Treatment of early glottic squamous cell carcinoma

International Nuclear Information System (INIS)

Rikimaru, Fumihide; Matsuo, Mioko; Higaki, Yuichiro; Tomita, Kichinobu

2011-01-01

We treat early glottic squamous cell carcinoma with chemoradiation and evaluate the effects of the chemoradiation at the dose of 30-40 Gy as an intermediate evaluation. To investigate the need for this intermediate evaluation, we retrospectively analyzed 97 patients, 92 men and 5 women aged 36 to 86 years, with glottic squamous cell carcinoma at stage I and II treated at our institution from January 2000 to May 2007. The three-year survival rate was 98% in all cases, 100% in T1a, 93% in T1b and 94% in T2. The three-year preservation rate of the larynx was 92% in all cases, 98% in T1a, 93% in T1b and 83% in T2. In the intermediate evaluation, complete response was 78% in T1a, 85% in T1b and 53% in T2. In cases of larynx preservation, the recurrence rate of the primary site was significantly higher in cases without complete response in the intermediate evaluation than in cases with complete response (p<0.05). It seemed that the not complete response case in the intermediate evaluation paid attention to a primary tumor recurrence in particular and needed careful follow-up. (author)

Problems of concurrent radiotherapy with S-1 for T2 glottic carcinoma

International Nuclear Information System (INIS)

Higashino, Masaaki; Kawata, Ryo; Suzuki, Norio; Ichihara, Takahiro; Terada, Tetsuya

2016-01-01

The aim of this study was to investigate the effectiveness and problems of concurrent radiotherapy with S-1 for T2 glottic carcinoma. The study included 48 patients (22 patients for radiotherapy alone (RT group), 26 patients for radiotherapy concurrent with S-1 (S-1 group) who underwent initial treatment as outpatients for T2 glottic carcinoma at Osaka Medical College. Six of the 26 patients of the S-1 group were suspected to have local recurrence, but 5 of them had necrosis and one had dysplasia. Three patients suffered bilateral vocal cord paralysis and underwent tracheostomy. On the other hand, 4 of the 22 patients of the RT group suffered local recurrence and one patient suffered unilateral vocal cord paralysis. The local control rate of the S-1 group was significantly higher than that of the RT group. In the S-1 group, 5 patients with laryngeal function disorder tended to develop upper and arytenoid cartilage. The local control rate of radiotherapy for T2 glottic carcinoma was improved by concurrent S-1. In the S-1 group, there was no local recurrence, but some cases suffered laryngeal dysfunction, so efforts should be made to preserve laryngeal function. (author)

Clinical assessment of tumor clearance during radiotherapy as a prognostic factor of early glottic carcinoma

International Nuclear Information System (INIS)

Inoue, Takehiro; Inoue, T.; Ikeda, H.; Teshima, T.; Murayama, S.

1992-01-01

From 1967 through 1985, 358 cases of early glottic carcinoma were treated with telecobalt therapy at the Department of Radiology, Osaka University Medical School. Among 278 cases treated with 2 Gy a day, the tumor response of 262 cases at 40, 50 and 60 Gy were evaluated by direct or indirect laryngoscope. The five-year local control rates of these evaluable cases of T1 and T2 glottic carcinoma were 79% and 70%, respectively. The local control rates of T1 glottic carcinoma with tumor clearance and persistence at 40 Gy were 83% (119/143) and 64% (43/67), and those of T2 cases were 86% (18/21) and 58% (18/31), respectively. The local control rates of the cases with tumor clearance and persistence at 40 Gy were same between T1 and T2 cases. The tumor clearance rates of T1 cases were significantly higher than those of T2 cases (p [de

Voice Quality after Treatment for T1a Glottic Carcinoma - Radiotherapy Versus Laser Cordectomy

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Krengli, Marco; Policarpo, Mario; Manfredda, Irene; Aluffi, Paolo; Gambaro, Giuseppina; Panella, Massimiliano; Pia, Francesco [Univ. of Piemonte Orientale ' Amedeo Avogadro' , Novara (Italy). Div. of Radiotherapy

2004-04-01

The purpose of this study was to assess the anatomic and functional outcomes and compare the voice quality in patients affected by T1a glottic carcinoma treated with curative intent with radiotherapy or laser cordectomy. Fifty-seven cases were analysed: 27 after curative radiotherapy and 30 after laser cordectomy. All patients were studied with videolaryngostroboscopy, voice analysis by narrow spectrogram, and vocal parameters (Jitter, Shimmer, noise/harmonic ratio, and diplophonia). Videolaryngostroboscopy showed severe glottic inadequacy in 25% of cases treated with radiation and insufficient compensation 'ventricular band' or 'with arytenoid hyperadduction' in 65% of cases after surgery. Severe dysphonia on the electro-acoustic analysis of voice was observed in 25% of cases after radiation and 70% after laser (p<0.001). Fundamental frequency and vocal parameters showed more favourable results in the radiation group (p<0.001). Voice assessment showed better results after radiotherapy compared with laser cordectomy. Voice outcome should be carefully considered in the treatment decision for T1 glottic carcinoma.

Definitive radiotherapy for early glottic carcinoma: prognostic factors and implications for treatment

International Nuclear Information System (INIS)

Burke, Lisa S.; Greven, Kathryn M.; McGuirt, Wyman T.; Case, Douglas; Hoen, Helena M.; Raben, Milton

1997-01-01

Purpose: Treatment and disease-related factors were analyzed for their influence on the outcome of patients treated definitively with irradiation (RT) for early glottic carcinoma. Methods and Materials: One hundred two patients with stage T1 or T2 glottic carcinomas were treated definitively with RT from December 1983 through September 1993. Median follow-up time was 63 months. Factors analyzed for each patient included age, sex, stage, anterior commissure involvement, surgical alternative, histologic differentiation, field size, total dose, fraction size, and total treatment time. Survival analysis methods were employed to assess the effects of these factors on local control and complication rates. Results: The 5-year local control rates by stage were as follows: T1a, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysis, factors found to have a significant impact on local control were stage, surgical alternative, fraction size, anterior commissure involvement, and overall treatment time. By multivariate analysis, stage, field size, and fraction size were the only significant factors that independently influenced local control. Conclusion: The inferior control rate for stage T2b lesions has implications for treatment. Our study supports the conclusion of reports in the literature showing that low fraction size negatively influences outcome in patients with early glottic cancer

Definitive radiotherapy for early glottic carcinoma: prognostic factors and implications for treatment

International Nuclear Information System (INIS)

Burke, Lisa S.; Greven, Kathryn M.; McGuirt, Wyman T.; Case, Douglas; Hoen, Helena M.; Raben, Milton

1997-01-01

Purpose: Treatment and disease-related factors were analyzed for their influence on the outcome of patients treated definitively with irradiation (RT) for early glottic carcinoma. Methods and Materials: One hundred two patients with stage T1 or T2 glottic carcinomas were treated definitively with RT from December 1983 through September 1993. Median follow-up time was 63 months. Factors analyzed for each patient included age, sex, stage, anterior commissure involvement, surgical alternative, histologic differentiation, field size, total dose, fraction size, and total treatment time. Survival analysis methods were employed to assess the effects of these factors on local control and complication rates. Results: The 5-year local control rates by stage were as follows: T1a, 92%; T1b, 80%; T2a, 94%; and T2b, 23%. By univariate analysis, factors found to have a significant impact on local control were stage, surgical alternative, fraction size, anterior commissure involvement, and overall treatment time. By multivariate analysis, stage, field size, and fraction size were the only significant factors that independently influenced local control. Conclusions: The inferior control rate for stage T2b lesions has implications for treatment. Our study supports the conclusions of reports in the literature showing that low fraction size negatively influences outcome in patients with early glottic cancer

Treatment of the early-stage glottic cancer using low-temperature radiofrequency coblation

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Bing Liu

2016-01-01

Conclusions: Although the current probe design has limitations for the resection of certain tumors, low-temperature RF coblation appears to be a potentially effective method for the endoscopic resection of selected glottic cancers.

Risk of Fatal Cerebrovascular Accidents after External Beam Radiation Therapy for Early Stage Glottic Larynx Cancer

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Swisher-McClure, Samuel; Mitra, Nandita; Lin, Alexander; Ahn, Peter; Wan, Fei; O’Malley, Bert; Weinstein, Gregory S.; Bekelman, Justin E.

2013-01-01

Background This study compared the risk of fatal cerebrovascular accidents (CVA) in patients with early stage glottic larynx cancer receiving surgery or external beam radiation therapy (EBRT). Methods and Materials Using a competing risks survival analysis, we compared the risk of death due to CVA among patients with early stage glottic larynx cancer receiving surgery or EBRT in the SEER database. Results The cumulative incidence of fatal CVA at 15 years was higher in patients receiving EBRT (2.8 %; 95% CI 2.3%–3.4%) compared to surgery (1.5 %; 95% CI 0.8 %–2.3%, p= 0.024). In multivariable competing risks regression models, EBRT remained associated with an increased risk of fatal CVA compared to surgery (adjusted HR 1.75; 95% CI 1.04–2.96, p= 0.037). Conclusion Treatment of early stage glottic larynx cancer with EBRT was associated with a small increase in the risk of late fatal CVA events relative to surgery. PMID:23595858

Influence of fractionation and time on local control of T1 and T2 glottic carcinoma

International Nuclear Information System (INIS)

Le, Quynh-Thu; Krieg, Richard M.; Quivey, Jeanne M.; Fu, Karen K.; Meyler, Thomas S.; Stuart, Alex A.; Phillips, Theodore L.

1996-01-01

Purpose: To evaluate the influence of fraction size and overall time on local control of T1 and T2 glottic carcinoma Methods and Materials: Between 1956 and 1995, 318 consecutive patients with early glottic carcinoma (250 T1, 68 T2) were treated with definitive megavoltage radiotherapy at UCSF. Treatment was delivered using conventional fractionation at one fraction/day, 5 days/week. Minimum tumor dose ranged from 50 to 81Gy (median: 61Gy). The fraction size was 200cGy. Conclusions: Risk of tumor recurrence increased with higher T-stage, smaller fraction size, and longer overall time. Our results suggest that for optimal local control, radiotherapy for early glottic carcinoma should be completed as soon as possible, preferably within 6 weeks, using a fraction size ≥ 225cGy. Our current policy is to treat T1 and T2 vocal cord carcinomas with 225cGy/fraction/day, 5 days/week to a total dose of 63-65Gy

Web thickness determines the therapeutic effect of endoscopic keel placement on anterior glottic web.

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Chen, Jian; Shi, Fang; Chen, Min; Yang, Yue; Cheng, Lei; Wu, Haitao

2017-10-01

This work is a retrospective analysis to investigate the critical risk factor for the therapeutic effect of endoscopic keel placement on anterior glottic web. Altogether, 36 patients with anterior glottic web undergoing endoscopic lysis and silicone keel placement were enrolled. Their voice qualities were evaluated using the voice handicap index-10 (VHI-10) questionnaire, and improved significantly 3 months after surgery (21.53 ± 3.89 vs 9.81 ± 6.68, P web recurrence during the at least 1-year follow-up. Therefore, patients were classified according to the Cohen classification or web thickness, and the recurrence rates were compared. The distribution of recurrence rates for Cohen type 1 ~ 4 were 28.6, 16.7, 33.3, and 40%, respectively. The difference was not statistically significant (P = 0.461). When classified by web thickness, only 2 of 27 (7.41%) thin type cases relapsed whereas 8 of 9 (88.9%) cases in the thick group reformed webs (P web thickness rather than the Cohen grades. Endoscopic lysis and keel placement is only effective for cases with thin glottic webs. Patients with thick webs should be treated by other means.

Carotid sparing intensity modulated radiotherapy on early glottic cancer: Preliminary study

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Choi, Hoon Sik; Jeong, Bae Kwon; Jeong, Ho Jin; Song, Jin Ho; Kim, Jin Pyeong; Park, Jung Je; Woo, Seung Hoon; Kang, Ki Mun [Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju (Korea, Republic of)

2016-03-15

To compare the dose distribution between carotid sparing intensity modulated radiotherapy (IMRT) and opposed lateral field technique (LAFT), and to determine the effects of carotid sparing IMRT in early glottic cancer patients who have risk factors for atherosclerosis. Ten early glottic cancer patients were treated with carotid sparing IMRT. For each patient, the conventional LAFT plan was developed for comparison. IMRT and LAFT plans were compared in terms of planning target volume (PTV) coverage, conformity index, homogeneity index, and the doses to planning organ at risk volume (PRV) for carotid arteries, spinal cord and pharyngeal constrictor muscle. Recurrence was not observed in any patients during the follow-up period. V95% for PTV showed no significant difference between IMRT and LAFT plans, while V100% was significantly higher in the IMRT plan (95.5% vs. 94.6%, p = 0.005). The homogeneity index (11.6%) and conformity index (1.4) in the IMRT plan were significantly better than those in the LAFT plans (8.5% and 5.1, respectively) (p = 0.005). The median V5Gy (90.0%), V25Gy (13.5%), and V50Gy (0%) for carotid artery PRV in the IMRT plan were significantly lower than those in the LAFT plan (99.1%, 89.0%, and 77.3%, respectively) (p = 0.005). Our study suggests that carotid sparing IMRT can significantly decrease the dose to carotid arteries compared to LAFT, and it would be considered for early glottic cancer patient with high risk of atherosclerosis.

Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients

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M N Vijai

2016-01-01

Full Text Available Background and Aims: Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP. Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Methods: Group I (n = 50 patients were intubated with HiLo Evac™ endotracheal (ET tube with facility for sub-glottic suctioning, and Group II (n = 50 patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher′s exact test, as appropriate, to analyse the significance of difference between the two groups. Results: The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021. Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001 and ICU stay (8.33 vs. 6.33; P = 0.001 on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006 with lower incidence of mortality (36% vs. 48%; P = 0.224 in the Group I. Conclusion: Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

Efficacy of intermittent sub-glottic suctioning in prevention of ventilator-associated pneumonia- A preliminary study of 100 patients.

Science.gov (United States)

Vijai, M N; Ravi, Parli R; Setlur, Rangaraj; Vardhan, Harsh

2016-05-01

Oropharyngeal colonisation followed by aspiration of contaminated secretions is the major cause for ventilator-associated pneumonia (VAP). Pooled secretions present in the sub-glottic area above inflated endotracheal tube cuff may be aspirated into the lower airways. It was hypothesised that intermittent suctioning of sub-glottic secretions would prevent VAP. Group I (n = 50) patients were intubated with HiLo Evac™ endotracheal (ET) tube with facility for sub-glottic suctioning, and Group II (n = 50) patients were intubated with HiLo Contour™ ET tube without such facility. In the Group I, sub-glottic suctioning was performed every 2 h. Incidence of VAP, mean ventilator days, Intensive Care Unit (ICU) stay and mortality were compared. Qualitative variables were reported as percentages and were compared by Chi-square test or unpaired two-tailed, Fisher's exact test, as appropriate, to analyse the significance of difference between the two groups. The two groups were similar with respect to demographic characteristics. VAP was seen in 6% of patients in Group I and 22% of patients in Group II (P = 0.021). Both early- and late-onset VAPs were significantly reduced in Group I. Both ventilator days (8.0 vs. 6.45; P = 0.001) and ICU stay (8.33 vs. 6.33; P = 0.001) on the day of onset of VAP were significantly more in the Group I. Total ventilator days were significantly less (6.52 vs. 8.32; P = 0.006) with lower incidence of mortality (36% vs. 48%; P = 0.224) in the Group I. Intermittent sub-glottic suctioning reduces the incidence of VAP including late-onset VAP.

Does pretreatment hemoglobin level affect outcome in patients with T1 glottic cancer?

International Nuclear Information System (INIS)

Canaday, Daniel J.; Regine, William F.; Mohiuddin, Mohammed; Zollinger, William; Machtay, Mitchell; Lee, Jason; Schultz, Delray; Rosenthal, David I.; Rudoltz, Marc S.

1997-01-01

Purpose/Objective: Recent reports have suggested that pretreatment hemoglobin (Hgb) is significantly associated with local control (LC) and overall survival (OS) in patients with T1 and T2 squamous cell carcinoma of the glottic larynx. This study evaluates the association of pretreatment Hgb level and other factors with outcome in patients limited to T1 squamous cell carcinoma of the glottic larynx treated with external beam radiation. Methods: One hundred fifty-eight patients with T1 squamous cell carcinoma of the glottic larynx were analyzed. Median follow-up was 5 years (range 2-22). Median pretreatment Hgb was 14.4 gm/dl (range 8.2-17.2). The following parameters were analyzed for their impact on LC, OS, and disease specific survival (DSS): age, gender, pretreatment Hgb, tumor grade, anterior commissure involvement, field size, total dose, dose per fraction, and overall treatment time. Results: Five year actuarial LC was 84%. Pretreatment Hgb was not a significant predictor for LC when assessed as a continuous variable (p=0.38). LC was 82% for patients with Hgb >13 vs 92% for Hgb ≤ 13 (p=0.13). No other factor was significant for LC. Five year actuarial OS was 74%. On univariate analysis, pretreatment Hgb ≤ 13 gm/dl was a significant factor for poorer OS (78% vs 68%, p=0.004), as were total dose 61 years (p=0.017). On multivariate analysis, only age >61 (p=0.014) and Hgb ≤ 13 (p=0.001) retained significance for OS. Five year actuarial DSS was 92%. Pretreatment Hgb was not a prognostic factor for DSS, nor were any other analyzed factors. Conclusion: Pretreatment Hgb is not a significant prognostic factor for LC in patients with T1 squamous cell carcinoma of the glottic larynx, but it does predict for a poorer OS without affecting DSS. This suggests that patients with lower pretreatment Hgb may have confounding medical problems which detract from their overall survival

Risk of fatal cerebrovascular accidents after external beam radiation therapy for early-stage glottic laryngeal cancer.

Science.gov (United States)

Swisher-McClure, Samuel; Mitra, Nandita; Lin, Alexander; Ahn, Peter; Wan, Fei; O'Malley, Bert; Weinstein, Gregory S; Bekelman, Justin E

2014-05-01

This study compared the risk of fatal cerebrovascular accidents (CVAs) in patients with early-stage glottic laryngeal cancer receiving surgery or external beam radiation therapy (EBRT). Using a competing risks survival analysis, we compared the risk of death because of CVA among patients with early-stage glottic laryngeal cancer receiving surgery or EBRT in the Surveillance, Epidemiology, and End Results (SEER) database. The cumulative incidence of fatal CVA at 15 years was higher in patients receiving EBRT (2.8%; 95% confidence interval [CI], 2.3% to 3.4%) compared to surgery (1.5%; 95% CI, 0.8% to 2.3%; p = .024). In multivariable competing risks regression models, EBRT remained associated with an increased risk of fatal CVA compared to surgery (adjusted hazard ratio [HR], 1.75; 95% CI, 1.04-2.96; p = .037). Treatment for early-stage glottic laryngeal cancer with EBRT was associated with a small increase in the risk of late fatal CVA events relative to surgery. Copyright © 2013 Wiley Periodicals, Inc.

Hypothyroidism after radiotherapy for early glottic cancer

International Nuclear Information System (INIS)

Katayama, Motoyuki; Nishimura, Tetsuo; Nozue, Masashi; Kawai, Hiroaki; Takai, Michikatsu; Kaneko, Masao; Nishi, Shigeo

1993-01-01

Reported is the case of a 46-year-old male with hypothyroidism after radiotherapy for early glottic cancer, T1N0M0, Stage I. Six months after 60 Co irradiation 66 Gy with the radiation field size of 5 x 5 cm was given, the clinical signs of acute hypothyroidism was presented. Retrospective CT examinations proved that over 80% of the total dose was irradiated to about 10% of whole thyroid volume. Since laboratory examinations revealed high serum level of thyrogobrin antibody, we postulated immunological mechanism was associated with the onset of hypothyroidism. (author)

Pattern of failure in 5001 patients treated for glottic squamous cell carcinoma with curative intent - A population based study from the DAHANCA group

DEFF Research Database (Denmark)

Lyhne, Nina Munk; Johansen, Jørgen; Kristensen, Claus A

2016-01-01

Purpose To describe the pattern of failure in a national consecutive cohort of patients with glottic squamous cell carcinomas (SCC) treated with primary radiotherapy (RT) with curative intent over a 41-year period. Materials and methods All patients undergoing curative treatment for a glottic SCC...

Eletromiografia laríngea em pacientes com disfonia e fechamento glótico incompleto Laryngeal electromyography in dysphonic patients with incomplete glottic closure

Directory of Open Access Journals (Sweden)

Noemi Grigoletto De Biase

2012-12-01

Full Text Available O diagnóstico de comprometimento do nervo laríngeo superior e de ramos do laríngeo recorrente demanda eletromiografia, pois as alterações à laringoscopia são inespecíficas. OBJETIVO: Avaliar eletrofisiologicamente a função dos nervos laríngeo superior e inferior por meio da atividade elétrica dos músculos por eles inervados, em pacientes com disfonia com coaptação incompleta das pregas vocais à fonação. MÉTODO: Estudo prospectivo; 39 indivíduos com disfonia e fechamento glótico incompleto foram submetidos à eletromiografia dos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente. Foram avaliadas atividade de inserção, no repouso (fibrilação, onda positiva e fasciculação e durante contração voluntária dos músculos (recrutamento, amplitude e duração do potencial e latência entre início da atividade elétrica e a sonorização. RESULTADOS: Não observamos alteração na atividade de inserção e no repouso. Nenhum paciente apresentou recrutamento alterado. A média da amplitude dos potenciais elétricos esteve compatível com a normalidade nos músculos testados, assim como a duração do potencial e o tempo de latência entre o início da atividade elétrica e a sonorização. CONCLUSÃO: Não observamos sinais de desnervação nos músculos tireoaritenóideo, cricotireóideo e cricoaritenóideo lateral bilateralmente nos pacientes estudados.The lack of specificity in laryngoscopical examination requires that the diagnosis of superior laryngeal and recurrent laryngeal nerve involvement be carried out with the aid of electromyography. OBJECTIVE: This study aims to assess the electrophysiological function of the superior and inferior laryngeal nerves by measuring the electrical activity of the muscles they innervate in dysphonic patients with incomplete closure of the vocal folds during phonation. METHOD: Thirty-nine patients with incomplete glottic closure were enrolled in a

Glottic cancer with subglottic extension

International Nuclear Information System (INIS)

Ampil, F.L.; Menezes, C.-A.O.

1997-01-01

The outcomes of 27 patients with glottic cancer extending into the subglottis (GCSE) who were treated by surgery and radiation (n=17) or radiation alone (n=10) during a 13-year period were retrospectively reviewed. Since this study was nonrandomized and retrospective, the patient groups were not equally matched with regard to age (p>0.05), gender (p>0.30), or disease stage (p>0.05). The locoregional failure rate was 18±(95% CI) 20% in patients who received combined therapy and 40±31% in persons treated by radiation alone (p=0.20); the corresponding survival rates at two years were 53±24% and 42±31% (p>0.50). These findings suggest that GCSE may be better managed by a combination of surgery and radiotherapy than by the use of radiotherapy alone. (author)

Office-Based Autologous Fat Injection Laryngoplasty for Glottic Insufficiency in Patients Under 50 Years Old.

Science.gov (United States)

Hu, Hao-Chun; Hung, Yi-Ting; Lin, Shu-Yi; Tung, Tao-Hsin; Chang, Shyue-Yih

2018-04-17

We sought to determine the outcomes of office-based autologous fat injection laryngoplasty in the treatment of patients under 50 years old with glottic insufficiency but without neurological problems or acquired organic lesions in the vocal fold. We conducted a retrospective chart review of consecutive patients under 50 years of age who underwent office-based autologous fat injection laryngoplasty for glottic insufficiency. None of the patients presented neurological problems or acquired organic lesions in the vocal fold. Videolaryngostroboscopic data, objective voice assessment, perceptual measurements of vocal quality, and subjective ratings of voice quality were evaluated before and after treatment. The 23 patients (7 men and 16 women) in this study presented significant improvements in phonatory function in terms of maximum phonation time, jitter, grade, asthenia, and Voice Handicap Index-10 (VHI-10) values at 3 months. Significant improvements in terms of jitter, noise-to-harmonic ratio, grade, roughness, breathiness, asthenia, and the VHI-10 values were also observed at 6 months. Glottic insufficiency in younger patients without neurological problems or acquired organic lesions in the vocal fold can be treated effectively using office-based autologous fat injection laryngoplasty. Significant improvements in phonatory function were observed even 6 months after surgery. Copyright © 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Impact of initial tumor volume on radiotherapy outcome in patients with T2 glottic cancer

International Nuclear Information System (INIS)

Rutkowski, T.

2014-01-01

The aim of this study was to quantify the impact of initial tumor volume (TV) on radiotherapy (RT) outcome in patients with T2 glottic cancer. Initial TV was calculated for 115 consecutive patients with T2 glottic cancer who had been treated with definitive RT alone at a single institution. The results showed strong correlations of TV with 3-year local tumor control (LTC) and disease-free survival (DFS). For TV ≤ 0.7 cm 3 , 3-year LTC was 83 %; for TV 0.7-3.6 cm 3 this was 70 % and for TV 3.6-17 cm 3 44 %. Analysis of total dose vs. initial TV showed that larger T2 glottic tumors with a TV of around 5 cm 3 (2-2.5 cm in diameter with 10 10 cancer cells) need an extra 6.5 Gy to achieve similar 3-year LTC rates as for small tumors with a TV of 0.5 cm 3 (∝1 cm in diameter with 10 9 cancer cells). Although classification of tumors according to TV cannot replace TNM staging in daily practice, it could represent a valuable numerical supplement for planning the optimal dose fractionation scheme for individual patients. (orig.)

Laryngeal Amyloidosis Mimicking Glottic Cancer: A Case Report

International Nuclear Information System (INIS)

Lee, Sun Jin; Kim, Jee Young; Ahn, Kook Jin; Kim, Bum Soo; Park, Young Hak

2010-01-01

Amyloidosis is a slowly progressive, benign disease that is characterized by the extracellular deposition of fibrillar proteins in many different tissues and organs throughout the body. Primary amyloidosis can be subdivided into the systemic and localized forms. The localized form is less common than the systemic form and the larynx is the most frequently affected site. The importance of laryngeal amyloidosis lies in its possible confusion with glottic cancer because of the clinical feature. We report here on a case of laryngeal amyloidosis in a 47-year-old man who suffered from progressive dyspnea

Laryngeal Amyloidosis Mimicking Glottic Cancer: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Lee, Sun Jin; Kim, Jee Young; Ahn, Kook Jin; Kim, Bum Soo [The Catholic University of Korea, Seoul (Korea, Republic of); Park, Young Hak [St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

2010-08-15

Amyloidosis is a slowly progressive, benign disease that is characterized by the extracellular deposition of fibrillar proteins in many different tissues and organs throughout the body. Primary amyloidosis can be subdivided into the systemic and localized forms. The localized form is less common than the systemic form and the larynx is the most frequently affected site. The importance of laryngeal amyloidosis lies in its possible confusion with glottic cancer because of the clinical feature. We report here on a case of laryngeal amyloidosis in a 47-year-old man who suffered from progressive dyspnea.

Reflexives and reflexive constructions in Afrikaans

African Journals Online (AJOL)

Kate H

2. Reflexives. Afrikaans items belonging to the traditional lexical category of reflexives (or reflexive ... reflexive and non-reflexive pronouns are syntactically derived from the same lexical root pronoun √PRON. The ...... 32 The matrix verbs in (33) and (34) both concern a future activity of an entity: belowe (“promise”) in the (a).

The effect of vocal fold augmentation on cough symptoms in the presence of glottic insufficiency.

Science.gov (United States)

Litts, Juliana K; Fink, Daniel S; Clary, Matthew S

2017-10-08

To determine the effect of injection augmentation of the vocal folds on chronic cough symptoms in patients with glottic insufficiency. Medical records from 146 consecutive patients who underwent vocal fold injection augmentation by a fellowship-trained laryngologist between 2013 and 2015 were reviewed. Twenty-three patients (12 male) met inclusion criteria of a vocal fold augmentation injection, cough symptoms lasting more than 8 weeks, and glottic insufficiency as determined by shortened closed phase on stroboscopy. Exclusion criteria included lack of cough complaints, diagnosis of vocal fold immobility, previous history of vocal fold augmentation, and incomplete data sets. Data collected included age, gender, pre- and 1-month postinjection Cough Severity Index (CSI) scores, location of injection (unilateral or bilateral), and patient statement of percent change in symptoms that was recorded at 1-month postinjection visit. Paired t test indicated a significant decrease in CSI scores from pre- (m = 18.5) to 1-month postinjection (m = 12.1) (P = 0.004). Eighteen patients (78.2%) reported a 50% or greater improvement in cough symptoms at the 1-month postinjection visit. Injection augmentation of the vocal folds in the presence of glottic insufficiency appears to improve cough symptoms, as was reported by CSI in patients who are refractory to other medical and behavioral treatments. 4. Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

A reflexing electron microwave amplifier for rf particle accelerator applications

International Nuclear Information System (INIS)

Fazio, M.V.; Hoeberling, R.F.

1988-01-01

The evolution of rf-accelerator technology toward high-power, high-current, low-emittance beams produces an ever-increasing demand for efficient, very high power microwave power sources. The present klystron technology has performed very well but is not expected to produce reliable gigawatt peak-power units in the 1- to 10-GHz regime. Further major advancements must involve other types of sources. The reflexing-electron class of sources can produce microwave powers at the gigawatt level and has demonstrated operation from 800-MHz to 40-GHz. The pulse length appears to be limited by diode closure, and reflexing-electron devices have been operated in a repetitively pulsed mode. A design is presented for a reflexing electron microwave amplifier that is frequency and phase locked. In this design, the generated microwave power can be efficiently coupled to one or several accelerator loads. Frequency and phase-locking capability may permit parallel-source operation for higher power. The low-frequency (500-MHz to 10-GHz) operation at very high power required by present and proposed microwave particle accelerators makes an amplifier, based on reflexing electron phenomena, a candidate for the development of new accelerator power sources. (author)

Reflex epileptic mechanisms in humans: Lessons about natural ictogenesis.

Science.gov (United States)

Wolf, Peter

2017-06-01

The definition of reflex epileptic seizures is that specific seizure types can be triggered by certain sensory or cognitive stimuli. Simple triggers are sensory (most often visual, more rarely tactile or proprioceptive; simple audiogenic triggers in humans are practically nonexistent) and act within seconds, whereas complex triggers like praxis, reading and talking, and music are mostly cognitive and work within minutes. The constant relation between a qualitatively, often even quantitatively, well-defined stimulus and a specific epileptic response provides unique possibilities to investigate seizure generation in natural human epilepsies. For several reflex epileptic mechanisms (REMs), this has been done. Reflex epileptic mechanisms have been reported less often in focal lesional epilepsies than in idiopathic "generalized" epilepsies (IGEs) which are primarily genetically determined. The key syndrome of IGE is juvenile myoclonic epilepsy (JME), where more than half of the patients present reflex epileptic traits (photosensitivity, eye closure sensitivity, praxis induction, and language-induced orofacial reflex myocloni). Findings with multimodal investigations of cerebral function concur to indicate that ictogenic mechanisms in IGEs largely (ab)use preexisting functional anatomic networks (CNS subsystems) normally serving highly complex physiological functions (e.g., deliberate complex actions and linguistic communication) which supports the concept of system epilepsy. Whereas REMs in IGEs, thus, are primarily function-related, in focal epilepsies, they are primarily localization-related. This article is part of a Special Issue entitled "Genetic and Reflex Epilepsies, Audiogenic Seizures and Strains: From Experimental Models to the Clinic". Copyright © 2015 Elsevier Inc. All rights reserved.

Superselective intra-arterial chemoradiotherapy for laryngeal cancer. Is it reasonable to treat glottic cancer in a similar way to supraglottic cancer?

International Nuclear Information System (INIS)

Yoshizaki, Tomokazu; Murono, Shigeyuki; Wakisaka, Naohiro; Kondo, Satoru; Furukawa, Mitsuru

2006-01-01

The standard treatment for advanced laryngeal cancer has been shifting from total laryngectomy to various organ preservation therapies such as subtotal laryngectomy and chemoradiotherapy. Robbins showed remarkable results with RADPLAT, the superselective intra-arterial infusion of supradose cisplatin (150 mg/m 2 ), against advanced head and neck cancer. However, the volume of laryngeal cancer is smaller than those of the other sites of head and neck cancers, and so a swaller less dose of cisplatin could save advanced laryngeal cancer patients. It may be reasonable to treat these subtypes of laryngeal cancer with a different modality. Thirty-five patients with laryngeal cancer were treated with tri-weekly intra-arterial infusion of cisplatin (100 mg/body). A 200 times molar excessive amount of sodium thiosulfate was intravenously infused to reduce the toxicity of cisplatin. Ten of 16 patients with glottic cancer and 10 of 19 patients with supraglottic cancer were followed for more than 2 years. Larynx preservation rate of glottic and supraglottic cancer was 80% and 70%, and progression-free survival rate was 80% and 50%, respectively. Grade III and IV toxic events were less frequent than with RADPLAT or systemic administration of a similar dose of cisplatin. Glottic and supraglottic cancers show different clinical behaviors. Our protocol with less cisplatin than RADPLAT is especially effective for glottic cancer. (author)

Treatment outcome and prognostic factor of CO2 laser cordectomy for early glottic cancer

Science.gov (United States)

Chung, Phil-Sang; Lee, Sang Joon

2012-02-01

Objectives: Laser cordectomy is very popular nowadays and become one of the treatments of choice for early glottis carcinoma. Transoral laser microsurgery has many advantages comparing conventional open surgery or radiation therapy. In this study, we examined the oncologic results of laser cordectomy for early glottic cancer and analyzed the prognostic impact on the survival of the several tumor-related and treatment-related factors. Methods: Patients who were diagnosed as early glottic squamous cell carcinoma, treated by laser cordectomy with curative intent were analyzed. Patients with preivous radiation therapy were included. From June 1988 to March 2005, 202 patients from five hospitals were analyzed (174 T1, 28 T2). Results: Five-year overall survival and disease-free survival were 98.4% and 84.9%. Twenty two patients developed local recurrence. Total laryngectomy was done in 6 patients and laryngeal preservation rate was 97%. Recurrence was higher in the patients with anterior commissure involvement (9/39) than without anterior commissure involvement (13/163). Recurrence was higher in T1b (4/15) than T1a (13/159). Previous radiation was also highly related to the recurrence (7/20 vs 15/182). Twenty patients with local recurrence after radiation therapy were treated by salvage laser cordectomy. Of them, 7 patients developed local recurrence and 5 year disease-free survival was 57%. Complication was rare with one case of hemorrhage. Tracheotomy was not necessary in all patients. Conclusions: Laser cordectomy for early glottic carcinoma showed high survival, laryngeal preservation rate and low complication rate. The prognostic factors were anterior commissure involvement, both vocal fold involvement and previous radiotherapy.

Pretreatment hemoglobin in early stage glottic cancer: red flag or red herring?

International Nuclear Information System (INIS)

Tucker, J. Curtis; Hixson, William C.; Kim, Robert Y.; Smith, Judy W.; Mayo, Matthew S.

1996-01-01

Purpose: To evaluate the impact of pretreatment hemoglobin levels on the recurrence rate of patients with early stage glottic carcinoma treated with definitive radiotherapy. Materials and Methods: Between May 1972 and December 1992, one hundred three patients with stage I or II glottic carcinoma were treated with definitive radiotherapy. The records were reviewed and analyzed for the effects of pretreatment hemoglobin and hematocrit, stage, dose per fraction (180 vs 200 cGy), treatment interruptions, and differentiation of the tumor. The majority of stage I patients were treated to a total dose of 64 to 66 Gy, and stage II patients were treated to 68 to 70 Gy. Mean and median follow up were 85 and 75 months, respectively. Results: With mean follow up of 85 months, the recurrence rate for patients with hemoglobin ≤13 g/dL was 33.3%, and patients with hemoglobin >13 g/dL was 20% (p 0.19). For stage I (n = 84), the recurrence rate with hemoglobin ≤13 g/dL and >13 g/dL was 26% and 17%, respectively (p = 0.51). For stage II patients (n = 19) with hemoglobin ≤13 g/dL and >13 g/dL, the recurrence rate was 50% and 36%, respectively (p = 0.66). Using a Fisher's exact test, the only variables showing a statistically significant prognosis for recurrence were treatment interruption and stage. The recurrence rate with a treatment interruption was 40% compared with 15% if there was no interruption (p 0.0039). The recurrence rate for stage I was 19%, and for stage II was 42% (p = 0.067). Other factors showed no significant increase in recurrence; dose per fraction (p = 0.421), grade of differentiation (p = 0.740). Conclusion: While pretreatment hemoglobin levels below 13 g/dL do not significantly affect the recurrence rates for T1N0 and T2N0 glottic carcinomas, treatment interruptions are a significant factor in the failure of these patients

Radiotherapy or surgery for T2N0M0 glottic carcinoma?

International Nuclear Information System (INIS)

Stalpers, L.J.A.; Daal, W.A.J. van; Verbeek, A.L.M.

1989-01-01

Decision analysis was used to evaluate the results of treatment of T 2 N 0 M 0 glottic carcinoma as presented in the literature. Based on mean values for recurrence, salvage eligibility after recurrence and salvage success, the 5-year survival after radiotherapy and surgery proved to be almost identical, 85 and 86%. If the recurrence rates and the salvage rates were varied, a marginal advantage for surgery in small tumours and a major advantage in more extended tumours was seen if only survival is considered. To take the quality of speech into account, a utility analysis was performed. A utility scale was defined ranging from 0.0 as the value for death, to 1.0 for a successfully irradiated patient with preservation of normal speech. A utility of 0.99 or less for the laryngectomized patient would favour radiotherapy over surgery for all T 2 tumours. In patients with T 2b tumours and in extreme circumstances, e.g. if failure rates of radiotherapy are extremely low, an exact assessment of patient utilities may be pivotal. Under normal circumstances radiotherapy is preferred for T 2 N 0 M 0 glottic carcinoma if both survival and the quality of speech are taken into account. (author). 39 refs.; 5 figs.; 1 tab

Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer

Energy Technology Data Exchange (ETDEWEB)

Suzuki, Gen; Hayabuchi, Naofumi; Toda, Yukihiro; Suefuji, Hiroaki; Ogo, Etuyo; Nakajima, Tadashi [Kurume Univ., Fukuoka (Japan). School of Medicine

2002-03-01

The purpose of this study was to evaluate the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer in order to preserve the larynx. The subjects consisted of 52 patients with T2N0M0 laryngeal-glottic cancer treated with laser-radiation combined therapy between 1980 and 1999. Patients ranged in age from 40-88 years, with a median of 70 years, and included 51 men and one woman. During this period, treatment was administered with different radiation devices ({sup 60}Co or 4 MV-X ray), and 40-72 Gy (median, 60Gy) of radiation therapy were administered. Tumor and treatment characteristics were correlated with local control at a median follow-up of 61 months (range 12-210 months). Concurrent chemotherapy was administered to 32 patients; 29 were treated with 5-FU and vitamin A (FAR), and 3 were treated with low-dose CDDP. Post treatment vocal function was examined in 37 patients. The voice was evaluated in terms of four parameters: maximum phonation time (MPT), mean air flow rate during phonation over a comfortable duration (MFR), fundamental frequency range of phonation (F0 range), and sound pressure level range of phonation (SPL range). The five-year cause-specific-survival rate was 98.0%, and the local control rate was 91.8%. Three of 4 patients who had locally relapsed were administered total laryngectomy as salvage therapy. One patient was administered the tracheostomy for late complication. The actuarial laryngeal preservation rate was 92.3%. We did not find any significant relationship between local relapse and extent of disease, subglottic extension, or anterior commissure involvement. Concurrent chemotherapy was not a significant prognostic factor. Laser debulking followed by radiation therapy did not change the voice significantly except the F0 range. We conclude that the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer was effective therapy for not only preservation of the voice but also for vocal function. (author)

Laser-radiation therapy for T2N0M0 laryngeal-glottic cancer

International Nuclear Information System (INIS)

Suzuki, Gen; Hayabuchi, Naofumi; Toda, Yukihiro; Suefuji, Hiroaki; Ogo, Etuyo; Nakajima, Tadashi

2002-01-01

The purpose of this study was to evaluate the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer in order to preserve the larynx. The subjects consisted of 52 patients with T2N0M0 laryngeal-glottic cancer treated with laser-radiation combined therapy between 1980 and 1999. Patients ranged in age from 40-88 years, with a median of 70 years, and included 51 men and one woman. During this period, treatment was administered with different radiation devices ( 60 Co or 4 MV-X ray), and 40-72 Gy (median, 60Gy) of radiation therapy were administered. Tumor and treatment characteristics were correlated with local control at a median follow-up of 61 months (range 12-210 months). Concurrent chemotherapy was administered to 32 patients; 29 were treated with 5-FU and vitamin A (FAR), and 3 were treated with low-dose CDDP. Post treatment vocal function was examined in 37 patients. The voice was evaluated in terms of four parameters: maximum phonation time (MPT), mean air flow rate during phonation over a comfortable duration (MFR), fundamental frequency range of phonation (F0 range), and sound pressure level range of phonation (SPL range). The five-year cause-specific-survival rate was 98.0%, and the local control rate was 91.8%. Three of 4 patients who had locally relapsed were administered total laryngectomy as salvage therapy. One patient was administered the tracheostomy for late complication. The actuarial laryngeal preservation rate was 92.3%. We did not find any significant relationship between local relapse and extent of disease, subglottic extension, or anterior commissure involvement. Concurrent chemotherapy was not a significant prognostic factor. Laser debulking followed by radiation therapy did not change the voice significantly except the F0 range. We conclude that the laser-radiation combined therapy for T2N0M0 laryngeal-glottic cancer was effective therapy for not only preservation of the voice but also for vocal function. (author)

Forced eye closure-induced reflex seizure and non-ketotic hyperglycemia

International Nuclear Information System (INIS)

Tiras, Raziye; Mutlu, Aytul; Ozben, Serkan; Aydemir Tuba; Ozerab, Feriha

2009-01-01

We report an uncommon case of 53-year-old female patient with partial seizure induced by forced voluntary eye closure due to non-ketotic hyperglycemia. The initial laboratory tests showed an elevated blood glucose level of 550 mg/dL but no evidence of ketosis. Brain magnetic resonance imaging was normal. When the blood glucose levels decreased slowly to about 150 mg/dL in five days, the seizures ended completely. No anticonvulsants were used. Since seizures are generally refractory to antiepileptic medication, control of blood glucose is essential. (author)

Effectiveness of Transoral Laser Microsurgery for Precancerous Lesions and Early Glottic Cancer Guided by Analysis of Voice Quality

Czech Academy of Sciences Publication Activity Database

Bahannan, A.; Slavíček, A.; Černý, L.; Vokřál, J.; Valenta, Zdeněk; Lohynská, R.; Chovanec, M.; Betka, J.

2014-01-01

Roč. 36, č. 6 (2014), s. 763-767 ISSN 1043-3074 Institutional support: RVO:67985807 Keywords : cordectomy * voice analysis * glottic cancer * precancerous lesion * larynx Subject RIV: FF - HEENT, Dentistry Impact factor: 2.641, year: 2014

Incidence of and survival after glottic squamous cell carcinoma in Denmark from 1971 to 2011-A report from the Danish Head and Neck Cancer Group

DEFF Research Database (Denmark)

Lyhne, Nina Munk; Johansen, Jørgen; Kristensen, Claus Andrup

2016-01-01

.4 to 0.6). The 5-year DSM was 16% (15–17%) and the 5-year OS was 63% (61–64). The hazard rate of DSM adjusted for patient characteristics, tumour characteristics and waiting-time was significantly lower in the 2000s (p ...Aim To describe the incidence, disease-specific mortality (DSM), and overall survival (OS) of patients with glottic squamous cell carcinomas (SCC) in Denmark from 1971–2011 in a national population-based cohort of consecutive patients. Materials and methods All patients diagnosed with glottic SCC...... and national registries. Results In total 5132 patients with glottic SCC were included. The yearly number of new cases increased from 107 in the 1970s to 139 in the 2000s. Overall, the incidence increased from 1.9 to 2.6 per 100,000, with a more prominent increase in men (3.5 to 4.7) compared with women (0...

Utility approach to decision-making in extended T1 and limited T2 glottic carcinoma.

Science.gov (United States)

van Loon, Yda; Stiggelbout, Anne M; Hakkesteegt, Marieke M; Langeveld, Ton P M; de Jong, Rob J Baatenburg; Sjögren, Elisabeth V

2017-04-01

It is still undecided if endoscopic laser surgery or radiotherapy is the preferable treatment in extended T1 and limited T2 glottic tumors. Health utilities assessed from patients can aid in decision-making. Patients treated for extended T1 or limited T2 glottic carcinoma by laser surgery (n = 12) or radiotherapy (n = 14) assigned health utilities using a visual analog scale (VAS), time tradeoff (TTO) technique and scored their voice handicap using the Voice Handicap Index (VHI). VAS and TTO scores were slightly lower for the laser group compared to the radiotherapy group, however, not significantly so. The VHI showed a correlation with the VAS score, which was very low in both groups and can be considered (near) normal. Patients show no clear preference for the outcomes of laser surgery or radiotherapy from a quality of life (QOL) or voice handicap point of view. These data can now be incorporated into decision-making models. © 2017 Wiley Periodicals, Inc. Head Neck, 2017 © 2016 Wiley Periodicals, Inc. Head Neck 39: 779-785, 2017. © 2017 Wiley Periodicals, Inc.

Radiographic assessment of laryngeal reflexes in ketamine-anesthetized cats

International Nuclear Information System (INIS)

Robinson, E.P.; Johnston, G.R.

1986-01-01

The competence of the laryngeal closure reflexes of cats anesthetized with ketamine was assessed. Radiographic evaluations of the respiratory and digestive tracts were made after colloidal barium suspension was instilled into the pharynges of conscious and ketamine-anesthetized cats. There was a significant ketamine dose-related response of spread of contrast medium into the supraglottic laryngeal area and into the stomach 2 minutes after contrast medium was instilled into the pharynx (P less than 0.05). Cats did not aspirate contrast medium into the lower respiratory tract. Three ketamine-anesthetized cats aspirated contrast medium into the subglottic area of the larynx, and 2 of these cats also aspirated the material into the cranial part of the trachea. This material was coughed up and swallowed within 5 minutes. Transit time of contrast medium into the stomach seemed to be increased in 11 of the 15 cats given the larger dosages of ketamine (24, 36, 48 mg/kg of body weight), compared with that in conscious cats and those given ketamine at 12 mg/kg. Competent laryngeal protective reflexes in cats can be maintained with ketamine anesthesia. Contrast radiography could be used as a diagnostic aid in ketamine-anesthetized cats suspected of laryngeal reflex abnormalities

FADD Expression as a Prognosticator in Early-Stage Glottic Squamous Cell Carcinoma of the Larynx Treated Primarily With Radiotherapy

International Nuclear Information System (INIS)

Schrijvers, Michiel L.; Pattje, Wouter J.; Slagter-Menkema, Lorian; Mastik, Mirjam F.; Gibcus, Johan H.; Langendijk, Johannes A.; Wal, Jacqueline E. van der; Laan, Bernard F.A.M. vn der; Schuuring, E.

2012-01-01

Purpose: We recently reported on the identification of the Fas-associated death domain (FADD) as a possible driver of the chromosome 11q13 amplicon and the association between increased FADD expression and disease-specific survival in advanced-stage laryngeal carcinoma. The aim of this study was to examine whether expression of FADD and its Ser194-phosphorylated isoform (pFADD) predicts local control in patients with early-stage glottic carcinoma primarily treated with radiotherapy only. Methods and Materials: Immunohistochemical staining for FADD and pFADD was performed on pretreatment biopsy specimens of 92 patients with T1–T2 glottic squamous cell carcinoma primarily treated with radiotherapy between 1996 and 2005. Cox regression analysis was used to correlate expression levels with local control. Results: High levels of pFADD were associated with significantly better local control (hazard ratio, 2.40; 95% confidence interval, 1.04–5.55; p = 0.040). FADD overexpression showed a trend toward better local control (hazard ratio, 3.656; 95% confidence interval, 0.853–15.663; p = 0.081). Multivariate Cox regression analysis showed that high pFADD expression was the best predictor of local control after radiotherapy. Conclusions: This study showed that expression of phosphorylated FADD is a new prognostic biomarker for better local control after radiotherapy in patients with early-stage glottic carcinomas.

Middle frontal horizontal partial laryngectomy (MFHPL: a treatment for stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure.

Directory of Open Access Journals (Sweden)

Wen-bin Lei

Full Text Available OBJECTIVE: The therapeutic effect of middle frontal horizontal partial laryngectomy (MFHPL in treating stage T1b squamous cell carcinoma of the glottic larynx involving anterior vocal commissure (AVC was compared with that of the anterior frontolateral vertical partial laryngectomy (AFVPL. The feasibility and practical significance of MFHPL in clinical application was discussed in the present study. METHODS: From January 1996 to January 2010, a total of 65 patients diagnosed with stage T1bN0M0 glottic laryngeal cancer were treated with MFHPL or AFVPL. The postoperative complications, glottic reconstruction, recurrence rate, voice quality and survival rates were evaluated and compared between two treatments. RESULTS: AFVPL and MFHPL were performed in 34 and 31 patients, respectively. Flexible fiberoptic laryngoscopy revealed that in the MFHPL-treated patients the reconstructed glottis was spacious and symmetric. In contrast, AFVPL treatment resulted in irregular glottic area with poor symmetry and tubular glottis. The incidence of postoperative laryngeal stenosis significantly differed between the MFHPL- and AFVPL-treated groups (P = 0.025. No significant difference was detected in the 3- and 5-year overall- or tumor-free survival rates between two treatments. The Voice Handicap Index (VHI and maximum phonation time (MPT after surgery were 51.0±12.99 and 12.42±3.44 sec in the AFVPL-treated group; while in the MFHPL-treated patients they were 31.81±7.48 and 7.65±1.98 sec, respectively. Both differences in VHI (P = 0.012 and MPT (P = 0.024 were significant between two treatments. CONCLUSIONS: MFHPL was comparable to AFVPL with respect to postoperative complications, recurrence rate and survival rates, but possessed advantages over AFVPL in terms of the incidence of laryngeal stenosis and voice quality. Our study indicated that MFHPL has a potential value in clinical practice of treating stage T1b squamous cell carcinoma of the

Factors affecting the quality of voice in the early glottic cancer treated with radiotherapy

International Nuclear Information System (INIS)

Agarwal, Jai Prakash; Baccher, Gurmit K.; Waghmare, Chaitali M.; Mallick, Indranil; Ghosh-Laskar, Sarbani; Budrukkar, Ashwini; Pai, Prathamesh; Chaturvedi, Pankaj; D'Cruz, Anil; Shrivastava, Shyam K.; Dinshaw, Ketayun A.

2009-01-01

Aims: To prospectively analyze the objective voice quality before and after radiotherapy (RT) for early glottic cancer and to evaluate the role of different factors that may affect it. Methods: Patients with T1-T2N0M0 glottic cancer underwent voice quality assessment before treatment and after radical RT. Post-RT voice quality was compared to the voice at diagnosis and the voice of healthy individuals used as controls. A comprehensive set of voice parameters were measured. The effects of age, smoking history, T stage, anterior commissure (AC) involvement, radiation dose, fractionation and volumes on pre-treatment and post-treatment voice quality were analyzed. Results: The voice quality data of 50 patients were analyzed. Following treatment, there was a significant improvement in the majority of measured parameters. However, perturbation and HNR remained inferior compared to controls. A history of smoking, AC involvement and larger RT volumes resulted in poorer voice parameters following RT. There was no significant impact of age alone. T2 tumors had an inferior voice quality before treatment, but did not remain inferior following RT. Hypofractionated RT did not show any negative impact. Conclusions: There is a considerable improvement of voice quality following RT. Several factors may have specific effects on pre-treatment and post-treatment voice

[Long term results of exclusive chemotherapy for glottic squamous cell carcinoma complete clinical responders after induction chemotherapy].

Science.gov (United States)

Vachin, F; Hans, S; Atlan, D; Brasnu, D; Menard, M; Laccourreye, O

2004-06-01

To evaluate the long-term results of exclusive chemotherapy for T1-T3N0M0 glottic squamous cell carcinoma complete clinical responders after induction chemotherapy. Between 1985 and 2000, 69 patients with glottic squamous cell carcinoma complete clinical responders after induction chemotherapy were managed with exclusive chemotherapy at our department. Chemotherapy associated platinum and fluorouracil. This retrospective analysis evaluated actuarial survival, treatment morbidity, oncologic events and laryngeal preservation. Various independent factors were tested for potential correlation with survival and local recurrence. The 5-year Kaplan-Meier actuarial survival, local control, lymph node control estimate were 83,6%, 64,8%, 98,6% respectively. Chemotherapy never resulted in death. The 10-year actuarial metachronous second primary tumors estimate was 32%. The overall laryngeal preservation rate was 98,6%. Altogether our data and the review of the literature suggest that in patients achieving a complete clinical response after and induction based chemotherapy regimen, the completion of an exclusive chemotherapy regimen appears to be a valid alternative to the conventional use of radiotherapy or chemo-radiation protocols.

Análise videolaringoestroboscópica de pacientes submetidos à radioterapia para tratamento de câncer glótico Videolaryngostroboscopic analysis of patients submitted to radiation therapy for the treatment of glottic cancer

Directory of Open Access Journals (Sweden)

André Luís Quarteiro

2010-02-01

Full Text Available Sendo a radioterapia oncologicamente adequada no tratamento do câncer precoce da laringe, é importante estudar o padrão vibratório, que é componente crítico para os resultados vocais. OBJETIVO: Analisar os achados videolaringoestroboscópicos em um grupo de pacientes submetidos à radioterapia para o tratamento do câncer glótico precoce. MÉTODOS: Estudo retrospectivo realizado através da avaliação de 20 pacientes estadiados como T1a glótico de 1995 a 2005. Um protocolo videolaringoestroboscópico foi aplicado. RESULTADOS: O fechamento glótico foi completo em 17 pacientes. A amplitude foi normal em 14 pregas vocais tratadas e em 18 pregas contralaterais. O padrão da onda vibratória mucosa foi sempre totalmente presente, normal ou discretamente diminuído em ambas as pregas vocais, com melhores resultados para a prega vocal contralateral em comparação com aqueles verificados nas pregas vocais com o tumor. A periodicidade foi sempre regular em todos os casos. A simetria e os movimentos das pregas vestibulares e das aritenoides foram normais. Houve constrição supraglótica lateral ocasional em quatro casos. O aspecto da mucosa foi edematoso em seis pacientes. Formação de bola de muco foi observada em 12 pacientes. CONCLUSÕES: O padrão vibratório foi normal ou discretamente diminuído para ambas as pregas vocais após tratamento radioterápico para câncer glótico T1a.Radiation therapy is an adequate treatment for early laryngeal cancer, and it is important to study the vocal fold vibratory pattern, which is essential for a favorable voice outcome. AIM: To analyze laryngostroboscopic findings in a group of patients who underwent radiation therapy for the treatment of early glottic cancer. METHODS: A retrospective study was conducted in order to evaluate 20 patients staged as T1a glottic tumors in the period from 1995 to 2005. A laryngostroboscopic protocol was applied. RESULTS: Glottic closure was complete in 17 patients

Vocal changes in patients undergoing radiation therapy for glottic carcinoma

International Nuclear Information System (INIS)

Miller, S.; Harrison, L.B.; Solomon, B.; Sessions, R.B.

1990-01-01

A prospective evaluation of vocal changes in patients receiving radiation therapy for T1 and T2 (AJC) glottic carcinoma was undertaken in January 1987. Vocal analysis was performed prior to radiotherapy and at specific intervals throughout the radiation treatment program. The voicing ratio was extrapolated from a sustained vowel phonation using the Visipitch interfaced with the IBM-PC. Preliminary observations suggested three distinct patterns of vocal behavior: 1. reduced voicing ratio with precipitous improvement within the course of treatment, 2. high initial voicing ratio with reduction secondary to radiation induced edema, with rapid improvement in the voicing component after the edema subsided, and 3. fluctuating voicing ratio during and following treatment. Enrollment of new patients and a 2-year follow-up of current patients was undertaken

Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in an homogenous patient population

International Nuclear Information System (INIS)

Dinapoli, Nicola; Parrilla, Claudio; Galli, Jacopo

2010-01-01

To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma. Patients, affected by laryngeal glottic carcinoma, treated by laser CO 2 surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software. A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001). This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined. (orig.)

Multidisciplinary approach in the treatment of T1 glottic cancer. The role of patient preference in an homogenous patient population

Energy Technology Data Exchange (ETDEWEB)

Dinapoli, Nicola [Catholic Univ. of the Sacred Heart, Rome (Italy). Dept. of Radiation Oncology; Parrilla, Claudio; Galli, Jacopo [Catholic Univ. of the Sacred Heart, Rome (IT). Dept. of Otorhinolaryngoiatry] (and others)

2010-11-15

To compare oncological outcome and voice quality among a uniform and well-defined subset of patients with T1 glottic carcinoma. Patients, affected by laryngeal glottic carcinoma, treated by laser CO{sub 2} surgery or radiotherapy, have been analyzed. Overall survival and disease-free survival were calculated. In order to verify differences in functional outcomes and voice quality, all patients were interviewed during their last follow-up visit during 2009 using the VHI (Voice Handicap Index) questionnaire. The data were analyzed using the MedCalc software. A total of 143 patients were analyzed: 73 underwent surgery and 70 underwent radiotherapy. No statistically significant differences were found between the two groups in terms of overall survival and disease-free survival; dividing patients into stages T1a and T1b also made no difference. In order to evaluate the differences in outcomes for surgery and radiotherapy, patients were interviewed using the VHI questionnaire. Better scores for each category in the VHI were found for patients receiving radiotherapy compared to surgery (physical: p = 0.0023; functional: p < 0.0001; environmental: p < 0.001). The median VHI score for radiotherapy patients was 4, while for surgical patients it was 18 (p < 0.0001). This study confirms the well-known knowledge that results from radiotherapy and surgery in early glottic cancer treatment are equivalent. Furthermore, the role of patient preference in the treatment modality choice and the value of a multidisciplinary approach for a detailed and multi-oriented discussion with the patient are outlined. (orig.)

Being reflexive in qualitative grounded theory: discussion and application of a model of reflexivity.

Science.gov (United States)

Engward, Hilary; Davis, Geraldine

2015-07-01

A discussion of the meaning of reflexivity in research with the presentation of examples of how a model of reflexivity was used in a grounded theory research project. Reflexivity requires the researcher to make transparent the decisions they make in the research process and is therefore important in developing quality in nursing research. The importance of being reflexive is highlighted in the literature in relation to nursing research, however, practical guidance as to how to go about doing research reflexively is not always clearly articulated. This is a discussion paper. The concept of reflexivity in research is explored using the Alvesson and Skoldberg model of reflexivity and practical examples of how a researcher developed reflexivity in a grounded theory project are presented. Nurse researchers are encouraged to explore and apply the concept of reflexivity in their research practices to develop transparency in the research process and to increase robustness in their research. The Alvesson and Skoldberg model is of value in applying reflexivity in qualitative nursing research, particularly in grounded theory research. Being reflexive requires the researcher to be completely open about decisions that are made in the research process. The Alvesson and Skolberg model of reflexivity is a useful model that can enhance reflexivity in the research process. It can be a useful practical tool to develop reflexivity in grounded theory research. © 2015 John Wiley & Sons Ltd.

A predictive model for recurrence in patients with glottic cancer implemented in a mobile application for Android.

Science.gov (United States)

Jover-Esplá, Ana Gabriela; Palazón-Bru, Antonio; Folgado-de la Rosa, David Manuel; Severá-Ferrándiz, Guillermo; Sancho-Mestre, Manuela; de Juan-Herrero, Joaquín; Gil-Guillén, Vicente Francisco

2018-05-01

The existing predictive models of laryngeal cancer recurrence present limitations for clinical practice. Therefore, we constructed, internally validated and implemented in a mobile application (Android) a new model based on a points system taking into account the internationally recommended statistical methodology. This longitudinal prospective study included 189 patients with glottic cancer in 2004-2016 in a Spanish region. The main variable was time-to-recurrence, and its potential predictors were: age, gender, TNM classification, stage, smoking, alcohol consumption, and histology. A points system was developed to predict five-year risk of recurrence based on a Cox model. This was validated internally by bootstrapping, determining discrimination (C-statistics) and calibration (smooth curves). A total of 77 patients presented recurrence (40.7%) in a mean follow-up period of 3.4 ± 3.0 years. The factors in the model were: age, lymph node stage, alcohol consumption and stage. Discrimination and calibration were satisfactory. A points system was developed to obtain the probability of recurrence of laryngeal glottic cancer in five years, using five clinical variables. Our system should be validated externally in other geographical areas. Copyright © 2018 Elsevier Ltd. All rights reserved.

The results of radiotherapy for T1 glottic cancers. Influence of radiation beam energy

International Nuclear Information System (INIS)

Yamamoto, Michinori; Joja, Ikuo; Takemoto, Mitsuhiro; Kuroda, Masahiro; Hiraki, Yoshio

1999-01-01

We analyzed the influence of various parameters on the results of radiotherapy for T1 glottic cancer by assessing the outcomes of 60 patients with this cancer who received definitive radiotherapy between 1985 and 1994. Seven patients were treated with a cobalt-60 unit, and the other 53 with a linear accelerator (26 patients at 3-MV, 10 at 6-MV, and 17 at 10-MV). Of the 17 patients treated at 10-MV, 4 also received part of their treatment with a cobalt-60 unit. The total radiation dose ranged from 56 Gy to 70 Gy (mean, 61 Gy). The total radiation dose of 51 patients (85%) was 60 Gy. The factors found to influence local control were the strength of the radiation beam energy and whether or not there was gross tumor invasion of the anterior commissure. The local control rate was 71% in the patients treated with a 10-MV linear accelerator, 56% in those treated with a 6-MV linear accelerator and, 97% in those treated with a cobalt-60 unit or a 3-MV linear accelerator (P=0.0173). The local control rate was 43% in the patients with gross anterior commissure invasion and 88% in those without (P=0.0075). We conclude that low energy photon beams are more suitable for the treatment of early glottic cancers, especially if the lesion grossly invades the anterior commissure. (author)

Early glottic carcinoma: results of treatment by radiotherapy

International Nuclear Information System (INIS)

Smee, R.; Williams, J.; Fisher, R.; Bridger, G.P.

2000-01-01

The purpose of the present paper was to review the results of treating early stages glottic, squamous cell carcinoma by radiotherapy in the Department of Radiation Oncology, Prince of Wales Hospital, Sydney. A retrospective review was carried out of all patients seen in the department from 1967 to 1994, inclusive. To be eligible, patients had to have newly diagnosed cancer and to have been treated with curative intent by radiotherapy alone. Three hundred and sixty-nine patients satisfied the eligibility requirements. The mean follow-up time was 12.2 years (maximum: 28 years). At 5 years the actuarial local control rate was 80% (84% for stage T 1 and 72% for T 2 ). The ultimate local control rate was 96%. The overall survival rates at 5 and 10 years were 73% and 52%, respectively. The risk of nodal recurrence was much higher after persisting disease or local recurrence. Our results confirm the high cure rates achieved with this modality of treatment and are comparable with those reported in the literature. Copyright (1999) Blackwell Science Pty. Ltd

Unilateral Optic Neuropathy and Acute Angle-Closure Glaucoma following Snake Envenomation

Directory of Open Access Journals (Sweden)

Osman Okan Olcaysu

2015-01-01

Full Text Available Purpose. We aimed to describe a unique case in which a patient developed unilateral optic neuritis and angle-closure glaucoma as a result of snake envenomation. Case Report. Approximately 18 hours after envenomation, a 67-year-old female patient described visual impairment and severe pain in her left eye (LE. The patient’s best corrected visual acuity was 10/10 in the RE and hand motion in the LE. Cranial magnetic resonance imaging showed signs of neuropathy in the left optic nerve. In the LE, corneal haziness, closure of the iridocorneal angle, and mild mydriasis were observed and pupillary light reflex was absent. Intraocular pressure was 25 mmHg and 57 mmHg in the RE and LE, respectively. The patient was diagnosed with acute angle-closure glaucoma in the LE. Optic neuropathy was treated with intravenous pulse methylprednisolone. Left intraocular pressure was within normal range starting on the fourth day. One month after the incident, there was no sign of optic neuropathy; relative afferent pupillary defect and optic nerve swelling disappeared. Conclusions. Patients with severe headache and visual loss after snake envenomation must be carefully examined for possible optic neuropathy and angle-closure glaucoma. Early diagnosis and treatment of these cases are necessary to prevent permanent damage to optic nerves.

Etnography and Reflexivity

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Mario Cardano

2014-01-01

Full Text Available This essay deals with a relevant and controversial topic – objectivity in ethnographic research. More specifically, I would like to examine how reflexive procedures, more precisely “reflexive account”, can increase the robustness of results gained through an ethnographic research. The essay is organized in five parts. I will start by giving a preliminary definition of the two key concepts which are at the center of the analysis – objectivity and reflexivity. I will then give a brief description of the epistemological framework in which the proposed conceptions of objectivity and reflexivity are located. Thirdly, I move on to consider the epistemic status of ethnographic research, and will emphasize that ethnographies are not just “theory-laden”, as many writers have stated, but also “praxis” or “procedure laden”. In other words, I will stress that it is not only theories which are inevitably embedded in research, influencing how observations can be made; much the same can also be said of the concrete research practices which contribute to determine the experience of the ethnographer and its representation in a text. Fourthly, I will discuss why it is useful to employ reflexive practices, and then immediately afterwards will illustrate the ways in which reflexive descriptions can contribute to greater objectivity of ethnographic accounts. In conclusion, I will discuss a number of objections which have been raised against this use of reflexivity.

Radiation treatment of glottic squamous cell carcinoma, Stage I and II: analysis of factors affecting prognosis

International Nuclear Information System (INIS)

Franchin, Giovanni; Minatel, Emilio; Gobitti, Carlo; Talamini, Renato; Sartor, Giovanna; Caruso, Giuseppe; Grando, Giuseppe; Politi, Doriano; Gigante, Marco; Toffoli, Giuseppe; Trovo, Mauro G.; Barzan, Luigi

1998-01-01

Purpose: At least in some European Countries, there is still considerable controversy regarding the choice between surgery and radiotherapy for the treatment of patients with early laryngeal-glottic carcinoma. Methods and Materials: Two hundred and forty-six patients with laryngeal-glottic neoplasms, Stage I-II, were treated with radical radiotherapy. Before radiotherapy the patients were evaluated to determine the surgical procedure of choice. Either 66-68.4 Gy (33-38 fractions) or 63-65 Gy (28-29 fractions) of radiation therapy (RT) were administered. The overall disease free survival was determined for each subgroup of patients. Univariate and multivariate analyses were performed to determine significant prognostic variables. Results: Five- and 10-year overall survival rates were 83 and 72%, respectively. At a median follow-up of 6 years 204 patients are alive and disease free. No patient developed distant metastases. One patient died of a large local recurrence, 38 patients died of causes unrelated to their tumor, and 3 patients were lost to follow-up. The multivariate analysis confirmed that performance status (PS), macroscopic presentation of the lesion, and persistence of dysphonia after radiotherapy are significant prognostic factors. Conclusions: According to the multivariate analysis, the patients with PS >80 and with exophytic lesions are eligible for radical RT. The surgical procedure proposed for each patient was not found to be an independent prognostic factor

Simple Carotid-Sparing Intensity-Modulated Radiotherapy Technique and Preliminary Experience for T1-2 Glottic Cancer

International Nuclear Information System (INIS)

Rosenthal, David I.; Fuller, Clifton D.; Barker, Jerry L.; Mason, Bryan M.S.; Garcia, John A. C.; Lewin, Jan S.; Holsinger, F. Christopher; Stasney, C. Richard; Frank, Steven J.; Schwartz, David L.; Morrison, William H.; Garden, Adam S.; Ang, K. Kian

2010-01-01

Purpose: To investigate the dosimetry and feasibility of carotid-sparing intensity-modulated radiotherapy (IMRT) for early glottic cancer and to report preliminary clinical experience. Methods and Materials: Digital Imaging and Communications in Medicine radiotherapy (DICOM-RT) datasets from 6 T1-2 conventionally treated glottic cancer patients were used to create both conventional IMRT plans. We developed a simplified IMRT planning algorithm with three fields and limited segments. Conventional and IMRT plans were compared using generalized equivalent uniform dose and dose-volume parameters for in-field carotid arteries, target volumes, and organs at risk. We have treated 11 patients with this simplified IMRT technique. Results: Intensity-modulated radiotherapy consistently reduced radiation dose to the carotid arteries (p < 0.05) while maintaining the clinical target volume coverage. With conventional planning, median carotid V35, V50, and V63 were 100%, 100%, and 69.0%, respectively. With IMRT planning these decreased to 2%, 0%, and 0%, respectively (p < 0.01). Radiation planning and treatment times were similar for conventional radiotherapy and IMRT. Treatment results have been excellent thus far. Conclusions: Intensity-modulated radiotherapy significantly reduced unnecessary radiation dose to the carotid arteries compared with conventional lateral fields while maintaining clinical target volume coverage. Further experience and longer follow-up will be required to demonstrate outcomes for cancer control and carotid artery effects.

Phantom-to-clinic development of hypofractionated stereotactic body radiotherapy for early-stage glottic laryngeal cancer

Energy Technology Data Exchange (ETDEWEB)

Ding, Chuxiong [Department of Radiation Oncology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX (United States); Chun, Stephen G. [Department of Radiation Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX (United States); Sumer, Baran D. [Department of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX (United States); Nedzi, Lucien A.; Abdulrahman, Ramzi E. [Department of Radiation Oncology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX (United States); Yordy, John S. [Valley Radiation Therapy Center, Anchorage, AK (United States); Lee, Pam; Hrycushko, Brian [Department of Radiation Oncology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX (United States); Solberg, Timothy D. [Department of Radiation Oncology, Abramson Comprehensive Cancer Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA (United States); Ahn, Chul [Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX (United States); Timmerman, Robert D. [Department of Radiation Oncology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX (United States); Schwartz, David L., E-mail: david.schwartz214@gmail.com [Department of Radiation Oncology, Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX (United States)

2017-07-01

The purpose of this study was to commission and clinically test a robotic stereotactic delivery system (CyberKnife, Sunnyvale, CA) to treat early-stage glottic laryngeal cancer. We enrolled 15 patients with cTis-T2N0M0 carcinoma of the glottic larynx onto an institutional review board (IRB)-approved clinical trial. Stereotactic body radiotherapy (SBRT) plans prescribed 45 Gy/10 fractions to the involved hemilarynx. SBRT dosimetry was compared with (1) standard carotid-sparing laryngeal intensity-modulated radiation therapy (IMRT) and (2) selective hemilaryngeal IMRT. Our results demonstrate that SBRT plans improved sparing of the contralateral arytenoid (mean 20.0 Gy reduction, p <0.001), ipsilateral carotid D{sub max} (mean 20.6 Gy reduction, p <0.001), contralateral carotid D{sub max} (mean 28.1 Gy reduction, p <0.001), and thyroid D{sub mean} (mean 15.0 Gy reduction, p <0.001) relative to carotid-sparing IMRT. SBRT also modestly improved dose sparing to the contralateral arytenoid (mean 4.8 Gy reduction, p = 0.13) and spinal cord D{sub max} (mean 4.9 Gy reduction, p = 0.015) relative to selective hemilaryngeal IMRT plans. This “phantom-to-clinic” feasibility study confirmed that hypofractionated SBRT treatment for early-stage laryngeal cancer can potentially spare dose to adjacent normal tissues relative to current IMRT standards. Clinical efficacy and toxicity correlates continue to be collected through an ongoing prospective trial.

T1-2 glottic cancer treated with radiotherapy and/or surgery

Energy Technology Data Exchange (ETDEWEB)

Shelan, Mohamed; Bojaxhiu, Beat; Dal Pra, Alan; Aebersold, Daniel M.; Elicin, Olgun [University of Bern, Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern (Switzerland); Anschuetz, Lukas; Schubert, Adrian D.; Giger, Roland [University of Bern, Department of Otorhinolaryngology - Head and Neck Surgery, Inselspital, Bern University Hospital, Bern (Switzerland); Behrensmeier, Frank [University of Bern, Department of Radiation Oncology, Inselspital, Bern University Hospital, Bern (Switzerland); Radiation-Oncology-Centre, Biel - Seeland - Berner Jura, Biel (Switzerland)

2017-12-15

The optimal treatment strategy for stage I-II glottic squamous cell carcinoma (SCC) is not well-defined. This study analyzed treatment results and prognostic factors. This is a single-institution retrospective analysis of 244 patients with T1-2 glottic SCC who underwent normofractionated radiotherapy (RT) and/or surgery between 1990 and 2013. The primary endpoint was relapse-free survival (RFS). Median age was 65 years (range: 36-92 years), the majority (82%) having stage I disease. Definitive RT was used in 82% (median dose: 68 Gy, 2 Gy per fraction). Median follow-up was 59 months. The 5-year RFS rates were 83 and 75% (p = 0.05) for stage I and 62 and 50% (p = 0.47) for stage II in the RT and surgery groups, respectively. Multivariate analyses indicate T1 vs. T2 and RT vs. surgery as independent prognostic factors for RFS, with hazard ratios of 0.38 (95% confidence interval, CI: 0.21-0.72) and 0.53 (95% CI: 0.30-0.99), respectively (p < 0.05). The 5-year overall and cause-specific survival rates in the whole cohort were 92 and 96%, respectively, with no significant differences between treatment groups. Anterior commissure involvement was neither a prognostic nor a predictive factor. The incidence of secondary malignancies was not significantly different between patients treated with and without RT (22 vs. 9% at 10 years, respectively, p = 0.18). Despite a possible selection bias, our series demonstrates improved RFS with RT over surgery in stage I glottic SCC. (orig.) [German] Die optimale Behandlungsstrategie fuer ein Plattenepithelkarzinom (SCC) der Stimmbaender im Stadium I-II ist nicht gut definiert. In dieser Studie wurden Behandlungsergebnisse und prognostische Faktoren untersucht. In dieser retrospektiv unizentrischen Studie wurden 244 Patienten mit einem fruehen Glottis-SCC (T1-2) zwischen 1990 und 2013 strahlentherapeutisch (RT) und/oder chirurgisch behandelt. Primaerer Endpunkt war das rezidivfreie Ueberleben (RFS). Das mediane Alter betrug 65 Jahre

Predicting the local outcome of glottic squamous cell carcinoma after definitive radiation therapy: value of computed tomography-determined tumour parameters

International Nuclear Information System (INIS)

Hermans, R.; Van den Bogaert, W.; Rijnders, A.; Doornaert, P.; Baert, A.L.

1999-01-01

Background and purpose: The T-classification has shortcomings in the prediction of local outcome of glottic squamous cell carcinoma (SCC) treated by definitive radiation therapy. In this regard, the value of several CT-derived tumour parameters as predictors of local outcome was investigated. Materials and methods: The pretreatment CT studies of 119 patients with glottic SCC (T1, n=61; T2, n=40; T3, n=14; T4, n=4) treated with curative intent by radiation therapy were reviewed for tumoral involvement of specific laryngeal anatomic subsites (including laryngeal cartilages). Tumour volume was calculated with the summation-of-areas technique. Actuarial (life-table) statistical analysis was done for each of the covariates; multivariate analysis was performed using the Cox proportional hazards model.Results: In the actuarial analysis tumour volume was significantly correlated with local recurrence rate (P=0.0062). Involvement of the cricoid cartilage (P=0.0052), anterior commissure (P=0.0203), subglottis (P=0.0481) and preepiglottic space (P=0.0134) and degree of involvement of the true vocal cord (P=0.0441) and paraglottic space at the level of the true vocal cord (P=0.0002) were also significantly correlated with local recurrence rate. In the multivariate analysis, only degree of involvement of the paraglottic space (at the level of the true vocal cord) (P=0.0001) and preepiglottic space (P=0.02) were found to be independent predictors of local recurrence. The T-category was significantly correlated with local outcome in the actuarial analysis (P=0.0001), but not in the multivariate analysis (P=0.5915). Conclusions: Several CT-derived parameters are powerful predictors of local outcome in glottic cancer treated with radiation therapy; some of these parameters are stronger linked to the local control rate than the T-classification. (Copyright (c) 1999 Elsevier Science B.V., Amsterdam. All rights reserved.)

T1N0 to T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated With Definitive Radiotherapy

International Nuclear Information System (INIS)

Chera, Bhishamjit S.; Amdur, Robert J.; Morris, Christopher G.; Kirwan, Jessica M.; Mendenhall, William M.

2010-01-01

Purpose: To report the treatment outcomes of definitive radiotherapy (RT) for early-stage squamous cell carcinoma (SCCA) of the glottic larynx. Methods and Materials: We retrospectively reviewed the medical records of 585 patients with T1N0 to T2N0 invasive SCCA of the glottic larynx treated between 1964 and 2006 with RT alone. All patients had at least 2 years of follow-up, had histologic diagnosis of invasive SCCA, and received continuous-course RT. None of these patients received chemotherapy or had elective nodal RT. The probabilities of local control (LC), ultimate LC, ultimate LC with larynx preservation, neck control, cause-specific survival (CSS), and overall survival (OS) were calculated by the Kaplan-Meier product-limit method. Results: The median follow-up for survivors was 12 years. Five-year LC rates were as follows: T1A, 94%; T1B, 93%; T2A, 80%; and T2B, 70%. Multivariate analysis revealed that overall treatment time greater than 41 days (p = 0.001) and poorly differentiated histology (p = 0.016) adversely affected LC. Five-year rates of ultimate LC with laryngeal preservation were: T1A, 95%; T1B, 94%, T2A, 81%; and T2B, 74%. Twenty-four (4%) of 585 patients failed in the neck; only 7 neck failures (1%) were isolated. Five-year CSS and OS rates were as follows: T1A, 97% and 82%; T1B, 99% and 83%; T2A, 94% and 76%; and T2B, 90% and 78%, respectively. Ten (1.7%) patients had severe and/or fatal complications. One patient died of a radiation-induced carotid artery angiosarcoma. Conclusion: Based on our study results, RT cures a high proportion of patients with T1N0 to T2N0 glottic SCCAs and has a low rate of severe complications.

Treatment of the glottic squamous cell carcinoma in stages T1-T2, N0: surgery versus radiotherapy: retrospective study of 50 patients attended at the Hospital Mexico in the period 2005 to 2011

International Nuclear Information System (INIS)

Diaz Munoz, Angie

2014-01-01

Recurrence rates are compared in patients with glottic cancer in early stages, treated with surgery and/or radiotherapy. The study was composed by all patients diagnosed with glottic cancer in the Servicio de Otorrinolaringologia from Hospital Mexico, in early stages during the period 2005 to 2011. The local and locoregional recurrence rates are determined. Differences in recurrence rates are analyzed. Factors associated to higher recurrence rates are identified. Treatment with radiotherapy has had statistically a higher proportion of local recurrence than treatment with surgery [es

Reflexivity in qualitative research

DEFF Research Database (Denmark)

Evans, Adam Brian; Nistrup, Anne; Henderson, Hannah

2018-01-01

There has been something of a “reflexive shift” in sociological research. Sociological researchers are increasingly encouraged to be “present” within their work, and to recognize their own role in structuring the entire research process. One way to achieve this is through engagement in reflexive...... practice, that is, to reflect on our own values, beliefs, and biographies. It can be difficult to know exactly how a researcher should engage in these practices, however. Here, we discuss our reflexive practice in two case studies, both which utilized the same figurational theoretical framework...... Kingdom. Reflexive practice in both studies was affected by researcher biographies and by study design. In Study 1, both researchers were reasonably detached from the study context, the theoretical framework was in place from the very beginning, and reflexive practice was embedded in the study design...

Cordectomy by CO2 laser or radiotherapy for small T1a glottic carcinomas : Costs, local control, survival, quality of life, and voice quality

NARCIS (Netherlands)

Goor, Kim M.; Peeters, A. Jeanne G. E.; Mahieu, Hans F.; Langendijk, Johannes A.; Leemans, C. Rene; Verdonck-de Leeuw, Irma M.; van Agthoven, Michel

Background, The clinical results of radiotherapy and endoscopic cordectomy for T1a glottic carcinoma are reported to be similar, but costs of both treatments may differ. Therefore, we retrospectively evaluated the costs, voice quality, quality of life, and clinical results of both treatments.

Factors influencing the treatment outcome for patients with T2N0 glottic carcinoma treated by definitive radiotherapy

International Nuclear Information System (INIS)

Fukuda, Ichiro; Kanehira, Chihiro; Kobayashi, Masao; Aoki, Manabu; Takagi, Sayako; Shirahama, Jun; Honda, Chikara

2007-01-01

The purpose of this study was to determine the prognostic factors affecting local outcomes for patients with T2N0 glottic carcinoma treated by definitive radiotherapy. A total of 48 patients with T2N0 squamous cell carcinoma treated by definitive radiotherapy between 1992 and 2005 were studied. Cumulative probability of overall survival, cause-specific survival, local control and larynx-preserving were calculated according the Kaplan-Meier method, and the prognostic significance of patient's age, number of subsites involved, impaired cord mobility, anterior commisure involved, total dose and overall treatment time were analyzed using the log-rank test in univariate analysis and Cox regression in multivariate analysis. Follow-up ranged from 13 to 141 months (median, 62 months). Five-year survivals were: overall, 95.3%; cause-specific, 97.9% and five years rates were local control, 61.4%; larynx-preserving, 76.4%. Multivariate analyses of the six parameters showed that overall treatment time significantly influenced the probability of local control, and impaired mobility and overall treatment time affected the probability of larynx-preserving. Our study showed that longer overall treatment time significantly worsened the percentage of local control and larynx-preserving for patients with T2N0 glottic carcinoma treated with definitive radiotherapy. Therefore, we suggest treating, the patients in a shorter treatment course. (author)

[Reflex seizures, cinema and television].

Science.gov (United States)

Olivares-Romero, Jesús

2015-12-16

In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot.

Arakeri’s Reflex: an Alternative Pathway for Dento-Cardiac Reflex Mediated Syncope

Directory of Open Access Journals (Sweden)

Veena Arali

2010-03-01

Full Text Available Introduction: Dentocardiac reflex, a variant of trigeminocardiac reflex elicited specifically during tooth extraction procedures in den-tal/maxillofacial surgery and is believed to cause syncope with an afferent link mediated by posterior superior alveolar nerve. Another variant of trigeminocardiac reflex which is also of interest to the oral and maxillofacial surgeon is oculocardiac reflex which can be triggered by direct or indirect manipulation of eye globe or muscles around it.The hypothesis: Excessive or injudicious pressure or manipulations around the maxillary first molars during extraction procedure are as-sociated with maximum incidence of bradycardia and hypotension than around incisor/ canine/ third molars. This is because; the pressure on eye globe and ophthalmic rectus muscle is maximum during extraction of first molar than incisor/canine and third molars. This observation led us to postulate an alternative pathway for dentocardiac reflex mediated syncope which may possibly justify the maxillary first molar region as a prone factor for the trigger. Evaluation of the hypothesis: Present hypothesis may not confer the specific factor responsible for switch in autonomic response in syncope origin during the tooth extraction procedure, but may provide a clue to where we should be looking.

[H reflex in patients with spastic quadriplegia].

Science.gov (United States)

Miyama, Sahoko; Arimoto, Kiyoshi; Kimiya, Satoshi

2009-01-01

Hoffmann reflex (H reflex) is an electrically elicited spinal monosynaptic reflex. H reflex was examined in 18 patients with spastic quadriplegia who had perinatal or postnatal problems. H reflex was elicitable in 11 patients for the abductor pollicis brevis (61.1%), 10 for the abductor digiti minimi (55.6%) and 16 for the abductor hallucis (88.9%). Because the abductor pollicis brevis and the abductor digiti minimi do not exhibit H reflex in normal subjects, it was suggested that the excitability of alpha motor neurons innervating these muscles was increased. H reflex was not detected for the extensor digitorum brevis in any patients, indicating the difference in the excitability among alpha motor neurons. In some patients, H reflex did not disappear under supramaximal stimuli. We conclude that the mechanism of evolution of H reflex in patients with spastic quadriplegia is different from that in normal subjects.

Results of Investigations on the Blink Reflex as a Protective Means against Laser and LED Radiation: A Description Based on Fundamental Psychophysical Laws

Energy Technology Data Exchange (ETDEWEB)

Hans-Dieter Reidenbach [Cologne University of Applied Sciences Research Laboratory on Medical Technology/HLT Betzdorfer Str. 2, 50679 Koeln (Germany)

2006-07-01

2,650 volunteers have been investigated in blink-reflex studies with various test equipment, where a laser beam or a single element L.E.D. or an array have been used to irradiate the human eye in order to initiate a physiological reaction. In addition 1,196 volunteers took part in aversion response studies. 491 persons out of 2,650, i.e., 18.53 %, showed a blink reflex or lid closure, upon exposure to irradiation from a laser or an L.E.D.. Only 6.19 %, i. e., 74 out of 1,196 volunteers, showed other aversion responses, like gross eye or head movements. The different parameters which are mainly responsible for the respective results concerning the blink reflex will be dealt with and explained, as they have been achieved up to now. In addition some experimentally verified dependencies on fundamental psychophysical laws will be described. Besides the statement that the blink reflex should not be used as a sufficient physiological protective means it can be generally stated that in order to ensure their safety, in spite of the missing blink-reflex and other aversion responses, users of low-power lasers should be instructed to perform active protective reactions, e.g., to close the eyes voluntarily and simultaneously move the head away from the beam in the case of an unintentional exposure or intrabeam viewing. (author)

Results of Investigations on the Blink Reflex as a Protective Means against Laser and LED Radiation: A Description Based on Fundamental Psychophysical Laws

International Nuclear Information System (INIS)

Hans-Dieter Reidenbach

2006-01-01

2,650 volunteers have been investigated in blink-reflex studies with various test equipment, where a laser beam or a single element L.E.D. or an array have been used to irradiate the human eye in order to initiate a physiological reaction. In addition 1,196 volunteers took part in aversion response studies. 491 persons out of 2,650, i.e., 18.53 %, showed a blink reflex or lid closure, upon exposure to irradiation from a laser or an L.E.D.. Only 6.19 %, i. e., 74 out of 1,196 volunteers, showed other aversion responses, like gross eye or head movements. The different parameters which are mainly responsible for the respective results concerning the blink reflex will be dealt with and explained, as they have been achieved up to now. In addition some experimentally verified dependencies on fundamental psychophysical laws will be described. Besides the statement that the blink reflex should not be used as a sufficient physiological protective means it can be generally stated that in order to ensure their safety, in spite of the missing blink-reflex and other aversion responses, users of low-power lasers should be instructed to perform active protective reactions, e.g., to close the eyes voluntarily and simultaneously move the head away from the beam in the case of an unintentional exposure or intrabeam viewing. (author)

On Reflexive Data Models

Energy Technology Data Exchange (ETDEWEB)

Petrov, S.

2000-08-20

An information system is reflexive if it stores a description of its current structure in the body of stored information and is acting on the base of this information. A data model is reflexive, if its language is meta-closed and can be used to build such a system. The need for reflexive data models in new areas of information technology applications is argued. An attempt to express basic notions related to information systems is made in the case when the system supports and uses meta-closed representation of the data.

Neurodevelopmental Reflex Testing in Neonatal Rat Pups.

Science.gov (United States)

Nguyen, Antoinette T; Armstrong, Edward A; Yager, Jerome Y

2017-04-24

Neurodevelopmental reflex testing is commonly used in clinical practice to assess the maturation of the nervous system. Neurodevelopmental reflexes are also referred to as primitive reflexes. They are sensitive and consistent with later outcomes. Abnormal reflexes are described as an absence, persistence, reappearance, or latency of reflexes, which are predictive indices of infants that are at high risk for neurodevelopmental disorders. Animal models of neurodevelopmental disabilities, such as cerebral palsy, often display aberrant developmental reflexes, as would be observed in human infants. The techniques described assess a variety of neurodevelopmental reflexes in neonatal rats. Neurodevelopmental reflex testing offers the investigator a testing method that is not otherwise available in such young animals. The methodology presented here aims to assist investigators in examining developmental milestones in neonatal rats as a method of detecting early-onset brain injury and/or determining the effectiveness of therapeutic interventions. The methodology presented here aims to provide a general guideline for investigators.

Reflex and Non-Reflex Torque Responses to Stretch of the Human Knee Extensors

National Research Council Canada - National Science Library

Mrachacz-Kersting, N

2001-01-01

.... The quadriceps muscles were stretched at various background torques, produced either voluntarily or electrically and thus the purely reflex-mediated torque could be calculated. The contribution of the reflex mediated stiffness initially low, increased with increasing background torques for the range of torques investigated.

Charitable giving and reflexive individuals: How personal reflexivity mediates between structure and agency.

Science.gov (United States)

Sanghera, Balihar

2017-03-01

This article examines how individuals are reflexive beings who interpret the world in relation to things that matter to them, and how charitable acts are evaluated and embedded in their lives with different degrees of meaning and importance. Rather than framing the discussion of charitable practices in terms of an altruism/egoism binary or imputing motivations and values to social structures, the article explains how reflexivity is an important and neglected dimension of social practices, and how it interacts with sympathy, sentiments and discourses to shape giving. The study also shows that there are different modes of reflexivity, which have varied effects on charity and volunteering.

Early glottic cancer: the influence of primary treatment on voice preservation

International Nuclear Information System (INIS)

Lesnicar, Hotimir; Smid, Lojze; Zakotnik, Branko

1996-01-01

Purpose: Retrospective analysis was performed to assess the influence of primary surgical or irradiation treatment on local control, survival, and final preservation of larynx in comparable groups of patients with T1N0 and T2N0 glottic cancer. Methods and Materials: Two hundred sixty-three previously untreated patients with invasive squamous cell carcinoma of the glottis (187T1 and 76T2) were treated with primary radiotherapy (159T1 and 60T2) or primary surgery (28T1 and 16T2) between January 1976 and December 1990, at the University of Ljubljana, Slovenia. Conventional one daily fraction of 2 Gy to doses of 60-74 Gy (median: 65 Gy) were used in 98% of primarily irradiated patients through out the observed period. To enable better comparison between the two treatment groups, primarily irradiated patients were retrospectively stratified by the criteria of suitability for primary voice-sparing operation. Several host, tumor, and treatment parameters were analyzed. Results: Only the stage of the disease significantly influenced both 10-year recurrence-free and disease-specific survival regardless primary treatment modality (p = 0.0002). In all primary irradiated patients local control was significantly better for those with overall treatment time of less than 48 days (p = 0.007). In patients suitable for voice-sparing operation, local control of primarily operated patients was similar to that of patients primarily irradiated with shorter overall treatment time, which was 93 and 88% for T1 and 67 and 64% for T2 tumors, respectively. Ultimate local control in primary surgery and radiotherapy group was 96 and 96% for T1 and 89 and 88% for T2 tumors, respectively. Equal larynx preservation of 100% in T1 and 90% in T2 patients was achieved in finally cured primarily operated patients and those patients primarily irradiated with a shorter overall treatment time. If treatment time was longer than 48 days, significantly worse final larynx preservation of 84% in T1 and 75% in

Effect of chronic and acute cigarette smoking on the pharyngo-upper oesophageal sphincter contractile reflex and reflexive pharyngeal swallow

OpenAIRE

Dua, K; Bardan, E; Ren, J; Sui, Z; Shaker, R

1998-01-01

Background—Cigarette smoking is known to affect adversely the defence mechanisms against gastro-oesophageal reflux. The effect of smoking on the supraoesophageal reflexes that prevent aspiration of gastric contents has not been previously studied. 
Aims—To elucidate the effect of cigarette smoking on two of the supraoesophageal reflexes: the pharyngo-upper oesophageal sphincter (UOS) contractile reflex; and the reflexive pharyngeal swallow. 
Methods—Ten chronic smokers and 10 non-...

A novel reflex cough testing device.

Science.gov (United States)

Fujiwara, Kazunori; Kawamoto, Katsuyuki; Shimizu, Yoko; Fukuhara, Takahiro; Koyama, Satoshi; Kataoka, Hideyuki; Kitano, Hiroya; Takeuchi, Hiromi

2017-01-18

The reflex cough test is useful for detecting silent aspiration, a risk factor for aspiration pneumonia. However, assessing the risk of aspiration pneumonia requires measuring not only the cough reflex but also cough strength. Currently, no reflex cough testing device is available that can directly measure reflex cough strength. We therefore developed a new testing device that can easily and simultaneously measure cough strength and the time until the cough reflex, and verified whether screening with this new instrument is feasible for evaluating the risk of aspiration pneumonia. This device consists of a special pipe with a double lumen, a nebulizer, and an electronic spirometer. We used a solution of prescription-grade L-tartaric acid to initiate the cough reflex. The solution was inhaled through a mouthpiece as a microaerosol produced by an ultrasonic nebulizer. The peak cough flow (PCF) of the induced cough was measured with the spirometer. The 70 patients who participated in this study comprised 49 patients without a history of pneumonia (group A), 21 patients with a history of pneumonia (group B), and 10 healthy volunteers (control group). With the novel device, PCF and time until cough reflex could be measured without adverse effects. The PCF values were 118.3 ± 64.0 L/min, 47.7 ± 38.5 L/min, and 254.9 ± 83.8 L/min in group A, group B, and the control group, respectively. The PCF of group B was significantly lower than that of group A and the control group (p reflex was 4.2 ± 5.9 s, 7.0 ± 7.0 s, and 1 s in group A, group B, and the control group, respectively. This duration was significantly longer for groups A and B than for the control group (A: p reflex and the strength of involuntary coughs for assessment of patients at risk of aspiration pneumonia.

Closure requirements

International Nuclear Information System (INIS)

Hutchinson, I.P.G.; Ellison, R.D.

1992-01-01

Closure of a waste management unit can be either permanent or temporary. Permanent closure may be due to: economic factors which make it uneconomical to mine the remaining minerals; depletion of mineral resources; physical site constraints that preclude further mining and beneficiation; environmental, regulatory or other requirements that make it uneconomical to continue to develop the resources. Temporary closure can occur for a period of several months to several years, and may be caused by factors such as: periods of high rainfall or snowfall which prevent mining and waste disposal; economic circumstances which temporarily make it uneconomical to mine the target mineral; labor problems requiring a cessation of operations for a period of time; construction activities that are required to upgrade project components such as the process facilities and waste management units; and mine or process plant failures that require extensive repairs. Permanent closure of a mine waste management unit involves the provision of durable surface containment features to protect the waters of the State in the long-term. Temporary closure may involve activities that range from ongoing maintenance of the existing facilities to the installation of several permanent closure features in order to reduce ongoing maintenance. This paper deals with the permanent closure features

"On Becoming a Critically Reflexive Practitioner" Redux: What Does It Mean to "Be" Reflexive?

Science.gov (United States)

Cunliffe, Ann L.

2016-01-01

In this commentary, Cunliffe states that is convinced that reflexivity offers a way of foregrounding our moral and ethical responsibility for people and for the world around us. To "BE" reflexive was defined as embracing "subjective understandings of reality as a basis for thinking more critically about the impact of our…

AMPUTATION AND REFLEX SYMPATHETIC DYSTROPHY

NARCIS (Netherlands)

GEERTZEN, JHB; EISMA, WH

Reflex sympathetic dystrophy is a chronic pain syndrome characterized by chronic burning pain, restricted range of motion, oedema and vasolability. Patients are difficult to treat and the prognosis is very often poor. This report emphasizes that an amputation in case of a reflex sympathetic

Portraying Reflexivity in Health Services Research.

Science.gov (United States)

Rae, John; Green, Bill

2016-09-01

A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. © The Author(s) 2016.

Prognostic value of age, subglottic, and anterior commissure involvement for early glottic carcinoma treated with CO2 laser transoral microsurgery: a retrospective, single-center cohort study of 261 patients.

Science.gov (United States)

Carta, Filippo; Bandino, Fabrizio; Olla, Aurora Marta; Chuchueva, Natalia; Gerosa, Clara; Puxeddu, Roberto

2018-05-01

 CO 2 laser transoral microsurgery for glottic carcinoma, when indicated, has the well-established advantages of low morbidity and positive oncological outcomes. The present study aims to determine how patient age, and tumor site could negatively impact prognosis; other variables such as the status of the margins of resection, tobacco and alcohol intake, and the grade of differentiation of the tumors have been evaluated. This was a retrospective analysis on 261 patients with a glottic carcinoma who underwent CO 2 laser transoral microsurgery. The impact of different variables was calculated using univariate and multivariate analyses. The study included 248 males and 13 females. The median follow-up period was 4.3 years. Five-year disease-specific survival, recurrence-free survival, local control with laser alone, overall laryngeal preservation, and overall survival rates were 99.4, 92.2, 93.8, 97.6, and 85.5%, respectively. Equivalent results were observed in young and elderly patients. Patients with positive margins after CO 2 laser transoral microsurgery showed a reduced local control with laser alone. T2 patients with true subglottic spreading and patients with anterior commissure involvement of grade 3 (Rucci's classification) experienced worse local control rates, despite free surgical margins confirmed by histology.  CO 2 laser transoral microsurgery is an effective and reproducible single-stage modality therapy for young and elderly patients with glottic carcinoma. Superficial close margins can be managed by a careful wait-and-see policy, while positive margins should undergo surgical enlargement. In our experience, undifferentiated tumors, true subglottic extension, and anterior commissure involvement of grade 3 were associated with worse outcomes.

Too Busy for Reflexivity?

DEFF Research Database (Denmark)

Ratner, Helene

What Danish school managers can teach STS researchers about epistemological ideals and pragmatic morals. Reflexivity has an ambivalent status in both anthropology and Science and Technology Studies. On the one hand, the critique of representation at the heart of the reflexivity debates of the 1980s...... highlighted non-symmetric relationships between observer and observed and accused the academic text of enacting a realist genre, concealing the relativism entailed in textual production (Clifford and Marcus 1986, Woolgar 1988, Ashmore 1989). On the other hand, the reflexivity program produced fears...... of a “corrosive relativism in which everything is but a more or less clever expression of opinion” (Geertz 1988:2, 3) and it has suffered the little flattering accusations of piling "layer upon layer of self-consciousness to no avail" (Latour 1988:170) with little “interest [for] … theoretically ambitious...

The passive of reflexive verbs in Icelandic

Directory of Open Access Journals (Sweden)

Hlíf Árnadóttir

2011-10-01

Full Text Available The Reflexive Passive in Icelandic is reminiscent of the so-called New Passive (or New Impersonal in that the oblique case of a passivized object NP is preserved. As is shown by recent surveys, however, speakers who accept the Reflexive Passive do not necessarily accept the New Passive, whereas conversely, speakers who accept the New Passive do also accept the Reflexive Passive. Based on these results we suggest that there is a hierarchy in the acceptance of passive sentences in Icelandic, termed the Passive Acceptability Hierarchy. The validity of this hierarchy is confirmed by our diachronic corpus study of open access digital library texts from Icelandic journals and newspapers dating from the 19th and 20th centuries (tímarit.is. Finally, we sketch an analysis of the Reflexive Passive, proposing that the different acceptability rates of the Reflexive and New Passives lie in the argument status of the object. Simplex reflexive pronouns are semantically dependent on the verbs which select them, and should therefore be analyzed as syntactic arguments only, and not as semantic arguments of these verbs.

The stretch reflex and the contributions of C David Marsden

Directory of Open Access Journals (Sweden)

Kalyan B Bhattacharyya

2017-01-01

Full Text Available The stretch reflex or myotatic reflex refers to the contraction of a muscle in response to its passive stretching by increasing its contractility as long as the stretch is within physiological limits. For ages, it was thought that the stretch reflex was of short latency and it was synonymous with the tendon reflex, subserving the same spinal reflex arc. However, disparities in the status of the two reflexes in certain clinical situations led Marsden and his collaborators to carry out a series of experiments that helped to establish that the two reflexes had different pathways. That the two reflexes are dissociated has been proved by the fact that the stretch reflex and the tendon reflex, elicited by stimulation of the same muscle, have different latencies, that of the stretch reflex being considerably longer. They hypothesized that the stretch reflex had a transcortical course before it reached the spinal motor neurons for final firing. Additionally, the phenomenon of stimulus-sensitive cortical myoclonus lent further evidence to the presence of the transcortical loop where the EEG correlate preceded the EMG discharge. This concept has been worked out by later neurologists in great detail , and the general consensus is that indeed, the stretch reflex is endowed with a conspicuous transcortical component.

O conceito de reflexão de Hegel como crítica aos conceitos de essência e de reflexão tradicionais

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Christian Iber

2017-02-01

Full Text Available O presente artigo ilumina o específico do conceito de reflexão de Hegel em cinco momentos. Em um primeiro momento, delineia-se um esboço do conceito de reflexão na lógica da essência de Hegel. Em um segundo momento, o conceito de reflexão de Hegel é apresentado como estrutura lógica objetiva em contraste com a reflexão subjetiva da consciência e do entendimento, com a qual, ao mesmo tempo, o conceito de essência ontológica independente da reflexão é submetido a uma crítica. Do novo conceito de reflexão de Hegel resulta, em terceiro lugar, uma adaptação radical do círculo vicioso na teoria tradicional da reflexão da autoconsciência. Num quarto momento, lança-se um olhar sobre o conceito de reflexão anterior de Hegel como pensar do entendimento que separa, do qual o conceito de reflexão posterior se distingue. Por fim, apresenta-se, em quinto lugar, a lógica da reflexão de Hegel como crítica à fundação ontológica da reflexão em Schelling. O conceito de reflexão de Hegel se mostra, com isto, como crítica da metafísica ontológica tradicional e como fundação de uma metafísica da relacionalidade absoluta que supera a relatividade do pensar moderno do entendimento.

Impact of Close and Positive Margins in Transoral Laser Microsurgery for Tis–T2 Glottic Cancer

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Ivana Fiz

2017-10-01

Full Text Available IntroductionTransoral laser microsurgery (TLM represents one of the most effective treatment strategies for Tis–T2 glottic squamous cell carcinomas (SCC. The prognostic influence of close/positive margins is still debated, and the role of narrow band imaging (NBI in their intraoperative definition is still to be validated on large cohort of patients. This study analyzed the influence of margin status on recurrence-free survival (RFS and disease-specific survival (DSS.MethodsWe retrospectively studied 507 cases of pTis–T1b (Group A and 127 cases of pT2 (Group B glottic SCC. We identified the following margin status: negative (n = 232, close superficial (n = 79, close deep (CD (n = 35, positive single superficial (n = 146, positive multiple superficial (n = 94, and positive deep (n = 48 and analyzed their impact on RFS and DSS. Close margins were defined by tumor-margin distance <1 mm. Pre-TLM margins were defined by white light in 323 patients, whereas NBI was employed in 311 patients.ResultsIn Group A, DSS and RFS were reduced in positive multiple superficial and positive deep margins (DSS = 96.1 and 97%, both p < 0.05; RFS = 72%, p < 0.001 and 75.8%, p < 0.01. In Group B, DSS was reduced in positive multiple superficial margins (82.4%, p < 0.05. RFS was reduced in positive single superficial, positive multiple superficial, and positive deep margins (62.5, 41.2, and 53.3%, p < 0.01. In the entire population, RFS was reduced in CD margins (77.1%, p < 0.05. Use of NBI led to improvement in RFS and DSS.ConclusionThe study indicates that close and positive single superficial margins do not affect DSS. By contrast, all types of margin positivity predict the occurrence of relapses, albeit with different likelihood, depending on stage/margin type. CD margins should be considered as a single risk factor. Use of NBI granted better intraoperative margins definition.

Relationship between vomiting reflex during esophagogastroduodenoscopy and dyspepsia symptoms.

Science.gov (United States)

Enomoto, Shotaro; Watanabe, Mika; Yoshida, Takeichi; Mukoubayashi, Chizu; Moribata, Kosaku; Muraki, Yosuke; Shingaki, Naoki; Deguchi, Hisanobu; Ueda, Kazuki; Inoue, Izumi; Maekita, Takao; Iguchi, Mikitaka; Tamai, Hideyuki; Kato, Jun; Fujishiro, Mitsuhiro; Oka, Masashi; Mohara, Osamu; Ichinose, Masao

2012-09-01

Although frequent vomiting reflexes during esophagogastroduodenoscopy (EGD) causes suffering in patients, very few studies have investigated the characteristics of subjects who frequently develop vomiting reflexes. This study examined the incidence of the vomiting reflex and related factors, especially upper gastrointestinal symptoms, among individuals undergoing transoral EGD. Subjects included 488 consecutive adults (mean age, 56.1 ± 8.9 years) who underwent transoral EGD for gastric cancer screening between February 2010 and March 2011. All procedures were performed by an endoscopist with 15 years of experience. Based on a questionnaire survey using the frequency scale for the symptoms of gastroesophageal reflux disease (FSSG), symptoms (dyspepsia and acid reflux symptoms) and the number of vomiting reflexes during EGD were recorded. Of the 488 subjects, 271 (56%) developed vomiting reflexes (mean, 4.2 times). This reflex-positive group was younger (54.3 ± 9.5 years) than the reflex-negative group (58.3 ± 7.7 years, P reflex-positive group with a high FSSG dyspepsia score (2.27 ± 2.57 vs 1.23 ± 1.84; P acid reflux symptom score (1.96 ± 2.22 vs 1.34 ± 2.14; P reflex-negative group. Multivariate analysis also showed a significant correlation between these four factors and the occurrence of vomiting reflexes. Using an FSSG dyspepsia score of 1 as the cut-off offered 68% sensitivity and 57% specificity for predicting the occurrence of vomiting reflexes. Based on FSSG questionnaire responses on upper gastrointestinal symptoms, dyspepsia symptoms, in particular, are related to presence of vomiting reflexes during EGD. © 2012 The Authors. Digestive Endoscopy © 2012 Japan Gastroenterological Endoscopy Society.

Phase I/II trial of concurrent use of S-1 and radiation therapy for T2 glottic cancer

International Nuclear Information System (INIS)

Nakayama, Meijin; Hayakawa, Kazushige; Okamoto, Makito; Niibe, Yuzuru; Ishiyama, Hiromichi; Kotani, Shouko

2010-01-01

A Phase I/II study of S-1 combined radiation therapy was conducted in patients with Stage II (T2N0) glottic cancer. The purpose of the Phase I study was to identify the maximum tolerated dose, the recommended dose and the dose limiting toxicity. The objectives in the phase II study were to estimate the local control and the overall survival, and the incidence of adverse events. In Phase I, S-1 was administered orally in a split-course fashion as two doses of 40 mg/m 2 , for a total daily dose of 80 mg/m 2 . The course involved a 2-week rest after a 2-week administration (Level 1) and a 1-week rest after a 3-week administration (Level 2). Radiation therapy was administered in 2-Gy daily (total 60-Gy) standard fractionation. Seven patients were enrolled in the Phase I, and 19 in the Phase II study. Mucositis was the most common toxicity encountered. All 26 patients completed radiation therapy without delay. The overall response rate was 100% (26/26) with all patients showing a complete response. One patient developed a local recurrence 28 months after the treatment. The 3-year local control and overall survival rates were 94.7 and 85.4%, respectively (limited to 22 patients from Level 2). The use of S-1 at 80 mg/m 2 per day in a split-course with 1-week rest during the course of radiation therapy was safe and effective for Stage II glottic cancer. The treatment strategy employing orally available S-1 proved to be beneficial over the conventional injection of antitumor agents for maintaining the patients' quality of life. (author)

A near catastrophe from trigeminocardiac reflex

Directory of Open Access Journals (Sweden)

Parmod K Bithal

2017-01-01

Full Text Available Trigeminocardiac reflex is a brainstem reflex that results from stimulation of any branch of the trigeminal nerve along its course. It produces a constellation of signs and symptoms decrease in blood pressure (BP and heart rate, dysrhythmias, apnoea and increased gastric motility. We present a case of 80-year-old female patient who developed alarming hypotension and bradycardia during craniotomy for meningioma excision resulting from this reflex. In the face of refractory hypotension despite administering ephedrine and phenylephrine, we had to resort to adrenaline to restore her normal BP.

Road Closures

Data.gov (United States)

Montgomery County of Maryland — This is an up to date map of current road closures in Montgomery County.This dataset is updated every few minutes from the Department of Transportation road closure...

Attentional modulation of reflex cough.

Science.gov (United States)

Janssens, Thomas; Silva, Mitchell; Davenport, Paul W; Van Diest, Ilse; Dupont, Lieven J; Van den Bergh, Omer

2014-07-01

Reflex cough is a defensive response generated in the brainstem in response to chemical and mechanical stimulation of the airways. However, converging evidence shows that reflex cough is also influenced by central neural control processes. In this study, we investigate whether reflex cough can be modulated by attentional focus on either external stimuli or internal cough-related stimuli. Healthy volunteers (N = 24; seven men; age range, 18-25 years) completed four blocks of citric acid-induced cough challenges while, simultaneously, auditory stimuli were presented. Within each block, four concentrations were administered (30, 100, 300 and 1,000 mM, randomized). During two subsequent blocks, participants focused their attention externally (counting tones). During the other two blocks, participants focused their attention internally (counting coughs). The order of attentional focus was counterbalanced across participants. Ratings of the urge to cough were collected after each challenge. Cough frequency was determined by audio recording. Cough frequency was higher when participants focused their attention internally vs externally (P Reflex cough can be modulated by attentional focus. Internally focused attention may be a mechanism involved in excessive (idiopathic) cough, while an external focus may be introduced as part of treatments targeting excessive cough.

Interferometric Imaging Directly with Closure Phases and Closure Amplitudes

Science.gov (United States)

Chael, Andrew A.; Johnson, Michael D.; Bouman, Katherine L.; Blackburn, Lindy L.; Akiyama, Kazunori; Narayan, Ramesh

2018-04-01

Interferometric imaging now achieves angular resolutions as fine as ∼10 μas, probing scales that are inaccessible to single telescopes. Traditional synthesis imaging methods require calibrated visibilities; however, interferometric calibration is challenging, especially at high frequencies. Nevertheless, most studies present only a single image of their data after a process of “self-calibration,” an iterative procedure where the initial image and calibration assumptions can significantly influence the final image. We present a method for efficient interferometric imaging directly using only closure amplitudes and closure phases, which are immune to station-based calibration errors. Closure-only imaging provides results that are as noncommittal as possible and allows for reconstructing an image independently from separate amplitude and phase self-calibration. While closure-only imaging eliminates some image information (e.g., the total image flux density and the image centroid), this information can be recovered through a small number of additional constraints. We demonstrate that closure-only imaging can produce high-fidelity results, even for sparse arrays such as the Event Horizon Telescope, and that the resulting images are independent of the level of systematic amplitude error. We apply closure imaging to VLBA and ALMA data and show that it is capable of matching or exceeding the performance of traditional self-calibration and CLEAN for these data sets.

Movement of the Epiglottis in Mammals

Science.gov (United States)

1993-01-01

dysphagia . Arch. Otolaryngol. 109:376-380. Ekberg, 0. and S.V. Sigurjonsson (1982) Movement of the epiglottis during deglutition. Gastrointest...children : Preliminary observations. Dysphagia . 4:112-117. Koenig, J.S., A.M. Davies and B.T. Thach (1990) Coordination of breathing, sucking, and...Arndorfer (1990) Coordination of deglutitive glottic closure with oropharyngeal swallowing. Gastroenterology . 98:478-1484. Siegel, S. and N. J. Castellan

Wh-filler-gap dependency formation guides reflexive antecedent search

Directory of Open Access Journals (Sweden)

Michael eFrazier

2015-10-01

Full Text Available Prior studies on online sentence processing have shown that the parser can resolve non-local dependencies rapidly and accurately. This study investigates the interaction between the processing of two such non-local dependencies: wh-filler-gap dependencies (WhFGD and reflexive-antecedent dependencies. We show that reflexive-antecedent dependency resolution is sensitive to the presence of a WhFGD, and argue that the filler-gap dependency established by WhFGD resolution is selected online as the antecedent of a reflexive dependency. We investigate the processing of constructions like (1, where two NPs might be possible antecedents for the reflexive, namely which cowgirl and Mary. Even though Mary is linearly closer to the reflexive, the only grammatically licit antecedent for the reflexive is the more distant wh-NP, which cowgirl. 1. Which cowgirl did Mary expect to have injured herself due to negligence?Four eye-tracking text-reading experiments were conducted on examples like (1, differing in whether the embedded clause was non-finite (1 and 3 or finite (2 and 4, and in whether the tail of the wh-dependency intervened between the reflexive and its closest overt antecedent (1 and 2 or the wh-dependency was associated with a position earlier in the sentence (3 and 4.The results of Experiments 1 and 2 indicate the parser accesses the result of WhFGD formation during reflexive antecedent search. The resolution of a wh-dependency alters the representation that reflexive antecedent search operates over, allowing the grammatical but linearly distant antecedent to be accessed rapidly. In the absence of a long-distance WhFGD (Exp. 3 and 4, wh-NPs were not found to impact reading times of the reflexive, indicating that the parser's ability to select distant wh-NPs as reflexive antecedents crucially involves syntactic structure.

Reflexivity and social justice

DEFF Research Database (Denmark)

Maksimovic, Tijana; Jakobsen, Helle Nordentoft

2017-01-01

Career practitioners’ reflexive understanding of their professional role as change agents in career guidance and counselling practices has a major impact on how social justice can be achieved. This entitles an awareness of the way in which guidance and counselling practices are embedded in the co......Career practitioners’ reflexive understanding of their professional role as change agents in career guidance and counselling practices has a major impact on how social justice can be achieved. This entitles an awareness of the way in which guidance and counselling practices are embedded...

Operant conditioning of the soleus H-reflex does not induce long-term changes in the gastrocnemius H-reflexes and does not disturb normal locomotion in humans.

Science.gov (United States)

Makihara, Yukiko; Segal, Richard L; Wolpaw, Jonathan R; Thompson, Aiko K

2014-09-15

In normal animals, operant conditioning of the spinal stretch reflex or the H-reflex has lesser effects on synergist muscle reflexes. In rats and people with incomplete spinal cord injury (SCI), soleus H-reflex operant conditioning can improve locomotion. We studied in normal humans the impact of soleus H-reflex down-conditioning on medial (MG) and lateral gastrocnemius (LG) H-reflexes and on locomotion. Subjects completed 6 baseline and 30 conditioning sessions. During conditioning trials, the subject was encouraged to decrease soleus H-reflex size with the aid of visual feedback. Every sixth session, MG and LG H-reflexes were measured. Locomotion was assessed before and after conditioning. In successfully conditioned subjects, the soleus H-reflex decreased 27.2%. This was the sum of within-session (task dependent) adaptation (13.2%) and across-session (long term) change (14%). The MG H-reflex decreased 14.5%, due mainly to task-dependent adaptation (13.4%). The LG H-reflex showed no task-dependent adaptation or long-term change. No consistent changes were detected across subjects in locomotor H-reflexes, EMG activity, joint angles, or step symmetry. Thus, in normal humans, soleus H-reflex down-conditioning does not induce long-term changes in MG/LG H-reflexes and does not change locomotion. In these subjects, task-dependent adaptation of the soleus H-reflex is greater than it is in people with SCI, whereas long-term change is less. This difference from results in people with SCI is consistent with the fact that long-term change is beneficial in people with SCI, since it improves locomotion. In contrast, in normal subjects, long-term change is not beneficial and may necessitate compensatory plasticity to preserve satisfactory locomotion. Copyright © 2014 the American Physiological Society.

Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

International Nuclear Information System (INIS)

Hong, Julian C.; Kruser, Tim J.; Gondi, Vinai; Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M.; Bentzen, Søren M.

2013-01-01

Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients

Risk of Cerebrovascular Events in Elderly Patients After Radiation Therapy Versus Surgery for Early-Stage Glottic Cancer

Energy Technology Data Exchange (ETDEWEB)

Hong, Julian C.; Kruser, Tim J. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Gondi, Vinai [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Central Dupage Hospital Cancer Center, Warrenville, Illinois (United States); Mohindra, Pranshu; Cannon, Donald M.; Harari, Paul M. [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States); Bentzen, Søren M., E-mail: bentzen@humonc.wisc.edu [Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin (United States)

2013-10-01

Purpose: Comprehensive neck radiation therapy (RT) has been shown to increase cerebrovascular disease (CVD) risk in advanced-stage head-and-neck cancer. We assessed whether more limited neck RT used for early-stage (T1-T2 N0) glottic cancer is associated with increased CVD risk, using the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database. Methods and Materials: We identified patients ≥66 years of age with early-stage glottic laryngeal cancer from SEER diagnosed from 1992 to 2007. Patients treated with combined surgery and RT were excluded. Medicare CPT codes for carotid interventions, Medicare ICD-9 codes for cerebrovascular events, and SEER data for stroke as the cause of death were collected. Similarly, Medicare CPT and ICD-9 codes for peripheral vascular disease (PVD) were assessed to serve as an internal control between treatment groups. Results: A total of 1413 assessable patients (RT, n=1055; surgery, n=358) were analyzed. The actuarial 10-year risk of CVD was 56.5% (95% confidence interval 51.5%-61.5%) for the RT cohort versus 48.7% (41.1%-56.3%) in the surgery cohort (P=.27). The actuarial 10-year risk of PVD did not differ between the RT (52.7% [48.1%-57.3%]) and surgery cohorts (52.6% [45.2%-60.0%]) (P=.89). Univariate analysis showed an increased association of CVD with more recent diagnosis (P=.001) and increasing age (P=.001). On multivariate Cox analysis, increasing age (P<.001) and recent diagnosis (P=.002) remained significantly associated with a higher CVD risk, whereas the association of RT and CVD remained not statistically significant (HR=1.11 [0.91-1.37,] P=.31). Conclusions: Elderly patients with early-stage laryngeal cancer have a high burden of cerebrovascular events after surgical management or RT. RT and surgery are associated with comparable risk for subsequent CVD development after treatment in elderly patients.

Role of imaging in the follow-up of T2-T3 glottic cancer treated by transoral laser microsurgery.

Science.gov (United States)

Marchi, Filippo; Piazza, Cesare; Ravanelli, Marco; Gaggero, Giovanna; Parrinello, Giampiero; Paderno, Alberto; Perotti, Pietro; Filauro, Marta; Maroldi, Roberto; Peretti, Giorgio

2017-10-01

An unblinded retrospective analysis of prospectively collected data was carried out on 138 patients affected by glottic pT2 and selected pT3 squamous cell carcinomas (SCC) treated by transoral laser microsurgery (TLM). The entire cohort was divided into two groups: Group A included 78 "high-risk" patients (pT2 with impaired vocal cord mobility, pT3 for anterior paraglottic and/or pre-epiglottic space invasion, presence of angioembolization, perineural spread, and positive lymph nodes in the neck) who underwent postoperative surveillance by endoscopy and imaging (CT or MR), while Group B included 60 "low-risk" patients (pT2 with absence of the above-mentioned features) who underwent endoscopic follow-up alone. Aim of the present study was to assess the diagnostic gain in performing combined endoscopic and radiologic surveillance in the "high-risk" group compared to endoscopy alone in the "low-risk" one. There was no significant difference in terms of overall and disease-specific survivals between the two follow-up policies in spite of their different risk profiles. The same was true for organ preservation rate, which was 81% in the "high-risk" and 89% in the "low-risk" group. In contrast, the cumulative probability of disease-free survival was 54% for Group A and 65% for Group B (p = 0.0023). Therefore, our combined endoscopy and imaging surveillance protocol allowed increasing the submucosal recurrence detection rate in "high-risk" pT2-pT3 glottic SCC to 43%. An earlier detection of submucosal recurrences made salvage surgery by TLM feasible in at least half of cases, thus closing the gap between oncologic outcomes obtained in "high-"- vs. "low-risk" patients and leading to organ preservation rates that are favorably comparable to those obtained with open-neck partial laryngectomies and non-surgical organ preservation protocols.

The impact of treatment time and smoking on local control and complications in T1 glottic cancer

International Nuclear Information System (INIS)

Voet, Johannes C.M. van der; Keus, Ronald B.; Hart, Augustinus A.M.; Hilgers, Frans J.M.; Bartelink, Harry

1998-01-01

Purpose: To define the optimal treatment regimen, patients with T1N0M0 glottic larynx carcinoma were treated with six different radiotherapy (RT) schedules. To assess the influence of patient characteristics, complication rates, and to evaluate the overall larynx preservation. Methods and Materials: Out of a consecutive series of 383 patients treated for T1N0M0 glottic larynx carcinoma between 1965 and 1992, 352 evaluable patients were treated with six different 'standard' fractionation schedules: 65 Gy (20 x 3.25 Gy), 62 Gy (20 x 3.1 Gy), 61.6 Gy (22 x 2.8 Gy), 60 Gy (25 x 2.4 Gy), 66 Gy (33 x 2 Gy) and 60 Gy (30 x 2 Gy). The median follow-up of all patients was 89 months. Patient factors analyzed included: age, sex, concurrent illness, smoking habits, tumor localization and extension, tumor differentiation, the effect of tumor biopsy or stripping of the vocal cord, and the presence of visible tumor at the start of radiotherapy. Treatment parameters evaluated were: year of treatment, beam energy, treatment planning, field size, fractionation schedule, fraction size, number of fractions, total dose, treatment time and treatment gap, the use of wedges, and neck diameter. Results: The overall 5-year actuarial locoregional control was 89%, varying between 83 and 93% for the different schedules. Univariately, local control decreased with increasing treatment time. This could not be explained by the confounding variables sex, tumor extension, and field length (p = 0.0065). Adjusted for these variables, 5-year local control percentage decreased from 95% (SE 2%) for 22-29 days to 79% (SE 6%) for treatment time ≥ 40 days. The overall complication rate (grade I-IV) at 5 years was 15.3%, and varied between the different schedules, from 7 to 17%. No relation was found between complications and treatment factors. Patients who continued smoking had a higher complication rate than those who never smoked or stopped smoking, univariately as well as adjusted for tumor extension

Closure The Definitive Guide

CERN Document Server

Bolin, Michael

2010-01-01

If you're ready to use Closure to build rich web applications with JavaScript, this hands-on guide has precisely what you need to learn this suite of tools in depth. Closure makes it easy for experienced JavaScript developers to write and maintain large and complex codebases -- as Google has demonstrated by using Closure with Gmail, Google Docs, and Google Maps. Author and Closure contributor Michael Bolin has included numerous code examples and best practices, as well as valuable information not available publicly until now. You'll learn all about Closure's Library, Compiler, Templates, tes

O conceito de reflexão de Hegel como crítica aos conceitos de essência e de reflexão tradicionais

OpenAIRE

Christian Iber

2017-01-01

O presente artigo ilumina o específico do conceito de reflexão de Hegel em cinco momentos. Em um primeiro momento, delineia-se um esboço do conceito de reflexão na lógica da essência de Hegel. Em um segundo momento, o conceito de reflexão de Hegel é apresentado como estrutura lógica objetiva em contraste com a reflexão subjetiva da consciência e do entendimento, com a qual, ao mesmo tempo, o conceito de essência ontológica independente da reflexão é submetido a uma crítica. Do novo conceito d...

[Effects of morphine on pupillary light reflex in monkeys].

Science.gov (United States)

Meng, Zhi-Qiang; Zhang, Yu-Hua; Chen, Nan-Hui; Miao, Ying-Da; Hu, Xin-Tian; Ma, Yuan-Ye

2010-06-01

The pupil size of both human and other animals can be affected by light. Many kinds of psychiatrical and psychological disorders, such as drug abuse, associate with abnormal properties of pupillary light reflex. Thus, the properties of pupillary light reflex could serve as an indicator for drug abuse detection. However, the effect of drug abuse on pupillary light reflex is till unclear. To assess the effects of addictive drugs on pupillary light reflex quantificationally, in the present study, we examined the effects of morphine on pupil diameter and pupillary light reflex in rhesus monkeys. By measuring the pupil diameter at different timing points before and after the administration of morphine, we found that morphine administration reduced the diameter of pupil and decreased the constriction rate. Our present results provide an experimental support for applying the properties of pupillary light reflex as a reference in addicts' detection.

Impact of Close and Positive Margins in Transoral Laser Microsurgery for Tis-T2 Glottic Cancer.

Science.gov (United States)

Fiz, Ivana; Mazzola, Francesco; Fiz, Francesco; Marchi, Filippo; Filauro, Marta; Paderno, Alberto; Parrinello, Giampiero; Piazza, Cesare; Peretti, Giorgio

2017-01-01

Transoral laser microsurgery (TLM) represents one of the most effective treatment strategies for Tis-T2 glottic squamous cell carcinomas (SCC). The prognostic influence of close/positive margins is still debated, and the role of narrow band imaging (NBI) in their intraoperative definition is still to be validated on large cohort of patients. This study analyzed the influence of margin status on recurrence-free survival (RFS) and disease-specific survival (DSS). We retrospectively studied 507 cases of pTis-T1b (Group A) and 127 cases of pT2 (Group B) glottic SCC. We identified the following margin status: negative ( n  = 232), close superficial ( n  = 79), close deep (CD) ( n  = 35), positive single superficial ( n  = 146), positive multiple superficial ( n  = 94), and positive deep ( n  = 48) and analyzed their impact on RFS and DSS. Close margins were defined by tumor-margin distance <1 mm. Pre-TLM margins were defined by white light in 323 patients, whereas NBI was employed in 311 patients. In Group A, DSS and RFS were reduced in positive multiple superficial and positive deep margins (DSS = 96.1 and 97%, both p  < 0.05; RFS = 72%, p  < 0.001 and 75.8%, p  < 0.01). In Group B, DSS was reduced in positive multiple superficial margins (82.4%, p  < 0.05). RFS was reduced in positive single superficial, positive multiple superficial, and positive deep margins (62.5, 41.2, and 53.3%, p  < 0.01). In the entire population, RFS was reduced in CD margins (77.1%, p  < 0.05). Use of NBI led to improvement in RFS and DSS. The study indicates that close and positive single superficial margins do not affect DSS. By contrast, all types of margin positivity predict the occurrence of relapses, albeit with different likelihood, depending on stage/margin type. CD margins should be considered as a single risk factor. Use of NBI granted better intraoperative margins definition.

Impact of Different Standard Type A7A Drum Closure-Ring Practices on Gasket Contraction and Bolt Closure Distance– 15621

Energy Technology Data Exchange (ETDEWEB)

Ketusky, Edward [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Blanton, Paul [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Bobbitt, John H. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

2015-03-11

The Department of Energy, the Savannah River National Laboratory, several manufacturers of specification drums, and the United States Department of Transportation (DOT) are collaborating in the development of a guidance document for DOE contractors and vendors who wish to qualify containers to DOT 7A Type A requirements. Currently, the effort is focused on DOT 7A Type A 208-liter (55-gallons) drums with a standard 12-gauge bolted closure ring. The U.S. requirements, contained in Title 49, Part 178.350 “Specification 7A; general packaging, Type A specifies a competent authority review of the packaging is not required for the transport of (Class 7) radioactive material containing less than Type A quantities of radioactive material. For Type AF drums, a 4 ft. regulatory free drop must be performed, such that the drum “suffers maximum damage.” Although the actual orientation is not defined by the specification, recent studies suggest that maximum damage would result from a shallow angle top impact, where kinetic energy is transferred to the lid, ultimately causing heavy damage to the lid, or even worse, causing the lid to come off. Since each vendor develops closure recommendations/procedures for the drums they manufacture, key parameters applied to drums during closing vary based on vendor. As part of the initial phase of the collaboration, the impact of the closure variants on the ability of the drum to suffer maximum damage is investigated. Specifically, closure testing is performed varying: 1) the amount of torque applied to the closure ring bolt; and, 2) stress relief protocol, including: a) weight of hammer; and, b) orientation that the hammer hits the closure ring. After closure, the amount of drum lid gasket contraction and the distance that the closure bolt moves through the closure ring is measured.

Using ESO Reflex with Web Services

Science.gov (United States)

Järveläinen, P.; Savolainen, V.; Oittinen, T.; Maisala, S.; Ullgrén, M. Hook, R.

2008-08-01

ESO Reflex is a prototype graphical workflow system, based on Taverna, and primarily intended to be a flexible way of running ESO data reduction recipes along with other legacy applications and user-written tools. ESO Reflex can also readily use the Taverna Web Services features that are based on the Apache Axis SOAP implementation. Taverna is a general purpose Web Service client, and requires no programming to use such services. However, Taverna also has some restrictions: for example, no numerical types such integers. In addition the preferred binding style is document/literal wrapped, but most astronomical services publish the Axis default WSDL using RPC/encoded style. Despite these minor limitations we have created simple but very promising test VO workflow using the Sesame name resolver service at CDS Strasbourg, the Hubble SIAP server at the Multi-Mission Archive at Space Telescope (MAST) and the WESIX image cataloging and catalogue cross-referencing service at the University of Pittsburgh. ESO Reflex can also pass files and URIs via the PLASTIC protocol to visualisation tools and has its own viewer for VOTables. We picked these three Web Services to try to set up a realistic and useful ESO Reflex workflow. They also demonstrate ESO Reflex abilities to use many kind of Web Services because each of them requires a different interface. We describe each of these services in turn and comment on how it was used

Prevalence of family history in patients with reflex syncope

DEFF Research Database (Denmark)

Holmegard, Haya N; Benn, Marianne; Kaijer, Michelle Nymann

2013-01-01

Reflex syncope is defined by a rapid transient loss of consciousness caused by global cerebral hypoperfusion resulting from vasodilatation and/or bradycardia attributable to inappropriate cardiovascular reflexes. A hereditary component has been suggested, but prevalence of family history may differ...... among subtypes of reflex syncope, as these have different autonomic responses and pathogeneses may be diverse. The present study aimed to assess the prevalence of a positive family history of syncope and cardiovascular characteristics in patients with cardioinhibitory and vasodepressor reflex syncope....... Patients (n=74) were classified into subtypes of reflex syncope - cardioinhibition/asystole (Vasovagal Syncope International Study subtypes II-B [VASIS II-B], n=38) or vasodepressor (VASIS III, n=36) - using the head-up tilt test. Family history was obtained by questionnaires supplemented by interview...

(Re)constructing Reflexivity: A Relational Constructionist Approach

NARCIS (Netherlands)

Hosking, D.M.; Pluut, B.

2010-01-01

This article distinguishes three discourses of reflexivity in relation to human inquiry. One of these arises from a post-modern, relational constructionist perspective which radically re-conceptualizes reflexivity: (a) as a local and co-constructed process oriented towards the question (b) how are

Evaluation of treatment results in patients with early glottic cancer (stage T 1a N 0, T 1b N 0) treated with Manchester irradiation modality

International Nuclear Information System (INIS)

Przeorek, W.; Skladowski, K.; Przeorek, C.

2007-01-01

Data charts of 64 patients with stage I glottic cancer treated with Manchester irradiation modality in the 1 st Radiotherapy Clinic of Msc Memorial Institute in Gliwice has been retrospectively analyzed. There were 55 males and 9 females at median age 63 years (range from 37 to 83 years). In 40 (62%) patients pathological subtype of squamous cell cancer has not been established. In 19 (30%) patients microscopic examination revealed keratinizing and in 5 (8%) nonkeratinizing type of neoplasm. In 49 (77%) patients the tumour involved only one vocal cord, in 11 (17%) both, in 3 (5%) vocal cord and commissure and 1 (1%) patient both cords and commissure. All patients were treated with 60C o machines (36 patients - 56%) or high energy photons (28 patients - 44%). Radiotherapy was conducted with so called Manchester modality with one daily fraction of 3 Gy to a total dose of 51-54 Gy. Overall treatment time varied between 21 and 23 days. Acute mucosal reaction was evaluated with the morphological-functional Dische scale as well as with the EORTC/RTOG scoring system. The criteria of treatment efficacy were: 5-year local control, 5-year survival without serious complications (3 and 4 EORTC) and 5-year survival after salvage surgery in relapsed patients. In 63 patients complete regression of the tumour was observed up to 6 months of follow-up. One patient failed at the time of radiotherapy ending. In one case distant metastases to lungs were noticed. In 6 patients local relapses were discovered of which 3 were successfully salvaged with the surgery. In one patient, 18 months after radiotherapy massive oedema of laryngeal mucosa occurred. In this case tracheostomy was needed. 5-year local control, local control after salvage surgery and survival without serious complication rates are 89%, 97% and 95% respectively. 1. Radiotherapy with Manchester modality is a safe and effective treatment of stage I glottic cancer. 2. Despite hypofractionation the risk of severe complication

Ultimate concerns in late modernity: Archer, Bourdieu and reflexivity.

Science.gov (United States)

Farrugia, David; Woodman, Dan

2015-12-01

Through a critique of Margaret Archer's theory of reflexivity, this paper explores the theoretical contribution of a Bourdieusian sociology of the subject for understanding social change. Archer's theory of reflexivity holds that conscious 'internal conversations' are the motor of society, central both to human subjectivity and to the 'reflexive imperative' of late modernity. This is established through critiques of Bourdieu, who is held to erase creativity and meaningful personal investments from subjectivity, and late modernity is depicted as a time when a 'situational logic of opportunity' renders embodied dispositions and the reproduction of symbolic advantages obsolete. Maintaining Archer's focus on 'ultimate concerns' in a context of social change, this paper argues that her theory of reflexivity is established through a narrow misreading and rejection of Bourdieu's work, which ultimately creates problems for her own approach. Archer's rejection of any pre-reflexive dimensions to subjectivity and social action leaves her unable to sociologically explain the genesis of 'ultimate concerns', and creates an empirically dubious narrative of the consequences of social change. Through a focus on Archer's concept of 'fractured reflexivity', the paper explores the theoretical necessity of habitus and illusio for understanding the social changes that Archer is grappling with. In late modernity, reflexivity is valorized just as the conditions for its successful operation are increasingly foreclosed, creating 'fractured reflexivity' emblematic of the complex contemporary interaction between habitus, illusio, and accelerating social change. © London School of Economics and Political Science 2015.

Reflexive Aero Structures for Enhanced Survivability, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) proposes to develop an advanced reflexive structure system to increase the survivability of aerostructures. This reflexive...

Anticausatives are weak scalar expressions, not reflexive expressions

Directory of Open Access Journals (Sweden)

Florian Schäfer

2016-07-01

Full Text Available We discuss conceptual and empirical arguments from Germanic, Romance and Slavic languages against an analysis treating anticausative verbs as derived from their lexical causative counterparts under reflexivization. Instead, we defend the standard account to the semantics of the causative alternation according to which anticausatives in general, and anticausatives marked with reflexive morphology in particular, denote simple one-place inchoative events that are logically entailed by their lexical causative counterparts. Under such an account, anticausative verbs are weak scalar expressions that stand in a semantico-pragmatic opposition to their strong lexical causative counterparts. Due to this scalar relation, the use of an anticausative can trigger the implicature that the use of its lexical causative counterpart is too strong. As usual with implicatures, they can be ‘metalinguistically’ denied, cancelled, or reinforced and we argue that these mechanisms explain all central empirical facts brought up in the literature in favor of a treatment of anticausatives as semantically reflexive predicates. Our results reinforce the view that the reflexive morphemes used in many (Indo-European languages to mark anticausatives do not necessarily trigger reflexive semantics. However, we also show that a string involving a reflexively marked (anti-causative verb can be forced into a semantically reflexive construal under particular conceptual or grammatical circumstances.

Reflexive Planning as Design and Work

DEFF Research Database (Denmark)

Lissandrello, Enza; Grin, John

2011-01-01

in planning emerges as a new tool for generating critical knowledge and dialogue that can synthesise the perspectives of multiple actors in a common understanding, existing structural constraints and a collective imagination of alternative future possibilities. Such research highlights the potential......In recent years, planning theorists have advanced various interpretations of the notion of reflexivity, inspired by American pragmatism, complexity theory, hermeneutics, discursive and collaborative planning. Scholars agree that “reflexivity” has a strong temporal dimension: it not only aims...... to solve present planning problems, but to imagine and understand alternative trajectories for future action. This article explores the practical utility of reflexivity for planners, through a case study that focuses on a project to promote sustainable development in the Port of Amsterdam. Reflexivity...

Professional Closure Beyond State Authorization

Directory of Open Access Journals (Sweden)

Gitte Sommer Harrits

2014-03-01

Full Text Available For decades, the Weberian approach to the study of professions has been strong, emphasizing state authorization and market monopolies as constituting what is considered a profession. Originally, however, the Weberian conception of closure, or the ways in which a profession is constituted and made separate, was broader. This article suggests a revision of the closure concept, integrating insights from Pierre Bourdieu, and conceptualizing professional closure as the intersection of social, symbolic and legal closure. Based on this revision, this article demonstrates how to apply such a concept in empirical studies. This is done by exploring social, symbolic and legal closure across sixteen professional degree programs. The analyses show a tendency for some overlap between different forms of closure, with a somewhat divergent pattern for legal closure. Results support the argument that we need to study these processes as an intersection of different sources of closure, including capital, lifestyles and discourse

Tight closure and vanishing theorems

International Nuclear Information System (INIS)

Smith, K.E.

2001-01-01

Tight closure has become a thriving branch of commutative algebra since it was first introduced by Mel Hochster and Craig Huneke in 1986. Over the past few years, it has become increasingly clear that tight closure has deep connections with complex algebraic geometry as well, especially with those areas of algebraic geometry where vanishing theorems play a starring role. The purpose of these lectures is to introduce tight closure and to explain some of these connections with algebraic geometry. Tight closure is basically a technique for harnessing the power of the Frobenius map. The use of the Frobenius map to prove theorems about complex algebraic varieties is a familiar technique in algebraic geometry, so it should perhaps come as no surprise that tight closure is applicable to algebraic geometry. On the other hand, it seems that so far we are only seeing the tip of a large and very beautiful iceberg in terms of tight closure's interpretation and applications to algebraic geometry. Interestingly, although tight closure is a 'characteristic p' tool, many of the problems where tight closure has proved useful have also yielded to analytic (L2) techniques. Despite some striking parallels, there had been no specific result directly linking tight closure and L∼ techniques. Recently, however, the equivalence of an ideal central to the theory of tight closure was shown to be equivalent to a certain 'multiplier ideal' first defined using L2 methods. Presumably, deeper connections will continue to emerge. There are two main types of problems for which tight closure has been helpful: in identifying nice structure and in establishing uniform behavior. The original algebraic applications of tight closure include, for example, a quick proof of the Hochster-Roberts theorem on the Cohen-Macaulayness of rings of invariants, and also a refined version of the Brianqon-Skoda theorem on the uniform behaviour of integral closures of powers of ideals. More recent, geometric

40 CFR 264.228 - Closure and post-closure care.

Science.gov (United States)

2010-07-01

... remaining wastes to a bearing capacity sufficient to support final cover; and (iii) Cover the surface....112 must include both a plan for complying with paragraph (a)(1) of this section and a contingent plan... practicably removed at closure; and (ii) The owner or operator must prepare a contingent post-closure plan...

Voluntary Control of the Near Reflex: A Case Report

Directory of Open Access Journals (Sweden)

Serpil Akar

2014-03-01

Full Text Available Spasm of the near reflex is a rare disorder that involves intermittent and variable episodes of esotropia, pseudomyopia, and pupillary myosis. It is usually functional in origin and is seen mainly in young patients. Treatment options for spasm of the near reflex have had variable success. In instances where the etiology of spasm of the near reflex was suspected to be hysteria, psychotherapy has proven beneficial. We report the case of an 11-year-old girl who had functional spasm of the near reflex. The symptoms persisted for two years. Symptomatic relief was achieved by cycloplegia and spectacle correction (added plus lenses at near. The patient also underwent psychological counseling. In our case, the functional spasm of the near reflex spontaneously resolved after 2 years. (Turk J Ophthalmol 2014; 44: 161-3

RCRA corrective action and closure

International Nuclear Information System (INIS)

1995-02-01

This information brief explains how RCRA corrective action and closure processes affect one another. It examines the similarities and differences between corrective action and closure, regulators' interests in RCRA facilities undergoing closure, and how the need to perform corrective action affects the closure of DOE's permitted facilities and interim status facilities

Post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy

International Nuclear Information System (INIS)

Khan, A.W.; Maqsood, R.; Saleem, M.M.

2017-01-01

To compare the mean post-operative analgesic requirement in non-closure and closure of peritoneum during open appendectomy. Study Design: Randomized controlled trial. Place and Duration of Study: Department of General Surgery Combined Military Hospital Quetta, from 1st August 2014 to 30th April 2015. Material and Methods: A total of 60 patients were included in this study and were divided into two groups of 30 each. Patients in group A underwent open appendectomy with closure of peritoneum while patients in group B had non-closure of peritoneum during the same procedure. Post-operatively, pain severity was assessed on visual analogue scale (VAS) numeric pain distress scale. On presence of VAS numeric pain distress scale between 5 to 7, intramuscular (IM) diclofenac sodium was given and on score >7, intravascular (IV) tramadol was given. The final outcome was measured at day 0 and day 1. Results: Pain score and analgesic requirements were significantly less in non-closure group than closure group on day 0 and day 1, showing statistically significant difference between the two groups. Conclusion: Mean post-operative analgesic requirement is significantly less in non-closure group as compared to closure group during open appendectomy. (author)

Primary closure after carotid endarterectomy is not inferior to other closure techniques.

Science.gov (United States)

Avgerinos, Efthymios D; Chaer, Rabih A; Naddaf, Abdallah; El-Shazly, Omar M; Marone, Luke; Makaroun, Michel S

2016-09-01

Primary closure after carotid endarterectomy (CEA) has been much maligned as an inferior technique with worse outcomes than in patch closure. Our purpose was to compare perioperative and long-term results of different CEA closure techniques in a large institutional experience. A consecutive cohort of CEAs between January 1, 2000, and December 31, 2010, was retrospectively analyzed. Closure technique was used to divide patients into three groups: primary longitudinal arteriotomy closure (PRC), patch closure (PAC), and eversion closure (EVC). End points were perioperative events, long-term strokes, and restenosis ≥70%. Multivariate regression models were used to assess the effect of baseline predictors. There were 1737 CEA cases (bilateral, 143; mean age, 71.4 ± 9.3 years; 56.2% men; 35.3% symptomatic) performed during the study period with a mean clinical follow-up of 49.8 ± 36.4 months (range, 0-155 months). More men had primary closure, but other demographic and baseline symptoms were similar between groups. Half the patients had PAC, with the rest evenly distributed between PRC and EVC. The rate of nerve injury was 2.7%, the rate of reintervention for hematoma was 1.5%, and the length of hospital stay was 2.4 ± 3.0 days, with no significant differences among groups. The combined stroke and death rate was 2.5% overall and 3.9% and 1.7% in the symptomatic and asymptomatic cohort, respectively. Stroke and death rates were similar between groups: PRC, 11 (2.7%); PAC, 19 (2.2%); EVC, 13 (2.9%). Multivariate analysis showed baseline symptomatic disease (odds ratio, 2.4; P = .007) and heart failure (odds ratio, 3.1; P = .003) as predictors of perioperative stroke and death, but not the type of closure. Cox regression analysis demonstrated, among other risk factors, no statin use (hazard ratio, 2.1; P = .008) as a predictor of ipsilateral stroke and severe (glomerular filtration rate <30 mL/min/1.73 m(2)) renal insufficiency (hazard ratio, 2.6; P�

Post-activation depression of soleus stretch reflexes in healthy and spastic humans

DEFF Research Database (Denmark)

Grey, Michael James; Klinge, Klaus; Crone, Clarissa

2007-01-01

Reduced depression of transmitter release from Ia afferents following previous activation (post-activation depression) has been suggested to be involved in the pathophysiology of spasticity. However, the effect of this mechanism on the myotatic reflex and its possible contribution to increased...... reflex excitability in spastic participants has not been tested. To investigate these effects, we examined post-activation depression in Soleus H-reflex responses and in mechanically evoked Soleus stretch reflex responses. Stretch reflex responses were evoked with consecutive dorsiflexion perturbations...... of the soleus stretch reflex and H-reflex decreased as the interval between the stimulus/perturbation was decreased. Similarly, the stretch-evoked torque decreased. In the spastic participants, the post-activation depression of both reflexes and the stretch-evoked torque was significantly smaller than...

Impact and relationship of anterior commissure and time-dose factor on the local control of T1N0 glottic cancer treated by 6 MV photons

Directory of Open Access Journals (Sweden)

Fu Yiu-Tung

2011-05-01

Full Text Available Abstract Background To evaluate prognostic factors that may influence local control (LC of T1N0 glottic cancer treated by primary radiotherapy (RT with 6 MV photons. Methods We retrospectively reviewed the medical records of 433 consecutive patients with T1N0 glottic cancer treated between 1983 and 2005 by RT in our institution. All patients were treated with 6 MV photons. One hundred and seventy seven (41% patients received 52.5 Gy in 23 fractions with 2.5 Gy/fraction, and 256 (59% patients received 66 Gy in 33 fractions with 2 Gy/fraction. Results The median follow-up time was 10.5 years. The 10-year LC rates were 91% and 87% for T1a and T1b respectively. Multivariate analysis showed LC rate was adversely affected by poorly differentiated histology (Hazard Ratio [HR]: 7.5, p = 0.035; involvement of anterior commissure (HR: 2.34, p = 0.011; fraction size of 2.0 Gy (HR: 2.17, p = 0.035 and tumor biologically effective dose (BED 15 (HR: 3.38, p = 0.017. Conclusions The negative impact of anterior commissure involvement could be overcome by delivering a higher tumor BED through using fraction size of > 2.0 Gy. We recommend that fraction size > 2.0 Gy should be utilized, for radiation schedules with five daily fractions each week.

21 CFR 890.1450 - Powered reflex hammer.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... hammer. (a) Identification. A powered reflex hammer is a motorized device intended for medical purposes...

Effects of postural changes of the upper limb on reflex transmission in the lower limb. Cervicolumbar reflex interactions in man.

Science.gov (United States)

Delwaide, P J; Figiel, C; Richelle, C

1977-06-01

The influence of passive changes in upper limb position on the excitability of three myotatic arc reflexes (soleus, quadriceps, and biceps femoris) of the lower limb has been explored on 42 volunteers. The results indicate that the excitability of the three myotatic arcs can be influenced at a distance by postural modifications of the upper limb. When the ipsilateral upper limb is forwards or the contralateral backwards, a facilitation of both soleus and quadriceps tendon reflexes is observed while the biceps femoris reflexes are reduced. This pattern of facilitation and inhibition is reversed when the ipsilateral upper limb is backwards or the contralateral forwards. The facilitations as well as inhibitions of proximal myotatic arc reflexes are quantitatively more marked than that of the soleus reflex. Facilitation and inhibition are not linearly related to the angle of the arm with the trunk. Effects begin at a considerable angle, become maximal at 45 degrees, and progressively disappear for greater values. It is suggested that the distinct pattern of facilitation and inhibition which is exerted in reciprocal fashion on extensor and flexor motor nuclei might depend on the long propriospinal neurones connecting cervical and lumbar enlargements.

Quality of the voice after injection of hyaluronic acid into the vocal fold.

Science.gov (United States)

Szkiełkowska, Agata; Miaśkiewicz, Beata; Remacle, Marc; Krasnodębska, Paulina; Skarżyński, Henryk

2013-04-17

Voice disorders resulting from glottic insufficiency are a significant clinical problem in everyday phoniatric practice. One method of treatment is injection laryngoplasty. Our study aimed to assess the voice quality of patients treated with hyaluronic acid injection into the vocal fold. We studied 25 patients suffering from dysphonia, conducting laryngological and phoniatric examination, including videostroboscopy and acoustic voice analysis, before the operation and 1, 3, and 6 months later. In all cases there was complete or almost complete glottic closure after the operation. One month after the procedure, videostroboscopic examination revealed reappearance of vocal fold vibration in 8 cases; after 3 months this had risen to 15 cases. Perceptual voice quality (as assessed by the GRBAS scale) in patients with glottic insufficiency was improved. The most significant improvement was obtained 1 month after surgery (p=0.0002), and within the next months further statistically significant improvements (p=0.000002) were noted. Multidimensional voice analysis showed statistically significant and rapid improvement in frequency parameters, especially vFo. Other parameters were also improved 3 and 6 months after surgery. Injection of hyaluronic acid into the vocal fold improves phonatory functions of the larynx and the quality of voice in patients with glottic insufficiency. It may be a safe and conservative method for treatment of voice disorders. Hyaluronic acid injection to the vocal fold is an easy, effective, and fast method for restoration of good voice quality.

Outside home. Notes on reflexivity

Directory of Open Access Journals (Sweden)

Mara Clemente

2017-01-01

The paper proffers the idea in which a “reflexive process” on subjectivity can involve and/or hopefully involve the entire experience of the researcher, going beyond the borders of a single research. In the process, unexpected elements of subjectivity can come into play; in other cases the meaning attributed to them can change in time or can have a role different from what had been expected. Some elements, objects of epistemological analyses, as imposed by a reflexive approach, can become objects of attention also on the phenomenological level.

The Multiple Faces of Reflexive Research Designs

Directory of Open Access Journals (Sweden)

Karl H. Müller

2015-10-01

Full Text Available Reflexive research can be grouped into five clusters with circular relations between two elements x ↔ x, namely circular relations between observers, between scientific building blocks like concepts, theories or models, between systemic levels, between rules and rule systems or as circular relations or x ↔ y between these four components. By far the most important cluster is the second cluster which becomes reflexive through a re-entry operation RE into a scientific element x and which establishes its circular formation as x(x. Many of the research problems in these five clusters in reflexivity research are still unexplored and pose grand challenges for future research.

A Prototype Analysis of Spanish Indeterminate Reflexive Constructions.

Science.gov (United States)

Turley, Jeffrey S.

1998-01-01

Discussion of the Spanish indeterminate reflexive construction, the impersonal reflexive, finds that prototype theory allows this subjectless Spanish construction to be included within the category of generally subject-bearing indeterminates in Romance languages. (MSE)

Changes in soleus H-reflex during walking in middle-aged, healthy subjects

DEFF Research Database (Denmark)

Raffalt, Peter C; Alkjær, Tine; Simonsen, Erik B

2015-01-01

INTRODUCTION: To assess the effect of aging on stretch reflex modulation during walking, soleus H-reflexes obtained in 15 middle-aged (mean age 56.4±6.9 years) and 15 young (mean age 23.7±3.9 years) subjects were compared. METHODS: The H-reflex amplitude, muscle activity (EMG) of the soleus...... and tibialis anterior muscles, and EMG/H-reflex gain were measured during 4-km/h treadmill walking. RESULTS: The normalized H-reflex amplitude was lower in the swing phase for the middle-aged group, and there was no difference in muscle activity. EMG/H-reflex gain did not differ between groups. CONCLUSIONS: H......-reflex amplitude during walking was affected by aging, and changes during the swing phase could be seen in the middle-aged subjects. Subdividing the 2 age groups into groups of facilitated or suppressed swing-phase H-reflex revealed that the H-reflex amplitude modulation pattern in the group with facilitated swing...

Plasticity of the human otolith-ocular reflex

Science.gov (United States)

Wall, C. 3rd; Smith, T. R.; Furman, J. M.

1992-01-01

The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

Changes in Peak Airflow Measurement During Maximal Cough After Vocal Fold Augmentation in Patients With Glottic Insufficiency.

Science.gov (United States)

Dion, Gregory R; Achlatis, Efstratios; Teng, Stephanie; Fang, Yixin; Persky, Michael; Branski, Ryan C; Amin, Milan R

2017-11-01

Compromised cough effectiveness is correlated with dysphagia and aspiration. Glottic insufficiency likely yields decreased cough strength and effectiveness. Although vocal fold augmentation favorably affects voice and likely improves cough strength, few data exist to support this hypothesis. To assess whether vocal fold augmentation improves peak airflow measurements during maximal-effort cough following augmentation. This case series study was conducted in a tertiary, academic laryngology clinic. Participants included 14 consecutive individuals with glottic insufficiency due to vocal fold paralysis, which was diagnosed via videostrobolaryngoscopy as a component of routine clinical examination. All participants who chose to proceed with augmentation were considered for the study whether office-based or operative augmentation was planned. Postaugmentation data were collected only at the first follow-up visit, which was targeted for 14 days after augmentation but varied on the basis of participant availability. Data were collected from June 5, 2014, to October 1, 2015. Data analysis took place between October 2, 2015, and March 3, 2017. Peak airflow during maximal volitional cough was quantified before and after vocal fold augmentation. Participants performed maximal coughs, and peak expiratory flow during the maximal cough was captured according to American Thoracic Society guidelines. Among the 14 participants (7 men and 7 women), the mean (SD) age was 62 (18) years. Three types of injectable material were used for vocal fold augmentation: carboxymethylcellulose in 5 patients, hyaluronic acid in 5, and calcium hydroxylapatite in 4. Following augmentation, cough strength increased in 11 participants and decreased cough strength was observed in 3. Peak airflow measurements during maximal cough varied from a decrease of 40 L/min to an increase of 150 L/min following augmentation. When preaugmentation and postaugmentation peak airflow measurements were compared, the

Acoustic Reflex Screening of Conductive Hearing Loss for Third Window Disorders.

Science.gov (United States)

Hong, Robert S; Metz, Christopher M; Bojrab, Dennis I; Babu, Seilesh C; Zappia, John; Sargent, Eric W; Chan, Eleanor Y; Naumann, Ilka C; LaRouere, Michael J

2016-02-01

This study examines the effectiveness of acoustic reflexes in screening for third window disorders (eg, superior semicircular canal dehiscence) prior to middle ear exploration for conductive hearing loss. Case series with chart review. Outpatient tertiary otology center. A review was performed of 212 ears with acoustic reflexes, performed as part of the evaluation of conductive hearing loss in patients without evidence of chronic otitis media. The etiology of hearing loss was determined from intraoperative findings and computed tomography imaging. The relationship between acoustic reflexes and conductive hearing loss etiology was assessed. Eighty-eight percent of ears (166 of 189) demonstrating absence of all acoustic reflexes had an ossicular etiology of conductive hearing loss. Fifty-two percent of ears (12 of 23) with at least 1 detectable acoustic reflex had a nonossicular etiology. The positive and negative predictive values for an ossicular etiology were 89% and 57% when acoustic reflexes were used alone for screening, 89% and 39% when third window symptoms were used alone, and 94% and 71% when reflexes and symptoms were used together, respectively. Acoustic reflex testing is an effective means of screening for third window disorders in patients with a conductive hearing loss. Questioning for third window symptoms should complement screening. The detection of even 1 acoustic reflex or third window symptom (regardless of reflex status) should prompt further workup prior to middle ear exploration. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

Reflex epilepsy: triggers and management strategies

Directory of Open Access Journals (Sweden)

Okudan ZV

2018-01-01

Full Text Available Zeynep Vildan Okudan,1 Çiğdem Özkara2 1Department of Neurology, Bakirkoy Dr Sadi Konuk Education and Research Hospital, 2Department of Neurology and Clinical Neurophysiology, Cerrahpasa Faculty of Medicine, University of Istanbul, Istanbul, Turkey Abstract: Reflex epilepsies (REs are identified as epileptic seizures that are consistently induced by identifiable and objective-specific triggers, which may be an afferent stimulus or by the patient’s own activity. RE may have different subtypes depending on the stimulus characteristic. There are significant clinical and electrophysiologic differences between different RE types. Visual stimuli-sensitive or photosensitive epilepsies constitute a large proportion of the RE and are mainly related to genetic causes. Reflex epilepsies may present with focal or generalized seizures due to specific triggers, and sometimes seizures may occur spontaneously. The stimuli can be external (light flashes, hot water, internal (emotion, thinking, or both and should be distinguished from triggering precipitants, which most epileptic patients could report such as emotional stress, sleep deprivation, alcohol, and menstrual cycle. Different genetic and acquired factors may play a role in etiology of RE. This review will provide a current overview of the triggering factors and management of reflex seizures. Keywords: seizure, reflex epilepsy, photosensitivity, hot water, reading, thinking

Reflex responses of lip muscles in young and older women.

Science.gov (United States)

Wohlert, A B

1996-06-01

The perioral reflex in response to innocuous mechanical stimulation of the lip vermilion was studied in 20 young and 20 older women. Responses to stimuli at the right and left sides of both the upper and lower lips were recorded. Results show significant specificity of response, especially for upper lip sites. Reflex response at the site of stimulation was greatest in amplitude and shortest in latency, followed by response at sites ipsilateral to the site of stimulation. Younger subjects showed greater localizing tendency than older subjects. Stimulation was significantly less likely to produce a reflex response in the older group. When reflex responses did occur, they were significantly lower in amplitude and longer in latency than the responses of the younger group. Nonetheless, reflex responses were common in both groups, with responses at the site of stimulation occurring 78% of the time in older women and 90% of the time in younger women. Every participant showed at least one reflex response to lip stimulation. Results suggest decreasing complexity of synaptic drive to the perioral system in old age but also show that reflexive response does not deteriorate completely, remaining an available element for motor control in normal older women.

Ring closure in actin polymers

Energy Technology Data Exchange (ETDEWEB)

Sinha, Supurna, E-mail: supurna@rri.res.in [Raman Research Institute, Bangalore 560080 (India); Chattopadhyay, Sebanti [Doon University, Dehradun 248001 (India)

2017-03-18

We present an analysis for the ring closure probability of semiflexible polymers within the pure bend Worm Like Chain (WLC) model. The ring closure probability predicted from our analysis can be tested against fluorescent actin cyclization experiments. We also discuss the effect of ring closure on bend angle fluctuations in actin polymers. - Highlights: • Ring closure of biopolymers. • Worm like chain model. • Predictions for experiments.

Cerebellar interaction with the acoustic reflex.

Science.gov (United States)

Jastreboff, P J

1981-01-01

The involvement of the cerebellar vermis in the acoustic reflex was analyzed in 12 cats, decerebrated or in pentobarbital anesthesia. Anatomical data suggested the existence of a connection of lobules VIII with the ventral cochlear nucleus. Single cell recording and evoked potential techniques demonstrated the existence of the acoustic projection to lobulus VIII. Electrical stimulation of this area changed the tension of the middle ear muscle and caused evoked potential responses in the caudal part of the ventral cochlear nucleus. Electrical stimulation of the motor nucleus of the facial nerve evoked a slow wave in the recording taken from the surrounding of the cochlear round window. A hypothesis is proposed which postulates the involvement of the acoustic reflex in space localization of acoustic stimuli and the action of cerebellar vermis in order to assure the stability and plasticity of the acoustic reflex arc.

Reflex syncope: Diagnosis and treatment

Directory of Open Access Journals (Sweden)

Richard Sutton

2017-12-01

Full Text Available For the diagnosis of reflex syncope, diligent history-building with the patient and a witness is required. In the Emergency Department (ED, the assessment of syncope is a challenge which may be addressed by an ED Observation Unit or by a referral to a Syncope Unit. Hospital admission is necessary for those with life-threatening cardiac conditions although risk stratification remains an unsolved problem. Other patients may be investigated with less urgency by carotid sinus massage (>40 years, tilt testing, and electrocardiogram loop recorder insertion resulting in a clear cause for syncope. Management includes, in general terms, patient education, avoidance of circumstances in which syncope is likely, increase in fluid and salt consumption, and physical counter-pressure maneuvers. In older patients, those that will benefit from cardiac pacing are now well defined. In all patients, the benefit of drug therapy is often disappointing and there remains no ideal drug. A role for catheter ablation may emerge for the highly symptomatic reflex syncope patient. Keywords: Cardiac pacing, Catheter ablation, Diagnosis, Drugs, Management, Reflex syncope

Trigeminal cardiac reflex and cerebral blood flow regulation

Directory of Open Access Journals (Sweden)

Dominga Lapi

2016-10-01

Full Text Available The stimulation of some facial regions is known to trigger the trigemino-cardiac reflex: the main stimulus is represented by the contact of the face with water. This phenomenon called diving reflex induces a set of reactions in the cardiovascular and respiratory systems occurring in all mammals, especially marine (whales, seals. During the immersion of the face in the water, the main responses are aimed at reducing the oxygen consumption of the organism. Accordingly reduction in heart rate, peripheral vasoconstriction, blood pooling in certain organs, especially the heart and brain, and an increase in blood pressure have been reported. Moreover, the speed and intensity of the reflex is inversely proportional to the temperature of the water: more cold the water, more reactions as described are strong. In the case of deep diving an additional effect, such as blood deviation, has been reported: the blood is requested within the lungs, to compensate for the increase in the external pressure, preventing them from collapsing.The trigeminal-cardiac reflex is not just confined to the diving reflex; recently it has been shown that a brief proprioceptive stimulation (10 min by jaw extension in rats produces interesting effects both at systemic and cerebral level, reducing the arterial blood pressure and vasodilating the pial arterioles. The arteriolar dilation is associated with rhythmic diameter changes characterized by an increase in the endothelial activity. Fascinating the stimulation of trigeminal nerve is able to activated the nitric oxide release by vascular endothelial. Therefore the aim of this review was to highlight the effects due to trigeminal cardiac reflex induced by a simple mandibular extension, because produced opposite effects compared to those elicited by the diving reflex as it induces hypotension and modulation of cerebral arteriolar tone.

The acoustic reflex threshold in aging ears.

Science.gov (United States)

Silverman, C A; Silman, S; Miller, M H

1983-01-01

This study investigates the controversy regarding the influence of age on the acoustic reflex threshold for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators between Jerger et al. [Mono. Contemp. Audiol. 1 (1978)] and Jerger [J. Acoust. Soc. Am. 66 (1979)] on the one hand and Silman [J. Acoust. Soc. Am. 66 (1979)] and others on the other. The acoustic reflex thresholds for broadband noise, 500-, 1000-, 2000-, and 4000-Hz activators were evaluated under two measurement conditions. Seventy-two normal-hearing ears were drawn from 72 subjects ranging in age from 20-69 years. The results revealed that age was correlated with the acoustic reflex threshold for BBN activator but not for any of the tonal activators; the correlation was stronger under the 1-dB than under the 5-dB measurement condition. Also, the mean acoustic reflex thresholds for broadband noise activator were essentially similar to those reported by Jerger et al. (1978) but differed from those obtained in this study under the 1-dB measurement condition.

Soleus and lateral gastrocnemius H-reflexes during standing with unstable footwear.

Science.gov (United States)

Friesenbichler, Bernd; Lepers, Romuald; Maffiuletti, Nicola A

2015-05-01

Unstable footwear has been shown to increase lower extremity muscle activity, but the reflex response to perturbations induced by this intervention is unknown. Twenty healthy subjects stood in stable and unstable footwear conditions (presented randomly) while H-reflex amplitude and background muscle activity were measured in the soleus and lateral gastrocnemius (LG) muscles. Wearing unstable footwear resulted in larger H-reflexes (normalized to the maximal M-wave) for the LG (+12%; P = 0.025), but not for the soleus (+4%; P > 0.05). Background activity of both muscles was significantly higher in the unstable condition. The H-reflex facilitation observed with unstable footwear was unexpected, as challenging postural conditions usually result in reflex depression. Increased muscle activity, decreased presynaptic inhibition, and/or more forward postural position may have (over-)compensated the expected reflex depression. Differences between LG and soleus H-reflex modulation may be due to diverging motor unit recruitment thresholds. © 2015 Wiley Periodicals, Inc.

Sympathetic reflex control of blood flow in human peripheral tissues

DEFF Research Database (Denmark)

Henriksen, O

1991-01-01

Sympathetic vasoconstrictor reflexes are essential for the maintenance of arterial blood pressure in upright position. It has been generally believed that supraspinal sympathetic vasoconstrictor reflexes elicited by changes in baroreceptor activity play an important role. Recent studies on human...... sympathetic vasoconstrictor reflexes are blocked. Blood flow has been measure by the local 133Xe-technique. The results indicate the presence of spinal as well as supraspinal sympathetic vasoconstrictor reflexes to human peripheral tissues. Especially is emphasized the presence of a local sympathetic veno...... skeletal muscle, cutaneous and subcutaneous tissues of the limbs indicate that the situation is more complex. Measurements have been carried out during acute as well as chronic sympathetic denervation. Spinal sympathetic reflex mechanisms have been evaluated in tetraplegic patients, where supraspinal...

A simple measurement hammer for quantitative reflex studies

NARCIS (Netherlands)

Stam, J.; van Leeuwen, J. R.

1984-01-01

A reflex hammer for measurement of the mechanical stimulus strength was designed. Combined with standard EMG equipment this instrument permits the study of both stimulus-response relations and latencies of myotatic reflexes. Some results in normal subjects are discussed

Tubular closure device

International Nuclear Information System (INIS)

Klahn, F.C.; Nolan, J.H.; Wills, C.

1982-01-01

This invention relates to a closure mechanism for closing openings such as the bore of a conduit and for releasably securing members within the bore. More particularly, this invention relates to a closure mechanism for tubular irradiation surveillance specimen assembly holders used in nuclear reactors

Reflexive fatherhood in everyday life

DEFF Research Database (Denmark)

Westerling, Allan

2015-01-01

This article looks at fathering practices in Denmark, using the findings from a research project on everyday family life in Denmark. It takes a social psychological perspective and employs discursive psychology and theories about reflexive modernisation. It shows how fathers orient towards intimacy...... in their relationships with their children. Moreover, it discusses how fathers’ relatedness reflects individualisation and detraditionalisation. It is argued that reflexive modernisation entails subjective orientations that enable novel pathways to intimacy in contemporary father–child relationships. Through...... this analysis and discussion, the article offers a way to understand the complexities of fathering in everyday life from the perspective of fathers....

Reflexive intergroup bias in third-party punishment.

Science.gov (United States)

Yudkin, Daniel A; Rothmund, Tobias; Twardawski, Mathias; Thalla, Natasha; Van Bavel, Jay J

2016-11-01

Humans show a rare tendency to punish norm-violators who have not harmed them directly-a behavior known as third-party punishment. Research has found that third-party punishment is subject to intergroup bias, whereby people punish members of the out-group more severely than the in-group. Although the prevalence of this behavior is well-documented, the psychological processes underlying it remain largely unexplored. Some work suggests that it stems from people's inherent predisposition to form alliances with in-group members and aggress against out-group members. This implies that people will show reflexive intergroup bias in third-party punishment, favoring in-group over out-group members especially when their capacity for deliberation is impaired. Here we test this hypothesis directly, examining whether intergroup bias in third-party punishment emerges from reflexive, as opposed to deliberative, components of moral cognition. In 3 experiments, utilizing a simulated economic game, we varied participants' group relationship to a transgressor, measured or manipulated the extent to which they relied on reflexive or deliberative judgment, and observed people's punishment decisions. Across group-membership manipulations (American football teams, nationalities, and baseball teams) and 2 assessments of reflexive judgment (response time and cognitive load), reflexive judgment heightened intergroup bias, suggesting that such bias in punishment is inherent to human moral cognition. We discuss the implications of these studies for theories of punishment, cooperation, social behavior, and legal practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. II. The case of T2N0 disease

International Nuclear Information System (INIS)

Frata, Paolo; Cellai, Enrico; Magrini, Stefano M.; Bonetti, Bartolomea; Vitali, Elisabetta; Tonoli, Sandro; Buglione, Michela; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Biti, Gianpaolo

2005-01-01

Purpose: To retrospectively evaluate local control rates, late damage incidence, functional results, and second-tumor occurrence according to the different patient, tumor, and treatment features in a large bi-institutional series of T2 glottic cancer. Methods and Materials: A total of 256 T2 glottic cancer cases treated consecutively with radical intent at the Florence University Radiation Oncology Department (FLO) and at the Radiation Oncology Department of University of Brescia, Istituto del Radio 'O. Alberti' (BS) were studied. Cumulative probability of local control (LC), disease-specific survival (DSS), and overall survival (OS) rates were calculated and compared in the different clinical and therapeutic subgroups by both univariate and multivariate analysis. Types of relapse and their surgical salvage were evaluated, along with the functional results of treatment. Late-damage incidence and second-tumor cumulative probability (STP) were also calculated. Results: In the entire series, 3-year, 5-year, and 10-year OS rates were, respectively, 73%, 59%, and 37%. Corresponding values for cumulative LC probability were 73%, 73%, and 70% and for DSS, 89%, 86%, and 85%, taking into account surgical salvage of relapsed cases. Seventy-three percent of the patients were cured with function preserved. Main determinants of a worse LC at univariate analysis were larger tumor extent and impaired cord mobility. At multivariate analysis, the same factors retained statistical significance. Twenty-year STP was 23%, with second-tumor deaths less frequent than larynx cancer deaths (20 of 256 vs. 30 of 256). Incidence of late damage was higher in the first decade of accrual (22%) than in the last decade (10%, p = 0.03); the same was true for severe late damage (9% vs. 1.8%). Conclusion: Present-day radical radiotherapy can be considered a standard treatment for T2 glottic cancer. Better results are obtained in patients with less extended disease. Late damage is relatively

Snout and Visual Rooting Reflexes in Infantile Autism. Brief Report.

Science.gov (United States)

Minderaa, Ruud B.; And Others

1985-01-01

The authors conducted extensive neurological evaluations of 42 autistic individuals and were surprised to discover a consistently positive snout reflex in most of them. Difficulties with assessing the reflex are noted. The authors then reassessed the Ss for a series of primitive reflexes which are interpreted as signs of diffuse cortical brain…

The influence of reflexive educational environment on students ...

African Journals Online (AJOL)

The influence of reflexive educational environment on students' reflection development in ... based on them) from which, as they integrate, a reflexive personality style is developed. ... (narrative, dialogical, cognitive and axiological) are the factors influencing the outcome of social adaptation. ... AJOL African Journals Online.

CIRSE Vascular Closure Device Registry

NARCIS (Netherlands)

Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2011-01-01

Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. The CIRSE registry of closure devices

Management of vocal fold scar with autologous fat implantation: perceptual results.

Science.gov (United States)

Neuenschwander, M C; Sataloff, R T; Abaza, M M; Hawkshaw, M J; Reiter, D; Spiegel, J R

2001-06-01

Vocal fold scar disrupts the mucosal wave and interferes with glottic closure. Treatment involves a multidisciplinary approach that includes voice therapy, medical management, and sometimes surgery. We reviewed the records of the first eight patients who underwent autologous fat implantation for vocal fold scar. Information on the etiology of scar, physical findings, and prior interventions were collected. Videotapes of videostroboscopic findings and perceptual voice ratings [Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS)] were randomized and analyzed independently by four blinded observers. Etiology of scar included mass excision (7), vocal fold stripping (3), congenital sulcus (2), and hemorrhage (1). Prior surgical procedures performed included thyroplasty (1), autologous fat injection (9), excision of scar (2), and lysis of adhesions (2). Strobovideolaryngoscopy: Statistically significant improvement was found in glottic closure, mucosal wave, and stiffness (P = 0.05). Perceptual ratings (GRBAS): Statistically significant improvement was found in all five parameters, including overall Grade, Roughness, Breathiness, Asthenia, and Strain (P = 0.05). Patients appear to have improved vocal fold function and quality of voice after autologous fat implantation in the vocal fold. Autologous fat implantation is an important adjunctive procedure in the management of vocal fold scar, and a useful addition to the armamentarium of the experienced phonomicrosurgeon.

[Human physiology: images and practices of the reflex].

Science.gov (United States)

Wübben, Yvonne

2010-01-01

The essay examines the function of visualizations and practices in the formation of the reflex concept from Thomas Willis to Marshall Hall. It focuses on the specific form of reflex knowledge that images and practices can contain. In addition, the essay argues that it is through visual representations and experimental practices that technical knowledge is transferred to the field of human reflex physiology. When using technical metaphors in human physiology authors often seem to feel obliged to draw distinctions between humans, machines and animals. On closer scrutiny, these distinctions sometimes fail to establish firm borders between the human and the technical.

Nociceptive flexion reflexes during analgesic neurostimulation in man.

Science.gov (United States)

García-Larrea, L; Sindou, M; Mauguière, F

1989-11-01

Nociceptive flexion reflexes of the lower limbs (RIII responses) have been studied in 21 patients undergoing either epidural (DCS, n = 16) or transcutaneous (TENS, n = 5) analgesic neurostimulation (AN) for chronic intractable pain. Flexion reflex RIII was depressed or suppressed by AN in 11 patients (52.4%), while no modification was observed in 9 cases and a paradoxical increase during AN was evidenced in 1 case. In all but 2 patients, RIII changes were rapidly reversible after AN interruption. RIII depression was significantly associated with subjective pain relief, as assessed by conventional self-rating; moreover, in 2 patients it was possible to ameliorate the pain-suppressing effects of AN by selecting those stimulation parameters (intensity and frequency) that maximally depressed nociceptive reflex RIII. We recorded 2 cases of RIII attenuation after contralateral neurostimulation. AN appeared to affect nociceptive reflexes rather selectively, with no or very little effect on other cutaneous, non-nociceptive responses. Recording of RIII reflexes is relatively simple to implement as a routine paraclinical procedure. It facilitates the objective assessment of AN efficacy and may help to choose the most appropriate parameters of neurostimulation. In addition, RIII behavior in patients could be relevant to the understanding of some of the mechanisms involved in AN-induced pain relief.

Surgical desensitisation of the mechanoreceptors in Müller's muscle relieves chronic tension-type headache caused by tonic reflexive contraction of the occipitofrontalis muscle in patients with aponeurotic blepharoptosis.

Science.gov (United States)

Matsuo, Kiyoshi; Ban, Ryokuya

2013-02-01

Proprioceptively innervated intramuscular connective tissues in Müller's muscle function as exterior mechanoreceptors to induce reflex contraction of the levator and occipitofrontalis muscles. In aponeurotic blepharoptosis, since the levator aponeurosis is disinserted from the tarsus, stretching of the mechanoreceptors in Müller's muscle is increased even on primary gaze to induce phasic and tonic reflexive contraction of the occipitofrontalis muscle. It was hypothesised that in certain patients with aponeurotic blepharoptosis, the presence of tonic reflexive contraction of the occipitofrontalis muscle due to the sensitised mechanoreceptors in Müller's muscle, can cause chronic tension-type headache (CTTH) associated with occipitofrontalis tenderness. To verify this hypothesis, this study evaluated (1) what differentiates patients with CTTH from patients without CTTH, (2) how pharmacological contraction of Müller's smooth muscle fibres as a method for desensitising the mechanoreceptors in Müller's muscle affects electromyographic activity of the frontalis muscle, and (3) how surgical aponeurotic reinsertion to desensitise the mechanoreceptors in Müller's muscle electromyographically or subjectively affects activities of the occipitofrontalis muscle or CTTH. It was found that patients had sustained CTTH when light eyelid closure did not markedly reduce eyebrow elevation. However, pharmacological contraction of Müller's smooth muscle fibres or surgery to desensitise the mechanoreceptor electromyographically reduced the tonic contraction of the occipitofrontalis muscle on primary gaze and subjectively relieved aponeurotic blepharoptosis-associated CTTH. Over-stretching of the mechanoreceptors in Müller's muscle on primary gaze may induce CTTH due to tonic reflexive contraction of the occipitofrontalis muscle. Therefore, surgical desensitisation of the mechanoreceptors in Müller's muscle appears to relieve CTTH.

Simultaneous characterizations of reflex and nonreflex dynamic and static changes in spastic hemiparesis

Science.gov (United States)

Chung, Sun G.; Ren, Yupeng; Liu, Lin; Roth, Elliot J.; Rymer, W. Zev

2013-01-01

This study characterizes tonic and phasic stretch reflex and stiffness and viscosity changes associated with spastic hemiparesis. Perturbations were applied to the ankle of 27 hemiparetic and 36 healthy subjects under relaxed or active contracting conditions. A nonlinear delay differential equation model characterized phasic and tonic stretch reflex gains, elastic stiffness, and viscous damping. Tendon reflex was characterized with reflex gain and threshold. Reflexively, tonic reflex gain was increased in spastic ankles at rest (P hemiparesis may help to evaluate and treat them more effectively. PMID:23636726

Correlation of augmented startle reflex with brainstem electrophysiological responses in Tay-Sachs disease.

Science.gov (United States)

Nakamura, Sadao; Saito, Yoshiaki; Ishiyama, Akihiko; Sugai, Kenji; Iso, Takashi; Inagaki, Masumi; Sasaki, Masayuki

2015-01-01

To clarify the evolution of an augmented startle reflex in Tay-Sachs disease and compare the temporal relationship between this reflex and brainstem evoked potentials. Clinical and electrophysiological data from 3 patients with Tay-Sachs disease were retrospectively collected. The augmented startle reflex appeared between the age of 3 and 17 months and disappeared between the age of 4 and 6 years. Analysis of brainstem auditory evoked potentials revealed that poor segregation of peak I, but not peak III, coincided with the disappearance of the augmented startle reflex. A blink reflex with markedly high amplitude was observed in a patient with an augmented startle reflex. The correlation between the augmented startle reflex and the preservation of peak I but not peak III supports the theory that the superior olivary nucleus is dispensable for this reflex. The blink reflex with high amplitudes may represent augmented excitability of reticular formation at the pontine tegmentum in Tay-Sachs disease, where the pattern generators for the augmented startle and blink reflexes may functionally overlap. Copyright © 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Student Mobility and Transnational Social Ties as Factors of Reflexivity

Directory of Open Access Journals (Sweden)

Tea Golob

2018-03-01

Full Text Available The article seeks to develop and apply new quantitative measurement instruments capable of significantly improving understanding of the relationship between the transnational mobility and transnational social ties of students, along with their reflexive capacities. With a focus on students building their personal networks, educational and professional activities that extend beyond the nation’s borders and organising their day-to-day routines in transnational social spaces, we analyse the role of mobility in their reflexive capacities. Applying a tool that is line with Archer’s theory and indicators to measure reflexivity, and transnational social ties as proposed by Molina et al., we analyse data collected via an on-line survey questionnaire administered to Slovenian students. In addition, students from the Middle East (Lebanon and the USA (Hawai’i are added for comparative purposes. The results of path analysis show the Slovenian students’ mobility as such implies higher scores for meta reflexivity, combined with lower scores for communicative and fractured reflexivity. Further, social transactions reaching beyond one’s physical localities in terms of transnational social ties implies they have higher levels of reflexivity in general.

Observations on early and delayed colostomy closure.

Science.gov (United States)

Tade, A O; Salami, B A; Ayoade, B A

2011-06-01

Traditional treatment of a variety of colorectal pathologies had included a diverting colostomy that was closed eight or more weeks later during a readmission. The aim of this retrospective study was to determine the outcomes of early colostomy closure and delayed colostomy closure in patients with temporary colostomies following traumatic and non-traumatic colorectal pathologies. In this study early colostomy closure was the closure of a colostomy within three weeks of its construction, while delayed colostomy closure referred to closure after 3 weeks. Complete records of the 37 adult patients who had temporary colostomy constructed and closed between Jan. 1997 December 2003 for various colorectal pathologies were studied. Fourteen patients had early colostomy closure while 23 had delayed closure. In the early colostomy closure group there were 10 men and 4 women. The mean age of the patients was 28yr with a range of 18-65yr. Colostomies were closed 9-18 days after initial colostomy construction. There was no mortality. Morbidity rate 28.6% (4 out of 14). There were two faecal fistulas (14.3%). Twenty-three patients had delayed colostomy closure 8 weeks to 18 months after initial colostomy construction. These were patients unfit for early surgery after initial colostomy construction because of carcinoma, significant weight loss, or sepsis. There was no mortality. Morbidity rate was 26.1%. There were 3 faecal fistulas (13.2%). Outcomes following early colostomy closure and delayed closure were comparable. Patients fit for surgery should have early closure whilst patients who may have compromised health should have delayed closure.

Compromised local control due to treatment interruptions and late treatment breaks in early glottic cancer: Population-based outcomes study supporting need for intensified treatment schedules

International Nuclear Information System (INIS)

Groome, Patti A.; O'Sullivan, Brian; Mackillop, William J.; Jackson, Lynda D.; Schulze, Karleen M.Math.; Irish, Jonathan C.; Warde, Padraig R.; Schneider, Ken M.; Mackenzie, Robert G.; Hodson, D. Ian; Hammond, J. Alex; Gulavita, Sunil P.P.; Eapen, Libni J.; Dixon, Peter F. M.B.; Bissett, Randy J.

2006-01-01

Purpose: This population-based study describes the treatment of early glottic cancer in Ontario, Canada and assesses whether treatment variations were associated with treatment effectiveness. Methods and Materials: We studied 491 T1N0 and 213 T2N0 patients. Data abstracted from charts included age, sex, stage, treatment details, disease control, and survival. Results: The total dose ranged from 50 to 70 Gy, and the daily dose ranged from 1.9 to 2.8 Gy. In 90%, treatment duration was between 25 and 50 days. Field sizes, field reductions, beam arrangement, and beam energy varied. Late treatment breaks occurred in 13.6% of T1N0 and 27.1% of T2N0 cases. Local control was comparable to other reports for T1N0 (82% at 5 years), but was only 63.2% in T2N0. Variables associated with local failure in T1N0 were age less than 49 years (relative risk [RR], 3.21; 95% confidence interval [CI], 1.49-6.90) and >3 treatment interruption days (RR, 2.43; 95% CI, 1.00-5.91). In T2N0, these were field reduction (RR, 2.33; 95% CI, 1.23-4.42) and late treatment breaks (RR, 2.19; 95% CI, 1.09-4.41). Conclusion: Some aspects of treatment for early glottic cancer were associated with worse local control. Problems with protracted treatment are of particular concern, underscoring the need for randomized studies to intensify radiotherapy

Sternal exploration or closure

Science.gov (United States)

VAC - vacuum-assisted closure - sternal wound; Sternal dehiscence; Sternal infection ... in the wound to look for signs of infection Remove dead or infected ... use a VAC (vacuum-assisted closure) dressing. It is a negative ...

Reflexivity: The Creation of Liminal Spaces--Researchers, Participants, and Research Encounters.

Science.gov (United States)

Enosh, Guy; Ben-Ari, Adital

2016-03-01

Reflexivity is defined as the constant movement between being in the phenomenon and stepping outside of it. In this article, we specify three foci of reflexivity--the researcher, the participant, and the encounter--for exploring the interview process as a dialogic liminal space of mutual reflection between researcher and participant. Whereas researchers' reflexivity has been discussed extensively in the professional discourse, participants' reflexivity has not received adequate scholarly attention, nor has the promise inherent in reflective processes occurring within the encounter. © The Author(s) 2015.

Probabilities on Streams and Reflexive Games

Directory of Open Access Journals (Sweden)

Andrew Schumann

2014-01-01

Full Text Available Probability measures on streams (e.g. on hypernumbers and p-adic numbers have been defined. It was shown that these probabilities can be used for simulations of reflexive games. In particular, it can be proved that Aumann's agreement theorem does not hold for these probabilities. Instead of this theorem, there is a statement that is called the reflexion disagreement theorem. Based on this theorem, probabilistic and knowledge conditions can be defined for reflexive games at various reflexion levels up to the infinite level. (original abstract

Researching Reflexively With Patients and Families: Two Studies Using Video-Reflexive Ethnography to Collaborate With Patients and Families in Patient Safety Research.

Science.gov (United States)

Collier, Aileen; Wyer, Mary

2016-06-01

Patient safety research has to date offered few opportunities for patients and families to be actively involved in the research process. This article describes our collaboration with patients and families in two separate studies, involving end-of-life care and infection control in acute care. We used the collaborative methodology of video-reflexive ethnography, which has been primarily used with clinicians, to involve patients and families as active participants and collaborators in our research. The purpose of this article is to share our experiences and findings that iterative researcher reflexivity in the field was critical to the progress and success of each study. We present and analyze the complexities of reflexivity-in-the-field through a framework of multilayered reflexivity. We share our lessons here for other researchers seeking to actively involve patients and families in patient safety research using collaborative visual methods. © The Author(s) 2015.

Learning reflexively from a health promotion professional development program in Canada.

Science.gov (United States)

Tremblay, Marie-Claude; Richard, Lucie; Brousselle, Astrid; Beaudet, Nicole

2014-09-01

In recent decades, reflexivity has received much attention in the professional education and training literature, especially in the public health and health promotion fields. Despite general agreement on the importance of reflexivity, there appears to be no consensus on how to assess reflexivity or to conceptualize the different forms developed among professionals and participants of training programs. This paper presents an analysis of the reflexivity outcomes of the Health Promotion Laboratory, an innovative professional development program aimed at supporting practice changes among health professionals by fostering competency development and reflexivity. More specifically, this paper explores the difference between two levels of reflexivity (formative and critical) and highlights some implications of each for practice. Data were collected through qualitative interviews with participants from two intervention sites. Results showed that involvement in the Health Promotion Laboratory prompted many participants to modify their vision of their practice and professional role, indicating an impact on reflexivity. In many cases, new understandings seem to have played a formative function in enabling participants to improve their practice and their role as health promoters. The reflective process also served a critical function culminating in a social and moral understanding of the impacts on society of the professionals' practices and roles. This type of outcome is greatly desired in health promotion, given the social justice and equity concerns of this field of practice. By redefining the theoretical concept of reflexivity on two levels and discussing their impacts on practice, this study supports the usefulness of both levels of reflexivity. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Full closure strategic analysis.

Science.gov (United States)

2014-07-01

The full closure strategic analysis was conducted to create a decision process whereby full roadway : closures for construction and maintenance activities can be evaluated and approved or denied by CDOT : Traffic personnel. The study reviewed current...

Study of Achilles Tendon Reflex in Normal Korean and Various Thyroid Diseases

International Nuclear Information System (INIS)

Kang, Jin Yung; Kim, Kwang Won; Yae, Sung Bo; Lee, Hong Kyu; Koh, Chang Soon

1975-01-01

In an attempt to establish the diagnostic value of Achilles tendon reflex and to determine the normal value of Achilles tendon reflex time in normal Korean, the author measured the Achilles tendon reflex time by photomotograph. This study was carried out in 272 cases with various thyroid diseases and 340 normal Korean. 1) The Achilles tendon reflex time in normal Korean was like this, between 11 years old and 20 years old; male (62 cases); 250±27 msec, female (36 cases); 266±27 msec, between 21 years old and 30 years old; male (38 cases); 271±27 msec, female (21 cases); 284±27 msec, between 31 years old and 40 years old; male (26 cases); 275±25 msec, female (29 cases); 291±27 msec, between 41 years old and 50 years old; male (20 cases); 286±35 msec, female (24 cases); 307±42 msec, between 51 years old and 60 years old, male (20 cases); 296±33 msec, female (20 cases); 318±46 msec, over 61 years; male (24 cases) 301±33 msec, female (20 cases); 325±35 msec. The Achilles tendon reflex time was delayed with increasing age and delayed in the female. 2) The Achilles tendon reflex time was markedly shortened to 221±20 msec in untreated hyperthyroidism. 3) The Achilles tendon reflex time was markedly delayed to 435±59 msec in hypothyroidism. 4) The Achilles tendon reflex time was not changed significantly in other thyroid diseases with norms thyroid function. 5) The Achilles tendon reflex time showed good correlationship with ETR, T 3 RU, 131 I thyroid uptake and serum TSH. 6) Reproducibility of Achilles tendon reflex time was good, and no significant difference between left and right was noted. 7) Diagnostic accuracy of Achilles tendon reflex time was 71% in hyperthyroidism and 90% in hypothyroidism. 8) The Achilles tendon reflex time showed useful test to evaluate the clinical course of the hyperthyroidism.

Crack closure, a literature study

Science.gov (United States)

Holmgren, M.

1993-08-01

In this report crack closure is treated. The state of the art is reviewed. Different empirical formulas for determining the crack closure are compared with each other, and their benefits are discussed. Experimental techniques for determining the crack closure stress are discussed, and some results from fatigue tests are also reported. Experimental data from the literature are reported.

Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure.

Science.gov (United States)

Ramesh, S; Ajik, S

2012-12-01

Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

Revisit to Grad's Closure and Development of Physically Motivated Closure for Phenomenological High-Order Moment Model

International Nuclear Information System (INIS)

Myong, R. S.; Nagdewe, S. P.

2011-01-01

The Grad's closure for the high-order moment equation is revisited and, by extending his theory, a physically motivated closure is developed for the one-dimensional velocity shear gas flow. The closure is based on the physical argument of the relative importance of various terms appearing in the moment equation. Also, the closure is derived such that the resulting theory may be inclusive of the well established linear theory (Navier-Stokes-Fourier) as limiting case near local thermal equilibrium.

Avian reflex and electroencephalogram responses in different states of consciousness.

Science.gov (United States)

Sandercock, Dale A; Auckburally, Adam; Flaherty, Derek; Sandilands, Victoria; McKeegan, Dorothy E F

2014-06-22

Defining states of clinical consciousness in animals is important in veterinary anaesthesia and in studies of euthanasia and welfare assessment at slaughter. The aim of this study was to validate readily observable reflex responses in relation to different conscious states, as confirmed by EEG analysis, in two species of birds under laboratory conditions (35-week-old layer hens (n=12) and 11-week-old turkeys (n=10)). We evaluated clinical reflexes and characterised electroencephalograph (EEG) activity (as a measure of brain function) using spectral analyses in four different clinical states of consciousness: conscious (fully awake), semi-conscious (sedated), unconscious-optimal (general anaesthesia), unconscious-sub optimal (deep hypnotic state), as well as assessment immediately following euthanasia. Jaw or neck muscle tone was the most reliable reflex measure distinguishing between conscious and unconscious states. Pupillary reflex was consistently observed until respiratory arrest. Nictitating membrane reflex persisted for a short time (power (PTOT) significantly increased, whereas median (F50) and spectral edge (F95) frequencies significantly decreased. This study demonstrates that EEG analysis can differentiate between clinical states (and loss of brain function at death) in birds and provides a unique integration of reflex responses and EEG activity. Copyright © 2014 Elsevier Inc. All rights reserved.

Intrapartum synthetic oxytocin reduce the expression of primitive reflexes associated with breastfeeding.

Science.gov (United States)

Marín Gabriel, Miguel A; Olza Fernández, Ibone; Malalana Martínez, Ana M; González Armengod, Carmen; Costarelli, Valeria; Millán Santos, Isabel; Fernández-Cañadas Morillo, Aurora; Pérez Riveiro, Pilar; López Sánchez, Francisco; García Murillo, Lourdes

2015-05-01

Several synthetic peptide manipulations during the time surrounding birth can alter the specific neurohormonal status in the newborn brain. This study is aimed at assessing whether intrapartum oxytocin administration has any effect on primitive neonatal reflexes and determining whether such an effect is dose-dependent. A cohort prospective study was conducted at a tertiary hospital. Mother-infant dyads who received intrapartum oxytocin (n=53) were compared with mother-infant dyads who did not receive intrapartum oxytocin (n=45). Primitive neonatal reflexes (endogenous, antigravity, motor, and rhythmic reflexes) were quantified by analyzing videotaped breastfeeding sessions in a biological nurturing position. Two observers blind to the group assignment and the oxytocin dose analyzed the videotapes and assesed the newborn's state of consciousness according to the Brazelton scale. The release of all rhythmic reflexes (p=0.01), the antigravity reflex (p=0.04), and total primitive neonatal reflexes (p=0.02) in the group exposed to oxytocin was lower than in the group not exposed to oxytocin. No correlations were observed between the dose of oxytocin administered and the percentage of primitive neonatal reflexes released (r=0.03; p=0.82). Intrapartum oxytocin administration might inhibit the expression of several primitive neonatal reflexes associated with breastfeeding. This correlation does not seem to be dose-dependent.

FEFsem neuronal response during combined volitional and reflexive pursuit.

Science.gov (United States)

Bakst, Leah; Fleuriet, Jérome; Mustari, Michael J

2017-05-01

Although much is known about volitional and reflexive smooth eye movements individually, much less is known about how they are coordinated. It is hypothesized that separate cortico-ponto-cerebellar loops subserve these different types of smooth eye movements. Specifically, the MT-MST-DLPN pathway is thought to be critical for ocular following eye movements, whereas the FEF-NRTP pathway is understood to be vital for volitional smooth pursuit. However, the role that these loops play in combined volitional and reflexive behavior is unknown. We used a large, textured background moving in conjunction with a small target spot to investigate the eye movements evoked by a combined volitional and reflexive pursuit task. We also assessed the activity of neurons in the smooth eye movement subregion of the frontal eye field (FEFsem). We hypothesized that the pursuit system would show less contribution from the volitional pathway in this task, owing to the increased involvement of the reflexive pathway. In accordance with this hypothesis, a majority of FEFsem neurons (63%) were less active during pursuit maintenance in a combined volitional and reflexive pursuit task than during purely volitional pursuit. Interestingly and surprisingly, the neuronal response to the addition of the large-field motion was highly correlated with the neuronal response to a target blink. This suggests that FEFsem neuronal responses to these different perturbations-whether the addition or subtraction of retinal input-may be related. We conjecture that these findings are due to changing weights of both the volitional and reflexive pathways, as well as retinal and extraretinal signals.

Nevada Test Site closure program

International Nuclear Information System (INIS)

Shenk, D.P.

1994-08-01

This report is a summary of the history, design and development, procurement, fabrication, installation and operation of the closures used as containment devices on underground nuclear tests at the Nevada Test Site. It also addresses the closure program mothball and start-up procedures. The Closure Program Document Index and equipment inventories, included as appendices, serve as location directories for future document reference and equipment use

Evaluation of a novel trocar-site closure and comparison with a standard Carter-Thomason closure device.

Science.gov (United States)

del Junco, Michael; Okhunov, Zhamshid; Juncal, Samuel; Yoon, Renai; Landman, Jaime

2014-07-01

The aim of this study was to evaluate and compare a novel trocars-site closure device, the WECK EFx™ Endo Fascial Closure System (EFx) with the Carter-Thomason CloseSure System® (CT) for the closure of laparoscopic trocar site defects created by a 12-mm dilating trocar. We created standardized laparoscopic trocars-site abdominal wall defects in cadaver models using a standard 12-mm laparoscopic dilating trocar. Trocar defects were closed in a randomized fashion using one of the two closure systems. We recorded time and number of attempts needed for complete defect closure. In addition, we recorded the ability to maintain pneumoperitoneum, endoscopic visualization, safety, security, and facility based on the surgeon's subjective evaluations. We compared outcomes for the EFx and CT closure systems. We created 72 standardized laparoscopic trocars-site abdominal wall defects. The mean time needed for complete defect closure was 98.53 seconds (±28.9) for the EFx compared with 133.61 seconds (±54.61) for the CT (Psafety were 2.92 for EFx vs 2.19 for CT (Pvs 1.83 for EFx and CT, respectively (Pvs 2.33 for CT (P=0.022). No significant difference was observed between the EFx and the CT systems for endoscopic visualization (2.28 vs 2.50, P=0.080). In this in vitro cadaver trial, the EFx was superior in terms of time needed to complete defect closure, safety, and facility. CT was superior in terms of maintenance of pneumoperitoneum. Both systems were equal in the number of attempts needed to complete the defect closure and endoscopic visualization.

Orthodontic treatment-induced temporal alteration of jaw-opening reflex excitability.

Science.gov (United States)

Sasaki, Au; Hasegawa, Naoya; Adachi, Kazunori; Sakagami, Hiroshi; Suda, Naoto

2017-10-01

The impairment of orofacial motor function during orthodontic treatment needs to be addressed, because most orthodontic patients experience pain and motor excitability would be affected by pain. In the present study, the temporal alteration of the jaw-opening reflex excitability was investigated to determine if orthodontic treatment affects orofacial motor function. The excitability of jaw-opening reflex evoked by electrical stimulation on the gingiva and recorded bilaterally in the anterior digastric muscles was evaluated at 1 (D1), 3 (D3), and 7 days (D7) after orthodontic force application to the teeth of right side; morphological features (e.g., osteoclast genesis and tooth movement) were also evaluated. To clarify the underlying mechanism of orthodontic treatment-induced alteration of orofacial motor excitability, analgesics were administrated for 1 day. At D1 and D3, orthodontic treatment significantly decreased the threshold for inducing the jaw-opening reflex but significantly increased the threshold at D7. Other parameters of the jaw-opening reflex were also evaluated (e.g., latency, duration and area under the curve of anterior digastric muscles activity), and only the latency of the D1 group was significantly different from that of the other groups. Temporal alteration of the jaw-opening reflex excitability was significantly correlated with changes in morphological features. Aspirin (300 mg·kg -1 ·day -1 ) significantly increased the threshold for inducing the jaw-opening reflex, whereas a lower dose (75-150 mg·kg -1 ·day -1 ) of aspirin or acetaminophen (300 mg·kg -1 ·day -1 ) failed to alter the jaw-opening reflex excitability. These results suggest that an increase of the jaw-opening reflex excitability can be induced acutely by orthodontic treatment, possibly through the cyclooxygenase activation. NEW & NOTEWORTHY It is well known that motor function is affected by pain, but the effect of orthodontic treatment-related pain on the trigeminal

Reflexivity as a control factor of personal coping behavior

OpenAIRE

BEKHTER A.A.

2014-01-01

The article deals with the issue of coping behavior control. The author defines the criteria, levels and aspects of reflexivity within the framework of personal coping behavior. In conclusion the author describes the key facets of coping behavior control and how reflexivity affects them.

Isometric and Dynamic Control of Neck Muscles : Reflexive contributions and muscle synergies

NARCIS (Netherlands)

De Bruijn, E.

2014-01-01

It is well established that the central nervous system (CNS) stabilizes the head using reflexive feedback and cocontraction. The major reflexive pathways in the neck are through muscle spindles generating the cervicocollic reflex (CCR) and through the vestibular organ generating the vestibulocollic

Comparison of Stretch Reflex Torques in Ankle Dorsiflexors and Plantarflexors

National Research Council Canada - National Science Library

Tung, J

2001-01-01

...) ankle muscles, Pulse, step, and a combination of random perturbation and step inputs were used to identify the reflex and intrinsic contributions to the measured torque, TA reflex torques were very...

Occupancy estimation and the closure assumption

Science.gov (United States)

Rota, Christopher T.; Fletcher, Robert J.; Dorazio, Robert M.; Betts, Matthew G.

2009-01-01

1. Recent advances in occupancy estimation that adjust for imperfect detection have provided substantial improvements over traditional approaches and are receiving considerable use in applied ecology. To estimate and adjust for detectability, occupancy modelling requires multiple surveys at a site and requires the assumption of 'closure' between surveys, i.e. no changes in occupancy between surveys. Violations of this assumption could bias parameter estimates; however, little work has assessed model sensitivity to violations of this assumption or how commonly such violations occur in nature. 2. We apply a modelling procedure that can test for closure to two avian point-count data sets in Montana and New Hampshire, USA, that exemplify time-scales at which closure is often assumed. These data sets illustrate different sampling designs that allow testing for closure but are currently rarely employed in field investigations. Using a simulation study, we then evaluate the sensitivity of parameter estimates to changes in site occupancy and evaluate a power analysis developed for sampling designs that is aimed at limiting the likelihood of closure. 3. Application of our approach to point-count data indicates that habitats may frequently be open to changes in site occupancy at time-scales typical of many occupancy investigations, with 71% and 100% of species investigated in Montana and New Hampshire respectively, showing violation of closure across time periods of 3 weeks and 8 days respectively. 4. Simulations suggest that models assuming closure are sensitive to changes in occupancy. Power analyses further suggest that the modelling procedure we apply can effectively test for closure. 5. Synthesis and applications. Our demonstration that sites may be open to changes in site occupancy over time-scales typical of many occupancy investigations, combined with the sensitivity of models to violations of the closure assumption, highlights the importance of properly addressing

Eyelid closure at death

Directory of Open Access Journals (Sweden)

A D Macleod

2009-01-01

Full Text Available Aim: To observe the incidence of full or partial eyelid closure at death. Materials and Methods: The presence of ptosis was recorded in 100 consecutive hospice patient deaths. Results: Majority (63% of the patients died with their eyes fully closed, however, 37% had bilateral ptosis at death, with incomplete eye closure. In this study, central nervous system tumor involvement and/or acute hepatic encephalopathy appeared to be pre-mortem risk factors of bilateral ptosis at death. Conclusion: Organicity and not psychogenicity is, therefore, the likely etiology of failure of full eyelid closure at death.

Closure and Sealing Design Calculation

International Nuclear Information System (INIS)

T. Lahnalampi; J. Case

2005-01-01

The purpose of the ''Closure and Sealing Design Calculation'' is to illustrate closure and sealing methods for sealing shafts, ramps, and identify boreholes that require sealing in order to limit the potential of water infiltration. In addition, this calculation will provide a description of the magma that can reduce the consequences of an igneous event intersecting the repository. This calculation will also include a listing of the project requirements related to closure and sealing. The scope of this calculation is to: summarize applicable project requirements and codes relating to backfilling nonemplacement openings, removal of uncommitted materials from the subsurface, installation of drip shields, and erecting monuments; compile an inventory of boreholes that are found in the area of the subsurface repository; describe the magma bulkhead feature and location; and include figures for the proposed shaft and ramp seals. The objective of this calculation is to: categorize the boreholes for sealing by depth and proximity to the subsurface repository; develop drawing figures which show the location and geometry for the magma bulkhead; include the shaft seal figures and a proposed construction sequence; and include the ramp seal figure and a proposed construction sequence. The intent of this closure and sealing calculation is to support the License Application by providing a description of the closure and sealing methods for the Safety Analysis Report. The closure and sealing calculation will also provide input for Post Closure Activities by describing the location of the magma bulkhead. This calculation is limited to describing the final configuration of the sealing and backfill systems for the underground area. The methods and procedures used to place the backfill and remove uncommitted materials (such as concrete) from the repository and detailed design of the magma bulkhead will be the subject of separate analyses or calculations. Post-closure monitoring will not

Scope and closures

CERN Document Server

Simpson, Kyle

2014-01-01

No matter how much experience you have with JavaScript, odds are you don’t fully understand the language. This concise yet in-depth guide takes you inside scope and closures, two core concepts you need to know to become a more efficient and effective JavaScript programmer. You’ll learn how and why they work, and how an understanding of closures can be a powerful part of your development skillset.

ESO Reflex: a graphical workflow engine for data reduction

Science.gov (United States)

Hook, Richard; Ullgrén, Marko; Romaniello, Martino; Maisala, Sami; Oittinen, Tero; Solin, Otto; Savolainen, Ville; Järveläinen, Pekka; Tyynelä, Jani; Péron, Michèle; Ballester, Pascal; Gabasch, Armin; Izzo, Carlo

ESO Reflex is a prototype software tool that provides a novel approach to astronomical data reduction by integrating a modern graphical workflow system (Taverna) with existing legacy data reduction algorithms. Most of the raw data produced by instruments at the ESO Very Large Telescope (VLT) in Chile are reduced using recipes. These are compiled C applications following an ESO standard and utilising routines provided by the Common Pipeline Library (CPL). Currently these are run in batch mode as part of the data flow system to generate the input to the ESO/VLT quality control process and are also exported for use offline. ESO Reflex can invoke CPL-based recipes in a flexible way through a general purpose graphical interface. ESO Reflex is based on the Taverna system that was originally developed within the UK life-sciences community. Workflows have been created so far for three VLT/VLTI instruments, and the GUI allows the user to make changes to these or create workflows of their own. Python scripts or IDL procedures can be easily brought into workflows and a variety of visualisation and display options, including custom product inspection and validation steps, are available. Taverna is intended for use with web services and experiments using ESO Reflex to access Virtual Observatory web services have been successfully performed. ESO Reflex is the main product developed by Sampo, a project led by ESO and conducted by a software development team from Finland as an in-kind contribution to joining ESO. The goal was to look into the needs of the ESO community in the area of data reduction environments and to create pilot software products that illustrate critical steps along the road to a new system. Sampo concluded early in 2008. This contribution will describe ESO Reflex and show several examples of its use both locally and using Virtual Observatory remote web services. ESO Reflex is expected to be released to the community in early 2009.

Reflex epilepsy: a review

Directory of Open Access Journals (Sweden)

Karim Nikkhah

2017-01-01

Full Text Available Interesting phenomena of reflex epileptic syndromes are characterized by epileptic seizures each one induced by specific stimulus with a variety of types. Simple triggers, which lead to seizures within seconds, are of sensory type (most commonly visual, most rarely tactile or proprioceptive stimuli. Complex triggers, which are mostly of cognitive type such as praxis, reading, talking, and music, usually induce the epileptic event within minutes. It should differ from what most epileptic patients report as provocative precipitants for seizures (such as emotional stress, fatigue, fever, sleep deprivation, alcohol, and menstrual cycle. The identification of a specific trigger is not only important for patients or their parents to avoid seizures, but also it might help neurologists to choose the most effective antiepileptic drug for each case. In addition, research in this area may possibly reveal some underlying pathophysiology of epileptic phenomena in the brain.In this review, we briefly introduce reported reflex epileptic seizures, their clinical features and management.

Reflexive Dressing: Rethinking Retro

Directory of Open Access Journals (Sweden)

Stella North

2016-03-01

Full Text Available This article undertakes a philosophical exploration of the act we know, or think we know, as ‘dressing’. Inhabiting, in thought, the moment in which we dress, I examine some of its constituent mechanisms, attending to the impulses by which dressing is generated out of subjective experience.  When those impulses are temporally marked, as they are in the case of retro dress, this generation is a two-pronged process, in which the holding of the body in time, and the holding of time in the body, recalibrate one another. The process of ‘dressing,’ in this understanding, has a reflexivity which is double; it entails the turning of the body, with dress as medium, towards itself, and the turning of present experience towards some felt notion of the past. Reflexively dressing, we are always becoming ourselves, and becoming other than ourselves, at once; a movement of circuitous internalisation and externalisation by which the ambiguation inherent in material experience is realised.

Reflexive anaphor resolution in spoken language comprehension: Structural constraints and beyond

Directory of Open Access Journals (Sweden)

Kaili eClackson

2014-08-01

Full Text Available We report results from an eye-tracking during listening study examining English-speaking adults’ online processing of reflexive pronouns, and specifically whether the search for an antecedent is restricted to syntactically appropriate positions. Participants listened to a short story where the recipient of an object was introduced with a reflexive, and were asked to identify the object recipient as quickly as possible. This allowed for the recording of participants’ offline interpretation of the reflexive, response times, and eye movements on hearing the reflexive. Whilst our offline results show that the ultimate interpretation for reflexives was constrained by binding principles, the response time and eye-movement data revealed that during processing participants were temporarily distracted by a structurally inappropriate competitor antecedent when this was prominent in the discourse. These results indicate that in addition to binding principles, online referential decisions are also affected by discourse-level information.

Reflexive anaphor resolution in spoken language comprehension: structural constraints and beyond

Science.gov (United States)

Clackson, Kaili; Heyer, Vera

2014-01-01

We report results from an eye-tracking during listening study examining English-speaking adults’ online processing of reflexive pronouns, and specifically whether the search for an antecedent is restricted to syntactically appropriate positions. Participants listened to a short story where the recipient of an object was introduced with a reflexive, and were asked to identify the object recipient as quickly as possible. This allowed for the recording of participants’ offline interpretation of the reflexive, response times, and eye movements on hearing the reflexive. Whilst our offline results show that the ultimate interpretation for reflexives was constrained by binding principles, the response time, and eye-movement data revealed that during processing participants were temporarily distracted by a structurally inappropriate competitor antecedent when this was prominent in the discourse. These results indicate that in addition to binding principles, online referential decisions are also affected by discourse-level information. PMID:25191290

Management of Reflex Anoxic Seizures

Directory of Open Access Journals (Sweden)

J Gordon Millichap

2013-10-01

Full Text Available Investigators at the Roald Dahl EEG Unit, Alder Hey Children’s NHS Foundation, Liverpool, UK, review the definition, pathophysiology, clinical presentation, and management of reflex anoxic seizures (RAS in children.

Linear time delay methods and stability analyses of the human spine. Effects of neuromuscular reflex response.

Science.gov (United States)

Franklin, Timothy C; Granata, Kevin P; Madigan, Michael L; Hendricks, Scott L

2008-08-01

Linear stability methods were applied to a biomechanical model of the human musculoskeletal spine to investigate effects of reflex gain and reflex delay on stability. Equations of motion represented a dynamic 18 degrees-of-freedom rigid-body model with time-delayed reflexes. Optimal muscle activation levels were identified by minimizing metabolic power with the constraints of equilibrium and stability with zero reflex time delay. Muscle activation levels and associated muscle forces were used to find the delay margin, i.e., the maximum reflex delay for which the system was stable. Results demonstrated that stiffness due to antagonistic co-contraction necessary for stability declined with increased proportional reflex gain. Reflex delay limited the maximum acceptable proportional reflex gain, i.e., long reflex delay required smaller maximum reflex gain to avoid instability. As differential reflex gain increased, there was a small increase in acceptable reflex delay. However, differential reflex gain with values near intrinsic damping caused the delay margin to approach zero. Forward-dynamic simulations of the fully nonlinear time-delayed system verified the linear results. The linear methods accurately found the delay margin below which the nonlinear system was asymptotically stable. These methods may aid future investigations in the role of reflexes in musculoskeletal stability.

A new hypothesis of cause of syncope: trigeminocardiac reflex during extraction of teeth.

Science.gov (United States)

Arakeri, Gururaj; Arali, Veena

2010-02-01

Transient Loss Of Consciousness (TLOC) or vasovagal syncope is well known phenomenon in dental/maxillofacial surgery. Despite considerable study of vasovagal syncope, its pathophysiology remains to be fully elucidated. After having encountered a case of trigeminocardiac reflex after extraction of maxillary first molar we observed and studied 400 extractions under local anesthesia to know the relation between trigeminocardiac reflex and syncope. We make hypothesis that trigeminocardiac reflex which is usually seen under general anesthesia when all sympathetic reflexes are blunted can also occur under local anesthesia during extractions of maxillary molars (dento-cardiac reflex) and mediate syncope.

High-power ion beam generation with an inverse reflex tetrode

International Nuclear Information System (INIS)

Pasour, J.A.; Mahaffey, R.A.; Golden, J.; Kapetanakos, C.A.

1980-01-01

A new reflexing-electron ion source is described. The device produces a unidirectional ion beam with relatively high efficiency even when the applied magnetic field exceeds the self-field. This new source operates at a low, constant impedance during much of the applied voltage pulse and is better matched to available high-power, low-impedance generators than previous reflexing-electron devices. Proton pulses with peak current approx.500 kA have been produced with the inverse reflex tetrode coupled to the Gamble II generator

The Role of Transformational Leadership in Enhancing Team Reflexivity

NARCIS (Netherlands)

M.C. Schippers (Michaéla); D.N. den Hartog (Deanne); P.L. Koopman (Paul); D.L. van Knippenberg (Daan)

2007-01-01

textabstractTeam reflexivity, or the extent to which teams reflect upon and modify their functioning, has been identified as a key factor in the effectiveness of work teams. As yet, however, little is known about the factors that play a role in enhancing team reflexivity, and it is thus important to

The role of transformational leadership in enhancing team reflexivity

NARCIS (Netherlands)

Schippers, M.C.; den Hartog, D.N.; Koopman, P.L.; van Knippenberg, D.

2008-01-01

Team reflexivity, or the extent to which teams reflect upon and modify their functioning, has been identified as a key factor in the effectiveness of work teams. As yet, however, little is known about the factors that play a role in enhancing team reflexivity, and it is thus important to develop

100-D Ponds closure plan. Revision 1

International Nuclear Information System (INIS)

Petersen, S.W.

1997-09-01

The 100-D Ponds is a Treatment, Storage, and Disposal (TSD) unit on the Hanford Facility that received both dangerous and nonregulated waste. This Closure Plan (Rev. 1) for the 100-D Ponds TSD unit consists of a RCRA Part A Dangerous Waste Permit Application (Rev. 3), a RCRA Closure Plan, and supporting information contained in the appendices to the plan. The closure plan consists of eight chapters containing facility description, process information, waste characteristics, and groundwater monitoring data. There are also chapters containing the closure strategy and performance standards. The strategy for the closure of the 100-D Ponds TSD unit is clean closure. Appendices A and B of the closure plan demonstrate that soil and groundwater beneath 100-D Ponds are below cleanup limits. All dangerous wastes or dangerous waste constituents or residues associated with the operation of the ponds have been removed, therefore, human health and the environment are protected. Discharges to the 100-D Ponds, which are located in the 100-DR-1 operable unit, were discontinued in June 1994. Contaminated sediment was removed from the ponds in August 1996. Subsequent sampling and analysis demonstrated that there is no contamination remaining in the ponds, therefore, this closure plan is a demonstration of clean closure

Closure for spent-fuel transport and storage containers

International Nuclear Information System (INIS)

Ahner, S.; Knackstedt, H.G.; Srostlik, P.

1980-01-01

The container has a transport closure and a shielding closure. This shielding closure consists of two pieces (double closure system), which can be fartened to one another like a bayonet fixing. A central motion of rotation is enough to open the closure. It can be done remote-controlled as well as manually. (DG) [de

Echocardiographic predictors of coil vs device closure in patients undergoing percutaneous patent ductus arteriosus closure.

Science.gov (United States)

Roushdy, Alaa; Abd El Razek, Yasmeen; Mamdouh Tawfik, Ahmed

2018-01-01

To determine anatomic and hemodynamic echocardiographic predictors for patent ductus arteriosus (PDA) device vs coil closure. Seventy-six patients who were referred for elective transcatheter PDA closure were enrolled in the study. All patients underwent full echocardiogram including measurement of the PDA pulmonary end diameter, color flow width and extent, peak and end-diastolic Doppler gradients across the duct, diastolic flow reversal, left atrial dimensions and volume, left ventricular sphericity index, and volumes. The study group was subdivided into 2 subgroups based on the mode of PDA closure whether by coil (n = 42) or device (n = 34). Using univariate analysis there was a highly significant difference between the 2 groups as regard the pulmonary end diameter measured in both the suprasternal and parasternal short-axis views as well as the color flow width and color flow extent (P closure group had statistically significant higher end-systolic and end-diastolic volumes indexed, left atrial volume, and diastolic flow reversal. Receiver operating characteristic curve analysis showed a pulmonary end diameter cutoff point from the suprasternal view > 2.5 mm and from parasternal short-axis view > 2.61 mm to have the highest balanced sensitivity and specificity to predict the likelihood for device closure (AUC 0.971 and 0.979 respectively). The pulmonary end diameter measured from the suprasternal view was the most independent predictor of device closure. The selection between PDA coil or device closure can be done on the basis of multiple anatomic and hemodynamic echocardiographic variables. © 2017 Wiley Periodicals, Inc.

Proximally evoked soleus H-reflex to S1 nerve root stimulation in sensory neuronopathies (ganglionopathies).

Science.gov (United States)

Zhu, Dong-Qing; Zhu, Yu; Qiao, Kai; Zheng, Chao-Jun; Bradley, Scott; Weber, Robert; Chen, Xiang-Jun

2013-11-01

Sensory neuronopathy (SNN) mimics distal sensory axonopathy. The conventional H-reflex elicited by tibial nerve stimulation (tibial H-reflex) is usually abnormal in both conditions. We evaluated the proximally evoked soleus H-reflex in response to S1 nerve root stimulation (S1 foramen H-reflex) in SNN. Eleven patients with SNN and 6 with distal sensory axonopathy were studied. Tibial and S1 foramen H-reflexes were performed bilaterally in each patient. Tibial and S1 foramen H-reflexes were absent bilaterally in all patients with SNN. In the patients with distal sensory axonopathy, tibial H-reflexes were absent in 4 and demonstrated prolonged latencies in 2, but S1 foramen H-reflexes were normal. Characteristic absence of the H-reflex after both proximal and distal stimulation reflects primary loss of dorsal root ganglion (DRG) neurons and the distinct non-length-dependent impairment of sensory nerve fibers in SNN. Copyright © 2013 Wiley Periodicals, Inc.

Deprivation and Recovery of Sleep in Succession Enhances Reflexive Motor Behavior

OpenAIRE

Sprenger, Andreas; Weber, Frederik D.; Machner, Bjoern; Talamo, Silke; Scheffelmeier, Sabine; Bethke, Judith; Helmchen, Christoph; Gais, Steffen; Kimmig, Hubert; Born, Jan

2015-01-01

Sleep deprivation impairs inhibitory control over reflexive behavior, and this impairment is commonly assumed to dissipate after recovery sleep. Contrary to this belief, here we show that fast reflexive behaviors, when practiced during sleep deprivation, is consolidated across recovery sleep and, thereby, becomes preserved. As a model for the study of sleep effects on prefrontal cortex-mediated inhibitory control in humans, we examined reflexive saccadic eye movements (express saccades), as w...

Trigeminocardiac reflex during endoscopic juvenile nasopharyngeal angiofibroma surgery: an appraisal.

Science.gov (United States)

Sharma, Shilpee Bhatia; Janakiram, Trichy Narayanan; Baxi, Hina; Chinnasamy, Balamurugan

2017-07-01

Juvenile nasopharyngeal angiofibroma is a locally aggressive benign tumour which has propensity to erode the skull base. The tumour spreads along the pathways of least resistance and is in close proximity to the extracranial part of trigeminal nerve. Advancements in expanded approaches for endoscopic excision of tumours in infratemporal fossa and pterygopalatine fossa increase the vulnerability for the trigeminocardiac reflex. The manipulation of nerve and its branches during tumour dissection can lead to sensory stimulation and thus inciting the reflex. The aim of our study is to report the occurrence of trigeminocardiac reflex in endoscopic excision of juvenile nasopharyngeal angiofibroma. To describe the occurence of trigeminocardiac reflex during endoscopic endonasal excision of juvenile nasopharyngeal angiofibroma. We studied the occurrence of TCR in 15 patients (out of 242 primary cases and 52 revision cases) operated for endoscopic endonasal excision of JNA. The drop in mean arterial blood pressure and heart rate were observed and measured. To the best of our knowledge of English literature, this is the first case series reporting TCR as complication in endoscopic excision of JNA. occurence of this reflex has been mentioned in various occular, maxillofacial surgeries but its occurence during endoscopic excision of JNA has never been reported before. Manifestation of trigeminocardiac reflex during surgery can alter the course of the surgery and is a potential threat to life. It is essential for the anesthetist and surgeons to be familiar with the presentations, preventive measures and management protocols.

Comparison of Outcomes between Early Fascial Closure and Delayed Abdominal Closure in Patients with Open Abdomen: A Systematic Review and Meta-Analysis

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Yu Chen

2014-01-01

Full Text Available Up to the present, the optimal time to close an open abdomen remains controversial. This study was designed to evaluate whether early fascial abdominal closure had advantages over delayed approach for open abdomen populations. Medline, Embase, and Cochrane Library were searched until April 2013. Search terms included “open abdomen,” “abdominal compartment syndrome,” “laparostomy,” “celiotomy,” “abdominal closure,” “primary,” “delayed,” “permanent,” “fascial closure,” and “definitive closure.” Open abdomen was defined as “fail to close abdominal fascia after a laparotomy.” Mortality, complications, and length of stay were compared between early and delayed fascial closure. In total, 3125 patients were included for final analysis, and 1942 (62% patients successfully achieved early fascial closure. Vacuum assisted fascial closure had no impact on pooled fascial closure rate. Compared with delayed abdominal closure, early fascial closure significantly reduced mortality (12.3% versus 24.8%, RR, 0.53, P<0.0001 and complication incidence (RR, 0.68, P<0.0001. The mean interval from open abdomen to definitive closure ranged from 2.2 to 14.6 days in early fascial closure groups, but from 32.5 to 300 days in delayed closure groups. This study confirmed clinical advantages of early fascial closure over delayed approach in treatment of patients with open abdomen.

Tools for Closure Project and Contract Management: Development of the Rocky Flats Integrated Closure Project Baseline

International Nuclear Information System (INIS)

Gelles, C. M.; Sheppard, F. R.

2002-01-01

This paper details the development of the Rocky Flats Integrated Closure Project Baseline - an innovative project management effort undertaken to ensure proactive management of the Rocky Flats Closure Contract in support of the Department's goal for achieving the safe closure of the Rocky Flats Environmental Technology Site (RFETS) in December 2006. The accelerated closure of RFETS is one of the most prominent projects within the Department of Energy (DOE) Environmental Management program. As the first major former weapons plant to be remediated and closed, it is a first-of-kind effort requiring the resolution of multiple complex technical and institutional challenges. Most significantly, the closure of RFETS is dependent upon the shipment of all special nuclear material and wastes to other DOE sites. The Department is actively working to strengthen project management across programs, and there is increasing external interest in this progress. The development of the Rocky Flats Integrated Closure Project Baseline represents a groundbreaking and cooperative effort to formalize the management of such a complex project across multiple sites and organizations. It is original in both scope and process, however it provides a useful precedent for the other ongoing project management efforts within the Environmental Management program

50 CFR 648.161 - Closures.

Science.gov (United States)

2010-10-01

... Bluefish Fishery § 648.161 Closures. (a) EEZ closure. NMFS shall close the EEZ to fishing for bluefish by... dealer permit holders that no commercial quota is available for landing bluefish in that state. ...

From Incidental, Mechanically-Induced Arrhythmias to Reflex-Defined Arrhythmogenicity: On The Track of The Ternary Reflex System Resemblance to The "Infancy" of New Era or Rediscovery.

Science.gov (United States)

Stirbys, Petras

2016-01-01

The underlying pathophysiology of supraventricular and ventricular arrhythmias remains a matter of intense investigation. Though evolving, the contemporary explanations do not encompass all aspects of arrhythmogenicity. An improved understanding of arrhythmia substrate is needed to augment therapeutic capabilities. Our observation and literature sources demonstrate relatively high incidence of transitory arrhythmias which are non-intentionally generated by the endocardial lead/catheter manipulation. These findings are interesting and potentially may crystallize the reflex-dependent proarrhythmic cardiac activity. Herein we suggest the "reflexogenic arrhythmogenicity" concept extending an overall spectrum of known hypotheses. Cardiovascular reflex action can be categorized into three-tiered levels - intra-cellular, inter-cellular and inter-organic. The first two levels of the triplicate system reside within the cardiac anatomical landmarks (in fact intramurally, intra-organically), however the third one implicates central (cerebral) activity which boomerangs back via centripetal and centrifugal connections. These levels likely compose synoptic ternary reflex set system which may be validated in future studies. To hypothesize, coordinated mutual reciprocity of reflex activity results in stabilization of heart rhythm in robust heart. Any stressful cardiac event may lead to the shift of the rhythm toward unfavorable clinical entity probably via the loss of the influence of dominant reflex. Overall, an interaction and likely intrinsic inter-tiered competition along with possible interplay between physiological and pathological reflexes may be treated as contributing factors for the inception and maintaining of arrhythmias and cardiac performance as well. These assumptions await further documentation. If such a tenet were recognized, the changes in the clinical approach to arrhythmia management might be anticipated, preferably by selective reflex suppression or

Comparison of fasciotomy wound closures using traditional dressing changes and the vacuum-assisted closure device.

Science.gov (United States)

Zannis, John; Angobaldo, Jeff; Marks, Malcolm; DeFranzo, Anthony; David, Lisa; Molnar, Joseph; Argenta, Louis

2009-04-01

Fasciotomy wounds can be a major contributor to length of stay for patients as well as a difficult reconstructive challenge. Once the compartment pressure has been relieved and stabilized, the wound should be closed as quickly and early as possible to avoid later complications. Skin grafting can lead to morbidity and scarring at both the donor and fasciotomy site. Primary closure results in a more functional and esthetic outcome with less morbidity for the patient, but can often be difficult to achieve secondary to edema, skin retraction, and skin edge necrosis. Our objective was to examine fasciotomy wound outcomes, including time to definitive closure, comparing traditional wet-to-dry dressings, and the vacuum-assisted closure (VAC) device. This retrospective chart review included a consecutive series of patients over a 10-year period. This series included 458 patients who underwent 804 fasciotomies. Of these fasciotomy wounds, 438 received exclusively VAC. dressings, 270 received only normal saline wet-to-dry dressings, and 96 were treated with a combination of both. Of the sample, 408 patients were treated with exclusively VAC therapy or wet-to-dry dressings and 50 patients were treated with a combination of both. In comparing all wounds, there was a statistically significant higher rate of primary closure using the VAC versus traditional wet-to-dry dressings (P lower extremities and P extremities). The time to primary closure of wounds was shorter in the VAC. group in comparison with the non-VAC group. This study has shown that the use of the VAC for fasciotomy wound closure results in a higher rate of primary closure versus traditional wet-to-dry dressings. In addition, the time to primary closure of wounds or time to skin grafting is shorter when the VAC was employed. The VAC used in the described settings decreases hospitalization time, allows for earlier rehabilitation, and ultimately leads to increased patient satisfaction.

Emotion, reflexivity and social change in the era of extreme fossil fuels.

Science.gov (United States)

Davidson, Debra J

2018-05-09

Reflexivity is an important sociological lens through which to examine the means by which people engage in actions that contribute to social reproduction or social elaboration. Reflexivity theorists have largely overlooked the central place of emotions in reflexive processing, however, thus missing opportunities to enhance our understanding of reflexivity by capitalizing on recent scholarship on emotions emanating from other fields of inquiry. This paper explores the role of emotion in reflexivity, with a qualitative analysis of social responses to hydraulic fracturing in Alberta, Canada, utilizing narrative analysis of long-form interviews with rural landowners who have experienced direct impacts from hydraulic fracturing, and have attempted to voice their concerns in the public sphere. Based on interviews with a selection of two interview participants, the paper highlights the means by which emotions shape reflexivity in consequential ways, beginning with personal and highly individualized emotional responses to contingent situations, which then factor into the social interactions engaged in the pursuit of personal projects. The shared emotional context that emerges then plays a substantial role in shaping outcomes and their implications for social stasis or change. This study exemplifies the extent to which reflexive processing in response to breaches in the social order can be emotionally tumultuous affairs, constituting a significant personal toll that many may be unwilling to pay. © London School of Economics and Political Science 2018.

Affective Modulation of the Startle Eyeblink and Postauricular Reflexes in Autism Spectrum Disorder

Science.gov (United States)

Dichter, Gabriel S.; Benning, Stephen D.; Holtzclaw, Tia N.; Bodfish, James W.

2010-01-01

Eyeblink and postauricular reflexes to standardized affective images were examined in individuals without (n = 37) and with (n = 20) autism spectrum disorders (ASDs). Affective reflex modulation in control participants replicated previous findings. The ASD group, however, showed anomalous reflex modulation patterns, despite similar self-report…

No evidence hip joint angle modulates intrinsically produced stretch reflex in human hopping.

Science.gov (United States)

Gibson, W; Campbell, A; Allison, G

2013-09-01

Motor output in activities such as walking and hopping is suggested to be mediated neurally by purported stretch reflex augmentation of muscle output. Reflex EMG activity during these tasks has been frequently investigated in the soleus muscle; with alterations in reflex amplitude being associated with changes in hip joint angle/phase of the gait cycle. Previous work has focussed on reflex activity induced by an artificial perturbation or by induction of H-reflexes. As such, it is currently unknown if stretch reflex activity induced intrinsically (as part of the task) is modulated by changes in hip joint angle. This study investigated whether hip joint angle modulated reflex EMG 'burst' activity during a hopping task performed on a custom-built partially reclined sleigh. Ten subjects participated; EMG and kinematic data (VICON motor capture system) was collected for each hop cycle. Participants completed 5 sets of 30s of self-paced hopping in (1) hip neutral and (2) hip 60° flexion conditions. There was no difference in EMG 'burst' activity or in sagittal plane kinematics (knee/ankle) in the hopping task between the two conditions. The results indicate that during a functional task such as hopping, changes in hip angle do not alter the stretch reflex-like activity associated with landing. Copyright © 2013 Elsevier B.V. All rights reserved.

THE CONCEPT OF REFLEXIVE MANAGEMENT OF CONSUMER DEMAND

Directory of Open Access Journals (Sweden)

Maryna Mavrina

2017-11-01

Full Text Available Development of theoretical approaches of demand management is conducted from the moment of awareness of the importance of this concept. Many models of individual consumers were developed. However, to predict the reaction of consumers to the commercial policy of the enterprise, exact methods do not exist yet because the available ones are mostly empirical in nature. Models of behaviour often do not provide the expected result because they use an erroneous approach to the analysis of the mechanism of demand formation. The subject of the research is the theoretical and methodological basis, methods of assessment, and reflexive management of consumer demand of commercial enterprises. The purpose of the paper is developing a concept of reflexive management of consumer demand. To achieve the research goal, the following tasks are set and solved: to substantiate the theoretical and methodological foundations of reflexive consumer management, to analyse existing approaches to the modelling of consumer behaviour; to improve the model of consumer behaviour; to develop a concept of reflexive management of consumer behaviour. Methodology. In the paper, we use such methods and approaches to research as: reflexive approach (phenomenological method, behavioural economic theory, marketing approach, abstract-logical analysis, analysis of theoretical approaches to the modelling of consumer behaviour. Results. Modern approaches to modelling of consumer behaviour are mostly empirical in nature and have shortcomings of general models. In them, there is no description of specific situations of the purchase of goods. They cannot be quantified. Therefore, they cannot be practical models. But they have a weighty advantage in a comprehensive look at motivated purchases, what makes it possible to evaluate the relevance of individual variables and to understand the fundamental processes of consumer behaviour. It makes possible to identify the variables necessary for the

Hanford Patrol Academy Demolition Sites Closure Plan

International Nuclear Information System (INIS)

1992-11-01

From 1975 to 1991 the Hanford Patrol Academy Demolition Sites (HPADS) were used for demolition events. These demolition events were a form of thermal treatment for spent or abandoned chemical waste. Because the HPADS will no longer be used for this thermal activity, the sites will be closed. Closure will be conducted pursuant to the requirements of the Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and 40 CFR 270.1. Closure also will satisfy closure requirements of WAC 173-303-680 and for the thermal treatment closure requirements of 40 CFR 265.381. This closure plan presents a description of the HPADS, the history of the waste treated, and the approach that will be followed to close the HPADS. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. Only dangerous constituents derived from HPADS operations will be addressed in this closure plan in accordance with WAC 173-303-610(2)(b)(i). The HPADS are actually two distinct soil closure areas within the Hanford Patrol Academy training area

The ubiquitous reflex and its critics in post-revolutionary Russia.

Science.gov (United States)

Sirotkina, Irina

2009-03-01

In the last century, the reflex was more than a scientific concept: it was a cultural idiom that could be used to various aims--political, scholarly, and artistic. In Russia in the 1920s, the reflex became a ubiquitous notion and a current word, part of the revolutionary discourse and, finally, a password to modernity. Two major factors contributed to it: physiological theories of the reflex, widespread in Russia at the early twentieth-century, and the materialist philosophy backed after the Revolution by the Communist party. Everybody who wished to be modern and materialist, in conformity with the official communist views, had to refer to reflexes. Yet, even in this period, the concept was not unproblematic and was criticized by some scientists, philosophers, artists and even Party members. In the paper, I describe both the array of uses of the term and the criticism it received in political, scientific and artistic discourses. It is not uncommon that, taking their origins in culture and common language, scientific concepts later return there in the form of metaphors. Similarly, the reflex was made into a rigorous scientific concept in the nineteenth century but, in the next century, it circulated as a cultural idiom penetrating various areas of political, artistic and academic life.

Evaluation of cranial tibial and extensor carpi radialis reflexes before and after anesthetic block in cats.

Science.gov (United States)

Tudury, Eduardo Alberto; de Figueiredo, Marcella Luiz; Fernandes, Thaiza Helena Tavares; Araújo, Bruno Martins; Bonelli, Marília de Albuquerque; Diogo, Camila Cardoso; Silva, Amanda Camilo; Santos, Cássia Regina Oliveira; Rocha, Nadyne Lorrayne Farias Cardoso

2017-02-01

Objectives This study aimed to test the extensor carpi radialis and cranial tibial reflexes in cats before and after anesthetic block of the brachial and lumbosacral plexus, respectively, to determine whether they depend on a myotatic reflex arc. Methods Fifty-five cats with a normal neurologic examination that were referred for elective gonadectomy were divided into group 1 (29 cats) for testing the extensor carpi radialis reflex, and group 2 (26 cats) for testing the cranial tibial reflex. In group 1, the extensor carpi radialis reflex was tested after anesthetic induction and 15 mins after brachial plexus block with lidocaine. In group 2, the cranial tibial, withdrawal and patellar reflexes were elicited in 52 hindlimbs and retested 15 mins after epidural anesthesia. Results In group 1, before the anesthetic block, 55.17% of the cats had a decreased and 44.83% had a normal extensor carpi radialis reflex. After the block, 68.96% showed a decreased and 27.59% a normal reflex. No cat had an increased or absent reflex before anesthetic block. In group 2, prior to the anesthetic block, 15.38% of the cats had a decreased cranial tibial reflex and 84.62% had a normal response, whereas after the block it was decreased in 26.92% and normal in 73.08% of the cats. None of the cats had an increased or absent reflex. Regarding the presence of both reflexes before and after anesthetic block, there was no significant difference at 1% ( P = 0.013). Conclusions and relevance The extensor carpi radialis and cranial tibial reflexes in cats are not strictly myotatic reflexes, as they are independent of the reflex arc, and may be idiomuscular responses. Therefore, they are not reliable for neurologic examination in this species.

ASD Closure in Structural Heart Disease.

Science.gov (United States)

Wiktor, Dominik M; Carroll, John D

2018-04-17

While the safety and efficacy of percutaneous ASD closure has been established, new data have recently emerged regarding the negative impact of residual iatrogenic ASD (iASD) following left heart structural interventions. Additionally, new devices with potential advantages have recently been studied. We will review here the potential indications for closure of iASD along with new generation closure devices and potential late complications requiring long-term follow-up. With the expansion of left-heart structural interventions and large-bore transseptal access, there has been growing experience gained with management of residual iASD. Some recently published reports have implicated residual iASD after these procedures as a potential source of diminished clinical outcomes and mortality. Additionally, recent trials investigating new generation closure devices as well as expanding knowledge regarding late complications of percutaneous ASD closure have been published. While percutaneous ASD closure is no longer a novel approach to managing septal defects, there are several contemporary issues related to residual iASD following large-bore transseptal access and new generation devices which serve as an impetus for this review. Ongoing attention to potential late complications and decreasing their incidence with ongoing study is clearly needed.

32 CFR 989.25 - Base closure and realignment.

Science.gov (United States)

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Base closure and realignment. 989.25 Section 989... PROTECTION ENVIRONMENTAL IMPACT ANALYSIS PROCESS (EIAP) § 989.25 Base closure and realignment. Base closure or realignment may entail special requirements for environmental analysis. The permanent base closure...

Otolith and canal reflexes in human standing

Science.gov (United States)

Cathers, Ian; Day, Brian L; Fitzpatrick, Richard C

2005-01-01

We used galvanic vestibular stimulation (GVS) to identify human balance reflexes of the semicircular canals and otolith organs. The experiment used a model of vestibular signals arising from GVS modulation of the net signal from vestibular afferents. With the head upright, the model predicts that the GVS-evoked canal signal indicates lateral head rotation while the otolith signal indicates lateral tilt or acceleration. Both signify body sway transverse to the head. With the head bent forward, the model predicts that the canal signal indicates body spin about a vertical axis but the otolith signal still signifies lateral body motion. Thus, we compared electromyograms (EMG) in the leg muscles and body sway evoked by GVS when subjects stood with the head upright or bent forward. With the head upright, GVS evoked a large sway in the direction of the anodal electrode. This response was abolished with the head bent forward leaving only small, oppositely directed, transient responses at the start and end of the stimulus. With the head upright, GVS evoked short-latency (60–70 ms), followed by medium-latency (120 ms) EMG responses, of opposite polarity. Bending the head forward abolished the medium-latency but preserved the short-latency response. This is compatible with GVS evoking separate otolithic and canal reflexes, indicating that balance is controlled by independent canal and otolith reflexes, probably through different pathways. We propose that the short-latency reflex and small transient sway are driven by the otolith organs and the medium-latency response and the large sway are driven by the semicircular canals. PMID:15618274

Interindividual differences in H reflex modulation during normal walking

DEFF Research Database (Denmark)

Simonsen, Erik B; Dyhre-Poulsen, Poul; Alkjaer, T

2002-01-01

was greater for the S group. The hip joint moment was similar for the groups. The EMG activity in the vastus lateralis and anterior tibial muscles was greater prior to heel strike for the S group. These data indicate that human walking exhibits at least two different motor patterns as evaluated by gating...... of afferent input to the spinal cord, by EMG activity and by walking mechanics. Increasing H reflex excitability during the swing phase appears to protect the subject against unexpected perturbations around heel strike by a facilitated stretch reflex in the triceps surae muscle. Alternatively, in subjects...... with a suppressed H reflex in the swing phase the knee joint extensors seem to form the primary protection around heel strike....

Shoulder reflexes

DEFF Research Database (Denmark)

Diederichsen, L.; Krogsgaard, M.; Voigt, Michael

2002-01-01

long latency (300 ms) excitatory reflex has been found when nerves in the capsule were stimulated electrically during shoulder surgery. In addition, when the anterior-inferior capsule was excited in conscious humans with modest amplitude electrical stimuli during muscle activity, a strong inhibition...... activity around the shoulder. This has implications for rehabilitation and shoulder surgery.......Dynamic shoulder stability is dependent on muscular coordination and sensory inputs. In the shoulder, mechanoreceptors are found in the coracoacromial ligament, the rotator cuff tendons, the musculotendinous junctions of the rotator cuff and in the capsule. The number of receptors in the capsule...

An Intelligent Computerized Stretch Reflex Measurement System For Clinical And Investigative Neurology

Science.gov (United States)

Flanagan, P. M.; Chutkow, J. G.; Riggs, M. T.; Cristiano, V. D.

1987-05-01

We describe the design of a reliable, user-friendly preprototype system for quantifying the tendon stretch reflexes in humans and large mammals. A hand-held, instrumented reflex gun, the impactor of which contains a single force sensor, interfaces with a computer. The resulting test system can deliver sequences of reproducible stimuli at graded intensities and adjustable durations to a muscle's tendon ("tendon taps"), measure the impacting force of each tap, and record the subsequent reflex muscle contraction from the same tendon -- all automatically. The parameters of the reflex muscle contraction include latency; mechanical threshold; and peak time, peak magnitude, and settling time. The results of clinical tests presented in this paper illustrate the system's potential usefulness in detecting neurologic dysfunction affecting the tendon stretch reflexes, in documenting the course of neurologic illnesses and their response to therapy, and in clinical and laboratory neurologic research.

Patent ductus arteriosus closure using an Amplatzer™ ventricular septal defect closure device

Science.gov (United States)

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs. PMID:24294051

Orthodoxy and reflexivity in international comparative analysis

DEFF Research Database (Denmark)

Lind, Jens; Valkenburg, Ben

2002-01-01

This contribution aims at four points.First we want to argue why we think a reflexive social science is more adequate than the orthodox consensus. In current practice much of the criticism on the orthodox consensus is shared on a theoretical level, without considering the implications and acting...... upon the consequences on the level of empirical research. We want to avoid that, so our second and third subject will be the practical implications of reflexivity for empirical research as well as for social policy. Our discussion on these subjects is based on the practical experiences in the INPART...

The reflexive case study method

DEFF Research Database (Denmark)

Rittenhofer, Iris

2015-01-01

This paper extends the international business research on small to medium-sized enterprises (SME) at the nexus of globalization. Based on a conceptual synthesis across disciplines and theoretical perspectives, it offers management research a reflexive method for case study research of postnational...

Evaluation of the Momentum Closure Schemes in MPAS-Ocean

Science.gov (United States)

Zhao, Shimei; Liu, Yudi; Liu, Wei

2018-04-01

In order to compare and evaluate the performances of the Laplacian viscosity closure, the biharmonic viscosity closure, and the Leith closure momentum schemes in the MPAS-Ocean model, a variety of physical quantities, such as the relative reference potential energy (RPE) change, the RPE time change rate (RPETCR), the grid Reynolds number, the root mean square (RMS) of kinetic energy, and the spectra of kinetic energy and enstrophy, are calculated on the basis of results of a 3D baroclinic periodic channel. Results indicate that: 1) The RPETCR demonstrates a saturation phenomenon in baroclinic eddy tests. The critical grid Reynolds number corresponding to RPETCR saturation differs between the three closures: the largest value is in the biharmonic viscosity closure, followed by that in the Laplacian viscosity closure, and that in the Leith closure is the smallest. 2) All three closures can effectively suppress spurious dianeutral mixing by reducing the grid Reynolds number under sub-saturation conditions of the RPETCR, but they can also damage certain physical processes. Generally, the damage to the rotation process is greater than that to the advection process. 3) The dissipation in the biharmonic viscosity closure is strongly dependent on scales. Most dissipation concentrates on small scales, and the energy of small-scale eddies is often transferred to large-scale kinetic energy. The viscous dissipation in the Laplacian viscosity closure is the strongest on various scales, followed by that in the Leith closure. Note that part of the small-scale kinetic energy is also transferred to large-scale kinetic energy in the Leith closure. 4) The characteristic length scale L and the dimensionless parameter D in the Leith closure are inherently coupled. The RPETCR is inversely proportional to the product of D and L. When the product of D and L is constant, both the simulated RPETCR and the inhibition of spurious dianeutral mixing are the same in all tests using the Leith

Reconceptualizing reflexivity and dissonance in professional and personal domains.

Science.gov (United States)

Brooks, Ann

2008-09-01

Debates around 'reflexivity' and the construction of the gendered self within late modernity have occupied the attention of both 'reflexive modernization' theorists (Beck, Giddens and Lash 1994; Beck and Beck-Gernsheim 1996; Giddens 1991, 1992) as well as gender and feminist theorists. While theorists such as Beck and Giddens have been preoccupied with establishing the connection between reflexivity and the construction of the 'non-gendered' self, gender and feminist theorists have sought to amplify the debate by exploring the intersecting nexus of contemporary theorizing, more fully within this context. This paper explores the theoretical underpinnings of these debates and their application to specific professional and personal domains. I consider three case studies to assess these issues as outlined in my own work, Brooks 2006, and in the work of Wajcman and Martin 2002, and McDowell 1997, which draw on empirical research and explore changes to gender identity within professional and personal domains. I conclude that there is little evidence in the research presented here of any systematic reconfiguring of gender identities leading to a detraditionalization of gender as suggested by the 'reflexive modernization' theorists.

Modulation of the masseteric reflex by gastric vagal afferents.

Science.gov (United States)

Pettorossi, V E

1983-04-01

Several investigations have shown that the vagal nerve can affect the reflex responses of the masticatory muscles acting at level either of trigeminal motoneurons or of the mesencephalic trigeminal nucleus (MTN). The present experiments have been devoted to establish the origin of the vagal afferent fibres involved in modulating the masseteric reflex. In particular, the gastric vagal afferents were taken into consideration and selective stimulations of such fibres were performed in rabbit. Conditioning electrical stimulation of truncus vagalis ventralis (TVV) reduced the excitability of the MTN cells as shown by a decrease of the antidromic response recorded from the semilunar ganglion and elicited by MTN single-shock electrical stimulation. Sympathetic and cardiovascular influences were not involved in these responses. Mechanical stimulation of gastric receptors, by means of gastric distension, clearly diminished the amplitude of twitch tension of masseteric reflex and inhibited the discharge frequency of proprioceptive MTN units. The effect was phasic and depended upon the velocity of distension. Thus the sensory volleys originating from rapid adapting receptors reach the brain stem through vagal afferents and by means of a polysynaptic connection inhibits the masseteric reflex at level of MTN cells.

Radical radiotherapy for early glottic cancer: Results in a series of 1087 patients from two Italian radiation oncology centers. I. The case of T1N0 disease

International Nuclear Information System (INIS)

Cellai, Enrico; Frata, Paolo; Magrini, Stefano M.; Paiar, Fabiola; Barca, Raffaella; Fondelli, Simona; Polli, Caterina; Livi, Lorenzo; Bonetti, Bartolomea; Vitali, Elisabetta; De Stefani, Agostina; Buglione, Michela; Biti, Gianpaolo

2005-01-01

Purpose: To retrospectively evaluate local control rates, late damage incidence, functional results, and second tumor occurrence according to the different patient, tumor, and treatment features in a large bi-institutional series of T1 glottic cancer. Methods and Materials: A total of 831 T1 glottic cancer cases treated consecutively with radical intent at the Florence University Radiation Oncology Department (FLO) and at the Radiation Oncology Department of University of Brescia-Istituto del Radio 'O. Alberti' (BS) were studied. Actuarial cumulative local control probability (LC), disease-specific (DSS), and overall survival (OS) rates have been calculated and compared in the different clinical and therapeutic subgroups with both univariate and multivariate analysis. Types of relapse and their surgical salvage have been evaluated, along with the functional results of treatment. Late damage incidence and second tumor cumulative probability (STP) have been also calculated. Results: In the entire series, 3-, 5-, and 10-year OS was equal to 86%, 77%, and 57%, respectively. Corresponding values for LC were 86%, 84%, and 83% and for DSS 96%, 95%, and 93%, taking into account surgical salvage of relapsed cases. Eighty-seven percent of the patients were cured with function preserved. Main determinants of a worse LC at univariate analysis were: male gender, earlier treatment period, larger tumor extent, anterior commissure involvement, and the use of Cobalt 60. At multivariate analysis, only gender, tumor extent, anterior commissure involvement, and beam type retained statistical significance. Higher total doses and larger field sizes are significantly related (logistic regression) with a higher late damage incidence. Scatterplot analysis of various combinations of field dimensions and total dose showed that field dimensions >35 and 2 , together with doses of >65 Gy, offer the best local control results together with an acceptably low late damage incidence. Twenty-year STP

Results of definitive radiotherapy in T1 and T2 glottic carcinoma: Institute of Rotary Cancer Hospital experience

International Nuclear Information System (INIS)

Mohanti, B.K.; Rath, G.K.; Tanwar, R.K.; Lal, P.; Biswal, B.M.; Tandon, D.A.; Bahadur, S.

1996-01-01

Early glottic carcinomas (T1 and T2) constitute only 2% of all laryngeal cancers in our data. Seventy patients were seen between 1985 and 1992. All patients were treated by cobalt-60 small field radiotherapy using a beam directed shell. The total dose delivered was 60-65Gy in 31 patients and 66-70Gy in 39 patients. The follow-up period ranged from 5 to 126 months, with a mean follow up of 37 months overall and 55 months in the surgical salvage group. Radiation therapy controlled disease in 71% (50 of 70) of patients overall; 75% with T1 and 67% with T2 lesions. Total laryngectomy as salvage surgery was performed in 70% (14 of 20) of patients whose disease recurred. Ultimate control including surgical salvage occurred in 64 (91 %) of 70 patients in the present study. The actuarial 5 year survival was 83 and 80% in T1 and T2 tumours, respectively (statistically insignificant). This report supports the policy of definitive irradiation, reserving surgical salvage for radiation failures in early laryngeal cancers. 17 refs., 2 tabs

T1/T2 glottic cancer managed by external beam radiotherapy - the influence of pretreatment hemoglobin on local control

International Nuclear Information System (INIS)

Warde, P.R.; O'Sullivan, B.; Panzarella, T.; Keane, T.J.; Gullane, P.; Payne, D.; Liu, F.-F.; McLean, M.; Waldron, J.; Cummings, B.

1996-01-01

Purpose: Pretreatment hemoglobin (Hb) level has been reported to be an important prognostic factor for local control and survival in various malignancies. However in many settings, the adverse effect of a low Hb may be related to more advanced disease and the purpose of this analysis was to assess the influence of pretreatment Hb on local control in a large series of patients with a localised cancer (T1/T2 glottic cancer, AJCC 1992) treated in a standard fashion. Materials and Methods: Between Jan 1981 and Dec 1989, 735 patients (median age 63, 657 males 78 females) with T1/T2 glottic cancer were treated with RT. The standard RT prescription was 50Gy in 20 fractions over 4 weeks (97% patients). Factors studied for prognostic importance for local failure included pretreatment Hb (assessed as a continuous variable) age, sex, T category, anterior commissure involvement, subglottic extension, tumour bulk (presence of visible tumour vs subclinical disease), treatment time and RT technique (Cobalt vs 6 MV). Results: With a median follow-up of 6.8 years (range 0.2 - 14.3), 131 patients have relapsed for an actuarial 5-year relapse free rate of 81.7%. The 5-year actuarial survival was 75.8%, cause specific survival - 92.4%. The median pretreatment hemoglobin level was 14.8 g/dl and was the same in all T categories. On multivariate analysis, using the Cox proportional hazards model, pretreatment Hb (p=0.001) predicted for local failure after RT. The relative risk (RR) for relapse was calculated for various Hb levels eg the RR for a Hb of 12 g/dl vs a Hb of 15 g/dl was 1.8, (95% C.I. 1.3 - 2.7). Previously noted factors including gender (p=0.0038), T category (p=0.007)) as well as tumour bulk (p=0.02) were also prognostically important for local control. Conclusions: This analysis, in a large number of similarly treated patients, indicates that pretreatment Hb is an independent prognostic factor for local control in patients with T1/T2 carcinoma of the glottis treated with

Phacoemulsification with intraocular lens implantation in primary angle-closure suspect, primary angle-closure and primary angle-closure glaucoma with cataract

Directory of Open Access Journals (Sweden)

Kun Zeng

2013-08-01

Full Text Available AIM: To evaluate the features and clinical outcomes of cataract extraction by phacoemulsification with intraocular lens implantation in primary angle-closure suspect(PACS, primary angle-closure(PACand primary angle-closure glaucoma(PACGwith cataract.METHODS:Phacoemulsification with intraocular lens implantation was performed on 86 cases(86 eyesdiagnosed as PACS, PAC and PACG co-existing cataract from January to December 2012. All cases were followed up for 3 months to 1 year. Pre-operative and post-operative visual acuity, intraocular pressure(IOP, gonioscopy, ultrasound biomicroscopy(UBM, visual field and usage of anti-glaucomaous eye drops were recorded.RESULTS:Zonular dialysis existed in 19 eyes(22%. The post-operative visual acuity improved in 84 eyes(98%. The post-operative visual acuity was CONCLUSION: PACS, PAC and PACG co-existing zonular dialysis is common. Phacoemulsification with IOL implantation can reduce IOP, deepen anterior chamber and open angle.

Adaptation to sensory-motor reflex perturbations is blind to the source of errors.

Science.gov (United States)

Hudson, Todd E; Landy, Michael S

2012-01-06

In the study of visual-motor control, perhaps the most familiar findings involve adaptation to externally imposed movement errors. Theories of visual-motor adaptation based on optimal information processing suppose that the nervous system identifies the sources of errors to effect the most efficient adaptive response. We report two experiments using a novel perturbation based on stimulating a visually induced reflex in the reaching arm. Unlike adaptation to an external force, our method induces a perturbing reflex within the motor system itself, i.e., perturbing forces are self-generated. This novel method allows a test of the theory that error source information is used to generate an optimal adaptive response. If the self-generated source of the visually induced reflex perturbation is identified, the optimal response will be via reflex gain control. If the source is not identified, a compensatory force should be generated to counteract the reflex. Gain control is the optimal response to reflex perturbation, both because energy cost and movement errors are minimized. Energy is conserved because neither reflex-induced nor compensatory forces are generated. Precision is maximized because endpoint variance is proportional to force production. We find evidence against source-identified adaptation in both experiments, suggesting that sensory-motor information processing is not always optimal.

Emotional Dissonance and Burnout: The Moderating Role of Team Reflexivity and Re-Evaluation.

Science.gov (United States)

Andela, Marie; Truchot, Didier

2017-08-01

The aim of the present study was to better understand the relationship between emotional dissonance and burnout by exploring the buffering effects of re-evaluation and team reflexivity. The study was conducted with a sample of 445 nurses and healthcare assistants from a general hospital. Team reflexivity was evaluated with the validation of the French version of the team reflexivity scale (Facchin, Tschan, Gurtner, Cohen, & Dupuis, 2006). Burnout was measured with the MBI General Survey (Schaufeli, Leiter, Maslach, & Jackson, 1996). Emotional dissonance and re-evaluation were measured with the scale developed by Andela, Truchot, & Borteyrou (2015). With reference to Rimé's theoretical model (2009), we suggested that both dimensions of team reflexivity (task and social reflexivity) respond to both psychological necessities induced by dissonance (cognitive clarification and socio-affective necessities). Firstly, results indicated that emotional dissonance was related to burnout. Secondly, regression analysis confirmed the buffering role of re-evaluation and social reflexivity on the emotional exhaustion of emotional dissonance. Overall, results contribute to the literature by highlighting the moderating effect of re-evaluation and team reflexivity in analysing the relationship between emotional dissonance and burnout. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

40 CFR 264.178 - Closure.

Science.gov (United States)

2010-07-01

... Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Use and Management of Containers § 264.178 Closure. At closure, all hazardous waste and hazardous waste residues must be removed...

Soleus muscle H-reflex monitoring in endoscopic surgery under general anesthesia percutaneous interlaminar approach.

Science.gov (United States)

Wang, Huixue; Gao, Yingji; Ji, Lixin; Bai, Wanshan

2018-05-01

The clinical value of soleus muscle H-reflex monitoring in general anesthesia percutaneous interlaminar approach was investigated. A total of 80 cases with unilateral L5-S1 disc herniation between January 2015 and October 2016 were randomly divided into control group (without soleus muscle H-reflex monitoring, n=40) and observation group (with soleus muscle H-reflex monitoring, n=40). Results showed that the operation time of the observation group was shorter than that of the control group (Ph after operation, the amplitude of H-reflex in diseased side soleus muscle was significantly lower than that in healthy side (Ph postoperatively, the latency of H-reflex in diseased side soleus muscle was shorter than that of healthy side (PH-reflex latency in soleus muscle were significantly lower (PH-reflex monitoring can effectively reduce the damage to the nerve roots under percutaneous endoscopic intervertebral endoscopic surgery under general anesthesia, improve the accuracy of surgery, reduce the complications, shorten the operation time and reduce the surgical bleeding, which is more beneficial to patients smooth recovery.

Closure report for N Reactor

International Nuclear Information System (INIS)

1994-01-01

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule

Closure report for N Reactor

Energy Technology Data Exchange (ETDEWEB)

1994-01-01

This report has been prepared to satisfy Section 3156(b) of Public Law 101-189 (Reports in Connection with Permanent Closures of Department of Energy Defense Nuclear Facilities), which requires submittal of a Closure Report to Congress by the Secretary of Energy upon the permanent cessation of production operations at a US Department of Energy (DOE) defense nuclear facility (Watkins 1991). This closure report provides: (1) A complete survey of the environmental problems at the facility; (2) Budget quality data indicating the cost of environmental restoration and other remediation and cleanup efforts at the facility; (3) A proposed cleanup schedule.

Inhibition of reflex vagal bradycardia by a central action of 5-hydroxytryptophan.

OpenAIRE

Tadepalli, A. S.

1980-01-01

1 Vagally mediated reflex bradycardia was elicited in spinal cats with intravenous pressor doses of noradrenaline. Administration of 5-hydroxytryptophan (1.5 and 3 mg total dose) into the fourth cerebral ventricle reduced the reflex bradycardia. 2 Inhibition of central amino acid decarboxylase with R044602 prevented the effects of 5-hydroxytryptophan. After intravenous administration of 5-hydroxytryptophan, vagal reflex bradycardia was not affected. 3 Results suggest that 5-hydroxytryptophan ...

Fundamental Principles underlying Motor Reflexes

NARCIS (Netherlands)

K. Zhou (Kuikui)

2017-01-01

markdownabstractThe cerebellum has been suggested to be involved in motor control ever since the early 19th century. The motor control ranges from timing and strength of simple reflexes to multiple joint/limb coordination and complex motor sequence acquisition. The current thesis discusses the

Acid-sensing ion channels contribute to the metaboreceptor component of the exercise pressor reflex

OpenAIRE

McCord, Jennifer L.; Tsuchimochi, Hirotsugu; Kaufman, Marc P.

2009-01-01

The exercise pressor reflex is evoked by both mechanical and metabolic stimuli arising in contracting skeletal muscle. Recently, the blockade of acid-sensing ion channels (ASICs) with amiloride and A-316567 attenuated the reflex. Moreover, amiloride had no effect on the mechanoreceptor component of the reflex, prompting us to determine whether ASICs contributed to the metaboreceptor component of the exercise pressor reflex. The metaboreceptor component can be assessed by measuring mean arteri...

Effects of brainstem lesions on the masseter inhibitory reflex. Functional mechanisms of reflex pathways

NARCIS (Netherlands)

Ongerboer de Visser, B. W.; Cruccu, G.; Manfredi, M.; Koelman, J. H.

1990-01-01

The masseter inhibitory reflex (MIR) was investigated in 16 patients with localized brainstem lesions involving the trigeminal system. The MIR consists of two phases of EMG silence (S1 and S2) evoked by stimulation of the mental nerve during maximal clenching of the teeth. The extent of the lesions

Femoral Artery Stenosis Following Percutaneous Closure Using a Starclose Closure Device

International Nuclear Information System (INIS)

Bent, Clare Louise; Kyriakides, Constantinos; Matson, Matthew

2008-01-01

Starclose (Abbott Vascular Devices, Redwood City, CA) is a new arterial closure device that seals a femoral puncture site with an extravascular star-shaped nitinol clip. The clip projects small tines into the arterial wall which fold inward, causing the arterial wall to pucker, producing a purse-string-like seal closing the puncture site. The case history is that of a 76-year-old female patient who underwent day-case percutaneous diagnostic coronary angiography. A Starclose femoral artery closure device was used to achieve hemostasis with subsequent femoral artery stenosis.

Hip proprioceptors preferentially modulate reflexes of the leg in human spinal cord injury

Science.gov (United States)

Onushko, Tanya; Hyngstrom, Allison

2013-01-01

Stretch-sensitive afferent feedback from hip muscles has been shown to trigger long-lasting, multijoint reflex responses in people with chronic spinal cord injury (SCI). These reflexes could have important implications for control of leg movements during functional activities, such as walking. Because the control of leg movement relies on reflex regulation at all joints of the limb, we sought to determine whether stretch of hip muscles modulates reflex activity at the knee and ankle and, conversely, whether knee and ankle stretch afferents affect hip-triggered reflexes. A custom-built servomotor apparatus was used to stretch the hip muscles in nine chronic SCI subjects by oscillating the legs about the hip joint bilaterally from 10° of extension to 40° flexion. To test whether stretch-related feedback from the knee or ankle would be affected by hip movement, patellar tendon percussions and Achilles tendon vibration were delivered when the hip was either extending or flexing. Surface electromyograms (EMGs) and joint torques were recorded from both legs. Patellar tendon percussions and Achilles tendon vibration both elicited reflex responses local to the knee or ankle, respectively, and did not influence reflex responses observed at the hip. Rather, the movement direction of the hip modulated the reflex responses local to the joint. The patellar tendon reflex amplitude was larger when the perturbation was delivered during hip extension compared with hip flexion. The response to Achilles vibration was modulated by hip movement, with an increased tonic component during hip flexion compared with extension. These results demonstrate that hip-mediated sensory signals modulate activity in distal muscles of the leg and appear to play a unique role in modulation of spastic muscle activity throughout the leg in SCI. PMID:23615544

Spasm of the near reflex: a spectrum of anomalies.

Science.gov (United States)

Goldstein, J H; Schneekloth, B B

1996-01-01

Spasm of the near reflex has been characterized as the variable appearance of pseudomyopia, convergent strabismus and miosis. These characteristics may appear together or separately. In addition, abnormalities of accommodation may appear not only as pseudomyopia, but may also be manifest in cases with significant hypermetropia in which the patient is unable to relax accommodation even when plus lenses are used. The intent of this review is to identify the various clinical presentations of anomalies of the entire near reflex as well as the component parts. The relationship to functional and organic disorders are discussed as well as the related neuroanatomy. We suggest that one may more readily understand the clinical manifestations as a spectrum of anomalies of the near reflex rather than a multitude of disconnected entities.

9 CFR 318.301 - Containers and closures.

Science.gov (United States)

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Containers and closures. 318.301... Canning and Canned Products § 318.301 Containers and closures. (a) Examination and cleaning of empty containers. (1) Empty containers, closures, and flexible pouch roll stock shall be evaluated by the...

75 FR 29322 - Base Closure and Realignment

Science.gov (United States)

2010-05-25

... DEPARTMENT OF DEFENSE Office of the Secretary Base Closure and Realignment AGENCY: Office of...)(ii) of the Defense Base Closure and Realignment Act of 1990. It provides a partial list of military installations closing or realigning pursuant to the 2005 Base Closure and Realignment (BRAC) Report. It also...

The Gateway Reflex, a Novel Neuro-Immune Interaction for the Regulation of Regional Vessels

Directory of Open Access Journals (Sweden)

Yuki Tanaka

2017-10-01

Full Text Available The gateway reflex is a new phenomenon that explains how immune cells bypass the blood–brain barrier to infiltrate the central nervous system (CNS and trigger neuroinflammation. To date, four examples of gateway reflexes have been discovered, each described by the stimulus that evokes the reflex. Gravity, electricity, pain, and stress have all been found to create gateways at specific regions of the CNS. The gateway reflex, the most recently discovered of the four, has also been shown to upset the homeostasis of organs in the periphery through its action on the CNS. These reflexes provide novel therapeutic targets for the control of local neuroinflammation and organ function. Each gateway reflex is activated by different neural activations and induces inflmammation at different regions in the CNS. Therefore, it is theoretically possible to manipulate each independently, providing a novel therapeutic strategy to control local neuroinflammation and peripheral organ homeostasis.

[Developing team reflexivity as a learning and working tool for medical teams].

Science.gov (United States)

Riskin, Arieh; Bamberger, Peter

2014-01-01

Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

A tapetal-like fundus reflex in a healthy male

DEFF Research Database (Denmark)

Schatz, Patrik; Bregnhøj, Jesper; Arvidsson, Henrik

2012-01-01

To report on the retinal function and structure in a 37-year-old male who presented with a tapetal-like reflex (TLR) indistinguishable from that seen in female carriers of X-linked retinitis pigmentosa (XLRP).......To report on the retinal function and structure in a 37-year-old male who presented with a tapetal-like reflex (TLR) indistinguishable from that seen in female carriers of X-linked retinitis pigmentosa (XLRP)....

Closure Welding of Plutonium Bearing Storage Containers

International Nuclear Information System (INIS)

Cannell, G.R.

2002-01-01

A key element in the Department of Energy (DOE) strategy for the stabilization, packaging and storage of plutonium-bearing materials involves closure welding of DOE-STD-3013 Outer Containers (3013 container). The 3013 container provides the primary barrier and pressure boundary preventing release of plutonium-bearing materials to the environment. The final closure (closure weld) of the 3013 container must be leaktight, structurally sound and meet DOE STD 3013 specified criteria. This paper focuses on the development, qualification and demonstration of the welding process for the closure welding of Hanford PFP 3013 outer containers

Automated data reduction workflows for astronomy. The ESO Reflex environment

Science.gov (United States)

Freudling, W.; Romaniello, M.; Bramich, D. M.; Ballester, P.; Forchi, V.; García-Dabló, C. E.; Moehler, S.; Neeser, M. J.

2013-11-01

Context. Data from complex modern astronomical instruments often consist of a large number of different science and calibration files, and their reduction requires a variety of software tools. The execution chain of the tools represents a complex workflow that needs to be tuned and supervised, often by individual researchers that are not necessarily experts for any specific instrument. Aims: The efficiency of data reduction can be improved by using automatic workflows to organise data and execute a sequence of data reduction steps. To realize such efficiency gains, we designed a system that allows intuitive representation, execution and modification of the data reduction workflow, and has facilities for inspection and interaction with the data. Methods: The European Southern Observatory (ESO) has developed Reflex, an environment to automate data reduction workflows. Reflex is implemented as a package of customized components for the Kepler workflow engine. Kepler provides the graphical user interface to create an executable flowchart-like representation of the data reduction process. Key features of Reflex are a rule-based data organiser, infrastructure to re-use results, thorough book-keeping, data progeny tracking, interactive user interfaces, and a novel concept to exploit information created during data organisation for the workflow execution. Results: Automated workflows can greatly increase the efficiency of astronomical data reduction. In Reflex, workflows can be run non-interactively as a first step. Subsequent optimization can then be carried out while transparently re-using all unchanged intermediate products. We found that such workflows enable the reduction of complex data by non-expert users and minimizes mistakes due to book-keeping errors. Conclusions: Reflex includes novel concepts to increase the efficiency of astronomical data processing. While Reflex is a specific implementation of astronomical scientific workflows within the Kepler workflow

Quality of life following endoscopic resection or radio-therapy for early glottic cancer

International Nuclear Information System (INIS)

Bahannan, Abdulrahman A.; Zabrodsky, M.; Chovanec, M.; Cerny, L.; Lohynska, R.

2007-01-01

To compare post treatment quality of life (QoL) of patients treated by radiotherapy or endoscopic transoral endolaryngeal surgery using two quality of life scoring tools. From May 1998 to July 2005, 48 patients (11 women and 37 men) with early glottic cancer were treated with curative radiotherapy (18 patients) or laser cordectomy (30 patients), and retrospectively evaluated using QoL questionnaires; European Organization for Research and Treatment of Cancer (EORTC) - EORTC-QoL Core Questionnaire (QLQ-C30 version 2.0) and organ specific EORTC - QLQ, Head and Neck Module (QLQ-H and N35) at the University Hospital Motol, Czech Republic. Mean follow-up was 24 months. Only patients in complete remission were enrolled in the study. The overall score calculated separately for both questionnaires was not statistically different between both groups. Statistically significant differences were found only in specific group of questions focusing on saliva production (p=0.034) and sexuality performance (p=0.002). The majority of cases treated with cordectomy were Tis lesions. In the radiotherapy group, T1 lesions predominated (p=0.0001). Patients treated with radiotherapy were significantly older than those treated with cordectomy (p=0.027), which could explain the worsened score in sexuality questions. There were no significant differences found between genders allocated either to cordectomy or radiotherapy group. The overall QoL did not differ between patients treated with cordectomy or radiotherapy, despite the fact that patients treated with radiotherapy had more advanced disease and were older. There was significantly worse saliva and sexuality question score in the radiotherapy group. (author)

Fuel channel closure and adapter

International Nuclear Information System (INIS)

Cashen, W.S.

1985-01-01

This invention provides a mechanical closure/actuating ram combination particularly suited for use in sealing the ends of the pressure tubes when a CANDU-type reactor is refueled. It provides a cluster that may be inserted into a fuel channel end fitting to provide at least partial closing off of a pressure tube while permitting the disengagement of the fueling machine and its withdrawal from the closure for other purposes. The invention also provides a ram/closure combination wherein the application of loading force to a deformable sealing disk is regulated by a massive load bar component forming part of the fueling machine and being therefore accessible for maintenance or replacement

Monosynaptic Stretch Reflex Fails to Explain the Initial Postural Response to Sudden Lateral Perturbations

Directory of Open Access Journals (Sweden)

Andreas Mühlbeier

2017-06-01

Full Text Available Postural reflexes are essential for locomotion and postural stability, and may play an important role in the etiology of chronic back pain. It has recently been theoretically predicted, and with the help of unilateral perturbations of the trunk experimentally confirmed that the sensorimotor control must lower the reflex amplitude for increasing reflex delays to maintain spinal stability. The underlying neuromuscular mechanism for the compensation of postural perturbations, however, is not yet fully understood. In this study, we applied unilateral and bilateral sudden external perturbations to the trunk of healthy subjects and measured the muscular activity and the movement onset of the trunk. We found that the onset of the trunk muscle activity is prior to, or coincident with, the onset of the trunk movement. Additionally, the results of our experiments imply that the muscular response mechanism integrates distant sensory information from both sides of the body. These findings rule out a simple monosynaptic stretch reflex in favor of a more complex polysynaptic postural reflex mechanism to compensate postural perturbations. Moreover, the previously predicted negative correlation between reflex delay and reflex gain was also confirmed for bilateral perturbations.

Restaurant closures

CERN Document Server

Novae Restauration

2012-01-01

Christmas Restaurant closures Please note that the Restaurant 1 and Restaurant 3 will be closed from Friday, 21 December at 5 p.m. to Sunday, 6 January, inclusive. They will reopen on Monday, 7 January 2013.   Restaurant 2 closure for renovation To meet greater demand and to modernize its infrastructure, Restaurant 2 will be closed from Monday, 17 December. On Monday, 14 January 2013, Sophie Vuetaz’s team will welcome you to a renovated self-service area on the 1st floor. The selections on the ground floor will also be expanded to include pasta and pizza, as well as snacks to eat in or take away. To ensure a continuity of service, we suggest you take your break at Restaurant 1 or Restaurant 3 (Prévessin).

Soleus stretch reflex during cycling

DEFF Research Database (Denmark)

Grey, Michael James; Pierce, C. W.; Milner, T. E.

2001-01-01

The modulation and strength of the human soleus short latency stretch reflex was investigated by mechanically perturbing the ankle during an unconstrained pedaling task. Eight subjects pedaled at 60 rpm against a preload of 10 Nm. A torque pulse was applied to the crank at various positions durin...

Anterior Segment Imaging Predicts Incident Gonioscopic Angle Closure.

Science.gov (United States)

Baskaran, Mani; Iyer, Jayant V; Narayanaswamy, Arun K; He, Yingke; Sakata, Lisandro M; Wu, Renyi; Liu, Dianna; Nongpiur, Monisha E; Friedman, David S; Aung, Tin

2015-12-01

To investigate the incidence of gonioscopic angle closure after 4 years in subjects with gonioscopically open angles but varying degrees of angle closure detected on anterior segment optical coherence tomography (AS OCT; Visante; Carl Zeiss Meditec, Dublin, CA) at baseline. Prospective, observational study. Three hundred forty-two subjects, mostly Chinese, 50 years of age or older, were recruited, of whom 65 were controls with open angles on gonioscopy and AS OCT at baseline, and 277 were cases with baseline open angles on gonioscopy but closed angles (1-4 quadrants) on AS OCT scans. All subjects underwent gonioscopy and AS OCT at baseline (horizontal and vertical single scans) and after 4 years. The examiner performing gonioscopy was masked to the baseline and AS OCT data. Angle closure in a quadrant was defined as nonvisibility of the posterior trabecular meshwork by gonioscopy and visible iridotrabecular contact beyond the scleral spur in AS OCT scans. Gonioscopic angle closure in 2 or 3 quadrants after 4 years. There were no statistically significant differences in age, ethnicity, or gender between cases and controls. None of the control subjects demonstrated gonioscopic angle closure after 4 years. Forty-eight of the 277 subjects (17.3%; 95% confidence interval [CI], 12.8-23; P < 0.0001) with at least 1 quadrant of angle closure on AS OCT at baseline demonstrated gonioscopic angle closure in 2 or more quadrants, whereas 28 subjects (10.1%; 95% CI, 6.7-14.6; P < 0.004) demonstrated gonioscopic angle closure in 3 or more quadrants after 4 years. Individuals with more quadrants of angle closure on baseline AS OCT scans had a greater likelihood of gonioscopic angle closure developing after 4 years (P < 0.0001, chi-square test for trend for both definitions of angle closure). Anterior segment OCT imaging at baseline predicts incident gonioscopic angle closure after 4 years among subjects who have gonioscopically open angles and iridotrabecular contact on AS OCT at

Low Incidence Of Extensor Plantar Reflex In Newborns In An ...

African Journals Online (AJOL)

Healthy term newborns with Apgar score of 8 and above at one minute were recruited into the study consecutively in a maternity hospital in Ibadan, Nigeria. The plantar reflex was elicited by stroking the lateral side of the sole with firm pressure, between 24 - 48 hours after delivery. Results Of 461 newborns, the plantar reflex ...

Randomized clinical trial of intestinal ostomy takedown comparing pursestring wound closure vs conventional closure to eliminate the risk of wound infection.

Science.gov (United States)

Camacho-Mauries, Daniel; Rodriguez-Díaz, José Luis; Salgado-Nesme, Noel; González, Quintín H; Vergara-Fernández, Omar

2013-02-01

The use of temporary stomas has been demonstrated to reduce septic complications, especially in high-risk anastomosis; therefore, it is necessary to reduce the number of complications secondary to ostomy takedowns, namely wound infection, anastomotic leaks, and intestinal obstruction. To compare the rates of superficial wound infection and patient satisfaction after pursestring closure of ostomy wound vs conventional linear closure. Patients undergoing colostomy or ileostomy closure between January 2010 and February 2011 were randomly assigned to linear closure (n = 30) or pursestring closure (n = 31) of their ostomy wound. Wound infection within 30 days of surgery was defined as the presence of purulent discharge, pain, erythema, warmth, or positive culture for bacteria. Patient satisfaction, healing time, difficulty managing the wound, and limitation of activities were analyzed with the Likert questionnaire. The infection rate for the control group was 36.6% (n = 11) vs 0% in the pursestring closure group (p ostomy wound closure (shorter healing time and improved patient satisfaction).

Patent ductus arteriosus closure using an Amplatzer(™) ventricular septal defect closure device.

Science.gov (United States)

Fernando, Rajeev; Koranne, Ketan; Loyalka, Pranav; Kar, Biswajit; Gregoric, Igor

2013-01-01

The ductus arteriosus originates from the persistence of the distal portion of the left sixth aortic arch. It connects the descending aorta (immediately distal to the left subclavian artery) to the roof of the main pulmonary artery, near the origin of the left pulmonary artery. Persistence of the duct beyond 48 h after birth is abnormal and results in patent ductus arteriosus (PDA). PDA is rare in adults because it is usually discovered and treated in childhood. Mechanical closure remains the definitive therapy because the patency of ductus arteriosus may lead to multiple complications, depending on the size and flow through the ductus. PDA closure is indicated in patients with symptoms and evidence of left heart enlargement, and in patients with elevated pulmonary pressures when reversal is possible. Transcatheter closure is the preferred technique in adults because it avoids sternotomy, reduces the length of hospital stay and is associated with fewer complications compared with surgery. First demonstrated in 1967, both the technique and the occluder devices used have since evolved. However, designing an ideal PDA occluder has been a challenge due to the variability in size, shape and orientation of PDAs. The present article describes a case involving a 35-year-old woman who presented to the Center for Advanced Heart Failure (Houston, USA) with congestive heart failure due to a large PDA, which was successfully occluded using an Amplatzer (St Jude Medical, USA) muscular ventricular septal defect closure device. The wider waist and dual-retention discs of these ventricular septal defect closure devices may be important factors to consider in the future development of devices for the occlusion of large PDAs.

Temporary Closure of the Open Abdomen: A Systematic Review on Delayed Primary Fascial Closure in Patients with an Open Abdomen

NARCIS (Netherlands)

Boele van Hensbroek, Pieter; Wind, Jan; Dijkgraaf, Marcel G. W.; Busch, Olivier R. C.; Goslings, J. Carel

2009-01-01

Background This study was designed to systematically review the literature to assess which temporary abdominal closure (TAC) technique is associated with the highest delayed primary fascial closure (FC) rate. In some cases of abdominal trauma or infection, edema or packing precludes fascial closure

Special closures for steel drum shipping containers

International Nuclear Information System (INIS)

Bonzon, L.L.; Otts, J.V.

1976-01-01

The objective of this program was to develop special lid closures for typical, steel drum, radioactive material shipping containers. Previous experience and testing had shown that the existing container was adequate to withstand the required environmental tests for certification, but that the lid and closure were just marginally effective. Specifically, the lid closure failed to consistently maintain a tight seal between the container and the lid after drop tests, thus causing the package contents to be vulnerable in the subsequent fire test. Recognizing the deficiency, the United States Energy Research and Development Administration requested the development of new closure(s) which would: (1) be as strong and resistant to a drop as the bottom of the container; (2) have minimal economic impact on the overall container cost; (3) maximize the use of existing container designs; (4) consider crush loads; and (5) result in less dependence on personnel and loading procedures. Several techniques were evaluated and found to be more effective than the standard closure mechanism. Of these, three new closure techniques were designed, fabricated, and proven to be structurally adequate to provide containment when a 454-kg drum was drop tested from 9.14-m onto an unyielding surface. The three designs were: (1) a 152-mm long lid extension or skirt welded to the standard drum lid, (2) a separate inner lid, with 152-mm long skirt and (3) C-clamps used at the container-lid interface. Based upon structural integrity, economic impact, and minimal design change, the lid extension is the recommended special closure

Functionality of the contralateral biceps femoris reflex response during human walking

DEFF Research Database (Denmark)

Stevenson, Andrew James Thomas; Geertsen, Svend Sparre; Sinkjaer, Thomas

2014-01-01

of the body in order to maintain dynamic equilibrium during walking. Therefore, we hypothesized that if we suddenly slowed the treadmill participants were walking on, the cBF reflex would be inhibited because the necessity to break the forward progression of the body would be decreased. Conversely, if we...... the treadmill velocity was altered concurrently or 50 ms after knee perturbation onset. These results, together with the finding that the cBF reflex response is under some cortical control [1], strongly suggest a functional role for the cBF reflex during walking that is adaptable to the environmental situation....

Contribution of the maculo-ocular reflex to gaze stability in the rabbit.

Science.gov (United States)

Pettorossi, V E; Errico, P; Santarelli, R M

1991-01-01

The contribution of the maculo-ocular reflex to gaze stability was studied in 10 pigmented rabbits by rolling the animals at various angles of sagittal inclination of the rotation and/or longitudinal animal axes. At low frequencies (0.005-0.01 Hz) of sinusoidal stimulation the vestibulo-ocular reflex (VOR) was due to macular activation, while at intermediate and high frequencies it was mainly due to ampullar activation. The following results were obtained: 1) maculo-ocular reflex gain decreased as a function of the cosine of the angle between the rotation axis and the earth's horizontal plane. No change in gain was observed when longitudinal animal axis alone was inclined. 2) At 0 degrees of rotation axis and with the animal's longitudinal axis inclination also set at 0 degrees, the maculo-ocular reflex was oriented about 20 degrees forward and upward with respect to the earth's vertical axis. This orientation remained constant with sagittal inclinations of the rotation and/or longitudinal animal axes ranging from approximately 5 degrees upward to 30 degrees downward. When the longitudinal animal axis was inclined beyond these limits, the eye trajectory tended to follow the axis inclination. In the upside down position, the maculo-ocular reflex was anticompensatory, oblique and fixed with respect to orbital coordinates. 3) Ampullo-ocular reflex gain did not change with inclinations of the rotation and/or longitudinal animal axes. The ocular responses were consistently oriented to the stimulus plane. At intermediate frequencies the eye movement trajectory was elliptic because of directional differences between the ampullo- and maculo-ocular reflexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Some Recent Developments in Turbulence Closure Modeling

Science.gov (United States)

Durbin, Paul A.

2018-01-01

Turbulence closure models are central to a good deal of applied computational fluid dynamical analysis. Closure modeling endures as a productive area of research. This review covers recent developments in elliptic relaxation and elliptic blending models, unified rotation and curvature corrections, transition prediction, hybrid simulation, and data-driven methods. The focus is on closure models in which transport equations are solved for scalar variables, such as the turbulent kinetic energy, a timescale, or a measure of anisotropy. Algebraic constitutive representations are reviewed for their role in relating scalar closures to the Reynolds stress tensor. Seamless and nonzonal methods, which invoke a single closure model, are reviewed, especially detached eddy simulation (DES) and adaptive DES. Other topics surveyed include data-driven modeling and intermittency and laminar fluctuation models for transition prediction. The review concludes with an outlook.

VizieR Online Data Catalog: RefleX : X-ray-tracing code (Paltani+, 2017)

Science.gov (United States)

Paltani, S.; Ricci, C.

2017-11-01

We provide here the RefleX executable, for both Linux and MacOSX, together with the User Manual and example script file and output file Running (for instance): reflex_linux will produce the file reflex.out Note that the results may differ slightly depending on the OS, because of slight differences in some implementations numerical computations. The difference are scientifically meaningless. (5 data files).

Motricidade reflexa na morte cerebral The reflex activity in the brain death

Directory of Open Access Journals (Sweden)

Wilson L. Sanvito

1972-03-01

Full Text Available O diagnóstico de morte cerebral está baseado em critérios clínicos, eletrencefalográficos e angiográficos. Do ponto de vista clínico deve ser evidenciado o seguinte quadro: coma profundo, midríase paralítica bilateral, ausência de reação a qualquer estímulo externo, apnéia, arreflexia superficial e profunda. Do ponto de vista eletrencefalográfico são necessários dois registros, separados por um intervalo de 24 horas, evidenciando traçados iselétricos. No presente trabalho são estudados 15 pacientes com morte cerebral comprovada do ponto de vista clínico e eletrencefalográfico. Em 8 pacientes havia persistência de atividade reflexa durante a fase de morte cerebral (reflexos profundos e/ou superficiais. Fenômenos de automatismos medulares também foram verificados em 3 pacientes.The diagnosis of brain death is based in clinical, electroencephalographic and angiographic data. The criteria for diagnosis of brain death are: deep coma with unreceptivity and unresponsiveness, no movements or breathing (the patient's respiration must be maintained artificially, bilateral dilated and fixed pupils, absence of corneal reflexes, no response to caloric test, absence of deep tendon reflexes and of the superficial abdominal and plantar reflexes, isoelectric EEG maintained for twenty-four hours. The purpose of this study was to observe the natural clinical courses of 15 patients with brain death, specially the data concerning the deep and superficial reflexes. From 15 patients fulfilling the criteria of brain death, 8 maintained spinal reflexes up to the time of cardiac arrest; in five of these patients the superficial abdominal reflexes were present and the reflexes of spinal automatism could be elicited. These results show that the absence of deep and superficial reflexes can't be considered as essencial for the diagnosis of brain death.

Analysis of Mining-induced Valley Closure Movements

Science.gov (United States)

Zhang, C.; Mitra, R.; Oh, J.; Hebblewhite, B.

2016-05-01

Valley closure movements have been observed for decades in Australia and overseas when underground mining occurred beneath or in close proximity to valleys and other forms of irregular topographies. Valley closure is defined as the inward movements of the valley sides towards the valley centreline. Due to the complexity of the local geology and the interplay between several geological, topographical and mining factors, the underlying mechanisms that actually cause this behaviour are not completely understood. A comprehensive programme of numerical modelling investigations has been carried out to further evaluate and quantify the influence of a number of these mining and geological factors and their inter-relationships. The factors investigated in this paper include longwall positional factors, horizontal stress, panel width, depth of cover and geological structures around the valley. It is found that mining in a series passing beneath the valley dramatically increases valley closure, and mining parallel to valley induces much more closure than other mining orientations. The redistribution of horizontal stress and influence of mining activity have also been recognised as important factors promoting valley closure, and the effect of geological structure around the valley is found to be relatively small. This paper provides further insight into both the valley closure mechanisms and how these mechanisms should be considered in valley closure prediction models.

A task dependent change in the medium latency component of the soleus stretch reflex

DEFF Research Database (Denmark)

Grey, Michael James; Larsen, Birgit; Sinkjær, Thomas

2002-01-01

In comparison to the H-reflex, the task dependency of the human stretch reflex during locomotive and postural tasks has not received a great deal of attention in the literature. The few studies on reflex task dependency that have been performed to date have concentrated on either the group Ia...

Biomechanics Strategies for Space Closure in Deep Overbite

Directory of Open Access Journals (Sweden)

Harryanto Wijaya

2013-07-01

Full Text Available Space closure is an interesting aspect of orthodontic treatment related to principles of biomechanics. It should be tailored individually based on patient’s diagnosis and treatment plan. Understanding the space closure biomechanics basis leads to achieve the desired treatment objective. Overbite deepening and losing posterior anchorage are the two most common unwanted side effects in space closure. Conventionally, correction of overbite must be done before space closure resulted in longer treatment. Application of proper space closure biomechanics strategies is necessary to achieve the desired treatment outcome. This cases report aimed to show the space closure biomechanics strategies that effectively control the overbite as well as posterior anchorage in deep overbite patients without increasing treatment time. Two patients who presented with class II division 1 malocclusion were treated with fixed orthodontic appliance. The primary strategies included extraction space closure on segmented arch that employed two-step space closure, namely single canine retraction simultaneously with incisors intrusion followed by enmasse retraction of four incisors by using differential moment concept. These strategies successfully closed the space, corrected deep overbite and controlled posterior anchorage simultaneously so that the treatment time was shortened. Biomechanics strategies that utilized were effective to achieve the desired treatment outcome.

Erecting Closets and Outing Ourselves: Uncomfortable Reflexivity and Community-Based Research

Science.gov (United States)

Reed, Sarah J.; Miller, Robin Lin; Nnawulezi, Nkiru; Valenti, Maria T.

2012-01-01

Feminist scholars and community psychologists have argued that reflexivity is a necessary component to conducting socially conscious research. Reflexivity, however, is rarely evident in community psychology. In this article, we share the uncomfortable realities that surfaced during a community-based research project in which we adapted and…

Magnetisable container closure and means for its removal

International Nuclear Information System (INIS)

Barrett, W.I.

1984-01-01

A container has a closed lower end and an open upper end, is made of a non-magnetic material such as aluminium, and has a peripheral groove spaced from the open end. A disc-like closure is of magnetic material such as ferritic steel, has a pair of spring jaws joined to the disc by a joining member such that when the disc of the closure is in position closing the open end of the container, the jaws engage in groove and hold the closure in position. To remove the closure, it is engaged by magnetic means mounted for example on a wall and having a step such that when the container is moved laterally away the closure is retained by the magnetic means aided by the step and thereby the closure becomes removed from the container. (author)

Urethrovaginal fistula closure.

Science.gov (United States)

Clifton, Marisa M; Goldman, Howard B

2017-01-01

In the developed world, urethrovaginal fistulas are most the likely the result of iatrogenic injury. These fistulas are quite rare. Proper surgical repair requires careful dissection and tension-free closure. The objective of this video is to demonstrate the identification and surgical correction of an urethrovaginal fistula. The case presented is of a 59-year-old woman with a history of pelvic organ prolapse and symptomatic stress urinary incontinence who underwent vaginal hysterectomy, anterior colporrhaphy, posterior colporrhaphy, and synthetic sling placement. Postoperatively, she developed a mesh extrusion and underwent sling excision. After removal of her synthetic sling, she began to experience continuous urinary incontinence. Physical examination and cystourethroscopy demonstrated an urethrovaginal fistula at the midurethra. Options were discussed and the patient wished to undergo transvaginal fistula repair. The urethrovaginal fistula was intubated with a Foley catheter. The fistula tract was isolated and removed. The urethra was then closed with multiple tension-free layers. This video demonstrates several techniques for identifying and subsequently repairing an urethrovaginal fistula. Additionally, it demonstrates the importance of tension-free closure. Urethrovaginal fistulas are rare. They should be repaired with careful dissection and tension-free closure.

Muscle and reflex changes with varying joint angle in hemiparetic stroke

Directory of Open Access Journals (Sweden)

Alibiglou Laila

2008-02-01

Full Text Available Abstract Background Despite intensive investigation, the origins of the neuromuscular abnormalities associated with spasticity are not well understood. In particular, the mechanical properties induced by stretch reflex activity have been especially difficult to study because of a lack of accurate tools separating reflex torque from torque generated by musculo-tendinous structures. The present study addresses this deficit by characterizing the contribution of neural and muscular components to the abnormally high stiffness of the spastic joint. Methods Using system identification techniques, we characterized the neuromuscular abnormalities associated with spasticity of ankle muscles in chronic hemiparetic stroke survivors. In particular, we systematically tracked changes in muscle mechanical properties and in stretch reflex activity during changes in ankle joint angle. Modulation of mechanical properties was assessed by applying perturbations at different initial angles, over the entire range of motion (ROM. Experiments were performed on both paretic and non-paretic sides of stroke survivors, and in healthy controls. Results Both reflex and intrinsic muscle stiffnesses were significantly greater in the spastic/paretic ankle than on the non-paretic side, and these changes were strongly position dependent. The major reflex contributions were observed over the central portion of the angular range, while the intrinsic contributions were most pronounced with the ankle in the dorsiflexed position. Conclusion In spastic ankle muscles, the abnormalities in intrinsic and reflex components of joint torque varied systematically with changing position over the full angular range of motion, indicating that clinical perceptions of increased tone may have quite different origins depending upon the angle where the tests are initiated. Furthermore, reflex stiffness was considerably larger in the non-paretic limb of stroke patients than in healthy control subjects

A critical reflexive Perspective on othering in collaborative knowledge production

DEFF Research Database (Denmark)

Jakobsen, Helle Nordentoft; Olesen, Birgitte Ravn

2018-01-01

Purpose The purpose of the article is to show power mechanisms of in- and exclusion in moments where certain participants appeared to be othered in two collaborative research and development projects in a health care setting. Design/methodology/approach The article contributes to critical......-reflexive analyses of reflexive processes within collaborative knowledge production We use an analytical framework combining Bakhtin and Foucault to investigate processes of inclusion and exclusion in the interplay between dominant and subordinated voices in a moment-by-moment analysis of two incidents from...... interdisciplinary workshops. Findings The analysis illuminates how differences between voices challenge participants’ reflexive awareness and lead to the reproduction of contextual power and knowledge hierarchies and the concomitant silencing of particular participants. Thus, the findings draw attention...

The Reflexive Principle of Sociological Theorization

Directory of Open Access Journals (Sweden)

R T Ubaidullayeva

2013-12-01

Full Text Available The article attempts to describe the reflexive principle in theory-making, which integrates the basic modern methodological paradigms and lays the foundation for the development of sociology. On the basis of the theoretical ideas of P. Bourdieu, A. Giddens and P. Ricoeur the author defines the concept of social reflexion and reveals its peculiarities in sociology as compared to reflexion in philosophy. According to the author, the fulfillment of reflexive functions in sociology is connected with the task of analyzing the complex structure of the polysemantic object, considering the specific quality of the subjects and their various trends of development. The presence of the poles — objectivity-subjectivity, rationality-irrationality, consciousness-unconsciousness etc, requires a reproduction of the dichotomies engendering them in social life and development of cognitive methods for their study in sociology.

Grounded theory research: literature reviewing and reflexivity.

Science.gov (United States)

McGhee, Gerry; Marland, Glenn R; Atkinson, Jacqueline

2007-11-01

This paper is a report of a discussion of the arguments surrounding the role of the initial literature review in grounded theory. Researchers new to grounded theory may find themselves confused about the literature review, something we ourselves experienced, pointing to the need for clarity about use of the literature in grounded theory to help guide others about to embark on similar research journeys. The arguments for and against the use of a substantial topic-related initial literature review in a grounded theory study are discussed, giving examples from our own studies. The use of theoretically sampled literature and the necessity for reflexivity are also discussed. Reflexivity is viewed as the explicit quest to limit researcher effects on the data by awareness of self, something seen as integral both to the process of data collection and the constant comparison method essential to grounded theory. A researcher who is close to the field may already be theoretically sensitized and familiar with the literature on the study topic. Use of literature or any other preknowledge should not prevent a grounded theory arising from the inductive-deductive interplay which is at the heart of this method. Reflexivity is needed to prevent prior knowledge distorting the researcher's perceptions of the data.

Collaborative Research in Contexts of Inequality: The Role of Social Reflexivity

Science.gov (United States)

Leibowitz, Brenda; Bozalek, Vivienne; Farmer, Jean; Garraway, James; Herman, Nicoline; Jawitz, Jeff; McMillan, Wendy; Mistri, Gita; Ndebele, Clever; Nkonki, Vuyisile; Quinn, Lynn; van Schalkwyk, Susan; Vorster, Jo-Anne; Winberg, Chris

2017-01-01

This article reports on the role and value of social reflexivity in collaborative research in contexts of extreme inequality. Social reflexivity mediates the enablements and constraints generated by the internal and external contextual conditions impinging on the research collaboration. It fosters the ability of participants in a collaborative…

Closure of shallow underground injection wells

International Nuclear Information System (INIS)

Veil, J.A.; Grunewald, B.

1993-01-01

Shallow injection wells have long been used for disposing liquid wastes. Some of these wells have received hazardous or radioactive wastes. According to US Environmental Protection Agency (EPA) regulations, Class IV wells are those injection wells through which hazardous or radioactive wastes are injected into or above an underground source of drinking water (USDW). These wells must be closed. Generally Class V wells are injection wells through which fluids that do not contain hazardous or radioactive wastes are injected into or above a USDW. Class V wells that are responsible for violations of drinking water regulations or that pose a threat to human health must also be closed. Although EPA regulations require closure of certain types of shallow injection wells, they do not provide specific details on the closure process. This paper describes the regulatory background, DOE requirements, and the steps in a shallow injection well closure process: Identification of wells needing closure; monitoring and disposal of accumulated substances; filling and sealing of wells; and remediation. In addition, the paper describes a major national EPA shallow injection well enforcement initiative, including closure plan guidance for wells used to dispose of wastes from service station operations

Single Vocal Cord Irradiation: Image Guided Intensity Modulated Hypofractionated Radiation Therapy for T1a Glottic Cancer: Early Clinical Results

Energy Technology Data Exchange (ETDEWEB)

Al-Mamgani, Abrahim, E-mail: a.almamgani@nki.nl [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Kwa, Stefan L.S.; Tans, Lisa; Moring, Michael; Fransen, Dennie; Mehilal, Robert; Verduijn, Gerda M. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands); Baatenburg de Jong, Rob J. [Department of Otolaryngology and Head and Neck Surgery – Erasmus MC, University Medical Center Rotterdam, Rotterdam (Netherlands); Heijmen, Ben J.M.; Levendag, Peter C. [Department of Radiation Oncology – Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam (Netherlands)

2015-10-01

Purpose: To report, from a retrospective analysis of prospectively collected data, on the feasibility, outcome, toxicity, and voice-handicap index (VHI) of patients with T1a glottic cancer treated by a novel intensity modulated radiation therapy technique developed at our institution to treat only the involved vocal cord: single vocal cord irradiation (SVCI). Methods and Materials: Thirty patients with T1a glottic cancer were treated by means of SVCI. Dose prescription was set to 16 × 3.63 Gy (total dose 58.08 Gy). The clinical target volume was the entire vocal cord. Setup verification was done by means of an online correction protocol using cone beam computed tomography. Data for voice quality assessment were collected prospectively at baseline, end of treatment, and 4, 6, and 12 weeks and 6, 12, and 18 months after treatment using VHI questionnaires. Results: After a median follow-up of 30 months (range, 7-50 months), the 2-year local control and overall survival rates were 100% and 90% because no single local recurrence was reported and 3 patients died because of comorbidity. All patients have completed the intended treatment schedule; no treatment interruptions and no grade 3 acute toxicity were reported. Grade 2 acute dermatitis or dysphagia was reported in only 5 patients (17%). No serious late toxicity was reported; only 1 patient developed temporary grade 2 laryngeal edema, and responded to a short-course of corticosteroid. The VHI improved significantly, from 33.5 at baseline to 9.5 and 10 at 6 weeks and 18 months, respectively (P<.001). The control group, treated to the whole larynx, had comparable local control rates (92.2% vs 100%, P=.24) but more acute toxicity (66% vs 17%, P<.0001) and higher VHI scores (23.8 and 16.7 at 6 weeks and 18 months, respectively, P<.0001). Conclusion: Single vocal cord irradiation is feasible and resulted in maximal local control rate at 2 years. The deterioration in VHI scores was slight and temporary and

Reliability assessment of underground shaft closure

International Nuclear Information System (INIS)

Fossum, A.F.; Munson, D.E.

1994-01-01

The intent of the WIPP, being constructed in the bedded geologic salt deposits of Southeastern New Mexico, is to provide the technological basis for the safe disposal of radioactive Transuranic (TRU) wastes generated by the defense programs of the United States. In determining this technological basis, advanced reliability and structural analysis techniques are used to determine the probability of time-to-closure of a hypothetical underground shaft located in an argillaceous salt formation and filled with compacted crushed salt. Before being filled with crushed salt for sealing, the shaft provides access to an underground facility. Reliable closure of the shaft depends upon the sealing of the shaft through creep closure and recompaction of crushed backfill. Appropriate methods are demonstrated to calculate cumulative distribution functions of the closure based on laboratory determined random variable uncertainty in salt creep properties

Effect of joint mobilization on the H Reflex amplitude in people with spasticity

OpenAIRE

Pérez Parra, Julio Ernesto; Henao Lema, Claudia Patricia

2011-01-01

Objective: To determine the effect of ankle joint mobilization on the H reflex amplitude of thesoleus muscle in people with spasticity. Materials and methods: A quasi-experimental study withcrossover design and simple masking was conducted in 24 randomized subjects to initiate thecontrol or experimental group. Traction and rhythmic oscillation were applied for five minutesto the ankle joint. H wave amplitude changes of Hoffmann reflex (electrical equivalent of themonosynaptic spinal reflex) w...

Turtle Flexion Reflex Motor Patterns Show Windup, Mediated Partly by L-type Calcium Channels

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Keith P. Johnson

2017-10-01

Full Text Available Windup is a form of multisecond temporal summation in which identical stimuli, delivered seconds apart, trigger increasingly strong neuronal responses. L-type Ca2+ channels have been shown to play an important role in the production of windup of spinal cord neuronal responses, initially in studies of turtle spinal cord and later in studies of mammalian spinal cord. L-type Ca2+ channels have also been shown to contribute to windup of limb withdrawal reflex (flexion reflex in rats, but flexion reflex windup has not previously been described in turtles and its cellular mechanisms have not been studied. We studied windup of flexion reflex motor patterns, evoked with weak mechanical and electrical stimulation of the dorsal hindlimb foot skin and assessed via a hip flexor (HF nerve recording, in spinal cord-transected and immobilized turtles in vivo. We found that an L-type Ca2+ channel antagonist, nifedipine, applied at concentrations of 50 μM or 100 μM to the hindlimb enlargement spinal cord, significantly reduced windup of flexion reflex motor patterns, while lower concentrations of nifedipine had no such effect. Nifedipine similarly reduced the amplitude of an individual flexion reflex motor pattern evoked by a stronger mechanical stimulus, in a dose-dependent manner, suggesting that L-type Ca2+ channels contribute to each flexion reflex as well as to multisecond summation of flexion reflex responses in turtles. We also found that we could elicit flexion reflex windup consistently using a 4-g von Frey filament, which is not usually considered a nociceptive stimulus. Thus, it may be that windup can be evoked by a wide range of tactile stimuli and that L-type calcium channels contribute to multisecond temporal summation of diverse tactile stimuli across vertebrates.

Fixed Pupillary Light Reflex due to Peripheral Neuropathy after Liver Transplantation

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Kwan Hyung Kim

2015-08-01

Full Text Available A 46-year-old female patient was admitted to the intensive care unit (ICU after liver transplantation. About an hour later after the ICU admission, she had no pupillary light reflex. Both pupils were also fixed at 5 mm. Patients who undergo liver transplantation are susceptible to neurologic disorders including hepatic encephalopathy, thromboembolism and intracranial hemorrhage. Abnormal pupillary light reflex usually indicates a serious neurologic emergency in these patients; however, benign neurologic disorders such as peripheral autonomic neuropathy or Holmes-Adie syndrome should also be considered. We experienced a case of fixed pupillary light reflex after liver transplantation diagnosed as peripheral autonomic neuropathy.

Intralimb and Interlimb Cutaneous Reflexes during Locomotion in the Intact Cat.

Science.gov (United States)

Hurteau, Marie-France; Thibaudier, Yann; Dambreville, Charline; Danner, Simon M; Rybak, Ilya A; Frigon, Alain

2018-04-25

When the foot contacts an obstacle during locomotion, cutaneous inputs activate spinal circuits to ensure dynamic balance and forward progression. In quadrupeds, this requires coordinated reflex responses between the four limbs. Here, we investigated the patterns and phasic modulation of cutaneous reflexes in forelimb and hindlimb muscles evoked by inputs from all four limbs. Five female cats were implanted to record muscle activity and to stimulate the superficial peroneal and superficial radial nerves during locomotion. Stimulating these nerves evoked short-, mid-, and longer-latency excitatory and/or inhibitory responses in all four limbs that were phase-dependent. The largest responses were generally observed during the peak activity of the muscle. Cutaneous reflexes during mid-swing were consistent with flexion of the homonymous limb and accompanied by modification of the stance phases of the other three limbs, by coactivating flexors and extensors and/or by delaying push-off. Cutaneous reflexes during mid-stance were consistent with stabilizing the homonymous limb by delaying and then facilitating its push-off and modifying the support phases of the homolateral and diagonal limbs, characterized by coactivating flexors and extensors, reinforcing extensor activity and/or delaying push-off. The shortest latencies of homolateral and diagonal responses were consistent with fast-conducting disynaptic or trisynaptic pathways. Descending homolateral and diagonal pathways from the forelimbs to the hindlimbs had a higher probability of eliciting responses compared with ascending pathways from the hindlimbs to the forelimbs. Thus, in quadrupeds, intralimb and interlimb reflexes activated by cutaneous inputs ensure dynamic coordination of the four limbs, producing a whole-body response. SIGNIFICANCE STATEMENT The skin contains receptors that, when activated, send inputs to spinal circuits, signaling a perturbation. Rapid responses, or reflexes, in muscles of the

Comparison of cost-effectiveness and postoperative outcome of device closure and open surgery closure techniques for treatment of patent ductus arteriosus

Directory of Open Access Journals (Sweden)

Alireza Ahmadi

2014-01-01

Full Text Available BACKGROUND: Various devices have been recently employed for percutaneous closure of the patent ductus arteriosus (PDA. Although the high effectiveness of device closure techniques has been clearly determined, a few studies have focused on the cost-effectiveness and also postoperative complications of these procedures in comparison with open surgery. The present study aimed to evaluate the clinical outcome and cost-effectiveness of PDA occlusion by Amplatzer and coil device in comparisong with open surgery. METHODS: In this cross-sectional study, a randomized sample of 201 patients aged 1 month to 16 years (105 patients with device closure and 96 patients with surgical closure was selected. The ratio of total pulmonary blood flow to total systemic blood flow, the Qp/Qs ratio, was measured using a pulmonary artery catheter. The cost analysis included direct medical care costs associated with device implantation and open surgery, as well as professional fees. All costs were calculated in Iranian Rials and then converted to US dollars. RESULTS: There was no statistical difference in mean Qp/Qs ratio before the procedure between the device closure group and the open surgery group (2.1 ± 0.7 versus 1.7 ± 0.6, P = 0.090. The mean measured costs were overall higher in the device closure group than in open closure group (948.87 ± 548.76 US$ versus 743.70 ± 696.91 US$, P < 0.001. This difference remained significant after adjustment for age and gender (Standardized Beta = 0.160, P = 0.031. PDA closure with the Amplatzer ductal occluder (1053.05 ± 525.73 US$ or with Nit-Occlud coils (PFM (912.73 ± 565.94 US$, P < 0.001 was more expensive than that via open surgery. However, the Cook detachable spring coils device closure (605.65 ± 194.62 US$, P = 0.650 had a non-significant cost difference with open surgery. No event was observed in the device closure group regarding in-hospital mortality or morbidity; however, in another group, 2 in-hospital deaths

Effect of straining on diaphragmatic crura with identification of the straining-crural reflex. The "reflex theory" in gastroesophageal competence

Directory of Open Access Journals (Sweden)

El Sibai Olfat

2004-09-01

Full Text Available Abstract Background The role of the crural diaphragm during increased intra-abdominal pressure is not exactly known. We investigated the hypothesis that the crural diaphragm undergoes reflex phasic contraction on elevation of the intra-abdominal pressure with a resulting increase of the lower esophageal pressure and prevention of gastro-esophageal reflux. Methods The esophageal pressure and crural diaphragm electromyographic responses to straining were recorded in 16 subjects (10 men, 6 women, age 36.6 ± 11.2 SD years during abdominal hernia repair. The electromyogram of crural diaphragm was recorded by needle electrode inserted into the crural diaphragm, and the lower esophageal pressure by a saline-perfused catheter. The study was repeated after crural anesthetization and after crural infiltration with saline. Results The crural diaphragm exhibited resting electromyographic activity which showed a significant increase on sudden (coughing, p Conclusions Straining effected an increase of the electromyographic activity of the crural diaphragm and of the lower esophageal pressure. This effect is suggested to be reflex in nature and to be mediated through the "straining-crural reflex". The crural diaphragm seems to play a role in the lower esophageal competence mechanism. Further studies are required to assess the clinical significance of the current results in gastro-esophageal reflux disease and hiatus hernia.

Numerical approximation of the Boltzmann equation : moment closure

NARCIS (Netherlands)

Abdel Malik, M.R.A.; Brummelen, van E.H.

2012-01-01

This work applies the moment method onto a generic form of kinetic equations to simplify kinetic models of particle systems. This leads to the moment closure problem which is addressed using entropy-based moment closure techniques utilizing entropy minimization. The resulting moment closure system

WASTE PACKAGE OPERATIONS FY99 CLOSURE METHODS REPORT

Energy Technology Data Exchange (ETDEWEB)

M. C. Knapp

1999-09-23

The waste package (WP) closure weld development task is part of a larger engineering development program to develop waste package designs. The purpose of the larger waste package engineering development program is to develop nuclear waste package fabrication and closure methods that the Nuclear Regulatory Commission will find acceptable and will license for disposal of spent nuclear fuel (SNF), non-fuel components, and vitrified high-level waste within a Monitored Geologic Repository (MGR). Within the WP closure development program are several major development tasks, which, in turn, are divided into subtasks. The major tasks include: WP fabrication development, WP closure weld development, nondestructive examination (NDE) development, and remote in-service inspection development. The purpose of this report is to present the objectives, technical information, and work scope relating to the WP closure weld development.and NDE tasks and subtasks and to report results of the closure weld and NDE development programs for fiscal year 1999 (FY-99). The objective of the FY-99 WP closure weld development task was to develop requirements for closure weld surface and volumetric NDE performance demonstrations, investigate alternative NDE inspection techniques, and develop specifications for welding, NDE, and handling system integration. In addition, objectives included fabricating several flat plate mock-ups that could be used for NDE development, stress relief peening, corrosion testing, and residual stress testing.

WASTE PACKAGE OPERATIONS FY-99 CLOSURE METHODS REPORT

International Nuclear Information System (INIS)

M. C. Knapp

1999-01-01

The waste package (WP) closure weld development task is part of a larger engineering development program to develop waste package designs. The purpose of the larger waste package engineering development program is to develop nuclear waste package fabrication and closure methods that the Nuclear Regulatory Commission will find acceptable and will license for disposal of spent nuclear fuel (SNF), non-fuel components, and vitrified high-level waste within a Monitored Geologic Repository (MGR). Within the WP closure development program are several major development tasks, which, in turn, are divided into subtasks. The major tasks include: WP fabrication development, WP closure weld development, nondestructive examination (NDE) development, and remote in-service inspection development. The purpose of this report is to present the objectives, technical information, and work scope relating to the WP closure weld development.and NDE tasks and subtasks and to report results of the closure weld and NDE development programs for fiscal year 1999 (FY-99). The objective of the FY-99 WP closure weld development task was to develop requirements for closure weld surface and volumetric NDE performance demonstrations, investigate alternative NDE inspection techniques, and develop specifications for welding, NDE, and handling system integration. In addition, objectives included fabricating several flat plate mock-ups that could be used for NDE development, stress relief peening, corrosion testing, and residual stress testing

T-tube vs Primary Common Bile Duct Closure

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M R Joshi

2010-09-01

Full Text Available INTRODUCTION: Closure of the common bile duct over T-tube after exploration is a widely practiced traditional method. However, its use may give rise to many complications. We do primary closure of common bile duct after exploration. Aim of the study is to see the efficacy and safety of the primary closure. METHODS: Study was carried out to compare the results of both the techniques from 2006 to 2009 in the cases proven to have common bile duct stone with or without the features of obstructive jaundice. Post operative hospital stay and morbidities related to both the groups were recorded and analyzed. RESULTS: There were total 71 cases included in the study. Thirty one in T-tube group and 40 in primary closure group. T-tube was removed in most of the cases after three weeks where as average time of drain removal in primary closure group is 5.79 +/-1.79 days. Incidence of retained stone was equal in each group. Major complication in T-tube group is biliary peritonitis in four patients at the time of T-tube removal whereas none of the patient from primary closure group suffered from such major complication. CONCLUSIONS: Primary closure after the common bile duct exploration is safe and it helps to avoid the morbidities related to T-tube. Keywords: Choledocholithiasis, Primary closure, retained stone, T-tube, Ureterorenoscope.

Restoring walking after spinal cord injury: operant conditioning of spinal reflexes can help.

Science.gov (United States)

Thompson, Aiko K; Wolpaw, Jonathan R

2015-04-01

People with incomplete spinal cord injury (SCI) frequently suffer motor disabilities due to spasticity and poor muscle control, even after conventional therapy. Abnormal spinal reflex activity often contributes to these problems. Operant conditioning of spinal reflexes, which can target plasticity to specific reflex pathways, can enhance recovery. In rats in which a right lateral column lesion had weakened right stance and produced an asymmetrical gait, up-conditioning of the right soleus H-reflex, which increased muscle spindle afferent excitation of soleus, strengthened right stance and eliminated the asymmetry. In people with hyperreflexia due to incomplete SCI, down-conditioning of the soleus H-reflex improved walking speed and symmetry. Furthermore, modulation of electromyographic activity during walking improved bilaterally, indicating that a protocol that targets plasticity to a specific pathway can trigger widespread plasticity that improves recovery far beyond that attributable to the change in the targeted pathway. These improvements were apparent to people in their daily lives. They reported walking faster and farther, and noted less spasticity and better balance. Operant conditioning protocols could be developed to modify other spinal reflexes or corticospinal connections; and could be combined with other therapies to enhance recovery in people with SCI or other neuromuscular disorders. © The Author(s) 2014.

Techniques for Abdominal Wall Closure after Damage Control Laparotomy: From Temporary Abdominal Closure to Early/Delayed Fascial Closure—A Review

Directory of Open Access Journals (Sweden)

Qian Huang

2016-01-01

Full Text Available Open abdomen (OA has been an effective treatment for abdominal catastrophes in traumatic and general surgery. However, management of patients with OA remains a formidable task for surgeons. The central goal of OA is closure of fascial defect as early as is clinically feasible without precipitating abdominal compartment syndrome. Historically, techniques such as packing, mesh, and vacuum-assisted closure have been developed to assist temporary abdominal closure, and techniques such as components separation, mesh-mediated traction, bridging fascial defect with permanent synthetic mesh, or biologic mesh have also been attempted to achieve early primary fascial closure, either alone or in combined use. The objective of this review is to present the challenges of these techniques for OA with a goal of early primary fascial closure, when the patient’s physiological condition allows.

The legacy of care as reflexive learning.

Science.gov (United States)

García, Marta Rodríguez; Moya, Jose Luis Medina

2016-06-14

to analyze whether the tutor's use of reflexive strategies encourages the students to reflect. The goal is to discover what type of strategies can help to achieve this and how tutors and students behave in the practical context. a qualitative and ethnographic focus was adopted. Twenty-seven students and 15 tutors from three health centers participated. The latter had received specific training on reflexive clinical tutoring. The analysis was developed through constant comparisons of the categories. the results demonstrate that the tutors' use of reflexive strategies such as didactic questioning, didactic empathy and pedagogical silence contributes to encourage the students' reflection and significant learning. reflexive practice is key to tutors' training and students' learning. analisar se o uso de estratégias reflexivas por parte da tutora de estágio clínico estimula a reflexão nos estudantes. A intenção é descobrir qual tipo de estratégias podem ajudar a fazê-lo e como as tutoras e os estudantes se comportam no contexto prático. foi adotado um enfoque qualitativo de cunho etnográfico em que participaram 27 estudantes e 15 tutores de três centros de saúde que haviam recebido formação específica sobre tutoria clínica reflexiva. A análise foi realizada por meio de comparações constantes das categorias. os resultados demonstram que o uso de estratégias reflexivas como a interrogação didática, a empatia didática e o silêncio pedagógico por parte das tutoras, contribui para fomentar a reflexão do estudante e sua aprendizagem significativa. a prática reflexiva é a chave para a formação dos tutores e para a aprendizagem dos estudantes. analizar si el uso de estrategias reflexivas por parte de la tutora de prácticas clínicas fomenta la reflexión en los estudiantes. Se trata de conocer qué tipo de estrategias pueden ayudar a hacerlo y cómo se comportan tutoras y estudiantes en el contexto práctico. se ha utilizado un enfoque

Uncertainty Quantification of Multi-Phase Closures

Energy Technology Data Exchange (ETDEWEB)

Nadiga, Balasubramanya T. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Baglietto, Emilio [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States)

2017-10-27

In the ensemble-averaged dispersed phase formulation used for CFD of multiphase ows in nuclear reactor thermohydraulics, closures of interphase transfer of mass, momentum, and energy constitute, by far, the biggest source of error and uncertainty. Reliable estimators of this source of error and uncertainty are currently non-existent. Here, we report on how modern Validation and Uncertainty Quanti cation (VUQ) techniques can be leveraged to not only quantify such errors and uncertainties, but also to uncover (unintended) interactions between closures of di erent phenomena. As such this approach serves as a valuable aide in the research and development of multiphase closures. The joint modeling of lift, drag, wall lubrication, and turbulent dispersion|forces that lead to tranfer of momentum between the liquid and gas phases|is examined in the frame- work of validation of the adiabatic but turbulent experiments of Liu and Banko , 1993. An extensive calibration study is undertaken with a popular combination of closure relations and the popular k-ϵ turbulence model in a Bayesian framework. When a wide range of super cial liquid and gas velocities and void fractions is considered, it is found that this set of closures can be validated against the experimental data only by allowing large variations in the coe cients associated with the closures. We argue that such an extent of variation is a measure of uncertainty induced by the chosen set of closures. We also nd that while mean uid velocity and void fraction pro les are properly t, uctuating uid velocity may or may not be properly t. This aspect needs to be investigated further. The popular set of closures considered contains ad-hoc components and are undesirable from a predictive modeling point of view. Consequently, we next consider improvements that are being developed by the MIT group under CASL and which remove the ad-hoc elements. We use non-intrusive methodologies for sensitivity analysis and calibration (using

Factors affecting closure of a temporary stoma.

Science.gov (United States)

Taylor, Claire; Varma, Sarah

2012-01-01

The purpose of the study was to examine time to reversal of a temporary ostomy, reasons for delayed closure, and patient satisfaction with the scheduling of their closure and related hospital care. Cross-sectional, descriptive study. The target population comprised patients who underwent creation of a temporary ostomy and reversal surgery within one National Health System Hospital Trust in the United Kingdom. The population served by this Trust are ethnically and socioeconomically diverse, predominantly living in urban areas around Greater London. Sixty-one persons who met inclusion criteria were identified. A two-step analytical process was undertaken. First, a literature review examining incidence and causes of delayed stoma closure was undertaken. Second, a postal survey of all patients who had had their stoma closed in 2009 was conducted. Respondents were allowed 2 weeks to complete and return the questionnaire. The survey instrument was developed locally and subjected to content validation using ostomy patients, surgical and nursing colleagues. It consisted of 9 questions querying time from original surgery to closure, reasons for delaying closure surgery beyond 12 weeks, and satisfaction with care. Twenty-seven patients returned their questionnaires, indicating they consented to participate; a response rate of 44%. Half of the respondents (n = 14 [52%]) underwent closure surgery within 6 months of stoma formation; the remaining 48% waited more than 6 months (median: 6.5 months, range: 1.5-26 months). Thirteen patients (48%) reported a delay in receiving their stoma closure; the main reason cited was the need for a course of adjuvant postoperative chemotherapy. Three quarters of respondents (22 [74%]) were satisfied with the overall care they received. Findings from this study suggest that stoma closure may be associated with fewest complications if performed before 12 weeks.

Propranolol, but not naloxone, enhances spinal reflex bladder activity and reduces pudendal inhibition in cats.

Science.gov (United States)

Rogers, Marc J; Xiao, Zhiying; Shen, Bing; Wang, Jicheng; Schwen, Zeyad; Roppolo, James R; de Groat, William C; Tai, Changfeng

2015-01-01

This study examined the role of β-adrenergic and opioid receptors in spinal reflex bladder activity and in the inhibition induced by pudendal nerve stimulation (PNS) or tibial nerve stimulation (TNS). Spinal reflex bladder contractions were induced by intravesical infusion of 0.25% acetic acid in α-chloralose-anesthetized cats after an acute spinal cord transection (SCT) at the thoracic T9/T10 level. PNS or TNS at 5 Hz was applied to inhibit these spinal reflex contractions at 2 and 4 times the threshold intensity (T) for inducing anal or toe twitch, respectively. During a cystrometrogram (CMG), PNS at 2T and 4T significantly (P reflex bladder contractions. After administering propranolol (3 mg/kg iv, a β₁/β₂-adrenergic receptor antagonist), the effects of 2T and 4T PNS on bladder capacity were significantly (P reflex bladder contractions or PNS inhibition. At the end of experiments, hexamethonium (10 mg/kg iv, a ganglionic blocker) significantly (P reflex bladder contractions. This study indicates an important role of β₁/β₂-adrenergic receptors in pudendal inhibition and spinal reflex bladder activity. Copyright © 2015 the American Physiological Society.

The medial olivocochlear reflex in children during active listening.

Science.gov (United States)

Smith, Spencer B; Cone, Barbara

2015-08-01

To determine if active listening modulates the strength of the medial olivocochlear (MOC) reflex in children. Click-evoked otoacoustic emissions (CEOAEs) were recorded from the right ear in quiet and in four test conditions: one with contralateral broadband noise (BBN) only, and three with active listening tasks wherein attention was directed to speech embedded in contralateral BBN. Fifteen typically-developing children (ranging in age from 8 to14 years) with normal hearing. CEOAE levels were reduced in every condition with contralateral acoustic stimulus (CAS) when compared to preceding quiet conditions. There was an additional systematic decrease in CEOAE level with increased listening task difficulty, although this effect was very small. These CEOAE level differences were most apparent in the 8-18 ms region after click onset. Active listening may change the strength of the MOC reflex in children, although the effects reported here are very subtle. Further studies are needed to verify that task difficulty modulates the activity of the MOC reflex in children.

Single Canonical Model of Reflexive Memory and Spatial Attention

Science.gov (United States)

Patel, Saumil S.; Red, Stuart; Lin, Eric; Sereno, Anne B.

2015-01-01

Many neurons in the dorsal and ventral visual stream have the property that after a brief visual stimulus presentation in their receptive field, the spiking activity in these neurons persists above their baseline levels for several seconds. This maintained activity is not always correlated with the monkey’s task and its origin is unknown. We have previously proposed a simple neural network model, based on shape selective neurons in monkey lateral intraparietal cortex, which predicts the valence and time course of reflexive (bottom-up) spatial attention. In the same simple model, we demonstrate here that passive maintained activity or short-term memory of specific visual events can result without need for an external or top-down modulatory signal. Mutual inhibition and neuronal adaptation play distinct roles in reflexive attention and memory. This modest 4-cell model provides the first simple and unified physiologically plausible mechanism of reflexive spatial attention and passive short-term memory processes. PMID:26493949

Single Canonical Model of Reflexive Memory and Spatial Attention.

Science.gov (United States)

Patel, Saumil S; Red, Stuart; Lin, Eric; Sereno, Anne B

2015-10-23

Many neurons in the dorsal and ventral visual stream have the property that after a brief visual stimulus presentation in their receptive field, the spiking activity in these neurons persists above their baseline levels for several seconds. This maintained activity is not always correlated with the monkey's task and its origin is unknown. We have previously proposed a simple neural network model, based on shape selective neurons in monkey lateral intraparietal cortex, which predicts the valence and time course of reflexive (bottom-up) spatial attention. In the same simple model, we demonstrate here that passive maintained activity or short-term memory of specific visual events can result without need for an external or top-down modulatory signal. Mutual inhibition and neuronal adaptation play distinct roles in reflexive attention and memory. This modest 4-cell model provides the first simple and unified physiologically plausible mechanism of reflexive spatial attention and passive short-term memory processes.

A reflexive perspective in problem solving

OpenAIRE

Chio, José Angel; Álvarez, Aida; López, Margarita

2013-01-01

The objective of this paper is to favour the methodological process of reflexive analysis in problem solving in the general teaching methods that concentrates in strengthening the dimensional analysis, to gain a greater preparation of the students for the solution of mathematical problems.

CIRSE Vascular Closure Device Registry

International Nuclear Information System (INIS)

Reekers, Jim A.; Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2011-01-01

Purpose: Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods: The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results: Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion: The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters.

Human investigations into the exercise pressor reflex

DEFF Research Database (Denmark)

Secher, Niels H; Amann, Markus

2012-01-01

During exercise, neural input from skeletal muscles reflexly maintains or elevates blood pressure (BP) despite a maybe fivefold increase in vascular conductance. This exercise pressor reflex is illustrated by similar heart rate (HR) and BP responses to electrically induced and voluntary exercise....... The importance of the exercise pressor reflex for tight cardiovascular regulation during dynamic exercise is supported by studies using pharmacological blockade of lower limb muscle afferent nerves. These experiments show attenuation of the increase in BP and cardiac output when exercise is performed...... with attenuated neural feedback. Additionally, there is no BP response to electrically induced exercise with paralysing epidural anaesthesia or when similar exercise is evoked in paraplegic patients. Furthermore, BP decreases when electrically induced exercise is carried out in tetraplegic patients. The lack...

40 CFR 267.143 - Financial assurance for closure.

Science.gov (United States)

2010-07-01

...), utilizing the certificate of insurance for closure specified at 40 CFR 264.151(e). (f) Corporate financial... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Financial assurance for closure. 267... PERMIT Financial Requirements § 267.143 Financial assurance for closure. The owner or operator must...

Tubular closure mechanism

International Nuclear Information System (INIS)

Kalen, D.D.; Mitchem, J.W.

1982-01-01

This invention relates to a closure mechanism for tubular irradiation surveillance specimen assembly holder used in nuclear reactors. The closure mechanism is composed of a latching member which includes a generally circular chamber with a plurality of elongated latches depending therefrom. The latching member circumscribes part of an actuator member which is disposed within the latching member so as to be axially movable. The axial movement of the actuator actuates positioning of the latches between positions in which the latches are locked and secured within the actuator member. Means, capable of being remotely manipulated, are provided to move the actuator in order to position the latches and load the articles within the tube

Design and analysis of PCRV core cavity closure

International Nuclear Information System (INIS)

Lee, T.T.; Schwartz, A.A.; Koopman, D.C.A.

1980-05-01

Design requirements and considerations for a core cavity closure which led to the choice of a concrete closure with a toggle hold-down as the design for the Gas-Cooled Fast Breeder Reactor (GCFR) plant are discussed. A procedure for preliminary stress analysis of the closure by means of a three-dimensional finite element method is described. A limited parametric study using this procedure indicates the adequacy of the present closure design and the significance of radial compression developed as a result of inclined support reaction

40 CFR 265.280 - Closure and post-closure.

Science.gov (United States)

2010-07-01

... contaminants caused by wind erosion; and (4) Compliance with § 265.276 concerning the growth of food-chain... and post-closure care objectives of paragraph (a) of this section: (1) Type and amount of hazardous..., including amount, frequency, and pH of precipitation; (5) Geological and soil profiles and surface and...

Airport Movement Area Closure Planner, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — This SBIR research develops an automation tool improving temporary and permanent runway closure management. The Movement Area Closure Planner (MACP) provides airport...

Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats

Science.gov (United States)

Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

2009-01-01

In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and γ-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABAA receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABAA receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin–NTS, lingual muscle–NTS and lingual muscle–Pa5–NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures. PMID:19124539

Involvement of ERK phosphorylation in brainstem neurons in modulation of swallowing reflex in rats.

Science.gov (United States)

Tsujimura, Takanori; Kondo, Masahiro; Kitagawa, Junichi; Tsuboi, Yoshiyuki; Saito, Kimiko; Tohara, Haruka; Ueda, Koichiro; Sessle, Barry J; Iwata, Koichi

2009-02-15

In order to evaluate the neuronal mechanisms underlying functional abnormalities of swallowing in orofacial pain patients, this study investigated the effects of noxious orofacial stimulation on the swallowing reflex, phosphorylated extracellular signal-regulated kinase (pERK) and gamma-aminobutyric acid (GABA) immunohistochemical features in brainstem neurons, and also analysed the effects of brainstem lesioning and of microinjection of GABA receptor agonist or antagonist into the nucleus tractus solitarii (NTS) on the swallowing reflex in anaesthetized rats. The swallowing reflex elicited by topical administration of distilled water to the pharyngolaryngeal region was inhibited after capsaicin injection into the facial (whisker pad) skin or lingual muscle. The capsaicin-induced inhibitory effect on the swallowing reflex was itself depressed after the intrathecal administration of MAPK kinase (MEK) inhibitor. No change in the capsaicin-induced inhibitory effect was observed after trigeminal spinal subnucleus caudalis lesioning, but the inhibitory effect was diminished by paratrigeminal nucleus (Pa5) lesioning. Many pERK-like immunoreactive neurons in the NTS showed GABA immunoreactivity. The local microinjection of the GABA(A) receptor agonist muscimol into the NTS produced a significant reduction in swallowing reflex, and the capsaicin-induced depression of the swallowing reflex was abolished by microinjection of the GABA(A) receptor antagonist bicuculline into the NTS. The present findings suggest that facial skin-NTS, lingual muscle-NTS and lingual muscle-Pa5-NTS pathways are involved in the modulation of swallowing reflex by facial and lingual pain, respectively, and that the activation of GABAergic NTS neurons is involved in the inhibition of the swallowing reflex following noxious stimulation of facial and intraoral structures.

Primary reflex persistence in children with reading difficulties (dyslexia): a cross-sectional study.

Science.gov (United States)

McPhillips, Martin; Jordan-Black, Julie-Anne

2007-03-02

The primary reflex system emerges during fetal life and is inhibited during the first year after birth. Our aim was to examine the effects of persistence of this early neurological system on the attainment of core literacy skills in dyslexic and non-dyslexic poor readers. We assessed the prevalence of a persistent primary reflex in a cross-sectional, representative sample of children (n=739) aged 7-9 years old attending mainstream primary school in Northern Ireland using standardised educational tests, and a clinical diagnostic test for a primary reflex (the asymmetrical tonic neck reflex (ATNR)). Multiple regression analyses, involving all of the sample children, revealed that persistence of the ATNR was significantly predictive of attainments in reading (t=-8.34, pschooling, the attainment of core educational skills may be affected by the persistence of a brainstem mediated reflex system that should have been inhibited in the first year after birth. Furthermore, these findings suggest that dyslexia is not a distinct category of poor reading, and that it may be more valid to term all poor readers as dyslexic irrespective of IQ.

Left ventricular remodeling and change of systolic function after closure of patent ductus arteriosus in adults: device and surgical closure.

Science.gov (United States)

Jeong, Young-Hoon; Yun, Tae-Jin; Song, Jong-Min; Park, Jung-Jun; Seo, Dong-Man; Koh, Jae-Kon; Lee, Se-Whan; Kim, Mi-Jeong; Kang, Duk-Hyun; Song, Jae-Kwan

2007-09-01

Left ventricular (LV) remodeling and predictors of LV systolic function late after closure of patent ductus arteriosus (PDA) in adults remain to be clearly demonstrated. In 45 patients with PDA, including 28 patients who received successful occlusion using the Amplatzer device (AD group) (AGA, Golden Valley, MN) and 17 patients who received surgical closure (OP group), echocardiography studies were performed before closure and 1 day (AD group) or within 7 days (OP group) after closure, and then were repeated at > or = 6 months (17 +/- 13 months). In both groups, LV ejection fraction (EF) and end-diastolic volume index were significantly decreased immediately after closure, whereas end-systolic volume index did not change. During the long-term follow-up period, end-systolic as well as end-diastolic volume indices decreased significantly in both groups and LV EF recovered compared to the immediate postclosure state. However, LV EF remained low compared to the preclosure state. Five patients (11.1%) including 3 patients in the AD group and 2 patients in the OP group showed persistent late LV systolic dysfunction (EF or = 62% had a sensitivity of 72% and a specificity of 83% for predicting late normal LV EF after closure. Left ventricular EF remains low late after PDA closure compared with preclosure state in adults. Preclosure LV EF is the best index to predict late postclosure LV EF.

Single-site neural tube closure in human embryos revisited.

Science.gov (United States)

de Bakker, Bernadette S; Driessen, Stan; Boukens, Bastiaan J D; van den Hoff, Maurice J B; Oostra, Roelof-Jan

2017-10-01

Since the multi-site closure theory was first proposed in 1991 as explanation for the preferential localizations of neural tube defects, the closure of the neural tube has been debated. Although the multi-site closure theory is much cited in clinical literature, single-site closure is most apparent in literature concerning embryology. Inspired by Victor Hamburgers (1900-2001) statement that "our real teacher has been and still is the embryo, who is, incidentally, the only teacher who is always right", we decided to critically review both theories of neural tube closure. To verify the theories of closure, we studied serial histological sections of 10 mouse embryos between 8.5 and 9.5 days of gestation and 18 human embryos of the Carnegie collection between Carnegie stage 9 (19-21 days) and 13 (28-32 days). Neural tube closure was histologically defined by the neuroepithelial remodeling of the two adjoining neural fold tips in the midline. We did not observe multiple fusion sites in neither mouse nor human embryos. A meta-analysis of case reports on neural tube defects showed that defects can occur at any level of the neural axis. Our data indicate that the human neural tube fuses at a single site and, therefore, we propose to reinstate the single-site closure theory for neural tube closure. We showed that neural tube defects are not restricted to a specific location, thereby refuting the reasoning underlying the multi-site closure theory. Clin. Anat. 30:988-999, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Moment Closure for the Stochastic Logistic Model

National Research Council Canada - National Science Library

Singh, Abhyudai; Hespanha, Joao P

2006-01-01

..., which we refer to as the moment closure function. In this paper, a systematic procedure for constructing moment closure functions of arbitrary order is presented for the stochastic logistic model...

Cortical tremor: a variant of cortical reflex myoclonus.

Science.gov (United States)

Ikeda, A; Kakigi, R; Funai, N; Neshige, R; Kuroda, Y; Shibasaki, H

1990-10-01

Two patients with action tremor that was thought to originate in the cerebral cortex showed fine shivering-like finger twitching provoked mainly by action and posture. Surface EMG showed relatively rhythmic discharge at a rate of about 9 Hz, which resembled essential tremor. However, electrophysiologic studies revealed giant somatosensory evoked potentials (SEPs) with enhanced long-loop reflex and premovement cortical spike by the jerk-locked averaging method. Treatment with beta-blocker showed no effect, but anticonvulsants such as clonazepam, valproate, and primidone were effective to suppress the tremor and the amplitude of SEPs. We call this involuntary movement "cortical tremor," which is in fact a variant of cortical reflex myoclonus.

Comparison of cost-effectiveness and postoperative outcome of device closure and open surgery closure techniques for treatment of patent ductus arteriosus.

Science.gov (United States)

Ahmadi, Alireza; Sabri, Mohammadreza; Bigdelian, Hamid; Dehghan, Bahar; Gharipour, Mojgan

2014-01-01

Various devices have been recently employed for percutaneous closure of the patent ductus arteriosus (PDA). Although the high effectiveness of device closure techniques has been clearly determined, a few studies have focused on the cost-effectiveness and also postoperative complications of these procedures in comparison with open surgery. The present study aimed to evaluate the clinical outcome and cost-effectiveness of PDA occlusion by Amplatzer and coil device in comparisong with open surgery. In this cross-sectional study, a randomized sample of 201 patients aged 1 month to 16 years (105 patients with device closure and 96 patients with surgical closure) was selected. The ratio of total pulmonary blood flow to total systemic blood flow, the Qp/Qs ratio, was measured using a pulmonary artery catheter. The cost analysis included direct medical care costs associated with device implantation and open surgery, as well as professional fees. All costs were calculated in Iranian Rials and then converted to US dollars. There was no statistical difference in mean Qp/Qs ratio before the procedure between the device closure group and the open surgery group (2.1 ± 0.7 versus 1.7 ± 0.6, P = 0.090). The mean measured costs were overall higher in the device closure group than in open closure group (948.87 ± 548.76 US$ versus 743.70 ± 696.91 US$, P gender (Standardized Beta = 0.160, P = 0.031). PDA closure with the Amplatzer ductal occluder (1053.05 ± 525.73 US$) or with Nit-Occlud coils (PFM) (912.73 ± 565.94 US$, P < 0.001) was more expensive than that via open surgery. However, the Cook detachable spring coils device closure (605.65 ± 194.62 US$, P = 0.650) had a non-significant cost difference with open surgery. No event was observed in the device closure group regarding in-hospital mortality or morbidity; however, in another group, 2 in-hospital deaths occurred, two patients experienced pneumonia and seizure, and one suffered electrolyte abnormalities including

The effects of team reflexivity on psychological well-being in manufacturing teams.

Science.gov (United States)

Chen, Jingqiu; Bamberger, Peter A; Song, Yifan; Vashdi, Dana R

2018-04-01

While the impact of team reflexivity (a.k.a. after-event-reviews, team debriefs) on team performance has been widely examined, we know little about its implications on other team outcomes such as member well-being. Drawing from prior team reflexivity research, we propose that reflexivity-related team processes reduce demands, and enhance control and support. Given the centrality of these factors to work-based strain, we posit that team reflexivity, by affecting these factors, may have beneficial implications on 3 core dimensions of employee burnout, namely exhaustion, cynicism, and inefficacy (reduced personal accomplishment). Using a sample of 469 unskilled manufacturing workers employed in 73 production teams in a Southern Chinese factory, we implemented a time lagged, quasi-field experiment, with half of the teams trained in and executing an end-of-shift team debriefing, and the other half assigned to a control condition and undergoing periodic postshift team-building exercises. Our findings largely supported our hypotheses, demonstrating that relative to team members assigned to the control condition, those assigned to the reflexivity condition experienced a significant improvement in all 3 burnout dimensions over time. These effects were mediated by control and support (but not demands) and amplified as a function of team longevity. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Mass extraction container closure integrity physical testing method development for parenteral container closure systems.

Science.gov (United States)

Yoon, Seung-Yil; Sagi, Hemi; Goldhammer, Craig; Li, Lei

2012-01-01

Container closure integrity (CCI) is a critical factor to ensure that product sterility is maintained over its entire shelf life. Assuring the CCI during container closure (C/C) system qualification, routine manufacturing and stability is important. FDA guidance also encourages industry to develop a CCI physical testing method in lieu of sterility testing in a stability program. A mass extraction system has been developed to check CCI for a variety of container closure systems such as vials, syringes, and cartridges. Various types of defects (e.g., glass micropipette, laser drill, wire) were created and used to demonstrate a detection limit. Leakage, detected as mass flow in this study, changes as a function of defect length and diameter. Therefore, the morphology of defects has been examined in detail with fluid theories. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water, placebo, or drug product (3 mg/mL concentration) solution. Also, it has been verified that the method was robust, and capable of determining the acceptance limit using 3σ for syringes and 6σ for vials. Sterile products must maintain their sterility over their entire shelf life. Container closure systems such as those found in syringes and vials provide a seal between rubber and glass containers. This seal must be ensured to maintain product sterility. A mass extraction system has been developed to check container closure integrity for a variety of container closure systems such as vials, syringes, and cartridges. In order to demonstrate the method's capability, various types of defects (e.g., glass micropipette, laser drill, wire) were created in syringes and vials and were tested. This study demonstrated that a mass extraction system was able to distinguish between intact samples and samples with 2 μm defects reliably when the defect was exposed to air, water

105-DR Large Sodium Fire Facility closure activities evaluation report

International Nuclear Information System (INIS)

Adler, J.G.

1996-01-01

This report evaluates the closure activities at the 105-DR Large Sodium Fire Facility. The closure activities discussed include: the closure activities for the structures, equipment, soil, and gravel scrubber; decontamination methods; materials made available for recycling or reuse; and waste management. The evaluation compares these activities to the regulatory requirements and closure plan requirements. The report concludes that the areas identified in the closure plan can be clean closed

Storage shaft definitive closure plug and method

International Nuclear Information System (INIS)

Dardaine, M.

1992-01-01

A definitive closure plug system for radioactive waste storage at any deepness, is presented. The inherent weight of the closure materials is used to set in the plug: these materials display an inclined sliding surface in such a way that when the closure material rests on a stable surface of the shaft storage materials, the relative sliding of the different materials tends to spread them towards the shaft internal wall so as to completely occlude the shaft

Swedish Massage and Abnormal Reflexes of Children with Spastic Cerebral Palsy

Directory of Open Access Journals (Sweden)

Vida Alizad

2007-09-01

Full Text Available Objectives: Massage therapy is one of the most widely used complementary and alternative medicine therapies for children. This study was conducted to determine the effect of wedish massage on abnormal reflexes in children with spastic cerebral palsy (CP. Methods: This study was a single blind clinical trial conducted on forty children with spastic CP who were recruited from clinics of the University of Social Welfare & Rehabilitation Sciences. They were randomly assigned to intervention and control groups. The routine occupational therapy (OT techniques were performed during a 3 month-period in both groups. The intervention group also received Swedish massage for 30 minutes before every OT session. Primary, spinal, brain stem, midbrain, cortical and automatic reflexes were evaluated at the beginning of the study and 3 months later. The data analysis was done by parametric and nonparametric tests. Results: Finally, thirteen subjects in the intervention group and 14 subjects in the control group were remained and studied. The average ages in the intervention and control groups were 49.5 and 42.1 months respectively. There were no statistically significant differences in abnormal reflexes in the intervention group in comparison to the control (P>0.05. Discussion: Adding Swedish massage to traditional OT techniques had no significant effects on abnormal reflexes in children with spastic cerebral palsy. Evidently more research is required in order to completely reject the effects of Swedish massage on abnormal reflexes of children with CP.

Computer simulation model of reflex e-beam systems coupled to an external circuit

International Nuclear Information System (INIS)

Jungwirth, K.; Stavinoha, P.

1982-01-01

Dynamics of ions and relativistic electrons in various high-voltage reflexing systems (reflex diodes and triodes) was investigated numerically by means of 1 1/2-dimensional PIC simulation model OREBIA. Its perfected version OREBIA-REX also accounts for system coupling to an external power source circuit, thus yielding the currents and applied voltage self-consistently. Various modes of operation of reflex diode and triode were studied using both models. It is shown that neglecting the influence of the external circuit can lead to seve--re overestimation of both ion currents and electron accumulation rates. In coupled systems with ions repeated collapses of impedance due to electron-ion relaxation processes are observed. The current and voltage pulses calculated for several reflex diodes and triodes with and without ions are presented. (J.U.)

SU-E-T-63: Carotid Sparing Tomohelical Three Dimensional Conformal Radiotherapy for T1N0 Glottic Cancer

Energy Technology Data Exchange (ETDEWEB)

Hong, C; Ju, S; Ahn, Y; Oh, D; Noh, J; Chung, K; Kim, J; Han, Y; Choi, D [Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2014-06-01

Purpose: We investigated the dosimetric benefit and treatment efficiency of carotid-sparing TomoHelical (TH) three-dimensional conformal radiotherapy (3DCRT) for early glottic cancer. Methods: Computed tomography (CT) simulation was performed for 10 patients with early-stage (T1N0M0) glottic squamous cell carcinoma. The clinical target volume, planning target volume (PTV), carotid artery (CA), and spinal cord (SP) were delineated for each CT data set. Two-field 3DCRT (2F-3DCRT), three-field intensity-modulated radiation therapy (IMRT) (3F-IMRT), TomoHelical-IMRT (TH-IMRT), and TH-3DCRT plans were generated, with a total prescribed dose of 67.5 Gy in 30 fractions to the PTV for each patient. In order to evaluate plan quality, dosimetric characteristics were compared in terms of the conformity index (CI) and homogeneity index (HI) for the PTV, V35, V50, and V63 for the CAs and in terms of the maximum dose for the SP. Additionally, treatment planning and delivery times were compared to evaluate treatment efficiency. Results: The CIs for 3F-IMRT (0.650±0.05), TH-IMRT (0.643±0.03), and TH-3DCRT (0.631±0.03) were much better than that for 2F-3DCRT (0.318±0.03). The HIs for TH-IMRT (1.053±0.01) and TH-3DCRT (1.055±0.01) were slightly better than those for 2F-3DCRT (1.062±0.01) and 3F-IMRT (1.091±0.007). 2F-3DCRT showed poor CA sparing in terms of the V35, V50, and V63 compared to 3F-IMRT, TH-IMRT, and TH-3DCRT (p<0.05), whereas there was no significant dose difference between 3F-IMRT, TH-IMRT, and TH-3DCRT (p>0.05). The maximum dose to the SP with all plans was below 45 Gy. The treatment planning times for 2F-3DCRT (5.9±0.66 min) and TH-3DCRT (7.32±0.94 min) were much lower than those for 3F-IMRT (45.51±2.76 min) and TH-IMRT (35.58±4.41 min), whereas the delivery times with all plans was below 3 minutes. Conclusion: TH-3DCRT showed excellent carotid sparing capability, comparable to that with TH-IMRT, with high treatment efficiency and short planning and

Laser peripheral iridoplasty for angle-closure.

Science.gov (United States)

Ng, Wai Siene; Ang, Ghee Soon; Azuara-Blanco, Augusto

2012-02-15

Angle-closure glaucoma is a leading cause of irreversible blindness in the world. Treatment is aimed at opening the anterior chamber angle and lowering the IOP with medical and/or surgical treatment (e.g. trabeculectomy, lens extraction). Laser iridotomy works by eliminating pupillary block and widens the anterior chamber angle in the majority of patients. When laser iridotomy fails to open the anterior chamber angle, laser iridoplasty may be recommended as one of the options in current standard treatment for angle-closure. Laser peripheral iridoplasty works by shrinking and pulling the peripheral iris tissue away from the trabecular meshwork. Laser peripheral iridoplasty can be used for crisis of acute angle-closure and also in non-acute situations.   To assess the effectiveness of laser peripheral iridoplasty in the treatment of narrow angles (i.e. primary angle-closure suspect), primary angle-closure (PAC) or primary angle-closure glaucoma (PACG) in non-acute situations when compared with any other intervention. In this review, angle-closure will refer to patients with narrow angles (PACs), PAC and PACG. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2011, Issue 12), MEDLINE (January 1950 to January 2012), EMBASE (January 1980 to January 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to January 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 5 January 2012. We included only randomised controlled trials (RCTs) in this review. Patients with narrow angles, PAC or PACG were eligible. We excluded studies that included only patients with acute presentations

Effect of e-Cigarette Use on Cough Reflex Sensitivity.

Science.gov (United States)

Dicpinigaitis, Peter V; Lee Chang, Alfredo; Dicpinigaitis, Alis J; Negassa, Abdissa

2016-01-01

E-cigarettes (e-cigs) have attained widespread popularity, yet knowledge of their physiologic effects remains minimal. The aim of this study was to evaluate the effect of a single exposure to e-cig vapor on cough reflex sensitivity. Thirty healthy nonsmokers underwent cough reflex sensitivity measurement using capsaicin cough challenge at baseline, 15 min, and 24 h after e-cig exposure (30 puffs 30 s apart). The end point of cough challenge is the concentration of capsaicin inducing five or more coughs (C5). The number of coughs induced by each e-cig inhalation was counted. A subgroup of subjects (n = 8) subsequently underwent an identical protocol with a non-nicotine-containing e-cig. Cough reflex sensitivity was significantly inhibited (C5 increased) 15 min after e-cig use (?0.29; 95% CI, ?0.43 to ?0.15; P < .0001); 24 h later, C5 returned to baseline (0.24; 95% CI, 0.10-0.38; P = .0002 vs post-15-min value). A subgroup of eight subjects demonstrating the largest degree of cough reflex inhibition had no suppression after exposure to a non-nicotine-containing e-cig (P = .0078 for comparison of ?C5 after nicotine vs non-nicotine device). Furthermore, more coughing was induced by the nicotine-containing vs non-nicotine-containing device (P = .0156). A single session of e-cig use, approximating nicotine exposure of one tobacco cigarette, induces significant inhibition of cough reflex sensitivity. Exploratory analysis of a subgroup of subjects suggests that nicotine is responsible for this observation. Our data, consistent with previous studies of nicotine effect, suggest a dual action of nicotine: an immediate, peripheral protussive effect and a delayed central antitussive effect. ClinicalTrials.gov; No.: NCT02203162; URL: www.clinicaltrials.gov. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

The potential migration effect of rural hospital closures

DEFF Research Database (Denmark)

Sørensen, Jens Fyhn Lykke

2008-01-01

to out-migration, although the hypothetical way of questioning leaves uncertainty about the actual scale of out-migration. Child families appear to be the most likely out-migrants. Elderly people may be hardest hit by a hospital closure, being most reliant on health care and least inclined to move away.......Rural hospital closures are high on the current health care agenda in Denmark. One raised concern is that rural hospital closures may further decrease population numbers in rural areas, as closures may induce some residents to move away from affected areas, i.e. closer to health care services...

Role of spinal metabotropic glutamate receptor 5 in pudendal inhibition of the nociceptive bladder reflex in cats.

Science.gov (United States)

Reese, Jeremy N; Rogers, Marc J; Xiao, Zhiying; Shen, Bing; Wang, Jicheng; Schwen, Zeyad; Roppolo, James R; de Groat, William C; Tai, Changfeng

2015-04-15

This study examined the role of spinal metabotropic glutamate receptor 5 (mGluR5) in the nociceptive C-fiber afferent-mediated spinal bladder reflex and in the inhibtion of this reflex by pudendal nerve stimulation (PNS). In α-chloralose-anesthetized cats after spinal cord transection at the T9/T10 level, intravesical infusion of 0.25% acetic acid irritated the bladder, activated nociceptive C-fiber afferents, and induced spinal reflex bladder contractions of low amplitude (reflexes were responsible for a major component of the contractions. This study shows that spinal mGluR5 plays an important role in the nociceptive C-fiber afferent-mediated spinal bladder reflex and in pudendal inhibition of this spinal reflex. Copyright © 2015 the American Physiological Society.

304 Concretion facility closure plan

International Nuclear Information System (INIS)

1990-04-01

The Hanford Site, located northwest of Richland, Washington, houses reactors, chemical-separation systems, and related facilities used for the production of special nuclear materials. The 300 Area of the Hanford Site contains reactor fuel manufacturing facilities and several research and development laboratories. Recyclable scrap uranium Zircaloy-2 and copper silicon alloy, uranium-titanium alloy, beryllium/Zircaloy-2 alloy, and Zircaloy-2 chips and fines were secured in concrete billets in the 304 Concretion Facility, located in the 300 Area. The beryllium/Zircaloy-2 alloy and Zircaloy-2 chips and fines are designated as low-level radioactive mixed waste (LLRMW) with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 304 Concretion Facility is now undergoing closure as defined in the Resource Conservation and Recovery Act of 1976 (RCRA). This closure plan presents a description of the facility, the history of materials and wastes managed, and the procedures that will be followed to close the 304 Concretion Facility (304 Facility). Clean closure of the 304 Facility is the proposed method for closure of the facility. Justification for this proposal is presented. 15 refs., 22 figs., 4 tabs

CIRSE Vascular Closure Device Registry

Science.gov (United States)

Müller-Hülsbeck, Stefan; Libicher, Martin; Atar, Eli; Trentmann, Jens; Goffette, Pierre; Borggrefe, Jan; Zeleňák, Kamil; Hooijboer, Pieter; Belli, Anna-Maria

2010-01-01

Purpose Vascular closure devices are routinely used after many vascular interventional radiology procedures. However, there have been no major multicenter studies to assess the safety and effectiveness of the routine use of closure devices in interventional radiology. Methods The CIRSE registry of closure devices with an anchor and a plug started in January 2009 and ended in August 2009. A total of 1,107 patients were included in the registry. Results Deployment success was 97.2%. Deployment failure specified to access type was 8.8% [95% confidence interval (95% CI) 5.0–14.5] for antegrade access and 1.8% (95% CI 1.1–2.9) for retrograde access (P = 0.001). There was no difference in deployment failure related to local PVD at the access site. Calcification was a reason for deployment failure in only 5.9 cm, and two vessel occlusions. Conclusion The conclusion of this registry of closure devices with an anchor and a plug is that the use of this device in interventional radiology procedures is safe, with a low incidence of serious access site complications. There seems to be no difference in complications between antegrade and retrograde access and other parameters. PMID:20981425

200 West Ash Pit Demolition Site closure plan

International Nuclear Information System (INIS)

1992-11-01

The Hanford Facility is owned by the US Government and operated by the US Department of Energy, Richland Field Office. Dangerous waste and mixed waste (containing both radioactive and dangerous components) are managed and produced on the Hanford Facility. Westinghouse Hanford Company is a major contractor to the US Department of Energy, Richland Field Office and serves as cooperator of the 200 West Ash Pit Demolition Site, the unit addressed in this closure plan. The 200 West Ash Pit Demolition Site Closure Plan consists of a Part A Permit Application (Revision 3) and a closure plan. An explanation of the Part A Permit Application revision is provided at the beginning of the Part A section. The closure plan consists of nine chapters and three appendices. This 200 West Ash Pit Demolition Site Closure Plan submittal contains information current as of October 15, 1992

Reflexive journaling on emotional research topics: ethical issues for team researchers.

Science.gov (United States)

Malacrida, Claudia

2007-12-01

Traditional epistemological concerns in qualitative research focus on the effects of researchers' values and emotions on choices of research topics, power relations with research participants, and the influence of researcher standpoints on data collection and analysis. However, the research process also affects the researchers' values, emotions, and standpoints. Drawing on reflexive journal entries of assistant researchers involved in emotionally demanding team research, this article explores issues of emotional fallout for research team members, the implications of hierarchical power imbalances on research teams, and the importance of providing ethical opportunities for reflexive writing about the challenges of doing emotional research. Such reflexive approaches ensure the emotional safety of research team members and foster opportunities for emancipatory consciousness among research team members.

Short-term locomotor adaptation to a robotic ankle exoskeleton does not alter soleus Hoffmann reflex amplitude.

Science.gov (United States)

Kao, Pei-Chun; Lewis, Cara L; Ferris, Daniel P

2010-07-26

To improve design of robotic lower limb exoskeletons for gait rehabilitation, it is critical to identify neural mechanisms that govern locomotor adaptation to robotic assistance. Previously, we demonstrated soleus muscle recruitment decreased by approximately 35% when walking with a pneumatically-powered ankle exoskeleton providing plantar flexor torque under soleus proportional myoelectric control. Since a substantial portion of soleus activation during walking results from the stretch reflex, increased reflex inhibition is one potential mechanism for reducing soleus recruitment when walking with exoskeleton assistance. This is clinically relevant because many neurologically impaired populations have hyperactive stretch reflexes and training to reduce the reflexes could lead to substantial improvements in their motor ability. The purpose of this study was to quantify soleus Hoffmann (H-) reflex responses during powered versus unpowered walking. We tested soleus H-reflex responses in neurologically intact subjects (n=8) that had trained walking with the soleus controlled robotic ankle exoskeleton. Soleus H-reflex was tested at the mid and late stance while subjects walked with the exoskeleton on the treadmill at 1.25 m/s, first without power (first unpowered), then with power (powered), and finally without power again (second unpowered). We also collected joint kinematics and electromyography. When the robotic plantar flexor torque was provided, subjects walked with lower soleus electromyographic (EMG) activation (27-48%) and had concomitant reductions in H-reflex amplitude (12-24%) compared to the first unpowered condition. The H-reflex amplitude in proportion to the background soleus EMG during powered walking was not significantly different from the two unpowered conditions. These findings suggest that the nervous system does not inhibit the soleus H-reflex in response to short-term adaption to exoskeleton assistance. Future studies should determine if the

Assessment of consistent two-equation closure for forest flows

DEFF Research Database (Denmark)

Sogachev, Andrey; Cavar, Dalibor; Bechmann, Andreas

of grid turbulence and wall-bounded flow, the closure suggested is also valid for homogeneous shear flows commonly observed inside tall vegetative canopies. The present work assess the plant drag closure by comparing results of two different CFD models against observations derived over the forested area...... and can be applied for any twoequation closure. Results derived by different CFD models with k-epsilon and k-omega closure are similar and in good comparison with observations. Overall, numerical results show that the closure performs well, opening new possibilities for application to tasks related...... to the atmospheric boundary layer—where it is important to adequately account for the influences of vegetation....

How Can Hypnodontics Manage Severe Gag Reflex for Root Canal Therapy? A Case Report

Science.gov (United States)

Ramazani, Mohsen; zarenejad, Nafiseh; Parirokh, Masoud; Zahedpasha, Samir

2016-01-01

In endodontics, severe involuntary gagging can have a severe impact on treatment procedure. There are many ways to ease the gag reflex, one of which is hypnosis. A 34-year-old male was referred for root canal treatment of a molar tooth. He had not received any dental treatments for the past nine years due to fear of severe gag reflex. Three hypnotic sessions based upon eye fixation, progressive muscle relaxation and guided imagery techniques were spent for psychosomatic management. The gag reflex was controlled and reduced to a normal level, and the required dental treatments including root canal therapy and restoration were performed successfully. This report shows that hypnosis can control gag reflex for dental treatments. PMID:27141226

A successful environmental remediation program closure and post-closure activities (CAPCA) Y-12 Plant, Oak Ridge, Tennessee

International Nuclear Information System (INIS)

Bowers, M.H.

1991-01-01

The Resource Conservation and Recovery Act (RCRA) closure of eleven waste management units at the Department of Energy's (DOE's) Oak Ridge Y-12 Plant is nearing completion. The Oak Ridge Y-12 Plant is managed by Martin Marietta Energy Systems, Inc. for the US Department of Energy under Contract DE-AC05-84OR21400. The Closure and Post Closure Program (CAPCA) has been accomplished on an accelerated schedule through the efforts of a dedicated team from several organizations. This paper relates experience gained from the program that can be of benefit on other DOE environmental remediation projects. Technical design and construction aspects, as well as project management considerations, are discussed

Evaluation of Container Closure System Integrity for Frozen Storage Drug Products.

Science.gov (United States)

Nieto, Alejandra; Roehl, Holger; Brown, Helen; Nikoloff, Jonas; Adler, Michael; Mahler, Hanns-Christian

2016-01-01

Sometimes, drug product for parenteral administration is stored in a frozen state (e.g., -20 °C or -80 °C), particularly during early stages of development of some biotech molecules in order to provide sufficient stability. Shipment of frozen product could potentially be performed in the frozen state, yet possibly at different temperatures, for example, using dry ice (-80 °C). Container closure systems of drug products usually consist of a glass vial, rubber stopper, and an aluminum crimped cap. In the frozen state, the glass transition temperature (Tg) of commonly used rubber stoppers is between -55 and -65 °C. Below their Tg, rubber stoppers are known to lose their elastic properties and become brittle, and thus potentially fail to maintain container closure integrity in the frozen state. Leaks during frozen temperature storage and transportation are likely to be transient, yet, can possibly risk container closure integrity and lead to microbial contamination. After thawing, the rubber stopper is supposed to re-seal the container closure system. Given the transient nature of the possible impact on container closure integrity in the frozen state, typical container closure integrity testing methods (used at room temperature conditions) are unable to evaluate and thus confirm container closure integrity in the frozen state. Here we present the development of a novel method (thermal physical container closure integrity) for direct assessment of container closure integrity by a physical method (physical container closure integrity) at frozen conditions, using a modified He leakage test. In this study, different container closure systems were evaluated with regard to physical container closure integrity in the frozen state to assess the suitability of vial/stopper combinations and were compared to a gas headspace method. In summary, the thermal physical container closure integrity He leakage method was more sensitive in detecting physical container closure

Educational Strategies to Enhance Reflexivity Among Clinicians and Health Professional Students: A Scoping Study

Directory of Open Access Journals (Sweden)

Rachel Landy

2016-09-01

Full Text Available Reflexivity involves the ability to understand how one's social locations and experiences of advantage or disadvantage have shaped the way one understands the world. The capacity for reflexivity is crucial because it informs clinical decisions, which can lead to improvements in service delivery and patient outcomes. In this article, we present a scoping study that explored educational strategies designed to enhance reflexivity among clinicians and/or health profession students. We reviewed articles and grey literature that address the question: What is known about strategies for enhancing reflexivity among clinicians and students in health professional training programs? We searched multiple databases using keywords including: reflexivity, reflective, allied health professionals, pedagogy, learning, and education. The search strategy was iterative and involved three reviews. Each abstract was independently reviewed by two team members. Sixty-eight texts met the inclusion criteria. There was great diversity among the educational strategies and among health professions. Commonalities across strategies were identified related to reflective writing, experiential learning, classroom-based activities, continuing education, and online learning. We also summarize the 19 texts that evaluated educational strategies to enhance reflexivity. Further research and education is urgently needed for more equitable and socially-just health care. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1603140

Considerations for closure of low-level radioactive waste engineered disposal facilities

International Nuclear Information System (INIS)

1992-01-01

Proper stabilization and closure of low-level radioactive waste disposal facilities require detailed planning during the early stages of facility development. This report provides considerations for host States, compact regions, and unaffiliated States on stabilization and closure of engineered low-level radioactive waste and mixed waste disposal facilities. A time line for planning closure activities, which identifies closure considerations to be addressed during various stages of a facility's development, is presented. Current Federal regulatory requirements and guidance for closure and post-closure are outlined. Significant differences between host State and Federal closure requirements are identified. Design features used as stabilization measures that support closure, such as waste forms and containers, backfill materials, engineered barrier systems, and site drainage systems, are described. These design features are identified and evaluated in terms of how they promote long-term site stability by minimizing water infiltration, controlling subsidence and surface erosion, and deterring intrusion. Design and construction features critical to successful closure are presented for covers and site drainage. General considerations for stabilization and closure operations are introduced. The role of performance and environmental monitoring during closure is described

Tank closure reducing grout

International Nuclear Information System (INIS)

Caldwell, T.B.

1997-01-01

A reducing grout has been developed for closing high level waste tanks at the Savannah River Site in Aiken, South Carolina. The grout has a low redox potential, which minimizes the mobility of Sr 90 , the radionuclide with the highest dose potential after closure. The grout also has a high pH which reduces the solubility of the plutonium isotopes. The grout has a high compressive strength and low permeability, which enhances its ability to limit the migration of contaminants after closure. The grout was designed and tested by Construction Technology Laboratories, Inc. Placement methods were developed by the Savannah River Site personnel

The Reflexive Nature of Reading as Ethnographic Practice: Editorial Note

Directory of Open Access Journals (Sweden)

Wolff-Michael Roth

2004-01-01

Full Text Available In this editorial, I suggest that not only is reading published texts a way of doing ethno­graph­ic research, but also reading concretely realizes itself in the productions of new texts that reproduce the cultural practices that are analyzed in the published text. Reading as ethnographic method is therefore a reflexive project. I provide a dialectical framework for theorizing the reflexive nature of reading. URN: urn:nbn:de:0114-fqs0401390

Reflex control of the spine and posture: a review of the literature from a chiropractic perspective

Directory of Open Access Journals (Sweden)

Schlappi Mark

2005-08-01

Full Text Available Abstract Objective This review details the anatomy and interactions of the postural and somatosensory reflexes. We attempt to identify the important role the nervous system plays in maintaining reflex control of the spine and posture. We also review, illustrate, and discuss how the human vertebral column develops, functions, and adapts to Earth's gravity in an upright position. We identify functional characteristics of the postural reflexes by reporting previous observations of subjects during periods of microgravity or weightlessness. Background Historically, chiropractic has centered around the concept that the nervous system controls and regulates all other bodily systems; and that disruption to normal nervous system function can contribute to a wide variety of common ailments. Surprisingly, the chiropractic literature has paid relatively little attention to the importance of neurological regulation of static upright human posture. With so much information available on how posture may affect health and function, we felt it important to review the neuroanatomical structures and pathways responsible for maintaining the spine and posture. Maintenance of static upright posture is regulated by the nervous system through the various postural reflexes. Hence, from a chiropractic standpoint, it is clinically beneficial to understand how the individual postural reflexes work, as it may explain some of the clinical presentations seen in chiropractic practice. Method We performed a manual search for available relevant textbooks, and a computer search of the MEDLINE, MANTIS, and Index to Chiropractic Literature databases from 1970 to present, using the following key words and phrases: "posture," "ocular," "vestibular," "cervical facet joint," "afferent," "vestibulocollic," "cervicocollic," "postural reflexes," "spaceflight," "microgravity," "weightlessness," "gravity," "posture," and "postural." Studies were selected if they specifically tested any or

Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

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Yang Wang

Full Text Available Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown.To 1 review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2 review the evidence relating hearing impairment and parasympathetic activity and 3 seek evidence of possible connections between hearing impairment and the pupil light reflex.Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment.Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment.As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing

Parasympathetic Nervous System Dysfunction, as Identified by Pupil Light Reflex, and Its Possible Connection to Hearing Impairment.

Science.gov (United States)

Wang, Yang; Zekveld, Adriana A; Naylor, Graham; Ohlenforst, Barbara; Jansma, Elise P; Lorens, Artur; Lunner, Thomas; Kramer, Sophia E

2016-01-01

Although the pupil light reflex has been widely used as a clinical diagnostic tool for autonomic nervous system dysfunction, there is no systematic review available to summarize the evidence that the pupil light reflex is a sensitive method to detect parasympathetic dysfunction. Meanwhile, the relationship between parasympathetic functioning and hearing impairment is relatively unknown. To 1) review the evidence for the pupil light reflex being a sensitive method to evaluate parasympathetic dysfunction, 2) review the evidence relating hearing impairment and parasympathetic activity and 3) seek evidence of possible connections between hearing impairment and the pupil light reflex. Literature searches were performed in five electronic databases. All selected articles were categorized into three sections: pupil light reflex and parasympathetic dysfunction, hearing impairment and parasympathetic activity, pupil light reflex and hearing impairment. Thirty-eight articles were included in this review. Among them, 36 articles addressed the pupil light reflex and parasympathetic dysfunction. We summarized the information in these data according to different types of parasympathetic-related diseases. Most of the studies showed a difference on at least one pupil light reflex parameter between patients and healthy controls. Two articles discussed the relationship between hearing impairment and parasympathetic activity. Both studies reported a reduced parasympathetic activity in the hearing impaired groups. The searches identified no results for pupil light reflex and hearing impairment. As the first systematic review of the evidence, our findings suggest that the pupil light reflex is a sensitive tool to assess the presence of parasympathetic dysfunction. Maximum constriction velocity and relative constriction amplitude appear to be the most sensitive parameters. There are only two studies investigating the relationship between parasympathetic activity and hearing impairment

Factitious lymphoedema as a psychiatric condition mimicking reflex sympathetic dystrophy: a case report

Directory of Open Access Journals (Sweden)

Nwaejike Nnamdi

2008-06-01

Full Text Available Abstract Introduction Reflex sympathetic dystrophy can result in severe disability with only one in five patients able to fully resume prior activities. Therefore, it is important to diagnose this condition early and begin appropriate treatment. Factitious lymphoedema can mimic reflex sympathetic dystrophy and is caused by self-inflicted tourniquets, blows to the arm or repeated skin irritation. Patients with factitious lymphoedema have an underlying psychiatric disorder but usually present to emergency or orthopaedics departments. Factitious lymphoedema can then be misdiagnosed as reflex sympathetic dystrophy. The treatment for factitious lymphoedema is dealing with the underlying psychiatric condition. Case presentation We share our experience of treating a 33-year-old man, who presented with factitious lymphoedema, initially diagnosed as reflex sympathetic dystrophy. Conclusion Awareness of this very similar differential diagnosis allows early appropriate treatment to be administered.

A kinematic view of loop closure.

Science.gov (United States)

Coutsias, Evangelos A; Seok, Chaok; Jacobson, Matthew P; Dill, Ken A

2004-03-01

We consider the problem of loop closure, i.e., of finding the ensemble of possible backbone structures of a chain segment of a protein molecule that is geometrically consistent with preceding and following parts of the chain whose structures are given. We reduce this problem of determining the loop conformations of six torsions to finding the real roots of a 16th degree polynomial in one variable, based on the robotics literature on the kinematics of the equivalent rotator linkage in the most general case of oblique rotators. We provide a simple intuitive view and derivation of the polynomial for the case in which each of the three pair of torsional axes has a common point. Our method generalizes previous work on analytical loop closure in that the torsion angles need not be consecutive, and any rigid intervening segments are allowed between the free torsions. Our approach also allows for a small degree of flexibility in the bond angles and the peptide torsion angles; this substantially enlarges the space of solvable configurations as is demonstrated by an application of the method to the modeling of cyclic pentapeptides. We give further applications to two important problems. First, we show that this analytical loop closure algorithm can be efficiently combined with an existing loop-construction algorithm to sample loops longer than three residues. Second, we show that Monte Carlo minimization is made severalfold more efficient by employing the local moves generated by the loop closure algorithm, when applied to the global minimization of an eight-residue loop. Our loop closure algorithm is freely available at http://dillgroup. ucsf.edu/loop_closure/. Copyright 2004 Wiley Periodicals, Inc. J Comput Chem 25: 510-528, 2004

Socket sclerosis--an obstacle for orthodontic space closure?

Science.gov (United States)

Baumgaertel, Sebastian

2009-07-01

Socket sclerosis is a rare reaction to tooth extraction resulting in high-density bone in the center of the alveolar process, where, under normal circumstances, cancellous bone is to be expected. In an adult orthodontic patient, routine extractions of the mandibular first permanent bicuspids were performed, resulting in socket sclerosis and unsuccessful orthodontic space closure. Orthodontic mini-implants were inserted to augment anchorage and aid in space closure. In the presence of socket sclerosis, conventional orthodontic mechanics failed to close the extraction spaces. However, with absolute anchorage in place, space closure occurred at a nearly normal rate. After treatment, no signs of socket sclerosis were discernible on the periapical radiographs. Socket sclerosis can be an obstacle for orthodontic space closure if traditional mechanics are employed. However, mini-implant-reinforced anchorage can lead to successful space closure, resulting in complete resolution of the sclerotic sites.

Peripheral δ-opioid receptors attenuate the exercise pressor reflex.

Science.gov (United States)

Leal, Anna K; Yamauchi, Katsuya; Kim, Joyce; Ruiz-Velasco, Victor; Kaufman, Marc P

2013-10-15

In rats with ligated femoral arteries, the exercise pressor reflex is exaggerated, an effect that is attenuated by stimulation of peripheral μ-opioid receptors on group IV metabosensitive afferents. In contrast, δ-opioid receptors are expressed mostly on group III mechanosensitive afferents, a finding that prompted us to determine whether stimulation of these opioid receptors could also attenuate the exaggerated exercise pressor reflex in "ligated" rats. We found femoral arterial injection of [D-Pen2,D-Pen5]enkephalin (DPDPE; 1.0 μg), a δ-opioid agonist, significantly attenuated the pressor and cardioaccelerator components of the exercise pressor reflex evoked by hindlimb muscle contraction in both rats with ligated and patent femoral arteries. DPDPE significantly decreased the pressor responses to muscle mechanoreflex activation, evoked by tendon stretch, in ligated rats only. DPDPE (1.0 μg) had no effect in either group on the pressor and cardioaccelerator responses to capsaicin (0.2 μg), which primarily stimulates group IV afferents. DPDPE (1.0 μg) had no effect on the pressor and cardioaccelerator responses to lactic acid (24 mM), which stimulates group III and IV afferents, in rats with patent femoral arteries but significantly decreased the pressor response in ligated rats. Western blots revealed the amount of protein comprising the δ-opioid receptor was greater in dorsal root ganglia innervating hindlimbs with ligated femoral arteries than in dorsal root ganglia innervating hindlimbs with patent femoral arteries. Our findings support the hypothesis that stimulation of δ-opioid receptors on group III afferents attenuated the exercise pressor reflex.

Primary closure of equine laryngotomy incisions

DEFF Research Database (Denmark)

Lindegaard, C.; Karlsson, L.; Ekstrøm, Claus Thorn

2016-01-01

incision between January 1995 and June 2012 were reviewed. Horses with a laryngotomy incision closed in three layers for primary healing were included. Descriptive data on healing characteristics and complications of laryngotomy wounds were collected from the medical records and via follow......The objective was to report healing characteristics and complications after primary closure of equine laryngotomies and analyse factors potentially associated with complications. This retrospective case series of the medical records of horses (n = 180) undergoing laryngoplasty and laryngotomy...... after primary closure of equine laryngotomy incisions are infrequent and considered of minimal severity and can be performed safely when paying careful attention to the closure of the cricothyroid membrane....

Team performance in the Italian NHS: the role of reflexivity.

Science.gov (United States)

Urbini, Flavio; Callea, Antonino; Chirumbolo, Antonio; Talamo, Alessandra; Ingusci, Emanuela; Ciavolino, Enrico

2018-04-09

Purpose The purpose of this paper is twofold: first, to investigate the goodness of the input-process-output (IPO) model in order to evaluate work team performance within the Italian National Health Care System (NHS); and second, to test the mediating role of reflexivity as an overarching process factor between input and output. Design/methodology/approach The Italian version of the Aston Team Performance Inventory was administered to 351 employees working in teams in the Italian NHS. Mediation analyses with latent variables were performed via structural equation modeling (SEM); the significance of total, direct, and indirect effect was tested via bootstrapping. Findings Underpinned by the IPO framework, the results of SEM supported mediational hypotheses. First, the application of the IPO model in the Italian NHS showed adequate fit indices, showing that the process mediates the relationship between input and output factors. Second, reflexivity mediated the relationship between input and output, influencing some aspects of team performance. Practical implications The results provide useful information for HRM policies improving process dimensions of the IPO model via the mediating role of reflexivity as a key role in team performance. Originality/value This study is one of a limited number of studies that applied the IPO model in the Italian NHS. Moreover, no study has yet examined the role of reflexivity as a mediator between input and output factors in the IPO model.

Detailed design report for an operational phase panel-closure system

International Nuclear Information System (INIS)

1996-01-01

Under contract to Westinghouse Electric Corporation (Westinghouse), Waste Isolation Division (WID), IT Corporation has prepared a detailed design of a panel-closure system for the Waste Isolation Pilot Plant (WIPP). Preparation of this detailed design of an operational-phase closure system is required to support a Resource Conservation and Recovery Act (RCRA) Part B permit application and a non-migration variance petition. This report describes the detailed design for a panel-closure system specific to the WIPP site. The recommended panel-closure system will adequately isolate the waste-emplacement panels for at least 35 years. This report provides detailed design and material engineering specifications for the construction, emplacement, and interface-grouting associated with a panel-closure system at the WIPP repository, which would ensure that an effective panel-closure system is in place for at least 35 years. The panel-closure system provides assurance that the limit for the migration of volatile organic compounds (VOC) will be met at the point of compliance, the WIPP site boundary. This assurance is obtained through the inherent flexibility of the panel-closure system

Percutaneous Transcatheter PDA Device Closure in Infancy

International Nuclear Information System (INIS)

Ullah, M.; Sultan, M.; Akhtar, K.; Sadiq, N.; Akbar, H.

2014-01-01

Objective: To evaluate the results and complications associated with transcatheter closure of patent ductus arteriosus (PDA) in infants. Study Design: Quasi-experimental study. Place and Duration of Study: Paediatric Cardiology Department of Armed Forces Institute of Cardiology / National Institute of Heart Diseases (AFIC/NIHD), Rawalpindi, from December 2010 to June 2012. Methodology: Infants undergoing transcatheter device closure of PDA were included. All patients were evaluated by experienced Paediatric Cardiologists with 2-D echocardiography and Doppler before the procedure. Success of closure and complications were recorded. Results: The age of patients varied from 05 - 12 months and 31 (56.4%) were females. Out of the 55 infants, 3 (5.4%) were not offered device closure after aortogram (two large tubular type ducts and one tiny duct, considered unsuitable for device closure); while in 50 (96.1%) patients out of remaining 52, the duct was successfully closed with transcatheter PDA device or coil. In one infant, device deployment resulted in acquired coarctation, necessitating device retrieval by Snare followed by surgical duct interruption and another patient had non-fatal cardiac arrest during device deployment leading to abandonment of procedure and subsequent successful surgical interruption. Local vascular complications occurred in 12 (21.8%) of cases and all were satisfactorily treated. Conclusion: Transcatheter device closure of PDA in infants was an effective procedure in the majority of cases; however, here were considerable number of local access site vascular complications. (author)

3718-F Alkali Metal Treatment and Storage Facility Closure Plan

International Nuclear Information System (INIS)

1991-12-01

Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references

3718-F Alkali Metal Treatment and Storage Facility Closure Plan

Energy Technology Data Exchange (ETDEWEB)

None

1991-12-01

Since 1987, Westinghouse Hanford Company has been a major contractor to the U.S. Department of Energy-Richland Operations Office and has served as co-operator of the 3718-F Alkali Metal Treatment and Storage Facility, the waste management unit addressed in this closure plan. The closure plan consists of a Part A Dangerous waste Permit Application and a RCRA Closure Plan. An explanation of the Part A Revision (Revision 1) submitted with this document is provided at the beginning of the Part A section. The closure plan consists of 9 chapters and 5 appendices. The chapters cover: introduction; facility description; process information; waste characteristics; groundwater; closure strategy and performance standards; closure activities; postclosure; and references.

Dynamic clinical measurements of voluntary vaginal contractions and autonomic vaginal reflexes.

Science.gov (United States)

Broens, Paul M A; Spoelstra, Symen K; Weijmar Schultz, Willibrord C M

2014-12-01

The vaginal canal is an active and responsive canal. It has pressure variations along its length and shows reflex activity. At present, the prevailing idea is that the vaginal canal does not have a sphincter mechanism. It is hypothesized that an active vaginal muscular mechanism exists and might be involved in the pathophysiology of genito-pelvic pain/penetration disorder. The aim of this study was to detect the presence of a canalicular vaginal "sphincter mechanism" by measuring intravaginal pressure at different levels of the vaginal canal during voluntary pelvic floor contractions and during induced reflexive contractions. Sixteen nulliparous women, without sexual dysfunction and pelvic floor trauma, were included in the study. High-resolution solid-state circumferential catheters were used to measure intravaginal pressures and vaginal contractions at different levels in the vaginal canal. Voluntary intravaginal pressure measurements were performed in the left lateral recumbent position only, while reflexive intravaginal pressure measurements during slow inflation of a vaginal balloon were performed in the left lateral recumbent position and in the sitting position. Intravaginal pressures and vaginal contractions were the main outcome measures. In addition, a general demographic and medical history questionnaire was administered to gain insight into the characteristics of the study population. Fifteen out of the sixteen women had deep and superficial vaginal high-pressure zones. In one woman, no superficial high-pressure zone was found. The basal and maximum pressures, as well as the duration of the autonomic reflexive contractions significantly exceeded the pressures and the duration of the voluntary contractions. There were no significant differences between the reflexive measurements obtained in the left lateral recumbent and the sitting position. The two high-pressure zones found in this study, as a result of voluntary contractions and, even more pronounced

ASSESSMENT OF LENS THICKNESS IN ANGLE CLOSURE DISEASE

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Nishat Sultana Khayoom

2016-08-01

Full Text Available BACKGROUND Anterior chamber depth and lens thickness have been considered as important biometric determinants in primary angle-closure glaucoma. Patients with primary narrow angle may be classified as a primary angle closure suspect (PACS, or as having primary angle closure (PAC or primary angle closure glaucoma (PACG. 23.9% of patients with primary angle closure disease are in India, which highlights the importance of understanding the disease, its natural history, and its underlying pathophysiology, so that we may try to establish effective methods of treatment and preventative measures to delay, or even arrest, disease progression, thereby reducing visual morbidity. AIM To determine the lens thickness using A-scan biometry and its significance in various stages of angle closure disease. MATERIALS AND METHODS Patients attending outpatient department at Minto Ophthalmic Hospital between October 2013 to May 2015 were screened for angle closure disease and subsequently evaluated at glaucoma department. In our study, lens thickness showed a direct correlation with shallowing of the anterior chamber by determining the LT/ ACD ratio. A decrease in anterior chamber depth is proportional to the narrowing of the angle which contributes to the progression of the angle closure disease from just apposition to occlusion enhancing the risk for optic nerve damage and visual field loss. Hence, if the lens thickness values are assessed earlier in the disease process, appropriate intervention can be planned. CONCLUSION Determination of lens changes along with anterior chamber depth and axial length morphometrically can aid in early detection of angle closure. The role of lens extraction for PACG is a subject of increased interest. Lens extraction promotes the benefits of anatomical opening of the angle, IOP reduction and improved vision. This potential intervention may be one among the armamentarium of approaches for PACG. Among the current treatment modalities

Transcatheter closure of patent ductus arteriosus: past, present and future.

Science.gov (United States)

Baruteau, Alban-Elouen; Hascoët, Sébastien; Baruteau, Julien; Boudjemline, Younes; Lambert, Virginie; Angel, Claude-Yves; Belli, Emre; Petit, Jérôme; Pass, Robert

2014-02-01

This review aims to describe the past history, present techniques and future directions in transcatheter treatment of patent ductus arteriosus (PDA). Transcatheter PDA closure is the standard of care in most cases and PDA closure is indicated in any patient with signs of left ventricular volume overload due to a ductus. In cases of left-to-right PDA with severe pulmonary arterial hypertension, closure may be performed under specific conditions. The management of clinically silent or very tiny PDAs remains highly controversial. Techniques have evolved and the transcatheter approach to PDA closure is now feasible and safe with current devices. Coils and the Amplatzer Duct Occluder are used most frequently for PDA closure worldwide, with a high occlusion rate and few complications. Transcatheter PDA closure in preterm or low-bodyweight infants remains a highly challenging procedure and further device and catheter design development is indicated before transcatheter closure is the treatment of choice in this delicate patient population. The evolution of transcatheter PDA closure from just 40 years ago with 18F sheaths to device delivery via a 3F sheath is remarkable and it is anticipated that further improvements will result in better safety and efficacy of transcatheter PDA closure techniques. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Patent foramen ovale closure using a bioabsorbable closure device: safety and efficacy at 6-month follow-up.

Science.gov (United States)

Van den Branden, Ben J; Post, Martijn C; Plokker, Herbert W; ten Berg, Jurriën M; Suttorp, Maarten J

2010-09-01

The aim of this study was to assess the mid-term safety and efficacy of percutaneous patent foramen ovale (PFO) closure using a bioabsorbable device (BioSTAR, NMT Medical, Boston, Massachusetts). Closure of PFO in patients with cryptogenic stroke has proven to be safe and effective using different types of permanent devices. All consecutive patients who underwent percutaneous PFO closure with the bioabsorbable closure device between November 2007 and January 2009 were included. Residual shunt was assessed using contrast transthoracic echocardiography. Sixty-two patients (55% women, mean age 47.7 ± 11.8 years) underwent PFO closure. The in-hospital complications were a surgical device retrieval in 2 patients (3.2%), device reposition in 1 (1.6%), and a minimal groin hematoma in 6 patients (9.7%). The short-term complications at 1-month follow-up (n = 60) were a transient ischemic attack in the presence of a residual shunt in 1 patient and new supraventricular tachycardia in 7 patients (11.3%). At 6-month follow-up (n = 60), 1 patient without residual shunt developed a transient ischemic attack and 1 developed atrial fibrillation. A mild or moderate residual shunt was noted in 51.7%, 33.9%, and 23.7% after 1-day, 1-month, and 6-month follow-up, respectively. A large shunt was present in 8.3%, 3.4%, and 0% after 1-day, 1-month, and 6-month follow-up. Closure of PFO using the bioabsorbable device is associated with a low complication rate and a low recurrence rate of embolic events. However, a relatively high percentage of mild or moderate residual shunting is still present at 6-month follow-up. Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Medial olivocochlear reflex interneurons are located in the posteroventral cochlear nucleus: a kainic acid lesion study in guinea pigs.

Science.gov (United States)

de Venecia, Ronald K; Liberman, M Charles; Guinan, John J; Brown, M Christian

2005-07-11

The medial olivocochlear (MOC) reflex arc is probably a three-neuron pathway consisting of type I spiral ganglion neurons, reflex interneurons in the cochlear nucleus, and MOC neurons that project to the outer hair cells of the cochlea. We investigated the identity of MOC reflex interneurons in the cochlear nucleus by assaying their regional distribution using focal injections of kainic acid. Our reflex metric was the amount of change in the distortion product otoacoustic emission (at 2f(1)-f(2)) just after onset of the primary tones. This metric for MOC reflex strength has been shown to depend on an intact reflex pathway. Lesions involving the posteroventral cochlear nucleus (PVCN), but not the other subdivisions, produced long-term decreases in MOC reflex strength. The degree of cell loss within the dorsal part of the PVCN was a predictor of whether the lesion affected MOC reflex strength. We suggest that multipolar cells within the PVCN have the distribution and response characteristics appropriate to be the MOC reflex interneurons. (c) 2005 Wiley-Liss, Inc.

Two Reflexivities in Current Social Science: Remarks on an Absent Debate

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Andreas Langenohl

2009-02-01

Full Text Available This paper traces and compares two different uses of the category of reflexivity in contemporary methodological debates in the social sciences. While a first use is strongly influenced by the textual turn in cultural anthropology, a second use is aligned with Pierre BOURDIEU's notion of "scientific reflexivity." Whereas the first use postulates an epistemological break with scientific modernity and argues for a perpetual contextualization and interrelation of research results and methods, BOURDIEU defends sociology’s claim of objectivity, which, according to him, can be redeemed through a reflexive objectification of sociological practice. Up to the present these two uses have existed in almost complete isolation from each other. They represent alternating reactions to, and reconstructions and translations of, poststructuralism and postmodernism in the social sciences. URN: urn:nbn:de:0114-fqs090297

Danish Working Environment Regulation. How reflexive - how political? -a Scandinavian case

DEFF Research Database (Denmark)

Koch, Christian

an understanding of the directions of the reforms made in this period. The paper operate with two analytical perspectives: The reflexive regulation perspective and the political process perspective. Danish working environment regulation is discussed through the general political initiatives taken, and through four...... specific regulation topics: The Occupational Health Services (OHS), regulation of the psychological working environment, the 'Monotonous Repeated Work'-plan and the workers' compensation. Taking the last twenty years' development as a whole the main developments in the regulation is a further shift...... in balance between material and reflexive regulation elements to the benefit of the latter. But although the reflexive elements seem to stabilize, they are vulnerable to a loss of legitimacy and changes in the political pattern.The impact on enterprise power patterns is summed up in a polarization thesis...

Aplicações de Gelfoam® como tratamento de emergência na insuficiência glótica em cantora Gelfoam® applications as an emergency treatment in glottic insufficiency in singer

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Paulo A. L. Pontes

2004-06-01

Full Text Available O Gelfoam®, produto utilizado em pacientes com paralisias unilaterais de prega vocal, foi aplicado em uma cantora que apresentava insuficiência glótica por atrofia de prega vocal e que necessitava prosseguir em suas atividades profissionais com urgência. O produto foi aplicado por via percutânea e transluminar em consultório e, em seguida, foram realizadas avaliações vocais para acompanhamento e comprovação da eficácia do tratamento. Foram realizadas duas séries com intervalo de um ano, ambas com duas aplicações a cada 28 e 30 dias respectivamente. O resultado foi positivo, permitindo que a paciente retornasse às suas atividades e concluísse o trabalho durante o período em que o Gelfoam®, mesmo sofrendo absorção progressiva, permitiu coaptação glótica compatível com as exigências do uso da voz.Gelfoam® , a product referred to patients presenting unilateral vocal fold paralysis, was applied to a female singer who showed glottic insufficiency by vocal fold atrophy and who needed urgently to proceed with her professional activities. The product was applied through percutaneous and translumination viae, in clinic, and followed by vocal assessments to confirm the efficacy of the treatment. There were realized two series with one year of interval, both with two applications, respectively 28 and 30 days. The result was positive allowing the patient to return to her activities and to conclude her work during the period that Gelfoam®, that was in progressive absorption, permitted a glottic coaptation compatible with the necessities of the voice use.

Reflexive Aero Structures for Enhanced Survivability, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — Cornerstone Research Group Inc. (CRG) will develop an advanced reflexive structure technology system to increase the survivability of future systems constructed of...

The Use of Restoring Resources of the Survival Roles and Reflex Patterns in MNRI® (Reflex Integration Interactive Training of Personality Growth and Interpersonal Relations

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Masgutova S.K.

2017-12-01

Full Text Available Personality growth as a socio-psychological problem is a multi-complex phenomenon that targets Self-identity, Self-actualization, and other areas. During the last decade scientists started studying other factors limiting the personality growth, such as stress and post-trauma. However, the Survival Roles, the socio-individual patterns based on neurophysiological and psychological defense mechanisms blocking the personality Self-actualization, social interaction and professional business qualities, are rarely discussed. Thus this study based on Survival Roles may extend the personality growth oriented concepts and therapy modality tools. This study showed a correlation between Survival Role patterns, stress resilience, and survival reflexes (integrative units of the nervous system functions. Comparative data on 464 business professionals from high management jobs (Study Group — n=340, and Control Group — n=124 participated in this research which found 70.9 % (n=329 of the total group was in stress. This stress activated socio-individual Survival Roles and protective reflex patterns which responded with reactivity, over-protection, non-constructive interactions with others and limited business strategies. The MNRI® reflex integrative training used in this study demonstrated improvement of functions of the protective reflex patterns effected positively the survival mechanisms including increased stress resilience, and decreased negative effect of Survival Roles. MNRI® proposes a new paradigm in the realm of personality growth and socio-interpersonal activity, and supports the neurophysiological aspects to optimize the overall quality of life of business professionals from a variety of high management business areas.

On reflexivity and the conduct of the self in everyday life: reflections on Bourdieu and Archer.

Science.gov (United States)

Akram, Sadiya; Hogan, Anthony

2015-12-01

This article provides a critique of the concept of reflexivity in social theory today and argues against the tendency to define agency exclusively in terms of reflexivity. Margaret Archer, in particular, is highlighted as a key proponent of this thesis. Archer argues that late modernity is characterized by reflexivity but, in our view, this position neglects the impact of more enduring aspects of agency, such as the routinization of social life and the role of the taken-for-granted. These concepts were pivotal to Bourdieu and Giddens' theorization of everyday life and action and to Foucault's understanding of technologies of the self. We offer Bourdieu's habitus as a more nuanced approach to theorizing agency, and provide an alternative account of reflexivity. Whilst accepting that reflexivity is a core aspect of agency, we argue that it operates to a backdrop of the routinization of social life and operates from within and not outside of habitus. We highlight the role of the breach in reflexivity, suggesting that it opens up a critical window for agents to initiate change. The article suggests caution in over-ascribing reflexivity to agency, instead arguing that achieving reflexivity and change is a difficult and fraught process, which has emotional and moral consequences. The effect of this is that people often prefer the status quo, rather than to risk change and uncertainty. © London School of Economics and Political Science 2015.

Diagnostic utility of the acoustic reflex in predicting hearing in paediatric populations.

Science.gov (United States)

Pérez-Villa, Yolanda E; Mena-Ramírez, María E; Aguirre, Laura E Chamlati; Mora-Magaña, Ignacio; Gutiérrez-Farfán, Ileana S

2014-01-01

The sensitivity of prediction of acoustic reflex, in determining the level of hearing loss, is especially useful in paediatric populations. It is based on the difference between the pure tone stapedius reflex threshold and contralateral white noise. The white noise threshold was 60 dB and that of pure tone was 80 dB. Our objective was to determine the diagnostic sensitivity of the prediction of the acoustic reflex. We studied children aged <10 years, from October 2011 to May 2012, by measuring the acoustic reflex with white noise and pure tone. We used contrast tests, with X2 and student t-test. Concordance was measured with Kappa. Results were considered significant at P≤.05. Our protocol was approved by Institutional Ethics Committee. Informed consent was obtained from the parents in all cases. Prediction of normal hearing was 0.84 for the right ear and 0.78 in left ear, while for hearing loss of an unspecified grade, it was 0.98 for the right ear and 0.96 in the left ear. Kappa value was 0.7 to 0.6 for the right ear and left ear. The acoustic reflex is of little diagnostic utility in predicting the degree of hearing loss, but it predicts more than 80% of normal hearing. The clinical utility of the reflex is indisputable, as it is an objective method, simple and rapid to use, that can be performed from birth and whose results are independent of the cooperation and willingness of the subject. It is proposed as an obligatory part of hearing screening. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

Emergent properties during dorsal closure in Drosophila morphogenesis

International Nuclear Information System (INIS)

Peralta, X G; Toyama, Y; Edwards, G S; Kiehart, D P

2008-01-01

Dorsal closure is an essential stage of Drosophila development that is a model system for research in morphogenesis and biological physics. Dorsal closure involves an orchestrated interplay between gene expression and cell activities that produce shape changes, exert forces and mediate tissue dynamics. We investigate the dynamics of dorsal closure based on confocal microscopic measurements of cell shortening in living embryos. During the mid-stages of dorsal closure we find that there are fluctuations in the width of the leading edge cells but the time-averaged analysis of measurements indicate that there is essentially no net shortening of cells in the bulk of the leading edge, that contraction predominantly occurs at the canthi as part of the process for zipping together the two leading edges of epidermis and that the rate constant for zipping correlates with the rate of movement of the leading edges. We characterize emergent properties that regulate dorsal closure, i.e., a velocity governor and the coordination and synchronization of tissue dynamics

Does diurnal variation in cough reflex testing exist in healthy young adults?

Science.gov (United States)

Perry, Sarah; Huckabee, Maggie-Lee

2017-05-01

The aim of this study was to investigate whether diurnal variation in cough reflex sensitivity exists in healthy young adults when a tidal-breathing method is used. Fifty-three participants (19-37 years) underwent cough reflex testing on two occasions: once in the morning (between 9 am - midday) and once in the afternoon (between 2-5 pm). The order of testing was counter-balanced. Within each assessment, participants inhaled successively higher citric acid concentrations via a facemask, with saline solution randomly interspersed to control for a placebo response. The lowest concentration that elicited a reflexive cough response was recorded. Morning cough thresholds (mean=0.6mol/L) were not different from afternoon cough thresholds (mean=0.6mol/L), p=0.16, T=101, r=-0.14. We found no evidence of diurnal variability in cough reflex testing. There was, however, an order effect irrespective of time of day, confirming that healthy participants are able to volitionally modulate their cough response. Copyright © 2017 Elsevier B.V. All rights reserved.

Economic evaluation of closure cap barrier materials study

Energy Technology Data Exchange (ETDEWEB)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration.

Economic evaluation of closure cap barrier materials study

International Nuclear Information System (INIS)

Serrato, M.G.; Bhutani, J.S.; Mead, S.M.

1993-09-01

Volume II of the Economic Evaluation of the Closure Cap Barrier Materials, Revision I contains detailed cost estimates for closure cap barrier materials. The cost estimates incorporate the life cycle costs for a generic hazardous waste seepage basin closure cap under the RCRA Post Closure Period of thirty years. The economic evaluation assessed six barrier material categories. Each of these categories consists of several composite cover system configurations, which were used to develop individual cost estimates. The information contained in this report is not intended to be used as a cost estimating manual. This information provides the decision makers with the ability to screen barrier materials, cover system configurations, and identify cost-effective materials for further consideration

Prognostic Value of Impaired Preoperative Ankle Reflex in Surgical Outcome of Lumbar Disc Herniation

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Farzad Omidi-Kashani

2016-01-01

Full Text Available Background: Several prognostic factors exist influencing the outcome of surgical discectomy in the patients with lumbar disc herniation (LDH. The aim of this study is to evaluate the relationship between severity of preoperative impaired ankle reflex and outcomes of lumbar discectomy in the patients with L5-S1 LDH. Methods: We retrospectively evaluated 181 patients (108 male and 73 female who underwent simple discectomy in our orthopedic department from April 2009 to April 2013 and followed them up for more than one year. The mean age of the patients was 35.3±8.9 years old. Severity of reflex impairment was graded from 0 to 4+ and radicular pain and disability were assessed by visual analogue scale (VAS and Oswestry disability index (ODI questionnaires, respectively. Subjective satisfaction was also evaluated at the last follow-up visit. Chi-square and Kruskal-Wallis tests were used to compare qualitative variables. Results: Reflex impairment existed in 44.8% preoperatively that improved to 10% at the last follow-up visit. Statistical analyses could not find a significant relationship between the severity of impaired ankle reflex and sex or age (P=0.538 and P=0.709, respectively. There was a remarkable relationship between severity of reflex impairment and preoperative radicular pain or disability (P=0.012 and P=0.002, respectively. Kruskal-Wallis test showed that a more severity in ankle reflex impairment was associated with not only less improvement in postoperative pain and disability but also less satisfaction rate (P Conclusions: In the patients with L5-S1 LDH, more severe ankle reflex impairment is associated with less improvement in postoperative pain, disability, and subjective satisfaction.

Key financial ratios can foretell hospital closures.

Science.gov (United States)

Lynn, M L; Wertheim, P

1993-11-01

An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.

Evaluating Red Reflex and Surgeon Preference Between Nearly-Collimated and Focused Beam Microscope Illumination Systems.

Science.gov (United States)

Cionni, Robert J; Pei, Ron; Dimalanta, Ramon; Lubeck, David

2015-08-01

To evaluate the intensity and stability of the red reflex produced by ophthalmic surgical microscopes with nearly-collimated versus focused illumination systems and to assess surgeon preference in a simulated surgical setting. This two-part evaluation consisted of postproduction surgical video analysis of red reflex intensity and a microscope use and preference survey completed by 13 experienced cataract surgeons. Survey responses were based on bench testing and experience in a simulated surgical setting. A microscope with nearly-collimated beam illumination and two focused beam microscopes were assessed. Red reflex intensity and stability were greater with the nearly-collimated microscope illumination system. In the bench testing survey, surgeons reported that the red reflex was maintained over significantly greater distances away from pupillary center, and depth of focus was numerically greater with nearly-collimated illumination relative to focused illumination. Most participating surgeons (≥64%) reported a preference for the microscope with nearly-collimated illumination with regard to red reflex stability, depth of focus, visualization, surgical working distance, and perceived patient comfort. The microscope with nearly-collimated illumination produced a more intense and significantly more stable red reflex and was preferred overall by more surgeons. This is the first report of an attempt to quantify red reflex intensity and stability and to evaluate surgically-relevant parameters between microscope systems. The data and methods presented here may provide a basis for future studies attempting to quantify differences between surgical microscopes that may affect surgeon preference and microscope use in ophthalmic surgery.

Hospital closure: Phoenix, Hydra or Titanic?

Science.gov (United States)

Dunne, T; Davis, S

1996-01-01

Very little has been published about the effects of hospital closure in terms of the service, financial or management issues of the process. Attempts through a case-study format to redress the balance and as such represents the reflections of practitioners who have recently undergone the experience of hospital closure and the often neglected issues arising both during and after the process.

Plantar reflex excitability is increased in the evening in restless legs syndrome patients.

Science.gov (United States)

Dafkin, Chloe; Green, Andrew; Olivier, Benita; McKinon, Warrick; Kerr, Samantha

2017-11-01

To investigate if diurnal changes in spinal excitability (plantar reflex) occur in restless legs syndrome (RLS) participants compared to healthy matched controls. Thirteen RLS participants and 13 healthy control participants' plantar reflex responses were evaluated in the evening (PM) and the morning (AM). Plantar reflex responses were assessed electromyographically, using motion analysis (kinematically) and by subjective nociception (Visual Analogue Scale). RLS participants showed a circadian variation in plantar reflex responses whilst control participants did not. Evening ankle angle changes were larger and faster in RLS participants compared to morning responses. In addition RLS participants displayed significantly smaller change in ankle angle and significantly slower ankle movements in the evening and the morning as well as significantly lower lateral gastrocnemius maximum amplitude in the compared to control participants. The findings of the current study support the theory of RLS circadian fluctuations in spinal excitability. An unexpected finding was decreased plantar reflex responses in RLS participants compared to healthy control participants. However this finding supports the theory of mechanical hypoesthesia in RLS. The results of this study provide further insight into the pathophysiology of RLS, highlighting that not all sensory processing is affected in the same manner. Copyright © 2017 Elsevier B.V. All rights reserved.

A Study on the Effects of Bee Venom Aqua-Acupuncture on Writhing Reflex

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Jeong Sun-Hee

2000-07-01

Full Text Available Introduction:In spite of the use of Bee Venom aqua-acupuncture in the clinics, the scientific evaluation on effects is not enough. Bee Venom aqua-acupuncture is used according to the stimulation of acupuncture point and the chemical effects of Bee Venom. The aims of this study is to investigate the analgegic effects of the Bee Venom aqua-acupuncture, through the change of writhing reflex Materials and Methods:Pain animal model was used acetic acid method. The changes of writhing reflex of the mice which were derived pain by injecting acetic acid into the abdomen, after stimulating Bee Venom aqua-acupuncture on Chungwan(CV12 and non acupuncture point on the backside were measured. Results:1. It showed that the writhing reflex were appeared on the groups which injected acetic acid only, and saline-acetic acid group(sample I, but not on the group bee venom-saline group(sample II. 2. The change of writhing reflex by Chungwan(CV12 Bee Venom aqua-acupuncture showed significant decrease in the order of Chungwan(CV12 Bee Venom aqua-acupuncture group III(2.5×10-3g/kg, II(2.5×10-4g/kg, and I(2.5×10-5g/kg, compared with control group. There were significant decrease of number of writhing reflex in 5～10, 10～15 and 15～20 minutes intervals of Chung wan(CV12 Bee Venom aqua-acupuncture group I, and in 0～5, 5～10, 10～15 and 15～20 minutes intervals of II and III, compared with control group. 3. The change of writhing reflex by non acupuncture point Bee Venom aqua-acupuncture showed significant decrease in the 0～5 and 5～10 minutes intervals and the total number of writhing reflex in 2.5×10-4g/kg group, compared with control group 4. The effects of writhing reflex of Chungwan(CV12 Bee Venom aqua-acupuncture group showed significant decrease, compared with non acupuncture point Bee Venom aqua-acupuncture group. Conclusion:This study shows that the Bee Venom aqua-acupuncture on Chungwan(CV12 decreases the numbers of writhing reflex. As the

Simulating school closure policies for cost effective pandemic decision making

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Araz Ozgur M

2012-06-01

Full Text Available Abstract Background Around the globe, school closures were used sporadically to mitigate the 2009 H1N1 influenza pandemic. However, such closures can detrimentally impact economic and social life. Methods Here, we couple a decision analytic approach with a mathematical model of influenza transmission to estimate the impact of school closures in terms of epidemiological and cost effectiveness. Our method assumes that the transmissibility and the severity of the disease are uncertain, and evaluates several closure and reopening strategies that cover a range of thresholds in school-aged prevalence (SAP and closure durations. Results Assuming a willingness to pay per quality adjusted life-year (QALY threshold equal to the US per capita GDP ($46,000, we found that the cost effectiveness of these strategies is highly dependent on the severity and on a willingness to pay per QALY. For severe pandemics, the preferred strategy couples the earliest closure trigger (0.5% SAP with the longest duration closure (24 weeks considered. For milder pandemics, the preferred strategies also involve the earliest closure trigger, but are shorter duration (12 weeks for low transmission rates and variable length for high transmission rates. Conclusions These findings highlight the importance of obtaining early estimates of pandemic severity and provide guidance to public health decision-makers for effectively tailoring school closures strategies in response to a newly emergent influenza pandemic.

Potential socio-economic consequences of mine closure

Directory of Open Access Journals (Sweden)

Marietjie Ackermann

2018-01-01

Full Text Available Background: Mine closures generally reveal negligence on the part of mining houses, not only in terms of the environment, but also the surrounding mining communities. Aim: This article reflects on the findings of research into the socio-economic consequences of mine closure. The research specifically explored how mineworkers’ dependency on their employment at a mine affects their ability to sustain their livelihood. Setting: The research was conducted at the Orkney Mine and the Grootvlei Mine (Springs. Methods: The research was conducted within a naturalistic domain, guided by a relativist orientation, a constructivist ontology and an interpretivist epistemology. Data were collected by means of document analysis, semi-structured interviews, focus group discussion and unstructured observation. Results: From the research findings, it is evident that mine closures, in general, have a devastating effect on the surrounding mining communities as well as on the employees. Mine closures in the case studies gradually depleted the mining communities’ livelihood assets and resulted in the collapse of their coping strategies and livelihood outcomes. It generally affected the communities’ nutrition, health, education, food security, water, shelter, levels of community participation and personal safety. Conclusion: If not managed efficiently and effectively, mine closures may pose significant challenges to the mining industry, government, the environment, national and local economic prosperity and communities in the peripheral areas of mines. This truly amplifies that mine closure, whether temporary or permanent, is an issue that needs to be addressed with responsibility towards all stakeholders, including the mining community and the labour force.

Creating safety by strengthening clinicians' capacity for reflexivity

Science.gov (United States)

2011-01-01

This commentary explores the nature of creating safety in the here-and-now. Creating safety encompasses two dimensions: revisiting specific behaviours by focusing on substandard performance (reflection), and a more broad-ranging attention to everyday behaviours that are taken as given (reflexivity). The piece pays particular attention to this second dimension of creating safety. Two techniques that promote reflexivity are discussed: video-filming real-time, everyday clinical practice and inviting clinicians' feedback about their own footage, and reflecting on the knowledge and questions that patients and families have about their care, and about unexpected outcomes and clinical incidents. The piece concludes that feedback about everyday practice using these methods is critical to enhancing the safety of everyday activity. PMID:21450780

Top closure for control rod drive for nuclear reactor

International Nuclear Information System (INIS)

Raas, J.H.; Schwartz, J.I.

1978-01-01

A removable top closure and venting assembly for the tubular housing of a control rod drive includes a mounting ring threadably inserted in the upper end of the housing, a fluid-sealing closure member beneath the mounting ring and which is mounted in and coupled to the mounting ring by means of a ball and socket joint, a gas vent defined by interconnecting passages extending through the closure and through the ball and socket joint, and a vent valve accessible from the top of the closure assembly. 3 claims, 2 figures

Transcatheter closure of ventricular septal defect with Occlutech Duct Occluder.

Science.gov (United States)

Atik-Ugan, Sezen; Saltik, Irfan Levent

2018-04-01

Patent ductus arteriosus occluders are used for transcatheter closure of ventricular septal defects, as well as for closure of patent ductus arteriosus. The Occlutech Duct Occluder is a newly introduced device for transcatheter closure of patent ductus arteriosus. Here, we present a case in which the Occlutech Duct Occluder was successfully used on a patient for the closure of a perimembraneous ventricular septal defect.

A method of reflexive balancing in a pragmatic, interdisciplinary and reflexive bioethics.

Science.gov (United States)

Ives, Jonathan

2014-07-01

In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an 'abstract' philosophical analysis. Bioethics has (arguably) always been an interdisciplinary field, and the rise of 'empirical' (bio)ethics need not be seen as an attempt to give a new name to the longstanding practice of interdisciplinary collaboration, but can perhaps best be understood as a substantive attempt to engage with the nature of that interdisciplinarity and to articulate the relationship between the many different disciplines (some of them empirical) that contribute to the field. It can also be described as an endeavour to explain how different disciplinary approaches can be integrated to effectively answer normative questions in bioethics, and fundamental to that endeavour is the need to think about how a robust methodology can be articulated that successfully marries apparently divergent epistemological and metaethical perspectives with method. This paper proposes 'Reflexive Bioethics' (RB) as a methodology for interdisciplinary and empirical bioethics, which utilizes a method of 'Reflexive Balancing' (RBL). RBL has been developed in response to criticisms of various forms of reflective equilibrium, and is built upon a pragmatic characterization of Bioethics and a 'quasi-moral foundationalism', which allows RBL to avoid some of the difficulties associated with RE and yet retain the flexible egalitarianism that makes it intuitively appealing to many. © 2013 John Wiley & Sons Ltd.

Seven-year follow-up of percutaneous closure of patent foramen ovale.

Science.gov (United States)

Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Johansson, Magnus Carl; Furenäs, Eva; Eriksson, Peter; Dellborg, Mikael

2013-12-01

Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure. Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012. Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed. Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.

Genetic Influence on Slope Variability in a Childhood Reflexive Attention Task.

Directory of Open Access Journals (Sweden)

Rebecca A Lundwall

Full Text Available Individuals are not perfectly consistent, and interindividual variability is a common feature in all varieties of human behavior. Some individuals respond more variably than others, however, and this difference may be important to understanding how the brain works. In this paper, we explore genetic contributions to response time (RT slope variability on a reflexive attention task. We are interested in such variability because we believe it is an important part of the overall picture of attention that, if understood, has the potential to improve intervention for those with attentional deficits. Genetic association studies are valuable in discovering biological pathways of variability and several studies have found such associations with a sustained attention task. Here, we expand our knowledge to include a reflexive attention task. We ask whether specific candidate genes are associated with interindividual variability on a childhood reflexive attention task in 9-16 year olds. The genetic makers considered are on 11 genes: APOE, BDNF, CHRNA4, COMT, DRD4, HTR4, IGF2, MAOA, SLC5A7, SLC6A3, and SNAP25. We find significant associations with variability with markers on nine and we discuss the results in terms of neurotransmitters associated with each gene and the characteristics of the associated measures from the reflexive attention task.

Permanent Closure of the TAN-664 Underground Storage Tank

Energy Technology Data Exchange (ETDEWEB)

Bradley K. Griffith

2011-12-01

This closure package documents the site assessment and permanent closure of the TAN-664 gasoline underground storage tank in accordance with the regulatory requirements established in 40 CFR 280.71, 'Technical Standards and Corrective Action Requirements for Owners and Operators of Underground Storage Tanks: Out-of-Service UST Systems and Closure.'

Single-shell tank closure work plan. Revision A

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-06-01

In January 1994, the Hanford Federal Facility Agreement and Conset Order (Tri-Party Agreement) was amended to reflect a revised strategy for remediation of radioactive waste in underground storage tanks. These amendments include milestones for closure of the single-shell tank (SST) operable units, to be initiated by March 2012 and completed by September 2024. This SST-CWP has been prepared to address the principal topical areas identified in Tri-Party Agreement Milestone M-45-06 (i.e., regulatory pathway, operable unit characterization, waste retrieval, technology development, and a strategy for achieving closure). Chapter 2.0 of this SST-CWP provides a brief description of the environmental setting, SST System, the origin and characteristics of SST waste, and ancillary equipment that will be remediated as part of SST operable unit closure. Appendix 2A provides a description of the hydrogeology of the Hanford Site, including information on the unsaturated sediments (vadose zone) beneath the 200 Areas Plateau. Chapter 3.0 provides a discussion of the laws and regulations applicable to closure of the SST farm operable units. Chapter 4.0 provides a summary description of the ongoing characterization activities that best align with the proposed regulatory pathway for closure. Chapter 5.0 describes aspects of the SST waste retrieval program, including retrieval strategy, technology, and sequence, potential tank leakage during retrieval, and considerations of deployment of subsurface barriers. Chapter 6.0 outlines a proposed strategy for closure. Chapter 7.0 provides a summary of the programs underway or planned to develop technologies to support closure. Ca. 325 refs.

Single-shell tank closure work plan. Revision A

International Nuclear Information System (INIS)

1995-06-01

In January 1994, the Hanford Federal Facility Agreement and Conset Order (Tri-Party Agreement) was amended to reflect a revised strategy for remediation of radioactive waste in underground storage tanks. These amendments include milestones for closure of the single-shell tank (SST) operable units, to be initiated by March 2012 and completed by September 2024. This SST-CWP has been prepared to address the principal topical areas identified in Tri-Party Agreement Milestone M-45-06 (i.e., regulatory pathway, operable unit characterization, waste retrieval, technology development, and a strategy for achieving closure). Chapter 2.0 of this SST-CWP provides a brief description of the environmental setting, SST System, the origin and characteristics of SST waste, and ancillary equipment that will be remediated as part of SST operable unit closure. Appendix 2A provides a description of the hydrogeology of the Hanford Site, including information on the unsaturated sediments (vadose zone) beneath the 200 Areas Plateau. Chapter 3.0 provides a discussion of the laws and regulations applicable to closure of the SST farm operable units. Chapter 4.0 provides a summary description of the ongoing characterization activities that best align with the proposed regulatory pathway for closure. Chapter 5.0 describes aspects of the SST waste retrieval program, including retrieval strategy, technology, and sequence, potential tank leakage during retrieval, and considerations of deployment of subsurface barriers. Chapter 6.0 outlines a proposed strategy for closure. Chapter 7.0 provides a summary of the programs underway or planned to develop technologies to support closure. Ca. 325 refs

Social and macro economic impact of closure

International Nuclear Information System (INIS)

Medeliene, D.

1999-01-01

The social consequences of closure of Ignalina NPP will largely depend on the actions the Government takes. If it puts in place the conditions which enable the International Financial Institutions to assist Lithuania, both in providing loans and grants for decommissioning and (in the case of the EU) providing Structural Adjustment Funds for the regional economic development of the Visaginas area, then solutions to the problems of closure can be found. But if the Government delays putting into place the necessary conditions, then Lithuania will be left to solve the problems of - inter alia necessary - closure of Ignalina NPP on its own. (author)

Encouraging Reflexivity in Urban Geography Fieldwork: Study Abroad Experiences in Singapore and Malaysia

Science.gov (United States)

Glass, Michael R.

2014-01-01

Fieldwork in urban geography courses can encourage reflexivity among students regarding the cities they encounter. This article outlines how student reflexivity was encouraged within a new international field research course in Singapore and Malaysia. Drawing on examples from students' field exercises written during an intensive and occasionally…

Angle closure glaucoma in congenital ectropion uvea

Directory of Open Access Journals (Sweden)

Grace M. Wang

2018-06-01

Full Text Available Purpose: Congenital ectropion uvea is a rare anomaly, which is associated with open, but dysplastic iridocorneal angles that cause childhood glaucoma. Herein, we present 3 cases of angle-closure glaucoma in children with congenital ectropion uvea. Observations: Three children were initially diagnosed with unilateral glaucoma secondary to congenital ectropion uvea at 7, 8 and 13 years of age. The three cases showed 360° of ectropion uvea and iris stromal atrophy in the affected eye. In one case, we have photographic documentation of progression to complete angle closure, which necessitated placement of a glaucoma drainage device 3 years after combined trabeculotomy and trabeculectomy. The 2 other cases, which presented as complete angle closure, also underwent glaucoma drainage device implantation. All three cases had early glaucoma drainage device encapsulation (within 4 months and required additional surgery (cycloablation or trabeculectomy. Conclusions and importance: Congenital ectropion uvea can be associated with angle-closure glaucoma, and placement of glaucoma drainage devices in all 3 of our cases showed early failure due to plate encapsulation. Glaucoma in congenital ectropion uvea requires attention to angle configuration and often requires multiple surgeries to obtain intraocular pressure control. Keywords: Congenital ectropion uvea, Juvenile glaucoma, Angle-closure glaucoma, Glaucoma drainage device

Mitochondrial Myopathy: A Rare Cause of Early-Onset Vocal Fold Atrophy

Science.gov (United States)

Kelly, Elizabeth A.; Bock, Jonathan M.; Peltier, Amanda C.; Oh, Shin J.; Garrett, C. Gaelyn

2014-01-01

Objectives We present the second published case of laryngeal involvement in mitochondrial myopathy. Methods A patient with laryngeal involvement of mitochondrial myopathy is presented, together with a literature review. Results A 41-year-old man presented with progressive breathy dysphonia. His brother had mitochondrial myopathy. Biopsy of the biceps muscle demonstrated cytochrome C oxidase–negative ragged blue fibers confirming mitochondrial myopathy. Videostroboscopy showed marked vocal fold atrophy, but subsequent injection laryngoplasty did not significantly improve the patient’s voice, despite improved postoperative glottic closure. Conclusions Mitochondrial myopathy should be considered in the differential diagnosis of severe early-onset vocal fold atrophy. PMID:23577570

Reflexivity in the Interstices: A Tale of Reflexivity at Work in, during, and behind the Scenes

Science.gov (United States)

Wickens, Corrine M.; Cohen, James A.; Walther, Carol S.

2017-01-01

This article is a story of how the authors came to make sense of the significance of those words in relation to gender, race/ethnicity, and citizenship in writing a manuscript about L[subscript 1]L[subscript 2] acquisition. It is a tale about how Reflexivity wove itself into the conversations, into the writing, into the in-between spaces, the…

Short-term plasticity in a monosynaptic reflex pathway to forearm muscles after continuous robot-assisted passive stepping

Directory of Open Access Journals (Sweden)

Tsuyoshi Nakajima

2016-07-01

Full Text Available Both active and passive rhythmic limb movements reduce the amplitude of spinal cord Hoffmann (H- reflexes in muscles of moving and distant limbs. This could have clinical utility in remote modulation of the pathologically hyperactive reflexes found in spasticity after stroke or spinal cord injury. However, such clinical translation is currently hampered by a lack of critical information regarding the minimum or effective duration of passive movement needed for modulating spinal cord excitability. We therefore investigated the H-reflex modulation in the flexor carpi radialis (FCR muscle during and after various durations (5, 10, 15, and 30 min of passive stepping in 11 neurologically normal subjects. Passive stepping was performed by a robotic gait trainer system (Lokomat® while a single pulse of electrical stimulation to the median nerve elicited H-reflexes in the FCR. The amplitude of the FCR H-reflex was significantly suppressed during passive stepping. Although 30 minutes of passive stepping was sufficient to elicit a persistent H-reflex suppression that lasted up to 15 minutes, 5 minutes of passive stepping was not. The duration of H-reflex suppression correlated with that of the stepping. These findings suggest that the accumulation of stepping-related afferent feedback from the leg plays a role in generating short-term interlimb plasticity in the circuitry of the FCR H-reflex.

The articulo-cardiac sympathetic reflex in spinalized, anesthetized rats.

Science.gov (United States)

Nakayama, Tomohiro; Suzuki, Atsuko; Ito, Ryuzo

2006-04-01

Somatic afferent regulation of heart rate by noxious knee joint stimulation has been proven in anesthetized cats to be a reflex response whose reflex center is in the brain and whose efferent arc is a cardiac sympathetic nerve. In the present study we examined whether articular stimulation could influence heart rate by this efferent sympathetic pathway in spinalized rats. In central nervous system (CNS)-intact rats, noxious articular movement of either the knee or elbow joint resulted in an increase in cardiac sympathetic nerve activity and heart rate. However, although in acutely spinalized rats a noxious movement of the elbow joint resulted in a significant increase in cardiac sympathetic nerve activity and heart rate, a noxious movement of the knee joint had no such effect and resulted in only a marginal increase in heart rate. Because this marginal increase was abolished by adrenalectomy suggests that it was due to the release of adrenal catecholamines. In conclusion, the spinal cord appears to be capable of mediating, by way of cardiac sympathetic nerves, the propriospinally induced reflex increase in heart rate that follows noxious stimulation of the elbow joint, but not the knee joint.

Strategic Planning for Hot Cell Closure

International Nuclear Information System (INIS)

LANGSTAFF, D.C.

2001-01-01

The United States Department of Energy (DOE) and its contractor were remediating a large hot cell complex to mitigate the radiological hazard. A Resource Conservation and Recovery Act (RCRA) closure unit was determined to be located within the complex. The regulator established a challenge to develop an acceptable closure plan on a short schedule (four months). The scope of the plan was to remove all excess equipment and mixed waste from the closure unit, establish the requirements of the legally binding Closure Plan and develop an acceptable schedule. The complex has several highly radioactive tanks, tank vaults, piping, and large hot cells containing complex chemical processing equipment. Driven by a strong need to develop an effective strategy to meet cleanup commitments, three principles were followed to develop an acceptable plan: (1) Use a team approach, (2) Establish a buffer zone to support closure, and (3) Use good practice when planning the work sequence. The team was composed of DOE, contractor, and Washington State Department of Ecology (Regulator) staff. The team approach utilized member expertise and fostered member involvement and communication. The buffer zone established an area between the unregulated parts of the building and the areas that were allegedly not in compliance with environmental standards. Introduction of the buffer zone provided simplicity, clarity, and flexibility into the process. Using good practice means using the DOE Integrated Safety Management Core Functions for planning and implementing work safely. Paying adequate attention to detail when the situation required contributed to the process credibility and a successful plan

Subcostal closure technique for prevention of postthoracotomy pain syndrome.

Science.gov (United States)

Hong, Kipyo; Bae, Mikyung; Han, Sora

2016-09-01

The purpose of this study was to evaluate the efficacy of our subcostal closure technique in prevention of postthoracotomy pain syndrome. From July 2012 to March 2015, 29 patients in whom a lobectomy was indicated underwent a thoracotomy. The thoracotomy wounds were closed using a subcostal closure technique (subcostal closure group) and outcomes were compared with 31 patients who underwent video-assisted thoracoscopic surgery (thoracoscopy group). The duration of oral opioid consumption was evaluated from medical records, and postoperative pain was evaluated by telephone interview conducted by a trained nurse practitioner who was unaware of the patient's group. Pain scores were higher in the thoracoscopy group compared to the subcostal closure group, reaching statistical significance (Numeric Rating Scale 0.55 ± 0.948 in the subcostal closure group vs. 1.84 ± 1.614 in the thoracoscopy group; p Pain Scale 0.24 ± 0.435 in the subcostal closure group vs. 0.81 ± 0.703 in the thoracoscopy group; p pain syndrome. © The Author(s) 2016.

Iterative Algorithm for Solving a Class of Quaternion Matrix Equation over the Generalized (P,Q-Reflexive Matrices

Directory of Open Access Journals (Sweden)

Ning Li

2013-01-01

Full Text Available The matrix equation ∑l=1uAlXBl+∑s=1vCsXTDs=F, which includes some frequently investigated matrix equations as its special cases, plays important roles in the system theory. In this paper, we propose an iterative algorithm for solving the quaternion matrix equation ∑l=1uAlXBl+∑s=1vCsXTDs=F over generalized (P,Q-reflexive matrices. The proposed iterative algorithm automatically determines the solvability of the quaternion matrix equation over generalized (P,Q-reflexive matrices. When the matrix equation is consistent over generalized (P,Q-reflexive matrices, the sequence {X(k} generated by the introduced algorithm converges to a generalized (P,Q-reflexive solution of the quaternion matrix equation. And the sequence {X(k} converges to the least Frobenius norm generalized (P,Q-reflexive solution of the quaternion matrix equation when an appropriate initial iterative matrix is chosen. Furthermore, the optimal approximate generalized (P,Q-reflexive solution for a given generalized (P,Q-reflexive matrix X0 can be derived. The numerical results indicate that the iterative algorithm is quite efficient.

Dynamics of a stabilized motor defense conditioned reflex at different levels of motivation in irradiated rats

Energy Technology Data Exchange (ETDEWEB)

Shtemberg, A S

1982-05-01

Postradiation dynamics of strengthened motor-defense conditioned reflex in rats-males irradiated with the doses of 94.111 and 137 Gy was studied. Phase disturbances of conditioned-reflex activity increased with enhancing irradiation dose have been revealed. Rapid recovery of conditioned reflex after short primary aggravation was a characteristic peculiarity. At that, the dynamics of relation of main nervous processes in cortex was noted for significant instability increasing with radiation syndrome development. Enhancement of force of electro-defense support promoted more effective strengthening of temporary connections and conditioned high stability of trained-reflex reactions during serious functional disturbances resulted from sublethal dose irradiation.

Neurophysiology and Clinical Implications of the Laryngeal Adductor Reflex.

Science.gov (United States)

Domer, Amanda S; Kuhn, Maggie A; Belafsky, Peter C

2013-09-01

The laryngeal adductor reflex (LAR) is an involuntary protective response to stimuli in the larynx. The superior laryngeal nerve (SLN) acts as the afferent limb and the recurrent laryngeal nerve (RLN) as the efferent limb of this reflex, which is modulated by the central nervous system. Perhaps the most clinically significant application of the LAR is its use in laryngopharyngeal (LP) sensory discrimination testing. Importantly, aberrations in the LAR may predict dysphagia or portend clinical phenotypes of chronic cough, vocal cord dysfunction or pediatric apneas. LP sensation is a potential target for interventions addressing the aforementioned conditions though currently remains an area of active investigation.

Comparing over-the-scope clip versus endoloop and clips (KING closure) for access site closure: a randomized experimental study

Czech Academy of Sciences Publication Activity Database

Martínek, J.; Ryska, O.; Tučková, I.; Filípková, T.; Doležel, R.; Juhás, Štefan; Motlík, Jan; Zavoral, M.; Ryska, M.

2013-01-01

Roč. 27, č. 4 (2013), s. 1203-1210 ISSN 0930-2794 R&D Projects: GA MZd NS9994 Institutional research plan: CEZ:AV0Z50450515 Keywords : NOTES * gastrotomy closure * rectotomy closure Subject RIV: FJ - Surgery incl. Transplants Impact factor: 3.313, year: 2013

Hexone Storage and Treatment Facility closure plan

International Nuclear Information System (INIS)

1992-11-01

The HSTF is a storage and treatment unit subject to the requirements for the storage and treatment of dangerous waste. Closure is being conducted under interim status and will be completed pursuant to the requirements of Washington State Department of Ecology (Ecology) Dangerous Waste Regulations, Washington Administrative Code (WAC) 173-303-610 and WAC 173-303-640. Because dangerous waste does not include the source, special nuclear, and by-product material components of mixed waste, radionuclides are not within the scope of WAC 173-303 or of this closure plan. The information on radionuclides is provided only for general knowledge where appropriate. The known hazardous/dangerous waste remaining at the site before commencing other closure activities consists of the still vessels, a tarry sludge in the storage tanks, and residual contamination in equipment, piping, filters, etc. The treatment and removal of waste at the HSTF are closure activities as defined in the Resource Conservation and Recovery Act (RCRA) of 1976 and WAC 173-303

Cyanoacrylate for Intraoral Wound Closure: A Possibility?

Directory of Open Access Journals (Sweden)

Parimala Sagar

2015-01-01

Full Text Available Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

Project Management Approach to Transition of the Miamisburg Closure Project From Environmental Cleanup to Post-Closure Operations

International Nuclear Information System (INIS)

Carpenter, C.P.; Marks, M.L.; Smiley, S.L.; Gallaher, D.M.; Williams, K.D.

2006-01-01

The U.S. Department of Energy (DOE) used a project management approach to transition the Miamisburg Closure Project from cleanup by the Office of Environmental Management (EM) to post-closure operations by the Office of Legacy Management (LM). Two primary DOE orders were used to guide the site transition: DOE Order 430.1B, Real Property Asset Management, for assessment and disposition of real property assets and DOE Order 413.3, Program and Project Management for Acquisition of Capital Assets, for project closeout of environmental cleanup activities and project transition of post-closure activities. To effectively manage these multiple policy requirements, DOE chose to manage the Miamisburg Closure Project as a project under a cross-member transitional team using representatives from four principal organizations: DOE-LM, the LM contractor S.M. Stoller Corporation, DOE-EM, and the EM contractor CH2M Hill Mound Inc. The mission of LM is to manage the Department's post-transition responsibilities and long-term care of legacy liabilities and to ensure the future protection of human health and the environment for cleanup sites after the EM has completed its cleanup activities. (authors)

Human H-reflexes are smaller in difficult beam walking than in normal treadmill walking.

Science.gov (United States)

Llewellyn, M; Yang, J F; Prochazka, A

1990-01-01

Hoffman (H) reflexes were elicited from the soleus (SOL) muscle while subjects walked on a treadmill and on a narrow beam (3.5 cm wide, raised 34 cm from the floor). The speed of walking on the treadmill was selected for each subject to match the background activation level of their SOL muscle during beam walking. The normal reciprocal activation pattern of the tibialis anterior and SOL muscles in treadmill walking was replaced by a pattern dominated by co-contraction on the beam. In addition, the step cycle duration was more variable and the time spent in the swing phase was reduced on the beam. The H-reflexes were highly modulated in both tasks, the amplitude being high in the stance phase and low in the swing phase. The H-reflex amplitude was on average 40% lower during beam walking than treadmill walking. The relationship between the H-reflex amplitude and the SOL EMG level was quantified by a regression line relating the two variables. The slope of this line was on average 41% lower in beam walking than treadmill walking. The lower H-reflex gain observed in this study and the high level of fusimotor drive observed in cats performing similar tasks suggest that the two mechanisms which control the excitability of this reflex pathway (i.e. fusimotor action and control of transmission at the muscle spindle to moto-neuron synapse) may be controlled independently.

Transcranial Direct Current Stimulation (tDCS) Enhances the Excitability of Trigemino-Facial Reflex Circuits.

Science.gov (United States)

Cabib, Christopher; Cipullo, Federica; Morales, Merche; Valls-Solé, Josep

2016-01-01

Transcranial direct current stimulation (tDCS) causes a tiny burning sensation through activation of local cutaneous trigeminal afferents. Trigeminal sensory inputs from tDCS may generate excitability changes in the trigemino-facial reflex circuits. Sixteen healthy volunteers were submitted to 20 minutes tDCS sessions with two types of electrode-montage conditions: 1. Real vs Sham 'bi-hemispheric' tDCS (cathode/anode: C4/C3), for blinded assessment of effects, and 2. 'uni-hemispheric' tDCS (cathode/anode: Fp3/C3), for assessment of laterality of the effects. Supraorbital nerve stimuli were used to obtain blink reflexes before, during (10 minutes from onset) and after (30 minutes from onset) the tDCS session. Outcome measures were R2 habituation (R2H) to repeated stimuli, the blink reflex excitability recovery (BRER) to paired stimuli and the blink reflex inhibition by a prepulse (BRIP). Real but not sham bi-hemispheric tDCS caused a significant decrease of R2H and leftward shift of BRER curve (p tDCS on BRER and BRIP were larger on ipsilateral than on contralateral blink reflexes (p tDCS enhances the excitability of trigemino-facial reflex circuits. The finding of larger ipsilateral than contralateral effects suggests that sensitization through cutaneous trigeminal afferents adds on other possible mechanisms such as activation of cortico-nuclear or cortico-reticular connections. Copyright © 2016 Elsevier Inc. All rights reserved.

Design, production and initial state of the closure

International Nuclear Information System (INIS)

2010-12-01

The report is included in a set of Production reports, presenting how the KBS-3 repository is designed, produced and inspected. The production reports are included in the safety report for the KBS-3 repository and repository facility. The report provides input on the initial state of the closure and plugs in underground openings other than deposition tunnels for the assessment of the long-term safety, SR-Site. The initial state refers to the properties of the engineered barriers once they have been finally placed in the KBS-3 repository and will not be further handled within the repository facility. In addition, the report provides some input to the operational safety report, SR-Operation, on how the closure and plugs shall be handled and installed. The report presents the design premises and reference designs of the closure and plugs and verifies their conformity to the design premises. It also briefly deals with the production of the closure and plugs. Finally, the initial state of the closure and plugs and their conformity to the reference designs and design premises are presented

Design, production and initial state of the closure

Energy Technology Data Exchange (ETDEWEB)

2010-12-15

The report is included in a set of Production reports, presenting how the KBS-3 repository is designed, produced and inspected. The production reports are included in the safety report for the KBS-3 repository and repository facility. The report provides input on the initial state of the closure and plugs in underground openings other than deposition tunnels for the assessment of the long-term safety, SR-Site. The initial state refers to the properties of the engineered barriers once they have been finally placed in the KBS-3 repository and will not be further handled within the repository facility. In addition, the report provides some input to the operational safety report, SR-Operation, on how the closure and plugs shall be handled and installed. The report presents the design premises and reference designs of the closure and plugs and verifies their conformity to the design premises. It also briefly deals with the production of the closure and plugs. Finally, the initial state of the closure and plugs and their conformity to the reference designs and design premises are presented

Role of the brain stem in tibial inhibition of the micturition reflex in cats.

Science.gov (United States)

Ferroni, Matthew C; Slater, Rick C; Shen, Bing; Xiao, Zhiying; Wang, Jicheng; Lee, Andy; Roppolo, James R; de Groat, William C; Tai, Changfeng

2015-08-01

This study examined the role of the brain stem in inhibition of bladder reflexes induced by tibial nerve stimulation (TNS) in α-chloralose-anesthetized decerebrate cats. Repeated cystometrograms (CMGs) were performed by infusing saline or 0.25% acetic acid (AA) to elicit normal or overactive bladder reflexes, respectively. TNS (5 or 30 Hz) at three times the threshold (3T) intensity for inducing toe movement was applied for 30 min between CMGs to induce post-TNS inhibition or applied during the CMGs to induce acute TNS inhibition. Inhibition was evident as an increase in bladder capacity without a change in amplitude of bladder contractions. TNS applied for 30 min between saline CMGs elicited prolonged (>2 h) poststimulation inhibition that significantly (P reflexes but are not involved in inhibition of normal bladder reflexes. Copyright © 2015 the American Physiological Society.

Sensor-Motor Maps for Describing Linear Reflex Composition in Hopping

Directory of Open Access Journals (Sweden)

Christian Schumacher

2017-11-01

Full Text Available In human and animal motor control several sensory organs contribute to a network of sensory pathways modulating the motion depending on the task and the phase of execution to generate daily motor tasks such as locomotion. To better understand the individual and joint contribution of reflex pathways in locomotor tasks, we developed a neuromuscular model that describes hopping movements. In this model, we consider the influence of proprioceptive length (LFB, velocity (VFB and force feedback (FFB pathways of a leg extensor muscle on hopping stability, performance and efficiency (metabolic effort. Therefore, we explore the space describing the blending of the monosynaptic reflex pathway gains. We call this reflex parameter space a sensor-motor map. The sensor-motor maps are used to visualize the functional contribution of sensory pathways in multisensory integration. We further evaluate the robustness of these sensor-motor maps to changes in tendon elasticity, body mass, segment length and ground compliance. The model predicted that different reflex pathway compositions selectively optimize specific hopping characteristics (e.g., performance and efficiency. Both FFB and LFB were pathways that enable hopping. FFB resulted in the largest hopping heights, LFB enhanced hopping efficiency and VFB had the ability to disable hopping. For the tested case, the topology of the sensor-motor maps as well as the location of functionally optimal compositions were invariant to changes in system designs (tendon elasticity, body mass, segment length or environmental parameters (ground compliance. Our results indicate that different feedback pathway compositions may serve different functional roles. The topology of the sensor-motor map was predicted to be robust against changes in the mechanical system design indicating that the reflex system can use different morphological designs, which does not apply for most robotic systems (for which the control often follows a

Sensor-Motor Maps for Describing Linear Reflex Composition in Hopping.

Science.gov (United States)

Schumacher, Christian; Seyfarth, André

2017-01-01

In human and animal motor control several sensory organs contribute to a network of sensory pathways modulating the motion depending on the task and the phase of execution to generate daily motor tasks such as locomotion. To better understand the individual and joint contribution of reflex pathways in locomotor tasks, we developed a neuromuscular model that describes hopping movements. In this model, we consider the influence of proprioceptive length (LFB), velocity (VFB) and force feedback (FFB) pathways of a leg extensor muscle on hopping stability, performance and efficiency (metabolic effort). Therefore, we explore the space describing the blending of the monosynaptic reflex pathway gains. We call this reflex parameter space a sensor-motor map . The sensor-motor maps are used to visualize the functional contribution of sensory pathways in multisensory integration. We further evaluate the robustness of these sensor-motor maps to changes in tendon elasticity, body mass, segment length and ground compliance. The model predicted that different reflex pathway compositions selectively optimize specific hopping characteristics (e.g., performance and efficiency). Both FFB and LFB were pathways that enable hopping. FFB resulted in the largest hopping heights, LFB enhanced hopping efficiency and VFB had the ability to disable hopping. For the tested case, the topology of the sensor-motor maps as well as the location of functionally optimal compositions were invariant to changes in system designs (tendon elasticity, body mass, segment length) or environmental parameters (ground compliance). Our results indicate that different feedback pathway compositions may serve different functional roles. The topology of the sensor-motor map was predicted to be robust against changes in the mechanical system design indicating that the reflex system can use different morphological designs, which does not apply for most robotic systems (for which the control often follows a specific

Transcatheter Closure of Patent Foramen Ovale: Devices and Technique.

Science.gov (United States)

Price, Matthew J

2017-10-01

Transcatheter closure of a patent foramen ovale (PFO) reduces the risk of recurrent cryptogenic stroke compared with medical therapy. PFO closure is a prophylactic procedure, and will not provide the patient with symptomatic improvement, except in cases of hypoxemia due to right-to-left shunt or possibly migraine headaches. Therefore, appropriate patient selection is critical, and procedural safety is paramount. Herein, we review key characteristics of the devices currently available for transcatheter PFO closure within the United States, and highlight key technical aspects of the PFO closure procedure that will maximize procedural success. Copyright © 2017 Elsevier Inc. All rights reserved.

Digital signal processing of data from borehole creep closure

International Nuclear Information System (INIS)

Chakrabarti, S.; Patrick, W.C.; Duplancic, N.

1987-01-01

Digital signal processing, a technique commonly used in the fields of electrical engineering and communication technology, has been successfully used to analyze creep closure data obtained from a 0.91 m diameter by 5.13 deep borehole in bedded salt. By filtering the ''noise'' component of the closure data from a test borehole, important data trends were made more evident and average creep closure rates were able to be calculated. This process provided accurate estimates of closure rates that are used in the design of lined boreholes in which heat-generating transuranic nuclear wastes are emplaced at the Waste Isolation Pilot Plant

40 CFR 264.119 - Post-closure notices.

Science.gov (United States)

2010-07-01

...) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Closure... closure of each hazardous waste disposal unit, the owner or operator must submit to the local zoning... disposal unit of the facility. For hazardous wastes disposed of before January 12, 1981, the owner or...

Research progress of the relationship between abnormal vestibular reflexes and adolescent idiopathic scoliosis

Directory of Open Access Journals (Sweden)

Yi-Lin Yang

2017-01-01

Full Text Available Adolescent idiopathic scoliosis (AIS is an agnogenic structural scoliosis occurring in adolescence, and the main diagnostic criteria is coronal Cobb angle >10°in total spine X-ray. Studies have shown that AIS may be associated with abnormal postural reflexes, vestibular system is an important component of postural reflexes and its mechanism in the occurrence and development of scoliosis has received wide attention in recent years. In the study, the research progress on the role of abnormal vestibular reflexes in the pathogenesis of AIS was mainly introduced to help the clinicians better understand the pathogenesis of AIS and provide new ideas for AIS study.

A closure test for time-specific capture-recapture data

Science.gov (United States)

Stanley, T.R.; Burnham, K.P.

1999-01-01

The assumption of demographic closure in the analysis of capture-recapture data under closed-population models is of fundamental importance. Yet, little progress has been made in the development of omnibus tests of the closure assumption. We present a closure test for time-specific data that, in principle, tests the null hypothesis of closed-population model M(t) against the open-population Jolly-Seber model as a specific alternative. This test is chi-square, and can be decomposed into informative components that can be interpreted to determine the nature of closure violations. The test is most sensitive to permanent emigration and least sensitive to temporary emigration, and is of intermediate sensitivity to permanent or temporary immigration. This test is a versatile tool for testing the assumption of demographic closure in the analysis of capture-recapture data.

Reliability in maintenance and design of elastomer sealed closures

International Nuclear Information System (INIS)

Lake, W.H.

1978-01-01

The methods of reliability are considered for maintenance and design of elastomer sealed containment closures. Component reliability is used to establish a replacement schedule for system maintenance. Reliability data on elastomer seals is used to evaluate the common practice of annual replacement, and to calculate component reliability values for several typical shipment time periods. System reliability methods are used to examine the relative merits of typical closure designs. These include single component and redundant seal closure, with and without closure verification testing. The paper presents a general method of quantifying the merits of closure designs through the use of reliability analysis, which is a probabilistic technique. The reference list offers a general source of information in the field of reliability, and should offer the opportunity to extend the procedures discussed in this paper to other design safety applications

RELAP-7 Closure Correlations

Energy Technology Data Exchange (ETDEWEB)

Zou, Ling [Idaho National Lab. (INL), Idaho Falls, ID (United States); Berry, R. A. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Martineau, R. C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Andrs, D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhang, H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Hansel, J. E. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Sharpe, J. P. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Johns, Russell C. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-04-01

The RELAP-7 code is the next generation nuclear reactor system safety analysis code being developed at the Idaho National Laboratory (INL). The code is based on the INL’s modern scientific software development framework, MOOSE (Multi-Physics Object Oriented Simulation Environment). The overall design goal of RELAP-7 is to take advantage of the previous thirty years of advancements in computer architecture, software design, numerical integration methods, and physical models. The end result will be a reactor systems analysis capability that retains and improves upon RELAP5’s and TRACE’s capabilities and extends their analysis capabilities for all reactor system simulation scenarios. The RELAP-7 code utilizes the well-posed 7-equation two-phase flow model for compressible two-phase flow. Closure models used in the TRACE code has been reviewed and selected to reflect the progress made during the past decades and provide a basis for the colure correlations implemented in the RELAP-7 code. This document provides a summary on the closure correlations that are currently implemented in the RELAP-7 code. The closure correlations include sub-grid models that describe interactions between the fluids and the flow channel, and interactions between the two phases.

CAROTID BODY CHEMO-REFLEX: A DRIVER OF AUTONOMIC ABNORMALITIES IN SLEEP APNEA

Science.gov (United States)

Prabhakar, Nanduri R.

2016-01-01

Carotid bodies are the principal peripheral chemoreceptors for detecting changes in arterial blood oxygen levels, and the resulting chemo-reflex is a potent regulator of the sympathetic tone, blood pressure, and breathing. Sleep apnea is a disease of the respiratory system affecting several million adult humans. Apneas occur during sleep often due to obstruction of the upper airway (obstructive sleep apnea, OSA) or due to defective respiratory rhythm generation by the central nervous system (central sleep apnea). Patients with sleep apnea exhibit several co-morbidities; most notable among them being the heightened sympathetic nerve activity, and hypertension. Emerging evidence suggests that intermittent hypoxia (IH) resulting from periodic apnea stimulates the carotid body and the ensuing chemo-reflex mediates the increased sympathetic tone and hypertension in sleep apnea patients. Rodent models of IH, simulating the O2 saturation profiles encountered during sleep apnea have provided important insights into the cellular and molecular mechanisms underlying the heightened carotid body chemo-reflex. This article describes how IH affects the carotid body function, and discusses the cellular, molecular and epigenetic mechanisms underlying the exaggerated chemo-reflex. PMID:27474260

The effectiveness of eye-closure in repeated interviews

OpenAIRE

Vredeveldt, A.; Baddeley, A.D.; Hitch, G.J.

2014-01-01

Purpose Closing the eyes during recall can help witnesses remember more about a witnessed event. This study examined the effectiveness of eye-closure in a repeated recall paradigm with immediate free recall followed 1 week later by both free and cued recall. We examined whether eye-closure was more or less effective during the second free-recall attempt compared with the first, whether eye-closure during the first recall attempt had an impact on subsequent free- and cued-recall performance, a...

Closure of the squared Zakharov--Shabat eigenstates

International Nuclear Information System (INIS)

Kaup, D.J.

1976-01-01

By solution of the inverse scattering problem for a third-order (degenerate) eigenvalue problem, the closure of the squared eigenfunctions of the Zakharov--Shabat equations is found. The question of the completeness of squared eigenstates occurs in many aspects of ''inverse scattering transforms'' (solving nonlinear evolution equations exactly by inverse scattering techniques), as well as in various aspects of the inverse scattering problem. The method used here is quite suggestive as to how one might find the closure of the squared eigenfunctions of other eigenvalue equations, and the strong analogy between these results and the problem of finding the closure of the eigenvectors of a nonself-adjoint matrix is pointed out

The mechano-gated channel inhibitor GsMTx4 reduces the exercise pressor reflex in decerebrate rats.

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Copp, Steven W; Kim, Joyce S; Ruiz-Velasco, Victor; Kaufman, Marc P

2016-02-01

Mechanical and metabolic stimuli from contracting muscles evoke reflex increases in blood pressure, heart rate and sympathetic nerve activity. Little is known, however, about the nature of the mechano-gated channels on the thin fibre muscle afferents that contribute to evoke this reflex, termed the exercise pressor reflex. We determined the effect of GsMTx4, an inhibitor of mechano-gated Piezo channels, on the exercise pressor reflex evoked by intermittent contraction of the triceps surae muscles in decerebrated, unanaesthetized rats. GsMTx4 reduced the pressor, cardioaccelerator and renal sympathetic nerve responses to intermittent contraction but did not reduce the pressor responses to femoral arterial injection of compounds that stimulate the metabolically-sensitive thin fibre muscle afferents. Expression levels of Piezo2 channels were greater than Piezo1 channels in rat dorsal root ganglia. Our findings suggest that mechanically-sensitive Piezo proteins contribute to the generation of the mechanical component of the exercise pressor reflex in rats. Mechanical and metabolic stimuli within contracting skeletal muscles evoke reflex autonomic and cardiovascular adjustments. In cats and rats, gadolinium has been used to investigate the role played by the mechanical component of this reflex, termed the exercise pressor reflex. Gadolinium, however, has poor selectivity for mechano-gated channels and exerts multiple off-target effects. We tested the hypothesis that GsMTX4, a more selective mechano-gated channel inhibitor than gadolinium and a particularly potent inhibitor of mechano-gated Piezo channels, reduced the exercise pressor reflex in decerebrate rats. Injection of 10 μg of GsMTx4 into the arterial supply of the hindlimb reduced the peak pressor (control: 24 ± 5, GsMTx4: 12 ± 5 mmHg, P acid. Moreover, injection of 10 μg of GsMTx4 into the arterial supply of the hindlimb reduced the peak pressor (control: 24 ± 2, GsMTx4: 14 ± 3 mmHg, P reflex in

[Early diagnosis and prognosis evaluation of Bell palsy with blink reflex ].

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Xie, Dan-dan; Li, Xiao-song; Liu, Yuan-yuan

2014-11-01

To determine the value of blink reflex in early diagnosis and prognosis evaluation of Bell palsy. Blink reflex and facial nerve conduction were examined in 58 patients with Bell palsy within one week after symptom onset. The patients without response of R1 , R2 and R2 ' waves were classified as complete efferent retardarce (Group A, 30 cases), and those with response of R1 , R2 and R2 ' waves were classified as incomplete efferent anomalies (Group B, 28 cases). The clinical outcomes after three months of systemic therapy were evaluated using the House-Blackmann (H-B) scale. Efferent anomalies of blink reflex occurred in ail of the 58 patients. Abnormal results of facial nerve conduction appeared in 23 (39. 7%) patients. The three months therapy was effective in 93% patients in Group B and 70% patients in Group A (PBell palsy.

Sympathetic β-adrenergic mechanism in pudendal inhibition of nociceptive and non-nociceptive reflex bladder activity.

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Kadow, Brian T; Lyon, Timothy D; Zhang, Zhaocun; Lamm, Vladimir; Shen, Bing; Wang, Jicheng; Roppolo, James R; de Groat, William C; Tai, Changfeng

2016-07-01

This study investigated the role of the hypogastric nerve and β-adrenergic mechanisms in the inhibition of nociceptive and non-nociceptive reflex bladder activity induced by pudendal nerve stimulation (PNS). In α-chloralose-anesthetized cats, non-nociceptive reflex bladder activity was induced by slowly infusing saline into the bladder, whereas nociceptive reflex bladder activity was induced by replacing saline with 0.25% acetic acid (AA) to irritate the bladder. PNS was applied at multiple threshold (T) intensities for inducing anal sphincter twitching. During saline infusion, PNS at 2T and 4T significantly (P reflex bladder activity. In addition to this peripheral mechanism, a central nervous system mechanism involving metabotropic glutamate 5 receptors also has a role in PNS inhibition. Copyright © 2016 the American Physiological Society.

Review Essay: Grenzgänger Seeks Reflexive Methodology

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Wolff-Michael Roth

2002-09-01

Full Text Available Reflexive Methodology reviews major strands of current thought in epistemology, philosophy, social science, and interpretive methods. The book falls short in that it neither does a thorough job reviewing the literature nor does it provide method-related advice useful to students. Grenzgängerin constitutes a collection of essays on a broad range of topics, but which are only loosely connected if at all. Drawing on DERRIDA and the notion of a historical science of the historical subject, I attempt to practice method, something I missed in both texts. I make explicit the historical nature of my own writing and the historical nature of my subject. I make explicit intertextuality and in the process practice reflexivity in the particular way I am writing. URN: urn:nbn:de:0114-fqs020328

Faroese long-distance reflexives face off against Icelandic long-distance reflexives

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Tania E. Strahan

2009-01-01

Full Text Available Long-distance reflexives (LDRs in Faroese are often compared to those in Icelandic, and are even considered to have the same distribution (Thráinsson et al., 2004. In this paper I evaluate the extent to which this is true. The results from recent fieldwork show that there are clear differences between the LDR in the two closely related languages, in particular that Faroese speakers often reject LDR sentences that contain a non-third person, and that Faroese LDR is often completely acceptable out of a non-complement clause. In addition, initial findings suggest that there may be dialectal variation with respect to at least these two aspects of LDR in Faroese.

The Office of Site Closure: Progress in the Face of Challenges

International Nuclear Information System (INIS)

Fiore, J. J.; Murphie, W. E.; Meador, S. W.

2002-01-01

The Office of Site Closure (OSC) was formed in November 1999 when the Department of Energy's (DOE's) Office of Environmental Management (EM) reorganized to focus specifically on site cleanup and closure. OSC's objective is to achieve safe and cost-effective cleanups and closures that are protective of our workers, the public, and the environment, now and in the future. Since its inception, OSC has focused on implementing a culture of safe closure, with emphasis in three primary areas: complete our responsibility for the Closure Sites Rocky Flats, Mound, Fernald, Ashtabula, and Weldon Spring; complete our responsibility for cleanup at sites where the DOE mission has been completed (examples include Battelle King Avenue and Battelle West Jefferson in Columbus, and General Atomics) or where other Departmental organizations have an ongoing mission (examples include the Brookhaven, Livermore, or Los Alamos National Laboratories, and the Nevada Test Site); and create a framework a nd develop specific business closure tools that will help sites close, such as guidance for and decisions on post-contract benefit liabilities, records retention, and Federal employee incentives for site closure. This paper discusses OSC's 2001 progress in achieving site cleanups, moving towards site closure, and developing specific business closure tools to support site closure. It describes the tools used to achieve progress towards cleanup and closure, such as the application of new technologies, changes in contracting approaches, and the development of agreements between sites and with host states. The paper also identifies upcoming challenges and explores options for how Headquarters and the sites can work together to address these challenges. Finally, it articulates OSC's new focus on oversight of Field Offices to ensure they have the systems in place to oversee contractor activities resulting in site cleanups and closures

COMPARATIVE ANALYSIS OF PERSONALITY CORRELATES OF REFLEXIVITY IN THE CONTEXT OF PROFESSIONAL FORMATION OF THE TEACHER

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T. V. Mayasova

2017-01-01

Full Text Available This article examines the reflexive, the most important professional quality of a teacher's personality in the context of professional development. Reflexivity is a basic property of the individual, whereby the awareness and regulation of the subject of their activities. As a personal correlates of reflexivity studied mental stability, individual styles of decision making (vigilance and avoidance, spontaneity, emotional intelligence (empathy and the ability to manage emotions of other people. The paper conducts a comparative analysis of reflexivity and qualities correlated with her young teachers, working in the specialty from 1 to 5 years and students from different areas of training of pedagogical University. Obtained in the course of the empirical research results confirmed that the process of professional development of teachers is the development of these qualities. Were no significant differences in the indicators options system the reflexivity, alertness,spontaneity, empathy, which differ among teachers and students.

Dilemmas and Deliberations in Reflexive Ethnographic Research

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Robinson, Janean Valerie

2014-01-01

This paper traces insights into the challenges and dilemmas experienced whilst researching students' interpretations and understandings of the Behaviour Management in Schools policy in Western Australia. Journal records, supported by student transcripts, are woven together in a reflexive ethnographic journey--from the beginning phase of searching…

sEMG during Whole-Body Vibration Contains Motion Artifacts and Reflex Activity

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Karin Lienhard

2015-01-01

Full Text Available The purpose of this study was to determine whether the excessive spikes observed in the surface electromyography (sEMG spectrum recorded during whole-body vibration (WBV exercises contain motion artifacts and/or reflex activity. The occurrence of motion artifacts was tested by electrical recordings of the patella. The involvement of reflex activity was investigated by analyzing the magnitude of the isolated spikes during changes in voluntary background muscle activity. Eighteen physically active volunteers performed static squats while the sEMG was measured of five lower limb muscles during vertical WBV using no load and an additional load of 33 kg. In order to record motion artifacts during WBV, a pair of electrodes was positioned on the patella with several layers of tape between skin and electrodes. Spectral analysis of the patella signal revealed recordings of motion artifacts as high peaks at the vibration frequency (fundamental and marginal peaks at the multiple harmonics were observed. For the sEMG recordings, the root mean square of the spikes increased with increasing additional loads (p < 0.05, and was significantly correlated to the sEMG signal without the spikes of the respective muscle (r range: 0.54 - 0.92, p < 0.05. This finding indicates that reflex activity might be contained in the isolated spikes, as identical behavior has been found for stretch reflex responses evoked during direct vibration. In conclusion, the spikes visible in the sEMG spectrum during WBV exercises contain motion artifacts and possibly reflex activity.

Stomal Closure: Strategies to Prevent Incisional Hernia

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Harries, Rhiannon L.; Torkington, Jared

2018-01-01

Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias. PMID:29670882

Stomal Closure: Strategies to Prevent Incisional Hernia

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Rhiannon L. Harries

2018-04-01

Full Text Available Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable. There is a limited amount of evidence to suggest that prophylactic mesh reinforcement may be of benefit to reduce the post stoma closure incisional hernia rate but a further large scale randomised controlled trial is due to report in the near future. There appears to be weak evidence to suggest that surgeons should favour circular, or “purse-string” closure of the skin following stoma closure in order to reduce the risk of SSI, which in turn may reduce incisional hernia formation. There remains the need for further evidence in relation to suture technique, skin closure techniques, mechanical bowel preparation and oral antibiotic prescription focusing on incisional hernia development as an outcome measure. Within this review, we discuss in detail the evidence base for the risk factors for the development of, and the strategies to prevent ostomy reversal site incisional hernias.

Reflexive Language and Ethnic Minority Activism in Hong Kong: A Trajectory-Based Analysis

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Pérez-Milans, Miguel; Soto, Carlos

2016-01-01

This article engages with Archer's call to further research on reflexivity and social change under conditions of late modernity (2007, 2010, 2012) from the perspective of existing work on reflexive discourse in the language disciplines (Silverstein 1976, Lucy 1993). Drawing from a linguistic ethnography of the networked trajectories of a group of…

Prevalence of Persistent Primary Reflexes and Motor Problems in Children with Reading Difficulties

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McPhillips, M.; Sheehy, N.

2004-01-01

It has been shown that some children with reading difficulties have underlying developmental delay and that this may be related to the persistence of primary reflexes. This study investigated the prevalence of persistent primary reflexes in the ordinary primary school population and how this related to other cognitive and social factors. Three…

Reflexive cartography a new perspective in mapping

CERN Document Server

Casti, Emanuela

2015-01-01

Reflexive Cartography addresses the adaptation of cartography, including its digital forms (GIS, WebGIS, PPGIS), to the changing needs of society, and outlines the experimental context aimed at mapping a topological space. Using rigorous scientific analysis based on statement consistency, relevance of the proposals, and model accessibility, it charts the transition from topographical maps created by state agencies to open mapping produced by citizens. Adopting semiotic theory to uncover the complex communicative mechanisms of maps and to investigate their ability to produce their own messages and new perspectives, Reflexive Cartography outlines a shift in our way of conceptualizing maps: from a plastic metaphor of reality, as they are generally considered, to solid tools that play the role of agents, assisting citizens as they think and plan their own living place and make sense of the current world. Applies a range of technologies to theoretical perspectives on mapping to innovatively map the world's geogr...

Mucosal wave characteristics in three voice modes (fry, hiss & overpressure) produced by a female speaker: a preliminary study using stroboscopy, HSDI and analyzed by kymography, P-FFT & Nyquist plots

Science.gov (United States)

Izdebski, Krzysztof; Ward, Ronald R.; Yan, Yuling

2012-02-01

HSDI provides a whole new way to investigate visually intra-laryngeal behavior and posturing during phonation by providing detailed real-time information about laryngeal biomechanics that include observations about mucosal wave, wave motion directionality, glottic area wave form, asymmetry of vibrations within and across vocal folds and contact area of the glottis including posterior commissure closure. These observations are fundamental to our understanding and modeling of both normal and disordered phonation. In this preliminary report we focus on direct HSDI in vivo observations of not only the glottic region, but also on the entire supraglottic laryngeal posturing during fry, breathy/hiss and over-pressured phonation modes produced in a non-pathological settings. Analysis included spatio-temporal vibration patterns of vocal folds, multi-line kymograms, spectral PFFT analysis, and Nyquist spatio-temporal plots. The presented examples reveal that supraglottic contraction assists in prolonged closed phase of the vibratory cycle, and that prolonged closed phase is longest in fry and overpressure and shortest albeit complex in hiss. Hiss also allows for vocal fold vibration despite glottis separation. These findings need to be compared to pathologic phonation representing the three voice modes to derive at better differential diagnosis.

Retrieval Interference in Syntactic Processing: The Case of Reflexive Binding in English.

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Patil, Umesh; Vasishth, Shravan; Lewis, Richard L

2016-01-01

It has been proposed that in online sentence comprehension the dependency between a reflexive pronoun such as himself/herself and its antecedent is resolved using exclusively syntactic constraints. Under this strictly syntactic search account, Principle A of the binding theory-which requires that the antecedent c-command the reflexive within the same clause that the reflexive occurs in-constrains the parser's search for an antecedent. The parser thus ignores candidate antecedents that might match agreement features of the reflexive (e.g., gender) but are ineligible as potential antecedents because they are in structurally illicit positions. An alternative possibility accords no special status to structural constraints: in addition to using Principle A, the parser also uses non-structural cues such as gender to access the antecedent. According to cue-based retrieval theories of memory (e.g., Lewis and Vasishth, 2005), the use of non-structural cues should result in increased retrieval times and occasional errors when candidates partially match the cues, even if the candidates are in structurally illicit positions. In this paper, we first show how the retrieval processes that underlie the reflexive binding are naturally realized in the Lewis and Vasishth (2005) model. We present the predictions of the model under the assumption that both structural and non-structural cues are used during retrieval, and provide a critical analysis of previous empirical studies that failed to find evidence for the use of non-structural cues, suggesting that these failures may be Type II errors. We use this analysis and the results of further modeling to motivate a new empirical design that we use in an eye tracking study. The results of this study confirm the key predictions of the model concerning the use of non-structural cues, and are inconsistent with the strictly syntactic search account. These results present a challenge for theories advocating the infallibility of the human

Clinical and electrophysiological findings in patients with phenylketonuria and epilepsy: Reflex features.

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Yildiz Celik, Senay; Bebek, Nerses; Gurses, Candan; Baykan, Betul; Gokyigit, Aysen

2018-03-23

Phenylketonuria (PKU) is the most common form of amino acid metabolism disorders with autosomal recessive inheritance. The brain damage can be prevented by early diagnosis and a phenylalanine-restricted diet. Untreated or late-treated patients may show mental retardation and other cognitive dysfunctions, as well as motor disability and/or epilepsy. Three patients with PKU and epilepsy were recognized to have reflex epileptic features, and there were ten consecutive adult patients with PKU and epilepsy who were evaluated retrospectively. Medical history, ages at diagnosis and therapy onset, age at seizure onset, seizure types and reflex features, neurological findings, cranial imaging, electroencephalography (EEG) findings, and final clinical condition were evaluated. Reflex epilepsy features were examined in detail. The cases (6 females, 4 males) were diagnosed at ages between 3.5months and 12years. All patients had various degrees of mental-motor retardation and focal or generalized seizures with age at seizure onset varied between neonatal period and 15years. Three patients had febrile seizure, 3 patients had myoclonia, and 3 patients had status epilepticus. All patients had abnormal EEG findings except one. There was a slowing of background activity, and generalized discharges were observed in 7 patients; 3 of them had asymmetrical discharges. One patient had right hippocampal sclerosis (HS), and another patient had hypointensities in the basal ganglia and corpus callosum. Reflex features were clinically observed in 3 of the patients; however, EEG results did not show any related findings. One patient had reflex seizures triggered by photic stimuli, hot water, and startling; one by photic stimuli; and the other one by startling. Reports on the clinical and electrophysiological features of adult patients with PKU were scant. We emphasized that reflex clinical features may be observed in this metabolic disease, and focal epileptiform abnormalities and asymmetry

Case Report: Rapid staged abdominal closure using Gore-Tex® mesh as a bridge to primary omphalocele sac closure

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William C. Kethman

2016-06-01

Full Text Available Omphaloceles present an ongoing challenge due to significant variations in presentation and associated co-morbidities. Diverse management strategies have been described to tackle many of the fundamental challenges of closure and reconstruction of the abdominal wall – this fact demonstrates a need for increasingly individualized management options for this complex disease. We describe a novel method of rapid staged abdominal wall closure using Gore-Tex® mesh as a bridge to primary omphalocele closure in an infant with partial Pentalogy of Cantrell and giant ruptured omphalocele. This strategy can be used in management of some of the most complex abdominal wall defects.

Bidirectional Barbed Sutures for Wound Closure: Evolution and Applications

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Paul, Malcolm D.

2009-01-01

Traditionally, wound closure sutures have in common the need to tie knots with the inherent risk of extrusion, palpability, microinfarcts, breakage, and slippage. Bidirectional barbed sutures have barbs arrayed in a helical fashion in opposing directions on either side of an unbarbed midsegment. This suture is inserted at the midpoint of a wound and pulled through till resistance is encountered from the opposing barbs; each half of the suture is then advanced to the lateral ends of the wound. This design provides a method of evenly distributing tension along the incision line, a faster suture placement and closure time with no need to tie knots, and the possibility of improved cosmesis. Bidirectional barbed sutures, which are available in both absorbable and nonabsorbable forms, can be used for simple closures, multilayered closures, and closure of high-tension wounds in a variety of surgical settings. PMID:24527114

Primary angle closure glaucoma in a myopic kinship.

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Hagan, J C; Lederer, C M

1985-03-01

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

Closure of a mixed waste landfill: Lessons learned

International Nuclear Information System (INIS)

Phifer, M.A.

1990-01-01

Much experience has been gained during the closure of the Mixed Waste Management Facility (MWMF) at the Savannah River Site (SRS) and many lessons were learned. This knowledge was applied to other closures at SRS yielding decreased costs, schedule enhancement, and increased overall project efficiency. The next major area of experience to be gained at SRS in the field of waste site closures will be in the upkeep, maintenance, and monitoring of clay caps. Further test programs will be required to address these requirements

Influence of Closure & Non-Closure of the Visceral and Parietal Peritoneum on Post Cesarean Morbidity

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Tabasi Z.

2010-01-01

Full Text Available AbstractBackground and Objectives: One of the most important issues in promoting mother and child health is reducing the morbidity rate after cesarean section. The aim of this study was to investigate the influence of closure and non-closure of the visceral and parietal peritoneum on post cesarean morbidity in women attending Shabihkhani Maternity Hospital in Kashan, Iran.Methods: This study was conducted with a single blind randomized clinical trial method on 100 parturient women that underwent emergency or elective cesarean section. Patients with previous cesarean section and or abdominal surgery, diseases such as hypertension, diabetes mellitus and premature rupture of membrane and pre operative bleeding, were excluded from this study. Then, the participants were randomly divided into two groups: in one group both peritoneal layers were closed while in the other group, they were not closed. Post operative morbidity including fever, bleeding, post operative pain, analgesic consumption and time of operation were assessed. Data were analyzed with t-tests, and χ2 and a P<0.05 were considered significant.Results: In this study, there were no significant differences between the two groups with respect to age, gestational age, the reason for caesarean section and gravidity, nor were there any differences with respect to the incidence of fever or bleeding and was similar between the two groups, but there was a significant difference between the two groups regarding to feeling of severe pain (P=0.0003, analgesic consumption (P=0.0003 and time of operation (P=0.004. In the non-closure group, dose of analgesic drugs, pain severity and time of operation were less than those of the other group.Conclusion: The Findings showed that non-closure of peritoneal layers as a shorter and simpler procedure has no influence on increasing post cesarean morbidity. Therefore, due to maternal health promotion and early neonatal breastfeeding, non closure of peritoneal

Integrating Reflexivity in Livelihoods Research

DEFF Research Database (Denmark)

Prowse, Martin

2010-01-01

Much poverty and development research is not explicit about its methodology or philosophical foundations. Based on the extended case method of Burawoy and the epistemological standpoint of critical realism, this paper discusses a methodological approach for reflexive inductive livelihoods research...... that overcomes the unproductive social science dualism of positivism and social constructivism. The approach is linked to a conceptual framework and a menu of research methods that can be sequenced and iterated in light of research questions....

The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

DEFF Research Database (Denmark)

Holst, H.; Arendt-Nielsen, Lars; Mosbech, H.

2010-01-01

between groups in age, body mass index or pulmonary function. The median C5 were 129 micromol/L (control group), 48 micromol/L (multiple chemical sensitivity patients), 32 micromol/L (eczema patients). The reporting of lower airway symptoms from odorous chemicals was significantly (p......Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced...... when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen...

Spinal mechanism of micturition reflex inhibition by naftopidil in rats.

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Sugaya, Kimio; Nishijima, Saori; Kadekawa, Katsumi; Ashitomi, Katsuhiro; Ueda, Tomoyuki; Yamamoto, Hideyuki

2014-10-29

We investigated the spinal mechanism through which naftopidil inhibits the micturition reflex by comparing the effects of noradrenaline and naftopidil in rats. The following were investigated: the influence of oral naftopidil on plasma monoamine and amino acid levels, the distribution of oral 14C-naftopidil, the effects of intravenous (IV) or intrathecal (IT) injection of noradrenaline or naftopidil on isovolumetric bladder contractions, amino acid levels in the lumbosacral spinal cord after IT noradrenaline or naftopidil, and the effects of IT naftopidil and strychnine and/or bicuculline on isovolumetric bladder contractions. Oral naftopidil decreased the plasma adrenaline level, while it increased the serotonin and glycine levels. After oral administration, 14C-naftopidil was detected in the spinal cord and cerebrum, as well as in plasma and the prostate gland. When the bladder volume was below the threshold for isovolumetric reflex contractions, IV (0.1mg) or IT (0.1μg) noradrenaline evoked bladder contractions, but IV (1mg) or IT (0.01-1μg) naftopidil did not. When the bladder volume was above the threshold for isovolumetric reflex contractions, IV or IT noradrenaline transiently abolished bladder contractions. IT noradrenaline decreased the levels of glycine and gamma-aminobutyric acid (GABA) in the lumbosacral cord, while IT naftopidil increased the GABA level. IT strychnine and/or bicuculline blocked the inhibitory effect of IT naftopidil on bladder contractions. Naftopidil inhibits the micturition reflex by blocking α1 receptors, as well as by the activation of serotonergic, glycinergic, and GABAergic neurons in the central nervous system. Copyright © 2014 Elsevier Inc. All rights reserved.

Are the unken reflex and the aposematic colouration of Red-Bellied Toads efficient against bird predation?

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Caorsi, Valentina Zaffaroni; Colombo, Patrick; Abadie, Michelle; Brack, Ismael Verrastro; Dasoler, Bibiana Terra; Borges-Martins, Márcio

2018-01-01

Aposematic signals as well as body behaviours may be important anti-predator defences. Species of the genus Melanophryniscus are characterised by having toxic lipophilic alkaloids in the skin and for presenting a red ventral colouration, which can be observed when they perform the behaviour called the unken reflex. Both the reflex behaviour and the colouration pattern are described as defence mechanisms. However, there are currently no studies testing their effectiveness against predators. This study aimed to test experimentally if both ventral conspicuous colouration and the unken reflex in Melanophryniscus cambaraensis function as aposematic signals against visually oriented predators (birds). We simulated the species studied using three different clay toad models as follows: (a) in a normal position with green coloured bodies, (b) in the unken reflex position with green coloured body and extremities and (c) in the unken reflex position with a green body and red extremities. Models were distributed on a known M. cambaraensis breeding site and in the adjacent forest. More than half of the attacks on the models were from birds; however, there was no preference for any model type. Thus, just the presence of the red colour associated with the motionless unken reflex position does not seem to prevent attacks from potential predators. It is possible that the effective aposematic signal in Melanophryniscus is achieved through the unken reflex movement together with the subsequent exhibition of the warning colouration and the secretion of toxins. PMID:29596437

Biological Motion Cues Trigger Reflexive Attentional Orienting

Science.gov (United States)

Shi, Jinfu; Weng, Xuchu; He, Sheng; Jiang, Yi

2010-01-01

The human visual system is extremely sensitive to biological signals around us. In the current study, we demonstrate that biological motion walking direction can induce robust reflexive attentional orienting. Following a brief presentation of a central point-light walker walking towards either the left or right direction, observers' performance…

Hamiltonian closures in fluid models for plasmas

Science.gov (United States)

Tassi, Emanuele

2017-11-01

This article reviews recent activity on the Hamiltonian formulation of fluid models for plasmas in the non-dissipative limit, with emphasis on the relations between the fluid closures adopted for the different models and the Hamiltonian structures. The review focuses on results obtained during the last decade, but a few classical results are also described, in order to illustrate connections with the most recent developments. With the hope of making the review accessible not only to specialists in the field, an introduction to the mathematical tools applied in the Hamiltonian formalism for continuum models is provided. Subsequently, we review the Hamiltonian formulation of models based on the magnetohydrodynamics description, including those based on the adiabatic and double adiabatic closure. It is shown how Dirac's theory of constrained Hamiltonian systems can be applied to impose the incompressibility closure on a magnetohydrodynamic model and how an extended version of barotropic magnetohydrodynamics, accounting for two-fluid effects, is amenable to a Hamiltonian formulation. Hamiltonian reduced fluid models, valid in the presence of a strong magnetic field, are also reviewed. In particular, reduced magnetohydrodynamics and models assuming cold ions and different closures for the electron fluid are discussed. Hamiltonian models relaxing the cold-ion assumption are then introduced. These include models where finite Larmor radius effects are added by means of the gyromap technique, and gyrofluid models. Numerical simulations of Hamiltonian reduced fluid models investigating the phenomenon of magnetic reconnection are illustrated. The last part of the review concerns recent results based on the derivation of closures preserving a Hamiltonian structure, based on the Hamiltonian structure of parent kinetic models. Identification of such closures for fluid models derived from kinetic systems based on the Vlasov and drift-kinetic equations are presented, and

Monitoring calculation of closure change of Extradosed Cable-stayed Bridge

Science.gov (United States)

Shi, Jing Xian; Ran, Zhi Hong

2018-06-01

During the construction of extradosed cable-stayed bridge in Yunnan province, China, the construction unit has made certain changes in the construction process of the closure section due to environmental restrictions: remove the hanging basket after the closure, the sling shall not be provided in closure section, the function of the sling is realized by the hanging basket on the 16th beam. In case of this change, the bridge has been constructed to section 15th. In order to ensure the smooth and orderly progress of each stage in the closure phase, this article is arranged according to the construction plan, appropriate adjustment of related procedures, checking the bridge safety at all stages of construction, the stress and force of the main girder are compared to ensure the safety of the construction after closure changes. Adjust the height of the beam of the 16th and 17th to adapt the new construction plan, and the bridge closure smoothly.

Soleus H-reflex tests in causalgia-dystonia compared with dystonia and mimicked dystonic posture

NARCIS (Netherlands)

Koelman, J. H.; Hilgevoord, A. A.; Bour, L. J.; Speelman, J. D.; Ongerboer de Visser, B. W.

1999-01-01

Dystonia in the causalgia-dystonia syndrome is characterized by a fixed dystonic posture. To identify involvement of central pathophysiologic mechanisms, we analyzed soleus H-reflex tests in five patients with causalgia-dystonia. Soleus H-reflex test results in these patients differed from those in

Influence of stimulus intensity on the soleus H-reflex amplitude and modulation during locomotion

DEFF Research Database (Denmark)

Simonsen, Erik B; Alkjær, Tine; Raffalt, Peter C

2013-01-01

-reflex methodology itself. Accordingly, the purpose of the present study was to study the effect on the soleus H-reflex during walking and running using stimulus intensities normally considered too high (up to 45% Mmax). Using M-waves of 25-45% Mmax as opposed to 5-25% Mmax showed a significant suppression...... of the peak H-reflex during the stance phase of walking, while no changes were observed during running. No differences were observed regarding modulation pattern. So a possible use of too high stimulus intensity cannot explain the differences mentioned. The surprising result in running may be explained...

MNC Subsidiary Closures

DEFF Research Database (Denmark)

Sofka, Wolfgang; Torres Preto, Miguel; de Faria, Pedro

2014-01-01

We investigate the consequences of MNC subsidiary closures for employees who lose their jobs. In particular, we examine the extent to which the human capital that these employees acquired while employed by the MNC influences the wages they receive in their new jobs. We propose an employee...

Enhancement of the intrinsic defecation reflex by mosapride, a 5-HT4 agonist, in chronically lumbosacral denervated guinea pigs.

Science.gov (United States)

Kojima, Yu; Fujii, Hisao; Katsui, Renta; Nakajima, Yoshiyuki; Takaki, Miyako

2006-10-01

The defecation reflex is composed of rectal distension-evoked rectal (R-R) reflex contractions and synchronous internal anal sphincter (R-IAS) reflex relaxations in guinea pigs. These R-R and R-IAS reflexes are controlled via extrinsic sacral excitatory nerve pathway (pelvic nerves), lumbar inhibitory nerve pathways (colonic nerves) and by intrinsic cholinergic excitatory and nitrergic inhibitory nerve pathways. The effect of mosapride (a prokinetic benzamide) on the intrinsic reflexes, mediated via enteric 5-HT(4) receptors, was evaluated by measuring the mechanical activity of the rectum and IAS in anesthetized guinea pigs using an intrinsic R-R and R-IAS reflex model resulting from chronic (two to nine days) lumbosacral denervation (PITH). In this model, the myenteric plexus remains undamaged and the distribution of myenteric and intramuscular interstitial cells of Cajal is unchanged. Although R-R and R-IAS reflex patterns markedly changed, the reflex indices (reflex pressure or force curve-time integral) of both the R-R contractions and the synchronous R-IAS relaxations were unchanged. The frequency of the spontaneous R and IAS motility was also unchanged. Mosapride (0.1-1.0 mg/kg) dose-dependently increased both intrinsic R-R (maximum: 1.82) and R-IAS reflex indices (maximum: 2.76) from that of the control (1.0) 6-9 days following chronic PITH. The dose-response curve was similar to that in the intact guinea pig, and had shifted to the left from that in the guinea pig after acute PITH. A specific 5-HT(4) receptor antagonist, GR 113808 (1.0 mg/kg), decreased both reflex indices by approximately 50% and antagonized the effect of mosapride 1.0 mg/kg. This was quite different from the result in the intact guinea pig where GR 113808 (1.0 mg/kg) did not affect either of the reflex indices. The present results indicate that mosapride enhanced the intrinsic R-R and R-IAS reflexes and functionally compensated for the deprivation of extrinsic innervation. The actions of

Práticas e reflexões de professoras numa pesquisa longitudinal

Directory of Open Access Journals (Sweden)

Edda Curi

Full Text Available Analisa práticas e reflexões de professoras que participam de um grupo colaborativo no âmbito do Projeto Observatório da Educação, financiado pela Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes. Destaca a constituição do grupo, as ações desenvolvidas, as reflexões das professoras e as considerações que permitem avançar nos processos de ensino de Matemática e formação de professores. Examina cadernos de registros das professoras, atas de memória do grupo e depoimentos e apresenta a análise desse conteúdo, pela perspectiva de Bardin. Conclui ter havido avanços significativos nas práticas, pois o trabalho em grupo favoreceu o processo reflexivo das professoras sobre sua prática e seu desenvolvimento profissional, embora ainda existam fragilidades em algumas reflexões.

Dissociative identity disorder and prepulse inhibition of the acoustic startle reflex

Science.gov (United States)

Dale, Karl Yngvar; Flaten, Magne Arve; Elden, Åke; Holte, Arne

2008-01-01

A group of persons with dissociative identity disorder (DID) was compared with a group of persons with other dissociative disorders, and a group of nondiagnosed controls with regard to prepulse inhibition (PPI) of the acoustic startle reflex. The findings suggest maladaptive attentional processes at a controlled level, but not at a preattentive automatic level, in persons with DID. The prepulse occupied more controlled attentional resources in the DID group compared with the other two groups. Preattentive automatic processing, on the other hand, was normal in the DID group. Moreover, startle reflexes did not habituate in the DID group. In conclusion, increased PPI and delayed habituation is consistent with increased vigilance in individuals with DID. The present findings of reduced habituation of startle reflexes and increased PPI in persons with DID suggest the operation of a voluntary process that directs attention away from unpleasant or threatening stimuli. Aberrant voluntary attentional processes may thus be a defining characteristic in DID. PMID:18830396

Improvement of tricuspid regurgitation after transcatheter ASD closure in older patients.

Science.gov (United States)

Chen, L; Shen, J; Shan, X; Wang, F; Kan, T; Tang, X; Zhao, X; Qin, Y

2017-07-19

Adult patients with undiagnosed atrial septal defect (ASD) may have right heart cavity enlargement and functional tricuspid valve insufficiency. Moderate or more severe tricuspid regurgitation has been associated with a worse prognosis, and more serious complications are typically seen in older patients. This study aimed to evaluate the improvement in functional tricuspid regurgitation and heart geometry after transcatheter ASD closure in older patients. The data of 111 patients over 60 years of age with moderate or severe tricuspid regurgitation before ASD closure were analyzed. At the 1‑month and 6‑month follow-up after closure, both tricuspid regurgitation jet area and right atrial volume decreased significantly. Right ventricular volume decreased 1 month after closure, showing a further decrease at the end of the 6‑month follow-up. However, 24 patients (21.6%) still had persistent severe tricuspid regurgitation after the procedure. Multivariate analysis revealed that patient age at ASD closure and pulmonary artery systolic pressure determined by echocardiography before closure were predictors of persistent tricuspid regurgitation after closure. Transcatheter ASD closure in older patients could significantly decrease tricuspid regurgitation and improve right heart geometry.

2727-S Nonradioactive Dangerous Waste Storage Facility clean closure evaluation report

International Nuclear Information System (INIS)

Luke, S.N.

1994-01-01

This report presents the analytical results of 2727-S NRDWS facility closure verification soil sampling and compares these results to clean closure criteria. The results of this comparison will determine if clean closure of the unit is regulatorily achievable. This report also serves to notify regulators that concentrations of some analytes at the site exceed sitewide background threshold levels (DOE-RL 1993b) and/or the limits of quantitation (LOQ). This report also presents a Model Toxics Control Act Cleanup (MTCA) (WAC 173-340) regulation health-based closure standard under which the unit can clean close in lieu of closure to background levels or LOQ in accordance with WAC 173-303-610. The health-based clean closure standard will be closure to MTCA Method B residential cleanup levels. This report reconciles all analyte concentrations reported above background or LOQ to this health-based cleanup standard. Regulator acceptance of the findings presented in this report will qualify the TSD unit for clean closure in accordance with WAC 173-303-610 without further TSD unit soil sampling, or soil removal and/or decontamination. Nondetected analytes require no further evaluation

Soleus H reflex extinction in controls and spastic patients: ordered occlusion or diffuse inhibition?

NARCIS (Netherlands)

Hilgevoord, A. A.; Bour, L. J.; Koelman, J. H.; Ongerboer de Visser, B. W.

1995-01-01

Extinction of the soleus H reflex at higher stimulus intensities is commonly attributed to retrograde conduction of action potentials in motor axons. This study was designed to gain further insight into the mechanisms underlying the extinction. The decrease of the H reflex was quantified in a group

Cortical and spinal assessment - a comparative study using encephalography and the nociceptive withdrawal reflex

DEFF Research Database (Denmark)

Fischer, I W; Gram, M; Hansen, T M

2017-01-01

solution in randomized order. The electroencephalogram (EEG) was recorded during rest and during immersion of the hand into ice-water. Electrical stimulation of the sole of the foot was used to elicit the nociceptive withdrawal reflex and the reflex amplitude was recorded. RESULTS: Data from thirty...

Waste Dump Closure and Cost Estimates at AngloGold Ashanti ...

African Journals Online (AJOL)

Michael

2017-12-02

Dec 2, 2017 ... 2University of Mines and Technology, P.O. Box 237, Tarkwa, Ghana ... The mine has closure plans for the waste dumps and the closure activity ... incur additional cost, it was advised that the mine should execute the closure and reclamation plan without delay. .... Progressively rehabilitate the project area.

A short summary on finite element modelling of fatigue crack closure

Energy Technology Data Exchange (ETDEWEB)

Singh, Konjengbam Darunkumar [Indian Institute of Technology, Guwahati (India); Parry, Matthew Roger [Airbus Operations Ltd, Bristol(United Kingdom); Sinclair, Ian [University of Southampton, Southampton (United Kingdom)

2011-12-15

This paper presents a short summary pertaining to the finite element modelling of fatigue crack closure. Several key issues related to finite element modelling of fatigue crack closure are highlighted: element type, mesh refinement, stabilization of crack closure, crack-tip node release scheme, constitutive model, specimen geometry, stress-states (i.e., plane stress, plane strain), crack closure monitoring. Reviews are presented for both straight and deflected cracks.

Staged closure of a giant omphalocele with amnion preservation, modified technique

Directory of Open Access Journals (Sweden)

Akram H. Aljahdali

2017-04-01

Full Text Available Closure of a giant omphalocele can be challenging. Preservation of the amnion in staged closure is not commonly practiced. Here, we describe 2 cases of giant omphalocele treated with a modified amnion preservation, staged closure technique. This paper demonstrates the feasibility and safety of this technique, and the versatility of amnion to adapt to an escharization strategy if closure is not achievable.

DESIGN OF A WELDING AND INSPECTION SYSTEM FOR WASTE STORAGE CLOSURE

International Nuclear Information System (INIS)

H.B. Smartt; A.D. Watkins; D.P. Pace; R.J. Bitsoi; E.D. Larsen T.R. McJunkin; C.R. Tolle

2005-01-01

This work reported here was done to provide a conceptual design for a robotic welding and inspection system for the Yucca Mountain Repository waste package closure system. The welding and inspection system is intended to make the various closure welds that seal and/or structurally join the lids to the waste package vessels. The welding and inspection system will also perform surface and volumetric inspections of the various closure welds and has the means to repair closure welds, if required. The system is designed to perform these various activities remotely, without the necessity of having personnel in the closure cell

Evolutionary problems in non-reflexive spaces

Czech Academy of Sciences Publication Activity Database

Kružík, Martin; Zimmer, J.

2010-01-01

Roč. 16, č. 1 (2010), s. 1-22 ISSN 1262-3377 R&D Projects: GA AV ČR IAA1075402 Institutional research plan: CEZ:AV0Z10750506 Keywords : concentrations * energetic solution * energies with linear growth * oscillations * relaxation Subject RIV: BA - General Mathematics Impact factor: 1.084, year: 2009 http://library.utia.cas.cz/separaty/2008/MTR/kruzik-evolutionary problems in non-reflexive spaces.pdf

Friction or Closure

DEFF Research Database (Denmark)

Lundahl, Mikela

2014-01-01

Heritage is a discourse that aims at closure. It fixates the narrative of the past through the celebration of specific material (or sometimes immaterial non-) ob-jects. It organizes temporality and construct events and freezes time. How does this unfold in the case of the UNESCO World Heritage si...

Multipass mining sequence room closures: In situ data report

International Nuclear Information System (INIS)

Munson, D.E.; Jones, R.L.; Northrop-Salazar, C.L.; Woerner, S.J.

1992-12-01

During the construction of the Thermal/Structural In Situ Test Rooms at the Waste Isolation Pilot Plant (WIPP) facility, measurements of the salt displacements were obtained at very early times, essentially concurrent with the mining activity. This was accomplished by emplacing manually read closure gage stations directly at the mining face, actually between the face and the mining machine, immediately upon mining of the intended gage location. Typically, these mining sequence closure measurements were taken within one hour of mining of the location and within one meter of the mining face. Readings were taken at these gage stations as the multipass mining continued, with the gage station reestablished as each successive mining pass destroyed the earlier gage points. Data reduction yields the displacement history during the mining operation. These early mining sequence closure data, when combined with the later data of the permanently emplaced closure gages, gives the total time-dependent closure displacements of the test rooms. This complete closure history is an essential part of assuring that the in situ test databases will provide an adequate basis for validation of the predictive technology of salt creep behavior, as required by the WIPP technology development program for disposal of radioactive waste in bedded salt

Closure Plan for Active Low Level Burial Grounds

Energy Technology Data Exchange (ETDEWEB)

SKELLY, W.A.

2000-11-16

This plan has been prepared in response to direction from the U.S. Department of Energy. The purpose of the plan is to define approaches that will be implemented to ensure protection of the public and the environment when active Low-Level Burial Grounds (LLBGs) at the Hanford Site are closed. Performance assessments for active burial grounds in the 200 East and West 200 Areas provide current estimates of potential environmental contamination and doses to the ''maximum exposed individual'' from burial ground operation and closure and compare dose estimates to performance objective dose limits for the facilities. This is an Operational Closure Plan. The intent of the guidance in DOE Order 435.1 is that this plan will be a living document, like the facility performance assessments, and will be revised periodically through the operational life of the LLBGs to reflect updated information on waste inventory. management practices, facility transition planning, schedule dates, assessments of post-closure performance, and environmental consequences. Out year dates identified in this plan are tentative. A Final Closure Plan will be prepared in the future when the timing and extent of closure-related activities for LLBGs can be established with greater certainty. After current operations at the LLBGs are concluded, this plan proposes transitioning of these facilities to the Environmental Restoration Program. This action will enable the Environmental Restoration Program to design and implement consistent and coordinated final remedial actions for active and inactive LLBGs. Active and inactive burial grounds in the 200 West and 200 East Areas are commingled. This plan describes approaches that will be implemented during Interim Closure, Final Closure, and Institutional Control Periods to prepare LLBGs for surface barriers, and the construction of barriers, as well as the scope of inspection, monitoring and maintenance practices that will be performed during

The capsaicin cough reflex in patients with symptoms elicited by odorous chemicals

DEFF Research Database (Denmark)

Holst, H; Arendt-Nielsen, L; Mosbech, H

2010-01-01

Patients with multiple chemical sensitivity and eczema patients with airway symptoms elicited by odorous chemicals have enhanced cough reflex to capsaicin when applying the tidal breathing method. The aims of the present study were to test whether the capsaicin induced cough reflex was enhanced...... when applying the single breath inhalation method in similar groups of patients with symptoms related to odorous chemicals e.g. other persons wearing of perfume; and to investigate to what extent the reporting of lower airway symptoms influenced the cough reflex. Sixteen patients fulfilling Cullen......'s criteria for multiple chemical sensitivity and 15 eczema patients with airway symptoms elicited by odorous chemicals were compared with 29 age-matched, healthy controls. We measured C5--the capsaicin concentration causing five coughs or more--using the single breath inhalation test. No difference was found...

The joint discourse 'reflexive sustainable development'. From weak towards strong sustainable development

International Nuclear Information System (INIS)

Nilsen, Heidi Rapp

2010-01-01

The purpose of this paper is to contribute towards moving the predominant situation of weak sustainable development (WSD) in the direction of strong sustainable development (SSD). More people - academics, politicians, bureaucrats and laymen alike - need to recognize SSD as an alternative to WSD. A joint discourse of WSD and SSD is suggested, called reflexive sustainable development. Here, advocates of WSD and SSD must argue for each specific case why their solution is better. This will expose, amongst other things, the ethical foundations which form part of resulting policy advice. Reflexive sustainable development is to be framed in discourse ethics, thereby remedying the power imbalance and allowing for substantial discussion. Reflexive sustainable development builds on a common theoretical base but will not lead to consensus in all matters. A family metaphor is introduced to inspire a discourse of both consensus and compromise. (author)

Effects of gamma-aminobutyric acid on the Hering-Breuer inspiration-inhibiting reflex.

Science.gov (United States)