labor, the mode of delivery, Apgar scores, and arterial cord pH. In all, 100 patients were randomized into each group. A total of 193 patients (96 in the dextrose with normal saline group and 97 in the normal saline group) were analyzed in the study. The median total duration of labor was significantly less in the dextrose with normal saline group (499 vs 423 minutes, P = .024) than in the normal saline group. The probabilities of a woman being delivered at 200 minutes and 450 minutes were 18.8% and 77.1% in the dextrose with normal saline group vs 8

  4. Middle infrared (wavelength range: 8 μm-14 μm) 2-dimensional spectroscopy (total weight with electrical controller: 1.7 kg, total cost: less than 10,000 USD) so-called hyperspectral camera for unmanned air vehicles like drones

    Science.gov (United States)

    Yamamoto, Naoyuki; Saito, Tsubasa; Ogawa, Satoru; Ishimaru, Ichiro

    2016-05-01

    We developed the palm size (optical unit: 73[mm]×102[mm]×66[mm]) and light weight (total weight with electrical controller: 1.7[kg]) middle infrared (wavelength range: 8[μm]-14[μm]) 2-dimensional spectroscopy for UAV (Unmanned Air Vehicle) like drone. And we successfully demonstrated the flights with the developed hyperspectral camera mounted on the multi-copter so-called drone in 15/Sep./2015 at Kagawa prefecture in Japan. We had proposed 2 dimensional imaging type Fourier spectroscopy that was the near-common path temporal phase-shift interferometer. We install the variable phase shifter onto optical Fourier transform plane of infinity corrected imaging optical systems. The variable phase shifter was configured with a movable mirror and a fixed mirror. The movable mirror was actuated by the impact drive piezo-electric device (stroke: 4.5[mm], resolution: 0.01[μm], maker: Technohands Co.,Ltd., type:XDT50-45, price: around 1,000USD). We realized the wavefront division type and near common path interferometry that has strong robustness against mechanical vibrations. Without anti-mechanical vibration systems, the palm-size Fourier spectroscopy was realized. And we were able to utilize the small and low-cost middle infrared camera that was the micro borometer array (un-cooled VOxMicroborometer, pixel array: 336×256, pixel pitch: 17[μm], frame rate 60[Hz], maker: FLIR, type: Quark 336, price: around 5,000USD). And this apparatus was able to be operated by single board computer (Raspberry Pi.). Thus, total cost was less than 10,000 USD. We joined with KAMOME-PJ (Kanagawa Advanced MOdule for Material Evaluation Project) with DRONE FACTORY Corp., KUUSATSU Corp., Fuji Imvac Inc. And we successfully obtained the middle infrared spectroscopic imaging with multi-copter drone.

  5. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  6. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  7. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  8. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  9. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  10. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  11. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  12. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  13. Can Arthroplasty Stem INfluence Outcome? (CASINO): a randomized controlled equivalence trial of 125 mm versus 150 mm Exeter V40 stems in total hip arthroplasty.

    Science.gov (United States)

    Hamilton, David F; Ohly, Nicholas E; Gaston, Paul

    2018-04-16

    The use of shorter length femoral stems during total hip arthroplasty has been suggested to accommodate wider patient femoral geometry and offer maximal bone preservation. However, cemented short-stem designs may increase the risk of varus stem malalignment and influence patient outcomes. CASINO is a multi-centre randomised equivalence trial that will recruit 220 patients undergoing total hip arthroplasty for osteoarthritis at two NHS hospitals in Scotland. Patients will be aged 45-80, undergoing unilateral primary hip arthroplasty, with no plan for contralateral procedure within the study timeframe, and able to comply with the protocol. Participants will be randomised to receive either a short (125 mm) or a standard (150 mm) Exeter V40 stem. The Contemporary acetabular component will be used in all cases. All implants will be cemented. Patient pain, function and satisfaction will be assessed using change from baseline measurement in Oxford Hip Score, Forgotten Joint Score, EQ-5D, pain numerical rating scores, and patient satisfaction questionnaire at baseline and at 1 and 2 years following surgery. Radiographic assessment will evaluate stem position and will be appraised by independent reviewers. Patients will be blind to implant allocation. Stem length may be associated with outcome; however, we can find no randomised trial in which researchers investigated the effect of stem length on patient outcome following cemented total hip arthroplasty. The aim of this trial is to determine if the use of short cemented stems offers equivalent patient outcomes to those achieved following surgery with standard length stems. International Standard Randomised Controlled Trial Number, ISRCTN13154542 , Registered on 30 June 2017.

  14. Migration and head penetration of Vitamin-E diffused cemented polyethylene cup compared to standard cemented cup in total hip arthroplasty: study protocol for a randomised, double-blind, controlled trial (E1 HIP).

    Science.gov (United States)

    Sköldenberg, Olof; Rysinska, Agata; Chammout, Ghazi; Salemyr, Mats; Muren, Olle; Bodén, Henrik; Eisler, Thomas

    2016-07-07

    In vitro, Vitamin-E-diffused, highly cross-linked polyethylene (PE) has been shown to have superior wear resistance and improved mechanical properties when compared to those of standard highly cross-linked PE liners used in total hip arthroplasty (THA). The aim of the study is to evaluate the safety of a new cemented acetabular cup with Vitamin-E-doped PE regarding migration, head penetration and clinical results. In this single-centre, double-blinded, randomised controlled trial, we will include 50 patients with primary hip osteoarthritis scheduled for THA and randomise them in a 1:1 ratio to a cemented cup with either argon gas-sterilised PE (control group) or Vitamin-E-diffused PE (vitamin-e group). All patients and the assessor of the primary outcome will be blinded and the same uncemented stem will be used for all participants. The primary end point will be proximal migration of the cup at 2 years after surgery measured with radiostereometry. Secondary end points include proximal migration at other follow-ups, total migration, femoral head penetration, clinical outcome scores and hip-related complications. Patients will be followed up at 3 months and at 1, 2, 5 and 10 years postoperatively. Results will be analysed using 95% CIs for the effect size. A regression model will also be used to adjust for stratification factors. The ethical committee at Karolinska Institutet has approved the study. The first results from the study will be disseminated to the medical community via presentations and publications in relevant medical journals when the last patient included has been followed up for 2 years. NCT02254980. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Patient blood management in elective total hip- and knee-replacement surgery (part 2): a randomized controlled trial on blood salvage as transfusion alternative using a restrictive transfusion policy in patients with a preoperative hemoglobin above 13 g/dl.

    Science.gov (United States)

    So-Osman, Cynthia; Nelissen, Rob G H H; Koopman-van Gemert, Ankie W M M; Kluyver, Ewoud; Pöll, Ruud G; Onstenk, Ron; Van Hilten, Joost A; Jansen-Werkhoven, Thekla M; van den Hout, Wilbert B; Brand, Ronald; Brand, Anneke

    2014-04-01

    Patient blood management is introduced as a new concept that involves the combined use of transfusion alternatives. In elective adult total hip- or knee-replacement surgery patients, the authors conducted a large randomized study on the integrated use of erythropoietin, cell saver, and/or postoperative drain reinfusion devices (DRAIN) to evaluate allogeneic erythrocyte use, while applying a restrictive transfusion threshold. Patients with a preoperative hemoglobin level greater than 13 g/dl were ineligible for erythropoietin and evaluated for the effect of autologous blood reinfusion. Patients were randomized between autologous reinfusion by cell saver or DRAIN or no blood salvage device. Primary outcomes were mean intra- and postoperative erythrocyte use and proportion of transfused patients (transfusion rate). Secondary outcome was cost-effectiveness. In 1,759 evaluated total hip- and knee-replacement surgery patients, the mean erythrocyte use was 0.19 (SD, 0.9) erythrocyte units/patient in the autologous group (n = 1,061) and 0.22 (0.9) erythrocyte units/patient in the control group (n = 698) (P = 0.64). The transfusion rate was 7.7% in the autologous group compared with 8.3% in the control group (P = 0.19). No difference in erythrocyte use was found between cell saver and DRAIN groups. Costs were increased by €298 per patient (95% CI, 76 to 520). In patients with preoperative hemoglobin levels greater than 13 g/dl, autologous intra- and postoperative blood salvage devices were not effective as transfusion alternatives: use of these devices did not reduce erythrocyte use and increased costs.

  16. Facile morphology-controlled synthesis of nickel-coated graphite core-shell particles for excellent conducting performance of polymer-matrix composites and enhanced catalytic reduction of 4-nitrophenol

    Science.gov (United States)

    Bian, Juan; Lan, Fang; Wang, Yilong; Ren, Ke; Zhao, Suling; Li, Wei; Chen, Zhihong; Li, Jiangyu; Guan, Jianguo

    2018-04-01

    We have developed a novel seed-mediated growth method to fabricate nickel-coated graphite composite particles (GP@Ni-CPs) with controllable shell morphology by simply adjusting the concentration of sodium hydroxide ([NaOH]). The fabrication of two kinds of typical GP@Ni-CPs includes adsorption of Ni2+ via electrostatic attraction, sufficient heterogeneous nucleation of Ni atoms by an in situ reduction, and shell-controlled growth by regulating the kinetics of electroless Ni plating in turn. High [NaOH] results in fast kinetics of electroless plating, which causes heterogeneous nuclei to grow isotropically. After fast and uniform growth of Ni nuclei, GP@Ni-CPs with dense shells can be achieved. The first typical GP@Ni-CPs exhibit denser shells, smaller diameters and higher conductivities than the available commercial ones, indicating their important applications in the conducting of polymer-matrix composites. On the other hand, low [NaOH] favors slow kinetics. Thus, the reduction rate of Ni2+ slows down to a relatively low level so that electroless plating is dominated thermodynamically instead of kinetically, leading to an anisotropic crystalline growth of nuclei and finally to the formation of GP@Ni-CPs with nanoneedle-like shells. The second typical samples can effectively catalyze the reduction of p-nitrophenol into p-aminophenol with NaBH4 in comparison with commercial GP@Ni-CPs and RANEY® Ni, owing to the strong charge accumulation effect of needle-like Ni shells. This work proposes a model system for fundamental investigations and has important applications in the fields of electronic interconnection and catalysis.

  17. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  18. TOTAL PERFORMANCE SCORECARD

    Directory of Open Access Journals (Sweden)

    Anca ȘERBAN

    2013-06-01

    Full Text Available The purpose of this paper is to present the evolution of the Balanced Scorecard from a measurement instrument to a strategic performance management tool and to highlight the advantages of implementing the Total Performance Scorecard, especially for Human Resource Management. The study has been accomplished using the methodology of bibliographic study and various secondary sources. Implementing the classical Balanced Scorecard indicated over the years, repeatedly failure. It can be indicated that the crucial level is determined by the learning and growth perspective. It has been developed from a human perspective, which focused on staff satisfaction, innovation perspective with focus on future developments. Integrating the Total Performance Scorecard in an overall framework assures the company’s success, by keeping track of the individual goals, the company’s objectives and strategic directions. Like this, individual identity can be linked to corporate brand, individual aspirations to business goals and individual learning objectives to needed organizational capabilities.

  19. Totally parallel multilevel algorithms

    Science.gov (United States)

    Frederickson, Paul O.

    1988-01-01

    Four totally parallel algorithms for the solution of a sparse linear system have common characteristics which become quite apparent when they are implemented on a highly parallel hypercube such as the CM2. These four algorithms are Parallel Superconvergent Multigrid (PSMG) of Frederickson and McBryan, Robust Multigrid (RMG) of Hackbusch, the FFT based Spectral Algorithm, and Parallel Cyclic Reduction. In fact, all four can be formulated as particular cases of the same totally parallel multilevel algorithm, which are referred to as TPMA. In certain cases the spectral radius of TPMA is zero, and it is recognized to be a direct algorithm. In many other cases the spectral radius, although not zero, is small enough that a single iteration per timestep keeps the local error within the required tolerance.

  20. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  1. MFTF TOTAL benchmark

    International Nuclear Information System (INIS)

    Choy, J.H.

    1979-06-01

    A benchmark of the TOTAL data base management system as applied to the Mirror Fusion Test Facility (MFTF) data base was implemented and run in February and March of 1979. The benchmark was run on an Interdata 8/32 and involved the following tasks: (1) data base design, (2) data base generation, (3) data base load, and (4) develop and implement programs to simulate MFTF usage of the data base

  2. Total Absorption Spectroscopy

    International Nuclear Information System (INIS)

    Rubio, B.; Gelletly, W.

    2007-01-01

    The problem of determining the distribution of beta decay strength (B(GT)) as a function of excitation energy in the daughter nucleus is discussed. Total Absorption Spectroscopy is shown to provide a way of determining the B(GT) precisely. A brief history of such measurements and a discussion of the advantages and disadvantages of this technique, is followed by examples of two recent studies using the technique. (authors)

  3. Sobredentadura total superior implantosoportada

    Directory of Open Access Journals (Sweden)

    Luis Orlando Rodríguez García

    2010-06-01

    Full Text Available Se presenta un caso de un paciente desdentado total superior, rehabilitado en la consulta de implantología de la Clínica "Pedro Ortiz" del municipio Habana del Este en Ciudad de La Habana, Cuba, en el año 2009, mediante prótesis sobre implantes osteointegrados, técnica que se ha incorporado a la práctica estomatológica en Cuba como alternativa al tratamiento convencional en los pacientes desdentados totales. Se siguió un protocolo que comprendió una fase quirúrgica, procedimiento con o sin realización de colgajo y carga precoz o inmediata. Se presenta un paciente masculino de 56 años de edad, que acudió a la consulta multidisciplinaria, preocupado, porque se le habían elaborado tres prótesis en los últimos dos años y ninguna reunía los requisitos de retención que él necesitaba para sentirse seguro y cómodo con las mismas. El resultado final fue la satisfacción total del paciente, con el mejoramiento de la calidad estética y funcional.

  4. Post-operative analgesia following total knee arthroplasty: comparison of low-dose intrathecal morphine and single-shot ultrasound-guided femoral nerve block: a randomized, single blinded, controlled study.

    Science.gov (United States)

    Frassanito, L; Vergari, A; Zanghi, F; Messina, A; Bitondo, M; Antonelli, M

    2010-07-01

    Total knee arthroplasty often results in marked postoperative pain. A recent meta-analysis supports the use of femoral nerve block or alternatively spinal injection of morphine plus local anaesthetic for post-operative analgesia. On the other hand, the use of intrathecal morphine may be associated with a large number of distressing side effects (itching, urinary retention, nausea and vomiting, delayed respiratory depression). The aim of this study was to compare the effectiveness of femoral nerve block and low dose intrathecal morphine in post-operative analgesia after primary unilateral total knee arthroplasty. Fifty-two consecutive patients scheduled for primary unilateral total knee arthroplasty were allocated to the intrathecal morphine group (ITM group) or to the femoral nerve block group (FNB group). In ITM group a subarachnoid puncture was performed at the L3-L4 inter-vertebral space with hyperbaric bupivacaine 15 mg plus 100 mcg of preservative-free morphine. Patients allocated to the FNB group received a single-injection ultrasound-assisted femoral nerve block with ropivacaine 0.75% 25 ml before the spinal injection of hyperbaric bupivacaine 15 mg. All patients received postoperative patient-controlled-analgesia (PCA) morphine, using a 1-mg bolus and a 5-minute lockout period. Data were analyzed using Student t test or two-way analysis of variance (ANOVA) for repeated measures with time and treatment as the 2 factors. Post hoc comparisons were performed by Bonferroni test. Statistical significance for all test was a p value < 0.05. Patient characteristics were similar between the 2 groups. We found a statistically significant differences in postoperative pain between the two groups: ITM group had the lower visual analogic pain score (VAS) values. Morphine consumption was lower in the ITM group: average consumption within the first 6 hours was 0.9 mg in IT group compared to 3.1 mg in FNB group; at 12 h 4.2 mg vs 6.3 mg; at 24 h 6.9 mg vs 10.3 mg; at 48 h 9

  5. Discussions on the business strategy against total reimbursement control of medical insurance for large public hospitals%医保总额控制下大型公立医院经营策略探讨

    Institute of Scientific and Technical Information of China (English)

    余臻峥; 陈敏芳

    2015-01-01

    为解决医疗费用过快上涨、医保对供方行为约束不足、基金运行风险加剧等问题,人力资源和社会保障部等要求在统筹地区开展以总额控制为主的医保支付方式改革.总额控制对城市大型公立医院的经营管理产生了较大的影响.按照总额控制政策,提出3个层面的转型策略.在发展战略方面,转变增长方式,发挥医联体作用,增强辐射能力;在业务管理方面,确保医疗质量和安全,落实临床路径,优化服务流程;在行政管理方面,强化成本控制,加强信息化建设,转变管理职能.%To address such challenges as the rapid rise in health care costs,insufficient constraints on supply-side behavior by medical insurance,and rising risk exposure of the insurance foundation,the Ministry of Human Resources and Social Security has proposed a payment mode reform featuring total reimbursement control.Such a total control policy will affect significantly the business operation of urban public hospitals.To adapt to the impacts so incurred,a three-level transformation strategy is recommended as follows.A development strategy calling for a new growth model,greater role of hospital-health alliances for greater service coverage; a business management strategy to ensure quality of care and safety,clinical pathways in place and optimize service processes; an administrative strategy to enhance cost control,strengthen information technology,and transform the management functions.

  6. The effect of ultrapro or prolene mesh on postoperative pain and well-being following endoscopic Totally Extraperitoneal (TEP hernia repair (TULP: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schouten Nelleke

    2012-06-01

    Full Text Available Abstract Background The purpose of this study was to describe the rationale and design of a randomized controlled trial analyzing the effects of mesh type (Ultrapro versus Prolene mesh on postoperative pain and well-being following an endoscopic Totally Extraperitoneal (TEP repair for inguinal hernias (short: TULP trial. Methods and design The TULP trial is a prospective, two arm, double blind, randomized controlled trial to assess chronic postoperative pain and quality of life following implantation of a lightweight (Ultrapro and heavyweight (Prolene mesh in endoscopic TEP hernia repair. The setting is a high-volume single center hospital, specializing in TEP hernia repair. All patients are operated on by one of four surgeons. Adult male patients (≥18 years of age with primary, reducible, unilateral inguinal hernias and no contraindications for TEP repair are eligible for inclusion in the study. The primary outcome is substantial chronic postoperative pain, defined as moderate to severe pain persisting ≥ 3 months postoperatively (Numerical Rating Scale, NRS 4–10. Secondary endpoints are the individual development of pain until three years after the TEP procedure, the quality of life (QoL, recurrence rate, patient satisfaction and complications. Discussion Large prospective randomized controlled studies with a long follow-up evaluating the incidence of chronic postoperative pain following implantation of lightweight and heavyweight mesh in endoscopic (TEP hernia repair are limited. By studying the presence of pain and quality of life, but also complications and recurrences in a large patient population, a complete efficiency and feasibility assessment of both mesh types in TEP hernia repair will be performed. Trial registration The TULP study is registered in the Dutch Trial Register (NTR2131

  7. Optimization and Control of Cyber-Physical Vehicle Systems

    Directory of Open Access Journals (Sweden)

    Justin M. Bradley

    2015-09-01

    Full Text Available A cyber-physical system (CPS is composed of tightly-integrated computation, communication and physical elements. Medical devices, buildings, mobile devices, robots, transportation and energy systems can benefit from CPS co-design and optimization techniques. Cyber-physical vehicle systems (CPVSs are rapidly advancing due to progress in real-time computing, control and artificial intelligence. Multidisciplinary or multi-objective design optimization maximizes CPS efficiency, capability and safety, while online regulation enables the vehicle to be responsive to disturbances, modeling errors and uncertainties. CPVS optimization occurs at design-time and at run-time. This paper surveys the run-time cooperative optimization or co-optimization of cyber and physical systems, which have historically been considered separately. A run-time CPVS is also cooperatively regulated or co-regulated when cyber and physical resources are utilized in a manner that is responsive to both cyber and physical system requirements. This paper surveys research that considers both cyber and physical resources in co-optimization and co-regulation schemes with applications to mobile robotic and vehicle systems. Time-varying sampling patterns, sensor scheduling, anytime control, feedback scheduling, task and motion planning and resource sharing are examined.

  8. Optimization and Control of Cyber-Physical Vehicle Systems.

    Science.gov (United States)

    Bradley, Justin M; Atkins, Ella M

    2015-09-11

    A cyber-physical system (CPS) is composed of tightly-integrated computation, communication and physical elements. Medical devices, buildings, mobile devices, robots, transportation and energy systems can benefit from CPS co-design and optimization techniques. Cyber-physical vehicle systems (CPVSs) are rapidly advancing due to progress in real-time computing, control and artificial intelligence. Multidisciplinary or multi-objective design optimization maximizes CPS efficiency, capability and safety, while online regulation enables the vehicle to be responsive to disturbances, modeling errors and uncertainties. CPVS optimization occurs at design-time and at run-time. This paper surveys the run-time cooperative optimization or co-optimization of cyber and physical systems, which have historically been considered separately. A run-time CPVS is also cooperatively regulated or co-regulated when cyber and physical resources are utilized in a manner that is responsive to both cyber and physical system requirements. This paper surveys research that considers both cyber and physical resources in co-optimization and co-regulation schemes with applications to mobile robotic and vehicle systems. Time-varying sampling patterns, sensor scheduling, anytime control, feedback scheduling, task and motion planning and resource sharing are examined.

  9. Total Synthesis of Hyperforin.

    Science.gov (United States)

    Ting, Chi P; Maimone, Thomas J

    2015-08-26

    A 10-step total synthesis of the polycyclic polyprenylated acylphloroglucinol (PPAP) natural product hyperforin from 2-methylcyclopent-2-en-1-one is reported. This route was enabled by a diketene annulation reaction and an oxidative ring expansion strategy designed to complement the presumed biosynthesis of this complex meroterpene. The described work enables the preparation of a highly substituted bicyclo[3.3.1]nonane-1,3,5-trione motif in only six steps and thus serves as a platform for the construction of easily synthesized, highly diverse PPAPs modifiable at every position.

  10. Total quality is people

    International Nuclear Information System (INIS)

    Vogel, C.E.

    1991-01-01

    Confronted by changing market conditions and increased global competition, in 1983 the Commercial Nuclear Fuel Division (CNFD) of Westinghouse Electric embarked on an ambitious plan to make total quality the centerpiece of its long-term business strategy. Five years later, the division's efforts in making continuous quality improvement a way of life among its more than 2,000 employees gained national recognition when it was named a charter recipient of the Malcolm Baldridge National Quality Award. What CNFD achieved during the 1980s was a cultural transformation, characterized by an empowered work force committed to a common vision. The company's quality program development strategy is described

  11. Total quality accounting

    Directory of Open Access Journals (Sweden)

    Andrijašević Maja

    2008-01-01

    Full Text Available The focus of competitive "battle" shifted from the price towards non-price instruments, above all, towards quality that became the key variable for profitability increase and achievement of better comparative position of a company. Under such conditions, management of a company, which, according to the established and certified system of total quality, strives towards achieving of a better market position, faces the problem of quality cost measurement and determination. Management, above all, cost accounting can help in solving of this problem, but the question is how much of its potential is being used for that purpose.

  12. Total_Aktion

    DEFF Research Database (Denmark)

    Søndergaard, Morten

    2008-01-01

    digitale medier er registreringen og muligheden for at opbevare og håndtere digital data uden begrænsninger. Oplevelse, registrering og bevaring knyttes sammen i en ny museal virkelighed, hvor samlingens særlige dokumentariske karakter og fokus, som er unikt for Museet for Samtidskunst, er i centrum...... at mikse deres personlige drinks. TOTAL_AKTION viser Hørbar#3, som er en videreudvikling af den første version. METASYN af Carl Emil Carlsen: Metadata er centralt for Carl Emil Carlsens projekt, der betragter museets samling som et ”univers” af værker (analoge og digitale), beskrivelser og relationer. I...

  13. Total Factbook 2003

    International Nuclear Information System (INIS)

    2003-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2003. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  14. Total 2004 fact book

    International Nuclear Information System (INIS)

    2004-01-01

    This report presents the activities and results of the Group Total-Fina-Elf for the year 2004. It brings information and economic data on the following topics: the corporate and business; the upstream activities with the reserves, the costs, standardized measure and changes of discounted future net cash flow,oil and gas acreage, drilling, liquefied natural gas, pipelines; downstream activities with refining and marketing maps, refinery, petroleum products, sales, retail gasoline outlets; chemicals with sales and operating income by sector, major applications, base chemicals and polymers, intermediates and performance polymers. (A.L.B.)

  15. Total knee arthroplasty

    DEFF Research Database (Denmark)

    Schrøder, Henrik M.; Petersen, Michael M.

    2016-01-01

    Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

  16. TOTAL user manual

    Science.gov (United States)

    Johnson, Sally C.; Boerschlein, David P.

    1994-01-01

    Semi-Markov models can be used to analyze the reliability of virtually any fault-tolerant system. However, the process of delineating all of the states and transitions in the model of a complex system can be devastatingly tedious and error-prone. Even with tools such as the Abstract Semi-Markov Specification Interface to the SURE Tool (ASSIST), the user must describe a system by specifying the rules governing the behavior of the system in order to generate the model. With the Table Oriented Translator to the ASSIST Language (TOTAL), the user can specify the components of a typical system and their attributes in the form of a table. The conditions that lead to system failure are also listed in a tabular form. The user can also abstractly specify dependencies with causes and effects. The level of information required is appropriate for system designers with little or no background in the details of reliability calculations. A menu-driven interface guides the user through the system description process, and the program updates the tables as new information is entered. The TOTAL program automatically generates an ASSIST input description to match the system description.

  17. Effect of Medications for Gastric Acid-Related Symptoms on Total Motile Sperm Count and Concentration: A Case-Control Study in Men of Subfertile Couples from the Netherlands.

    Science.gov (United States)

    Huijgen, Nicole A; Goijen, Hedwig J; Twigt, John M; Mulders, Annemarie G M G J; Lindemans, Jan; Dohle, Gert R; Laven, Joop S E; Steegers-Theunissen, Régine P M

    2017-03-01

    Gastric acid-related symptoms are highly prevalent in the general population (21-40%), and more than 11% of individuals use medication for the treatment of these symptoms. The uptake of micronutrients is dependent on the gastrointestinal potential of hydrogen (pH). We hypothesized that medication affecting gastrointestinal pH reduces the availability of B vitamins, thereby deranging one-carbon metabolism and detrimentally affecting spermatogenesis. This explorative nested case-control study in men of subfertile couples investigated associations between medication used for gastric acid-related symptoms and semen parameters. We included 40 men using medication for gastric acid-related symptoms and 843 men not using medication. Semen analyses were performed between 70 days before and 21 days after the visit. The use of medication was associated with a twofold higher risk of a low total motile sperm count [TMSC sperm concentration (β -0.320, p = 0.028). Red blood cell folate was positively associated with TMSC (β 0.257, p = 0.026), sperm count (β 1.679, p = 0.013) and ejaculate volume (β 0.120, p = 0.023), and total homocysteine (tHcy) was negatively associated with sperm count (β -0.077, p = 0.021). Here we delineate associations between the use of medication for gastric acid-related symptoms and poor semen quality in men of subfertile couples. The use of medication for gastric acid-related symptoms is associated with a twofold higher risk of a low TMSC and a decreased sperm concentration. Although these findings warrant further research on causality, the associations between folate, tHcy and semen quality emphasize the importance of preconception counselling in male subfertility.

  18. Efficacy of treatment of insomnia in migraineurs with eszopiclone (Lunesta®) and its effect on total sleep time, headache frequency, and daytime functioning: A randomized, double-blind, placebo-controlled, parallel-group, pilot study.

    Science.gov (United States)

    Spierings, Egilius L H; McAllister, Peter J; Bilchik, Tanya R

    2015-04-01

    A review on headache and insomnia revealed that insomnia is a risk factor for increased headache frequency and headache intensity in migraineurs. The authors designed a randomized, double blind, placebo-controlled, parallel-group, pilot study in which migraineurs who also had insomnia were enrolled, to test this observation. In the study, the authors treated 79 subjects with IHS-II migraine with and/or without aura and with DSM-IV primary insomnia for 6 weeks with 3 mg eszopiclone (Lunesta(®)) or placebo at bedtime. The treatment was preceded by a 2-week baseline period and followed by a 2-week run-out period. Of the 79 subjects treated, 75 were evaluable, 35 in the eszopiclone group, and 40 in the placebo group. At baseline, the groups were comparable except for sleep latency. Of the three remaining sleep variables, total sleep time, nighttime awakenings, and sleep quality, the number of nighttime awakenings during the 6-week treatment period was significantly lower in the eszopiclone group than in the placebo group (P = 0.03). Of the three daytime variables, alertness, fatigue, and functioning, this was also the case for fatigue (P = 005). The headache variables, frequency, duration, and intensity, did not show a difference from placebo during the 6-week treatment period. The study did not meet primary endpoint, that is, the difference in total sleep time during the 6-week treatment period between eszopiclone and placebo was less than 40 minutes. Therefore, it failed to answer the question as to whether insomnia is, indeed, a risk factor for increased headache frequency and headache intensity in migraineurs.

  19. A report on the indoor residual spraying (IRS) in the control of Phlebotomus argentipes, the vector of visceral leishmaniasis in Bihar (India): an initiative towards total elimination targeting 2015 (Series-1).

    Science.gov (United States)

    Kumar, V; Kesari, S; Dinesh, D S; Tiwari, A K; Kumar, A J; Kumar, R; Singh, V P; Das, P

    2009-09-01

    Visceral leishmaniasis, commonly known as kala-azar is endemic in Bihar state, India. Current vector control programme in Bihar focuses mainly on spraying the sandfly infested dwellings with DDT. The Government of India in collaboration with WHO has fixed the target 2015 for total elimination of kala-azar. The present study was carried out to see the impact of DDT and improved IEC in the containment of vector density vis-à-vis disease transmission. Before the start of the spraying operations training was imparted to all the medical and paramedical personnel regarding the methods of spraying operations. Pre- and post-sandfly density was monitored in four selected districts. Incidences of kala-azar cases were compared for pre- and post-spray periods. Social acceptability and perceptions of households was collected through questionnaires from 500 randomly selected households in the study districts. House index in three study districts reduced considerably during post-spray when compared to pre-spray. Kala-azar incidence in many districts was reduced after the DDT spray. Either partial or complete refusal was reported in 14.4%, while 35% were not satisfied with the suspension concentration and coverage; and 46.6% were found satisfied with the spraying procedure. Strengthening the IEC activities to sensitise the community, proper training of health personnel, monitoring of spray, good surveillance, proper treatment of cases and two rounds of DDT spray with good coverage in the endemic districts up to three years are essential to achieve the desired total elimination of kala-azar in Bihar state.

  20. Deficiency of RgpG Causes Major Defects in Cell Division and Biofilm Formation, and Deficiency of LytR-CpsA-Psr Family Proteins Leads to Accumulation of Cell Wall Antigens in Culture Medium by Streptococcus mutans.

    Science.gov (United States)

    De, Arpan; Liao, Sumei; Bitoun, Jacob P; Roth, Randy; Beatty, Wandy L; Wu, Hui; Wen, Zezhang T

    2017-09-01

    Streptococcus mutans is known to possess rhamnose-glucose polysaccharide (RGP), a major cell wall antigen. S. mutans strains deficient in rgpG , encoding the first enzyme of the RGP biosynthesis pathway, were constructed by allelic exchange. The rgpG deficiency had no effect on growth rate but caused major defects in cell division and altered cell morphology. Unlike the coccoid wild type, the rgpG mutant existed primarily in chains of swollen, "squarish" dividing cells. Deficiency of rgpG also causes significant reduction in biofilm formation ( P cell envelope biogenesis, were constructed using the rgpG mutant. There were no major differences in growth rates between the wild-type strain and the rgpG brpA and rgpG psr double mutants, but the growth rate of the rgpG brpA psr triple mutant was reduced drastically ( P cells with multiple asymmetric septa. When analyzed by immunoblotting, the rgpG mutant displayed major reductions in cell wall antigens compared to the wild type, while little or no signal was detected with the double and triple mutants and the brpA and psr single mutants. These results suggest that RgpG in S. mutans plays a critical role in cell division and biofilm formation and that BrpA and Psr may be responsible for attachment of cell wall antigens to the cell envelope. IMPORTANCE Streptococcus mutans , a major etiological agent of human dental caries, produces rhamnose-glucose polysaccharide (RGP) as the major cell wall antigen. This study provides direct evidence that deficiency of RgpG, the first enzyme of the RGP biosynthesis pathway, caused major defects in cell division and morphology and reduced biofilm formation by S. mutans , indicative of a significant role of RGP in cell division and biofilm formation in S. mutans These results are novel not only in S. mutans , but also other streptococci that produce RGP. This study also shows that the LytR-CpsA-Psr family proteins BrpA and Psr in S. mutans are involved in attachment of RGP and probably

  1. Total process surveillance: (TOPS)

    International Nuclear Information System (INIS)

    Millar, J.H.P.

    1992-01-01

    A Total Process Surveillance system is under development which can provide, in real-time, additional process information from a limited number of raw measurement signals. This is achieved by using a robust model based observer to generate estimates of the process' internal states. The observer utilises the analytical reduncancy among a diverse range of transducers and can thus accommodate off-normal conditions which lead to transducer loss or damage. The modular hierarchical structure of the system enables the maximum amount of information to be assimilated from the available instrument signals no matter how diverse. This structure also constitutes a data reduction path thus reducing operator cognitive overload from a large number of varying, and possibly contradictory, raw plant signals. (orig.)

  2. Total and EDF invest

    International Nuclear Information System (INIS)

    Signoret, St.

    2008-01-01

    So as to prepare the future of their industrial sector,the Total company plans to invest (14 billion Euros in 2008) to increase its production capacities and strengthen in of other activities as the liquefied natural gas and the renewable energies; EDF plans to inject 35 billion Euros over three years to multiply the new projects of power plants (wind turbines, coal in Germany, gas in Great Britain and nuclear power in Flamanville). EDF wants to exploit its knowledge of leader to run more than ten E.P.R.(European pressurized water reactor) in the world before 2020, projects are in examination with China, Great Britain, South Africa and United States. (N.C.)

  3. Total quality at source

    International Nuclear Information System (INIS)

    Chiandone, A.C.

    1990-01-01

    The Total Quality at Source philosophy is based on optimizing the effectiveness of people in achieving ZERO-DEFECT results. In this paper a philosophy of what, I have come to perceive, it takes to get people to perform to the very best of their abilities and thereby achieve the best results they can, is presented. In the examples I shall describe I have played an instrumental role since it has become my belief that any job can always be done better provided that the people doing it can themselves become convinced that they can do better. Clearly there are many ideas on how to do this. The philosophy that I am presenting in this paper is based on my own experience, where I have both participated and observed it being applied; its effectiveness may be judged by the results. (author)

  4. Total ankle joint replacement.

    Science.gov (United States)

    2016-02-01

    Ankle arthritis results in a stiff and painful ankle and can be a major cause of disability. For people with end-stage ankle arthritis, arthrodesis (ankle fusion) is effective at reducing pain in the shorter term, but results in a fixed joint, and over time the loss of mobility places stress on other joints in the foot that may lead to arthritis, pain and dysfunction. Another option is to perform a total ankle joint replacement, with the aim of giving the patient a mobile and pain-free ankle. In this article we review the efficacy of this procedure, including how it compares to ankle arthrodesis, and consider the indications and complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. Anestesia venosa total com infusão alvo-controlada de remifentanil e propofol para ablação de fibrilação atrial Anestesia venosa total con infusión objeto-controlada de remifentanil y propofol para ablación de la fibrilación atrial Total intravenous anesthesia with target-controlled infusion of remifetanil and propofol for ablation of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Fernando Squeff Nora

    2009-12-01

    choice of anesthesia, monitors, and anesthesiologic care for this procedure performed outside the surgical center has not been described. The objective of this report was to describe an anesthesia technique for ablation of AF. CASE REPORT: This is a 49-year old female weighing 73 kg, 155 cm, and ASA II due to hypertension. The patient was monitored with a 12-lead ECG, pulse oximetry, heart rate, bispectral electroencephalography for BIS measurement, suppression rate (SR, and SEF95, and mean arterial pressure (MAP. Intravenous target-controlled infusion (TCI of propofol with a target of 4 µg.mL-1, intravenous TCI of remifentanil with a target of 3 ng.mL-1, and intravenous bolus of rocuronium 0.2 mg.kg-1 were used for induction of anesthesia. The pharmacokinetic model of propofol described by Marsh was used and incorporated into the propofol PFS pump®. The pharmacokinetic model of remifentanil described by Minto was incorporated into the Alaris PK® infusion pump. Local effector, or biophase, concentrations corresponded to the information obtained from the infusion pumps and represented predictive measurements of the concentrations of both drugs on their sites of action. The concentrations of propofol and remifentanil were regulated according to BIS and MAP, respectively. CONCLUSIONS: Total intravenous anesthesia for ablation of AF can be a safe option considering the lack of electrophysiological changes in accessory pathways. The literature on this subject is scarce and new publications could justify, or not, this type of anesthesia during ablation of AF.

  6. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Anon.

    1980-01-01

    An outline review notes recent work on total lymphoid irradiation (TLI) as a means of preparing patients for grafts and particularly for bone-marrow transplantation. T.L.I. has proved immunosuppressive in rats, mice, dogs, monkeys and baboons; when given before bone-marrow transplantation, engraftment took place without, or with delayed rejection or graft-versus-host disease. Work with mice has indicated that the thymus needs to be included within the irradiation field, since screening of the thymus reduced skin-graft survival from 50 to 18 days, though irradiation of the thymus alone has proved ineffective. A more lasting tolerance has been observed when T.L.I. is followed by an injection of donor bone marrow. 50% of mice treated in this way accepted allogenic skin grafts for more than 100 days, the animals proving to be stable chimeras with 50% of their peripheral blood lymphocytes being of donor origin. Experiments of a similar nature with dogs and baboons were not so successful. (U.K.)

  7. The total artificial heart.

    Science.gov (United States)

    Cook, Jason A; Shah, Keyur B; Quader, Mohammed A; Cooke, Richard H; Kasirajan, Vigneshwar; Rao, Kris K; Smallfield, Melissa C; Tchoukina, Inna; Tang, Daniel G

    2015-12-01

    The total artificial heart (TAH) is a form of mechanical circulatory support in which the patient's native ventricles and valves are explanted and replaced by a pneumatically powered artificial heart. Currently, the TAH is approved for use in end-stage biventricular heart failure as a bridge to heart transplantation. However, with an increasing global burden of cardiovascular disease and congestive heart failure, the number of patients with end-stage heart failure awaiting heart transplantation now far exceeds the number of available hearts. As a result, the use of mechanical circulatory support, including the TAH and left ventricular assist device (LVAD), is growing exponentially. The LVAD is already widely used as destination therapy, and destination therapy for the TAH is under investigation. While most patients requiring mechanical circulatory support are effectively treated with LVADs, there is a subset of patients with concurrent right ventricular failure or major structural barriers to LVAD placement in whom TAH may be more appropriate. The history, indications, surgical implantation, post device management, outcomes, complications, and future direction of the TAH are discussed in this review.

  8. Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management

    International Nuclear Information System (INIS)

    Smith, J. Joshua; Chow, Oliver S.; Gollub, Marc J.; Nash, Garrett M.; Temple, Larissa K.; Weiser, Martin R.; Guillem, José G.; Paty, Philip B.; Avila, Karin; Garcia-Aguilar, Julio

    2015-01-01

    Treatment of patients with non-metastatic, locally advanced rectal cancer (LARC) includes pre-operative chemoradiation, total mesorectal excision (TME) and post-operative adjuvant chemotherapy. This trimodality treatment provides local tumor control in most patients; but almost one-third ultimately die from distant metastasis. Most survivors experience significant impairment in quality of life (QoL), due primarily to removal of the rectum. A current challenge lies in identifying patients who could safely undergo rectal preservation without sacrificing survival benefit and QoL. This multi-institutional, phase II study investigates the efficacy of total neoadjuvant therapy (TNT) and selective non-operative management (NOM) in LARC. Patients with MRI-staged Stage II or III rectal cancer amenable to TME will be randomized to receive FOLFOX/CAPEOX: a) before induction neoadjuvant chemotherapy (INCT); or b) after consolidation neoadjuvant chemotherapy (CNCT), with 5-FU or capecitabine-based chemoradiation. Patients in both arms will be re-staged after completing all neoadjuvant therapy. Those with residual tumor at the primary site will undergo TME. Patients with clinical complete response (cCR) will receive non-operative management (NOM). NOM patients will be followed every 3 months for 2 years, and every 6 months thereafter. TME patients will be followed according to NCCN guidelines. All will be followed for at least 5 years from the date of surgery or—in patients treated with NOM—the last day of treatment. The studies published thus far on the safety of NOM in LARC have compared survival between select groups of patients with a cCR after NOM, to patients with a pathologic complete response (pCR) after TME. The current study compares 3-year disease-free survival (DFS) in an entire population of patients with LARC, including those with cCR and those with pCR. We will compare the two arms of the study with respect to organ preservation at 3 years, treatment

  9. The efficiency of risedronate in reducing bone resorption after total hip arthroplasty: a meta-analysis of randomized control trials at a minimum of 6 months' follow-up.

    Science.gov (United States)

    Yang, Liqing

    2018-04-17

    Recently risedronate is suggested to be effective for the prevention and treatment of for osteoporosis in total hip arthroplasty. This meta-analysis aimes to evaluate the efficacy of risedronate in reducing femoral periprosthetic bone mineral density loss in patients undergoing primary total hip arthroplasty. A systematic search was performed in Medline (1966-31 October 2017), PubMed (1966-31 October 2017), Embase (1980-31 October 2017), ScienceDirect (1985-31 October 2017) and the Cochrane Library. Only randomized controlled trial (RCT) were included. Fixed/random effect model was used according to the heterogeneity tested by I2 statistic. Meta-analysis was performed using Stata 11.0 software. The outcome measures included periprosthetic bone mineral density, length of stay and adverse effects. Four RCTs including 198 patients met the inclusion criteria. The present meta-analysis showed that there were significant differences between treatment groups in terms of periprosthetic bone mineral density in Gruen zones 1 (standard mean difference (SMD) = 0.758, 95% CI 0.469 to 1.047, P = 0.000), 2 (SMD = 0.814, 95% CI 0.523 to 1.106, P = 0.000), 3 (SMD = 0.340, 95% CI 0.059 to 0.622, P = 0.018), 6 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000), and 7 (SMD = 2.400, 95% CI 2.029 to 2.771, P = 0.000). Oral risedronate could significantly reduce periprosthetic bone resorption around an uncemented femoral stem (Gruen zones 1, 2, 3, 6, and 7) up to 6 months after THA. In addition, no severe adverse events were identified. Future trials of risedronate treatment after THA should focus on clinically relevant end points such as the risks of fracture and revision arthroplasty.

  10. Organ Preservation in Rectal Adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management.

    Science.gov (United States)

    Smith, J Joshua; Chow, Oliver S; Gollub, Marc J; Nash, Garrett M; Temple, Larissa K; Weiser, Martin R; Guillem, José G; Paty, Philip B; Avila, Karin; Garcia-Aguilar, Julio

    2015-10-23

    Treatment of patients with non-metastatic, locally advanced rectal cancer (LARC) includes pre-operative chemoradiation, total mesorectal excision (TME) and post-operative adjuvant chemotherapy. This trimodality treatment provides local tumor control in most patients; but almost one-third ultimately die from distant metastasis. Most survivors experience significant impairment in quality of life (QoL), due primarily to removal of the rectum. A current challenge lies in identifying patients who could safely undergo rectal preservation without sacrificing survival benefit and QoL. This multi-institutional, phase II study investigates the efficacy of total neoadjuvant therapy (TNT) and selective non-operative management (NOM) in LARC. Patients with MRI-staged Stage II or III rectal cancer amenable to TME will be randomized to receive FOLFOX/CAPEOX: a) before induction neoadjuvant chemotherapy (INCT); or b) after consolidation neoadjuvant chemotherapy (CNCT), with 5-FU or capecitabine-based chemoradiation. Patients in both arms will be re-staged after completing all neoadjuvant therapy. Those with residual tumor at the primary site will undergo TME. Patients with clinical complete response (cCR) will receive non-operative management (NOM). NOM patients will be followed every 3 months for 2 years, and every 6 months thereafter. TME patients will be followed according to NCCN guidelines. All will be followed for at least 5 years from the date of surgery or--in patients treated with NOM--the last day of treatment. The studies published thus far on the safety of NOM in LARC have compared survival between select groups of patients with a cCR after NOM, to patients with a pathologic complete response (pCR) after TME. The current study compares 3-year disease-free survival (DFS) in an entire population of patients with LARC, including those with cCR and those with pCR. We will compare the two arms of the study with respect to organ preservation at 3 years, treatment compliance

  11. Aligator: A computational tool for optimizing total chemical synthesis of large proteins.

    Science.gov (United States)

    Jacobsen,