Goal-Directed and Goal-Less Imitation in Autism Spectrum Disorder

Science.gov (United States)

Wild, Kelly S.; Poliakoff, Ellen; Jerrison, Andrew; Gowen, Emma

2012-01-01

To investigate how people with Autism are affected by the presence of goals during imitation, we conducted a study to measure movement kinematics and eye movements during the imitation of goal-directed and goal-less hand movements. Our results showed that a control group imitated changes in movement kinematics and increased the level that they…

Infants Show Stability of Goal-Directed Imitation

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Sakkalou, Elena; Ellis-Davies, Kate; Fowler, Nia C.; Hilbrink, Elma E.; Gattis, Merideth

2013-01-01

Previous studies have reported that infants selectively reproduce observed actions and have argued that this selectivity reflects understanding of intentions and goals, or goal-directed imitation. We reasoned that if selective imitation of goal-directed actions reflects understanding of intentions, infants should demonstrate stability across…

Cardiac output-based fluid optimization for kidney transplant recipients: a proof-of-concept trial.

Science.gov (United States)

Corbella, Davide; Toppin, Patrick Jason; Ghanekar, Anand; Ayach, Nour; Schiff, Jeffery; Van Rensburg, Adrian; McCluskey, Stuart A

2018-04-10

Intravenous fluid management for deceased donor kidney transplantation is an important, modifiable risk factor for delayed graft function (DGF). The primary objective of this study was to determine if goal-directed fluid therapy using esophageal Doppler monitoring (EDM) to optimize stroke volume (SV) would alter the amount of fluid given. This randomized, proof-of-concept trial enrolled 50 deceased donor renal transplant recipients. Data collected included patient characteristics, fluid administration, hemodynamics, and complications. The EDM was used to optimize SV in the EDM group. In the control group, fluid management followed the current standard of practice. The groups were compared for the primary outcome of total intraoperative fluid administered. There was no difference in the mean (standard deviation) volume of intraoperative fluid administered to the 24 control and 26 EDM patients [2,307 (750) mL vs 2,675 (842) mL, respectively; mean difference, 368 mL; 95% confidence interval (CI), - 87 to + 823; P = 0.11]. The incidence of complications in the control and EDM groups was similar (15/24 vs 17/26, respectively; P = 0.99), as was the incidence of delayed graft failure (8/24 vs 11/26, respectively; P = 0.36). Goal-directed fluid therapy did not alter the volume of fluid administered or the incidence of complications. This proof-of-concept trial provides needed data for conducting a larger trial to determine the influence of fluid therapy on the incidence in DGF in deceased donor kidney transplantation. www.clinicaltrials.gov (NCT02512731). Registered 31 July 2015.

Revised Starling equation and the glycocalyx model of transvascular fluid exchange: an improved paradigm for prescribing intravenous fluid therapy.

Science.gov (United States)

Woodcock, T E; Woodcock, T M

2012-03-01

I.V. fluid therapy does not result in the extracellular volume distribution expected from Starling's original model of semi-permeable capillaries subject to hydrostatic and oncotic pressure gradients within the extracellular fluid. Fluid therapy to support the circulation relies on applying a physiological paradigm that better explains clinical and research observations. The revised Starling equation based on recent research considers the contributions of the endothelial glycocalyx layer (EGL), the endothelial basement membrane, and the extracellular matrix. The characteristics of capillaries in various tissues are reviewed and some clinical corollaries considered. The oncotic pressure difference across the EGL opposes, but does not reverse, the filtration rate (the 'no absorption' rule) and is an important feature of the revised paradigm and highlights the limitations of attempting to prevent or treat oedema by transfusing colloids. Filtered fluid returns to the circulation as lymph. The EGL excludes larger molecules and occupies a substantial volume of the intravascular space and therefore requires a new interpretation of dilution studies of blood volume and the speculation that protection or restoration of the EGL might be an important therapeutic goal. An explanation for the phenomenon of context sensitivity of fluid volume kinetics is offered, and the proposal that crystalloid resuscitation from low capillary pressures is rational. Any potential advantage of plasma or plasma substitutes over crystalloids for volume expansion only manifests itself at higher capillary pressures.

Treatment goals and treatment in exercise therapy.

NARCIS (Netherlands)

Zuijderduin, W.M.; Dekker, J.

1994-01-01

In the present study a quantitative description is given of treatment in exercise therapy according to Cesar and according to Mensendieck. Information was gathered from saurvey on exercise therapy in the Netherlands. Characteristics of treatment are described including treatment goals, emphasis of

Goal-directed diuresis: A case - control study of continuous furosemide infusion in critically ill trauma patients

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Daniel Dante Yeh

2015-01-01

Full Text Available Background: Excessive crystalloid administration is common and associated with negative outcomes in critically ill trauma patients. Continuous furosemide infusion (CFI to remove excessive fluid has not been previously described in this population. We hypothesized that a goal-directed CFI is more effective for fluid removal than intermittent bolus injection (IBI diuresis without excess incidence of hypokalemia or renal failure. Materials and Methods: CFI cases were prospectively enrolled between November 2011 and August 2012, and matched to historic IBI controls by age, gender, Injury Severity Score (ISS, and net fluid balance (NFB at diuresis initiation. Paired and unpaired analyses were performed to compare groups. The primary endpoints were net fluid balance, potassium and creatinine levels. Secondary endpoints included intensive care unit (ICU and hospital length of stay (LOS, ventilator-free days (VFD, and mortality. Results: 55 patients were included, with 19 cases and 36 matched controls. Mean age was 54 years, mean ISS was 32.7, and mean initial NFB was +7.7 L. After one day of diuresis with CFI vs. IBI, net 24 h fluid balance was negative (−0.55 L vs. +0.43 L, P = 0.026 only for the CFI group, and there was no difference in potassium and creatinine levels. Cumulative furosemide dose (59.4mg vs. 25.4mg, P < 0.001 and urine output (4.2 L vs. 2.8 L, P < 0.001 were also significantly increased with CFI vs. IBI. There were no statistically significant differences in ICU LOS, hospital LOS, VFD, or mortality. Conclusions: Compared to IBI, goal-directed diuresis by CFI is more successful in achieving net negative fluid balance in patients with fluid overload with no detrimental side effects on renal function or patient outcome.

Cerebrospinal fluid asparagine depletion during pegylated asparaginase therapy in children with acute lymphoblastic leukaemia

DEFF Research Database (Denmark)

Henriksen, Louise Tram; Nersting, Jacob; Raja, Raheel A

2014-01-01

L-asparaginase is an important drug in the treatment of childhood acute lymphoblastic leukaemia (ALL). Cerebrospinal fluid (CSF) asparagine depletion is considered a marker of asparaginase effect in the central nervous system (CNS) and may play a role in CNS-directed anti-leukaemia therapy. The o...... in CSF asparagine corresponded to serum enzyme activities above 50 iu/l. Higher serum enzyme activities were not followed by more extensive depletion. In conclusion, pegylated asparaginase 1000 iu/m(2) i.m. every second week effectively reduced CSF asparagine levels.......L-asparaginase is an important drug in the treatment of childhood acute lymphoblastic leukaemia (ALL). Cerebrospinal fluid (CSF) asparagine depletion is considered a marker of asparaginase effect in the central nervous system (CNS) and may play a role in CNS-directed anti-leukaemia therapy....... The objective of this study was to describe CSF asparagine depletion during 30 weeks of pegylated asparaginase therapy, 1000 iu/m(2) i.m. every second week, and to correlate CSF asparagine concentration with serum L-asparaginase enzyme activity. Danish children (1-17 years) with ALL, treated according...

Fluid Therapy: Double-Edged Sword during Critical Care?

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Benes, Jan; Kirov, Mikhail; Kuzkov, Vsevolod; Lainscak, Mitja; Molnar, Zsolt; Voga, Gorazd; Monnet, Xavier

2015-01-01

Fluid therapy is still the mainstay of acute care in patients with shock or cardiovascular compromise. However, our understanding of the critically ill pathophysiology has evolved significantly in recent years. The revelation of the glycocalyx layer and subsequent research has redefined the basics of fluids behavior in the circulation. Using less invasive hemodynamic monitoring tools enables us to assess the cardiovascular function in a dynamic perspective. This allows pinpointing even distinct changes induced by treatment, by postural changes, or by interorgan interactions in real time and enables individualized patient management. Regarding fluids as drugs of any other kind led to the need for precise indication, way of administration, and also assessment of side effects. We possess now the evidence that patient centered outcomes may be altered when incorrect time, dose, or type of fluids are administered. In this review, three major features of fluid therapy are discussed: the prediction of fluid responsiveness, potential harms induced by overzealous fluid administration, and finally the problem of protocol-led treatments and their timing.

Habitual versus goal-directed action control in Parkinson disease.

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de Wit, Sanne; Barker, Roger A; Dickinson, Anthony D; Cools, Roshan

2011-05-01

This study presents the first direct investigation of the hypothesis that dopamine depletion of the dorsal striatum in mild Parkinson disease leads to impaired stimulus-response habit formation, thereby rendering behavior slow and effortful. However, using an instrumental conflict task, we show that patients are able to rely on direct stimulus-response associations when a goal-directed strategy causes response conflict, suggesting that habit formation is not impaired. If anything our results suggest a disease severity-dependent deficit in goal-directed behavior. These results are discussed in the context of Parkinson disease and the neurobiology of habitual and goal-directed behavior.

Goal-Directed Decision Making with Spiking Neurons.

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Friedrich, Johannes; Lengyel, Máté

2016-02-03

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules

Neutrophil gelatinase-associated lipocalin and albuminuria as predictors of acute kidney injury in patients treated with goal-directed haemodynamic therapy after major abdominal surgery.

LENUS (Irish Health Repository)

Cullen, Mr

2013-10-11

Neutrophil gelatinase-associated lipocalin (NGAL) is emerging as a new biomarker for the early identification of acute kidney injury (AKI). There is also increasing evidence of an association between urinary albumin\\/creatinine ratio (ACR) and AKI. The primary aim of this study was to evaluate the clinical utility of these biomarkers to predict AKI in a population of perioperative patients treated with goal-directed haemodynamic therapy (GDHT). Secondary aims were to examine NGAL and ACR as sensitive biomarkers to detect the effects of GDHT and to investigate the association of these biomarkers with secondary outcomes.

Directed Fluid Transport with Biomimetic ``Silia'' Arrays

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Shields, A. R.; Evans, B. A.; Carstens, B. L.; Falvo, M. R.; Washburn, S.; Superfine, R.

2008-10-01

We present results on the long-range, directed fluid transport produced by the collective beating of arrays of biomimetic ``silia.'' Silia are arrays of free-standing nanorods roughly the size of biological cilia, which we fabricate from a polymer-magnetic nanoparticle composite material. With external permanent magnets we actuate our silia such that their motion mimics the beating of biological cilia. Biological cilia have evolved to produce microscale fluid transport and are increasingly being recognized as critical components in a wide range of biological systems. However, despite much effort cilia generated fluid flows remain an area of active study. In the last decade, cilia-driven fluid flow in the embryonic node of vertebrates has been implicated as the initial left-right symmetry breaking event in these embryos. With silia we generate directional fluid transport by mimicking the tilted conical beating of these nodal cilia and seek to answer open questions about the nature of particle advection in such a system. By seeding fluorescent microparticles into the fluid we have noted the existence of two distinct flow regimes. The fluid flow is directional and coherent above the tips of the silia, while between the silia tips and floor particle motion is complicated and suggestive of chaotic advection.

Enteral fluid therapy through nasogastric tube in rumen cannulated goats

Directory of Open Access Journals (Sweden)

Katia Atoji-Henrique

2012-12-01

Full Text Available This paper reports the effects of fluid therapy in goats through nasogastric route with an electrolyte solution composed by concentrations of sodium, potassium and chloride similar to goat plasma (140mmol/L of Na+, 4.5mmol/L of K+, 110mmol/L of Cl-. Four Alpine Chamoisee goats, two of them with evident leakage of the rumen cannulas, were used in a crossover experimental design of two periods and two groups. In one group the two goats were submitted to a treatment protocol to induce dehydration before the fluid therapy, whereas the other group was not. Fluid therapy consisted supplying 10mL/kg/h of the electrolyte solution during 8 hours. No signs of discomfort or stress were observed. The dehydration model employed caused a mild dehydration indicated by decrease in feces humidity, body weight and abdominal circumference, and increase in plasma total solids concentration. During fluid therapy globular volume and plasma total solids decreased, whereas % body weight and abdominal circumference increased. No signs of hyperhydration were observed and serum electrolytes (Na+, Cl-, K+ presented no significant alterations in both groups. Fluid therapy proposed in this study was efficient to treat dehydration, even for rumen cannulated animals with evident leakage, and can be administrated safely with no electrolyte imbalance.

Oral rehydration therapy for preoperative fluid and electrolyte management.

Science.gov (United States)

Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae

2011-01-01

Preoperative fluid and electrolyte management is usually performed by intravenous therapy. We investigated the safety and effectiveness of oral rehydration therapy (ORT) for preoperative fluid and electrolyte management of surgical patients. The study consisted of two studies, designed as a prospective observational study. In a pilot study, 20 surgical patients consumed 1000 mL of an oral rehydration solution (ORS) until 2 h before induction of general anesthesia. Parameters such as serum electrolyte concentrations, fractional excretion of sodium (FENa) as an index of renal blood flow, volume of esophageal-pharyngeal fluid and gastric fluid (EPGF), and patient satisfaction with ORT were assessed. In a follow-up study to assess the safety of ORT, 1078 surgical patients, who consumed ORS until 2 h before induction of general anesthesia, were assessed. In the pilot study, water, electrolytes, and carbohydrate were effectively and safely supplied by ORT. The FENa value was increased at 2 h following ORT. The volume of EPGF collected following the induction of anesthesia was 5.3±5.6 mL. In the follow-up study, a small amount of vomiting occurred in one patient, and no aspiration occurred in the patients. These results suggest that ORT is a safe and effective therapy for the preoperative fluid and electrolyte management of selected surgical patients.

Goal-directed learning and obsessive–compulsive disorder

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Gillan, Claire M.; Robbins, Trevor W.

2014-01-01

Obsessive–compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence, historical and recent, that originally led to this supposition and continues to support a habit hypothesis of OCD. We will then discuss a number of recent studies that have directly tested this hypothesis, using behavioural experiments in patient populations. Based on this research evidence, which suggests that rather than goal-directed avoidance behaviours, compulsions in OCD may derive from manifestations of excessive habit formation, we present the details of a novel account of the functional relationship between these habits and the full symptom profile of the disorder. Borrowing from a cognitive dissonance framework, we propose that the irrational threat beliefs (obsessions) characteristic of OCD may be a consequence, rather than an instigator, of compulsive behaviour in these patients. This lays the foundation for a potential shift in both clinical and neuropsychological conceptualization of OCD and related disorders. This model may also prove relevant to other putative disorders of compulsivity, such as substance dependence, where the experience of ‘wanting’ drugs may be better understood as post hoc rationalizations of otherwise goal-insensitive, stimulus-driven behaviour. PMID:25267818

Preoperative fluid and electrolyte management with oral rehydration therapy.

Science.gov (United States)

Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae; Takamori, Mina; Kawasaki, Rieko; Momiyama, Yukinori; Takano, Osami; Shibata, Toshinari; Goto, Takahisa

2009-01-01

We hypothesized that oral rehydration therapy using an oral rehydration solution may be effective for preoperative fluid and electrolyte management in surgical patients before the induction of general anesthesia, and we investigated the safety and effectiveness of oral rehydration therapy as compared with intravenous therapy. Fifty female patients who underwent breast surgery were randomly allocated to two groups. Before entry to the operation room and the induction of general anesthesia, 25 patients drank 1000 ml of an oral rehydration solution ("oral group") and 25 patients were infused with 1000 ml of an intravenous electrolyte solution ("intravenous group"). Parameters such as electrolyte concentrations in serum and urine, urine volume, vital signs, vomiting and aspiration, volumes of esophageal-pharyngeal fluid and gastric fluid (EPGF), and patient satisfaction with the therapy (as surveyed by a questionnaire) were assessed. After treatment, the serum sodium concentration and the hematocrit value, which both declined within the normal limits, were significantly higher in the oral group than in the intravenous group (sodium, 140.8 +/- 2.9 mEq x l(-1) in the oral group and 138.7 +/- 1.9 mEq x l(-1) in the intravenous group; P = 0.005; hematocrit, 39.03 +/- 4.16% in the oral group and 36.15 +/- 3.41% in the intravenous group; P = 0.01). No significant difference was observed in serum glucose values. Urine volume was significantly larger in the oral group (864.9 +/- 211.5 ml) than in the intravenous group (561.5 +/- 216.0 ml; P rehydration therapy, as judged by factors such as "feeling of hunger", "occurrence of dry mouth", and "less restriction in physical activity". The volume of EPGF collected following the induction of anesthesia was significantly smaller in the oral group than in the intravenous group (6.03 +/- 9.14 ml in the oral group and 21.76 +/- 30.56 ml in the intravenous group; P rehydration therapy with an oral rehydration solution before surgery is

Fluid and electrolyte disturbances in critically ill patients.

Science.gov (United States)

Lee, Jay Wook

2010-12-01

Disturbances in fluid and electrolytes are among the most common clinical problems encountered in the intensive care unit (ICU). Recent studies have reported that fluid and electrolyte imbalances are associated with increased morbidity and mortality among critically ill patients. To provide optimal care, health care providers should be familiar with the principles and practice of fluid and electrolyte physiology and pathophysiology. Fluid resuscitation should be aimed at restoration of normal hemodynamics and tissue perfusion. Early goal-directed therapy has been shown to be effective in patients with severe sepsis or septic shock. On the other hand, liberal fluid administration is associated with adverse outcomes such as prolonged stay in the ICU, higher cost of care, and increased mortality. Development of hyponatremia in critically ill patients is associated with disturbances in the renal mechanism of urinary dilution. Removal of nonosmotic stimuli for vasopressin secretion, judicious use of hypertonic saline, and close monitoring of plasma and urine electrolytes are essential components of therapy. Hypernatremia is associated with cellular dehydration and central nervous system damage. Water deficit should be corrected with hypotonic fluid, and ongoing water loss should be taken into account. Cardiac manifestations should be identified and treated before initiating stepwise diagnostic evaluation of dyskalemias. Divalent ion deficiencies such as hypocalcemia, hypomagnesemia and hypophosphatemia should be identified and corrected, since they are associated with increased adverse events among critically ill patients.

Directed Fluid Transport and Mixing with Biomimetic Cilia Arrays

Science.gov (United States)

Shields, A. R.; Evans, B. A.; Carstens, B. L.; Falvo, M. R.; Washburn, S.; Superfine, R.

2009-03-01

We present results on the long-range, directed fluid transport and fluidic mixing produced by the collective beating of arrays of biomimetic cilia. These artificial cilia are arrays of free-standing nanorods roughly the size of biological cilia, which we fabricate from a polymer-magnetic nanoparticle composite material and actuate with permanent magnets to mimic biological cilia. Biological cilia have evolved to produce microscale fluid transport and are increasingly being recognized as critical components in a wide range of biological systems. However, despite much effort cilia generated fluid flows remain an area of active study. In the last decade, cilia-driven fluid flow in the embryonic node of vertebrates has been implicated as the initial left-right symmetry breaking event in these embryos. With silia we generate directional fluid transport by mimicking the tilted conical beating of these nodal cilia. By seeding fluorescent microparticles into the fluid we have noted the existence of two distinct flow regimes. The fluid flow is directional and coherent above the cilia tips, while between the cilia tips and the floor particle motion is complicated and suggestive of chaotic advection.

The Neural Representation of Goal-Directed Actions and Outcomes in the Ventral Striatum's Olfactory Tubercle

Science.gov (United States)

Gadziola, Marie A.

2016-01-01

The ventral striatum is critical for evaluating reward information and the initiation of goal-directed behaviors. The many cellular, afferent, and efferent similarities between the ventral striatum's nucleus accumbens and olfactory tubercle (OT) suggests the distributed involvement of neurons within the ventral striatopallidal complex in motivated behaviors. Although the nucleus accumbens has an established role in representing goal-directed actions and their outcomes, it is not known whether this function is localized within the nucleus accumbens or distributed also within the OT. Answering such a fundamental question will expand our understanding of the neural mechanisms underlying motivated behaviors. Here we address whether the OT encodes natural reinforcers and serves as a substrate for motivational information processing. In recordings from mice engaged in a novel water-motivated instrumental task, we report that OT neurons modulate their firing rate during initiation and progression of the instrumental licking behavior, with some activity being internally generated and preceding the first lick. We further found that as motivational drive decreases throughout a session, the activity of OT neurons is enhanced earlier relative to the behavioral action. Additionally, OT neurons discriminate the types and magnitudes of fluid reinforcers. Together, these data suggest that the processing of reward information and the orchestration of goal-directed behaviors is a global principle of the ventral striatum and have important implications for understanding the neural systems subserving addiction and mood disorders. SIGNIFICANCE STATEMENT Goal-directed behaviors are widespread among animals and underlie complex behaviors ranging from food intake, social behavior, and even pathological conditions, such as gambling and drug addiction. The ventral striatum is a neural system critical for evaluating reward information and the initiation of goal-directed behaviors. Here we

Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: “A clinical outcome and biomarker-based study”

Directory of Open Access Journals (Sweden)

Poonam Malhotra Kapoor

2016-01-01

Full Text Available Goal-directed therapy (GDT encompasses guidance of intravenous (IV fluid and vasopressor/inotropic therapy by cardiac output or similar parameters to help in early recognition and management of high-risk cardiac surgical patients. With the aim of establishing the utility of perioperative GDT using robust clinical and biochemical outcomes, we conducted the present study. This multicenter randomized controlled study included 130 patients of either sex, with European system for cardiac operative risk evaluation ≥3 undergoing coronary artery bypass grafting on cardiopulmonary bypass. The patients were randomly divided into the control and GDT group. All the participants received standardized care; arterial pressure monitored through radial artery, central venous pressure (CVP through a triple lumen in the right internal jugular vein, electrocardiogram, oxygen saturation, temperature, urine output per hour, and frequent arterial blood gas (ABG analysis. In addition, cardiac index (CI monitoring using FloTrac™ and continuous central venous oxygen saturation (ScVO2 using PreSep™ were used in patients in the GDT group. Our aim was to maintain the CI at 2.5–4.2 L/min/m2, stroke volume index 30–65 ml/beat/m2, systemic vascular resistance index 1500–2500 dynes/s/cm5/m2, oxygen delivery index 450–600 ml/min/m2, continuous ScVO2 >70%, and stroke volume variation 30%, and urine output >1 ml/kg/h. The aims were achieved by altering the administration of IV fluids and doses of inotropes or vasodilators. The data of sixty patients in each group were analyzed in view of ten exclusions. The average duration of ventilation (19.89 ± 3.96 vs. 18.05 ± 4.53 h, P = 0.025, hospital stay (7.94 ± 1.64 vs. 7.17 ± 1.93 days, P = 0.025, and Intensive Care Unit (ICU stay (3.74 ± 0.59 vs. 3.41 ± 0.75 days, P = 0.012 was significantly less in the GDT group, compared to the control group. The extra volume added and the number of inotropic dose adjustments were

Outcomes of implementation of enhanced goal directed therapy in high-risk patients undergoing abdominal surgery

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Lakshmi Kumar

2015-01-01

Full Text Available Background and Aims: Advanced monitoring targeting haemodynamic and oxygenation variables can improve outcomes of surgery in high-risk patients. We aimed to assess the impact of goal directed therapy (GDT targeting cardiac index (CI and oxygen extraction ratio (O 2 ER on outcomes of high-risk patients undergoing abdominal surgery. Methods: In a prospective randomised trial, forty patients (American Society of Anaesthesiologists II and III undergoing major abdominal surgeries were randomised into two groups. In-Group A mean arterial pressure ≥ 65 mmHg, central venous pressure ≥ 8-10 mmHg, urine output ≥ 0.5 mL/kg/h and central venous oxygen saturation ≥ 70% were targeted intra-operatively and 12 h postoperatively. In-Group-B (enhanced GDT, in addition to the monitoring in-Group-A, CI ≥ 2.5 L/min/m 2 and O 2 ER ≤ 27% were targeted. The end-points were lactate levels and base deficit during and after surgery. The secondary end points were length of Intensive Care Unit (ICU and hospital stay and postoperative complications. Wilcoxon Mann Whitney and Chi-square tests were used for statistical assessment. Results: Lactate levels postoperatively at 4 and 8 h were lower in-Group-B (P < 0.05. The mean base deficit at 3, 4, 5 and 6 h intra-operatively and postoperatively after 4, 8 and 12 h were lower in-Group-B (P < 0.05. There were no significant differences in ICU stay (2.10 ± 1.52 vs. 2.90 ± 2.51 days or hospital stay (10.85 + 4.39 vs. 13.35 + 6.77 days between Group A and B. Conclusions: Implementation of enhanced GDT targeting CI and OER was associated with improved tissue oxygenation.

Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids

Science.gov (United States)

2008-08-01

SUBJECT TERMS Cancer therapy by localized immune response, Magneto -rehological Fluids 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT...Metastasized Breast Cancer by Localized Therapy utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit Evrensel...2008 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy utilizing

Hope and self-regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior.

NARCIS (Netherlands)

Poels, K.; Dewitte, S.

2008-01-01

This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

Hope and self regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior

NARCIS (Netherlands)

Poels, K.; Dewitte, S.; Astregaard, S.; Dwight, M.

2007-01-01

This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

Mirroring "meaningful" actions: sensorimotor learning modulates imitation of goal-directed actions.

Science.gov (United States)

Catmur, Caroline; Heyes, Cecilia

2017-06-19

Imitation is important in the development of social and technological skills throughout the lifespan. Experiments investigating the acquisition and modulation of imitation (and of its proposed neural substrate, the mirror neuron system) have produced evidence that the capacity for imitation depends on associative learning in which connections are formed between sensory and motor representations of actions. However, evidence that the development of imitation depends on associative learning has been found only for non-goal-directed actions. One reason for the lack of research on goal-directed actions is that imitation of such actions is commonly confounded with the tendency to respond in a spatially compatible manner. However, since the most prominent account of mirror neuron function, and hence of imitation, suggests that these cells encode goal-directed actions, it is important to establish whether sensorimotor learning can also modulate imitation of goal-directed actions. Experiment 1 demonstrated that imitation of goal-directed grasping can be measured while controlling for spatial compatibility, and Experiment 2 showed that this imitation effect can be modulated by sensorimotor training. Together these data support the hypothesis that the capacity for behavioural imitation, and the properties of the mirror neuron system, are constructed in the course of development through associative learning.

A Unifying Approach to Goal-Directed Evaluation

DEFF Research Database (Denmark)

Danvy, Olivier; Rhiger, Morten; Grobauer, Bernd

2001-01-01

Goal-directed evaluation, as embodied in Icon and Snobol, is built on the notions of backtracking and of generating successive results, and therefore it has always been something of a challenge to specify and implement. In this article, we address this challenge using computational monads and par...

Standard on microbiological management of fluids for hemodialysis and related therapies by the Japanese Society for Dialysis Therapy 2008.

Science.gov (United States)

Kawanishi, Hideki; Akiba, Takashi; Masakane, Ikuto; Tomo, Tadashi; Mineshima, Michio; Kawasaki, Tadayuki; Hirakata, Hideki; Akizawa, Tadao

2009-04-01

The Committee of Scientific Academy of the Japanese Society for Dialysis Therapy (JSDT) proposes a new standard on microbiological management of fluids for hemodialysis and related therapies. This standard is within the scope of the International Organization for Standardization (ISO), which is currently under revision. This standard is to be applied to the central dialysis fluid delivery systems (CDDS), which are widely used in Japan. In this standard, microbiological qualities for dialysis water and dialysis fluids are clearly defined by endotoxin level and bacterial count. The qualities of dialysis fluids were classified into three levels: standard, ultrapure, and online prepared substitution fluid. In addition, the therapeutic application of each dialysis fluid is clarified. Since high-performance dialyzers are frequently used in Japan, the standard recommends that ultrapure dialysis fluid be used for all dialysis modalities at all dialysis facilities. It also recommends that the dialysis equipment safety management committee at each facility should validate the microbiological qualities of online prepared substitution fluid.

The Direct Effect of Flexible Walls on Fontan Connection Fluid Dynamics

Science.gov (United States)

Tree, Mike; Fagan, Kiley; Yoganathan, Ajit

2014-11-01

The current standard treatment for sufferers of congenital heart defects is the palliative Fontan procedure. The Fontan procedure results in an anastomosis of major veins directly to the branched pulmonary arteries bypassing the dysfunctional ventricle. This total cavopulmonary connection (TCPC) extends life past birth, but Fontan patients still suffer long-term complications like decreased exercise capacity, protein-losing enteropathy, and pulmonary arteriovenous malformations (PAVM). These complications have direct ties to fluid dynamics within the connection. Previous experimental and computation studies of Fontan connection fluid dynamics employed rigid vessel models. More recent studies utilize flexible models, but a direct comparison of the fundamental fluid dynamics between rigid and flexible vessels only exists for a computational model, without a direct experimental validation. Thus, this study was a direct comparison of fluid dynamics within a rigid and two compliant idealized TCPCs. 2D particle image velocimetry measurements were collected at the connection center plane. Results include power loss, hepatic flow distribution, fluid shear stress, and flow structure recognition. The effect of flexible walls on these values and clinical impact will be discussed.

Explosive Evaporating Phenomena of Cryogenic Fluids by Direct Contacting Normal Temperature Fluids

Directory of Open Access Journals (Sweden)

T Watanabe

2016-09-01

Full Text Available Cryogenic fluids have characteristics such as thermal stratification and flashing by pressure release in storage vessel. The mixture of the extreme low temperature fluid and the normal temperature fluid becomes the cause which causes pressure vessel and piping system crush due to explosive boiling and rapid freezing. In recent years in Japan, the demand of cryogenic fluids like a LH2, LNG is increasing because of the advance of fuel cell device technology, hydrogen of engine, and stream of consciousness for environmental agreement. These fuel liquids are cryogenic fluids. On the other hand, as for fisheries as well, the use of a source of energy that environment load is small has been being a pressing need. And, the need of the ice is high, as before, for keeping freshness of marine products in fisheries. Therefore, we carried out the experiments related to promotion of evaporating cryogenic fluids and generation of ice, in the contact directly of the water and liquid nitrogen. From the results of visualization, phenomena of explosive evaporating and ice forming were observed by using video camera.

Sleep Deprivation Promotes Habitual Control over Goal-Directed Control: Behavioral and Neuroimaging Evidence.

Science.gov (United States)

Chen, Jie; Liang, Jie; Lin, Xiao; Zhang, Yang; Zhang, Yan; Lu, Lin; Shi, Jie

2017-12-06

Sleep is one of the most fundamental processes of life, playing an important role in the regulation of brain function. The long-term lack of sleep can cause memory impairments, declines in learning ability, and executive dysfunction. In the present study, we evaluated the effects of sleep deprivation on instrumental learning behavior, particularly goal-directed and habitual actions in humans, and investigated the underlying neural mechanisms. Healthy college students of either gender were enrolled and randomly divided into sleep deprivation group and sleep control group. fMRI data were collected. We found that one night of sleep deprivation led to greater responsiveness to stimuli that were associated with devalued outcomes in the slips-of-action test, indicating a deficit in the formation of goal-directed control and an overreliance on habits. Furthermore, sleep deprivation had no effect on the expression of acquired goal-directed action. The level of goal-directed action after sleep deprivation was positively correlated with baseline working memory capacity. The neuroimaging data indicated that goal-directed learning mainly recruited the ventromedial PFC (vmPFC), the activation of which was less pronounced during goal-directed learning after sleep deprivation. Activation of the vmPFC during goal-directed learning during training was positively correlated with the level of goal-directed action performance. The present study suggests that people rely predominantly on habits at the expense of goal-directed control after sleep deprivation, and this process involves the vmPFC. These results contribute to a better understanding of the effects of sleep loss on decision-making. SIGNIFICANCE STATEMENT Understanding the cognitive consequences of sleep deprivation has become extremely important over the past half century, given the continued decline in sleep duration in industrialized societies. Our results provide novel evidence that goal-directed action may be

Fluid therapy in the perioperative setting-a clinical review

DEFF Research Database (Denmark)

Voldby, Anders Winther; Brandstrup, Birgitte

2016-01-01

BACKGROUND: Perioperative hypovolemia and fluid overload have effects on both complications following surgery and on patient survival. Therefore, the administration of intravenous fluids before, during, and after surgery at the right time and in the right amounts is of great importance. This review...... aims to analyze the literature concerning perioperative fluid therapy in abdominal surgery and to provide evidence-based recommendations for clinical practice. RESULTS: Preoperative oral or intravenous administration of carbohydrate containing fluids has been shown to improve postoperative well...... for most patients. It is less expensive and simpler than the zero-balance GDT approach and therefore recommended in this review. In outpatient surgery, 1-2 L of balanced crystalloids reduces postoperative nausea and vomiting and improves well-being....

Using shared goal setting to improve access and equity: a mixed methods study of the Good Goals intervention in children’s occupational therapy

Directory of Open Access Journals (Sweden)

Kolehmainen Niina

2012-08-01

Full Text Available Abstract Background Access and equity in children’s therapy services may be improved by directing clinicians’ use of resources toward specific goals that are important to patients. A practice-change intervention (titled ‘Good Goals’ was designed to achieve this. This study investigated uptake, adoption, and possible effects of that intervention in children’s occupational therapy services. Methods Mixed methods case studies (n = 3 services, including 46 therapists and 558 children were conducted. The intervention was delivered over 25 weeks through face-to-face training, team workbooks, and ‘tools for change’. Data were collected before, during, and after the intervention on a range of factors using interviews, a focus group, case note analysis, routine data, document analysis, and researchers’ observations. Results Factors related to uptake and adoptions were: mode of intervention delivery, competing demands on therapists’ time, and leadership by service manager. Service managers and therapists reported that the intervention: helped therapists establish a shared rationale for clinical decisions; increased clarity in service provision; and improved interactions with families and schools. During the study period, therapists’ behaviours changed: identifying goals, odds ratio 2.4 (95% CI 1.5 to 3.8; agreeing goals, 3.5 (2.4 to 5.1; evaluating progress, 2.0 (1.1 to 3.5. Children’s LoT decreased by two months [95% CI −8 to +4 months] across the services. Cost per therapist trained ranged from £1,003 to £1,277, depending upon service size and therapists’ salary bands. Conclusions Good Goals is a promising quality improvement intervention that can be delivered and adopted in practice and may have benefits. Further research is required to evaluate its: (i impact on patient outcomes, effectiveness, cost-effectiveness, and (ii transferability to other clinical contexts.

Intensity and direction of competitive anxiety as a function of goal attainment expectation and competition goal generation.

Science.gov (United States)

O'Brien, M; Hanton, S; Mellalieu, S D

2005-12-01

Jones's control model was adopted to investigate differences in the labelling of symptoms associated with pre-competition anxiety and self-confidence as a function of goal attainment expectation and competition goal generation. Team sport performers (N = 96) were divided into outcome, performance and process goal groups. Anxiety intensity and direction, and self-confidence were then examined as a function of goal expectancy (positive or negative) and perceived input into goal production (input or no input). MANOVA and follow-up ANOVA supported the study predictions. Specifically, participants who reported positive expectations of goal achievement and indicated some input into the goal generation process experienced the most facilitative interpretations of cognitive symptoms and greater self-confidence. The results highlight the need to consider how goals are generated when attempting to foster a sense of control and help athletes cope with the psychological demands of competition.

Fluid therapy in neurotrauma: basic and clinical concepts

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Hernando Raphael Alvis-Miranda

2014-01-01

Full Text Available The patient with head trauma is a challenge for the emergency physician and for the neurosurgeon. Currently traumatic brain injury constitutes a public health problem. Knowledge of the various therapeutic strategies to provide support in the prehospital and perioperative are essential for optimal care. Rapid infusion of large volumes of crystalloids to restore blood volume and blood pressure quickly is now the standard treatment for patients with combined TBI and HS The fluid in patients with brain and especially in the carrier of brain injury is a critical topic; we present a review of the literature about the history, physiology of current fluid preparations, and a discussion regard the use of fluid therapy in traumatic brain injury and decompressive craniectomy.http://dx.doi.org/10.7175/rhc.v5i1.636

Dielectric fluid directional spreading under the action of corona discharge

Science.gov (United States)

Zhou, Shangru; Liu, Jie; Hu, Qun; Jiang, Teng; Yang, Jinchu; Liu, Sheng; Zheng, Huai

2018-01-01

Liquid spreading is a very common nature phenomenon and of significant importance for a broad range of applications. In this study, a dielectric fluid directional spreading phenomenon is presented. Under the action of corona discharge, a dielectric fluid, here a typical silicone directionally spreads along conductive patterns on conductive/nonconductive substrates. Directional spreading behaviors of silicone were experimentally observed on different conductive patterns in detail. Spreading speeds were analyzed at different driving voltages, which induced the corona discharge. The presented phenomenon may be useful to inspire several techniques of manipulating liquid transportation and fabricating micropatterns.

New Directions in Mathematical Fluid Mechanics

CERN Document Server

Fursikov, Andrei V

2010-01-01

The scientific interests of Professor A.V. Kazhikhov were fundamentally devoted to Mathematical Fluid Mechanics, where he achieved outstanding results that had, and still have, a significant influence on this field. This volume, dedicated to the memory of A.V. Kazhikhov, presents the latest contributions from renowned world specialists in a number of new important directions of Mathematical Physics, mostly of Mathematical Fluid Mechanics, and, more generally, in the field of nonlinear partial differential equations. These results are mostly related to boundary value problems and to control problems for the Navier-Stokes equations, and for equations of heat convection. Other important topics include non-equilibrium processes, Poisson-Boltzmann equations, dynamics of elastic body, and related problems of function theory and nonlinear analysis.

Fluid bed direct denitration process for plutonium nitrate to oxide conversion

International Nuclear Information System (INIS)

Souply, K.R.; Neal, D.H.

1977-01-01

The fluid bed direct-denitration process appears feasible for reprocessing Light Water Reactor fuel. Considerable experience with the fluid bed process exists in the denitration of uranyl nitrate and it shows promise for use in the denitration of plutonium nitrate. The process will require some development work before it can be used in a production-size facility. This report describes a fluid bed direct-denitration process for converting plutonium nitrate to plutonium oxide, and the information should be used when making comparisons of alternative processes or as a basis for further detailed studies

Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids. Addendum

Science.gov (United States)

2009-08-01

Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible Magnetic Fluids PRINCIPAL INVESTIGATOR: Cahit A. Evrensel...AND SUBTITLE 5a. CONTRACT NUMBER Immune Response Augmentation in Metastasized Breast Cancer by Localized Therapy Utilizing Biocompatible... Magneto -rheological Fluid (MRF) iron nano-particles were synthesized using the reverse micelle technique and coated with poly(NIPAAm). The size

The Effects of Methylphenidate on Goal-Directed Behavior in a Rat Model of ADHD

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Joman Y. Natsheh

2015-11-01

Full Text Available Although attentional and motor alterations in Attention Deficit Hyperactivity Disorder (ADHD have been well characterized, less is known about how this disorder impacts goal-directed behavior. To investigate whether there is a misbalance between goal-directed and habitual behaviors in an animal model of ADHD, we tested adult [P75-P105] Spontaneously Hypertensive Rats (SHR (ADHD rat model and Wistar-Kyoto rats (WKY, the normotensive control strain, on an instrumental conditioning paradigm with two phases: a free-operant training phase in which rats separately acquired two distinct action-outcome contingencies, and a choice test conducted in extinction prior to which one of the food outcomes was devalued through specific satiety. To assess the effects of Methylphenidate, a commonly used ADHD medication, on goal-directed behavior, we injected rats with either Methylphenidate or saline prior to the choice test. Both rat strains acquired an instrumental response, with SHR responding at greater rates over the course of training. During the choice test WKY demonstrated goal-directed behavior, responding more frequently on the lever that delivered, during training, the still-valued outcome. In contrast, SHR showed no goal-directed behavior, responding equally on both levers. However, methylphenidate administration prior to the choice test restored goal-directed behavior in SHR, and disrupted this behavior in WKY rats. This study provides the first experimental evidence for selective impairment in goal-directed behavior in rat models of ADHD, and how methylphenidate acts differently on SHR and WKY animals to restore or impair this behavior, respectively.

When Preferences Are in the Way: Children's Predictions of Goal-Directed Behaviors.

Science.gov (United States)

Yang, Fan; Frye, Douglas

2017-12-18

Across three studies, we examined 4- to 7-year-olds' predictions of goal-directed behaviors when goals conflict with preferences. In Study 1, when presented with stories in which a character had to act against basic preferences to achieve an interpersonal goal (e.g., playing with a partner), 6- and 7-year-olds were more likely than 4- and 5-year-olds to predict the actor would act in accordance with the goal to play with the partner, instead of fulfilling the basic preference of playing a favored activity. Similar results were obtained in Study 2 with scenarios that each involved a single individual pursuing intrapersonal goals that conflicted with his or her basic preferences. In Study 3, younger children's predictions of goal-directed behaviors did not increase for novel goals and preferences, when the influences of their own preferences, future thinking, or a lack of impulse control were minimized. The results suggest that between ages 4 and 7, children increasingly integrate and give more weight to other sources of motivational information (e.g., goals) in addition to preferences when predicting people's behaviors. This increasing awareness may have implications for children's self-regulatory and goal pursuit behaviors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

A Unifying Approach to Goal-Directed Evaluation

DEFF Research Database (Denmark)

Danvy, Olivier; Grobauer, Bernd; Rhiger, Morten

2001-01-01

semantics coincides with Gudeman’s continuation semantics of Icon. We then compile Icon programs by specializing their interpreter (i.e., by using the first Futamura projection), using type-directed partial evaluation. Through various back ends, including a run-time code generator, we generate ML code, C......Goal-directed evaluation, as embodied in Icon and Snobol, is built on the notions of backtracking and of generating successive results, and therefore it has always been something of a challenge to specify and implement. In this article, we address this challenge using computational monads...... code, and OCaml byte code. Binding-time analysis and partial evaluation of the continuation-based interpreter automatically give rise to C programs that coincide with the result of Proebsting’s optimized compiler....

Evaluation of financial burden following complications after major surgery in France: Potential return after perioperative goal-directed therapy.

Science.gov (United States)

Landais, Alain; Morel, Morgane; Goldstein, Jacques; Loriau, Jerôme; Fresnel, Annie; Chevalier, Corinne; Rejasse, Gilles; Alfonsi, Pascal; Ecoffey, Claude

2017-06-01

Perioperative goal-directed therapy (PGDT) has been demonstrated to improve postoperative outcomes and reduce the length of hospital stays. The objective of our analysis was to evaluate the cost of complications, derived from French hospital payments, and calculate the potential cost savings and length of hospital stay reductions. The billing of 2388 patients who underwent scheduled high-risk surgery (i.e. major abdominal, gynaecologic, urological, vascular, and orthopaedic interventions) over three years was retrospectively collected from three French hospitals (one public-teaching, one public, and one private hospital). A relationship between mortality, length of hospital stays, cost/patient, and severity scores, based mainly on postoperative complications but also on preoperative clinical status, were analysed. Statistical analysis was performed using Student's t-tests or Wilcoxon tests. Our analyses determined that a severity score of 3 or 4 was associated with complications in 90% of cases and this represented 36% of patients who, compared with those with a score of 1 or 2, were associated with significantly increased costs (€ 8205±3335 to € 22,081±16,090; Prisk surgeries per year), the potential financial savings ranged from € 40M to € 68M, not including the costs of PGDT and its implementation. Our analysis demonstrates that patients with complications are significantly more expensive to care for than those without complications. In our model, it was projected that implementing PGDT during high-risk surgery may significantly reduce healthcare costs and the length of hospital stays in France while probably improving patient access to care and reducing waiting times for procedures. Copyright © 2017. Published by Elsevier Masson SAS.

Impaired acquisition of goal-directed action in healthy aging

NARCIS (Netherlands)

de Wit, S.; van de Vijver, I.; Ridderinkhof, K.R.

2014-01-01

According to dual-system theories, instrumental learning is supported by dissociable goal-directed and habitual systems. Previous investigations of the dual-system balance in healthy aging have yielded mixed results. To further investigate this issue, we compared performance of young (17-24 years)

The hemodynamic "target": a visual tool of goal-directed therapy for septic patients Alvo hemodinâmico: uma ferramenta visual de terapia "goal-directed" para pacientes sépticos

Directory of Open Access Journals (Sweden)

Fabrice Vallée

2007-01-01

Full Text Available OBJECTIVE: To improve understanding of the hemodynamic status of patients with sepsis by nursing teams through the attainment of hemodynamic parameters using a pentaxial "target" diagram as a clinical tool. Parameters include cardiac index (CI, arterial oxygen saturation (SaO2, mean arterial pressure (MAP, arterial blood lactate, and central venous oxygen saturation (ScvO2. METHODS: Design: Prospective descriptive study. Setting: The intensive care unit of a university hospital. Patients: During a 6-month period, 38 intubated septic shock patients were included in the study. Survivors and nonsurvivors were compared. Interventions: MAP, CI, SaO2, ScvO2 and lactate were measured at 0, 6, 12, 24, 36, and 48 h. Measurements were recorded on the target diagram along with the norepinephrine infusion rate and the hemoglobin (Hb level. The number of lactate and ScvO2 measurements achieved during the target period were compared to a 6-month retrospective control period just before starting the protocol. We assessed the nurse knowledge status prior to the introduction of target diagram. We then performed a post-test after implementing the new recording technique. MEASUREMENTS AND RESULTS: The nursing team expressed a positive attitude toward the target concept. The mean number of lactate and ScvO2 measurements performed for each patient during the control period was significantly lower than during the target period, and those values were rarely used as goal values before the introduction of the target diagram. At 24 hours, 46% of the survivors had achieved all the goal parameter values of the target diagram, compared to only 10% of nonsurvivors (P = .01. CONCLUSION: The target diagram is a visual multiparametric tool involving all the medical and nursing team that helps achieve goal-directed therapy for septic patients. The number of goal values reached at each time point during the first 48 hours was closely linked to mortality.OBJETIVO: Melhorar a

Effects of Intraoperative Fluid Management on Postoperative Outcomes : A Hospital Registry Study

NARCIS (Netherlands)

Shin, Christina H; Long, Dustin R; McLean, Duncan; Grabitz, Stephanie D; Ladha, Karim; Timm, Fanny P; Thevathasan, Tharusan; Pieretti, Alberto; Ferrone, Cristina; Hoeft, Andreas; Scheeren, Thomas W L; Thompson, Boyd Taylor; Kurth, Tobias; Eikermann, Matthias

2017-01-01

OBJECTIVE: Evaluate the dose-response relationship between intraoperative fluid administration and postoperative outcomes in a large cohort of surgical patients. BACKGROUND: Healthy humans may live in a state of fluid responsiveness without the need for fluid supplementation. Goal-directed protocols

Direct numerical simulation of granular flows with fluid; Simulation numerique directe d'ecoulements granulaires en presence de fluide

Energy Technology Data Exchange (ETDEWEB)

Komiwes, V.

1999-09-01

Numerical models applied to simulation of granular flow with fluid are developed. The physical model selected to describe particles flow is a discrete approach. Particle trajectories are calculated by the Newton law and collision is describe by a soft-sphere approach. The fluid flow is modelled by Navier-Stokes equations. The modelling of the momentum transfer depends on the resolution scale: for a scale of the order of the particle diameter, it is modelled by a drag-law and for a scale smaller than the particle diameter, it is directly calculated by stress tensor computation around particles. The direct model is used to find representative elementary volume and prove the local character of the Ergun's law. This application shows the numerical (mesh size), physical (Reynolds number) and computational (CPU time and memory consumptions) limitations. The drag law model and the direct model are validated with analytical and empirical solutions and compared. For the two models, the CPU time and the memory consumptions are discussed. The drag law model is applied to the simulation of gas-solid dense fluidized-beds. In the case of uniform gas distribution, the fluidized-bed simulation heights are compared to experimental data for particle of group A and B of the Geldart classification. (author)

[State of the art in fluid and volume therapy : A user-friendly staged concept].

Science.gov (United States)

Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-03-01

Adequate fluid therapy is highly important for the perioperative outcome of our patients. Both, hypovolemia and hypervolemia can lead to an increase in perioperative complications and can impair the outcome. Therefore, perioperative infusion therapy should be target-oriented. The main target is to maintain the patient's preoperative normovolemia by using a sophisticated, rational infusion strategy.Perioperative fluid losses should be discriminated from volume losses (surgical blood loss or interstitial volume losses containing protein). Fluid losses as urine or perspiratio insensibilis (0.5-1.0 ml/kg/h) should be replaced by balanced crystalloids in a ratio of 1:1. Volume therapy step 1: Blood loss up to a maximum value of 20% of the patient's blood volume should be replaced by balanced crystalloids in a ratio of 4(-5):1. Volume therapy step 2: Higher blood losses should be treated by using iso-oncotic, preferential balanced colloids in a ratio of 1:1. For this purpose hydroxyethyl starch can also be used perioperatively if there is no respective contraindication, such as sepsis, burn injuries, critically ill patients, renal impairment or renal replacement therapy, and severe coagulopathy. Volume therapy step 3: If there is an indication for red cell concentrates or coagulation factors, a differentiated application of blood and blood products should be performed.

Object-based processes in the planning of goal-directed hand movements

NARCIS (Netherlands)

Bekkering, H.; Pratt, J.

2004-01-01

Theories in motor control suggest that the parameters specified during the planning of goal-directed hand movements to a visual target are defined in spatial parameters like direction and amplitude. Recent findings in the visual attention literature, however, argue widely for early object-based

Direct differentiation of the quasi-incompressible fluid formulation of fluid-structure interaction using the PFEM

Science.gov (United States)

Zhu, Minjie; Scott, Michael H.

2017-07-01

Accurate and efficient response sensitivities for fluid-structure interaction (FSI) simulations are important for assessing the uncertain response of coastal and off-shore structures to hydrodynamic loading. To compute gradients efficiently via the direct differentiation method (DDM) for the fully incompressible fluid formulation, approximations of the sensitivity equations are necessary, leading to inaccuracies of the computed gradients when the geometry of the fluid mesh changes rapidly between successive time steps or the fluid viscosity is nonzero. To maintain accuracy of the sensitivity computations, a quasi-incompressible fluid is assumed for the response analysis of FSI using the particle finite element method and DDM is applied to this formulation, resulting in linearized equations for the response sensitivity that are consistent with those used to compute the response. Both the response and the response sensitivity can be solved using the same unified fractional step method. FSI simulations show that although the response using the quasi-incompressible and incompressible fluid formulations is similar, only the quasi-incompressible approach gives accurate response sensitivity for viscous, turbulent flows regardless of time step size.

Effect of maternal intravenous fluid therapy on external cephalic version at term: a prospective cohort study.

Science.gov (United States)

Burgos, Jorge; Quintana, Eider; Cobos, Patricia; Osuna, Carmen; Centeno, María del Mar; Melchor, Juan Carlos

2014-12-01

We sought to analyze whether maternal intravenous fluid therapy prior to external cephalic version (ECV) increases the amount of amniotic fluid and the success rate of the procedure. This was a prospective single-center cohort study of 200 women with a consecutive cohort of 100 pregnant women with a breech presentation at term who were administered intravenous fluid therapy with 2 L of hypotonic saline before the version attempt, compared to a control cohort of 100 pregnant women not given hydration treatment. The mean increase in the amniotic fluid index (AFI) after intravenous maternal hydration was 3.75 ± 2.71 cm. The amount of fluid before hydration was the only variable found to be associated with increases in amniotic fluid levels, both in absolute and relative terms (odds ratio, -0.21; 95% confidence interval, -0.37 to -0.05 and odds ratio, -4.62; 95% confidence interval, -6.17 to -3.06; P < .01, respectively). We did not observe any severe complications secondary to the intravenous fluid therapy. The ECV success rate was 43% in the study group compared to 47% in the control group (P = .67). The success rate was significantly lower the larger the relative increase in the AFI, although no correlation was found in absolute terms (χ(2) for linear trend = 0.03 and 0.34, respectively). Maternal intravenous fluid therapy with 2 L of hypotonic saline prior to ECV is an effective and safe technique for increasing the AFI. However, its use in ECV does not increase the success rate of the procedure. Copyright © 2014 Elsevier Inc. All rights reserved.

Resolution of conflict between goal-directed actions: outcome encoding and neural control processes.

Science.gov (United States)

de Wit, Sanne; Ostlund, Sean B; Balleine, Bernard W; Dickinson, Anthony

2009-07-01

According to O-R theory of instrumental learning, incongruent biconditional discriminations should be impossible to solve in a goal-directed manner because the event acting as the outcome of one response also acts as a discriminative stimulus for an opposite response. Each event should therefore be associated with two competing responses. However, Dickinson and de Wit (2003) have presented evidence that rats can learn incongruent discriminations. The present study investigated whether rats were able to engage additional processes to solve incongruent discriminations in a goal-directed manner. Experiment 1 provides evidence that rats resolve the response conflict that arises in the incongruent discrimination by differentially encoding events in their roles as discriminative stimulus and as outcome. Furthermore, Experiment 2 shows that once goal-directed control has been established the dorsomedial prefrontal cortex is not directly involved in its maintenance but rather plays a central role in conflict resolution processes.

Fluid overload in the ICU: evaluation and management.

Science.gov (United States)

Claure-Del Granado, Rolando; Mehta, Ravindra L

2016-08-02

Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential. Achieving an appropriate level of volume management requires knowledge of the underlying pathophysiology, evaluation of volume status, and selection of appropriate solution for volume repletion, and maintenance and modulation of the tissue perfusion. Numerous recent studies have established a correlation between fluid overload and mortality in critically ill patients. Fluid overload recognition and assessment requires an accurate documentation of intakes and outputs; yet, there is a wide difference in how it is evaluated, reviewed and utilized. Accurate volume status evaluation is essential for appropriate therapy since errors of volume evaluation can result in either in lack of essential treatment or unnecessary fluid administration, and both scenarios are associated with increased mortality. There are several methods to evaluate fluid status; however, most of the tests currently used are fairly inaccurate. Diuretics, especially loop diuretics, remain a valid therapeutic alternative. Fluid overload refractory to medical therapy requires the application of extracorporeal therapies. In critically ill patients, fluid overload is related to increased mortality and also lead to several complications like pulmonary edema, cardiac failure, delayed wound healing, tissue breakdown, and impaired bowel function. Therefore, the evaluation of volume status is crucial in the early management of critically ill patients. Diuretics are frequently used as an initial therapy; however, due to their limited effectiveness the use of continuous

Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

Science.gov (United States)

Liu, Shuyan; Schad, Daniel J; Kuschpel, Maxim S; Rapp, Michael A; Heinz, Andreas

2016-01-01

Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

Is goal-directed attentional guidance just intertrial priming? A review.

Science.gov (United States)

Lamy, Dominique F; Kristjánsson, Arni

2013-07-01

According to most models of selective visual attention, our goals at any given moment and saliency in the visual field determine attentional priority. But selection is not carried out in isolation--we typically track objects through space and time. This is not well captured within the distinction between goal-directed and saliency-based attentional guidance. Recent studies have shown that selection is strongly facilitated when the characteristics of the objects to be attended and of those to be ignored remain constant between consecutive selections. These studies have generated the proposal that goal-directed or top-down effects are best understood as intertrial priming effects. Here, we provide a detailed overview and critical appraisal of the arguments, experimental strategies, and findings that have been used to promote this idea, along with a review of studies providing potential counterarguments. We divide this review according to different types of attentional control settings that observers are thought to adopt during visual search: feature-based settings, dimension-based settings, and singleton detection mode. We conclude that priming accounts for considerable portions of effects attributed to top-down guidance, but that top-down guidance can be independent of intertrial priming.

The Use of Personal Projects Analysis to Enhance Occupational Therapy Goal Identification

Directory of Open Access Journals (Sweden)

Mary Egan

2016-01-01

Full Text Available Background: Client-centered occupational therapy begins with the identification of personally-relevant patient goals. This study aimed to determine whether the elicitation module of Personal Projects Analysis (PPA could help patients in an acquired brain injury day hospital program identify more meaningful goals than those identified using the Canadian Occupational Performance Measure (COPM alone. Method: Ten patients completed the COPM. They rated the importance of each goal and their confidence that they could attain each goal. During the next session, using the elicitation module of PPA, they identified personal projects just prior to their brain injuries, current personal projects, and future desired personal projects. They were then invited to revise their COPM goals and re-rate them for importance and confidence. Results: Following completion of the elicitation module of PPA, seven participants changed at least one goal. Of the goals that were changed, half were revised to include the mention of another person. There were no significant changes in average goal importance or perceived attainability. Occupational therapists reported that the elicitation module of PPA helped them get to know their patients better and identify potential therapeutic occupations. Discussion: The elicitation module of PPA may help people develop goals that are more embedded in their social contexts.

Towards host-directed therapies for tuberculosis.

Science.gov (United States)

Zumla, Alimuddin; Maeurer, Markus; Chakaya, Jeremiah; Hoelscher, Michael; Ntoumi, Francine; Rustomjee, Roxana; Vilaplana, Cristina; Yeboah-Manu, Dorothy; Rasolof, Voahangy; Munderi, Paula; Singh, Nalini; Aklillu, Eleni; Padayatchi, Nesri; Macete, Eusebio; Kapata, Nathan; Mulenga, Modest; Kibiki, Gibson; Mfinanga, Sayoki; Nyirenda, Thomas; Maboko, Leonard; Garcia-Basteiro, Alberto; Rakotosamimanana, Niaina; Bates, Matthew; Mwaba, Peter; Reither, Klaus; Gagneux, Sebastien; Edwards, Sarah; Mfinanga, Elirehema; Abdulla, Salim; Cardona, Pere-Joan; Russell, James B W; Gant, Vanya; Noursadeghi, Mahdad; Elkington, Paul; Bonnet, Maryline; Menendez, Clara; Dieye, Tandakha N; Diarra, Bassirou; Maiga, Almoustapha; Aseffa, Abraham; Parida, Shreemanta; Wejse, Christian; Petersen, Eskild; Kaleebu, Pontiano; Oliver, Matt; Craig, Gill; Corrah, Tumena; Tientcheu, Leopold; Antonio, Martin; Rao, Martin; McHugh, Timothy D; Sheikh, Aziz; Ippolito, Giuseppe; Ramjee, Gita; Kaufmann, Stefan H E; Churchyard, Gavin; Steyn, Andrie; Grobusch, Martin; Sanne, Ian; Martinson, Neil; Madansein, Rajhmun; Wilkinson, Robert J; Mayosi, Bongani; Schito, Marco; Wallis, Robert S

2015-08-01

The treatment of tuberculosis is based on combinations of drugs that directly target Mycobacterium tuberculosis. A new global initiative is now focusing on a complementary approach of developing adjunct host-directed therapies.

[Individual therapy goals: on outcome documentation of inpatient psychotherapy from the patient and therapist viewpoint].

Science.gov (United States)

Heuft, G; Senf, W; Wagener, R; Pintelon, C; Lorenzen, J

1996-01-01

The results of a study evaluation in practicability of two newly developed documentation forms are presented. Examined are 82 inpatient treatment episodes in an already published clinical concept with different treatment settings. Parallel versions of the forms were completed by patients and therapists. The 'Erge-Doku-A-Form' allows for the naming of up to five therapy goals determined at the beginning of therapy and evaluated in relation to their achieved quality at the end of therapy. The 'Erge-Doku-B-Form' describes a variety of problem areas as well as questions related to medication and changes induced by therapy. Surprising there were a high number of 230 Individual Therapy Goals (ITG) by patients and 262 ITG by therapists which could be arranged into 89 content categories and 5 main categories. Outcome measurement shows different results. There was a significant relationship between the 'well-being', the impression of 'satisfying treatment' at the end of the inpatient period and 'success in the main ITG'. The documentation forms presented here allow an outcome-measurement depending on differential indications.

Applying Tiab’s direct synthesis technique to dilatant non-Newtonian/Newtonian fluids

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Javier Andrés Martínez

2011-09-01

Full Text Available Non-Newtonian fluids, such as polymer solutions, have been used by the oil industry for many years as fracturing agents and drilling mud. These solutions, which normally include thickened water and jelled fluids, are injected into the formation to enhanced oil recovery by improving sweep efficiency. It is worth noting that some heavy oils behave non-Newtonianly. Non-Newtonian fluids do not have direct proportionality between applied shear stress and shear rate and viscosity varies with shear rate depending on whether the fluid is either pseudoplastic or dilatant. Viscosity decreases as shear rate increases for the former whilst the reverse takes place for dilatants. Mathematical models of conventional fluids thus fail when applied to non-Newtonian fluids. The pressure derivative curve is introduced in this descriptive work for a dilatant fluid and its pattern was observed. Tiab’s direct synthesis (TDS methodology was used as a tool for interpreting pressure transient data to estimate effective permeability, skin factors and non-Newtonian bank radius. The methodology was successfully verified by its application to synthetic examples. Also, comparing it to pseudoplastic behavior, it was found that the radial flow regime in the Newtonian zone of dilatant fluids took longer to form regarding both the flow behavior index and consistency factor.

Predictors of Unattempted Central Venous Catheterization in Septic Patients Eligible for Early Goal-directed Therapy

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David R. Vinson

2014-02-01

Full Text Available Introduction: Central venous catheterization (CVC can be an important component of the management of patients with severe sepsis and septic shock. CVC, however, is a time- and resource-intensive procedure associated with serious complications. The effects of the absence of shock or the presence of relative contraindications on undertaking central line placement in septic emergency department (ED patients eligible for early goal-directed therapy (EGDT have not been well described. We sought to determine the association of relative normotension (sustained systolic blood pressure >90 mmHg independent of or in response to an initial crystalloid resuscitation of 20 mL/kg, obesity (body mass index [BMI] ≥30, moderate thrombocytopenia (platelet count <50,000 per μL, and coagulopathy (international normalized ratio ≥2.0 with unattempted CVC in EGDT-eligible patients. Methods: This was a retrospective cohort study of 421 adults who met EGDT criteria in 5 community EDs over a period of 13 months. We compared patients with attempted thoracic (internal jugular or subclavian CVC with those who did not undergo an attempted thoracic line. We also compared patients with any attempted CVC (either thoracic or femoral with those who did not undergo any attempted central line. We used multivariate logistic regression analysis to calculate adjusted odd ratios (AORs. Results: In our study, 364 (86.5% patients underwent attempted thoracic CVC and 57 (13.5% did not. Relative normotension was significantly associated with unattempted thoracic CVC (AOR 2.6 95% confidence interval [CI], 1.6-4.3, as were moderate thrombocytopenia (AOR 3.9; 95% CI, 1.5-10.1 and coagulopathy (AOR 2.7; 95% CI, 1.3-5.6. When assessing for attempted catheterization of any central venous site (thoracic or femoral, 382 (90.7% patients underwent attempted catheterization and 39 (9.3% patients did not. Relative normotension (AOR 2.3; 95% CI, 1.2-4.5 and moderate thrombocytopenia (AOR 3.9; 95

Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

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Shuyan Liu

Full Text Available Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

Dynamical Intention: Integrated Intelligence Modeling for Goal-directed Embodied Agents

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Eric Aaron

2016-11-01

Full Text Available Intelligent embodied robots are integrated systems: As they move continuously through their environments, executing behaviors and carrying out tasks, components for low-level and high-level intelligence are integrated in the robot's cognitive system, and cognitive and physical processes combine to create their behavior. For a modeling framework to enable the design and analysis of such integrated intelligence, the underlying representations in the design of the robot should be dynamically sensitive, capable of reflecting both continuous motion and micro-cognitive influences, while also directly representing the necessary beliefs and intentions for goal-directed behavior. In this paper, a dynamical intention-based modeling framework is presented that satisfies these criteria, along with a hybrid dynamical cognitive agent (HDCA framework for employing dynamical intentions in embodied agents. This dynamical intention-HDCA (DI-HDCA modeling framework is a fusion of concepts from spreading activation networks, hybrid dynamical system models, and the BDI (belief-desire-intention theory of goal-directed reasoning, adapted and employed unconventionally to meet entailments of environment and embodiment. The paper presents two kinds of autonomous agent learning results that demonstrate dynamical intentions and the multi-faceted integration they enable in embodied robots: with a simulated service robot in a grid-world office environment, reactive-level learning minimizes reliance on deliberative-level intelligence, enabling task sequencing and action selection to be distributed over both deliberative and reactive levels; and with a simulated game of Tag, the cognitive-physical integration of an autonomous agent enables the straightforward learning of a user-specified strategy during gameplay, without interruption to the game. In addition, the paper argues that dynamical intentions are consistent with cognitive theory underlying goal-directed behavior, and

Impaired cognitive plasticity and goal-directed control in adolescent obsessive-compulsive disorder.

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Gottwald, Julia; de Wit, Sanne; Apergis-Schoute, Annemieke M; Morein-Zamir, Sharon; Kaser, Muzaffer; Cormack, Francesca; Sule, Akeem; Limmer, Winifred; Morris, Anna Conway; Robbins, Trevor W; Sahakian, Barbara J

2018-01-22

Youths with obsessive-compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study. A total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control. Adolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control. This study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.

[Fluid therapy in cardiac surgery. An update].

Science.gov (United States)

Boix, E; Vicente, R; Pérez-Artacho, J

2014-01-01

The anesthetist has 2 major tools for optimizing haemodynamics in cardiac surgery: Vasoactive drugs and the intravascular volume. It is necessary to identify which patients would benefit from one or the other therapies for a suitable response to treatment. Hemodynamic monitoring with the different existing parameters (pressure, volumetric static, volumetric functional and echocardiography) allows the management of these patients to be optimized. In this article a review is presented on the most recent and relevant publications, and the different tools available to control the management of the fluid therapy in this context, and to suggest a few guidelines for the haemodynamics monitoring of patients submitted to cardiac surgery. A systematic search has been made in PubMed, limiting the results to the publications over the last five years up to February 2012. Copyright © 2012 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

Goal-directed action control in children with autism spectrum disorders

NARCIS (Netherlands)

Geurts, H.M.; de Wit, S.

2014-01-01

Repetitive behavior is a key characteristic of autism spectrum disorders. Our aim was to investigate the hypothesis that this abnormal behavioral repetition results from a tendency to over-rely on habits at the expense of flexible, goal-directed action. Twenty-four children with autism spectrum

Maintenance fluid therapy and fluid creep impose more significant fluid, sodium, and chloride burdens than resuscitation fluids in critically ill patients: a retrospective study in a tertiary mixed ICU population.

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Van Regenmortel, Niels; Verbrugghe, Walter; Roelant, Ella; Van den Wyngaert, Tim; Jorens, Philippe G

2018-04-01

Research on intravenous fluid therapy and its side effects, volume, sodium, and chloride overload, has focused almost exclusively on the resuscitation setting. We aimed to quantify all fluid sources in the ICU and assess fluid creep, the hidden and unintentional volume administered as a vehicle for medication or electrolytes. We precisely recorded the volume, sodium, and chloride burdens imposed by every fluid source administered to 14,654 patients during the cumulative 103,098 days they resided in our 45-bed tertiary ICU and simulated the impact of important strategic fluid choices on patients' chloride burdens. In septic patients, we assessed the impact of the different fluid sources on cumulative fluid balance, an established marker of morbidity. Maintenance and replacement fluids accounted for 24.7% of the mean daily total fluid volume, thereby far exceeding resuscitation fluids (6.5%) and were the most important sources of sodium and chloride. Fluid creep represented a striking 32.6% of the mean daily total fluid volume [median 645 mL (IQR 308-1039 mL)]. Chloride levels can be more effectively reduced by adopting a hypotonic maintenance strategy [a daily difference in chloride burden of 30.8 mmol (95% CI 30.5-31.1)] than a balanced resuscitation strategy [daily difference 3.0 mmol (95% CI 2.9-3.1)]. In septic patients, non-resuscitation fluids had a larger absolute impact on cumulative fluid balance than did resuscitation fluids. Inadvertent daily volume, sodium, and chloride loading should be avoided when prescribing maintenance fluids in view of the vast amounts of fluid creep. This is especially important when adopting an isotonic maintenance strategy.

Collaborating with Parents to Establish Behavioral Goals in Child-Centered Play Therapy

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Post, Phyllis B.; Ceballos, Peggy L.; Penn, Saundra L.

2012-01-01

The purpose of this article is to provide specific guidelines for child-centered play therapists to set behavioral outcome goals to effectively work with families and to meet the demands for accountability in the managed care environment. The child-centered play therapy orientation is the most widely practiced approach among play therapists who…

Early Childhood Inclusion in the United States: Goals, Current Status, and Future Directions

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Guralnick, Michael J.; Bruder, Mary Beth

2016-01-01

The current status and future directions of early childhood inclusion in the United States are discussed from the perspective of 4 key goals: access, accommodations and feasibility, developmental progress, and social integration. Recommendations are put forward to promote inclusion goals emphasizing administrative structures, personnel…

Directive and Non-Directive Movement in Child Therapy.

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Krason, Katarzyna; Szafraniec, Grazyna

1999-01-01

Presents a new authorship method of child therapy based on visualization through motion. Maintains that this method stimulates motor development and musical receptiveness, and promotes personality development. Suggests that improvised movement to music facilitates the projection mechanism and that directed movement starts the channeling phase.…

Emotion, Intent and Voluntary Movement in Children with Autism. an Example: The Goal Directed Locomotion

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Longuet, Sophie; Ferrel-Chapus, Carole; Oreve, Marie-Joelle; Chamot, Jean-Marc; Vernazza-Martin, Sylvie

2012-01-01

This article focuses on the impact of intentionality on goal directed locomotion in healthy and autistic children. Closely linked with emotions and motivation, it is directly connected with movement planning. Is planning only preserved when the goal of the action appears motivating for healthy and autistic children? Is movement programming similar…

Drunk decisions: Alcohol shifts choice from habitual towards goal-directed control in adolescent intermediate-risk drinkers.

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Obst, Elisabeth; Schad, Daniel J; Huys, Quentin Jm; Sebold, Miriam; Nebe, Stephan; Sommer, Christian; Smolka, Michael N; Zimmermann, Ulrich S

2018-05-01

Studies in humans and animals suggest a shift from goal-directed to habitual decision-making in addiction. We therefore tested whether acute alcohol administration reduces goal-directed and promotes habitual decision-making, and whether these effects are moderated by self-reported drinking problems. Fifty-three socially drinking males completed the two-step task in a randomised crossover design while receiving an intravenous infusion of ethanol (blood alcohol level=80 mg%), or placebo. To minimise potential bias by long-standing heavy drinking and subsequent neuropsychological impairment, we tested 18- to 19-year-old adolescents. Alcohol administration consistently reduced habitual, model-free decisions, while its effects on goal-directed, model-based behaviour varied as a function of drinking problems measured with the Alcohol Use Disorders Identification Test. While adolescents with low risk for drinking problems (scoring towards goal-directed decision-making, such that alcohol possibly even improved their performance. We assume that alcohol disrupted basic cognitive functions underlying habitual and goal-directed decisions in low-risk drinkers, thereby enhancing hasty choices. Further, we speculate that intermediate-risk drinkers benefited from alcohol as a negative reinforcer that reduced unpleasant emotional states, possibly displaying a novel risk factor for drinking in adolescence.

Associative theories of goal-directed behaviour: a case for animal-human translational models

NARCIS (Netherlands)

de Wit, S.; Dickinson, A.

2009-01-01

Associative accounts of goal-directed action, developed in the fields of human ideomotor action and that of animal learning, can capture cognitive belief-desire psychology of human decision-making. Whereas outcome-response accounts can account for the fact that the thought of a goal can call to mind

Increasing cerebrospinal fluid chemokine concentrations despite undetectable cerebrospinal fluid HIV RNA in HIV-1-infected patients receiving antiretroviral therapy

NARCIS (Netherlands)

Gisolf, E. H.; van Praag, R. M.; Jurriaans, S.; Portegies, P.; Goudsmit, J.; Danner, S. A.; Lange, J. M.; Prins, J. M.

2000-01-01

Only limited data on cerebrospinal fluid (CSF) HIV-1 RNA responses and markers of local inflammation in CSF during antiretroviral therapy are available. HIV-RNA, soluble tumor necrosis factor (TNF)-receptor (sTNFr)-II, monocyte chemoattractant protein (MCP)-1, and interferon-gamma-inducible protein

Direct modeling for computational fluid dynamics

Science.gov (United States)

Xu, Kun

2015-06-01

All fluid dynamic equations are valid under their modeling scales, such as the particle mean free path and mean collision time scale of the Boltzmann equation and the hydrodynamic scale of the Navier-Stokes (NS) equations. The current computational fluid dynamics (CFD) focuses on the numerical solution of partial differential equations (PDEs), and its aim is to get the accurate solution of these governing equations. Under such a CFD practice, it is hard to develop a unified scheme that covers flow physics from kinetic to hydrodynamic scales continuously because there is no such governing equation which could make a smooth transition from the Boltzmann to the NS modeling. The study of fluid dynamics needs to go beyond the traditional numerical partial differential equations. The emerging engineering applications, such as air-vehicle design for near-space flight and flow and heat transfer in micro-devices, do require further expansion of the concept of gas dynamics to a larger domain of physical reality, rather than the traditional distinguishable governing equations. At the current stage, the non-equilibrium flow physics has not yet been well explored or clearly understood due to the lack of appropriate tools. Unfortunately, under the current numerical PDE approach, it is hard to develop such a meaningful tool due to the absence of valid PDEs. In order to construct multiscale and multiphysics simulation methods similar to the modeling process of constructing the Boltzmann or the NS governing equations, the development of a numerical algorithm should be based on the first principle of physical modeling. In this paper, instead of following the traditional numerical PDE path, we introduce direct modeling as a principle for CFD algorithm development. Since all computations are conducted in a discretized space with limited cell resolution, the flow physics to be modeled has to be done in the mesh size and time step scales. Here, the CFD is more or less a direct

Goal-Directed Action Control in Children with Autism Spectrum Disorders

Science.gov (United States)

Geurts, Hilde M; de Wit, Sanne

2014-01-01

Repetitive behavior is a key characteristic of autism spectrum disorders. Our aim was to investigate the hypothesis that this abnormal behavioral repetition results from a tendency to over-rely on habits at the expense of flexible, goal-directed action. Twenty-four children with autism spectrum disorders and 24 age- and gender-matched controls…

Goal Direction and Effectiveness, Emotional Maturity, and Nuclear Family Functioning

Science.gov (United States)

Klever, Phillip

2009-01-01

Differentiation of self, a cornerstone concept in Bowen theory, has a profound influence over time on the functioning of the individual and his or her family unit. This 5-year longitudinal study tested this hypothesis with 50 developing nuclear families. The dimensions of differentiation of self that were examined were goal direction and…

Review article: closed-loop systems in anesthesia: is there a potential for closed-loop fluid management and hemodynamic optimization?

Science.gov (United States)

Rinehart, Joseph; Liu, Ngai; Alexander, Brenton; Cannesson, Maxime

2012-01-01

Closed-loop (automated) controllers are encountered in all aspects of modern life in applications ranging from air-conditioning to spaceflight. Although these systems are virtually ubiquitous, they are infrequently used in anesthesiology because of the complexity of physiologic systems and the difficulty in obtaining reliable and valid feedback data from the patient. Despite these challenges, closed-loop systems are being increasingly studied and improved for medical use. Two recent developments have made fluid administration a candidate for closed-loop control. First, the further description and development of dynamic predictors of fluid responsiveness provides a strong parameter for use as a control variable to guide fluid administration. Second, rapid advances in noninvasive monitoring of cardiac output and other hemodynamic variables make goal-directed therapy applicable for a wide range of patients in a variety of clinical care settings. In this article, we review the history of closed-loop controllers in clinical care, discuss the current understanding and limitations of the dynamic predictors of fluid responsiveness, and examine how these variables might be incorporated into a closed-loop fluid administration system.

Outcome producing potential influences twelve-month-olds' interpretation of a novel action as goal-directed.

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Biro, Szilvia; Verschoor, Stephan; Coalter, Esther; Leslie, Alan M

2014-11-01

Learning about a novel, goal-directed action is a complex process. It requires identifying the outcome of the action and linking the action to its outcome for later use in new situations to predict the action or to anticipate its outcome. We investigated the hypothesis that linking a novel action to a salient change in the environment is critical for infants to assign a goal to the novel action. We report a study in which we show that 12-month-old infants, who were provided with prior experience with a novel action accompanied with a salient visible outcome in one context, can interpret the same action as goal-directed even in the absence of the outcome in another context. Our control condition shows that prior experience with the action, but without the salient effect, does not lead to goal-directed interpretation of the novel action. We also found that, for the case of 9-month-olds infants, prior experience with the outcome producing potential of the novel action does not facilitate a goal-directed interpretation of the action. However, this failure was possibly due to difficulties with generalizing the learnt association to another context rather than with linking the action to its outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

Neural systems analysis of decision making during goal-directed navigation.

Science.gov (United States)

Penner, Marsha R; Mizumori, Sheri J Y

2012-01-01

The ability to make adaptive decisions during goal-directed navigation is a fundamental and highly evolved behavior that requires continual coordination of perceptions, learning and memory processes, and the planning of behaviors. Here, a neurobiological account for such coordination is provided by integrating current literatures on spatial context analysis and decision-making. This integration includes discussions of our current understanding of the role of the hippocampal system in experience-dependent navigation, how hippocampal information comes to impact midbrain and striatal decision making systems, and finally the role of the striatum in the implementation of behaviors based on recent decisions. These discussions extend across cellular to neural systems levels of analysis. Not only are key findings described, but also fundamental organizing principles within and across neural systems, as well as between neural systems functions and behavior, are emphasized. It is suggested that studying decision making during goal-directed navigation is a powerful model for studying interactive brain systems and their mediation of complex behaviors. Copyright © 2011. Published by Elsevier Ltd.

Loss of lateral prefrontal cortex control in food-directed attention and goal-directed food choice in obesity.

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Janssen, Lieneke K; Duif, Iris; van Loon, Ilke; Wegman, Joost; de Vries, Jeanne H M; Cools, Roshan; Aarts, Esther

2017-02-01

Loss of lateral prefrontal cortex (lPFC)-mediated attentional control may explain the automatic tendency to eat in the face of food. Here, we investigate the neurocognitive mechanism underlying attentional bias to food words and its association with obesity using a food Stroop task. We tested 76 healthy human subjects with a wide body mass index (BMI) range (19-35kg/m 2 ) using fMRI. As a measure of obesity we calculated individual obesity scores based on BMI, waist circumference and waist-to-hip ratio using principal component analyses. To investigate the automatic tendency to overeat directly, the same subjects performed a separate behavioral outcome devaluation task measuring the degree of goal-directed versus automatic food choices. We observed that increased obesity scores were associated with diminished lPFC responses during food attentional bias. This was accompanied by decreased goal-directed control of food choices following outcome devaluation. Together these findings suggest that deficient control of both food-directed attention and choice may contribute to obesity, particularly given our obesogenic environment with food cues everywhere, and the choice to ignore or indulge despite satiety. Copyright © 2016 Elsevier Inc. All rights reserved.

Interpersonal Circumplex Profiles Of Persistent Depression: Goals, Self-Efficacy, Problems, And Effects Of Group Therapy.

Science.gov (United States)

Locke, Kenneth D; Sayegh, Liliane; Penberthy, J Kim; Weber, Charlotte; Haentjens, Katherine; Turecki, Gustavo

2017-06-01

We assessed severely and persistently depressed patients' interpersonal self-efficacy, problems, and goals, plus changes in interpersonal functioning and depression during 20 weeks of group therapy. Outpatients (32 female, 26 male, mean age = 45 years) completed interpersonal circumplex measures of goals, efficacy, and problems before completing 20 weeks of manualized group therapy, during which we regularly assessed depression and interpersonal style. Compared to normative samples, patients lacked interpersonal agency, including less self-efficacy for expressive/assertive actions; stronger motives to avoid conflict, scorn, and humiliation; and more problems with being too submissive, inhibited, and accommodating. Behavioral Activation and especially Cognitive Behavioral Analysis System of Psychotherapy interventions produced improvements in depression and interpersonal agency, with increases in "agentic and communal" efficacy predicting subsequent decreases in depression. While severely and persistently depressed patients were prone to express maladaptive interpersonal dispositions, over the course of group therapy, they showed increasingly agentic and beneficial patterns of cognitions, motives, and behaviors. © 2016 Wiley Periodicals, Inc.

Physics of Nontraditional Electrorheological and Magnetorheological Fluids

Science.gov (United States)

Gu, G. Q.; Tao, R.

Nontraditional electrorheology (ER) and magnetorheology (MR) are new areas. It started with high demands, such as reducing the viscosity of crude oil and suppressing turbulence to improve crude oil flow in pipelines. Normally, these two goals conflict each other. When the viscosity is reduced, Reynolds number goes up, and the turbulence would get worse. The non-traditional ER and MR have provided unconventional technologies to solve such issues. Different from traditional ER and MR, where the strong electric field or magnetic field is applied in the direction perpendicular to the flow or shearing, the fluid can even be solidified as the viscosity increases dramatically. In nontraditional ER and MR, the electric field or magnetic field is applied in the direction parallel to the flow, the particles are aggregated into short chains along the flow direction by the field, and the fluid viscosity becomes anisotropic. Along the flow direction, the viscosity is reduced, while in the directions perpendicular to the flow, the viscosity is dramatically increased. Thus the turbulence is suppressed; the flow becomes laminar and is further improved by the reduced viscosity along the flow direction. The original conflicted two goals can now be accomplished simultaneously. The new physics began to produce big impacts on energy, food industry, and medical science.

Reliance on habits at the expense of goal-directed control following dopamine precursor depletion

OpenAIRE

de Wit, Sanne; Standing, Holly R.; DeVito, Elise E.; Robinson, Oliver J.; Ridderinkhof, K. Richard; Robbins, Trevor W.; Sahakian, Barbara J.

2011-01-01

Rationale Dopamine is well known to play an important role in learning and motivation. Recent animal studies have implicated dopamine in the reinforcement of stimulus?response habits, as well as in flexible, goal-directed action. However, the role of dopamine in human action control is still not well understood. Objectives We present the first investigation of the effect of reducing dopamine function in healthy volunteers on the balance between habitual and goal-directed action control. Metho...

Neuronal activity in primate prefrontal cortex related to goal-directed behavior during auditory working memory tasks.

Science.gov (United States)

Huang, Ying; Brosch, Michael

2016-06-01

Prefrontal cortex (PFC) has been documented to play critical roles in goal-directed behaviors, like representing goal-relevant events and working memory (WM). However, neurophysiological evidence for such roles of PFC has been obtained mainly with visual tasks but rarely with auditory tasks. In the present study, we tested roles of PFC in auditory goal-directed behaviors by recording local field potentials in the auditory region of left ventrolateral PFC while a monkey performed auditory WM tasks. The tasks consisted of multiple events and required the monkey to change its mental states to achieve the reward. The events were auditory and visual stimuli, as well as specific actions. Mental states were engaging in the tasks and holding task-relevant information in auditory WM. We found that, although based on recordings from one hemisphere in one monkey only, PFC represented multiple events that were important for achieving reward, including auditory and visual stimuli like turning on and off an LED, as well as bar touch. The responses to auditory events depended on the tasks and on the context of the tasks. This provides support for the idea that neuronal representations in PFC are flexible and can be related to the behavioral meaning of stimuli. We also found that engaging in the tasks and holding information in auditory WM were associated with persistent changes of slow potentials, both of which are essential for auditory goal-directed behaviors. Our study, on a single hemisphere in a single monkey, reveals roles of PFC in auditory goal-directed behaviors similar to those in visual goal-directed behaviors, suggesting that functions of PFC in goal-directed behaviors are probably common across the auditory and visual modality. This article is part of a Special Issue entitled SI: Auditory working memory. Copyright © 2016 Elsevier B.V. All rights reserved.

Future directions in lipid therapies.

Science.gov (United States)

Ansell, Benjamin

2002-01-01

Cholesterol management to reduce the burden of cardiovascular disease is a major public health concern. Despite widespread recognition of lipid abnormalities as cardiovascular risk factors, significant cardiovascular event reductions with cholesterol-lowering therapies, and dissemination of treatment guidelines, most high-risk patients are not at target lipid levels. In addition to lifestyle changes, four major drug classes are available to modify lipid levels: fibrates, niacin, resins, and statins. High efficacy and tolerability in clinical trials make statins the most widely prescribed of these agents. Newer, more potent members of this class and novel formulations of niacin and resins may provide more effective therapy for dyslipidemia with fewer side effects. Several agents in development (cholesterol-absorption inhibitors and ACAT inhibitors) exploit mechanisms of action complementary to those of current treatments and combined with statins may produce greater improvements in lipid profiles than are now possible. These innovations should enable a greater number of patients to achieve more aggressive cholesterol goals, thereby reducing the risk of cardiovascular events.

Analysis and hazard evaluation of heat-transfer fluids for the direct contact cooling system

International Nuclear Information System (INIS)

Hong, Joo Hi; Lee, Yeon Hee; Shin, You Hwan; Karng, Sarng Woo; Kim, Seo Young; Kim, Young Gil

2006-01-01

This paper discusses several low-temperature heat-transfer fluids, including water-based inorganic salt, organic salt, alcohol/glycol mixtures, silicones, and halogenated hydrocarbons in order to choose the best heat-transfer fluid for the newly designed direct contact refrigeration system. So, it contains a survey on commercial products such as propylene glycol and potassium formate as newly used in super market and food processing refrigeration. The stability of commercial fluids at the working temperature of -20 .deg. C was monitored as a function of time up to two months. And organic and inorganic compositions of candidate fluids were obtained by analytical instruments such as ES, XRF, AAS, ICP-AES, GC, and GC-MS. Analysis results indicate that commercial propylene glycol is very efficient and safe heat transfer fluids for the direct cooling system with liquid phase

Framing the frame: How task goals determine the likelihood and direction of framing effects

OpenAIRE

Todd McElroy; John J. Seta

2007-01-01

We examined how the goal of a decision task influences the perceived positive, negative valence of the alternatives and thereby the likelihood and direction of framing effects. In Study 1 we manipulated the goal to increase, decrease or maintain the commodity in question and found that when the goal of the task was to increase the commodity, a framing effect consistent with those typically observed in the literature was found. When the goal was to decrease, a framing effect opposite to the ty...

Comparative Study on Uni- and Bi-Directional Fluid Structure Coupling of Wind Turbine Blades

Directory of Open Access Journals (Sweden)

Mesfin Belayneh Ageze

2017-09-01

Full Text Available The current trends of wind turbine blade designs are geared towards a longer and slender blade with high flexibility, exhibiting complex aeroelastic loadings and instability issues, including flutter; in this regard, fluid-structure interaction (FSI plays a significant role. The present article will conduct a comparative study between uni-directional and bi-directional fluid-structural coupling models for a horizontal axis wind turbine. A full-scale, geometric copy of the NREL 5MW blade with simplified material distribution is considered for simulation. Analytical formulations of the governing relations with appropriate approximation are highlighted, including turbulence model, i.e., Shear Stress Transport (SST k-ω. These analytical relations are implemented using Multiphysics package ANSYS employing Fluent module (Computational Fluid Dynamics (CFD-based solver for the fluid domain and Transient Structural module (Finite Element Analysis-based solver for the structural domain. ANSYS system coupling module also is configured to model the two fluid-structure coupling methods. The rated operational condition of the blade for a full cycle rotation is considered as a comparison domain. In the bi-directional coupling model, the structural deformation alters the angle of attack from the designed values, and by extension the flow pattern along the blade span; furthermore, the tip deflection keeps fluctuating whilst it tends to stabilize in the uni-directional coupling model.

Reliance on habits at the expense of goal-directed control following dopamine precursor depletion.

Science.gov (United States)

de Wit, Sanne; Standing, Holly R; Devito, Elise E; Robinson, Oliver J; Ridderinkhof, K Richard; Robbins, Trevor W; Sahakian, Barbara J

2012-01-01

Dopamine is well known to play an important role in learning and motivation. Recent animal studies have implicated dopamine in the reinforcement of stimulus-response habits, as well as in flexible, goal-directed action. However, the role of dopamine in human action control is still not well understood. We present the first investigation of the effect of reducing dopamine function in healthy volunteers on the balance between habitual and goal-directed action control. The dietary intervention of acute dietary phenylalanine and tyrosine depletion (APTD) was adopted to study the effects of reduced global dopamine function on action control. Participants were randomly assigned to either the APTD or placebo group (ns = 14) to allow for a between-subjects comparison of performance on a novel three-stage experimental paradigm. In the initial learning phase, participants learned to respond to different stimuli in order to gain rewarding outcomes. Subsequently, an outcome-devaluation test and a slips-of-action test were conducted to assess whether participants were able to flexibly adjust their behaviour to changes in the desirability of the outcomes. APTD did not prevent stimulus-response learning, nor did we find evidence for impaired response-outcome learning in the subsequent outcome-devaluation test. However, when goal-directed and habitual systems competed for control in the slips-of-action test, APTD tipped the balance towards habitual control. These findings were restricted to female volunteers. We provide direct evidence that the balance between goal-directed and habitual control in humans is dopamine dependent. The results are discussed in light of gender differences in dopamine function and psychopathologies.

Goal-Directed Visual Attention Drives Health Goal Priming: An Eye-Tracking Experiment

NARCIS (Netherlands)

Laan, van der Laura N.; Hooge, I.T.C.; Smeets, P.A.M.

2017-01-01

Objective: Several lab and field experiments have shown that goal priming interventions can be highly effective in promoting healthy food choices. Less is known, however, about the mechanisms by which goal priming affects food choice. This experiment tested the hypothesis that goal priming affects

Standardization of Thermo-Fluid Modeling in Modelica.Fluid

Energy Technology Data Exchange (ETDEWEB)

Franke, Rudiger; Casella, Francesco; Sielemann, Michael; Proelss, Katrin; Otter, Martin; Wetter, Michael

2009-09-01

This article discusses the Modelica.Fluid library that has been included in the Modelica Standard Library 3.1. Modelica.Fluid provides interfaces and basic components for the device-oriented modeling of onedimensional thermo-fluid flow in networks containing vessels, pipes, fluid machines, valves and fittings. A unique feature of Modelica.Fluid is that the component equations and the media models as well as pressure loss and heat transfer correlations are decoupled from each other. All components are implemented such that they can be used for media from the Modelica.Media library. This means that an incompressible or compressible medium, a single or a multiple substance medium with one or more phases might be used with one and the same model as long as the modeling assumptions made hold. Furthermore, trace substances are supported. Modeling assumptions can be configured globally in an outer System object. This covers in particular the initialization, uni- or bi-directional flow, and dynamic or steady-state formulation of mass, energy, and momentum balance. All assumptions can be locally refined for every component. While Modelica.Fluid contains a reasonable set of component models, the goal of the library is not to provide a comprehensive set of models, but rather to provide interfaces and best practices for the treatment of issues such as connector design and implementation of energy, mass and momentum balances. Applications from various domains are presented.

Executive control of stimulus-driven and goal-directed attention in visual working memory.

Science.gov (United States)

Hu, Yanmei; Allen, Richard J; Baddeley, Alan D; Hitch, Graham J

2016-10-01

We examined the role of executive control in stimulus-driven and goal-directed attention in visual working memory using probed recall of a series of objects, a task that allows study of the dynamics of storage through analysis of serial position data. Experiment 1 examined whether executive control underlies goal-directed prioritization of certain items within the sequence. Instructing participants to prioritize either the first or final item resulted in improved recall for these items, and an increase in concurrent task difficulty reduced or abolished these gains, consistent with their dependence on executive control. Experiment 2 examined whether executive control is also involved in the disruption caused by a post-series visual distractor (suffix). A demanding concurrent task disrupted memory for all items except the most recent, whereas a suffix disrupted only the most recent items. There was no interaction when concurrent load and suffix were combined, suggesting that deploying selective attention to ignore the distractor did not draw upon executive resources. A final experiment replicated the independent interfering effects of suffix and concurrent load while ruling out possible artifacts. We discuss the results in terms of a domain-general episodic buffer in which information is retained in a transient, limited capacity privileged state, influenced by both stimulus-driven and goal-directed processes. The privileged state contains the most recent environmental input together with goal-relevant representations being actively maintained using executive resources.

Directly observed therapy for treating tuberculosis

OpenAIRE

Karumbi, Jamlick; Garner, Paul

2015-01-01

Background Tuberculosis (TB) requires at least six months of treatment. If treatment is incomplete, patients may not be cured and drug resistance may develop. Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose. Objectives To evaluate DOT compared to self-administered therapy in people on treatment for active TB...

Influence of fluid therapy for stabilization of dogs in shock caused with different etiology

Directory of Open Access Journals (Sweden)

Novakov Todor

2009-05-01

Full Text Available The aim of this work is the portrayal of shock in a small practice and its timely and proper treatment. This study included a total of 8 dogs that are numbered from 1 to 8. In all animals was performed complete general clinical index, the venous route was applyed, and are accompanied by clinical parameters during treatment. Research showing that all animals were received in shock. In all our study patients, fluid therapy was occurred to update and maintain lost volume, exception makes patient number one witch with respect to the diagnosis and classification of shock succumb on other therapy. All patients received fluid therapy in the form of one or multiple bolus colloid fluids Hydroxyethyl Starch 6% (HAES-a dosage of 3-15 ml/kg with a physiological solution in the dosage of 10-50 ml/kg. Our study showed a positive response after applications of bolus HAES and physiological solutions. Dogs 1, 2, 5 and 6 after therapy was stabilize body temperature (TT, CRT, and the frequency. The most relevant example is the dog number 2, who received value of TT 40.9, CRT 4 seconds, and the frequency was 222, which the value for 18 hours changed to TT 38.4, CRT 3 seconds and the frequency was 180th. Dogs (5, 6 gave a positive response to the protocol to stabilize shock. Dogs 3, 4, 7 and 8 have an initial positive reactions in some parameters, but etiological situation has led to deterioration and mortalities. We have concluded that the time of applications and attempt have significant role in the successible treatment to stabilize a patients. Significant results are possible only if treatment is timely and adequately (a combination of colloids and crystalloid. The basis of shock therapy is the correction hipovolemia appropriate liquid, intravenous applied in the fastest possible time.

Four Weeks of Goal-Directed Learning in Primary Physical Education Classes

NARCIS (Netherlands)

Platvoet, Sebastiaan W. J.; Elferink-Gemser, Marije T.; Kannekens, Rianne; de Niet, Mark; Visscher, Chris

Relatively little is known about how practice relates to children's improvement in gross motor skill performance. The aim of this study is to determine to what extent 6- and 7-year-old children improve their gross motor skill performance in a four-week period, in which goal-directed learning is

Speed/accuracy trade-off between the habitual and the goal-directed processes.

Directory of Open Access Journals (Sweden)

Mehdi Keramati

2011-05-01

Full Text Available Instrumental responses are hypothesized to be of two kinds: habitual and goal-directed, mediated by the sensorimotor and the associative cortico-basal ganglia circuits, respectively. The existence of the two heterogeneous associative learning mechanisms can be hypothesized to arise from the comparative advantages that they have at different stages of learning. In this paper, we assume that the goal-directed system is behaviourally flexible, but slow in choice selection. The habitual system, in contrast, is fast in responding, but inflexible in adapting its behavioural strategy to new conditions. Based on these assumptions and using the computational theory of reinforcement learning, we propose a normative model for arbitration between the two processes that makes an approximately optimal balance between search-time and accuracy in decision making. Behaviourally, the model can explain experimental evidence on behavioural sensitivity to outcome at the early stages of learning, but insensitivity at the later stages. It also explains that when two choices with equal incentive values are available concurrently, the behaviour remains outcome-sensitive, even after extensive training. Moreover, the model can explain choice reaction time variations during the course of learning, as well as the experimental observation that as the number of choices increases, the reaction time also increases. Neurobiologically, by assuming that phasic and tonic activities of midbrain dopamine neurons carry the reward prediction error and the average reward signals used by the model, respectively, the model predicts that whereas phasic dopamine indirectly affects behaviour through reinforcing stimulus-response associations, tonic dopamine can directly affect behaviour through manipulating the competition between the habitual and the goal-directed systems and thus, affect reaction time.

Setting goals in psychotherapy

DEFF Research Database (Denmark)

Emiliussen, Jakob; Wagoner, Brady

2013-01-01

The present study is concerned with the ethical dilemmas of setting goals in therapy. The main questions that it aims to answer are: who is to set the goals for therapy and who is to decide when they have been reached? The study is based on four semi-­‐structured, phenomenological interviews...

DIRECT-DEPOSITION INFRARED SPECTROMETRY WITH GAS AND SUPERCRITICAL FLUID CHROMATOGRAPHY

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A direct-deposition Fourier transform infrared (FT-IR) system has been evaluated for applicability to gas chromatography (GC) and supercritical fluid chromatography (SFC) of environmental analytes. A 100-um i.d. fused-silica transfer line was used for GC, and a 50-um transfer lin...

Factors affecting osteoarthritis patients' self-reported goal-directed drug information-seeking behaviors after exposure to direct-to-consumer advertising from physicians and the internet.

Science.gov (United States)

Liu, Yifei; Farris, Karen B; Doucette, William R

2011-10-01

The objective of this study was to investigate appraisal of means (ie, self-efficacy, outcome expectancy, and affect) in predicting patients' goal-directed behaviors of direct-to-consumer advertising (DTCA)-prompted drug-information search from physicians and the internet. One thousand patients were randomly selected from a nationwide sample frame of 3000 osteoarthritis patients. A self-administered survey assessed exposure to DTCA, drug-information search as goal, self-efficacy, outcome expectancy, affect, and osteoarthritis pain. After 6 weeks, another survey measured the behavior of drug-information search for respondents to the first survey. Study subjects were those who were exposed to DTCA in the previous month, and who set drug-information search as their goal. For each information source, a multiple regression analysis was conducted in which drug-information search was the dependent variable, and self-efficacy, outcome expectancy, affect, and osteoarthritis pain were the independent variables. Among 454 patients who were exposed to DTCA, 174 patients set drug-information search as their goal and were the study subjects. The regression for physicians was not statistically significant. The regression for the internet was significant, accounting for 15% of behavior variance. Self-efficacy was a strong predictor of goal-directed drug-information search from the internet. Appraisal of means was useful to predict the goal-directed behavior of DTCA-prompted drug-information search from the internet. For patients who set drug-information search as a goal, actions to promote drug-information search from the internet need to focus on self-efficacy.

Maximizing the probability of satisfying the clinical goals in radiation therapy treatment planning under setup uncertainty

International Nuclear Information System (INIS)

Fredriksson, Albin; Hårdemark, Björn; Forsgren, Anders

2015-01-01

Purpose: This paper introduces a method that maximizes the probability of satisfying the clinical goals in intensity-modulated radiation therapy treatments subject to setup uncertainty. Methods: The authors perform robust optimization in which the clinical goals are constrained to be satisfied whenever the setup error falls within an uncertainty set. The shape of the uncertainty set is included as a variable in the optimization. The goal of the optimization is to modify the shape of the uncertainty set in order to maximize the probability that the setup error will fall within the modified set. Because the constraints enforce the clinical goals to be satisfied under all setup errors within the uncertainty set, this is equivalent to maximizing the probability of satisfying the clinical goals. This type of robust optimization is studied with respect to photon and proton therapy applied to a prostate case and compared to robust optimization using an a priori defined uncertainty set. Results: Slight reductions of the uncertainty sets resulted in plans that satisfied a larger number of clinical goals than optimization with respect to a priori defined uncertainty sets, both within the reduced uncertainty sets and within the a priori, nonreduced, uncertainty sets. For the prostate case, the plans taking reduced uncertainty sets into account satisfied 1.4 (photons) and 1.5 (protons) times as many clinical goals over the scenarios as the method taking a priori uncertainty sets into account. Conclusions: Reducing the uncertainty sets enabled the optimization to find better solutions with respect to the errors within the reduced as well as the nonreduced uncertainty sets and thereby achieve higher probability of satisfying the clinical goals. This shows that asking for a little less in the optimization sometimes leads to better overall plan quality

Ultrasound directed self-assembly of three-dimensional user-specified patterns of particles in a fluid medium

Science.gov (United States)

Prisbrey, M.; Greenhall, J.; Guevara Vasquez, F.; Raeymaekers, B.

2017-01-01

We use ultrasound directed self-assembly to organize particles dispersed in a fluid medium into a three-dimensional (3D) user-specified pattern. The technique employs ultrasound transducers that line the boundary of a fluid reservoir to create a standing ultrasound wave field. The acoustic radiation force associated with the wave field drives particles dispersed in the fluid medium into organized patterns, assuming that the particles are much smaller than the wavelength and do not interact with each other. We have theoretically derived a direct solution method to calculate the ultrasound transducer operating parameters that are required to assemble a user-specified 3D pattern of particles in a fluid reservoir of arbitrary geometry. We formulate the direct solution method as a constrained optimization problem that reduces to eigendecomposition. We experimentally validate the solution method by assembling 3D patterns of carbon nanoparticles in a water reservoir and observe good quantitative agreement between theory and experiment. Additionally, we demonstrate the versatility of the solution method by simulating ultrasound directed self-assembly of complex 3D patterns of particles. The method works for any 3D simple, closed fluid reservoir geometry in combination with any arrangement of ultrasound transducers and enables employing ultrasound directed self-assembly in a myriad of engineering applications, including biomedical and materials fabrication processes.

Occupational Needs and Goals of Survivors of Domestic Violence.

Science.gov (United States)

Javaherian-Dysinger, Heather; Krpalek, Dragana; Huecker, Esther; Hewitt, Liane; Cabrera, Michelle; Brown, Canique; Francis, Jason; Rogers, Katie; Server, Sage

2016-01-01

This study's purpose was to describe the occupational needs and goals of women residing in a domestic violence shelter and their self-perceived changes in satisfaction and occupational performance. Using a retrospective design, data from 68 occupational therapy evaluations from two domestic violence shelter settings were examined. Data were analyzed by coding problem areas and occupational goals and calculating frequencies for these variables. Where data were available, we also analyzed changes in pre- and postscores for self-perceived satisfaction and occupational performance (n = 25). The most common problem areas were leisure, education, work, child rearing, and health management. The most common goals were in the areas of education, work, health management, child rearing, and home management. Retrospective pre- and postchange scores in performance and satisfaction for 25 women were statistically significant. Findings provide direction for, and highlight the importance of occupational therapy services within domestic violence shelters as women regain their life skills.

Tryptophan Depletion Promotes Habitual over Goal-Directed Control of Appetitive Responding in Humans.

Science.gov (United States)

Worbe, Yulia; Savulich, George; de Wit, Sanne; Fernandez-Egea, Emilio; Robbins, Trevor W

2015-02-05

Optimal behavioral performance results from a balance between goal-directed and habitual systems of behavioral control, which are modulated by ascending monoaminergic projections. While the role of the dopaminergic system in behavioral control has been recently addressed, the extent to which changes in global serotonin neurotransmission could influence these 2 systems is still poorly understood. We employed the dietary acute tryptophan depletion procedure to reduce serotonin neurotransmission in 18 healthy volunteers and 18 matched controls. We used a 3-stage instrumental learning paradigm that includes an initial instrumental learning stage, a subsequent outcome-devaluation test, and a slip-of-action stage, which directly tests the balance between hypothetical goal-directed and habitual systems. We also employed a separate response inhibition control test to assess the behavioral specificity of the results. Acute tryptophan depletion produced a shift of behavioral performance towards habitual responding as indexed by performance on the slip-of-action test. Moreover, greater habitual responding in the acute tryptophan depletion group was predicted by a steeper decline in plasma tryptophan levels. In contrast, acute tryptophan depletion left intact the ability to use discriminative stimuli to guide instrumental choice as indexed by the instrumental learning stage and did not impair inhibitory response control. The major implication of this study is that serotonin modulates the balance between goal-directed and stimulus-response habitual systems of behavioral control. Our findings thus imply that diminished serotonin neurotransmission shifts behavioral control towards habitual responding. © The Author 2015. Published by Oxford University Press on behalf of CINP.

Progress toward cell-directed therapy for phenylketonuria

Science.gov (United States)

Harding, CO

2009-01-01

Phenylketonuria (PKU) is one of the most common inborn errors of metabolism with an annual incidence of approximately 1:16,000 live births in North America. Contemporary therapy relies upon lifelong dietary protein restriction and supplementation with phenylalanine-free medical foods. This therapy is expensive and unpalatable; dietary compliance is difficult to maintain throughout life. Non-adherence to the diet is associated with learning disabilities, adult-onset neurodegenerative disease, and maternal PKU syndrome. The fervent dream of many individuals with PKU is a more permanent cure for this disease. This paper will review ongoing efforts to develop viable cell-directed therapies, in particular cell transplantation and gene therapy, for the treatment of PKU. PMID:18498375

Effect of nonsurgical periodontal therapy on serum and gingival crevicular fluid cytokine levels during pregnancy and postpartum.

Science.gov (United States)

Fiorini, T; Susin, C; da Rocha, J M; Weidlich, P; Vianna, P; Moreira, C H C; Bogo Chies, J A; Rösing, C K; Oppermann, R V

2013-02-01

A low-grade systemic inflammatory status originating from periodontal infection has been proposed to explain the association between periodontal disease and systemic conditions, including adverse obstetric outcomes. The aim of this study was to evaluate the effect of periodontal therapy during pregnancy on the gingival crevicular fluid and serum levels of six cytokines associated with periodontal disease and preterm birth. A subsample of 60 women (18-35 years of age) up to 20 gestational weeks, previously enrolled in a larger randomized clinical trial, was recruited for the present study. Participants were randomly allocated to receive either comprehensive nonsurgical periodontal therapy before 24 gestational weeks (n = 30, test group) or only one appointment for supragingival calculus removal (n = 30, control group). Clinical data, and samples of blood and gingival crevicular fluid, were collected at baseline, at 26-28 gestational weeks and 30 d after delivery. The levels of interleukin (IL)-1β, IL-6, IL-8, IL-10, IL-12p70 and tumor necrosis factor-α were analyzed by flow cytometry. After treatment, a major reduction in periodontal inflammation was observed in the test group, with bleeding on probing decreasing from 49.62% of sites to 11.66% of sites (p Periodontal therapy significantly reduced the levels of IL-1β and IL-8 in gingival crevicular fluid (p periodontal therapy during pregnancy successfully reduced periodontal inflammation and gingival crevicular fluid cytokine levels, it did not have a significant impact on serum biomarkers. © 2012 John Wiley & Sons A/S.

How to Build an Intentional Android: Infants' Imitation of a Robot's Goal-Directed Actions

Science.gov (United States)

Itakura, Shoji; Ishida, Hiraku; Kanda, Takayuki; Shimada, Yohko; Ishiguro, Hiroshi; Lee, Kang

2008-01-01

This study examined whether young children are able to imitate a robot's goal-directed actions. Children (24-35 months old) viewed videos showing a robot attempting to manipulate an object (e.g., putting beads inside a cup) but failing to achieve its goal (e.g., beads fell outside the cup). In 1 video, the robot made eye contact with a human…

Is gaze following purely reflexive or goal-directed instead? Revisiting the automaticity of orienting attention by gaze cues.

Science.gov (United States)

Ricciardelli, Paola; Carcagno, Samuele; Vallar, Giuseppe; Bricolo, Emanuela

2013-01-01

Distracting gaze has been shown to elicit automatic gaze following. However, it is still debated whether the effects of perceived gaze are a simple automatic spatial orienting response or are instead sensitive to the context (i.e. goals and task demands). In three experiments, we investigated the conditions under which gaze following occurs. Participants were instructed to saccade towards one of two lateral targets. A face distracter, always present in the background, could gaze towards: (a) a task-relevant target--("matching" goal-directed gaze shift)--congruent or incongruent with the instructed direction, (b) a task-irrelevant target, orthogonal to the one instructed ("non-matching" goal-directed gaze shift), or (c) an empty spatial location (no-goal-directed gaze shift). Eye movement recordings showed faster saccadic latencies in correct trials in congruent conditions especially when the distracting gaze shift occurred before the instruction to make a saccade. Interestingly, while participants made a higher proportion of gaze-following errors (i.e. errors in the direction of the distracting gaze) in the incongruent conditions when the distracter's gaze shift preceded the instruction onset indicating an automatic gaze following, they never followed the distracting gaze when it was directed towards an empty location or a stimulus that was never the target. Taken together, these findings suggest that gaze following is likely to be a product of both automatic and goal-driven orienting mechanisms.

Slips of action and sequential decisions: a cross-validation study of tasks assessing habitual and goal-directed action control

Directory of Open Access Journals (Sweden)

Zsuzsika Sjoerds

2016-12-01

Full Text Available Instrumental learning and decision-making rely on two parallel systems: a goal-directed and a habitual system. In the past decade, several paradigms have been developed to study these systems in animals and humans by means of e.g. overtraining, devaluation procedures and sequential decision-making. These different paradigms are thought to measure the same constructs, but cross-validation has rarely been investigated. In this study we compared two widely used paradigms that assess aspects of goal-directed and habitual behavior. We correlated parameters from a two-step sequential decision-making task that assesses model-based and model-free learning with a slips-of-action paradigm that assesses the ability to suppress cue-triggered, learnt responses when the outcome has been devalued and is therefore no longer desirable. Model-based control during the two-step task showed a very moderately positive correlation with goal-directed devaluation sensitivity, whereas model-free control did not. Interestingly, parameter estimates of model-based and goal-directed behavior in the two tasks were positively correlated with higher-order cognitive measures (e.g. visual short-term memory. These cognitive measures seemed to (at least partly mediate the association between model-based control during sequential decision-making and goal-directed behavior after instructed devaluation. This study provides moderate support for a common framework to describe the propensity towards goal-directed behavior as measured with two frequently used tasks. However, we have to caution that the amount of shared variance between the goal-directed and model-based system in both tasks was rather low, suggesting that each task does also pick up distinct aspects of goal-directed behavior. Further investigation of the commonalities and differences between the model-free and habit systems as measured with these, and other, tasks is needed. Also, a follow-up cross-validation on the neural

Protocol for the administration of haemofiltration fluids and using patient group electrolytes direction.

Science.gov (United States)

Kingston, Diana; Sykes, Siobhan; Raper, Sarah

2002-01-01

A patient group direction (PGD) is a specific written instruction for the supply or administration of named medicines in an identified clinical situation The introduction of a PGD must demonstrate a benefit for patients Haemofiltration is widely accepted as the treatment of choice when caring for critically ill patients in acute renal failure on an intensive care unit The haemofiltration PGD improves patient care by providing standardisation in administration of fluids and electrolytes and enabling nurses to respond rapidly to changes in biochemistry during haemofiltration This paper describes the development and implementation of a protocol to enable nurses to administer haemofiltration fluids and electrolytes under a patient group direction.

Evolução de variáveis hemodinâmicas e perfusionais durante o choque séptico experimental tratado com ressuscitação volêmica guiada por metas Hemodynamic and perfusion variables during experimental septic shock treated with goal-directed fluid resuscitation

Directory of Open Access Journals (Sweden)

Marcelo Park

2011-09-01

gold standard in sepsis therapy, few studies have described hemodynamic and perfusion parameters during this procedure. This study aims to describe these parameters during septic shock without resuscitation and after 12 hours of goal-directed resuscitation. METHODS: Thirteen anesthetized pigs (35-45 kg had peritonitis caused by fecal inoculation (0.75 g/kg. After developing persistent hypotension, both groups were given antibiotics and randomized either to the control group (n=7 or the experimental group (n=6. In the control group, hemodynamic control was optimized to maintain a central venous pressure of 8-12 mmHg, a urinary output above 0.5 mL/kg/hour and a mean arterial blood pressure above 65 mmHg. The experimental group received the above target therapy in addition to maintaining a SvO2 above 65%. The interventions included lactated Ringer's solution and norepinephrine for both groups and dobutamine in the SvO2 group. The animals were treated for 12 hours or until death. RESULTS: Untreated sepsis was associated with significant reductions in SvO2, PvO2, cardiac output and central venous pressure in addition to increased arteriovenous oxygen saturation and veno-arterial CO2 differences. Following resuscitation, these parameters were corrected in both groups. Goal-directed resuscitation was associated with a better hemodynamic profile, characterized by higher SvO2, cardiac output and central venous pressure. CONCLUSIONS: Non-resuscitated sepsis showed a hemodynamic profile suggesting hypovolemia, with worsened perfusion and hemodynamics, which is reversed upon fluid resuscitation. Goal-directed resuscitation is associated with significantly improved hemodynamic and perfusion parameters

Determination of the influence of fluid therapy on hematological and urinary parameters in dogs

Directory of Open Access Journals (Sweden)

Mariah Gois Ceregatti

2016-09-01

Full Text Available ABSTRACT. Ceregatti M.G., Volpato J., Mattoso C.R.S., da Costa A., Weinert N.C., Tocheto R., Comasseto F. & Saito M.E. [Determination of the influence of fluid therapy on hematological and urinary parameters in dogs.] Determinação da influência da fluidoterapia nos parâmetros hematológicos e urinários em cães. Revista Brasileira de Medicina Veterinária, 38(3:292-298, 2016. Departamento de Medicina Veterinária, Universidade do Estado de Santa Catarina, Avenida Luiz de Camões, 2090, Conta Dinheiro, Lages, SC 88520-000, Brasil. E-mail: jully_volps@hotmail.com The aim of the present study was to evaluate the effects of different fluid infusion rates on hematologic and urinary parameters in dogs. A total of 30 mixed-breed, male dogs were distributed into three groups. Fluid (0.9% NaCl was administered during a one-hour period at rates: G5 (5 mL/ kg; G10 (10 mL/ kg; G50 (50 mL/kg. Blood samples for erythrogram, and urine to perform urine specific gravity were taken over the following time points studied. Urinary volume produced was also evaluated during the same time points. Erythrogram values were statistically lower between T10 and T240 in G10 and G50, compared to T0, and the lowest values were found in G50. Urine specific gravity decreased statistically between all time points only in G50. Statistical differences were found in urinary output between groups, with higher volumes in G50 in most of the time points studied, it can be concluded that fluid therapy changes hematologic indices in rates of 10 and 50 mL/ kg for one hour. At least a four hour period must be respected after the end of infusion to collect blood for erythrogram samples. Fluid therapy affects the urine specific gravity only at high infusion rates (50 mL/kg for 1 hour, and in this case urine samples should be collected after more than 4 hours after the end of infusion, although lower rates (5 and 10 mL / kg for 1 hour do not interfere with urine specific gravity.

Magnetohydrodynamic pump with a system for promoting flow of fluid in one direction

Science.gov (United States)

Lemoff, Asuncion V [Union City, CA; Lee, Abraham P [Irvine, CA

2010-07-13

A magnetohydrodynamic pump for pumping a fluid. The pump includes a microfluidic channel for channeling the fluid, a MHD electrode/magnet system operatively connected to the microfluidic channel, and a system for promoting flow of the fluid in one direction in the microfluidic channel. The pump has uses in the medical and biotechnology industries for blood-cell-separation equipment, biochemical assays, chemical synthesis, genetic analysis, drug screening, an array of antigen-antibody reactions, combinatorial chemistry, drug testing, medical and biological diagnostics, and combinatorial chemistry. The pump also has uses in electrochromatography, surface micromachining, laser ablation, inkjet printers, and mechanical micromilling.

A systematic review and meta-analysis of early goal-directed therapy for septic shock: the ARISE, ProCESS and ProMISe Investigators.

Science.gov (United States)

Angus, D C; Barnato, A E; Bell, D; Bellomo, R; Chong, C-R; Coats, T J; Davies, A; Delaney, A; Harrison, D A; Holdgate, A; Howe, B; Huang, D T; Iwashyna, T; Kellum, J A; Peake, S L; Pike, F; Reade, M C; Rowan, K M; Singer, M; Webb, S A R; Weissfeld, L A; Yealy, D M; Young, J D

2015-09-01

To determine whether early goal-directed therapy (EGDT) reduces mortality compared with other resuscitation strategies for patients presenting to the emergency department (ED) with septic shock. Using a search strategy of PubMed, EmBase and CENTRAL, we selected all relevant randomised clinical trials published from January 2000 to January 2015. We translated non-English papers and contacted authors as necessary. Our primary analysis generated a pooled odds ratio (OR) from a fixed-effect model. Sensitivity analyses explored the effect of including non-ED studies, adjusting for study quality, and conducting a random-effects model. Secondary outcomes included organ support and hospital and ICU length of stay. From 2395 initially eligible abstracts, five randomised clinical trials (n = 4735 patients) met all criteria and generally scored high for quality except for lack of blinding. There was no effect on the primary mortality outcome (EGDT: 23.2% [495/2134] versus control: 22.4% [582/2601]; pooled OR 1.01 [95% CI 0.88-1.16], P = 0.9, with heterogeneity [I(2) = 57%; P = 0.055]). The pooled estimate of 90-day mortality from the three recent multicentre studies (n = 4063) also showed no difference [pooled OR 0.99 (95% CI 0.86-1.15), P = 0.93] with no heterogeneity (I(2) = 0.0%; P = 0.97). EGDT increased vasopressor use (OR 1.25 [95% CI 1.10-1.41]; P < 0.001) and ICU admission [OR 2.19 (95% CI 1.82-2.65); P < 0.001]. Including six non-ED randomised trials increased heterogeneity (I(2) = 71%; P < 0.001) but did not change overall results [pooled OR 0.94 (95% CI 0.82 to 1.07); P = 0.33]. EGDT is not superior to usual care for ED patients with septic shock but is associated with increased utilisation of ICU resources.

The role of play themes in non-directive play therapy.

Science.gov (United States)

Ryan, Virginia; Edge, Andrew

2012-07-01

Describing the processes underlying play therapy is important for evidence based practice in child therapy. Employing play themes to describe children's play session contents is in widespread use by practitioners, but an adequate classification of these themes for non-directive play therapy practice has not yet been established. This article sets out to fill this gap by first describing how themes can be distinguished and distilled from the contents of play therapy contents. Second, a classification of main themes and sub-themes with exemplars to illustrate these concepts which is compatible with non-directive play therapy practice is set out. Finally a pilot project with experienced play therapists to test this classification in practice is suggested, along with the research questions that will need to be investigated in the shorter and longer terms.

Fronto-parietal coding of goal-directed actions performed by artificial agents.

Science.gov (United States)

Kupferberg, Aleksandra; Iacoboni, Marco; Flanagin, Virginia; Huber, Markus; Kasparbauer, Anna; Baumgartner, Thomas; Hasler, Gregor; Schmidt, Florian; Borst, Christoph; Glasauer, Stefan

2018-03-01

With advances in technology, artificial agents such as humanoid robots will soon become a part of our daily lives. For safe and intuitive collaboration, it is important to understand the goals behind their motor actions. In humans, this process is mediated by changes in activity in fronto-parietal brain areas. The extent to which these areas are activated when observing artificial agents indicates the naturalness and easiness of interaction. Previous studies indicated that fronto-parietal activity does not depend on whether the agent is human or artificial. However, it is unknown whether this activity is modulated by observing grasping (self-related action) and pointing actions (other-related action) performed by an artificial agent depending on the action goal. Therefore, we designed an experiment in which subjects observed human and artificial agents perform pointing and grasping actions aimed at two different object categories suggesting different goals. We found a signal increase in the bilateral inferior parietal lobule and the premotor cortex when tool versus food items were pointed to or grasped by both agents, probably reflecting the association of hand actions with the functional use of tools. Our results show that goal attribution engages the fronto-parietal network not only for observing a human but also a robotic agent for both self-related and social actions. The debriefing after the experiment has shown that actions of human-like artificial agents can be perceived as being goal-directed. Therefore, humans will be able to interact with service robots intuitively in various domains such as education, healthcare, public service, and entertainment. © 2017 Wiley Periodicals, Inc.

Hypertonic saline (HTS versus standard (isotonic fluid therapy for traumatic brain injuries: a systematic review

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Andrit Lourens

2014-12-01

Full Text Available Traumatic Brain Injury (TBI is one of the foremost causes of mortality secondary to trauma. Poorer outcomes are associated with secondary insults, after the initial brain injury occurred. The management goal of TBI is to prevent or minimise the effects of secondary brain injuries. The primary objective of this systematic review/meta-analysis was to assess the effects of Hypertonic Saline (HTS compared to Standard Fluid Therapy (SFT in the treatment and resuscitation of TBI patients. We searched CENTRAL, MEDLINE (from 1966, EBSCOhost, Scopus, ScienceDirect, Proquest Medical Library and EMBASE (from 1980 in May 2010 and updated searches in February 2011. Data were assessed and extracted by two independent authors. Risk ratios (RR with a 95% confidence interval (CI were used as the effect measure. The review included three RCTs (1184 participants of which two were of high to moderate quality (1005 participants. HTS was not found to be associated with a reduction in mortality (3 RCTs, 1184 participants, RR 0.91, 95%CI 0.76 to 1.09 and morbidity in TBI patients. No significant improvement in haemodynamical stability was found whereas insufficient data were available to indicate a reduction in the intracranial pressure (ICP. In the HTS group, cerebral perfusion pressure (CPP (MD 3.83 mmHg, 95%CI 1.08 to 6.57 and serum sodium level (MD 8 mEq/L, 95%CI 7.47 to 8.53 were higher. Existing studies show no indication that HTS, in comparison to SFT, reduces mortality or morbidity after the occurrence of TBI. Against this backdrop, some uncertainties still exist in terms of the use of different concentrations and volumes of HTS, the timing of administration as well as the benefit in specific injury profiles. As a result, formulating conclusive recommendations is complex.

A direct method of natural frequency analysis on pipeline conveying fluid with both ends supported

International Nuclear Information System (INIS)

Huang Yimin; Ge Seng; Wu Wei; Jie He

2012-01-01

Highlights: ► A direct method which derived from Ferrari's method was used to solve quartic equations. ► Frequency equations of pipeline conveying fluid with both ends supported was studied. ► Each order natural frequencies can be obtained by using the direct method. ► The first five critical flow velocities were obtained by using numerical method. - Abstract: The natural frequency equations of fluid–structure interaction in pipeline conveying fluid with both ends supported is investigated by a direct method, and the direct method is derived from Ferrari's method which is used to solve quartic equations. The dynamic equation of pipeline conveying fluid with two variables is obtained by Hamilton's variation principle based on Euler–Bernoulli Beam theory. By using the separation of variables method and the derived method from Ferrari's method, the natural frequency equations and the critical flow velocity equations of pipeline conveying fluid with both ends supported are obtained in mathematical decoupling. Each order natural frequencies and critical flow velocities can be obtained by using numerical method. The first five order dimensionless critical flow velocities are obtained, and the results indicate that clamped–simply supported is less stable than clamped–clamped supported and more stable than simply–simply supported. All the conclusions can be applied to nuclear installations and other engineering fields of improving the vibration.

Closed-loop feedback control for microfluidic systems through automated capacitive fluid height sensing

OpenAIRE

Trumper, David; Kassis, Timothy; Griffith, Linda; Noh, Minkyun; Soenksen, Luis

2018-01-01

Precise fluid height sensing in open-channel microfluidics has long been a desirable feature for a wide range of applications. However, performing accurate measurements of the fluid level in small-scale reservoirs (<1mL) has proven to be an elusive goal, especially if direct fluid-sensor contact needs to be avoided. In particular, gravity-driven systems used in several microfluidic applications to establish pressure gradients and impose flow remain open-loop and largely unmonitored due to ...

Direct measurement of the ballistic motion of a freely floating colloid in Newtonian and viscoelastic fluids.

Science.gov (United States)

Hammond, Andrew P; Corwin, Eric I

2017-10-01

A thermal colloid suspended in a liquid will transition from a short-time ballistic motion to a long-time diffusive motion. However, the transition between ballistic and diffusive motion is highly dependent on the properties and structure of the particular liquid. We directly observe a free floating tracer particle's ballistic motion and its transition to the long-time regime in both a Newtonian fluid and a viscoelastic Maxwell fluid. We examine the motion of the free particle in a Newtonian fluid and demonstrate a high degree of agreement with the accepted Clercx-Schram model for motion in a dense fluid. Measurements of the functional form of the ballistic-to-diffusive transition provide direct measurements of the temperature, viscosity, and tracer radius. We likewise measure the motion in a viscoelastic Maxwell fluid and find a significant disagreement between the theoretical asymptotic behavior and our measured values of the microscopic properties of the fluid. We observe a greatly increased effective mass for a freely moving particle and a decreased plateau modulus.

Effect of Working Fluids on the Thermal Performance of a Bi-directional Solar Thermodiode

International Nuclear Information System (INIS)

Ko, Yung Joo

2008-02-01

(Smart Module System) were made. Six kinds of working fluids were used to investigate their effects on the thermal performance of a bi-directional solar thermo diode. Two kinds of thermo diodes were studied. The first one is the mono-directional thermo diode that allows heat flow in the desired direction but blocks in the opposite direction. The second one is the bi-directional thermo diode of which the direction of heat flow, surface absorptivity and heat capacity of the module can be adjusted for maximum energy efficiency. This hi-directional can be used both for the summer cooling and winter heating of buildings and shelters. Usually, the thermo diodes are simple beam shape, but in this study, they were redesigned a s two L-shaped loops mounted between a collector plate and a Storage tank. Rotable joints between the horizontal and inclined segments of the loop enable easy alteration of geat transfer direction. The loops and tank were filled with a working fluid for effective heat transfer when the solar thermo diode was forwarded biased. The solar thermo diode was heated by a radiant heater that consisted of 20 halogen lamps that generates a heat flux of about 1000W/m 2 on the collector surface. The working fluids used in the study were water, acetone, ethylalcohol. In addition, three kinds of silicon oil with different viscosity were studied. And three mixtures of water and ethylalcohol of different volume ratio were used. Finally, the nano fluids were also studied. Working fluids were tested with thermal conductivity values ranging from 0.1 to 0.56 W/m- .deg. C, thermal expansion coefficient values ranging from 1.8 x 10 -4 to 1.3 x 10 -3 K -1 , and kinematic viscosity values ranging from 0.65 x 10 -6 to 100 x 10 -6 m 2 /s. Through the study, it was found that the circulation point(CP) at the onset of fluid flow is very important. for a given working fluid, the heat transfer and heated stability of the system depends strongly on the circulation point of the fluid

The search for and analysis of direct samples of early Solar System aqueous fluids.

Science.gov (United States)

Zolensky, Michael E; Bodnar, Robert J; Yurimoto, Hisayoshi; Itoh, Shoichi; Fries, Marc; Steele, Andrew; Chan, Queenie H-S; Tsuchiyama, Akira; Kebukawa, Yoko; Ito, Motoo

2017-05-28

We describe the current state of the search for direct, surviving samples of early, inner Solar System fluids-fluid inclusions in meteorites. Meteoritic aqueous fluid inclusions are not rare, but they are very tiny and their characterization is at the state of the art for most analytical techniques. Meteoritic fluid inclusions offer us a unique opportunity to study early Solar System brines in the laboratory. Inclusion-by-inclusion analyses of the trapped fluids in carefully selected samples will, in the immediate future, provide us detailed information on the evolution of fluids as they interacted with anhydrous solid materials. Thus, real data can replace calculated fluid compositions in thermochemical calculations of the evolution of water and aqueous reactions in comets, asteroids, moons and the terrestrial planets.This article is part of the themed issue 'The origin, history and role of water in the evolution of the inner Solar System'. © 2017 The Author(s).

Interaction of Instrumental and Goal-Directed Learning Modulates Prediction Error Representations in the Ventral Striatum.

Science.gov (United States)

Guo, Rong; Böhmer, Wendelin; Hebart, Martin; Chien, Samson; Sommer, Tobias; Obermayer, Klaus; Gläscher, Jan

2016-12-14

Goal-directed and instrumental learning are both important controllers of human behavior. Learning about which stimulus event occurs in the environment and the reward associated with them allows humans to seek out the most valuable stimulus and move through the environment in a goal-directed manner. Stimulus-response associations are characteristic of instrumental learning, whereas response-outcome associations are the hallmark of goal-directed learning. Here we provide behavioral, computational, and neuroimaging results from a novel task in which stimulus-response and response-outcome associations are learned simultaneously but dominate behavior at different stages of the experiment. We found that prediction error representations in the ventral striatum depend on which type of learning dominates. Furthermore, the amygdala tracks the time-dependent weighting of stimulus-response versus response-outcome learning. Our findings suggest that the goal-directed and instrumental controllers dynamically engage the ventral striatum in representing prediction errors whenever one of them is dominating choice behavior. Converging evidence in human neuroimaging studies has shown that the reward prediction errors are correlated with activity in the ventral striatum. Our results demonstrate that this region is simultaneously correlated with a stimulus prediction error. Furthermore, the learning system that is currently dominating behavioral choice dynamically engages the ventral striatum for computing its prediction errors. This demonstrates that the prediction error representations are highly dynamic and influenced by various experimental context. This finding points to a general role of the ventral striatum in detecting expectancy violations and encoding error signals regardless of the specific nature of the reinforcer itself. Copyright © 2016 the authors 0270-6474/16/3612650-11$15.00/0.

Term amniotic fluid: an unexploited reserve of mesenchymal stromal cells for reprogramming and potential cell therapy applications.

Science.gov (United States)

Moraghebi, Roksana; Kirkeby, Agnete; Chaves, Patricia; Rönn, Roger E; Sitnicka, Ewa; Parmar, Malin; Larsson, Marcus; Herbst, Andreas; Woods, Niels-Bjarne

2017-08-25

Mesenchymal stromal cells (MSCs) are currently being evaluated in numerous pre-clinical and clinical cell-based therapy studies. Furthermore, there is an increasing interest in exploring alternative uses of these cells in disease modelling, pharmaceutical screening, and regenerative medicine by applying reprogramming technologies. However, the limited availability of MSCs from various sources restricts their use. Term amniotic fluid has been proposed as an alternative source of MSCs. Previously, only low volumes of term fluid and its cellular constituents have been collected, and current knowledge of the MSCs derived from this fluid is limited. In this study, we collected amniotic fluid at term using a novel collection system and evaluated amniotic fluid MSC content and their characteristics, including their feasibility to undergo cellular reprogramming. Amniotic fluid was collected at term caesarean section deliveries using a closed catheter-based system. Following fluid processing, amniotic fluid was assessed for cellularity, MSC frequency, in-vitro proliferation, surface phenotype, differentiation, and gene expression characteristics. Cells were also reprogrammed to the pluripotent stem cell state and differentiated towards neural and haematopoietic lineages. The average volume of term amniotic fluid collected was approximately 0.4 litres per donor, containing an average of 7 million viable mononuclear cells per litre, and a CFU-F content of 15 per 100,000 MNCs. Expanded CFU-F cultures showed similar surface phenotype, differentiation potential, and gene expression characteristics to MSCs isolated from traditional sources, and showed extensive expansion potential and rapid doubling times. Given the high proliferation rates of these neonatal source cells, we assessed them in a reprogramming application, where the derived induced pluripotent stem cells showed multigerm layer lineage differentiation potential. The potentially large donor base from caesarean section

Direct Identification of Enteroviruses in Cerebrospinal Fluid of Patients with Suspected Meningitis by Nested PCR Amplification

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Alexandr Krasota

2016-01-01

Full Text Available Enteroviruses, the most common human viral pathogens worldwide, have been associated with serous meningitis, encephalitis, syndrome of acute flaccid paralysis, myocarditis and the onset of diabetes type 1. In the future, the rapid identification of the etiological agent would allow to adjust the therapy promptly and thereby improve the course of the disease and prognosis. We developed RT-nested PCR amplification of the genomic region coding viral structural protein VP1 for direct identification of enteroviruses in clinical specimens and compared it with the existing analogs. One-hundred-fifty-nine cerebrospinal fluids (CSF from patients with suspected meningitis were studied. The amplification of VP1 genomic region using the new method was achieved for 86 (54.1% patients compared with 75 (47.2%, 53 (33.3% and 31 (19.5% achieved with previously published methods. We identified 11 serotypes of the Enterovirus species B in 2012, including relatively rare echovirus 14 (E-14, E-15 and E-32, and eight serotypes of species B and 5 enteroviruses A71 (EV-A71 in 2013. The developed method can be useful for direct identification of enteroviruses in clinical material with the low virus loads such as CSF.

Perioperative Intravascular Fluid Assessment and Monitoring: A Narrative Review of Established and Emerging Techniques

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Sumit Singh

2011-01-01

Full Text Available Accurate assessments of intravascular fluid status are an essential part of perioperative care and necessary in the management of the hemodynamically unstable patient. Goal-directed fluid management can facilitate resuscitation of the hypovolemic patient, reduce the risk of fluid overload, reduce the risk of the injudicious use of vasopressors and inotropes, and improve clinical outcomes. In this paper, we discuss the strengths and limitations of a spectrum of noninvasive and invasive techniques for assessing and monitoring intravascular volume status and fluid responsiveness in the perioperative and critically ill patient.

Application of the linear-quadratic model with incomplete repair to radionuclide directed therapy

International Nuclear Information System (INIS)

Millar, W.T.; Glasgow Univ.

1991-01-01

The LQ model has now been extended to include a general time varying dose rate profile, and the equations can be readily evaluated if an exponential radiation damage repair process is assumed. These equations are applicable to radionuclide directed therapy, including brachytherapy. Kinetic uptake data obtained during radionuclide directed therapy may therefore be used to determine the radiobiological dosimetry of the target and non-target tissues. Also, preliminary tracer studies may be used to pre-plan the radionuclide directed therapy, provided that tracer and therapeutic amounts of the radionuclide carrier are identically processed by the tissues. It is also shown that continuous radionuclide therapy will induce less damage in late-responding tissues than 2 Gy/fraction external beam therapy if the ratio of the maximum dose rate and the sublethal damage repair half-life in the tissue is less than 1.0 Gy. Similar inequalities may be derived for β-particle radionuclide directed therapy. (author)

Goal-directed, habitual and Pavlovian prosocial behavior

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Filip eGęsiarz

2015-05-01

Full Text Available Although prosocial behaviors have been widely studied across disciplines, the mechanisms underlying them are not fully understood. Evidence from psychology, biology and economics suggests that prosocial behaviors can be driven by a variety of seemingly opposing factors: altruism or egoism, intuition or deliberation, inborn instincts or learned dispositions, and utility derived from actions or their outcomes. Here we propose a framework inspired by research on reinforcement learning and decision making that links these processes and explains characteristics of prosocial behaviors in different contexts. More specifically, we suggest that prosocial behaviors inherit features of up to three decision-making systems employed to choose between self- and other- regarding acts: a goal-directed system that selects actions based on their predicted consequences, a habitual system that selects actions based on their reinforcement history, and a Pavlovian system that emits reflexive responses based on evolutionarily prescribed priors. This framework, initially described in the field of cognitive neuroscience and machine learning, provides insight into the potential neural circuits and computations shaping prosocial behaviors. Furthermore, it identifies specific conditions in which each of these three systems should dominate and promote other- or self- regarding behavior.

SHOULD I STAY OR SHOULD I GO? CONCEPTUAL UNDERPINNINGS OF GOAL-DIRECTED ACTIONS

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GIOVANNI eMIRABELLA

2014-11-01

Full Text Available All actions, even the simplest like moving an arm to grasp a pen, are associated with energy costs. Thus all mobile organisms possess the ability to evaluate resources and select those behaviours that are most likely to lead to the greatest accrual of valuable items (rewards in the near or, especially in the case of humans, distant future. The evaluation process is performed at all possible stages of the series of decisions that lead to the building of a goal-directed action or to its suppression. This is because all animals have a limited amount of energy and resources; to survive and be able to reproduce they have to minimize the costs and maximize the outcomes of their actions. These computations are at the root of behavioral flexibility. Two executive functions play a major role in generating flexible behaviors: i the ability to predict future outcomes of goal-directed actions; and ii the ability to cancel them when they are unlikely to accomplish valuable results. These two processes operate continuously during the entire course of a movement: during its genesis, its planning and even its execution, so that the motor output can be modulated or suppressed at any time before its execution.In this review, functional interactions of the extended neural network subserving generation and inhibition of goal-directed movements will be outlined, leading to the intriguing hypothesis that the performance of actions and their suppression are not specified by independent sets of brain regions. Rather, it will be proposed that acting and stopping are functions emerging from specific interactions between largely overlapping brain regions, whose activity is intimately linked (directly or indirectly to the evaluations of pros and cons of an action. Such mechanism would allow the brain to perform as a highly efficient and flexible system, as different functions could be computed exploiting the same components operating in different configurations.

Achievement Goal Orientations and Adolescents’ Subjective Well-Being in School: The Mediating Roles of Academic Social Comparison Directions

OpenAIRE

Tian, Lili; Yu, Tingting; Huebner, E. Scott

2017-01-01

The purpose of this study was to examine the multiple mediational roles of academic social comparison directions (upward academic social comparison and downward academic social comparison) on the relationships between achievement goal orientations (i.e., mastery goals, performance-approach goals, and performance-avoidance goals) and subjective well-being (SWB) in school (school satisfaction, school affect) in adolescent students in China. A total of 883 Chinese adolescent students (430 males;...

Wearable Therapy - Detecting Information from Wearables and Mobiles that are Relevant to Clinical and Self-directed Therapy.

Science.gov (United States)

Arnrich, Bert; Ersoy, Cem; Mayora, Oscar; Dey, Anind; Berthouze, Nadia; Kunze, Kai

2017-01-09

This accompanying editorial provides a brief introduction into the focus theme "Wearable Therapy". The focus theme "Wearable Therapy" aims to present contributions which target wearable and mobile technologies to support clinical and self-directed therapy. A call for papers was announced to all participants of the "9th International Conference on Pervasive Computing Technologies for Healthcare" and was published in November 2015. A peer review process was conducted to select the papers for the focus theme. Six papers were selected to be included in this focus theme. The paper topics cover a broad range including an approach to build a health informatics research program, a comprehensive literature review of self-quantification for health self-management, methods for affective state detection of informal care givers, social-aware handling of falls, smart shoes for supporting self-directed therapy of alcohol addicts, and reference information model for pervasive health systems. More empirical evidence is needed that confirms sustainable effects of employing wearable and mobile technology for clinical and self-directed therapy. Inconsistencies between different conceptual approaches need to be revealed in order to enable more systematic investigations and comparisons.

An update clinical application of amniotic fluid-derived stem cells (AFSCs) in cancer cell therapy and tissue engineering.

Science.gov (United States)

Gholizadeh-Ghaleh Aziz, Shiva; Fathi, Ezzatollah; Rahmati-Yamchi, Mohammad; Akbarzadeh, Abolfazl; Fardyazar, Zahra; Pashaiasl, Maryam

2017-06-01

Recent studies have elucidated that cell-based therapies are promising for cancer treatments. The human amniotic fluid stem (AFS) cells are advantageous cells for such therapeutic schemes that can be innately changed to express therapeutic proteins. HAFSCs display a natural tropism to cancer cells in vivo. They can be useful in cancer cells targeting. Moreover, they are easily available from surplus diagnostic samples during pregnancy and less ethical and legal concern are associated with the collection and application than other putative cells are subjected. This review will designate representatives of amniotic fluid and stem cell derived from amniotic fluid. For this propose, we collect state of human AFS cells data applicable in cancer therapy by dividing this approach into two main classes (nonengineered and engineered based approaches). Our study shows the advantage of AFS cells over other putative cells types in terms differentiation ability to a wide range of cells by potential and effective use in preclinical studies for a variety of diseases. This study has shown the elasticity of human AFS cells and their favorable potential as a multipotent cell source for regenerative stem cell therapy and capable of giving rise to multiple lineages including such as osteoblasts and adipocyte.

Effects of psychosocial stress on the goal-directed and habit memory systems during learning and later execution.

Science.gov (United States)

Fournier, Marion; d'Arripe-Longueville, Fabienne; Radel, Rémi

2017-03-01

Instrumental learning occurs through both goal-directed and habit memory systems, which are supported by anatomically distinct brain systems. Interestingly, stress may promote habits at the expense of goal-directed performance, since stress before training in an instrumental task was found to cause individuals to carry on with the learned association in spite of a devalued outcome. These findings nevertheless left pending questions, and it has been difficult to determine which system is primarily affected by stress (an improved habit system, an impaired goal-directed system, or both) and at what point the stress acts (at the moment of learning by making more resistant habits, or after devaluation by making individuals less sensitive to change in the outcome value). The present study (N=72 participants, 63 males and 9 females) aimed to answer these questions with (i) an instrumental task that dissociates the two memory systems and (ii) three conditions of psychosocial stress exposure (Trier Social Stress Test): stress induced before learning, before devaluation, and not induced for the control group. The study confirms that exposure to psychosocial stress leads to habitual performance. Moreover, it provides new insight into this effect by locating its origin as an impairment in the capacity of the goal-directed system rather than a reinforcement in habit learning. These results are discussed in light of recent neurobiological models of stress and memory. Copyright © 2016 Elsevier Ltd. All rights reserved.

Product behavior and appearance effects on experienced engagement during experimental and goal-directed tasks

NARCIS (Netherlands)

Rozendaal, M.C.; Keyson, D.V.; Ridder, de H.

2007-01-01

This study examines how digital products can be designed towards increased levels of experienced engagement. An experiment was conducted in which 24 participants were asked to interact with a videogame that varied in behavior and appearance aspects during experiential and goal-directed tasks.

Functional Magnetic Resonance Imaging of Goal-Directed Reaching in Children with Autism Spectrum Disorders: A Feasibility Study

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Nicole M. G. Salowitz

2014-04-01

Full Text Available An unanswered question concerning the neural basis of autism spectrum disorders (ASD is how sensorimotor deficits in individuals with ASD are related to abnormalities of brain function. We previously described a robotic joystick and video game system that allows us to record functional magnetic resonance images (FMRI while adult humans make goal-directed wrist motions. We anticipated several challenges in extending this approach to studying goal-directed behaviors in children with ASD and in typically developing (TYP children. In particular we were concerned that children with autism may express increased levels of anxiety as compared to typically developing children due to the loud sounds and small enclosed space of the MRI scanner. We also were concerned that both groups of children might become restless during testing, leading to an unacceptable amount of head movement. Here we performed a pilot study evaluating the extent to which autistic and typically developing children exhibit anxiety during our experimental protocol as well as their ability to comply with task instructions. Our experimental controls were successful in minimizing group differences in drop-out due to anxiety. Kinematic performance and head motion also were similar across groups. Both groups of children engaged cortical regions (frontal, parietal, temporal, occipital while making goal-directed movements. In addition, the ASD group exhibited task-related correlations in subcortical regions (cerebellum, thalamus, whereas correlations in the TYP group did not reach statistical significance in subcortical regions. Four distinct regions in frontal cortex showed a significant group difference such that TYP children exhibited positive correlations between the hemodynamic response and movement, whereas children with ASD exhibited negative correlations. These findings demonstrate feasibility of simultaneous application of robotic manipulation and functional imaging to study goal-directed

Prediction of Reach Goals in Depth and Direction from the Parietal Cortex

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Matteo Filippini

2018-04-01

Full Text Available Summary: The posterior parietal cortex is well known to mediate sensorimotor transformations during the generation of movement plans, but its ability to control prosthetic limbs in 3D environments has not yet been fully demonstrated. With this aim, we trained monkeys to perform reaches to targets located at various depths and directions and tested whether the reach goal position can be extracted from parietal signals. The reach goal location was reliably decoded with accuracy close to optimal (>90%, and this occurred also well before movement onset. These results, together with recent work showing a reliable decoding of hand grip in the same area, suggest that this is a suitable site to decode the entire prehension action, to be considered in the development of brain-computer interfaces. : Filippini et al. show that it is possible to use parietal cortex activity to predict in which direction the arm will move and how far it will reach. This opens up the possibility of neural prostheses that can accurately guide reach and grasp using signals from this part of the brain. Keywords: neuroprosthetics, offline neural decoding, reaching in depth, monkey, V6A, machine learning, visuomotor transformations, hand guidance, prehension, robotics

Cerebrospinal Fluid HIV Escape from Antiretroviral Therapy.

Science.gov (United States)

Ferretti, Francesca; Gisslen, Magnus; Cinque, Paola; Price, Richard W

2015-06-01

CNS infection is a nearly constant facet of systemic CNS infection and is generally well controlled by suppressive systemic antiretroviral therapy (ART). However, there are instances when HIV can be detected in the cerebrospinal fluid (CSF) despite suppression of plasma viruses below the clinical limits of measurement. We review three types of CSF viral escape: asymptomatic, neuro-symptomatic, and secondary. The first, asymptomatic CSF escape, is seemingly benign and characterized by lack of discernable neurological deterioration or subsequent CNS disease progression. Neuro-symptomatic CSF escape is an uncommon, but important, entity characterized by new or progressive CNS disease that is critical to recognize clinically because of its management implications. Finally, secondary CSF escape, which may be even more uncommon, is defined by an increase of CSF HIV replication in association with a concomitant non-HIV infection, as a consequence of the local inflammatory response. Understanding these CSF escape settings not only is important for clinical diagnosis and management but also may provide insight into the CNS HIV reservoir.

Future directions for ICT in aphasia therapy for older adults: enhancing current practices through interdisciplinary perspectives

OpenAIRE

Kötteritzsch, Anna; Gerling, Kathrin

2015-01-01

Growing numbers of older adults requiring aphasia therapy create challenges for the health care system. Information and communication technology (ICT) has the potential to provide computer-mediated, self-administered aphasia therapy that complements conventional therapy. We explore overlaps in ICT for older adults and aphasia therapy applications with the goal of integrating innovative ICT in aphasia therapy. Based on a case study, we explain how results of different disciplines developing IC...

Is cupping blister harmful?-A proteomical analysis of blister fluid induced by cupping therapy and scald.

Science.gov (United States)

Liu, Zhidan; Chen, Chunlan; Li, Xiaoyan; Zhao, Chuang; Li, Zunyuan; Liang, Wei; Lin, Yufang

2018-02-01

Cupping therapy has a long history in traditional medicine especially in Asian countries. It was controversial whether cupping induced blisters are beneficial to healing effects, and the formation and content in the blisters remain unexplored. We aimed to identify and compare the molecular components of the blister fluid from the cupping therapy and the scalds to explore the necessary of inducing cupping induced blisters. Fluid sample of blisters from fifteen patients receiving cupping therapy (Cupping group) and scald burns (Scald group) were collected in this study. Proteins from the blisters were separated by two-dimensional electrophoresis (2D-gel) and further analyzed by mass spectrometry. In addition, the changes in particular proteins were confirmed by Western blotting. The protein components are significantly different between blister from cupping therapy and scalds. The immune responses, oxidative stress and metabolic related proteins (Ig lambda-2 chain C regions, Ig gamma-1 chain C region, hemopexin, prdx2, calmodulin, succinyl-CoA ligase and tetranectin) were increased, whereas the hemoglobin subunit beta was decreased in the Cupping group compared with the Scald group. Cupping induced blisters contain several proteins which relate to the activation of certain immune pathways including anti-oxidation, anti-apoptosis, tissue repairing and metabolic regulation. This proteomic analysis may indicate a significant clue to the mechanism study of cupping. Copyright © 2017 Elsevier Ltd. All rights reserved.

Indirect vs Direct Voice Therapy for Children With Vocal Nodules: A Randomized Clinical Trial.

Science.gov (United States)

Hartnick, Christopher; Ballif, Catherine; De Guzman, Vanessa; Sataloff, Robert; Campisi, Paolo; Kerschner, Joseph; Shembel, Adrianna; Reda, Domenic; Shi, Helen; Sheryka Zacny, Elinore; Bunting, Glenn

2018-02-01

Benign vocal fold nodules affect 12% to 22% of the pediatric population, and 95% of otolaryngologists recommend voice therapy as treatment. However, no randomized clinical trials that we are aware of have shown its benefits. To determine the impact of voice therapy in children with vocal fold nodules according to pretherapy and posttherapy scores on the Pediatric Voice-Related Quality of Life (PVRQOL) survey; secondary objectives included changes in phonatory parameters. For this multicenter randomized clinical trial, 114 children ages 6 to 10 years with vocal fold nodules, PVRQOL scores less than 87.5, and dysphonia for longer than 12 weeks were recruited from outpatient voice and speech clinics. This age range was identified because these patients have not experienced pubertal changes of the larynx, tolerate stroboscopy, and cooperate with voice therapy. Participants were blinded to treatment arm. Participants received either indirect or direct therapy for 8 to 12 weeks. Indirect therapy focused on education and discussion of voice principles, while direct treatment used the stimulus, response, antecedent paradigm. The primary outcome measure was PVRQOL score change before and after treatment. Secondary phonatory measures were also compared. Overall, 114 children were recruited for study (mean [SD] age, 8 [1.4] years; 83 males [73%]); with 57 randomized to receive either indirect or direct therapy. Both direct and indirect therapy approaches showed significant differences in PVRQOL scores pretherapy to posttherapy. The mean increase in PVRQOL score for direct therapy was 19.2, and 14.7 for indirect therapy (difference, 4.5; 95.3% CI, -10.8 to 19.8). Of 44 participants in the direct therapy group, 27 (61%) achieved a clinically meaningful PVRQOL improvement, compared with 26 of 49 (53%) for indirect therapy (difference, 8%; 95% CI, -12 to 28). Post hoc stratification showed robust effects in the direct therapy group for older children (Cohen d = 0.50) and the

Group Therapy Goals: A Comparison of Group Therapy Providers and Male Inmates

Science.gov (United States)

Morgan, Robert D.; Garland, J. Travis; Rozycki, Alicia T.; Reich, Darcy A.; Wilson, Scott

2005-01-01

This study was designed to identify important process and content goals from the perspective of inmates and compare these goals to the goals identified by group therapists in a previous study conducted by Winterowd, Morgan, and Ferrell (2001). Utilizing survey data from 156 incarcerated adult males, an initial confirmatory factor analysis…

INSTALLING AN ERP SYSTEM WITH A METHODOLOGY BASED ON THE PRINCIPLES OF GOAL DIRECTED PROJECT MANAGEMENT

Directory of Open Access Journals (Sweden)

Ioannis Zafeiropoulos

2010-01-01

Full Text Available This paper describes a generic methodology to support the process of modelling, adaptation and implementation (MAI of Enterprise Resource Planning Systems (ERPS based on the principles of goal directed project management (GDPM. The proposed methodology guides the project manager through specific stages in order to successfully complete the ERPS implementation. The development of the proper MAI methodology is deemed necessary because it will simplify the installation process of ERPS. The goal directed project management method was chosen since it provides a way of focusing all changes towards a predetermined goal. The main stages of the methodology are the promotion and preparation steps, the proposal, the contract, the implementation and the completion. The methodology was applied as a pilot application by a major ERPS development company. Important benefits were the easy and effective guidance for all installation and analysis stages, the faster installation for the ERPS and the control and cost reduction for the installation, in terms of time, manpower, technological equipment and other resources.

The attribution of navigational- and goal-directed agency in dogs (Canis familiaris) and human toddlers (Homo sapiens).

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Tauzin, Tibor; Csík, Andor; Lovas, Kata; Gergely, György; Topál, József

2017-02-01

Both human infants and nonhuman primates can recognize unfamiliar entities as instrumental agents ascribing to them goals and efficiency of goal-pursuit. This competence relies on movement cues indicating distal sensitivity to the environment and choice of efficient goal-approach. Although dogs' evolved sensitivity to social cues allow them to recognize humans as communicative agents, it remains unclear whether they have also evolved a basic concept of instrumental agency. We used a preferential object-choice procedure to test whether adult pet dogs and human toddlers can identify unfamiliar entities as agents based on different types of movement cues that specify different levels of agency. In the navigational agency condition, dogs preferentially chose an object that modified its pathway to avoid collision with obstacles over another object showing no evidence of distal sensitivity (regularly bumping into obstacles). However, in the goal-efficiency condition where neither object collided with obstacles as it navigated toward a distal target, but only 1 of them exhibited efficient goal-approach as well, toddlers, but not dogs, showed a preference toward the efficient goal-directed agent. These findings indicate that dogs possess a limited concept of environmentally sensitive navigational agency that they attribute to self-propelled entities capable of modifying their movement to avoid colliding with obstacles. Toddlers, in contrast, demonstrated clear sensitivity to cues of efficient variability of goal-approach as the basis for differentiating, attributing, and showing preference for goal-directed instrumental agency. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Determination of drugs in biological fluids by direct injection of samples for liquid-chromatographic analysis.

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Mullett, Wayne M

2007-03-10

The analysis of drugs in various biological fluids is an important criterion for the determination of the physiological performance of a drug. After sampling of the biological fluid, the next step in the analytical process is sample preparation. The complexity of biological fluids adds to the challenge of direct determination of the drug by chromatographic analysis, therefore demanding a sample preparation step that is often time-consuming, tedious, and frequently overlooked. However, direct on-line injection methods offer the advantage of reducing sample preparation steps and enabling effective pre-concentration and clean-up of biological fluids. These procedures can be automated and therefore reduce the requirements for handling potentially infectious biomaterial, improve reproducibility, and minimize sample manipulations and potential contamination. The objective of this review is to present an overview of the existing literature with emphasis on advances in automated sample preparation methods for liquid-chromatographic methods. More specifically, this review concentrates on the use of direct injection techniques, such as restricted-access materials, turbulent-flow chromatography and other automated on-line solid-phase extraction (SPE) procedures. It also includes short overviews of emerging automated extraction-phase technologies, such as molecularly imprinted polymers, in-tube solid-phase micro-extraction, and micro-extraction in a packed syringe for a more selective extraction of analytes from complex samples, providing further improvements in the analysis of biological materials. Lastly, the outlook for these methods and potential new applications for these technologies are briefly discussed.

Bolus fluid therapy and sodium homeostasis in paediatric gastroenteritis.

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Freedman, Stephen B; Geary, Denis F

2013-03-01

The study aims to assess the risk of developing hyponatraemia when large-volume bolus fluid rehydration therapy is administered. We conducted a prospective randomised study in a tertiary-care centre emergency department. Participants included children with gastroenteritis and dehydration requiring intravenous rehydration. They were randomised to receive 60 mL/kg (large) or 20 mL/kg (standard) 0.9% saline bolus followed by maintenance 0.9% saline for 3 h. Biochemical tests were performed at baseline and 4 h. The primary outcome measure was the development of hyponatraemia at 4 h. Secondary outcome measures were (i) change in sodium relative to baseline value; (ii) magnitude of decrease among those who experienced a decrease; (iii) risk of hypernatraemia; (iv) correlations between urine parameters and hyponatraemia; and (v) fluid overload. Eighty-four of 224 (38%) participants were hyponatraemic at baseline. At 4 h, 22% (48/217) had a dysnatraemia, and similar numbers of children were hyponatraemic in both groups: large (23% (26/112)) versus standard (21% (22/105)) (P = 0.69). Among initially hyponatraemic children, 63% (30/48) who received large-volume rehydration and 44% (15/34) of those administered standard rehydration were isonatraemic at 4 h (P = 0.10). Overall, children who received 60 mL/kg experienced a larger mean increase (1.6 ± 2.4 mEq/L vs. 0.9 ± 2.2 mEq/L; P = 0.04) and were less likely to experience a sodium decrease of ≥2 mEq/L (8/112 vs. 17/105; P = 0.04) than those administered 20 mL/kg. Large-volume bolus rehydration therapy with 0.9% saline is safe. It does not promote the development of hyponatraemia over the short term, but hastens the resolution of baseline hyponatraemia. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Reliance on habits at the expense of goal-directed control following dopamine precursor depletion

NARCIS (Netherlands)

de Wit, S.; Standing, H.R.; DeVito, E.E.; Robinson, O.J.; Ridderinkhof, K.R.; Robbins, T.W.; Sahakian, B.J.

2012-01-01

Rationale Dopamine is well known to play an important role in learning and motivation. Recent animal studies have implicated dopamine in the reinforcement of stimulus-response habits, as well as in flexible, goal-directed action. However, the role of dopamine in human action control is still not

Crystal Growth and Fluid Mechanics Problems in Directional Solidification

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Tanveer, Saleh A.; Baker, Gregory R.; Foster, Michael R.

2001-01-01

Our work in directional solidification has been in the following areas: (1) Dynamics of dendrites including rigorous mathematical analysis of the resulting equations; (2) Examination of the near-structurally unstable features of the mathematically related Hele-Shaw dynamics; (3) Numerical studies of steady temperature distribution in a vertical Bridgman device; (4) Numerical study of transient effects in a vertical Bridgman device; (5) Asymptotic treatment of quasi-steady operation of a vertical Bridgman furnace for large Rayleigh numbers and small Biot number in 3D; and (6) Understanding of Mullins-Sererka transition in a Bridgman device with fluid dynamics is accounted for.

How Does Awareness Modulate Goal-Directed and Stimulus-Driven Shifts of Attention Triggered by Value Learning?

Directory of Open Access Journals (Sweden)

Alexia Bourgeois

Full Text Available In order to behave adaptively, attention can be directed in space either voluntarily (i.e., endogenously according to strategic goals, or involuntarily (i.e., exogenously through reflexive capture by salient or novel events. The emotional or motivational value of stimuli can also strongly influence attentional orienting. However, little is known about how reward-related effects compete or interact with endogenous and exogenous attention mechanisms, particularly outside of awareness. Here we developed a visual search paradigm to study subliminal value-based attentional orienting. We systematically manipulated goal-directed or stimulus-driven attentional orienting and examined whether an irrelevant, but previously rewarded stimulus could compete with both types of spatial attention during search. Critically, reward was learned without conscious awareness in a preceding phase where one among several visual symbols was consistently paired with a subliminal monetary reinforcement cue. Our results demonstrated that symbols previously associated with a monetary reward received higher attentional priority in the subsequent visual search task, even though these stimuli and reward were no longer task-relevant, and despite reward being unconsciously acquired. Thus, motivational processes operating independent of conscious awareness may provide powerful influences on mechanisms of attentional selection, which could mitigate both stimulus-driven and goal-directed shifts of attention.

How Does Awareness Modulate Goal-Directed and Stimulus-Driven Shifts of Attention Triggered by Value Learning?

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Bourgeois, Alexia; Neveu, Rémi; Vuilleumier, Patrik

2016-01-01

In order to behave adaptively, attention can be directed in space either voluntarily (i.e., endogenously) according to strategic goals, or involuntarily (i.e., exogenously) through reflexive capture by salient or novel events. The emotional or motivational value of stimuli can also strongly influence attentional orienting. However, little is known about how reward-related effects compete or interact with endogenous and exogenous attention mechanisms, particularly outside of awareness. Here we developed a visual search paradigm to study subliminal value-based attentional orienting. We systematically manipulated goal-directed or stimulus-driven attentional orienting and examined whether an irrelevant, but previously rewarded stimulus could compete with both types of spatial attention during search. Critically, reward was learned without conscious awareness in a preceding phase where one among several visual symbols was consistently paired with a subliminal monetary reinforcement cue. Our results demonstrated that symbols previously associated with a monetary reward received higher attentional priority in the subsequent visual search task, even though these stimuli and reward were no longer task-relevant, and despite reward being unconsciously acquired. Thus, motivational processes operating independent of conscious awareness may provide powerful influences on mechanisms of attentional selection, which could mitigate both stimulus-driven and goal-directed shifts of attention.

Bidirectional modulation of goal-directed actions by prefrontal cortical dopamine.

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Hitchcott, Paul K; Quinn, Jennifer J; Taylor, Jane R

2007-12-01

Instrumental actions are a vital cognitive asset that endows an organism with sensitivity to the consequences of its behavior. Response-outcome feedback allows responding to be shaped in order to maximize beneficial, and minimize detrimental, outcomes. Lesions of the medial prefrontal cortex (mPFC) result in behavior that is insensitive to changes in outcome value in animals and compulsive behavior in several human psychopathologies. Such insensitivity to changes in outcome value is a defining characteristic of instrumental habits: responses that are controlled by antecedent stimuli rather than goal expectancy. Little is known regarding the neurochemical substrates mediating this sensitivity. The present experiments used sensitivity to posttraining outcome devaluation to index the action-habit status of instrumental responding. Infusions of dopamine into the ventral mPFC (vmPFC), but not dorsal mPFC, restored outcome sensitivity bidirectionally-decreasing responding following outcome devaluation and increasing responding when the outcome was not devalued. This bidirectionality makes the possibility that these infusions nonspecifically dysregulated vmPFC dopamine transmission unlikely. VmPFC dopamine promoted instrumental responding appropriate to outcome value. Reinforcer consumption data indicated that this was not a consequence of altered sensitivity to the reinforcer itself. We suggest that vmPFC dopamine reengages attentional processes underlying goal-directed behavior.

Developing a typology of patient-generated behavioral goals for cognitive behavioral therapy for chronic pain (CBT-CP): classification and predicting outcomes.

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Heapy, Alicia A; Wandner, Laura; Driscoll, Mary A; LaChappelle, Kathryn; Czlapinski, Rebecca; Fenton, Brenda T; Piette, John D; Aikens, James E; Janevic, Mary R; Kerns, Robert D

2018-04-01

Patient-generated treatment goals describe what patients value, yet the content of these goals, and the relationship among goal types, goal accomplishment, and treatment outcomes has received little examination. We used inductive sorting to categorize patient-generated goals made by 147 adults receiving cognitive-behavioral therapy for chronic pain. The resulting goal categories were: Physical Activity (29.0%), Functional Status (24.6%), Wellness (16.3%), Recreational Activities (11.3%), House/Yard Work (9.7%), Socializing (7.1%), and Work/School (2.0%). Next, we examined associations between number of goals by category, goal accomplishment, and clinically meaningful improvements in pain-related interference, pain intensity and depressive symptoms. Improvement in all outcome domains was related to goal accomplishment. Additionally, depressive symptoms were related to number of Physical Activity, House/Yard Work, Recreational Activities, and Wellness goals, whereas improved pain-intensity was significantly related to House/Yard Work. Classifying patient-generated goals facilitates investigation of the relationships among goal type, goal accomplishment and treatment outcomes.

[Becoming more "goal-oriented" in therapy of dyslipidemias: results of the Hungarian MULTI GAP 2010].

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Reiber, István; Paragh, György; Márk, László; Pados, Gyula

2011-05-22

Previous studies have found that many high-risk patients are not achieving their LDL-cholesterol goals, and many patients, despite being treated with lipid-lowering therapy, also have elevated triglycerides and/or low levels of HDL-cholesterol. Authors analyzed the treatment strategies for dyslipidemic subjects following cardiovascular events similarly to their former survey from 2008 and 2009. In the MULTI GAP (MULTI Goal Attainment Problem) 2010 trial data from standard and structured questionnaires of 2332 patients were processed. Authors analyzed the proportion of the patients reaching target levels for total cholesterol, LDL-C, HDL-C, A-C (atherogen cholesterol) and triglyceride. 15% (n = 355) of the patients did not receive any lipid lowering treatment. 44% of the patients treated by specialists reached the target LDL-C level of 2.5 mmol/l. In "high risk" group target levels for HDL-C were reached by 61% of the patients, and for triglyceride by 43% of the subjects. 43% of the patients with the best compliance (>90%) reached the target LDL-C level of 2.5 mmol/l. There is a need for more effective lipid lowering therapy with more frequent use of higher doses of statins or combinations of lipid lowering drugs.

Motivation and value influences in the relative balance of goal-directed and habitual behaviours in obsessive-compulsive disorder.

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Voon, V; Baek, K; Enander, J; Worbe, Y; Morris, L S; Harrison, N A; Robbins, T W; Rück, C; Daw, N

2015-11-03

Our decisions are based on parallel and competing systems of goal-directed and habitual learning, systems which can be impaired in pathological behaviours. Here we focus on the influence of motivation and compare reward and loss outcomes in subjects with obsessive-compulsive disorder (OCD) on model-based goal-directed and model-free habitual behaviours using the two-step task. We further investigate the relationship with acquisition learning using a one-step probabilistic learning task. Forty-eight OCD subjects and 96 healthy volunteers were tested on a reward and 30 OCD subjects and 53 healthy volunteers on the loss version of the two-step task. Thirty-six OCD subjects and 72 healthy volunteers were also tested on a one-step reversal task. OCD subjects compared with healthy volunteers were less goal oriented (model-based) and more habitual (model-free) to reward outcomes with a shift towards greater model-based and lower habitual choices to loss outcomes. OCD subjects also had enhanced acquisition learning to loss outcomes on the one-step task, which correlated with goal-directed learning in the two-step task. OCD subjects had greater stay behaviours or perseveration in the one-step task irrespective of outcome. Compulsion severity was correlated with habitual learning in the reward condition. Obsession severity was correlated with greater switching after loss outcomes. In healthy volunteers, we further show that greater reward magnitudes are associated with a shift towards greater goal-directed learning further emphasizing the role of outcome salience. Our results highlight an important influence of motivation on learning processes in OCD and suggest that distinct clinical strategies based on valence may be warranted.

Decreasing Striatopallidal Pathway Function Enhances Motivation by Energizing the Initiation of Goal-Directed Action

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Carvalho Poyraz, Fernanda; Holzner, Eva; Bailey, Matthew R.; Meszaros, Jozsef; Kenney, Lindsay; Kheirbek, Mazen A.

2016-01-01

Altered dopamine D2 receptor (D2R) binding in the striatum has been associated with abnormal motivation in neuropsychiatric disorders, including schizophrenia. Here, we tested whether motivational deficits observed in mice with upregulated D2Rs (D2R-OEdev mice) are reversed by decreasing function of the striatopallidal “no-go” pathway. To this end, we expressed the Gαi-coupled designer receptor hM4D in adult striatopallidal neurons and activated the receptor with clozapine-N-oxide (CNO). Using a head-mounted miniature microscope we confirmed with calcium imaging in awake mice that hM4D activation by CNO inhibits striatopallidal function measured as disinhibited downstream activity in the globus pallidus. Mice were then tested in three operant tasks that address motivated behavior, the progressive ratio task, the progressive hold-down task, and outcome devaluation. Decreasing striatopallidal function in the dorsomedial striatum or nucleus accumbens core enhanced motivation in D2R-OEdev mice and control littermates. This effect was due to increased response initiation but came at the cost of goal-directed efficiency. Moreover, response vigor and the sensitivity to changes in reward value were not altered. Chronic activation of hM4D by administering CNO for 2 weeks in drinking water did not affect motivation due to a tolerance effect. However, the acute effect of CNO on motivation was reinstated after discontinuing chronic treatment for 48 h. Used as a therapeutic approach, striatopallidal inhibition should consider the risk of impairing goal-directed efficiency and behavioral desensitization. SIGNIFICANCE STATEMENT Motivation involves a directional component that allows subjects to efficiently select the behavior that will lead to an optimal outcome and an activational component that initiates and maintains the vigor and persistence of actions. Striatal output pathways modulate motivated behavior, but it remains unknown how these pathways regulate specific

Decreasing Striatopallidal Pathway Function Enhances Motivation by Energizing the Initiation of Goal-Directed Action.

Science.gov (United States)

Carvalho Poyraz, Fernanda; Holzner, Eva; Bailey, Matthew R; Meszaros, Jozsef; Kenney, Lindsay; Kheirbek, Mazen A; Balsam, Peter D; Kellendonk, Christoph

2016-06-01

Altered dopamine D2 receptor (D2R) binding in the striatum has been associated with abnormal motivation in neuropsychiatric disorders, including schizophrenia. Here, we tested whether motivational deficits observed in mice with upregulated D2Rs (D2R-OEdev mice) are reversed by decreasing function of the striatopallidal "no-go" pathway. To this end, we expressed the Gαi-coupled designer receptor hM4D in adult striatopallidal neurons and activated the receptor with clozapine-N-oxide (CNO). Using a head-mounted miniature microscope we confirmed with calcium imaging in awake mice that hM4D activation by CNO inhibits striatopallidal function measured as disinhibited downstream activity in the globus pallidus. Mice were then tested in three operant tasks that address motivated behavior, the progressive ratio task, the progressive hold-down task, and outcome devaluation. Decreasing striatopallidal function in the dorsomedial striatum or nucleus accumbens core enhanced motivation in D2R-OEdev mice and control littermates. This effect was due to increased response initiation but came at the cost of goal-directed efficiency. Moreover, response vigor and the sensitivity to changes in reward value were not altered. Chronic activation of hM4D by administering CNO for 2 weeks in drinking water did not affect motivation due to a tolerance effect. However, the acute effect of CNO on motivation was reinstated after discontinuing chronic treatment for 48 h. Used as a therapeutic approach, striatopallidal inhibition should consider the risk of impairing goal-directed efficiency and behavioral desensitization. Motivation involves a directional component that allows subjects to efficiently select the behavior that will lead to an optimal outcome and an activational component that initiates and maintains the vigor and persistence of actions. Striatal output pathways modulate motivated behavior, but it remains unknown how these pathways regulate specific components of motivation. Here

Personalised fluid resuscitation in the ICU: still a fluid concept?

Science.gov (United States)

van Haren, Frank

2017-12-28

The administration of intravenous fluid to critically ill patients is one of the most common, but also one of the most fiercely debated, interventions in intensive care medicine. Even though many thousands of patients have been enrolled in large trials of alternative fluid strategies, consensus remains elusive and practice is widely variable. Critically ill patients are significantly heterogeneous, making a one size fits all approach unlikely to be successful.New data from basic, animal, and clinical research suggest that fluid resuscitation could be associated with significant harm. There are several important limitations and concerns regarding fluid bolus therapy as it is currently being used in clinical practice. These include, but are not limited to: the lack of an agreed definition; limited and short-lived physiological effects; no evidence of an effect on relevant patient outcomes; and the potential to contribute to fluid overload, specifically when fluid responsiveness is not assessed and when targets and safety limits are not used.Fluid administration in critically ill patients requires clinicians to integrate abnormal physiological parameters into a clinical decision-making model that also incorporates the likely diagnosis and the likely risk or benefit in the specific patient's context. Personalised fluid resuscitation requires careful attention to the mnemonic CIT TAIT: context, indication, targets, timing, amount of fluid, infusion strategy, and type of fluid.The research agenda should focus on experimental and clinical studies to: improve our understanding of the physiological effects of fluid infusion, e.g. on the glycocalyx; evaluate new types of fluids; evaluate novel fluid minimisation protocols; study the effects of a no-fluid strategy for selected patients and scenarios; and compare fluid therapy with other interventions. The adaptive platform trial design may provide us with the tools to evaluate these types of interventions in the intrinsically

Corticostriatal connectivity underlies individual differences in the balance between habitual and goal-directed action control

NARCIS (Netherlands)

Wit, S. de; Watson, A.J.P.; Harsay, H.A.; Cohen, M.X.; Vijver, I. van de; Ridderinkhof, K.R.

2012-01-01

Why are some individuals more susceptible to the formation of inflexible habits than others? In the present study, we used diffusion tensor imaging to demonstrate that brain connectivity predicts individual differences in relative goal-directed and habitual behavioral control in humans.

Self-directed therapy programmes for arm rehabilitation after stroke: a systematic review.

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Da-Silva, Ruth H; Moore, Sarah A; Price, Christopher I

2018-05-01

To investigate the effectiveness of self-directed arm interventions in adult stroke survivors. A systematic review of Medline, EMBASE, CINAHL, SCOPUS and IEEE Xplore up to February 2018 was carried out. Studies of stroke arm interventions were included where more than 50% of the time spent in therapy was initiated and carried out by the participant. Quality of the evidence was assessed using the Cochrane risk of bias tool. A total of 40 studies ( n = 1172 participants) were included (19 randomized controlled trials (RCTs) and 21 before-after studies). Studies were grouped according to no technology or the main additional technology used (no technology n = 5; interactive gaming n = 6; electrical stimulation n = 11; constraint-induced movement therapy n = 6; robotic and dynamic orthotic devices n = 8; mirror therapy n = 1; telerehabilitation n = 2; wearable devices n = 1). A beneficial effect on arm function was found for self-directed interventions using constraint-induced movement therapy ( n = 105; standardized mean difference (SMD) 0.39, 95% confidence interval (CI) -0.00 to 0.78) and electrical stimulation ( n = 94; SMD 0.50, 95% CI 0.08-0.91). Constraint-induced movement therapy and therapy programmes without technology improved independence in activities of daily living. Sensitivity analysis demonstrated arm function benefit for patients >12 months poststroke ( n = 145; SMD 0.52, 95% CI 0.21-0.82) but not at 0-3, 3-6 or 6-12 months. Self-directed interventions can enhance arm recovery after stroke but the effect varies according to the approach used and timing. There were benefits identified from self-directed delivery of constraint-induced movement therapy, electrical stimulation and therapy programmes that increase practice without using additional technology.

Effects of direct-to-consumer advertising of hydroxymethylglutaryl coenzyme a reductase inhibitors on attainment of LDL-C goals.

Science.gov (United States)

Bradford, W David; Kleit, Andrew N; Nietert, Paul J; Ornstein, Steven

2006-12-01

Although highly controversial, directto-consumer (DTC) television advertising for prescription drugs is an established practice in the US health care industry. While the US Food and Drug Administration is currently reexamining its regulatory stance, little evidence exists regarding the impact of DTC advertising on patient health outcomes. The objective of this research was to study the relationship between heavy television promotion of 3 major hydroxymethylglutaryl coenzyme A reductase inhibitors ("statins") and the frequency with which patients are able to attain low-density lipoprotein cholesterol (LDL-C) blood-level goals after treatment with any statin. We used logistic regression to determine achievement of LDL-C goals at 6 months after statin treatment, using electronic medical record extract data from patients from geographically dispersed primary care practices in the United States. We identified LDL-C blood levels as being at or less than goal, as defined by risk-adjusted guidelines published by the National Heart, Lung, and Blood Institute from the Adult Treatment Panel III (ATP III) data. A total of 50,741 patients, identified from 88 practices, were diagnosed with hyperlipidemia and had begun therapy with any statin medication during the 1998-2004 time period. In addition, total dollars spent each month on television advertising at the national and local levels for atorvastatin, pravastatin, and simvastatin were obtained. DTC advertising data were merged by local media market where the physician practice was located and by the month in which the patient was first prescribed a statin. The models were run for all patients who initiated therapy, and also on a subsample of patients who continued to receive prescriptions for the drugs for at least 6 months. Logistic regressions were used to predict the likelihood that each patient attained the ATP III LDL-C blood-level goals as a function of DTC advertising and other factors. High levels of national DTC

State of the art in fluid and volume therapy : A user-friendly staged concept. English version.

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Rehm, M; Hulde, N; Kammerer, T; Meidert, A S; Hofmann-Kiefer, K

2017-04-10

Adequate intraoperative infusion therapy is essential for the perioperative outcome of a patient. Both hypo- and hypervolemia can lead to an increased rate of perioperative complications and to a worse outcome. Perioperative infusion therapy should therefore be needs-based. The primary objective is the maintenance of preoperative normovolemia using a rational infusion strategy. Perioperative fluid losses should be differentiated from volume losses due to surgical bleeding or protein losses into the interstitial space. Fluid loss via urine excretion or insensible perspiration (0.5-1.0 ml/kg/h) should be replaced with balanced, isooncotic, crystalloid infusion solutions in a ratio of 1:1. Volume therapy stage 1: intraoperative volume losses up to a blood loss corresponding to 20% of the patient's total blood volume are compensated for by balanced crystalloids in a ratio of 4-5:1. Stage 2: blood losses exceeding this level are to be treated with isooncotic colloids (preferably balanced) in a 1:1 ratio. In this regard taking into consideration the contraindications, e. g., sepsis, burns, critical illness (usually patients in the intensive care unit), impaired renal function or renal replacement therapy, intracranial hemorrhage, or severe coagulopathy, artificial colloids such as hydroxyethyl starch (HES) can be used perioperatively for volume replacement. Stage 3: if an allogeneic blood transfusion is indicated, blood and blood products are applied in a differentiated manner.

Using clinical parameters to guide fluid therapy in high-risk thoracic surgery. A retrospective, observational study

DEFF Research Database (Denmark)

Bjerregaard, Lars Stryhn; Møller-Sørensen, Hasse; Hansen, Kristoffer Lindskov

2015-01-01

the use of central venous oxygen saturation and intended low urine output to guide therapy in the early postoperative period. Here we evaluate the consequences of our changes. METHODS: Retrospective, observational study of 30 consecutive patients undergoing EPP; 18 who had surgery before and 12 who had...... surgery after the changes. Data were collected from patient files and from institutional databases. Outcome measures included: Volumes of administered fluids, fluid balances, length of stays and postoperative complications. Dichotomous variables were compared with Fisher's exact test, whereas continuous...... increasing the incidence of postoperative complications. Mean length of stay in the intensive care unit (LOSI) was reduced from three to one day (p = 0.04) after the changes. CONCLUSION: The use of clinical parameters to balance fluid restriction and a sufficient circulation in patients undergoing EPP...

Feature Interactions Enable Decoding of Sensorimotor Transformations for Goal-Directed Movement

Science.gov (United States)

Barany, Deborah A.; Della-Maggiore, Valeria; Viswanathan, Shivakumar; Cieslak, Matthew

2014-01-01

Neurophysiology and neuroimaging evidence shows that the brain represents multiple environmental and body-related features to compute transformations from sensory input to motor output. However, it is unclear how these features interact during goal-directed movement. To investigate this issue, we examined the representations of sensory and motor features of human hand movements within the left-hemisphere motor network. In a rapid event-related fMRI design, we measured cortical activity as participants performed right-handed movements at the wrist, with either of two postures and two amplitudes, to move a cursor to targets at different locations. Using a multivoxel analysis technique with rigorous generalization tests, we reliably distinguished representations of task-related features (primarily target location, movement direction, and posture) in multiple regions. In particular, we identified an interaction between target location and movement direction in the superior parietal lobule, which may underlie a transformation from the location of the target in space to a movement vector. In addition, we found an influence of posture on primary motor, premotor, and parietal regions. Together, these results reveal the complex interactions between different sensory and motor features that drive the computation of sensorimotor transformations. PMID:24828640

Undergraduate medical textbooks do not provide adequate information on intravenous fluid therapy: a systematic survey and suggestions for improvement.

Science.gov (United States)

Powell, Arfon G M T; Paterson-Brown, Simon; Drummond, Gordon B

2014-02-20

Inappropriate prescribing of intravenous (IV) fluid, particularly 0.9% sodium chloride, causes post-operative complications. Fluid prescription is often left to junior medical staff and is frequently poorly managed. One reason for poor intravenous fluid prescribing practices could be inadequate coverage of this topic in the textbooks that are used. We formulated a comprehensive set of topics, related to important common clinical situations involving IV fluid therapy, (routine fluid replacement, fluid loss, fluids overload) to assess the adequacy of textbooks in common use. We assessed 29 medical textbooks widely available to students in the UK, scoring the presence of information provided by each book on each of the topics. The scores indicated how fully the topics were considered: not at all, partly, and adequately. No attempt was made to judge the quality of the information, because there is no consensus on these topics. The maximum score that a book could achieve was 52. Three of the topics we chose were not considered by any of the books. Discounting these topics as "too esoteric", the maximum possible score became 46. One textbook gained a score of 45, but the general score was poor (median 11, quartiles 4, 21). In particular, coverage of routine postoperative management was inadequate. Textbooks for undergraduates cover the topic of intravenous therapy badly, which may partly explain the poor knowledge and performance of junior doctors in this important field. Systematic revision of current textbooks might improve knowledge and practice by junior doctors. Careful definition of the remit and content of textbooks should be applied more widely to ensure quality and "fitness for purpose", and avoid omission of vital knowledge.

VAC Therapy Direct to the Medullary Cavity for Chronic Tibial Osteomyelitis.

Science.gov (United States)

Miyamura, Satoshi; Tsuji, Shigeyoshi; Iwai, Takao; Hamada, Masayuki

2016-06-01

Vacuum-assisted wound closure (VAC) is useful for difficult wound beds, although sites where bleeding or infection is expected are usually regarded as problematic for this therapy. This report outlines the treatment of chronic tibial osteomyelitis (Cierny- Mader type III) due to mixed infection with Nocardia spp and Bacteroi- des fragilis by postoperative VAC therapy direct to the medullary cavity, followed by wound coverage with a gastrocnemius myocutaneous skin flap. A 64-year-old man developed chronic left tibial os- teomyelitis after a work injury. The nonviable tissues were debrided, including a sequestrum. Nocardia spp and B. fragilis were isolated from surgical bone specimens, and chronic tibial osteomyelitis due to mixed infection was diagnosed. Postoperatively, VAC therapy was performed directly to the open medullary cavity of the tibia and sub- sequently covered the residual soft tissue defect with a gastrocnemius myocutaneous flap. The authors could not find any English literature on VAC therapy direct to the medullary cavity combined with transplantation of a myocutaneous flap for osteomyelitis. Nocardia spp can cause a variety of infections, among which osteomyelitis occupies a relatively small percentage. This case raises the possibil- ity of treating chronic tibial osteomyelitis caused by mixed infection with Nocardia spp and B. fragilis by applying postoperative VAC ther- apy directly to the medullary cavity and covering the residual wound with a gastrocnemius myocutaneous flap.

Measurement of warfarin in the oral fluid of patients undergoing anticoagulant oral therapy.

Directory of Open Access Journals (Sweden)

Silvia Ghimenti

Full Text Available BACKGROUND: Patients on warfarin therapy undergo invasive and expensive checks for the coagulability of their blood. No information on coagulation levels is currently available between two controls. METHODOLOGY: A method was developed to determine warfarin in oral fluid by HPLC and fluorimetric detection. The chromatographic separation was performed at room temperature on a C-18 reversed-phase column, 65% PBS and 35% methanol mobile phase, flow rate 0.7 mL/min, injection volume 25 µL, excitation wavelength 310 nm, emission wavelength 400 nm. FINDINGS: The method was free from interference and matrix effect, linear in the range 0.2-100 ng/mL, with a detection limit of 0.2 ng/mL. Its coefficient of variation was <3% for intra-day measurements and <5% for inter-day measurements. The average concentration of warfarin in the oral fluid of 50 patients was 2.5±1.6 ng/mL (range 0.8-7.6 ng/mL. Dosage was not correlated to INR (r = -0.03, p = 0.85 but positively correlated to warfarin concentration in the oral fluid (r = 0.39, p = 0.006. The correlation between warfarin concentration and pH in the oral fluid (r = 0.37, p = 0.009 confirmed the importance of pH in regulating the drug transfer from blood. A correlation between warfarin concentration in the oral fluid and INR was only found in samples with pH values ≥7.2 (r = 0.84, p = 0.004. CONCLUSIONS: Warfarin diffuses from blood to oral fluid. The method allows to measure its concentration in this matrix and to analyze correlations with INR and other parameters.

Fluid inclusion geothermometry

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Cunningham, C.G.

1977-01-01

Fluid inclusions trapped within crystals either during growth or at a later time provide many clues to the histories of rocks and ores. Estimates of fluid-inclusion homogenization temperature and density can be obtained using a petrographic microscope with thin sections, and they can be refined using heating and freezing stages. Fluid inclusion studies, used in conjunction with paragenetic studies, can provide direct data on the time and space variations of parameters such as temperature, pressure, density, and composition of fluids in geologic environments. Changes in these parameters directly affect the fugacity, composition, and pH of fluids, thus directly influencing localization of ore metals. ?? 1977 Ferdinand Enke Verlag Stuttgart.

Colloids versus crystalloids in objective-guided fluid therapy, systematic review and meta-analysis. Too early or too late to draw conclusions

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Javier Ripollés

2015-08-01

Full Text Available INTRODUCTION: Several clinical trials on Goal directed fluid therapy (GDFT were carried out, many of those using colloids in order to optimize the preload. After the decision of European Medicines Agency, there is such controversy regarding its use, benefits, and possible contribution to renal failure. The objective of this systematic review and meta-analysis is to compare the use of last-generation colloids, derived from corn, with crystalloids in GDFT to determine associated complications and mortality.METHODS: A bibliographic research was carried out in MEDLINE PubMed, EMBASE and Cochrane Library, corroborating randomized clinical trials where crystalloids are compared to colloids in GDFT for major non-cardiac surgery in adults.RESULTS: One hundred thirty references were found and among those 38 were selected and 29 analyzed; of these, six were included for systematic review and meta-analysis, including 390 patients. It was observed that the use of colloids is not associated with the increase of complications, but rather with a tendency to a higher mortality (RR [95% CI] 3.87 [1.121-13.38]; I2 = 0.0%; p = 0.635.CONCLUSIONS: Because of the limitations of this meta-analysis due to the small number of randomized clinical trials and patients included, the results should be taken cautiously, and the performance of new randomized clinical trials is proposed, with enough statistical power, comparing balanced and unbalanced colloids to balanced and unbalanced crystalloids, following the protocols of GDFT, considering current guidelines and suggestions made by groups of experts.

Immunological indices of blood and interstitial fluid in estimation of a program of therapy of upper limb secondary edemas

International Nuclear Information System (INIS)

Kuz'mina, E.G.; Degtyareva, A.A.; Doroshenko, L.N.; Rogova, N.M.; Zorina, L.N.

1990-01-01

The efficacy of therapy of upper limb secondary edemas after 4 programs was compared among 83 patients. The methods were as follows: traditional method (TM) including routine conservative therapy, acupuncture (AP), He-Ne laser OKG-13 and semiconductor laser against a background of traditional therapy. A study was made of the time course of the extent of edema, total protein, IG, G, A and M and circulating immune complexes (CIC) during therapy of such patients. Blood serum and interstitial fluid indices were compared. It was shown that the application of both lasers led to increasing efficacy of TM and AP

Helping Children with Disabilities through Animal-Assisted Therapy

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Watts, Katie; Everly, Janet Stout

2009-01-01

The Delta Society defines animal-assisted therapy as "a goal-directed intervention in which an animal is incorporated as an integral part of the clinical healthcare treatment process." Unlike other animal-assisted activities, animal-assisted therapy, or AAT, is led by a professional such as a physical therapist, occupational therapist,…

The Current Status and Future Directions of Heavy Charged Particle Therapy in Medicine

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Levy, Richard P.; Blakely, Eleanor A.; Chu, William T.; Coutrakon, George B.; Hug, Eugen B.; Kraft, Gerhard; Tsujii, Hirohiko

2009-03-01

As aggressive, 3D-conformal treatment has become the clearly accepted goal of radiation oncology, heavy charged-particle treatment with protons and heavier ions has concurrently and relentlessly ascended to the forefront. Protons and helium nuclei, with relatively low linear-energy-transfer (LET) properties, have consistently been demonstrated to be beneficial for aggressive (high-dose) local treatment of many types of tumors. Protons have been applied to the majority of solid tumors, and have reached a high degree of general acceptance in radiation oncology after three decades and 55,000 patients treated. However, some 15% to 20% of tumor types have proven resistant to even the most aggressive low-LET irradiation. For these radio-resistant tumors, treatment with heavier ions (e.g., carbon) offers great potential benefit. These high-LET particles have increased relative biological effectiveness (RBE) that reaches its maximum in the Bragg peak. Irradiation with these heavier ions offers the unique combination of excellent 3D-dose distribution and increased RBE. We are presently witnessing several, important parallel developments in particle therapy. Protons will likely continue their exponential growth phase, and more compact design systems will make protons available to a larger patient population—thus becoming the "heavy charged particle of choice" for Cancer Centers with limited financial resources. In parallel, major academic efforts will further advance the field of heavier ion therapy, exploring all opportunities for particle treatment and continuing the search for the ideal particle(s) for specific tumors. The future of ion therapy will be best realized by clinical trials that have ready access to top-quality delivery of both protons and heavier ions that can be accurately shaped for treatment of a specific pathology, and which will permit direct randomized-trial comparison of the effectiveness of the various ions for different diseases. Optimal results

Value of information: interim analysis of a randomized, controlled trial of goal-directed hemodynamic treatment for aged patients.

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Bartha, Erzsebet; Davidson, Thomas; Brodtkorb, Thor-Henrik; Carlsson, Per; Kalman, Sigridur

2013-07-09

A randomized, controlled trial, intended to include 460 patients, is currently studying peroperative goal-directed hemodynamic treatment (GDHT) of aged hip-fracture patients. Interim efficacy analysis performed on the first 100 patients was statistically uncertain; thus, the trial is continuing in accordance with the trial protocol. This raised the present investigation's main question: Is it reasonable to continue to fund the trial to decrease uncertainty? To answer this question, a previously developed probabilistic cost-effectiveness model was used. That model depicts (1) a choice between routine fluid treatment and GDHT, given uncertainty of current evidence and (2) the monetary value of further data collection to decrease uncertainty. This monetary value, that is, the expected value of perfect information (EVPI), could be used to compare future research costs. Thus, the primary aim of the present investigation was to analyze EVPI of an ongoing trial with interim efficacy observed. A previously developed probabilistic decision analytic cost-effectiveness model was employed to compare the routine fluid treatment to GDHT. Results from the interim analysis, published trials, the meta-analysis, and the registry data were used as model inputs. EVPI was predicted using (1) combined uncertainty of model inputs; (2) threshold value of society's willingness to pay for one, quality-adjusted life-year; and (3) estimated number of future patients exposed to choice between GDHT and routine fluid treatment during the expected lifetime of GDHT. If a decision to use GDHT were based on cost-effectiveness, then the decision would have a substantial degree of uncertainty. Assuming a 5-year lifetime of GDHT in clinical practice, the number of patients who would be subject to future decisions was 30,400. EVPI per patient would be €204 at a €20,000 threshold value of society's willingness to pay for one quality-adjusted life-year. Given a future population of 30,400 individuals

Effect of Nonsurgical Periodontal Therapy on Crevicular Fluid and Serum Glutathione Peroxidase Levels

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Swati Pradeep Patel

2012-01-01

Full Text Available Background: Plasma glutathione peroxidase (eGPx is an important selenium containing antioxidant in human defense against oxidative stress. While crevicular fluid (GCF eGPx levels and its association with periodontal disease is well documented, there is no data on correlation of GCF and serum eGPx levels in chronic periodontitis. Hence this study was undertaken to further probe into the role of oxidative stress in periodontal diseases and effect of nonsurgical periodontal therapy (NSPT by correlating GCF and serum levels of eGPx.

Alcohol-paired contextual cues produce an immediate and selective loss of goal-directed action in rats

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Sean B Ostlund

2010-07-01

Full Text Available We assessed whether the presence of contextual cues paired with alcohol would disrupt rats’ capacity to express appropriate goal-directed action control. Rats were first given differential context conditioning such that one set of contextual cues was paired with the injection of ethanol and a second, distinctive set of cues was paired with the injection of saline. All rats were then trained in a third, neutral context to press one lever for grain pellets and another lever for sucrose pellets. They were then given two extinction tests to evaluate their ability to choose between the two actions in response to the devaluation of one of the two food outcomes with one test conducted in the alcohol-paired context and the other conducted in the control (saline-paired context. In the control context, rats exhibited goal-directed action control; i.e., they were able selectively to withhold the action that previously earned the now devalued outcome. However, these same rats were impaired when tested in the alcohol-paired context, performing both actions at the same rate regardless of the current value of their respective outcomes. Subsequent testing revealed that the rats were capable of overcoming this impairment if they were giving response-contingent feedback about the current value of the food outcomes. These results provide a clear demonstration of the disruptive influence that alcohol-paired cues can exert on decision-making in general and goal-directed action selection and choice in particular.

Aptamer conjugated paclitaxel and magnetic fluid loaded fluorescently tagged PLGA nanoparticles for targeted cancer therapy

Energy Technology Data Exchange (ETDEWEB)

Aravind, Athulya; Nair, Remya; Raveendran, Sreejith; Veeranarayanan, Srivani; Nagaoka, Yutaka; Fukuda, Takahiro; Hasumura, Takahashi; Morimoto, Hisao; Yoshida, Yasuhiko; Maekawa, Toru; Sakthi Kumar, D., E-mail: sakthi@toyo.jp

2013-10-15

Controlled and targeted drug delivery is an essential criterion in cancer therapy to reduce the side effects caused by non-specific drug release and toxicity. Targeted chemotherapy, sustained drug release and optical imaging have been achieved using a multifunctional nanocarrier constructed from poly (D, L-lactide-co-glycolide) nanoparticles (PLGA NPs), an anticancer drug paclitaxel (PTX), a fluorescent dye Nile red (NR), magnetic fluid (MF) and aptamers (Apt, AS1411, anti-nucleolin aptamer). The magnetic fluid and paclitaxel loaded fluorescently labeled PLGA NPs (MF-PTX-NR-PLGA NPs) were synthesized by a single-emulsion technique/solvent evaporation method using a chemical cross linker bis (sulfosuccinimidyl) suberate (BS3) to enable binding of aptamer on to the surface of the nanoparticles. Targeting aptamers were then introduced to the particles through the reaction with the cross linker to target the nucleolin receptors over expressed on the cancer cell surface. Specific binding and uptake of the aptamer conjugated magnetic fluid loaded fluorescently tagged PLGA NPs (Apt-MF-NR-PLGA NPs) to the target cancer cells induced by aptamers was observed using confocal microscopy. Cytotoxicity assay conducted in two cell lines (L929 and MCF-7) confirmed that targeted MCF-7 cancer cells were killed while control cells were unharmed. In addition, aptamer mediated delivery resulting in enhanced binding and uptake to the target cancer cells exhibited increased therapeutic effect of the drug. Moreover, these aptamer conjugated magnetic polymer vehicles apart from actively transporting drugs into specifically targeted tumor regions can also be used to induce hyperthermia or for facilitating magnetic guiding of particles to the tumor regions. - Highlights: • Aptamer escorted, theranostic biodegradable PLGA carriers were developed. • Can target cancer cells, control drug release, image and magnetically guide. • Highly specific to the targeted cancer cells thus delivering

Achievement Goal Orientations and Adolescents' Subjective Well-Being in School: The Mediating Roles of Academic Social Comparison Directions.

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Tian, Lili; Yu, Tingting; Huebner, E Scott

2017-01-01

The purpose of this study was to examine the multiple mediational roles of academic social comparison directions (upward academic social comparison and downward academic social comparison) on the relationships between achievement goal orientations (i.e., mastery goals, performance-approach goals, and performance-avoidance goals) and subjective well-being (SWB) in school (school satisfaction, school affect) in adolescent students in China. A total of 883 Chinese adolescent students (430 males; Mean age = 12.99) completed a multi-measure questionnaire. Structural equation modeling was used to examine the hypotheses. Results indicated that (1) mastery goal orientations and performance-approach goal orientations both showed a statistically significant, positive correlation with SWB in school whereas performance-avoidance goal orientations showed a statistically significant, negative correlation with SWB in school among adolescents; (2) upward academic social comparisons mediated the relation between the three types of achievement goal orientations (i.e., mastery goals, performance-approach goals, and performance-avoidance goals) and SWB in school; (3) downward academic social comparisons mediated the relation between mastery goal orientations and SWB in school as well as the relation between performance-avoidance goal orientations and SWB in school. The findings suggest possible important cultural differences in the antecedents of SWB in school in adolescent students in China compared to adolescent students in Western nations.

Shaping magnetic fields to direct therapy to ears and eyes.

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Shapiro, B; Kulkarni, S; Nacev, A; Sarwar, A; Preciado, D; Depireux, D A

2014-07-11

Magnetic fields have the potential to noninvasively direct and focus therapy to disease targets. External magnets can apply forces on drug-coated magnetic nanoparticles, or on living cells that contain particles, and can be used to manipulate them in vivo. Significant progress has been made in developing and testing safe and therapeutic magnetic constructs that can be manipulated by magnetic fields. However, we do not yet have the magnet systems that can then direct those constructs to the right places, in vivo, over human patient distances. We do not yet know where to put the external magnets, how to shape them, or when to turn them on and off to direct particles or magnetized cells-in blood, through tissue, and across barriers-to disease locations. In this article, we consider ear and eye disease targets. Ear and eye targets are too deep and complex to be targeted by a single external magnet, but they are shallow enough that a combination of magnets may be able to direct therapy to them. We focus on how magnetic fields should be shaped (in space and time) to direct magnetic constructs to ear and eye targets.

Inter-individual differences in decision-making, flexible and goal-directed behaviors: novel insights within the prefronto-striatal networks.

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Fitoussi, Aurélie; Renault, Prisca; Le Moine, Catherine; Coutureau, Etienne; Cador, Martine; Dellu-Hagedorn, Françoise

2018-03-01

Inflexible behavior is a hallmark of several decision-making-related disorders such as ADHD and addiction. As in humans, a subset of healthy rats makes poor decisions and prefers immediate larger rewards despite suffering large losses in a rat gambling task (RGT). They also display a combination of traits reminiscent of addiction, notably inflexible behavior and perseverative responses. The goal of the present work was twofold: (1) to elucidate if behavioral inflexibility of poor decision-makers could be related to a lower quality of goal-directed behavior (action-outcome associations); (2) to uncover the neural basis of inter-individual differences in goal-directed behavior. We specifically assessed inter-individual differences in decision-making in the RGT, flexibility in the RGT-reversed version and goal-directed behavior in a contingency degradation test, i.e., response adaptation when dissociating reward delivery from the animal's action. The contributions of the medial prefrontal cortex and the dorsal striatum to action-outcome associations were assessed using Zif268 immunodetection. Inflexible behavior was related to a lower sensitivity to contingency degradation in all poor decision-makers and only in a few good decision-makers. This poorer sensitivity was associated with a lower immunoreactivity in prelimbic and infralimbic cortices and a higher one in the dorsomedial and dorsolateral striatum. These findings suggest that an imbalanced prefronto-striatal activity could underlie inaccurate goal representation in changing environments and may promote maladaptive habit formation among poor decision-makers. These data strengthen our previous work identifying biomarkers of vulnerability to develop psychiatric disorders and demonstrate the relevance of inter-individual differences to model maladaptive behaviors.

Mapping the timecourse of goal-directed attention to location and colour in human vision.

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Adams, Rachel C; Chambers, Christopher D

2012-03-01

Goal-directed attention prioritises perception of task-relevant stimuli according to location, features, or onset time. In this study we compared the behavioural timecourse of goal-directed selection to locations and colours by varying the stimulus-onset asynchrony (SOA) between cue and target in a strategic cueing paradigm. Participants reported the presence or absence of a target following prior information regarding its location or colour. Results revealed that preparatory selection by colour is more effective at enhancing perceptual sensitivity than selection by location, even though both types of cue provided equivalent overall information. More detailed analysis revealed that this advantage arose due a limitation of spatial attention in maintaining a sufficiently broad focus (>2°) for target detection across multiple stimuli. In contrast, when target stimuli fell within 2° of the spatial attention spotlight, the strategic advantages and speed of spatial and colour attention were equated. Our findings are consistent with the conclusion that, under spatially optimal conditions, prior spatial and colour information are equally proficient at guiding top-down selection. When spatial locations are ambiguous, however, colour-based selection is the more efficient mechanism. Copyright © 2012 Elsevier B.V. All rights reserved.

Pharmacological Blockade of Adenosine A2A but Not A1 Receptors Enhances Goal-Directed Valuation in Satiety-Based Instrumental Behavior

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Yan Li

2018-04-01

Full Text Available The balance and smooth shift between flexible, goal-directed behaviors and repetitive, habitual actions are critical to optimal performance of behavioral tasks. The striatum plays an essential role in control of goal-directed versus habitual behaviors through a rich interplay of the numerous neurotransmitters and neuromodulators to modify the input, processing and output functions of the striatum. The adenosine receptors (namely A2AR and A1R, with their high expression pattern in the striatum and abilities to interact and integrate dopamine, glutamate and cannabinoid signals in the striatum, may represent novel therapeutic targets for modulating instrumental behavior. In this study, we examined the effects of pharmacological blockade of the A2ARs and A1Rs on goal-directed versus habitual behaviors in different information processing phases of instrumental learning using a satiety-based instrumental behavior procedure. We found that A2AR antagonist acts at the coding, consolidation and expression phases of instrumental learning to modulate animals’ sensitivity to goal-directed valuation without modifying action-outcome contingency. However, pharmacological blockade and genetic knockout of A1Rs did not affect acquisition or sensitivity to goal-valuation of instrumental behavior. These findings provide pharmacological evidence for a potential therapeutic strategy to control abnormal instrumental behaviors associated with drug addiction and obsessive-compulsive disorder by targeting the A2AR.

Pro-Social Goals in Achievement Situations: Amity Goal Orientation Enhances the Positive Effects of Mastery Goal Orientation.

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Levontin, Liat; Bardi, Anat

2018-04-01

Research has neglected the utility of pro-social goals within achievement situations. In this article, four studies demonstrate that amity goal orientation, promoting mutual success of oneself together with others, enhances the utility of mastery goal orientation. We demonstrate this in longitudinally predicting performance (Studies 1 and 2) and in maintaining motivation after a disappointing performance (Studies 3 and 4). The studies demonstrate the same interaction effect in academic and in work achievement contexts. Specifically, whereas amity goal orientation did not predict achievement on its own, it enhanced the positive effect of mastery goal orientation. Together, these studies establish the importance of amity goal orientation while also advancing our understanding of the effects of other achievement goal orientations. We suggest future directions in examining the utility of amity goals in other contexts.

Early goal-directed nutrition in icU patients (EAT-ICU)

DEFF Research Database (Denmark)

Allingstrup, Matilde Jo; Kondrup, Jens; Wiis, Jørgen

2016-01-01

-energy nutrition based on measured requirements on short-term clinical outcomes and long-term physical quality of life in ICU patients. METHODS: The EAT-ICU trial is a single-centre, randomised, parallel-group trial with concealed allocation and blinded outcome assessment. A total of 200 consecutive, acutely...... admitted, mechanically ventilated intensive care patients will be randomised 1:1 to early goal-directed nutrition versus standard of care to show a potential 15% relative risk reduction in the primary outcome measure (physical function) at six months (two-sided significance level α = 0.05; power β = 80......%). Secondary outcomes include energy- and protein balances, metabolic control, new organ failure, use of life support, nosocomial infections, ICU- and hospital length of stay, mortality and cost analyses. CONCLUSION: The optimal nutrition strategy for ICU patients remains unsettled. The EAT-ICU trial...

Real-time decreased sensitivity to an audio-visual illusion during goal-directed reaching.

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Luc Tremblay

Full Text Available In humans, sensory afferences are combined and integrated by the central nervous system (Ernst MO, Bülthoff HH (2004 Trends Cogn. Sci. 8: 162-169 and appear to provide a holistic representation of the environment. Empirical studies have repeatedly shown that vision dominates the other senses, especially for tasks with spatial demands. In contrast, it has also been observed that sound can strongly alter the perception of visual events. For example, when presented with 2 flashes and 1 beep in a very brief period of time, humans often report seeing 1 flash (i.e. fusion illusion, Andersen TS, Tiippana K, Sams M (2004 Brain Res. Cogn. Brain Res. 21: 301-308. However, it is not known how an unfolding movement modulates the contribution of vision to perception. Here, we used the audio-visual illusion to demonstrate that goal-directed movements can alter visual information processing in real-time. Specifically, the fusion illusion was linearly reduced as a function of limb velocity. These results suggest that cue combination and integration can be modulated in real-time by goal-directed behaviors; perhaps through sensory gating (Chapman CE, Beauchamp E (2006 J. Neurophysiol. 96: 1664-1675 and/or altered sensory noise (Ernst MO, Bülthoff HH (2004 Trends Cogn. Sci. 8: 162-169 during limb movements.

Goal-directed behaviour and instrumental devaluation: a neural system-level computational model

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Francesco Mannella

2016-10-01

Full Text Available Devaluation is the key experimental paradigm used to demonstrate the presence of instrumental behaviours guided by goals in mammals. We propose a neural system-level computational model to address the question of which brain mechanisms allow the current value of rewards to control instrumental actions. The model pivots on and shows the computational soundness of the hypothesis for which the internal representation of instrumental manipulanda (e.g., levers activate the representation of rewards (or `action-outcomes', e.g. foods while attributing to them a value which depends on the current internal state of the animal (e.g., satiation for some but not all foods. The model also proposes an initial hypothesis of the integrated system of key brain components supporting this process and allowing the recalled outcomes to bias action selection: (a the sub-system formed by the basolateral amygdala and insular cortex acquiring the manipulanda-outcomes associations and attributing the current value to the outcomes; (b the three basal ganglia-cortical loops selecting respectively goals, associative sensory representations, and actions; (c the cortico-cortical and striato-nigro-striatal neural pathways supporting the selection, and selection learning, of actions based on habits and goals. The model reproduces and integrates the results of different devaluation experiments carried out with control rats and rats with pre- and post-training lesions of the basolateral amygdala, the nucleus accumbens core, the prelimbic cortex, and the dorso-medial striatum. The results support the soundness of the hypotheses of the model and show its capacity to integrate, at the system-level, the operations of the key brain structures underlying devaluation. Based on its hypotheses and predictions, the model also represents an operational framework to support the design and analysis of new experiments on the motivational aspects of goal-directed behaviour.

New directions for feminist therapy based on social constructionism.

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Finfgeld, D L

2001-06-01

Feminist therapy has made significant contributions in the area of women's mental health care. Of late, however, critics have argued that feminist therapists are neglecting the needs of many women. The unique perspectives of women of color, lower and upper class women, lesbians, and other persons have been ignored. As such, it is proposed that social constructionism offers a metaframework for reinterpreting feminist therapy tenets to better address the needs of a broad range of individuals. Clinical implications are offered along with future directions for research and education. Copyright 2001 by W.B. Saunders Company

Auxillary Fluid Flowmeter

DEFF Research Database (Denmark)

RezaNejad Gatabi, Javad; Forouzbakhsh, Farshid; Ebrahimi Darkhaneh, Hadi

2010-01-01

The Auxiliary Fluid Flow meter is proposed to measure the fluid flow of any kind in both pipes and open channels. In this kind of flow measurement, the flow of an auxiliary fluid is measured Instead of direct measurement of the main fluid flow. The auxiliary fluid is injected into the main fluid ...

Achievement Goal Orientations and Adolescents’ Subjective Well-Being in School: The Mediating Roles of Academic Social Comparison Directions

Science.gov (United States)

Tian, Lili; Yu, Tingting; Huebner, E. Scott

2017-01-01

The purpose of this study was to examine the multiple mediational roles of academic social comparison directions (upward academic social comparison and downward academic social comparison) on the relationships between achievement goal orientations (i.e., mastery goals, performance-approach goals, and performance-avoidance goals) and subjective well-being (SWB) in school (school satisfaction, school affect) in adolescent students in China. A total of 883 Chinese adolescent students (430 males; Mean age = 12.99) completed a multi-measure questionnaire. Structural equation modeling was used to examine the hypotheses. Results indicated that (1) mastery goal orientations and performance-approach goal orientations both showed a statistically significant, positive correlation with SWB in school whereas performance-avoidance goal orientations showed a statistically significant, negative correlation with SWB in school among adolescents; (2) upward academic social comparisons mediated the relation between the three types of achievement goal orientations (i.e., mastery goals, performance-approach goals, and performance-avoidance goals) and SWB in school; (3) downward academic social comparisons mediated the relation between mastery goal orientations and SWB in school as well as the relation between performance-avoidance goal orientations and SWB in school. The findings suggest possible important cultural differences in the antecedents of SWB in school in adolescent students in China compared to adolescent students in Western nations. PMID:28197109

Fluids with highly directional attractive forces. III. Multiple attraction sites

International Nuclear Information System (INIS)

Wertheim, M.S.

1986-01-01

The authors derive a reformulation of statistical thermodynamics for fluids of molecules which interact by highly directional attraction. The molecular model consists of a repulsive core and several sites of very short-ranged attraction. The authors explore the relationship between graph cancellation in the fugacity expansion and three types of steric incompatibility between repulsive and attractive interactions involving several molecules. The steric effects are used to best advantage in a limited regrouping of bonds. This controls the density parameters which appear when articulation points are eliminated in the graphical representation. Each density parameter is a singlet density for a species consisting of molecules with a specified set of sites bonded. The densities satisfy subsidiary conditions of internal consistency. These conditions are equivalent to a minimization of the Helmholtz free energy A. Graphical expressions for A and for the pressure are derived. Analogs of the s-particle direct correlation functions and of the Ornstein-Zernike equation are found

An example of genetically distinct HIV type 1 variants in cerebrospinal fluid and plasma during suppressive therapy.

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Dahl, Viktor; Gisslen, Magnus; Hagberg, Lars; Peterson, Julia; Shao, Wei; Spudich, Serena; Price, Richard W; Palmer, Sarah

2014-05-15

We sequenced the genome of human immunodeficiency virus type 1 (HIV-1) recovered from 70 cerebrospinal fluid (CSF) specimens and 29 plasma samples and corresponding samples obtained before treatment initiation from 17 subjects receiving suppressive therapy. More CSF sequences than plasma sequences were hypermutants. We determined CSF sequences and plasma sequences in specimens obtained from 2 subjects after treatment initiation. In one subject, we found genetically distinct CSF and plasma sequences, indicating that they came from HIV-1 from 2 different compartments, one potentially the central nervous system, during suppressive therapy. In addition, there was little evidence of viral evolution in the CSF during therapy, suggesting that continuous virus replication is not the major cause of viral persistence in the central nervous system.

How does reward compete with goal-directed and stimulus-driven shifts of attention?

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Bourgeois, Alexia; Neveu, Rémi; Bayle, Dimitri J; Vuilleumier, Patrik

2017-01-01

In order to behave adaptively, attention can be directed in space either voluntarily (i.e. endogenously) according to strategic goals, or involuntarily (i.e. exogenously) through reflexive capture by salient or novel events. The emotional or motivational values of stimuli can also influence attentional orienting. However, little is known about how reward-related effects compete or interact with endogenous and exogenous attention mechanisms. Here we designed a visual search paradigm in which goal-driven and stimulus-driven shifts of attention were manipulated by classic spatial cueing procedures, while an irrelevant, but previously rewarded stimulus also appeared as a distractor and hence competed with both types of spatial attention during search. Our results demonstrated that stimuli previously associated with a high monetary reward received higher attentional priority in the subsequent visual search task, even though these stimuli and reward were no longer task-relevant, mitigating the attentional orienting induced by both endogenous and exogenous cues.

Development of a novel method for amniotic fluid stem cell storage.

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Zavatti, Manuela; Beretti, Francesca; Casciaro, Francesca; Comitini, Giuseppina; Franchi, Fabrizia; Barbieri, Veronica; Bertoni, Laura; De Pol, Anto; La Sala, Giovanni B; Maraldi, Tullia

2017-08-01

Current procedures for collection of human amniotic fluid stem cells (hAFSCs) indicate that cells cultured in a flask for 2 weeks can then be used for research. However, hAFSCs can be retrieved directly from a small amount of amniotic fluid that can be obtained at the time of diagnostic amniocentesis. The aim of this study was to determine whether direct freezing of amniotic fluid cells is able to maintain or improve the potential of a sub-population of stem cells. We compared the potential of the hAFSCs regarding timing of freezing, cells obtained directly from amniotic fluid aspiration (D samples) and cells cultured in a flask before freezing (C samples). Colony-forming-unit ability, proliferation, morphology, stemness-related marker expression, senescence, apoptosis and differentiation potential of C and D samples were compared. hAFSCs isolated from D samples expressed mesenchymal stem cells markers until later passages, had a good proliferation rate and exhibited differentiation capacity similar to hAFSCs of C samples. Interestingly, direct freezing induced a higher concentration of cells positive for pluripotency stem cell markers, without teratoma formation in vivo. This study suggests that minimal processing may be adequate for the banking of amniotic fluid cells, avoiding in vitro passages before the storage and exposure to high oxygen concentration, which affect stem cell properties. This technique might be a cost-effective and reasonable approach to the process of Good Manufacturing Process accreditation for stem-cell banks. Copyright © 2017 International Society for Cellular Therapy. Published by Elsevier Inc. All rights reserved.

Estimation of Dry Fracture Weakness, Porosity, and Fluid Modulus Using Observable Seismic Reflection Data in a Gas-Bearing Reservoir

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Chen, Huaizhen; Zhang, Guangzhi

2017-05-01

Fracture detection and fluid identification are important tasks for a fractured reservoir characterization. Our goal is to demonstrate a direct approach to utilize azimuthal seismic data to estimate fluid bulk modulus, porosity, and dry fracture weaknesses, which decreases the uncertainty of fluid identification. Combining Gassmann's (Vier. der Natur. Gesellschaft Zürich 96:1-23, 1951) equations and linear-slip model, we first establish new simplified expressions of stiffness parameters for a gas-bearing saturated fractured rock with low porosity and small fracture density, and then we derive a novel PP-wave reflection coefficient in terms of dry background rock properties (P-wave and S-wave moduli, and density), fracture (dry fracture weaknesses), porosity, and fluid (fluid bulk modulus). A Bayesian Markov chain Monte Carlo nonlinear inversion method is proposed to estimate fluid bulk modulus, porosity, and fracture weaknesses directly from azimuthal seismic data. The inversion method yields reasonable estimates in the case of synthetic data containing a moderate noise and stable results on real data.

Gingival crevicular fluid tissue/blood vessel-type plasminogen activator and plasminogen activator inhibitor-2 levels in patients with rheumatoid arthritis: effects of nonsurgical periodontal therapy.

Science.gov (United States)

Kurgan, Ş; Önder, C; Balcı, N; Fentoğlu, Ö; Eser, F; Balseven, M; Serdar, M A; Tatakis, D N; Günhan, M

2017-06-01

The aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel-type plasminogen activator (t-PA) and plasminogen activator inhibitor-2 (PAI-2) in patients with periodontitis, with or without rheumatoid arthritis (RA). Fifteen patients with RA and chronic periodontitis (RA-P), 15 systemically healthy patients with chronic periodontitis (H-P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t-PA and PAI-2 levels, erythrocyte sedimentation rate, serum C-reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy. All periodontal clinical parameters were significantly higher in the RA-P and H-P groups compared with the C group (p periodontitis groups (p periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t-PA levels, which were significantly correlated with gingival crevicular fluid PAI-2 levels. The significantly higher t-PA and PAI-2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Goal setting in psychotherapy: the relevance of approach and avoidance goals for treatment outcome.

Science.gov (United States)

Wollburg, Eileen; Braukhaus, Christoph

2010-07-01

The present study is the first aimed at investigating the influence of goal definition on treatment outcome in a sample of depressed patients. Data from 657 inpatients admitted to a psychosomatic clinic in Germany being treated in a cognitive-behavioral therapy program were analyzed. Treatment goals were identified as either approach or avoidance, and the sample was classified accordingly. Patients who identified approach goals only were placed in the approach group, and those who identified at least one avoidance goal were placed in the avoidance group. Results showed that framing goals using avoidance terms was associated with less symptomatic improvement but did not affect goal attainment. Findings from this research should be utilized in practice not only for process management such as individual treatment planning but also to control outcome quality. Furthermore, goal definition should be considered as a control variable in research on depression.

The cerebrospinal fluid/serum leptin ratio during pharmacological therapy for obesity.

Science.gov (United States)

Rodrigues, Adriane Maria; Radominski, Rosana Bento; Suplicy, Henrique de Lacerda; De Almeida, Sergio Monteiro; Niclewicz, Patricia Artigas; Boguszewski, Cesar Luiz

2002-04-01

The aim of the present study was to evaluate the cerebrospinal fluid (CSF)/serum leptin ratio during pharmacological therapy for obesity with centrally and peripherally acting drugs. Thirty-one obese women (mean age, 32.3 +/- 10 yr; body mass index, 38.2 +/- 5.2 kg/m(2); body fat, 43.3 +/- 5.4%) were studied before and 2 months after a weight loss program consisting of a balanced diet (1200 kcal/d) plus drug therapy. The patients were randomly assigned into three study groups: group I, fenproporex 25 mg/d (n = 10); group II, sibutramine 10 mg/d (n = 10); and group III, orlistat 120 mg tid (n = 11). Body fat, measured by dual-energy x-ray absorptiometry, and serum and CSF concentrations of leptin were examined at baseline and 2 months after therapy. At baseline, clinical and biochemical characteristics of the groups were similar. All of the women lost weight, approximately 7.0% of their initial body weight, and the reduction was not different among the groups. Serum leptin fell significantly after 2 months in all groups, and the decline was proportional to the reduction in body fat, because leptin levels adjusted for body fat did not change after treatment. CSF leptin levels showed a significant decrease after 2 months in all groups, and this decline was higher on group III compared with group I (P = 0.006). After therapy, the CSF/serum leptin ratio did not change in group I (1.57 +/- 0.3 to 1.72 +/- 0.62%) and group II (1.78 +/- 1.01 to 1.69 +/- 1.27%), whereas it declined significantly in group III (1.65 +/- 0.43 to 1.09 +/- 0.47%; P obese women treated during 2 months with orlistat, whereas this ratio did not change in this period of time in obese women treated with fenproporex and sibutramine.

Dynamic muscle O2 saturation response is impaired during major non-cardiac surgery despite goal-directed haemodynamic therapy.

Science.gov (United States)

Feldheiser, A; Hunsicker, O; Kaufner, L; Köhler, J; Sieglitz, H; Casans Francés, R; Wernecke, K-D; Sehouli, J; Spies, C

2016-03-01

Near-infrared spectroscopy combined with a vascular occlusion test (VOT) could indicate an impairment of microvascular reactivity (MVR) in septic patients by detecting changes in dynamic variables of muscle O2 saturation (StO2). However, in the perioperative context the consequences of surgical trauma on dynamic variables of muscle StO2 as indicators of MVR are still unknown. This study is a sub-analysis of a randomised controlled trial in patients with metastatic primary ovarian cancer undergoing debulking surgery, during which a goal-directed haemodynamic algorithm was applied using oesophageal Doppler. During a 3 min VOT, near-infrared spectroscopy was used to assess dynamic variables arising from changes in muscle StO2. At the beginning of surgery, values of desaturation and recovery slope were comparable to values obtained in healthy volunteers. During the course of surgery, both desaturation and recovery slope showed a gradual decrease. Concomitantly, the study population underwent a transition to a surgically induced systemic inflammatory response state shown by a gradual increase in norepinephrine administration, heart rate, and Interleukin-6, with a peak immediately after the end of surgery. Higher rates of norepinephrine and a higher heart rate were related to a faster decline in StO2 during vascular occlusion. Using near-infrared spectroscopy combined with a VOT during surgery showed a gradual deterioration of MVR in patients treated with optimal haemodynamic care. The deterioration of MVR was accompanied by the transition to a surgically induced systemic inflammatory response state. Copyright © 2015 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Controlled capillary assembly of magnetic Janus Particles at fluid-fluid interfaces

NARCIS (Netherlands)

Xie, Q.; Davies, G.B.; Harting, J.D.R.

2016-01-01

Capillary interactions can be used to direct assembly of particles adsorbed at fluid-fluid interfaces. Precisely controlling the magnitude and direction of capillary interactions to assemble particles into favoured structures for materials science purposes is desirable but challenging. In this

Therapy of Sjögren's syndrome. New aspects and future directions.

Science.gov (United States)

Vlachoyiannopoulos, P G

1998-02-01

Therapy of Sjögren's syndrome remains empirical and symptomatic. The main goals are to treat the disease related features, especially sicca manifestations, since the immunosuppressive therapy has not given promising results. For the treatment of keratoconjunctivitis sicca: local stimulators of tear secretion, protective bicarbonate buffered solutions, replacement therapy or supportive operative procedures should be tried. For oral manifestations: stimulators of salivary secretion such as pilocarpine, or agents changing the consistency of saliva such as bromhexine orally should be tried. Saliva substitutes have a transient effect. Frequent ingestion of sugar free liquids may help. Oral hygiene is important to avoid oral candidiasis and dental caries. Treatment of parotid gland swelling is not necessary. Pulmonary manifestations include pulmonary infiltrates in perialveolar areas, nodular or cavitary lesions which may represent lymphoma. Hilar adenopathy, solid or cavitary lesions should be biopsied. In case of vasculitis prednisolone 1 mg/kg/day with progressive tapering should be tried. Renal involvement is manifested mainly as interstitial disease. Administration of NaHCO3 or sodium citrate is important to prevent acidosis and nephrocalcinosis. Vasculitis, when it is of the leukoclasic form, does not need therapy; when it is manifested with severe major organ involvement corticosteroids and/or cytotoxic therapy should be tried. Lymphoma is treated as in the patients without Sjögren's in close collaboration with the oncology department.

Intraoperative fluid therapy in neonates

African Journals Online (AJOL)

Differences from adults and children in physiology and anatomy of neonates inform our ... is based on energy expenditure indexed to bodyweight.2 Energy ... fragile and poorly keratinised.5 ... neonates means that very conservative fluid regimes in neonates ..... I make an estimation of insensible loss from the skin, viscera,.

Bronchiolitis obliterans organising pneumonia syndrome presenting with neutrophilia in bronchoalveolar lavage fluid after breast-conserving therapy

Science.gov (United States)

Chiba, Sahoko; Jinta, Torahiko; Chohnabayashi, Naohiko; Fujie, Toshihide; Sumi, Yuki; Inase, Naohiko

2012-01-01

A 61-year-old female presented with a dry cough and fever 4 months after tangential radiation therapy (RT) following conserving surgery for breast cancer. Chest radiography and CT demonstrated consolidation with air bronchogram outside the irradiated area. Neutrophil granulocytes were abundant in bronchoalveolar lavage fluid (BALF) (39.6% of total cells), and transbronchial lung biopsy revealed organising pneumonia (OP) histologically. Antibiotic therapy had no effect, but corticosteroid therapy brought about clinical improvement. Her condition was diagnosed as bronchiolitis obliterans OP (BOOP) syndrome. Lymphocytic BALF has been identified as a characteristic of BOOP syndrome induced after RT for breast cancer. The BALF in this case, however, was neutrophilic. In our analysis of differential cell counts in the BALF of 24 patients with BOOP syndrome, the BALF was neutrophilic (>5%) in 16 (76%) cases, and the neutrophilia was severe in some of those patients. PMID:22605699

Direct numerical simulations of fluid flow, heat transfer and phase changes

Science.gov (United States)

Juric, D.; Tryggvason, G.; Han, J.

1997-01-01

Direct numerical simulations of fluid flow, heat transfer, and phase changes are presented. The simulations are made possible by a recently developed finite difference/front tracking method based on the one-field formulation of the governing equations where a single set of conservation equations is written for all the phases involved. The conservation equations are solved on a fixed rectangular grid, but the phase boundaries are kept sharp by tracking them explicitly by a moving grid of lower dimension. The method is discussed and applications to boiling heat transfer and the solidification of drops colliding with a wall are shown.

Patient-relevant treatment goals in psoriasis.

Science.gov (United States)

Blome, Christine; Gosau, Ramona; Radtke, Marc A; Reich, Kristian; Rustenbach, Stephan J; Spehr, Christina; Thaçi, Diamant; Augustin, Matthias

2016-03-01

Patient-oriented care requires therapeutic decisions to agree with the patients' treatment needs and goals. This study addressed the following questions: What is important to psoriasis patients starting systemic treatment? How stable are these preferences within the first year of treatment? Are treatment goals associated with age, gender, or treatment success? The importance of treatment goals was assessed for patients with moderate-to-severe psoriasis in the German Psoriasis Registry (PsoBest) at baseline (onset of a systemic treatment; n = 3066) and at a 1-year follow-up (n = 1444) using the Patient Benefit Index (PBI). Treatment success was measured with PBI global score and Psoriasis Area Severity Index (PASI). Patients with moderate-to-severe psoriasis pursued a wide range of different goals. The most general treatment goals were rated most relevant, including skin healing and quick skin improvement (94.8/94.5 % "quite" or "very" important), confidence in the therapy (93.0 %), control over the disease (92.3 %), and a clear diagnosis and therapy (89.6 %). Further important goals related to not being in fear of the disease getting worse (84.8 %), reduction in itching (83.9 %), burning (70.6 %), and pain (60.6 %) as well as attaining a normal everyday life (78.4 %) and low treatment burden (64.2-77.9 %). Goals were mostly not associated with sex and gender. Goal importance slightly increased with treatment success. In a substantial proportion of patients (30.3-54.7 %) goal importance changed within 1 year after onset of systemic treatment. We conclude that treatment goal importance should be assessed in clinical practice on a regular basis.

The role of metastasis-directed therapy and local therapy of the primary tumor in the management of oligometastatic prostate cancer.

Science.gov (United States)

Kim, Jongchan; Park, Jee Soo; Ham, Won Sik

2017-09-01

Oligometastasis has been proposed as an intermediate stage of cancer spread between localized disease and widespread metastasis. Oligometastatic malignancy is now being diagnosed more frequently as the result of improvements in diagnostic modalities such as functional imaging. The importance of oligometastasis in managing metastatic prostate cancer is that it is possible to treat with a curative aim by metastasis-directed or local therapy in selected patients. Many studies have shown that these aggressive treatments lead to improved survival in other oligometastatic malignancies. However, few studies have shown definitive benefits of metastasis-directed or local therapy in oligometastatic prostate cancer. Review of the available studies suggests that stereotactic radiotherapy (RT) of metastatic lesions in oligorecurrent disease is a feasible and safe modality for managing oligometastatic prostate cancer. Also, stereotactic RT can delay the start of androgen deprivation therapy. Many retrospective studies of metastatic prostate cancer have shown that patients undergoing local therapy seem to have superior overall and cancer-specific survival compared with patients not receiving local therapy. Ongoing prospective randomized trials would be helpful to evaluate the role of local therapy in oligometastatic prostate cancer.

The role of metastasis-directed therapy and local therapy of the primary tumor in the management of oligometastatic prostate cancer

Directory of Open Access Journals (Sweden)

Jongchan Kim

2017-09-01

Full Text Available Oligometastasis has been proposed as an intermediate stage of cancer spread between localized disease and widespread metas-tasis. Oligometastatic malignancy is now being diagnosed more frequently as the result of improvements in diagnostic modalities such as functional imaging. The importance of oligometastasis in managing metastatic prostate cancer is that it is possible to treat with a curative aim by metastasis-directed or local therapy in selected patients. Many studies have shown that these aggressive treatments lead to improved survival in other oligometastatic malignancies. However, few studies have shown definitive benefits of metastasis-directed or local therapy in oligometastatic prostate cancer. Review of the available studies suggests that stereotac-tic radiotherapy (RT of metastatic lesions in oligorecurrent disease is a feasible and safe modality for managing oligometastatic prostate cancer. Also, stereotactic RT can delay the start of androgen deprivation therapy. Many retrospective studies of metastatic prostate cancer have shown that patients undergoing local therapy seem to have superior overall and cancer-specific survival compared with patients not receiving local therapy. Ongoing prospective randomized trials would be helpful to evaluate the role of local therapy in oligometastatic prostate cancer.

Effect of working fluids on the performance of a novel direct vapor generation solar organic Rankine cycle system

International Nuclear Information System (INIS)

Li, Jing; Alvi, Jahan Zeb; Pei, Gang; Ji, Jie; Li, Pengcheng; Fu, Huide

2016-01-01

Highlights: • A novel, flexible direct vapor generation solar ORC is proposed. • Technical feasibility of the system is discussed. • Fluid effect on collector efficiency is explored. • The system is more efficient than solar ORC with HTF. - Abstract: A novel solar organic Rankine cycle (ORC) system with direct vapor generation (DVG) is proposed. A heat storage unit is embedded in the ORC to guarantee the stability of power generation. Compared with conventional solar ORCs, the proposed system avoids the secondary heat transfer intermediate and shows good reaction to the fluctuation of solar radiation. The technical feasibility of the system is discussed. Performance is analyzed by using 17 dry and isentropic working fluids. Fluid effects on the efficiencies of ORC, collectors and the whole system are studied. The results indicate that the collector efficiency generally decreases while the ORC and system efficiencies increase with the increment in fluid critical temperature. At evaporation temperature of 120 °C and solar radiation of 800 Wm −2 , the ORC, collector and overall thermal efficiencies of R236fa are 10.59, 56.14 and 5.08% while their values for Benzene are 12.5, 52.58 and 6.57% respectively. The difference between collector efficiencies using R236fa and Benzene gets larger at lower solar radiation. The heat collection is strongly correlated with latent and sensible heat of the working fluid. Among the fluids, R123 exhibits the highest overall performance and seems to be suitable for the proposed system in the short term.

Intact goal-directed control in treatment-seeking drug users indexed by outcome-devaluation and Pavlovian to instrumental transfer: Critique of habit theory.

Science.gov (United States)

Hogarth, Lee; Lam-Cassettari, Christa; Pacitti, Helena; Currah, Tara; Mahlberg, Justin; Hartley, Lucie; Moustafa, Ahmed

2018-05-22

Animal studies have demonstrated that chronic exposure to drugs of abuse impairs goal-directed control over action selection indexed by the outcome-devaluation and specific Pavlovian to instrumental transfer procedures, suggesting this impairment might underpin addiction. However, there is currently only weak evidence for impaired goal-directed control in human drug users. Two experiments were undertaken in which treatment-seeking drug users and non-matched normative reference samples (controls) completed outcome-devaluation and specific Pavlovian to instrumental transfer procedures notionally translatable to animal procedures (Experiment 2 used a more challenging biconditional schedule). The two experiments found significant outcome-devaluation and specific Pavlovian to instrumental transfer effects overall and there was no significant difference between groups in the magnitude of these effects. Moreover, Bayes factor supported the null hypothesis for these group comparisons. Although limited by non-matched group comparisons and small sample sizes, the two studies suggest that treatment-seeking drug users have intact goal-directed control over action selection, adding uncertainty to already mixed evidence concerning the role of habit learning in human drug dependence. Neuro-interventions might seek to tackle goal-directed drug-seeking rather than habit formation in drug users. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Habit strength is predicted by activity dynamics in goal-directed brain systems during training.

Science.gov (United States)

Zwosta, Katharina; Ruge, Hannes; Goschke, Thomas; Wolfensteller, Uta

2018-01-15

Previous neuroscientific research revealed insights into the brain networks supporting goal-directed and habitual behavior, respectively. However, it remains unclear how these contribute to inter-individual differences in habit strength which is relevant for understanding not only normal behavior but also more severe dysregulations between these types of action control, such as in addiction. In the present fMRI study, we trained subjects on approach and avoidance behavior for an extended period of time before testing the habit strength of the acquired stimulus-response associations. We found that stronger habits were associated with a stronger decrease in inferior parietal lobule activity for approach and avoidance behavior and weaker vmPFC activity at the end of training for avoidance behavior, areas associated with the anticipation of outcome identity and value. VmPFC in particular showed markedly different activity dynamics during the training of approach and avoidance behavior. Furthermore, while ongoing training was accompanied by increasing functional connectivity between posterior putamen and premotor cortex, consistent with previous assumptions about the neural basis of increasing habitualization, this was not predictive of later habit strength. Together, our findings suggest that inter-individual differences in habitual behavior are driven by differences in the persistent involvement of brain areas supporting goal-directed behavior during training. Copyright © 2017. Published by Elsevier Inc.

Advanced Parkinson’s disease effect on goal-directed and habitual processes involved in visuomotor associative learning

Directory of Open Access Journals (Sweden)

Fadila eHadj-Bouziane

2013-01-01

Full Text Available The present behavioral study readdresses the question of habit learning in Parkinson's disease. Patients were early onset, non-demented, dopa-responsive, candidates for surgical treatment, similar to those we found earlier as suffering greater dopamine depletion in the putamen than in the caudate nucleus. The task was the same conditional associative learning task as that used previously in monkeys and healthy humans to unveil the striatum involvement in habit learning. Sixteen patients and 20 age- and education-matched healthy control subjects learned sets of 3 visuo-motor associations between complex patterns and joystick displacements during two testing sessions separated by a few hours. We distinguished errors preceding versus following the first correct response to compare patients' performance during the earliest phase of learning dominated by goal-directed actions with that observed later on, when responses start to become habitual. The disease significantly retarded both learning phases, especially in patients under sixty years of age. However, only the late phase deficit was disease severity-dependent and persisted on the second testing session. These findings provide the first corroboration in Parkinson patients of two ideas well-established in the animal literature. The first is the idea that associating visual stimuli to motor acts is a form of habit learning that engages the striatum. It is confirmed here by the global impairment in visuo-motor learning induced by Parkinson's disease. The second idea is that goal-directed behaviors are predominantly caudate-dependent whereas habitual responses are primarily putamen-dependent. At the advanced Parkinson's disease stages tested here, dopamine depletion is greater in the putamen than in the caudate nucleus. Accordingly, the late phase of learning corresponding to the emergence of habitual responses was more vulnerable to the disease than the early phase dominated by goal-directed

[Synergistic effect of cell kinetics-directed chemo-endocrine therapy on experimental mammary tumors].

Science.gov (United States)

Ueki, H

1987-11-01

We tried to demonstrate that the cell kinetics-directed chemoendocrine therapy is more effective on hormone dependent breast cancer than empirical combination of the endocrine therapy and chemotherapy. Cell kinetics of each tumor was measured by flow cytometric analysis. Estrogen dependent human breast cancer cell line MCF-7 was used in vitro. In vivo, androgen dependent SC-115 carcinoma was transplanted to DDS mice. In vitro, tamoxifen was administered as the endocrine therapy. In vivo, we carried out testectomy on DDS mice. Effect of the endocrine therapy on the cell kinetics of the tumor was thought to be G1-S depression. High density 5FU was administered as the chemotherapeutic agents, whose content was 1 microgram/ml in vitro and 40 mg/kg in vivo. 5FU brought temporary decrease of cells in S phase. Only anteceding 5FU administration had synergistic effect in combination of 5FU and the endocrine therapy. 5FU was convinced to act more effectively on cells in S phase, so it was shown that cell kinetics-directed schedule was superior to the empirical treatment schedule in chemoendocrine therapy.

Movement Structure in Young and Elderly Adults during Goal-Directed Movements of the Left and Right Arm

Science.gov (United States)

Poston, Brach; Van Gemmert, Arend W. A.; Barduson, Beth; Stelmach, George E.

2009-01-01

Elderly adults often exhibit performance deficits during goal-directed movements of the dominant arm compared with young adults. Recent studies involving hemispheric lateralization have provided evidence that the dominant and non-dominant hemisphere-arm systems are specialized for controlling different movement parameters and that hemispheric…

Effects of Fluid Directions on Heat Exchange in Thermoelectric Generators

DEFF Research Database (Denmark)

Suzuki, Ryosuke; Sasaki, Yuto; Fujisaka, Takeyuki

2012-01-01

Thermal fluids can transport heat to the large surface of a thermoelectric (TE) panel from hot and/or cold sources. The TE power thus obtainable was precisely evaluated using numerical calculations based on fluid dynamics and heat transfer. The commercial software FLUENT was coupled with a TE model...... for this purpose. The fluid velocity distribution and the temperature profiles in the fluids and TE modules were calculated in two-dimensional space. The electromotive force was then evaluated for counter-flow and split-flow models to show the effect of a stagnation point. Friction along the fluid surface along...

Towards a three-dimensional framework of centrally regulated and goal-directed exercise behaviour: a narrative review.

Science.gov (United States)

Venhorst, Andreas; Micklewright, Dominic; Noakes, Timothy D

2017-08-23

The Central Governor Model (CGM) ignited a paradigm shift from concepts of catastrophic failure towards central regulation of exercise performance. However, the CGM has focused on the central integration of afferent feedback in homeostatic control. Accordingly, it neglected the important role of volitional self-regulatory control and the integration of affective components inherently attached to all physiological cues. Another limitation is the large reliance on the Gestalt phenomenon of perceived exertion. Thus, progress towards a comprehensive multidimensional model of perceived fatigability and exercise regulation is needed. Drawing on Gate Control Theory of pain, we propose a three-dimensional framework of centrally regulated and goal-directed exercise behaviour, which differentiates between sensory, affective and cognitive processes shaping the perceptual milieu during exercise. We propose that: (A) perceived mental strain and perceived physical strain are primary determinants of pacing behaviour reflecting sensory-discriminatory processes necessary to align planned behaviour with current physiological state, (B) core affect plays a primary and mediatory role in exercise and performance regulation, and its underlying two dimensions hedonicity and arousal reflect affective-motivational processes triggering approach and avoidance behaviour, and (C) the mindset-shift associated with an action crisis plays a primary role in volitional self-regulatory control reflecting cognitive-evaluative processes between further goal-pursuit and goal-disengagement. The proposed framework has the potential to enrich theory development in centrally regulated and goal-directed exercise behaviour by emphasising the multidimensional dynamic processes underpinning perceived fatigability and provides a practical outline for investigating the complex interplay between the psychophysiological determinants of pacing and performance during prolonged endurance exercise. © Article author

Computational Properties of the Hippocampus Increase the Efficiency of Goal-Directed Foraging through Hierarchical Reinforcement Learning

Directory of Open Access Journals (Sweden)

Eric Chalmers

2016-12-01

Full Text Available The mammalian brain is thought to use a version of Model-based Reinforcement Learning (MBRL to guide goal-directed behavior, wherein animals consider goals and make plans to acquire desired outcomes. However, conventional MBRL algorithms do not fully explain animals’ ability to rapidly adapt to environmental changes, or learn multiple complex tasks. They also require extensive computation, suggesting that goal-directed behavior is cognitively expensive. We propose here that key features of processing in the hippocampus support a flexible MBRL mechanism for spatial navigation that is computationally efficient and can adapt quickly to change. We investigate this idea by implementing a computational MBRL framework that incorporates features inspired by computational properties of the hippocampus: a hierarchical representation of space, forward sweeps through future spatial trajectories, and context-driven remapping of place cells. We find that a hierarchical abstraction of space greatly reduces the computational load (mental effort required for adaptation to changing environmental conditions, and allows efficient scaling to large problems. It also allows abstract knowledge gained at high levels to guide adaptation to new obstacles. Moreover, a context-driven remapping mechanism allows learning and memory of multiple tasks. Simulating dorsal or ventral hippocampal lesions in our computational framework qualitatively reproduces behavioral deficits observed in rodents with analogous lesions. The framework may thus embody key features of how the brain organizes model-based RL to efficiently solve navigation and other difficult tasks.

Goal setting with mothers in child development services.

Science.gov (United States)

Forsingdal, S; St John, W; Miller, V; Harvey, A; Wearne, P

2014-07-01

The aim of this grounded theory study was to explore mothers' perspectives of the processes of collaborative goal setting in multidisciplinary child development services involving follow-up home therapy. Semi-structured interviews were conducted in South East Queensland, Australia with 14 mothers of children aged 3-6 years who were accessing multidisciplinary child development services. Interviews were focussed around the process of goal setting. A grounded theory of Maternal Roles in Goal Setting (The M-RIGS Model) was developed from analysis of data. Mothers assumed Dependent, Active Participator and Collaborator roles when engaging with the therapist in goal-setting processes. These roles were characterized by the mother's level of dependence on the therapist and insight into their child's needs and therapy processes. Goal Factors, Parent Factors and Therapist Factors influenced and added complexity to the goal-setting process. The M-RIGS Model highlights that mothers take on a range of roles in the goal-setting process. Although family-centred practice encourages negotiation and collaborative goal setting, parents may not always be ready to take on highly collaborative roles. Better understanding of parent roles, goal-setting processes and influencing factors will inform better engagement with families accessing multidisciplinary child development services. © 2013 John Wiley & Sons Ltd.

Direct numerical simulation of fluid-particle heat transfer in fixed random arrays of non-spherical particles

NARCIS (Netherlands)

Tavassoli Estahbanati, H.; Peters, E.A.J.F.; Kuipers, J.A.M.

2015-01-01

Direct numerical simulations are conducted to characterize the fluid-particle heat transfer coefficient in fixed random arrays of non-spherical particles. The objective of this study is to examine the applicability of well-known heat transfer correlations, that are proposed for spherical particles,

From Creatures of Habit to Goal-Directed Learners: Tracking the Developmental Emergence of Model-Based Reinforcement Learning.

Science.gov (United States)

Decker, Johannes H; Otto, A Ross; Daw, Nathaniel D; Hartley, Catherine A

2016-06-01

Theoretical models distinguish two decision-making strategies that have been formalized in reinforcement-learning theory. A model-based strategy leverages a cognitive model of potential actions and their consequences to make goal-directed choices, whereas a model-free strategy evaluates actions based solely on their reward history. Research in adults has begun to elucidate the psychological mechanisms and neural substrates underlying these learning processes and factors that influence their relative recruitment. However, the developmental trajectory of these evaluative strategies has not been well characterized. In this study, children, adolescents, and adults performed a sequential reinforcement-learning task that enabled estimation of model-based and model-free contributions to choice. Whereas a model-free strategy was apparent in choice behavior across all age groups, a model-based strategy was absent in children, became evident in adolescents, and strengthened in adults. These results suggest that recruitment of model-based valuation systems represents a critical cognitive component underlying the gradual maturation of goal-directed behavior. © The Author(s) 2016.

Reinforcement Learning Approach to Generate Goal-directed Locomotion of a Snake-Like Robot with Screw-Drive Units

DEFF Research Database (Denmark)

Chatterjee, Sromona; Nachstedt, Timo; Tamosiunaite, Minija

2014-01-01

Abstract—In this paper we apply a policy improvement algorithm called Policy Improvement using Path Integrals (PI2) to generate goal-directed locomotion of a complex snake-like robot with screw-drive units. PI2 is numerically simple and has an ability to deal with high dimensional systems. Here...

The Evidence from Inclusions in Pumices for the Direct Degassing of Volatiles from the Magma to the Hydrothermal Fluids in the Okinawa Trough

Institute of Scientific and Technical Information of China (English)

YU Zenghui; ZHAI Shikui; ZHAO Guangtao

2002-01-01

This article presents the evidence in support of the direct magma degassing as the principal mechanism of volatilesreleasing into the hydrothermal fluids in the Okinawa Trough, as contrasted to the argument for the hydrothermal strippingof volatiles from the volcanic rocks.Laser Raman microprobe and stepped-heating techniques are employed to determine the compositions and contents of thevolatiles in pumices in the middle Okinawa Trough. The results show that the volatiles are similar to the gases in the hy-drothermal fluids and hydrothermal minerals in composition, the mean percent content of each component and variationtrend. This indicates the direct influence of magma degassing on the hydrothermal fluids. In addition, the contents ofvolatiles in pumices are rather low and do not support the hydrothermal stripping as the main mechanism to enrich the fluidswith gases. The results are consistent with the idea that the direct magma degassing is more important than hydrothermalstripping in supplying gases to the hydrothermal fluids in the Okinawa Trough.

Tabletted guar gum microspheres of piroxicam for targeted adjuvant therapy for colonic adenocarcinomas.

Science.gov (United States)

Vats, Anima; Pathak, Kamla

2012-11-01

In recent years, nonsteroidal anti-inflammatory drugs have been found to be cogent as an adjuvant therapeutic agent in mitigating colorectal cancer. Thus, this present investigation was aimed to formulate an oral, targeted tablet of piroxicam microspheres for sustained and targeted adjuvant therapy for colonic adenocarcinomas. Crosslinked guar gum microspheres of piroxicam were directly compressed into matrix tablet and coated with Eudragit S100. The optimized tablet that displayed 0% release in simulated gastric fluid, 15% in simulated intestinal fluid and 97.1% in simulated colonic fluid underwent roentgenographic study in rabbits to check its safe transit to the colon. x-ray images revealed intactness of the tablet until it reached the colon where the tablet matrix eroded. The designed, conceptual formulation emerged as potential carrier for targeted adjuvant therapy of piroxicam.

Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

NARCIS (Netherlands)

Thomas, N.; Hayward, M.; Peters, E; van der Gaag, M.; Bentall, R.P.; Jenner, J.; Strauss, C.; Sommer, I.E.; Johns, L.C.; Varese, F.; Gracia-Montes, J.M.; Waters, F.; Dodgson, G.; McCarthy-Jones, S.

2014-01-01

This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions,

Animal-assisted therapy for clients with dementia.

Science.gov (United States)

Buettner, Linda L; Fitzsimmons, Suzanne; Barba, Beth

2011-05-01

The purpose of this article is to increase nurses' awareness of animal-assisted therapy as a treatment option for older adults with dementia. We describe the differences between animal visitation programs and goal-directed therapy. We also address credentials of human-animal teams and provide an overview of possible therapeutic outcomes for older adults with dementia. Step-by-step methods are outlined for nurses to advocate for clients with dementia to receive these services. Copyright 2011, SLACK Incorporated.

Mediodorsal thalamus hypofunction impairs flexible goal-directed behavior.

Science.gov (United States)

Parnaudeau, Sébastien; Taylor, Kathleen; Bolkan, Scott S; Ward, Ryan D; Balsam, Peter D; Kellendonk, Christoph

2015-03-01

Cognitive inflexibility is a core symptom of several mental disorders including schizophrenia. Brain imaging studies in schizophrenia patients performing cognitive tasks have reported decreased activation of the mediodorsal thalamus (MD). Using a pharmacogenetic approach to model MD hypofunction, we recently showed that decreasing MD activity impairs reversal learning in mice. While this demonstrates causality between MD hypofunction and cognitive inflexibility, questions remain about the elementary cognitive processes that account for the deficit. Using the Designer Receptors Exclusively Activated by Designer Drugs system, we reversibly decreased MD activity during behavioral tasks assessing elementary cognitive processes inherent to flexible goal-directed behaviors, including extinction, contingency degradation, outcome devaluation, and Pavlovian-to-instrumental transfer (n = 134 mice). While MD hypofunction impaired reversal learning, it did not affect the ability to learn about nonrewarded cues or the ability to modulate action selection based on the outcome value. In contrast, decreasing MD activity delayed the ability to adapt to changes in the contingency between actions and their outcomes. In addition, while Pavlovian learning was not affected by MD hypofunction, decreasing MD activity during Pavlovian learning impaired the ability of conditioned stimuli to modulate instrumental behavior. Mediodorsal thalamus hypofunction causes cognitive inflexibility reflected by an impaired ability to adapt actions when their consequences change. Furthermore, it alters the encoding of environmental stimuli so that they cannot be properly utilized to guide behavior. Modulating MD activity could be a potential therapeutic strategy for promoting adaptive behavior in human subjects with cognitive inflexibility. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

False-negative HIV tests using oral fluid tests in children taking antiretroviral therapy from Harare, Zimbabwe.

Science.gov (United States)

Olaru, Ioana D; McHugh, Grace; Dakshina, Suba; Majonga, Edith; Dauya, Ethel; Bandason, Tsitsi; Kranzer, Katharina; Mujuru, Hilda; Ferrand, Rashida A

2017-08-29

Rapid diagnostic tests (RDT) for HIV infection have high sensitivity and specificity, but in the setting of longstanding antiretroviral therapy (ART), can give false results that can lead to misinterpretation, confusion and inadequate management. The objective of this study was to evaluate the proportion of falsely negative results of a RDT performed on oral fluid in HIV-infected children on longstanding ART. One hundred and twenty-nine children with known HIV infection and receiving ART were recruited from the HIV Clinic at the Harare Central Hospital, Zimbabwe. HIV testing was performed on oral fluid and on finger-stick blood. Children included in the study had a median age of 12 years (IQR 10-14) and 67 (51.9%) were female. Median age at HIV diagnosis was 5 years (IQR 3-6) and the median time on ART was 6.3 years (IQR 4.3-8.1). The oral fluid test was negative in 11 (8.5%) patients and indeterminate in 2 (1.6%). Finger-stick blood test was negative in 1 patient. Patients with a negative oral fluid test had a higher CD4 cell count (967 vs. 723 cells/mm 3 , p  = 0.016) and a longer time on ART (8.5 vs. 6 years, p  = 0.016). This study found that a substantial proportion of false-negative HIV test results in children on longstanding ART when using an oral fluid test. This could lead to misinterpretation of HIV test results and in the false perception of cure or delayed diagnosis.

Peri-operative troponin monitoring using a prototype high-sensitivity cardiac troponin I (hs-cTnI) assay: comparisons with hs-cTnT and contemporary cTnI assays.

LENUS (Irish Health Repository)

Lee, Graham R

2013-09-18

Non-cardiac surgery is associated with major vascular complications and higher incidences of elevated plasma troponin (cTn) concentration. Goal-directed therapy (GDT) is a stroke volume (SV)-guided approach to intravenous (IV) fluid therapy that improves tissue perfusion, oxygenation and reduces post-operative complications. In patients undergoing major gastro-intestinal surgery, we compared high sensitive and contemporary troponin assays and correlated results with patient outcome.

Monetary reward magnitude effects on behavior and brain function during goal-directed behavior.

Science.gov (United States)

Rosell-Negre, P; Bustamante, J C; Fuentes-Claramonte, P; Costumero, V; Benabarre, S; Barrós-Loscertales, A

2017-08-01

Reward may modulate the cognitive processes required for goal achievement, while individual differences in personality may affect reward modulation. Our aim was to test how different monetary reward magnitudes modulate brain activation and performance during goal-directed behavior, and whether individual differences in reward sensitivity affect this modulation. For this purpose, we scanned 37 subjects with a parametric design in which we varied the magnitude of monetary rewards (€0, €0.01, €0.5, €1 or €1.5) in a blocked fashion while participants performed an interference counting-Stroop condition. The results showed that the brain activity of left dorsolateral prefrontal cortex (DLPFC) and the striatum were modulated by increasing and decreasing reward magnitudes, respectively. Behavioral performance improved as the magnitude of monetary reward increased while comparing the non reward (€0) condition to any other reward condition, or the lower €0.01 to any other reward condition, and this improvement was related with individual differences in reward sensitivity. In conclusion, the locus of influence of monetary incentives overlaps the activity of the regions commonly involved in cognitive control.

Non-Steroidal Anti-inflammatory Drugs As Host-Directed Therapy for Tuberculosis : A Systematic Review

NARCIS (Netherlands)

Kroesen, Vera M.; Gröschel, Matthias I.; Martinson, Neil; Zumla, Alimuddin; Maeurer, Markus; van der Werf, Tjip S.; Vilaplana, Cristina

2017-01-01

Lengthy, antimicrobial therapy targeting the pathogen is the mainstay of conventional tuberculosis treatment, complicated by emerging drug resistances. Host-directed therapies, including non-steroidal anti-inflammatory drugs (NSAIDs), in contrast, target host factors to mitigate disease severity. In

ALS Biomarkers for Therapy Development: State of the Field & Future Directions

Science.gov (United States)

Benatar, Michael; Boylan, Kevin; Jeromin, Andreas; Rutkove, Seward B.; Berry, James; Atassi, Nazem; Bruijn, Lucie

2015-01-01

Biomarkers have become the focus of intense research in the field of amyotrophic lateral sclerosis (ALS), with the hope that they might aid therapy development efforts. Notwithstanding the discovery of many candidate biomarkers, none have yet emerged as validated tools for drug development. In this review we present a nuanced view of biomarkers based on the perspective of the FDA; highlight the distinction between discovery and validation; describe existing and emerging resources; review leading biological fluid-based, electrophysiological and neuroimaging candidates relevant to therapy development efforts; discuss lessons learned from biomarker initiatives in related neurodegenerative diseases; and outline specific steps that we, as a field, might take in order to hasten the development and validation of biomarkers that will prove useful in enhancing efforts to develop effective treatments for ALS patients. Most important among these perhaps is the proposal to establish a federated ALS Biomarker Consortium (ABC) in which all interested and willing stakeholders may participate with equal opportunity to contribute to the broader mission of biomarker development and validation. PMID:26574709

3-D direct current resistivity anisotropic modelling by goal-oriented adaptive finite element methods

Science.gov (United States)

Ren, Zhengyong; Qiu, Lewen; Tang, Jingtian; Wu, Xiaoping; Xiao, Xiao; Zhou, Zilong

2018-01-01

Although accurate numerical solvers for 3-D direct current (DC) isotropic resistivity models are current available even for complicated models with topography, reliable numerical solvers for the anisotropic case are still an open question. This study aims to develop a novel and optimal numerical solver for accurately calculating the DC potentials for complicated models with arbitrary anisotropic conductivity structures in the Earth. First, a secondary potential boundary value problem is derived by considering the topography and the anisotropic conductivity. Then, two a posteriori error estimators with one using the gradient-recovery technique and one measuring the discontinuity of the normal component of current density are developed for the anisotropic cases. Combing the goal-oriented and non-goal-oriented mesh refinements and these two error estimators, four different solving strategies are developed for complicated DC anisotropic forward modelling problems. A synthetic anisotropic two-layer model with analytic solutions verified the accuracy of our algorithms. A half-space model with a buried anisotropic cube and a mountain-valley model are adopted to test the convergence rates of these four solving strategies. We found that the error estimator based on the discontinuity of current density shows better performance than the gradient-recovery based a posteriori error estimator for anisotropic models with conductivity contrasts. Both error estimators working together with goal-oriented concepts can offer optimal mesh density distributions and highly accurate solutions.

Approach to the critically ill camelid.

Science.gov (United States)

Bedenice, Daniela

2009-07-01

The estimation of fluid deficits in camelids is challenging. However, early recognition and treatment of shock and hypovolemia is instrumental to improve morbidity and mortality of critically ill camelids. Early goal-directed fluid therapy requires specific knowledge of clinical indicators of hypovolemia and assessment of resuscitation endpoints, but may significantly enhance the understanding, monitoring, and safety of intravenous fluid therapy in South American camelids (SAC). It is important to recognize that over-aggressive fluid resuscitation is just as detrimental as under resuscitation. Nonetheless, a protocol of conservative fluid management is often indicated in the treatment of camelids with pulmonary inflammation, to counteract edema formation. The early recognition of lung dysfunction is often based on advanced diagnostic techniques, including arterial blood gas analysis, diagnostic imaging, and noninvasive pulmonary function testing.

Distributed coordination of heterogeneous agents using a semantic overlay network and a goal-directed graphplan planner.

Directory of Open Access Journals (Sweden)

António Luís Lopes

Full Text Available In this paper, we describe a distributed coordination system that allows agents to seamlessly cooperate in problem solving by partially contributing to a problem solution and delegating the subproblems for which they do not have the required skills or knowledge to appropriate agents. The coordination mechanism relies on a dynamically built semantic overlay network that allows the agents to efficiently locate, even in very large unstructured networks, the necessary skills for a specific problem. Each agent performs partial contributions to the problem solution using a new distributed goal-directed version of the Graphplan algorithm. This new goal-directed version of the original Graphplan algorithm provides an efficient solution to the problem of "distraction", which most forward-chaining algorithms suffer from. We also discuss a set of heuristics to be used in the backward-search process of the planning algorithm in order to distribute this process amongst idle agents in an attempt to find a solution in less time. The evaluation results show that our approach is effective in building a scalable and efficient agent society capable of solving complex distributable problems.

Atomistic Modeling of the Fluid-Solid Interface in Simple Fluids

Science.gov (United States)

Hadjiconstantinou, Nicolas; Wang, Gerald

2017-11-01

Fluids can exhibit pronounced structuring effects near a solid boundary, typically manifested in a layered structure that has been extensively shown to directly affect transport across the interface. We present and discuss several results from molecular-mechanical modeling and molecular-dynamics (MD) simulations aimed at characterizing the structure of the first fluid layer directly adjacent to the solid. We identify a new dimensionless group - termed the Wall number - which characterizes the degree of fluid layering, by comparing the competing effects of wall-fluid interaction and thermal energy. We find that in the layering regime, several key features of the first layer layer - including its distance from the solid, its width, and its areal density - can be described using mean-field-energy arguments, as well as asymptotic analysis of the Nernst-Planck equation. For dense fluids, the areal density and the width of the first layer can be related to the bulk fluid density using a simple scaling relation. MD simulations show that these results are broadly applicable and robust to the presence of a second confining solid boundary, different choices of wall structure and thermalization, strengths of fluid-solid interaction, and wall geometries.

Understanding the Self-Directed Online Learning Preferences, Goals, Achievements, and Challenges of MIT OpenCourseWare Subscribers

Science.gov (United States)

Bonk, Curtis J.; Lee, Mimi Miyoung; Kou, Xiaojing; Xu, Shuya; Sheu, Feng-Ru

2015-01-01

This research targeted the learning preferences, goals and motivations, achievements, challenges, and possibilities for life change of self-directed online learners who subscribed to the monthly OpenCourseWare (OCW) e-newsletter from MIT. Data collection included a 25-item survey of 1,429 newsletter subscribers; 613 of whom also completed an…

The contribution of goal specificity to goal achievement in collaborative goal setting for the management of asthma.

Science.gov (United States)

Smith, Lorraine; Alles, Chehani; Lemay, Kate; Reddel, Helen; Saini, Bandana; Bosnic-Anticevich, Sinthia; Emmerton, Lynne; Stewart, Kay; Burton, Debbie; Krass, Ines; Armour, Carol

2013-01-01

Goal setting was investigated as part of an implementation trial of an asthma management service (PAMS) conducted in 96 Australian community pharmacies. Patients and pharmacists identified asthma-related issues of concern to the patient and collaboratively set goals to address these. Although goal setting is commonly integrated into disease state management interventions, the nature of goals, and their contribution to goal attainment and health outcomes are not well understood. To identify and describe: 1) goals set collaboratively between adult patients with asthma and their pharmacist, 2) goal specificity and goal achievement, and 3) describe the relationships between specificity, achievement, asthma control and asthma-related quality of life. Measures of goal specificity, and goal achievement were developed and applied to patient data records. Goals set were thematically analyzed into goal domains. Proportions of goals set, goals achieved and their specificity were calculated. Correlational and regression analyses were undertaken to determine the relationships between goal specificity, goal achievement, asthma control and asthma-related quality of life. Data were drawn from 498 patient records. Findings showed that patients set a wide range and number of asthma-related goals (N = 1787) and the majority (93%) were either achieved or being working toward by the end of the study. Goal achievement was positively associated with specific and moderately specific goals, but not non-specific goals. However, on closer inspection, an inconsistent pattern of relationships emerged as a function of goal domain. Findings also showed that goal setting was associated with end-of-study asthma control but not to asthma-related quality of life. Pharmacists can help patients to set achievable and specific asthma management goals, and these have the potential to directly impact health outcomes such as asthma control. Goal specificity appears to be an important feature in the

Processing and Integration of Contextual Information in Monkey Ventrolateral Prefrontal Neurons during Selection and Execution of Goal-Directed Manipulative Actions.

Science.gov (United States)

Bruni, Stefania; Giorgetti, Valentina; Bonini, Luca; Fogassi, Leonardo

2015-08-26

The prefrontal cortex (PFC) is deemed to underlie the complexity, flexibility, and goal-directedness of primates' behavior. Most neurophysiological studies performed so far investigated PFC functions with arm-reaching or oculomotor tasks, thus leaving unclear whether, and to which extent, PFC neurons also play a role in goal-directed manipulative actions, such as those commonly used by primates during most of their daily activities. Here we trained two macaques to perform or withhold grasp-to-eat and grasp-to-place actions, depending on the combination of two subsequently presented cues: an auditory go/no-go cue (high/low tone) and a visually presented target (food/object). By varying the order of presentation of the two cues, we could segment and independently evaluate the processing and integration of contextual information allowing the monkey to make a decision on whether or not to act, and what action to perform. We recorded 403 task-related neurons from the ventrolateral prefrontal cortex (VLPFC): unimodal sensory-driven (37%), motor-related (21%), unimodal sensory-and-motor (23%), and multisensory (19%) neurons. Target and go/no-go selectivity characterized most of the recorded neurons, particularly those endowed with motor-related discharge. Interestingly, multisensory neurons appeared to encode a behavioral decision independently from the sensory modality of the stimulus allowing the monkey to make it: some of them reflected the decision to act or refraining from acting (56%), whereas others (44%) encoded the decision to perform (or withhold) a specific action (e.g., grasp-to-eat). Our findings indicate that VLPFC neurons play a role in the processing of contextual information underlying motor decision during goal-directed manipulative actions. We demonstrated that macaque ventrolateral prefrontal cortex (VLPFC) neurons show remarkable selectivity for different aspects of the contextual information allowing the monkey to select and execute goal-directed

Understanding the heterogeneity in volume overload and fluid distribution in decompensated heart failure is key to optimal volume management: role for blood volume quantitation.

Science.gov (United States)

Miller, Wayne L; Mullan, Brian P

2014-06-01

This study sought to quantitate total blood volume (TBV) in patients hospitalized for decompensated chronic heart failure (DCHF) and to determine the extent of volume overload, and the magnitude and distribution of blood volume and body water changes following diuretic therapy. The accurate assessment and management of volume overload in patients with DCHF remains problematic. TBV was measured by a radiolabeled-albumin dilution technique with intravascular volume, pre-to-post-diuretic therapy, evaluated at hospital admission and at discharge. Change in body weight in relation to quantitated TBV was used to determine interstitial volume contribution to total fluid loss. Twenty-six patients were prospectively evaluated. Two patients had normal TBV at admission. Twenty-four patients were hypervolemic with TBV (7.4 ± 1.6 liters) increased by +39 ± 22% (range, +9.5% to +107%) above the expected normal volume. With diuresis, TBV decreased marginally (+30 ± 16%). Body weight declined by 6.9 ± 5.2 kg, and fluid intake/fluid output was a net negative 8.4 ± 5.2 liters. Interstitial compartment fluid loss was calculated at 6.2 ± 4.0 liters, accounting for 85 ± 15% of the total fluid reduction. TBV analysis demonstrated a wide range in the extent of intravascular overload. Dismissal measurements revealed marginally reduced intravascular volume post-diuretic therapy despite large reductions in body weight. Mobilization of interstitial fluid to the intravascular compartment with diuresis accounted for this disparity. Intravascular volume, however, remained increased at dismissal. The extent, composition, and distribution of volume overload are highly variable in DCHF, and this variability needs to be taken into account in the approach to individualized therapy. TBV quantitation, particularly serial measurements, can facilitate informed volume management with respect to a goal of treating to euvolemia. Copyright © 2014 American College of Cardiology Foundation. Published

Fluids with highly directional attractive forces. IV. Equilibrium polymerization

International Nuclear Information System (INIS)

Wertheim, M.S.

1986-01-01

The author investigates approximation methods for systems of molecules interacting by core repulsion and highly directional attraction due to several attraction sites. The force model chosen imitates a chemical bond by providing for bond saturation when binding occurs. The dense fluid is an equilibrium mixture of s-mers with mutual repulsion. The author uses a previously derived reformulation of statistical thermodynamics in which the particle species are monomeric units with a specified set of attraction sites bonded. Thermodynamic perturbation theory (TPT) and integral equations of two types are derived. The use of TPT is illustrated by explicit calculation for a molecular model with two attraction sites capable of forming chain and ring polymers. Successes and defects of TPT are discussed. The integral equations for pair correlations between particles of specified bonding include calculation of self-consistent densities of species. Methods of calculating thermodynamic properties from the solutions of integral equations are given

Counterfactual Processing of Economic Action-Outcome Alternatives in Obsessive-Compulsive Disorder: Further Evidence of Impaired Goal-Directed Behavior

Science.gov (United States)

Gillan, Claire M.; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A.; Sule, Akeem; Sahakian, Barbara J.; Cardinal, Rudolf N.; Robbins, Trevor W.

2014-01-01

Background Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. Methods We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. Results The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Conclusions Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. PMID:23452663

Psychological Therapies for Auditory Hallucinations (Voices): Current Status and Key Directions for Future Research

Science.gov (United States)

Thomas, Neil; Hayward, Mark; Peters, Emmanuelle; van der Gaag, Mark; Bentall, Richard P.; Jenner, Jack; Strauss, Clara; Sommer, Iris E.; Johns, Louise C.; Varese, Filippo; García-Montes, José Manuel; Waters, Flavie; Dodgson, Guy; McCarthy-Jones, Simon

2014-01-01

This report from the International Consortium on Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and coping-focused interventions, through formulation-driven interventions using methods from cognitive therapy, to a number of contemporary developments. Recent developments include the application of acceptance- and mindfulness-based approaches, and consolidation of methods for working with connections between voices and views of self, others, relationships and personal history. In this article, we discuss the development of therapies for voices and review the empirical findings. This review shows that psychological therapies are broadly effective for people with positive symptoms, but that more research is required to understand the specific application of therapies to voices. Six key research directions are identified: (1) moving beyond the focus on overall efficacy to understand specific therapeutic processes targeting voices, (2) better targeting psychological processes associated with voices such as trauma, cognitive mechanisms, and personal recovery, (3) more focused measurement of the intended outcomes of therapy, (4) understanding individual differences among voice hearers, (5) extending beyond a focus on voices and schizophrenia into other populations and sensory modalities, and (6) shaping interventions for service implementation. PMID:24936081

A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock

Science.gov (United States)

O’Hara, Caitlin B; Canter, Ruth R; Mouncey, Paul R; Carter, Anjali; Jones, Nicola; Nadel, Simon; Peters, Mark J; Lyttle, Mark D; Harrison, David A; Rowan, Kathryn M; Inwald, David; Woolfall, Kerry

2018-01-01

Objective The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. Design Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. Participants Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child’s hospital admission (range: 1–41). Results All parents said they would have provided consent for the use of their child’s data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child’s death, but supported a personalised postal ‘opt-out’ approach to consent. Conclusions Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents’ views informed the development of the pilot trial protocol and site staff training. Trial registration number ISRCTN15244462—results. PMID:28847877

Differentiating neural systems mediating the acquisition versus expression of goal-directed and habitual behavioral control

Science.gov (United States)

Liljeholm, Mimi; Dunne, Simon; O'Doherty, John P.

2015-01-01

Considerable behavioral data indicates that operant actions can become habitual, as evidenced by insensitivity to changes in the action-outcome contingency and in subjective outcome values. Notably, although several studies have investigated the neural substrates of habits, none has clearly differentiated the areas of the human brain that support habit formation from those that implement habitual control. We scanned participants with fMRI as they learned and performed an operant task in which the conditional structure of the environment encouraged either goal-directed encoding of the consequences of actions, or a habit-like mapping of actions to antecedent cues. Participants were also scanned during a subsequent assessment of insensitivity to outcome devaluation. We identified dissociable roles of the cerebellum and ventral striatum, across learning and test performance, in behavioral insensitivity to outcome devaluation. We also show that the inferior parietal lobule – an area previously implicated in several aspects of goal-directed action selection, including the attribution of intent and awareness of agency – predicts sensitivity to outcome devaluation. Finally, we reveal a potential functional homology between the human subgenual cortex and rodent infralimbic cortex in the implementation of habitual control. In summary, our findings suggest a broad systems division, at the cortical and subcortical levels, between brain areas mediating the encoding and expression of action-outcome and stimulus-response associations. PMID:25892332

The Goal Specificity Effect on Strategy Use and Instructional Efficiency during Computer-Based Scientific Discovery Learning

Science.gov (United States)

Kunsting, Josef; Wirth, Joachim; Paas, Fred

2011-01-01

Using a computer-based scientific discovery learning environment on buoyancy in fluids we investigated the "effects of goal specificity" (nonspecific goals vs. specific goals) for two goal types (problem solving goals vs. learning goals) on "strategy use" and "instructional efficiency". Our empirical findings close an important research gap,…

Fluid therapy in the emergency unit

African Journals Online (AJOL)

Senior Specialist Paediatrician, Department of Ambulatory and Emergency Paediatrics, Red Cross War Memorial Children's Hospital, Cape. Town. Dr Diedericks is currently head of the Paediatric Emergency Service at Red Cross Hospital. He has previous experience ... intravenous fluid administration. Choosing the correct ...

Direct numerical simulation of complex multi-fluid flows using a combined front tracking and immersed boundary method

NARCIS (Netherlands)

Deen, N.G.; van Sint Annaland, M.; Kuipers, J.A.M.

2009-01-01

In this paper a simulation model is presented for the Direct Numerical Simulation (DNS) of complex multi-fluid flows in which simultaneously (moving) deformable (drops or bubbles) and non-deformable (moving) elements (particles) are present, possibly with the additional presence of free surfaces.

Immunotherapy With Magentorheologic Fluids

Science.gov (United States)

2011-08-01

anti-tumor effects are weakened by removal of the tumor antigen pool (i.e. surgery) or use of cytoreductive and immunosuppressive therapies (i.e...particles were injected as magneto -rheological fluid (MRF) into an orthotopic primary breast cancer and followed by application of a magnetic field to...SUBJECT TERMS MRF: Magneto -rehological fluid iron particles, IT: immunotherapy, necrotic death, DCs: dendritic cells, cytokines, chemokines

LDL-cholesterol goal attainment under persistent lipid-lowering therapy in northeast China: Subgroup analysis of the dyslipidemia international study of China (DYSIS-China).

Science.gov (United States)

Zheng, Wen; Zhang, Yu-Jiao; Bu, Xiang-Ting; Guo, Xin-Zhu; Hu, Da-Yi; Li, Zhan-Quan; Sun, Jian

2017-11-01

Lipid-lowering therapy with statins reduces the risk of cardiovascular events, but the efficacy of persistent treatment in a real-world setting may vary from regions. Routine lipid-lowering therapy in the region with a high prevalence of cardiovascular disease may lead to more failures of goal attainment. We therefore performed a study to observe different lipid-lowering strategies in northeast (NE) China with respect to low-density lipoprotein-cholesterol (LDL-C) reduction and goal attainments.A cross-sectional study (DYSIS-China) was conducted in 2012, involving 25,317 patients from 122 centers across China who were diagnosed with hyperlipidemia and treated with lipid-lowering therapy for at least 3 months. Of these patients, 4559 (18.0%) were assigned to the NE group according to their residential zones.Patients in the NE group tended to be younger, female, overweight, and had more comorbidities and higher blood lipid levels than those in the non-NE group (P 24 kg/m, drinking alcohol, smoking, and being residence in NE China as independent predictors of LDL-C attainment.Despite having received persistent lipid-lowering treatments, the current situation of dyslipidemia patients in NE China is unsatisfactory. The main treatment gap might be related to the choice of statin and effective combination therapy and the control of comorbidities and obesity, especially for high-risk patients.

Directly observed therapy for treating tuberculosis

Science.gov (United States)

Karumbi, Jamlick; Garner, Paul

2015-01-01

Background Tuberculosis (TB) requires at least six months of treatment. If treatment is incomplete, patients may not be cured and drug resistance may develop. Directly Observed Therapy (DOT) is a specific strategy, endorsed by the World Health Organization, to improve adherence by requiring health workers, community volunteers or family members to observe and record patients taking each dose. Objectives To evaluate DOT compared to self-administered therapy in people on treatment for active TB or on prophylaxis to prevent active disease. We also compared the effects of different forms of DOT. Search methods We searched the following databases up to 13 January 2015: the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; EMBASE; LILACS and mRCT. We also checked article reference lists and contacted relevant researchers and organizations. Selection criteria Randomized controlled trials (RCTs) and quasi-RCTs comparing DOT with routine self-administration of treatment or prophylaxis at home. Data collection and analysis Two review authors independently assessed risk of bias of each included trial and extracted data. We compared interventions using risk ratios (RR) with 95% confidence intervals (CI). We used a random-effects model if meta-analysis was appropriate but heterogeneity present (I2 statistic = 50%). We assessed the quality of the evidence using the GRADE approach. Main results Eleven trials including 5662 participants met the inclusion criteria. DOT was performed by a range of people (nurses, community health workers, family members or former TB patients) in a variety of settings (clinic, the patient's home or the home of a community volunteer). DOT versus self-administered Six trials from South Africa, Thailand, Taiwan, Pakistan and Australia compared DOT with self-administered therapy for treatment. Trials included DOT at home by family members

Teachers' goal orientations: Effects on classroom goal structures and emotions.

Science.gov (United States)

Wang, Hui; Hall, Nathan C; Goetz, Thomas; Frenzel, Anne C

2017-03-01

Prior research has shown teachers' goal orientations to influence classroom goal structures (Retelsdorf et al., 2010, Learning and Instruction, 20, 30) and to also impact their emotions (Schutz et al., 2007, Emotion in education, Academic Press, Amsterdam, the Netherlands). However, empirical research evaluating possible causal ordering and mediation effects involving these variables in teachers is presently lacking. The present 6-month longitudinal study investigated the relations between varied motivational, behavioural, and emotional variables in practising teachers. More specifically, this study examined the reciprocal, longitudinal relations between teachers' achievement goals, classroom goal structures, and teaching-related emotions, as well as cumulative mediational models in which observed causal relations were evaluated. Participants were 495 practising teachers from Canada (86% female, M = 42 years). Teachers completed a web-based questionnaire at two time points assessing their instructional goals, perceived classroom goal structures, achievement emotions, and demographic items. Results from cross-lagged analyses and structural equation modelling showed teachers' achievement goals to predict their perceived classroom goal structures that, in turn, predicted their teaching-related emotions. The present results inform both Butler's (2012, Journal of Educational Psychology, 104, 726) theory on teachers' achievement goals and Frenzel's (2014, International handbook of emotions in education, Routledge, New York, NY) model of teachers' emotions in showing teachers' instructional goals to both directly predict their teaching-related emotions, as well as indirectly through the mediating effects of classroom goal structures. © 2016 The British Psychological Society.

Goal directed worry rules are associated with distinct patterns of amygdala functional connectivity and vagal modulation during perseverative cognition

OpenAIRE

Meeten, Frances; Davey, Graham C L; Makovac, Elena; Watson, David R.; Garfinkel, Sarah N.; Critchley, Hugo D.; Ottaviani, Cristina

2016-01-01

Excessive and uncontrollable worry is a defining feature of Generalized Anxiety Disorder (GAD). An important endeavor in the treatment of pathological worry is to understand why some people are unable to stop worrying once they have started. Worry perseveration is associated with a tendency to deploy goal-directed worry rules (known as “as many as can” worry rules; AMA). These require attention to the goal of the worry task and continuation of worry until the aims of the “worry bout” are achi...

Synergistic effect of combined transcranial direct current stimulation/constraint-induced movement therapy in children and young adults with hemiparesis: study protocol.

Science.gov (United States)

Gillick, Bernadette; Menk, Jeremiah; Mueller, Bryon; Meekins, Gregg; Krach, Linda E; Feyma, Timothy; Rudser, Kyle

2015-11-12

Perinatal stroke occurs in more than 1 in 2,500 live births and resultant congenital hemiparesis necessitates investigation into interventions which may improve long-term function and decreased burden of care beyond current therapies ( http://www.cdc.gov/ncbddd/cp/data.html ). Constraint-Induced Movement Therapy (CIMT) is recognized as an effective hemiparesis rehabilitation intervention. Transcranial direct current stimulation as an adjunct treatment to CIMT may potentiate neuroplastic responses and improve motor function. The methodology of a clinical trial in children designed as a placebo-controlled, serial -session, non-invasive brain stimulation trial incorporating CIMT is described here. The primary hypotheses are 1) that no serious adverse events will occur in children receiving non-invasive brain stimulation and 2) that children in the stimulation intervention group will show significant improvements in hand motor function compared to children in the placebo stimulation control group. A randomized, controlled, double-blinded clinical trial. Twenty children and/or young adults (ages 8-21) with congenital hemiparesis, will be enrolled. The intervention group will receive ten 2-hour sessions of transcranial direct current stimulation combined with constraint-induced movement therapy and the control group will receive sham stimulation with CIMT. The primary outcome measure is safety assessment of transcranial direct current stimulation by physician evaluation, vital sign monitoring and symptom reports. Additionally, hand function will be evaluated using the Assisting Hand Assessment, grip strength and assessment of goals using the Canadian Occupational Performance Measure. Neuroimaging will confirm diagnoses, corticospinal tract integrity and cortical activation. Motor cortical excitability will also be examined using transcranial magnetic stimulation techniques. Combining non-invasive brain stimulation and CIMT interventions has the potential to improve motor

Amniotic fluid stem cells: a promising therapeutic resource for cell-based regenerative therapy.

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Antonucci, Ivana; Pantalone, Andrea; Tete, Stefano; Salini, Vincenzo; Borlongan, Cesar V; Hess, David; Stuppia, Liborio

2012-01-01

Stem cells have been proposed as a powerful tool in the treatment of several human diseases, both for their ability to represent a source of new cells to replace those lost due to tissue injuries or degenerative diseases, and for the ability of produce trophic molecules able to minimize damage and promote recovery in the injured tissue. Different cell types, such as embryonic, fetal or adult stem cells, human fetal tissues and genetically engineered cell lines, have been tested for their ability to replace damaged cells and to restore the tissue function after transplantation. Amniotic fluid -derived Stem cells (AFS) are considered a novel resource for cell transplantation therapy, due to their high renewal capacity, the "in vitro" expression of embryonic cell lineage markers, and the ability to differentiate in tissues derived from all the three embryonic layers. Moreover, AFS do not produce teratomas when transplanted into animals and are characterized by a low antigenicity, which could represent an advantage for cell transplantation or cell replacement therapy. The present review focuses on the biological features of AFS, and on their potential use in the treatment of pathological conditions such as ischemic brain injury and bone damages.

Dosimetric model for antibody targeted radionuclide therapy of tumor cells in cerebrospinal fluid

International Nuclear Information System (INIS)

Millar, W.T.; Barrett, A.

1990-01-01

Although encouraging results have been obtained using systemic radioimmunotherapy in the treatment of cancer, it is likely that regional applications may prove more effective. One such strategy is the treatment of central nervous system leukemia in children by intrathecal instillation of targeting or nontargeting beta particle emitting radionuclide carriers. The beta particle dosimetry of the spine is assessed, assuming that the spinal cord and the cerebrospinal fluid compartment can be adequately represented by a cylindrical annulus. The radionuclides investigated were 90 Y, 131 I, 67 Cu, and 199 Au. It is shown that the radiation dose to the cord can be significantly reduced using short range beta particle emitters and that there is little advantage in using targeting carriers with these radionuclides. 199 Au and 67 Cu also have the advantage of having a suitable gamma emission for imaging, permitting pretherapy imaging and dosimetric calculations to be undertaken prior to therapy. If these methods prove successful, it may be possible to replace the external beam component used in the treatment of central nervous system leukemia in children by intrathecal radionuclide therapy, thus reducing or avoiding side effects such as growth and intellectual impairment

Effect of Periodontal Therapy on Crevicular Fluid Interleukin-6 and Interleukin-8 Levels in Chronic Periodontitis

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Paschalina Goutoudi

2012-01-01

Full Text Available Purpose. The aim of this study was to analyse the levels of interleukin-6 (IL-6 and interleukin-8 (IL-8 in gingival crevicular fluid (GCF of patients with chronic periodontitis prior to and following surgical and/or nonsurgical periodontal therapy for a period of 32 weeks. Methods. GCF samples were obtained from 24 nondiseased and 72 diseased sites of 12 periodontal patients prior to as well as at 6, 16, and 32 weeks following non-surgical and surgical periodontal therapy. IL-6 and IL-8 levels were determined by enzyme-linked immunosorbent assay (ELISA. Results. Periodontal treatment improved all clinical parameters. Both treatment modalities resulted in similar IL-6 as well as IL-8 levels. Mean IL-6 and IL-8 concentrations were significantly higher in non-diseased compared to diseased sites and increased significantly following treatment in diseased sites. Mean total amounts of IL-6 and IL-8 (TAIL-6, TAIL-8 did not differ significantly between diseased and nondiseased sites, while following therapy TAIL-8 levels decreased significantly. Conclusions. The data suggest that periodontal therapy reduced the levels of IL-8 in GCF. However, a strong relationship between IL-6, IL-8 amounts in GCF and periodontal destruction and inflammation was not found.

Dynamics of multiple-goal pursuit.

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Louro, Maria J; Pieters, Rik; Zeelenberg, Marcel

2007-08-01

The authors propose and test a model of multiple-goal pursuit that specifies how individuals allocate effort among multiple goals over time. The model predicts that whether individuals decide to step up effort, coast, abandon the current goal, or switch to pursue another goal is determined jointly by the emotions that flow from prior goal progress and the proximity to future goal attainment, and proximally determined by changes in expectancies about goal attainment. Results from a longitudinal diary study and 2 experiments show that positive and negative goal-related emotions can have diametrically opposing effects on goal-directed behavior, depending on the individual's proximity to goal attainment. The findings resolve contrasting predictions about the influence of positive and negative emotions in volitional behavior, critically amend the goal gradient hypothesis, and provide new insights into the dynamics and determinants of multiple-goal pursuit.

The Effect of Inconsistency Appeals on the Influence of Direct-to-Consumer Prescription Drug Advertisements: An Application of Goal Disruption Theory.

Science.gov (United States)

Rosenberg, Benjamin D; Siegel, Jason T

2016-01-01

Scholars across multiple domains have identified the presence of inconsistency-arousing information in direct-to-consumer prescription drug advertisements and have suggested that these appeals, which highlight differences between people's actual and desired lives, may create psychological disequilibrium. However, experimental assessment of the distinct influence of inconsistency-arousing information in this domain is rare. Guided by goal disruption theory-a framework that outlines people's reactions to goal expectation violations-we created direct-to-consumer advertisements designed to make people's life inconsistencies salient. The influence of these ads on people's perceptions of, and intentions to use, prescription drugs was then assessed. Results from a structural equation modeling analysis supported the proposed model, indicating that compared to a control ad, an ad containing a goal expectation violation manipulation resulted in higher levels of psychological disequilibrium; in turn, psychological disequilibrium led to positive evaluations of the ad and the drug, positive outcome expectations of the drug, increased purposive harm endurance, and increased usage intentions. The current results suggest a psychological pathway that begins with a negative goal expectation violation and ends with increased usage intentions and a greater willingness to endure harm to make use possible.

Analyse der Auswirkungen zweier Infusionsregime auf den Säure-Basen-Haushalt mit Hilfe des Stewart-Modells im Rahmen einer intraoperativen zielgerichteten Hämodynamiktherapie

OpenAIRE

Hoffmann, Benedikt

2018-01-01

Objective: Intraoperative fluid and volume therapy is an essential component of anaesthesiologic patient care with the aim to maintain normovolaemia with minimal impact on acid-base balance. So far, there is little data of the effects of guided fluid regimens on the acid-base balance in the perioperative context. Therefore, the aim of this study was to investigate the effects of two different infusion regimens guided by a goal-directed intraoperative hemodynamic algorithm on th...

Counterfactual processing of economic action-outcome alternatives in obsessive-compulsive disorder: further evidence of impaired goal-directed behavior.

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Gillan, Claire M; Morein-Zamir, Sharon; Kaser, Muzaffer; Fineberg, Naomi A; Sule, Akeem; Sahakian, Barbara J; Cardinal, Rudolf N; Robbins, Trevor W

2014-04-15

Obsessive-compulsive disorder (OCD) is a disorder of automatic, uncontrollable behaviors and obsessive rumination. There is evidence that OCD patients have difficulties performing goal-directed actions, instead exhibiting repetitive stimulus-response habit behaviors. This might result from the excessive formation of stimulus-response habit associations or from an impairment in the ability to use outcome value to guide behavior. We investigated the latter by examining counterfactual decision making, which is the ability to use comparisons of prospective action-outcome scenarios to guide economic choice. We tested decision making (forward counterfactual) and affective responses (backward counterfactual) in 20 OCD patients and 20 matched healthy control subjects using an economic choice paradigm that previously revealed attenuation of both the experience and avoidance of counterfactual emotion in schizophrenia patients and patients with orbitofrontal cortex lesions. The use of counterfactual comparison to guide decision making was diminished in OCD patients, who relied primarily on expected value. Unlike the apathetic affective responses previously shown to accompany this decision style, OCD patients reported increased emotional responsivity to the outcomes of their choices and to the counterfactual comparisons that typify regret and relief. Obsessive-compulsive disorder patients exhibit a pattern of decision making consistent with a disruption in goal-directed forward modeling, basing decisions instead on the temporally present (and more rational) calculation of expected value. In contrast to this style of decision making, emotional responses in OCD were more extreme and reactive than control subjects. These results are in line with an account of disrupted goal-directed cognitive control in OCD. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Of goals and habits: Age-related and individual differences in goal-directed decision-making

Directory of Open Access Journals (Sweden)

Ben eEppinger

2013-12-01

Full Text Available In this study we investigated age-related and individual differences in habitual (model-free and goal-directed (model-based decision-making. Specifically, we were interested in three questions. First, does age affect the balance between model-based and model-free decision mechanisms? Second, are these age-related changes due to age differences in working memory (WM capacity? Third, can model-based behavior be affected by manipulating the distinctiveness of the reward value of choice options? To answer these questions we used a two-stage Markov decision task in in combination with computational modeling to dissociate model-based and model-free decision mechanisms. To affect model-based behavior in this task we manipulated the distinctiveness of reward probabilities of choice options. The results show age-related deficits in model-based decision-making, which are particularly pronounced if unexpected reward indicates the need for a shift in decision strategy. In this situation younger adults explore the task structure, whereas older adults show perseverative behavior. Consistent with previous findings, these results indicate that older adults have deficits in the representation and updating of expected reward value. We also observed substantial individual differences in model-based behavior. In younger adults high WM capacity is associated with greater model-based behavior and this effect is further elevated when reward probabilities are more distinct. However, in older adults we found no effect of WM capacity. Moreover, age differences in model-based behavior remained statistically significant, even after controlling for WM capacity. Thus, factors other than decline in WM, such as deficits in the in the integration of expected reward value into strategic decisions may contribute to the observed impairments in model-based behavior in older adults.

Neuromodulatory adaptive combination of correlation-based learning in cerebellum and reward-based learning in basal ganglia for goal-directed behavior control.

Science.gov (United States)

Dasgupta, Sakyasingha; Wörgötter, Florentin; Manoonpong, Poramate

2014-01-01

Goal-directed decision making in biological systems is broadly based on associations between conditional and unconditional stimuli. This can be further classified as classical conditioning (correlation-based learning) and operant conditioning (reward-based learning). A number of computational and experimental studies have well established the role of the basal ganglia in reward-based learning, where as the cerebellum plays an important role in developing specific conditioned responses. Although viewed as distinct learning systems, recent animal experiments point toward their complementary role in behavioral learning, and also show the existence of substantial two-way communication between these two brain structures. Based on this notion of co-operative learning, in this paper we hypothesize that the basal ganglia and cerebellar learning systems work in parallel and interact with each other. We envision that such an interaction is influenced by reward modulated heterosynaptic plasticity (RMHP) rule at the thalamus, guiding the overall goal directed behavior. Using a recurrent neural network actor-critic model of the basal ganglia and a feed-forward correlation-based learning model of the cerebellum, we demonstrate that the RMHP rule can effectively balance the outcomes of the two learning systems. This is tested using simulated environments of increasing complexity with a four-wheeled robot in a foraging task in both static and dynamic configurations. Although modeled with a simplified level of biological abstraction, we clearly demonstrate that such a RMHP induced combinatorial learning mechanism, leads to stabler and faster learning of goal-directed behaviors, in comparison to the individual systems. Thus, in this paper we provide a computational model for adaptive combination of the basal ganglia and cerebellum learning systems by way of neuromodulated plasticity for goal-directed decision making in biological and bio-mimetic organisms.

A qualitative feasibility study to inform a randomised controlled trial of fluid bolus therapy in septic shock.

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O'Hara, Caitlin B; Canter, Ruth R; Mouncey, Paul R; Carter, Anjali; Jones, Nicola; Nadel, Simon; Peters, Mark J; Lyttle, Mark D; Harrison, David A; Rowan, Kathryn M; Inwald, David; Woolfall, Kerry

2018-01-01

The Fluids in Shock (FiSh) Trial proposes to evaluate whether restrictive fluid bolus therapy (10 mL/kg) is more beneficial than current recommended practice (20 mL/kg) in the resuscitation of children with septic shock in the UK. This qualitative feasibility study aimed to explore acceptability of the FiSh Trial, including research without prior consent (RWPC), potential barriers to recruitment and participant information for a pilot trial. Qualitative interview study involving parents of children who had presented to a UK emergency department or been admitted to a paediatric intensive care unit with severe infection in the previous 3 years. Twenty-one parents (seven bereaved) were interviewed 16 (median) months since their child's hospital admission (range: 1-41). All parents said they would have provided consent for the use of their child's data in the FiSh Trial. The majority were unfamiliar with RWPC, yet supported its use. Parents were initially concerned about the change from currently recommended treatment, yet were reassured by explanations of the current evidence base, fluid bolus therapy and monitoring procedures. Parents made recommendations about the timing of the research discussion and content of participant information. Bereaved parents stated that recruiters should not discuss research immediately after a child's death, but supported a personalised postal 'opt-out' approach to consent. Findings show that parents whose child has experienced severe infection supported the proposed FiSh Trial, including the use of RWPC. Parents' views informed the development of the pilot trial protocol and site staff training. ISRCTN15244462-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

From Cholera to Burns: A Role for Oral Rehydration Therapy

Science.gov (United States)

Green, W.B.; Asuku, M.E.; Feldman, M.; Makam, R.; Noppenberger, D.; Price, L.A.; Prosciak, M.; van Loon, I.N.

2011-01-01

According to the practice guidelines of the American Burn Association on burn shock resuscitation, intravenous (IV) fluid therapy is the standard of care for the replacement of fluid and electrolyte losses in burn injury of ≥20% of the total body surface area. However, in mass burn casualties, IV fluid resuscitation may be delayed or unavailable. Oral rehydration therapy (ORT), which has been shown to be highly effective in the treatment of dehydration in epidemics of cholera, could be an alternate way to replace fluid losses in burns. A prospective case series of three patients was carried out as an initial step to establish whether oral Ceralyte®90 could replace fluid losses requiring IV fluid therapy in thermal injury. The requirement of the continuing IV fluid therapy was reduced by an average of 58% in the first 24 hours after the injury (range 37-78%). ORT may be a feasible alternative to IV fluid therapy in the resuscitation of burns. It could also potentially save many lives in mass casualty situations or in resource-poor settings where IV fluid therapy is not immediately available. Further studies are needed to assess the efficacy of this treatment and to determine whether the present formulations of ORT for cholera need modification. PMID:22283039

Effects of Botulinum Toxin-A and Goal-Directed Physiotherapy in Children with Cerebral Palsy GMFCS Levels I & II.

Science.gov (United States)

Löwing, Kristina; Thews, Karin; Haglund-Åkerlind, Yvonne; Gutierrez-Farewik, Elena M

2017-08-01

To evaluate short and long-term effects of botulinum toxin-A combined with goal-directed physiotherapy in children with cerebral palsy (CP). A consecutive selection of 40 children, ages 4-12 years, diagnosed with unilateral or bilateral CP, and classified in GMFCS levels I-II. During the 24 months, 9 children received one BoNT-A injection, 10 children two injections, 11 children three injections, and 10 children received four injections. 3D gait analysis, goal-attainment scaling, and body function assessments were performed before and at 3, 12, and 24 months after initial injections. A significant but clinically small long-term improvement in gait was observed. Plantarflexor spasticity was reduced after three months and remained stable, while passive ankle dorsiflexion increased after 3 months but decreased slightly after 12 months. Goal-attainment gradually increased, reached the highest levels at 12 months, and levels were maintained at 24 months. The treatments' positive effect on spasticity reduction was identified, but did not relate to improvement in gait or goal-attainment. No long-term positive change in passive ankle dorsiflexion was observed. Goal attainment was achieved in all except four children. The clinical significance of the improved gait is unclear. Further studies are recommended to identify predictors for positive treatment outcome.

Seismic properties of fluid bearing formations in magmatic geothermal systems: can we directly detect geothermal activity with seismic methods?

Science.gov (United States)

Grab, Melchior; Scott, Samuel; Quintal, Beatriz; Caspari, Eva; Maurer, Hansruedi; Greenhalgh, Stewart

2016-04-01

Seismic methods are amongst the most common techniques to explore the earth's subsurface. Seismic properties such as velocities, impedance contrasts and attenuation enable the characterization of the rocks in a geothermal system. The most important goal of geothermal exploration, however, is to describe the enthalpy state of the pore fluids, which act as the main transport medium for the geothermal heat, and to detect permeable structures such as fracture networks, which control the movement of these pore fluids in the subsurface. Since the quantities measured with seismic methods are only indirectly related with the fluid state and the rock permeability, the interpretation of seismic datasets is difficult and usually delivers ambiguous results. To help overcome this problem, we use a numerical modeling tool that quantifies the seismic properties of fractured rock formations that are typically found in magmatic geothermal systems. We incorporate the physics of the pore fluids, ranging from the liquid to the boiling and ultimately vapor state. Furthermore, we consider the hydromechanics of permeable structures at different scales from small cooling joints to large caldera faults as are known to be present in volcanic systems. Our modeling techniques simulate oscillatory compressibility and shear tests and yield the P- and S-wave velocities and attenuation factors of fluid saturated fractured rock volumes. To apply this modeling technique to realistic scenarios, numerous input parameters need to be indentified. The properties of the rock matrix and individual fractures were derived from extensive literature research including a large number of laboratory-based studies. The geometries of fracture networks were provided by structural geologists from their published studies of outcrops. Finally, the physical properties of the pore fluid, ranging from those at ambient pressures and temperatures up to the supercritical conditions, were taken from the fluid physics

A Curriculum and Software Design Scaffolding Goal Directed Teaching in Classrooms

DEFF Research Database (Denmark)

Misfeldt, Morten; Bundsgaard, Jeppe; Slot, Marie Falkesgaard

, the tool itself, and selected findings from qualitative and quantitative studies in the project. 2. International trends in goal oriented and data driven teaching The Danish curriculum reform builds on recent trends in school development and curriculum research suggesting the importance of a competence...... development and curriculum research suggesting the importance of a competence framework, learning goals and aggregation of classroom data to efficient teaching (Earl & Fullan 2003). Learning goals are supposed to support the student’s pace and sense of progression, inform classroom decisions, structure...... student has knowledge of text structure”). The curriculum can be presented in a number of graphical modes, e.g. in a matrix or in a hypertext structure. The curriculum reform was implemented in order to promote a goal oriented teaching and learning practice based heavily on research around data driven...

A nudge in a healthier direction: How environmental cues help restrained eaters pursue their weight-control goal.

Science.gov (United States)

Stämpfli, Aline E; Stöckli, Sabrina; Brunner, Thomas A

2017-03-01

Losing weight is a goal for many people, but it is hard to pursue. However, dieting cues in the environment hold promise for improving individuals' eating behavior. For example, exposure to thin, human-like sculptures by the artist Alberto Giacometti has been found to promote healthy snack choices at a vending machine. Whether health- or weight-related processes drive such effects has not yet been determined. However, a detailed understanding of the content-related drivers of environmental cues' effects provides the first indications regarding a cue's possible use. Therefore, two laboratory studies were conducted. They examined the Giacometti sculptures' effects on unhealthy and healthy food intake (Study 1) and on the completion of weight- and health-related fragmented words (Study 2). Study 1 indicated that the sculptures are weight-related by showing that they reduced food intake independent of food healthiness. Furthermore, the "Giacometti effect" was moderated by restrained eating. Restrained eaters, who are known for their weight-control goal, ate less after having been exposed to the thin sculptures. The results of Study 2 pointed in the same direction. Restrained eaters completed more weight-related words after being exposed to the sculptures. Overall, these studies suggest that the thin sculptures are primarily weight-related cues and particularly helpful for restrained eaters. Environmental weight-control cues such as the Giacometti sculptures could act as a counterforce to our obesogenic environment and help restrained eaters pursue their weight-control goal. In this way, they could nudge food decisions in a healthier direction. Copyright © 2016 Elsevier Ltd. All rights reserved.

Euvolemia in hemodialysis patients: a potentially dangerous goal?

Science.gov (United States)

Huang, Shih-Han S; Filler, Guido; Lindsay, Robert; McIntyre, Chris W

2015-01-01

Dialysis patients have high mortality rate and the leading cause of death is cardiovascular disease. Uremic cardiomyopathy differs from that due to conventional atherosclerosis, where cardiovascular changes result in ineffective circulation and lead to tissue ischemia. Modern dialysis has significant limitations with fluid management probably the most challenging. Current evidence suggests that both volume overload and aggressive fluid removal can induce circulatory stress and multi-organ injury. Furthermore, we do not have accurate volume assessment tools. As a result, targeting euvolemia might result in more harm than benefit with conventional hemodialysis therapy. Therefore, it might be time to consider a degree of permissive over-hydration until we have better tools to both determine ideal weight and improve current renal replacement therapy so that the process of achieving it is not so fraught with the current dangers. © 2014 Wiley Periodicals, Inc.

Distinct roles of theta and alpha oscillations in the involuntary capture of goal-directed attention.

Science.gov (United States)

Harris, Anthony M; Dux, Paul E; Jones, Caelyn N; Mattingley, Jason B

2017-05-15

Mechanisms of attention assign priority to sensory inputs on the basis of current task goals. Previous studies have shown that lateralized neural oscillations within the alpha (8-14Hz) range are associated with the voluntary allocation of attention to the contralateral visual field. It is currently unknown, however, whether similar oscillatory signatures instantiate the involuntary capture of spatial attention by goal-relevant stimulus properties. Here we investigated the roles of theta (4-8Hz), alpha, and beta (14-30Hz) oscillations in human goal-directed visual attention. Across two experiments, we had participants respond to a brief target of a particular color among heterogeneously colored distractors. Prior to target onset, we cued one location with a lateralized, non-predictive cue that was either target- or non-target-colored. During the behavioral task, we recorded brain activity using electroencephalography (EEG), with the aim of analyzing cue-elicited oscillatory activity. We found that theta oscillations lateralized in response to all cues, and this lateralization was stronger if the cue matched the target color. Alpha oscillations lateralized relatively later, and only in response to target-colored cues, consistent with the capture of spatial attention. Our findings suggest that stimulus induced changes in theta and alpha amplitude reflect task-based modulation of signals by feature-based and spatial attention, respectively. Copyright © 2017 Elsevier Inc. All rights reserved.

Dissociating Goal-Directed and Stimulus-Driven Determinants in Attentional Capture

Directory of Open Access Journals (Sweden)

Louis K. H. Chan

2011-05-01

Full Text Available Although attentional capture is now a commonplace finding, the exact roles played by goal-directed and stimulus-driven determents remain elusive. An unsettled issue is on the relative contribution of attentional set and visual saliency. In the present study, we investigated this issue by mixing color and orientation search trials, so that distractors of either feature dimension fell into the current attentional set. In our test, color features were more salient. As a result, in orientation search, whereas a color distractor produced huge capture (109 ms, an orientation distractor produced moderate capture (50 ms. With color targets, distractors were not interfering. On one hand, these results reflect that relative salience of the target and the distractor is critical for producing capture; on the other hand, a huge capture size associated with a nontarget dimension feature is novel. Similar previous measurements, but without matching the attentional set, consistently report attentional capture of only 20-30 ms. This comparison shows the role played by attentional set. Taken together, we suggest that visual saliency determines search order, and sets the platform for capture. However, attentional dwell time on the distractor is determined by how much it matches the current attentional set, and in turn explains the capture size.

The efficacy of self-directed modules for clinical learning: advanced competencies in entry-level physical therapy education.

Science.gov (United States)

Peck, Kirk; Paschal, Karen; Black, Lisa; Nelson, Kelly

2014-01-01

Prior to graduation, students often express an interest to advance clinical and professional skills in teaching, research, administration, and various niche practice areas. The acquisition of advanced education in selected areas of practice is believed to improve employment opportunities, accelerate career advancement including eligibility for professional certifications, and contribute to personal satisfaction in the profession. The purpose of this paper is to (1) describe an innovative model of education, the Directed Practice Experience (DPE) elective, that incorporates a student-initiated learning process designed to achieve student-identified professional goals, and (2) report the outcomes for graduates who have completed the DPE in an entry-level program in physical therapy education. Students who met select criteria were eligible to complete a DPE. Applicants designed a 4- to 6-week clinical education experience consisting of stated rationale for personal and professional growth, examples of leadership and service, and self-directed objectives that are beyond entry-level expectations as measured by the revised Physical Therapist Clinical Performance Instrument, version 2006. Twenty-six students have completed DPEs since 2005. Fifty percent resulted in new academic partnerships. At least 25% of graduates now serve as clinical instructors for the entry-level program. Those who participated in DPEs have also completed post-graduate residencies, attained ABPTS Board certifications, authored peer-reviewed publications, and taught in both PT and residency programs. The DPE model allows qualified students to acquire advanced personal skills and knowledge prior to graduation in areas of professional practice that exceed entry-level expectations. The model is applicable to all CAPTE accredited physical therapy education programs and is especially beneficial for academic programs desiring to form new community partnerships for student clinical education.

Implementation of a Goal-Directed Mechanical Ventilation Order Set Driven by Respiratory Therapists Improves Compliance With Best Practices for Mechanical Ventilation.

Science.gov (United States)

Radosevich, Misty A; Wanta, Brendan T; Meyer, Todd J; Weber, Verlin W; Brown, Daniel R; Smischney, Nathan J; Diedrich, Daniel A

2017-01-01

Data regarding best practices for ventilator management strategies that improve outcomes in acute respiratory distress syndrome (ARDS) are readily available. However, little is known regarding processes to ensure compliance with these strategies. We developed a goal-directed mechanical ventilation order set that included physician-specified lung-protective ventilation and oxygenation goals to be implemented by respiratory therapists (RTs). We sought as a primary outcome to determine whether an RT-driven order set with predefined oxygenation and ventilation goals could be implemented and associated with improved adherence with best practice. We evaluated 1302 patients undergoing invasive mechanical ventilation (1693 separate episodes of invasive mechanical ventilation) prior to and after institution of a standardized, goal-directed mechanical ventilation order set using a controlled before-and-after study design. Patient-specific goals for oxygenation partial pressure of oxygen in arterial blood (Pao 2 ), ARDS Network [Net] positive end-expiratory pressure [PEEP]/fraction of inspired oxygen [Fio 2 ] table use) and ventilation (pH, partial pressure of carbon dioxide) were selected by prescribers and implemented by RTs. Compliance with the new mechanical ventilation order set was high: 88.2% compliance versus 3.8% before implementation of the order set ( P mechanical ventilation, intensive care unit (ICU) length of stay, and in-hospital or ICU mortality. A standardized best practice mechanical ventilation order set can be implemented by a multidisciplinary team and is associated with improved compliance to written orders and adherence to the ARDSNet PEEP/Fio 2 table.

Can children identify and achieve goals for intervention? A randomized trial comparing two goal-setting approaches.

Science.gov (United States)

Vroland-Nordstrand, Kristina; Eliasson, Ann-Christin; Jacobsson, Helén; Johansson, Ulla; Krumlinde-Sundholm, Lena

2016-06-01

The efficacy of two different goal-setting approaches (children's self-identified goals and goals identified by parents) were compared on a goal-directed, task-oriented intervention. In this assessor-blinded parallel randomized trial, 34 children with disabilities (13 males, 21 females; mean age 9y, SD 1y 4mo) were randomized using concealed allocation to one of two 8-week, goal-directed, task-oriented intervention groups with different goal-setting approaches: (1) children's self-identified goals (n=18) using the Perceived Efficacy and Goal-Setting System, or (2) goals identified by parents (n=16) using the Canadian Occupational Performance Measure (COPM). Participants were recruited through eight paediatric rehabilitation centres and randomized between October 2011 and May 2013. The primary outcome measure was the Goal Attainment Scaling and the secondary measure, the COPM performance scale (COPM-P). Data were collected pre- and post-intervention and at the 5-month follow-up. There was no evidence of a difference in mean characteristics at baseline between groups. There was evidence of an increase in mean goal attainment (mean T score) in both groups after intervention (child-goal group: estimated mean difference [EMD] 27.84, 95% CI 22.93-32.76; parent-goal group: EMD 21.42, 95% CI 16.16-26.67). There was no evidence of a difference in the mean T scores post-intervention between the two groups (EMD 6.42, 95% CI -0.80 to 13.65). These results were sustained at the 5-month follow-up. Children's self-identified goals are achievable to the same extent as parent-identified goals and remain stable over time. Thus children can be trusted to identify their own goals for intervention, thereby influencing their involvement in their intervention programmes. © 2015 Mac Keith Press.

Analysis of Direct Samples of Early Solar System Aqueous Fluids

Science.gov (United States)

Zolensky, Michael E.; Bodnar, R J.; Fedele, L.; Yurimoto,H.; Itoh, S.; Fries, M.; Steele, A.

2012-01-01

Over the past three decades we have become increasingly aware of the fundamental importance of water, and aqueous alteration, on primitive solar-system bodies. Some carbonaceous and ordinary chondrites have been altered by interactions with liquid water within the first 10 million years after formation of their parent asteroids. Millimeter to centimeter-sized aggregates of purple halite containing aqueous fluid inclusions were found in the matrix of two freshly-fallen brecciated H chondrite falls, Monahans (1998, hereafter simply "Monahans") (H5) and Zag (H3-6) (Zolensky et al., 1999; Whitby et al., 2000; Bogard et al., 2001) In order to understand origin and evolution of the aqueous fluids inside these inclusions we much measure the actual fluid composition, and also learn the O and H isotopic composition of the water. It has taken a decade for laboratory analytical techniques to catch up to these particular nanomole-sized aqueous samples. We have recently been successful in (1) measuring the isotopic composition of H and O in the water in a few fluid inclusions from the Zag and Monahans halite, (2) mineralogical characterization of the solid mineral phases associated with the aqueous fluids within the halite, and (3) the first minor element analyses of the fluid itself. A Cameca ims-1270 equipped with a cryo-sample-stage of Hokkaido University was specially prepared for the O and H isotopic measurements. The cryo-sample-stage (Techno. I. S. Corp.) was cooled down to c.a. -190 C using liquid nitrogen at which the aqueous fluid in inclusions was frozen. We excavated the salt crystal surfaces to expose the frozen fluids using a 15 keV Cs+ beam and measured negative secondary ions. The secondary ions from deep craters of approximately 10 m in depth emitted stably but the intensities changed gradually during measurement cycles because of shifting states of charge compensation, resulting in rather poor reproducibility of multiple measurements of standard fluid

Effects of FVIII immunity on hepatocyte and hematopoietic stem cell–directed gene therapy of murine hemophilia A

Science.gov (United States)

Lytle, Allison M; Brown, Harrison C; Paik, Na Yoon; Knight, Kristopher A; Wright, J Fraser; Spencer, H Trent; Doering, Christopher B

2016-01-01

Immune responses to coagulation factors VIII (FVIII) and IX (FIX) represent primary obstacles to hemophilia treatment. Previously, we showed that hematopoietic stem cell (HSC) retroviral gene therapy induces immune nonresponsiveness to FVIII in both naive and preimmunized murine hemophilia A settings. Liver-directed adeno-associated viral (AAV)-FIX vector gene transfer achieved similar results in preclinical hemophilia B models. However, as clinical immune responses to FVIII and FIX differ, we investigated the ability of liver-directed AAV-FVIII gene therapy to affect FVIII immunity in hemophilia A mice. Both FVIII naive and preimmunized mice were administered recombinant AAV8 encoding a liver-directed bioengineered FVIII expression cassette. Naive animals receiving high or mid-doses subsequently achieved near normal FVIII activity levels. However, challenge with adjuvant-free recombinant FVIII induced loss of FVIII activity and anti-FVIII antibodies in mid-dose, but not high-dose AAV or HSC lentiviral (LV) vector gene therapy cohorts. Furthermore, unlike what was shown previously for FIX gene transfer, AAV-FVIII administration to hemophilia A inhibitor mice conferred no effect on anti-FVIII antibody or inhibitory titers. These data suggest that functional differences exist in the immune modulation achieved to FVIII or FIX in hemophilia mice by gene therapy approaches incorporating liver-directed AAV vectors or HSC-directed LV. PMID:26909355

Pharmacogenetics of hepatitis C: transition from interferon-based therapies to direct-acting antiviral agents

Directory of Open Access Journals (Sweden)

Kamal SM

2014-06-01

Full Text Available Sanaa M Kamal1,21Department of Medicine, Division of Hepatology, Gastroenterology and Tropical Medicine, Ain Shams Faculty of Medicine, Cairo, Egypt, 2Department of Medicine, Salman Bin Abdul Aziz College of Medicine, Kingdom of Saudi ArabiaAbstract: Hepatitis C virus (HCV has emerged as a major viral pandemic over the past two decades, infecting 170 million individuals, which equates to approximately 3% of the world's population. The prevalence of HCV varies according to geographic region, being highest in developing countries such as Egypt. HCV has a high tendency to induce chronic progressive liver damage in the form of hepatic fibrosis, cirrhosis, or liver cancer. To date, there is no vaccine against HCV infection. Combination therapy comprising PEGylated interferon-alpha and ribavirin has been the standard of care for patients with chronic hepatitis C for more than a decade. However, many patients still do not respond to therapy or develop adverse events. Recently, direct antiviral agents such as protease inhibitors, polymerase inhibitors, or NS5A inhibitors have been used to augment PEGylated interferon and ribavirin, resulting in better efficacy, better tolerance, and a shorter treatment duration. However, most clinical trials have focused on assessing the efficacy and safety of direct antiviral agents in patients with genotype 1, and the response of other HCV genotypes has not been elucidated. Moreover, the prohibitive costs of such triple therapies will limit their use in patients in developing countries where most of the HCV infection exists. Understanding the host and viral factors associated with viral clearance is necessary for individualizing therapy to maximize sustained virologic response rates, prevent progression to liver disease, and increase the overall benefits of therapy with respect to its costs. Genome wide studies have shown significant associations between a set of polymorphisms in the region of the interleukin-28B (IL

Direct laboratory observation of fluid distribution and its influence on acoustic properties of patchy saturated rocks

Science.gov (United States)

Lebedev, M.; Clennell, B.; Pervukhina, M.; Shulakova, V.; Mueller, T.; Gurevich, B.

2009-04-01

samples (38 mm in diameter, approximately 60 mm long) were dried in oven under reduced pressure. In dynamic saturation experiments, samples were jacketed in the experimental cell, made from transparent for X-radiation material (PMMA). Distillate water was injected into the sample from the one side. Fluid distribution in such "dynamic" experiment: both spatial and time dependant was measured using X-ray Computer Tomograph (CT) with resolution 0.2 x 0.2 x 1 mm3. Velocities (Vp, and Vs) at ultrasonic frequency of 1 MHz, were measured in the direction perpendicular to initial direction of the fluid flow injection. Sample saturation was estimated from the CT results. In "quasi static" experiments samples were saturated during long period of time (over 2 weeks) to achieve uniform distribution of liquid inside the sample. Saturation was determined by measurement of the weight of water fraction. All experiments were performed at laboratory environments at temperature 25 C. Ultrasonic velocities and fluid saturations were measured simultaneously during water injection into sandstone core samples. The experimental results obtained on low-permeability samples show that at low saturation values the velocity-saturation dependence can be described by the Gassmann-Wood relationship. However, with increasing saturation a sharp increase of P-wave velocity is observed, eventually approaching the Gassmann-Hill relationship. We connect the characteristics of the transition behavior of the velocity-saturation relationships to the increasing size of the patches inside the rock sample. In particular, we show that for relatively large fluid injection rate this transition occurs at smaller degrees of saturation as compared with high injection rate. We model the experimental data using the so-called White model (Toms 2007) that assumes fluid patch distribution as a periodic assemblage of concentric spheres. We can observe reasonable agreement between experimental results and theoretical

Dissociable corticostriatal circuits underlie goal-directed vs. cue-elicited habitual food seeking after satiation : Evidence from a multimodal MRI study

NARCIS (Netherlands)

van Steenbergen, H.; Watson, P.; Wiers, R.W.; Hommel, B.; de Wit, S.

The present multimodal MRI study advances our understanding of the corticostriatal circuits underlying goal-directed vs. cue-driven, habitual food seeking. To this end, we employed a computerized Pavlovian-instrumental transfer paradigm. During the test phase, participants were free to perform

Thermophysical properties of supercritical fluids and fluid mixtures

International Nuclear Information System (INIS)

Sengers, J.V.

1991-07-01

This research is concerned with the development of a quantitative scientific description of the thermodynamic and transport properties of supercritical and subcritical fluids and fluid mixtures. It is known that the thermophysical properties of fluids and fluid mixtures asymptotically close to the critical point satisfy scaling laws with universal critical exponents and universal scaling functions. However, the range of validity of these asymptotic scaling laws is quite small. As a consequence, the impact of the modern theory of critical phenomena on chemical engineering has been limited. On the other hand, an a priori estimate of the range of temperatures and densities, where critical fluctuations become significant, can be made on the basis of the so-called Ginzburg criterion. A recent analysis of this criterion suggests that this range is actually quite large and for a fluid like carbon dioxide can easily extend to 100 degrees or so above the critical temperature. Hence, the use of traditional engineering equations like cubic equations is not scientifically justified in a very wide range of temperatures and densities around the critical point. We have therefore embarked on a scientific approach to deal with the global effects of critical fluctuations on the thermophysical properties of fluids and fluid mixtures. For this purpose it is not sufficient to consider the asymptotic critical fluctuations but we need to deal also with the nonasymptotic critical fluctuations. The goal is to develop scientifically based questions that account for the crossover of the thermophysical properties from their asymptotic singular behavior in the near vicinity of the critical point to their regular behavior very far away from the critical point

Practical Fluid Therapy and Treatment Modalities for Field Conditions for Horses and Foals with Gastrointestinal Problems.

Science.gov (United States)

Fielding, C Langdon

2018-04-01

With advances in technology and owner education, field management in equine veterinary medicine continues to evolve. Equine gastrointestinal disease is one of the most common types of emergencies evaluated by equine practitioners, and many of these patients can be effectively managed in the field. Although the equine veterinarian must make numerous decisions, fluid therapy, pain management, and antimicrobial use are 3 of the major choices that must be addressed when initiating field treatment of equine gastrointestinal disease. This article addresses the practical use of these 3 treatment categories that are essential to field practice. Copyright © 2018 Elsevier Inc. All rights reserved.

Microneedle pH Sensor: Direct, Label-Free, Real-Time Detection of Cerebrospinal Fluid and Bladder pH.

Science.gov (United States)

Mani, Ganesh Kumar; Miyakoda, Kousei; Saito, Asuka; Yasoda, Yutaka; Kajiwara, Kagemasa; Kimura, Minoru; Tsuchiya, Kazuyoshi

2017-07-05

Acid-base homeostasis (body pH) inside the body is precisely controlled by the kidneys and lungs and buffer systems, such that even a minor pH change could severely affect many organs. Blood and urine pH tests are common in day-to-day clinical trials and require little effort for diagnosis. There is always a great demand for in vivo testing to understand more about body metabolism and to provide effective diagnosis and therapy. In this article, we report the simple fabrication of microneedle-based direct, label-free, and real-time pH sensors. The reference and working electrodes were Ag/AgCl thick films and ZnO thin films on tungsten (W) microneedles, respectively. The morphological and structural characteristics of microneedles were carefully investigated through various analytical methods. The developed sensor exhibited a Nernstian response of -46 mV/pH. Different conditions were used to test the sensor to confirm their accuracy and stability, such as various buffer solutions, with respect to time, and we compared the reading with commercial pH electrodes. Besides that, the fabricated microneedle sensor ability is proven by in vivo testing in mouse cerebrospinal fluid (CSF) and bladders. The pH sensor procedure reported here is totally reversible, and results were reproducible after several rounds of testing.

Patient-directed music therapy reduces anxiety and sedation exposure in mechanically-ventilated patients: a research critique.

Science.gov (United States)

Gullick, Janice G; Kwan, Xiu Xian

2015-05-01

This research appraisal, guided by the CASP Randomised Controlled Trial Checklist, critiques a randomised, controlled trial of patient-directed music therapy compared to either noise-cancelling headphones or usual care. This study recruited 373 alert, mechanically-ventilated patients across five intensive care units in the United States. The Music Assessment Tool, administered by a music therapist, facilitated music selection by participants in the intervention group. Anxiety was measured using the VAS-A scale. Sedation exposure was measured by both sedation frequency and by sedation intensity using a daily sedation intensity score. Context for the data was supported by an environmental scan form recording unit activity and by written comments from nurses about the patient's responses to the protocol. Patient-directed music therapy allowed a significant reduction in sedation frequency compared to noise-cancelling headphones and usual care participants. Patient-directed music therapy led to significantly lower anxiety and sedation intensity compared to usual care, but not compared to noise-cancelling headphones. This is a robust study with clear aims and a detailed description of research methods and follow-up. While no participants were lost to follow-up, not all were included in the analysis: 37% did not have the minimum of two anxiety assessments for comparison and 23% were not included in sedation analysis. While some participants utilised the intervention or active control for many hours-per-day, half the music therapy participants listened for 12min or less per day and half of the noise-cancelling headphone participants did not appear to use them. While the results suggest that patient-directed music therapy and noise-cancelling headphones may be useful and cost-effective interventions that lead to an overall improvement in anxiety and sedation exposure, these may appeal to a subset of ICU patients. The self-directed use of music therapy and noise

The NASA Computational Fluid Dynamics (CFD) program - Building technology to solve future challenges

Science.gov (United States)

Richardson, Pamela F.; Dwoyer, Douglas L.; Kutler, Paul; Povinelli, Louis A.

1993-01-01

This paper presents the NASA Computational Fluid Dynamics program in terms of a strategic vision and goals as well as NASA's financial commitment and personnel levels. The paper also identifies the CFD program customers and the support to those customers. In addition, the paper discusses technical emphasis and direction of the program and some recent achievements. NASA's Ames, Langley, and Lewis Research Centers are the research hubs of the CFD program while the NASA Headquarters Office of Aeronautics represents and advocates the program.

Indirect versus direct feedback in computer-based Prism Adaptation Therapy

DEFF Research Database (Denmark)

Wilms, Inge Linda; Rytter, Hana Malá

2010-01-01

Prism Adaptation Therapy (PAT) is an intervention method in the treatment of the attention disorder neglect (Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002; Rossetti, et al., 1998). The aim of this study was to investigate whether one session of PAT using a computer-attached touchscreen...... in the aftereffect. The findings have direct implications for future implementations of computer-based methods of treatment of visuospatial disorders and computer-assisted rehabilitation in general....

Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy?

Science.gov (United States)

Darrah, J; Wiart, L; Magill-Evans, J; Ray, L; Andersen, J

2012-01-01

Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada. Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes. All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports. Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite

Mild cognitive impairment in Parkinson's disease is improved by transcranial direct current stimulation combined with physical therapy.

Science.gov (United States)

Manenti, Rosa; Brambilla, Michela; Benussi, Alberto; Rosini, Sandra; Cobelli, Chiara; Ferrari, Clarissa; Petesi, Michela; Orizio, Italo; Padovani, Alessandro; Borroni, Barbara; Cotelli, Maria

2016-05-01

Parkinson's disease (PD) is characterized by both motor and cognitive deficits. In PD, physical exercise has been found to improve physical functioning. Recent studies demonstrated that repeated sessions of transcranial direct current stimulation led to an increased performance in cognitive and motor tasks in patients with PD. The present study investigated the effects of anodal transcranial direct current stimulation applied over the dorsolateral prefrontal cortex and combined with physical therapy in PD patients. A total of 20 patients with PD were assigned to 1 of 2 study groups: group 1, anodal transcranial direct current stimulation plus physical therapy (n = 10) or group 2, placebo transcranial direct current stimulation plus physical therapy (n = 10). The 2 weeks of treatment consisted of daily direct current stimulation application for 25 minutes during physical therapy. Long-term effects of treatment were evaluated on clinical, neuropsychological, and motor task performance at 3-month follow-up. An improvement in motor abilities and a reduction of depressive symptoms were observed in both groups after the end of treatment and at 3-month follow-up. The Parkinson's Disease Cognitive Rating Scale and verbal fluency test performances increased only in the anodal direct current stimulation group with a stable effect at follow-up. The application of anodal transcranial direct current stimulation may be a relevant tool to improve cognitive abilities in PD and might be a novel therapeutic strategy for PD patients with mild cognitive impairment. © 2016 International Parkinson and Movement Disorder Society. © 2016 International Parkinson and Movement Disorder Society.

[Significance of emotion-focused concepts to cognitive-behavioral therapy].

Science.gov (United States)

Lammers, C-H

2006-09-01

Emotions are the central process of motivation and play a key role in adaptive behavior in humans. Although cognitive-behavioral therapy stresses the importance of changing both cognition and behavior, there is growing emphasis on direct therapeutic work on emotions and emotional processing, as problematic emotional processes are at the core of nearly all psychic disorders. This type of work is the goal of emotion-focused psychotherapy, which centers on direct change of problematic emotions, especially those which are usually suppressed resp. overregulated by the patient. This paper examines the basic phobic/emotional conflict, the problematic emotional processes arising from this conflict, and the importance to cognitive-behavioral therapy of their potentially integrative role.

The radioimmunoassay of biologically active compounds in parotid fluid and plasma

International Nuclear Information System (INIS)

Walker, R.F.; Read, G.F.; Riad-Fahmy, D.

1978-01-01

Parotid fluid collection is a simple stress-free procedure. The potential value of parotid fluid estimations of clomipramine, a tricyclic antidepressant, d-norgestrel, a synthetic contraceptive steroid and cortisol have been evaluated for assessment of clinical status and patient compliance. These compounds circulate bound largely to plasma proteins. Their concentration in parotid fluid, which reflects the non-protein bound fraction, is low but assay sensitivity (10, 1 and 30 pg/tube respectively) is adequate. Excellent agreement (r>0.9) was observed when parotid fluid samples were assayed with and without chromatographic purification. Clomipramine levels following oral dosage (150 mg) rose steadily to a maximum in plasma but showed wide fluctuations in parotid fluid. Clomipramine therapy can only be assessed by plasma assays, but patient compliance may be checked by parotid fluid concentrations. Following an oral dose of d-norgestrel (0.3 mg), parotid fluid levels rose steadily to a maximum but plasma response was biphasic making correlation impossible. The sensitivity and high throughput of the d-norgestrel methodology suggests its use in evaluating patient compliance in large-scale fertility control programmes. Changes in circulating cortisol concentrations were rapidly and accurately reflected in parotid fluid in normal volunteers. Parotid fluid cortisol showed a marked diurnal rhythm, suppression to low levels after dexamethasone, and elevation following Synacthen. Low levels after Synacthen stimulation in a patient with secondary adrenal atrophy and constant high levels in Cushingoid patients indicate that parotid fluid cortisol levels could be used for accurate adrenocortical evaluation. The value in rapid screening procedures is stressed since the assay can be performed directly on only 10 μl of parotid fluid. (author)

The role of selective attention in short-term memory and goal-directed behavior

OpenAIRE

Vissers, M.E.

2018-01-01

Selective attention enables the prioritization of goal-relevant aspects of our sensory environment in order to guide our actions, or to store goal-relevant information in short-term memory. Yet, it remains largely unclear how attention prioritizes goal-relevant information. For example, selective attention may enhance processing of goal-relevant information, suppress processing of distracting information, or both. The research presented in this dissertation examined the neurophysiological mec...

Is proBNP a Reliable Marker for the Evaluation of Fluid Load in Patients Undergoing Continuous Renal Replacement Therapy?

Directory of Open Access Journals (Sweden)

Seher Erdogan

2016-11-01

Full Text Available Aim: Pro-B type natriuretic peptide (proBNP has been defined as a volume marker in hemodialysis patients. In the present study we aimed to evaluate the role of serum proBNP levels to indicate fluid load in patients undergoing continuous renal replacement therapy (CRRT due to overhydration. Material and Method: Patients who were admitted to a tertiary 7-bed pediatric intensive care unit and underwent CRRT due to overhydration were included in the study. Results: The study was conducted with 15 girls (53.6% and 13 boys (46.4%. The mean age was 61.46±56.13 months (range, 2-183 months; the mean CRRT administration time was 20.8±14.9 hours (range, 5-60 hours; and the mean percentage of fluid extracted from the body was 8.43 ± 4.51% (range, 2.5-20%. CRRT was administered to 12 patients because of fluid overload (42.9% and to 12 (57.1% because of fluid load accompanied by uremia.. There was a statistically significant difference between body weight, urea, and creatinine levels of patients before and after treatment (p= 0.001. The mean proBNP level was 23.306 ± 13.943 pg/mL immediately before CRRT and the mean proBNP after CRRT was 22.178 ± 15.473 pg/mL. There was no statistically significant difference between the initial and final proBNP levels (p= 0.756. With the exception of serum sodium levels, there was no correlation between the final proBNP levels and body weight, urea, and creatinine (p>0.05. Similarly, there was also no correlation between initial proBNP levels and fluid load (p= 0.602 or between the percentage of extracted fluid and final proBNP levels (p= 0.155. Discussion: There was no significant correlation between the fluid load and initial proBNP levels or with the extracted fluid percentage and final proBNP levels in patients undergoing CRRT because of fluid overload.In conclusion, no appropriate marker was determined to evaluate cumulative fluid load and the extracted liquid volume.

Effects of FVIII immunity on hepatocyte and hematopoietic stem cell–directed gene therapy of murine hemophilia A

Directory of Open Access Journals (Sweden)

Allison M Lytle

2016-01-01

Full Text Available Immune responses to coagulation factors VIII (FVIII and IX (FIX represent primary obstacles to hemophilia treatment. Previously, we showed that hematopoietic stem cell (HSC retroviral gene therapy induces immune nonresponsiveness to FVIII in both naive and preimmunized murine hemophilia A settings. Liver-directed adeno-associated viral (AAV-FIX vector gene transfer achieved similar results in preclinical hemophilia B models. However, as clinical immune responses to FVIII and FIX differ, we investigated the ability of liver-directed AAV-FVIII gene therapy to affect FVIII immunity in hemophilia A mice. Both FVIII naive and preimmunized mice were administered recombinant AAV8 encoding a liver-directed bioengineered FVIII expression cassette. Naive animals receiving high or mid-doses subsequently achieved near normal FVIII activity levels. However, challenge with adjuvant-free recombinant FVIII induced loss of FVIII activity and anti-FVIII antibodies in mid-dose, but not high-dose AAV or HSC lentiviral (LV vector gene therapy cohorts. Furthermore, unlike what was shown previously for FIX gene transfer, AAV-FVIII administration to hemophilia A inhibitor mice conferred no effect on anti-FVIII antibody or inhibitory titers. These data suggest that functional differences exist in the immune modulation achieved to FVIII or FIX in hemophilia mice by gene therapy approaches incorporating liver-directed AAV vectors or HSC-directed LV.

Phospholipid micelle-based magneto-plasmonic nanoformulation for magnetic field-directed, imaging-guided photo-induced cancer therapy.

Science.gov (United States)

Ohulchanskyy, Tymish Y; Kopwitthaya, Atcha; Jeon, Mansik; Guo, Moran; Law, Wing-Cheung; Furlani, Edward P; Kim, Chulhong; Prasad, Paras N

2013-11-01

We present a magnetoplasmonic nanoplatform combining gold nanorods (GNR) and iron-oxide nanoparticles within phospholipid-based polymeric nanomicelles (PGRFe). The gold nanorods exhibit plasmon resonance absorbance at near infrared wavelengths to enable photoacoustic imaging and photothermal therapy, while the Fe3O4 nanoparticles enable magnetophoretic control of the nanoformulation. The fabricated nanoformulation can be directed and concentrated by an external magnetic field, which provides enhancement of a photoacoustic signal. Application of an external field also leads to enhanced uptake of the magnetoplasmonic formulation by cancer cells in vitro. Under laser irradiation at the wavelength of the GNR absorption peak, the PGRFe formulation efficiently generates plasmonic nanobubbles within cancer cells, as visualized by confocal microscopy, causing cell destruction. The combined magnetic and plasmonic functionalities of the nanoplatform enable magnetic field-directed, imaging-guided, enhanced photo-induced cancer therapy. In this study, a nano-formulation of gold nanorods and iron oxide nanoparticles is presented using a phospholipid micelle-based delivery system for magnetic field-directed and imaging-guided photo-induced cancer therapy. The gold nanorods enable photoacoustic imaging and photothermal therapy, while the Fe3O4 nanoparticles enable magnetophoretic control of the formulation. This and similar systems could enable more precise and efficient cancer therapy, hopefully in the near future, after additional testing. Copyright © 2013 Elsevier Inc. All rights reserved.

A direct force model for Galilean invariant lattice Boltzmann simulation of fluid-particle flows

Science.gov (United States)

Tao, Shi; He, Qing; Chen, Baiman; Yang, Xiaoping; Huang, Simin

The lattice Boltzmann method (LBM) has been widely used in the simulation of particulate flows involving complex moving boundaries. Due to the kinetic background of LBM, the bounce-back (BB) rule and the momentum exchange (ME) method can be easily applied to the solid boundary treatment and the evaluation of fluid-solid interaction force, respectively. However, recently it has been found that both the BB and ME schemes may violate the principle of Galilean invariance (GI). Some modified BB and ME methods have been proposed to reduce the GI error. But these remedies have been recognized subsequently to be inconsistent with Newton’s Third Law. Therefore, contrary to those corrections based on the BB and ME methods, a unified iterative approach is adopted to handle the solid boundary in the present study. Furthermore, a direct force (DF) scheme is proposed to evaluate the fluid-particle interaction force. The methods preserve the efficiency of the BB and ME schemes, and the performance on the accuracy and GI is verified and validated in the test cases of particulate flows with freely moving particles.

Implementing communication and decision-making interventions directed at goals of care: a theory-led scoping review.

Science.gov (United States)

Cummings, Amanda; Lund, Susi; Campling, Natasha; May, Carl R; Richardson, Alison; Myall, Michelle

2017-10-06

To identify the factors that promote and inhibit the implementation of interventions that improve communication and decision-making directed at goals of care in the event of acute clinical deterioration. A scoping review was undertaken based on the methodological framework of Arksey and O'Malley for conducting this type of review. Searches were carried out in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to identify peer-reviewed papers and in Google to identify grey literature. Searches were limited to those published in the English language from 2000 onwards. Inclusion and exclusion criteria were applied, and only papers that had a specific focus on implementation in practice were selected. Data extracted were treated as qualitative and subjected to directed content analysis. A theory-informed coding framework using Normalisation Process Theory (NPT) was applied to characterise and explain implementation processes. Searches identified 2619 citations, 43 of which met the inclusion criteria. Analysis generated six themes fundamental to successful implementation of goals of care interventions: (1) input into development; (2) key clinical proponents; (3) training and education; (4) intervention workability and functionality; (5) setting and context; and (6) perceived value and appraisal. A broad and diverse literature focusing on implementation of goals of care interventions was identified. Our review recognised these interventions as both complex and contentious in nature, making their incorporation into routine clinical practice dependent on a number of factors. Implementing such interventions presents challenges at individual, organisational and systems levels, which make them difficult to introduce and embed. We have identified a series of factors that influence successful implementation and our analysis has distilled key learning points, conceptualised as a set of propositions, we consider relevant to implementing other complex

The Effect of Nonsurgical Periodontal Therapy on HNP1-3 Level in Gingival Crevicular Fluid of Chronic Periodontitis Patients.

Science.gov (United States)

Dolińska, Ewa; Skurska, Anna; Pietruska, Małgorzata; Dymicka-Piekarska, Violetta; Milewski, Robert; Pietruski, Jan; Sculean, Anton

2017-08-01

The rich bacterial flora of oral cavity is controlled by innate immune response, including antibacterial peptides and among them human neutrophil peptides 1-3 (HNP1-3). The knowledge of the involvement of HNPs in innate and acquired immunity of the periodontium is fragmentary. The aim of the study was to assess alterations in HNP1-3 levels in the gingival crevicular fluid (GCF) of chronic periodontitis patients before and after nonsurgical periodontal therapy. Nineteen patients with chronic periodontitis were qualified to the study. After periodontal examination, one site with pocket depth (PD) ≥4 mm was selected. All the patients received periodontal treatment involving scaling and root planing with additional systemic antibiotic therapy (Amoxicillin 375 mg three times daily and Metronidazole 250 mg three times daily for 7 days). Prior to therapy, 3 and 6 months after it, clinical periodontal parameters were measured and GCF was collected from previously chosen site. The level of HNP1-3 in GCF was determined by means of a commercially available enzyme-linked immunoassay kit. The periodontal therapy caused a statistically significant (p periodontal therapy with additional systemic administration of Amoxicillin and Metronidazole increases the level of HNP1-3 in GCF.

Contexts Paired with Junk Food Impair Goal-Directed Behavior in Rats: Implications for Decision Making in Obesogenic Environments.

Science.gov (United States)

Kendig, Michael D; Cheung, Ambrose M K; Raymond, Joel S; Corbit, Laura H

2016-01-01

The high prevalence of obesity and related metabolic diseases calls for greater understanding of the factors that drive excess energy intake. Calorie-dense palatable foods are readily available and often are paired with highly salient environmental cues. These cues can trigger food-seeking and consumption in the absence of hunger. Here we examined the effects of palatable food-paired environmental cues on control of instrumental food-seeking behavior. In Experiment 1, adult male rats received exposures to one context containing three "junk" foods (JFs context) and another containing chow (Chow context). Next, rats were food-deprived and trained to perform instrumental responses (lever-press) for two novel food rewards in a third, distinct context. Contextual influences on flexible control of food-seeking behavior were then assessed by outcome devaluation tests held in the JF, chow and training contexts. Devaluation was achieved using specific satiety and test order was counterbalanced. Rats exhibited goal-directed control over behavior when tested in the training and chow-paired contexts. Notably, performance was habitual (insensitive to devaluation) when tested in the JF context. In Experiment 2 we tested whether the impairment found in the JF context could be ameliorated by the presentation of a discrete auditory cue paired with the chow context, relative to a second cue paired with the JF context. Consistent with the results of Experiment 1, the devaluation effect was not significant when rats were tested in the JF context with the JF cue. However, presenting the chow cue increased the impact of the devaluation treatment leading to a robust devaluation effect. Further tests confirmed that performance in the chow context was goal-directed and that sensory-specific satiety in the JF context was intact. These results show that environments paired with palatable foods can impair goal-directed control over food-seeking behavior, but that this deficit was improved by

Contexts paired with junk food impair goal-directed behaviour in rats: implications for decision making in obesogenic environments

Directory of Open Access Journals (Sweden)

Michael D. Kendig

2016-11-01

Full Text Available The high prevalence of obesity and related metabolic diseases calls for greater understanding of the factors that drive excess energy intake. Calorie-dense palatable foods are readily available and often are paired with highly salient environmental cues. These cues can trigger food-seeking and consumption in the absence of hunger. Here we examined the effects of palatable food-paired environmental cues on control of instrumental food-seeking behaviour. In Experiment 1, adult male rats received exposures to one context containing three ‘junk’ foods (JF context and another containing chow (Chow context. Next, rats were food-deprived and trained to perform instrumental responses (lever-press for two novel food rewards in a third, distinct context. Contextual influences on flexible control of food-seeking behaviour were then assessed by outcome devaluation tests held in the JF, chow, and training contexts. Devaluation was achieved using specific satiety and test order was counterbalanced. Rats exhibited goal-directed control over behaviour when tested in the training and chow-paired contexts. Notably, performance was habitual (insensitive to devaluation when tested in the JF context. In Experiment 2 we tested whether the impairment found in the JF context could be ameliorated by the presentation of a discrete auditory cue paired with the chow context, relative to a second cue paired with the JF context. Consistent with the results of Experiment 1, the devaluation effect was not significant when rats were tested in the JF context with the JF cue. However, presenting the chow cue increased the impact of the devaluation treatment leading to a robust devaluation effect. Further tests confirmed that performance in the chow context was goal-directed and that sensory-specific satiety in the JF context was intact. These results show that environments paired with palatable foods can impair goal-directed control over food-seeking behaviour, but that this

The role of selective attention in short-term memory and goal-directed behavior

NARCIS (Netherlands)

Vissers, M.E.

2018-01-01

Selective attention enables the prioritization of goal-relevant aspects of our sensory environment in order to guide our actions, or to store goal-relevant information in short-term memory. Yet, it remains largely unclear how attention prioritizes goal-relevant information. For example, selective

Verification of extended model of goal directed behavior applied on aggression

Directory of Open Access Journals (Sweden)

Katarína Vasková

2016-01-01

Full Text Available The study was aimed to verify Model of Goal Directed Behavior (EMGB by Perugini and Bagozzi (2001 applied on aggression by Richetin, Richardson and Boykin (2011. Two different studies were performed. Firstly original form of model was verified. In the second study, modification of EMGB through new conceptualization of scale of perceived behavioral control was executed. The research sample consisted together from 385 students of University of P.J. Šafárik and High school in Košice (182 respondents (78 men, 104 women with average age 20,84 years and standard deviation 1,94, who were involved in first study and 203 students (49 men and 154 women, with average age 19,71 and standard deviation 1,99 participated in second study who were administrated questionnaire by Richetin et al. (2011 and Richardson Conflict Response Questionnaire (Richardson & Green, 2006. Expectancy of comparable relationships between particular factors of EMGB in comparison to its published original version was verified. Data were analyzed by structural equation modeling. In first study was shown insufficient fit of EMGB model. There were hypothesized two main sources of problems. At first, weak relationship between attitudes and behavioral desire was shown. Following statistical procedures confirmed its direct impact on intention, what is in correspondence with another studies (see Leone, Perugini & Ercolani, 2004, Perugini & Bagozzi, 2001, Richetin et al., 2011. Second source of problems was identified in factor named perceived behavioral control. Difficulties from our point of view lied in conceptualization of the term and its subsequent measurement. In the second study was involved new conceptualization of control. It corresponded with Baumeister´s understanding of selfcontrol as asserting control over one´s emotions, thoughts and behavior. After this modification sufficient fit of EMGB was shown. Besides this, factor of self-control was the strongest predictor of

"Nihilism" of chronic heart failure therapy in children and why effective therapy is withheld.

Science.gov (United States)

Schranz, Dietmar; Voelkel, Norbert F

2016-04-01

Major advances in chronic heart failure (cHF) therapy have been achieved and documented in adult patients, while research regarding the mechanisms and therapy of cHF in children has lagged behind. Based on receptor physiological studies and pharmacological knowledge, treatment with specific ß1-adrenergic receptor blocker (ARB), tissue angiotensin-converting enzyme inhibitor (ACE-I), and mineralocorticoid antagonists have to be recommended in children despite lack of sufficient data derived from prospective randomized studies. At our institution, bisoprolol, lisinopril, and spironolactone have been firmly established to treat systolic cHF, hypoplastic left heart syndrome (HLHS) following hybrid approach and congenital left-right shunt diseases, latest in patients where surgery has to be delayed. Chronic therapy with long-acting diuretics and fluid restriction are not advocated because short-term effects are achieved at the expense of further neuro-humoral stimulation. It remains unclear why diuretics are recommended although evidence-based studies, documenting long-term benefit, are missing. However, that is true for all currently used drugs for pediatric cHF. This review focuses on the prevailing "nihilism" of cHF therapy in children with the goal to encourage physicians to treat pediatric cHF with a rationally designed therapy, which combines available agents that have been shown to improve survival in adult patients with cHF. Because of the lack of clinical trials, which generate the needed evidence, surrogate variables like heart and respiratory rate, weight gain, image-derived data, and biomarkers should be monitored and used instead. The recommended pharmacological therapy for systolic heart failure is also provided as the basis for utilizing reversible pulmonary arterial banding (PAB) as a novel strategy in young children with dilative cardiomyopathy (DCM) with preserved right ventricular function. • Heart failure (HF) in children is a serious public

Parametric investigation of working fluids for organic Rankine cycle applications

International Nuclear Information System (INIS)

Brown, J. Steven; Brignoli, Riccardo; Quine, Timothy

2015-01-01

This paper investigates working fluids for organic Rankine cycle (ORC) applications with a goal of identifying “ideal” working fluids for five renewable/alternative energy sources. It employs a methodology for screening and comparing with good engineering accuracy the thermodynamic performance potential of ORC operating with working fluids that are not well characterized experimentally or by high-accuracy equations of state. A wide range of “theoretical” working fluids are investigated with the goals to identify potential alternative working fluids and to guide future research and development efforts of working fluids. The “theoretical” working fluids investigated are described in terms of critical state properties, acentric factor, and ideal gas specific heat capacity at constant pressure and are obtained by parametrically varying each of these parameters. The performances of these “theoretical” working fluids are compared to the performances of several “real” working fluids. The study suggests a working fluid's critical temperature and its critical ideal gas molar heat capacity have the largest impact on the cycle efficiency and volumetric work output, with “ideal” working fluids for high efficiency possessing critical temperatures on the order of 100%–150% of the source temperature and possessing intermediate values of critical ideal gas molar heat capacity. - Highlights: • “Ideal” working fluids are investigated for organic Rankine cycles (ORC). • The thermodynamic space of “ideal” working fluids is parametrically investigated. • Five low- and high-temperature ORC applications are investigated. • 1620 “ideal” and several “real” working fluids per application are investigated.

A review of Green's function methods in computational fluid mechanics: Background, recent developments and future directions

International Nuclear Information System (INIS)

Dorning, J.

1981-01-01

The research and development over the past eight years on local Green's function methods for the high-accuracy, high-efficiency numerical solution of nuclear engineering problems is reviewed. The basic concepts and key ideas are presented by starting with an expository review of the original fully two-dimensional local Green's function methods developed for neutron diffusion and heat conduction, and continuing through the progressively more complicated and more efficient nodal Green's function methods for neutron diffusion, heat conduction and neutron transport to establish the background for the recent development of Green's function methods in computational fluid mechanics. Some of the impressive numerical results obtained via these classes of methods for nuclear engineering problems are briefly summarized. Finally, speculations are proffered on future directions in which the development of these types of methods in fluid mechanics and other areas might lead. (orig.) [de

Characteristics of human amniotic fluid mesenchymal stem cells and their tropism to human ovarian cancer.

Directory of Open Access Journals (Sweden)

Liru Li

Full Text Available The mesenchymal stem cells (MSCs derived from amniotic fluid (AF have become an attractive stem cells source for cell-based therapy because they can be harvested at low cost and avoid ethical disputes. In human research, stem cells derived from AF gradually became a hot research direction for disease treatment, specifically for their plasticity, their reduced immunogenicity and their tumor tropism regardless of the tumor size, location and source. Our work aimed to obtain and characterize human amniotic fluid mesenchymal stem cells (AFMSCs and detect their ovarian cancer tropsim in nude mice model. Ten milliliters of twenty independent amniotic fluid samples were collected from 16-20 week pregnant women who underwent amniocentesis for fetal genetic determination in routine prenatal diagnosis in the first affiliated hospital of Harbin medical university. We successfully isolated the AFMSCs from thirteen of twenty amniotic fluid samples. AFMSCs presented a fibroblastic-like morphology during the culture. Flow cytometry analyses showed that the cells were positive for specific stem cell markers CD73,CD90, CD105, CD166 and HLA-ABC (MHC class I, but negative for CD 45,CD40, CD34, CD14 and HLA-DR (MHC class II. RT-PCR results showed that the AFMSCs expressed stem cell marker OCT4. AFMSCs could differentiate into bone cells, fat cells and chondrocytes under certain conditions. AFMSCs had the high motility to migrate to ovarian cancer site but didn't have the tumorigenicity. This study enhances the possibility of AFMSCs as drug carrier in human cell-based therapy. Meanwhile, the research emphasis in the future can also put in targeting therapy of ovarian cancer.

Non-Steroidal Anti-inflammatory Drugs As Host-Directed Therapy for Tuberculosis: A Systematic Review

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Vera M. Kroesen

2017-06-01

Full Text Available Lengthy, antimicrobial therapy targeting the pathogen is the mainstay of conventional tuberculosis treatment, complicated by emerging drug resistances. Host-directed therapies, including non-steroidal anti-inflammatory drugs (NSAIDs, in contrast, target host factors to mitigate disease severity. In the present Systematic Review, we investigate whether NSAIDs display any effects as therapy of TB and discuss possible mechanisms of action of NSAIDs as adjunctive therapy of TB. Ten studies, seven preclinical studies in mice and three clinical trials, were included and systematically reviewed. Our results point toward a beneficial effect of NSAIDs as adjunct to current TB therapy regimens, mediated by decreased lung pathology balancing host-immune reaction. The determination of the best timing for their administration in order to obtain the potential beneficial effects needs further investigation. Even if the preclinical evidence requires clinical evaluation, NSAIDs might represent a potential safe, simple, and cheap improvement in therapy of TB.

Rational Emotive Behvioural Therapy (REBT) untuk Meningkatkan Kemampuan Regulasi Emosi Remaja Korban Kekerasan Seksual.

OpenAIRE

Anggreiny, Nila

2014-01-01

This study ia a pre-experimental research that aimed to examine the effect of therapy Rational Emotive Behavior Therapy (REBT) in improving emotion regulation in young victims of sexual abuse. Emotion regulation ability differences seen using Difficulties in Emotion Regulation Scale (ders) that reveals Difficulties engaging in goal direct behaviour, impulse control difficulties, nonaccept of emotional responses, lack of awareness, limited access to emotion regulation strateg...

Self-regulated magnetic fluid hyperthermia: A potential cancer therapy

Science.gov (United States)

Bagaria, Hitesh Ghanshyam

An emerging cancer therapy, self-regulated magnetic fluid hyperthermia (MFH), is the motivation for this work. In this therapy, cancer is annihilated by heating the tumor to desired therapeutic temperatures (˜45°C) by using magnetic nanoparticles of controlled Curie temperatures (Tc). This work was aimed at preparing and characterizing FePt, NiPd and NiPt nanoparticles for self-regulated MFH because their Tc could be tuned by changing their composition. Based on the excellent colloidal stability, size tunability and toxicity considerations, FePt was an obvious choice for self-regulated MFH. The 3.2 nm Fe61Pt39 particles displayed a Tc of 151°C, which is well below the Tc of bulk Fe61Pt39 (˜327°C). To reach the desired Tc of 45°C the composition of iron needs to be increased. However, a major obstacle was the formation of iron oxide shells with increase in iron composition of the particles. A recent finding that the composition of individual FePt particles deviated significantly from the average value encouraged us to study the mechanism of formation of FePt particles. Our analysis showed that early in the reaction the particles were Pt-rich and as the reaction proceeded the Fe content increased. It was found that the wide distribution in the composition of individual particles started early in the synthesis, suggesting that the compositional variability may be attributed to the Pt nuclei. The synthesized FePt particles are unsuitable for biological applications because of their hydrophobic surface. Hence, their surface was modified by ligand exchange with mercapto alkanoic acids. After ligand exchange, stable FePt dispersions could be formed in alkaline water. The study revealed that both the carboxylate and thiol groups were required to form stable FePt dispersions. In addition, 15 nm gold particles were successfully conjugated to genetically modified adenoviruses that selectively bind to cancer tumors. We also modeled the thermal transport in tissues during

Milestone Report #2: Direct Evaporator Leak and Flammability Analysis Modifications and Optimization of the Organic Rankine Cycle to Improve the Recovery of Waste Heat

Energy Technology Data Exchange (ETDEWEB)

Guillen, Donna Post [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2013-09-01

The direct evaporator is a simplified heat exchange system for an Organic Rankine Cycle (ORC) that generates electricity from a gas turbine exhaust stream. Typically, the heat of the exhaust stream is transferred indirectly to the ORC by means of an intermediate thermal oil loop. In this project, the goal is to design a direct evaporator where the working fluid is evaporated in the exhaust gas heat exchanger. By eliminating one of the heat exchangers and the intermediate oil loop, the overall ORC system cost can be reduced by approximately 15%. However, placing a heat exchanger operating with a flammable hydrocarbon working fluid directly in the hot exhaust gas stream presents potential safety risks. The purpose of the analyses presented in this report is to assess the flammability of the selected working fluid in the hot exhaust gas stream stemming from a potential leak in the evaporator. Ignition delay time for cyclopentane at temperatures and pressure corresponding to direct evaporator operation was obtained for several equivalence ratios. Results of a computational fluid dynamic analysis of a pinhole leak scenario are given.

Fluid elastic instability tests on an array of tubes preferentially flexible in the flow direction

International Nuclear Information System (INIS)

Mureithi, N.W.; Zhang, C.; Pettigrew, M.J.

2004-01-01

The present work is motivated by the observation that, in the presence of flat bar supports (AVBs), U-tubes in steam generators and heat exchangers are not positively restrained in the in-plane direction. The stability behavior of a rotated triangular array is investigated in detail in the work presented here. Tubes within the array are flexible only in the flow direction. Tests are conducted with a fully flexible array, a single flexible tube, and a finite number of flexible tubes at several locations within the otherwise rigid array. In all cases tube flexibility is purely in the flow direction. The fully flexible array is shown to undergo fluid-elastic instability. Despite the unidirectional flexibility constraint, the critical instability velocity is of the same order of magnitude when compared with previous tests on an unconstrained fully flexible array. A single flexible tube, on the other hand, is found to be stable. Results of tests on partially flexible array configurations are also presented. (authors)

Early goal-directed nutrition versus standard of care in adult intensive care patients

DEFF Research Database (Denmark)

Allingstrup, Matilde Jo; Kondrup, Jens; Wiis, Jørgen

2017-01-01

Purpose: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. Methods: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we...... estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition. In the standard of care group we aimed at providing 25 kcal/kg/day by enteral nutrition. If this was not met by day 7......, patients were supplemented with parenteral nutrition. The primary outcome was physical component summary (PCS) score of SF-36 at 6 months. We performed multiple imputation for data of the non-responders. Results: We randomised 203 patients and included 199 in the intention-to-treat analyses; baseline...

Examining Motivational Orientation and Learning Strategies in Computer-Supported Self-Directed Learning (CS-SDL) for Mathematics: The Perspective of Intrinsic and Extrinsic Goals

Science.gov (United States)

Lao, Andrew Chan-Chio; Cheng, Hercy N. H.; Huang, Mark C. L.; Ku, Oskar; Chan, Tak-Wai

2017-01-01

One-to-one technology, which allows every student to receive equal access to learning tasks through a personal computing device, has shown increasing potential for self-directed learning in elementary schools. With computer-supported self-directed learning (CS-SDL), students may set their own learning goals through the suggestions of the system…

Direct numerical simulation of solidification microstructures affected by fluid flow

International Nuclear Information System (INIS)

Juric, D.

1997-12-01

The effects of fluid flow on the solidification morphology of pure materials and solute microsegregation patterns of binary alloys are studied using a computational methodology based on a front tracking/finite difference method. A general single field formulation is presented for the full coupling of phase change, fluid flow, heat and solute transport. This formulation accounts for interfacial rejection/absorption of latent heat and solute, interfacial anisotropies, discontinuities in material properties between the liquid and solid phases, shrinkage/expansion upon solidification and motion and deformation of the solid. Numerical results are presented for the two dimensional dendritic solidification of pure succinonitrile and the solidification of globulitic grains of a plutonium-gallium alloy. For both problems, comparisons are made between solidification without fluid flow and solidification within a shear flow

Tolvaptan alleviates excessive fluid retention of nephrotic diabetic renal failure unresponsive to furosemide.

Science.gov (United States)

Takada, Tesshu; Masaki, Tsuguto; Hoshiyama, Ayako; Toki, Takuya; Kamata, Yuji; Shichiri, Masayoshi

2018-04-17

Patients with diabetic nephropathy develop nephrotic syndrome, and may show limited response to conventional therapy. They often require earlier initiation of renal replacement therapy because they become refractory to diuretics, and experience excessive fluid retention. We aimed to investigate the efficacy of tolvaptan, an oral arginine vasopressin type 2 receptor antagonist, in a case series of 14 severe diabetic renal failure patients who were severely refractory to maximal doses of furosemide and had excessive fluid retention despite preserved cardiac function and residual renal function. All 14 patients experienced immediate and sustained water diuretic effects, resulting in alleviation of congestive heart failure. None required initiation of renal replacement therapy. Tolvaptan promptly increased urine volume and free water clearance, reversed progressive fluid retention, and alleviated congestive heart failure. Thus, tolvaptan could serve as a potential adjunct therapy for severe diabetic renal failure patients with excessive fluid retention and congestive heart failure. This article is protected by copyright. All rights reserved.

Neonatal lesions of orbital frontal areas 11/13 in monkeys alter goal-directed behavior but spare fear conditioning and safety signal learning.

Directory of Open Access Journals (Sweden)

Andy M Kazama

2014-03-01

Full Text Available Recent studies in monkeys have demonstrated that damage to the lateral subfields of orbital frontal cortex (OFC areas 11/13 yields profound changes in flexible modulation of goal-directed behaviors and a lack in fear regulation. Yet, little consideration has been placed on its role in emotional and social development throughout life. The current study investigated the effects of neonatal lesions of the OFC on the flexible modulation of goal-directed behaviors and fear responses in monkeys. Infant monkeys received neonatal lesions of OFC areas 11/13 or sham-lesions during the first post-natal week. Modulation of goal-directed behaviors was measured with a devaluation task at 3-4 years and 6-7 years. Modulation of fear reactivity by safety signals was assessed with the AX+/BX- potentiated-startle paradigm at 6-7 years. Similar to adult-onset OFC lesions, selective neonatal lesions of OFC areas 11/13 yielded a failure to modulate behavioral responses guided by changes in reward value, but spared the ability to modulate fear responses in the presence of safety signals. These results suggest that these areas play a critical role in the development of behavioral adaptation during goal-directed behaviors, but not, or less so, in the development of the ability to process emotionally salient stimuli and to modulate emotional reactivity using environmental contexts, which could be supported by other OFC subfields, such as the most ventromedial subfields (i.e. areas 14/25. Given similar impaired decision-making abilities and spared modulation of fear followed both neonatal lesions of either OFC areas 11 and 13 or amygdala (Kazama et al., 2012; Kazama & Bachevalier, 2013, the present results suggest that interactions between these two neural structures play a critical role in the development of behavioral adaptation; an ability essential for the self-regulation of emotion and behavior that assures the maintenance of successful social relationships.

Stem Cells Derived from Amniotic Fluid: A Potential Pluripotent-Like Cell Source for Cellular Therapy?

Science.gov (United States)

Ramasamy, Thamil Selvee; Velaithan, Vithya; Yeow, Yelena; Sarkar, Fazlul H

2018-01-01

Regenerative medicine aims to provide therapeutic treatment for disease or injury, and cell-based therapy is a newer therapeutic approach different from conventional medicine. Ethical issues that rose by the utilisation of human embryonic stem cells (hESC) and the limited capacity of adult stem cells, however, hinder the application of these stem cells in regenerative medicine. Recently, isolation and characterisation of c-kit positive cells from human amniotic fluid, which possess intermediate characteristics between hESCs and adult stem cells, provided a new approach towards realising their promise for fetal and adult regenerative medicine. Despite the number of studies that have been initiated to characterize their molecular signature, research on developing approaches to maintain and enhance their regenerative potential is urgently needed and must be developed. Thus, this review is focused on understanding their potential uses and factors influencing their pluripotent status in vitro. In short, this cell source could be an ideal cellular resource for pluripotent cells for potential applications in allogeneic cellular replacement therapies, fetal tissue engineering, pharmaceutical screening, and in disease modelling. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Flow Diode and Method for Controlling Fluid Flow Origin of the Invention

Science.gov (United States)

Dyson, Rodger W (Inventor)

2015-01-01

A flow diode configured to permit fluid flow in a first direction while preventing fluid flow in a second direction opposite the first direction is disclosed. The flow diode prevents fluid flow without use of mechanical closures or moving parts. The flow diode utilizes a bypass flowline whereby all fluid flow in the second direction moves into the bypass flowline having a plurality of tortuous portions providing high fluidic resistance. The portions decrease in diameter such that debris in the fluid is trapped. As fluid only travels in one direction through the portions, the debris remains trapped in the portions.

  Indirect versus direct feedback in computer-based Prism Adaptation Therapy

DEFF Research Database (Denmark)

Wilms, Inge Linda; Rytter, Hana Malá

2010-01-01

  Prism Adaptation Therapy (PAT) is an intervention method in the treatment of the attention disorder neglect (Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002; Rossetti, et al., 1998). The aim of this study was to investigate whether one session of PAT using a computer-attached touchscreen...... have direct implications for future implementations of computer-based methods of treatment of visuospatial disorders and computer-assisted rehabilitation in general....

Decreased synovial fluid ghrelin levels are linked with disease severity in primary knee osteoarthritis patients and are increased following laser therapy.

Science.gov (United States)

Zou, Yu-Cong; Deng, Hong-Yu; Mao, Zheng; Zhao, Chang; Huang, Ju; Liu, Gang

2017-07-01

Ghrelin has been proved to inhibit inflammation and promote cartilage growth. So far, its role in patients with primary knee osteoarthritis has not been investigated. The current study was performed to explore the serum and synovial ghrelin levels as well as the relationship between ghrelin levels and disease severity in primary knee OA patients. 52 primary knee OA patients were recruited in the study. 52 sex and age-matched patients visiting our hospital for regular body check were selected as controls. The serum and synovial fluid ghrelin levels were examined by enzyme linked immunosorbent assay (ELISA) before treatment, one week and four weeks after laser therapy, respectively. The inflammation markers IL-6 and TNF-α were also investigated. The radiographic progression was assessed by Kellgren-Lawrence (K-L) grade scale and the symptomatic severity was evaluated by visual analog scale (VAS), Lequesne index and Lysholm scores. The Receiver Operating Characteristic (ROC) analysis curve was conducted to test the diagnostic value of ghrelin, IL-6 and TNF-α for radiographic progression. No significant difference of serum ghrelin levels was found between knee OA patients and healthy controls. Synovial fluid ghrelin concentrations were significantly negatively correlated with K-L grading (r=-0.591, Pghrelin levels were also related to clinical severity determined by Lequesne index (r=-0.308, P=0.025),VAS scores (r=-0.591, Pghrelin levels were also negatively associated with TNF-α (r=-0.424, P=0.002) and IL-6 concentrations (r=-0.428, P=0.002). ROC curve analysis demonstrated that ghrelin exhibited more diagnostic value than IL-6 and TNF-α for assessing radiographic progression in medium-late stage. Decreased synovial fluid ghrelin levels are related to disease severity in patients with primary osteoarthritis and are increased following laser therapy. Local application of ghrelin may serve as an adjunctive therapy for knee OA. Copyright © 2017. Published by

From goal motivation to goal progress: the mediating role of coping in the Self-Concordance Model.

Science.gov (United States)

Gaudreau, Patrick; Carraro, Natasha; Miranda, Dave

2012-01-01

The present studies examined the mediating role of self-regulatory mechanisms in the relationship between goal motivation and goal progress in the Self-Concordance Model. First, a systematic review, using meta-analytical path analysis, supported the mediating role of effort and action planning in the positive association between autonomous goal motivation and goal progress. Second, results from two additional empirical studies, using structural equation modeling, lent credence to the mediating role of coping in the relationship between goal motivation and goal progress of university students. Autonomous goal motivation was positively associated with task-oriented coping, which predicted greater goal progress during midterm exams (Study 1, N=702) and at the end of the semester in a different sample (Study 2, N=167). Controlled goal motivation was associated with greater disengagement-oriented coping (Study 1 and Study 2) and lesser use of task-oriented coping (Study 2), which reduced goal progress. These results held up after controlling for perceived stress (Study 2). Our findings highlight the importance of coping in the "inception-to-attainment" goal process because autonomous goal motivation indirectly rather than directly predicts goal progress of university students through their usage of task-oriented coping.

The role of fluid overload in the prediction of outcome in acute kidney injury.

Science.gov (United States)

Selewski, David T; Goldstein, Stuart L

2018-01-01

Our understanding of the epidemiology and the impact of acute kidney injury (AKI) and fluid overload on outcomes has improved significantly over the past several decades. Fluid overload occurs commonly in critically ill children with and without associated AKI. Researchers in pediatric AKI have been at the forefront of describing the impact of fluid overload on outcomes in a variety of populations. A full understanding of this topic is important as fluid overload represents a potentially modifiable risk factor and a target for intervention. In this state-of-the-art review, we comprehensively describe the definition of fluid overload, the impact of fluid overload on kidney function, the impact of fluid overload on the diagnosis of AKI, the association of fluid overload with outcomes, the targeted therapy of fluid overload, and the impact of the timing of renal replacement therapy on outcomes.

Geophysical fluid dynamics

CERN Document Server

Pedlosky, Joseph

1982-01-01

The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which land my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same tim...

Geophysical fluid dynamics

CERN Document Server

Pedlosky, Joseph

1979-01-01

The content of this book is based, largely, on the core curriculum in geophys­ ical fluid dynamics which I and my colleagues in the Department of Geophysical Sciences at The University of Chicago have taught for the past decade. Our purpose in developing a core curriculum was to provide to advanced undergraduates and entering graduate students a coherent and systematic introduction to the theory of geophysical fluid dynamics. The curriculum and the outline of this book were devised to form a sequence of courses of roughly one and a half academic years (five academic quarters) in length. The goal of the sequence is to help the student rapidly advance to the point where independent study and research are practical expectations. It quickly became apparent that several topics (e. g. , some aspects of potential theory) usually thought of as forming the foundations of a fluid-dynamics curriculum were merely classical rather than essential and could be, however sadly, dispensed with for our purposes. At the same ti...

Some evidence for the usefulness of an optimal foraging theory perspective on goal conflict and goal facilitation.

Science.gov (United States)

Tomasik, Martin J; Knecht, Michaela; Freund, Alexandra M

2017-12-01

Based on optimal foraging theory, we propose a metric that allows evaluating the goodness of goal systems, that is, systems comprising multiple goals with facilitative and conflicting interrelations. This optimal foraging theory takes into account expectancy and value, as well as opportunity costs, of foraging. Applying this approach to goal systems provides a single index of goodness of a goal system for goal striving. Three quasi-experimental studies (N = 277, N = 145, and N = 210) provide evidence for the usefulness of this approach for goal systems comprising between 3 to 10 goals. Results indicate that persons with a more optimized goal-system are more conscientious and open to new experience, are more likely to represent their goals in terms of means (i.e., adopt a process focus), and are more satisfied and engaged with their goals. Persons with a suboptimal goal system tend to switch their goals more often and thereby optimize their goal system. We discuss limitations as well as possible future directions of this approach. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Fiber optic fluid detector

Science.gov (United States)

Angel, S.M.

1987-02-27

Particular gases or liquids are detected with a fiber optic element having a cladding or coating of a material which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses. 10 figs.

Elucidating a Goal-Setting Continuum in Brain Injury Rehabilitation.

Science.gov (United States)

Hunt, Anne W; Le Dorze, Guylaine; Trentham, Barry; Polatajko, Helene J; Dawson, Deirdre R

2015-08-01

For individuals with brain injury, active participation in goal setting is associated with better rehabilitation outcomes. However, clinicians report difficulty engaging these clients in goal setting due to perceived or real deficits (e.g., lack of awareness). We conducted a study using grounded theory methods to understand how clinicians from occupational therapy facilitate client engagement and manage challenges inherent in goal setting with this population. Through constant comparative analysis, a goal-setting continuum emerged. At one end of the continuum, therapists embrace client-determined goals and enable clients to decide their own goals. At the other, therapists accept preset organization-determined goals (e.g., "the goal is discharge") and pay little attention to client input. Although all participants aspired to embrace client-determined goal setting, most felt powerless to do so within perceived organizational constraints. Views of advocacy and empowerment help to explain our findings and inform more inclusive practice. © The Author(s) 2015.

The Impact of Solid Surface Features on Fluid-Fluid Interface Configuration

Science.gov (United States)

Araujo, J. B.; Brusseau, M. L. L.

2017-12-01

Pore-scale fluid processes in geological media are critical for a broad range of applications such as radioactive waste disposal, carbon sequestration, soil moisture distribution, subsurface pollution, land stability, and oil and gas recovery. The continued improvement of high-resolution image acquisition and processing have provided a means to test the usefulness of theoretical models developed to simulate pore-scale fluid processes, through the direct quantification of interfaces. High-resolution synchrotron X-ray microtomography is used in combination with advanced visualization tools to characterize fluid distributions in natural geologic media. The studies revealed the presence of fluid-fluid interface associated with macroscopic features on the surfaces of the solids such as pits and crevices. These features and respective fluid interfaces, which are not included in current theoretical or computational models, may have a significant impact on accurate simulation and understanding of multi-phase flow, energy, heat and mass transfer processes.

Goal-orientated cognitive rehabilitation for dementias associated with Parkinson's disease-A pilot randomised controlled trial.

Science.gov (United States)

Hindle, John V; Watermeyer, Tamlyn J; Roberts, Julie; Brand, Andrew; Hoare, Zoe; Martyr, Anthony; Clare, Linda

2018-05-01

To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study. This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9). Primary outcomes were ratings of goal attainment and satisfaction with goal attainment. Secondary outcomes included quality of life, mood, cognition, health status, everyday functioning, and carers' ratings of goal attainment and their own quality of life and stress levels. Assessments were at 2 and 6 months following randomisation. At 2 months, cognitive rehabilitation was superior to treatment-as-usual and relaxation therapy for the primary outcomes of self-rated goal attainment (d = 1.63 and d = 1.82, respectively) and self-rated satisfaction with goal attainment (d = 2.04 and d = 1.84). At 6 months, cognitive rehabilitation remained superior to treatment-as-usual (d = 1.36) and relaxation therapy (d = 1.77) for self-rated goal attainment. Cognitive rehabilitation was superior to treatment as usual and/or relaxation therapy in a number of secondary outcomes at 2 months (mood, self-efficacy, social domain of quality of life, carers' ratings of participants' goal attainment) and at 6 months (delayed recall, health status, quality of life, carer ratings of participants' goal attainment). Carers receiving cognitive rehabilitation reported better quality of life, health status, and lower stress than those allocated to treatment-as-usual. Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson's disease. Copyright © 2018 John Wiley & Sons, Ltd.

Chromate Dissociation from Primer Paint in Simulated Lung Fluid.

Science.gov (United States)

2000-03-01

and simulated interstitial lung fluid is surface active component (dipalmitoyl lecithin : DPL) in simulated surfactant lung fluid (Dennis, 1982:470...Biology in Health and Disease Vol 84: Surfactant Therapy for Lung Disease. Ed. Bengt Robertson and H. William Taeusch. New York, NY: Mrecel Dekker inc

Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

Science.gov (United States)

Jones, Wallace; Drake, Cynthia; Mack, David; Reeder, Blaine; Trautner, Barbara; Wald, Heidi

2017-06-20

Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication

Oral versus intravenous rehydration therapy in severe gastroenteritis.

Science.gov (United States)

Sharifi, J; Ghavami, F; Nowrouzi, Z; Fouladvand, B; Malek, M; Rezaeian, M; Emami, M

1985-01-01

A controlled, randomised trial comparing the results of oral rehydration therapy with those of intravenous fluid treatment in 470 children with severe gastroenteritis was undertaken. The oral rehydration therapy was divided into two phases--a rehydration phase that used high sodium isotonic fluid at 40 ml/kg per hour and a maintenance phase using low sodium isotonic fluid (sodium 40, potassium 30, bicarbonate 25, chloride 45, and dextrose 130 mmol/l). The results indicate that oral rehydration treatment, used according to this protocol, is successful in treating severe diarrhoea and dehydration, and has considerable advantages over intravenous fluid therapy in reducing complications associated with the treatment of hypernatraemia, in promoting rapid correction of hypokalaemia and acidosis, in decreasing the duration of diarrhoea, and in promoting a greater weight gain at hospital discharge. PMID:3901934

Vital Signs Directed Therapy: Improving Care in an Intensive Care Unit in a Low-Income Country.

Directory of Open Access Journals (Sweden)

Tim Baker

Full Text Available Global Critical Care is attracting increasing attention. At several million deaths per year, the worldwide burden of critical illness is greater than generally appreciated. Low income countries (LICs have a disproportionally greater share of critical illness, and yet critical care facilities are scarce in such settings. Routines utilizing abnormal vital signs to identify critical illness and trigger medical interventions have become common in high-income countries but have not been investigated in LICs. The aim of the study was to assess whether the introduction of a vital signs directed therapy protocol improved acute care and reduced mortality in an Intensive Care Unit (ICU in Tanzania.Prospective, before-and-after interventional study in the ICU of a university hospital in Tanzania. A context-appropriate protocol that defined danger levels of severely abnormal vital signs and stipulated acute treatment responses was implemented in a four week period using sensitisation, training, job aids, supervision and feedback. Acute treatment of danger signs at admission and during care in the ICU and in-hospital mortality were compared pre and post-implementation using regression models. Danger signs from 447 patients were included: 269 pre-implementation and 178 post-implementation. Acute treatment of danger signs was higher post-implementation (at admission: 72.9% vs 23.1%, p<0.001; in ICU: 16.6% vs 2.9%, p<0.001. A danger sign was five times more likely to be treated post-implementation (Prevalence Ratio (PR 4.9 (2.9-8.3. Intravenous fluids were given in response to 35.0% of hypotensive episodes post-implementation, as compared to 4.1% pre-implementation (PR 6.4 (2.5-16.2. In patients admitted with hypotension, mortality was lower post-implementation (69.2% vs 92.3% p = 0.02 giving a numbers-needed-to-treat of 4.3. Overall in-hospital mortality rates were unchanged (49.4% vs 49.8%, p = 0.94.The introduction of a vital signs directed therapy protocol

A Neurocomputational Model of Goal-Directed Navigation in Insect-Inspired Artificial Agents.

Science.gov (United States)

Goldschmidt, Dennis; Manoonpong, Poramate; Dasgupta, Sakyasingha

2017-01-01

Despite their small size, insect brains are able to produce robust and efficient navigation in complex environments. Specifically in social insects, such as ants and bees, these navigational capabilities are guided by orientation directing vectors generated by a process called path integration. During this process, they integrate compass and odometric cues to estimate their current location as a vector, called the home vector for guiding them back home on a straight path. They further acquire and retrieve path integration-based vector memories globally to the nest or based on visual landmarks. Although existing computational models reproduced similar behaviors, a neurocomputational model of vector navigation including the acquisition of vector representations has not been described before. Here we present a model of neural mechanisms in a modular closed-loop control-enabling vector navigation in artificial agents. The model consists of a path integration mechanism, reward-modulated global learning, random search, and action selection. The path integration mechanism integrates compass and odometric cues to compute a vectorial representation of the agent's current location as neural activity patterns in circular arrays. A reward-modulated learning rule enables the acquisition of vector memories by associating the local food reward with the path integration state. A motor output is computed based on the combination of vector memories and random exploration. In simulation, we show that the neural mechanisms enable robust homing and localization, even in the presence of external sensory noise. The proposed learning rules lead to goal-directed navigation and route formation performed under realistic conditions. Consequently, we provide a novel approach for vector learning and navigation in a simulated, situated agent linking behavioral observations to their possible underlying neural substrates.

Host-directed therapy of tuberculosis: what is in it for microRNA?

Science.gov (United States)

Iannaccone, Marco; Dorhoi, Anca; Kaufmann, Stefan H E

2014-05-01

Tuberculosis (TB) is a major health threat and current intervention measures are far from satisfactory. MicroRNAs (miRs) have become major targets of investigations for different diseases due to their propensity to regulate gene expression in various biological processes. More recently, miRs have been found to play key roles in the control of infectious diseases. Consequently, the potential of miRs for diagnosis and therapy of TB is being considered. In this editorial, we discuss most recent lines of evidence for regulation of the immune response in TB by miRs that could form the basis for diagnosis and host-directed therapy in adjunct to canonical intervention measures in TB.

The effects of treatment adherence and treatment-specific therapeutic competencies on outcome and goal attainment in telephone-based therapy with caregivers of people with dementia.

Science.gov (United States)

Schinköthe, Denise; Altmann, Uwe; Wilz, Gabriele

2015-01-01

Contradictory results have been found for the impact of therapist's adherence and competence on intervention outcomes. Most studies focus on generic aspects of competence and adherence, rather than taking into account treatment-specific aspects or specific challenges of the clientele. Appropriate analyses are lacking for cognitive behavioral therapy (CBT) with caregivers of people with dementia. In a sample of 43 caregivers, we examined adherence and different competence ratings of 80 complete sessions, as predictors of symptom change and goal attainment. Therapist's competence was evaluated by four raters, using an adapted version of the cognitive therapy scale (CTS) on three subscales of competence: General therapeutic (GT), session-structuring (SS), and treatment-specific CBT technique (CT). Therapist's adherence to the manual was also assessed. The results show that GT competencies were associated with lower post-test depression scores and that CT competencies predicted a decrease in caregiver burden and higher goal attainment, while SS competencies predicted higher post-test burden. Therapist's adherence had no relationship to outcome, but the higher application of modifying dysfunctional thoughts was associated with higher goal attainment. The results suggest the importance of treatment-specific competencies for outcome. Future research should identify empirically what kind of therapeutic behavior is appropriate to the challenges of a specific clientele such as caregivers of people with dementia.

Analysis of the distribution of magnetic fluid inside tumors by a giant magnetoresistance probe

KAUST Repository

Gooneratne, Chinthaka P.

2013-11-29

Magnetic fluid hyperthermia (MFH) therapy uses the magnetic component of electromagnetic fields in the radiofrequency spectrum to couple energy to magnetic nanoparticles inside tumors. In MFH therapy, magnetic fluid is injected into tumors and an alternating current (AC) magnetic flux is applied to heat the magnetic fluid- filled tumor. If the temperature can be maintained at the therapeutic threshold of 42C for 30 minutes or more, the tumor cells can be destroyed. Analyzing the distribution of the magnetic fluid injected into tumors prior to the heating step in MFH therapy is an essential criterion for homogenous heating of tumors, since a decision can then be taken on the strength and localization of the applied external AC magnetic flux density needed to destroy the tumor without affecting healthy cells. This paper proposes a methodology for analyzing the distribution of magnetic fluid in a tumor by a specifically designed giant magnetoresistance (GMR) probe prior to MFH heat treatment. Experimental results analyzing the distribution of magnetic fluid suggest that different magnetic fluid weight densities could be estimated inside a single tumor by the GMR probe. 2013 Gooneratne et al.

Analysis of the distribution of magnetic fluid inside tumors by a giant magnetoresistance probe

KAUST Repository

Gooneratne, Chinthaka P.; Kurnicki, Adam; Yamada, Sotoshi; Mukhopadhyay, Subhas C.; Kosel, Jü rgen

2013-01-01

Magnetic fluid hyperthermia (MFH) therapy uses the magnetic component of electromagnetic fields in the radiofrequency spectrum to couple energy to magnetic nanoparticles inside tumors. In MFH therapy, magnetic fluid is injected into tumors and an alternating current (AC) magnetic flux is applied to heat the magnetic fluid- filled tumor. If the temperature can be maintained at the therapeutic threshold of 42C for 30 minutes or more, the tumor cells can be destroyed. Analyzing the distribution of the magnetic fluid injected into tumors prior to the heating step in MFH therapy is an essential criterion for homogenous heating of tumors, since a decision can then be taken on the strength and localization of the applied external AC magnetic flux density needed to destroy the tumor without affecting healthy cells. This paper proposes a methodology for analyzing the distribution of magnetic fluid in a tumor by a specifically designed giant magnetoresistance (GMR) probe prior to MFH heat treatment. Experimental results analyzing the distribution of magnetic fluid suggest that different magnetic fluid weight densities could be estimated inside a single tumor by the GMR probe. 2013 Gooneratne et al.

Analysis of the distribution of magnetic fluid inside tumors by a giant magnetoresistance probe.

Directory of Open Access Journals (Sweden)

Chinthaka P Gooneratne

Full Text Available Magnetic fluid hyperthermia (MFH therapy uses the magnetic component of electromagnetic fields in the radiofrequency spectrum to couple energy to magnetic nanoparticles inside tumors. In MFH therapy, magnetic fluid is injected into tumors and an alternating current (AC magnetic flux is applied to heat the magnetic fluid- filled tumor. If the temperature can be maintained at the therapeutic threshold of 42 °C for 30 minutes or more, the tumor cells can be destroyed. Analyzing the distribution of the magnetic fluid injected into tumors prior to the heating step in MFH therapy is an essential criterion for homogenous heating of tumors, since a decision can then be taken on the strength and localization of the applied external AC magnetic flux density needed to destroy the tumor without affecting healthy cells. This paper proposes a methodology for analyzing the distribution of magnetic fluid in a tumor by a specifically designed giant magnetoresistance (GMR probe prior to MFH heat treatment. Experimental results analyzing the distribution of magnetic fluid suggest that different magnetic fluid weight densities could be estimated inside a single tumor by the GMR probe.

Comparing Three Models of Achievement Goals: Goal Orientations, Goal Standards, and Goal Complexes

Science.gov (United States)

Senko, Corwin; Tropiano, Katie L.

2016-01-01

Achievement goal theory (Dweck, 1986) initially characterized mastery goals and performance goals as opposites in a good-bad dualism of student motivation. A later revision (Harackiewicz, Barron, & Elliot, 1998) contended that both goals can provide benefits and be pursued together. Perhaps both frameworks are correct: Their contrasting views…

Purposeful Goal-Directed Movements Give Rise to Higher Tactile Discrimination Performance

Directory of Open Access Journals (Sweden)

Georgiana Juravle

2011-10-01

Full Text Available Tactile perception is inhibited during goal-directed reaching movements (sensory suppression. Here, participants performed simple reaching or exploratory movements (where contact with the table surface was maintained. We measured tactile discrimination thresholds for vibratory stimuli delivered to participants' wrists while executing the movement, and while at rest. Moreover, we measured discrimination performance (in a same vs. different task for the materials covering the table surface, during the execution of the different movements. The threshold and discrimination tasks could be performed either singly or together, both under active movement and passive conditions (ie, no movement required, but with tactile stimulation. Thresholds measured at rest were significantly lower than thresholds measured during both active movements and passive touches. This provides a clear indication of sensory suppression during movement execution. Moreover, the discrimination data revealed main effects of task (single vs. dual, movement execution type (passive vs. active, and movement type (reach vs. exploration: Discrimination performance was significantly higher under conditions of single-tasking, active movements, as well as exploratory movements. Therefore, active movement of the hand with the purpose of gaining tactual information about the surface of the table gives rise to enhanced performance, thus suggesting that we feel more when we need to; It would appear that tactual information is prioritized when relevant for the movement being executed.

Teaching fluid mechanics to high schoolers: methods, challenges, and outcome

Science.gov (United States)

Manikantan, Harishankar

2017-11-01

This talk will summarize the goals, methods, and both short- and long-term feedback from two high-school-level courses in fluid mechanics involving 43 students and cumulatively spanning over 100 hours of instruction. The goals of these courses were twofold: (a) to spark an interest in science and engineering and attract a more diverse demographic into college-level STEM programs; and (b) to train students in a `college-like' method of approaching the physics of common phenomena, with fluid mechanics as the context. The methods of instruction included classes revolving around the idea of dispelling misconceptions, group activities, `challenge' rounds and mock design projects to use fluid mechanics phenomena to achieve a specified goal, and simple hands-on experiments. The feedback during instruction was overwhelmingly positive, particularly in terms of a changing and favorable attitude towards math and engineering. Long after the program, a visible impact lies in a diverse group of students acknowledging that the course had a positive effect in their decision to choose an engineering or science major in a four-year college.

Managing Fluid and Electrolyte Disorders in Kidney Disease.

Science.gov (United States)

Langston, Cathy

2017-03-01

Because of the role of the kidneys in maintaining homeostasis in the body, kidney disease leads to derangements of fluid, electrolyte, and acid-base balance. The most effective therapy of a uremic crisis is careful management of fluid balance, which involves thoughtful assessment of hydration, a fluid treatment plan personalized for the specific patient, and repeated and frequent reassessment of fluid and electrolyte balance. Disorders of sodium, chloride, potassium, calcium, and phosphorus are commonly encountered in kidney disease and some may be life-threatening. Treatment of metabolic acidosis and nutritional support is frequently needed. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparing the achievement goal orientation of mathematics ...

African Journals Online (AJOL)

Comparing the achievement goal orientation of mathematics learners with and without attention-deficit hyperactivity disorder. ... in recognising methods to direct learners' goals for better engagement with and improved results in mathematics, which could support learners to develop to their full potential in the subject.

[Therapeutic goals and indications: psychotherapy patient's self-reports during diagnostic assessment].

Science.gov (United States)

Faller, H

2000-07-01

Although individual therapeutic goals are considered to be important factors motivating patients to engage in therapeutic work, they have gained little attention in empirical research. In the present study, patients were given a questionnaire containing 24 therapeutic goals which could be rated according to their subjective relevance on a 5-point scale. N = 152 patients (mean age 34.5 years, 59.2% female) who presented at a university psychotherapy outpatient department to attend a diagnostic interview participated in the study. "To solve my problems" and "to get relief from my complaints" were the goals that were rated as most important. Goals pertaining to mental health such as more contentness and calmness, self-assertion and insight scored high, too. Three rational scales were constructed: 1. insight, 2. sociability, and 3. self-assertion. These scales were correlated with both patients' causal attributions and therapy expectations in plausible ways. However, the general strength of intercorrelations point of the conception patients goals were not very succinct at the time of the intake interview. Indication groups regarding specific therapeutic measures did not differ with respect to therapy goals. Only the general decision whether to recommend a psychotherapeutic intervention or not seemed to be influenced by patients' therapeutic aims.

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

Science.gov (United States)

Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

2011-07-15

The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

Fluid-structure interactions models, analysis and finite elements

CERN Document Server

Richter, Thomas

2017-01-01

This book starts by introducing the fundamental concepts of mathematical continuum mechanics for fluids and solids and their coupling. Special attention is given to the derivation of variational formulations for the subproblems describing fluid- and solid-mechanics as well as the coupled fluid-structure interaction problem. Two monolithic formulations for fluid-structure interactions are described in detail: the well-established ALE formulation and the modern Fully Eulerian formulation, which can effectively deal with problems featuring large deformation and contact. Further, the book provides details on state-of-the-art discretization schemes for fluid- and solid-mechanics and considers the special needs of coupled problems with interface-tracking and interface-capturing techniques. Lastly, advanced topics like goal-oriented error estimation, multigrid solution and gradient-based optimization schemes are discussed in the context of fluid-structure interaction problems.

MOTIVATION: Goals and Goal Setting

Science.gov (United States)

Stratton, Richard K.

2005-01-01

Goal setting has great impact on a team's performance. Goals enable a team to synchronize their efforts to achieve success. In this article, the author talks about goals and goal setting. This articles complements Domain 5--Teaching and Communication (p.14) and discusses one of the benchmarks listed therein: "Teach the goal setting process and…

Fiber optic fluid detector

Science.gov (United States)

Angel, S. Michael

1989-01-01

Particular gases or liquids are detected with a fiber optic element (11, 11a to 11j) having a cladding or coating of a material (23, 23a to 23j) which absorbs the fluid or fluids and which exhibits a change of an optical property, such as index of refraction, light transmissiveness or fluoresence emission, for example, in response to absorption of the fluid. The fluid is sensed by directing light into the fiber optic element and detecting changes in the light, such as exit angle changes for example, that result from the changed optical property of the coating material. The fluid detector (24, 24a to 24j) may be used for such purposes as sensing toxic or explosive gases in the atmosphere, measuring ground water contamination or monitoring fluid flows in industrial processes, among other uses.

Efficacy and safety of olmesartan/amlodipine/hydrochlorothiazide in patients with hypertension not at goal with mono, dual or triple drug therapy: results of the CHAMPiOn study.

Science.gov (United States)

Punzi, Henry A

2014-02-01

To assess the efficacy and safety of once daily olmesartan medoxomil (OM)/amlodipine besylate (AM)/hydrochlorothiazide (HCTZ) 40/10/25 mg in patients with hypertension not at goal with mono, dual or triple drug therapy. This was a single-center, prospective, open-label, blinded-endpoint study. After a 1-week screening visit, 40 patients were enrolled into the study and given once daily treatment with OM/AM/HCTZ after the patients underwent baseline ambulatory blood pressure monitoring (ABPM) on their original therapy. The primary endpoint was changes from baseline in mean 24 h ABPM [systolic blood pressure (SBP)] after the first day of therapy with OM/AM/HCTZ 40/10/25 mg. Secondary endpoints were changes from baseline in mean 24 h ABPM [diastolic blood pressure (DBP)] after the first day of therapy with OM/AM/HCTZ 40/10/25 mg; mean changes from baseline in trough seated SBP (SeSBP) at day 1 and SeSBP at weeks 1, 2, 3 and 4; mean changes from baseline in trough seated DBP (SeDBP) at day 1 and SeDBP at weeks 1, 2, 3 and 4; and the percentage of subjects achieving mean 24 h, daytime and night-time ABPM BP goals. The baseline paired t-test systolic ABPM was 134.0 ± 2.77 mmHg and day 1 was 128.6 ± 2.47 mmHg with a treatment difference of -5.55 ± 1.3 mmHg (pABPM SBP reduction was 117.7 ± 2.0 mmHg with a treatment difference of -16.5 ± 1.8 mmHg (p ABPM SBP reduction was 115.8 ± 1.8 mmHg with a treatment difference of -18.4 ± 2.0 mmHg (p ABPM SBP reduction was 115.5 ± 1.9 mmHg with a treatment difference of -18.6 ± 2.0 mmHg (p ABPM SBP reduction was 115.5 ± 1.8 mmHg with a treatment difference of -18.6 ± 2.2 mmHg (p ABPM reductions compared with mono, dual or triple drug therapy, resulting in all patients achieving systolic ABPM goal without ABPM documented hypotension.

Patient-Centered Goal Setting in a Hospital-Based Outpatient Stroke Rehabilitation Center.

Science.gov (United States)

Rice, Danielle B; McIntyre, Amanda; Mirkowski, Magdalena; Janzen, Shannon; Viana, Ricardo; Britt, Eileen; Teasell, Robert

2017-09-01

Goal-setting can have a positive impact on stroke recovery during rehabilitation. Patient participation in goal formulation can ensure that personally relevant goals are set, and can result in greater satisfaction with the rehabilitation experience, along with improved recovery of stroke deficits. This, however, not yet been studied in a stroke outpatient rehabilitation setting. To assess patient satisfaction of meeting self-selected goals during outpatient rehabilitation following a stroke. Retrospective chart review. Stroke patients enrolled in a multidisciplinary outpatient rehabilitation program, who set at least 1 goal during rehabilitation. Patients recovering from a stroke received therapy through the outpatient rehabilitation program between January 2010 and December 2013. Upon admission and discharge from rehabilitation, patients rated their satisfaction with their ability to perform goals that they wanted to achieve. Researchers independently sorted and labeled recurrent themes of goals. Goals were further sorted into International Classification of Functioning, Disability and Health (ICF) categories. To compare the perception of patients' goal satisfaction, repeated-measures analysis of variance was conducted across the 3 ICF goal categorizations. Goal satisfaction scores. A total of 286 patients were included in the analysis. Patient goals concentrated on themes of improving hand function, mobility, and cognition. Goals were also sorted into ICF categories in which impairment-based and activity limitation-based goals were predominant. Compared to activity-based and participation-based goals, patients with impairment-based goals perceived greater satisfaction with meeting their goals at admission and discharge (P rehabilitation program (P stroke rehabilitation setting, patients set heterogeneous goals that were predominantly impairment based. Satisfaction in achieving goals significantly improved after receiving therapy. The type of goals that patients

Between practice, policy and politics: Music therapy and the Dementia Strategy, 2009.

Science.gov (United States)

Spiro, Neta; Farrant, Camilla L; Pavlicevic, Mercédès

2017-04-01

Does current music therapy practice address the goals encapsulated in the UK Department of Health document, Living well with dementia: a national dementia strategy (the Dementia Strategy) published in 2009? A survey elicited the views of clients, family members, music therapists, care home staff and care home managers, about this question by focusing on the relationship between music therapy and the 17 objectives outlined in the Dementia Strategy. The results showed that the objectives that are related to direct activity of the music therapists (such as care and understanding of the condition) were seen as most fulfilled by music therapy, while those regarding practicalities (such as living within the community) were seen as least fulfilled. Although the responses from the four groups of participants were similar, differences for some questions suggest that people's direct experience of music therapy influences their views. This study suggests that many aspects of the Dementia Strategy are already seen as being achieved. The findings suggest that developments of both music therapy practices and government strategies on dementia care may benefit from being mutually informed.

Directed motion of spheres induced by unbiased driving forces in viscous fluids beyond the Stokes' law regime

Science.gov (United States)

Casado-Pascual, Jesús

2018-03-01

The emergence of directed motion is investigated in a system consisting of a sphere immersed in a viscous fluid and subjected to time-periodic forces of zero average. The directed motion arises from the combined action of a nonlinear drag force and the applied driving forces, in the absence of any periodic substrate potential. Necessary conditions for the existence of such directed motion are obtained and an analytical expression for the average terminal velocity is derived within the adiabatic approximation. Special attention is paid to the case of two mutually perpendicular forces with sinusoidal time dependence, one with twice the period of the other. It is shown that, although neither of these two forces induces directed motion when acting separately, when added together, the resultant force generates directed motion along the direction of the force with the shortest period. The dependence of the average terminal velocity on the system parameters is analyzed numerically and compared with that obtained using the adiabatic approximation. Among other results, it is found that, for appropriate parameter values, the direction of the average terminal velocity can be reversed by varying the forcing strength. Furthermore, certain aspects of the observed phenomenology are explained by means of symmetry arguments.

Theory for site-site pair distribution functions of molecular fluids. II. Approximations for the Percus--Yevick site-site direct correlation functions

International Nuclear Information System (INIS)

Johnson, E.

1977-01-01

A theory for site-site pair distribution functions of molecular fluids is derived from the Ornstein-Zernike equation. Atom-atom pair distribution functions of this theory which were obtained by using different approximations for the Percus-Yevick site-site direct correlation functions are compared

Direct Detection of Protein Biomarkers in Human Fluids Using Site-Specific Antibody Immobilization Strategies

Directory of Open Access Journals (Sweden)

Maria Soler

2014-01-01

Full Text Available Design of an optimal surface biofunctionalization still remains an important challenge for the application of biosensors in clinical practice and therapeutic follow-up. Optical biosensors offer real-time monitoring and highly sensitive label-free analysis, along with great potential to be transferred to portable devices. When applied in direct immunoassays, their analytical features depend strongly on the antibody immobilization strategy. A strategy for correct immobilization of antibodies based on the use of ProLinker™ has been evaluated and optimized in terms of sensitivity, selectivity, stability and reproducibility. Special effort has been focused on avoiding antibody manipulation, preventing nonspecific adsorption and obtaining a robust biosurface with regeneration capabilities. ProLinker™-based approach has demonstrated to fulfill those crucial requirements and, in combination with PEG-derivative compounds, has shown encouraging results for direct detection in biological fluids, such as pure urine or diluted serum. Furthermore, we have implemented the ProLinker™ strategy to a novel nanoplasmonic-based biosensor resulting in promising advantages for its application in clinical and biomedical diagnosis.

Direct detection of protein biomarkers in human fluids using site-specific antibody immobilization strategies.

Science.gov (United States)

Soler, Maria; Estevez, M-Carmen; Alvarez, Mar; Otte, Marinus A; Sepulveda, Borja; Lechuga, Laura M

2014-01-29

Design of an optimal surface biofunctionalization still remains an important challenge for the application of biosensors in clinical practice and therapeutic follow-up. Optical biosensors offer real-time monitoring and highly sensitive label-free analysis, along with great potential to be transferred to portable devices. When applied in direct immunoassays, their analytical features depend strongly on the antibody immobilization strategy. A strategy for correct immobilization of antibodies based on the use of ProLinker™ has been evaluated and optimized in terms of sensitivity, selectivity, stability and reproducibility. Special effort has been focused on avoiding antibody manipulation, preventing nonspecific adsorption and obtaining a robust biosurface with regeneration capabilities. ProLinker™-based approach has demonstrated to fulfill those crucial requirements and, in combination with PEG-derivative compounds, has shown encouraging results for direct detection in biological fluids, such as pure urine or diluted serum. Furthermore, we have implemented the ProLinker™ strategy to a novel nanoplasmonic-based biosensor resulting in promising advantages for its application in clinical and biomedical diagnosis.

The Fluid Foil: The Seventh Simple Machine

Science.gov (United States)

Mitts, Charles R.

2012-01-01

A simple machine does one of two things: create a mechanical advantage (lever) or change the direction of an applied force (pulley). Fluid foils are unique among simple machines because they not only change the direction of an applied force (wheel and axle); they convert fluid energy into mechanical energy (wind and Kaplan turbines) or vice versa,…

Associations of Hospital and Patient Characteristics with Fluid Resuscitation Volumes in Patients with Severe Sepsis

DEFF Research Database (Denmark)

Hjortrup, Peter Buhl; Haase, Nicolai; Wetterslev, Jørn

2016-01-01

PURPOSE: Fluid resuscitation is a key intervention in patients with sepsis and circulatory impairment. The recommendations for continued fluid therapy in sepsis are vague, which may result in differences in clinical practice. We aimed to evaluate associations between hospital and patient characte....... The data indicate variations in clinical practice not explained by patient characteristics emphasizing the need for RCTs assessing fluid resuscitation volumes fluid in patients with sepsis.......PURPOSE: Fluid resuscitation is a key intervention in patients with sepsis and circulatory impairment. The recommendations for continued fluid therapy in sepsis are vague, which may result in differences in clinical practice. We aimed to evaluate associations between hospital and patient...... characteristics and fluid resuscitation volumes in ICU patients with severe sepsis. METHODS: We explored the 6S trial database of ICU patients with severe sepsis needing fluid resuscitation randomised to hydroxyethyl starch 130/0.42 vs. Ringer's acetate. Our primary outcome measure was fluid resuscitation volume...

Emotion and goal-directed behavior: ERP evidence on cognitive and emotional conflict

Science.gov (United States)

Kanske, Philipp; Obermeier, Christian; Schröger, Erich; Kotz, Sonja A.

2015-01-01

Cognitive control supports goal-directed behavior by resolving conflict among opposing action tendencies. Emotion can trigger cognitive control processes, thus speeding up conflict processing when the target dimension of stimuli is emotional. However, it is unclear what role emotionality of the target dimension plays in the processing of emotional conflict (e.g. in irony). In two EEG experiments, we compared the influence of emotional valence of the target (emotional, neutral) in cognitive and emotional conflict processing. To maximally approximate real-life communication, we used audiovisual stimuli. Participants either categorized spoken vowels (cognitive conflict) or their emotional valence (emotional conflict), while visual information was congruent or incongruent. Emotional target dimension facilitated both cognitive and emotional conflict processing, as shown in a reduced reaction time conflict effect. In contrast, the N100 in the event-related potentials showed a conflict-specific reversal: the conflict effect was larger for emotional compared with neutral trials in cognitive conflict and smaller in emotional conflict. Additionally, domain-general conflict effects were observed in the P200 and N200 responses. The current findings confirm that emotions have a strong influence on cognitive and emotional conflict processing. They also highlight the complexity and heterogeneity of the interaction of emotion with different types of conflict. PMID:25925271

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: An exploratory prospective study

Directory of Open Access Journals (Sweden)

Campbell Neil C

2011-07-01

Full Text Available Abstract Background The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Methods Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Results Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate. Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively in behaviour over and above intention and perceived behavioural control. Conclusions Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better

Response of the Pre-oriented Goal-directed Attention to Usual and Unusual Distractors: A Preliminary Study

Directory of Open Access Journals (Sweden)

Golnaz Baghdadi

2017-03-01

Full Text Available Introduction: In this study, we investigated the distraction power of the unusual and usual images on the attention of 20 healthy primary school children. Methods: Our study was different from previous ones in that the participants were asked to fix the initial position of their attention on a pre-defined location after being presented with unusual images as distractors. The goals were presented in locations, which were far from the attraction basin of distractors. Our expectation was that the pre-orienting of the attention to the position of targets can reduce the attractive effect of unusual images compared to the usual ones. The percentage of correct responses and the reaction time have been measured as behavioral indicators of attention performance. Results: Results showed that using the goal-directed attention, subjects ignored both kinds of distractors nearly the same way. Conclusion: With regard to previous reports about the more attraction towards the unusual images, it is suggested that the dynamics of the visual attention system be sensitive to the initial condition. That is, changing the initial position of the attention can lead to the decrement of the unusual images’ effects. However, several other possibilities such as a probable delay in processing unusual features could explain this observation, too. 

Isogeometric shape optimization in fluid mechanics

DEFF Research Database (Denmark)

Nørtoft, Peter; Gravesen, Jens

2013-01-01

The subject of this work is numerical shape optimization in fluid mechanics, based on isogeometric analysis. The generic goal is to design the shape of a 2-dimensional flow domain to minimize some prescribed objective while satisfying given geometric constraints. As part of the design problem...

Mastitis therapy: Direct and indirect costs

OpenAIRE

Boboš, S.; Radinović, M.; Vidić, B.; Pajić, M.; Vidić, V.; Galfi, A.

2013-01-01

One of the most important problems in milk production, causing great economic loses is certainly mastitis. In order to minimize economic losses from mastitis dairy farms introduce different mastitis management programs. These programs include mastitis therapy and prevention. In mastitis control prevention is most important and when mastitis occurs cost of therapy and milk discharge is very important. In our study we examined cost of mastitis treatment and m...

A computational neural model of goal-directed utterance selection.

Science.gov (United States)

Klein, Michael; Kamp, Hans; Palm, Guenther; Doya, Kenji

2010-06-01

It is generally agreed that much of human communication is motivated by extra-linguistic goals: we often make utterances in order to get others to do something, or to make them support our cause, or adopt our point of view, etc. However, thus far a computational foundation for this view on language use has been lacking. In this paper we propose such a foundation using Markov Decision Processes. We borrow computational components from the field of action selection and motor control, where a neurobiological basis of these components has been established. In particular, we make use of internal models (i.e., next-state transition functions defined on current state action pairs). The internal model is coupled with reinforcement learning of a value function that is used to assess the desirability of any state that utterances (as well as certain non-verbal actions) can bring about. This cognitive architecture is tested in a number of multi-agent game simulations. In these computational experiments an agent learns to predict the context-dependent effects of utterances by interacting with other agents that are already competent speakers. We show that the cognitive architecture can account for acquiring the capability of deciding when to speak in order to achieve a certain goal (instead of performing a non-verbal action or simply doing nothing), whom to address and what to say. Copyright 2010 Elsevier Ltd. All rights reserved.

Citizen Goals Online

Directory of Open Access Journals (Sweden)

Catalin Vrabie

2013-01-01

Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.” Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc. Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page. Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark. Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create. Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

Citizen Goals Online

Directory of Open Access Journals (Sweden)

Catalin Vrabie

2012-07-01

Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.”Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc.Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page.Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark.Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create.Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

Dependence of Achievable Plan Quality on Treatment Technique and Planning Goal Refinement: A Head-and-Neck Intensity Modulated Radiation Therapy Application

International Nuclear Information System (INIS)

Qi, X. Sharon; Ruan, Dan; Lee, Steve P.; Pham, Andrew; Kupelian, Patrick; Low, Daniel A.; Steinberg, Michael; Demarco, John

2015-01-01

Purpose: To develop a practical workflow for retrospectively analyzing target and normal tissue dose–volume endpoints for various intensity modulated radiation therapy (IMRT) delivery techniques; to develop technique-specific planning goals to improve plan consistency and quality when feasible. Methods and Materials: A total of 165 consecutive head-and-neck patients from our patient registry were selected and retrospectively analyzed. All IMRT plans were generated using the same dose–volume guidelines for TomoTherapy (Tomo, Accuray), TrueBeam (TB, Varian) using fixed-field IMRT (TB-IMRT) or RAPIDARC (TB-RAPIDARC), or Siemens Oncor (Siemens-IMRT, Siemens). A MATLAB-based dose–volume extraction and analysis tool was developed to export dosimetric endpoints for each patient. With a fair stratification of patient cohort, the variation of achieved dosimetric endpoints was analyzed among different treatment techniques. Upon identification of statistically significant variations, technique-specific planning goals were derived from dynamically accumulated institutional data. Results: Retrospective analysis showed that although all techniques yielded comparable target coverage, the doses to the critical structures differed. The maximum cord doses were 34.1 ± 2.6, 42.7 ± 2.1, 43.3 ± 2.0, and 45.1 ± 1.6 Gy for Tomo, TB-IMRT, TB-RAPIDARC, and Siemens-IMRT plans, respectively. Analyses of variance showed significant differences for the maximum cord doses but no significant differences for other selected structures among the investigated IMRT delivery techniques. Subsequently, a refined technique-specific dose–volume guideline for maximum cord dose was derived at a confidence level of 95%. The dosimetric plans that failed the refined technique-specific planning goals were reoptimized according to the refined constraints. We observed better cord sparing with minimal variations for the target coverage and other organ at risk sparing for the Tomo cases, and higher

Effects of enteral and intravenous fluid therapy, magnesium sulfate, and sodium sulfate on colonic contents and feces in horses.

Science.gov (United States)

Lopes, Marco A F; White, Nathaniel A; Donaldson, Lydia; Crisman, Mark V; Ward, Daniel L

2004-05-01

To assess changes in systemic hydration, concentrations of electrolytes in plasma, hydration of colonic contents and feces, and gastrointestinal transit in horses treated with IV fluid therapy or enteral administration of magnesium sulfate (MgSO4), sodium sulfate (NaSO4), water, or a balanced electrolyte solution. 7 horses with fistulas in the right dorsal colon (RDC). In a crossover design, horses alternately received 1 of 6 treatments: no treatment (control); IV fluid therapy with lactated Ringer's solution; or enteral administration of MgSO4, Na2SO4, water, or a balanced electrolyte solution via nasogastric intubation. Physical examinations were performed and samples of blood, RDC contents, and feces were collected every 6 hours during the 48 hour-observation period. Horses were muzzled for the initial 24 hours but had access to water ad libitum. Horses had access to hay, salt, and water ad libitum for the last 24 hours. Enteral administration of a balanced electrolyte solution and Na2SO4 were the best treatments for promoting hydration of RDC contents, followed by water. Sodium sulfate was the best treatment for promoting fecal hydration, followed by MgSO4 and the balanced electrolyte solution. Sodium sulfate caused hypocalcemia and hypernatremia, and water caused hyponatremia. Enteral administration of a balanced electrolyte solution promoted hydration of RDC contents and may be useful in horses with large colon impactions. Enteral administration of either Na2SO4 or water may promote hydration of RDC contents but can cause severe electrolyte imbalances.

Identity Processes and Intrinsic and Extrinsic Goal Pursuits: Directionality of Effects in College Students.

Science.gov (United States)

Luyckx, Koen; Duriez, Bart; Green, Lindsey M; Negru-Subtirica, Oana

2017-08-01

Identity research has mainly focused on the degree to which adolescents and emerging adults engage in exploration and commitment to identity goals and strivings. Somewhat lacking from this research tradition is an explicit focus on the content of the identity goals that individuals deem important and pursue. The present manuscript describes two longitudinal studies sampling college students in which we examine how exploration and commitment processes relate to intrinsic and extrinsic goal pursuits as defined in Self-Determination Theory. Study 1 was a two-wave longitudinal study spanning 6 months (N = 370; 77.4% women; mean age 18.24 years); Study 2 was a three-wave longitudinal study spanning 6 months (N = 458 students; 84.9% women; mean age 18.25 years). Using cross-lagged path analyses, hypotheses were supported to various degrees of convergence between studies, pointing to the extent of which results were replicated across our two independent longitudinal samples. Whereas an intrinsic goal orientation positively predicted commitment making (Study 1) and identification with commitment over time (Studies 1 and 2), an extrinsic goal orientation positively predicted ruminative exploration over time, which led to decreases in intrinsic orientation over time (Study 2). Further, an intrinsic goal orientation negatively predicted ruminative exploration over time (Study 1). The findings in for pro-active exploration processes were inconsistent across both studies, being prospectively related to both intrinsic (Study 2) and extrinsic goal orientations (Study 1). Implications and suggestions for future research are discussed.

SU-G-TeP4-06: An Integrated Application for Radiation Therapy Treatment Plan Directives, Management, and Reporting

Energy Technology Data Exchange (ETDEWEB)

Matuszak, M; Anderson, C; Lee, C; Vineberg, K; Green, M; Younge, K; Moran, J; Mayo, C [University of Michigan, Ann Arbor, MI (United States)

2016-06-15

Purpose: With electronic medical records, patient information for the treatment planning process has become disseminated across multiple applications with limited quality control and many associated failure modes. We present the development of a single application with a centralized database to manage the planning process. Methods: The system was designed to replace current functionalities of (i) static directives representing the physician intent for the prescription and planning goals, localization information for delivery, and other information, (ii) planning objective reports, (iii) localization and image guidance documents and (iv) the official radiation therapy prescription in the medical record. Using the Eclipse Scripting Application Programming Interface, a plug-in script with an associated domain-specific SQL Server database was created to manage the information in (i)–(iv). The system’s user interface and database were designed by a team of physicians, clinical physicists, database experts, and software engineers to ensure usability and robustness for clinical use. Results: The resulting system has been fully integrated within the TPS via a custom script and database. Planning scenario templates, version control, approvals, and logic-based quality control allow this system to fully track and document the planning process as well as physician approval of tradeoffs while improving the consistency of the data. Multiple plans and prescriptions are supported along with non-traditional dose objectives and evaluation such as biologically corrected models, composite dose limits, and management of localization goals. User-specific custom views were developed for the attending physician review, physicist plan checks, treating therapists, and peer review in chart rounds. Conclusion: A method was developed to maintain cohesive information throughout the planning process within one integrated system by using a custom treatment planning management application that

Nonlinear transport processes and fluid dynamics: Cylindrical Couette flow of Lennard-Jones fluids

International Nuclear Information System (INIS)

Khayat, R.E.; Eu, B.C.

1988-01-01

In this paper we report on calculations of flow profiles for cylindrical Couette flow of a Lennard-Jones fluid. The flow is subjected to a temperature gradient and thermoviscous effects are taken into consideration. We apply the generalized fluid dynamic equations which are provided by the modified moment method for the Boltzmann equation reported previously. The results of calculations are in good agreement with the Monte Carlo direct simulation method by K. Nanbu [Phys. Fluids 27, 2632 (1984)] for most of Knudsen numbers for which the simulation data are available

Fluid flow and convective transport of solutes within the intervertebral disc.

Science.gov (United States)

Ferguson, Stephen J; Ito, Keita; Nolte, Lutz P

2004-02-01

Previous experimental and analytical studies of solute transport in the intervertebral disc have demonstrated that for small molecules diffusive transport alone fulfils the nutritional needs of disc cells. It has been often suggested that fluid flow into and within the disc may enhance the transport of larger molecules. The goal of the study was to predict the influence of load-induced interstitial fluid flow on mass transport in the intervertebral disc. An iterative procedure was used to predict the convective transport of physiologically relevant molecules within the disc. An axisymmetric, poroelastic finite-element structural model of the disc was developed. The diurnal loading was divided into discrete time steps. At each time step, the fluid flow within the disc due to compression or swelling was calculated. A sequentially coupled diffusion/convection model was then employed to calculate solute transport, with a constant concentration of solute being provided at the vascularised endplates and outer annulus. Loading was simulated for a complete diurnal cycle, and the relative convective and diffusive transport was compared for solutes with molecular weights ranging from 400 Da to 40 kDa. Consistent with previous studies, fluid flow did not enhance the transport of low-weight solutes. During swelling, interstitial fluid flow increased the unidirectional penetration of large solutes by approximately 100%. Due to the bi-directional temporal nature of disc loading, however, the net effect of convective transport over a full diurnal cycle was more limited (30% increase). Further study is required to determine the significance of large solutes and the timing of their delivery for disc physiology.

Integrated learning through student goal development.

Science.gov (United States)

Price, Deborah; Tschannen, Dana; Caylor, Shandra

2013-09-01

New strategies are emerging to promote structure and increase learning in the clinical setting. Nursing faculty designed a mechanism by which integrative learning and situated coaching could occur more readily in the clinical setting. The Clinical Goals Initiative was implemented for sophomore-, junior-, and senior-level students in their clinical practicums. Students developed weekly goals reflecting three domains of professional nursing practice. Goals were shared with faculty and staff nurse mentors at the beginning of the clinical day to help guide students and mentors with planning for learning experiences. After 6 weeks, faculty and students were surveyed to evaluate project effectiveness. Faculty indicated that goal development facilitated clinical learning by providing more student engagement, direction, and focus. Students reported that goal development allowed them to optimize clinical learning opportunities and track their growth and progress. Faculty and students indicated the goals promoted student self-learning, autonomy, and student communication with nurse mentors and faculty. Copyright 2013, SLACK Incorporated.

Adlerian Marriage Therapy.

Science.gov (United States)

Carlson, Jon; Dinkmeyer, Don, Sr.

1987-01-01

Describes the assumptions, processes, and techniques used in Alderian marriage therapy. Describes purpose of therapy as assessing current beliefs and behaviors while educating the couple in new procedures that can help the couple establish new goals. (Author/ABL)

CIME Summer School on Mathematical Thermodynamics of Complex Fluids

CERN Document Server

Rocca, Elisabetta

2017-01-01

The main goal of this book is to provide an overview of the state of the art in the mathematical modeling of complex fluids, with particular emphasis on its thermodynamical aspects. The central topics of the text, the modeling, analysis and numerical simulation of complex fluids, are of great interest and importance both for the understanding of various aspects of fluid dynamics and for its applications to special real-world problems.  New emerging trends in the subject are highlighted with the intent to inspire and motivate young researchers and PhD students.

Achievement of Optimal Medical Therapy Goals for US Adults with Coronary Artery Disease: Results from the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Science.gov (United States)

Brown, Todd M.; Voeks, Jenifer H.; Bittner, Vera; Brenner, David A.; Cushman, Mary; Goff, David C.; Glasser, Stephen; Muntner, Paul; Tabereaux, Paul B.; Safford, Monika M.

2014-01-01

Objective In a non-clinical trial setting, to determine the proportion of individuals with coronary artery disease (CAD) with optimal risk factor levels based on the Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial. Background In COURAGE, the addition of percutaneous coronary intervention (PCI) to optimal medical therapy did not reduce the risk of death or myocardial infarction in stable CAD patients but resulted in more revascularization procedures. Methods REGARDS is a national prospective cohort study of 30,239 African American and White community-dwelling individuals aged >45 years enrolled in 2003-7. We calculated the proportion of 3,167 participants with self-reported CAD meeting 7 risk factor goals based on COURAGE: 1) aspirin use, 2) systolic blood pressure 40 mg/dL, and triglycerides goals met was 4. Less than a quarter met ≥5 of the 7 goals, and 16% met all 3 goals for aspirin, blood pressure, and LDL-C. Older age, white race, higher income, more education, and higher physical functioning were independently associated with meeting more goals. Conclusions There is substantial room for improvement in risk factor reduction among US individuals with CAD. PMID:24534599

The perceptual control of goal-directed locomotion: a common control architecture for interception and navigation?

Science.gov (United States)

Chardenon, A; Montagne, G; Laurent, M; Bootsma, R J

2004-09-01

Intercepting a moving object while locomoting is a highly complex and demanding ability. Notwithstanding the identification of several informational candidates, the role of perceptual variables in the control process underlying such skills remains an open question. In this study we used a virtual reality set-up for studying locomotor interception of a moving ball. The subject had to walk along a straight path and could freely modify forward velocity, if necessary, in order to intercept-with the head-a ball moving along a straight path that led it to cross the agent's displacement axis. In a series of experiments we manipulated a local (ball size) and a global (focus of expansion) component of the visual flow but also the egocentric orientation of the ball. The experimental observations are well captured by a dynamic model linking the locomotor acceleration to properties of both global flow and egocentric direction. More precisely the changes in locomotor velocity depend on a linear combination of the change in bearing angle and the change in egocentric orientation, allowing the emergence of adaptive behavior under a variety of circumstances. We conclude that the mechanisms underlying the control of different goal-directed locomotion tasks (i.e. steering and interceptive tasks) could share a common architecture.

Fluid–fluid coexistence in colloidal systems with short-ranged strongly directional attraction

NARCIS (Netherlands)

Kern, N.; Frenkel, D.

2003-01-01

We present a systematic numerical study of the phase behavior of square-well fluids with a "patchy" short-ranged attraction. In particular, we study the effect of the size and number of attractive patches on the fluid–fluid coexistence. The model that we use is a generalization of the hard sphere

Cholesterol treatment with statins: Who is left out and who makes it to goal?

Directory of Open Access Journals (Sweden)

Winters Paul

2010-03-01

Full Text Available Abstract Background Whether patient socio-demographic characteristics (age, sex, race/ethnicity, income, and education are independently associated with failure to receive indicated statin therapy and/or to achieve low density lipoprotein cholesterol (LDL-C therapy goals are not known. We examined socio-demographic factors associated with a eligibility for statin therapy among those not on statins, and b achievement of statin therapy goals. Methods Adults (21-79 years participating in the United States (US National Health and Nutrition Examination Surveys, 1999-2006 were studied. Statin eligibility and achievement of target LDL-C was assessed using the US Third Adult Treatment Panel (ATP III on Treatment of High Cholesterol guidelines. Results Among 6,043 participants not taking statins, 10.4% were eligible. Adjusted predictors of statin eligibility among statin non-users were being older, male, poorer, and less educated. Hispanics were less likely to be eligible but not using statins, an effect that became non-significant with adjustment for language usually spoken at home. Among 537 persons taking statins, 81% were at LDL-C goal. Adjusted predictors of goal failure among statin users were being male and poorer. These risks were not attenuated by adjustment for healthcare access or utilization. Conclusion Among person's not taking statins, the socio-economically disadvantaged are more likely to be eligible and among those on statins, the socio-economically disadvantaged are less likely to achieve statin treatment goals. Further study is needed to identify specific amenable patient and/or physician factors that contribute to these disparities.

Neural Control Mechanisms and Body Fluid Homeostasis

Science.gov (United States)

Johnson, Alan Kim

1998-01-01

The goal of the proposed research was to study the nature of afferent signals to the brain that reflect the status of body fluid balance and to investigate the central neural mechanisms that process this information for the activation of response systems which restore body fluid homeostasis. That is, in the face of loss of fluids from intracellular or extracellular fluid compartments, animals seek and ingest water and ionic solutions (particularly Na(+) solutions) to restore the intracellular and extracellular spaces. Over recent years, our laboratory has generated a substantial body of information indicating that: (1) a fall in systemic arterial pressure facilitates the ingestion of rehydrating solutions and (2) that the actions of brain amine systems (e.g., norepinephrine; serotonin) are critical for precise correction of fluid losses. Because both acute and chronic dehydration are associated with physiological stresses, such as exercise and sustained exposure to microgravity, the present research will aid in achieving a better understanding of how vital information is handled by the nervous system for maintenance of the body's fluid matrix which is critical for health and well-being.

Evaluation of MALDI-TOF mass spectrometry and Sepsityper Kit™ for the direct identification of organisms from sterile body fluids in a Canadian pediatric hospital

OpenAIRE

Tadros, Manal; Petrich, Astrid

2013-01-01

Matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS) can be used to identify bacteria directly from positive blood and sterile fluid cultures. The authors evaluated a commercially available kit – the Sepsityper Kit (Bruker Daltonik, Germany) – and MALDI-TOF MS for the rapid identification of organisms from 80 flagged positive blood culture broths, of which 73 (91.2%) were blood culture specimens and seven (8.7%) were cerebrospinal fluid specimens, in com...

Comparison of Bladder Directed and Pelvic Floor Therapy in Women With Interstitial Cystitis/Bladder Pain Syndrome

Science.gov (United States)

2017-09-01

PROJECT NUMBER Kenneth M. Peters 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION REPORT...AWARD NUMBER: W81XWH-16-1-0307 TITLE: Comparison of Bladder-Directed and Pelvic Floor Therapy in Women With Interstitial Cystitis/Bladder Pain...Pelvic Floor Therapy in Women With Interstitial Cystitis/Bladder Pain Syndrome 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d

A protocol for resuscitation of severe burn patients guided by transpulmonary thermodilution and lactate levels: a 3-year prospective cohort study

OpenAIRE

Sánchez, Manuel; García-de-Lorenzo, Abelardo; Herrero, Eva; Lopez, Teresa; Galvan, Beatriz; Asensio, María José; Cachafeiro, Lucia; Casado, Cesar

2013-01-01

Introduction: The use of urinary output and vital signs to guide initial burn resuscitation may lead to suboptimal resuscitation. Invasive hemodynamic monitoring may result in over-resuscitation. This study aimed to evaluate the results of a goal-directed burn resuscitation protocol that used standard measures of mean arterial pressure (MAP) and urine output, plus transpulmonary thermodilution (TPTD) and lactate levels to adjust fluid therapy to achieve a minimum level of preload ...

Compliance with guideline-directed therapy in diabetic patients admitted with acute coronary syndrome: Findings from the American Heart Association's Get With The Guidelines-Coronary Artery Disease (GWTG-CAD) program.

Science.gov (United States)

Deedwania, Prakash; Acharya, Tushar; Kotak, Kamal; Fonarow, Gregg C; Cannon, Christopher P; Laskey, Warren K; Peacock, W Frank; Pan, Wenqin; Bhatt, Deepak L

2017-05-01

To evaluate and compare baseline characteristics, outcomes and compliance with guideline based therapy at discharge among diabetic and non-diabetic patients admitted with acute coronary syndromes (ACS). Study population consisted of 151,270 patients admitted with ACS from 2002 through 2008 at 411 sites participating in the American Heart Association's Get with the Guidelines (GWTG) program. Demographic variables, physical exam findings, laboratory data, left ventricular ejection fraction, length of stay, in-hospital mortality and discharge medications were compared between diabetic and non-diabetic patients. Temporal trends in compliance with guidelines directed therapy were evaluated. Of 151,270 patients, 48,938 (32%) had diabetes. Overall, diabetic patients were significantly older and more likely non-white. They had significantly more hypertension, atherosclerotic disease, CKD, and LV dysfunction and were more likely to present as NSTEMI. They had longer hospital stay and higher hospital mortality than non-diabetic patients. Diabetic patients were less likely to get LDL checks (65% vs 70%) and less frequently prescribed statins (85% vs 89%), RAAS blockers for LV dysfunction (80% vs 84%) and dual-antiplatelet therapy (69% vs 74%). Diabetic patients were less likely to achieve BP goals before discharge (75% vs 82%). Fewer diabetic patients met first medical contact to PCI time for STEMI (44% vs 52%). Temporal trends, however, showed continued progressive improvement in most performance measures from 2002 to 2008 (all P<.001). These data from a large cohort of ACS patients demonstrate gaps in compliance with guidelines directed therapy in diabetic patients but also indicate significant and continued improvement in most performance measures over time. Concerted efforts are needed to continue this positive trend. Copyright © 2017. Published by Elsevier Inc.

A possible utilization of the mice forced swim test for modeling manic-like increase in vigor and goal-directed behavior.

Science.gov (United States)

Flaisher-Grinberg, Shlomit; Einat, Haim

2009-01-01

The lack of appropriate animal models for bipolar disorder (BPD) is a major factor hindering the research of its pathophysiology and the development of new drug treatments. In line with the notion that BPD might represent a heterogeneous group of disorders, it was suggested that models for specific domains of BPD should be developed. The present study tested the possible utilization of the forced swim test (FST) as a model for the heightened vigor and goal-directed behavior domain of mania, using mice with low baseline immobility. Black Swiss mice were previously identified to have low immobility in the FST but similar spontaneous activity levels compared with several other mice strains. Thus, spontaneous activity and behavior in the FST were evaluated following treatment with the mood stabilizer valproate and the antidepressant imipramine. The results indicated that valproate increased immobility in the FST without affecting spontaneous activity whereas imipramine had no effect in the FST but increased spontaneous activity. These findings suggest that in mice with low baseline immobility scores, the FST might be a useful model for the elevated vigor and goal-directed behavior domain of mania. As such, this test might be well integrated into a battery of models for different domains of BPD.

How to assess the plasma delivery of RONS into tissue fluid and tissue

Science.gov (United States)

Oh, Jun-Seok; Szili, Endre J.; Gaur, Nishtha; Hong, Sung-Ha; Furuta, Hiroshi; Kurita, Hirofumi; Mizuno, Akira; Hatta, Akimitsu; Short, Robert D.

2016-08-01

The efficacy of helium (He) and argon (Ar) plasma jets are being investigated for different healthcare applications including wound and cancer therapy, sterilisation and surface disinfections. Current research points to a potential link between the generation of reactive oxygen and nitrogen species (RONS) and outcomes in a range of biological and medical applications. As new data accrue, further strengthening this link, it becomes important to understand the controlled delivery of RONS into solutions, tissue fluids and tissues. This paper investigates the use of He and Ar plasma jets to deliver three RONS (hydrogen peroxide—H2O2, nitrite—\\text{NO}2- and nitrate—\\text{NO}3- ) and molecular oxygen (O2) directly into deionised (DI) water, or indirectly into DI water through an agarose target. The DI water is used in place of tissue fluid and the agarose target serves as a surrogate of tissue. Direct plasma jet treatments deliver more RONS and O2 than the through-agarose treatments for equivalent treatments times. The former only deliver RONS whilst the plasma jets are ignited; the latter continues to deliver RONS into the DI water long after the plasmas are extinguished. The He plasma jet is more effective at delivering H2O2 and \\text{NO}2- directly into DI water, but the Ar plasma jet is more effective at nitrating the DI water in both direct and through-agarose treatments. DI water directly treated with the plasma jets is deoxygenated, with the He plasma jet purging more O2 than the Ar plasma jet. This effect is known as ‘sparging’. In contrast, for through-agarose treatments both jets oxygenated the DI water. These results indicate that in the context of direct and indirect plasma jet treatments of real tissue fluids and tissue, the choice of process gas (He or Ar) could have a profound effect on the concentrations of RONS and O2. Irrespective of operating gas, sparging of tissue fluid (in an open wound) for long prolonged periods during direct plasma

Auger radiation targeted into DNA: a therapy perspective

Energy Technology Data Exchange (ETDEWEB)

Buchegger, Franz [University Hospital of Lausanne CHUV, Service of Nuclear Medicine, Lausanne (Switzerland); University Hospital of Lausanne, Service of Nuclear Medicine, Lausanne (Switzerland); Perillo-Adamer, Florence; Bischof Delaloye, Angelika [University Hospital of Lausanne CHUV, Service of Nuclear Medicine, Lausanne (Switzerland); Dupertuis, Yves M. [University Hospital of Geneva, Service of Nutrition, Geneva (Switzerland)

2006-11-15

Auger electron emitters that can be targeted into DNA of tumour cells represent an attractive systemic radiation therapy goal. In the situation of DNA-associated decay, the high linear energy transfer (LET) of Auger electrons gives a high relative biological efficacy similar to that of {alpha} particles. In contrast to {alpha} radiation, however, Auger radiation is of low toxicity when decaying outside the cell nucleus, as in cytoplasm or outside cells during blood transport. The challenge for such therapies is the requirement to target a high percentage of all cancer cells. An overview of Auger radiation therapy approaches of the past decade shows several research directions and various targeting vehicles. The latter include hormones, peptides, halogenated nucleotides, oligonucleotides and internalising antibodies. Here, we will discuss the basic principles of Auger electron therapy as compared with vector-guided {alpha} and {beta} radiation. We also review some radioprotection issues and briefly present the main advantages and disadvantages of the different targeting modalities that are under investigation. (orig.)

Auger radiation targeted into DNA: a therapy perspective

International Nuclear Information System (INIS)

Buchegger, Franz; Perillo-Adamer, Florence; Bischof Delaloye, Angelika; Dupertuis, Yves M.

2006-01-01

Auger electron emitters that can be targeted into DNA of tumour cells represent an attractive systemic radiation therapy goal. In the situation of DNA-associated decay, the high linear energy transfer (LET) of Auger electrons gives a high relative biological efficacy similar to that of α particles. In contrast to α radiation, however, Auger radiation is of low toxicity when decaying outside the cell nucleus, as in cytoplasm or outside cells during blood transport. The challenge for such therapies is the requirement to target a high percentage of all cancer cells. An overview of Auger radiation therapy approaches of the past decade shows several research directions and various targeting vehicles. The latter include hormones, peptides, halogenated nucleotides, oligonucleotides and internalising antibodies. Here, we will discuss the basic principles of Auger electron therapy as compared with vector-guided α and β radiation. We also review some radioprotection issues and briefly present the main advantages and disadvantages of the different targeting modalities that are under investigation. (orig.)

Hormone Therapy

Science.gov (United States)

... it also can be a sign of endometrial cancer. All bleeding after menopause should be evaluated. Other side effects reported by women who take hormone therapy include fluid retention and breast soreness. This soreness usually lasts for a short ...

The Influence of Money on Goal Pursuit and Decision-Making: Understanding Money's Unique Impact on Goal Pursuit

Science.gov (United States)

Moran, Nora

Previous research suggests that activating concepts of money and wealth can increase motivation to achieve personal goals. In this dissertation, I investigate how money affects pursuit of important personal goals, and how this motivation may be affected by goal attainability. In eight studies, I show that priming concepts of money and wealth leads individuals to pursue important personal goals to a greater degree than control groups, but only when a goal is more attainable. In contrast, when a goal is less attainable, those primed with money will be less likely to work towards goals relative to control groups. Furthermore, I examine why money may have a detrimental effect on motivation when individuals are faced with less attainable but important goals, and argue those primed with money become more concerned with maintaining a sense of efficacy, and thus disengage from pursuit when success is less certain. Thus, this research identifies the needs made salient by activating money--validating one's abilities. Finally, I show the relevance of these findings for consumer behavior, and discuss the additional implications of this work, as well as future research directions.

Rayleigh-Taylor instability in a visco-plastic fluid

International Nuclear Information System (INIS)

Demianov, A Yu; Doludenko, A N; Son, E E; Inogamov, N A

2010-01-01

The Rayleigh-Taylor and Richtmyer-Meshkov instabilities of a visco-plastic fluid are discussed. The Bingham model is used as an effective rheological model which takes into account plastic effects. For the purposes of numerical simulation a one-mode disturbance of the contact surface between two fluids is considered. The main goal of this work is to construct numerical 2D and 3D models and to obtain the relationship between yield stress and the development of instability.

Rayleigh-Taylor instability in a visco-plastic fluid

Science.gov (United States)

Demianov, A. Yu; Doludenko, A. N.; Inogamov, N. A.; Son, E. E.

2010-12-01

The Rayleigh-Taylor and Richtmyer-Meshkov instabilities of a visco-plastic fluid are discussed. The Bingham model is used as an effective rheological model which takes into account plastic effects. For the purposes of numerical simulation a one-mode disturbance of the contact surface between two fluids is considered. The main goal of this work is to construct numerical 2D and 3D models and to obtain the relationship between yield stress and the development of instability.

Cardiac resynchronization therapy by multipoint pacing improves response of left ventricular mechanics and fluid dynamics: a three-dimensional and particle image velocimetry echo study.

Science.gov (United States)

Siciliano, Mariachiara; Migliore, Federico; Badano, Luigi; Bertaglia, Emanuele; Pedrizzetti, Gianni; Cavedon, Stefano; Zorzi, Alessandro; Corrado, Domenico; Iliceto, Sabino; Muraru, Denisa

2017-11-01

To characterize the effect of multipoint pacing (MPP) compared to biventricular pacing (BiV) on left ventricle (LV) mechanics and intraventricular fluid dynamics by three-dimensional echocardiography (3DE) and echocardiographic particle imaging velocimetry (Echo-PIV). In 11 consecutive patients [8 men; median age 65 years (57-75)] receiving cardiac resynchronization therapy (CRT) with a quadripolar LV lead (Quartet,St.Jude Medical,Inc.), 3DE and Echo-PIV data were collected for each pacing configuration (CRT-OFF, BiV, and MPP) at follow-up after 6 months. 3DE data included LV volumes, LV ejection fraction (LVEF), strain, and systolic dyssynchrony index (SDI). Echo-PIV was used to evaluate the directional distribution of global blood flow momentum, ranging from zero, when flow force is predominantly along the base-apex direction, up to 90° when it becomes transversal. MPP resulted in significant reduction in end-diastolic and end-systolic volumes compared with both CRT-OFF (P = 0.02; P = 0.008, respectively) and BiV (P = 0.04; P = 0.03, respectively). LVEF and cardiac output were significant superior in MPP compared with CRT-OFF, but similar between MPP and BiV. Statistical significant differences when comparing global longitudinal and circumferential strain and SDI with MPP vs. CRT-OFF were observed (P = 0.008; P = 0.008; P = 0.01, respectively). There was also a trend towards improvement in strain between BiV and MPP that did not reach statistical significance. MPP reflected into a significant reduction of the deviation of global blood flow momentum compared with both CRT-OFF and BiV (P = 0.002) indicating a systematic increase of longitudinal alignment from the base-apex orientation of the haemodynamic forces. These preliminary results suggest that MPP resulted in significant improvement of LV mechanics and fluid dynamics compared with BiV. However, larger studies are needed to confirm this hypothesis. © Crown copyright 2016.

Molecular Dynamics Simulation of Binary Fluid in a Nanochannel

International Nuclear Information System (INIS)

Mullick, Shanta; Ahluwalia, P. K.; Pathania, Y.

2011-01-01

This paper presents the results from a molecular dynamics simulation of binary fluid (mixture of argon and krypton) in the nanochannel flow. The computational software LAMMPS is used for carrying out the molecular dynamics simulations. Binary fluids of argon and krypton with varying concentration of atom species were taken for two densities 0.65 and 0.45. The fluid flow takes place between two parallel plates and is bounded by horizontal walls in one direction and periodic boundary conditions are imposed in the other two directions. To drive the flow, a constant force is applied in one direction. Each fluid atom interacts with other fluid atoms and wall atoms through Week-Chandler-Anderson (WCA) potential. The velocity profile has been looked at for three nanochannel widths i.e for 12σ, 14σ and 16σ and also for the different concentration of two species. The velocity profile of the binary fluid predicted by the simulations agrees with the quadratic shape of the analytical solution of a Poiseuille flow in continuum theory.

Emotion and goal-directed behavior: ERP evidence on cognitive and emotional conflict.

Science.gov (United States)

Zinchenko, Artyom; Kanske, Philipp; Obermeier, Christian; Schröger, Erich; Kotz, Sonja A

2015-11-01

Cognitive control supports goal-directed behavior by resolving conflict among opposing action tendencies. Emotion can trigger cognitive control processes, thus speeding up conflict processing when the target dimension of stimuli is emotional. However, it is unclear what role emotionality of the target dimension plays in the processing of emotional conflict (e.g. in irony). In two EEG experiments, we compared the influence of emotional valence of the target (emotional, neutral) in cognitive and emotional conflict processing. To maximally approximate real-life communication, we used audiovisual stimuli. Participants either categorized spoken vowels (cognitive conflict) or their emotional valence (emotional conflict), while visual information was congruent or incongruent. Emotional target dimension facilitated both cognitive and emotional conflict processing, as shown in a reduced reaction time conflict effect. In contrast, the N100 in the event-related potentials showed a conflict-specific reversal: the conflict effect was larger for emotional compared with neutral trials in cognitive conflict and smaller in emotional conflict. Additionally, domain-general conflict effects were observed in the P200 and N200 responses. The current findings confirm that emotions have a strong influence on cognitive and emotional conflict processing. They also highlight the complexity and heterogeneity of the interaction of emotion with different types of conflict. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Development of Personalized Cancer Therapy for Men with Advanced Prostate Cancer

Science.gov (United States)

2017-10-01

of this study is to develop a strategy to identify molecular markers of response of advanced prostate cancer to specific therapies using clinically...combination treatment strategies are urgently needed. The purpose of this study is to develop a strategy for identifying molecular markers of response of...PENDING) Level of Funding: $125,978 annual direct Project Goals: To develop a strategy for identifying molecular therapeutic response markers of

Cystic Echinococcal Liver Disease: New Insights into an Old Disease and an Algorithm for Therapy Planning

International Nuclear Information System (INIS)

Rozanes, Izzet; Gueven, Koray; Acunas, Buelent; Emre, Ali

2007-01-01

Human cystic echinococcosis (CE) continues to be a major health problem in developing countries. A review of current literature discloses four alternatives for the management of active CE, consisting of surgery, percutaneous treatment (PT), chemotherapy, and follow-up without intervention, but no clear guidelines for directing patients to the different management options. Palliation of symptoms or prevention of complications is the main rationale for the treatment of CE. Surgery has long been considered as the gold standard treatment. However, a meta-analysis comparing the clinical outcomes of patients treated with PT with those of a control group treated with surgery found PT to be more effective, safer, and cheaper. Medical therapy is considered to be ineffective when the criterion of success is defined as the disappearance of the lesion. However, medical therapy seems to be effective when the goal of therapy is defined as the prevention of complications in asymptomatic patients. We propose an algorithm for therapy planning in CE where the first line of therapy for patients with active lesions is PT. Patients with lesions unsuitable for PT are directed to surgery if they are symptomatic, have complicated lesions or have lesions that are prone to rupture. Asymptomatic patients with uncomplicated lesions are directed to medical therapy. Medical therapy failures are redirected to surgery

Assessing the Importance of Treatment Goals in Patients with Psoriasis: Analytic Hierarchy Process vs. Likert Scales.

Science.gov (United States)

Gutknecht, Mandy; Danner, Marion; Schaarschmidt, Marthe-Lisa; Gross, Christian; Augustin, Matthias

2018-02-15

functioning". Concerning the Patient Needs Questionnaire results, these dimensions were ranked in second and fifth position, whereas "strengthening of confidence in the therapy and in a possible healing" was ranked most important, which was least important in the analytic hierarchy process ranking. In both methods, "improvement of psychological well-being" and "reduction of impairments due to therapy" were equally ranked in positions three and four. In contrast to this, on the level of sub-criteria, predominantly a similar ranking of treatment goals could be observed between the analytic hierarchy process and the Patient Needs Questionnaire. From the patients' point of view, the Likert scales (Patient Needs Questionnaire) were easier to complete than the analytic hierarchy process pairwise comparisons. Patients with psoriasis assign different importance to health dimensions and associated treatment goals. In choosing a method to assess the importance of health dimensions and/or treatment goals, it needs to be considered that resulting importance weights may differ in dependence on the used method. However, in this study, observed discrepancies in importance weights of the health dimensions were most likely caused by the different methodological approaches focusing on treatment goals to assess the importance of health dimensions on the one hand (Patient Needs Questionnaire) or directly assessing health dimensions on the other hand (analytic hierarchy process).

Early development of de novo hepatocellular carcinoma after direct-acting agent therapy: Comparison with pegylated interferon-based therapy in chronic hepatitis C patients.

Science.gov (United States)

Yoo, S H; Kwon, J H; Nam, S W; Kim, H Y; Kim, C W; You, C R; Choi, S W; Cho, S H; Han, J-Y; Song, D S; Chang, U I; Yang, J M; Lee, H L; Lee, S W; Han, N I; Kim, S-H; Song, M J; Hwang, S; Sung, P S; Jang, J W; Bae, S H; Choi, J Y; Yoon, S K

2018-04-16

Patients with chronic hepatitis C who achieve a sustained viral response after pegylated interferon therapy have a reduced risk of hepatocellular carcinoma, but the risk after treatment with direct-acting antivirals is unclear. We compared the rates of early development of hepatocellular carcinoma after direct-acting antivirals and after pegylated interferon therapy. We retrospectively analysed 785 patients with chronic hepatitis C who had no history of hepatocellular carcinoma (211 treated with pegylated interferon, 574 with direct-acting antivirals) and were followed up for at least 24 weeks after antiviral treatment. De novo hepatocellular carcinoma developed in 6 of 574 patients receiving direct-acting antivirals and in 1 of 211 patients receiving pegylated interferon. The cumulative incidence of early hepatocellular carcinoma development did not differ between the treatment groups either for the whole cohort (1.05% vs 0.47%, P = .298) or for those patients with Child-Pugh Class A cirrhosis (3.73% vs 2.94%, P = .827). Multivariate analysis indicated that alpha-fetoprotein level >9.5 ng/mL at the time of end-of-treatment response was the only independent risk factor for early development of hepatocellular carcinoma in all patients (P hepatocellular carcinoma did not differ between patients treated with pegylated interferon and those treated with direct-acting antivirals and was associated with the serum alpha-fetoprotein level at the time of end-of-treatment response. © 2018 John Wiley & Sons Ltd.

Management of hepatitis C infection in the era of direct-acting antiviral therapy

Science.gov (United States)

Zain, L. H.; Sungkar, T.

2018-03-01

Hepatitis C viral infection globally affects millions of people and commonly results in debilitating complications and mortality. Initial mainstay therapy consisted of pegylated interferon α (pegIFNα) with additional ribavirin that showed unsatisfactory cure rate, common side effects and complicated dosing, contributing to high discontinuation rate. Over the last few years, newer antivirals have been extensively studied, that are Direct-Acting Antivirals (DAAs). Specifically targeting viral protein mainly during replication phase, DAAs showed greater cure rate (commonly measured as sustained virologic response), improved safety profile and shorter treatment duration compared to traditional interferon-ribavirin therapy. Current guidelines have also included Interferon-free, often ribavirin-free, DAAs combinations that suggest promising outcomes. The current review highlights development of rapidly growing hepatitis C treatment including DAAs recommendations.

Potential application of ecological models in the European environmental risk assessment of chemicals. I. Review of protection goals in EU directives and regulations.

Science.gov (United States)

Hommen, Udo; Baveco, J M Hans; Galic, Nika; van den Brink, Paul J

2010-07-01

Several European directives and regulations address the environmental risk assessment of chemicals. We used the protection of freshwater ecosystems against plant protection products, biocidal products, human and veterinary pharmaceuticals, and other chemicals and priority substances under the Water Framework Directive as examples to explore the potential of ecological effect models for a refined risk assessment. Our analysis of the directives, regulations, and related guidance documents lead us to distinguish the following 5 areas for the application of ecological models in chemical risk assessment: 1) Extrapolation of organism-level effects to the population level: The protection goals are formulated in general terms, e.g., avoiding "unacceptable effects" or "adverse impact" on the environment or the "viability of exposed species." In contrast, most of the standard ecotoxicological tests provide data only on organism-level endpoints and are thus not directly linked to the protection goals which focus on populations and communities. 2) Extrapolation of effects between different exposure profiles: Especially for plant protection products, exposure profiles can be very variable and impossible to cover in toxicological tests. 3) Extrapolation of recovery processes: As a consequence of the often short-term exposures to plant protection products, the risk assessment is based on the community recovery principle. On the other hand, assessments under the other directives assume a more or less constant exposure and are based on the ecosystem threshold principle. 4) Analysis and prediction of indirect effects: Because effects on 1 or a few taxa might have consequences on other taxa that are not directly affected by the chemical, such indirect effects on communities have to be considered. 5) Prediction of bioaccumulation within food chains: All directives take the possibility of bioaccumulation, and thus secondary poisoning within the food chain, into account. (c) 2010 SETAC.

Applying the model of Goal-Directed Behavior, including descriptive norms, to physical activity intentions: A contribution to improving the Theory of Planned Behavior

Science.gov (United States)

The theory of planned behavior (TPB) has received its fair share of criticism lately, including calls for it to retire. We contributed to improving the theory by testing extensions such as the model of goal-directed behavior (MGDB, which adds desire and anticipated positive and negative emotions) ap...

Using a virtual reality game to assess goal-directed hand movements in children: A pilot feasibility study.

Science.gov (United States)

Gabyzon, M Elboim; Engel-Yeger, B; Tresser, S; Springer, S

2016-01-01

Virtual reality gaming environments may be used as a supplement to the motor performance assessment tool box by providing clinicians with quantitative information regarding motor performance in terms of movement accuracy and speed, as well as sensory motor integration under different levels of dual tasking. To examine the feasibility of using the virtual reality game `Timocco' as an assessment tool for evaluating goal-directed hand movements among typically developing children. In this pilot study, 47 typically-developing children were divided into two age groups, 4-6 years old and 6-8 years old. Performance was measured using two different virtual environment games (Bubble Bath and Falling Fruit), each with two levels of difficulty. Discriminative validity (age effect) was examined by comparing the performance of the two groups, and by comparing the performance between levels of the games for each group (level effect). Test-retest reliability was examined by reassessing the older children 3-7 days after the first session. The older children performed significantly better in terms of response time, action time, game duration, and efficiency in both games compared to the younger children. Both age groups demonstrated poorer performance at the higher game level in the Bubble Bath game compared to the lower level. A similar level effect was found in the Falling Fruit game for both age groups in response time and efficiency, but not in action time. The performance of the older children was not significantly different between the two sessions at both game levels. The discriminative validity and test-retest reliability indicate the feasibility of using the Timocco virtual reality game as a tool for assessing goal-directed hand movements in children. Further studies should examine its feasibility for use in children with disabilities.

Numerical investigations on unstable direct contact condensation of cryogenic fluids

Science.gov (United States)

Jayachandran, K. N.; Arnab, Roy; Parthasarathi, Ghosh

2017-02-01

A typical problem of Direct Contact Condensation (DCC) occurs at the liquid oxygen (LOX) booster turbopump exit of oxidiser rich staged combustion cycle based semi-cryogenic rocket engines, where the hot gas mixture (predominantly oxygen and small amounts of combustion products) that runs the turbine mixes with LOX from the pump exit. This complex multiphase phenomena leads to the formation of solid CO2 & H2O, which is undesirable for the functioning of the main LOX turbopump. As a starting point for solving this complex problem, in this study, the hot gas mixture is taken as pure oxygen and hence, DCC of pure oxygen vapour jets in subcooled liquid oxygen is simulated using the commercial CFD package ANSYS CFX®. A two fluid model along with the thermal phase change model is employed for capturing the heat and mass transfer effects. The study mainly focuses on the subsonic DCC bubbling regime, which is reported as unstable with bubble formation, elongation, necking and collapsing effects. The heat transfer coefficients over a period of time have been computed and the various stages of bubbling have been analysed with the help of vapour volume fraction and pressure profiles. The results obtained for DCC of oxygen vapour-liquid mixtures is in qualitative agreement with the experimental results on DCC of steam-water mixtures.

Amniotic Fluid Cells Show Higher Pluripotency-Related Gene Expression Than Allantoic Fluid Cells.

Science.gov (United States)

Kehl, Debora; Generali, Melanie; Görtz, Sabrina; Geering, Diego; Slamecka, Jaroslav; Hoerstrup, Simon P; Bleul, Ulrich; Weber, Benedikt

2017-10-01

Amniotic fluid represents an abundant source of multipotent stem cells, referred as broadly multipotent given their differentiation potential and expression of pluripotency-related genes. However, the origin of this broadly multipotent cellular fraction is not fully understood. Several sources have been proposed so far, including embryonic and extraembryonic tissues. In this regard, the ovine developmental model uniquely allows for direct comparison of fetal fluid-derived cells from two separate fetal fluid cavities, the allantois and the amnion, over the entire duration of gestation. As allantoic fluid mainly collects fetal urine, cells originating from the efferent urinary tract can directly be compared with cells deriving from the extraembryonic amniotic tissues and the fetus. This study shows isolation of cells from the amniotic [ovine amniotic fluid cells (oAFCs)] and allantoic fluid [ovine allantoic fluid cells (oALCs)] in a strictly paired fashion with oAFCs and oALCs derived from the same fetus. Both cell types showed cellular phenotypes comparable to standard mesenchymal stem cells (MSCs), with trilineage differentiation potential, and expression of common ovine MSC markers. However, the expression of MSC markers per single cell was higher in oAFCs as measured by flow cytometry. oAFCs exhibited higher proliferative capacities and showed significantly higher expression of pluripotency-related genes OCT4, STAT3, NANOG, and REX1 by quantitative real-time polymerase chain reaction compared with paired oALCs. No significant decrease of pluripotency-related gene expression was noted over gestation, implying that cells with high differentiation potential may be isolated at the end of pregnancy. In conclusion, this study suggests that cells with highest stem cell characteristics may originate from the fetus itself or the amniotic fetal adnexa rather than from the efferent urinary tract or the allantoic fetal adnexa.

Motivational Function of Plans and Goals

Directory of Open Access Journals (Sweden)

Sabina Alispahić

2013-10-01

Full Text Available The academic literature shows that by helping tune out distractions, goals can get individuals' to try harder, work longer, and achieve more. Goals that people set for themselves and that are devoted to attaining mastery are usually healthy. But goals imposed by others—sales targets, quarterly returns, standardized test scores—can sometimes have dangerous side effects (Pink, 2009. Because understanding action demands understanding intention, the idea of motivation is natural and readily expressed in everyday language. Cognitive mental events like goals and expectancies can function as a “spring to action”, a moving force that energizes and directs action in purposive ways (Reeve, 2005. Cognitive studies of motivation are dealing with relationship between cognition and action. Literature is indicating a few cognitive elements that can have motivational significance. The article presents the overview of theory and research about the motivational function of plans and goals, according to Goal setting theory (Locke & Latham, 1990 and Self-determination Theory (Deci & Ryan, 2000. Suggestions for additional research are also indicated.

Laboratory-directed research and development: FY 1996 progress report

Energy Technology Data Exchange (ETDEWEB)

Vigil, J.; Prono, J. [comps.

1997-05-01

This report summarizes the FY 1996 goals and accomplishments of Laboratory-Directed Research and Development (LDRD) projects. It gives an overview of the LDRD program, summarizes work done on individual research projects, and provides an index to the projects` principal investigators. Projects are grouped by their LDRD component: Individual Projects, Competency Development, and Program Development. Within each component, they are further divided into nine technical disciplines: (1) materials science, (2) engineering and base technologies, (3) plasmas, fluids, and particle beams, (4) chemistry, (5) mathematics and computational sciences, (6) atomic and molecular physics, (7) geoscience, space science, and astrophysics, (8) nuclear and particle physics, and (9) biosciences.

Laboratory-directed research and development: FY 1996 progress report

International Nuclear Information System (INIS)

Vigil, J.; Prono, J.

1997-05-01

This report summarizes the FY 1996 goals and accomplishments of Laboratory-Directed Research and Development (LDRD) projects. It gives an overview of the LDRD program, summarizes work done on individual research projects, and provides an index to the projects' principal investigators. Projects are grouped by their LDRD component: Individual Projects, Competency Development, and Program Development. Within each component, they are further divided into nine technical disciplines: (1) materials science, (2) engineering and base technologies, (3) plasmas, fluids, and particle beams, (4) chemistry, (5) mathematics and computational sciences, (6) atomic and molecular physics, (7) geoscience, space science, and astrophysics, (8) nuclear and particle physics, and (9) biosciences

A Theoretical Framework for Goal-directed Care within the Prison System

NARCIS (Netherlands)

Bulten, B.H.; Vissers, A.W.T.M.; Oei, K.

2008-01-01

Mental health care in prisons involves many stakeholders. As a consequence, the goals involved are divergent but there is no sound theoretical framework that accounts for the complexity of care in prison. This paper considers a broad theory and its conceptual framework that differentiates between

Fluid jet electric discharge source

Science.gov (United States)

Bender, Howard A [Ripon, CA

2006-04-25

A fluid jet or filament source and a pair of coaxial high voltage electrodes, in combination, comprise an electrical discharge system to produce radiation and, in particular, EUV radiation. The fluid jet source is composed of at least two serially connected reservoirs, a first reservoir into which a fluid, that can be either a liquid or a gas, can be fed at some pressure higher than atmospheric and a second reservoir maintained at a lower pressure than the first. The fluid is allowed to expand through an aperture into a high vacuum region between a pair of coaxial electrodes. This second expansion produces a narrow well-directed fluid jet whose size is dependent on the size and configuration of the apertures and the pressure used in the reservoir. At some time during the flow of the fluid filament, a high voltage pulse is applied to the electrodes to excite the fluid to form a plasma which provides the desired radiation; the wavelength of the radiation being determined by the composition of the fluid.

Proton Beam Therapy for Non-Small Cell Lung Cancer: Current Clinical Evidence and Future Directions

International Nuclear Information System (INIS)

Berman, Abigail T.; James, Sara St.; Rengan, Ramesh

2015-01-01

Lung cancer is the leading cancer cause of death in the United States. Radiotherapy is an essential component of the definitive treatment of early-stage and locally-advanced lung cancer, and the palliative treatment of metastatic lung cancer. Proton beam therapy (PBT), through its characteristic Bragg peak, has the potential to decrease the toxicity of radiotherapy, and, subsequently improve the therapeutic ratio. Herein, we provide a primer on the physics of proton beam therapy for lung cancer, present the existing data in early-stage and locally-advanced non-small cell lung cancer (NSCLC), as well as in special situations such as re-irradiation and post-operative radiation therapy. We then present the technical challenges, such as anatomic changes and motion management, and future directions for PBT in lung cancer, including pencil beam scanning

Direct Visualization of the Hydration Layer on Alumina Nanoparticles with the Fluid Cell STEM in situ.

Science.gov (United States)

Firlar, Emre; Çınar, Simge; Kashyap, Sanjay; Akinc, Mufit; Prozorov, Tanya

2015-05-21

Rheological behavior of aqueous suspensions containing nanometer-sized powders is of relevance to many branches of industry. Unusually high viscosities observed for suspensions of nanoparticles compared to those of micron size powders cannot be explained by current viscosity models. Formation of so-called hydration layer on alumina nanoparticles in water was hypothesized, but never observed experimentally. We report here on the direct visualization of aqueous suspensions of alumina with the fluid cell in situ. We observe the hydration layer formed over the particle aggregates and show that such hydrated aggregates constitute new particle assemblies and affect the flow behavior of the suspensions. We discuss how these hydrated nanoclusters alter the effective solid content and the viscosity of nanostructured suspensions. Our findings elucidate the source of high viscosity observed for nanoparticle suspensions and are of direct relevance to many industrial sectors including materials, food, cosmetics, pharmaceutical among others employing colloidal slurries with nanometer-scale particles.

Utilization of a single antiserum for the direct radioimmunoassay of prostaglandins E and F in semen and prostaglandin F in amniotic fluid

International Nuclear Information System (INIS)

Clarke, A.H.; Ing, R.M.Y.; Jones, W.R.; Llewellyn-Jones, D.; Shutt, D.A.

1974-01-01

Antibodies to both prostaglandin F (PGF) and prostaglandin E (PGE) were raised in rabbits after they were immunized with prostaglandin F/sub 2a/ conjugated to bovine serum albumin (PGF/sub 2a/--BSA). The antisera were group specific although the antibodies to the F group of prostaglandins showed greater specificity than those to the E group. The antisera were sufficiently specific however to allow the direct radioimmunoassay of PGF and PGE in human semen and PGF in amniotic fluid during induced abortion. Specificity of the direct radioimmunoassay was checked by chromatographic separation of the prostaglandins prior to analysis. Estimation of the prostaglandins in the semen of 30 men attending the infertility clinic showed that 19 of the men had normal semen levels of PGE and PGF of 68 +- 7 (SE) and 6.0 +- 0.6 μg/ml respectively, as compared with data on normal fertile males, whilst the other 11 men had lower levels of 16 +- 2 (SE) and 0.8 +- 0.1 μg/ml respectively. Application of the method to amniotic fluid showed that the PGF concentration in amniotic fluid during the induction of abortion with extra-ovular saline increased from less than 0.6 ng/ml to 6.4 ng/ml when the induction-abortion intervals ranged from 6 to 48 hours. (U.S.)

Relativistic thermodynamics of fluids

International Nuclear Information System (INIS)

Souriau, J.-M.

1977-05-01

The relativistic covariant definition of a statistical equilibrium, applied to a perfect gas, involves a 'temperature four-vector', whose direction is the mean velocity of the fluid, and whose length is the reciprocal temperature. The hypothesis of this 'temperature four-vector' being a relevant variable for the description of the dissipative motions of a simple fluid is discussed. The kinematics is defined by using a vector field and measuring the number of molecules. Such a dissipative fluid is subject to motions involving null entropy generation; the 'temperature four-vector' is then a Killing vector; the equations of motion can be completely integrated. Perfect fluids can be studied by this way and the classical results of Lichnerowicz are obtained. In weakly dissipative motions two viscosity coefficient appear together with the heat conductibility coefficient. Two other coefficients perharps measurable on real fluids. Phase transitions and shock waves are described with using the model [fr

Intravenous fluid prescription practices among pediatric residents in Korea.

Science.gov (United States)

Lee, Jiwon M; Jung, Younghwa; Lee, Se Eun; Lee, Jun Ho; Kim, Kee Hyuck; Koo, Ja Wook; Park, Young Seo; Cheong, Hae Il; Ha, Il-Soo; Choi, Yong; Kang, Hee Gyung

2013-07-01

Recent studies have established the association between hypotonic fluids administration and hospital-acquired hyponatremia in children. The present paper investigated the pattern of current practice in intravenous fluid prescription among Korean pediatric residents, to underscore the need for updated education. A survey-based analysis was carried out. Pediatric residents at six university hospitals in Korea completed a survey consisting of four questions. Each question proposed a unique scenario in which the respondents had to prescribe either a hypotonic or an isotonic fluid for the patient. Ninety-one responses were collected and analyzed. In three of the four scenarios, a significant majority prescribed the hypotonic fluids (98.9%, 85.7%, and 69.2%, respectively). Notably, 69.2% of the respondents selected the hypotonic fluids for postoperative management. Almost all (96.7%) selected the isotonic fluids for hydration therapy. In the given scenarios, the majority of Korean pediatric residents would prescribe a hypotonic fluid, except for initial hydration. The current state of pediatric fluid management, notably, heightens the risk of hospital-acquired hyponatremia. Updated clinical practice education on intravenous fluid prescription, therefore, is urgently required.

Direct anti-atherosclerotic therapy; development of natural anti-atherosclerotic drugs preventing cellular cholesterol retention.

Science.gov (United States)

Orekhov, Alexander N

2013-01-01

The results of numerous clinical trials with statins and other drugs have demonstrated the principal possibility of the prevention and regression of atherosclerosis by pharmacotherapy. This review describes the use of cultured human arterial cells for the mass screening of anti-atherosclerotic substances, the investigation of the mechanisms responsible for their atherosclerosis-related effects, and the optimization of anti-atherosclerotic and anti-atherogenic drug and dietary therapies. Natural products can be considered promising drugs for anti-atherosclerotic therapy. Our basic studies have shown that cellular lipidosis is the principal event in the genesis of atherosclerotic lesions. Using cellular models and natural products, we have developed an approach to prevent lipid accumulation in arterial cells. Based on our knowledge of atherosclerosis, we developed drugs that possess direct anti-atherosclerotic activity. Two-year treatment with allicor (garlic powder) has a direct anti-atherosclerotic effect on carotid atherosclerosis in asymptomatic men. Inflaminat (calendula, elder, and violet), which possesses anti-cytokine activity, has been shown to cause the regression of carotid atherosclerosis following the treatment of asymptomatic men for one year. The phytoestrogen-rich drug karinat (garlic powder, extract of grape seeds, green tea leaves, hop cones, β-carotene, α-tocopherol, and ascorbic acid) prevents the development of carotid atherosclerosis in postmenopausal women. Thus, our basic findings were successfully translated into clinical practice. Because of this translation, a novel approach to antiatherosclerotic therapy was developed. Our clinical trial confirmed the efficacy of both the novel approach and the novel drugs.

[Improving myocardial mechanics parameters of severe burn rabbits with oral fluid resuscitation].

Science.gov (United States)

Ruan, Jing; Zhang, Bing-qian; Wang, Guang; Luo, Zhong-hua; Zheng, Qing-yi; Zheng, Jian-sheng; Huang, Yue-sheng; Xiao, Rong

2008-08-01

To investigate the protective effect of oral fluid resuscitation on cardiac function in severe burn rabbits. One hundred and fifty rabbits were randomly divided into normal control group (NC group, n = 6, without treatment), burn group (B group, n = 42, without fluid therapy), immediate oral fluid resuscitation group (C group, n = 42), delayed oral fluid resuscitation group (D group, n = 30) and delayed and rapid oral fluid resuscitation group (E group, n = 30). The rabbits in B, C, D, E groups were subjected to 40% TBSA full-thickness burn, then were treated with fluid therapy immediately after burn (C group), at 6 hour after burn (D, E groups). The myocardial mechanics parameters including mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV +/- dp/dt max were observed at 2, 6, 8, 12, 24, 36 and 48 post burn hour (PBH). Urine output was also examined. The level of LVSP, LV +/- dp/dt max in B roup were significantly lower than those in NC group. The level of LVSP, LV +/- dp/dt max in the C and E group were singnificantly increased during 24 hour after burn. The level of LV + dp/dt max and LV-dp/dt max in C group peaked at 8 PBH (892 +/- 116 kPa/s) and at 6PBH (724 +/- 149 kPa/s) respectively. The levels of LV +/- dp/dt max, LVSP in D group at each time point were similar to B group (P > 0.05). Both the levels of LV +/- dp/dt max in E group peaked at 8 PBH. The level of LVEDP was no obvious difference between B and other groups at each time point (P > 0.05). The changes of MAP and urine output on 24 PBH in each group were similar to above indices. Effective oral fluid therapy in severe burn rabbits during 24 hours after burn can ameliorate myocardial mechanics parameters. The amount of fluid resuscitation can be estimated according to relevant formula for delayed fluid resuscitation in burn rabbits.

Which cue to ‘want’? Opioid stimulation of central amygdala makes goal-trackers show stronger goal-tracking, just as sign-trackers show stronger sign-tracking

Science.gov (United States)

DiFeliceantonio, Alexandra G.; Berridge, Kent C.

2012-01-01

Pavlovian cues that have been paired with reward can gain incentive salience. Drug addicts find drug cues motivationally attractive and binge eaters are attracted by food cues. But the level of incentive salience elicited by a cue re-encounter still varies across time and brain states. In an animal model, cues become attractive and ‘wanted’ in an ‘autoshaping’ paradigm, where different targets of incentive salience emerge for different individuals. Some individuals (sign-trackers) find a predictive discrete cue attractive while others find a reward contiguous and goal cue more attractive (location where reward arrives: goal-trackers). Here we assessed whether central amygdala mu opioid receptor stimulation enhances the phasic incentive salience of the goal-cue for goal-trackers during moments of predictive cue presence (expressed in both approach and consummatory behaviors to goal cue), just as it enhances the attractiveness of the predictive cue target for sign-trackers. Using detailed video analysis we measured the approaches, nibbles, sniffs, and bites directed at their preferred target for both sign-trackers and goal-trackers. We report that DAMGO microinjections in central amygdala made goal-trackers, like sign-trackers, show phasic increases in appetitive nibbles and sniffs directed at the goal-cue expressed selectively whenever the predictive cue was present. This indicates enhancement of incentive salience attributed by both goal trackers and sign-trackers, but attributed in different directions: each to their own target cue. For both phenotypes, amygdala opioid stimulation makes the individual’s prepotent cue into a stronger motivational magnet at phasic moments triggered by a CS that predicts the reward UCS. PMID:22391118

An analysis of budgetary goals impacting organizational performance

Directory of Open Access Journals (Sweden)

Cheok MUI YEE

2016-05-01

Full Text Available This study proposes a conceptual review of how budgetary goals impact organizational performance. The aim of this study is to get a better understanding of the direct and indirect relationship between the organization’s decision-making process and operational performances. Setting the budget particularly influences subordinates’ budget goal levels and motivations (i.e., budget goal acceptance and budget goal commitment, which ultimately enhances the organization’s performance. To test these relationships, data were collected using the three perspectives approach: budgetary goal, budgetary participation and budgetary evaluation. The study provided evidence that perception of fairness mediates the relation between the levels of budget participation and goal commitment, whereas goal commitment mediates the relation between fairness perceptions and performance. At the end of the article, there are some implications for SMEs industries and some suggestions for future studies.

Current guidelines for high-density lipoprotein cholesterol in therapy and future directions

Directory of Open Access Journals (Sweden)

Subedi BH

2014-04-01

Full Text Available Bishnu H Subedi,1,2 Parag H Joshi,1 Steven R Jones,1 Seth S Martin,1 Michael J Blaha,1 Erin D Michos1 1Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, 2Greater Baltimore Medical Center, Baltimore, MD, USA Abstract: Many studies have suggested that a significant risk factor for atherosclerotic cardiovascular disease (ASCVD is low high-density lipoprotein cholesterol (HDL-C. Therefore, increasing HDL-C with therapeutic agents has been considered an attractive strategy. In the prestatin era, fibrates and niacin monotherapy, which cause modest increases in HDL-C, reduced ASCVD events. Since their introduction, statins have become the cornerstone of lipoprotein therapy, the benefits of which are primarily attributed to decrease in low-density lipoprotein cholesterol. Findings from several randomized trials involving niacin or cholesteryl ester transfer protein inhibitors have challenged the concept that a quantitative elevation of plasma HDL-C will uniformly translate into ASCVD benefits. Consequently, the HDL, or more correctly, HDL-C hypothesis has become more controversial. There are no clear guidelines thus far for targeting HDL-C or HDL due to lack of solid outcomes data for HDL specific therapies. HDL-C levels are only one marker of HDL out of its several structural or functional properties. Novel approaches are ongoing in developing and assessing agents that closely mimic the structure of natural HDL or replicate its various functions, for example, reverse cholesterol transport, vasodilation, anti-inflammation, or inhibition of platelet aggregation. Potential new approaches like HDL infusions, delipidated HDL, liver X receptor agonists, Apo A-I upregulators, Apo A mimetics, and gene therapy are in early phase trials. This review will outline current therapies and describe future directions for HDL therapeutics. Keywords: high-density lipoprotein, lipids, cholesterol, atherosclerosis, cardiovascular disease, therapy

Introduction to the internal fluid mechanics research session

Science.gov (United States)

Miller, Brent A.; Povinelli, Louis A.

1990-01-01

Internal fluid mechanics research at LeRC is directed toward an improved understanding of the important flow physics affecting aerospace propulsion systems, and applying this improved understanding to formulate accurate predictive codes. To this end, research is conducted involving detailed experimentation and analysis. The following three papers summarize ongoing work and indicate future emphasis in three major research thrusts: inlets, ducts, and nozzles; turbomachinery; and chemical reacting flows. The underlying goal of the research in each of these areas is to bring internal computational fluid mechanic to a state of practical application for aerospace propulsion systems. Achievement of this goal requires that carefully planned and executed experiments be conducted in order to develop and validate useful codes. It is critical that numerical code development work and experimental work be closely coupled. The insights gained are represented by mathematical models that form the basis for code development. The resultant codes are then tested by comparing them with appropriate experiments in order to ensure their validity and determine their applicable range. The ultimate user community must be a part of this process to assure relevancy of the work and to hasten its practical application. Propulsion systems are characterized by highly complex and dynamic internal flows. Many complex, 3-D flow phenomena may be present, including unsteadiness, shocks, and chemical reactions. By focusing on specific portions of a propulsion system, it is often possible to identify the dominant phenomena that must be understood and modeled for obtaining accurate predictive capability. The three major research thrusts serve as a focus leading to greater understanding of the relevant physics and to an improvement in analytic tools. This in turn will hasten continued advancements in propulsion system performance and capability.

Non-goal-directed recall of specific events in apes after long delays.

Science.gov (United States)

Lewis, Amy; Call, Josep; Berntsen, Dorthe

2017-07-12

We examined if apes spontaneously remember one-time, distinctive events across long delays when probed by discriminant cues. Apes witnessed an experimenter hide a cache of food, which they could then retrieve. They retrieved one of two food types; one more distinctive than the other. Two, 10 or 50 weeks later, the apes returned to the same enclosure and found a piece of the previously hidden food on the ground. An experimenter who had not hidden the food was also present. Apes immediately searched the location where the food was previously hidden (no food was here), showing recall of the event. One week later, apes returned to the same enclosure, with the same food on the ground, but now the experimenter that had hidden the food was present. Again, apes immediately searched the hiding location. Apes that had not witnessed the hiding event did not search. There was no significant effect of food type, and retention declined from exposure to the two-week delay, then levelled, consistent with the forgetting curve in humans (Ebbinghaus, H. 1964 Memory: a contribution to experimental psychology (transl. H.A. Ruger & C.E. Bussenvis). New York, NY: Dover. (Original work published 1885.)). This is the first study to show apes can recall a one-time, non-goal-directed event longer than two weeks ago and that apes' recall declines in accordance with a standard retention function. © 2017 The Author(s).

External and internal radiation therapy: Past and future directions

Directory of Open Access Journals (Sweden)

Sadeghi Mahdi

2010-01-01

Full Text Available Cancer is a leading cause of morbidity and mortality in the modern world. Treatment modalities comprise radiation therapy, surgery, chemotherapy and hormonal therapy. Radiation therapy can be performed by using external or internal radiation therapy. However, each method has its unique properties which undertakes special role in cancer treatment, this question is brought up that: For cancer treatment, whether external radiation therapy is more efficient or internal radiation therapy one? To answer this question, we need to consider principles and structure of individual methods. In this review, principles and application of each method are considered and finally these two methods are compared with each other.

Aqueous cutting fluid for machining fissionable materials

Science.gov (United States)

Duerksen, Walter K.; Googin, John M.; Napier, Jr., Bradley

1984-01-01

The present invention is directed to a cutting fluid for machining fissionable material. The cutting fluid is formed of glycol, water and boron compound in an adequate concentration for effective neutron attenuation so as to inhibit criticality incidents during machining.

Molecular mechanics and structure of the fluid-solid interface in simple fluids

Science.gov (United States)

Wang, Gerald J.; Hadjiconstantinou, Nicolas G.

2017-09-01

Near a fluid-solid interface, the fluid spatial density profile is highly nonuniform at the molecular scale. This nonuniformity can have profound effects on the dynamical behavior of the fluid and has been shown to play an especially important role when modeling a wide variety of nanoscale heat and momentum transfer phenomena. We use molecular-mechanics arguments and molecular-dynamics (MD) simulations to develop a better understanding of the structure of the first fluid layer directly adjacent to the solid in the layering regime, as delineated by a nondimensional number that compares the effects of wall-fluid interaction to thermal energy. Using asymptotic analysis of the Nernst-Planck equation, we show that features of the fluid density profile close to the wall, such as the areal density of the first layer ΣFL (defined as the number of atoms in this layer per unit of fluid-solid interfacial area), can be expressed as polynomial functions of the fluid average density ρave. This is found to be in agreement with MD simulations, which also show that the width of the first layer hFL is a linear function of the average density and only a weak function of the temperature T . These results can be combined to show that, for system average densities corresponding to a dense fluid (ρave≥0.7 ), the ratio C ≡ΣFLρavehFL, representing a density enhancement with respect to the bulk fluid, depends only weakly on temperature and is essentially independent of density. Further MD simulations suggest that the above results, nominally valid for large systems (solid in contact with semi-infinite fluid), also describe fluid-solid interfaces under considerable nanoconfinement, provided ρave is appropriately defined.

Preparatory Training, States of Goal Orientation, and Mentoring Relationship Effectiveness

Science.gov (United States)

Scielzo, Shannon; Neeper, Michael; Smith-Jentsch, Kimberly A.

2012-01-01

We used an online academic-advising program to examine the effects of preparatory training designed to elicit high states of learning-goal orientation and low states of avoid goal orientation. Results indicate that training was effective in some cases for manipulating states of goal orientation. The training did not directly affect behaviors as…

Urine and oral fluid drug testing in support of pain management.

Science.gov (United States)

Kwong, Tai C; Magnani, Barbarajean; Moore, Christine

2017-09-01

In recent years, the abuse of opioid drugs has resulted in greater prevalence of addiction, overdose, and deaths attributable to opioid abuse. The epidemic of opioid abuse has prompted professional and government agencies to issue practice guidelines for prescribing opioids to manage chronic pain. An important tool available to providers is the drug test for use in the initial assessment of patients for possible opioid therapy, subsequent monitoring of compliance, and documentation of suspected aberrant drug behaviors. This review discusses the issues that most affect the clinical utility of drug testing in chronic pain management with opioid therapy. It focuses on the two most commonly used specimen matrices in drug testing: urine and oral fluid. The advantages and disadvantages of urine and oral fluid in the entire testing process, from specimen collection and analytical methodologies to result interpretation are reviewed. The analytical sensitivity and specificity limitations of immunoassays used for testing are examined in detail to draw attention to how these shortcomings can affect result interpretation and influence clinical decision-making in pain management. The need for specific identification and quantitative measurement of the drugs and metabolites present to investigate suspected aberrant drug behavior or unexpected positive results is analyzed. Also presented are recent developments in optimization of test menus and testing strategies, such as the modification of the standard screen and reflexed-confirmation testing model by eliminating some of the initial immunoassay-based tests and proceeding directly to definitive testing by mass spectrometry assays.