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Sample records for hypertension initial results

  1. Association of Baseline Depressive Symptoms with Prevalent and Incident Pre-Hypertension and Hypertension in Postmenopausal Hispanic Women: Results from the Women's Health Initiative.

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    Ruth E Zambrana

    Full Text Available Depression and depressive symptoms are risk factors for hypertension (HTN and cardiovascular disease (CVD. Hispanic women have higher rates of depressive symptoms compared to other racial/ethnic groups yet few studies have investigated its association with incident prehypertension and hypertension among postmenopausal Hispanic women. This study aims to assess if an association exists between baseline depression and incident hypertension at 3 years follow-up among postmenopausal Hispanic women.Prospective cohort study, Women's Health Initiative (WHI, included 4,680 Hispanic women who participated in the observational and clinical trial studies at baseline and at third-year follow-up. Baseline current depressive symptoms and past depression history were measured as well as important correlates of depression-social support, optimism, life events and caregiving. Multinomial logistic regression was used to estimate prevalent and incident prehypertension and hypertension in relation to depressive symptoms.Prevalence of current baseline depression ranged from 26% to 28% by hypertension category and education moderated these rates. In age-adjusted models, women with depression were more likely to be hypertensive (OR = 1.25; 95% CI 1.04-1.51, although results were attenuated when adjusting for covariates. Depression at baseline in normotensive Hispanic women was associated with incident hypertension at year 3 follow-up (OR = 1.74; 95% CI 1.10-2.74 after adjustment for insurance and behavioral factors. However, further adjustment for clinical covariates attenuated the association. Analyses of psychosocial variables correlated with depression but did not alter findings. Low rates of antidepressant medication usage were also reported.In the largest longitudinal study to date of older Hispanic women which included physiologic, behavioral and psychosocial moderators of depression, there was no association between baseline depressive symptoms and prevalent nor

  2. Myocardial delayed contrast enhancement in patients with arterial hypertension: Initial results of cardiac MRI

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    Andersen, Kjel [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: kjel_andersen@web.de; Hennersdorf, Marcus [Department of Cardiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: hennersdorf@med.uni-duesseldorf.de; Cohnen, Mathias [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: cohnen@med.uni-duesseldorf.de; Blondin, Dirk [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: blondin@med.uni-duesseldorf.de; Moedder, Ulrich [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: moedder@uni-duesseldorf.de; Poll, Ludger W. [Institute of Diagnostic Radiology, University Hospital Duesseldorf, Moorenstr. 5, 40225 Duesseldorf (Germany)], E-mail: poll@gmx.de

    2009-07-15

    Purpose: In arterial hypertension left ventricular hypertrophy comprises myocyte hypertrophy, interstitial fibrosis and structural alterations of the coronary microcirculation. MRI enables the detection of myocardial fibrosis, infarction and scar tissue by delayed enhancement (DE) after contrast media application. Aim of this study was to investigate patients with arterial hypertension but without known coronary disease or previous myocardial infarction to detect areas of DE. Methods and material: Twenty patients with arterial hypertension with clinical symptoms of myocardial ischemia, but without history of myocardial infarction and normal coronary arteries during coronary angiography were investigated on a 1.0 T superconducting magnet (Gyroscan T10-NT, Intera Release 8.0, Philips). Fast gradient-echo cine sequences and T2-weighted STIR-sequences were acquired. Fifteen minutes after injection of Gadobenate dimeglumine inversion recovery gradient-echo sequences were performed for detection of myocardial DE. Presence or absence of DE on MRI was correlated with clinical data and the results of echocardiography and electrocardiography, respectively. Results: Nine of 20 patients showed DE in the interventricular septum and the anteroseptal left ventricular wall. In 6 patients, DE was localized intramurally and in 3 patients subendocardially. There was a significant correlation between myocardial DE and ST-segment depressions during exercise and between DE and left-ventricular enddiastolic pressure. Patients with intermittent atrial fibrillation showed a myocardial DE more often than patients without atrial fibrillation. Conclusion: In our series, 45% of patients with arterial hypertension showed DE on cardiac MRI. In this clinical setting, delayed enhancement may be due to coronary microangiopathy. The more intramurally localization of DE, however, rather indicates myocardial interstitial fibrosis.

  3. Myocardial delayed contrast enhancement in patients with arterial hypertension: Initial results of cardiac MRI

    International Nuclear Information System (INIS)

    Andersen, Kjel; Hennersdorf, Marcus; Cohnen, Mathias; Blondin, Dirk; Moedder, Ulrich; Poll, Ludger W.

    2009-01-01

    Purpose: In arterial hypertension left ventricular hypertrophy comprises myocyte hypertrophy, interstitial fibrosis and structural alterations of the coronary microcirculation. MRI enables the detection of myocardial fibrosis, infarction and scar tissue by delayed enhancement (DE) after contrast media application. Aim of this study was to investigate patients with arterial hypertension but without known coronary disease or previous myocardial infarction to detect areas of DE. Methods and material: Twenty patients with arterial hypertension with clinical symptoms of myocardial ischemia, but without history of myocardial infarction and normal coronary arteries during coronary angiography were investigated on a 1.0 T superconducting magnet (Gyroscan T10-NT, Intera Release 8.0, Philips). Fast gradient-echo cine sequences and T2-weighted STIR-sequences were acquired. Fifteen minutes after injection of Gadobenate dimeglumine inversion recovery gradient-echo sequences were performed for detection of myocardial DE. Presence or absence of DE on MRI was correlated with clinical data and the results of echocardiography and electrocardiography, respectively. Results: Nine of 20 patients showed DE in the interventricular septum and the anteroseptal left ventricular wall. In 6 patients, DE was localized intramurally and in 3 patients subendocardially. There was a significant correlation between myocardial DE and ST-segment depressions during exercise and between DE and left-ventricular enddiastolic pressure. Patients with intermittent atrial fibrillation showed a myocardial DE more often than patients without atrial fibrillation. Conclusion: In our series, 45% of patients with arterial hypertension showed DE on cardiac MRI. In this clinical setting, delayed enhancement may be due to coronary microangiopathy. The more intramurally localization of DE, however, rather indicates myocardial interstitial fibrosis.

  4. Value of high spatial and high temporal resolution magnetic resonance angiography for differentiation between idiopathic and thromboembolic pulmonary hypertension: initial results

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    Ley, Sebastian; Eichinger, Monika [DKFZ, Department of Radiology (E010), Heidelberg (Germany); Johannes Gutenberg-University, Department of Radiology, University Hospital Mainz, Mainz (Germany); Fink, Christian; Zaporozhan, Julia; Puderbach, Michael; Plathow, Christian; Kauczor, Hans-Ulrich [DKFZ, Department of Radiology (E010), Heidelberg (Germany); Borst, Mathias M.; Meyer, F. Joachim; Gruenig, Ekkehard [University Heidelberg, Department of Internal Medicine, Heidelberg (Germany); Kreitner, Karl-Friedrich [Johannes Gutenberg-University, Department of Radiology, University Hospital Mainz, Mainz (Germany)

    2005-11-01

    Differentiation between different forms of pulmonary hypertension (PH) is essential for correct disease management. The goal of this study was to elucidate the clinical impact of high spatial resolution MR angiography (SR-MRA) and time-resolved MRA (TR-MRA) to differentiate between patients with chronic thromboembolic PH (CTEPH) and idiopathic pulmonary arterial hypertension (IPAH). Ten PH patients and five volunteers were examined. Twenty TR-MRA data sets (TA 1.5 s) and SR-MRA (TA 23 s) were acquired. TR-MRA data sets were subtracted as angiography and perfusion images. Evaluation comprised analysis of vascular pathologies on a segmental basis, detection of perfusion defects, and bronchial arteries by two readers in consensus. Technical evaluation comprised evaluation of image quality, signal-to-noise ratio (SNR) measurements, and contrast-media passage time. Visualization of the pulmonary arteries was possible down to a subsegmental (SR-MRA) and to a segmental (TR-MRA) level. SR-MRA outperformed TR-MRA in direct visualization of intravascular changes. Patients with IPAH predominantly showed tortuous pulmonary arteries while in CTEPH wall irregularities and abnormal proximal-to-distal tapering was found. Perfusion images showed a diffuse pattern in IPAH and focal defects in CTEPH. TR-MRA and SR-MRA resulted in the same final diagnosis. Both MRA techniques allowed for differentiation between IPAH and CTEPH. Therefore, TR-MRA can be used in the clinical setting, especially in dyspneic patients. (orig.)

  5. Patient-initiated Electronic Messages and Quality of Care for Patients With Diabetes and Hypertension in a Large Fee-for-Service Medical Group: Results From a Natural Experiment.

    Science.gov (United States)

    McClellan, Sean R; Panattoni, Laura; Chan, Albert S; Tai-Seale, Ming

    2016-03-01

    Few studies have examined the association between patient-initiated electronic messaging (e-messaging) and clinical outcomes in fee-for-service settings. To estimate the association between patient-initiated e-messages and quality of care among patients with diabetes and hypertension. Longitudinal observational study from 2009 to 2013. In March 2011, the medical group eliminated a $60/year patient user fee for e-messaging and established a provider payment of $3-5 per patient-initiated e-message. Quality of care for patients initiating e-messages was compared before and after March 2011, relative to nonmessaging patients. Propensity score weighting accounted for differences between e-messaging and nonmessaging patients in generalized estimating equations. Large multispecialty practice in California compensating providers' fee-for-service. Patients with diabetes (N=4232) or hypertension (N=15,463) who had activated their online portal but not e-messaged before e-messaging became free. Quality of care included HEDIS-based process measures for hemoglobin (Hb) A1c, blood pressure, low-density lipoprotein (LDL), nephropathy, and retinopathy tests, and outcome measures for HbA1c, blood pressure, and LDL. E-messaging was measured as counts of patient-initiated e-message threads sent to providers. Patients were categorized into quartiles by e-messaging frequency. The probability of annually completing indicated tests increased by 1%-7% for e-messaging patients, depending on the outcome and e-messaging frequency. E-messaging was associated with small improvements in HbA1c and LDL for some patients with diabetes. Patient-initiated e-messaging may increase the likelihood of completing recommended tests, but may not be sufficient to improve clinical outcomes for most patients with diabetes or hypertension without additional interventions.

  6. Canadian Initiatives to Prevent Hypertension by Reducing Dietary Sodium

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    Campbell, Norm R. C.; Willis, Kevin J.; L’Abbe, Mary; Strang, Robert; Young, Eric

    2011-01-01

    Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity). The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO), and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada’s dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the recommendations of

  7. Canadian Initiatives to Prevent Hypertension by Reducing Dietary Sodium

    Directory of Open Access Journals (Sweden)

    Robert Strang

    2011-08-01

    Full Text Available Hypertension is the leading risk for premature death in the world. High dietary sodium is an important contributor to increased blood pressure and is strongly associated with other important diseases (e.g., gastric cancer, calcium containing kidney stones, osteoporosis, asthma and obesity. The average dietary sodium intake in Canada is approximately 3400 mg/day. It is estimated that 30% of hypertension, more than 10% of cardiovascular events and 1.4 billion dollars/year in health care expenses are caused by this high level of intake in Canada. Since 2006, Canada has had a focused and evolving effort to reduce dietary sodium based on actions from Non Governmental Organizations (NGO, and Federal and Provincial/Territorial Government actions. NGOs initiated Canadian sodium reduction programs by developing a policy statement outlining the health issue and calling for governmental, NGO and industry action, developing and disseminating an extensive health care professional education program including resources for patient education, developing a public awareness campaign through extensive media releases and publications in the lay press. The Federal Government responded by striking a Intersectoral Sodium Work Group to develop recommendations on how to implement Canada’s dietary reference intake values for dietary sodium and by developing timelines and targets for foods to be reduced in sodium, assessing key research gaps with funding for targeted dietary sodium based research, developing plans for public education and for conducting evaluation of the program to reduce dietary sodium. While food regulation is a Federal Government responsibility Provincial and Territorial governments indicated reducing dietary sodium needed to be a priority. Federal and Provincial Ministers of Health have endorsed a target to reduce the average consumption of sodium to 2300 mg/day by 2016 and the Deputy Ministers of Health have tasked a joint committee to review the

  8. Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Obstructive sleep apnea is a potentially serious sleep ...

  9. Initial approach to hypertension in the hemodynamics unit: review article

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    Gustavo Teixeira Fulton Schimit

    2013-06-01

    Full Text Available Correct identification and early management of hypertensive disorders should be a part of the therapeutic repertoire of every professional working in hemodynamics units. Based on recent publications, this study aims to propose a practical approach to the identification and early management of these disorders in this type of service.

  10. Prevalence of Hypertension in Area I Cienfuegos Municipality. Second Measurement of CARMEN Initiative

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    Hilda María Delgado Acosta

    2015-02-01

    Full Text Available Background: the prevalence of hypertension has increased, associated to inadequate alimentary patterns, decrease of physical activity, and other behaviour patterns related to toxic habits. Objective: characterizing the prevalence of hypertension in the Area I Cienfuegos in 2010 - 2011. Methods: a descriptive and cross-section study was conducted. The sampling units were: districts, areas and sections that contained the houses, were the individuals were selected; the sample consisted on 373 people, their blood pressure was taken and an opinion poll was applied, the variables were: age, sex, personal record of hypertension and diabetes mellitus, tobacco addiction, type of physical activity, weight, size, abdominal circumference. Results: prevalence of hypertension was a 33.8 %, with predominance of the masculine sex, the 65.0 % of the hypertensive knew their condition and a 35.0 % was hypertensive and did not know it. Only the 23.8 % of the total of them were controlled, and the 44.1 % of them were under treatment. The prevalence of hypertension among smokers was 32.7 %. The 55% were diabetics, the 46.5 % were obese and the 50 % had an altered measurement of the abdominal waist. Conclusions: it was detected a hidden prevalence of hypertension and lack of control in patients under treatment with predominance of the masculine sex, among the studied risk factors, the diabetics and the obese presented a prevalence of hypertension two times bigger than the ones that did not have these risk factors.

  11. Ward Round-A rare tumor of the kidney resulting in hypertension ...

    African Journals Online (AJOL)

    2011-03-19

    Mar 19, 2011 ... in hypertension, renal failure and a cerebrovascular accident in a young ... Her blood pressure was poorly controlled, despite being on Furosemide .... accident as a result of hypertension secondary to juxtaglomerular cell ...

  12. Treatment initiation in paediatric pulmonary hypertension: insights from a multinational registry.

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    Humpl, Tilman; Berger, Rolf M F; Austin, Eric D; Fasnacht Boillat, Margrit S; Bonnet, Damien; Ivy, Dunbar D; Zuk, Malgorzata; Beghetti, Maurice; Schulze-Neick, Ingram

    2017-08-01

    Different treatment options for pulmonary hypertension have emerged in recent years, and evidence-based management strategies have improved quality of life and survival in adults. In children with pulmonary vascular disease, therapeutic algorithms are not so clearly defined; this study determined current treatment initiation in children with pulmonary hypertension in participating centres of a registry. Through the multinational Tracking Outcomes and Practice in Pediatric Pulmonary Hypertension registry, patient demographics, diagnosis, and treatment as judged and executed by the local physician were collected. Inclusion criteria were >3 months and pulmonary hypertension (mean pulmonary arterial pressure ⩾25 mmHg, pulmonary vascular resistance index ⩾3 Wood units×m2, and mean pulmonary capillary wedge pressure ⩽12 mmHg). At diagnostic catheterisation, 217/244 patients (88.9%) were treatment naïve for pulmonary hypertension-targeted therapy. Targeted therapy was initiated after catheterisation in 170 (78.3%) treatment-naïve patients. A total of 19 patients received supportive therapy, 28 patients were not started on therapy, and 26 patients (10.7%) were on targeted treatment before catheterisation. Among treatment-naïve subjects, treatment was initiated with one targeted drug (n=112, 51.6%), dual therapy (n=39, 18%) or triple-therapy (n=5, 2.3%), and calcium channel blockers with one targeted medication in one patient (0.5%). Phosphodiesterase inhibitors type 5 were used frequently; some patients with pulmonary hypertension related to lung disease received targeted therapy. There is a diverse therapeutic approach for children with pulmonary hypertension with a need of better-defined treatment algorithms based on paediatric consensus for different aetiologies including the best possible diagnostic workup.

  13. Neurocognitive Function in Children with Primary Hypertension after Initiation of Antihypertensive Therapy.

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    Lande, Marc B; Batisky, Donald L; Kupferman, Juan C; Samuels, Joshua; Hooper, Stephen R; Falkner, Bonita; Waldstein, Shari R; Szilagyi, Peter G; Wang, Hongyue; Staskiewicz, Jennifer; Adams, Heather R

    2018-04-01

    To determine the change in neurocognitive test performance in children with primary hypertension after initiation of antihypertensive therapy. Subjects with hypertension and normotensive control subjects had neurocognitive testing at baseline and again after 1 year, during which time the subjects with hypertension received antihypertensive therapy. Subjects completed tests of general intelligence, attention, memory, executive function, and processing speed, and parents completed rating scales of executive function. Fifty-five subjects with hypertension and 66 normotensive control subjects underwent both baseline and 1-year assessments. Overall, the blood pressure (BP) of subjects with hypertension improved (24-hour systolic BP load: mean baseline vs 1 year, 58% vs 38%, P < .001). Primary multivariable analyses showed that the hypertension group improved in scores of subtests of the Rey Auditory Verbal Learning Test, Grooved Pegboard, and Delis-Kaplan Executive Function System Tower Test (P < .05). However, the control group also improved in the same measures with similar effects sizes. Secondary analyses by effectiveness of antihypertensive therapy showed that subjects with persistent ambulatory hypertension at 1 year (n = 17) did not improve in subtests of Rey Auditory Verbal Learning Test and had limited improvement in Grooved Pegboard. Overall, children with hypertension did not improve in neurocognitive test performance after 1 year of antihypertensive therapy, beyond that also seen in normotensive controls, suggesting improvements with age or practice effects because of repeated neurocognitive testing. However, the degree to which antihypertensive therapy improves BP may affect its impact upon neurocognitive function. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Sleep quality among relatively younger patients with initial diagnosis of hypertension: dippers versus non-dippers.

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    Yilmaz, Mehmet Birhan; Yalta, Kenan; Turgut, Okan Onur; Yilmaz, Ahmet; Yucel, Oguzhan; Bektasoglu, Gokhan; Tandogan, Izzet

    2007-01-01

    Sleep is a basic physiological process. Normal sleep yields decrease in sympathetic activity, blood pressure (BP) and heart rate. Those, who do not have expected decrease in their BP are considered "non-dippers". We aimed to determine if there was any association between the non-dipping status and sleep quality, designed a cross-sectional study, and enrolled and evaluated the sleep quality of relatively young patients with an initial diagnosis of hypertension. Seventy-five consecutive patients, diagnosed to have stage 1 hypertension by their primary physicians, were referred to our study. Patients had newly diagnosed with stage 1 hypertension. Patients with a prior use of any anti-hypertensive medication were not included. Eligible patients underwent the Pittsburgh Sleep Quality Index (PSQI), which has an established role in evaluating sleep disturbances. All patients underwent ambulatory BP monitoring. There were 42 non-dipper patients (mean age = 47.5+/-11.9 years, 24 male/18 female), as a definition, 31 dipper hypertensive patients (mean age = 48.5+/-12.8 years, 21 male/10 female) and two with white coat hypertension. Daytime systolic and diastolic mean BPs were not significantly different between the two groups. Night-time mean systolic and diastolic BPs were significantly higher in non-dippers compared with dippers. PSQI scores, globally, were significantly higher in non-dippers compared with dippers. Total PSQI score was not correlated with body mass index. It was noticed that, individually, sleep quality, sleep efficiency and sleep disturbance scores were significantly higher in non-dippers. Being a poor sleeper in terms of high PSQI score (total score>5) was associated with 2.955-fold increased risk of being a non-dipper (95% confidence interval 1.127-7.747). We showed that the risk of having non-dipping hypertension, a risk factor for poor cardiovascular outcomes among hypertensive individuals, was tripled (odds ratios) among poor sleepers. We think that

  15. hypertension

    Directory of Open Access Journals (Sweden)

    Emine Hatipoglu

    2013-05-01

    Full Text Available Hypertension is a common disease associated with important cardiovascular complications. Persistent blood pressure of 140/90 or higher despite combined use of a reninangiotensin system blocker, calcium channel blocker and a diuretic at highest tolerated doses constitutes resistant hypertension. Excess sympathetic activity plays an important pathogenic role in resistant hypertension in addition to contributing to the development of metabolic problems, in particular diabetes. Reduction of renal sympathetic activity by percutaneous catheter-based radiofrequency ablation via the renal arteries has been shown in several studies to decrease blood pressure in patients with resistant hypertension, and importantly is largely free of significant complications. However, longer term follow-up is required to confirm both long-term safety and efficacy.

  16. Hypertension

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for hypertension hyperlipidemia. The data is provided by three managed care organizations in Allegheny County...

  17. Aquarius: The Instrument and Initial Results

    Science.gov (United States)

    Vine, David M Le; Lagerloef, G.S.E.; Ruf, C.; Wentz, F.; Yueh, S.; Piepmeier, J.; Lindstrom, E.; Dinnat, E.

    2012-01-01

    Aquarius was launched on June 10, 2011 aboard the Aquarius/SAC-D observatory and the instrument has been operating continuously since the initial turned-on was completed on August 25. The initial observed antenna temperatures were close to predicted and the first salinity map was released in September. In order to map the ocean salinity field, Aquarius includes several special features such as the inclusion of a scatterometer to provide a roughness correction, measurement of the third Stokes parameter to correct for Faraday rotation, and fast sampling to mitigate the effects of RFI. This paper provides an overview of the instrument and an example of initial results. Details are covered in subsequent papers in the session on Aquarius

  18. Hypertension

    OpenAIRE

    Farrugia, Emanuel

    2004-01-01

    Hypertension is a rapidly moving clinical field with frequent developments in new pharmacologic agents and management strategies. Perhaps more importantly, there have been substantial improvements in our understanding of how best to use the drugs available to us. In this article, I will review some of the more important advances in our understanding of hypertension over the past two years, specifically by reviewing six important trials, one survey and two sets of guidelines, all published bet...

  19. [Magnetotherapy of initial manifestations of cerebrovascular disorders in hypertension].

    Science.gov (United States)

    Miasnikov, I G

    1992-01-01

    The paper is concerned with the data on 147 subjects who underwent magnetotherapy with the unit "Magniter-AMT-01" applied to the cervical area. The main group included 102 subjects, 45 person served as control. The purpose of the work was to base the application of MT under inpatient and home conditions with the use of the above-indicated unit. In view of this fact, a study was made of cerebral hemo- and thermodynamics with the aid of rheoencephalography and encephaloradiothermography under the action of different modes of the functioning of the unit "Magniter-AMT-01" (pulse and variable magnet induction fields 12-15 mTl and 30-35 mTl). A method of measuring magnetosensitivity of patients depending on the temperature reaction of the brain to a single MT session was elaborated. The greatest clinical effect was attained with the use of pulse magnetic field 15 mTl. Magnetotherapy with the use of the unit "Magniter-AMT-01" provided good results under inpatient and home conditions. The magnetosensitive patients demonstrated the highest effect.

  20. Care initiation area yields dramatic results.

    Science.gov (United States)

    2009-03-01

    The ED at Gaston Memorial Hospital in Gastonia, NC, has achieved dramatic results in key department metrics with a Care Initiation Area (CIA) and a physician in triage. Here's how the ED arrived at this winning solution: Leadership was trained in and implemented the Kaizen method, which eliminates redundant or inefficient process steps. Simulation software helped determine additional space needed by analyzing arrival patterns and other key data. After only two days of meetings, new ideas were implemented and tested.

  1. Economic analysis of Heart and Stroke Foundation of Ontario's Hypertension Management Initiative

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    de Oliveira C

    2012-11-01

    Full Text Available Claire de Oliveira,1,2 Harindra C Wijeysundera,2,3 Sheldon W Tobe,4 Margaret Moy Lum-Kwong,5 Shirley Von Sychowski,5 Xuesong Wang,6 Jack V Tu,6 Murray D Krahn2,71University Health Network, Toronto, ON, Canada; 2Toronto Health Economics and Technology Assessment Collaborative, Toronto, ON, Canada; 3Schulich Heart Centre, Division of Cardiology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 4Division of Nephrology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada; 5Heart and Stroke Foundation of Ontario, Toronto, ON, Canada; 6Institute for Clinical Evaluative Sciences, Toronto, ON, Canada; 7Department of Medicine and Faculty of Pharmacy, University of Toronto, Toronto, ON, CanadaObjectives: Hypertension is suboptimally treated in primary care settings. We evaluated the cost-effectiveness of the Heart and Stroke Foundation of Ontario's Hypertension Management Initiative (HMI, an interdisciplinary, evidence-informed chronic disease management model for primary care that focuses on improving blood pressure management and control by primary care providers and patients according to clinical best practice guidelines.Methods: The perspective of our analysis was that of the Ontario Ministry of Health and Long-Term Care with a lifetime horizon and 5% annual discount rate. Using data from a prospective cohort study from the HMI, we created two matched groups: pre-HMI (standard care, and post-HMI (n = 1720. For each patient, we estimated the 10-year risk of cardiovascular disease (CVD using the Framingham risk equation and life expectancy from life tables. Long-term health care costs incurred with physician visits, acute and chronic care hospitalizations, emergency department visits, same-day surgeries, and medication use were determined through linkage to administrative databases, using a bottom-up approach.Results: The HMI intervention was

  2. Overview of the initial NSTX experimental results

    International Nuclear Information System (INIS)

    Ono, M.; Bell, M.G.; Bell, R.E.

    2001-01-01

    The main aim of the National Spherical Torus Experiment (NSTX) is to establish the fusion physics principles of the spherical torus (ST) concept. The NSTX device began plasma operations in February 1999 and the plasma current I p was successfully brought up to the design value of 1 MA on 14 December 1999. The planned plasma shaping parameters, elongation κ=1:6-2.2 and triangularity δ=0:2-0.4, were achieved in inner wall limited, and single null and double null diverted configurations. The coaxial helicity injection (CHI) and high harmonic fast wave (HHFW) experiments were also initiated. CHI current of 27 kA produced up to 260 kA toroidal current without using an ohmic solenoid. With the injection of 2.3 MW of HHFW power, using 12 antennas connected to six transmitters, electrons were heated from a central temperature of 400 eV to 900 eV at a central density of 3.5x10 13 cm 3 , increasing the plasma energy to 59 kJ and the toroidal β, β T , to 10%. The NBI system commenced operation in September 2000. The initial results with two ion sources (P NBI =2:8 MW) show good heating, producing a total plasma stored energy of 90 kJ corresponding to β T ∼18% at a plasma current of 1.1 MA. (author)

  3. Overview of the initial NSTX experimental results

    International Nuclear Information System (INIS)

    Ono, M.; Bell, M.; Bell, R.

    2001-01-01

    The main aim of the National Spherical Torus Experiment (NSTX) is to establish the fusion physics principles of the spherical torus (ST) concept. The NSTX device began plasma operations in February 1999 and the plasma current I p was successfully brought up to the design value of 1 million amperes on December 14, 1999. The planned plasma shaping parameters, κ=1.6-2.2 and δ=0.2-0.4, were achieved in inner limited, single null and double null configurations. The CHI (Coaxial Helicity Injection) and HHFW (High Harmonic Fast Wave) experiments were also initiated. A CHI injected current of 27 kA produced up to 260 kA of toroidal current without using an ohmic solenoid. With an injection of 2.3 MW of HHFW power, using twelve antennas connected to six transmitters, electrons were heated from a central temperature of 400 eV to 900 eV at a central density of 3.5x10 13 cm -3 increasing the plasma energy to 59 kJ and the toroidal beta, β T to 10 %. Finally, the NBI system commenced operation in Sept. 2000. The initial results with two ion sources (P NBI =2.8MW) shows good heating, producing a total plasma stored energy of 90 kJ corresponding to β T ∼18% at a plasma current of 1.1 MA. (author)

  4. Overview of the Initial NSTX Experimental Results

    International Nuclear Information System (INIS)

    Ono, M.; Bell, M.; Bell, R. E.; Bigelow, T.; Bitter, M.

    2000-01-01

    The main aim of the National Spherical Torus Experiment (NSTX) is to establish the fusion physics principles of the spherical torus (ST) concept. The NSTX device began plasma operations in February 1999 and the plasma current Ip was successfully brought up to the design value of 1 million amperes on December 14, 1999. The planned plasma shaping parameters, k = 1.6 ± 2.2 and d = 0.2 ± 0.4, were achieved in inner limited, single null and double null configurations. The CHI (Coaxial Helicity Injection) and HHFW (High Harmonic Fast Wave) experiments were also initiated. A CHI injected current of 27 kA produced up to 260 kA of toroidal current without using an ohmic solenoid. With an injection of 2.3 MW of HHFW power, using twelve antennas connected to six transmitters, electrons were heated from a central temperature of 400 eV to 900 eV at a central density of 3.5 x 1013 cm-3 increasing the plasma energy to 59 kJ and the toroidal beta, bT to 10 %. Finally, the NBI system commenced operation in Sept. 2000. The initial results with two ion sources (PNBI = 2.8 MW) shows good heating, producing a total plasma stored energy of 90 kJ corresponding to bT = 18 % at a plasma current of 1.1 MA

  5. Angiographic assessment of initial balloon angioplasty results.

    Science.gov (United States)

    Gardiner, Geoffrey A; Sullivan, Kevin L; Halpern, Ethan J; Parker, Laurence; Beck, Margaret; Bonn, Joseph; Levin, David C

    2004-10-01

    To determine the influence of three factors involved in the angiographic assessment of balloon angioplasty-interobserver variability, operator bias, and the definition used to determine success-on the primary (technical) results of angioplasty in the peripheral arteries. Percent stenosis in 107 lesions in lower-extremity arteries was graded by three independent, experienced vascular radiologists ("observers") before and after balloon angioplasty and their estimates were compared with the initial interpretations reported by the physician performing the procedure ("operator") and an automated quantitative computer analysis. Observer variability was measured with use of intraclass correlation coefficients and SD. Differences among the operator, observers, and the computer were analyzed with use of the Wilcoxon signed-rank test and analysis of variance. For each evaluator, the results in this series of lesions were interpreted with three different definitions of success. Estimation of residual stenosis varied by an average range of 22.76% with an average SD of 8.99. The intraclass correlation coefficients averaged 0.59 for residual stenosis after angioplasty for the three observers but decreased to 0.36 when the operator was included as the fourth evaluator. There was good to very good agreement among the three independent observers and the computer, but poor correlation with the operator (P definition of success was used. Significant differences among the operator, the three observers, and the computer were not present when the definition of success was based on less than 50% residual stenosis. Observer variability and bias in the subjective evaluation of peripheral angioplasty can have a significant influence on the reported initial success rates. This effect can be largely eliminated with the use of residual stenosis of less than 50% to define success. Otherwise, meaningful evaluation of angioplasty results will require independent panels of evaluators or

  6. Homestake surface-underground scintillators: Initial results

    International Nuclear Information System (INIS)

    Cherry, M.L.; Corbato, S.; Daily, T.; Fenyves, E.J.; Kieda, D.; Lande, K.; Lee, C.K.

    1986-01-01

    The first 70 tons of the 140-ton Large Area Scintillation Detector (LASD) have been operating since Jan. 1985 at a depth of 4850 ft. (4200 m.w.e.) in the Homestake Gold Mine, Lead, S.D. A total of 4 x 10(4) high-energy muons (E sub mu is approx. 2.7 TeV at the surface) have been detected. The remainder of the detector is scheduled to be in operation by the Fall of 1985. In addition, a surface air shower array is under construction. The first 27 surface counters, spaced out over an area of 270' x 500', began running in June, 1985. The LASD performance, the potential of the combined shower array and underground muon experiment for detecting point sources, and the initial results of a search for periodic emission from Cygnus X-3 are discussed

  7. [The role of clevidipine in hypertension management: clinical results].

    Science.gov (United States)

    Zuleta-Alarcón, A; Castellón-Larios, K; Bergese, S

    2014-12-01

    The prevalence of hypertension in general population is from 30% to 45%(.) Anesthesiologists frequently deal with the challenge of maintaining adequate control of perioperative blood pressure. On sudden elevations, a precise control is required to prevent end-organ damage. Recently, clevidipine, an ultra-short acting calcium antagonist has been approved by the FDA (www.accessdata.fda.gov), as a strategy for the intravenous treatment of hypertension; and by the Spanish Agency of Medicines and Medical Devices (www.aemps.gob.es) for the rapid reduction of arterial blood pressure in the perioperative setting. This medication has shown to have a rapid onset, easy titratability, and to exert a precise control of blood pressure. In addition, clevidipine has shown to be highly effective as monotherapy, and to have an excellent transition to oral antihypertensive therapy. For this article, an online search of the Medline literature was conducted up to February 2014 and "clevidipine" and "hypertension" used as keywords in order to analyze pharmacokinetics and pharmacodynamics of clevidipine. There are also clinical studies that provide evidence of the rapid and effective control that clevidipine has on blood pressure, especially in acute perioperative and emergency settings. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Initial results from MARmara SuperSITE

    Science.gov (United States)

    Meral Ozel, Nurcan; Necmioglu, Ocal; Favali, Paolo; Douglas, John; Mathieu, Pierre-Philippe; Geli, Louis; Ergintav, Semih; Oguz Ozel, Asım; Tan, Onur; Gurbuz, Cemil; Erdik, Mustafa

    2014-05-01

    MARSite Project was initiated in November 2012 under the EC/FP-7 framework as an initiative towards establishment of new directions in seismic hazard assessment through focused earth observation in Marmara Region. Within MARSite, collection of the first comprehensive data set of fluids composition around the Sea of Marmara has been accomplished and first insight in the geochemical features of the fluids are expelled from tectonic structures around the Sea of Marmara. GPS time series and velocity fields are periodically updated and a project proposal has been prepared for Supersite initiative to take SAR data and integrate the results with in-situ data sets, which is accepted by the scientific committee of GEOSS. In the meantime, special focus was given to develop the processing algorithms, starting from low level atmospheric correction to high level modeling routines. Considerable progress has been made in the novel design of a multiparameter borehole system consisting of very wide dynamic range and stable borehole (VBB) broad band seismic sensor also incorporating 3-D strain meter, tilt meter, and temperature and local hydrostatic pressure measuring devices. Borehole and surface array locations and borehole bedrock depth of 137 m has been identified. A modeling scheme for the scenario earthquake simulation has been set up in order to realize processing of real-time high-rate GPS data and simulating of scenario earthquakes. The probability of occurrence for the fault segmentation in the Marmara region were calculated using the Poisson, BPT and BPT with a stress interaction models for time intervals of 5-10-30 and 50 years. High resolution seismic reflection and multibeam data in the easternmost Cinarcik basin obtained during the cruise MARMARA 2013 carried out onboard the CNR R/V Urania ship provided information on diffuse gravitational failures. An in situ multi-parameter observational system for landslide monitoring, including displacement, rainfall and seismic

  9. CHOICE OF THE INITIAL TREATMENT FOR MILD TO MODERATE ARTERIAL HYPERTENSION IN MOSCOW PRIMARY PRACTICE

    Directory of Open Access Journals (Sweden)

    S. V. Gatsura

    2015-09-01

    Full Text Available Aim. To assess the choice of initial pharmacotherapy of uncomplicated mild to moderate arterial hypertension (HT in Moscow primary care as well as to clear up the influence of regulatory measures on this choice.Material and methods. Results of two similar surveys conducted in 2011-2012 (452 respondents and 2013-2014 (273 respondents were compared to estimate preferences of Moscow primary care physicians regarding initial antihypertensive agents for therapy of uncomplicated mild to moderate HT taking into consideration an influence of regulatory requirement to prescribe medicinal products by international nonproprietary name (INN since July 2012. All participants were proposed to write down their preferred antihypertensive agents for initial mono- or combined therapy of mild to moderate HT with moderate cardiovascular risk and absence of compelling indications.Results. Angiotensin converting enzyme inhibitors (ACEI remained the leading class of antihypertensive agents, though their popularity slightly but significantly declined from 44.4% in 2011-12 to 37.2% in 2013-14 (р<0.05. Angiotensin receptor blockers partially displaced the leaders and increased their popularity from 11.3% in 2011-12 to 18.0% in 2013-14 (р<0.01. ACEI/diuretic combination remained on the 3rd position (16.4% and 15.3% respectively. Beta-blockers and diuretics as monotherapy shared 4th and 5th places in this rating. Calcium channel blockers popularity among Moscow prescribers remained unchanged and poor – 2.1%. The most popular medicine by trade name was Noliprel, perindopril/indapamide fixed combination, – 14.0% and 13.7% of respondents in 2011-12 and 2013-14, respectively. The share of medicine products recommended by INN went up from 11.9% to 22.8% among top-10 popular medications (р<0.01.Conclusion. Blockers of renin-angiotensin-aldosterone system remain the leading drugs for the initial treatment of uncomplicated mild to moderate HT without compelling indications

  10. Initial results from the RHEPP module

    International Nuclear Information System (INIS)

    Harjes, H.C.; Penn, K.J.; Reed, K.W.; McClenahan, C.R.; Laderach, G.E.; Wavrik, R.W.; Adcock, J.L.; Butler, M.E.; Mann, G.A.; Pena, G.E.

    1993-01-01

    Several potential applications such as medical waste treatment, chemical waste treatment, food treatment, and flue gas cleanup have been identified for high average power electron beam systems. In the RHEPP (Repetitive High Energy Pulsed Power) project, the technology for such a system is being developed. The RHEPP module consists of a magnetic pulse compressor driving a linear induction voltage adder with an e-beam diode load. It has been designed to operate continuously, delivering 350 kW of average power to the diode in 60-ns FWHM, 2.5-MV, 2.9-kJ pulses. The module is presently under construction with the first phase scheduled for completion in the summer of 1992. In the first phase, four of ten adder stages are being built so that testing can begin with a 1-MV, 160-kW diode with the balance of the power from the compressor diverted to a resistive load. A description of the system and test results from the initial stages of the compressor will be presented

  11. Initial Results from the Kwajalein Micrometeorite Collections

    Science.gov (United States)

    Wozniakiewicz, P. J.; Bradley, J. P.; Price, M. C.; Zolensky, M. E.; Ishii, H. A.; Brownlee, D. E.; Dearborn, D.; Jones, T.; Barnett, B.; Yakuma, S.; hide

    2014-01-01

    Micrometeorites are constantly arriving at the Earth's surface, however, they are quickly diluted by the natural and anthropogenic back-ground dust. The successful collection of micromete-orites requires either the employment of a separation technique (e.g. using magnets to separate metal-bearing micrometeorites from deepsea sediments [e.g. 1,2] and dissolved pre-historic limestones and salts [e.g. 3,4]), or an approach that limits contamination by terrestrial dust (e.g. collecting from ice, snow and well water in polar regions - locations where the terrestrial dust flux is so low that micrometeorites repre-sent the major dust component [e.g. 5-7]). We have recently set up a micrometeorite collection station on Kwajalein Island in the Republic of the Marshall Is-lands in the Pacific Ocean, using high volume air samplers to collect particles directly from the atmosphere. Collecting at this location exploits the considerably reduced anthropogenic background; Kwajalein is >1000 miles from the nearest continent and for much of the year, trade winds blow from the northeast at 15 to 20 knots providing a continuous stream of oceanic aerosol for sampling. By collecting directly from the atmosphere, the terrestrial age of the particles, and hence weathering they experience, is minimal. We therefore anticipate that the Kwajalein col-lection may include particles that are highly susceptible to weathering and either not preserved well or not found at all in other collections. In addition, this collection method allows for particle arrival times to be constrained so that collections can be timed to correlate with celestial events (e.g. meteor showers). Here we describe the collections and their preparation and report on the initial results.

  12. Controlled treatment of primary hypertension with propranolol and spironolactone. A crossover study with special reference to initial plasma renin activity.

    Science.gov (United States)

    Karlberg, B E; Kågedal, B; Tegler, L; Tolagen, K; Bergman, B

    1976-03-31

    Twenty-seven patients with hypertension were randomly allocated to a 10 month crossover study. Treatment consisted of spironolactone (200 mg/day for 2 months), propranolol (320 mg/day for 2 months) and combined administration of both drugs at half the dosage. Between treatment periods placebo was given for 2 months. Fourteen patients were previously untreated. The average pretreatment blood pressure for the entire group was 188/114 +/- 16/7(mean +/- standard deviation) mm Hg supine and 188/118 +/- 20/9 mm Hg standing. Both spironolactone and propranolol reduced blood pressure significantly in both the supine and standing positions. Upright plasma renin activity was determined by radioimmunoassay of angiotensin I. The average initial level was 1.9 +/- 1.2 (range 0.4 to 5.0) ng/ml/hr. There was a close correlation between plasma renin activity and the effects of the drugs: With increasing renin level the response to propranolol was better whereas the opposite was true for spironolactone. The combination of spironolactone and propranolol decreased the blood pressure still further in the supine and standing positions, irrespective of initial plasma renin activity. All patients achieved a normal supine pressure. Blood pressure and plasma renin activity returned toward pretreatment values during placebo administration. It is concluded that pretreatment levels of plasma renin activity can predict the antihypertensive response to propranolol and spironolactone. The combination of the two drugs, which have different modes of action, will effectively reduce blood pressure in hypertension. The results support the concept that the renin-angiotensin-aldo-sterone system may be involved in primary hypertension.

  13. METOPROLOL VERSUS THIAZIDE DIURETICS IN HYPERTENSION - MORBIDITY RESULTS FROM THE MAPHY STUDY

    NARCIS (Netherlands)

    WIKSTRAND, J; WARNOLD, [No Value; TUOMILEHTO, J; OLSSON, G; BARBER, HJ; ELIASSON, K; ELMFELDT, D; JASTRUP, B; KARATZAS, NB; LEER, J; MARCHETTA, F; RAGNARSSON, J; ROBITAILLE, NM; VALKOVA, L; WESSELING, H; BERGLUND, G

    The present study in hypertensive men (40-64 years old) with untreated diastolic blood pressure above 100 mm Hg was aimed at investigating whether metoprolol (n = 1,609) given as initial treatment would lower the risk for coronary events (sudden death and myocardial infarction) more effectively than

  14. Arase: mission overview and initial results

    Science.gov (United States)

    Miyoshi, Y.; Shinohara, I.; Takashima, T.; Asamura, K.; Wang, S. Y.; Kazama, Y.; Kasahara, S.; Yokota, S.; Mitani, T.; Higashio, N.; Kasahara, Y.; Kasaba, Y.; Yagitani, S.; Matsuoka, A.; Kojima, H.; Kazuo, S.; Seki, K.; Hori, T.; Shoji, M.; Teramoto, M.; Chang, T. F.; Kurita, S.; Matsuda, S.; Keika, K.; Miyashita, Y.; Hosokawa, K.; Ogawa, Y.; Kadokura, A.; Kataoka, R.; Ono, T.

    2017-12-01

    Geospace Exploation Project; ERG addresses what mechanisms cause acceleration, transportation and loss of MeV electrons of the radiation belts and evolutions of space storms. Cross-energy and cross-regional couplings are key concepts for the project. In order to address questions, the project has been organized by three research teams; satellite observations, ground-based observations, and modeling/data-analysis studies, and interdisciplinary research are realized for comprehensive understanding of geospace. The Arase (ERG) satellite had been developed and 9 science instruments are developed and provided from JAXA, universities and instituted in Japan and Taiwan. The Arase satellite was successfully launched on December 20, 2016. After the initial operation including maneuvers, Arase has started normal observations since March, 2017. Until now, Arase has observed several geomagnetic storms driven by coronal hole streams and CMEs, and several interesting features are observed associated with geomagnetic disturbances. The six particle instruments; LEP-e/LEP-i/MEP-e/MEP-i/HEP/XEP have shown large enhancement as well as loss of wide energy electrons and ions and variations as well as changes of pitch angle and energy spectrum. The two field/wave instruments: PWE and MGF observed several kinds of plasma waves such as chorus, hiss, EMIC as well as large scale electric and magnetic field variations. And newly developed S-WPIA has been operated to identify micro-process of wave-particle interactions. Since conjugate observations between Arase and ground-based observations are essential for comprehensive understanding of geospace, we organized several campaign observations that include both satellite and ground-based observations. The project has collaborated with the international projects, EISCAT, SuperDARN and other ground-based observations, and various data are obtained from such international collaborations. Moreover, multi-point satellite observations by

  15. REXEBTS, design and initial commissioning results

    CERN Document Server

    Wenander, F; Jonson, B; Liljeby, L; Nyman, G H; Rensfelt, K G; Skeppstedt, Ö; Wolf, B

    2001-01-01

    The REXEDIS is an Electron Beam Ion Source (EBIS) developed particularly for charge breeding of rare and short-lived isotopes produced at ISOLDE for the REX-ISOLDE post accelerator. Bunches of singly charged radioactive ions are injected into the EBIS and charge bred to a charge-to-mass ratio of approximately 1/4 and thereafter extracted and injected into a short LINAC. This novel concept, employing a Penning trap to bunch and cool the ions from an on-line mass separator prior to charge breeding in an EBIS, results in an efficient and compact system. In this article the final REXEBIS design is presented together with results from the first tests. (19 refs).

  16. [Secondary hypertension].

    Science.gov (United States)

    Yoshida, Yuichi; Shibata, Hirotaka

    2015-11-01

    Hypertension is a common disease and a crucial predisposing factor of cardiovascular diseases. Approximately 10% of hypertensive patients are secondary hypertension, a pathogenetic factor of which can be identified. Secondary hypertension consists of endocrine, renal, and other diseases. Primary aldosteronism, Cushing's syndrome, pheochromocytoma, hyperthyroidism, and hypothyroidism result in endocrine hypertension. Renal parenchymal hypertension and renovascular hypertension result in renal hypertension. Other diseases such as obstructive sleep apnea syndrome are also very prevalent in secondary hypertension. It is very crucial to find and treat secondary hypertension at earlier stages since most secondary hypertension is curable or can be dramatically improved by specific treatment. One should keep in mind that screening of secondary hypertension should be done at least once in a daily clinical practice.

  17. ERNIE performance with TSA portals Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Labov, S. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2018-01-05

    This project extends the “Enhanced Radiological Nuclear Inspection and Evaluation” (ERNIE) system developed with CBP and DNDO to improve performance of PVT-based Radiation Portal Monitors (RPMs). ERNIE was designed to be used with any RPM system. The first implementation was with the SAIC (Leidos) RPM-8 systems. In this project, we are demonstrating how effective the ERNIE approach can be when applied to the VM250 TSA portals used in NSDD programs. Part of the challenge in adapting ERNIE to handle VM250 portals is the lack of gamma spectral information. We report here on the first results showing how the ERNIE analysis can improve analysis of measurements with the VM250 RPMs.

  18. Heart and Stroke Foundation of Ontario (HSFO high blood pressure strategy's hypertension management initiative study protocol

    Directory of Open Access Journals (Sweden)

    Von Sychowski Shirley

    2008-12-01

    Full Text Available Abstract Background Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community. Methods This study will test the effect of a systems change on the management of high blood pressure in real world practice in primary care in Ontario, Canada. The systems change intervention involves an interprofessional educational program bringing together physicians, nurses and pharmacists with tools for both providers and patients to facilitate blood pressure management. Each of two waves of subjects were enrolled over a 6 month period with the initial enrollment between waves separated by 9 months. Blood pressure will be measured with the BpTru ® automated blood pressure device. To determine the effectiveness of the intervention, a before and after analysis within all subjects will compare blood pressure at baseline to annual measurements for the three year study. To assess whether the intervention has an impact on blood pressure control independent of community trends, a betwen group comparison of baseline blood pressures in the delayed wave will be made with the immediate wave during the same time period, so that the immediate wave has experienced the intervention for at least 9 months. The total enrollment goal is 5,000 subjects. The practice locations include 10 Family Health Teams (FHTs and 1 Community Health Centre (CHC and approximately 49 primary care physicians, 15 nurse practitioners, 37 registered nurses and over 150

  19. Breast tomosynthesis in clinical practice: initial results

    International Nuclear Information System (INIS)

    Teertstra, Hendrik J.; Loo, Claudette E.; Bosch, Maurice A.A.J. van den; Muller, Sara H.; Gilhuijs, Kenneth G.A.; Tinteren, Harm van; Rutgers, Emiel J.T.

    2010-01-01

    The purpose of this study was to assess the potential value of tomosynthesis in women with an abnormal screening mammogram or with clinical symptoms. Mammography and tomosynthesis investigations of 513 woman with an abnormal screening mammogram or with clinical symptoms were prospectively classified according to the ACR BI-RADS criteria. Sensitivity and specificity of both techniques for the detection of cancer were calculated. In 112 newly detected cancers, tomosynthesis and mammography were each false-negative in 8 cases (7%). In the false-negative mammography cases, the tumor was detected with ultrasound (n=4), MRI (n=2), by recall after breast tomosynthesis interpretation (n=1), and after prophylactic mastectomy (n=1). Combining the results of mammography and tomosynthesis detected 109 cancers. Therefore in three patients, both mammography and tomosynthesis missed the carcinoma. The sensitivity of both techniques for the detection of breast cancer was 92.9%, and the specificity of mammography and tomosynthesis was 86.1 and 84.4%, respectively. Tomosynthesis can be used as an additional technique to mammography in patients referred with an abnormal screening mammogram or with clinical symptoms. Additional lesions detected by tomosynthesis, however, are also likely to be detected by other techniques used in the clinical work-up of these patients. (orig.)

  20. Hypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: A multidisciplinary group practice observational study.

    Science.gov (United States)

    Chaddha, Ashish; Smith, Maureen A; Palta, Mari; Johnson, Heather M

    2018-04-23

    Patients with diabetes mellitus and cardiovascular disease have a high risk of mortality and/or recurrent cardiovascular events. Hypertension control is critical for secondary prevention of cardiovascular events. The objective was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed. The primary outcome was hypertension control within 1 year after hospital discharge for an initial cardiac event. Cox proportional hazard models assessed sociodemographics, medications, utilization, and comorbidities as predictors of control. Medicare patients with diabetes were more likely to achieve hypertension control when prescribed beta-blockers at discharge or with a history of more specialty visits. Adults ≥ 80 were more likely to achieve control with diuretics. These findings demonstrate the importance of implementing guideline-directed multidisciplinary care in this complex and high-risk population. ©2018 Wiley Periodicals, Inc.

  1. [Economic efficiency of renal denervation in patients with resistant hypertension: results of Markov modeling].

    Science.gov (United States)

    Kontsevaia, A V; Suvorova, E I; Khudiakov, M B

    2014-01-01

    Aim of this study was to evaluate the cost-effectiveness of renal denervation (RD) in resistant arterial hypertension (AH) in Russia. Modeling of Markov conducted economic impact of RD on the Russian population of patients with resistant hypertension in combination with optimal medical therapy (OMT) compared with OMT using a model developed by American researchers based on the results of international research. The model contains data on Russian mortality, and costs of major complications of hypertension. The simulation results showed a significant reduction in relative risk reduction of adverse outcomes in patients with resistant hypertension for 10 years (risk of stroke is reduced by 30%, myocardial infarction - 32%). RD saves 0.9 years of quality-adjusted life (QALY) by an average of 1 patient with resistant hypertension. Costs for 1 year stored in the application of quality of life amounted to RD 203 791.6 rubles. Which is below the 1 gross domestic product and therefore indicates the feasibility of this method in Russia.

  2. Relationship between initial therapy and blood pressure control for high-risk hypertension patients in the UK: a retrospective cohort study from the THIN general practice database.

    Science.gov (United States)

    Weir, Sharada; Juhasz, Attila; Puelles, Jorge; Tierney, Travis S

    2017-07-28

    To examine the UK practice patterns in treating newly diagnosed hypertension and to determine whether subgroups of high-risk patients are more or less likely to follow particular therapeutic protocols and to reach blood pressure goals. Retrospective cohort study. This study examined adults in The Health Improvement Network (THIN) UK general practice medical records database who were initiated on medication for hypertension. 48 131 patients with essential hypertension diagnosed between 2008 and 2010 who were registered with a participating practice for a minimum of 13 months prior to, and 6 months following, initiation of therapy. We excluded patients with gestational hypertension or secondary hypertension. Patients were classified into risk groups based on blood pressure readings and comorbid conditions. Odds of receiving single versus fixed or free-drug combination therapy and odds of achieving blood pressure control were assessed using multivariable logistic regression. The vast majority of patients (95.8%) were initiated on single drug therapy. Patients with high cardiovascular risk (patients with grade 2-3 hypertension or those with high normal/grade 1 hypertension plus at least one cardiovascular condition pretreatment) had a statistically significant benefit of starting immediately on combination therapy when blood pressure control was the desired goal (OR: 1.23; 95% CI: 1.06 to 1.42) but, surprisingly, were less likely than patients with no risk factors to receive combination therapy (OR: 0.53; 95% CI: 0.47 to 0.59). Our results suggest that combination therapy may be indicated for patients with high cardiovascular risk, who accounted for 60.6% of our study population. The National Institute for Health and Care Excellence guideline CG34 of 2006 (in effect during the study period) recommended starting with single drug class therapy for most patients, and this advice does seem to have been followed even in cases where a more aggressive approach might

  3. Portal hypertension as the initial manifestation of POEMS syndrome: a case report.

    Science.gov (United States)

    Wu, Lina; Li, Yue; Yao, Fang; Lu, Chongmei; Li, Jian; Zhou, Weixun; Qian, Jiaming

    2017-01-01

    Portal hypertension has a broad differential diagnosis. POEMS syndrome is an uncommon cause of it. POEMS syndrome is a rare disease involving multiple organs. In differential diagnosis of portal hypertension, POEMS syndrome should be considered especially when other symptoms such as numbness, organomegaly, endocrine alteration and skin changes also present, as it is highlighted by our case. We report a 46-year-old Chinese male, a teacher, presenting with portal hypertension. Electromyography revealed peripheral neuropathy. Immunofixation showed monoclonal immunoglobulin A lambda protein. The diagnosis of POEMS syndrome was established. After treatment of lenalidomide combined with dexamethasone over 2 years, the patient achieved a considerable improvement. This case highlights the manifestation of portal hypertension in POEMS syndrome. Lenalidomide with or without dexamethasone is effective for portal hypertension due to POEMS syndrome, though esophageal and gastric varices seems not reversible so easily.

  4. Residential Air Pollution, Road Traffic, Greenness and Maternal Hypertension: Results from GINIplus and LISAplus

    Directory of Open Access Journals (Sweden)

    Mario Jendrossek

    2017-07-01

    Full Text Available Background: The public health burden of hypertension is high, but its relationship with long-term residential air pollution, road traffic, and greenness remains unclear. Objective: To investigate associations between residential air pollution, traffic, greenness, and hypertension among mothers. Methods: Information on doctor-diagnosed maternal hypertension was collected at the 15-year follow-up of two large population-based multicenter German birth cohorts—GINIplus and LISAplus (n=3063. Residential air pollution was modelled by land use regression models within the ESCAPE and universal kriging within the APMoSPHERE projects. Road traffic was defined as traffic load on major roads within a 100-m buffer around residences. Vegetation level (ie, greenness was defined as the mean Normalized Difference Vegetation Index in a 500-m buffer around residences and was assessed from Landsat 5 TM satellite images. All the exposure variables were averaged over three residential addresses during the last 10 years and categorized into tertiles or dichotomized. The individual associations between each of the exposure variables and hypertension were assessed using logistic regression analysis. Results: No significant and consistent associations across different levels of adjustment were observed between the exposures of interest and hypertension. The only significant estimate was found with coarse particulate matter concentrations (OR 1.66, 95% CI 1.01 to 2.74; 3rd vs 1st tertile among mothers residing in the Wesel area. No significant associations were observed with traffic load or greenness. Conclusion: This study does not provide evidence on detrimental effects of air pollution and road traffic or beneficial effects of greenness on hypertension among German adults.

  5. Relationship of Hypertension, Blood Pressure, and Blood Pressure Control With White Matter Abnormalities in the Women’s Health Initiative Memory Study (WHIMS)—MRI Trial

    Science.gov (United States)

    Kuller, Lewis H.; Margolis, Karen L.; Gaussoin, Sarah A.; Bryan, Nick R.; Kerwin, Diana; Limacher, Marian; Wassertheil-Smoller, Sylvia; Williamson, Jeff; Robinson, Jennifer G.

    2010-01-01

    This paper evaluates the relationship of blood pressure (BP) levels at Women’s Health Initiative (WHI) baseline, treatment of hypertension, and white matter abnormalities among women in conjugated equine estrogen (CEE) and medroxyprogesterone acetate and CEE-alone arms. The WHI Memory Study—Magnetic Resonance Imaging (WHIMS-MRI) trial scanned 1424 participants. BP levels at baseline were significantly positively related to abnormal white matter lesion (WML) volumes. Participants treated for hypertension but who had BP ≥140/90 mm Hg had the greatest amount of WML volumes. Women with untreated BP ≥140/90 mm Hg had intermediate WML volumes. Abnormal WML volumes were related to hypertension in most areas of the brain and were greater in the frontal lobe than in the occipital, parietal, or temporal lobes. Level of BP at baseline was strongly related to amount of WML volumes. The results of the study reinforce the relationship of hypertension and BP control and white matter abnormalities in the brain. The evidence to date supports tight control of BP levels, especially beginning at younger and middle age as a possible and perhaps only way to prevent dementia. PMID:20433539

  6. Psychosocial and organizational work factors and incidence of arterial hypertension among female healthcare workers: results of the Organisation des Soins et Santé des Soignants cohort.

    Science.gov (United States)

    Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

    2014-06-01

    Many studies have supported the role of organizational work factors (OWFs) on the risk of cardiovascular diseases (CVDs) and CVD risk factors, including arterial hypertension. However, a little information is available concerning the role of collective stressors deriving from work organization on nurse's risk of hypertension. This study aimed to test the independent longitudinal relationships linking the 2-year incidence of arterial hypertension to collective stressors at the work unit level, among baseline normotensive female hospital registered nurses and nursing assistants, after adjusting for known individual predictors of CVDs and for occupational stress. Arterial hypertension was defined as the intake of antihypertensive drug or as blood pressure (BP) measures higher than 140  mmHg (SBP) or 90  mmHg (DBP) at both the clinical visit and 1 month later. We analyzed the effect of OWFs at the work unit level, constraints related to the physical work environment and the individual perception of the work environment in 2006 on the risk of arterial hypertension in 2008 among 1882 initially normotensive female healthcare workers followed in the French Organisation des soins et santé des soignants (ORSOSA) cohort. We showed that OWFs at the work unit level may influence the 2-year risk of arterial hypertension independently of work factors at the worker level, baseline BP, age and BMI. In this study, OWFs affected 2-year risk of arterial hypertension only through direct effects. Our results pointed out the possibility of a primary prevention of arterial hypertension through interventions based at the work unit level among healthcare workers.

  7. Transcatheter Potts shunt creation in patients with severe pulmonary arterial hypertension: initial clinical experience.

    Science.gov (United States)

    Esch, Jesse J; Shah, Pinak B; Cockrill, Barbara A; Farber, Harrison W; Landzberg, Michael J; Mehra, Mandeep R; Mullen, Mary P; Opotowsky, Alexander R; Waxman, Aaron B; Lock, James E; Marshall, Audrey C

    2013-04-01

    Patients with severe pulmonary arterial hypertension (PAH) face significant morbidity and death as a consequence of progressive right heart failure. Surgical shunt placement between the left PA and descending aorta (Potts shunt) appears promising for PAH palliation in children; however, surgical mortality is likely to be unacceptably high in adults with PAH. We describe a technique for transcatheter Potts shunt (TPS) creation by fluoroscopically guided retrograde needle perforation of the descending aorta at the site of apposition to the left PA to create a tract for deployment of a covered stent between these vessels. This covered stent-anchored by the vessel walls and surrounding tissue-serves as the shunt. TPS creation was considered in 7 patients and performed in 4. The procedure was technically successful in 3 patients; 1 patient died during the procedure as a result of uncontrolled hemothorax. One acute survivor, critically ill at the time of TPS creation, later died of comorbidities. The 2 mid-term survivors (follow-up of 10 and 4 months) are well at home, with symptomatic improvement and no late complications. The 3 candidate patients in whom the procedure was not performed died within 1 month of consideration, underscoring the tenuous nature of this population. TPS creation is feasible and may offer symptomatic relief to select patients with refractory PAH. Further study of this innovative approach is warranted. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  8. Awareness of hypertension guidelines in primary care: results of a regionwide survey in Italy.

    Science.gov (United States)

    Cuspidi, C; Michev, I; Meani, S; Severgnini, B; Sala, C; Salerno, M; Valerio, C; Bertazzoli, G; Leonetti, G; Magrini, F; Zanchetti, A

    2003-08-01

    Unsatisfactory blood pressure (BP) control so often described in treated hypertensive populations is also explained by insufficient physicians' awareness of experts' guidelines. We assessed awareness of current recommendations about hypertension management in a general practice setting, using the World Health Organization/International Society of Hypertension (WHO/ISH) 1999 guidelines as reference. In a regionwide survey, a total of 5133 physicians (three-quarters of all active general practitioners in Lombardy, a region of north-western Italy) were contacted by letter and received a multiple choice 10-item questionnaire. Data on physicians' demographic characteristics, information on hypertension prevalence and their perception of BP control among their patients were also requested in an additional form. The number of answers in agreement with WHO/ISH guidelines was used as an awareness measure. This was considered adequate if correct answers to six out of 10 questions, including an appropriate definition of hypertension, were provided. Of the 1256 returned questionnaires (a 24.5% response rate), 1162 were suitable for analysis. The mean score of correct answers was 5.3 points and only 20.1% of the study population correctly answered at least six of the questions (including that on the definition of hypertension in the elderly). Guidelines awareness was negatively related to increase in physicians' age and duration of clinical practice and by the male gender. Finally, the physicians reported a high rate of achieved BP control, and those who were considered to have achieved highest rates (>75%) of control in their patients had a lower rate of adequate knowledge than those who reported less-successful therapeutic results (18 vs 25%, P<0.01), suggesting that they ignored or disregarded the goal BP recommended by the guidelines. This large regional survey shows that a sufficient degree of guidelines awareness is present in a minority of primary-care physicians in the

  9. [Process indicators and result indicators in the control of arterial hypertension].

    Science.gov (United States)

    Dalfó Baqué, A; Sisó Almirall, A; Vila Coll, M A; Núñez Vázquez, S; Botinas Martí, M; Gibert Llorach, E

    2000-12-01

    To find whether better compliance with the indicators of procedure of a hypertension monitoring programme guarantees better control in the final blood pressure figures. Descriptive cross-sectional study. Gòtic Area Health Centre, Barcelona. Annual audit through random sampling of the computerised records of all the hypertense patients attended at the centre in each of 5 years (1992, n = 337; 1993, n = 318; 1994, n = 322; 1995, n = 325; 1996, n = 325). 1. Procedure indicators: complete physical examination took place in 1996 in only 12% of cases, proportion similar to at the start of the development of the programme (12.2%). Completion of at least two of the three records of protocols (complete physical examination, ECG and analysis) dropped during the period and did not cover half the patients. Screening of the various cardiovascular risk factors (CRF) increased markedly in the 1992-1995 period. 2. RESULTS INDICATORS: The proportion of patients under 66 with SP and DP < 140 and 99 mmHg went up from 23.2% in 1992 to 45.2% in 1996. In the over-65 age-group, it went from 58.9% in 1992 to 81.2% in 1996. The procedure indicators are still useful, in that they are necessary for designing a new hypertension programme. However, we must not forget that any health programme is designed in order to achieve good control and population impact (survival) results. The procedure is only an aid to reach these aims.

  10. Does a medical history of hypertension influence disclosing genetic testing results of the risk for salt-sensitive hypertension, in primary care?

    Directory of Open Access Journals (Sweden)

    Okayama M

    2016-07-01

    Full Text Available Masanobu Okayama,1,2 Taro Takeshima,2 Masanori Harada,3 Ryusuke Ae,4 Eiji Kajii2 1Division of Community Medicine and Medical Education, Kobe University Graduate School of Medicine, Kobe, Hyogo, 2Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, 3Department of Support of Rural Medicine, Yamaguchi Grand Medical Center, Hofu, Yamaguchi, 4Division of Public Health, Center for Community Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan Objective: Disclosing genetic testing results may contribute to the prevention and management of many common diseases. However, whether the presence of a disease influences these effects is unclear. This study aimed to clarify the difference in the effects of disclosing genetic testing results of the risk for developing salt-sensitive hypertension on the behavioral modifications with respect to salt intake in hypertensive and nonhypertensive patients.Methods: A cross-sectional study using a self-administered questionnaire was conducted for outpatients aged >20 years (N=2,237 at six primary care clinics and hospitals in Japan. The main factors assessed were medical histories of hypertension, salt preferences, reduced salt intakes, and behavior modifications for reducing salt intake. Behavioral modifications of participants were assessed using their behavior stages before and after disclosure of the hypothetical genetic testing results. Results: Of the 2,237 participants, 1,644 (73.5% responded to the survey. Of these respondents, 558 (33.9% patients were hypertensive and 1,086 (66.1% were nonhypertensive. After being notified of the result “If with genetic risk”, the nonhypertensive participants were more likely to make positive behavioral modifications compared to the hypertensive patients among all participants and in those aged <65 years (adjusted relative ratio [ad-RR], 1.76; 95% confidence interval, 1.12−2.76 and ad-RR, 1

  11. Evaluation of an Initiative for Fostering Provider-Pharmacist Team Management of Hypertension in Communities

    Directory of Open Access Journals (Sweden)

    William R. Doucette

    2014-01-01

    Full Text Available Objectives: 1 Conduct team building activities for provider-community pharmacist teams in small communities and 2 Determine the impact of the team approach on practitioner-reported consequences and 3 Identify obstacles to the team approach and ways to overcome them. Methods: Eleven provider-pharmacist teams were recruited in rural/micropolitan communities in Iowa. The teams participated in team building sessions facilitated by the project leaders, to discuss the team approach. Decisions included patient identification, practitioner roles, and communications. Most pharmacists conducted blood pressure (BP checks in the pharmacy and assessed the anti-hypertensive medications. If the BP was not at goal, the pharmacist worked with the patient and provider to make improvements. Teams followed their strategies for 3-5 months. Data were collected from pharmacy logs and on-line surveys of team members before and after the team period. Results: Using a multi-case approach, 4 cases were classified as Worked-Well, 5 as Limited-Success, and 2 as No-Team-Care. The Worked-Well teams provided an average of 26.5 BP visits per team, while the Limited-Success teams averaged 6.8 BP visits. The Worked-Well teams established and used a system to support the team approach. The Limited-Success teams either didn't fully establish their team system, or used it sparingly. The No-Team-Care cases did not provide any team care. Conclusions: Factors supporting success were: positive provider-pharmacist relations, established team system, commitment to team care, and patient willingness to participate. While this program had some success, potential improvements were identified: more follow-up after the team building session, additional patient materials, and guidance for practice changes.   Type: Case Study

  12. Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon.

    Science.gov (United States)

    Salameh, Pascale; Chahine, Mirna; Hallit, Souheil; Farah, Rita; Zeidan, Rouba Karen; Asmar, Roland; Hosseiny, Hassan

    2018-04-01

    Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.

  13. Lack of control of hypertension in primary cardiovascular disease prevention in Europe: Results from the EURIKA study.

    Science.gov (United States)

    Borghi, Claudio; Tubach, Florence; De Backer, Guy; Dallongeville, Jean; Guallar, Eliseo; Medina, Jesús; Perk, Joep; Roy, Carine; Banegas, José R; Rodriguez-Artalejo, Fernando; Halcox, Julian P

    2016-09-01

    The prevalence of and factors associated with uncontrolled hypertension and apparent resistant hypertension were assessed in the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; NCT00882336). EURIKA was a cross-sectional observational study including patients being treated for the primary prevention of cardiovascular disease in 12 European countries. Patients were assessed if they were being treated for hypertension (N=5220). Blood pressure control was defined according to European guidelines, with sensitivity analysis taking account of patients' age and diabetes status. Associated factors were assessed using multivariate analysis. In the primary analysis, a total of 2691 patients (51.6%) had uncontrolled hypertension. Factors significantly associated with an increased risk of having uncontrolled hypertension included female sex (odds ratio [OR]: 2.29; 95% confidence interval [CI]: 1.93-2.73), body mass index (BMI; OR per kg/m(2): 1.03; 95% CI: 1.01-1.04), and geographic location. A total of 749 patients (14.3%) had apparent resistant hypertension. Factors significantly associated with an increased risk of having apparent resistant hypertension included BMI (OR per kg/m(2): 1.06; 95% CI: 1.04-1.08), diabetes (OR: 1.28; 95% CI: 1.06-1.53), use of statins (OR: 1.36; 95% CI: 1.15-1.62), serum uric acid levels (OR: 1.16; 95% CI: 1.09-1.23), and geographic location. Similar results were seen in sensitivity analyses. Over 50% of patients treated for hypertension continued to have uncontrolled blood pressure and 14.3% had apparent resistant hypertension. Positive associations were seen with other cardiovascular risk factors. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Metabolic Syndrome and Hypertension Resulting from Fructose Enriched Diet in Wistar Rats

    Directory of Open Access Journals (Sweden)

    Julie Dupas

    2017-01-01

    Full Text Available Increased sugar consumption, especially fructose, is strongly related to the development of type 2 diabetes (T2D and metabolic syndrome. The aim of this study was to evaluate long term effects of fructose supplementation on Wistar rats. Three-week-old male rats were randomly divided into 2 groups: control (C; n=14 and fructose fed (FF; n=18, with a fructose enriched drink (20–25% w/v fructose in water for 21 weeks. Systolic blood pressure, fasting glycemia, and bodyweight were regularly measured. Glucose tolerance was evaluated three times using an oral glucose tolerance test. Insulin levels were measured concomitantly and insulin resistance markers were evaluated (HOMA 2-IR, Insulin Sensitivity Index for glycemia (ISI-gly. Lipids profile was evaluated on plasma. This fructose supplementation resulted in the early induction of hypertension without renal failure (stable theoretical creatinine clearance and in the progressive development of fasting hyperglycemia and insulin resistance (higher HOMA 2-IR, lower ISI-gly without modification of glucose tolerance. FF rats presented dyslipidemia (higher plasma triglycerides and early sign of liver malfunction (higher liver weight. Although abdominal fat weight was increased in FF rats, no significant overweight was found. In Wistar rats, 21 weeks of fructose supplementation induced a metabolic syndrome (hypertension, insulin resistance, and dyslipidemia but not T2D.

  15. [Experiences and results in hypertension screening in women between 20 and 65 years of age in Karl-Marx-City].

    Science.gov (United States)

    Voigt, G; Börker, G; Edelmann, S; Hartung, A; Hartung, G; Heyne, S; Töpfer, V

    1980-11-15

    From 1975 to 1979 in the district of the City of Karl-Marx-Stadt 91,130 females at the age between 20 and 65 years were summoned to a gynaecologico-cardiological mass examination which was supported by computer. 56,460 females underwent the examination. According to the WHO-criteria two measurements of blood pressure were carried out, when increased blood pressure was present a third one and a fourth one by an examination group. A diagnostic standard programme was used. In the second measurement of blood pressure we established 19.8% of patients with hypertension and 28.6% patients with borderline values. 52.8% of the hypertensions were known. Of 10,685 females with known or established hypertension 10.1% underwent an optimum therapy. On the basis of these results a programme for the fight against hypertension was developed for the county Karl-Marx-Stadt.

  16. Initial results from the Tokapole-II poloidal divertor device

    International Nuclear Information System (INIS)

    Biddle, A.P.; Dexter, R.N.; Groebner, R.J.; Holly, D.J.; Lipschultz, B.; Phillips, M.W.; Prager, S.C.; Sprott, J.C.

    1979-01-01

    The latest in a series of internal-ring devices, called Tokapole II, has recently begun operation at the University of Wisconsin. Its purpose is to permit the study of the production and confinement of hot, dense plasmas in either a toroidal octupole (with or without toroidal field) or a tokamak with a four-node poloidal divertor. The characteristics of the device and the results of its initial operation are described here. Quantitative measurements of impurity concentration and radiated power have been made. Poloidal divertor equilibria of square and dee shapes have been produced, and an axisymmetric instability has been observed with the inverse dee. Electron cyclotron resonance heating is used to initiate the breakdown near the axis and to control the initial influx of impurities. A 2-MW RF source at the second harmonic of the ion cyclotron frequency is available and has been used to double the ion temperature when operated at low power with an unoptimized antenna. Initial results of operation as a pure octupole with poloidal Ohmic heating suggest a tokamak-like scaling of density (n proportional to Bsub(p)) and confinement time (tau proportional to n). (author)

  17. [Atherosclerotic renovascular hypertension: clinical findings and results of treatment over 15 years].

    Science.gov (United States)

    Alfonzo, J P; Rosario, M N; Ugarte, C; Banasco, J; Fraxedas, R; Lahera, J

    2003-01-01

    The aim of this study was to present our clinical experience and results of different treatments in 83 atherosclerotic renovascular hypertensive patients treated in the last 15 years in the Instituto de nefrologia in Havana. Regardless of the type of treatment the patients were divided in two groups. Group I: 52 (62.3%) cases with standard oral hypotensive drugs alone and control of other cardiovascular risk factors (mean age 53 years old, sex m/f 50/50%, race white/no-white 75/25%, mean known hypertension follow-up 10.2 +/- 10 years, mean SBP 208 +/- 30 mmHg, mean DBP 123 +/- 17 mmHg, mean serum creatinina 1.62 mg/dl and increase peripheral plasma renin value in 61.6% of patients) and group II: 31 (37.7%) cases treated with revascularización procedures (PTA or surgery) or nephrectomy in selected patients (mean age 50 years old, sex m/f 68/32%, race white/no-white 16/84%, mean known hypertension follow-up 8.5 +/- 8.6 years, mean SBP 214 +/- 32 mmHg, mean DBP 1.31 +/- 16 mmHg, mean serum creatinina 1.85 mg/dl and increase peripheral plasma renin value 78.3% of patients). As end point for treatment results we selected: 1) hypertension cure or control, 2) evolution of the serum creatinine value and 3) kidney and patients survival. In those cases with a follow up for more than one year, in 82.9% the blood pressure was cure (21.4%) or controlled (61.4%). The proportion of failed was superior in group I (20.9%) than in group II (11.1%). All 18 cases treated by PTA with a follow up period longer than a year, blood pressure cure in 10 (55.6%), ameliorate in 5 (27.8%) and in 3 (16.6%) was unchanged (one patient lost of follow up). Nine patients were treated by surgery (3 revascularization and 6 nephrectomy), 5 (55.5%) cases cured and 4 (44.5%) ameliorate his blood pressure. Patients in group II maintain normal renal function in more cases than in group I (48.4% vs 30.8%). Both group had similar percentage of normal-normal + pathology-normal renal function (G I: 65.4% vs G

  18. Thin Air Resulting in High Pressure: Mountain Sickness and Hypoxia-Induced Pulmonary Hypertension

    Science.gov (United States)

    Richter, Manuel; Tello, Khodr; Sommer, Natascha; Gall, Henning; Ghofrani, Hossein Ardeschir

    2017-01-01

    With rising altitude the partial pressure of oxygen falls. This phenomenon leads to hypobaric hypoxia at high altitude. Since more than 140 million people permanently live at heights above 2500 m and more than 35 million travel to these heights each year, understanding the mechanisms resulting in acute or chronic maladaptation of the human body to these circumstances is crucial. This review summarizes current knowledge of the body's acute response to these circumstances, possible complications and their treatment, and health care issues resulting from long-term exposure to high altitude. It furthermore describes the characteristic mechanisms of adaptation to life in hypobaric hypoxia expressed by the three major ethnic groups permanently dwelling at high altitude. We additionally summarize current knowledge regarding possible treatment options for hypoxia-induced pulmonary hypertension by reviewing in vitro, rodent, and human studies in this area of research. PMID:28522921

  19. Cognitive impairment and computer tomography image in patients with arterial hypertension -preliminary results

    International Nuclear Information System (INIS)

    Yaneva-Sirakova, T.; Tarnovska-Kadreva, R.; Traykov, L.; Zlatareva, D.

    2012-01-01

    Arterial hypertension is the leading risk factor for cognitive impairment, but it is developed only in some of the patients with pour control. On the other hand, not all of the patents with white matter changes have cognitive deficit. There may be a variety of reasons for this: the accuracy of methods for blood pressure measurement, the specific brain localization or some other reason. Here are the preliminary results of a study (or the potential correlation between self-measured, office-, ambulatory monitored blood pressure, central aortic blood pressure, minimal cognitive impairment and the specific brain image on contrast computer tomography. We expect to answer, the question whether central aortic or self-measured blood pressure have the leading role for the development of cognitive impairment in the presence of a specific neuroimaging finding, as well as what is the prerequisite for the clinical manifestation of cognitive dysfunction in patients with computer tomographic pathology. (authors)

  20. Do corporate environmental initiatives lead to results in SMEs?

    DEFF Research Database (Denmark)

    Madsen, Henning; Ulhøi, John Parm

    , it is relevant to study the situation between these two stages in order to identify to which extent corporate environmental initiatives actually lead to results and reductions. The research is based on data collected by surveys of industrial companies in Denmark in 1999, 2003, 2007 and 2011. They information...... with previous research demonstrating that companies generally are re-active in their attitude when perceiving stakeholder influence on taking environmental initiative and mainly respond to influence from stakeholders representing authorities, owners or employees. However, the size of the company may have...... a negative influence in some situations. That is, it seems to be easier for smaller companies to achieve an improvement compared to medium-sized companies....

  1. Cabo Verde telemedicine program: initial results of nationwide implementation.

    Science.gov (United States)

    Latifi, Rifat; Dasho, Erion; Merrell, Ronald C; Lopes, Miguel; Azevedo, Vanda; Bekteshi, Flamur; Osmani, Kalterina L; Qesteri, Orland; Kucani, Julian; Lecaj, Ismet

    2014-11-01

    Telemedicine and e-health have been suggested as one solution for closing the health disparity gap between the developed world and the developing world. Yet evidence is lacking from current successful programs in the developing world and, in particular, from sub-Saharan Africa. The primary objective of our study was to present the preliminary results of our efforts in building the Integrated Telemedicine and e-Health Program for Cabo Verde (ITeHP-CV), with an emphasis on initial utilization and results. This is a prospective study of data collected while we worked to establish a fully functional, integrated national telemedicine network and virtual education network in Cabo Verde. We used the International Virtual e-Hospital Foundation strategic approach known as "initiate-build-operate-transfer" over a 26-month period (November 2011-December 2013). We describe herein the five main pillars of this process that have been implemented: (1) capacity building; (2) network development and deployment of equipment; (3) implementation of clinical telemedicine; (4) implementation of activities related to continuing medical education, delivered from within the country and from abroad; and (5) establishment and use of the electronic virtual library. Based on comprehensive technical and medical assessment of the country's needs, 10 fully functional telemedicine centers in all nine inhabited islands of the Republic of Cabo Verde have been established. RESULTS are presented under the five main pillars of capacity building, network deployment, implementation of clinical telemedicine, implementation of continuing medical education activities, and establishment of the electronic virtual library. The ITeHP-CV has been successfully launched, and the initial results are encouraging. The continuity of the program and sustainability are primary goals once the program is transferred fully to the Ministry of Health of Cabo Verde. A long-term follow-up study is required in order to ensure

  2. Initial results from the TST-2 spherical tokamak

    International Nuclear Information System (INIS)

    Takase, Y.; Ejiri, A.; Kasuya, N.

    2001-01-01

    A new spherical tokamak TST-2 was constructed at the University of Tokyo and started operation in September 1999. Reliable plasma initiation is achieved with typically 1 kW of ECH power at 2.45 GHz. Plasma currents of up to 90 kA and toroidal fields of up to 0.2 T have been achieved during the initial experimental campaign. The ion temperature is typically 100 eV. Internal reconnection events (IREs) are often observed. The internal magnetic field measured at r/a=2/3 indicated growth of fluctuations up to the 4 th harmonic, suggesting the existence of modes with several different mode numbers. In the presence of a toroidal field and a vertically oriented mirror field, noninductively driven currents of order 1 kA were observed with 1 kW of ECH power. The driven current increased with decreasing filling pressure, down to 3x10 -6 torr. A study of high harmonic fast wave (HHFW) excitation and propagation has begun. Initial results indicate highly efficient wave launching. (author)

  3. Experimental test accelerator: description and results of initial experiments

    International Nuclear Information System (INIS)

    Fessenden, T.; Birx, D.; Briggs, R.

    1980-01-01

    The ETA is a high current (10,000 Amp) linear induction accelerator that produces short (30 ns) pulses of electrons at 5 MeV twice per second or in bursts of 5 pulses separated by as little as one millisecond. At this time the machine has operated at 65% of its design current and 90% of the design voltage. This report contains a description of the accelerator and its diagnostics; the results of the initial year of operation; a comparison of design codes with experiments on beam transport; and a discussion of some of the special problems and their status

  4. Hypertension in Mexican adults: results from the National Health and Nutrition Survey 2006.

    Science.gov (United States)

    Barquera, Simón; Campos-Nonato, Ismael; Hernández-Barrera, Lucía; Villalpando, Salvador; Rodríguez-Gilabert, César; Durazo-Arvizú, Ramón; Aguilar-Salinas, Carlos A

    2010-01-01

    To describe the prevalence of hypertension among Mexican adults, and to compare to that observed among Mexican-Americans living in the US. The primary data source came from adults (>20 years) sampled (n=33366) in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006). Hypertension was defined when systolic blood pressure was >or=140 and/or diastolic was >or= 90 or patients previously diagnosed. A total of 43.2% of participants were classified as having hypertension. We found a positive statistically significant association (p<0.05) between hypertension and BMI, abdominal obesity, previous diagnosis of diabetes and hypercholesterolemia. Subjects with hypertension had a significantly higher odd of having a history of diabetes or hypercholesterolemia. Hypertension had a higher prevalence in Mexico than among Mexican-Americans living in the US. Hypertension is one of the most prevalent chronic diseases in Mexico. In the last six years in Mexico, a substantial increase (25%) has been observed in contrast to the reduction seen among Mexican-Americans (-15%).

  5. Preliminary results from initial in-pile debris bed experiments

    International Nuclear Information System (INIS)

    Rivard, J.B.

    1977-01-01

    An accident in a liquid metal fast breeder reactor (LMFBR) in which molten core material is suddenly quenched with subcooled liquid sodium could result in extensive fragmentation and dispersal of fuel as subcritical beds of frozen particulate debris within the reactor vessel. Since this debris will continue to generate power due to decay of retained fission products, containment of the debris is threatened if the generated heat is not removed. Therefore, the initial safety question is the capacity which debris beds may have for transfer of the decay heat to overlying liquid sodium by natural processes--i.e., without the aid of forced circulation of the coolant. Up to the present time, all experiments on debris bed behavior either have used substitute materials (e.g., sand and water) or have employed actual materials, but atypical heating methods. Increased confidence in the applicability of debris bed simulations is afforded if the heat is generated within the fuel component of the appropriate fast reactor materials. The initial series of in-pile tests reported on herein constitutes the first experiments in which the internal heating mode has been produced in particulate oxide fuel immersed in liquid sodium. Fission heating of the fully-enriched UO 2 in the experiment while it is contained within Sandia Laboratories Annular Core Pulse Reactor (ACPR), operating in its steady-state mode, approximates the decay heating of debris. Preliminary results are discussed

  6. Blood pressure control with amlodipine add-on therapy in patients with hypertension and diabetes: results of the Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial.

    Science.gov (United States)

    Kloner, Robert A; Neutel, Joel; Roth, Eli M; Weiss, Robert; Weinberger, Myron H; Thakker, Kamlesh M; Schwartz, Brian; Shi, Harry; Gregg, Anne-Marie

    2008-11-01

    Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk of cardiovascular events and to delay the progression of renal disease. While therapeutic guidelines advise initial therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy with these agents may not be sufficient to attain target BP. The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated the efficacy and safety of adding amlodipine to the treatment regimen of patients with hypertension and diabetes who were already receiving either quinapril or losartan as monotherapy. ADHT was a double-blind, double-dummy, 22-week trial conducted in the US. After a washout period of 7-13 days, patients (aged 30-75 y) with hypertension and diabetes were randomized to receive quinapril 20 mg/day plus placebo or losartan 50 mg/day plus placebo for 4 weeks, titrated to 40 mg or 100 mg (if required), respectively, for an additional 4 weeks to achieve their BP goals (<130/80 mm Hg). At week 8, either amlodipine 5 mg/day or placebo was added for an additional 12 weeks, with titration to 10 mg at week 14 if the BP goal was not achieved. Efficacy of add-on therapy was evaluated in 411 patients (amlodipine 211, placebo 200). BP goal was reached by 27.5% of patients when amlodipine was added to quinapril or losartan monotherapy, compared with 12.5% when placebo was added (OR 2.73; 95% CI 1.61 to 4.64; p < 0.001). When added to quinapril or losartan monotherapy, amlodipine reduced BP by 8.1/5.4 mm Hg, compared with a 1.6/0.7 mm Hg decrease with add-on placebo (p < 0.001). Amlodipine, quinapril, and losartan were well tolerated. Amlodipine is safe and effective when added to quinapril or losartan monotherapy to help lower BP toward therapeutic targets in patients with hypertension and diabetes.

  7. Chronic thromboembolic pulmonary hypertension (CTEPH): results from an international prospective registry

    NARCIS (Netherlands)

    Pepke-Zaba, Joanna; Delcroix, Marion; Lang, Irene; Mayer, Eckhard; Jansa, Pavel; Ambroz, David; Treacy, Carmen; D'Armini, Andrea M.; Morsolini, Marco; Snijder, Repke; Bresser, Paul; Torbicki, Adam; Kristensen, Bent; Lewczuk, Jerzy; Simkova, Iveta; Barberà, Joan A.; de Perrot, Marc; Hoeper, Marius M.; Gaine, Sean; Speich, Rudolf; Gomez-Sanchez, Miguel A.; Kovacs, Gabor; Hamid, Abdul Monem; Jaïs, Xavier; Simonneau, Gérald

    2011-01-01

    Chronic thromboembolic pulmonary hypertension (CTEPH) is often a sequel of venous thromboembolism with fatal natural history; however, many cases can be cured by pulmonary endarterectomy. The clinical characteristics and current management of patients enrolled in an international CTEPH registry was

  8. Household food insecurity, diabetes and hypertension among Mexican adults: results from Ensanut 2012.

    Science.gov (United States)

    Pérez-Escamilla, Rafael; Villalpando, Salvador; Shamah-Levy, Teresa; Méndez-Gómez Humarán, Ignacio

    2014-01-01

    To examine the independent association of household food insecurity (HFI) with diabetes and hypertension in a nationally representative cross-sectional sample from Mexico. We assessed the association between HFI and self-reported doctor diagnosed diabetes and hypertension among 32 320 adult individuals using multiple logistic regression. HFI was measured using an adapted version for Mexico of the Latin American and Caribbean Food Security Scale (ELCSA). HFI was a risk factor for diabetes among women but not men and for hypertension among both genders. Diabetes odds were higher by 31, 67 and 48%, among women living in mild, moderate, and severe food-insecure (vs. food-secure) households, respectively. Living in moderate to severe food-insecure (vs. food-secure) households was associated with hypertension odds that were 28 and 32% higher, respectively. Decreasing HFI may help improve public health and national development in Mexico.

  9. Blood pressure normalization in a large population of hypertensive patients treated with perindopril/indapamide combination: results of the OPTIMAX trial

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Mourad

    2007-03-01

    Full Text Available Jean-Jacques Mourad1, Viet Nguyen1, Marilucy Lopez-Sublet1, Bernard Waeber21Dept Internal Medicine and Hypertension Unit, Avicenne hospital-APHP and Paris 13 University, Bobigny, France; 2Bernard Waeber, Division de Physiopathologie Clinique, Lausanne, SwitzerlandObjective: To determine if the fixed-dose perindopril/indapamide combination (Per/Ind normalizes blood pressure (BP in the same fraction of hypertensive patients when treated in everyday practice or in controlled trials.Methods: In this prospective trial, 17 938 hypertensive patients were treated with Per 2 mg/Ind 0.625 mg for 3–6 months. In Group 1 Per/Ind was initiated in newly diagnosed patients (n = 7032; in Group 2 Per/Ind replaced previous therapy in patients already treated but having either their BP still uncontrolled or experiencing side-effects (n = 7423; in Group 3 Per/Ind was added to previous treatment in patients with persistently high BP (n = 3483. BP was considered normalized when ≤ 140/90 mm Hg. A multivariate analysis for predictors of BP normalization was performed.Results: Subjects were on average 62 years old and had a baseline BP of 162.3/93.6 mm Hg. After treatment with Per/Ind, BP normalization was reached in 69.6% of patients in the Initiation group, 67.5% in the Replacement Group, and 67.4% in the Add-on Group (where patients were more frequently at risk, diabetic, or with target organ damage. Mean decreases in systolic BP of 22.8 mm Hg and in diastolic BP of 12.4 mm Hg were recorded. Conclusions: This trial was established to reflect everyday clinical practice, and a treatment strategy based on the Per/Ind combination, administered as initial, replacement, or add-on therapy, led to normalization rates that were superior to those observed in Europe in routine practice. These results support recent hypertension guidelines which encourage the use of combination therapy in the management of arterial hypertension.Keywords: perindopril, indapamide, blood

  10. Determinants of persistence in hypertensive patients treated with irbesartan: results of a postmarketing survey

    Directory of Open Access Journals (Sweden)

    Greminger Peter

    2005-06-01

    Full Text Available Abstract Background Persistence is a key factor for long-term blood pressure control, which is of high prognostic importance for patients at increased cardiovascular risk. Here we present the results of a post-marketing survey including 4769 hypertensive patients treated with irbesartan in 886 general practices in Switzerland. The goal of this survey was to evaluate the tolerance and the blood pressure lowering effect of irbesartan as well as the factors affecting persistence in a large unselected population. Methods Prospective observational survey conducted in general practices in all regions of Switzerland. Previously untreated and uncontrolled pre-treated patients were started with a daily dose of 150 mg irbesartan and followed up to 6 months. Results After an observation time slightly exceeding 4 months, the average reduction in systolic and diastolic blood pressure was 20 (95% confidence interval (CI -19.6 to -20.7 mmHg and 12 mmHg (95% CI -11.4 to -12.1 mmHg, respectively. At this time, 26% of patients had a blood pressure Conclusion The results of this survey confirm that irbesartan is effective, well tolerated and well accepted by patients, as indicated by the good persistence. This post-marketing survey also emphasizes the importance of the tolerability profile and of achieving an early control of blood pressure as positive predictors of persistence.

  11. Initial CGE Model Results Summary Exogenous and Endogenous Variables Tests

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Brian Keith [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Boero, Riccardo [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rivera, Michael Kelly [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-08-07

    The following discussion presents initial results of tests of the most recent version of the National Infrastructure Simulation and Analysis Center Dynamic Computable General Equilibrium (CGE) model developed by Los Alamos National Laboratory (LANL). The intent of this is to test and assess the model’s behavioral properties. The test evaluated whether the predicted impacts are reasonable from a qualitative perspective. This issue is whether the predicted change, be it an increase or decrease in other model variables, is consistent with prior economic intuition and expectations about the predicted change. One of the purposes of this effort is to determine whether model changes are needed in order to improve its behavior qualitatively and quantitatively.

  12. LWR aerosol containment experiments (LACE) program and initial test results

    International Nuclear Information System (INIS)

    Muhlestein, L.D.; Hilliard, R.K.; Bloom, G.R.; McCormack, J.D.; Rahn, F.J.

    1985-01-01

    The LWR aerosol containment experiments (LACE) program is described. The LACE program is being performed at the Hanford Engineer Development Laboratory (operated by Westinghouse Hanford Company) and the initial tests are sponsored by EPRI. The objectives of the LACE program are: to demonstrate, at large-scale, inherent radioactive aerosol retention behavior for postulated high consequence LWR accident situations; and to provide a data base to be used for aerosol behavior . Test results from the first phase of the LACE program are presented and discussed. Three large-scale scoping tests, simulating a containment bypass accident sequence, demonstrated the extent of agglomeration and deposition of aerosols occurring in the pipe pathway and vented auxiliary building under realistic accident conditions. Parameters varied during the scoping tests were aerosol type and steam condensation

  13. C-reactive protein implications in new-onset hypertension in a healthy population initially aged 65 years : the Proof study

    NARCIS (Netherlands)

    Dauphinot, Virginie; Roche, Frederic; Kossovsky, Michel P.; Schott, Anne-Marie; Pichot, Vincent; Gaspoz, Jean-Michel; Gosse, Philippe; Barthelemy, Jean-Claude

    Background Because inflammation is known to be related with several cardiovascular diseases, we sought to determine whether C-reactive protein (CRP) might precede the onset of hypertension. Methods The study population was selected from the Proof study cohort including 1011 individuals initially

  14. Stable fetal hemodynamics measured by Doppler flow after initiation of anti-hypertensive treatment with methyldopa in pregnant women with diabetes

    DEFF Research Database (Denmark)

    Pedersen, Berit Woetmann; Ringholm, Lene; Damm, Peter

    2016-01-01

    AIM: To evaluate whether initiation of anti-hypertensive treatment with methyldopa affects fetal hemodynamics in women with pregestational diabetes. METHODS: Prospective study of unselected singleton pregnant women with diabetes (seven type 1 and two type 2 diabetes), normal blood pressure and ki...

  15. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. M. Batyushin

    2015-12-01

    Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

  16. RESULTS OF OUTPATIENT PROGRAM ON EFFECTIVE THERAPY OF REFRACTORY ARTERIAL HYPERTENSION

    Directory of Open Access Journals (Sweden)

    M. M. Batyushin

    2007-01-01

    Full Text Available Aim. To increase in efficacy of antihypertensive therapy in patients with refractory arterial hypertension (HT.Material and methods. Patients with refractory HT were revealed during first month of program. The causes of refractory HT were analyzed. Combined antihypertensive therapy was prescribed to reach target level of blood pressure (BP. This therapy lasted 24 weeks and included angiotensin converting enzyme (ACE inhibitor, thiazid diuretic (indapamide and dihydropyridine calcium antagonist (nifedipine XL.Results. 200 patients with refractory HT were revealed. True refractory HT took place in 59,9% of patients and pseudo refractory HT – in 40,1% of patients. Lack of diuretics or combined antihypertensive therapy were the main reason of insufficient BP control. Proposed 3-drugs therapy resulted in reduction of systolic BP from 190 to 132 Hg mm and diastolic BP from 104 to 81 Hg mm. Target level of BP was reached in 94% patients. There were no side effects which demanded to stop therapy.Conclusion. High incidence of pseudorefractory HT (40,1% is revealed. Significant prevalence of renal disturbances especially chronic interstitial inflammatory could be responsible for refractory HT development. Use of 3-drugs therapy (ACE inhibitor, indapamide and nifedipine XL provides effective control of BP in refractory and pseudorefractory HT.

  17. Congenital absence of the portal vein presenting as pulmonary hypertension

    International Nuclear Information System (INIS)

    Jun, Sur Young; Lee, Whal; Cheon, Jung Eun; Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo

    2007-01-01

    Congenital absence of the portal vein (CAPV) is a rare malformation in which intestinal and splenic venous flow bypasses the liver and drains directly into the systemic circulation via a congenital portosystemic shunt. We describe two cases of CAPV presenting as pulmonary hypertension that were initially suspected as primary pulmonary hypertension. However, subsequent ultrasonography and CT detected the absence of a portal vein and the presence of a portosystemic shunt. Pulmonary hypertension is a recognized complication of liver disease and portal hypertension. However, these two cases illustrate that CAPV may result in pulmonary hypertension without liver disease or portal hypertension

  18. Congenital absence of the portal vein presenting as pulmonary hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Jun, Sur Young; Lee, Whal; Cheon, Jung Eun; Kim, Woo Sun; Kim, In One; Yeon, Kyung Mo [Seoul National University Hospital, Seoul (Korea, Republic of)

    2007-11-15

    Congenital absence of the portal vein (CAPV) is a rare malformation in which intestinal and splenic venous flow bypasses the liver and drains directly into the systemic circulation via a congenital portosystemic shunt. We describe two cases of CAPV presenting as pulmonary hypertension that were initially suspected as primary pulmonary hypertension. However, subsequent ultrasonography and CT detected the absence of a portal vein and the presence of a portosystemic shunt. Pulmonary hypertension is a recognized complication of liver disease and portal hypertension. However, these two cases illustrate that CAPV may result in pulmonary hypertension without liver disease or portal hypertension.

  19. Mars Science Laboratory relative humidity observations: Initial results.

    Science.gov (United States)

    Harri, A-M; Genzer, M; Kemppinen, O; Gomez-Elvira, J; Haberle, R; Polkko, J; Savijärvi, H; Rennó, N; Rodriguez-Manfredi, J A; Schmidt, W; Richardson, M; Siili, T; Paton, M; Torre-Juarez, M De La; Mäkinen, T; Newman, C; Rafkin, S; Mischna, M; Merikallio, S; Haukka, H; Martin-Torres, J; Komu, M; Zorzano, M-P; Peinado, V; Vazquez, L; Urqui, R

    2014-09-01

    The Mars Science Laboratory (MSL) made a successful landing at Gale crater early August 2012. MSL has an environmental instrument package called the Rover Environmental Monitoring Station (REMS) as a part of its scientific payload. REMS comprises instrumentation for the observation of atmospheric pressure, temperature of the air, ground temperature, wind speed and direction, relative humidity (REMS-H), and UV measurements. We concentrate on describing the REMS-H measurement performance and initial observations during the first 100 MSL sols as well as constraining the REMS-H results by comparing them with earlier observations and modeling results. The REMS-H device is based on polymeric capacitive humidity sensors developed by Vaisala Inc., and it makes use of transducer electronics section placed in the vicinity of the three humidity sensor heads. The humidity device is mounted on the REMS boom providing ventilation with the ambient atmosphere through a filter protecting the device from airborne dust. The final relative humidity results appear to be convincing and are aligned with earlier indirect observations of the total atmospheric precipitable water content. The water mixing ratio in the atmospheric surface layer appears to vary between 30 and 75 ppm. When assuming uniform mixing, the precipitable water content of the atmosphere is ranging from a few to six precipitable micrometers. Atmospheric water mixing ratio at Gale crater varies from 30 to 140 ppmMSL relative humidity observation provides good dataHighest detected relative humidity reading during first MSL 100 sols is RH75.

  20. Prevalence and risk factors of hypertension for the middle-aged population in China - results from the China Health and Retirement Longitudinal Study (CHARLS).

    Science.gov (United States)

    Li, Zhen; Fu, Chang; Yang, Fan; Mao, Zongfu

    2018-03-19

    The prevalence of hypertension in middle-aged people is increasing. However, few studies have examined the risk factors of hypertension among the middle-aged population. The aim of this study is to present the prevalence of hypertension and its risk factors for the middle-aged population in China. The data were from the third-wave national survey (2015) of the China Health and Retirement Longitudinal Study (CHARLS). A total of 7,178 respondents aged 45-59 years were included in this study. Hypertension was defined as SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg or currently taking antihypertensive medicines. Multivariate logistic regression analyses were used to identify the risk factors of hypertension. The prevalence of hypertension was 29.12% (95%CI = 28.07-30.17). Hypertension was more prevalent among men than women (31.63% vs. 27.03%). Older age, higher BMI, chronic diseases, and poor health status were independently associated with hypertension in both genders (p < 0.05). Among women, college education (OR = 0.302, 95%CI = 0.152-0.598), marriage or cohabitation (OR = 0.756, 95%CI = 0.584-0.98), and drinking more than once a month (OR = 0.645, 95% = 0.498-0.836) led to a decreased likelihood of hypertension. Individuals with larger waist circumference were more likely to have hypertension (OR = 1.57, 95%CI = 1.294-1.906). Our results indicate that hypertension is highly prevalent in the middle-aged population in China. Men are more likely to have hypertension than women. Older age, higher BMI, chronic diseases and poor self-rated health are risk factors for hypertension in both genders. Large waist circumference, singleness, low educational level, and non-drinking are risk factors of hypertension among women but not among men.

  1. Results of a hypertension and diabetes treatment program in the slums of Nairobi: a retrospective cohort study

    NARCIS (Netherlands)

    Werner, Marie E.; van de Vijver, Steven; Adhiambo, Mildred; Egondi, Thaddaeus; Oti, Samuel O.; Kyobutungi, Catherine

    2015-01-01

    Cardiovascular diseases (CVD) are the world's leading cause of death and their prevalence is rising. Diabetes and hypertension, major risk factors for CVD, are highly prevalent among the urban poor in Africa, but treatment options are often limited in such settings. This study reports on the results

  2. Implementation of a quality improvement initiative in Belgian diabetic foot clinics: feasibility and initial results.

    Science.gov (United States)

    Doggen, Kris; Van Acker, Kristien; Beele, Hilde; Dumont, Isabelle; Félix, Patricia; Lauwers, Patrick; Lavens, Astrid; Matricali, Giovanni A; Randon, Caren; Weber, Eric; Van Casteren, Viviane; Nobels, Frank

    2014-07-01

    This article aims to describe the implementation and initial results of an audit-feedback quality improvement initiative in Belgian diabetic foot clinics. Using self-developed software and questionnaires, diabetic foot clinics collected data in 2005, 2008 and 2011, covering characteristics, history and ulcer severity, management and outcome of the first 52 patients presenting with a Wagner grade ≥ 2 diabetic foot ulcer or acute neuropathic osteoarthropathy that year. Quality improvement was encouraged by meetings and by anonymous benchmarking of diabetic foot clinics. The first audit-feedback cycle was a pilot study. Subsequent audits, with a modified methodology, had increasing rates of participation and data completeness. Over 85% of diabetic foot clinics participated and 3372 unique patients were sampled between 2005 and 2011 (3312 with a diabetic foot ulcer and 111 with acute neuropathic osteoarthropathy). Median age was 70 years, median diabetes duration was 14 years and 64% were men. Of all diabetic foot ulcers, 51% were plantar and 29% were both ischaemic and deeply infected. Ulcer healing rate at 6 months significantly increased from 49% to 54% between 2008 and 2011. Management of diabetic foot ulcers varied between diabetic foot clinics: 88% of plantar mid-foot ulcers were off-loaded (P10-P90: 64-100%), and 42% of ischaemic limbs were revascularized (P10-P90: 22-69%) in 2011. A unique, nationwide quality improvement initiative was established among diabetic foot clinics, covering ulcer healing, lower limb amputation and many other aspects of diabetic foot care. Data completeness increased, thanks in part to questionnaire revision. Benchmarking remains challenging, given the many possible indicators and limited sample size. The optimized questionnaire allows future quality of care monitoring in diabetic foot clinics. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Initial Results from Lunar Electromagnetic Sounding with ARTEMIS

    Science.gov (United States)

    Fuqua, H.; Fatemi, S.; Poppe, A. R.; Delory, G. T.; Grimm, R. E.; De Pater, I.

    2016-12-01

    Electromagnetic Sounding constrains conducting layers of the lunar interior by observing variations in the Interplanetary Magnetic Field. Here, we focus our analysis on the time domain transfer function method locating transient events observed by two magnetometers near the Moon. We analyze ARTEMIS and Apollo magnetometer data. This analysis assumes the induced field responds undisturbed in a vacuum. In actuality, the dynamic plasma environment interacts with the induced field. Our models indicate distortion but not confinement occurs in the nightside wake cavity. Moreover, within the deep wake, near-vacuum region, distortion of the induced dipole fields due to the interaction with the wake is minimal depending on the magnitude of the induced field, the geometry of the upstream fields, and the upstream plasma parameters such as particle densities, solar wind velocity, and temperatures. Our results indicate the assumption of a vacuum dipolar response is reasonable within this minimally disturbed zone. We then interpret the ATEMIS magnetic field signal through a geophysical forward model capturing the induced response based on prescribed electrical conductivity models. We demonstrate our forward model passes benchmarking analyses and solves the magnetic induction response for any input signal as well as any 2 or 3 dimensional conductivity profile. We locate data windows according to the following criteria: (1) probe locations such that the wake probe is within 500km altitude within the wake cavity and minimally disturbed zone, and the second probe is in the free streaming solar wind; (2) a transient event consisting of an abrupt change in the magnetic field occurs enabling the observation of induction; (3) cross correlation analysis reveals the magnetic field signals are well correlated between the two probes and distances observed. Here we present initial ARTEMIS results providing further insight into the lunar interior structure. This method and modeling results

  4. Initial water quantification results using neutron computed tomography

    Science.gov (United States)

    Heller, A. K.; Shi, L.; Brenizer, J. S.; Mench, M. M.

    2009-06-01

    Neutron computed tomography is an important imaging tool in the field of non-destructive testing and in fundamental research for many engineering applications. Contrary to X-rays, neutrons can be attenuated by some light materials, such as hydrogen, but can penetrate many heavy materials. Thus, neutron computed tomography is useful in obtaining important three-dimensional information about a sample's interior structure and material properties that other traditional methods cannot provide. The neutron computed tomography system at the Pennsylvania State University's Radiation Science and Engineering Center is being utilized to develop a water quantification technique for investigation of water distribution in fuel cells under normal conditions. A hollow aluminum cylinder test sample filled with a known volume of water was constructed for purposes of testing the quantification technique. Transmission images of the test sample at different angles were easily acquired through the synthesis of a dedicated image acquisition computer driving a rotary table controller and an in-house developed synchronization software package. After data acquisition, Octopus (version 8.2) and VGStudio Max (version 1.2) were used to perform cross-sectional and three-dimensional reconstructions of the sample, respectively. The initial reconstructions and water quantification results are presented.

  5. Initial results from the NSTX Real-Time Velocity diagnostic

    Science.gov (United States)

    Podesta, M.; Bell, R. E.

    2011-10-01

    A new diagnostic for fast measurements of plasma rotation through active charge-exchange recombination spectroscopy (CHERS) was installed on NSTX. The diagnostic infers toroidal rotation from carbon ions undergoing charge-exchange with neutrals from a heating Neutral Beam (NB). Each of the 4 channels, distributed along the outer major radius, includes active views intercepting the NB and background views missing the beam. Estimated uncertainties in the measured velocity are system. Signals are acquired on 2 CCD detectors, each controlled by a dedicated PC. Spectra are fitted in real-time through a C++ processing code and velocities are made available to the Plasma Control System for future implementation of feedback on velocity. Results from the initial operation during the 2011 run are discussed, emphasizing the fast dynamics of toroidal rotation, e . g . during L-H mode transition and breaking caused by instabilities and by externally-imposed magnetic perturbations. Work supported by USDOE Contract No. DE-AC02-09CH11466.

  6. Ground Operations Demonstration Unit for Liquid Hydrogen Initial Test Results

    Science.gov (United States)

    Notardonato, W. U.; Johnson, W. L.; Swanger, A. M.; Tomsik, T.

    2015-01-01

    NASA operations for handling cryogens in ground support equipment have not changed substantially in 50 years, despite major technology advances in the field of cryogenics. NASA loses approximately 50% of the hydrogen purchased because of a continuous heat leak into ground and flight vessels, transient chill down of warm cryogenic equipment, liquid bleeds, and vent losses. NASA Kennedy Space Center (KSC) needs to develop energy-efficient cryogenic ground systems to minimize propellant losses, simplify operations, and reduce cost associated with hydrogen usage. The GODU LH2 project has designed, assembled, and started testing of a prototype storage and distribution system for liquid hydrogen that represents an advanced end-to-end cryogenic propellant system for a ground launch complex. The project has multiple objectives including zero loss storage and transfer, liquefaction of gaseous hydrogen, and densification of liquid hydrogen. The system is unique because it uses an integrated refrigeration and storage system (IRAS) to control the state of the fluid. This paper will present and discuss the results of the initial phase of testing of the GODU LH2 system.

  7. Initial water quantification results using neutron computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Heller, A.K. [Department of Mechanical and Nuclear Engineering, Pennsylvania State University (United States)], E-mail: axh174@psu.edu; Shi, L.; Brenizer, J.S.; Mench, M.M. [Department of Mechanical and Nuclear Engineering, Pennsylvania State University (United States)

    2009-06-21

    Neutron computed tomography is an important imaging tool in the field of non-destructive testing and in fundamental research for many engineering applications. Contrary to X-rays, neutrons can be attenuated by some light materials, such as hydrogen, but can penetrate many heavy materials. Thus, neutron computed tomography is useful in obtaining important three-dimensional information about a sample's interior structure and material properties that other traditional methods cannot provide. The neutron computed tomography system at Pennsylvania State University's Radiation Science and Engineering Center is being utilized to develop a water quantification technique for investigation of water distribution in fuel cells under normal conditions. A hollow aluminum cylinder test sample filled with a known volume of water was constructed for purposes of testing the quantification technique. Transmission images of the test sample at different angles were easily acquired through the synthesis of a dedicated image acquisition computer driving a rotary table controller and an in-house developed synchronization software package. After data acquisition, Octopus (version 8.2) and VGStudio Max (version 1.2) were used to perform cross-sectional and three-dimensional reconstructions of the sample, respectively. The initial reconstructions and water quantification results are presented.

  8. Application of Terahertz Radiation to Soil Measurements: Initial Results

    Science.gov (United States)

    Dworak, Volker; Augustin, Sven; Gebbers, Robin

    2011-01-01

    Developing soil sensors with the possibility of continuous online measurement is a major challenge in soil science. Terahertz (THz) electromagnetic radiation may provide the opportunity for the measurement of organic material density, water content and other soil parameters at different soil depths. Penetration depth and information content is important for a functional soil sensor. Therefore, we present initial research on the analysis of absorption coefficients of four different soil samples by means of THz transmission measurements. An optimized soil sample holder to determine absorption coefficients was used. This setup improves data acquisition because interface reflections can be neglected. Frequencies of 340 GHz to 360 GHz and 1.627 THz to 2.523 THz provided information about an existing frequency dependency. The results demonstrate the potential of this THz approach for both soil analysis and imaging of buried objects. Therefore, the THz approach allows different soil samples to be distinguished according to their different absorption properties so that relations among soil parameters may be established in future. PMID:22163737

  9. NICER observations of highly magnetized neutron stars: Initial results

    Science.gov (United States)

    Enoto, Teruaki; Arzoumanian, Zaven; Gendreau, Keith C.; Nynka, Melania; Kaspi, Victoria; Harding, Alice; Guver, Tolga; Lewandowska, Natalia; Majid, Walid; Ho, Wynn C. G.; NICER Team

    2018-01-01

    The Neutron star Interior Composition Explorer (NICER) was launched on June 3, 2017, and attached to the International Space Station. The large effective area of NICER in soft X-rays makes it a powerful tool not only for its primary science objective (diagnostics of the nuclear equation state) but also for studying neutron stars of various classes. As one of the NICER science working groups, the Magnetars and Magnetospheres (M&M) team coordinates monitoring and target of opportunity (ToO) observations of magnetized neutron stars, including magnetars, high-B pulsars, X-ray dim isolated neutron stars, and young rotation-powered pulsars. The M&M working group has performed simultaneous X-ray and radio observations of the Crab and Vela pulsars, ToO observations of the active anomalous X-ray pulsar 4U 0142+61, and a monitoring campaign for the transient magnetar SGR 0501+4516. Here we summarize the current status and initial results of the M&M group.

  10. Initial Results from the New Stress Map of Texas Project

    Science.gov (United States)

    Lund Snee, J. E.; Zoback, M. D.

    2015-12-01

    Modern techniques for characterizing tectonic stress orientation and relative magnitude have been successfully used for more than 35 years. Nevertheless, large areas of North America lack high spatial resolution maps of stress orientation, magnitude, and faulting regime. In Texas, for example, data are foundational elements of attempts to characterize tectonic driving forces, understand hazards associated with induced seismicity, and optimize production of oil, gas, and geothermal resources. This year, we launched the Texas Stress Map project to characterize tectonic stress patterns at higher spatial resolution across Texas and nearby areas. Following a successful effort just completed in Oklahoma, we will evaluate borehole breakouts, drilling-induced tensile fractures, shear wave anisotropy, and earthquake data. The principal data source will be FMI (fullbore formation microimager), UBI (ultrasonic borehole imager), cross-dipole sonic, density, and caliper logs provided by private industry. Earthquake moment tensor solutions from the U.S. Geological Survey, Saint Louis University and other sources will also be used. Our initial focus is on the Permian Basin and Barnett Shale petroleum plays due to the availability of data, but we will expand our analysis across the state as the project progresses. In addition, we hope to eventually apply the higher spatial resolution data coverage to understanding tectonic and geodynamic characteristics of the southwestern United States and northeastern Mexico. Here we present early results from our work to constrain stress orientations and faulting regime in and near Texas, and we also provide a roadmap for the ongoing research.

  11. Initial results from the fast imaging solar spectrograph (FISS)

    CERN Document Server

    2015-01-01

    This collection of papers describes the instrument and initial results obtained from the Fast Imaging Solar Spectrograph (FISS),  one of the post-focus instruments of the 1.6 meter New Solar Telescope at the Big Bear Solar Observatory. The FISS primarily aims at investigating structures and dynamics of  chromospheric features. This instrument is a dual-band Echelle spectrograph optimized for the simultaneous recording of the H I 656.3 nm band and the Ca II 854.2 nm band. The imaging is done with the fast raster scan realized by the linear motion of a two-mirror scanner, and its quality is determined by the performance of the adaptive optics of the telescope.    These papers illustrate the capability of the early FISS observations in the study of chromospheric features. Since the imaging quality has been improved a lot with the advance of the adaptive optics, one can obtain much better data with the current FISS observations.        This volume is aimed at graduate students and researchers working in...

  12. Residential Air Pollution, Road Traffic, Greenness and Maternal Hypertension: Results from GINIplus and LISAplus.

    Science.gov (United States)

    Jendrossek, Mario; Standl, Marie; Koletzko, Sibylle; Lehmann, Irina; Bauer, Carl-Peter; Schikowski, Tamara; von Berg, Andrea; Berdel, Dietrich; Heinrich, Joachim; Markevych, Iana

    2017-07-01

    The public health burden of hypertension is high, but its relationship with long-term residential air pollution, road traffic, and greenness remains unclear. To investigate associations between residential air pollution, traffic, greenness, and hypertension among mothers. Information on doctor-diagnosed maternal hypertension was collected at the 15-year follow-up of two large population-based multicenter German birth cohorts-GINIplus and LISAplus (n=3063). Residential air pollution was modelled by land use regression models within the ESCAPE and universal kriging within the APMoSPHERE projects. Road traffic was defined as traffic load on major roads within a 100-m buffer around residences. Vegetation level ( ie , greenness) was defined as the mean Normalized Difference Vegetation Index in a 500-m buffer around residences and was assessed from Landsat 5 TM satellite images. All the exposure variables were averaged over three residential addresses during the last 10 years and categorized into tertiles or dichotomized. The individual associations between each of the exposure variables and hypertension were assessed using logistic regression analysis. No significant and consistent associations across different levels of adjustment were observed between the exposures of interest and hypertension. The only significant estimate was found with coarse particulate matter concentrations (OR 1.66, 95% CI 1.01 to 2.74; 3 rd vs 1 st tertile) among mothers residing in the Wesel area. No significant associations were observed with traffic load or greenness. This study does not provide evidence on detrimental effects of air pollution and road traffic or beneficial effects of greenness on hypertension among German adults.

  13. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

    International Nuclear Information System (INIS)

    Okada, Takuya; Pellerin, Olivier; Savard, Sébastien; Curis, Emmanuel; Monge, Matthieu; Frank, Michael; Bobrie, Guillaume; Yamaguchi, Masato; Sugimoto, Koji; Plouin, Pierre-François; Azizi, Michel; Sapoval, Marc

    2015-01-01

    PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future

  14. Eligibility for Renal Denervation: Anatomical Classification and Results in Essential Resistant Hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Okada, Takuya, E-mail: okabone@gmail.com; Pellerin, Olivier [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France); Savard, Sébastien [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Curis, Emmanuel; Monge, Matthieu [INSERM, Clinical Investigation Center 9201 (France); Frank, Michael; Bobrie, Guillaume [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Yamaguchi, Masato; Sugimoto, Koji [Kobe University Hospital, Department of Radiology and Center for Endovascular Therapy (Japan); Plouin, Pierre-François; Azizi, Michel [Georges Pompidou European Hospital, Department of Hypertension, Assistance Publique des Hôpitaux de Paris (France); Sapoval, Marc [Georges Pompidou European Hospital, Department of Cardiovascular and Interventional Radiology, Assistance Publique des Hôpitaux de Paris (France)

    2015-02-15

    PurposeTo classify the renal artery (RA) anatomy based on specific requirements for endovascular renal artery denervation (RDN) in patients with drug-resistant hypertension (RH).Materials and MethodsThe RA anatomy of 122 consecutive RH patients was evaluated by computed tomography angiography and classified as two types: A (main RA ≥20 mm in length and ≥4.0 mm in diameter) or B (main RA <20 mm in length or main RA <4.0 mm in diameter). The A type included three subtypes: A1 (without accessory RAs), A2 (with accessory RAs <3.0 mm in diameter), and A3 (with accessory RAs ≥3.0 mm in diameter]. A1 and A2 types were eligible for RDN with the Simplicity Flex catheter. Type B included twi subtypes based on the main RA length and diameter. Patients were accordingly classified into three eligibility categories: complete (CE; both RAs were eligible), partial (PE; one eligible RA), and noneligibility (NE; no eligible RA).ResultsBilateral A1 type was the most prevalent and was observed in 48.4 % of the patients followed by the A1/A2 type (18 %). CE, PE, and NE were observed in 69.7, 22.9, and 7.4 % of patients, respectively. The prevalence of accessory RAs was 41 %.ConclusionsOf RH patients, 30.3 % were not eligible for bilateral RDN with the current Simplicity Flex catheter. This classification provides the basis for standardized reporting to allow for pooling of results of larger patient cohorts in the future.

  15. SAFARI - RANDOMISED TRIAL ON COMPLEX THERAPY OF ARTERIAL HYPERTENSION AND DISLIPIDEMY. THE MAIN RESULTS

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2016-01-01

    Full Text Available Aim. To evaluate possibility of complex pharmaceutical effect simultaneously on 2 risk factors – arterial hypertension (HT and hypercholesterolemia (HH in patients with high risk of cardiovascular complications (CVC.Material and methods. 101 patients with HT of 1-2 stage, HH and high risk of CVC (SCORE>5 were included in the study. Patients were randomized in 2 groups: active therapy group (ATG and control group (CG. ATG patients were actively treated for HT and HH control. The long-acting nifedipine (Nifecard XL, LEK 30 mg once daily (OD was prescribed as start antihypertensive drug. Hydrochlorothiazide 12,5 mg/day OD and bisiprolol 5 mg OD was added if antihypertensive effect was insufficient. Atorvastatin (Tulip, LEK 20-40 mg OD was prescribed for HH control. Management of CG patients was performed by doctors of out-patient clinics. The study duration was 12 weeks.Results. Systolic and diastolic blood pressure (BP levels in ATG patients were lower than these in CG patients. Target BP level was reached in 88,4% of ATG patients and only in 48,9% of CG patients. Cholesterol of low density lipoprotein (CH LPLD level was also lower in ATG patients than this in CG patients. Target CH LPLD level was reached in 37,2 % of ATG patients and in 8,3 % of CG patients. Relative risk of CVC was significantly lower in ATG patients than this in CG patients.Conclusion. SAFARI trial shows that effective pharmaceutical simultaneous control of 2 key risk factors, HT and HH, results in risk reduction of CVC.

  16. SAFARI - RANDOMISED TRIAL ON COMPLEX THERAPY OF ARTERIAL HYPERTENSION AND DISLIPIDEMY. THE MAIN RESULTS

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2009-01-01

    Full Text Available Aim. To evaluate possibility of complex pharmaceutical effect simultaneously on 2 risk factors – arterial hypertension (HT and hypercholesterolemia (HH in patients with high risk of cardiovascular complications (CVC.Material and methods. 101 patients with HT of 1-2 stage, HH and high risk of CVC (SCORE>5 were included in the study. Patients were randomized in 2 groups: active therapy group (ATG and control group (CG. ATG patients were actively treated for HT and HH control. The long-acting nifedipine (Nifecard XL, LEK 30 mg once daily (OD was prescribed as start antihypertensive drug. Hydrochlorothiazide 12,5 mg/day OD and bisiprolol 5 mg OD was added if antihypertensive effect was insufficient. Atorvastatin (Tulip, LEK 20-40 mg OD was prescribed for HH control. Management of CG patients was performed by doctors of out-patient clinics. The study duration was 12 weeks.Results. Systolic and diastolic blood pressure (BP levels in ATG patients were lower than these in CG patients. Target BP level was reached in 88,4% of ATG patients and only in 48,9% of CG patients. Cholesterol of low density lipoprotein (CH LPLD level was also lower in ATG patients than this in CG patients. Target CH LPLD level was reached in 37,2 % of ATG patients and in 8,3 % of CG patients. Relative risk of CVC was significantly lower in ATG patients than this in CG patients.Conclusion. SAFARI trial shows that effective pharmaceutical simultaneous control of 2 key risk factors, HT and HH, results in risk reduction of CVC.

  17. Site Specific Advisory Board initiative, evaluation survey results supplementary appendix: Summary of individual site results

    International Nuclear Information System (INIS)

    1996-08-01

    This Appendix presents results of the Site-Specific Advisory Board (SSAB) Initiative for each of the 11 sites that participated in the survey. These individual results are a supplement to the June 1996 Summary Report which presented overall survey results. Results are presented in 11 sections, arranged alphabetically by site. Each section includes a series of figures and tables that parallel those presented in the Summary Report. To facilitate comparison, figures are presented both for the individual site and for the overall long survey. The sequence of sections is: Fernald, Hanford, Idaho, Los Alamos, Monticello, Nevada, Pantex, Rocky Flats, St. Louis, Sandia, and Savannah River

  18. The Frontier Fields: Survey Design and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Lotz, J. M.; Koekemoer, A.; Grogin, N.; Mack, J.; Anderson, J.; Avila, R.; Barker, E. A.; Borncamp, D.; Durbin, M.; Gunning, H.; Hilbert, B.; Jenkner, H.; Khandrika, H.; Levay, Z.; Lucas, R. A.; MacKenty, J.; Ogaz, S. [Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, MD 21218 (United States); Coe, D.; Capak, P.; Brammer, G., E-mail: lotz@stsci.edu [European Space Agency/Space Telescope Science Institute, 3700 Sam Martin Drive, Baltimore, MD 21218 (United States); and others

    2017-03-01

    What are the faintest distant galaxies we can see with the Hubble Space Telescope ( HST ) now, before the launch of the James Webb Space Telescope ? This is the challenge taken up by the Frontier Fields, a Director’s discretionary time campaign with HST and the Spitzer Space Telescope to see deeper into the universe than ever before. The Frontier Fields combines the power of HST and Spitzer with the natural gravitational telescopes of massive high-magnification clusters of galaxies to produce the deepest observations of clusters and their lensed galaxies ever obtained. Six clusters—Abell 2744, MACSJ0416.1-2403, MACSJ0717.5+3745, MACSJ1149.5+2223, Abell S1063, and Abell 370—have been targeted by the HST ACS/WFC and WFC3/IR cameras with coordinated parallel fields for over 840 HST orbits. The parallel fields are the second-deepest observations thus far by HST with 5 σ point-source depths of ∼29th ABmag. Galaxies behind the clusters experience typical magnification factors of a few, with small regions magnified by factors of 10–100. Therefore, the Frontier Field cluster HST images achieve intrinsic depths of ∼30–33 mag over very small volumes. Spitzer has obtained over 1000 hr of Director’s discretionary imaging of the Frontier Field cluster and parallels in IRAC 3.6 and 4.5 μ m bands to 5 σ point-source depths of ∼26.5, 26.0 ABmag. We demonstrate the exceptional sensitivity of the HST Frontier Field images to faint high-redshift galaxies, and review the initial results related to the primary science goals.

  19. DART Core/Combustor-Noise Initial Test Results

    Science.gov (United States)

    Boyle, Devin K.; Henderson, Brenda S.; Hultgren, Lennart S.

    2017-01-01

    Contributions from the combustor to the overall propulsion noise of civilian transport aircraft are starting to become important due to turbofan design trends and advances in mitigation of other noise sources. Future propulsion systems for ultra-efficient commercial air vehicles are projected to be of increasingly higher bypass ratio from larger fans combined with much smaller cores, with ultra-clean burning fuel-flexible combustors. Unless effective noise-reduction strategies are developed, combustor noise is likely to become a prominent contributor to overall airport community noise in the future. The new NASA DGEN Aero0propulsion Research Turbofan (DART) is a cost-efficient testbed for the study of core-noise physics and mitigation. This presentation gives a brief description of the recently completed DART core combustor-noise baseline test in the NASA GRC Aero-Acoustic Propulsion Laboratory (AAPL). Acoustic data was simultaneously acquired using the AAPL overhead microphone array in the engine aft quadrant far field, a single midfield microphone, and two semi-infinite-tube unsteady pressure sensors at the core-nozzle exit. An initial assessment shows that the data is of high quality and compares well with results from a quick 2014 feasibility test. Combustor noise components of measured total-noise signatures were educed using a two-signal source-separation method an dare found to occur in the expected frequency range. The research described herein is aligned with the NASA Ultra-Efficient Commercial Transport strategic thrust and is supported by the NASA Advanced Air Vehicle Program, Advanced Air Transport Technology Project, under the Aircraft Noise Reduction Subproject.

  20. Obesity, diabetes, hypertension, and vegetarian status among Seventh-Day Adventists in Barbados: preliminary results.

    Science.gov (United States)

    Brathwaite, Noel; Fraser, Henry S; Modeste, Naomi; Broome, Hedy; King, Rosaline

    2003-01-01

    A population-based sample of Seventh-Day Adventists was studied to determine the relationship between vegetarian status, body mass index (BMI), obesity, diabetes mellitus (DM), and hypertension, in order to gain a better understanding of factors influencing chronic diseases in Barbados. A systematic sampling from a random start technique was used to select participants for the study. A standard questionnaire was used to collect data on demographic and lifestyle characteristics, to record anthropometrics and blood pressure measurements, and to ascertain the hypertension and diabetes status of participants. The sample population consisted of 407 Barbadian Seventh-Day Adventists (SDAs), who ranged in age from 25 to 74 years. One hundred fifty-three (37.6%) participants were male, and 254 (62.4%) were female, and 43.5% were vegetarians. The prevalence rates of diabetes and hypertension were lower among long-term vegetarians, compared to non-vegetarians, and long-term vegetarians were, on average, leaner than non-vegetarians within the same cohort. A significant association was observed between a vegetarian diet and obesity (vegetarian by definition P=.04, self-reported vegetarian P=.009) in this population. Other components of the study population lifestyle should be further analyzed to determine the roles they may plan in lessening the prevalence rates of obesity, diabetes, and hypertension.

  1. Contemporary trends in the diagnosis and management of pulmonary arterial hypertension: an initiative to close the care gap.

    Science.gov (United States)

    McLaughlin, Vallerie V; Langer, Anatoly; Tan, Mary; Clements, Philip J; Oudiz, Ronald J; Tapson, Victor F; Channick, Richard N; Rubin, Lewis J

    2013-02-01

    The Pulmonary Arterial Hypertension-Quality Enhancement Research Initiative (PAHQuERI) was created to help clinicians to implement a guidelines-based approach to the diagnosis and management of pulmonary arterial hypertension (PAH). Patients with PAH represent a heterogeneous population, and physician evaluation and treatment paradigms may vary considerably. Using an electronic data management system, participating physicians recorded data on diagnostic workup, disease management, and outcomes of patients with PAH. Queries were generated automatically following each follow-up visit if the tests recommended by the American College of Chest Physicians (ACCP) were not performed at least once. Of 791 patients enrolled in PAH-QuERI, 77% were women; 64% received a diagnosis . 3 months prior to enrollment; 9% were in New York Heart Association functional class I, 39% in II, 48% in III, and 5% in IV; and the median age was 55 years (interquartile range, 45-66 years). At enrollment, all ACCP-recommended tests had been performed in only 6% of patients. The automated program generated 1,530 reminders for 642 patients (81%) with validated enrollment data. The proportion of recommended tests performed was 91% for CBC count, 91% for liver function test, 50% for connective tissue disease screen, 29% for HIV screen, 88% for chest radiograph, 82% for ECG, 97% for two-dimensional echocardiogram, 83% for pulmonary function tests, 41% for oximetry, 57% for ventilation/perfusion scan, 79% for 6-min walk distance, and 90% for right-sided heart catheterization. Regarding management, 78% of patients were on disease specific therapy, and the use of these therapies tended to increase with the functional disability of the patient. One hundred seventy patients were taking calcium channel blockers, 91 specifically for PAH. Only six of 91 patients (7%) who received calcium channel blockers specifically for PAH had met the current guideline for acute vasoreactivity. When comparing reported

  2. Drug adherence in treatment resistant and in controlled hypertension-Results from the Swedish Primary Care Cardiovascular Database (SPCCD).

    Science.gov (United States)

    Holmqvist, Lina; Boström, Kristina Bengtsson; Kahan, Thomas; Schiöler, Linus; Qvarnström, Miriam; Wettermark, Björn; Hjerpe, Per; Hasselström, Jan; Manhem, Karin

    2018-03-01

    To assess drug adherence in patients treated with ≥3 antihypertensive drug classes, with both controlled and uncontrolled blood pressure and describe associated factors for nonadherence. Patients with hypertension, without cardiovascular comorbidity, aged >30 years treated with ≥3 antihypertensive drug classes were followed for 2 years. Both patients with treatment resistant hypertension (TRH) and patients with controlled hypertension were included. Clinical data were derived from a primary care database. Pharmacy refill data from the Swedish Prescribed drug registry was used to calculate proportion of days covered (PDC). Patients with a PDC level ≥ 80% were included. We found 5846 patients treated ≥3 antihypertensive drug classes, 3508 with TRH (blood pressure ≥ 140/90), and 2338 with controlled blood pressure (drug therapy had similar decline in adherence over time regardless of initial blood pressure control. Diabetes was associated with better adherence, which may imply that the structured caregiving of these patients enhances antihypertensive drug treatment. Copyright © 2018 John Wiley & Sons, Ltd.

  3. FFTF initial fuel loading, preanalyses, and comparison with preliminary results

    International Nuclear Information System (INIS)

    Rothrock, R.B.; Daughtry, J.W.; Zimmerman, B.D.; Petrowicz, N.E.; Bennett, R.A.; Ombrellaro, P.A.

    1980-02-01

    Disadvantages of conventional loading from the center out were circumvented by loading one trisector at a time, and connecting the control rod drivelines in each sector after it was loaded so that the rods could be operated during the loading of subsequent trisectors. This sequence was interrupted once during the loading of the final sector, to achieve initial criticality at an approximately minimum critical loading and to measure absolute subcriticality by the rod drop technique. An in-core detector was preferable to the standard FTR ex-core detectors for monitoring the initial fuel loading. Consequently, special fission chambers were installed in an instrument thimble near the core center to monitor the initial fuel loading

  4. ANTXR2 Knock-Out Does Not Result in the Development of Hypertension in Rats.

    Science.gov (United States)

    Liu, Xiaoyan; Yuan, Wen; Li, Jing; Yang, Lei; Cai, Jun

    2017-02-01

    Our recent genetic study as well as robust evidences reported by previous genome-wide association studies (GWASs) have indicated that the single nucleotide polymorphism rs16998073, located near gene anthrax toxin receptor 2 (ANTXR2), was significantly associated with hypertension in Asians and Europeans. The aim of the present study was to determine whether ANTXR2 is the causal gene of hypertension at the 4q21 locus using an ANTXR2 knock-out model. Relative expression of ANTXR2 in Wistar-Kyoto rats (WKYs) and spontaneously hypertensive rats (SHRs) were determined by real-time quantitative polymerase chain reaction and western blot analysis. ANTXR2 knock-out rats were created using CRISPR/Cas9-mediated genome editing and blood pressure values were measured in ANTXR2 -/- and wild type (WT) rats by tail-cuff method and carotid arterial catheterization method. Neither the mRNA nor protein levels of ANTXR2 were significantly different between tissues from SHRs and WKYs. To create ANTXR2 -/- rats, 67 base pairs were deleted in exon 1 of ANTXR2 using CRISPR/Cas9-mediated genome editing. ANTXR2 protein decreased significantly in aortas of ANTXR2 -/- rats, suggesting sufficient efficiency of ANTXR2 knock-out in this model. However, ANTXR2 -/- rats exhibited nearly the same blood pressure as WT rats at baseline conditions as well as during Angiotensin II (400ng/kg/min) infusion or high-salt diet treatment. These findings suggest that ANTXR2 might not be associated with hypertension and thus further functional analysis is warranted to identify the causal gene at this locus. © American Journal of Hypertension, Ltd 2016. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Hypertension Subtypes among Hypertensive Patients in Ibadan

    Directory of Open Access Journals (Sweden)

    Abiodun M. Adeoye

    2014-01-01

    Full Text Available Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% female, hypertensive, aged 18 and above were recruited into the study from two centers in Ibadan, Nigeria. Hypertension was identified using JNCVII definition and was further grouped into four subtypes: controlled hypertension (CH, isolated systolic hypertension (ISH, isolated diastolic hypertension (IDH, and systolic-diastolic hypertension (SDH. Results. Systolic-diastolic hypertension was the most prevalent. Whereas SDH (77.6% versus 73.5% and IDH (4.9% versus 4.7% were more prevalent among females, ISH (10.1% versus 6.2% was higher among males (P=0.048. Female subjects were more obese (P<0.0001 and SDH was prevalent among the obese group. Conclusion. Gender and obesity significantly influenced the distribution of the hypertension subtypes. Characterization of hypertension by subtypes in genetic association studies could lead to identification of previously unknown genetic variants involved in the etiology of hypertension. Large-scale studies among various ethnic groups may be needed to confirm these observations.

  6. Initial Results from Coaxial Helicity Injection Experiments in NSTX

    International Nuclear Information System (INIS)

    Raman, R.; Jarboe, T.R.; Mueller, D.; Schaffer, M.J.; Maqueda, R.; Nelson, B.A.; Sabbagh, S.; Bell, M.; Ewig, R.; Fredrickson, E.; Gates, D.; Hosea, J.; Ji, H.; Kaita, R.; Kaye, S.M.; Kugel, H.; Maingi, R.; Menard, J.; Ono, M.; Orvis, D.; Paolette, F.; Paul, S.; Peng, M.; Skinner, C.H.; Wilgen, W.; Zweben, S.

    2001-01-01

    Coaxial Helicity Injection (CHI) has been investigated on the National Spherical Torus Experiment (NSTX). Initial experiments produced 130 kA of toroidal current without the use of the central solenoid. The corresponding injector current was 20 kA. Discharges with pulse lengths up to 130 ms have been produced

  7. Initial results in SST-1 after up-gradation

    Science.gov (United States)

    Pradhan, S.; Khan, Z.; Tanna, V. L.; Prasad, U.; Paravastu, Y.; Raval, D. C.; Masand, H.; Kumar, Aveg; Dhongde, J. R.; Jana, S.; Kakati, B.; Patel, K. B.; Bhandarkar, M. K.; Shukla, B. K.; Ghosh, D.; Patel, H. S.; Parekh, T. J.; Mansuri, I. A.; Dhanani, K. R.; Varadharajulu, A.; Khristi, Y. S.; Biswas, P.; Gupta, C. N.; George, S.; Semwal, P.; Sharma, D. K.; Gulati, H. K.; Mahajan, K.; Praghi, B. R.; Banaudha, M.; Makwana, A. R.; Chudasma, H. H.; Kumar, M.; Manchanda, R.; Joisa, Y. S.; Asudani, K.; Pandya, S. N.; Pathak, S. K.; Banerjee, S.; Patel, P. J.; Santra, P.; Pathan, F. S.; Chauhan, P. K.; Khan, M. S.; Thankey, P. L.; Prakash, A.; Panchal, P. N.; Panchal, R. N.; Patel, R. J.; Mahsuria, G. I.; Sonara, D. P.; Patel, K. M.; Jayaswal, S. P.; Sharma, M.; Patel, J. C.; Varmora, P.; Srikanth, G. L. N.; Christian, D. R.; Garg, A.; Bairagi, N.; Babu, G. R.; Panchal, A. G.; Vora, M. M.; Singh, A. K.; Sharma, R.; Nimavat, H. D.; Shah, P. R.; Purwar, G.; Raval, T. Y.; Sharma, A. L.; Ojha, A.; Kumar, S.; Ramaiya, N. K.; Siju, V.; Gopalakrishna, M. V.; Kumar, A.; Sharma, P. K.; Atrey, P. K.; Kulkarni, SV; Ambulkar, K. K.; Parmar, P. R.; Thakur, A. L.; Raval, J. V.; Purohit, S.; Mishra, P. K.; Adhiya, A. N.; Nagora, U. C.; Thomas, J.; Chaudhari, V. K.; Patel, K. G.; Dalakoti, S.; Virani, C. G.; Gupta, S.; Kumar, Ajay; Chaudhari, B.; Kaur, R.; Srinivasan, R.; Raju, D.; Kanabar, D. H.; Jha, R.; Das, A.; Bora, D.

    2017-04-01

    SST-1 Tokamak has recently completed the 1st phase of up-gradation with successful installation and integration of all its First Wall components. The First Wall of SST-1 comprises of ∼ 3800 high heat flux compatible graphite tiles being assembled and installed on 132 CuCrZr heat sink back plates engraved with ∼ 4 km of leak tight baking and cooling channels in five major sub groups equipped with ∼ 400 sensors and weighing ∼ 6000 kg in total in thirteen isolated galvanic and six isolated hydraulic circuits. The phase-1 up-gradation spectrum also includes addition of Supersonic Molecular Beam Injection (SMBI) both on the in-board and out-board side, installation of fast reciprocating probes, adding some edge plasma probe diagnostics in the SOL region, installation and integration of segmented and up-down symmetric radial coils aiding/controlling plasma rotations, introduction of plasma position feedback and density controls etc. Post phase-I up-gradation spanning from Nov 2014 till June 2016, initial plasma experiments in up-graded SST-1 have begun since Aug 2016 after a brief engineering validation period in SST-1. The first experiments in SST-1 have revealed interesting aspects on the ‘eddy currents in the First Wall support structures’ influencing the ‘magnetic Null evolution dynamics’ and the subsequent plasma start-up characteristics after the ECH pre-ionization, the influence of the first walls on the ‘field errors’ and the resulting locked modes observed, the magnetic index influencing the evolution of the equilibrium of the plasma column, low density supra-thermal electron induced discharges and normal ohmic discharges etc. Presently; repeatable ohmic discharges regimes in SST-1 having plasma currents in excess of 65 KA (qa ∼ 3.8, BT = 1.5 T) with a current ramp rates ∼ 1.2 MA/s over a duration of ∼ 300 ms with line averaged densities ∼ 0.8 × 1019 and temperatures ∼ 200 eV with copious MHD signatures have been experimentally

  8. Kidney Disease and Perinatal Programming of Arterial Hypertension: the Results of Experimental Researches

    Directory of Open Access Journals (Sweden)

    Olga P. Kovtun

    2017-01-01

    Full Text Available Deterioration of development conditions in the perinatal period (starvation of the mother, excess sodium ions in her diet, exposure to glucocorticosteroids, placental insufficiency programs significant  changes in the excretion of sodium ions in the newborn and leads to the development of hypertension. Studies on experimental animals show  that unfavourable conditions of intrauterine development can reduce the effective area of glomerular filtration and its rate. These circumstances  increase the expression of membrane carriers of sodium ions in the  apical membranes, the production of superoxide radicals and enhance  the reabsorption of sodium. The article discusses the potential mechanisms of perinatal programming of renal hypertension in humans.

  9. Pulmonary Hypertension Due to Left Ventricular Cardiomyopathy: Is it the Result or Cause of Disease Progression?

    Science.gov (United States)

    Adusumalli, Srinath; Mazurek, Jeremy A

    2017-12-01

    The purpose of this review is to define pulmonary hypertension in the setting of left heart disease (PH-LHD), discuss its epidemiology and pathophysiology, and highlight the cause and effect relationship it has with disease progression in the setting of cardiomyopathy. Both pulmonary hypertension (PH) and heart failure are becoming increasingly common. As such, PH-LHD is now the most common form of PH. The pathophysiology of the condition relates to backward transmission of elevated left ventricular filling pressures into the pulmonary circulation and, ultimately, right ventricular (RV) strain/dysfunction. It is evident that these pathophysiologic processes are both the effect and cause of left heart disease progression. In this review, we describe the complex relationship between disease progression in left ventricular cardiomyopathy and PH-LHD. Clinicians and researchers should take note of the importance of PH-LHD and RV dysfunction to appropriately risk stratify patients and develop therapies for the condition.

  10. Relationship of Hypertension, Blood Pressure, and Blood Pressure Control With White Matter Abnormalities in the Women’s Health Initiative Memory Study (WHIMS)—MRI Trial

    OpenAIRE

    Kuller, Lewis H.; Margolis, Karen L.; Gaussoin, Sarah A.; Bryan, Nick R.; Kerwin, Diana; Limacher, Marian; Wassertheil-Smoller, Sylvia; Williamson, Jeff; Robinson, Jennifer G.

    2010-01-01

    This paper evaluates the relationship of blood pressure (BP) levels at Women’s Health Initiative (WHI) baseline, treatment of hypertension, and white matter abnormalities among women in conjugated equine estrogen (CEE) and medroxyprogesterone acetate and CEE-alone arms. The WHI Memory Study—Magnetic Resonance Imaging (WHIMS-MRI) trial scanned 1424 participants. BP levels at baseline were significantly positively related to abnormal white matter lesion (WML) volumes. Participants treated for h...

  11. Hypertension screening

    Science.gov (United States)

    Foulke, J. M.

    1975-01-01

    An attempt was made to measure the response to an announcement of hypertension screening at the Goddard Space Center, to compare the results to those of previous statistics. Education and patient awareness of the problem were stressed.

  12. A first glance at the initial ATF experimental results

    International Nuclear Information System (INIS)

    Carreras, B.A.; Dominguez, N.; Leboeuf, J.N.; Lynch, V.E.; Charlton, L.A.

    1989-05-01

    In the initial phase of ATF operation, the plasma minor radius and the edge rotational transform were reduced by field errors. This caused an effective change of the magnetic configuration: it improved the stability properties but worsened the equilibrium properties. The threshold for the second stability regime was lowered to β 0 /approximately/ 1.5%. Experimental profile data are compatible with operation in the second stability regime, and the achieved beta values, β 0 /approximately/ 3%, are well beyond the theoretically calculated threshold. Magnetic fluctuation measurements showed the effects of beta self-stabilization. They are in reasonable agreement with the predictions of the theory and support the evidence that ATF has already operated in the second stability regime. 24 refs., 20 figs., 1 tab

  13. Associated factors to self-rated health among hypertensive and/or diabetic elderly: results from Bambuí project

    Directory of Open Access Journals (Sweden)

    Antônio Ignácio de Loyola Filho

    2013-09-01

    Full Text Available Objective: This study investigated the associated factors with negative self-rated health among hypertensive and/or diabetic elderly. Methods: All the participants of Bambuí Project elderly cohort who suffered from hypertension and/or diabetes and who answered the questionnaire without the help of a close informant were selected for this (n = 942. Covariates encompassed sociodemographic characteristics, social support, health behaviors, health status and use of health services. Results: Negative self-rated health showed positively associated with dissatisfaction with social relations (PR = 1.98, 95%CI 1.42 - 2.76, attendance at religious services less than once a month (PR = 1.96, 95%CI 1.44 - 2.68; be smokers (PR = 1.64, 95%CI 1.24 - 2.17, presence of arthritis (PR = 1.35, 95%CI 1.07 - 1.71, depressive symptoms (PR = 1.81, 95%CI 1.37 - 2.39 and insomnia (PR = 1.37, 95%CI 1.06 - 1.78, having consulted the doctor two or more times in the last twelve months (PR = 2.18; 95%CI 1.14 - 4.19 and PR = 3.96; 95%CI 2.10 - 7.48, respectively for "2 - 3" and "4+" visits, and have hypertension and diabetes (compared to the isolated presence of hypertension Conclusions: Our results confirmed the multidimensional nature of self-rated health and were consistent with that observed in other national and international studies.

  14. Health behaviour advice from health professionals to Canadian adults with hypertension: results from a national survey.

    Science.gov (United States)

    Walker, Robin L; Gee, Marianne E; Bancej, Christina; Nolan, Robert P; Kaczorowski, Janusz; Joffres, Michel; Bienek, Asako; Gwadry-Sridhar, Femida; Campbell, Norman R C

    2011-01-01

    Health professionals play an important role in providing health information to patients. The objectives of this study were to examine the type of advice that Canadians with hypertension recall receiving from health professionals to manage their condition, and to assess if there is an association between health behaviour advice provided by health professionals and self-reported engagement in health behaviour modification. Respondents of the 2009 Survey on Living with Chronic Diseases in Canada (N = 6142) were asked about sociodemographic characteristics, health care utilization, and health behaviour modification to control hypertension. Association between receipt of advice from health professional and ever engaging, continuing to engage, and not engaging in health behaviour modification was quantified by prevalence rate ratios. Most participants (90.9%; 95% confidence interval [CI], 89.6-92.2) reported that the health professional most responsible for treating their high blood pressure was their general practitioner. Approximately 9% reported that they had not received or do not recall receiving any advice for blood pressure control. The most commonly reported advice received from a health professional was to participate in physical activity or exercise (70.0%). Respondents who had received advice on health behaviour change to manage their high blood pressure were more likely to report engaging in the behaviour compared with those who did not receive such advice. Many Canadians with hypertension receive health behaviour change advice from their health professionals. Receiving this advice was associated with a greater likelihood of attempting health behaviour change and attempting to sustain that change. Copyright © 2011 Canadian Cardiovascular Society. All rights reserved.

  15. Initial results of a positron tomograph for prostate imaging

    Energy Technology Data Exchange (ETDEWEB)

    Huber, J.S.; Choong, W.S.; Moses, W.W.; Qi, J.; Hu, J.; Wang,G.C.; Wilson, D.; Oh, S.; Huesman, R.H.; Derenzo, S.E.; Budinger, T.F.

    2004-11-29

    We present the status and initial images of a positrontomograph for prostate imaging that centers a patient between a pair ofexternal curved detector banks (ellipse: 45 cm minor, 70 cm major axis).The distance between detector banks adjusts to allow patient access andto position the detectors as closely as possible for maximum sensitivitywith patients of various sizes. Each bank is composed of two axial rowsof 20 CTI PET Systems HR+ block detectors for a total of 80 modules inthe camera. Compared to an ECAT HR PET system operating in 3D mode, ourcamera uses about one-quarter the number of detectors and hasapproximately the same sensitivity for a central point source, becauseour detectors are close to the patient. The individual detectors areangled in the plane to point towards the prostate to minimize resolutiondegradation in that region. The detectors are read out by modified CTIdata acquisition electronics. We have completed construction of thegantry and electronics, have developed detector calibration and dataacquisition software, and are taking coincidence data. We demonstratethat we can clearly visualize a "prostate" in a simple phantom.Reconstructed images of two phantoms are shown.

  16. Initial results of Pakistan's first road traffic injury surveillance project.

    Science.gov (United States)

    Shamim, Shahzad; Razzak, Junaid A; Jooma, Rashid; Khan, Uzma

    2011-09-01

    Our aim is to report the findings of the initial three years of road traffic injuries (RTI) surveillance at Karachi and to compare it with previously published RTI-related data from Pakistan and other low-and middle-income countries. Data were collected through the RTI surveillance programme at Karachi (RTIRP) from the five biggest emergency departments of the city, which receive almost all the major emergencies of the city for the period September 2006 till September 2009. A total of 99,272 victims were enlisted by the RTIRP during the study period. Annual incidence of RTI is calculated to be 184.3 per 100,000 populations and mortality is 5.7 per 100,000 populations. Eighty nine per cent of victims are male and 73% are between 15 and 44 years of age. Commonest road user to be affected is riders of two wheelers (45%). Only 7% of affected motorcyclists were found to be wearing helmets at the time of the accident. Trends of injuries remained uniform over the years. Most frequent injuries were external wounds, followed by orthopaedic injuries. On the basis of our surveillance system, we have presented the largest RTI-related data from a metropolitan city of Pakistan to date.

  17. Results of a randomized controlled pilot trial of intravascular renal denervation for management of treatment-resistant hypertension.

    Science.gov (United States)

    Jacobs, Lotte; Persu, Alexandre; Huang, Qi-Fang; Lengelé, Jean-Philippe; Thijs, Lutgarde; Hammer, Frank; Yang, Wen-Yi; Zhang, Zhen-Yu; Renkin, Jean; Sinnaeve, Peter; Wei, Fang-Fei; Pasquet, Agnès; Fadl Elmula, Fadl Elmula M; Carlier, Marc; Elvan, Arif; Wunder, Cora; Kjeldsen, Sverre E; Toennes, Stefan W; Janssens, Stefan; Verhamme, Peter; Staessen, Jan A

    2017-12-01

    Previous trials of catheter-based renal-artery denervation (RDN) as treatment modality in resistant hypertension (rHT) generated unconvincing results. In the Investigator-Steered Project on Intravascular Denervation for Management of Treatment-Resistant Hypertension (INSPiRED; NCT01505010), we optimized selection and management of rHT patients. With ethical clearance to randomize 18 patients, three Belgian hypertension centers screened 29 rHT patients on treatment with ≥3 drugs, of whom 17 after optimization of treatment (age efficacy endpoint, and 2.5 mL/min/1.73 m 2 (+1.5 vs. -1.1 mL/min/1.73 m 2 ; P = .86) for eGFR, the primary safety endpoint. At 6 month, ECG voltages and the number of prescribed drugs (P ≤ .036) were lower in RDN patients, but quality of life and adherence, captured by questionnaire and urine analysis were similar in both groups. Changes in BP and adherence were unrelated. No major complications occurred. The INSPiRED pilot suggests that RDN with the EnligHTN ™ system is effective and safe and generated insights useful for the design of future RDN trials.

  18. Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings.

    Science.gov (United States)

    McElfish, Pearl Anna; Rowland, Brett; Long, Christopher R; Hudson, Jonell; Piel, Michelle; Buron, Bill; Riklon, Sheldon; Bing, Williamina Ioanna; Warmack, T Scott

    2017-12-01

    The Pacific Islander population in the USA is growing rapidly. However, research on Pacific Islanders in the USA is limited, or sometimes misleading due to aggregation with Asian Americans. This project seeks to add to the dearth of health literature by conducting a health assessment of Marshallese in northwest Arkansas. Using a community-based participatory research approach, nine health screening events were conducted at local Marshallese churches. Participants completed the Behavioral Risk Factors Surveillance Survey core questionnaire and diabetes module if applicable. Biometric data, including Hemoglobin A1c, blood pressure, and body mass index, were gathered by an interprofessional team. Four hundred one participants completed health screenings. High proportions of diabetes, obesity, and hypertension were found. A high percentage of participants were uninsured, and multiple barriers to health care were found within the sample. This project represents one of the first broad health assessments of Pacific Islanders in the USA. Proportions of diabetes, hypertension, obesity, and uninsured found in the sample are much higher than national proportions.

  19. Quantitative MR imaging in fracture dating--Initial results.

    Science.gov (United States)

    Baron, Katharina; Neumayer, Bernhard; Widek, Thomas; Schick, Fritz; Scheicher, Sylvia; Hassler, Eva; Scheurer, Eva

    2016-04-01

    For exact age determinations of bone fractures in a forensic context (e.g. in cases of child abuse) improved knowledge of the time course of the healing process and use of non-invasive modern imaging technology is of high importance. To date, fracture dating is based on radiographic methods by determining the callus status and thereby relying on an expert's experience. As a novel approach, this study aims to investigate the applicability of magnetic resonance imaging (MRI) for bone fracture dating by systematically investigating time-resolved changes in quantitative MR characteristics after a fracture event. Prior to investigating fracture healing in children, adults were examined for this study in order to test the methodology for this application. Altogether, 31 MR examinations in 17 subjects (♀: 11 ♂: 6; median age 34 ± 15 y, scanned 1-5 times over a period of up to 200 days after the fracture event) were performed on a clinical 3T MR scanner (TimTrio, Siemens AG, Germany). All subjects were treated conservatively for a fracture in either a long bone or in the collar bone. Both, qualitative and quantitative MR measurements were performed in all subjects. MR sequences for a quantitative measurement of relaxation times T1 and T2 in the fracture gap and musculature were applied. Maps of quantitative MR parameters T1, T2, and magnetisation transfer ratio (MTR) were calculated and evaluated by investigating changes over time in the fractured area by defined ROIs. Additionally, muscle areas were examined as reference regions to validate this approach. Quantitative evaluation of 23 MR data sets (12 test subjects, ♀: 7 ♂: 5) showed an initial peak in T1 values in the fractured area (T1=1895 ± 607 ms), which decreased over time to a value of 1094 ± 182 ms (200 days after the fracture event). T2 values also peaked for early-stage fractures (T2=115 ± 80 ms) and decreased to 73 ± 33 ms within 21 days after the fracture event. After that time point, no

  20. The changing scene of radiology: Value of urography as initial examination in infectious and hypertensive disease, hematuria and malignant disease

    International Nuclear Information System (INIS)

    Goethlin, J.H.; Gadeholt, G.; Hoeiem, L.; Aslaksen, A.

    1988-01-01

    Four to 20% positive findings were found in a review of 1913 excretory urographics. Possibly relevant findings were 20% in patients referred for infectious disease, 10% in hypertensive disease, 6% in hematuria and 4% in neoplasms. Urography influenced treatment mainly in the 2 groups with few positive findings. The costs for positive findings may be acceptable in patients with hematuria or suspicion of neoplasms, but are too high in the other groups. Until ultrasonography can replace intravenous urography as the first screening method in upper urinary tract disease, the patient selection for urography in infectious and hypertensive disease should be improved. (orig.)

  1. Influence of Gestational Age at Initiation of Antihypertensive Therapy: Secondary Analysis of CHIPS Trial Data (Control of Hypertension in Pregnancy Study).

    Science.gov (United States)

    Pels, Anouk; Mol, Ben Willem J; Singer, Joel; Lee, Terry; von Dadelszen, Peter; Ganzevoort, Wessel; Asztalos, Elizabeth; Magee, Laura A

    2018-06-01

    For hypertensive women in CHIPS (Control of Hypertension in Pregnancy Study), we assessed whether the maternal benefits of tight control could be achieved, while minimizing any potentially negative effect on fetal growth, by delaying initiation of antihypertensive therapy until later in pregnancy. For the 981 women with nonsevere, chronic or gestational hypertension randomized to less-tight (target diastolic blood pressure, 100 mm Hg), or tight (target, 85 mm Hg) control, we used mixed-effects logistic regression to examine whether the effect of less-tight (versus tight) control on major outcomes was dependent on gestational age at randomization, adjusting for baseline factors as in the primary analysis and including an interaction term between gestational age at randomization and treatment allocation. Gestational age was considered categorically (quartiles) and continuously (linear or quadratic form), and the optimal functional form selected to provide the best fit to the data based on the Akaike information criterion. Randomization before (but not after) 24 weeks to less-tight (versus tight) control was associated with fewer babies with birth weight 48 hours ( P interaction =0.354). For the mother, less-tight (versus tight) control was associated with more severe hypertension at all gestational ages but particularly so before 28 weeks ( P interaction =0.076). In women with nonsevere, chronic, or gestational hypertension, there seems to be no gestational age at which less-tight (versus tight) control is the preferred management strategy to optimize maternal or perinatal outcomes. URL: https://www.isrctn.com. Unique identifier: ISRCTN71416914. © 2018 The Authors.

  2. Complex decision-making: initial results of an empirical study

    Directory of Open Access Journals (Sweden)

    Pier Luigi Baldi

    2011-09-01

    Full Text Available A brief survey of key literature on emotions and decision-making introduces an empirical study of a group of university students exploring the effects of decision-making complexity on error risk. The results clearly show that decision-making under stress in the experimental group produces significantly more errors than in the stress-free control group.

  3. Complex decision-making: initial results of an empirical study

    OpenAIRE

    Pier Luigi Baldi

    2011-01-01

    A brief survey of key literature on emotions and decision-making introduces an empirical study of a group of university students exploring the effects of decision-making complexity on error risk. The results clearly show that decision-making under stress in the experimental group produces significantly more errors than in the stress-free control group.

  4. Alternative multi-user interaction screen: initial ergonomic test results

    CSIR Research Space (South Africa)

    Smith, Andrew C

    2010-05-01

    Full Text Available excitement. In some instances the recording volume was too low and the recording had to be repeated. Participants were very keen to record their own sound clip and the activity would invariably result in general laughter when played back. We captured...

  5. Initial Results of a New Mobile Spectrum Occupancy Monitoring Network

    NARCIS (Netherlands)

    van Bloem, J.W.H.; Schiphorst, Roelof; Slump, Cornelis H.

    2010-01-01

    In this paper we present results of the new monitoring network for spectrum governance. The network is based on the RFeye system of CRFS where the data is collected employing mobile monitoring vehicles. The measurement data, obtained from a frequency sweep between 10 MHz and 6 GHz, is further

  6. Small-Scale Spray Releases: Initial Aerosol Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Mahoney, Lenna A.; Gauglitz, Phillip A.; Kimura, Marcia L.; Brown, Garrett N.; Kurath, Dean E.; Buchmiller, William C.; Smith, Dennese M.; Blanchard, Jeremy; Song, Chen; Daniel, Richard C.; Wells, Beric E.; Tran, Diana N.; Burns, Carolyn A.

    2013-05-29

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and across processing facilities in the DOE complex. Two key technical areas were identified where testing results were needed to improve the technical basis by reducing the uncertainty due to extrapolating existing literature results. The first technical need was to quantify the role of slurry particles in small breaches where the slurry particles may plug and result in substantially reduced, or even negligible, respirable fraction formed by high-pressure sprays. The second technical need was to determine the aerosol droplet size distribution and volume from prototypic breaches and fluids, specifically including sprays from larger breaches with slurries where data from the literature are scarce. To address these technical areas, small- and large-scale test stands were constructed and operated with simulants to determine aerosol release fractions and net generation rates from a range of breach sizes and geometries. The properties of the simulants represented the range of properties expected in the WTP process streams and included water, sodium salt solutions, slurries containing boehmite or gibbsite, and a hazardous chemical simulant. The effect of antifoam agents was assessed with most of the simulants. Orifices included round holes and

  7. Small-Scale Spray Releases: Initial Aerosol Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Mahoney, Lenna A.; Gauglitz, Phillip A.; Kimura, Marcia L.; Brown, Garrett N.; Kurath, Dean E.; Buchmiller, William C.; Smith, Dennese M.; Blanchard, Jeremy; Song, Chen; Daniel, Richard C.; Wells, Beric E.; Tran, Diana N.; Burns, Carolyn A.

    2012-11-01

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and across processing facilities in the DOE complex. Two key technical areas were identified where testing results were needed to improve the technical basis by reducing the uncertainty due to extrapolating existing literature results. The first technical need was to quantify the role of slurry particles in small breaches where the slurry particles may plug and result in substantially reduced, or even negligible, respirable fraction formed by high-pressure sprays. The second technical need was to determine the aerosol droplet size distribution and volume from prototypic breaches and fluids, specifically including sprays from larger breaches with slurries where data from the literature are scarce. To address these technical areas, small- and large-scale test stands were constructed and operated with simulants to determine aerosol release fractions and generation rates from a range of breach sizes and geometries. The properties of the simulants represented the range of properties expected in the WTP process streams and included water, sodium salt solutions, slurries containing boehmite or gibbsite, and a hazardous chemical simulant. The effect of anti-foam agents was assessed with most of the simulants. Orifices included round holes and

  8. Large-Scale Spray Releases: Initial Aerosol Test Results

    Energy Technology Data Exchange (ETDEWEB)

    Schonewill, Philip P.; Gauglitz, Phillip A.; Bontha, Jagannadha R.; Daniel, Richard C.; Kurath, Dean E.; Adkins, Harold E.; Billing, Justin M.; Burns, Carolyn A.; Davis, James M.; Enderlin, Carl W.; Fischer, Christopher M.; Jenks, Jeromy WJ; Lukins, Craig D.; MacFarlan, Paul J.; Shutthanandan, Janani I.; Smith, Dennese M.

    2012-12-01

    One of the events postulated in the hazard analysis at the Waste Treatment and Immobilization Plant (WTP) and other U.S. Department of Energy (DOE) nuclear facilities is a breach in process piping that produces aerosols with droplet sizes in the respirable range. The current approach for predicting the size and concentration of aerosols produced in a spray leak involves extrapolating from correlations reported in the literature. These correlations are based on results obtained from small engineered spray nozzles using pure liquids with Newtonian fluid behavior. The narrow ranges of physical properties on which the correlations are based do not cover the wide range of slurries and viscous materials that will be processed in the WTP and across processing facilities in the DOE complex. Two key technical areas were identified where testing results were needed to improve the technical basis by reducing the uncertainty due to extrapolating existing literature results. The first technical need was to quantify the role of slurry particles in small breaches where the slurry particles may plug and result in substantially reduced, or even negligible, respirable fraction formed by high-pressure sprays. The second technical need was to determine the aerosol droplet size distribution and volume from prototypic breaches and fluids, specifically including sprays from larger breaches with slurries where data from the literature are scarce. To address these technical areas, small- and large-scale test stands were constructed and operated with simulants to determine aerosol release fractions and generation rates from a range of breach sizes and geometries. The properties of the simulants represented the range of properties expected in the WTP process streams and included water, sodium salt solutions, slurries containing boehmite or gibbsite, and a hazardous chemical simulant. The effect of anti-foam agents was assessed with most of the simulants. Orifices included round holes and

  9. Initial results from the Donner 600-crystal positron tomograph

    International Nuclear Information System (INIS)

    Derenzo, S.E.; Huesman, R.H.; Cahoon, J.L.; Geyer, A.B.; Uber, D.C.; Vuletich, T.; Budinger, T.F.

    1987-01-01

    These results show the 3-mm BGO crystals can improve the resolution in positron tomography by a substantial factor. This measured crystal-pair resolution of 2.4 mm FWHM and the reconstructed image resolution of 2.9 mm FWHM at the center of the tomograph are in good agreement with expected values. The most serious limitation of the detector design is that only a single section can be imaged. 4 refs., 4 figs

  10. Results of initial nuclear tests on LWBR (LWBR Development Program)

    International Nuclear Information System (INIS)

    Sarber, W.K.

    1979-06-01

    This report presents and discusses the results of physics tests performed at beginning of life on the Light Water Breeder Reactor (LWBR). These tests have confirmed that movable seed assembly critical positions and reactivity worths, temperature coefficients, xenon transient characteristics, core symmetry, and core shutdown are within the range of values used in the design of the LWBR and its reactor protection analysis. Measured core physics parameters were found to be in good agreement with the calculated values

  11. Initial commissioning results from the APS loss monitor system

    International Nuclear Information System (INIS)

    Patterson, D.R.

    1996-01-01

    The design of the beam loss monitor system for the Argonne National Laboratory Advanced Photon Source is based on using a number of air dielectric coaxial cables as long ionization chambers. Results to date show that the loss monitor is useful in helping to determine the cause of injection losses and losses large enough to limit circulating currents in the storage ring to short lifetimes. Sensitivities ranging from 13 to 240 pC of charge collected in the injector BTS (booster-to-storage-ring) loss monitor per picocoulomb of loss have been measured, depending on the loss location. These results have been used to predict that the storage ring loss monitor leakage current limit of 10 pA per cable should allow detection of losses resulting in beam lifetimes of 100 hours or less with 100 mA stored beam. Significant DC bias levels associated with the presence of stored beam have been observed. These large bias levels are most likely caused by the loss monitor responding to hard x-ray synchrotron radiation. No such response to synchrotron radiation was observed during earlier tests at SSRL. However, the loss monitor response to average stored beam current in APS has provided a reasonable alternative to the DC current transformer (DCCT) for measuring beam lifetimes

  12. Emergence of hepatic fibrosis and portal hypertension in infants and children with autosomal recessive polycystic kidney disease. Initial and follow-up sonographic and radiographic findings

    Energy Technology Data Exchange (ETDEWEB)

    Premkumar, A; Berdon, W E; Abramson, S J; Newhouse, J H; Levy, J

    1988-02-01

    Long-term imaging and clinical findings are reported in six children whose polycystic kidney disease was detected in infancy or early childhood. Over time (2 years to 20 years) all patients developed portal hypertension from hepatic fibrosis, a problem primarily noted in recessive pattern polycystic kidney disease. Mild renal failure (two patients) was accompanied by serious systemic hypertension in the same patients. In one family, one of the babies also showed dilated right hepatic ducts. Imaging studies included urography and CT although recently ultrasonography was the method of choice. The relative renal and hepatic manifestations in these patients so changed with time that it would seem fallacious to attempt to use rigid classifications based on findings at initial diagnosis.

  13. Initial combination therapy with ambrisentan and tadalafil in connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH): subgroup analysis from the AMBITION trial.

    Science.gov (United States)

    Coghlan, John Gerry; Galiè, Nazzareno; Barberà, Joan Albert; Frost, Adaani E; Ghofrani, Hossein-Ardeschir; Hoeper, Marius M; Kuwana, Masataka; McLaughlin, Vallerie V; Peacock, Andrew J; Simonneau, Gérald; Vachiéry, Jean-Luc; Blair, Christiana; Gillies, Hunter; Miller, Karen L; Harris, Julia H N; Langley, Jonathan; Rubin, Lewis J

    2017-07-01

    Patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH), in particular systemic sclerosis (SSc), had an attenuated response compared with idiopathic PAH in most trials. Thus, there is uncertainty regarding the benefit of PAH-targeted therapy in some forms of CTD-PAH. To explore the safety and efficacy of initial combination therapy with ambrisentan and tadalafil versus ambrisentan or tadalafil monotherapy in patients with CTD-PAH and SSc-PAH enrolled in the AMBITION trial. This was a post hoc analysis of patients with CTD-PAH and SSc-PAH from AMBITION, an event-driven, double-blind trial in patients with WHO functional class II/III PAH. Treatment-naive patients were randomised 2:1:1 to once-daily initial combination therapy with ambrisentan plus tadalafil or monotherapy with ambrisentan or tadalafil, respectively. The primary endpoint was time to the first clinical failure event (first occurrence of death, hospitalisation for worsening PAH, disease progression or unsatisfactory long-term clinical response). In the primary analysis set (N=500), 187 patients had CTD-PAH, of whom 118 had SSc-PAH. Initial combination therapy reduced the risk of clinical failure versus pooled monotherapy in each subgroup: CTD-PAH (HR 0.43 (95% CI 0.24 to 0.77)) and SSc-PAH (0.44 (0.22 to 0.89)). The most common AE was peripheral oedema, which was reported more frequently with initial combination therapy than monotherapy in the two PAH subgroups. The relative frequency of adverse events between those on combination therapy versus monotherapy was similar across subgroups. This post hoc subgroup analysis provides evidence that CTD-PAH and SSc-PAH patients benefit from initial ambrisentan and tadalafil combination therapy. NCT01178073, post results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  14. Initial results from 50mm short SSC dipoles at Fermilab

    International Nuclear Information System (INIS)

    Bossert, R.C.; Brandt, J.S.; Carson, J.A.; Coulter, K.; Delchamps, S.; Ewald, K.D.; Fulton, H.; Gonczy, I.; Gourlay, S.A.; Jaffery, T.S.; Kinney, W.; Koska, W.; Lamm, M.J.; Strait, J.B.; Wake, M.; Gordon, M.; Hassan, N.; Sims, R.; Winters, M.

    1991-03-01

    Several short model SSC 50 mm bore dipoles are being built and tested at Fermilab. Mechanical design of these magnets has been determined from experience involved in the construction and testing of 40 mm dipoles. Construction experience includes coil winding, curing and measuring, coil end part design and fabrication, ground insulation, instrumentation, collaring and yoke assembly. Fabrication techniques are explained and construction problems are discussed. Similarities and differences from the 40 mm dipole tooling and management components are outlined. Test results from the first models are presented. 19 refs., 12 figs

  15. [Integrated intensive treatment of tinnitus: method and initial results].

    Science.gov (United States)

    Mazurek, B; Georgiewa, P; Seydel, C; Haupt, H; Scherer, H; Klapp, B F; Reisshauer, A

    2005-07-01

    In recent years, no major advances have been made in understanding the mechanisms underlying the development of tinnitus. Hence, the present therapeutic strategies aim at decoupling the subconscious from the perception of tinnitus. Mindful of the lessons drawn from existing tinnitus retraining and desensitisation therapies, a new integrated day hospital strategy of treatment lasting 7-14 days has been developed at the Charité Hospital and is presented in the present paper. The strategy for treating tinnitus in the proximity of patient domicile is designed for patients who feel disturbed in their world of perception and their efficiency due to tinnitus and give evidence of mental and physical strain. In view of the etiologically non-uniform and multiple events connected with tinnitus, consideration was also given to the fact that somatic and psychosocial factors are equally involved. Therefore, therapy should aim at diagnosing and therapeutically influencing those psychosocial factors that reduce the hearing impression to such an extent that the affected persons suffer from strain. The first results of therapy-dependent changes of 46 patients suffering from chronic tinnitus are presented. The data were evaluated before and after 7 days of treatment and 6 months after the end of treatment. Immediately after the treatment, the scores of both the tinnitus questionnaire (Goebel and Hiller) and the subscales improved significantly. These results were maintained during the 6-month post-treatment period and even improved.

  16. New results on initial state & quarkonia with ATLAS

    CERN Document Server

    Tapia Araya, Sebastian; The ATLAS collaboration

    2017-01-01

    Weak bosons do not interact strongly with the dense and hot medium formed in the nuclear collisions, thus should be sensitive to the nuclear modification of parton distribution functions (nPDFs). The in-medium modification of heavy quarkonium states plays an important role in studying the hot and dense medium formed in the larger collision systems. The ATLAS detector, optimized for searching new physics in proton-proton collisions, is especially well equipped to measure Z, W bosons and quakonium in the high occupancy environment produced in heavy-ion collisions. We will present recent results on the Z boson and quarkonia yields as a function of centrality, transverse momentum and rapidity, from the ATLAS experiment.

  17. Overview and initial results of the ETE spherical tokamak

    International Nuclear Information System (INIS)

    Berni, L.A.; Del Bosco, E.; Ferreira, J.G.; Ludwig, G.O.; Oliveira, R.M.; Shibata, C.S.; Barbosa, L.F.F.P.W.; Vilela, W.A.

    2003-01-01

    The ETE spherical tokamak is a small size aspect-ratio machine with major and minor radius of 30 cm and 20 cm, respectively. The vessel was made of Inconel 625 and provides good access for plasma diagnostics through 58 Conflat ports. The first plasma was obtained at the end of 2000 and presently plasma currents of about 45 kA lasting for about 4 ms with electron temperature up to 160 eV and densities of 2.2x10 19 m -3 are routinely obtained. Achievement of the designed parameters for the first phase of operation is expected by the end of this year, with plasma current up to 200 kA lasting for about 15 ms. This paper describes some details of the ETE project, construction and mainly the first results and analysis of basic parameters. (author)

  18. Initial Hubble Diagram Results from the Nearby Supernova Factory

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, S. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France); Aldering, G. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Antilogus, P. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France); Aragon, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Baltay, C. [Yale Univ., New Haven, CT (United States); Bongard, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Buton, C [Inst. of Nuclear Physics of Lyon (France); Childress, M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Copin, Y. [Inst. of Nuclear Physics of Lyon (France); Gangler, E. [Inst. of Nuclear Physics of Lyon (France); Loken, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Nugent, P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Pain, R. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France); Pecontal, E. [Center of Research Astrophysics of Lyon (CRAL) (France); Pereira, R. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France); Perlmutter, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rabinowitz, D. [Yale Univ., New Haven, CT (United States); Rigaudier, G. [Center of Research Astrophysics of Lyon (CRAL) (France); Ripoche, P. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France); Runge, K. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Scalzo, R. [Yale Univ., New Haven, CT (United States); Smadja, G. [Inst. of Nuclear Physics of Lyon (France); Tao, C. [Inst. of Nuclear Physics of Lyon (France); Thomas, R. C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wu, C. [Lab. Nuclear and High-Energy Physics (LPNHE), Paris (France)

    2017-07-06

    The use of Type Ia supernovae as distance indicators led to the discovery of the accelerating expansion of the universe a decade ago. Now that large second generation surveys have significantly increased the size and quality of the high-redshift sample, the cosmological constraints are limited by the currently available sample of ~50 cosmologically useful nearby supernovae. The Nearby Supernova Factory addresses this problem by discovering nearby supernovae and observing their spectrophotometric time development. Our data sample includes over 2400 spectra from spectral timeseries of 185 supernovae. This talk presents results from a portion of this sample including a Hubble diagram (relative distance vs. redshift) and a description of some analyses using this rich dataset.

  19. Temporo-spatial IMRT optimization: concepts, implementation and initial results

    International Nuclear Information System (INIS)

    Trofimov, Alexei; Rietzel, Eike; Lu Hsiaoming; Martin, Benjamin; Jiang, Steve; Chen, George T Y; Bortfeld, Thomas

    2005-01-01

    With the recent availability of 4D-CT, the accuracy of information on internal organ motion during respiration has improved significantly. We investigate the utility of organ motion information in IMRT treatment planning, using an in-house prototype optimization system. Four approaches are compared: (1) planning with optimized margins, based on motion information; (2) the 'motion kernel' approach, in which a more accurate description of the dose deposit from a pencil beam to a moving target is achieved either through time-weighted averaging of influence matrices, calculated for different instances of anatomy (subsets of 4D-CT data, corresponding to various phases of motion) or through convolution of the pencil beam kernel with the probability density function describing the target motion; (3) optimal gating, or tracking with beam intensity maps optimized independently for each instance of anatomy; and (4) optimal tracking with beam intensity maps optimized simultaneously for all instances of anatomy. The optimization is based on a gradient technique and can handle both physical (dose-volume) and equivalent uniform dose constraints. Optimization requires voxel mapping from phase to phase in order to score the dose in individual voxels as they move. The results show that, compared to the other approaches, margin expansion has a significant disadvantage by substantially increasing the integral dose to patient. While gating or tracking result in the best dose conformation to the target, the former elongates treatment time, and the latter significantly complicates the delivery procedure. The 'motion kernel' approach does not provide a dosimetric advantage, compared to optimal tracking or gating, but might lead to more efficient delivery. A combination of gating with the 'motion kernel' or margin expansion approach will increase the duty cycle and may provide one with the most efficient solution, in terms of complexity of the delivery procedure and dose conformality to

  20. Multi-slice CT urography after diuretic injection: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Nolte-Ernsting, C.C.A.; Wildberger, J.E.; Schmitz-Rode, T.; Guenther, R.W. [Technische Univ. Aachen (Germany). Dept. of Diagnostic Radiology; Borchers, H. [Technische Univ. Aachen (Germany). Dept. of Urology

    2001-03-01

    Purpose: To investigate the feasibility of CT urography (CTU) using a multi-slice (MS) scanner and to find out whether a low-dose diuretic injection is advantageous for the opacification of the urinary tract. Methods: MS-CTU was performed in 21 patients with urologic diseases. In 5/21 patients, 250 ml of physiologic saline solution were injected. In 16/21 patients, 10 mg of furosemide were injected 3-5 min before contrast material administration. A 4x2.5 mm collimation with a pitch of 1.25 and a tube curent of 100-150 mA were used. Scan time was 12-16 sec. 3 mm thin axial images with an overlap of 67% were reconstructed. Multiplanar maximum intensity projection (MIP) images were postprocessed to obtain urographic views. Bone structures were eliminated using the volume-of-interest method. Results: Furosemide-enhanced MS-CTU achieved either near complete or complete opacification in 30/32 (94%) ureters and in 32/32 (100%) pelvicaliceal systems up to a serum creatinine of 150 {mu}mol/l. In our series, only one CTU scan per patient was needed to obtain a diagnostic urogram after 10 min of contrast material injection. Ureteral compression was not necessary. When physiologic saline solution was used instead of furosemide, the radiopacity inside the enhanced pelvicalices was 4-5 times higher and more inhomogeneous. Diuretic-enhanced MS-CTU was more accurate in the depiction of pelvicaliceal details. In combination with furosemide, calculi were well identified inside the opacified urine and were safely differentiated from phleboliths. Postprocessing times of up to 20 minutes were problematic as were contrast-enhanced superimposing bowel loops on MIP images. Conclusion: Preliminary results demonstrate a good feasibility of furosemide-enhanced MS-CTU for obtaining detailed visualization of the entire upper urinary tract. (orig.) [German] Ziel: Untersuchung zur Durchfuehrbarkeit der CT Urographie (CTU) mit einem Multidetektor(MD)-Computertomographen und ob eine

  1. A prototype tap test imaging system: Initial field test results

    Science.gov (United States)

    Peters, J. J.; Barnard, D. J.; Hudelson, N. A.; Simpson, T. S.; Hsu, D. K.

    2000-05-01

    This paper describes a simple, field-worthy tap test imaging system that gives quantitative information about the size, shape, and severity of defects and damages. The system consists of an accelerometer, electronic circuits for conditioning the signal and measuring the impact duration, a laptop PC and data acquisition and processing software. The images are generated manually by tapping on a grid printed on a plastic sheet laid over the part's surface. A mechanized scanner is currently under development. The prototype has produced images for a variety of aircraft composite and metal honeycomb structures containing flaws, damages, and repairs. Images of the local contact stiffness, deduced from the impact duration using a spring model, revealed quantitatively the stiffness reduction due to flaws and damages, as well as the stiffness enhancement due to substructures. The system has been field tested on commercial and military aircraft as well as rotor blades and engine decks on helicopters. Field test results will be shown and the operation of the system will be demonstrated.—This material is based upon work supported by the Federal Aviation Administration under Contract #DTFA03-98-D-00008, Delivery Order No. IA016 and performed at Iowa State University's Center for NDE as part of the Center for Aviation Systems Reliability program.

  2. The Young Solar Analogs Project: Initial Photometric Results

    Science.gov (United States)

    Saken, Jon M.; Gray, R. O.; Corbally, C. J.

    2013-06-01

    Since 2007 we have been conducting spectroscopic monitoring of the Ca II H & K lines and G-band for a sample of 31 YSAs in order to better understand their activity cycles and variations, as well as the effects of young stars on their solar systems. The targets cover the spectral range of stars most likely to contain Earth analogs, F8-K2, and a broad enough range of ages, 0.3 Gyr - 1.5 Gyr, to investigate how activity level changes with stellar age. These studies are already showing possible evidence for activity cycles, large variations in starspot activity, and flaring events. In order to obtain a more complete picture of the nature of the stars' activity and examine the correlations between stellar brightness and chromospheric activity, we have started a complimentary campaign of photometric monitoring of these targets in Johnson B, V, and R, Stromgren v and H-alpha, with the use of a small robotic telescope dedicated to this project. This poster will present some results from the first year of photometric monitoring, focusing on the correlations between the photometric bands, and between the photometric and spectroscopic data, as well as an investigation of short-term (1-2 minutes) spectroscopic variations using data obtained earlier this year on the 1.8 m Vatican Advanced Technology Telescope (VATT).

  3. Interventional C-arm tomosynthesis for vascular imaging: initial results

    Science.gov (United States)

    Langan, David A.; Claus, Bernhard E. H.; Al Assad, Omar; Trousset, Yves; Riddell, Cyril; Avignon, Gregoire; Solomon, Stephen B.; Lai, Hao; Wang, Xin

    2015-03-01

    As percutaneous endovascular procedures address more complex and broader disease states, there is an increasing need for intra-procedure 3D vascular imaging. In this paper, we investigate C-Arm 2-axis tomosynthesis ("Tomo") as an alternative to C-Arm Cone Beam Computed Tomography (CBCT) for workflow situations in which the CBCT acquisition may be inconvenient or prohibited. We report on our experience in performing tomosynthesis acquisitions with a digital angiographic imaging system (GE Healthcare Innova 4100 Angiographic Imaging System, Milwaukee, WI). During a tomo acquisition the detector and tube each orbit on a plane above and below the table respectively. The tomo orbit may be circular or elliptical, and the tomographic half-angle in our studies varied from approximately 16 to 28 degrees as a function of orbit period. The trajectory, geometric calibration, and gantry performance are presented. We overview a multi-resolution iterative reconstruction employing compressed sensing techniques to mitigate artifacts associated with incomplete data reconstructions. In this work, we focus on the reconstruction of small high contrast objects such as iodinated vasculature and interventional devices. We evaluate the overall performance of the acquisition and reconstruction through phantom acquisitions and a swine study. Both tomo and comparable CBCT acquisitions were performed during the swine study thereby enabling the use of CBCT as a reference in the evaluation of tomo vascular imaging. We close with a discussion of potential clinical applications for tomo, reflecting on the imaging and workflow results achieved.

  4. Conditional ablation of the prorenin receptor in nephron progenitor cells results in developmental programming of hypertension.

    Science.gov (United States)

    Song, Renfang; Kidd, Laura; Janssen, Adam; Yosypiv, Ihor V

    2018-04-01

    Nephron induction during kidney development is driven by reciprocal interactions between progenitor cells (NPCs) of the cap mesenchyme (CM) and the ureteric bud (UB). The prorenin receptor (PRR) is a receptor for renin and prorenin, and an accessory subunit of the vacuolar proton pump V-ATPase. Previously, we demonstrated that conditional ablation of the PRR in Six2 + NPCs in mice (Six2 PRR -/- ) causes early neonatal death. Here, we identified genes that are regulated by PRR in Six2 + NPCs FACS-isolated from Six2 PRR -/- and control kidneys on embryonic day E15.5 using whole-genome expression analysis. Seven genes with expression in CM cells previously shown to direct kidney development, including Notch1, β-catenin, Lef1, Lhx1, Jag1, and p53, were downregulated. The functional groups within the downregulated gene set included genes involved in embryonic and cellular development, renal regeneration, cellular assembly and organization, cell morphology, death and survival. Double-transgenic Six2 PRR -/- /BatGal + mice, a reporter strain for β-catenin transcriptional activity, showed decreased β-catenin activity in the UB in vivo. Reduced PRR gene dosage in heterozygous Six2 PRR +/- mice was associated with decreased glomerular number, segmental thickening of the glomerular basement membrane with focal podocyte foot process effacement, development of hypertension and increased soluble PRR (sPRR) levels in the urine at 2 months of age. Together, these data demonstrate that NPC PRR performs essential functions during nephrogenesis via control of hierarchy of genes that regulate critical cellular processes. Both reduced nephron endowment and augmented urine sPRR likely contribute to programming of hypertension in Six2 PRR +/- mice. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  5. Mars Science Laboratory: Mission, Landing Site, and Initial Results

    Science.gov (United States)

    Grotzinger, John; Blake, D.; Crisp, J.; Edgett, K.; Gellert, R.; Gomez-Elvira, J.; Hassler, D.; Mahaffy, P.; Malin, M.; Meyer, M.; Mitrofanov, I.; Vasavada, A.; Wiens, R.

    2012-10-01

    Scheduled to land on August 5, 2012, the Mars Science Laboratory rover, Curiosity, will conduct an investigation of modern and ancient environments. Recent mission results will be discussed. Curiosity has a lifetime of at least one Mars year ( 23 months), and drive capability of at least 20 km. The MSL science payload was specifically assembled to assess habitability and includes a gas chromatograph-mass spectrometer and gas analyzer that will search for organic carbon in rocks, regolith fines, and the atmosphere; an x-ray diffractometer that will determine mineralogical diversity; focusable cameras that can image landscapes and rock/regolith textures in natural color; an alpha-particle x-ray spectrometer for in situ determination of rock and soil chemistry; a laser-induced breakdown spectrometer to remotely sense the chemical composition of rocks and minerals; an active neutron spectrometer designed to search for water in rocks/regolith; a weather station to measure modern-day environmental variables; and a sensor designed for continuous monitoring of background solar and cosmic radiation. The 155-km diameter Gale Crater was chosen as Curiosity’s field site based on several attributes: an interior mound of ancient flat-lying strata extending almost 5 km above the elevation of the landing site; the lower few hundred meters of the mound show a progression with relative age from clay-bearing to sulfate-bearing strata, separated by an unconformity from overlying likely anhydrous strata; the landing ellipse is characterized by a mixture of alluvial fan and high thermal inertia/high albedo stratified deposits; and a number of stratigraphically/geomorphically distinct fluvial features. Gale’s regional context and strong evidence for a progression through multiple potentially habitable environments, represented by a stratigraphic record of extraordinary extent, insure preservation of a rich record of the environmental history of early Mars.

  6. Initial results from the newborn hearing screening programme in Ireland.

    LENUS (Irish Health Repository)

    O'Connor, A

    2013-03-02

    INTRODUCTION: Hearing screening programmes aim to detect hearing loss in the neonate. The Health Service Executive (HSE) South was the first phase of a national roll-out of a neonatal hearing screening programme in Ireland, going live on 28 April 2011. RESULTS: Over 11,738 babies have been screened for permanent childhood hearing impairment (PCHI) during the first 12 months. The percentage of eligible babies offered hearing screening was 99.2 %. Only 0.2 % (n = 25) of those offered screening declined. 493 (4 %) were referred for immediate diagnostic audiological assessment. The average time between screen and diagnostic audiology appointment was 2 weeks. 15 (1.3\\/1,000) babies have been identified with a PCHI over the 12-month period. 946 (4 %) babies screened were admitted to the neonatal intensive care unit (NICU) for >48 h. The prevalance of PCHI is 7.3\\/1,000 in the NICU population compared to 0.6\\/1000 in the well baby population. 214 (1.8 % of total babies screened) had a clear response in the screening programmes, but were deemed to be at risk of an acquired childhood hearing impairment. These babies will be reassessed with a diagnostic audiology appointment at 8-9 months of age. To date, there is one case of acquired hearing impairment through this targeted follow-up screen. Of the 15 cases of PCHI identified, 8 (53 %) of these had one or more risk factors for hearing loss and 7 (37 %) were admitted to the NICU for >48 h. Four babies were referred for assessment at the National Cochlear Implant Centre.

  7. Changes in science classrooms resulting from collaborative action research initiatives

    Science.gov (United States)

    Oh, Phil Seok

    Collaborative action research was undertaken over two years between a Korean science teacher and science education researchers at the University of Iowa. For the purpose of realizing science learning as envisioned by constructivist principles, Group-Investigations were implemented three or five times per project year. In addition, the second year project enacted Peer Assessments among students. Student perceptions of their science classrooms, as measured by the Constructivist Learning Environment Survey (CLES), provided evidence that the collaborative action research was successful in creating constructivist learning environments. Student attitudes toward science lessons, as examined by the Enjoyment of Science Lessons Scale (ESLS), indicated that the action research also contributed to developing more positive attitudes of students about science learning. Discourse analysis was conducted on video-recordings of in-class presentations and discussions. The results indicated that students in science classrooms which were moving toward constructivist learning environments engaged in such discursive practices as: (1) Communicating their inquiries to others, (2) Seeking and providing information through dialogues, and (3) Negotiating conflicts in their knowledge and beliefs. Based on these practices, science learning was viewed as the process of constructing knowledge and understanding of science as well as the process of engaging in scientific inquiry and discourse. The teacher's discursive practices included: (1) Wrapping up student presentations, (2) Addressing misconceptions, (3) Answering student queries, (4) Coaching, (5) Assessing and advising, (6) Guiding students discursively into new knowledge, and (7) Scaffolding. Science teaching was defined as situated acts of the teacher to facilitate the learning process. In particular, when the classrooms became more constructivist, the teacher intervened more frequently and carefully in student activities to fulfill a

  8. [Initial results of the Erfurt Prevention of Prematurity Campaign].

    Science.gov (United States)

    Hoyme, U B; Grosch, A; Roemer, V M; Saling, E

    1998-01-01

    identification of women at risk for prematurity. Earliest possible intervention by the obstetrician appears to result in reducing the rate of prematures and in particular of very early prematures (< 32 + 0 weeks).

  9. Renal sympathetic denervation in hypertension.

    Science.gov (United States)

    Doumas, Michael; Faselis, Charles; Papademetriou, Vasilios

    2011-11-01

    Despite the abundance of antihypertensive drugs, resistant hypertension remains a major clinical problem. Recent technological advances render interventional management of resistant hypertension one of the hottest topics in the hypertension field. The aim of this review is to present the pathophysiologic background and the mechanisms mediating blood pressure reduction after renal sympathetic denervation, to analyze recent findings with this fascinating approach and to critically suggest future research directions. Catheter-based, ablation-induced renal sympathetic denervation was initially studied in 45 patients with resistant hypertension in a proof-of-concept study. Impressive blood pressure reductions of about 30/15  mmHg were achieved at 6 months, without serious complications. A second, controlled, randomized (but not blinded) study confirmed the results, verifying the efficacy and safety of the procedure. A recent report revealed the 2-year durability of blood pressure reduction. Data published so far indicate that ablation-induced renal denervation is a feasible, effective, and well tolerated interventional approach for the management of resistant hypertension. The groundbreaking studies of renal denervation in drug-resistant hypertension pave the way for further research in other disease conditions in which sympathetic overactivity seems to play a critical role. This initial wave of enthusiasm needs to be followed by rigorous investigation, for the proper identification of the potential and the limitations, indications, and contraindications of this approach.

  10. Lesion insertion in the projection domain: Methods and initial results

    International Nuclear Information System (INIS)

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Yu, Zhicong; Ma, Chi; McCollough, Cynthia

    2015-01-01

    Purpose: To perform task-based image quality assessment in CT, it is desirable to have a large number of realistic patient images with known diagnostic truth. One effective way of achieving this objective is to create hybrid images that combine patient images with inserted lesions. Because conventional hybrid images generated in the image domain fails to reflect the impact of scan and reconstruction parameters on lesion appearance, this study explored a projection-domain approach. Methods: Lesions were segmented from patient images and forward projected to acquire lesion projections. The forward-projection geometry was designed according to a commercial CT scanner and accommodated both axial and helical modes with various focal spot movement patterns. The energy employed by the commercial CT scanner for beam hardening correction was measured and used for the forward projection. The lesion projections were inserted into patient projections decoded from commercial CT projection data. The combined projections were formatted to match those of commercial CT raw data, loaded onto a commercial CT scanner, and reconstructed to create the hybrid images. Two validations were performed. First, to validate the accuracy of the forward-projection geometry, images were reconstructed from the forward projections of a virtual ACR phantom and compared to physically acquired ACR phantom images in terms of CT number accuracy and high-contrast resolution. Second, to validate the realism of the lesion in hybrid images, liver lesions were segmented from patient images and inserted back into the same patients, each at a new location specified by a radiologist. The inserted lesions were compared to the original lesions and visually assessed for realism by two experienced radiologists in a blinded fashion. Results: For the validation of the forward-projection geometry, the images reconstructed from the forward projections of the virtual ACR phantom were consistent with the images physically

  11. Lesion insertion in the projection domain: Methods and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Baiyu; Leng, Shuai; Yu, Lifeng; Yu, Zhicong; Ma, Chi; McCollough, Cynthia, E-mail: mccollough.cynthia@mayo.edu [Department of Radiology, Mayo Clinic, Rochester, Minnesota 55905 (United States)

    2015-12-15

    Purpose: To perform task-based image quality assessment in CT, it is desirable to have a large number of realistic patient images with known diagnostic truth. One effective way of achieving this objective is to create hybrid images that combine patient images with inserted lesions. Because conventional hybrid images generated in the image domain fails to reflect the impact of scan and reconstruction parameters on lesion appearance, this study explored a projection-domain approach. Methods: Lesions were segmented from patient images and forward projected to acquire lesion projections. The forward-projection geometry was designed according to a commercial CT scanner and accommodated both axial and helical modes with various focal spot movement patterns. The energy employed by the commercial CT scanner for beam hardening correction was measured and used for the forward projection. The lesion projections were inserted into patient projections decoded from commercial CT projection data. The combined projections were formatted to match those of commercial CT raw data, loaded onto a commercial CT scanner, and reconstructed to create the hybrid images. Two validations were performed. First, to validate the accuracy of the forward-projection geometry, images were reconstructed from the forward projections of a virtual ACR phantom and compared to physically acquired ACR phantom images in terms of CT number accuracy and high-contrast resolution. Second, to validate the realism of the lesion in hybrid images, liver lesions were segmented from patient images and inserted back into the same patients, each at a new location specified by a radiologist. The inserted lesions were compared to the original lesions and visually assessed for realism by two experienced radiologists in a blinded fashion. Results: For the validation of the forward-projection geometry, the images reconstructed from the forward projections of the virtual ACR phantom were consistent with the images physically

  12. [Mesenteric-cava shunt's results with autologous jugular vein graft in children with pre-sinusoidal portal hypertension].

    Science.gov (United States)

    Leal, N; López Santamaría, M; Gámez, M; Murcia, J; Andolfi, G; Berrocal, T; Frauca, E; Jara, P; Tovar, J

    2002-07-01

    Presinusoidal portal hypertension (PPH) in children evaluates without functional hepatic damage, and with the time, trends to compensate through the creation of spontaneous portosystemic shunts. Nevertheless, some patients suffer episodes of gastrointestinal bleeding (GIB) that because of its frequency or severity, force to propose the change of surgical treatment. To evaluate the results of the mesocaval shunt (MCS) with autologous jugular vein in children with PPH. Among the 32 children with PPH treated in our Hospital in the last 7 years, 10 had episodes of GIB that forced to perform a surgical shunt. The types of shunt were distal splenorenal in 3 patients and mesocaval in 7. These 7 cases are the material of this study. The origin of the PPH was a cavernomatosis transformation of the portal vein in 6 cases and a congenital hepatic fibrosis in 1. Before the surgery the average number of episodes of GIB was 9 (range 2-15); all the patients needed transfusion of blood products and variceal sclerosis. In 2 cases a tamponade with the Sengtaken balloon was required and 5 patients were treated with somatostatin and propranolol. The Doppler ultrasounds revealed and intense hepatofugal collateral circulation in all the cases. The initial flow through the shunt was adequate in all the patients except one who required a percutaneous balloon dilatation. Only this patient has suffered an episode of GIB. The hyperesplenism signs disappeared or improved in all the seven cases and the collateral circulation was significantly reduced. The pressure in the splenic territory decreased around 50% in the 4 patients that was measured. There were no cases of encephalopasty and only one child with congenital hepatic fibrosis shows signs of mild hepatic disfunction. The medium follow up post-shunt is 32 months (range 8 m-6 years). The MCS prevents the GIB in the PPH not responsive to the conservative treatment; its effectiveness is related with an adequate permeability though the graft

  13. Association between Anthropometric Measures and Indicators for Hypertension Control among Kazakh-Chinese Hypertension Patients in Xinjiang, China: Results from a Cross-sectional Study.

    Directory of Open Access Journals (Sweden)

    Qinghua Zhang

    Full Text Available Among Kazakh-Chinese population in Xinjiang province of China, prevalence of obesity and hypertension were 40.1% and 50.3% respectively, the highest across all ethnic groups residing in this pastureland. Despite this, there remained a dearth of information regarding the association between the anthropometric measures [body mass index (BMI, waist circumference (WC, waist-hip ratio (WHR, Waist-to-height ratio (WHtR etc.] and indicators for hypertension control [achieved levels of systolic and diastolic blood pressures (SBP and DBP, pulse pressure index (PPI, ankle-brachial index (ABI etc.] among them.A cross-sectional study was conducted in Xinjiang to determine the distribution and inter-relationships of the anthropometric measures and indicators for achieved BP control as well as their predictors among hypertension patients of Kazakh-Chinese ethnicity. Out of 550 randomly selected patients, 516 completed the interview, anthropometry and BP assessments.In the sample population, average SBP, DBP and PP were 156.26±24.40mmHg, 87.55±14.73mmHg and 68.71±19.39mmHg respectively. Bivariate analysis identified age, gender, education, duration of hypertension, WC and BMI being factors influencing the achieved levels of BP. Adjusted multiple linear regression models elicited positive associations of age (βa = 0.152, p = 0.001 and duration of hypertension (βa = 0.132, p = 0.003 with achieved level of SBP as well as BMI (βa = 0.135, p = 0.002 with DBP. Age (βa = 0.207, p<0.001 and WHtR (βa = 0.304, p = 0.005 were positively and WC (βa = -0.406, p<0.001 was negatively associated with PPI. Increasing age (βa = -0.125, p = 0.005, female gender (βa = -0.122, p = 0.005 and 5years' duration of hypertension (βa = -0.091, p<0.039 were negatively associated with ABI. After adjustment for socio-demographic variables, hypertensive patients with (reference = without abdominal obesity had 93% (p = 0.013 higher odds of missing the target BP control

  14. Road traffic noise and hypertension: results from a cross-sectional public health survey in southern Sweden

    Directory of Open Access Journals (Sweden)

    Östergren Per-Olof

    2009-09-01

    Full Text Available Abstract Background Results from studies of road traffic noise and hypertension are heterogeneous with respect to effect size, effects among males and females and with respect to effects across age groups. Our objective was to further explore these associations. Methods The study used cross-sectional public health survey data from southern Sweden, including 24,238 adults (18 - 80 years old. We used a geographic information system (GIS to assess the average road noise (LAeq 24 hr at the current residential address. Effects on self-reported hypertension were estimated by logistic regression with adjustment for age, sex, BMI, alcohol intake, exercise, education, smoking and socioeconomic status. Results Modest exposure effects (OR ≈ 1.1 were generally noted in intermediate exposure categories (45 -64 dB(A, and with no obvious trend. The effect was more pronounced at > 64 dB(A (OR 1.45, 95% CI 1.04 - 2.02. Age modified the relative effect (p = 0.018. An effect was seen among middle-aged (40 - 59 years old at noise levels 60 - 64 dB(A (OR = 1.27, 95% CI 1.02 - 1.58 and at > 64 dB(A (OR = 1.91, 95% CI 1.19 - 3.06. An effect was also indicated among younger adults but not among elderly. No apparent effect modification by gender, country of origin, disturbed sleep or strained economy was noted. Conclusion The study supports an association between road traffic noise at high average levels and self-reported hypertension in middle-aged. Future studies should use age group -specific relative effect models to account for differences in prevalence.

  15. Effects of social intervention on detection and efficacy of treatment for arterial hypertension. Main results of the Polish Four Cities Programme.

    Science.gov (United States)

    Zdrojewski, Tomasz; Głuszek, Jerzy; Posadzy-Małaczyńska, Anna; Drygas, Wojciech; Ornoch-Tabedzka, Małgorzata; Januszko, Wiktor; Tykarski, Andrzej; Dylewicz, Piotr; Kwaśniewska, Magdalena; Krupa-Wojciechowska, Barbara; Wyrzykowski, Bogdan

    2004-12-01

    Cardiovascular diseases are the main cause of death in the adult Polish population. Beside lipid disorders and cigarette smoking, hypertension represents the most important risk factor leading to cardiovascular complications. Representative studies conducted in Poland in 1994-2002 showed that in 2002 the number of respondents in the survey who stated they knew their own blood pressure values dropped by 3.5 million, compared with 1994. This decrease was predominantly seen in small towns and in the countryside. Preventive programmes should therefore be addressed mainly to the most vulnerable communities. Modern methods of social marketing may play a substantial role in the creation of a healthy lifestyle. The aim of the Polish Four Cities Programme (PP4M), conducted in 2000-2001, was to develop the most effective methods of detection of and improvement in treatment for hypertension among the residents of small towns and rural areas. One of the programme tasks was to compare the effectiveness of a standard medical screening intervention with a similar approach combined with the use of social marketing methods.Methods. The programme was conducted by an interdisciplinary team in three small Polish towns -- Kartuzy, Oborniki Wlkp. and Braniewo, as well as in one of the districts of a large city Łódź -- Olechów. Medical intervention combined with social marketing (community intervention) took place in Oborniki Wlkp. whereas the residents of Kartuzy and Łódź were subjected only to the traditional medical intervention. Braniewo served as a control location -- neither medical nor community intervention was implemented. Community intervention with elements of social marketing consisted of a three-month, intensive education and information campaign, initiated four weeks prior to the start of medical intervention. Epidemiological situation was assessed in all the four cities before and after the completion of the preventive interventions (screening), using representative

  16. Blood pressure normalization by fixed perindopril/indapamide combination in hypertensive patients with or without associate metabolic syndrome: results of the OPTIMAX 2 study

    Directory of Open Access Journals (Sweden)

    Jean-Jacques Mourad

    2008-04-01

    Full Text Available Jean-Jacques Mourad1, Dulce Lameira1, Pierre-Jean Guillausseau21APHP, Service de Médecine interne, Hôpital Avicenne, Bobigny, France; 2APHP, Service de Médecine B, Hôpital Lariboisière, et Université Paris, Paris, FranceAbstract: The aim of the observational pharmaco-epidemiological study Optimax II was to seek whether the pre-existence of a metabolic syndrome (MS defi ned by the NCEP-ATP III criteria impacts blood pressure (BP control in hypertensive patients receiving a fixed perindopril/indapamide combination therapy. The primary objective of the study was to compare in patients with and without MS the rate of BP control defined as a systolic BP ≤140 mmHg and a diastolic BP ≤90 mmHg. Patients were prospectively included and the follow-up lasted 6 months. The study population consisted of 24,069 hypertensive patients (56% men; mean age 62 ± 11 years; 18% diabetics; mean BP at inclusion 162 ± 13/93 ± 9 mmHg. MS was found in 30.4% of the patients (n = 7322: 35.2% women and 20.1% men. Three therapeutic subgroups were constituted: Group A, previously untreated, received the combination therapy as initial treatment; Group B, previously treated but with unsatisfactory results and/or treatment intolerance, had its previous treatment switched to perindopril/indapamide; and Group C, previously treated, with good treatment tolerance but uncontrolled BP, received the study treatment in adjunction to the previous one. The normalization rate was 70.3% in group A, 68.4% in Group B, and 64.1% in Group C (p < 0.0001. The pre-existence of MS did not show any significant influence on these rates since BP lowering was –22.7 ± 13.7 (SBP and –12.0 ± 10.0 mmHg (DBP in patients without MS and –22.6 ± 13.3 (SBP and −12.1 ± 9.7 (DBP in those with MS. The results of this study show a significant effect of perindopril/indapamide treatment on systolic BP lowering, whatever the treatment status: initiation, switch, or adjunctive therapy, and

  17. Long-term follow-up results of percutaneous balloon mitral valvuloplasty in mitral stenosis with severe pulmonary hypertension

    International Nuclear Information System (INIS)

    Hu Haibo; Jiang Shiliang; Dai Ruping; Huang Lianjun; Xu Zhongying; Zhao Shihua; Zheng Hong; Ling Jian; Xie Ruolan

    2002-01-01

    Objective: To assess long-term results (more than 5-year) after percutaneous balloon mitral valvuloplasty (PBMV) on mitral stenosis (MS) with severe pulmonary hypertension. Methods: Thirty patients after PBMV underwent critical evaluations including echocardiography, chest film and clinical status throughout the follow-up period (6.4 +- 1.4 years). Results: Before and after PBMV and at follow-up, mean mitral valve areas were (1.19 +- 0.32) cm 2 vs (1.99 +- 0.45) cm 2 vs (1.44 +- 0.42) cm 2 respectively (P<0.01 respectively). Restenosis rate was 53.3% at the end of follow-up. There were twenty-eight (93.3%) patients who obtained at least I class (NYHA class) improvement in cardiac function shortly after PBMV. At the end of follow-up, twenty-two (73.3%) patients were still in class I or II without mitral re-operation or repeated valvuloplasty. Conclusions: Long-term follow-up results after PBMV in mitral stenosis with severe pulmonary hypertension was satisfied, and PBMV can be an excellent therapy to improve the clinical status of such patients

  18. Quantitative analysis of pulmonary perfusion using time-resolved parallel 3D MRI - initial results

    International Nuclear Information System (INIS)

    Fink, C.; Buhmann, R.; Plathow, C.; Puderbach, M.; Kauczor, H.U.; Risse, F.; Ley, S.; Meyer, F.J.

    2004-01-01

    Purpose: to assess the use of time-resolved parallel 3D MRI for a quantitative analysis of pulmonary perfusion in patients with cardiopulmonary disease. Materials and methods: eight patients with pulmonary embolism or pulmonary hypertension were examined with a time-resolved 3D gradient echo pulse sequence with parallel imaging techniques (FLASH 3D, TE/TR: 0.8/1.9 ms; flip angle: 40 ; GRAPPA). A quantitative perfusion analysis based on indicator dilution theory was performed using a dedicated software. Results: patients with pulmonary embolism or chronic thromboembolic pulmonary hypertension revealed characteristic wedge-shaped perfusion defects at perfusion MRI. They were characterized by a decreased pulmonary blood flow (PBF) and pulmonary blood volume (PBV) and increased mean transit time (MTT). Patients with primary pulmonary hypertension or eisenmenger syndrome showed a more homogeneous perfusion pattern. The mean MTT of all patients was 3.3 - 4.7 s. The mean PBF and PBV showed a broader interindividual variation (PBF: 104-322 ml/100 ml/min; PBV: 8 - 21 ml/100 ml). Conclusion: time-resolved parallel 3D MRI allows at least a semi-quantitative assessment of lung perfusion. Future studies will have to assess the clinical value of this quantitative information for the diagnosis and management of cardiopulmonary disease. (orig.) [de

  19. Spironolactone versus sympathetic renal denervation to treat true resistant hypertension: results from the DENERVHTA study – a randomized controlled trial

    Science.gov (United States)

    Oliveras, Anna; Armario, Pedro; Clarà, Albert; Sans-Atxer, Laia; Vázquez, Susana; Pascual, Julio; De la Sierra, Alejandro

    2016-01-01

    Objective: Both renal denervation (RDN) and spironolactone have been proposed for the treatment of resistant hypertension. However, they have not been compared in a randomized clinical trial. We aimed to compare the efficacy of spironolactone versus RDN in patients with resistant hypertension. Methods: A total of 24 patients with office SBP at least 150 mmHg and 24-h SBP at least 140 mmHg despite receiving at least three full-dose antihypertensive drugs, one a diuretic, but without aldosterone antagonists, were randomized to receive RDN or spironolactone (50 mg) as add-on therapy. Primary endpoint was change in 24-h SBP at 6 months. Comparisons between treatment groups were performed using generalized linear models adjusted by age, sex, and baseline values. Results: Spironolactone was more effective than RDN in reducing 24-h SBP and 24-h DBP: mean baseline-adjusted differences between the two groups were −17.9 mmHg (95%CI −30.9 to −4.9); P = 0.010 and −6.6 mmHg (95%CI −12.9 to −0.3); P = 0.041, for 24-h SBP and 24-h DBP, respectively. As regards changes in office blood pressure, mean baseline-adjusted differences between the two groups were −12.1 mmHg (95%CI −29.1 to 5.1); P = 0.158 and of −5.3 mmHg (95%CI −16.3 to 5.8); P = 0.332, for office SBP and office DBP, respectively. Otherwise, the decrease of estimated glomerular filtration rate was greater in the spironolactone group; mean baseline-adjusted difference between the two groups was −10.7 ml/min per 1.73 m2 (95%CI −20.1 to −1.4); P = 0.027. Conclusion: We conclude that spironolactone is more effective than RDN to reduce 24-h SBP and 24-h DBP in patients with resistant hypertension. Therefore, spironolactone should be the fourth antihypertensive drug to prescribe if deemed well tolerated’ in all patients with resistant hypertension before considering RDN. PMID:27327441

  20. Ocular Hypertension

    Science.gov (United States)

    ... Español Eye Health / Eye Health A-Z Ocular Hypertension Sections What Is Ocular Hypertension? Ocular Hypertension Causes ... Hypertension Diagnosis Ocular Hypertension Treatment What Is Ocular Hypertension? Leer en Español: ¿Qué es la hipertensión ocular? ...

  1. Percutaneous device closure of patent ductus arteriosus with pulmonary artery hypertension: long-term results.

    Science.gov (United States)

    Vijayalakshmi, Ishwarappa Balekundri; Setty, Natraj; Narasimhan, Chitra; Singla, Vivek; Manjunath, Cholenahalli Nanjappa

    2014-12-01

    Device closure of patent ductus arteriosus (PDA) is treatment of choice. But device closure in presence of pulmonary artery hypertension (PAH) remains a challenge. Data on patient selection, technical considerations, and complications are limited. To know the challenges and efficacy of device closure of PDA with PAH. Out of 1,325 cases of device closure of PDA, 246 (18.6%) with PAH formed the study material. To test the feasibility, chosen device is used to occlude PDA for ten minutes without oxygen inhalation. The device is released only if PAH reduced. PAH decreased in all except in 1 patient after closure with muscular ventricular septal occluder (MVSDO), pulmonary artery pressure (PAP) transiently increased (became supra-systemic), without significant reduction in aortic pressure. Device embolized in 8 patients (3.3%). Percutaneous retrieval was done in 4 (by snare in 2 and by fixing the cable to device in 2) and replaced with bigger devices. The surgical removal of the embolized MVSDO and ligation was done in 4 cases. All patients were on oral sildenafil and bosentan until PAP regressed to normal. Follow up was from 6 months to 9 years. No residual shunt in any patient on follow-up. The PAP regressed to normal in all except 5 cases (2.03%) of Down's syndrome with systemic PAP. Device closure of PDA with PAH is feasible, safe in all age groups. Temporary PDA occlusion with device is effective and time saving for evaluating pulmonary vascular reactivity. Device embolization in aorta is higher with severe PAH. Novel method of retrieval is effective. © 2014, Wiley Periodicals, Inc.

  2. Isolated Diastolic Hypertension among Adults in Saudi Arabia: Prevalence, Risk Factors, Predictors and Treatment. Results of a National Survey

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    Abdalla Abdelwahid Saeed

    2016-02-01

    Full Text Available Background: In the past, diastolic hypertension was the main criterion for treatment, but currently, systolic pressure is the main criterion because it was thought that Isolated Diastolic Hypertension (IDH is not associated with complications. Studies later revealed that IDH carries significant risks. Quantifying the magnitude and risk factors of IDH in the community is essential for all intervention strategies. Aims: This study aims to determine the prevalence, risk factors, predictors, treatment modalities and lifestyle practices of IDH adult patients in the Kingdom of Saudi Arabia (KSA. Study Design: Cross-sectional study. Methods: A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample was carried out. Data were collected using questionnaires which included socio-demographics, blood pressure, biochemical, anthropometric measurements and lifestyle practices. Statistical analysis included calculating means and standard deviations, proportions, univariate and multiple logistic regression analysis. Results: Of a total 4562 subjects, 180 (3.95% suffered from IDH, which was significantly related to age, gender, employment, smoking, diabetes mellitus, obesity and hypercholesterolemia. More than 93% were using some form of treatment, with 77.2% on prescribed drugs, 63% using diet, and 23% using exercise. Significant predictors of IDH were retirement and hypercholesterolemia. Conclusion: IDH is associated with some sociodemographic characteristics and co-morbidity. Given the risk of cardiovascular disease associated with IDH, the findings of this study emphasize the need for diagnosing the disease in middle-aged persons focusing on the modifiable risk factors of IDH.

  3. Higher self-reported prevalence of hypertension among Moluccan-Dutch than among the general population of The Netherlands: results from a cross-sectional survey.

    Science.gov (United States)

    van der Wal, Junus M; Bodewes, Adee J; Agyemang, Charles O; Kunst, Anton E

    2014-12-15

    Several studies in The Netherlands revealed ethnic disparities in hypertension prevalence, but none have focused on the Moluccan-Dutch, a migrant group from Indonesia that settled in The Netherlands in 1951. The Moluccan-Dutch are considered to be fairly well integrated in Dutch society. The aim of this study was to compare hypertension prevalence among the Moluccan-Dutch to the native Dutch and to explore the contribution of known risk factors. A health interview survey was conducted from August 2012 till March 2013 among nineteen Moluccan neighborhoods, resulting in the inclusion of 708 participants. The primary outcome variable was self-reported prevalence of hypertension. Explanatory variables were BMI, exercise, smoking, alcohol intake and mental health status. Data on the control group was extracted from the Dutch National Health Survey 2011, using a similar questionnaire. Differences in risk factor exposure were explored using Chi-square tests and the contribution of risk factors, separately and combined, was explored using multivariate logistic regression analysis. Moluccan-Dutch showed higher odds for reporting hypertension when compared to native Dutch, after adjusting for age and level of education (OR = 1.38; 95% CI = 1.13-1.69) and additional risk factors (OR = 1.49; 95% CI = 1.19-1.88). A higher prevalence of hypertension was found in both Moluccan-Dutch men (26.4% vs. 16.7%; p Dutch men showed higher prevalence of hypertension. The Moluccan-Dutch may be at increased risk for reporting hypertension. These results suggest that long-term stay over several generations does not necessarily result in similar levels of hypertension prevalence as the host population.

  4. Renal denervation in patients with resistant hypertension: six-month results.

    Science.gov (United States)

    Dores, Hélder; de Sousa Almeida, Manuel; de Araújo Gonçalves, Pedro; Branco, Patrícia; Gaspar, Augusta; Sousa, Henrique; Canha Gomes, Angela; Andrade, Maria João; Carvalho, Maria Salomé; Campante Teles, Rui; Raposo, Luís; Mesquita Gabriel, Henrique; Pereira Machado, Francisco; Mendes, Miguel

    2014-04-01

    Increased activation of the sympathetic nervous system plays a central role in the pathophysiology of hypertension (HTN). Catheter-based renal denervation (RDN) was recently developed for the treatment of resistant HTN. To assess the safety and efficacy of RDN for blood pressure (BP) reduction at six months in patients with resistant HTN. In this prospective registry of patients with essential resistant HTN who underwent RDN between July 2011 and May 2013, the efficacy of RDN was defined as ≥ 10 mm Hg reduction in office systolic blood pressure (SBP) six months after the intervention. In a resistant HTN outpatient clinic, 177 consecutive patients were evaluated, of whom 34 underwent RDN (age 62.7 ± 7.6 years; 50.0% male). There were no vascular complications, either at the access site or in the renal arteries. Of the 22 patients with complete six-month follow-up, the response rate was 81.8% (n=18). The mean office SBP reduction was 22 mm Hg (174 ± 23 vs. 152 ± 22 mm Hg; p<0.001) and 9 mm Hg in diastolic BP (89 ± 16 vs. 80 ± 11 mm Hg; p=0.006). The number of antihypertensive drugs (5.5 ± 1.0 vs. 4.6 ± 1.1; p=0.010) and pharmacological classes (5.4 ± 0.7 vs. 4.6 ± 1.1; p=0.009) also decreased significantly. Of the 24-hour ambulatory BP monitoring and echocardiographic parameters analyzed, there were significant reductions in diastolic load (45 ± 29 vs. 27 ± 26%; p=0.049) and in left ventricular mass index (174 ± 56 vs. 158 ± 60 g/m(2); p=0.014). In this cohort of patients with resistant HTN, RDN was safe and effective, with a significant BP reduction at six-month follow-up. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  5. Effects of oral conjugated equine estrogens with or without medroxyprogesterone acetate on incident hypertension in the Women's Health Initiative hormone therapy trials.

    Science.gov (United States)

    Swica, Yael; Warren, Michelle P; Manson, JoAnn E; Aragaki, Aaron K; Bassuk, Shari S; Shimbo, Daichi; Kaunitz, Andrew; Rossouw, Jacques; Stefanick, Marcia L; Womack, Catherine R

    2018-01-29

    The aim of the study was to determine the effect of menopausal hormone therapy on incident hypertension in the two Women's Health Initiative hormone therapy trials and in extended postintervention follow-up. A total of 27,347 postmenopausal women aged 50 to 79 years were enrolled at 40 US centers. This analysis includes the subsample of 18,015 women who did not report hypertension at baseline and were not taking antihypertensive medication. Women with an intact uterus received conjugated equine estrogens (CEE; 0.625 mg/d) plus medroxyprogesterone acetate (MPA; 2.5 mg/d) (n = 5,994) or placebo (n = 5,679). Women with prior hysterectomy received CEE alone (0.625 mg/d) (n = 3,108) or placebo (n = 3,234). The intervention lasted a median of 5.6 years in the CEE plus MPA trial and 7.2 years in the CEE-alone trial with 13 years of cumulative follow-up until September 30, 2010. The primary outcome for these analyses was self-report of a new diagnosis of hypertension and/or high blood pressure requiring treatment with medication. During the CEE and CEE plus MPA intervention phase, the rate of incident hypertension was 18% higher for intervention than for placebo (CEE: hazard ratio [HR], 1.18; 95% CI, 1.09-1.29; CEE plus MPA: HR, 1.18; 95% CI, 1.09-1.27). This effect dissipated postintervention in both trials (CEE: HR, 1.06; 95% CI, 0.94-1.20; CEE plus MPA: HR, 1.02; 95% CI, 0.94-1.10). CEE (0.625 mg/d) administered orally, with or without CEE plus MPA, is associated with an increased risk of hypertension in older postmenopausal women. Whether lower doses, different estrogen formulations, or transdermal route of administration offer lower risks warrant further study.

  6. Iterative study of renal functions by the continuous perfusion of radioactive tracers before and after the initiation of treatment for diabetes mellitus and hypertension

    International Nuclear Information System (INIS)

    Mirouze, J.; Monnier, L.; Olivier, C.

    1975-01-01

    Glomerular filtration and renal plasma flux are measured simultaneously as a result of achieving isotopic equilibrium after the continuous perfusion of 125 I-iothalamate and 131 I-orthoiodohippurate. A good correlation is found between the clearances of 125 I-iothalamate (y) and of inulin or polyfructosan (x): y = 1.18 x + 8.43 (r 0.96; P 131 I-orthoiodohippurate (y') and para-aminohippuric acid (x'): y' = 0.62 x' + 21.2 (r = 0.93; P < 0.001). When the renal function is modified, the iothalamate is not suitable for this technique since the time necessary to reach a radioactive concentration plateau exceeds three hours. Orthoiodohippurate, on the contrary, yields good results. The main advantages of the method in this case are absence of urine collection and rapid achievement of isotopic equilibrium. The repeated study of the renal function of hypertensive patients and of diabetics makes it possible to investigate the effects of anti-hypertension drugs and insulin therapy. Since clonidin improves the clearances slightly, it may be considered for administration in cases of hypertension associated with chronic renal inadequacy. Insulin therapy very rapidly increases the glomerular filtration and renal plasma flux of diabetics by insulin extraction. This improvement depends more on metabolic and haemodynamic changes caused by the insulin than on the correction of disorders affecting the permeability of the basal glomerular membrane

  7. 12-month blood pressure results of catheter-based renal artery denervation for resistant hypertension: the SYMPLICITY HTN-3 trial.

    Science.gov (United States)

    Bakris, George L; Townsend, Raymond R; Flack, John M; Brar, Sandeep; Cohen, Sidney A; D'Agostino, Ralph; Kandzari, David E; Katzen, Barry T; Leon, Martin B; Mauri, Laura; Negoita, Manuela; O'Neill, William W; Oparil, Suzanne; Rocha-Singh, Krishna; Bhatt, Deepak L

    2015-04-07

    Results of the SYMPLICITY HTN-3 (Renal Denervation in Patients With Uncontrolled Hypertension) trial confirmed the safety but not the efficacy of renal denervation for treatment-resistant hypertension at 6 months post procedure. This study sought to analyze the 12-month SYMPLICITY HTN-3 results for the original denervation group, the sham subjects who underwent denervation after the 6-month endpoint (crossover group), and the sham subjects who did not undergo denervation after 6 months (non-crossover group). Eligible subjects were randomized 2:1 to denervation or sham procedure. Subjects were unblinded to their treatment group after the 6-month primary endpoint was ascertained; subjects in the sham group meeting eligibility requirements could undergo denervation. Change in blood pressure (BP) at 12 months post randomization (6 months for crossover subjects) was analyzed. The 12-month follow-up was available for 319 of 361 denervation subjects and 48 of 101 non-crossover subjects; 6-month denervation follow-up was available for 93 of 101 crossover subjects. In denervation subjects, the 12-month office systolic BP (SBP) change was greater than that observed at 6 months (-15.5 ± 24.1 mm Hg vs. -18.9 ± 25.4 mm Hg, respectively; p = 0.025), but the 24-h SBP change was not significantly different at 12 months (p = 0.229). The non-crossover group office SBP decreased by -32.9 ± 28.1 mm Hg at 6 months, but this response regressed to -21.4 ± 19.9 mm Hg (p = 0.01) at 12 months, increasing to 11.5 ± 29.8 mm Hg. These data support no further reduction in office or ambulatory BP after 1-year follow-up. Loss of BP reduction in the non-crossover group may reflect decreased medication adherence or other related factors. (Renal Denervation in Patients With Uncontrolled Hypertension [SYMPLICITY HTN-3]; NCT01418261). Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. The results of correction of endothelial dysfunction in type 2 diabetes mellitus in patients with diabetic retinopathy and associated hypertension

    Directory of Open Access Journals (Sweden)

    L. K. Moshetova

    2013-01-01

    Full Text Available Purpose:Studying the dynamics of clinical functional and morphological status of the retina against the metabolic and antiischemic therapy of retinopathy in type 2 diabetes associated with hypertension based on indicators in the tear fluid and serum nitric oxide metabolites.Methods: Following a standard ophthalmologic examination of 50 patients, among which are the two groups are similar in age andsex. The main group (n = 37 with Cd 2, DR and DR I and II hypertension II, III stage, the average age was 62,2±1,2 years, antihypertensive therapy — an ACE inhibitor Prestarium (5 mg. Patients of the group were divided into two subgroups: the first subgroup (n = 19who underwent parabulbarnom Mildronate (10 injections, the second subgroup (n = 18, which the drug was administered intranasally Semaks (20 days. The control group (n = 13 healthy (n = 6, and patients with type 2 diabetes without DR and GB (n = 7. Quantitative determination of the stable NO metabolites was determined in biochemical method samples of serum and lacrimal fluid.Results: After completing a course of therapy for patients of the first subgroup marked decrease in retinal thickness (p ≤ 0,05 in f.centralis, temporal lobe, the upper and lower bands parafovea and temporal area perifovea, while in the second group — in 9 areas of the macular area (p ≤ 0.05. It is also noted a significant increase in sensitivity to light in the macular area in patients of both subgroups (MAIA. On the background of the treatment observed reduction of NOx in the lacrimal fluid and serum of patients in both clinical groups. Thus, reduction of NOx in the lacrimal fluid was statistically significant in the subgroup of patients receiving anti-ischemic therapy semaks (p <0,05. In both clinical subgroups after treatment revealed correlation between systolic blood pressure and the level of NOx in the serum (r = 0,4; p <0,05.Conclusion: The positive effect (p <0,05 antioxidant (Mildronat and

  9. Is hypertension in adult age related to unemployment at a young age? Results from the Northern Swedish Cohort.

    Science.gov (United States)

    Nygren, Karina; Gong, Weidan; Hammarström, Anne

    2015-02-01

    The aim of this study was to analyse the relationship between early unemployment (ages 16-21 years) and adult hypertension after controlling for earlier hypertension, unemployment in adult life, risk factors for hypertension and confounders. A cohort of 927 (86.6% of the original cohort) 9th grade school-leavers was followed from 1981 until 2008. Data were collected through questionnaires, health examinations, and national registers. Univariate and multivariate logistic regression were used as primary statistical methods. At ages 21 and 43, hypertension was significantly more prevalent among men than women (p Unemployment between the ages of 16 and 21 was related to hypertension at age 43 among women but not men. The odds ratio (OR) was persistently high (OR 3.16 [95% confidence interval 1.45-6.89]) after controlling for late unemployment, hypertension at age 16, risk factors for hypertension and confounders. There was no significant relationship between exposure to early unemployment and hypertension at age 21 for women or men. From a public health perspective, youth unemployment is a societal problem in need of more attention and intervention in order to prevent long-term adverse health outcomes. © 2014 the Nordic Societies of Public Health.

  10. Accelerated Hypertension after Venlafaxine Usage

    Directory of Open Access Journals (Sweden)

    Yüksel Kıvrak

    2014-01-01

    Full Text Available Venlafaxine is the first antidepressant that acts via inhibiting serotonin and noradrenaline reuptake. Hypertension is observed in doses exceeding 300 mg/day and is the most feared complication. We report a patient with accelerated hypertension after venlafaxine use observed at a dose of 150 mg/day. A 23-year-old patient with symptoms of insomnia, depression, anhedonia, fatigue admitted our clinic. Venlafaxine at a dose of 75 mg/day was initiated after he was diagnosed with major depressive disorder. After 5 months, venlafaxine dose was uptitrated to 150 mg/day due to inadequate response to drug. After using venlafaxine for ten months at the dose of 150 mg/day, he admitted our clinic with headache and epistaxis. He was hospitalized after his blood pressure was measured as 210/170 mmHg. No secondary causes for hypertension were found, and venlafaxine treatment was considered possible etiologic factor. After stopping venlafaxine treatment, his blood pressure was reverted back to normal limits. While mild elevation of blood pressure could be observed after venlafaxine treatment, this case shows that accelerated hypertension with a diastolic blood pressure rise above 120 mmHg could be observed at relatively low doses of venlafaxine. Close monitoring of blood pressure is necessary after initiation of treatment, as accelerated hypertension could cause endorgan damage with potentially catastrophic results.

  11. Low-fat dietary pattern and cardiovascular disease: results from the Women's Health Initiative randomized controlled trial.

    Science.gov (United States)

    Prentice, Ross L; Aragaki, Aaron K; Van Horn, Linda; Thomson, Cynthia A; Beresford, Shirley Aa; Robinson, Jennifer; Snetselaar, Linda; Anderson, Garnet L; Manson, JoAnn E; Allison, Matthew A; Rossouw, Jacques E; Howard, Barbara V

    2017-07-01

    Background: The influence of a low-fat dietary pattern on the cardiovascular health of postmenopausal women continues to be of public health interest. Objective: This report evaluates low-fat dietary pattern influences on cardiovascular disease (CVD) incidence and mortality during the intervention and postintervention phases of the Women's Health Initiative Dietary Modification Trial. Design: Participants comprised 48,835 postmenopausal women aged 50-79 y; 40% were randomly assigned to a low-fat dietary pattern intervention (target of 20% of energy from fat), and 60% were randomly assigned to a usual diet comparison group. The 8.3-y intervention period ended in March 2005, after which >80% of surviving participants consented to additional active follow-up through September 2010; all participants were followed for mortality through 2013. Breast and colorectal cancer were the primary trial outcomes, and coronary heart disease (CHD) and overall CVD were additional designated outcomes. Results: Incidence rates for CHD and total CVD did not differ between the intervention and comparison groups in either the intervention or postintervention period. However, CHD HRs comparing these groups varied strongly with baseline CVD and hypertension status. Participants without prior CVD had an intervention period CHD HR of 0.70 (95% CI: 0.56, 0.87) or 1.04 (95% CI: 0.90, 1.19) if they were normotensive or hypertensive, respectively ( P -interaction = 0.003). The CHD benefit among healthy normotensive women was partially offset by an increase in ischemic stroke risk. Corresponding HRs in the postintervention period were close to null. Participants with CVD at baseline (3.4%) had CHD HRs of 1.47 (95% CI: 1.12, 1.93) and 1.61 (95% CI: 1.02, 2.55) in the intervention and postintervention periods, respectively. However, various lines of evidence suggest that results in women with CVD or hypertension at baseline are confounded by postrandomization use of cholesterol-lowering medications

  12. Role of measurement of cystatin C in analyzing the results of renal function tests in patients with essential hypertension

    Energy Technology Data Exchange (ETDEWEB)

    Xiaofeng, Zhang; Hongtai, Lu; Yaorong, Dong; Jing, Xia; Yi, Liu [Chinese Traditional Medicine of Shanghai Hospital, Shanghai (China)

    2003-08-01

    Objective: To explore the use of cystatin C for analysing the results of renal function tests and renal blood flow study in patients with essential hypertension. Methods: The following tests were performed in 62 patients with essential hypertension and 32 controls: plasma cystatin C (with LPET), plasma ET (with RIA), four urinary sensitive parameters for detecting early renal injury i.e. urinary Alb/Cr, NAG/Cr and {alpha}-mG/Cr (with ELISA) and renal blood flow study (with Doppler). Results: The patients could be divided into two groups: Cystatin C positive (above normal value, n=23) and cystamin C negative (n=39). Plasma ET levels in cystamin C positive group were significantly higher than those in the 32 controls. Values of the four urinary parameters in the two patient groups were very significantly higher than those in the controls (p<0.01), the difference between the two patient groups was also very significant (p<0.01). Renal arterial blood flow in the two patient groups was much different from that was no significant difference between the two groups themselves. In the patients, with the decrease of GFR, Serum creatinine levels were elevated but urea nitrogen levels remained within normal limit. Conclusion: In the cystamin C negative patients, there was already marked alteration of the renal blood flow through auto-regulation. Although GFR, serum creatinine and urea nitrogen levels remained within normal range, early renal injury, especially tubular ones had been present. As the disease worsened and cystatin levels increased, there was no progressive alteration of renal blood flow. Marked deterioration of renal glomeruli and tubular functions could be detected.

  13. Role of measurement of cystatin C in analyzing the results of renal function tests in patients with essential hypertension

    International Nuclear Information System (INIS)

    Zhang Xiaofeng; Lu Hongtai; Dong Yaorong; Xia Jing; Liu Yi

    2003-01-01

    Objective: To explore the use of cystatin C for analysing the results of renal function tests and renal blood flow study in patients with essential hypertension. Methods: The following tests were performed in 62 patients with essential hypertension and 32 controls: plasma cystatin C (with LPET), plasma ET (with RIA), four urinary sensitive parameters for detecting early renal injury i.e. urinary Alb/Cr, NAG/Cr and α-mG/Cr (with ELISA) and renal blood flow study (with Doppler). Results: The patients could be divided into two groups: Cystatin C positive (above normal value, n=23) and cystamin C negative (n=39). Plasma ET levels in cystamin C positive group were significantly higher than those in the 32 controls. Values of the four urinary parameters in the two patient groups were very significantly higher than those in the controls (p<0.01), the difference between the two patient groups was also very significant (p<0.01). Renal arterial blood flow in the two patient groups was much different from that was no significant difference between the two groups themselves. In the patients, with the decrease of GFR, Serum creatinine levels were elevated but urea nitrogen levels remained within normal limit. Conclusion: In the cystamin C negative patients, there was already marked alteration of the renal blood flow through auto-regulation. Although GFR, serum creatinine and urea nitrogen levels remained within normal range, early renal injury, especially tubular ones had been present. As the disease worsened and cystatin levels increased, there was no progressive alteration of renal blood flow. Marked deterioration of renal glomeruli and tubular functions could be detected

  14. Enfermedad hipertensiva en la gestante: Resultados de un servicio Hypertensive disease in the pregnant woman: Results of a service

    Directory of Open Access Journals (Sweden)

    Vivian Asunción Álvarez Ponce

    2008-09-01

    Full Text Available La preeclampsia constituye una de las principales causas de mortalidad materna en el mundo. Se realizó un estudio retrospectivo, longitudinal y descriptivo en el Hospital Docente Ginecoobstétrico de Guanabacoa de los años 2004 y 2005, de todas las gestantes que ingresaron en la Sala de Cuidados Perinatales, clasificadas como hipertensas, y que tuvieron su parto en igual período. El grupo estudio correspondió a 71 pacientes. Se tomó como grupo control igual número de gestantes que tuvieron su parto en el mismo período, y que no eran hipertensas ni presentaron la enfermedad durante la gestación. Predominó la preeclampsia como entidad única o asociada a una hipertensión crónica. Entre los factores de riesgo fueron más frecuentes la nuliparidad con un 45,1 %, el sobrepeso y la obesidad (22,5 y 25,4 % respectivamente, lo cual resultó de gran significación estadística. Fue significativa la diferencia en el parto por cesárea (77,5 % en el grupo estudio, en relación con el parto transpelviano. También el bajo peso tuvo diferencias estadísticas significativas (21,1 %. La morbilidad materna fue baja.Preeclampsia is one of the main causes of maternal mortality in the world. A retrospective, longitudinal and descriptive study was conducted in the Gynecoobstetric Hospital of Guanabacoa in 2004 and 2005. All the expectants admitted in the Perinatal Care Ward that were classified as hypertensive and that delivered in the same period were studied. The study group was composed of 71 patients. The same number of pregnant women that gave birth during this period were included in the control group. They were not hypertensive and and they did not suffer from this disease during pregnancy. Preeclampsia predominated as a unique entity or associated with chronic hypertension.The most common risk factors were nuliparity with 45.1 %, overweight and obesity (22.5 and 25.4 %, respectively, which had a great statistical significance. In the study group

  15. Evidence and Perspectives on the 24-hour Management of Hypertension: Hemodynamic Biomarker-Initiated 'Anticipation Medicine' for Zero Cardiovascular Event.

    Science.gov (United States)

    Kario, Kazuomi

    There are notable differences between Asians and Westerners regarding hypertension (HTN) and the relationship between HTN and cardiovascular disease (CVD). Asians show greater morning surges in blood pressure (BP) and a steeper slope illustrating the link between higher BP and the risk of CVD events. It is thus particularly important for Asian hypertensives to achieve 24-h BP control, including morning and night-time control. There are three components of 'perfect 24-h BP control:' the 24-h BP level, nocturnal BP dipping, and BP variability (BPV), such as the morning BP surge that can be assessed by ambulatory BP monitoring. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-h BP control, followed by the control of nocturnal HTN. We have been developing new HBPM devices that can measure nocturnal BP. BPV includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and yearly changes. The synergistic resonance of each type of BPV would produce a great dynamic BP surge (resonance hypothesis), which triggers a CVD event, especially in the high-risk patients with systemic hemodynamic atherothrombotic syndrome (SHATS). In the future, the innovative management of HTN based on the simultaneous assessment of the resonance of all of the BPV phenotypes using a beat by beat wearable 'surge' BP monitoring device (WSP) and an information and communication technology (ICT)-based data analysis system will produce a paradigm shift from 'dots' BP management to 'seamless' ultimate individualized 'anticipation medication' for reaching a zero CVD event rate. Copyright © 2016 The Author. Published by Elsevier Inc. All rights reserved.

  16. The association between hypertension and depression and anxiety disorders: results from a nationally-representative sample of South African adults.

    Directory of Open Access Journals (Sweden)

    Anna Grimsrud

    Full Text Available Growing evidence suggests high levels of comorbidity between hypertension and mental illness but there are few data from low- and middle-income countries. We examined the association between hypertension and depression and anxiety in South Africa.Data come from a nationally-representative survey of adults (n = 4351. The Composite International Diagnostic Interview was used to measure DSM-IV mental disorders during the previous 12-months. The relationships between self-reported hypertension and anxiety disorders, depressive disorders and comorbid anxiety-depression were assessed after adjustment for participant characteristics including experience of trauma and other chronic physical conditions.Overall 16.7% reported a previous medical diagnosis of hypertension, and 8.1% and 4.9% were found to have a 12-month anxiety or depressive disorder, respectively. In adjusted analyses, hypertension diagnosis was associated with 12-month anxiety disorders [Odds ratio (OR = 1.55, 95% Confidence interval (CI = 1.10-2.18] but not 12-month depressive disorders or 12-month comorbid anxiety-depression. Hypertension in the absence of other chronic physical conditions was not associated with any of the 12-month mental health outcomes (p-values all <0.05, while being diagnosed with both hypertension and another chronic physical condition were associated with 12-month anxiety disorders (OR = 2.25, 95% CI = 1.46-3.45, but not 12-month depressive disorders or comorbid anxiety-depression.These are the first population-based estimates to demonstrate an association between hypertension and mental disorders in sub-Saharan Africa. Further investigation is needed into role of traumatic life events in the aetiology of hypertension as well as the temporality of the association between hypertension and mental disorders.

  17. Portal Hypertension

    Science.gov (United States)

    ... Overview of Gallbladder Cancer Additional Content Medical News Portal Hypertension By Steven K. Herrine, MD, Professor of Medicine, ... Liver Hepatic Encephalopathy Jaundice in Adults Liver Failure Portal Hypertension Portal hypertension is abnormally high blood pressure in ...

  18. Secondary Hypertension

    Science.gov (United States)

    Secondary hypertension Overview Secondary hypertension (secondary high blood pressure) is high blood pressure that's caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, ...

  19. Determination of liver and spleen perfusion by quantitative sequential scintigraphy: results in normal subjects and in patients with portal hypertension

    International Nuclear Information System (INIS)

    Biersack, H.J.; Torres, J.; Thelen, M.; Monzon, O.; Winkler, C.

    1981-01-01

    Quantitative sequential hepatosplenic scintigraphy was performed to determine the arterial and portal components of the total liver circulation in 135 patients (no liver disease in 20, liver cirrhosis and portal ;hypertension in 115). Portal circulation in healthy patients is calculated to be 70.4 +/- 6.2% of the total liver blood flow, whereas patients with portal hypertension showed a clear reduction of portal perfusion to 20.2 +/- 10.9%. Thirteen of 20 patients having portosystemic shunt surgery showed no portal perfusion. This new, noninvasive diagnostic technique yields vital information particularly useful in ;the surgical evaluation of portal hypertension. Other indications are also discussed

  20. Major inducing factors of hypertensive complications and the interventions required to reduce their prevalence: an epidemiological study of hypertension in a rural population in China

    Directory of Open Access Journals (Sweden)

    Xiao Jianming

    2011-05-01

    Full Text Available Abstract Background The complications of hypertension cause severe health problems in rural areas in China. We (i screened the major factors inducing hypertensive complications and provided intervention measures; and (ii verified the efficacy of the New Rural Cooperative Medical Scheme (NRCMS; a medical insurance scheme for rural residents for hypertension management. Methods A survey was conducted in the villages of Yunnan (an underdeveloped province in southwest China. The NRCMS was initiated there in 2005. Data were collected through questionnaires, physical examination, electrocardiography, as well as blood and urine tests. To detect factors inducing hypertension complications, a generalized estimating equations model was developed. Multivariable logistic regression was used to analyze influencing factors for hypertension control. Results Poor management of hypertension was observed in women. Being female, old, poorly educated, a smoker, ignorant of the dangerousness of hypertension, and having uncontrolled hypertension made patients more prone to hypertension complications. Combination therapy with ≥2 drugs helped control hypertension, but most rural patients disliked multidrug therapy because they considered it to be expensive and inconvenient. The NRCMS contributed little to reduce the prevalence of complications and improve control of hypertension. Conclusions The present study suggested that the NRCMS needs to be reformed to concentrate on early intervention in hypertension and to concentrate on women. To increase hypertension control in rural areas in China, compound products containing effective and inexpensive drugs (and not multidrug therapy are needed.

  1. Health locus of control as a psychological factor in improving treatment results in adolescents with primary hypertension and diabetes

    Directory of Open Access Journals (Sweden)

    Marta Anna Biernacka

    2016-10-01

    Full Text Available Background The belief that an individual can influence and control the course of events is a factor which enables a person to overcome difficulties. Some studies, however, have questioned the universality of this statement. This study aims to investigate and explore the relationship between the self-health locus of control and the effectiveness of cooperation in the treatment process in adolescents with chronic diseases. Participants and procedure One hundred and sixty-four adolescent patients suffering from chronic diseases (61 girls and 103 boys ranging from 11 to 17 years old participated in the study. Eighty-seven had primary hypertension and 77 had type 1 diabetes. To investigate their sense of health control we used the Health Locus of Control Scale (HLC. Cooperation in the treatment process was assessed using a 4-item scale completed by a doctor. Results Better results in the treatment were positively correlated with a better internal health locus of control. A negative correlation between the chance health locus of control and results in the treatment was found. Differences in the health locus of control proved to be dependent on gender, age and different clinical groups. Conclusions Health locus of control in patients with chronic diseases seems to be a crucial factor in determining the results of the treatment process in such patients.

  2. [The effect of a single moderate physical exertion on serum leptin levels in patients with essential hypertension (preliminary results)].

    Science.gov (United States)

    Zyśko, D; Gajek, J; Jołda-Mydłowska, B

    2000-08-01

    Leptin is a product of the ob gene and is secreted by the adipose tissue. It takes part in regulation of nervous, cardiovascular, endocrine system and renal functions. The aim of this study was to assess the influence of short term moderate exercise on serum leptin levels in patients with arterial hypertension. The study group consisted of 34 patients with essential hypertension: 15 women (48.9 +/- 12.1 years old) and 19 men (43.5 +/- 14.6 years old). There were 7 patients with stage I of hypertension, 17 patients with stage II of hypertension and 10 patients with stage III of hypertension. The blood samples were taken before and after the exercise test. Serum leptin levels were assessed by radioimmunoassay. Serum leptin levels were significantly higher in women then in men. The logarithm of serum leptin levels after the exercise was significantly lower than before (0.8 +/- 0.4 and 0.9 +/- 0.5 respectively). The moderate, short term exercise decreases serum leptin levels in the hypertensive patients.

  3. Self-initiated actions result in suppressed auditory but amplified visual evoked components in healthy participants.

    Science.gov (United States)

    Mifsud, Nathan G; Oestreich, Lena K L; Jack, Bradley N; Ford, Judith M; Roach, Brian J; Mathalon, Daniel H; Whitford, Thomas J

    2016-05-01

    Self-suppression refers to the phenomenon that sensations initiated by our own movements are typically less salient, and elicit an attenuated neural response, compared to sensations resulting from changes in the external world. Evidence for self-suppression is provided by previous ERP studies in the auditory modality, which have found that healthy participants typically exhibit a reduced auditory N1 component when auditory stimuli are self-initiated as opposed to externally initiated. However, the literature investigating self-suppression in the visual modality is sparse, with mixed findings and experimental protocols. An EEG study was conducted to expand our understanding of self-suppression across different sensory modalities. Healthy participants experienced either an auditory (tone) or visual (pattern-reversal) stimulus following a willed button press (self-initiated), a random interval (externally initiated, unpredictable onset), or a visual countdown (externally initiated, predictable onset-to match the intrinsic predictability of self-initiated stimuli), while EEG was continuously recorded. Reduced N1 amplitudes for self- versus externally initiated tones indicated that self-suppression occurred in the auditory domain. In contrast, the visual N145 component was amplified for self- versus externally initiated pattern reversals. Externally initiated conditions did not differ as a function of their predictability. These findings highlight a difference in sensory processing of self-initiated stimuli across modalities, and may have implications for clinical disorders that are ostensibly associated with abnormal self-suppression. © 2016 Society for Psychophysiological Research.

  4. Impact of Balloon Pulmonary Angioplasty on Hemodynamics and Clinical Outcomes in Patients with Chronic Thromboembolic Pulmonary Hypertension: the Initial Korean Experience.

    Science.gov (United States)

    Kwon, Woochan; Yang, Jeong Hoon; Park, Taek Kyu; Chang, Sung A; Jung, Dong Seop; Cho, Young Seok; Kim, Sung Mok; Kim, Tae Jung; Park, Hye Yoon; Choi, Seung Hyuk; Kim, Duk Kyung

    2018-01-22

    The treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH) is pulmonary endarterectomy (PEA). However, not all patients are eligible for PEA, and some patients experience recurrence of pulmonary hypertension even after PEA. Patients who underwent balloon pulmonary angioplasty (BPA) between December 2015 and April 2017 were enrolled from the Samsung Medical Center CTEPH registry. Enrolled patients underwent right heart catheterization, echocardiography, and 6-minute walk distance (6MWD) at baseline, 4 and 24 weeks after their first BPA session. We compared clinical and hemodynamic parameters at the baseline and last BPA session. Fifty-two BPA sessions were performed in 15 patients, six of whom had a history of PEA. BPA resulted in improvements in World Health Organization (WHO) functional class (2.9 ± 0.8 to 1.7 ± 0.6, P = 0.002), 6MWD (387.0 ± 86.4 to 453.4 ± 64.8 m, P = 0.01), tricuspid annular plane systolic excursion (14.1 ± 3.6 to 15.6 ± 4.3 mm, P = 0.03) and hemodynamics, including a decline in mean pulmonary artery pressure (41.1 ± 13.1 to 32.1 ± 9.5 mmHg, P < 0.001) and in pulmonary vascular resistance (607.4 ± 452.3 to 406.7 ± 265.4 dyne.sec.cm⁻⁵, P = 0.01) but not in cardiac index (2.94 ± 0.79 to 2.96 ± 0.93 L/min/m², P = 0.92). Six cases of complications were recorded, including two cases of reperfusion injury. BPA might be a safe and effective treatment strategy for both inoperable CTEPH patients and patients with residual pulmonary hypertension after PEA. © 2018 The Korean Academy of Medical Sciences.

  5. Hypertension and health outcomes in the PICU.

    Science.gov (United States)

    Ehrmann, Brett J; Selewski, David T; Troost, Jonathan P; Hieber, Susan M; Gipson, Debbie S

    2014-06-01

    Reports of the burden of hypertension in hospitalized children are emerging, but the prevalence and significance of this condition within the PICU are not well understood. The aims of this study were to validate a definition of hypertension in the PICU and assess the associations between hypertension and acute kidney injury, PICU length of stay, and mortality. Single-center retrospective study using a database of PICU discharges between July 2011 and February 2013. All children discharged from the PICU with length of stay more than 6 hours, aged 1 month through 17 years. Exclusions were traumatic brain injury, incident renal transplant, or hypotension. None. Potential definitions of hypertension utilizing combinations of standardized cutoff percentiles, durations, initiation or dose escalation of antihypertensives, and/or billing diagnosis codes for hypertension were compared using receiver operator characteristic curves against a manual medical record review. Multivariable logistic and linear regression analyses were conducted using the selected definition of hypertension to assess its independent association with acute kidney injury and PICU length of stay, respectively. A definition requiring three systolic and/or diastolic readings above standardized 99th percentiles plus 5 mm Hg over 1 day was selected (area under the curve, 0.91; sensitivity, 94%; specificity, 87%). Among the 1,215 patients in this analysis, the prevalence of hypertension was 25%. Hypertension was independently associated with acute kidney injury (odds ratio, 2.89; 95% CI, 1.64-5.09; p hypertension group-but were statistically different (p = 0.02). Hypertension is common in the PICU and is associated with worse clinical outcomes. Future studies are needed to confirm these results.

  6. Demonstration of safety in Alzheimer's patients for intervention with an anti-hypertensive drug Nilvadipine: results from a 6-week open label study.

    LENUS (Irish Health Repository)

    Kennelly, S P

    2012-02-01

    BACKGROUND: Nilvadipine may lower rates of conversion from mild-cognitive impairment to Alzheimer\\'s disease (AD), in hypertensive patients. However, it remains to be determined whether treatment with nilvadipine is safe in AD patients, given the higher incidence of orthostatic hypotension (OH) in this population, who may be more likely to suffer from symptoms associated with the further exaggeration of a drop in BP. OBJECTIVE: The aim of this study was to investigate the safety and tolerability of nilvadipine in AD patients. METHODS: AD patients in the intervention group (n = 56) received nilvadipine 8 mg daily over 6-weeks, compared to the control group (n = 30) who received no intervention. Differences in systolic (SBP) and diastolic (DBP) blood pressure, before and after intervention, was assessed using automated sphygmomanometer readings and ambulatory BP monitors (ABP), and change in OH using a finometer. Reporting of adverse events was monitored throughout the study. RESULTS: There was a significant reduction in the SBP of treated patients compared to non-treated patients but no significant change in DBP. Individuals with higher initial blood pressure (BP) had greater reduction in BP but individuals with normal BP did not experience much change in their BP. While OH was present in 84% of the patients, there was no further drop in BP recorded on active stand studies. There were no significant differences in adverse event reporting between groups. CONCLUSION: Nilvadipine was well tolerated by patients with AD. This study supports further investigation of its efficacy as a potential treatment for AD.

  7. Fractional Differential Equations in Terms of Comparison Results and Lyapunov Stability with Initial Time Difference

    Directory of Open Access Journals (Sweden)

    Coşkun Yakar

    2010-01-01

    Full Text Available The qualitative behavior of a perturbed fractional-order differential equation with Caputo's derivative that differs in initial position and initial time with respect to the unperturbed fractional-order differential equation with Caputo's derivative has been investigated. We compare the classical notion of stability to the notion of initial time difference stability for fractional-order differential equations in Caputo's sense. We present a comparison result which again gives the null solution a central role in the comparison fractional-order differential equation when establishing initial time difference stability of the perturbed fractional-order differential equation with respect to the unperturbed fractional-order differential equation.

  8. The association between vitamin E intake and hypertension: results from the re-analysis of the National Health and Nutrition Survey.

    Science.gov (United States)

    Kuwabara, Akiko; Nakade, Makiko; Tamai, Hiroshi; Tsuboyama-Kasaoka, Nobuyo; Tanaka, Kiyoshi

    2014-01-01

    Recently, there has been an increasing concern about noncommunicable diseases (NCDs), in which oxidative damage plays a role. In this paper, we have re-analyzed the data from the National Health and Nutrition Survey (NHNS) 2007 to study the relationship between an NCD (e.g. hypertension) and the dietary intake of vitamin E, a potent anti-oxidative vitamin. The inclusion criteria were those aged 40 and over, excluding pregnant or lactating women, and data from 1,405 males and 2,102 females were analyzed. The mean ages were 63.5 and 62.4, respectively. Nutrients intake was evaluated from a semi-weighted, 1-d household dietary record. When the subjects were categorized into tertiles based on their vitamin E intake, higher vitamin E intake was associated with a lower percentage of subjects with hypertension (p for trend=0.01). Subjects with higher vitamin E intake had higher energy intake-adjusted intake of other nutrients which have been considered to be related to hypertension such as potassium, magnesium, and vitamin C. Logistic regression analysis was done with the low tertile of vitamin E intake as the reference. The medium and high tertiles of vitamin E intake were associated with a significantly lower odds ratio for hypertension, 0.73 (95% CI; 0.62-0.87) for the former and 0.81 (95% CI; 0.69-0.96) for the latter. Additional analyses, one adjusted for the indices associated with hypertension and one excluding the subjects with vitamin E supplementation, have yielded the similar results. In summary, re-analysis of data from NHNS has revealed that higher vitamin E intake was significantly associated with lower prevalence of hypertension.

  9. Interventional devascularization for the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension: mid-term to long-term results

    International Nuclear Information System (INIS)

    Liu Wei; Chen Hongbo; Chen Gensheng; Zhang Weiping; Zheng Qun

    2009-01-01

    Objective: To assess the mid-term to long-term results of interventional devascularization in the treatment of upper gastrointestinal hemorrhage in patients with portal hypertension. Methods: Interventional devascularization was performed in 49 patients with upper gastrointestinal hemorrhage due to portal hypertension caused by cirrhosis. The patients were followed up for 6-36 months after the procedure. The recurrence of bleeding, postoperative complications and outcome. were observed and analyzed. Results: The technical success rate was 98.0% (48 / 49) and the mortality was 2%. The re-bleeding occurrence rate at 1, 6, 12, 24 and 36 months was 0%, 2.1%, 12.5%, 24.5% and 27.9%, respectively. The causes of re-bleeding included re-rupture of varicose vein (25%), portal hypertensive gastropathy (58.3%) and peptic ulcer (16.7%). Conclusion: The interventional devascularization is a simple, safe and effective method for the treatment of upper gastrointestinal hemorrhage due to portal hypertension. (authors)

  10. A Community-Level Initiative to Prevent Obesity: Results From Kaiser Permanente's Healthy Eating Active Living Zones Initiative in California.

    Science.gov (United States)

    Cheadle, Allen; Atiedu, Akpene; Rauzon, Suzanne; Schwartz, Pamela M; Keene, Laura; Davoudi, Mehrnaz; Spring, Rebecca; Molina, Michelle; Lee, Lynda; Boyle, Kathryn; Williamson, Dana; Steimberg, Clara; Tinajero, Roberta; Ravel, Jodi; Nudelman, Jean; Azuma, Andrea Misako; Kuo, Elena S; Solomon, Loel

    2018-05-01

    A growing number of health systems are leading health promotion efforts in their wider communities. What impact are these efforts having on health behaviors and ultimately health status? This paper presents evaluation results from the place-based Kaiser Permanente Healthy Eating Active Living Zones obesity prevention initiative, implemented in 2011-2015 in 12 low-income communities in Kaiser Permanente's Northern and Southern California Regions. The Healthy Eating Active Living Zones design targeted places and people through policy, environmental, and programmatic strategies. Each Healthy Eating Active Living Zone is a small, low-income community of 10,000 to 20,000 residents with high obesity rates and other health disparities. Community coalitions planned and implemented strategies in each community. A population-dose approach and pre and post surveys were used to assess impact of policy, program, and environmental change strategies; the analysis was conducted in 2016. Population dose is the product of reach (number of people affected by a strategy divided by target population size) and strength (the effect size or relative change in behavior for each person exposed to the strategy). More than 230 community change strategies were implemented over 3 years, encompassing policy, environmental, and programmatic changes as well as efforts to build community capacity to sustain strategies and make changes in the future. Positive population-level results were seen for higher-dose strategies, particularly those targeting youth physical activity. Higher-dose strategies were more likely to be found in communities with the longest duration of investment. These results demonstrate that strong (high-dose), community-based obesity prevention strategies can lead to improved health behaviors, particularly among youth in school settings. This article is part of a supplement entitled Building Thriving Communities Through Comprehensive Community Health Initiatives, which is

  11. Systolic blood pressure target in systemic arterial hypertension: Is lower ever better? Results from a community-based Caucasian cohort.

    Science.gov (United States)

    Di Nora, Concetta; Cioffi, Giovanni; Iorio, Annamaria; Rivetti, Luigi; Poli, Stefano; Zambon, Elena; Barbati, Giulia; Sinagra, Gianfranco; Di Lenarda, Andrea

    2018-02-01

    Extensive evidence exists about the prognostic role of systolic blood pressure (SBP) reduction ≤140mmHg. Recently, the SPRINT trial successfully tested the strategy of lowering SBP<120mmHg in patients with arterial hypertension (AH). To assess whether the SPRINT results are reproducible in a real world community population. Cross-sectional, population-based study analyzing data of 24,537 Caucasian people with AH from the Trieste Observatory of CV disease, 2010 to 2015. We selected and divided 2306 subjects with AH according to the SPRINT trial criteria; similarly, SPRINT clinical outcomes were considered. Study patients median age was 75±8years, two third male, one third had ischemic heart disease. They were older, with lower body mass index, higher SBP and Framingham CV risk score than the SPRINT patients. Three-hundred-sixty-eight patients (16%) had SBP<120mmHg. During 48 [36-60] months of follow-up, 751 patients (32%) experienced a major adverse cardiac event (MACE). The SBP <120mmHg group had higher incidence of MACE, CV deaths and all-cause death than SBP≥120mmHg group (37% vs 31%; 10% vs 4%; 19% vs 10%, all p<0.05). The condition of SBP<120mmHg was an independent predictor of MACE in multivariate Cox analysis together with older age, male gender, higher Charlson score. In our experience, the SBP<120mmHg condition is associated with worse clinical outcomes, suggesting the SPRINT results are not reproducible tout court in Caucasian community populations. These differences should be taken as a warning against aggressive reducing of SBP<120mmHg. Copyright © 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Radiation-induced renovascular hypertension

    International Nuclear Information System (INIS)

    Staab, G.E.; Tegtmeyer, C.J.; Constable, W.C.

    1976-01-01

    Radiation is known to produce changes in the small vessels and interstitium of the kidneys resulting in hypertension. Two cases of renal artery stenosis and resultant hypertension secondary to abdominal irradiation are reported and the literature is reviewed

  13. Physician assessment of stroke risk in hypertensive patients in the Middle East and Africa: results of the action survey.

    Science.gov (United States)

    Badr, Kamal F; Boudia, Khereddine M Merad; Alami, Mohamed; Khoja, Waleed A; Belhani, Ali B; Nawar, Moustafa; Ragy, Hany; Ishaq, Mohammad; Baron, J M Muscat; Hammoudeh, Ayman J; De Mar Youssef, Suzan S; Nakhle, Reine M; Chalfoun, Amale G

    2007-01-01

    In the absence of reliable, contemporary national data, the ACTION survey was designed to: a) provide preliminary data on stroke risk in the MEA (Middle East and Africa); b) describe the contribution of specific cardiovascular risk factors; 3) assess blood pressure (BP) control. This was a multi-center observational study in nine countries in the MEA region. From 2003 to 2005, 562 physicians from a variety of specialties recorded observations of cardiovascular risk factors in 4,747 hypertensive patients, aged 54-80 years. The 10-year absolute stroke risk was calculated using a scoring system based on the Framingham Heart Study observations, and comparisons made with an age-matched cohort. The mean 10-year stroke risk was estimated at 22.7% and was significantly higher for men (25.4%) than for women (19.5%) (P age-matched Framingham cohort, the estimated stroke risk in our population was almost double, and was significantly higher for females (212%) than for males (192%) (P < .001). Hypertension, diabetes, left ventricular hypertrophy, and smoking were major contributing risk factors, as were physical inactivity and elevated cholesterol. Blood pressure was controlled in only 18% of the population and in 12% of diabetics. Physicians of all specialties were willing to participate in stroke risk assessment. The risk of stroke in hypertensive patients in the MEA region is high, and is higher than would be predicted using Framingham data, particularly for females. Hypertension appears to be poorly controlled in more than 80% of hypertensive patients in the MEA region.

  14. Initial results from a charge exchange q-diagnostic on TEXT-U

    International Nuclear Information System (INIS)

    Valanju, P.M.; Duraiappah, L.; Bengtson, R.D.; Karzhavin, Y.; Nikitin, A.

    1994-01-01

    The authors present initial results from a new q-diagnostic for TEXT-Upgrade. This method is based on using a toroidal array of detectors to determine the plane in which beam-injected neutrals are emitted after two charge-exchange collisions. The potential advantages are low cost, full plasma accessibility, and good time resolution. Their initial series of experiments on TEXT-U established the feasibility of this technique

  15. Results of surgery in symptomatic non-hydrocephalic pineal cysts: role of magnetic resonance imaging biomarkers indicative of central venous hypertension.

    Science.gov (United States)

    Eide, Per Kristian; Ringstad, Geir

    2017-02-01

    We have previously proposed that pineal cysts (PCs) may result in crowding of the pineal recess, causing symptoms due to compression of the internal cerebral veins and central venous hypertension. In the present study, we compared clinical outcome of different treatment modalities in symptomatic individuals with non-hydrocephalic PCs. The study included all patients managed surgically for non-hydrocephalic PCs in our Department of Neurosurgery over a 10-year period. We applied a questionnaire to determine occurrence of symptoms before and after surgery, which allowed the use of a grading scale for symptom severity. Magnetic resonance imaging (MRI) biomarkers indicative of central venous hypertension were assessed before and after surgery. Relief of symptoms after surgery was most efficiently obtained by complete microsurgical cyst removal [n = 15; no (0/15), some (1/15) or marked (14/15) improvement], and to a lesser extent by microsurgical cyst fenestration [n = 6; no (2/6), some (4/6) or marked (0/6) improvement]. Shunt surgery was not successful [n = 6; no (5/6), some (1/6) or marked (0/6) improvement]. In all patients, the proposed MRI biomarkers gave evidence of central venous hypertension (PC grades 2-4). Microsurgical cyst removal provided marked symptom relief in symptomatic individuals with non-hydrocephalic PCs and MRI biomarkers of central venous hypertension. The hypothesis that PC-induced crowding of the pineal recess may compromise venous run-off and induce a central venous hypertension syndrome deserves further study.

  16. Refeeding hypertension in dietary obesity

    International Nuclear Information System (INIS)

    Ernsberger, P.; Nelson, D.O.

    1988-01-01

    A novel model of nutritionally induced hypertension in the rat is described. Dietary obesity was produced by providing sweet milk in addition to regular chow, which elicited a 52% increase in caloric intake. Despite 54% greater body weight gain and 139% heavier retroperitoneal fat pads, 120 days of overfeeding failed to increase systolic pressure in the conscious state or mean arterial pressure under urethan anesthesia. In contrast, mild hypertension developed in intermittantly fasted obese animals. The first 4-day supplemented fast was initiated 4 wk after the introduction of sweet milk, when the animals were 47 g overweight relative to chow-fed controls. Thereafter, 4 days of starvation were alternated with 2 wk of refeeding for a total of 4 cycles. A rapid fall in systolic blood pressure accompanied the onset of supplemented fasting and was maintained thereafter. With refeeding, blood pressure rose precipitously, despite poststarvation anorexia. Blood pressure tended to rise slightly over the remainder of the realimentation period. After the 4th supplemented fast, hypertension was sustained during 30 days of refeeding. Cumulative caloric intake in starved-refed rats fell within 2% of that in chow-fed controls. Refeeding hypertension appeared to be due to increased sympathetic nervous activity, since (1) cardiac β-adrenergic receptors were downregulated, as indicated by a 40% decrease in the maximum binding of [ 3 H]dihydroalpranolol; and (2) the decrease in heart rate as a result of β-blockade was enhanced. Refeeding hypertension in the dietary obese rat may be a potential animal model for some forms of human obesity-related hypertension

  17. Hypertensive Crisis

    Science.gov (United States)

    ... Artery Disease Venous Thromboembolism Aortic Aneurysm More Hypertensive Crisis: When You Should Call 9-1-1 for ... Nov 13,2017 A hypertensive ( high blood pressure ) crisis is when blood pressure rises quickly and severely ...

  18. A Large-Scale Initiative Inviting Patients to Share Personal Fitness Tracker Data with Their Providers: Initial Results.

    Directory of Open Access Journals (Sweden)

    Joshua M Pevnick

    Full Text Available Personal fitness trackers (PFT have substantial potential to improve healthcare.To quantify and characterize early adopters who shared their PFT data with providers.We used bivariate statistics and logistic regression to compare patients who shared any PFT data vs. patients who did not.A patient portal was used to invite 79,953 registered portal users to share their data. Of 66,105 users included in our analysis, 499 (0.8% uploaded data during an initial 37-day study period. Bivariate and regression analysis showed that early adopters were more likely than non-adopters to be younger, male, white, health system employees, and to have higher BMIs. Neither comorbidities nor utilization predicted adoption.Our results demonstrate that patients had little intrinsic desire to share PFT data with their providers, and suggest that patients most at risk for poor health outcomes are least likely to share PFT data. Marketing, incentives, and/or cultural change may be needed to induce such data-sharing.

  19. Denervation (ablation) of nerve terminalis in renal arteries: early results of interventional treatment of arterial hypertension in Poland.

    Science.gov (United States)

    Bartuś, Krzysztof; Sadowski, Jerzy; Kapelak, Bogusław; Zajdel, Wojciech; Godlewski, Jacek; Bartuś, Stanisław; Bochenek, Maciej; Bartuś, Magdalena; Żmudka, Krzysztof; Sobotka, Paul A

    2013-01-01

    Arterial hypertension is one of the main causes of cardiovascular disease morbidity and overall mortality. To report the single centre experiences with changes in arterial blood pressure (BP) in patients after intra-arterial application of radiofrequency (RF) energy to cause renal sympathetic efferent and somatic afferent nerve and report vascular and kidney safety in a six month follow up. Twenty-eight patients, with hypertension despite medical therapy (median age 52.02 years, range 42-72 years) consented to therapeutic renal nerve ablation. SIMPLICITY RF catheters and generator provided by Ardian (currently Medtronic Inc., USA) were used to perform renal artery angiography and ablation. The mean BP at baseline, and after one month, three months and six months were measured [mm Hg]: systolic 176.6; 162.3 (p = 0.004); 150.6 (p arterial renal nerve denervation was not associated with either vascular or renal complications out to six months. Nerve ablation of renal arteries led to significant reduction of mean values of arterial systolic, diastolic BP and significant reduction of pulse pressure. The Polish experience is not significantly different compared to that reported in the Symplicity I and Symplicity II international cohorts. The long term durability of this therapy and its application to earlier stages of hypertension or other disease states will require further investigation.

  20. Quality initiatives: improving patient flow for a bone densitometry practice: results from a Mayo Clinic radiology quality initiative.

    Science.gov (United States)

    Aakre, Kenneth T; Valley, Timothy B; O'Connor, Michael K

    2010-03-01

    Lean Six Sigma process improvement methodologies have been used in manufacturing for some time. However, Lean Six Sigma process improvement methodologies also are applicable to radiology as a way to identify opportunities for improvement in patient care delivery settings. A multidisciplinary team of physicians and staff conducted a 100-day quality improvement project with the guidance of a quality advisor. By using the framework of DMAIC (define, measure, analyze, improve, and control), time studies were performed for all aspects of patient and technologist involvement. From these studies, value stream maps for the current state and for the future were developed, and tests of change were implemented. Comprehensive value stream maps showed that before implementation of process changes, an average time of 20.95 minutes was required for completion of a bone densitometry study. Two process changes (ie, tests of change) were undertaken. First, the location for completion of a patient assessment form was moved from inside the imaging room to the waiting area, enabling patients to complete the form while waiting for the technologist. Second, the patient was instructed to sit in a waiting area immediately outside the imaging rooms, rather than in the main reception area, which is far removed from the imaging area. Realignment of these process steps, with reduced technologist travel distances, resulted in a 3-minute average decrease in the patient cycle time. This represented a 15% reduction in the initial patient cycle time with no change in staff or costs. Radiology process improvement projects can yield positive results despite small incremental changes.

  1. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study.

    Science.gov (United States)

    Behrens, Ida; Basit, Saima; Melbye, Mads; Lykke, Jacob A; Wohlfahrt, Jan; Bundgaard, Henning; Thilaganathan, Baskaran; Boyd, Heather A

    2017-07-12

    Objectives  To determine how soon after delivery the risk of post-pregnancy hypertension increases in women with hypertensive disorders of pregnancy and how the risk evolves over time. Design  Nationwide register based cohort study. Setting  Denmark. Populations  482 972 primiparous women with a first live birth or stillbirth between 1995 and 2012 (cumulative incidence analyses), and 1 025 118 women with at least one live birth or stillbirth between 1978 and 2012 (Cox regression analyses). Main outcome measures  10 year cumulative incidences of post-pregnancy hypertension requiring treatment with prescription drugs, and hazard ratios estimated using Cox regression. Results  Of women with a hypertensive disorder of pregnancy in a first pregnancy in their 20s, 14% developed hypertension in the first decade post partum, compared with 4% of women with normotensive first pregnancies in their 20s. The corresponding percentages for women with a first pregnancy in their 40s were 32% and 11%, respectively. In the year after delivery, women with a hypertensive disorder of pregnancy had 12-fold to 25-fold higher rates of hypertension than did women with a normotensive pregnancy. Rates in women with a hypertensive disorder of pregnancy were threefold to 10-fold higher 1-10 years post partum and remained twice as high even 20 or more years later. Conclusions  The risk of hypertension associated with hypertensive disorders of pregnancy is high immediately after an affected pregnancy and persists for more than 20 years. Up to one third of women with a hypertensive disorder of pregnancy may develop hypertension within a decade of an affected pregnancy, indicating that cardiovascular disease prevention in these women should include blood pressure monitoring initiated soon after pregnancy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. General Atomic reprocessing pilot plant: description and results of initial testing

    International Nuclear Information System (INIS)

    1977-12-01

    In June 1976 General Atomic completed the construction of a reprocessing head-end cold pilot plant. In the year since then, each system within the head end has been used for experiments which have qualified the designs. This report describes the equipment in the plant and summarizes the results of the initial phase of reprocessing testing

  3. Gravitational Waves from Known Pulsars: Results from the Initial Detector Era

    NARCIS (Netherlands)

    Aasi, J.; et al., [Unknown; Hessels, J.W.T.

    2014-01-01

    We present the results of searches for gravitational waves from a large selection of pulsars using data from the most recent science runs (S6, VSR2 and VSR4) of the initial generation of interferometric gravitational wave detectors LIGO (Laser Interferometric Gravitational-wave Observatory) and

  4. Initial Laboratory-Scale Melter Test Results for Combined Fission Product Waste

    Energy Technology Data Exchange (ETDEWEB)

    Riley, Brian J.; Crum, Jarrod V.; Buchmiller, William C.; Rieck, Bennett T.; Schweiger, Michael J.; Vienna, John D.

    2009-10-01

    This report describes the methods and results used to vitrify a baseline glass, CSLNTM-C-2.5 in support of the AFCI (Advanced Fuel Cycle Initiative) using a Quartz Crucible Scale Melter at the Pacific Northwest National Laboratory. Document number AFCI-WAST-PMO-MI-DV-2009-000184.

  5. Novel Field test design and initial result for AC and DC characterization for PV-panels

    DEFF Research Database (Denmark)

    Thorsteinsson, Sune; Riedel, Nicholas; Santamaria Lancia, Adrian Alejo

    This work describes the design and initial test results of a field test for PV modules, where the PV modules the majority of the time operates to produce power at their maximum power point. Sequentially the individual modules are switched into a measurement circuitry for IV curves and impedance s...

  6. Infant exposure to Chinese famine increased the risk of hypertension in adulthood: results from the China Health and Retirement Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Zhenghe Wang

    2016-05-01

    Full Text Available Abstract Background Early-life developmental adaptations in response to severe malnutrition may play a crucial role in susceptibility to hypertension. This study aimed to explore the associations between exposure to the Chinese famine (1959–1961 at fetal, infant and preschool stages during fetal life or childhood and the risk of hypertension in adulthood. Methods We used the data of 1,966 adults born between 1956 and 1964 in selected families from the China Health and Retirement Longitudinal Study (CHARLS national survey. Results Prevalence of hypertension among adults in non-exposed, fetal-exposed, infant-exposed, and preschool-exposed cohorts was 18.9, 20.7, 28.7, and 23.4 %, respectively. In severely affected famine areas, only infant-exposed cohort had a significant increased risk of hypertension compared with non-exposed cohort (OR 2.12; 95 % CI 1.19, 3.79; P = 0.011, and the significance remained after adjusted gender, smoking, and drinking (OR 2.11; 95 % CI 1.18, 3.77; P = 0.012. After stratification by BMI and economic status, the risk of hypertension was higher for subjects with BMI ≥ 24 kg/m2(OR 2.09; 95 % CI 1.09, 4.01; P = 0.026 or high economic status(OR 2.26; 95 % CI 1.19, 4.31; P = 0.013 than those with BMI < 24 kg/m2(OR 1.65; 95 % CI 0.71, 3.83; P = 0.246 or low economic status (OR 2.18; 95 % CI 1.14, 4.18; P = 0.019 in infant-exposed cohort of severely affected famine areas. However, there was no consistent association observed in less severely affected area or other exposed cohorts in severely affected areas. Conclusions Infanthood exposed to famine might increase the risk of hypertension in adulthood, and a postnatal ‘rich’ nutrient environment further increased the risk.

  7. Advances in the treatment of portal hypertension in cirrhosis.

    Science.gov (United States)

    Kimer, N; Wiese, S; Mo, S; Møller, S; Bendtsen, F

    2016-08-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension.

  8. Advances in the treatment of portal hypertension in cirrhosis

    DEFF Research Database (Denmark)

    Kimer, Nina; Wiese, S; Mo, S S

    2016-01-01

    Non-selective beta-blockers and handling of esophageal varices has been key elements in the treatment of portal hypertension in recent decades. Liver vein catheterization has been essential in diagnosis and monitoring of portal hypertension, but ongoing needs for noninvasive tools has led...... to research in areas of both biomarkers, and transient elastography, which displays promising results in discerning clinically significant portal hypertension. Novel research into the areas of hepatic stellate cell function and the dynamic components of portal hypertension has revealed promising areas...... of treatment modalities, targeting intestinal decontamination, angiogenesis, inflammation and oxidative stress. Future studies may reveal if these initiatives lead to developments of new drugs for treatment of portal hypertension....

  9. Clinical Impact of a Pharmaceutical Care Programme Developed in a Family Health Unit: Results of a Pharmacist-Physician Collaboration in the Treatment of Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Mónica Condinho

    2016-07-01

    Full Text Available Introduction: The positive impact of pharmacist-physician collaborative care has been reported in the international literature, although examples of this impact are limited in Portugal. We aim to underline the clinical added value for hypertensive patients that results from pharmacist-physician collaborations. Methods: A community trial was conducted at a Portuguese family health unit for 19 months. The intervention group was randomly selected from the global records and members of the group received pharmaceutical care in addition to physician care. The comparison group received only physician care. Both groups were comparable at the beginning of the study. In the intervention group, we analysed the hypertensive patients to evaluate the impact of pharmacist-physician collaboration on the patients’ blood pressure levels. This evaluation was performed by comparing the obtained blood pressure levels with the levels at baseline and between the groups. Results: A total of 17 patients with hypertension were enrolled in the pharmaceutical care programme, 12 of whom were female. The mean age was 68.50±3.26 years and, on average, each patient consumed 6.06±0.93 medicinal products. Thirteen patients were uncontrolled. Compared with the baseline, the intervention group achieved mean reductions of 28.85±5.90 mmHg (p < 0.0005 and 11.23±2.75 mmHg (p < 0.005 in their systolic and diastolic blood pressure, respectively. Considering the comparison group, improvements of 18.63±6.44 mmHg (p = 0.011 in systolic blood pressure and 9.03±2.63 mmHg ( p < 0.005 in diastolic blood pressure were observed. Conclusion: Pharmacist-physician collaborative care adds clinical value to the typical physician care provided to hypertensive patients within the context of a Portuguese family health unit.

  10. Reciprocating magnetic refrigerator for 2--4 K operation: Initial results

    International Nuclear Information System (INIS)

    Barclay, J.A.; Moze, O.; Paterson, L.

    1979-01-01

    The basic theory and design of a reciprocating magnetic refrigerator to pump heat from 2.2 to 4.2 K is presented. The results of initial experiments are shown. These results include conduction losses, eddy current losses, frictional losses, and mixing losses. Two cooling cycles were attempted and a net cooling power of 52 mW was observed at 1/60 Hz. The key problems in this design are identified and discussed

  11. A urate gene-by-diuretic interaction and gout risk in participants with hypertension: results from the ARIC study.

    Science.gov (United States)

    McAdams-DeMarco, Mara A; Maynard, Janet W; Baer, Alan N; Kao, Linda W; Kottgen, Anna; Coresh, Josef

    2013-05-01

    To test for a urate gene-by-diuretic interaction on incident gout. The Atherosclerosis Risk in Communities Study is a prospective population-based cohort of 15 792 participants recruited from four US communities (1987-1989). Participants with hypertension and available single nucleotide polymorphism (SNP) genotype data were included. A genetic urate score (GUS) was created from common urate-associated SNPs for eight genes. Gout incidence was self-reported. Using logistic regression, the authors estimated the adjusted OR of incident gout by diuretic use, stratified by GUS median. Of 3524 participants with hypertension, 33% used a diuretic and 3.1% developed gout. The highest 9-year cumulative incidence of gout was in those with GUS above the median and taking a thiazide or loop diuretic (6.3%). Compared with no thiazide or loop diuretic use, their use was associated with an OR of 0.40 (95% CI 0.14 to 1.15) among those with a GUS below the median and 2.13 (95% CI 1.23 to 3.67) for those with GUS above the median; interaction p=0.006. When investigating the genes separately, SLC22A11 and SLC2A9 showed a significant interaction, consistent with the former encoding an organic anion/dicarboxylate exchanger, which mediates diuretic transport in the kidney. Participants who were genetically predisposed to hyperuricaemia were susceptible to developing gout when taking thiazide or loop diuretics, an effect not evident among those without a genetic predisposition. These findings argue for a potential benefit of genotyping individuals with hypertension to assess gout risk, relative in part to diuretic use.

  12. Spironolactone versus sympathetic renal denervation to treat true resistant hypertension: results from the DENERVHTA study - a randomized controlled trial.

    Science.gov (United States)

    Oliveras, Anna; Armario, Pedro; Clarà, Albert; Sans-Atxer, Laia; Vázquez, Susana; Pascual, Julio; De la Sierra, Alejandro

    2016-09-01

    Both renal denervation (RDN) and spironolactone have been proposed for the treatment of resistant hypertension. However, they have not been compared in a randomized clinical trial. We aimed to compare the efficacy of spironolactone versus RDN in patients with resistant hypertension. A total of 24 patients with office SBP at least 150 mmHg and 24-h SBP at least 140 mmHg despite receiving at least three full-dose antihypertensive drugs, one a diuretic, but without aldosterone antagonists, were randomized to receive RDN or spironolactone (50 mg) as add-on therapy. Primary endpoint was change in 24-h SBP at 6 months. Comparisons between treatment groups were performed using generalized linear models adjusted by age, sex, and baseline values. Spironolactone was more effective than RDN in reducing 24-h SBP and 24-h DBP: mean baseline-adjusted differences between the two groups were -17.9 mmHg (95%CI -30.9 to -4.9); P = 0.010 and -6.6 mmHg (95%CI -12.9 to -0.3); P = 0.041, for 24-h SBP and 24-h DBP, respectively. As regards changes in office blood pressure, mean baseline-adjusted differences between the two groups were -12.1 mmHg (95%CI -29.1 to 5.1); P = 0.158 and of -5.3 mmHg (95%CI -16.3 to 5.8); P = 0.332, for office SBP and office DBP, respectively. Otherwise, the decrease of estimated glomerular filtration rate was greater in the spironolactone group; mean baseline-adjusted difference between the two groups was -10.7 ml/min per 1.73 m (95%CI -20.1 to -1.4); P = 0.027. We conclude that spironolactone is more effective than RDN to reduce 24-h SBP and 24-h DBP in patients with resistant hypertension. Therefore, spironolactone should be the fourth antihypertensive drug to prescribe if deemed well tolerated' in all patients with resistant hypertension before considering RDN.

  13. CHANGE OF CARDIOVASCULAR RISK FACTORS AND QUALITY OF LIFE IN YOUNG HYPERTENSIVE PATIENTS AS A RESULT OF PREVENTIVE CONSULTATION IN PRIMARY HEALTH CARE

    Directory of Open Access Journals (Sweden)

    M. I. Shupina

    2016-01-01

    Full Text Available Aim. To evaluate changes of quality of life (QL in young hypertensive patients having «Health School» educational course in comparison with patients having standard non-drug therapy.Material and methods. 114 young patients with arterial hypertension, stage 1, and low and moderate cardiovascular risk were involved in the study. Patients were randomized in 2 groups. Patients of the 1st group (n=59 were trained at «Health School». Patients of the 2nd group had the routine doctor consultation. Changes of systolic and diastolic blood pressure (BP and QL were evaluated in 6, 12 and 36 months.Results. Decrease of systolic and diastolic BP as well as improvement of QL was observed in both groups. However «Health School» demonstrated significantly higher efficacy in comparison with routine consultation.Conclusion. Non-drug correction of the risk factors is effective method of BP control in young hypertensive patients. High efficacy of «Health School» educational course allows recommending it for implementation in practical medicine. 

  14. Resistant Hypertension.

    Science.gov (United States)

    Doroszko, Adrian; Janus, Agnieszka; Szahidewicz-Krupska, Ewa; Mazur, Grzegorz; Derkacz, Arkadiusz

    2016-01-01

    Resistant hypertension is a severe medical condition which is estimated to appear in 9-18% of hypertensive patients. Due to higher cardiovascular risk, this disorder requires special diagnosis and treatment. The heterogeneous etiology, risk factors and comorbidities of resistant hypertension stand in need of sophisticated evaluation to confirm the diagnosis and select the best therapeutic options, which should consider lifestyle modifications as well as pharmacological and interventional treatment. After having excluded pseudohypertension, inappropriate blood pressure measurement and control as well as the white coat effect, suspicion of resistant hypertension requires an analysis of drugs which the hypertensive patient is treated with. According to one definition - ineffective treatment with 3 or more antihypertensive drugs including diuretics makes it possible to diagnose resistant hypertension. A multidrug therapy including angiotensin - converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, diuretics, long-acting calcium channel blockers and mineralocorticoid receptor antagonists has been demonstrated to be effective in resistant hypertension treatment. Nevertheless, optional, innovative therapies, e.g. a renal denervation or baroreflex activation, may create a novel pathway of blood pressure lowering procedures. The right diagnosis of this disease needs to eliminate the secondary causes of resistant hypertension e.g. obstructive sleep apnea, atherosclerosis and renal or hormonal disorders. This paper briefly summarizes the identification of the causes of resistant hypertension and therapeutic strategies, which may contribute to the proper diagnosis and an improvement of the long term management of resistant hypertension.

  15. Knowledge and awareness of hypertension among patients with systemic hypertension.

    Science.gov (United States)

    Familoni, B. Oluranti; Ogun, S. Abayomi; Aina, A. Olutoyin

    2004-01-01

    BACKGROUND: In Nigeria, systemic hypertension is the commonest noncommunicable disease, and public awareness about hypertension and its determinants is poor. This study aims to assess the knowledge and level of awareness of the disease among hypertensive patients attending the medical outpatient clinic of Olabisi Onabanjo University Teaching Hospital (OOUTH). METHODOLOGY: Hypertensive patients who attended the medical outpatient clinic during the one-year study period and gave their consent were recruited into the study. Response to a questionnaire on various aspects of hypertension was analyzed using the STATA for Windows software. RESULTS: There were 254 hypertensive patients, of which 111 were males and 143 were females, giving a male: female ratio of 1:1.3. The mean age (SD) of the patients was 51 years +/- 12.2; 52.4% of the participants were aware that hypertension was the commonest noncommunicable disease in Nigeria. About one in 10 patients (11.4%) was aware that "nil symptom" is the commonest symptom of hypertension, while 37% were not aware that hypertension could cause renal failure. Only about one-third (35.4%) of the patients knew that hypertension should ideally be treated for life, while 58.3% believed that antihypertensive drugs should be used only when there are symptoms. The remaining 6.3% believed that the treatment of hypertension should be for periods ranging from two weeks to five years but not for life. CONCLUSION: This study has demonstrated inadequate knowledge of hypertension in patients with hypertension in our study population. Conscious efforts should be made and time set aside to health educate hypertensive patients. Organization of "hypertensive club or society" could be encouraged. These will reduce dissemination of false or inaccurate information by hypertensive patients to the public and its attendant dangers. PMID:15160976

  16. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE:: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS:: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS:: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION:: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  17. Overweight, adipocytokines and hypertension

    DEFF Research Database (Denmark)

    Seven, Ekim; Husemoen, Lise L N; Wachtell, Kristian

    2014-01-01

    OBJECTIVE: The adipocytokines, leptin, adiponectin, and interleukin-6, which stimulate liver C-reactive protein (CRP) production, are regarded as potential candidate intermediates between adipose tissue and overweight-induced hypertension. METHODS: We examined the associations between leptin......, adiponectin, and CRP levels with both prevalent and 5-year incident hypertension (IHT) in a general population of Danish adults (n = 5,868, 51.3% women, mean age 45.8 ± 7.9 years). RESULTS: We recorded 2195 prevalent and 379 incident cases of hypertension. In models including leptin, CRP, adiponectin, sex.......023) in the fully adjusted model. The population attributable risk estimate of IHT owing to overweight was 31%. CONCLUSION: Leptin, but not adiponectin or CRP, may play a mediating role in overweight-induced hypertension. However, as BMI was a strong independent predictor of hypertension, other factors than leptin...

  18. Initial results from beam commissioning of the LHC beam dump system

    CERN Document Server

    Goddard, B; Carlier, E; Ducimetière, L; Gallet, E; Gyr, M; Jensen, L; Jones, R; Kain, V; Kramer, T; Lamont, M; Meddahi, M; Mertens, V; Risselada, Thys; Uythoven, J; Wenninger, J; Weterings, W

    2010-01-01

    Initial commissioning of the LHC beam dump system with beam took place in August and September 2008. The preparation, setting-up and the tests performed are described together with results of the extractions of beam into the dump lines. Analysis of the first detailed aperture measurements of the extraction channels and kicker performance derived from dilution sweep shapes are presented. The performance of the other equipment subsystems is summarised, in particular that of the dedicated dump system beam instrumentation.

  19. Initial results from NuSTAR observations of the Norma arm

    DEFF Research Database (Denmark)

    Bodaghee, Arash; Tomsick, John A.; Krivonos, Roman

    2014-01-01

    Results are presented for an initial survey of the Norma Arm gathered with the focusing hard X-ray telescope NuSTAR. The survey covers 0.2 deg2 of sky area in the 3-79 keV range with a minimum and maximum raw depth of 15 ks and 135 ks, respectively. Besides a bright black-hole X-ray binary...

  20. Initial results for electrochemical dissolution of spent EBR-II fuel

    International Nuclear Information System (INIS)

    Li, S. X.

    1998-01-01

    Initial results are reported for the anode behavior of spent metallic nuclear fuel in an electrorefining process. The anode behavior has been characterized in terms of the initial spent fuel composition and the final composition of the residual cladding hulls. A variety of results have been obtained depending on the experimental conditions. Some of the process variables considered are average and maximum cell voltage, average and maximum anode voltage, amount of electrical charge passed (coulombs or amp-hours) during the experiment, and cell resistance. The main goal of the experiments has been the nearly complete dissolution of uranium with the retention of zirconium and noble metal fission products in the cladding hulls. Analysis has shown that the most indicative parameters for determining an endpoint to the process, recognizing the stated goal, are the maximum anode voltage and the amount of electrical charge passed. For the initial experiments reported here, the best result obtained is greater than 98% uranium dissolution with approximately 50% zirconium retention. Noble metal fission product retention appears to be correlated with zirconium retention

  1. Mineralocorticoid hypertension

    Directory of Open Access Journals (Sweden)

    Vishal Gupta

    2011-01-01

    Full Text Available Hypertension affects about 10 - 25% of the population and is an important risk factor for cardiovascular and renal disease. The renin-angiotensin system is frequently implicated in the pathophysiology of hypertension, be it primary or secondary. The prevalence of primary aldosteronism increases with the severity of hypertension, from 2% in patients with grade 1 hypertension to 20% among resistant hypertensives. Mineralcorticoid hypertension includes a spectrum of disorders ranging from renin-producing pathologies (renin-secreting tumors, malignant hypertension, coarctation of aorta, aldosterone-producing pathologies (primary aldosteronism - Conns syndrome, familial hyperaldosteronism 1, 2, and 3, non-aldosterone mineralocorticoid producing pathologies (apparent mineralocorticoid excess syndrome, Liddle syndrome, deoxycorticosterone-secreting tumors, ectopic adrenocorticotropic hormones (ACTH syndrome, congenitalvadrenal hyperplasia, and drugs with mineraocorticoid activity (locorice, carbenoxole therapy to glucocorticoid receptor resistance syndromes. Clinical presentation includes hypertension with varying severity, hypokalemia, and alkalosis. Ratio of plasma aldosterone concentraion to plasma renin activity remains the best screening tool. Bilateral adrenal venous sampling is the best diagnostic test coupled with a CT scan. Treatment is either surgical (adrenelectomy for unilateral adrenal disease versus medical therapy for idiopathic, ambiguous, or bilateral disease. Medical therapy focuses on blood pressure control and correction of hypokalemia using a combination of anti-hypertensives (calcium channel blockers, angiotensin converting enzyme inhibitors, or angiotensin receptor blockers and potassium-raising therapies (mineralcorticoid receptor antagonist or potassium sparing diuretics. Direct aldosterone synthetase antagonists represent a promising future therapy.

  2. Prepregnancy dietary patterns and risk of developing hypertensive disorders of pregnancy: results from the Australian Longitudinal Study on Women’s Health

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Soedamah-Muthu, S.S.; Callaway, L.K.; Mishra, G.D.

    2015-01-01

    Background: Hypertensive disorders of pregnancy (HDPs), including gestational hypertension and pre-eclampsia, are common obstetric complications associated with adverse health outcomes for the mother and child. It remains unclear how dietary intake can influence HDP risk. Objective: We investigated

  3. Non-lethal heat treatment of cells results in reduction of tumor initiation and metastatic potential

    International Nuclear Information System (INIS)

    Kim, Yoo-Shin; Lee, Tae Hoon; O'Neill, Brian E.

    2015-01-01

    Non-lethal hyperthermia is used clinically as adjuvant treatment to radiation, with mixed results. Denaturation of protein during hyperthermia treatment is expected to synergize with radiation damage to cause cell cycle arrest and apoptosis. Alternatively, hyperthermia is known to cause tissue level changes in blood flow, increasing the oxygenation and radiosensitivity of often hypoxic tumors. In this study, we elucidate a third possibility, that hyperthermia alters cellular adhesion and mechanotransduction, with particular impact on the cancer stem cell population. We demonstrate that cell heating results in a robust but temporary loss of cancer cell aggressiveness and metastatic potential in mouse models. In vitro, this heating results in a temporary loss in cell mobility, adhesion, and proliferation. Our hypothesis is that the loss of cellular adhesion results in suppression of cancer stem cells and loss of tumor virulence and metastatic potential. Our study suggests that the metastatic potential of cancer is particularly reduced by the effects of heat on cellular adhesion and mechanotransduction. If true, this could help explain both the successes and failures of clinical hyperthermia, and suggest ways to target treatments to those who would most benefit. - Highlights: • Non-lethal hyperthermia treatment of cancer cells is shown to cause a reduction in rates of tumor initiation and metastasis. • Dynamic imaging of cells during heat treatment shows temporary changes in cell shape, cell migration, and cell proliferation. • Loss of adhesion may lead to the observed effect, which may disproportionately impact the tumor initiating cell fraction. • Loss or suppression of the tumor initiating cell fraction results in the observed loss of metastatic potential in vivo. • This result may lead to new approaches to synergizing hyperthermia with surgery, radiation, and chemotherapy

  4. Non-lethal heat treatment of cells results in reduction of tumor initiation and metastatic potential

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yoo-Shin; Lee, Tae Hoon; O' Neill, Brian E., E-mail: BEOneill@houstonmethodist.org

    2015-08-14

    Non-lethal hyperthermia is used clinically as adjuvant treatment to radiation, with mixed results. Denaturation of protein during hyperthermia treatment is expected to synergize with radiation damage to cause cell cycle arrest and apoptosis. Alternatively, hyperthermia is known to cause tissue level changes in blood flow, increasing the oxygenation and radiosensitivity of often hypoxic tumors. In this study, we elucidate a third possibility, that hyperthermia alters cellular adhesion and mechanotransduction, with particular impact on the cancer stem cell population. We demonstrate that cell heating results in a robust but temporary loss of cancer cell aggressiveness and metastatic potential in mouse models. In vitro, this heating results in a temporary loss in cell mobility, adhesion, and proliferation. Our hypothesis is that the loss of cellular adhesion results in suppression of cancer stem cells and loss of tumor virulence and metastatic potential. Our study suggests that the metastatic potential of cancer is particularly reduced by the effects of heat on cellular adhesion and mechanotransduction. If true, this could help explain both the successes and failures of clinical hyperthermia, and suggest ways to target treatments to those who would most benefit. - Highlights: • Non-lethal hyperthermia treatment of cancer cells is shown to cause a reduction in rates of tumor initiation and metastasis. • Dynamic imaging of cells during heat treatment shows temporary changes in cell shape, cell migration, and cell proliferation. • Loss of adhesion may lead to the observed effect, which may disproportionately impact the tumor initiating cell fraction. • Loss or suppression of the tumor initiating cell fraction results in the observed loss of metastatic potential in vivo. • This result may lead to new approaches to synergizing hyperthermia with surgery, radiation, and chemotherapy.

  5. An Initiating-Event Analysis for PSA of Hanul Units 3 and 4: Results and Insights

    International Nuclear Information System (INIS)

    Kim, Dong-San; Park, Jin Hee

    2015-01-01

    As a part of the PSA, an initiating-event (IE) analysis was newly performed by considering the current state of knowledge and the requirements of the ASME/ANS probabilistic risk assessment (PRA) standard related to IE analysis. This paper describes the methods of, results and some insights from the IE analysis for the PSA of the Hanul units 3 and 4. In this study, as a part of the PSA for the Hanul units 3 and 4, an initiating-event (IE) analysis was newly performed by considering the current state of knowledge and the requirements of the ASME/ANS probabilistic risk assessment (PRA) standard. In comparison with the previous IE analysis, this study performed a more systematic and detailed analysis to identify potential initiating events, and calculated the IE frequencies by using the state-of-the-art methods and the latest data. As a result, not a few IE frequencies are quite different from the previous frequencies, which can change the major accident sequences obtained from the quantification of the PSA model

  6. Virtual enterprise architecture and methodology - Initial results from the Globeman21 project

    DEFF Research Database (Denmark)

    Vesterager, Johan; Larsen, Lars Bjørn; Gobbi, Chiara

    1999-01-01

    This paper will focus on presenting the initial results from the IMS project Globeman21 regarding generic models for Extended Enterprise Management (EEM). In particular the paper outlines a proposed architecture for the creation of virtual enterprises, industrial requirements regarding the generic...... models, terminology for describing extended enterprises, and initial considerations regarding a methodology for EEM. Globeman21 see the extended enterprise as a concept covering the totality of different concepts dealing with the expansion or extension of enterprise activities. One way of realising...... the concept of extended enterprise is through the creation of virtual enterprise, based on a more or less formalised network. This approach is the basis for the development of the generic EEM model within Globeman21....

  7. Leveraging finances for public health system improvement: results from the Turning Point initiative.

    Science.gov (United States)

    Bekemeier, Betty; Riley, Catharine M; Berkowitz, Bobbie

    2007-01-01

    Reforming the public health infrastructure requires substantial system changes at the state level; state health agencies, however, often lack the resources and support for strategic planning and systemwide improvement. The Turning Point Initiative provided support for states to focus on large-scale system changes that resulted in increased funding for public health capacity and infrastructure development. Turning Point provides a test case for obtaining financial and institutional resources focused on systems change and infrastructure development-areas for which it has been historically difficult to obtain long-term support. The purpose of this exploratory, descriptive survey research was to enumerate the actual resources leveraged toward public health system improvement through the partnerships, planning, and implementation activities funded by the Robert Wood Johnson Foundation as a part of the Turning Point Initiative.

  8. Treatment Patterns and Associated Health Care Costs Before and After Treatment Initiation Among Pulmonary Arterial Hypertension Patients in the United States.

    Science.gov (United States)

    Burger, Charles D; Ozbay, A Burak; Lazarus, Howard M; Riehle, Ellen; Montejano, Leslie B; Lenhart, Gregory; White, R James

    2018-02-13

    Despite multiple treatment options, the prognosis of pulmonary arterial hypertension (PAH) remains poor. PAH patients experience a high economic burden due to comorbidities, hospitalizations, and medication costs. Although combination therapy has been shown to reduce hospitalizations, the relationship between treatment, health care utilization, and costs remains unclear. To provide a characterization of health care utilization and costs in real-world settings by comparing periods before and after initiating PAH-specific treatment. This retrospective study identified PAH patients in the Truven Health MarketScan Commercial and Medicare Supplemental Databases between 2010 and 2014 who initiated treatment with endothelin receptor antagonists (ERAs), phosphodiesterase-5 inhibitors (PDE-5Is), or soluble guanylate cyclase (sGC) stimulators. The index date was the date of the first PAH pharmacy claim. We included patients with ≥ 2 medical claims with diagnoses for PAH (ICD-9-CM: 416.0, 416.8) or PAH-related conditions and continuous enrollment in medical and pharmacy benefits for the 6 months before and after the index date. Treatment patterns were assessed at the drug class level (ERAs, PDE-5Is, sGC stimulators, and prostacyclins) from outpatient pharmacy claims during the 6-month post-index period. All-cause and PAH-related utilization and costs were measured. McNemar's and paired t-tests were used to compare patients' health care resource utilization and costs in the 6-month pre- and posttreatment periods. A total of 3,908 patients met the selection criteria. The study sample was 63% female with a mean age of 63 ± 15 years. Only 5% of patients began initial combination therapy for PAH, defined as claims for ≥ 2 medication classes within the first 30 days of treatment. Treatment interruption (≥ 30-day gap in days supply) of any PAH-specific medication was observed in 38% of patients. Compared with the 6-month pre-index period, the proportion of patients in the 6

  9. Current status of portal vein thrombosis in Japan: Results of a questionnaire survey by the Japan Society for Portal Hypertension.

    Science.gov (United States)

    Kojima, Seiichiro; Watanabe, Norihito; Koizumi, Jun; Kokubu, Shigehiro; Murashima, Naoya; Matsutani, Shoichi; Obara, Katsutoshi

    2018-03-01

    To investigate the current status of portal vein thrombosis (PVT) in Japan, the Clinical Research Committee of the Japan Society of Portal Hypertension undertook a questionnaire survey. A questionnaire survey of 539 cases of PVT over the previous 10 years was carried out at institutions affiliated with the Board of Trustees of the Japan Society of Portal Hypertension. The most frequent underlying etiology of PVT was liver cirrhosis in 75.3% of patients. Other causes included inflammatory diseases of the hepatobiliary system and the pancreas, malignant tumors, and hematologic diseases. The most frequent site was the main trunk of the portal vein (MPV) in 70.5%, and complete obstruction of the MPV was present in 11.5%. Among the medications for PVT, danaparoid was given to 45.8%, warfarin to 26.2%, heparin to 17.3%, and anti-thrombin III to 16.9%. Observation of the course was practiced in 22.4%. Factors contributing to therapeutic efficacy were implementation of various medications, thrombi localized to either the right or left portal vein only, non-complete obstruction of the MPV and Child-Pugh class A liver function. A survival analysis showed that the prognosis was favorable with PVT disappearance regardless of treatment. The questionnaire survey showed the current status of PVT in Japan. Any appropriate medication should be given to a patient with PVT when PVT is recognized. It is necessary to compile a large amount of information and reach a consensus on safe and highly effective management of PVT. © 2017 The Japan Society of Hepatology.

  10. Gene Variation of Endoplasmic Reticulum Aminopeptidases 1 and 2, and Risk of Blood Pressure Progression and Incident Hypertension among 17,255 Initially Healthy Women

    Directory of Open Access Journals (Sweden)

    Robert Y. L. Zee

    2018-01-01

    Full Text Available Recent studies have demonstrated the importance of endoplasmic reticulum aminopeptidase (ERAP in blood pressure (BP homeostasis. To date, no large prospective, genetic–epidemiological data are available on genetic variation within ERAP and hypertension risk. The association of 45 genetic variants of ERAP1 and ERAP2 was investigated in 17,255 Caucasian female participants from the Women’s Genome Health Study. All subjects were free of hypertension at baseline. During an 18-year follow-up period, 10,216 incident hypertensive cases were identified. Multivariable linear, logistic, and Cox regression analyses were performed to assess the relationship of genotypes with baseline BP levels, BP progression at 48 months, and incident hypertension assuming an additive genetic model. Linear regression analyses showed associations of four tSNPs (ERAP1: rs27524; ERAP2: rs3733904, rs4869315, and rs2549782; all p<0.05 with baseline systolic BP levels. Three tSNPs (ERAP1: rs27851, rs27429, and rs34736, all p<0.05 were associated with baseline diastolic BP levels. Multivariable logistic regression analysis showed that ERAP1 rs27772 was associated with BP progression at 48 months (p=0.0366. Multivariable Cox regression analysis showed an association of three tSNPs (ERAP1: rs469783 and rs10050860; ERAP2: rs2927615; all p<0.05 with risk of incident hypertension. Analyses of dbGaP for genotype–phenotype association and GTEx Portal for gene expression quantitative trait loci revealed five tSNPs with differential association of BP and nine tSNPs with lower ERAP1 and ERAP2 mRNA expression levels, respectively. The present study suggests that ERAP1 and ERAP2 gene variation may be useful for risk assessment of BP progression and the development of hypertension.

  11. Spinal epidural neurostimulation for treatment of acute and chronic intractable pain: initial and long term results.

    Science.gov (United States)

    Richardson, R R; Siqueira, E B; Cerullo, L J

    1979-09-01

    Spinal epidural neurostimulation, which evolved from dorsal column stimulation, has been found to be effective in the treatment of acute and chronic intractable pain. Urban and Hashold have shown that it is a safe, simplified alternative to dorsal column stimulation, especially because laminectomy is not required if the electrodes are inserted percutaneously. Percutaneous epidural neurostimulation is also advantageous because there can be a diagnostic trial period before permanent internalization and implantation. This diagnostic and therapeutic modality has been used in 36 patients during the past 3 years at Northwestern Memorial Hospital. Eleven of these patients had acute intractable pain, which was defined as pain of less than 1 year in duration. Initial postimplantation results from the 36 patients indicate that spinal epidural neurostimulation is most effective in treating the intractable pain of diabetes, arachnoiditis, and post-traumatic and postamputation neuroma. Long term follow-up, varying from 1 year to 3 years postimplantation in the 20 initially responding patients, indicates that the neurostimulation continues to provide significant pain relief (50% or greater) in a majority of the patients who experienced initial significant pain relief.

  12. Initial Results from the Lost Alpha Diagnostics on Joint European Torus

    Energy Technology Data Exchange (ETDEWEB)

    Darrow, Doug; Cecil, Ed; Ellis, Bob; Fullard, Keith; Hill, Ken; Horton, Alan; Kiptily, Vasily; Pedrick, Les; Reich, Matthias

    2007-07-25

    Two devices have been installed in the Joint European Torus (JET) vacuum vessel near the plasma boundary to investigate the loss of energetic ions and fusion products in general and alpha particles in particular during the upcoming JET experiments. These devices are (i) a set of multichannel thin foil Faraday collectors, and (ii) a well collimated scintillator which is optically connected to a charge-coupled device. Initial results, including the radial energy and poloidal dependence of lost ions from hydrogen and deuterium plasmas during the 2005–06 JET restart campaign, will be presented.

  13. Neonatal screening for four lysosomal storage diseases with a digital microfluidics platform: Initial results in Brazil

    Directory of Open Access Journals (Sweden)

    Eurico Camargo Neto

    2018-06-01

    Full Text Available Abstract We describe the initial results of a neonatal screening program for four lysosomal storage diseases (MPS I, Pompe, Gaucher and Fabry using the digital microfluidics methodology. The method successfully identified patients previously diagnosed with these diseases and was used to test dried blood spot samples obtained from 10,527 newborns aged 2 to 14 days. The digital microfluidic technology shows potential for a simple, rapid and high-throughput screening for these four diseases in a standard neonatal screening laboratory.

  14. Initial Results from the Lost Alpha Diagnostics on Joint European Torus

    International Nuclear Information System (INIS)

    Darrow, Doug; Baeumel, Stefan; Cecil, Ed; Ellis, Bob; Fullard, Keith; Hill, Ken; Horton, Alan; Kiptily, Vasily; Pedrick, Les; Reich, Matthias; Werner, Andreas

    2007-01-01

    Two devices have been installed in the Joint European Torus (JET) vacuum vessel near the plasma boundary to investigate the loss of energetic ions and fusion products in general and alpha particles in particular during the upcoming JET experiments. These devices are (i) a set of multichannel thin foil Faraday collectors, and (ii) a well collimated scintillator which is optically connected to a charge-coupled device. Initial results, including the radial energy and poloidal dependence of lost ions from hydrogen and deuterium plasmas during the 2005-06 JET restart campaign, will be presented.

  15. Hypertension hos gravide

    DEFF Research Database (Denmark)

    Mathiesen, Elisabeth R; Johansen, Marianne; Kamper, Anne Lise

    2009-01-01

    There are four major hypertensive disorders in pregnancy: chronic hypertension, gestational hypertension, preeclampsia and chronic hypertension with superimposed preeclampsia. The indications and efficacy of antihypertensive treatment of the different hypertensive disorders are assessed. Advantages...

  16. Pharmacological and non- pharmacological treatment of hypertension: A review article

    Directory of Open Access Journals (Sweden)

    Marjan Seyedmazhari

    2013-01-01

    Full Text Available BACKGROUND: Hypertension is a worldwide epidemic disease. It is more common and more severe in elderly persons. Various studies however have estimated 41.9 million men and 27.8 million women to have prehypertension. Diagnosis and early treatment of prehypertension are of utmost importance. Although hypertension is usually divided into 2 general categories of essential (primary and secondary hypertension, the initial treatment for hypertension often depends on its stage which is determined by systolic and diastolic blood pressure. Lifestyle modification is the first step in treating stage one hypertension. Pharmaceutical treatments including diuretics, angiotensin converting enzyme (ACE inhibitors, calcium blockers, beta blockers, and angiotensin receptor blockers will be recommended if lifestyle modification fails to control blood pressure.    METHODS: The PubMed database was searched by a number of keywords including hypertension, pharmaceutical treatment, and non-pharmaceutical treatment. The results were limited by determining a date range of 2008-11.    RESULTS: High blood pressure causes major health problems for many people around the world. It should be controlled because of its high mortality and morbidity. However, in order to select an appropriate treatment modality, it is initially important to diagnose the kinds and stages of hypertension. Pharmaceutical or non-pharmaceutical treatments can then be employed to control this serious disease.    CONCLUSION: Treating hypertension depends on the kinds and stages of this disease. Several tips should be considered when selecting a method of treatment.       Keywords: Hypertension, Pharmacological treatment, Non-pharmacological treatment

  17. Compact Multipurpose Mobile Laser Scanning System — Initial Tests and Results

    Directory of Open Access Journals (Sweden)

    Craig Glennie

    2013-01-01

    Full Text Available We describe a prototype compact mobile laser scanning system that may be operated from a backpack or unmanned aerial vehicle. The system is small, self-contained, relatively inexpensive, and easy to deploy. A description of system components is presented, along with the initial calibration of the multi-sensor platform. The first field tests of the system, both in backpack mode and mounted on a helium balloon for real-world applications are presented. For both field tests, the acquired kinematic LiDAR data are compared with highly accurate static terrestrial laser scanning point clouds. These initial results show that the vertical accuracy of the point cloud for the prototype system is approximately 4 cm (1σ in balloon mode, and 3 cm (1σ in backpack mode while horizontal accuracy was approximately 17 cm (1σ for the balloon tests. Results from selected study areas on the Sacramento River Delta and San Andreas Fault in California demonstrate system performance, deployment agility and flexibility, and potential for operational production of high density and highly accurate point cloud data. Cost and production rate trade-offs place this system in the niche between existing airborne and tripod mounted LiDAR systems.

  18. Follow-up of Antihypertensive Therapy Improves Blood Pressure Control: Results of HYT (HYperTension survey) Follow-up.

    Science.gov (United States)

    Fici, F; Seravalle, G; Koylan, N; Nalbantgil, I; Cagla, N; Korkut, Y; Quarti-Trevano, F; Makel, W; Grassi, G

    2017-09-01

    Although improved during the past few years, blood pressure control remains sub optimal. The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. From the 4993 patients with uncontrolled blood pressure, (BP ≥ 140/90 or ≥140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen; (c) lipophilic CCBs induce less ankle edema.

  19. The impact and financial burden of pulmonary arterial hypertension on patients and caregivers: results from a national survey.

    Science.gov (United States)

    Zhai, Zhenguo; Zhou, Xia; Zhang, Shuai; Xie, Wanmu; Wan, Jun; Kuang, Tuguang; Yang, Yuanhua; Huang, Huan; Wang, Chen

    2017-09-01

    Pulmonary arterial hypertension (PAH) is a chronic progressive devastating disease. Symptom burden might impair health-related quality of life of patients. Furthermore, treatment on this disease brings significant financial burden to patients' families. Both physiological and psychological symptoms have been reported, but limited evidence regarding the impact of PAH on patients and caregivers exists, especially the emotional issues and their association with patients' health quality. The main purpose of this study was to describe the impact of PAH on patients and their caregivers in a Chinese population.This large-scale national survey enrolled 174 participants to complete questionnaires using face-to-face semistructured interviews.PAH influenced all aspects of patients' lives including daily activities, work, emotions, and personal relationships. Both patients and caregivers reported a major impact on family finances and on their work. The majority of patients had feelings of isolation. A lack of public understanding about PAH contributes to social isolation. Most patients and caregivers would like to get information regarding PAH doctors and patient organization contacts to obtain support.This survey-based report provides information regarding the way and extent to which PAH impacts both patients and their caregivers and provides some means for comparison with non-Chinese populations. It is important for physicians and the community to offer more support and information for PAH patients and their families.

  20. Self-perceived lactose intolerance results in lower intakes of calcium and dairy foods and is associated with hypertension and diabetes in adults.

    Science.gov (United States)

    Nicklas, Theresa A; Qu, Haiyan; Hughes, Sheryl O; He, Mengying; Wagner, Sara E; Foushee, Herman R; Shewchuk, Richard M

    2011-07-01

    Self-perceived lactose intolerance may result in adverse dietary modifications; thus, more studies are needed to understand the prevalence of self-perceived lactose intolerance and how it relates to calcium intake and selected health conditions. The objective was to examine the effects of self-perceived lactose intolerance as it relates to calcium intake and specific health problems that have been attributed to reduced intakes of calcium and dairy foods in a nationally representative multiethnic sample of adults. This was a cross-sectional study in a national sample of 3452 adults. The relation between self-perceived lactose intolerance, calcium intakes, and physician-diagnosed health conditions was analyzed by using linear regression analyses. Of the total sample, 12.3% of respondents perceived themselves to be lactose intolerant. The age-adjusted prevalence of self-perceived lactose intolerance was 7.8% for non-Hispanic whites, 20.1% for non-Hispanic blacks, and 8.8% for Hispanics. Respondents with self-perceived lactose intolerance had significantly lower (P lactose intolerance. A significantly higher (P lactose intolerance than of respondents without self-perceived lactose intolerance reported having physician-diagnosed diabetes and hypertension. The odds of self-reported physician-diagnosed diabetes or hypertension decreased by factors of 0.70 and 0.60, respectively, for a 1000-mg increase in calcium intake from dairy foods per day. Self-perceived lactose-intolerant respondents had a significantly lower calcium intake from dairy foods and reported having a significantly higher rate of physician-diagnosed diabetes and hypertension.

  1. Evaluation and management of pediatric hypertensive crises: hypertensive urgency and hypertensive emergencies

    Directory of Open Access Journals (Sweden)

    Patel NH

    2012-11-01

    Full Text Available Nirali H Patel,1 Sarah K Romero,2 David C Kaelber31Division of Emergency Medicine, Akron Children's Hospital, Akron, OH, USA; 2Division of Emergency Medicine, Rainbow Babies and Children's Hospital, Cleveland, OH, USA; 3Departments of Information Services, Internal Medicine, Pediatrics, and Epidemiology and Biostatistics, The Center for Clinical Informatics Research and Education, The MetroHealth System and School of Medicine, Case Western Reserve University, Cleveland OH, USAAbstract: Hypertension (HTN in the pediatric population is estimated to have a world-wide prevalence of 2%-5%. As with adults, pediatric patients with HTN can present with hypertensive crises include hypertensive urgency and hypertensive emergencies. However, pediatric blood pressure problems have a greater chance of being from secondary causes of HTN, as opposed to primary HTN, than in adults. Thorough evaluation of a child with a hypertensive emergency includes accurate blood pressure readings, complete and focused symptom history, and appropriate past medical, surgical, and family history. Physical exam should include height, weight, four-limb blood pressures, a general overall examination and especially detailed cardiovascular and neurological examinations, including fundoscopic examination. Initial work-up should typically include electrocardiography, chest X-ray, serum chemistries, complete blood count, and urinalysis. Initial management of hypertensive emergencies generally includes the use of intravenous or oral antihypertensive medications, as well as appropriate, typically outpatient, follow-up. Emergency department goals for hypertensive crises are to (1 safely lower blood pressure, and (2 treat/minimize acute end organ damage, while (3 identifying underlying etiology. Intravenous antihypertensive medications are the treatment modality of choice for hypertensive emergencies with the goal of reducing systolic blood pressure by 25% of the original value over an 8

  2. Turbulence modeling with fractional derivatives: Derivation from first principles and initial results

    Science.gov (United States)

    Epps, Brenden; Cushman-Roisin, Benoit

    2017-11-01

    Fluid turbulence is an outstanding unsolved problem in classical physics, despite 120+ years of sustained effort. Given this history, we assert that a new mathematical framework is needed to make a transformative breakthrough. This talk offers one such framework, based upon kinetic theory tied to the statistics of turbulent transport. Starting from the Boltzmann equation and ``Lévy α-stable distributions'', we derive a turbulence model that expresses the turbulent stresses in the form of a fractional derivative, where the fractional order is tied to the transport behavior of the flow. Initial results are presented herein, for the cases of Couette-Poiseuille flow and 2D boundary layers. Among other results, our model is able to reproduce the logarithmic Law of the Wall in shear turbulence.

  3. Results of the initial test program for the Sandia Pulsed Reactor III (SPR III)

    International Nuclear Information System (INIS)

    Estes, B.F.; Reuscher, J.A.

    1976-08-01

    This document presents a detailed discussion of the reactor including the mechanical and nuclear design characteristics. Also presented are the complete results of the Initial Approach to Critical and the Zero-and-Low Power testing programs. Reactivity worth measurements are given for such parameters as control element integral worth, Safety Block integral worth, and various materials (polyethylene, copper, lead, etc) as a function of position relative to the core. Subcritical reactivity measurements made during the approach to critical generally proved to be in reasonably good agreement with design values due to the good source-fuel-detector geometry possible with a reactor of this type. Subsequent dynamic measurements for reactivity worths are shown to be in good agreement with calculated results

  4. Results of initial analyses of the salt (macro) batch 11 Tank 21H qualification samples

    Energy Technology Data Exchange (ETDEWEB)

    Peters, T. B. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-10-23

    Savannah River National Laboratory (SRNL) analyzed samples from Tank 21H in support of qualification of Interim Salt Disposition Project (ISDP) Salt (Macro) Batch 11 for processing through the Actinide Removal Process (ARP) and the Modular Caustic-Side Solvent Extraction Unit (MCU). This document reports the initial results of the analyses of samples of Tank 21H. Analysis of the Tank 21H Salt (Macro) Batch 11 composite sample indicates that the material does not display any unusual characteristics or observations, such as floating solids, the presence of large amounts of solids, or unusual colors. Further sample results will be reported in a future document. This memo satisfies part of Deliverable 3 of the Technical Task Request (TTR).

  5. Effectiveness and tolerability of fixed-dose combination enalapril plus nitrendipine in hypertensive patients: results of the 3-month observational, post-marketing, multicentre, prospective CENIT study.

    Science.gov (United States)

    Sierra, Alejandro de la; Roca-Cusachs, Alejandro; Redón, Josep; Marín, Rafael; Luque, Manuel; Figuera, Mariano de la; Garcia-Garcia, Margarida; Falkon, Liliana

    2009-01-01

    dyslipidaemia (42.3%), obesity (29.2%) and diabetes (23.9%). After 3 months of treatment, SBP and DBP showed mean (+/- SD) decreases of 26.5 (+/- 14.4) mmHg and 14.9 (+/- 9.0) mmHg, respectively, and 73.0% of patients responded to treatment while 40.9% achieved BP control (70.8%/36.1% in 2658 patients aged >65 years; 61.7%/46.8% in 1521 patients with diabetes; 55.3%/44.2% in 731 patients with ISH; 72.0%/36.4% in 1762 obese patients). Adverse events were reported in 10.8% of patients (n = 689). During the follow-up period, ten patients died and seven patients had serious adverse events; in no case was a causal relationship attributed to the study product. The rate of SBP/DBP control achieved demonstrates the effectiveness of the fixed-dose enalapril/nitrendipine 10 mg/20 mg combination administered as a single daily dose in patients with essential hypertension not adequately controlled with monotherapy or with any combination other than enalapril + nitrendipine. The proportion and type of adverse events reported were as expected and have already been described for both components of the enalapril/nitrendipine 10 mg/20 mg combination. These results confirm the effectiveness of a strategy based on a fixed-dose enalapril/nitrendipine 10 mg/20 mg combination in reducing BP and achieving BP control goals.

  6. Recent advances in the management of resistant hypertension

    OpenAIRE

    Manolis, Athanasios J.; Kallistratos, Manolis S.; Doumas, Michalis; Pagoni, Stamatina; Poulimenos, Leonidas

    2015-01-01

    And suddenly, following the preliminary results of renal denervation and carotid baroreceptor stimulation, a big interest in resistant hypertension rose, and all interventionists, many of them with no previous experience with hypertension, fell in love with hypertension and especially resistant hypertension. In the European Society of Hypertension/International Society of Hypertension (ESH/ISH) 2014 Joint Hypertension meeting in Athens, there were no more than four to five sessions related to...

  7. Defective replication initiation results in locus specific chromosome breakage and a ribosomal RNA deficiency in yeast.

    Directory of Open Access Journals (Sweden)

    Joseph C Sanchez

    2017-10-01

    Full Text Available A form of dwarfism known as Meier-Gorlin syndrome (MGS is caused by recessive mutations in one of six different genes (ORC1, ORC4, ORC6, CDC6, CDT1, and MCM5. These genes encode components of the pre-replication complex, which assembles at origins of replication prior to S phase. Also, variants in two additional replication initiation genes have joined the list of causative mutations for MGS (Geminin and CDC45. The identity of the causative MGS genetic variants strongly suggests that some aspect of replication is amiss in MGS patients; however, little evidence has been obtained regarding what aspect of chromosome replication is faulty. Since the site of one of the missense mutations in the human ORC4 alleles is conserved between humans and yeast, we sought to determine in what way this single amino acid change affects the process of chromosome replication, by introducing the comparable mutation into yeast (orc4Y232C. We find that yeast cells with the orc4Y232C allele have a prolonged S-phase, due to compromised replication initiation at the ribosomal DNA (rDNA locus located on chromosome XII. The inability to initiate replication at the rDNA locus results in chromosome breakage and a severely reduced rDNA copy number in the survivors, presumably helping to ensure complete replication of chromosome XII. Although reducing rDNA copy number may help ensure complete chromosome replication, orc4Y232C cells struggle to meet the high demand for ribosomal RNA synthesis. This finding provides additional evidence linking two essential cellular pathways-DNA replication and ribosome biogenesis.

  8. Defective replication initiation results in locus specific chromosome breakage and a ribosomal RNA deficiency in yeast.

    Science.gov (United States)

    Sanchez, Joseph C; Kwan, Elizabeth X; Pohl, Thomas J; Amemiya, Haley M; Raghuraman, M K; Brewer, Bonita J

    2017-10-01

    A form of dwarfism known as Meier-Gorlin syndrome (MGS) is caused by recessive mutations in one of six different genes (ORC1, ORC4, ORC6, CDC6, CDT1, and MCM5). These genes encode components of the pre-replication complex, which assembles at origins of replication prior to S phase. Also, variants in two additional replication initiation genes have joined the list of causative mutations for MGS (Geminin and CDC45). The identity of the causative MGS genetic variants strongly suggests that some aspect of replication is amiss in MGS patients; however, little evidence has been obtained regarding what aspect of chromosome replication is faulty. Since the site of one of the missense mutations in the human ORC4 alleles is conserved between humans and yeast, we sought to determine in what way this single amino acid change affects the process of chromosome replication, by introducing the comparable mutation into yeast (orc4Y232C). We find that yeast cells with the orc4Y232C allele have a prolonged S-phase, due to compromised replication initiation at the ribosomal DNA (rDNA) locus located on chromosome XII. The inability to initiate replication at the rDNA locus results in chromosome breakage and a severely reduced rDNA copy number in the survivors, presumably helping to ensure complete replication of chromosome XII. Although reducing rDNA copy number may help ensure complete chromosome replication, orc4Y232C cells struggle to meet the high demand for ribosomal RNA synthesis. This finding provides additional evidence linking two essential cellular pathways-DNA replication and ribosome biogenesis.

  9. Fast food consumption and its associations with obesity and hypertension among children: results from the baseline data of the Childhood Obesity Study in China Mega-cities.

    Science.gov (United States)

    Zhao, Yaling; Wang, Liang; Xue, Hong; Wang, Huijun; Wang, Youfa

    2017-12-06

    China has seen rapid increase in obesity and hypertension prevalence and fast food consumption over the past decade. We examined status and risk factors for Western- and Chinese fast food consumption and their associations with health outcomes in Chinese children, and examined how maternal factors were associated with child health outcomes. Data of 1626 students aged 7-16 (11.6 ± 2.0) years and their parents in four mega-cities across China (Beijing, Shanghai, Nanjing, and Xi'an) were collected in the 2015 baseline survey of the Childhood Obesity Study in China Mega-cities. Weight, height, waist circumference, and blood pressure were measured. Food intake was assessed using questionnaire. Mixed models were used to examine the associations. Among the children, 11.1% were obese, 19.7% were centrally obese, and 9.0% had hypertension. Obesity prevalence was much higher in boys than in girls (15.2% vs. 6.9% and 27.4% vs. 11.7%, respectively, both P fast food, respectively, over the past 3 months. Compared to those with college or above maternal education level, those with elementary school or below maternal education level were 49% more likely to consume Western fast food (odds ratio [OR] and 95% confidence interval [CI]: 1.49 [1.10-2.03]). Chinese fast food consumption rate increased by 12% with each year of increase in child's age (OR and 95% CI: 1.12 [1.02-1.23]). No significant associations between fast food consumption and health outcomes were detected. Adjusting for Western fast food consumption, children with lower maternal education were 71% and 43% more likely to have obesity and central obesity (ORs and 95% CIs: 1.71 [1.12-2.61] and 1.43 [1.00-2.03], respectively), and maternal body mass index was positively associated with child obesity, central obesity, and hypertension (ORs and 95% CIs: 1.11 [1.06-1.17], 1.12 [1.07-1.17], and 1.09 [1.03-1.15], respectively). Results were similar when Chinese fast food consumption was adjusted for. The prevalence of

  10. Implementation of STUD Pulses at the Trident Laser and Initial Results

    Science.gov (United States)

    Johnson, R. P.; Shimada, T.; Montgomery, D. S.; Afeyan, B.; Hüller, S.

    2012-10-01

    Controlling and mitigating laser-plasma instabilities such as stimulated Brillouin scattering, stimulated Raman scattering, and crossed-beam energy transfer is important to achieve high-gain inertial fusion using laser drivers. Recent theory and simulations show that these instabilities can be largely controlled using laser pulses consisting of spike trains of uneven duration and delay (STUD) by modulating the laser on a picosecond time scale [1,2]. We have designed and implemented a STUD pulse generator at the LANL Trident Laser Facility using Fourier synthesis to produce a 0.5-ns envelope of psec-duration STUD pulses using a spatial light modulator. Initial results from laser propagation tests and measurements as well as initial laser-plasma characterization experiments will be presented.[4pt] [1] B. Afeyan and S. H"uller, ``Optimal Control of Laser Plasma Instabilities using STUD pulses,'' IFSA 2011, P.Mo.1, to appear in Euro. Phys. J. Web of Conf. (2012).[2] S. H"uller and B. Afeyan, ``Simulations of drastically reduced SBS with STUD pulses,'' IFSA 2011, O.Tu8-1, to appear in Euro. Phys. J. Web of Conf. (2012).

  11. Results from the Data & Democracy initiative to enhance community-based organization data and research capacity.

    Science.gov (United States)

    Carroll-Scott, Amy; Toy, Peggy; Wyn, Roberta; Zane, Jazmin I; Wallace, Steven P

    2012-07-01

    In an era of community-based participatory research and increased expectations for evidence-based practice, we evaluated an initiative designed to increase community-based organizations' data and research capacity through a 3-day train-the-trainer course on community health assessments. We employed a mixed method pre-post course evaluation design. Various data sources collected from 171 participants captured individual and organizational characteristics and pre-post course self-efficacy on 19 core skills, as well as behavior change 1 year later among a subsample of participants. Before the course, participants reported limited previous experience with data and low self-efficacy in basic research skills. Immediately after the course, participants demonstrated statistically significant increases in data and research self-efficacy. The subsample reported application of community assessment skills to their work and increased use of data 1 year later. Results suggest that an intensive, short-term training program can achieve large immediate gains in data and research self-efficacy in community-based organization staff. In addition, they demonstrate initial evidence of longer-term behavior change related to use of data and research skills to support their community work.

  12. Initial clinical results of linac-based stereotactic radiosurgery and stereotactic radiotherapy for pituitary adenomas

    International Nuclear Information System (INIS)

    Mitsumori, Michihide; Shrieve, Dennis C.; Alexander, Eben; Kaiser, Ursula B.; Richardson, Gary E.; Black, Peter McL.; Loeffler, Jay S.

    1998-01-01

    Purpose: To retrospectively evaluate the initial clinical results of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) for pituitary adenomas with regard to tumor and hormonal control and adverse effects of the treatment. Subjects and Methods: Forty-eight patients with pituitary adenoma who underwent SRS or SRT between September 1989 and September 1995 were analyzed. Of these, 18 received SRS and 30 received SRT. The median tumor volumes were 1.9 cm 3 for SRS and 5.7 cm 3 for SRT. Eleven of the SRS and 18 of the SRT patients were hormonally active at the time of the initial diagnosis. Four of the SRS and none of the SRT patients had a history of prior radiation therapy. Both SRS and SRT were performed using a dedicated stereotactic 6-MV linear accelerator (LINAC). The dose and normalization used for the SRS varied from 1000 cGy at 85% of the isodose line to 1500 cGy at 65% of the isodose line. For SRT patients, a total dose of 4500 cGy at 90% or 95% of the isodose line was delivered in 25 fractions of 180 cGy daily doses. Results: Disease control--The three year tumor control rate was 91.1% (100% for SRS and 85.3% for SRT). Normalization of the hormonal abnormality was achieved in 47% of the 48 patients (33% for SRS and 54% for SRT). The average time required for normalization was 8.5 months for SRS and 18 months for SRT. Adverse effects--The 3-year rate of freedom from central nervous system adverse effects was 89.7% (72.2% for SRS and 100% for SRT). Three patients who received SRS for a tumor in the cavernous sinus developed a ring enhancement in the temporal lobe as shown by follow-up magnetic resonance imaging. Two of these cases were irreversible and were considered to be radiation necrosis. None of the 48 patients developed new neurocognitive or visual disorders attributable to the irradiation. The incidence of endocrinological adverse effects were similar in the two groups, resulting in 3-year rates of freedom from newly

  13. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results

    International Nuclear Information System (INIS)

    Bhalgat, Parag S; Pinto, Robin; Dalvi, Bharat V

    2012-01-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term

  14. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results.

    Science.gov (United States)

    Bhalgat, Parag S; Pinto, Robin; Dalvi, Bharat V

    2012-07-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.

  15. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension: Short and intermediate term results

    Energy Technology Data Exchange (ETDEWEB)

    Bhalgat, Parag S [Department of Cardiology, King Edward VII Memorial Hospital, Mumbai, Maharashtra (India); Pinto, Robin; Dalvi, Bharat V, E-mail: bharatdalvi@hotmail.com [Glenmark Cardiac Center, 10 Nandadeep, 209 Dr. Ambedkar Road, Matunga (East), Mumbai, Maharashtra (India)

    2012-01-01

    To assess the efficacy and safety of transcatheter closure (TCC) of patent ductus arteriosus (PDA) with severe pulmonary arterial hypertension (PHT). TCC of small and moderate-sized PDAs is well established. However, there is a paucity of data on TCC of large PDA with severe PHT. This is a retrospective observational study of 76 patients with large PDA and severe PHT who were referred for TCC. Multiple clinical and investigational parameters were evaluated to decide the reversibility of PHT. Following the TCC, patients were serially followed up to assess the efficacy and safety of closure and its impact on PHT. Of 76 patients, nine were found to have PDA with Eisenmenger's syndrome. Of remaining 67, two were thought to have irreversible PHT based on hemodynamic data obtained after balloon occlusion of the duct. Sixty five patients, who eventually underwent TCC of PDA, had a median age of 9.1 years (range 1 month to 40 years). The weight ranged between 2.5 to 62 kg (median 14 kg). The PDA size was 9.1 ± 4.6 mm. The mean systolic pulmonary artery pressure was 66.9 ± 15.3 mm Hg. Duct occluder was used in 63 and muscular ventricular septal defect closure device in 2. The follow up was available in 56 (86%) with a mean follow up period of 65 ± 34 months. All the patients had complete closure of the PDA at 6 months follow up. Mild obstruction of left pulmonary artery (n=3) and aortic isthmus flow (n=6) was noted at the time of discharge. During the follow up, partial or complete resolution of PHT was observed in all the patients in whom Doppler-derived right ventricular systolic pressure was recorded (available in 40 of 56 patients). TCC of large PDA with severe PHT and significant left to right shunt was found to be effective and safe in the short and intermediate term.

  16. Initial test results of an ionization chamber shower detector for a LHC luminosity monitor

    International Nuclear Information System (INIS)

    Datte, P.; Beche, J.-F.; Haguenauer, M.; Manfredi, P.F.; Manghisoni, M.; Millaud, J.; Placidi, M.; Ratti, L.; Riot, V.; Schmickler, H.; Speziali, V.; Turner, W.

    2002-01-01

    A novel, segmented, multi-gap, pressurized gas ionization chamber is being developed for optimization of the luminosity of the LHC. The ionization chambers are to be installed in the front quadrupole and zero degree neutral particle absorbers in the high luminosity IRs and sample the energy deposited near the maxima of the hadronic/electromagnetic showers in these absorbers. The ionization chambers are instrumented with low noise, fast, pulse shaping electronics to be capable of resolving individual bunch crossings at 40 MHz. In this paper we report the initial results of our second test of this instrumentation in an SPS external proton beam. Single 300 GeV protons are used to simulate the hadronic/electromagnetic shower produced by the forward collision products from the interaction regions of the LHC. The capability of instrumentations to measure the luminosity of individual bunches in a 40 MHz bunch train is demonstrated

  17. Initial results from the ISEE-1 and -2 plasma wave investigation

    International Nuclear Information System (INIS)

    Gurnett, D.A.; Anderson, R.R.; Smith, E.J.

    1979-01-01

    In this paper the authors present an initial survey of results from the plasma wave experiments on the ISEE-1 and -2 spacecraft which are in nearly identical orbits passing through the Earth's magneotsphere at radial distances out to about 22.5 Rsub(e). Essentially every crossing of the Earth's bow shock can be associated with an intense burst of electrostatic and whistler-mode turbulence at the shock, with substanial wave intensities in both the upstream and downstream regions. In the magnetosphere high resolution spectrograms of the electric field show an extremely complex distribution of plasma and radio emission, with numerous resonance and cutoff effects. High resolution spectrograms of kilometric radio emissions are also presented which show an extremely complex frequency-time structure with many closely spaced narrow-band emissions. (Auth.)

  18. Initial cathode processing experiences and results for the treatment of spent fuel

    International Nuclear Information System (INIS)

    Westphal, B.R.; Laug, D.V.; Brunsvold, A.R.; Roach, P.D.

    1996-01-01

    As part of the spent fuel treatment demonstration at Argonne National Laboratory, a vacuum distillation process is being employed for the recovery of uranium following an electrorefining process. Distillation of a salt electrolyte, primarily consisting of a eutectic mixture of lithium and potassium chlorides, from uranium is achieved by a batch operation termed ''cathode processing.'' Cathode processing is performed in a retort furnace which enables the production of a stable uranium product that can be isotopically diluted and stored. To date, experiments have been performed with two distillation units; one for prototypical testing and the other for actual spent fuel treatment operations. The results and experiences from these initial experiments with both units will be discussed as well as problems encountered and their resolution

  19. Initial results from an agressive roentgenological and surgical approach to acute mesenteric ischemia.

    Science.gov (United States)

    Boley, S J; Sprayregan, S; Siegelman, S S; Veith, F J

    1977-12-01

    The 70% to 80% mortality rate of patients with acute mesenteric ischemia (AMI) has remained unchanged over the past 40 years. We report here the initial results using an aggressive approach to this problem. This included the earlier and more liberal use of angiography in patients at risk and the intra-arterial infusion of papaverine for the relief of superior mesenteric artery (SMA) vasoconstriction in both nonocclusive and occlusive forms of AMI. Of the first 50 patients managed by this approach, 35 (70%) had AMI demonstrated by SMA angiography, Nineteen (54%) of these 35 patients survived, including nine of 15 patients with nonocclusive mesenteric ischemia, seven of 16 with SMA embolus, two of three patients with SMA thrombosis, and the one patient with mesenteric venous thrombosis. Seventeen of the 19 survivors lost no bowel or had excision of less than 3 feet of small intestine.

  20. Initial results of the high resolution edge Thomson scattering upgrade at DIII-D.

    Science.gov (United States)

    Eldon, D; Bray, B D; Deterly, T M; Liu, C; Watkins, M; Groebner, R J; Leonard, A W; Osborne, T H; Snyder, P B; Boivin, R L; Tynan, G R

    2012-10-01

    Validation of models of pedestal structure is an important part of predicting pedestal height and performance in future tokamaks. The Thomson scattering diagnostic at DIII-D has been upgraded in support of validating these models. Spatial and temporal resolution, as well as signal to noise ratio, have all been specifically enhanced in the pedestal region. This region is now diagnosed by 20 view-chords with a spacing of 6 mm and a scattering length of just under 5 mm sampled at a nominal rate of 250 Hz. When mapped to the outboard midplane, this corresponds to ~3 mm spacing. These measurements are being used to test critical gradient models, in which pedestal gradients increase in time until a threshold is reached. This paper will describe the specifications of the upgrade and present initial results of the system.

  1. Initial results of NEXT-DEMO, a large-scale prototype of the NEXT-100 experiment

    International Nuclear Information System (INIS)

    Álvarez, V; Cárcel, S; Cervera, A; Díaz, J; Ferrario, P; Gil, A; Borges, F I G; Conde, C A N; Dias, T H V T; Fernandes, L M P; Freitas, E D C; Castel, J; Cebrián, S; Dafni, T; Egorov, M; Gehman, V M; Goldschmidt, A; Esteve, R; Evtoukhovitch, P; Ferreira, A L

    2013-01-01

    NEXT-DEMO is a large-scale prototype of the NEXT-100 detector, an electroluminescent time projection chamber that will search for the neutrinoless double beta decay of XE using 100–150 kg of enriched xenon gas. NEXT-DEMO was built to prove the expected performance of NEXT-100, namely, energy resolution better than 1% FWHM at 2.5 MeV and event topological reconstruction. In this paper we describe the prototype and its initial results. A resolution of 1.75% FWHM at 511 keV (which extrapolates to 0.8% FWHM at 2.5 MeV) was obtained at 10 bar pressure using a gamma-ray calibration source. Also, a basic study of the event topology along the longitudinal coordinate is presented, proving that it is possible to identify the distinct dE/dx of electron tracks in high-pressure xenon using an electroluminescence TPC.

  2. Initial tank calibration at NUCEF critical facility. 1. Measurement procedure and its result

    International Nuclear Information System (INIS)

    Yanagisawa, Hiroshi; Mineo, Hideaki; Tonoike, Kotaro; Takeshita, Isao; Hoshi, Katsuya; Hagiwara, Hiroyuki.

    1994-07-01

    Initial tank calibrations were carried out prior to hot operation of critical facilities in NUCEF: Nuclear Fuel Cycle Safety Engineering Research Facility, for the purpose of the nuclear material accountancy and control for the facility. Raw calibration data were collected from single run per one tank by measuring differential pressure with dip-tube systems, weight of calibration liquid (demineralized water) poured into the tank, temperature in the tank and so on, without operation of tank ventilation system. Volume and level data were obtained by applying density and buoyancy corrections to the raw data. As a result, the evaluated measurement errors of volume and level were small enough, e.g. within 0.2 lit. and 1.0 mm, respectively, for Pu accountancy tanks. This paper summarizes the above-mentioned measurement procedures, collected data, data correction procedures and evaluated measurement errors. (author)

  3. Sensitivity Analysis of FEAST-Metal Fuel Performance Code: Initial Results

    International Nuclear Information System (INIS)

    Edelmann, Paul Guy; Williams, Brian J.; Unal, Cetin; Yacout, Abdellatif

    2012-01-01

    This memo documents the completion of the LANL milestone, M3FT-12LA0202041, describing methodologies and initial results using FEAST-Metal. The FEAST-Metal code calculations for this work are being conducted at LANL in support of on-going activities related to sensitivity analysis of fuel performance codes. The objective is to identify important macroscopic parameters of interest to modeling and simulation of metallic fuel performance. This report summarizes our preliminary results for the sensitivity analysis using 6 calibration datasets for metallic fuel developed at ANL for EBR-II experiments. Sensitivity ranking methodology was deployed to narrow down the selected parameters for the current study. There are approximately 84 calibration parameters in the FEAST-Metal code, of which 32 were ultimately used in Phase II of this study. Preliminary results of this sensitivity analysis led to the following ranking of FEAST models for future calibration and improvements: fuel conductivity, fission gas transport/release, fuel creep, and precipitation kinetics. More validation data is needed to validate calibrated parameter distributions for future uncertainty quantification studies with FEAST-Metal. Results of this study also served to point out some code deficiencies and possible errors, and these are being investigated in order to determine root causes and to improve upon the existing code models.

  4. Renal denervation with a percutaneous bipolar radiofrequency balloon catheter in patients with resistant hypertension: 6-month results from the REDUCE-HTN clinical study.

    Science.gov (United States)

    Sievert, Horst; Schofer, Joachim; Ormiston, John; Hoppe, Uta C; Meredith, Ian T; Walters, Darren L; Azizi, Michel; Diaz-Cartelle, Juan; Cohen-Mazor, Meital

    2015-02-01

    To evaluate the safety and efficacy of the balloon-based bipolar Vessix Renal Denervation System in treating patients with resistant hypertension. In this prospective, multicentre, single-arm study, 146 patients (age 58.6±10.5 years; 61% men) with office systolic blood pressure (BP) ≥160 mmHg despite ≥3 antihypertensive medications at maximally tolerated doses were treated with the Vessix System. Efficacy endpoints were reductions in office and 24-hour ambulatory systolic and diastolic BPs at six months. Acute and long-term safety, with a focus on the renal artery and estimated glomerular filtration rate (eGFR), were assessed. Baseline office and ambulatory BPs were 182.4±18.4/100.2±14.0 mmHg and 153.0±15.1/87.5±13.2 mmHg, respectively. No acute renal artery injury requiring intervention or serious periprocedural cardiovascular events occurred. At six months, office BP was reduced by 24.7±22.1/10.3±12.7 mmHg (prenal artery stenosis which required stenting. Mean eGFR remained stable. Renal artery denervation with the Vessix System reduced both office and ambulatory BP at six months in patients with resistant hypertension. Renal artery safety and renal function results are favourable.

  5. Initial results from a multiple monoenergetic gamma radiography system for nuclear security

    Science.gov (United States)

    O'Day, Buckley E.; Hartwig, Zachary S.; Lanza, Richard C.; Danagoulian, Areg

    2016-10-01

    The detection of assembled nuclear devices and concealed special nuclear materials (SNM) such as plutonium or uranium in commercial cargo traffic is a major challenge in mitigating the threat of nuclear terrorism. Currently available radiographic and active interrogation systems use ∼1-10 MeV bremsstrahlung photon beams. Although simple to build and operate, bremsstrahlung-based systems deliver high radiation doses to the cargo and to potential stowaways. To eliminate problematic issues of high dose, we are developing a novel technique known as multiple monoenergetic gamma radiography (MMGR). MMGR uses ion-induced nuclear reactions to produce two monoenergetic gammas for dual-energy radiography. This allows us to image the areal density and effective atomic number (Zeff) of scanned cargo. We present initial results from the proof-of-concept experiment, which was conducted at the MIT Bates Research and Engineering Center. The purpose of the experiment was to assess the capabilities of MMGR to measure areal density and Zeff of container cargo mockups. The experiment used a 3.0 MeV radiofrequency quadrupole accelerator to create sources of 4.44 MeV and 15.11 MeV gammas from the 11B(d,nγ)12C reaction in a thick natural boron target; the gammas are detected by an array of NaI(Tl) detectors after transmission through cargo mockups . The measured fluxes of transmitted 4.44 MeV and 15.11 MeV gammas were used to assess the areal density and Zeff. Initial results show that MMGR is capable of discriminating the presence of high-Z materials concealed in up to 30 cm of iron shielding from low- and mid-Z materials present in the cargo mockup.

  6. What do Patients Want From Their Radiation Oncologist? Initial Results From a Prospective Trial

    International Nuclear Information System (INIS)

    Bhatnagar, Ajay K.; Land, Stephanie R.; Shogan, Alyson; Rodgers, Edwin E.; Heron, Dwight E.; Flickinger, John C.

    2007-01-01

    Purpose: To assess patients' initial physician preferences using a newly developed instrument. Methods and Materials: A total of 182 patients with a primary diagnosis of prostate, breast, or lung cancer referred for consultation to University of Pittsburgh Cancer Institute Department of Radiation Oncology enrolled in our institutional review board-approved protocol. All patients completed patient preference instrument surveys before meeting their radiation oncologist. Survey responses to 10 statements were categorized into three groups (agree, neutral, or disagree), and the association of survey responses by cancer site was tested with chi-squared tests. Results: Ninety-nine percent of all patients preferred to be addressed by their first name in encounters with their radiation oncologist. There were significant associations of Item 3 (hand holding) with gender (p = 0.039) and education (p = 0.028). The responses to Item 5, a statement that patients would feel uncomfortable if the radiation oncologist offered to hug them at the end of treatment, was significantly associated with disease site (p < 0.0001). Further analysis was performed for Item 5 and revealed that the male lung cancer patients had a much higher rate of disagreement with Item 5 compared with prostate cancer patients (37% vs. 18%). Conclusions: Results of this study may afford greater insight and foster better understanding of what patients want from their radiation oncologist. For breast, lung, and prostate cancer patients, initial preferences for their radiation oncologist are generally similar, according to this tool. However, there are important difference among cancer sites (and gender) regarding physical contact at the end of treatment

  7. Hypertension and cardiac arrhythmias

    DEFF Research Database (Denmark)

    Lip, Gregory Y.H.; Coca, Antonio; Kahan, Thomas

    2017-01-01

    Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both...... supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia......, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society...

  8. Endokrin hypertension

    DEFF Research Database (Denmark)

    Poulsen, Per Løgstrup; Ibsen, Hans

    2009-01-01

    Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma-aldosterone-to-renin ......Endocrine hypertension is rare, but frequently refractory. Adenomas are common incidental findings. Biochemical tests confirm the diagnosis. Primary aldosteronism is the most common form. Hypokalaemia is an important sign, but 50% of patients may be normokalaemic. The plasma...

  9. Resistant hypertension.

    Science.gov (United States)

    Wei, Fang-Fei; Zhang, Zhen-Yu; Huang, Qi-Fang; Yang, Wen-Yi; Staessen, Jan A

    2018-06-15

    The publication of the first non-randomised proof-of-concept trial of renal denervation as a treatment modality in treatment-resistant hypertension set the stage for a search for novel devices with the expectation that technology would reduce the burden of hypertension by reducing or eliminating the costly and lifelong use of blood pressure lowering medications. As we demonstrate in this review, this idea so attractive to manufacturers and invasive cardiologists and radiologists overlooked decades of careful pathophysiological research in a disease, which still remains enigmatic but remains the major cause of cardiovascular mortality worldwide. To make our point, we first reviewed the prevalence and risks associated with treatment-resistant hypertension. Next, we highlighted the key points required for the diagnosis of treatment-resistant hypertension, including the recording of the ambulatory blood pressure and the assessment of adherence to medication. Finally, we summarised new insights in the management of treatment-resistant hypertension by medication and devices and in the future research. Throughout our review, we focused on new evidence became available since 2013. Our conclusion is that optimising medical treatment based on simple algorithms remains the state of the art in treatment-resistant hypertension.

  10. Biology of portal hypertension.

    Science.gov (United States)

    McConnell, Matthew; Iwakiri, Yasuko

    2018-02-01

    Portal hypertension develops as a result of increased intrahepatic vascular resistance often caused by chronic liver disease that leads to structural distortion by fibrosis, microvascular thrombosis, dysfunction of liver sinusoidal endothelial cells (LSECs), and hepatic stellate cell (HSC) activation. While the basic mechanisms of LSEC and HSC dysregulation have been extensively studied, the role of microvascular thrombosis and platelet function in the pathogenesis of portal hypertension remains to be clearly characterized. As a secondary event, portal hypertension results in splanchnic and systemic arterial vasodilation, leading to the development of a hyperdynamic circulatory syndrome and subsequently to clinically devastating complications including gastroesophageal varices and variceal hemorrhage, hepatic encephalopathy from the formation of portosystemic shunts, ascites, and renal failure due to the hepatorenal syndrome. This review article discusses: (1) mechanisms of sinusoidal portal hypertension, focusing on HSC and LSEC biology, pathological angiogenesis, and the role of microvascular thrombosis and platelets, (2) the mesenteric vasculature in portal hypertension, and (3) future directions for vascular biology research in portal hypertension.

  11. 42 CFR 476.93 - Opportunity to discuss proposed initial denial determination and changes as a result of a DRG...

    Science.gov (United States)

    2010-10-01

    ... determination and changes as a result of a DRG validation. 476.93 Section 476.93 Public Health CENTERS FOR... initial denial determination and changes as a result of a DRG validation. Before a QIO reaches an initial denial determination or makes a change as a result of a DRG validation, it must— (a) Promptly notify the...

  12. 42 CFR 476.96 - Review period and reopening of initial denial determinations and changes as a result of DRG...

    Science.gov (United States)

    2010-10-01

    ... determinations and changes as a result of DRG validations. 476.96 Section 476.96 Public Health CENTERS FOR... initial denial determinations and changes as a result of DRG validations. (a) General timeframe. A QIO or... initial denial determination or a change as a result of a DRG validation. (b) Extended timeframes. (1) An...

  13. Initial results from the high resolution powder diffractometer HRPD at ISIS

    International Nuclear Information System (INIS)

    David, W.I.F.; Harrison, W.T.A.; Johnson, M.W.

    1986-07-01

    The paper reviews the initial commissioning of the high resolution time-of-flight neutron powder diffractometer, HRPD, on the Spallation Neutron Source, ISIS, at the Rutherford Appleton Laboratory. Preliminary results have confirmed both intensity and resolution predictions indicating that (Δd/d) lies between 0.04% and 0.08% for all d-spacings between 0.2 and 5A. The scientific potential of this increased resolution over existing time-of-flight diffractometers has been demonstrated in the successful ab initio structure determination of an unknown inorganic material, FeAsO 4 , and the detailed study of subtle symmetry changes in NiO. The true instrumental resolution, however, has been observed in only a small number of experiments: sample broadening is often seen to play a dominant role in the determination of the peak shape, particularly at longer d-spacings. This leads to additional useful information about macroscopic properties, such as anisotropic crystallite size, strain distribution and sample homogeneity, but also results in a significant increase in complexity of peak-shape description and data-analysis strategy. (author)

  14. Evaluation of wireless sensor networks (WSNs) for remote wetland monitoring: design and initial results.

    Science.gov (United States)

    Watras, Carl J; Morrow, Michael; Morrison, Ken; Scannell, Sean; Yaziciaglu, Steve; Read, Jordan S; Hu, Yu-Hen; Hanson, Paul C; Kratz, Tim

    2014-02-01

    Here, we describe and evaluate two low-power wireless sensor networks (WSNs) designed to remotely monitor wetland hydrochemical dynamics over time scales ranging from minutes to decades. Each WSN (one student-built and one commercial) has multiple nodes to monitor water level, precipitation, evapotranspiration, temperature, and major solutes at user-defined time intervals. Both WSNs can be configured to report data in near real time via the internet. Based on deployments in two isolated wetlands, we report highly resolved water budgets, transient reversals of flow path, rates of transpiration from peatlands and the dynamics of chromophoric-dissolved organic matter and bulk ionic solutes (specific conductivity)-all on daily or subdaily time scales. Initial results indicate that direct precipitation and evapotranspiration dominate the hydrologic budget of both study wetlands, despite their relatively flat geomorphology and proximity to elevated uplands. Rates of transpiration from peatland sites were typically greater than evaporation from open waters but were more challenging to integrate spatially. Due to the high specific yield of peat, the hydrologic gradient between peatland and open water varied with precipitation events and intervening periods of dry out. The resultant flow path reversals implied that the flux of solutes across the riparian boundary varied over daily time scales. We conclude that WSNs can be deployed in remote wetland-dominated ecosystems at relatively low cost to assess the hydrochemical impacts of weather, climate, and other perturbations.

  15. Initial results of tests of depth markers as a surface diagnostic for fusion devices

    Directory of Open Access Journals (Sweden)

    L.A. Kesler

    2017-08-01

    Full Text Available The Accelerator-Based In Situ Materials Surveillance (AIMS diagnostic was developed to perform in situ ion beam analysis (IBA on Alcator C-Mod in August 2012 to study divertor surfaces between shots. These results were limited to studying low-Z surface properties, because the Coulomb barrier precludes nuclear reactions between high-Z elements and the ∼1 MeV AIMS deuteron beam. In order to measure the high-Z erosion, a technique using deuteron-induced gamma emission and a low-Z depth marker is being developed. To determine the depth of the marker while eliminating some uncertainty due to beam and detector parameters, the energy dependence of the ratio of two gamma yields produced from the same depth marker will be used to determine the ion beam energy loss in the surface, and thus the thickness of the high-Z surface. This paper presents the results of initial trials of using an implanted depth marker layer with a deuteron beam and the method of ratios. First tests of a lithium depth marker proved unsuccessful due to the production of conflicting gamma peaks, among other issues. However, successful trials with a boron depth marker show that it is possible to measure the depth of the marker layer with the method of gamma yield ratios.

  16. [Implementation of a regional system for the emergency care of acute ischemic stroke: Initial results].

    Science.gov (United States)

    Soares-Oliveira, Miguel; Araújo, Fernando

    2014-06-01

    Implementing integrated systems for emergency care of patients with acute ischemic stroke helps reduce morbidity and mortality. We describe the process of organizing and implementing a regional system to cover around 3.7 million people and its main initial results. We performed a descriptive analysis of the implementation process and a retrospective analysis of the following parameters: number of patients prenotified by the pre-hospital system; number of times thrombolysis was performed; door-to-needle time; and functional assessment three months after stroke. The implementation process started in November 2005 and ended in December 2009, and included 11 health centers. There were 3574 prenotifications from the prehospital system. Thrombolysis was performed in 1142 patients. The percentage of patients receiving thrombolysis rose during the study period, with a maximum of 16%. Median door-to-needle time was 62 min in 2009. Functional recovery three months after stroke was total or near total in 50% of patients. The regional system implemented for emergency care of patients with acute ischemic stroke has led to health gains, with progressive improvements in patients' access to thrombolysis, and to greater equity in the health care system, thus helping to reduce mortality from cerebrovascular disease in Portugal. Our results, which are comparable with those of international studies, support the strategy adopted for implementation of this system. Copyright © 2013 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  17. Epistemology and expectations survey about experimental physics: Development and initial results

    Directory of Open Access Journals (Sweden)

    Benjamin M. Zwickl

    2014-06-01

    Full Text Available In response to national calls to better align physics laboratory courses with the way physicists engage in research, we have developed an epistemology and expectations survey to assess how students perceive the nature of physics experiments in the contexts of laboratory courses and the professional research laboratory. The Colorado Learning Attitudes about Science Survey for Experimental Physics (E-CLASS evaluates students’ epistemology at the beginning and end of a semester. Students respond to paired questions about how they personally perceive doing experiments in laboratory courses and how they perceive an experimental physicist might respond regarding their research. Also, at the end of the semester, the E-CLASS assesses a third dimension of laboratory instruction, students’ reflections on their course’s expectations for earning a good grade. By basing survey statements on widely embraced learning goals and common critiques of teaching labs, the E-CLASS serves as an assessment tool for lab courses across the undergraduate curriculum and as a tool for physics education research. We present the development, evidence of validation, and initial formative assessment results from a sample that includes 45 classes at 20 institutions. We also discuss feedback from instructors and reflect on the challenges of large-scale online administration and distribution of results.

  18. Dual-energy contrast-enhanced digital mammography: initial clinical results

    International Nuclear Information System (INIS)

    Dromain, Clarisse; Thibault, Fabienne; Tardivon, Anne; Muller, Serge; Rimareix, Francoise; Delaloge, Suzette; Balleyguier, Corinne

    2011-01-01

    To assess the diagnostic accuracy of Dual-Energy Contrast-Enhanced Digital Mammography (CEDM) as an adjunct to mammography (MX) versus MX alone and versus mammography plus ultrasound (US). 120 women with 142 suspect findings on MX and/or US underwent CEDM. A pair of low- and high-energy images was acquired using a modified full-field digital mammography system. Exposures were taken in MLO at 2 min and in CC at 4 min after the injection of 1.5 ml/kg of an iodinated contrast agent. One reader evaluated MX, US and CEDM images during 2 sessions 1 month apart. Sensitivity, specificity, and area under the ROC curve were estimated. The results from pathology and follow-up identified 62 benign and 80 malignant lesions. Areas under the ROC curves were significantly superior for MX+CEDM than it was for MX alone and for MX+US using BI-RADS. Sensitivity was higher for MX+CEDM than it was for MX (93% vs. 78%; p < 0.001) with no loss in specificity. The lesion size was closer to the histological size for CEDM. All 23 multifocal lesions were correctly detected by MX+CEDM vs. 16 and 15 lesions by MX and US respectively. Initial clinical results show that CEDM has better diagnostic accuracy than mammography alone and mammography+ultrasound. (orig.)

  19. Hypertension prevalence, awareness, treatment and its correlates among people 35 years and older: Result from pilot phase of the Azar cohort study.

    Science.gov (United States)

    Ghorbani, Zohreh; Shamshirgaran, Seyed Morteza; Ghaffari, Samad; Sarbakhsh, Parvin; Najafipour, Farzad; Aminisani, Nayyereh

    2018-01-01

    There is remarkable alteration in hypertension prevalence and awareness, and their correlates among various geographic locations and ethnic groups. The aim of this study was to report hypertension prevalence, awareness, and its correlates as well as hypertension treatment, and control among Azari people aged 35 years and older. The pilot phase of the Azar Cohort Study; a state level of a nationwide PERSIAN cohort study was conducted in Khameneh city between October 2014 and January 2015. All people 35 years of age and above were invited to take part in this study. A comprehensive range of different biomarkers, lifestyle, socioeconomic factors, and health-related factors was collected. Blood pressure was measured by a trained nurse/midwife. Descriptive statistical methods were used to present general characteristics of the study population as frequency tables. Separate multiple logistic regression models were built to assess the predictors of hypertension prevalence. A total of 1038 people were included in this study. The overall prevalence of hypertension was 22.9%. Awareness of hypertension was 60.5% and in those with known hypertension, 84% were using the antihypertensive medications, of those 68.5% had controlled hypertension. After adjustment; age (odds ratios [OR] adj = 1.12 95% confidence interval [CI]: 1.09-1.15), gender (OR adj = 1.65 95% CI: 1.08-2.51), obesity OR adj = 2.51 (1.40-4.88), waist-to-hip ratio (WHR) (OR adj = 1.70 (1.05-2.75), and comorbidities (OR adj = 2.51 (1.72-3.66) were independent predictors of hypertension. Age, sex, body mass index, WHR, and comorbidities were known as predictors of hypertension in this study, health promotion strategies including lifestyle modification to reduce overweight/obesity and secondary prevention programs for early detection of hypertension in high-risk groups according to age, gender, and disease profile are recommended.

  20. Factors to Consider in Selecting an Organisational Improvement Initiative: Survey Results

    Directory of Open Access Journals (Sweden)

    Mohammad Musli

    2017-01-01

    Full Text Available Organisations should select the appropriate improvement initiative that will fit with the context of organisation and provide value to the organisation. This paper presents 18 factors to be considered when selecting an organisational improvement initiative. Organisational improvement initiatives are approaches, management systems, tools and/or techniques that can be used for managing and improving organisations, such as Lean, ISO9001, Six Sigma and Improvement Team. A survey was conducted to identify the level of importance of these 18 factors as criteria for selecting an improvement initiative. Purposive sampling was used for this survey involving practitioners, managers, engineers, executives, consultants and/or academicians, who have been involved in the selection and/or implementation of organisational improvement initiatives in Malaysia. Two factors were rated as ‘very high importance’, which involve: (1 The ability to gain top management commitment and support to introduce and implement the initiative successfully, and (2 The initiative is aligned to the vision, mission and/or purpose of the organisation. All these factors can be adopted by the organisations as decision criteria to assist in the selection of the most appropriate improvement initiative based on rational decision making.

  1. Hypertension and Health Outcomes in the Pediatric Intensive Care Unit

    Science.gov (United States)

    Ehrmann, Brett J.; Selewski, David T; Troost, Jonathan P.; Hieber, Susan M.; Gipson, Debbie S.

    2014-01-01

    Objectives Reports of the burden of hypertension in hospitalized children are emerging, but the prevalence and significance of this condition within the pediatric intensive care unit (PICU) are not well understood. The aims of this study were to validate a definition of hypertension in the PICU and assess the associations between hypertension and acute kidney injury (AKI), PICU length of stay (LOS), and mortality. Design and Setting Single center retrospective study using a database of PICU discharges between July 2011 and February 2013. Patients All children discharged from the PICU with LOS > 6 hours, aged 1 month through 17 years. Exclusions were traumatic brain injury, incident renal transplant, or hypotension. Measurements and Main Results Potential definitions of hypertension utilizing combinations of standardized cutoff percentiles, durations, initiation or dose escalation of antihypertensives, and/or billing diagnosis codes for hypertension were compared using receiver operator characteristic curves against a manual medical record review. Multivariable logistic and linear regression analyses were conducted using the selected definition of hypertension to assess its independent association with AKI and PICU LOS, respectively. A definition requiring 3 systolic and/or diastolic readings above standardized 99th percentiles plus 5 mmHg over 1 day was selected (area under the curve 0.91, sensitivity 94%, specificity 87%). Among the 1,215 patients in this analysis, the prevalence of hypertension was 25%. Hypertension was independently associated with AKI (OR 2.89, 95% CI 1.64–5.09, Phypertension group—but were statistically different (P=0.02). Conclusions Hypertension is common in the PICU and is associated with worse clinical outcomes. Future studies are needed to confirm these results. PMID:24717906

  2. Research Initiatives and Preliminary Results In Automation Design In Airspace Management in Free Flight

    Science.gov (United States)

    Corker, Kevin; Lebacqz, J. Victor (Technical Monitor)

    1997-01-01

    The NASA and the FAA have entered into a joint venture to explore, define, design and implement a new airspace management operating concept. The fundamental premise of that concept is that technologies and procedures need to be developed for flight deck and ground operations to improve the efficiency, the predictability, the flexibility and the safety of airspace management and operations. To that end NASA Ames has undertaken an initial development and exploration of "key concepts" in the free flight airspace management technology development. Human Factors issues in automation aiding design, coupled aiding systems between air and ground, communication protocols in distributed decision making, and analytic techniques for definition of concepts of airspace density and operator cognitive load have been undertaken. This paper reports the progress of these efforts, which are not intended to definitively solve the many evolving issues of design for future ATM systems, but to provide preliminary results to chart the parameters of performance and the topology of the analytic effort required. The preliminary research in provision of cockpit display of traffic information, dynamic density definition, distributed decision making, situation awareness models and human performance models is discussed as they focus on the theme of "design requirements".

  3. Cosmic noise absorption and ionospheric currents at the South Pole and Frobisher Bay: Initial results

    International Nuclear Information System (INIS)

    Rosenberg, T.J.; Wolfe, A.; Lanzerotti, L.J.

    1987-01-01

    Studies of the conjugacy of auroral and ionospheric phenomena at very high latitudes are an important aspect of magnetospheric physics research. The extent to which auroral phenomena in opposite hemispheres are similar in occurrence and in the details of their temporal, spatial, and spectral characteristics can be used to infer the commonality of the source(s) of the disturbances. At one extreme in this consideration is the questions of whether sources lie on open or closed magnetic field lines. The University of Maryland and AT ampersand T Bell Laboratories have operated riometers and fluxgate magnetometers, respectively, at South Pole since 1982. Corresponding measurements at Frobisher Bay were begun in mid-1985. Riometers record the absorption of cosmic radio noise in the ionosphere produced by the enhances precipitation of energetic charged particles. The studies of the riometer data relate mainly to the effects of the influx of magnetospheric electrons, which give rise to auroral absorption of the cosmic signals. Intense currents (electrojets) that often flow in the ionosphere in association with auroral absorption events produce magnetic field changes that can be recorded on the ground by appropriately sited magnetometers. This report presents some initial results of the comparison of the two data sets

  4. Exploration of Compact Stellarators as Power Plants: Initial Results from ARIES-CS Study

    International Nuclear Information System (INIS)

    Najmabadi, Farrokh

    2005-01-01

    A detailed and integrated study of compact stellarators as power plants, ARIES-CS, was initiated recently to advance our understanding of attractive compact stellarator configurations and to define key R and D areas. We have completed phase 1 of ARIES-CS study - our results are described in this paper. We have identified several promising stellarator configurations. High α particle loss of these configurations is a critical issue. It appears that devices with an overall size similar to those envisioned for tokamak power plants are possible. A novel approach was developed in ARIES-CS in which the blanket at the critical areas of minimum stand-off is replaced by a highly efficient WC-based shield. In this manner, we have been able to reduce the minimum stand-off by ∼20%-30% compared to a uniform radial build which was assumed in previous studies. Our examination of engineering options indicates that overall assembly and maintenance procedure plays a critical role in identifying acceptable engineering design and has a major impact on the optimization of a plasma/coil configuration

  5. Initial results from the rebuilt EXTRAP T2R RFP device

    Science.gov (United States)

    Brunsell, P. R.; Bergsåker, H.; Cecconello, M.; Drake, J. R.; Gravestijn, R. M.; Hedqvist\\ad{2 }, A.; Malmberg, J.-A.

    2001-11-01

    The EXTRAP T2R thin shell reversed-field pinch (RFP) device has recently resumed operation after a major rebuild including the replacement of the graphite armour with molybdenum limiters, a fourfold increase of the shell time constant, and the replacement of the helical coil used for the toroidal field with a conventional solenoid-type coil. Wall-conditioning using hydrogen glow discharge cleaning was instrumental for successful RFP operation. Carbon was permanently removed from the walls during the first week of operation. The initial results from RFP operation with relatively low plasma currents in the range Ip = 70-100 kA are reported. RFP discharges are sustained for more than three shell times. Significant improvements in plasma parameters are observed, compared to operation before the rebuild. There is a substantial reduction in the carbon impurity level. The electron density behaviour is more shot-to-shot reproducible. The typical density is ne = 0.5-1×1019 m-3. Monitors of Hα line radiation indicate that the plasma wall interaction is more toroidally symmetric and that there is less transient gas release from the wall. The minimum loop voltage is in the range Vt = 28-35 V, corresponding to a reduction by a factor of two to three compared to the value before the rebuild.

  6. Susceptibility weighted imaging (SWI) of the kidney at 3 T. Initial results

    International Nuclear Information System (INIS)

    Mie, Moritz B.; Zoellner, Frank G.; Heilmann, Melanie; Schad, Lothar R.; Nissen, Johanna C.; Schoenberg, Stefan O.; Michaely, Henrik J.

    2010-01-01

    Susceptibility weighted imaging provides diagnostic information in strokes, hemorrhages, and cerebral tumors and has proven to be a valuable tool in imaging venous vessels in the cerebrum. The SWI principle is based on the weighting of T 2 * weighted magnitude images with a phase mask, therewith improving image contrast of veins or neighbouring structures of different susceptibility, in general. T 2 * weighted MRI is already used for assessment of kidney function. In this paper, the feasibility of SWI on kidneys was investigated. Translation of SWI from the brain to the kidneys comes along with two main challenges: (i) organ motion due to breathing and (ii) a higher oxygenation level of renal veins compared to the brain. To handle these problems, the acquisition time has been cut down to allow for breath-hold examinations, and different post-processing methods including a new phase mask were investigated to visualize renal veins. Results showed that by a new post-processing strategy SWI contrast was enhanced on average by a factor of 1.33 compared to the standard phase mask. In summary, initial experiences of SWI on the kidneys demonstrated the feasibility. However, further technical developments have to be performed to make this technology applicable in clinical abdominal MRI. (orig.)

  7. Initial results of local grid control using wind farms with grid support

    Energy Technology Data Exchange (ETDEWEB)

    Soerensen, Poul; Hansen, Anca D.; Iov, F.; Blaabjerg, F.

    2005-09-01

    This report describes initial results with simulation of local grid control using wind farms with grid support. The focus is on simulation of the behaviour of the wind farms when they are isolated from the main grid and establish a local grid together with a few other grid components. The isolated subsystems used in the work presented in this report do not intend to simulate a specific subsystem, but they are extremely simplified single bus bar systems using only a few more components than the wind farm. This approach has been applied to make it easier to understand the dynamics of the subsystem. The main observation is that the fast dynamics of the wind turbines seem to be able to contribute significantly to the grid control, which can be useful where the wind farm is isolated with a subsystem from the main grid with surplus of generation. Thus, the fast down regulation of the wind farm using automatic frequency control can keep the subsystem in operation and thereby improve the reliability of the grid. (LN)

  8. Initial Results of the SSPX Transient Internal Probe System for Measuring Toroidal Field Profiles

    Science.gov (United States)

    Holcomb, C. T.; Jarboe, T. R.; Mattick, A. T.; Hill, D. N.; McLean, H. S.; Wood, R. D.; Cellamare, V.

    2000-10-01

    Lawrence Livermore National Laboratory, Livermore, CA 94550, USA. The Sustained Spheromak Physics Experiment (SSPX) is using a field profile diagnostic called the Transient Internal Probe (TIP). TIP consists of a verdet-glass bullet that is used to measure the magnetic field by Faraday rotation. This probe is shot through the spheromak by a light gas gun at speeds near 2 km/s. An argon laser is aligned along the path of the probe. The light passes through the probe and is retro-reflected to an ellipsometer that measures the change in polarization angle. The measurement is spatially resolved down to the probes’ 1 cm length to within 15 Gauss. Initial testing results are given. This and future data will be used to determine the field profile for equilibrium reconstruction. TIP can also be used in conjunction with wall probes to map out toroidal mode amplitudes and phases internally. This work was performed under the auspices of US DOE by the University of California Lawrence Livermore National Laboratory under Contract No. W-7405-ENG-48.

  9. Project CONVERGE: Initial Results From the Mapping of Surface Currents in Palmer Deep

    Science.gov (United States)

    Statscewich, H.; Kohut, J. T.; Winsor, P.; Oliver, M. J.; Bernard, K. S.; Cimino, M. A.; Fraser, W.

    2016-02-01

    The Palmer Deep submarine canyon on the Western Antarctic Peninsula provides a conduit for upwelling of relatively warm, nutrient rich waters which enhance local primary production and support a food web productive enough to sustain a large top predator biomass. In an analysis of ten years of satellite-tagged penguins, Oliver et al. (2013) showed that circulation features associated with tidal flows may be a key driver of nearshore predator distributions. During diurnal tides, the penguins feed close to their breeding colonies and during semi-diurnal tides, the penguins make foraging trips to the more distant regions of Palmer Deep. It is hypothesized that convergent features act to concentrate primary producers and aggregate schools of krill that influence the behavior of predator species. The initial results from a six month deployment of a High Frequency Radar network in Palmer Deep are presented in an attempt to characterize and quantify convergent features. During a three month period from January through March 2015, we conducted in situ sampling consisting of multiple underwater glider deployments, small boat acoustic surveys of Antarctic krill, and penguin ARGOS-linked satellite telemetry and time-depth recorders (TDRs). The combination of real-time surface current maps with adaptive in situ sampling introduces High Frequency Radar to the Antarctic in a way that allows us to rigorously and efficiently test the influence of local tidal processes on top predator foraging ecology.

  10. Energetic neutral atom imaging with the Polar CEPPAD/IPS instrument: Initial forward modeling results

    International Nuclear Information System (INIS)

    Henderson, M.G.; Reeves, G.D.; Moore, K.R.; Spence, H.E.; Jorgensen, A.M.; Roelof, E.C.

    1997-01-01

    Although the primary function of the CEP-PAD/IPS instrument on Polar is the measurement of energetic ions in-situ, it has also proven to be a very capable Energetic neutral Atom (ENA) imager. Raw ENA images are currently being constructed on a routine basis with a temporal resolution of minutes during both active and quiet times. However, while analyses of these images by themselves provide much information on the spatial distribution and dynamics of the energetic ion population in the ring current, detailed modeling is required to extract the actual ion distributions. In this paper, the authors present the initial results of forward modeling an IPS ENA image obtained during a small geo-magnetic storm on June 9, 1997. The equatorial ion distribution inferred with this technique reproduces the expected large noon/midnight and dawn/dusk asymmetries. The limitations of the model are discussed and a number of modifications to the basic forward modeling technique are proposed which should significantly improve its performance in future studies

  11. Underground storage at Saint-Illiers-la-Ville. Initial results of filling. Reservoir control problems

    Energy Technology Data Exchange (ETDEWEB)

    Vernet, D

    1968-01-01

    The underground storage at Saint-Illiers-la-Ville (Yvelines in the Paris area) was discussed by Toche at the time when it was filled with gas in 1965. Now, 2-1/2 yr after the initial input, the volume of storage has reached 500 million cu m, and the first industrial withdrawals took place during the winter of 1967-1968. The results obtained in the operation of this underground storage are extremely satisfactory. In spite of differences in the composition of the sand layer, the gas bubble developed in a very regular way, horizontally and vertically, and the full penetration well equipment made a high output rate easy to obtain. Reservoir control was handled efficiently and the movements of the bubble contour were shown for every fluctuation of the injection and withdrawal volumes. Tests for production capacity showed the low extent to which the wells were affected by the phenomenon of water- coning and indicated measures to be taken to prevent the formation of hydrates. The measures effected and the conclusions which can be derived are discussed.

  12. Initial Results of Optical Vortex Laser Absorption Spectroscopy in the HYPER-I Device

    Science.gov (United States)

    Yoshimura, Shinji; Asai, Shoma; Aramaki, Mitsutoshi; Terasaka, Kenichiro; Ozawa, Naoya; Tanaka, Masayoshi; Morisaki, Tomohiro

    2015-11-01

    Optical vortex beams have a potential to make a new Doppler measurement, because not only parallel but perpendicular movement of atoms against the beam axis causes the Doppler shift of their resonant absorption frequency. As the first step of a proof-of-principle experiment, we have performed the optical vortex laser absorption spectroscopy for metastable argon neutrals in an ECR plasma produced in the HYPER-I device at the National Institute for Fusion Science, Japan. An external cavity diode laser (TOPTICA, DL100) of which center wavelength was 696.735 nm in vacuum was used for the light source. The Hermite-Gaussian (HG) beam was converted into the Laguerre-Gaussian (LG) beam (optical vortex) by a computer-generated hologram displayed on the spatial light modulator (Hamamatsu, LCOS-SLM X10468-07). In order to make fast neutral flow across the LG beam, a high speed solenoid valve system was installed on the HYPER-I device. Initial results including the comparison of absorption spectra for HG and LG beams will be presented. This study was supported by NINS young scientists collaboration program for cross-disciplinary study, NIFS collaboration research program (NIFS13KOAP026), and JSPS KAKENHI grant number 15K05365.

  13. Communications with Mars During Periods of Solar Conjunction: Initial Study Results

    Science.gov (United States)

    Morabito, D.; Hastrup, R.

    2001-07-01

    During the initial phase of the human exploration of Mars, a reliable communications link to and from Earth will be required. The direct link can easily be maintained during most of the 780-day Earth-Mars synodic period. However, during periods in which the direct Earth-Mars link encounters increased intervening charged particles during superior solar conjunctions of Mars, the resultant effects are expected to corrupt the data signals to varying degrees. The purpose of this article is to explore possible strategies, provide recommendations, and identify options for communicating over this link during periods of solar conjunctions. A significant improvement in telemetry data return can be realized by using the higher frequency 32 GHz (Ka-band), which is less susceptible to solar effects. During the era of the onset of probable human exploration of Mars, six superior conjunctions were identified from 2015 to 2026. For five of these six conjunctions, where the signal source is not occulted by the disk of the Sun, continuous communications with Mars should be achievable. Only during the superior conjunction of 2023 is the signal source at Mars expected to lie behind the disk of the Sun for about one day and within two solar radii (0. 5 deg) for about three days.

  14. Decoding white coat hypertension

    Science.gov (United States)

    Bloomfield, Dennis A; Park, Alex

    2017-01-01

    There is arguably no less understood or more intriguing problem in hypertension that the “white coat” condition, the standard concept of which is significantly blood pressure reading obtained by medical personnel of authoritative standing than that obtained by more junior and less authoritative personnel and by the patients themselves. Using hospital-initiated ambulatory blood pressure monitoring, the while effect manifests as initial and ending pressure elevations, and, in treated patients, a low daytime profile. The effect is essentially systolic. Pure diastolic white coat hypertension appears to be exceedingly rare. On the basis of the studies, we believe that the white coat phenomenon is a common, periodic, neuro-endocrine reflex conditioned by anticipation of having the blood pressure taken and the fear of what this measurement may indicate concerning future illness. It does not change with time, or with prolonged association with the physician, particularly with advancing years, it may be superimposed upon essential hypertension, and in patients receiving hypertensive medication, blunting of the nighttime dip, which occurs in about half the patients, may be a compensatory mechanisms, rather than an indication of cardiovascular risk. Rather than the blunted dip, the morning surge or the widened pulse pressure, cardiovascular risk appears to be related to elevation of the average night time pressure. PMID:28352632

  15. A conversation with Drs. Kaplan and Moser about conflicting data, confusing results, and some recent treatment recommendations for the management of hypertension.

    Science.gov (United States)

    Post, Wendy; Moser, Marvin; Kaplan, Norman

    2005-10-01

    Following a hypertension symposium in Baltimore, MD, on June 1, 2005, Dr. Wendy Post from the Johns Hopkins University School of Medicine, Baltimore, MD, had the opportunity to interview two of the outstanding hypertension experts in the United States on several controversial issues in hypertension management. Dr. Norman Kaplan is Clinical Professor of Medicine at the Southwestern Health Science Center in Dallas, TX, and Dr. Marvin Moser is Clinical Professor of Medicine at the Yale University School of Medicine, New Haven, CT. Both have been leaders in the field of hypertension treatment and education for more than 40 years. Dr. Kaplan's book Clinical Hypertension has been a standard textbook since 1973 and is now in its ninth edition. Dr. Marvin Moser was the Senior Medical Consultant to the National High Blood Pressure Education Program from 1974 to 2002 and was Chairman of the first Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure and a member of the six subsequent committees. His book Clinical Management of Hypertension is in its seventh edition. Drs. Moser and Kaplan were corecipients of the 2004 International Society of Hypertension Award for Outstanding Contributions to Hypertension Treatment and Education and have lectured extensively throughout the United States and overseas.

  16. 42 CFR 476.94 - Notice of QIO initial denial determination and changes as a result of a DRG validation.

    Science.gov (United States)

    2010-10-01

    ... changes as a result of a DRG validation. 476.94 Section 476.94 Public Health CENTERS FOR MEDICARE... changes as a result of a DRG validation. (a) Notice of initial denial determination—(1) Parties to be... retrospective review, (excluding DRG validation and post procedure review), within 3 working days of the initial...

  17. The Satellite based Monitoring Initiative for Regional Air quality (SAMIRA): Project summary and first results

    Science.gov (United States)

    Schneider, Philipp; Stebel, Kerstin; Ajtai, Nicolae; Diamandi, Andrei; Horalek, Jan; Nemuc, Anca; Stachlewska, Iwona; Zehner, Claus

    2017-04-01

    We present a summary and some first results of a new ESA-funded project entitled Satellite based Monitoring Initiative for Regional Air quality (SAMIRA), which aims at improving regional and local air quality monitoring through synergetic use of data from present and upcoming satellite instruments, traditionally used in situ air quality monitoring networks and output from chemical transport models. Through collaborative efforts in four countries, namely Romania, Poland, the Czech Republic and Norway, all with existing air quality problems, SAMIRA intends to support the involved institutions and associated users in their national monitoring and reporting mandates as well as to generate novel research in this area. The primary goal of SAMIRA is to demonstrate the usefulness of existing and future satellite products of air quality for improving monitoring and mapping of air pollution at the regional scale. A total of six core activities are being carried out in order to achieve this goal: Firstly, the project is developing and optimizing algorithms for the retrieval of hourly aerosol optical depth (AOD) maps from the Spinning Enhanced Visible and InfraRed Imager (SEVIRI) onboard of Meteosat Second Generation. As a second activity, SAMIRA aims to derive particulate matter (PM2.5) estimates from AOD data by developing robust algorithms for AOD-to-PM conversion with the support from model- and Lidar data. In a third activity, we evaluate the added value of satellite products of atmospheric composition for operational European-scale air quality mapping using geostatistics and auxiliary datasets. The additional benefit of satellite-based monitoring over existing monitoring techniques (in situ, models) is tested by combining these datasets using geostatistical methods and demonstrated for nitrogen dioxide (NO2), sulphur dioxide (SO2), and aerosol optical depth/particulate matter. As a fourth activity, the project is developing novel algorithms for downscaling coarse

  18. Design of and initial results from a Highly Instrumented Reactor for Atmospheric Chemistry (HIRAC

    Directory of Open Access Journals (Sweden)

    D. R. Glowacki

    2007-10-01

    Full Text Available The design of a Highly Instrumented Reactor for Atmospheric Chemistry (HIRAC is described and initial results obtained from HIRAC are presented. The ability of HIRAC to perform in-situ laser-induced fluorescence detection of OH and HO2 radicals with the Fluorescence Assay by Gas Expansion (FAGE technique establishes it as internationally unique for a chamber of its size and pressure/temperature variable capabilities. In addition to the FAGE technique, HIRAC features a suite of analytical instrumentation, including: a multipass FTIR system; a conventional gas chromatography (GC instrument and a GC instrument for formaldehyde detection; NO/NO2, CO, O3, and H2O vapour analysers. Ray tracing simulations and NO2 actinometry have been utilized to develop a detailed model of the radiation field within HIRAC. Comparisons between the analysers and the FTIR coupled to HIRAC have been performed, and HIRAC has also been used to investigate pressure dependent kinetics of the chlorine atom reaction with ethene and the reaction of O3 and t-2-butene. The results obtained are in good agreement with literature recommendations and Master Chemical Mechanism predictions. HIRAC thereby offers a highly instrumented platform with the potential for: (1 high precision kinetics investigations over a range of atmospheric conditions; (2 detailed mechanism development, significantly enhanced according to its capability for measuring radicals; and (3 field instrument intercomparison, calibration, development, and investigations of instrument response at a range of atmospheric conditions.

  19. Initial Surgical Experience with Aortic Valve Repair: Clinical and Echocardiographic Results

    Directory of Open Access Journals (Sweden)

    Francisco Diniz Affonso da Costa

    Full Text Available Abstract Introduction: Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. Methods: From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males. The aortic valve was bicuspid in 54% and tricuspid in the remaining. All were operated with the aid of intraoperative transesophageal echocardiography. Surgical techniques consisted of replacing the aortic root with a Dacron graft whenever it was dilated or aneurysmatic, using either the remodeling or the reimplantation technique, besides correcting leaflet prolapse when present. Patients were sequentially evaluated with clinical and echocardiographic studies and mean follow-up time was 16±5 months. Results: Thirty-day mortality was 2.7%. In addition there were two late deaths, with late survival being 85% (CI 95% - 68%-95% at two years. Two patients were reoperated due to primary structural valve failure. Freedom from reoperation or from primary structural valve failure was 90% (CI 95% - 66%-97% and 91% (CI 95% - 69%-97% at 2 years, respectively. During clinical follow-up up to 3 years, there were no cases of thromboembolism, hemorrhage or endocarditis. Conclusions: Although this represents an initial series, these data demonstrates that aortic valve repair and/or valve sparing aortic root surgery can be performed with satisfactory immediate and short-term results.

  20. Initial Results from the STEM Student Experiences Aboard Ships (STEMSEAS) Program

    Science.gov (United States)

    Lewis, J. C.; Cooper, S. K.; Thomson, K.; Rabin, B.; Alberts, J.

    2016-12-01

    The Science Technology Engineering and Math Student Experiences Aboard Ships (STEMSEAS) program was created as a response to NSF's call (through GEOPATHS) for improving undergraduate STEM education and enhancing diversity in the geosciences. It takes advantage of unused berths on UNOLS ships during transits between expeditions. During its 2016 pilot year - which consisted of three transits on three different research vessels in different parts of the country, each with a slightly different focus - the program has gained significant insights into how best to create and structure these opportunities and create impact on individual students. A call for applications resulted in nearly 900 applicants for 30 available spots. Of these applicants, 32% are from minority groups underrepresented in the geosciences (Black, Hispanic, or American Indian) and 20% attend community colleges. The program was able to sail socioeconomically diverse cohorts and include women, veterans, and students with disabilities and from two- and four-year colleges. Twenty-three are underrepresented minorities, 6 attend community colleges, 5 attend an HBCU or tribal college, and many are at HSIs or other MSIs. While longer term impact assessment will have to wait, initial results and 6-month tracking for the first cohort indicate that these kinds of relatively short but intense experiences can indeed achieve significant impacts on students' perception of the geosciences, in their understanding of STEM career opportunities, their desire to work in a geoscience lab setting, and to incorporate geosciences into non-STEM careers. Insights were also gained into the successful makeup of mentor/leader groups, factors to consider in student selection, necessary pre- and post-cruise logistics management, follow-up activities, structure of activities during daily life at sea, increasing student networks and access to mentorships, and leveraging of pre-existing resources and ship-based opportunities

  1. Magnesium intake, bone mineral density, and fractures: results from the Women's Health Initiative Observational Study1234

    Science.gov (United States)

    Orchard, Tonya S; Larson, Joseph C; Alghothani, Nora; Bout-Tabaku, Sharon; Cauley, Jane A; Chen, Zhao; LaCroix, Andrea Z; Wactawski-Wende, Jean; Jackson, Rebecca D

    2014-01-01

    Background: Magnesium is a necessary component of bone, but its relation to osteoporotic fractures is unclear. Objective: We examined magnesium intake as a risk factor for osteoporotic fractures and altered bone mineral density (BMD). Design: This prospective cohort study included 73,684 postmenopausal women enrolled in the Women's Health Initiative Observational Study. Total daily magnesium intake was estimated from baseline food-frequency questionnaires plus supplements. Hip fractures were confirmed by a medical record review; other fractures were identified by self-report. A baseline BMD analysis was performed in 4778 participants. Results: Baseline hip BMD was 3% higher (P 422.5 compared with magnesium. In contrast, risk of lower-arm or wrist fractures increased with higher magnesium intake [multivariate-adjusted HRs of 1.15 (95% CI: 1.01, 1.32) and 1.23 (95% CI: 1.07, 1.42) for quintiles 4 and 5, respectively, compared with quintile 1; P-trend = 0.002]. In addition, women with the highest magnesium intakes were more physically active and at increased risk of falls [HR for quintile 4: 1.11 (95% CI: 1.06, 1.16); HR for quintile 5: 1.15 (95% CI: 1.10, 1.20); P-trend magnesium intake is associated with lower BMD of the hip and whole body, but this result does not translate into increased risk of fractures. A magnesium consumption slightly greater than the Recommended Dietary Allowance is associated with increased lower-arm and wrist fractures that are possibly related to more physical activity and falls. This trial was registered at clinicaltrials.gov as NCT00000611. PMID:24500155

  2. The IGAC activity for the development of global emissions inventories: Description and initial results

    International Nuclear Information System (INIS)

    Benkovitz, C.M.; Graedel, T.E.

    1992-02-01

    Modeling assessments of the atmospheric chemistry, air quality and climatic conditions of the past, present and future require as input inventories of emissions of the appropriate chemical species constructed on appropriate spatial and temporal scales. The task of the Global Emissions Inventories Activity (GEIA) of the International Global Atmospheric Chemistry Project (IGAC) is the production of global inventories suitable for a range of research applications. Current GEIA programs are generally based on addressing emissions by species; these include CO 2 , NH 3 /N 2 O, SO 2 /NO x , CFC, volatile organic compounds and radioisotopes. In addition a separate program to inventory emissions from biomass burning is also being structured, plus an additional program to address data management issues for all the developing inventories. Program priorities are based on current knowledge and tasks needed to produce the desired inventories. This paper will discuss the different types of global inventories to be developed by the GEIA programs, their key characteristics, and areas to be addressed in the compilation of such inventories. Results of the first GEIA task, a survey of existing inventories and auxiliary data, will be presented. The survey included status assessments for the available inventory information for nineteen different atmospheric species or groups of species on global and regional scales and over time. Of this entire body of information, the only inventory regarded as satisfactory was that for the global emissions of CFCs. An implication of the results of these assessments is that properly gridded emissions inventories are badly needed to support atmospheric modeling calculations on a variety of spatial and temporal scales. Initial studies in the development of global inventories of sulfur dioxide, currently the most advanced GEIA program, will be presented and discussed

  3. Initial clinical results of linac stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) for pituitary adenomas

    International Nuclear Information System (INIS)

    Mitsumori, Michihide; Shrieve, Dennis C.; Alexander, Eben; Kaiser, Ursula B.; Richardson, Gary E.; McL Black, Peter; Loeffler, Jay S.

    1997-01-01

    Purpose: To evaluate the initial clinical results of stereotactic radiosurgery (SRS) and fractionated stereotactic radiotherapy (SRT) for pituitary adenomas with regard to tumor control and toxicity of the treatment, thus evaluate the feasibility of these technique for the treatment of pituitary adenomas. Subjects and Methods: 48 patients with either inoperable, recurrent or residual pituitary adenoma who underwent either SRS or SRT at the Brigham and Women's Hospital between 9/89 and 9/95 were analyzed. Of these, 18 received treatment with SRS, and 30 received SRT. SRS was contraindicated for the patients in whom the minimal distance of the target and optic chiasm or optic nerve was less than 5 mm. Patient characteristics were similar in the two groups, with the exception of tumor volume and previous irradiation. Median tumor volumes were 1.8 cm 3 and 7.7 cm 3 for SRS and SRT, respectively. Three of the SRS and none of the SRT patients had a history of previous external radiation therapy. Both SRS and SRT were performed by the use of dedicated stereotactic 6-MV linear accelerator with a treatment plan designed using a dedicated software. Doses were prescribed to the isodose distribution that covered the identified target. Dose and normalization used for SRS varied from 1000 cGy at 85 % isodose line to 1800 cGy at 80 % isodose line. For SRT patients, total dose of 4500 cGy was normalized at 90 or 95 % isodose line and this was delivered in 25 fractions of 180 cGy daily dose. Results: Local control: There was 1 case of local failure in each of SRS and SRT series (median follow up 42.5 months and 22 month, respectively). CNS adverse effects: There were 3 SRS cases in whom a ring enhancement in the temporal lobe was observed in follow-up MRI. (median follow up 32 months). Of these, one resolved spontaneously, whereas the other 2 lesion persisted and considered to be radiation necrosis. None of them required surgical intervention to date. These were observed in the

  4. Transanal minimally-invasive surgery (TAMIS: Technique and results from an initial experience

    Directory of Open Access Journals (Sweden)

    Carlos Ramon Silveira Mendes

    2013-10-01

    Full Text Available Transanal endoscopic microsurgery is a minimally-invasive approach for rectal lesions. Superior exposure and access to the entire rectum result in lesser risk of compromised margins and lower recurrence rates, when compared to conventional transanal excision. The aim of this study was to describe a single institution's initial experience with transanal minimally invasive surgery (TAMIS. This was a prospective review of our database. Elev- en procedures from January 2012 to June 2013 were analyzed. Results: eleven operations were completed. Five men were evaluated. Mean age was 62.9 (40-86. Mean follow-up was 9.3 (2-17 months. Average tumor size was 3.8 (1.8-8 cm. Mean distance from anal verge was 6.3 (3-12 cm. Mean operating time was 53.73 (28-118 min. Postoperative complica- tion rate was 9.1%. There were no readmissions. Mortality was null. Operative pathology disclosed the presence of adenoma in four patients, invasive adenocarcinoma in two, neu- roendocrine carcinoma in three, and no residual lesion in one case. TAMIS is a minimally- invasive procedure with low postoperative morbidity at the initial experience. TAMIS is a curative procedure for benign lesions and for selected early cancers. It is useful after neoadjuvant therapy for strictly selected cancers, pending the results of multi-institutional trials. Resumo: Microcirurgia endoscópica transanal é uma abordagem minimamente invasiva para lesões retais. Apresenta menor risco de margem comprometida e menores taxas de recorrência em comparação com excisão transanal convencional. Objetivou-se descrever a experiência inicial, de uma única instituição, com cirurgia minimamente invasiva transanal (TAMIS. Avaliação prospectiva de nosso banco de dados. Onze procedimentos de janeiro de 2012 a junho de 2013, foram analisados. Resultados: onze operações foram concluídas. Havia cinco homens. A média de idade foi de 62,9 (40-86. O acompanhamento médio foi de ww9,3 (2-17 meses. O

  5. Cardiac and renal damage in the elderly hypertensive

    Directory of Open Access Journals (Sweden)

    Jean Ribstein

    2002-03-01

    Full Text Available In the elderly patient with essential hypertension of long duration or de novo systolic hypertension, the prevalence of co-morbid conditions, be they apparent or not, the burden of associated diseases and the alteration in nutritional status and lifestyle, result in specific problems with regards to hypertension-related target organ damage. Accumulating data suggest that left ventricular (LV remodelling is a common finding in the nor-motensive elderly, and that LV hypertrophy (LVH will herald the development of heart failure in a fraction of patients with either systolic/diastolic or isolated systolic hypertension. Increased arterial stiffness, as well as impaired myocardial relaxation, reduced early diastolic filling and decreased ?-adrenergic responsiveness, contribute to the large prevalence of abnormalities in LV function in the elderly hypertensive. The response to exercise is clearly attenuated, and coronary heart disease, although highly prevalent, may be misdiagnosed because symptoms are altered. The elderly hypertensive is exquisitely sensitive to both volume depletion and excessive sodium intake, due to a marked sodium sensitivity of blood pressure (BP. A decline in renal blood flow and glomerular filtration rate (GFR is a common finding in the elderly. Although structural alterations attributed to age and hypertension may differ, hypertension is often looked upon as an accelerated form of ageing with regards to the heart and the kidney. Lifestyle modifications and initial monotherapy with a low-dose diuretic are warranted in the elderly hypertensive with no co-morbidity; a variety of specific approaches are considered when associated clinical conditions are present. Blockers of the renin-angiotensin system (RAS may be the preferred first-line agents in many patients with cardiac or renal damage.

  6. Renovascular hypertension

    International Nuclear Information System (INIS)

    Thomsen, H.S.; Sos, T.A.; Nielsen, S.L.; Koebenhavns Amts Sygehus, Herlev; Cornell Univ., New York

    1989-01-01

    Hypertension constitutes a major health problem and the challenge is to identify patients having 'surgically' curable renal vascular disease among the majority with so-called essential hypertension. The best of unsatisfactory diagnostic tests are renography and plasma renin activity both before and during angiotensin II blockade. The necessity of better screening tests has increased because of the recent advances in surgical techniques and especially percutaneous transluminal renal angioplasty. The latter has definitely become the method of choice for correction of suspected hemodynamically significant artery stenoses whenever technically feasible. With improved angioplasty techniques the risk of treating renal artery stenosis without hemodynamic and clinical importance (so-called cosmetic repair) has increased. Unfortunately randomized trials including surgery versus angioplasty are not available. It should be kept in mind that only after correction of the stenosis is achieved and the blood pressure has become normal, can the diagnosis of renovascular hypertension be made with certainty. (orig.)

  7. Initial reconstruction results from a simulated adaptive small animal C shaped PET/MR insert

    Energy Technology Data Exchange (ETDEWEB)

    Efthimiou, Nikos [Technological Educational Institute of Athens (Greece); Kostou, Theodora; Papadimitroulas, Panagiotis [Technological Educational Institute of Athens (Greece); Department of Medical Physics, School of Medicine, University of Patras (Greece); Charalampos, Tsoumpas [Division of Biomedical Imaging, University of Leeds, Leeds (United Kingdom); Loudos, George [Technological Educational Institute of Athens (Greece)

    2015-05-18

    Traditionally, most clinical and preclinical PET scanners, rely on full cylindrical geometry for whole body as well as dedicated organ scans, which is not optimized with regards to sensitivity and resolution. Several groups proposed the construction of dedicated PET inserts for MR scanners, rather than the construction of new integrated PET/MR scanners. The space inside an MR scanner is a limiting factor which can be reduced further with the use of extra coils, and render the use of non-flexible cylindrical PET scanners difficult if not impossible. The incorporation of small SiPM arrays, can provide the means to design adaptive PET scanners to fit in tight locations, which, makes imaging possible and improve the sensitivity, due to the closer approximation to the organ of interest. In order to assess the performance of such a device we simulated the geometry of a C shaped PET, using GATE. The design of the C-PET was based on a realistic SiPM-BGO scenario. In order reconstruct the simulated data, with STIR, we had to calculate system probability matrix which corresponds to this non standard geometry. For this purpose we developed an efficient multi threaded ray tracing technique to calculate the line integral paths in voxel arrays. One of the major features is the ability to automatically adjust the size of FOV according to the geometry of the detectors. The initial results showed that the sensitivity improved as the angle between the detector arrays increases, thus better angular sampling the scanner's field of view (FOV). The more complete angular coverage helped in improving the shape of the source in the reconstructed images, as well. Furthermore, by adapting the FOV to the closer to the size of the source, the sensitivity per voxel is improved.

  8. The Far Ultraviolet M-dwarf Evolution Survey (FUMES): Overview and Initial Results

    Science.gov (United States)

    Pineda, J. Sebastian; France, Kevin; Youngblood, Allison

    2018-01-01

    M-dwarf stars are prime targets for exoplanet searches because of their close proximity and favorable properties for both planet detection and characterization, with current searches around these targets having already discovered several Earth-sized planets within their star’s habitable zones. However, the atmospheric characterization and potential habitability of these exoplanetary systems depends critically on the high-energy stellar radiation environment from X-rays to NUV. Strong radiation at these energies can lead to atmospheric mass loss and is a strong driver of photochemistry in planetary atmospheres. Recently, the MUSCLES Treasury Survey provided the first comprehensive assessment of the high-energy radiation field around old, planet hosting M-dwarfs. However, the habitability and potential for such exoplanetary atmospheres to develop life also depends on the evolution of the atmosphere and hence the evolution of the incident radiation field. The strong high-energy spectrum of young M-dwarfs can have devastating consequences for the potential habitability of a given system. We, thus, introduce the Far Ultraviolet M-dwarf Evolution Survey (FUMES), a new HST-STIS observing campaign targeting 10 early-mid M dwarfs with known rotation periods, including 6 targets with known ages, to assess the evolution of the FUV radiation, including Lyα, of M-dwarf stars with stellar rotation period. We present the initial results of our survey characterizing the FUV emission features of our targets and the implications of our measurements for the evolution of the entire high-energy radiation environment around M-dwarfs from youth to old age.

  9. The SAGES Legacy Unifying Globulars and Galaxies survey (SLUGGS): sample definition, methods, and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Brodie, Jean P.; Romanowsky, Aaron J.; Jennings, Zachary G.; Pota, Vincenzo; Kader, Justin; Roediger, Joel C.; Villaume, Alexa; Arnold, Jacob A.; Woodley, Kristin A. [University of California Observatories, 1156 High Street, Santa Cruz, CA 95064 (United States); Strader, Jay [Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); Forbes, Duncan A.; Pastorello, Nicola; Usher, Christopher; Blom, Christina; Kartha, Sreeja S. [Centre for Astrophysics and Supercomputing, Swinburne University, Hawthorn, VIC 3122 (Australia); Foster, Caroline; Spitler, Lee R., E-mail: jbrodie@ucsc.edu [Australian Astronomical Observatory, P.O. Box 915, North Ryde, NSW 1670 (Australia)

    2014-11-20

    We introduce and provide the scientific motivation for a wide-field photometric and spectroscopic chemodynamical survey of nearby early-type galaxies (ETGs) and their globular cluster (GC) systems. The SAGES Legacy Unifying Globulars and GalaxieS (SLUGGS) survey is being carried out primarily with Subaru/Suprime-Cam and Keck/DEIMOS. The former provides deep gri imaging over a 900 arcmin{sup 2} field-of-view to characterize GC and host galaxy colors and spatial distributions, and to identify spectroscopic targets. The NIR Ca II triplet provides GC line-of-sight velocities and metallicities out to typically ∼8 R {sub e}, and to ∼15 R {sub e} in some cases. New techniques to extract integrated stellar kinematics and metallicities to large radii (∼2-3 R {sub e}) are used in concert with GC data to create two-dimensional (2D) velocity and metallicity maps for comparison with simulations of galaxy formation. The advantages of SLUGGS compared with other, complementary, 2D-chemodynamical surveys are its superior velocity resolution, radial extent, and multiple halo tracers. We describe the sample of 25 nearby ETGs, the selection criteria for galaxies and GCs, the observing strategies, the data reduction techniques, and modeling methods. The survey observations are nearly complete and more than 30 papers have so far been published using SLUGGS data. Here we summarize some initial results, including signatures of two-phase galaxy assembly, evidence for GC metallicity bimodality, and a novel framework for the formation of extended star clusters and ultracompact dwarfs. An integrated overview of current chemodynamical constraints on GC systems points to separate, in situ formation modes at high redshifts for metal-poor and metal-rich GCs.

  10. Tangible Results and Progress in Flood Risks Management with the PACTES Initiative

    Science.gov (United States)

    Costes, Murielle; Abadie, Jean-Paul; Ducuing, Jean-Louis; Denier, Jean-Paul; Stéphane

    The PACTES project (Prévention et Anticipation des Crues au moyen des Techniques Spatiales), initiated by CNES and the French Ministry of Research, aims at improving flood risk management, over the following three main phases : - Prevention : support and facilitate the analysis of flood risks and socio-economic impacts (risk - Forecasting and alert : improve the capability to predict and anticipate the flooding event - Crisis management : allow better situation awareness, communication and sharing of In order to achieve its ambitious objectives, PACTES: - integrates state-of-the-art techniques and systems (integration of the overall processing chains, - takes advantage of integrating recent model developments in wheather forecasting, rainfall, In this approach, space technology is thus used in three main ways : - radar and optical earth observation data are used to produce Digital Elevation Maps, land use - earth observation data are also an input to wheather forecasting, together with ground sensors; - satellite-based telecommunication and mobile positioning. Started in December 2000, the approach taken in PACTES is to work closely with users such as civil security and civil protection organisms, fire fighter brigades and city councils for requirements gathering and during the validation phase. It has lead to the development and experimentation of an integrated pre-operational demonstrator, delivered to different types of operational users. Experimentation has taken place in three watersheds representative of different types of floods (flash and plain floods). After a breaf reminder of what the PACTES project organization and aims are, the PACTES integrated pre-operational demonstrator is presented. The main scientific inputs to flood risk management are summarized. Validation studies for the three watersheds covered by PACTES (Moselle, Hérault and Thoré) are detailed. Feedback on the PACTES tangible results on flood risk management from an user point of view

  11. Initial results from the StratoClim aircraft campaign in the Asian Monsoon in summer 2017

    Science.gov (United States)

    Rex, M.

    2017-12-01

    The Asian Monsoon System is one of the Earth's largest and most energetic weather systems. Monsoon rainfall is critical to feeding over a billion people in Asia and the monsoon circulation affects weather patterns over the entire northern hemisphere. The Monsoon also acts like an enormous elevator, pumping vast amounts of air and pollutants from the surface up to the tropopause region at levels above 16km altitude, from where air can ascend into the stratosphere, where it spreads globally. Thus the monsoon affects the chemical composition of the global tropopause region and the stratosphere, and hence plays a key role for the composition of the UTS. Dynamically the monsoon circulation leads to the formation of a large anticyclone at tropopause levels above South Asia - the Asian Monsoon Anticyclone (AMA). Satellite images show a large cloud of aerosols directly above the monsoon, the Asian Tropopause Aerosol Layer (ATAL). In July to August 2017 the international research project StratoClim carried out the first in-situ aircraft measurements in the AMA and the ATAL with the high altitude research aircraft M55-Geophysica. Around 8 scientific flights took place in the airspaces of Nepal, India and Bangladesh and have horizontally and vertically probed the AMA and have well characterized the ATAL along flight patterns that have been carefully designed by a theory, modelling and satellite data analysing team in the field. The aircraft campaign has been complemented by launches of research balloons from ground stations in Nepal, Bangladesh, China and Palau. The presentation will give an overview of the StratoClim project, the aircraft and balloon activities and initial results from the StratoClim Asian Monsoon campaign in summer 2017.

  12. Initial Results from CASSIOPE/ePOP Satellite Overpasses above HAARP in 2014

    Science.gov (United States)

    Siefring, C. L.; Bernhardt, P. A.; Briczinski, S. J., Jr.; James, H. G.; Yau, A. W.; Knudsen, D. J.

    2015-12-01

    The High Frequency Active Auroral Research Program (HAARP) facility was operated in conjunction with overpasses of the enhanced Polar Outflow Probe (ePOP) instruments on the Canadian CASSIOPE satellite. During these overpasses HAARP was operated in several different heating modes and regimes as diagnosed by the characteristics of Stimulated Electromagnetic Emissions (SEE) using ground-based receivers while simultaneously ePOP monitored in-situ HF and VLF signals, looked for ion and electron heating, and provided VHF and UHF signals for propagation effects studies. The e-POP suite of instruments and particularly the ePOP Radio Receiver Instrument (RRI) offer a unique combination diagnostics appropriate for studying the non-linear plasma effects generated high-power HF waves in the ionosphere. In this presentation, the initial results from ePOP observations from two separate 2014 measurement campaigns at HAARP (April 16 to April 29 and May 25 to June 9) will be discussed. Several innovative experiments were performed during the campaign. Experiments explored a wide range of ionospheric effects. These include: 1) Penetration of HF pump waves into the ionosphere via large and small scale irregularities, 2) effects of gyro-harmonic heating and artificial ionization layers, 3) effects of HAARP beam shape with O- and X-mode transmissions, 4) coupling of Lower Hybrid modes into Whistler waves, 5) D/E-region VLF generation in the ionosphere using VLF modulation of the HF pump 6) scattering of VHF and UHF signals and 7) scattering and non-linear modulation of a 9.5 MHz probe wave propagating through the region of the ionosphere modified by HAARP. This work supported by the Naval Research Laboratory Base Program.

  13. Initial 2-year results of CardioCel® patch implantation in children.

    Science.gov (United States)

    Pavy, Carine; Michielon, Guido; Robertus, Jan Lukas; Lacour-Gayet, François; Ghez, Olivier

    2018-03-01

    We present the initial 2-year results of CardioCel® patch (Admedus Regen Pty Ltd, Perth, WA, Australia) implantation in paediatric patients with congenital heart diseases. This was a single-centre retrospective study with prospectively collected data of all patients aged 18 years and under operated for congenital heart disease. The patch was introduced in 2014, with clinical practice committee approval and a special consent in case of an Ozaki procedure. Standard follow-up was performed with systematic clinical exams and echocardiograms. In case of reoperation or graft failure, the patch was removed and sent for a histological examination. Between March 2014 and April 2016, 101 patients had surgical repair using a CardioCel patch. The mean age was 22 (±36.3) months, and the mean weight was 9.7 (±10.3) kg. No infections and no intraoperative implantation difficulties were associated with the patch. The median follow-up period was 212 (range 4-726) days. The overall 30-day postoperative mortality was 3.8% (n = 4), none of which were related to graft failure. Five children were reoperated because of graft failure, 4 of whom had the patch implanted for aortic and were aged less than 10 days. The indications for patch implantation in the aortic position were aortopulmonary window, truncus arteriosus, coarctation and aortic arch hypoplasia repair. The median time between the first and the second operation for graft failure was 245 (range 5-480) days. Our experience shows that the patch is well tolerated in the septal, valvar and pulmonary artery positions. However, we experienced graft failures in infants in the aortic position. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  14. Initial reconstruction results from a simulated adaptive small animal C shaped PET/MR insert

    International Nuclear Information System (INIS)

    Efthimiou, Nikos; Kostou, Theodora; Papadimitroulas, Panagiotis; Charalampos, Tsoumpas; Loudos, George

    2015-01-01

    Traditionally, most clinical and preclinical PET scanners, rely on full cylindrical geometry for whole body as well as dedicated organ scans, which is not optimized with regards to sensitivity and resolution. Several groups proposed the construction of dedicated PET inserts for MR scanners, rather than the construction of new integrated PET/MR scanners. The space inside an MR scanner is a limiting factor which can be reduced further with the use of extra coils, and render the use of non-flexible cylindrical PET scanners difficult if not impossible. The incorporation of small SiPM arrays, can provide the means to design adaptive PET scanners to fit in tight locations, which, makes imaging possible and improve the sensitivity, due to the closer approximation to the organ of interest. In order to assess the performance of such a device we simulated the geometry of a C shaped PET, using GATE. The design of the C-PET was based on a realistic SiPM-BGO scenario. In order reconstruct the simulated data, with STIR, we had to calculate system probability matrix which corresponds to this non standard geometry. For this purpose we developed an efficient multi threaded ray tracing technique to calculate the line integral paths in voxel arrays. One of the major features is the ability to automatically adjust the size of FOV according to the geometry of the detectors. The initial results showed that the sensitivity improved as the angle between the detector arrays increases, thus better angular sampling the scanner's field of view (FOV). The more complete angular coverage helped in improving the shape of the source in the reconstructed images, as well. Furthermore, by adapting the FOV to the closer to the size of the source, the sensitivity per voxel is improved.

  15. Initial results of the oesophageal and gastric cancer registry from the Comunidad Valenciana.

    Science.gov (United States)

    Escrig, Javier; Mingol, Fernando; Martí, Roberto; Puche, José; Trullenque, Ramón; Barreras, José Antonio; Asencio, Francisco; Aguiló, Javier; Navarro, José Manuel; Alberich, Carmen; Salas, Dolores; Lacueva, Francisco Javier

    2017-10-01

    To evaluate the initial results of the oesophagogastric cancer registry developed for the Sociedad Valenciana de Cirugía and the Health Department of the Comunidad Valenciana (Spain). Fourteen of the 24 public hospitals belonging to the Comunidad Valenciana participated. All patients with diagnosis of oesophageal or gastric carcinomas operated from January 2013 to December 2014 were evaluated. Demographic, clinical and pathological data were analysed. Four hundred and thirty-four patients (120 oesophageal carcinomas and 314 gastric carcinomas) were included. Only two hospitals operated more than 10 patients with oesophageal cancer per year. Transthoracic oesophaguectomy was the most frequent approach (84.2%) in tumours localized within the oesophagus. A total gastrectomy was performed in 50.9% patients with gastroesophageal junction (GOJ) carcinomas. Postoperative 30-day and 90-day mortality were 8% and 11.6% in oesophageal carcinoma and 5.9 and 8.6% in gastric carcinoma. Before surgery, middle oesophagus carcinomas were treated mostly (76,5%) with chemoradiotherapy. On the contrary, lower oesophagus and GOJ carcinomas were treated preferably with chemotherapy alone (45.5 and 53.4%). Any neoadjuvant treatment was administered to 73.6% of gastric cancer patients. Half patients with oesophageal carcinoma or gastric carcinoma received no adjuvant treatment. This registry revealed that half patients with oesophageal cancer were operated in hospitals with less than 10 cases per year at the Comunidad Valenciana. Also, it detected capacity improvement for some clinical outcomes of oesophageal and gastric carcinomas. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Preliminary results following the use of a fixed combination of timolol–brimonidine in patients with ocular hypertension and primary open-angle glaucoma

    Directory of Open Access Journals (Sweden)

    Dimitris Papaconstantinou

    2009-03-01

    Full Text Available Dimitris Papaconstantinou1, Ilias Georgalas2, Nikolaos Kourtis1, Christos Pitsas1, Efthimios Karmiris1, Chrysanthi Koutsandrea1, Ioannis Ladas1, Gerasimos Georgopoulos11Department of Ophthalmology, “G Gennimatas” Hospital of Athens, University of Athens, Athens, Greece; 2Department of Ophthalmology, “G Gennimatas” Hospital of Athens, NHS, Athens, Greece Purpose: The purpose of this prospective study was to evaluate the efficacy in intraocular pressure (IOP control and the tolerance of a topically administered fixed combination of timolol–brimonidine in 50 patients with ocular hypertension and primary open-angle glaucoma.Methods: After determining a baseline IOP, the fixed combination timolol–brimonidine was used twice daily for two months, while IOP, ophthalmic signs, and/or symptoms were monitored.Results: The mean IOP value was decreased from 23.09 mm Hg (±1.98 SD to 17.46 mm Hg (±1.47 SD during the 1st month (paired Student’s t test = 9.88 και p < 0.001, and to 17.51 mm Hg (±1.43 SD in the 2nd month. Between the 1st and 2nd month, no statistical difference was observed (paired Student’s t test = 0.02 και p < 0.1. In 8% of the patients during the 1st month and 10% of patients in the 2nd month, some ophthalmic signs were observed, while only mild ophthalmic symptoms were reported in 6% and 8% of the patients, respectively.Conclusions: In conclusion, the fixed combination of timolol–brimonidine has a satisfactory IOP-lowering effect without any serious side effects due to the topical use. Keywords: fixed combination 0.2% brimonidine–0.5% timolol, ocular hypertension, primary open-angle glaucoma

  17. COMPARATIVE CONTROLLED STUDY OF ANTIHYPERTENSIVE EFFICACY AND SAFETY OF CARVEDILOL IN PATIENTS WITH HYPERTENSION AND OBESITY OR DIABETES 2 TYPE (BASED ON RESULTS OF MULTICENTER TRIAL ACCORD

    Directory of Open Access Journals (Sweden)

    Yu. V. Yu.V. Lukina

    2009-01-01

    Full Text Available Aim. To study efficacy and safety of beta-blocker with vasodilating properties carvedilol (Acridilole, Akrihin, Russia as a part of the combined therapy of patients with arterial hypertension (HT and diabetes mellitus 2 type (DM2 and/or obesity.Material and methods. 592 patients: 176 men (29,7% and 416 women (70,3% with HT were examined. 194 patients had D2 and 398 patients had obesity. Patients were randomized for carvedilol therapy (n=291 or control group (n=301. Carvedilol was prescribed additionally to current therapy in dose of 6,25 mg BID, in 2 weeks the dose was increased to 12,5 mg BID if it was necessary. Blood pressure (BP and heart rate, number of angina attacks were registered at visits. ECG, laboratory analysis (plasma lipide profile, serum glucose, glycolised haemoglobin, serum K+ and Na+, evaluation of depression and anxiety status (according to special questionnaires were performed on the first and the last visits.Results. 582 patients completed the study. 7 patients dropped out from carvedilol group and 3 patients - from control group. The levels of systolic BP (SBP and diastolic BP (DBP were decreased during study, more significantly in carvedilol group (р<0,0001. SBP decreased on 24,8 mm Hg in patients of carvedilol group and on 21,4 mm Hg in patients of control group. DBP decreased on 12,5 mm Hg and 11 mm Hg respectively. Angina attacks were registered less often in patients of carvedilol group (р=0,001. Serum glucose and lipid spectrum did not change in both groups. Depression level decreased in patients receiving carvedilol. 17 side effects were registered in carvedilol group and 15 - in control group (р=0,575Conclusion. High antihypertensive efficacy of carvedilol is confirmed in hypertensive patients with DM2 and/or obesity. Good tolerability and metabolic neutrality of carvedilol is also observed.

  18. COMPARATIVE CONTROLLED STUDY OF ANTIHYPERTENSIVE EFFICACY AND SAFETY OF CARVEDILOL IN PATIENTS WITH HYPERTENSION AND OBESITY OR DIABETES 2 TYPE (BASED ON RESULTS OF MULTICENTER TRIAL ACCORD

    Directory of Open Access Journals (Sweden)

    Yu. V. Yu.V. Lukina

    2016-01-01

    Full Text Available Aim. To study efficacy and safety of beta-blocker with vasodilating properties carvedilol (Acridilole, Akrihin, Russia as a part of the combined therapy of patients with arterial hypertension (HT and diabetes mellitus 2 type (DM2 and/or obesity.Material and methods. 592 patients: 176 men (29,7% and 416 women (70,3% with HT were examined. 194 patients had D2 and 398 patients had obesity. Patients were randomized for carvedilol therapy (n=291 or control group (n=301. Carvedilol was prescribed additionally to current therapy in dose of 6,25 mg BID, in 2 weeks the dose was increased to 12,5 mg BID if it was necessary. Blood pressure (BP and heart rate, number of angina attacks were registered at visits. ECG, laboratory analysis (plasma lipide profile, serum glucose, glycolised haemoglobin, serum K+ and Na+, evaluation of depression and anxiety status (according to special questionnaires were performed on the first and the last visits.Results. 582 patients completed the study. 7 patients dropped out from carvedilol group and 3 patients - from control group. The levels of systolic BP (SBP and diastolic BP (DBP were decreased during study, more significantly in carvedilol group (р<0,0001. SBP decreased on 24,8 mm Hg in patients of carvedilol group and on 21,4 mm Hg in patients of control group. DBP decreased on 12,5 mm Hg and 11 mm Hg respectively. Angina attacks were registered less often in patients of carvedilol group (р=0,001. Serum glucose and lipid spectrum did not change in both groups. Depression level decreased in patients receiving carvedilol. 17 side effects were registered in carvedilol group and 15 - in control group (р=0,575Conclusion. High antihypertensive efficacy of carvedilol is confirmed in hypertensive patients with DM2 and/or obesity. Good tolerability and metabolic neutrality of carvedilol is also observed.

  19. EP3/FP dual receptor agonist ONO-9054 administered morning or evening to patients with open-angle glaucoma or ocular hypertension: results of a randomised crossover study

    Science.gov (United States)

    Berlin, Michael S; Rowe-Rendleman, Cheryl; Ahmed, Ike; Ross, Douglas T; Fujii, Akifumi; Ouchi, Takafumi; Quach, Christine; Wood, Andrew; Ward, Caroline L

    2016-01-01

    Background/aims The novel prostaglandin E (EP) 3 and prostaglandin F (FP) receptor agonist ONO-9054 is effective in lowering intraocular pressure (IOP) in patients with ocular hypertension and open-angle glaucoma when administered once daily. This study compares the effects of morning (AM) versus evening (PM) dosing of ONO-9054 on tolerability and IOP lowering. Methods This was a single-centre, randomised, double-masked, two-sequence, placebo-controlled crossover study in 12 subjects with bilateral primary open-angle glaucoma or ocular hypertension. Two 14-day crossover regimens were separated by a 2-week washout: ONO-9054 (1 drop to each eye) in the morning (07:00) and vehicle in the evening (19:00) and vice versa. IOP was measured multiple times during select days. Ocular examinations also evaluated safety and tolerability. Results Mild ocular hyperaemia, reported by six subjects with PM dosing, was the most frequent adverse event. Mild to moderate dryness was also slightly more frequent after PM dosing. Maximum IOP reduction from baseline occurred on day 2 with decreases from baseline of −7.4 mm Hg (−30.8%) for AM dosing and −9.1 mm Hg, (−38.0%) for PM dosing; after 14 days, mean reduction in IOP was −6.8 mm Hg (−28.6%) for AM dosing and −7.5 mm Hg (−31.0%) for PM dosing. Conclusions PM dosing of ONO-0954 was associated with a slightly increased frequency of mild hyperaemia and mild to moderate dryness. Both dosing schedules provided sustained reduction in IOP. Trial registration number NCT01670266. PMID:26453641

  20. Diagnostic accuracy of cardiovascular magnetic resonance imaging of right ventricular morphology and function in the assessment of suspected pulmonary hypertension results from the ASPIRE registry

    Directory of Open Access Journals (Sweden)

    Swift Andrew J

    2012-06-01

    Full Text Available Abstract Background Cardiovascular Magnetic Resonance (CMR imaging is accurate and reproducible for the assessment of right ventricular (RV morphology and function. However, the diagnostic accuracy of CMR derived RV measurements for the detection of pulmonary hypertension (PH in the assessment of patients with suspected PH in the clinic setting is not well described. Methods We retrospectively studied 233 consecutive treatment naïve patients with suspected PH including 39 patients with no PH who underwent CMR and right heart catheterisation (RHC within 48hours. The diagnostic accuracy of multiple CMR measurements for the detection of mPAP ≥ 25 mmHg was assessed using Fisher’s exact test and receiver operating characteristic (ROC analysis. Results Ventricular mass index (VMI was the CMR measurement with the strongest correlation with mPAP (r = 0.78 and the highest diagnostic accuracy for the detection of PH (area under the ROC curve of 0.91 compared to an ROC of 0.88 for echocardiography calculated mPAP. Late gadolinium enhancement, VMI ≥ 0.4, retrograde flow ≥ 0.3 L/min/m2 and PA relative area change ≤ 15% predicted the presence of PH with a high degree of diagnostic certainty with a positive predictive value of 98%, 97%, 95% and 94% respectively. No single CMR parameter could confidently exclude the presence of PH. Conclusion CMR is a useful alternative to echocardiography in the evaluation of suspected PH. This study supports a role for the routine measurement of ventricular mass index, late gadolinium enhancement and the use of phase contrast imaging in addition to right heart functional indices in patients undergoing diagnostic CMR evaluation for suspected pulmonary hypertension.

  1. Exercise Hypertension.

    Science.gov (United States)

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  2. Low-cost autonomous orbit control about Mars: Initial simulation results

    Science.gov (United States)

    Dawson, S. D.; Early, L. W.; Potterveld, C. W.; Königsmann, H. J.

    1999-11-01

    Interest in studying the possibility of extraterrestrial life has led to the re-emergence of the Red Planet as a major target of planetary exploration. Currently proposed missions in the post-2000 period are routinely calling for rendezvous with ascent craft, long-term orbiting of, and sample-return from Mars. Such missions would benefit greatly from autonomous orbit control as a means to reduce operations costs and enable contact with Mars ground stations out of view of the Earth. This paper present results from initial simulations of autonomously controlled orbits around Mars, and points out possible uses of the technology and areas of routine Mars operations where such cost-conscious and robust autonomy could prove most effective. These simulations have validated the approach and control philosophies used in the development of this autonomous orbit controller. Future work will refine the controller, accounting for systematic and random errors in the navigation of the spacecraft from the sensor suite, and will produce prototype flight code for inclusion on future missions. A modified version of Microcosm's commercially available High Precision Orbit Propagator (HPOP) was used in the preparation of these results due to its high accuracy and speed of operation. Control laws were developed to allow an autonomously controlled spacecraft to continuously control to a pre-defined orbit about Mars with near-optimal propellant usage. The control laws were implemented as an adjunct to HPOP. The GSFC-produced 50 × 50 field model of the Martian gravitational potential was used in all simulations. The Martian atmospheric drag was modeled using an exponentially decaying atmosphere based on data from the Mars-GRAM NASA Ames model. It is hoped that the simple atmosphere model that was implemented can be significantly improved in the future so as to approach the fidelity of the Mars-GRAM model in its predictions of atmospheric density at orbital altitudes. Such additional work

  3. Initial Results from the Micro-pulse Lidar Network (MPL-Net)

    Science.gov (United States)

    Welton, Ellsworth J.; Campbell, James R.; Berkoff, Timothy A.; Spinhirne, James D.; Ginoux, Paul; Starr, David OC. (Technical Monitor)

    2001-01-01

    The micro-pulse lidar system (MPL) was developed in the early 1990s and was the first small, eye-safe, and autonomous lidar built for full time monitoring of cloud and aerosol vertical distributions. In 2000, a new project using MPL systems was started at NASA Goddard Space Flight Center. This new project, the Micro-pulse Lidar Network or MPL-Net, was created to provide long-term observations of aerosol and cloud vertical profiles at key sites around the world. This is accomplished using both NASA operated sites and partnerships with other organizations owning MPL systems. The MPL-Net sites are co-located with NASA AERONET sunphotometers to provide aerosol optical depth data needed for calibration of the MPL. In addition to the long-term sites, MPL-Net provides lidar support for a limited number of field experiments and ocean cruises each year. We will present an overview of the MPL-Net project and show initial results from the first two MPL-Net sites at the South Pole and at Goddard Space Flight Center. Observations of dust layers transported from the Gobi desert, across the Pacific Ocean, to the east coast of the United States will also be shown. MPL-Net affiliated instruments were in place at the desert source region in China, on a research vessel in the Sea of Japan, at ARM sites in Alaska and Oklahoma, and finally at our home site in Maryland (GSFC) during the massive dust storms that occurred in April 2001. The MPL observations of dust layers at each location are shown in comparison to dust layers predicted using the Georgia Tech/Goddard Global Ozone Chemistry Aerosol Radiation and Transport model (GOCART). Finally, the MPL-Net project is the primary ground-validation program for the Geo-Science Laser Altimeter System (GLAS) satellite lidar project (launch date 2002). We will present an overview demonstrating how MPL-Net results are used to help prepare the GLAS data processing algorithms and assist in the calibration/validation of the GLAS data products.

  4. Exploratory X-ray monitoring of luminous radio-quiet quasars at high redshift: Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Shemmer, Ohad; Stein, Matthew S. [Department of Physics, University of North Texas, Denton, TX 76203 (United States); Brandt, W. N.; Schneider, Donald P. [Department of Astronomy and Astrophysics, The Pennsylvania State University, University Park, PA 16802 (United States); Paolillo, Maurizio [Dipartimento di Scienze Fisiche, Università Federico II di Napoli, via Cinthia 6, I-80126 Napoli (Italy); Kaspi, Shai [School of Physics and Astronomy and the Wise Observatory, Tel Aviv University, Tel Aviv 69978 (Israel); Vignali, Cristian [Dipartimento di Astronomia, Università degli studi di Bologna, via Ranzani 1, I-40127 Bologna (Italy); Lira, Paulina [Departamento de Astronomia, Universidad de Chile, Camino del Observatorio 1515, Santiago (Chile); Gibson, Robert R., E-mail: ohad@unt.edu [Department of Astronomy, University of Washington, Box 351580, Seattle, WA 98195 (United States)

    2014-03-10

    We present initial results from an exploratory X-ray monitoring project of two groups of comparably luminous radio-quiet quasars (RQQs). The first consists of four sources at 4.10 ≤ z ≤ 4.35, monitored by Chandra, and the second is a comparison sample of three sources at 1.33 ≤ z ≤ 2.74, monitored by Swift. Together with archival X-ray data, the total rest-frame temporal baseline spans ∼2-4 yr and ∼5-13 yr for the first and second group, respectively. Six of these sources show significant X-ray variability over rest-frame timescales of ∼10{sup 2}-10{sup 3} days; three of these also show significant X-ray variability on rest-frame timescales of ∼1-10 days. The X-ray variability properties of our variable sources are similar to those exhibited by nearby and far less luminous active galactic nuclei (AGNs). While we do not directly detect a trend of increasing X-ray variability with redshift, we do confirm previous reports of luminous AGNs exhibiting X-ray variability above that expected from their luminosities, based on simplistic extrapolation from lower luminosity sources. This result may be attributed to luminous sources at the highest redshifts having relatively high accretion rates. Complementary UV-optical monitoring of our sources shows that variations in their optical-X-ray spectral energy distribution are dominated by the X-ray variations. We confirm previous reports of X-ray spectral variations in one of our sources, HS 1700+6416, but do not detect such variations in any of our other sources in spite of X-ray flux variations of up to a factor of ∼4. This project is designed to provide a basic assessment of the X-ray variability properties of RQQs at the highest accessible redshifts that will serve as a benchmark for more systematic monitoring of such sources with future X-ray missions.

  5. [Evaluation of initial results of treatment of lead poisoning with EDTA].

    Science.gov (United States)

    Petkova, V; Adjarov, D; Pavlova, S; Naydenova, E; Kerimova, M; Kuneva, T

    1994-01-01

    The results of EDTA therapy were studied in 37 workers of a battery factory consisting of males with varying degrees of occupational lead poisoning (low exposure: 10 subjects, blood lead levels (PbB) lower than 400 micrograms/l with slight alterations in heme biosynthesis; beyond limit of effect: 5 subjects, PbB > 400 micrograms/l; slight intoxication: 19 subjects, with marked alterations in heme synthesis and preclinical signs of intoxication; average degree of intoxication: 3 subjects with clinical signs of intoxication. Clinical symptoms and the following parameters were investigated: blood lead (PbB), delta-aminolevulinic acid dehydratase in erythrocytes (ALA-D), zinc protoporphyrin (PP) in erythrocytes and delta-aminolevulinic acid (ALA) in 24-hour urine before and after EDTA chelating therapy. Simultaneous measurement of ALA-D and PP showed high diagnostic sensitivity in detecting lead poisoning in occupationally exposed subjects. In view of the high interindividual variability of the results, these indices did not, however, permit a useful differentiation to be made of the different degrees of intoxication at individual level, even though a good correlation was observed between PbB and porphyrin metabolism indices. From the alterations observed in ALA-D and PP values it was not possible to establish an association between degree of alteration and types of clinical symptoms in the different intoxication studies. At the end of EDTA treatment, a clinical improvement was observed in all cases studied but only in 5 cases was a reduction in PbB observed, to levels below 1.20 mol/l, which is accepted as a permissible limit for the general population; in 17 cases PbB remained at levels above the critical value for occupational lead poisoning (400 micrograms/l), although there was a decrease after treatment. The improvement observed in the indices of porphyrin metabolism at the end of treatment was only slight: significant variations were measured only for PbB. After

  6. Initial Results From The Micro-pulse Lidar Network (MPL-Net)

    Science.gov (United States)

    Welton, E. J.; Campbell, J. R.; Berkoff, T. A.; Spinhirne, J. D.; Ginoux, P.

    2001-12-01

    The micro-pulse lidar system (MPL) was developed in the early 1990s and was the first small, eye-safe, and autonomous lidar built for fulltime monitoring of cloud and aerosol vertical distributions. In 2000, a new project using MPL systems was started at NASA Goddard Space Flight Center. This new project, the Micro-pulse Lidar Network or MPL-Net, was created to provide long-term observations of aerosol and cloud vertical profiles at key sites around the world. This is accomplished using both NASA operated sites and partnerships with other organizations owning MPL systems. The MPL-Net sites are co-located with NASA AERONET sunphotometers to provide aerosol optical depth data needed for calibration of the MPL. In addition to the long-term sites, MPL-Net provides lidar support for a limited number of field experiments and ocean cruises each year. We will present an overview of the MPL-Net project and show initial results from the first two MPL-Net sites at the South Pole and at Goddard Space Flight Center. Observations of dust layers transported from the desert regions of China, across the Pacific Ocean, to the east coast of the United States will also be shown. MPL-Net affiliated instruments were in place at the desert source region in China, on a research vessel in the Sea of Japan, at ARM sites in Alaska and Oklahoma, and finally at our home site in Maryland (GSFC) during the massive dust storms that occurred in April 2001. The MPL observations of dust layers at each location are shown in comparison to dust layers predicted using the Georgia Tech/Goddard Global Ozone Chemistry Aerosol Radiation and Transport model (GOCART). Finally, the MPL-Net project is the primary ground-validation program for the Geo-Science Laser Altimeter System (GLAS) satellite lidar project (launch date 2002). We will present an overview demonstrating how MPL-Net results are used to help prepare the GLAS data processing algorithms and assist in the calibration/validation of the GLAS data

  7. Initial results with the Berkeley on-line mass separator-RAMA

    International Nuclear Information System (INIS)

    Cerny, J.; Moltz, D.M.; Evans, H.C.; Vieira, D.J.; Parry, R.F.; Wouters, J.M.; Gough, R.A.; Zisman, M.S.

    1977-11-01

    Initial performance is described for a reasonably fast and universal (having little or no chemical selectivity) on-line mass analysis system used to expand capabilities in studying nuclei far from stability. The system is termed RAMA, an acronym for Recoil Atom Mass Analyzer. Basically, this system utilizes the helium-jet method to transport activity to a Sidenius hollow-cathode ion source which is coupled to a mass spectrometer. Initial experiments and planned improvements are discussed. Transport efficiencies of between 10 and 60 percent have routinely been achieved, though the latter is much more typical when conditions are optimized

  8. antioxidant vitamins status of hypertensive subjects in sokoto ...

    African Journals Online (AJOL)

    DR. AMINU

    chronic diseases including cardiovascular diseases, diabetes, cancers and inflammatory diseases (Coyne,. 2005). Hypertension being a degenerative disease, therefore, may be initiated as a result of peroxidation caused by free radicals. Vitamins A, C, and E posses antioxidant properties. Deficiency of these may thus.

  9. Overview of results and perspectives from the Shoreham major common-cause initiating events study

    International Nuclear Information System (INIS)

    Joksimovich, V.; Orvis, D.D.; Paccione, R.J.

    1986-01-01

    This study represents the continuation of a large effort by LILCO to fully understand the potential hazards posed by future operation of the Shoreham Nuclear Power Stations (SNPS). The Shoreham Probabilistic Risk Assessment, a level 3 PRA without external events, provided a characterization of the accident sequences that could leave the core in a condition in which it would be vulnerable to severe damage if further mitigating actions were not taken. It estimated the frequency and magnitude of the potential radioactivity releases associated with such sequences. The study was limited to accident sequences initiated by so called internal events to the plant including a loss of offsite power. It also characterized the public risk associated with those accident sequences. The ''Major Common-Cause Initiating Events Study'' (MCCI) for the Shoreham plant was performed to obtain insights into the plant's susceptibility to, and inherent defenses against, certain MCCIs. Major common-cause initiating events are occurrences which have the potential to initiate a plant transient or LOCA and, also, damage one or more plant systems needed to mitigate the effects of a transient or LOCA. The scope of the MCCI study included detailed analyses of seismic events and fires through the severe core damage and bounding analyses of aircraft crashes, windstorms, turbine missiles and release of hazardous materials near the plant

  10. Fast pyrolysis in a novel wire-mesh reactor: design and initial results

    NARCIS (Netherlands)

    Hoekstra, E.; van Swaaij, Willibrordus Petrus Maria; Kersten, Sascha R.A.; Hogendoorn, Kees

    2012-01-01

    Pyrolysis is known to occur by decomposition processes followed by vapour phase reactions. The goal of this research is to develop a novel device to study the initial decomposition processes. For this, a novel wire-mesh reactor was constructed. A small sample (<0.1 g) was clamped between two meshes

  11. The magnetic field investigation on the ARASE (ERG) mission: Data characteristics and initial scientific results

    Science.gov (United States)

    Matsuoka, A.; Teramoto, M.; Nomura, R.; Nose, M.; Fujimoto, A.; Tanaka, Y.; Shinohara, M.; Nagatsuma, T.; Shiokawa, K.; Obana, Y.; Miyoshi, Y.; Takashima, T.; Shinohara, I.

    2017-12-01

    The ARASE (ERG) satellite was successfully launched on December 20 2016. A fluxgate magnetometer (MGF) was built for the ARASE satellite to measure DC and low-frequency magnetic field. The requirements to the magnetic field measurements by ARASE was defined as (1) accuracy of the absolute field intensity is within 5 nT (2) angular accuracy of the field direction is within 1 degree (3) measurement frequency range is from DC to 60Hz or wider. MGF measures the vector magnetic field with the original sampling frequency of 256 Hz. The dynamic range is switched between +/-8000nT and +/- 60000nT according to the background field intensity. The MGF initial checkout was carried on January 10th 2017, when the MGF normal performance and downlinked data were confirmed. The 5-m length MAST for the sensor was deployed on 17th January. The nominal operation of MGF started in March 2017. The MGF data are calibrated based on the results from the ground experiments and in-orbit data analysis. The MGF CDF files are distributed by the ARASE Science Center and available by Space Physics Environment Data Analysis Software (SPEDAS). The acceleration process of the charged particles in the inner magnetosphere is considered to be closely related to the deformation and perturbation of the magnetic field. Accurate measurement of the magnetic field is required to understand the acceleration mechanism of the charged particles, which is one of the major scientific objectives of the ARASE mission. We designed a fluxgate magnetometer which is optimized to investigate following topics; (1) accurate measurement of the background magnetic field - the deformation of the magnetic field and its relationship with the particle acceleration. (2) MHD waves - measurement of the ULF electromagnetic waves of frequencies about 1mHz (Pc4-5), and investigation of the radiation-belt electrons radially diffused by the resonance with the ULF waves. (3) EMIC waves - measurement of the electromagnetic ion

  12. Initial Results from the Vector Electric Field Investigation on the C/NOFS Satellite

    Science.gov (United States)

    Pfaff, R.; Rowland, D.; Acuna, M.; Le, G.; Farrell, W.; Holzworth, R.; Wilson, G.; Burke, W.; Freudenreich, H.; Bromund, K.; hide

    2009-01-01

    Initial results are presented from the Vector Electric Field Investigation (VEFI) on the Air Force Communication/Navigation Outage Forecasting System (C/NOFS) satellite, a mission designed to understand, model, and forecast the presence of equatorial ionospheric irregularities. The VEFI instrument includes a vector DC electric field detector, a fixed-bias Langmuir probe operating in the ion saturation regime, a flux gate magnetometer, an optical lightning detector, and associated electronics including a burst memory. The DC electric field detector has revealed zonal and meridional electric fields that undergo a diurnal variation, typically displaying eastward and outward-directed fields during the day and westward and downward-directed fields at night. In general, the measured DC electric field amplitudes are in the 0.5-2 mV/m range, corresponding to I3 x B drifts of the order of 30-150 m/s. What is surprising is the high degree of large-scale (10's to 100's of km) structure in the DC electric field, particularly at night, regardless of whether well-defined spread-F plasma density depletions are present. The spread-F density depletions and corresponding electric fields that have been detected thus far have displayed a preponderance to appear between midnight and dawn. Associated with the narrow plasma depletions that are detected are broad spectra of electric field and plasma density irregularities for which a full vector set of measurements is available for detailed study. On some occasions, localized regions of low frequency (field broadband irregularities have been detected, suggestive of filamentary currents, although there is no one-to-one correspondence of these waves with the observed plasma density depletions, at least within the data examined thus far. Finally, the data set includes a wide range of ELF/VLF/HF waves corresponding to a variety of plasma waves, in particular banded ELF hiss, whistlers, and lower hybrid wave turbulence triggered by lightning

  13. Overview of the Ozone Water-Land Environmental Transition Study: Summary of Observations and Initial Results

    Science.gov (United States)

    Berkoff, T.; Sullivan, J.; Pippin, M. R.; Gronoff, G.; Knepp, T. N.; Twigg, L.; Schroeder, J.; Carrion, W.; Farris, B.; Kowalewski, M. G.; Nino, L.; Gargulinski, E.; Rodio, L.; Sanchez, P.; Desorae Davis, A. A.; Janz, S. J.; Judd, L.; Pusede, S.; Wolfe, G. M.; Stauffer, R. M.; Munyan, J.; Flynn, J.; Moore, B.; Dreessen, J.; Salkovitz, D.; Stumpf, K.; King, B.; Hanisco, T. F.; Brandt, J.; Blake, D. R.; Abuhassan, N.; Cede, A.; Tzortziou, M.; Demoz, B.; Tsay, S. C.; Swap, R.; Holben, B. N.; Szykman, J.; McGee, T. J.; Neilan, J.; Allen, D.

    2017-12-01

    combination of observations provided a unique 4-D (horizontal, vertical, and time) view of O3 to help provide feedback to air quality forecast models as well as future satellite remote sensing systems such as NASA's TEMPO mission. In this presentation, a summary of observations and initial results will be presented from the OWLETS campaign.

  14. Penn State geoPebble system: Design,Implementation, and Initial Results

    Science.gov (United States)

    Urbina, J. V.; Anandakrishnan, S.; Bilen, S. G.; Fleishman, A.; Burkett, P.

    2014-12-01

    The Penn State geoPebble system is a new network of wirelessly interconnected seismic and GPS sensor nodes with flexible architecture. This network will be used for studies of ice sheets in Antarctica and Greenland, as well as to investigate mountain glaciers. The network will consist of ˜150 geoPebbles that can be deployed in a user-defined spatial geometry. We present our design methodology, which has enabled us to develop these state-of- the art sensors using commercial-off-the-shelf hardware combined with custom-designed hardware and software. Each geoPebble is a self- contained, wirelessly connected sensor for collecting seismic measurements and position information. Key elements of each node encompasses a three-component seismic recorder, which includes an amplifier, filter, and 24- bit analog-to-digital converter that can sample up to 10 kHz. Each unit also includes a microphone channel to record the ground-coupled airwave. The timing for each node is available from GPS measurements and a local precision oscillator that is conditioned by the GPS timing pulses. In addition, we record the carrier-phase measurement of the L1 GPS signal in order to determine location at sub-decimeter accuracy (relative to other geoPebbles within a few kilometers radius). Each geoPebble includes 16 GB of solid-state storage, wireless communications capability to a central supervisory unit, and auxiliary measurements capability (including tilt from accelerometers, absolute orientation from magnetometers and temperature). A novel aspect of the geoPebble is a wireless charging system for the internal battery (using inductive coupling techniques). The geoPebbles include all the sensors (geophones, GPS, microphone), communications (WiFi), and power (battery and charging) internally, so the geoPebble system can operate without any cabling connections (though we do provide an external connector so that different geophones can be used). We report initial field-deployment results and

  15. The path from ITER to a power plant - initial results from the ARIES ''Pathways'' program

    International Nuclear Information System (INIS)

    Najmabadi, F.

    2007-01-01

    The US national power plant studies program, ARIES, has initiated a 3-year integrated study, called the ''Pathways Program'' to investigate what the fusion program needs to do, in addition to successful operation of the ITER, in order to transform fusion into a commercial reality. The US power industry and regulatory agencies view the demonstration power plant, DEMO, as a device which is build and operated by industry, possibly with government participation, to demonstrate the commercial readiness of fusion power. As such, the ''Pathways'' programs will investigate what is needed, in addition to successful operation of ITER, to convince industry to move forward with a fusion DEMO. While many reports exists that provide a strategic view of the needs for fusion development; in the ITER era, a much more detailed view is needed to provide the necessary information for program planning. By comparing the anticipated results from ITER and existing facilities with the requirements for a power plant in the first phase of the Pathways study, we will develop a comprehensive list of remaining R and D items for developing fusion, will identify metrics for distributing resources among R and D issues, and will identify which of those items can/should be done in existing or simulation facilities. In the second phase of the study, we will develop potential embodiments for the fusion test facility (ies) and explore their cost/performance parametrically. An important by-product of this study is the identification of key R and D issues that can be performed and resolved in existing facilities to make the fusion facility cheaper and/or a higher performance device. This paper summarizes the results from the first phase of our study. We have adopted a ''holistic'' or integrated approach with the focus on the needs of the customer. In such an approach, the remaining R and D should generate all of the information needed by industry to move forward with the DEMO, i.e., data needed to

  16. Management of hypertension in pregnancy.

    Science.gov (United States)

    Chung, N A; Beevers, D G; Lip, G Y

    2001-01-01

    Hypertension is an important cause of both maternal and fetal morbidity and mortality in pregnant women. There are still no definitive guidelines as to when and how patients should be treated, but it is important that appropriate treatment is initiated early in patients at highest risk and they are closely monitored. Hypertension in pregnancy can be a difficult condition to diagnose and treat because of the numerous and differing classification systems that have been used in the past. One classification system, which accounts for the multisystem involvement which can occur in pre-eclampsia and eclampsia, divides hypertension in pregnancy into 3 main groups: pre-eclampsia, gestational hypertension and chronic hypertension. Little benefit to the fetus has been shown from treating gestational and chronic hypertension, but studies in this area have been small and would not have had the power to show a difference in outcome between treated and untreated groups. However, the reduction in morbidity and mortality in the treatment of pre-eclampsia is significant. Therefore, all pregnancies complicated by hypertension require monitoring to detect the possible onset of superimposed pre-eclampsia/eclampsia. Institutions should have a management strategy for those mothers with severe hypertension including a multidisciplinary approach, where the patient is to be monitored and which antihypertensive agents are to be used. It should not be forgotten that the definitive treatment for severe hypertension is delivery of the fetus despite risks to fetal morbidity and mortality. This will reduce blood pressure, but hypertension per se may still persist post partum requiring short term therapy.

  17. Essential hypertension vs. secondary hypertension among children.

    Science.gov (United States)

    Gupta-Malhotra, Monesha; Banker, Ashish; Shete, Sanjay; Hashmi, Syed Sharukh; Tyson, John E; Barratt, Michelle S; Hecht, Jacqueline T; Milewicz, Diane M; Boerwinkle, Eric

    2015-01-01

    The aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic. We evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review. We identified 275 (65%) hypertensive children (blood pressure >95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P secondary hypertension. The phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth. © American Journal of Hypertension, Ltd 2014. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

    Directory of Open Access Journals (Sweden)

    Nam-Ju Lee, DNSc, RN

    2010-03-01

    Conclusion: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

  19. Disparities in Hypertension Prevalence, Awareness, Treatment and Control between Bouyei and Han: Results from a Bi-Ethnic Health Survey in Developing Regions from South China.

    Science.gov (United States)

    Dong, Fen; Wang, Dingming; Pan, Li; Yu, Yangwen; Wang, Ke; Li, Ling; Wang, Li; Liu, Tao; Zeng, Xianjia; Sun, Liangxian; Zhu, Guangjin; Feng, Kui; Zhang, Biao; Xu, Ke; Pang, Xinglong; Chen, Ting; Pan, Hui; Ma, Jin; Zhong, Yong; Ping, Bo; Shan, Guangliang

    2016-02-19

    Hypertension is highly prevalent in low-income population. This study aims to investigate ethnic disparities in hypertension and identify modifiable factors related to its occurrence and control in developing regions in South China. Blood pressure was measured in the Bouyei and Han populations during a community-based health survey in Guizhou, 2012. A multistage stratified sampling method was adopted to recruit Bouyei and Han aged from 20 to 80 years. Taking mixed effects into consideration, multilevel logistic models with random intercept were used for data analysis. The prevalence rates of hypertension were 35.3% for the Bouyei and 33.7% for the Han. Among the hypertensive participants, 30.1% of the Bouyei and 40.2% of the Han were aware of their hypertensive conditions, 19.7% of the Bouyei and 31.1% of the Han were receiving treatment, and only 3.6% of the Bouyei and 9.9% of the Han had their blood pressure under control. Age-sex standardized rates of awareness, treatment, and control were consistently lower in the Bouyei than the Han. Such ethnic disparities were more evident in the elderly population. Avoidance of excessive alcohol consumption and better education were favorable lifestyle for reduction in risk of hypertension. Moderate physical activity improved control of hypertension in Bouyei patients under treatment. Conclusively, hypertension awareness, treatment, and control were substantially lower in Bouyei than Han, particularly in the elderly population. Such ethnic disparities indicate that elderly Bouyei population should be targeted for tailored interventions in the future.

  20. Adaptation, allometry, and hypertension.

    Science.gov (United States)

    Weder, A B; Schork, N J

    1994-08-01

    Essential hypertension is a "disease of civilization" but has a clear genetic component. From an evolutionary perspective, persistence in the human genome of elements capable of raising blood pressure presupposes their adaptive significance. Recently, two hypotheses that explicitly appeal to selectionist arguments, the "slavery" and "thrifty gene" theories, have been forwarded. We find neither completely successful, and we advance an alternative explanation of the adaptive importance of genes responsible for hypertension. We propose that blood pressure rises during childhood and adolescence to subserve homeostatic needs of the organism. Specifically, we contend that blood pressure is a flexible element in the repertoire of renal homeostatic mechanisms serving to match renal function to growth. The effect of modern diet and lifestyle on human growth stimulates earlier and more vigorous development, straining biologically necessary relationships between renal and general somatic growth and requiring compensation via homeostatic mechanisms preserved during evolution. Prime among such mechanisms is blood pressure, which rises as a compensation to maintain renal function in the face of greater growth. Since virtually all members of acculturated societies share in the modern lifestyle, the demands imposed by accelerated growth and development result in a populational shift to higher blood pressures, with a consequent increase in the prevalence of hypertension. We propose that hypertension is the product of maladaptation of highly genetically conserved mechanisms subserving important biological homeostatic needs. Elucidation of the mechanisms underlying hypertension will require approaches that examine the developmental processes linking growth to blood pressure.

  1. Initial Results of Using Daily CT Localization to Correct Portal Error in Prostate Cancer

    International Nuclear Information System (INIS)

    Lattanzi, Joseph; McNeely, Shawn; Barnes, Scott; Das, Indra; Schultheiss, Timothy E; Hanks, Gerald E.

    1997-01-01

    Purpose: To evaluate the use of daily CT simulation in prostate cancer to correct errors in portal placement and organ motion. Improved localization with this technique should allow the reduction of target margins and facilitate dose escalation in high risk patients while minimizing the risk of normal tissue morbidity. Methods and Materials : Five patients underwent standard CT simulation with the alpha cradle cast, IV contrast, and urethrogram. All were initially treated to 46 Gy in a four field conformal technique which included the prostate, seminal vesicles and pelvic lymph nodes (GTV 1 ). The prostate or prostate and seminal vesicles (GTV 2 ) then received 56 Gy with a 1.0 cm margin to the PTV. At 50 Gy a second CT simulation was performed with IV contrast, urethrogram and the alpha cradle secured to a rigid sliding board. The prostate was contoured, a new isocenter generated, and surface markers placed. Prostate only treatment portals for the final conedown (GTV 3 ) were created with 0.25 cm isodose margins to the PTV. The final six fractions in 2 patients with favorable disease and eight fractions in 3 patients with unfavorable disease were delivered using the daily CT technique. On each treatment day the patient was placed in his cast on the sliding board and a CT scan performed. The daily isocenter was calculated in the A/P and lateral dimension and compared to the 50 Gy CT simulation isocenter. Couch and surface marker shifts were calculated to produce perfect portal alignment. To maintain positioning, the patient was transferred to a gurney while on the sliding board in his cast, transported to the treatment room and then transferred to the treatment couch. The patient was then treated to the corrected isocenter. Portal films and real time images were obtained for each portal. Results: Utilizing CT-CT image registration (fusion) of the daily and 50 Gy baseline CT scans the isocenter changes were quantified to reflect the contribution of positional

  2. Preliminary Results from Initial Investigations of Ceres' Cratering Record from Dawn Imaging Data

    Science.gov (United States)

    Schmedemann, Nico; Michael, Gregory; Ivanov, Boris A.; Kneissl, Thomas; Neesemann, Adrian; Hiesinger, Harald; Jaumann, Ralf; Raymond, Carol A.; Russell, Christopher T.

    2015-04-01

    The highly successful Dawn mission [1] finished data collection at Vesta in 2012 and is now on its way to the dwarf planet Ceres. According to the current Ceres approach timeline of the Dawn mission, the ground resolution of the Dawn FC camera [2] will be about 10 times better than Hubble data [3] at the time of the presentation of this work. This may allow for identification of craters about 15 km in diameter. Initial mapping of sample areas may provide enough information of the cratering record in order to compare it with the theoretical Ceres crater production function we present at the 46th LPSC conference (March 16-20, 2015, The Woodlands, Texas) [4]. Our preliminary crater production function for Ceres is derived from the assumption of an icy crust just below a thin surface layer of dust [5], and a projectile population that is very similar to the one that impacted the Moon [6]. In order to scale the lunar cratering record to Ceres we use the Ivanov scaling laws [7], which allow for crater scaling based on parameters that can be derived from observations. The lunar-like approach gave reasonable good results for the crater production function on the asteroids Vesta, Ida, Lutetia and Gaspra [8]. Since the lunar surface is of basaltic composition, the correct scaling between the different materials is challenging. One crucial parameter is the transition diameter from simple to complex craters. Based on the simple to complex transition diameter on Iapetus, an icy satellite of Saturn, we expect this transition at about 12 km crater size at Ceres. This value may be slightly different due to the different temperatures at Ceres and Iapetus. If the simple to complex transition is observed at much larger diameters, the reason could be a substantial fraction of rock in the shallow subsurface of Ceres. In an ice-rich surface material high relaxation rates may also be expected that could change the shape of the crater production function. A thorough geological mapping

  3. Hypertension-attributed nephropathy: what's in a name?

    Science.gov (United States)

    Freedman, Barry I; Cohen, Arthur H

    2016-01-01

    Unrelated disease processes commonly occur in non-diabetic individuals with mild-to-moderate hypertension and low level or absent proteinuria who present with chronic kidney disease: primary glomerulosclerosis in those with recent African ancestry, and arteriolar nephrosclerosis with resultant glomerular ischaemia potentially related to hypertension and vascular disease risk factors in other cases. Unfortunately, nephrologists often indiscriminately apply a diagnosis of 'hypertensive nephrosclerosis' to patients in either scenario, which implies that the hypertension is causative of their renal disease. Although nephropathies that are associated with variants in the apolipoprotein L1 gene (APOL1) often cause secondarily elevated blood pressure, they belong to the spectrum of focal segmental glomerulosclerosis and are not initiated by systemic hypertension. Because genetic testing for APOL1 variants and other glomerulosclerosis-associated gene variants is available and can provide a precise definition of disease pathogenesis, we believe that the term 'hypertensive nephrosclerosis' should now be abandoned and replaced with either gene-based (for example, APOL1-associated) glomerulosclerosis or arteriolar nephrosclerosis. Precision medicine will be key to improving diagnostic accuracy in this field. Discrimination of these disparate disorders has the potential to eradicate primary forms of glomerulosclerosis that are associated with APOL1 renal-risk variants.

  4. Awake craniotomy for glioma resection: Technical aspects and initial results in a single institution.

    Science.gov (United States)

    Trimble, Gillian; McStravick, Clodagh; Farling, Peter; Megaw, Katie; McKinstry, Steven; Smyth, Graham; Law, Gillian; Courtney, Heather; Quigley, Gavin; Flannery, Thomas

    2015-01-01

    Although variations in the technique of awake craniotomy (AC) have been widely reported, a key member of this interdisciplinary procedure is the healthcare professional performing assessments of neurological function during resection. The expertise of the latter will depend on the neurological function to be tested and on available resources of the institution. This report details our initial experience of an AC service utilizing the expertise of a speech and language therapist (SLT) and an experienced neuro-physiotherapist (NP) to monitor patient function during glioma resection. Forty-five patients underwent 50 AC procedures for eloquently located gliomas over a 3-year period. Patients with a glioma involving speech or sensorimotor areas were assessed preoperatively by the SLT/NP respectively. The same therapist monitored the patient's neurological function intraoperatively and executed a rehabilitation program tailored to the needs of the patient in the postoperative period. Three patients underwent biopsy only, due to intraoperative seizures precluding intraoperative mapping (2 cases) or speech arrest on stimulation of a small recurrent tumor. The remaining 47 cases were suitable for repetitive neurological assessment "awake" during tumor debulking. One patient with a large sensorimotor tumor developed intraoperative hemiparesis due to outward brain herniation (which recovered postoperatively). Ten patients developed a new or worsened neurological deficit in the initial postoperative period (6 were detected intraoperatively), of which 5 eventually had resolution and returned to baseline function within 2 weeks. In our initial experience based anecdotally on a previous similar "non-awake" caseload, we have found AC with the input of the SLT/NP to be a key component in ensuring optimal functional outcomes for patients with gliomas in eloquently located areas.

  5. Automation and robotics for the Space Exploration Initiative: Results from Project Outreach

    Science.gov (United States)

    Gonzales, D.; Criswell, D.; Heer, E.

    1991-01-01

    A total of 52 submissions were received in the Automation and Robotics (A&R) area during Project Outreach. About half of the submissions (24) contained concepts that were judged to have high utility for the Space Exploration Initiative (SEI) and were analyzed further by the robotics panel. These 24 submissions are analyzed here. Three types of robots were proposed in the high scoring submissions: structured task robots (STRs), teleoperated robots (TORs), and surface exploration robots. Several advanced TOR control interface technologies were proposed in the submissions. Many A&R concepts or potential standards were presented or alluded to by the submitters, but few specific technologies or systems were suggested.

  6. THE STATE OF ARTERIAL HYPERTENSION DIAGNOSTICS AND TREATMENT, ACCORDING TO THE RESULTS OF THE POLL AMONG PHYSICIANS OF VOLGOGRAD AND VOLGOGRAD REGION

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2005-01-01

    Full Text Available Aim. Assessment and quality of diagnostics of treatment of patients with arterial hypertension (AH and their conformity with international and national recommendations on AH.Material and methods. The poll among physicians of Volgograd and Volgograd region, who took part in the regional conference, devoted to the problems of AH, was carried out in April 2004. The questionnaire included 13 questions about peculiarities of AH patients’ management 128 physicians took part in the poll, from them 90 thetapeutists (general physicians, 24 cardiologists, and 14 physicians of different therapeutic specializations.Results. Variability of conceptions of physicians on some principals of diagnostics and treatment of AH patients is revealed. Insufficient knowledge of criteria for division patients according to the risk category of cardiovascular complications. The same is observed for definition of AH grade according to the blood pressure level, and of the main approaches AH patients treatment. From all the questioned physicians only 25.2% correctly evaluated the risk level of cardiovascular diseases, 21% of physicians wrongly assessed the AH grade according to the blood pressure Level.Conclusion. Results, show that real practice of diagnostics and treatment of AH significantly deviates from international and national recommendations on AH.

  7. THE STATE OF ARTERIAL HYPERTENSION DIAGNOSTICS AND TREATMENT, ACCORDING TO THE RESULTS OF THE POLL AMONG PHYSICIANS OF VOLGOGRAD AND VOLGOGRAD REGION

    Directory of Open Access Journals (Sweden)

    S. Y. Martsevich

    2015-12-01

    Full Text Available Aim. Assessment and quality of diagnostics of treatment of patients with arterial hypertension (AH and their conformity with international and national recommendations on AH.Material and methods. The poll among physicians of Volgograd and Volgograd region, who took part in the regional conference, devoted to the problems of AH, was carried out in April 2004. The questionnaire included 13 questions about peculiarities of AH patients’ management 128 physicians took part in the poll, from them 90 thetapeutists (general physicians, 24 cardiologists, and 14 physicians of different therapeutic specializations.Results. Variability of conceptions of physicians on some principals of diagnostics and treatment of AH patients is revealed. Insufficient knowledge of criteria for division patients according to the risk category of cardiovascular complications. The same is observed for definition of AH grade according to the blood pressure level, and of the main approaches AH patients treatment. From all the questioned physicians only 25.2% correctly evaluated the risk level of cardiovascular diseases, 21% of physicians wrongly assessed the AH grade according to the blood pressure Level.Conclusion. Results, show that real practice of diagnostics and treatment of AH significantly deviates from international and national recommendations on AH.

  8. The renal transcriptome in experimental hypertension

    NARCIS (Netherlands)

    Wesseling, S.

    2007-01-01

    The renal transcriptome in experimental hypertension The kidneys importantly determine blood pressure. Kidney dysfunction can result in hypertension, which in turn leads to renal damage. In primary hypertension the cause is unknown. The condition is polygenic, however, which genetic defects cause

  9. 42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

    Science.gov (United States)

    2010-10-01

    ... determinations and changes as a result of DRG validations. 476.85 Section 476.85 Public Health CENTERS FOR... denial determinations and changes as a result of DRG validations. A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in...

  10. Hypertension Subtypes among Hypertensive Patients in Ibadan

    OpenAIRE

    Abiodun M. Adeoye; Adewole Adebiyi; Bamidele O. Tayo; Babatunde L. Salako; Adesola Ogunniyi; Richard S. Cooper

    2014-01-01

    Background. Certain hypertension subtypes have been shown to increase the risk for cardiovascular morbidity and mortality and may be related to specific underlying genetic determinants. Inappropriate characterization of subtypes of hypertension makes efforts at elucidating the genetic contributions to the etiology of hypertension largely vapid. We report the hypertension subtypes among patients with hypertension from South-Western Nigeria. Methods. A total of 1858 subjects comprising 76% fema...

  11. Hypercortisolism in obesity-associated hypertension.

    Science.gov (United States)

    Varughese, Amy G; Nimkevych, Oksana; Uwaifo, Gabriel I

    2014-07-01

    Obesity is prevalent worldwide and associated with co-morbidities that result in increased cardiovascular risk. Hypertension is the most prevalent obesity comorbidity associated with increased cardiovascular risk. Obesity hypertension is a distinct subtype of essential hypertension. While endogenous Cushing's syndrome is an uncommon cause of both obesity and hypertension, the recent recognition of other hypercortisolemic states has raised the profile of hypercortisolism as an important contributor in obesity hypertension. The high prevalence of exogenous, iatrogenic, pseudo, and subclinical Cushing's syndromes makes hypercortisolism an important diagnostic consideration in the evaluation and management of patients with obesity hypertension who are resistant to conventional management. Available data suggest that the renin-angiotensin-aldosterone system modulating antihypertensives have the best efficacy in hypercortisolism-mediated obesity hypertension. Strategies aimed at reducing cortisol production and action also have utility. This review provides a comprehensive overview of the epidemiology, etiopathogenesis and management options available for glucocorticoid-mediated obesity hypertension.

  12. DESTRUCTIVE LESIONS OF BONES AS A RESULT OF MYCOBACTERIAL PROCESS IN CHILDREN WITH INITIAL IMMUNODEFICIENCIES (CLINICAL, DIAGNOSTICAL AND TACTIC PECULIARITIES

    Directory of Open Access Journals (Sweden)

    A.Yu. Mushkin

    2011-01-01

    Full Text Available Initial immunodeficiencies are genetically conditioned defects of immune system; they are the basis for generalized infections including those induced by mycobacteria of tuberculosis complex. The lesions of skeleton in those patients are of different types depending on the kind of immunodeficiency. The article presents the results of clinical observation, conservative and surgical treatment of 12 children with mycobacterial lesions of skeleton on the ground different initial immunodeficiencies — severe combined immune deficiency, chronic granulematosis and insufficiency of interferon and interleukin 12.Key words: children, initial immunodeficiency, mycobacterial infection, bone lesions, surgical treatment.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2011; 10 (3: 60–64

  13. Controlling Hypertension

    Centers for Disease Control (CDC) Podcasts

    Hypertension, or high blood pressure, affects one third of U.S. adults and is a leading cause of heart disease and stroke. A recent study found an increase in self-reported high blood pressure among U.S. adults, and an increase in the use of medications to control high blood pressure. In this podcast, Dr. Fleetwood Loustalot discusses the importance of controlling high blood pressure.

  14. Initial results of high resolution L-H transition studies on DIII-D

    International Nuclear Information System (INIS)

    Wang, G; Rhodes, T L; Doyle, E J; Peebles, W A; Zeng, L; Burrell, K H; McKee, G R; Groebner, R J; Evans, T E

    2004-01-01

    Understanding the L-H transition in tokamaks has been an important area of research for more than two decades. High time resolution diagnostics on DIII-D allow detailed characterization of the L-H transition and, therefore, testing and benchmarking of theoretical models. An experiment was performed in DIII-D utilizing a novel, high temporal and spatial resolution reflectometer density profile system to measure densities from the SOL to the inside separatrix. Initial data analysis indicates different density profile evolution during L-H transitions in upper single-null and lower single-null divertor configuration plasmas. A detailed comparison of the density gradient and fluctuation changes is presented for these two cases

  15. Performance of the Argonne Wakefield Accelerator facility and initial experimental results

    International Nuclear Information System (INIS)

    Gai, W.; Conde, M.; Cox, G.; Konecny, R.; Power, J.; Schoessow, P.; Simpson, J.; Barov, N.

    1996-01-01

    The Argonne Wakefield Accelerator (AWA) facility has begun its experimental program. This unique facility is designed to address advanced acceleration research which requires very short, intense electron bunches. The facility incorporates two photo-cathode based electron sources. One produces up to 100 nC, multi-kiloamp 'drive' bunches which are used to excite wakefields in dielectric loaded structures and in plasma. The second source produces much lower intensity 'witness' pulses which are used to probe the fields produced by the drive. The drive and witness pulses can be precisely timed as well as laterally positioned with respect to each other. We discuss commissioning, initial experiments, and outline plans for a proposed 1 GeV demonstration accelerator. (author)

  16. Performance of the Argonne Wakefield Accelerator Facility and initial experimental results

    International Nuclear Information System (INIS)

    Gai, W.; Conde, M.; Cox, G.; Konecny, R.; Power, J.; Schoessow, P.; Simpson, J.; Barov, N.

    1996-01-01

    The Argonne Wakefield Accelerator facility has begun its experimental program. It is designed to address advanced acceleration research requiring very short, intense electron bunches. It incorporates two photocathode based electron sources. One produces up to 100 nC, multi-kiloamp 'drive' bunches which are used to excite wakefields in dielectric loaded structures and in plasma. The second source produces much lower intensity 'witness' pulses which are used to probe the fields produced by the drive. The drive and witness pulses can be precisely timed as well as laterally positioned with respect to each other. This paper discusses commissioning, initial experiments, and outline plans for a proposed 1 GeV demonstration accelerator

  17. Initial results of high resolution L-H transition studies on DIII-D

    Energy Technology Data Exchange (ETDEWEB)

    Wang, G [Department of Electrical Engineering and PSTI, University of California, Los Angeles, CA 90095 (United States); Rhodes, T L [Department of Electrical Engineering and PSTI, University of California, Los Angeles, CA 90095 (United States); Doyle, E J [Department of Electrical Engineering and PSTI, University of California, Los Angeles, CA 90095 (United States); Peebles, W A [Department of Electrical Engineering and PSTI, University of California, Los Angeles, CA 90095 (United States); Zeng, L [Department of Electrical Engineering and PSTI, University of California, Los Angeles, CA 90095 (United States); Burrell, K H [General Atomics, PO Box 85608, San Diego, CA 92186 (United States); McKee, G R [University of Wisconsin-Madison, 1500 Engineering Drive, Madison, WI 53706 (United States); Groebner, R J [General Atomics, PO Box 85608, San Diego, CA 92186 (United States); Evans, T E [General Atomics, PO Box 85608, San Diego, CA 92186 (United States)

    2004-05-01

    Understanding the L-H transition in tokamaks has been an important area of research for more than two decades. High time resolution diagnostics on DIII-D allow detailed characterization of the L-H transition and, therefore, testing and benchmarking of theoretical models. An experiment was performed in DIII-D utilizing a novel, high temporal and spatial resolution reflectometer density profile system to measure densities from the SOL to the inside separatrix. Initial data analysis indicates different density profile evolution during L-H transitions in upper single-null and lower single-null divertor configuration plasmas. A detailed comparison of the density gradient and fluctuation changes is presented for these two cases.

  18. Fibrosis of the pancreas: the initial tissue damage and the resulting pattern.

    Science.gov (United States)

    Klöppel, Günter; Detlefsen, Sönke; Feyerabend, Bernd

    2004-07-01

    Fibrosis in the pancreas is caused by such processes as necrosis/apoptosis, inflammation or duct obstruction. The initial event that induces fibrogenesis in the pancreas is an injury that may involve the interstitial mesenchymal cells, the duct cells and/or the acinar cells. Damage to any one of these tissue compartments of the pancreas is associated with cytokine-triggered transformation of resident fibroblasts/pancreatic stellate cells into myofibroblasts and the subsequent production and deposition of extracellular matrix. Depending on the site of injury in the pancreas and the involved tissue compartment, predominantly inter(peri)lobular fibrosis (as in alcoholic chronic pancreatitis), periductal fibrosis (as in hereditary pancreatitis), periductal and interlobular fibrosis (as in autoimmune pancreatitis) or diffuse inter- and intralobular fibrosis (as in obstructive chronic pancreatitis) develops.

  19. Initial results from the Auto/Oil Air Quality Improvement Research Program

    International Nuclear Information System (INIS)

    McCabe, L.J.

    1993-01-01

    The Auto/Air Quality Improvement Research Program (AQIRP), a cooperative effort by the three major US auto companies and fourteen oil companies, is the most comprehensive research effort ever undertaken to develop data on the air quality effects of the use of various motor fuels in various automotive systems and the relative cost-effectiveness of various fuel/vehicle combinations. Phase 1 of the Program, at a cost of about $15 million, is examining emissions and air quality impacts from current and older vehicles using reformulated gasolines with widely different values of aromatics content, olefin content, oxygenate content and type, sulfur content, vapor pressure (RVP) and 90% distillation temperature. Emissions from Flexible and Variable Fuel vehicles using methanol/gasoline mixtures are also being examined. A second phase with a $25 million budget over three years has also been approved. Initial findings for the Phase 1 study and Phase 2 plans are presented

  20. Initial formulation results for in situ grouting of a waste trench at ORNL Site No. 6

    International Nuclear Information System (INIS)

    Tallent, O.K.; McDaniel, E.W.; Spence, R.D.; Godsey, T.T.

    1987-01-01

    An investigation is being conducted by the Chemical Technology Division to assist the Environmental Sciences Division in developing a grout formulation for use in testing in situ grouting in a waste trench at ORNL Site 6. This final report satisfies the milestone of Subtack 12 entitled, ''Low Level Waste (LLW) Trench Grouting Assessment,'' which was initially issued as RAP-86-7, December 31, 1985. Grouts prepared from dry-solid blends containing Type I Portland cement, ASTM Class C or Class F fly ash, and bentonite, mixed water at ratios of 10 to 15 lb/gal, were evaluated. The grouts prepared with ASTM Class C fly ash exhibited significantly better properties than those prepared with ASTM Class F fly ash. The grouts containing ASTM Class C fly ash satisfy tentative performance criteria for the project. 8 refs., 7 tabs

  1. Initial experimental results from the Laboratory Biosphere closed ecological system facility.

    Science.gov (United States)

    Nelson, M; Dempster, W F; Alling, A; Allen, J P; Rasmussen, R; Silverstone, S; Van Thillo, M

    2003-01-01

    An initial experiment in the Laboratory Biosphere facility, Santa Fe, New Mexico, was conducted May-August 2002 using a soil-based system with light levels (at 12 h per day) of 58-mol m-2 d-1. The crop tested was soybean, cultivar Hoyt, which produced an aboveground biomass of 2510 grams. Dynamics of a number of trace gases showed that methane, nitrous oxide, carbon monoxide, and hydrogen gas had initial increases that were substantially reduced in concentration by the end of the experiment. Methane was reduced from 209 ppm to 11 ppm, and nitrous oxide from 5 ppm to 1.4 ppm in the last 40 days of the closure experiment. Ethylene was at elevated levels compared to ambient during the flowering/fruiting phase of the crop. Soil respiration from the 5.37 m2 (1.46 m3) soil component was estimated at 23.4 ppm h-1 or 1.28 g CO2 h-1 or 5.7 g CO2 m-2 d-1. Phytorespiration peaked near the time of fruiting at about 160 ppm h-1. At the height of plant growth, photosynthesis CO2 draw down was as high as 3950 ppm d-1, and averaged 265 ppm h-1 (whole day averages) during lighted hours with a range of 156-390 ppm h-1. During this period, the chamber required injections of CO2 to continue plant growth. Oxygen levels rose along with the injections of carbon dioxide. Upon several occasions, CO2 was allowed to be drawn down to severely limiting levels, bottoming at around 150 ppm. A strong positive correlation (about 0.05 ppm h-1 ppm-1 with r2 about 0.9 for the range 1000-5000 ppm) was observed between atmospheric CO2 concentration and the rate of fixation up to concentrations of around 8800 ppm CO2. c2003 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  2. Ten Years of Northern Eurasia Earth Science Partnership Initiative (NEESPI): Results and Future Plans

    Science.gov (United States)

    Groisman, P. Y.; Gutman, G.; Gulev, S.; Maksyutov, S. S.

    2014-12-01

    During recent decades, Northern Eurasia was affected by unprecedented climate and environmental changes. Several droughts and heat waves alternated with hazardous extreme precipitation and flood events. Permafrost thaw, retreating Arctic sea ice, increasing areas of forest fire, and dramatic regional warming buffeted this region, tossing northern Eurasia from one extreme condition to the next. The region stores nearly half of the Earth's terrestrial carbon in permafrost, wetlands, and forested land, so ecosystem changes that release stored carbon could profoundly affect the world's climate. Furthermore, changes to climate and to hydrological and biogeochemical cycles are starting to affect daily life. For example, infrastructure is collapsing as permafrost thaws, severe winter storms increasingly bring businesses to a halt, and a growing water deficit is beginning to strain agricultural production and forestry. To pool resources and facilitate research, the Northern Eurasia Earth Science Partnership Initiative (NEESPI, http://neespi.org) was launched in 2004. With its multidisciplinary focus, the internationally funded NEESPI (more than165 individual international projects during the past decade) has challenged participants to research climate-ecosystem interactions, societal impacts from extreme events in Northern Eurasia, and the feedbacks of these interactions and impacts to the global Earth system. Among the numerous Institutional and private sponsors from the United States, European Union, Russia, China, and Japan, the cornerstone support for the NEESPI studies was provided by the NASA Land Cover and Land Use Change Program and the Russian Academy of Sciences. At this presentation we shall overview the environmental studies conducted by the NEESPI community, brief the audience about the main achievements of the NEESPI researchers, and lay down the plans for the future studies. At the side event of the Meeting, we are going to initiate preparation of the book

  3. Design of an Object-Oriented Turbomachinery Analysis Code: Initial Results

    Science.gov (United States)

    Jones, Scott M.

    2015-01-01

    Performance prediction of turbomachines is a significant part of aircraft propulsion design. In the conceptual design stage, there is an important need to quantify compressor and turbine aerodynamic performance and develop initial geometry parameters at the 2-D level prior to more extensive Computational Fluid Dynamics (CFD) analyses. The Object-oriented Turbomachinery Analysis Code (OTAC) is being developed to perform 2-D meridional flowthrough analysis of turbomachines using an implicit formulation of the governing equations to solve for the conditions at the exit of each blade row. OTAC is designed to perform meanline or streamline calculations; for streamline analyses simple radial equilibrium is used as a governing equation to solve for spanwise property variations. While the goal for OTAC is to allow simulation of physical effects and architectural features unavailable in other existing codes, it must first prove capable of performing calculations for conventional turbomachines. OTAC is being developed using the interpreted language features available in the Numerical Propulsion System Simulation (NPSS) code described by Claus et al (1991). Using the NPSS framework came with several distinct advantages, including access to the pre-existing NPSS thermodynamic property packages and the NPSS Newton-Raphson solver. The remaining objects necessary for OTAC were written in the NPSS framework interpreted language. These new objects form the core of OTAC and are the BladeRow, BladeSegment, TransitionSection, Expander, Reducer, and OTACstart Elements. The BladeRow and BladeSegment consumed the initial bulk of the development effort and required determining the equations applicable to flow through turbomachinery blade rows given specific assumptions about the nature of that flow. Once these objects were completed, OTAC was tested and found to agree with existing solutions from other codes; these tests included various meanline and streamline comparisons of axial

  4. Hepatic angiography: Portal hypertension

    International Nuclear Information System (INIS)

    Oliver, T.W. Jr.; Sones, P.J. Jr.

    1985-01-01

    Portal hypertension is usually a manifestation of underlying hepatic parenchymal disease, although it may be secondary to portal or hepatic venous thrombosis and rarely to hyperdynamic portal states. Portal hypertension may present as encephalopathy, ascites, jaundice, hepatic failure, or catastrophic upper gastrointestinal hemorrhage. Radiologic investigation should include indirect or direct measurements of portal pressure, assessment of portal venous perfusion, visualization of collaterals, and demonstration of arterial and venous anatomy for potential shunt procedure. Following survival of initial variceal bleeding, the most effective procedure to prevent recurrent hemorrhage is a shunt to decompress the varices. The decision whether to intervene medically or surgically during the acute hemorrhagic episode as well as the type of shunt used to prevent future hemorrhage is the subject of continuing controversy

  5. [Exercise in arterial hypertension].

    Science.gov (United States)

    Predel, Hans-Georg; Schramm, Thomas

    2006-09-01

    Regular endurance training has established itself as a major therapeutic principle in the specter of nonpharmacological measures in arterial hypertension. An initial medical check as well as an adequate technique, dosage and intensity of the prescribed exercise training are mandatory. With respect to the concomitant pharmacological treatment, it should be considered that the beneficial effects of lifestyle modification will not be counteracted by the chosen antihypertensive drug but, ideally, synergistically supported. Based on the individual clinical situation, principally all antihypertensive drugs recommended by the current European guidelines, may be prescribed as mono- or combination therapy.beta-receptor blockers are especially capable of controlling excessive exercise-induced blood pressure increase; however, they have metabolic and exercise physiological limitations. The neutrality concerning metabolic and exercise physiological parameters as well as the positive profile of side effects favor ACE inhibitors, long-acting calcium channel blockers and especially AT(1) antagonists in physically active hypertensive patients with concomitant metabolic syndrome.

  6. Pulmonary Hypertension

    Science.gov (United States)

    Kim, John S.; McSweeney, Julia; Lee, Joanne; Ivy, Dunbar

    2015-01-01

    Objective Review the pharmacologic treatment options for pulmonary arterial hypertension (PAH) in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. Data Sources and Study Selection Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of PAH therapies. Data Extraction Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies. Data Synthesis Specific targeted therapies developed for the treatment of adult patients with PAH have been applied for the benefit of children with PAH. With the exception of inhaled nitric oxide, there are no PAH medications approved for children in the US by the FDA. Unfortunately, data on treatment strategies in children with PAH are limited by the small number of randomized controlled clinical trials evaluating the safety and efficacy of specific treatments. The treatment options for PAH in children focus on endothelial-based pathways. Calcium channel blockers are recommended for use in a very small, select group of children who are responsive to vasoreactivity testing at cardiac catheterization. Phosphodiesterase type 5 inhibitor therapy is the most-commonly recommended oral treatment option in children with PAH. Prostacyclins provide adjunctive therapy for the treatment of PAH as infusions (intravenous and subcutaneous) and inhalation agents. Inhaled nitric oxide is the first line vasodilator therapy in persistent pulmonary hypertension of the newborn, and is commonly used in the treatment of PAH in the Intensive Care Unit (ICU). Endothelin receptor antagonists have been shown to improve exercise tolerance and survival in adult patients with PAH. Soluble Guanylate Cyclase Stimulators are the first drug class to be FDA approved for the treatment of chronic thromboembolic pulmonary hypertension. Conclusions Literature and data supporting the

  7. Results of a Medicare Bundled Payments for Care Improvement Initiative for Chronic Obstructive Pulmonary Disease Readmissions.

    Science.gov (United States)

    Bhatt, Surya P; Wells, J Michael; Iyer, Anand S; Kirkpatrick, deNay P; Parekh, Trisha M; Leach, Lauren T; Anderson, Erica M; Sanders, J Greg; Nichols, Jessica K; Blackburn, Cindy C; Dransfield, Mark T

    2017-05-01

    Approximately 20% of Medicare beneficiaries hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) are readmitted within 30 days of discharge. In addition to implementing penalties for excess readmissions, the U.S. Centers for Medicare and Medicaid Services has developed Bundled Payments for Care Improvement (BPCI) initiatives to improve outcomes and control costs. To evaluate whether a comprehensive COPD multidisciplinary intervention focusing on inpatient, transitional, and outpatient care as part of our institution's BPCI participation would reduce 30-day all-cause readmission rates for COPD exacerbations and reduce overall costs. We performed a pre-postintervention study comparing all-cause readmissions and costs after index hospitalization for Medicare-only patients with acute exacerbation of COPD. The primary outcome was the difference in 30-day all-cause readmission rate compared with historical control subjects; secondary outcomes included the 90-day all-cause readmission rate and also health care costs compared with BPCI target prices. Seventy-eight consecutive Medicare patients were prospectively enrolled in the BPCI intervention in 2014 and compared with 109 patients in the historical group from 2012. Patients in BPCI were more likely to receive regular follow-up phone calls, pneumococcal and influenza vaccines, home health care, durable medical equipment, and pulmonary rehabilitation, and to attend pulmonary clinic. There was no difference in all-cause readmission rates at 30 days (BPCI, 12 events [15.4%] vs. non-BPCI, 19 events [17.4%]; P = 0.711), and 90 days (21 [26.9%] vs. 37 [33.9%]; P = 0.306). Compared with BPCI target prices, we incurred 4.3% lower 90-day costs before accounting for significant investment from the health system. A Medicare BPCI intervention did not reduce 30-day all-cause readmission rates or overall costs after hospitalization for acute exacerbation of COPD. Although additional studies

  8. Results From the Audit of DOD’s American Recovery and Reinvestment Act of 2009 Initial Data Quality Review Implementation

    Science.gov (United States)

    2009-11-03

    Results From the Audit of DoD’s American Recovery and Reinvestment Act of 2009 Initial Data Quality Review Implementation Memorandum No. D-2010-RAM...number. 1. REPORT DATE 03 NOV 2009 2. REPORT TYPE 3. DATES COVERED 00-00-2009 to 00-00-2009 4. TITLE AND SUBTITLE Results From the Audit of...SUBJECT: Results From the Audit of DOD’ s American Recovery and Reinvestment Act of2009 Initial Data Quality Review Implementation (Report No. D

  9. REFIR/BB initial observations in the water vapour rotational band: Results from a field campaign

    International Nuclear Information System (INIS)

    Esposito, F.; Grieco, G.; Leone, L.; Restieri, R.; Serio, C.; Bianchini, G.; Palchetti, L.; Pellegrini, M.; Cuomo, V.; Masiello, G.; Pavese, G.

    2007-01-01

    There is a growing interest in the far infrared spectral region 17-50 μm as a remote sensing tool in atmospheric sciences, since this portion of the spectrum contains the characteristic molecular rotational band for water vapour. Much of the Earth energy lost to space is radiated through this spectral region. The Radiation Explorer in the Far InfraRed Breadboard (REFIR/BB) spectrometer was born because of the quest to make observations in the far infrared. REFIR/BB is a Fourier Transform Spectrometer with a sampling resolution of 0.5 cm -1 and it was tested for the first time in the field to check its reliability and radiometric performance. The field campaign was held at Toppo di Castelgrande (40 o 49' N, 15 o 27' E, 1258 m a. s. l.), a mountain site in South Italy. The spectral and radiometric performance of the instrument and initial observations are shown in this paper. Comparisons to both (1) BOMEM MR100 Fourier Transform spectrometer observations and (2) line-by-line radiative transfer calculations for selected clear sky are presented and discussed. These comparisons (1) show a very nice agreement between radiance measured by REFIR/BB and by BOMEM MR100 and (2) demonstrate that REFIR/BB accurately observes the very fine spectral structure in the water vapour rotational band

  10. Core competencies for emergency medicine clerkships: results of a Canadian consensus initiative.

    Science.gov (United States)

    Penciner, Rick; Woods, Robert A; McEwen, Jill; Lee, Richard; Langhan, Trevor; Bandiera, Glen

    2013-01-01

    There is no consensus on what constitutes the core competencies for emergency medicine (EM) clerkship rotations in Canada. Existing EM curricula have been developed through informal consensus and often focus on EM content to be known at the end of training rather than what is an appropriate focus for a time-limited rotation in EM. We sought to define the core competencies for EM clerkship in Canada through consensus among an expert panel of Canadian EM educators. We used a modified Delphi method and the CanMEDS 2005 Physician Competency Framework to develop a consensus among expert EM educators from across Canada. Thirty experts from nine different medical schools across Canada participated on the panel. The initial list consisted of 152 competencies organized in the seven domains of the CanMEDS 2005 Physician Competency Framework. After the second round of the Delphi process, the list of competencies was reduced to 62 (59% reduction). A complete list of competencies is provided. This study established a national consensus defining the core competencies for EM clerkship in Canada.

  11. Initial results for a 170 GHz high power ITER waveguide component test stand

    Science.gov (United States)

    Bigelow, Timothy; Barker, Alan; Dukes, Carl; Killough, Stephen; Kaufman, Michael; White, John; Bell, Gary; Hanson, Greg; Rasmussen, Dave

    2014-10-01

    A high power microwave test stand is being setup at ORNL to enable prototype testing of 170 GHz cw waveguide components being developed for the ITER ECH system. The ITER ECH system will utilize 63.5 mm diameter evacuated corrugated waveguide and will have 24 >150 m long runs. A 170 GHz 1 MW class gyrotron is being developed by Communications and Power Industries and is nearing completion. A HVDC power supply, water-cooling and control system has been partially tested in preparation for arrival of the gyrotron. The power supply and water-cooling system are being designed to operate for >3600 second pulses to simulate the operating conditions planned for the ITER ECH system. The gyrotron Gaussian beam output has a single mirror for focusing into a 63.5 mm corrugated waveguide in the vertical plane. The output beam and mirror are enclosed in an evacuated duct with absorber for stray radiation. Beam alignment with the waveguide is a critical task so a combination of mirror tilt adjustments and a bellows for offsets will be provided. Analysis of thermal patterns on thin witness plates will provide gyrotron mode purity and waveguide coupling efficiency data. Pre-prototype waveguide components and two dummy loads are available for initial operational testing of the gyrotron. ORNL is managed by UT-Battelle, LLC, for the U.S. Dept. of Energy under Contract DE-AC-05-00OR22725.

  12. 75 FR 71072 - Initiation and Preliminary Results of Antidumping Duty Changed Circumstances Review: Certain...

    Science.gov (United States)

    2010-11-22

    ... factors including, but not limited to: (1) Management; (2) production facilities; (3) supplier relationships; and (4) customer base. See Brass Sheet and Strip from Canada: Final Results of Antidumping Duty... y Placa resulted in little or no change in management, production facilities, supplier relationships...

  13. Hypertension and age at onset of natural menopause in Korean postmenopausal women: Results from the Korea National Health and Nutrition Examination Survey (2008-2013).

    Science.gov (United States)

    Lim, Hee-Sook; Kim, Tae-Hee; Lee, Hae-Hyeog; Park, Yoon-Hyung; Kim, Jun-Mo; Lee, Bo-Ra

    2016-08-01

    Menopause is a natural phenomenon of aging, although the timing and management of menopause can significantly affect a woman's quality of life. It is therefore important to identify measures to ensure a healthy menopause. We set out to investigate the association between hypertension and early menopause in Korean women. This cross-sectional study was based on 2008-2013 data from the Korea National Health and Nutrition Examination Survey (KNHANES). Of the 53,829 participants surveyed, 13,584 women were selected. We analyzed the contents of the health interview, health examination, and nutrition survey. The main outcome was defined based on hazard ratios (HR) to identify the effects of hypertension on age at onset of menopause. Among postmenopausal women (n=6650), the mean age at onset of menopause was 50.4 years. Premenopausal hypertension was statistically significantly associated with age at menopause, oral contraceptive usage, household income, education level, occupation, marital status and smoking and drinking habits. With lower age at diagnosis of hypertension, HRs for menopause tended to be higher, and hypertension diagnosed before age 40 years conferred a statistically significantly higher HR (Model 1, HR=2.32, 95% CI=1.87-2.88; Model 2, HR=2.31, 95% CI=1.86-2.86; Model 3, HR=2.23, 95% CI=1.80-2.77; Model 4, HR=2.00, 95% CI=1.52-2.63). Premature menopause is strongly associated with lifestyle factors, in combination with incomplete management of chronic diseases. Our findings support the hypothesis that younger age at diagnosis of hypertension is associated with younger age at onset of menopause in Korean women. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Observations of Fabric Development in Polycrystalline Ice at Basal Pressures: Methods and Initial Results

    Science.gov (United States)

    Breton, D. J.; Baker, I.; Cole, D. M.

    2012-12-01

    Understanding and predicting the flow of polycrystalline ice is crucial to ice sheet modeling and paleoclimate reconstruction from ice cores. Ice flow rates depend strongly on the fabric (i.e. the distribution of grain sizes and crystallographic orientations) which evolves over time and enhances the flow rate in the direction of applied stress. The mechanisms for fabric evolution in ice have been extensively studied at atmospheric pressures, but little work has been done to observe these processes at the high pressures experienced deep within ice sheets where long-term changes in ice rheology are expected to have significance. We conducted compressive creep tests on a 917 kg m-3 polycrystalline ice specimen at 20 MPa hydrostatic pressure, thus simulating ~2,000 m depth. Initial specimen grain orientations were random, typical grain diameters were 1.2 mm, and the applied creep stress was 0.3 MPa. Subsequent microstructural analyses on the deformed specimen and a similarly prepared, undeformed specimen allowed characterization of crystal fabric evolution under pressure. Our microstructural analysis technique simultaneously collected grain shape and size data from Scanning Electron Microscope (SEM) micrographs and obtained crystallographic orientation data via Electron BackScatter Diffraction (EBSD). Combining these measurements allows rapid analysis of the ice fabric over large numbers of grains, yielding statistically useful numbers of grain size and full c- and a-axis grain orientation data. The combined creep and microstructural data demonstrate pressure-dependent effects on the mechanical and microstructural evolution of polycrystalline ice. We discuss possible mechanisms for the observed phenomena, and future directions for hydrostatic creep testing.

  15. Regional Collaboration Among Urban Area Security Initiative Regions: Results of the Johns Hopkins Urban Area Survey

    Science.gov (United States)

    Bowman, Calvin; Barnett, Daniel J.; Resnick, Beth A.; Frattaroli, Shannon; Rutkow, Lainie

    2014-01-01

    Regional collaboration has been identified as a potential facilitator of public health preparedness efforts. The Urban Area Security Initiative (UASI) grant program, administered by the Federal Emergency Management Agency (FEMA) since 2003, has provided 64 high-risk metropolitan areas funding to enhance their regional preparedness capabilities. This study describes informal and formal regional collaboration infrastructure, as well as regional collaboration–related activities and assessment methods, in FFY2010 UASI regions. A cross-sectional online survey was administered via Survey Monkey from September through December 2013. Points of contact from FFY2010 funded UASI metropolitan areas completed the survey, with a response rate of 77.8% (n=49). Summary statistics were calculated to describe the current informal and formal regional collaboration infrastructure. Additionally, the cross-sectional survey collected rates of agreement with 8 collaborative preparedness statements at 3 time points. The survey found that UASI regions are engaging in collaborative activities and investments to build capabilities, with most collaboration occurring in the prevention, protection, and response mission areas. Collaborative relationships in preparedness among emergency managers and municipal chief executive officers improved during the FFY2010 UASI performance period compared to the pre-UASI award period, with lasting effects. The majority of UASI regions reported conducting independent assessments of capabilities and their measurement at the UASI region level. Urban areas that received a FFY2010 UASI grant award are engaging in collaborative activities and have established interjurisdictional relationships in preparedness. The use of grant funds to encourage collaboration in preparedness has the potential to leverage limited resources and promote informed investments. PMID:25398073

  16. Regional collaboration among Urban Area Security Initiative regions: results of the Johns Hopkins urban area survey.

    Science.gov (United States)

    Errett, Nicole A; Bowman, Calvin; Barnett, Daniel J; Resnick, Beth A; Frattaroli, Shannon; Rutkow, Lainie

    2014-01-01

    Regional collaboration has been identified as a potential facilitator of public health preparedness efforts. The Urban Area Security Initiative (UASI) grant program, administered by the Federal Emergency Management Agency (FEMA) since 2003, has provided 64 high-risk metropolitan areas funding to enhance their regional preparedness capabilities. This study describes informal and formal regional collaboration infrastructure, as well as regional collaboration-related activities and assessment methods, in FFY2010 UASI regions. A cross-sectional online survey was administered via Survey Monkey from September through December 2013. Points of contact from FFY2010 funded UASI metropolitan areas completed the survey, with a response rate of 77.8% (n=49). Summary statistics were calculated to describe the current informal and formal regional collaboration infrastructure. Additionally, the cross-sectional survey collected rates of agreement with 8 collaborative preparedness statements at 3 time points. The survey found that UASI regions are engaging in collaborative activities and investments to build capabilities, with most collaboration occurring in the prevention, protection, and response mission areas. Collaborative relationships in preparedness among emergency managers and municipal chief executive officers improved during the FFY2010 UASI performance period compared to the pre-UASI award period, with lasting effects. The majority of UASI regions reported conducting independent assessments of capabilities and their measurement at the UASI region level. Urban areas that received a FFY2010 UASI grant award are engaging in collaborative activities and have established interjurisdictional relationships in preparedness. The use of grant funds to encourage collaboration in preparedness has the potential to leverage limited resources and promote informed investments.

  17. EPA program to demonstrate mitigation measures for indoor radon: initial results

    International Nuclear Information System (INIS)

    Henschel, D.B.; Scott, A.G.

    1986-01-01

    EPA has installed radon mitigation techniques in 18 concrete block basement homes in the Reading Prong region of eastern Pennsylvania. Three alternative active soil ventilation approaches were tested: suction on the void network within the concrete block basement walls; suction on the footing drain tile system; and suction on the aggregate underneath the concrete slab. The initial 18 mitigation installations were designed to demonstrate techniques which would have low to moderate installation and operating costs. Where effective closure of major openings in the block walls is possible, suction on the wall voids has proved to be extremely effective, able to reduce homes having very high radon Working Levels (up to 7 WL) to 0.02 WL and less. However, where inaccessible major openings are concealed within the wall, it is more difficult and/or more expensive to develop adequate suction on the void network, and performance is reduced. Testing is continuing to demonstrate the steps required to achieve high performance with wall suction in homes with such difficult-to close walls. Drain tile suction can be very effective where the drain tiles completely surround the home; drain tile suction is the least expensive and most aesthetic of the active soil ventilation approaches, but appears susceptible to spikes in radon levels when the basement is depressurized. Sub-slab suction as tested in this study - with one or two individual suction points in the slab - does not appear adequate to ensure sustained high levels of reduction on block wall basement homes; it appears to effectively treat slab-related soil gas entry routes so long as a uniform layer of aggregate is present, but it does not appear to effectively treat the wall-related entry routes. Closure of major openings might have improved sub-slab suction performance. 5 figures, 3 tables

  18. Imaging of tumor viability in lung cancer. Initial results using 23Na-MRI

    International Nuclear Information System (INIS)

    Henzler, T.; Apfaltrer, P.; Haneder, S.; Schoenberg, S.O.; Fink, C.; Konstandin, S.; Schad, L.; Schmid-Bindert, G.; Manegold, C.; Wenz, F.

    2012-01-01

    23 Na-MRI has been proposed as a potential imaging biomarker for the assessment of tumor viability and the evaluation of therapy response but has not yet been evaluated in patients with lung cancer. We aimed to assess the feasibility of 23 Na-MRI in patients with lung cancer. Three patients with stage IV adenocarcinoma of the lung were examined on a clinical 3 Tesla MRI system (Magnetom TimTrio, Siemens Healthcare, Erlangen, Germany). Feasibility of 23 Na-MRI images was proven by comparison and fusion of 23 Na-MRI with 1 H-MR, CT and FDG-PET-CT images. 23 Na signal intensities (SI) of tumor and cerebrospinal fluid (CSF) of the spinal canal were measured and the SI ratio in tumor and CSF was calculated. One chemonaive patient was examined before and after the initiation of combination therapy (Carboplatin, Gemcitabin, Cetuximab). All 23 Na-MRI examinations were successfully completed and were of diagnostic quality. Fusion of 23 Na-MRI images with 1 H-MRI, CT and FDG-PET-CT was feasible in all patients and showed differences in solid and necrotic tumor areas. The mean tumor SI and the tumor/CSF SI ratio were 13.3 ± 1.8 x 103 and 0.83 ± 0.14, respectively. In necrotic tumors, as suggested by central non-FDG-avid areas, the mean tumor SI and the tumor/CSF ratio were 19.4 x 103 and 1.10, respectively. 23 Na-MRI is feasible in patients with lung cancer and could provide valuable functional molecular information regarding tumor viability, and potentially treatment response. (orig.)

  19. Successfully Reducing Hospitalizations of Nursing Home Residents: Results of the Missouri Quality Initiative.

    Science.gov (United States)

    Rantz, Marilyn J; Popejoy, Lori; Vogelsmeier, Amy; Galambos, Colleen; Alexander, Greg; Flesner, Marcia; Crecelius, Charles; Ge, Bin; Petroski, Gregory

    2017-11-01

    The goals of the Missouri Quality Initiative (MOQI) for long-stay nursing home residents were to reduce the frequency of avoidable hospital admissions and readmissions, improve resident health outcomes, improve the process of transitioning between inpatient hospitals and nursing facilities, and reduce overall healthcare spending without restricting access to care or choice of providers. The MOQI was one of 7 program sites in the United States, with specific interventions unique to each site tested for the Centers for Medicaid and Medicare Services (CMS) Innovations Center. A prospective, single group intervention design, the MOQI included an advanced practice registered nurse (APRN) embedded full-time within each nursing home (NH) to influence resident care outcomes. Data were collected continuously for more than 3 years from an average of 1750 long-stay Medicare, Medicaid, and private pay residents living each day in 16 participating nursing homes in urban, metro, and rural communities within 80 miles of a major Midwestern city in Missouri. Performance feedback reports were provided to each facility summarizing their all-cause hospitalizations and potentially avoidable hospitalizations as well as a support team of social work, health information technology, and INTERACT/Quality Improvement Coaches. The MOQI achieved a 30% reduction in all-cause hospitalizations and statistically significant reductions in 4 single quarters of the 2.75 years of full implementation of the intervention for long-stay nursing home residents. As the population of older people explodes in upcoming decades, it is critical to find good solutions to deal with increasing costs of health care. APRNs, working with multidisciplinary support teams, are a good solution to improving care and reducing costs if all nursing home residents have access to APRNs nationwide. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Measuring success: results from a national survey of recruitment and retention initiatives in the nursing workforce.

    Science.gov (United States)

    Brooks Carthon, J Margo; Nguyen, Thai-Huy; Chittams, Jesse; Park, Elizabeth; Guevara, James

    2014-01-01

    The purpose of this study was to identify common components of diversity pipeline programs across a national sample of nursing institutions and determine what effect these programs have on increasing underrepresented minority enrollment and graduation. Linked data from an electronic survey conducted November 2012 to March 2013 and American Association of Colleges of Nursing baccalaureate graduation and enrollment data (2008 and 2012). Academic and administrative staff of 164 nursing schools in 26 states, including Puerto Rico in the United States. Chi-square statistics were used to (1) describe organizational features of nursing diversity pipeline programs and (2) determine significant trends in underrepresented minorities' graduation and enrollment between nursing schools with and without diversity pipeline programs Twenty percent (n = 33) of surveyed nursing schools reported a structured diversity pipeline program. The most frequent program measures associated with pipeline programs included mentorship, academic, and psychosocial support. Asian, Hispanic, and Native Hawaiian/Pacific Islander nursing student enrollment increased between 2008 and 2012. Hispanic/Latino graduation rates increased (7.9%-10.4%, p = .001), but they decreased among Black (6.8%-5.0%, p = .004) and Native American/Pacific Islander students (2.1 %-0.3%, p ≥ .001). Nursing diversity pipeline programs are associated with increases in nursing school enrollment and graduation for some, although not all, minority students. Future initiatives should build on current trends while creating targeted strategies to reverse downward graduation trends among Black, Native American, and Pacific Island nursing students. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. The green bank northern celestial cap pulsar survey. I. Survey description, data analysis, and initial results

    Energy Technology Data Exchange (ETDEWEB)

    Stovall, K.; Dartez, L. P.; Ford, A. J.; Garcia, A.; Hinojosa, J.; Jenet, F. A.; Leake, S. [Center for Advanced Radio Astronomy, University of Texas at Brownsville, One West University Boulevard, Brownsville, TX 78520 (United States); Lynch, R. S.; Archibald, A. M.; Karako-Argaman, C.; Kaspi, V. M. [Department of Physics, McGill University, 3600 University Street, Montreal, QC H3A 2T8 (Canada); Ransom, S. M. [National Radio Astronomy Observatory, 520 Edgemont Road, Charlottesville, VA 22901 (United States); Banaszak, S.; Biwer, C. M.; Day, D.; Flanigan, J.; Kaplan, D. L. [Physics Department, University of Wisconsin-Milwaukee, Milwaukee, WI 53211 (United States); Boyles, J. [Department of Physics and Astronomy, Western Kentucky University, Bowling Green, KY 42101 (United States); Hessels, J. W. T.; Kondratiev, V. I., E-mail: stovall.kevin@gmail.com [ASTRON, the Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo (Netherlands); and others

    2014-08-10

    We describe an ongoing search for pulsars and dispersed pulses of radio emission, such as those from rotating radio transients (RRATs) and fast radio bursts, at 350 MHz using the Green Bank Telescope. With the Green Bank Ultimate Pulsar Processing Instrument, we record 100 MHz of bandwidth divided into 4096 channels every 81.92 μs. This survey will cover the entire sky visible to the Green Bank Telescope (δ > –40°, or 82% of the sky) and outside of the Galactic Plane will be sensitive enough to detect slow pulsars and low dispersion measure (<30 pc cm{sup –3}) millisecond pulsars (MSPs) with a 0.08 duty cycle down to 1.1 mJy. For pulsars with a spectral index of –1.6, we will be 2.5 times more sensitive than previous and ongoing surveys over much of our survey region. Here we describe the survey, the data analysis pipeline, initial discovery parameters for 62 pulsars, and timing solutions for 5 new pulsars. PSR J0214+5222 is an MSP in a long-period (512 days) orbit and has an optical counterpart identified in archival data. PSR J0636+5129 is an MSP in a very short-period (96 minutes) orbit with a very low mass companion (8 M{sub J}). PSR J0645+5158 is an isolated MSP with a timing residual RMS of 500 ns and has been added to pulsar timing array experiments. PSR J1434+7257 is an isolated, intermediate-period pulsar that has been partially recycled. PSR J1816+4510 is an eclipsing MSP in a short-period orbit (8.7 hr) and may have recently completed its spin-up phase.

  2. Office blood pressure measurement alone often misclassifies treatment status in children with primary hypertension.

    Science.gov (United States)

    Samuel, Joyce P; Bell, Cynthia S; Hebert, Sean A; Varughese, Arun; Samuels, Joshua A; Tyson, Jon E

    2017-12-01

    Clinicians frequently rely on office blood pressure (BP) measurements alone to assess hypertension control, despite widespread acceptance of 24-h ambulatory blood pressure monitoring (ABPM) as the reference standard in the initial diagnosis of hypertension. This study was designed to investigate how often the hypertensive status differed between concurrent office BP versus ABPM measurements, and whether any patient-specific characteristics predict the risk for misclassification by office BP. This study evaluated 42 children with primary hypertension who underwent repeated ambulatory monitoring (190 total recordings) with concurrent office BP measurement as part of their participation in n-of-1 trials. In nearly 40% of the visits, the treatment status by office measurement was opposite to the status by ambulatory monitoring. Office BP underestimated the ambulatory hypertensive status (masked uncontrolled hypertension) in 25% of visits and overestimated ambulatory BP (white coat effect) in 14% of visits. The difference between office BP and ambulatory monitoring was consistent within patients across repeated visits. Patients whose office measurement underestimated or overestimated the ambulatory BP at the first visit were more likely to show persistent discrepancy at subsequent visits. The underuse of ambulatory monitoring in management decisions of children treated for primary hypertension may result in systematic misclassification of hypertension control.

  3. Some initial results from the new SLAC [Stanford Linear Accelerator Center] permeameter

    International Nuclear Information System (INIS)

    Cobb, J.K.; Early, R.A.

    1990-01-01

    A new permeameter has been built and is now available for testing samples of steel and other ferromagnetic materials for their magnetic characteristics such as permeability, remanent induction, coercive force and saturation induction. The present range of operation for the permeameter is from 0.5 Oe to 1250 Oe. Results are presented for two samples of low-carbon steel as well as some preliminary results for Vanadium Permendur. 4 refs., 8 figs

  4. Initial experience with a group presentation of study results to research participants

    Directory of Open Access Journals (Sweden)

    Bent Stephen

    2008-03-01

    Full Text Available Abstract Background Despite ethical imperatives, informing research participants about the results of the studies in which they take part is not often performed. This is due, in part, to the costs and burdens of communicating with each participant after publication of the results. Methods Following the closeout and publication of a randomized clinical trial of saw palmetto for treatment of symptoms of benign prostatic hyperplasia, patients were invited back to the research center to participate in a group presentation of the study results. Results Approximately 10% of participants attended one of two presentation sessions. Reaction to the experience of the group presentation was very positive among the attendees. Conclusion A group presentation to research participants is an efficient method of communicating study results to those who desire to be informed and was highly valued by those who attended. Prospectively planning for such presentations and greater scheduling flexibility may result in higher attendance rates. Trial Registration Number Clinicaltrials.gov #NCT00037154

  5. Initial results from a reconnaissance of cyanobacteria and associated toxins in Illinois, August--October 2012

    Science.gov (United States)

    Terrio, Paul J.; Ostrodka, Lenna M.; Loftin, Keith A.; Good, Gregg; Holland, Teri

    2013-01-01

    Ten lakes and two rivers in Illinois were sampled in August–October 2012 to determine the concentrations and spatial distribution of cyanobacteria and associated cyanotoxins throughout the State. The reconnaissance was a collaborative effort of the U.S. Geological Survey and the Illinois Environmental Protection Agency. Sample results indicated that concentrations of both total cyanobacterial cells and microcystin were commonly at levels likely to result in adverse human health effects, according to World Health Organization guidance values. Concentrations generally decreased from August to October following precipitation events and lower temperatures.

  6. Hormones and Hypertension

    Science.gov (United States)

    ... role in the start and continuation of primary hypertension. Secondary hypertension is due to other diseases such as kidney ... the body can greatly improve or even cure secondary hypertension. Resources • Find-an-Endocrinologist: www.hormone.org or ...

  7. Pulmonary Hypertension in Scleroderma

    Science.gov (United States)

    PULMONARY HYPERTENSION IN SCLERODERMA PULMONARY HYPERTENSION Pulmonary hypertension (PH) is high blood pressure in the blood vessels of the lungs. If the high ... the right side of the heart. Patients with scleroderma are at increased risk for developing PH from ...

  8. Hypertension and Spina Bifida

    Science.gov (United States)

    SBA National Resource Center: 800-621-3141 Hypertension A disease that often goes undetected. What is hypertension? Hypertension, also called high blood pressure , is a condition in which the arteries of ...

  9. Intracranial Hypertension Research Foundation

    Science.gov (United States)

    ... PARTNERSHIPS Meet our Fundraising Partners Tweet Welcome Intracranial hypertension (IH) is the general term for the neurological ... high. (Old names for IH include Benign Intracranial Hypertension and Pseudotumor Cerebri). The Intracranial Hypertension Research Foundation ...

  10. HIV and Pulmonary Hypertension

    Science.gov (United States)

    ... What do I need to know about pulmonary hypertension in connection with HIV? Although pulmonary hypertension and ... Should an HIV patient be tested for pulmonary hypertension? HIV patients know that medical supervision is critical ...

  11. Initial Results of an Intercomparison of AMS-Based Atmospheric 14CO2 Measurements

    NARCIS (Netherlands)

    Miller, John; Lehman, Scott; Wolak, Chad; Turnbull, Jocelyn; Dunn, Gregory; Graven, Heather; Keeling, Ralph; Meijer, Harro A. J.; Aerts-Bijma, Anita Th; Palstra, Sanne W. L.; Smith, Andrew M.; Allison, Colin; Southon, John; Xu, Xiaomei; Nakazawa, Takakiyo; Aoki, Shuji; Nakamura, Toshio; Guilderson, Thomas; LaFranchi, Brian; Mukai, Hitoshi; Terao, Yukio; Uchida, Masao; Kondo, Miyuki

    2013-01-01

    This article presents results from the first 3 rounds of an international intercomparison of measurements of Delta(CO2)-C-14 in liter-scale samples of whole air by groups using accelerator mass spectrometry (AMS). The ultimate goal of the intercomparison is to allow the merging of Delta(CO2)-C-14

  12. Electron Beam Return-Current Losses in Solar Flares: Initial Comparison of Analytical and Numerical Results

    Science.gov (United States)

    Holman, Gordon

    2010-01-01

    Accelerated electrons play an important role in the energetics of solar flares. Understanding the process or processes that accelerate these electrons to high, nonthermal energies also depends on understanding the evolution of these electrons between the acceleration region and the region where they are observed through their hard X-ray or radio emission. Energy losses in the co-spatial electric field that drives the current-neutralizing return current can flatten the electron distribution toward low energies. This in turn flattens the corresponding bremsstrahlung hard X-ray spectrum toward low energies. The lost electron beam energy also enhances heating in the coronal part of the flare loop. Extending earlier work by Knight & Sturrock (1977), Emslie (1980), Diakonov & Somov (1988), and Litvinenko & Somov (1991), I have derived analytical and semi-analytical results for the nonthermal electron distribution function and the self-consistent electric field strength in the presence of a steady-state return-current. I review these results, presented previously at the 2009 SPD Meeting in Boulder, CO, and compare them and computed X-ray spectra with numerical results obtained by Zharkova & Gordovskii (2005, 2006). The phYSical significance of similarities and differences in the results will be emphasized. This work is supported by NASA's Heliophysics Guest Investigator Program and the RHESSI Project.

  13. 75 FR 37757 - Frozen Warmwater Shrimp From Vietnam: Initiation and Preliminary Results of Changed-Circumstances...

    Science.gov (United States)

    2010-06-30

    ... including, but not limited to, changes in management, production facilities, supplier relationships, and customer base. See Industrial Phosphoric Acid From Israel: Final Results of Antidumping Duty Changed... Corp. is the successor-in- interest to Phuong Nam Co., Ltd. With respect to management prior to and...

  14. A 10-Year Mechatronics Curriculum Development Initiative: Relevance, Content, and Results--Part I

    Science.gov (United States)

    Das, S.; Yost, S. A.; Krishnan, M.

    2010-01-01

    This paper describes the first phase of a Mechatronics Curriculum Development effort--the design of an "Introduction to Mechatronics" course, the infusion of mechatronics activities throughout the curriculum and in outreach activities, and assessment results. In addition, the relevance and impact of such a curriculum on the education of engineers…

  15. 75 FR 61702 - Notice of Initiation and Preliminary Results of Antidumping Duty Changed Circumstances Review...

    Science.gov (United States)

    2010-10-06

    .../supplier relationships have not changed as a result of the corporate name change. To support its claims, A... 1, 2010, A Foods informed the Department that it changed its name from May Ao and [[Page 61703... that May Ao officially changed its name to A Foods on December 25, 2009. This constitutes changed...

  16. General Atomic HTGR fuel reprocessing pilot plant: results of initial sequential equipment operation

    International Nuclear Information System (INIS)

    1978-09-01

    In September 1977, the processing of 20 large high-temperature gas-cooled reactor (LHTGR) fuel elements was completed sequentially through the head-end cold pilot plant equipment. This report gives a brief description of the equipment and summarizes the results of the sequential operation of the pilot plant. 32 figures, 15 tables

  17. Tether dynamics and control results for tethered satellite system's initial flight

    Science.gov (United States)

    Chapel, Jim D.; Flanders, Howard

    The recent Tethered Satellite System-1 (TSS-1) mission has provided a wealth of data concerning the dynamics of tethered systems in space and has demonstrated the effectiveness of operational techniques designed to control these dynamics. In this paper, we review control techniques developed for managing tether dynamics, and discuss the results of using these techniques for the Tethered Satellite System's maiden flight on STS-46. In particular, the flight results of controlling libration dynamics, string dynamics, and slack tether are presented. These results show that tether dynamics can be safely managed. The overall stability of the system was found to be surprisingly good even at relatively short tether lengths. In fact, the system operated in passive mode at a tether length of 256 meters for over 9 hours. Only monitoring of the system was required during this time. Although flight anomalies prevented the planned deployment to 20 km, the extended operations at shorter tether lengths have proven the viability of using tethers in space. These results should prove invaluable in preparing for future missions with tethered objects in space.

  18. Initial results of combined anterior mitral leaflet extension and myectomy in patients with obstructive hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    M.J.M. Kofflard (Marcel); L.A. van Herwerden (Lex); D.J. Waldstein; P.N. Ruygrok (Peter); H. Boersma (Eric); M.A. Taams (Meindert); F.J. ten Cate (Folkert)

    1996-01-01

    textabstractObjectives. The purpose of this study was to describe the clinical and functional results of combined anterior mitral leaflet extension and myectomy in patients with hypertrophic obstructive cardiomyopathy. Background. Septal myectomy is the most commonly performed surgical procedure in

  19. High Prevalence of Hypertension Among Collegiate Football Athletes

    Science.gov (United States)

    Karpinos, Ashley Rowatt; Roumie, Christianne L.; Nian, Hui; Diamond, Alex B.; Rothman, Russell L.

    2014-01-01

    Background The prevalence of hypertension among collegiate football athletes is not well described. Methods and Results A retrospective cohort of all male athletes who participated in varsity athletics at a National Collegiate Athletic Association Division I university between 1999–2012 was examined through chart review. Mandatory annual preparticipation physical examinations included blood pressure, body mass index, medication use, and supplement use. Prevalence of hypertension was compared between football and non-football athletes. A mixed-effects linear regression model examined change in blood pressure over time. 636 collegiate athletes, including 323 football players, were identified. In the initial year of athletic participation, 19.2% of football athletes had hypertension and 61.9% had prehypertension. The prevalence of hypertension was higher among football athletes than non-football athletes in their initial (19.2% vs. 7.0%, Pfootball athletes in the initial year (AOR 2.28, 95% CI 1.21 to 4.30) but not the final year (AOR 1.25, 95% CI 0.69 to 2.28). Over the course of their collegiate career, football athletes had an annual decrease in systolic blood pressure (−0.82 mmHg, P=0.002), while non-football athletes did not (0.18 mmHg, P=0.58). Conclusions Hypertension and prehypertension were common among collegiate football athletes, and football athletes were more likely to have hypertension than male non-football athletes. This presents a potential cardiovascular risk in a young population of athletes. Strategies for increasing awareness, prevention and treatment are needed. PMID:24221829

  20. Operation results of 3-rd generation nuclear fuel WWER-440 in initial period

    International Nuclear Information System (INIS)

    Adeev, V.; Panov, A.

    2011-01-01

    On unit 4 of Kola NPP trial operation of 3-rd generation's fuel began in 2010. Fuel assemblies of 3-rd generation (FA-3) have a number of design features that provide better operational characteristics. Concise description of a design and the basic advantages of fuel of 3-rd generation are described in articles. Increasing of efficiency of nuclear fuel usage will be achieved by reduction of the parasitic capture of thermal neutrons in constructional materials (weight of zirconium is reduced), optimization of uranium-water relation (increase in fuel elements step), increasing of uranium loading (usage of fuel pellets with increased diameter and without central hole in them). By results of trial operation mass transition to use of given type of assemblies in WWER-440 is possible. This report presents the basic outcomes of the trial operation, a brief survey of the obtained data. The basic characteristics of the reactor core with fuel of 3-rd generation are resulted in work. (authors)

  1. Advances in the diagnosis of hereditary kidney cancer: Initial results of a multigene panel test.

    Science.gov (United States)

    Nguyen, Kevin A; Syed, Jamil S; Espenschied, Carin R; LaDuca, Holly; Bhagat, Ansh M; Suarez-Sarmiento, Alfredo; O'Rourke, Timothy K; Brierley, Karina L; Hofstatter, Erin W; Shuch, Brian

    2017-11-15

    Panel testing has been recently introduced to evaluate hereditary cancer; however, limited information is available regarding its use in kidney cancer. The authors retrospectively reviewed test results and clinical data from patients who underwent targeted multigene panel testing of up to 19 genes associated with hereditary kidney cancer from 2013 to 2016. The frequency of positive (mutation/variant likely pathogenic), inconclusive (variant of unknown significance), and negative results was evaluated. A logistic regression analysis evaluated predictive factors for a positive test. Patients (n = 1235) had a median age at diagnosis of 46 years, which was significantly younger than the US population of individuals with kidney cancer (P kidney cancer. Panel tests may be particularly useful for patients who lack distinguishing clinical characteristics of known hereditary kidney cancer syndromes. The current results support the use of early age of onset for genetic counseling and/or testing. Cancer 2017;123:4363-71. © 2017 American Cancer Society. © 2017 American Cancer Society.

  2. Secondary Hypertension: Discovering the Underlying Cause.

    Science.gov (United States)

    Charles, Lesley; Triscott, Jean; Dobbs, Bonnie

    2017-10-01

    Most patients with hypertension have no clear etiology and are classified as having primary hypertension. However, 5% to 10% of these patients may have secondary hypertension, which indicates an underlying and potentially reversible cause. The prevalence and potential etiologies of secondary hypertension vary by age. The most common causes in children are renal parenchymal disease and coarctation of the aorta. In adults 65 years and older, atherosclerotic renal artery stenosis, renal failure, and hypothyroidism are common causes. Secondary hypertension should be considered in the presence of suggestive symptoms and signs, such as severe or resistant hypertension, age of onset younger than 30 years (especially before puberty), malignant or accelerated hypertension, and an acute rise in blood pressure from previously stable readings. Additionally, renovascular hypertension should be considered in patients with an increase in serum creatinine of at least 50% occurring within one week of initiating angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy; severe hypertension and a unilateral smaller kidney or difference in kidney size greater than 1.5 cm; or recurrent flash pulmonary edema. Other underlying causes of secondary hypertension include hyperaldosteronism, obstructive sleep apnea, pheochromocytoma, Cushing syndrome, thyroid disease, coarctation of the aorta, and use of certain medications.

  3. RESISTANT HYPERTENSION IN A PATIENT WITH METABOLIC SYNDROME

    OpenAIRE

    O. M. Drapkina; J. S. Sibgatullina

    2016-01-01

    Clinical case of resistant hypertension in a patient with metabolic syndrome is presented. Features of hypertension in metabolic syndrome and features of metabolic syndrome in women of pre- and postmenopausal age are also considered. Understanding the features of metabolic syndrome in women, as well as features of hypertension and metabolic syndrome will improve the results of treatment in patients with resistant hypertension.

  4. Hypertension control and other cardiovascular risk factors among ...

    African Journals Online (AJOL)

    Their age, sex weight, height, blood pressure, fasting capillary blood glucose, lipid and renal profiles, hypertension and diabetes therapy were ascertained. Results: Hypertension prevalence was 54.7%. Treatment and control rates of hypertension were 81.7% and 34% respectively. Hypertensive patients were older, more ...

  5. Higher self-reported prevalence of hypertension among Moluccan-Dutch than among the general population of The Netherlands: results from a cross-sectional survey

    NARCIS (Netherlands)

    van der Wal, Junus M.; Bodewes, Adee J.; Agyemang, Charles O.; Kunst, Anton E.

    2014-01-01

    Several studies in The Netherlands revealed ethnic disparities in hypertension prevalence, but none have focused on the Moluccan-Dutch, a migrant group from Indonesia that settled in The Netherlands in 1951. The Moluccan-Dutch are considered to be fairly well integrated in Dutch society. The aim of

  6. Cardiovascular Risk Factors (Diabetes, Hypertension, Hypercholesterolemia and Metabolic Syndrome) in Older People with Intellectual Disability: Results of the HA-ID Study

    Science.gov (United States)

    de Winter, C. F.; Bastiaanse, L. P.; Hilgenkamp, T. I. M.; Evenhuis, H. M.; Echteld, M. A.

    2012-01-01

    Hypertension, diabetes, hypercholesterolemia and the metabolic syndrome are important risk factors for cardiovascular disease (CVD). In older people with intellectual disability (ID), CVD is a substantial morbidity risk. The aims of the present study, which was part of the Healthy Ageing in Intellectual Disability (HA-ID) study, were (1) to…

  7. The angiotensin II receptor antagonist telmisartan reduces urinary albumin excretion in patients with isolated systolic hypertension: results of a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Vogt, Liffert; Navis, Gerjan; Koester, Juergen; Manolis, Athanasios J.; Reid, John L.; de Zeeuw, Dick

    2005-01-01

    Objective To examine the effect of telmisartan or hydrochlorothiazide on the control of urinary albumin excretion (UAE) in patients with isolated systolic hypertension (ISH) unselected for albuminuria in a pre-planned substudy of a large, multicentre, double-blind, placebo-controlled, randomized

  8. The angiotensin II receptor antagonist telmisartan reduces urinary albumin excretion in patients with isolated systolic hypertension: results of a randomized, double-blind, placebo-controlled trial

    NARCIS (Netherlands)

    Vogt, Liffert; Navis, Gerjan; Köster, Jürgen; Manolis, Athanasios J.; Reid, John L.; de Zeeuw, Dick

    2005-01-01

    To examine the effect of telmisartan or hydrochlorothiazide on the control of urinary albumin excretion (UAE) in patients with isolated systolic hypertension (ISH) unselected for albuminuria in a pre-planned substudy of a large, multicentre, double-blind, placebo-controlled, randomized study. The

  9. Design of a low cost miniaturized SFCW GPR with initial results

    Science.gov (United States)

    Duggal, Swati; Sinha, Piyush; Gupta, Manish; Patel, Anand; Vedam, V. V.; Mevada, Pratik; Chavda, Rajesh; Shah, Amita; Putrevu, Deepak

    2016-05-01

    This paper discusses about the design &developmental of Ground Penetrating Radar (GPR), various scientific and commercial applications of GPR along with the testing and results of GPR at Antarctica for Ice thickness measurement. GPR instruments are categorised as per their frequency of operation, which is inversely proportional to the depth of penetration. GPRs are also categorized as per method of operation which is time-domain or frequency-domain. Indian market is presently procuring GPRs from only foreign suppliers. Space Applications Centre (SAC) had taken up GPR as R&D Technological development with a view to benchmark the technology which may be transferred to local industry for mass production of instrument at a relatively cheaper cost (~20 times cheaper). Hence, this instrument presents a viable indigenous alternative. Also, the design and configuration was targeted for terrestrial as well as future interplanetary (Lander/Rover) missions of ISRO to map subsurface features. The developed GPR has a very large bandwidth (100%, i.e. bandwidth of 500MHz with centre-frequency of 500MHz) and high dynamic range along with the advantage of being highly portable (<10kg). The system was configured as a Stepped-Frequency-Continuous-Wave (SFCW) GPR which is a frequency domain GPR with the aim to increase the detection capabilities with respect to current systems. In order to achieve this goal, innovative electronic equipment have been designed and developed. Three prototypes were developed and two of them have been delivered for Indian Scientific Expedition to Antarctica (ISEA) in 2013 and 2014-15, respectively and promising results have been obtained. The results from the same closely compare with that from commercial GPR too.

  10. Initial results of strand produced in Phase 2 of the SSCL Vendor Qualification Program

    International Nuclear Information System (INIS)

    Erdmann, M.; Capone, D. II; Coleman, S.; Jones, B.; Seuntjens, J.

    1993-05-01

    In 1991, the Superconducting Super Collider Laboratory (SSCL) instituted a program to qualify specific superconductor manufacturers for production of cable acceptable for use in both Collider Dipole (CDM) and Quadrupole (CQM) magnets. The SSCL Vendor Qualification Program (VQP) was designed with two Phases. Phase 1 was divided into two additional phases, 1A and 1B, which ran concurrently. In Phase 1B, each vendor was directed to manufacture roughly 3000 kg of cable using a ''baseline'' process. The baseline process was agreed to by both the SSCL and the vendor at the beginning of the VQP. In this phase, process control was closely monitored with the use of statistical methods and each vendor was graded based on these results. Phase 1A, known as the R ampersand D phase, was developed to allow each vendor an opportunity to optimize and improve on their baseline process in terms of both cost and manufacturability. In this phase, multifilament billets were designed to explore several key variables such as alternate alloy sources, process modifications and improved billet designs. At the end of Phase 1, the results from both 1A and 1B were evaluated at a review between the SSCL and each vendor, and a final Phase 2 process was generated and fixed using the best results. In Phase 2, each vendor is required to manufacture roughly 6000 kg of superconducting cable under a firm fixed price contract which can then be used to create an accurate price estimate for competitive bidding on the full rate production CDM and CQM contracts. At the end of Phase 2, each vendor must meet the minimum requirements outlined in the contract to become a qualified superconducting cable supplier. For one requirement, critical process variables identified by the SSCL Conductor Department at the beginning of the VQP will be evaluated to determine the quality and uniformity of the material produced during Phase 2 of the program

  11. Seroprevalence of Dengue Fever in US Army Special Operations Forces: Initial Results and the Way Ahead.

    Science.gov (United States)

    Caci, Jennifer B; Blaylock, Jason M; De La Barrera, Rafael; Griggs, April N; Lin, Leyi; Jarman, Richard G; Thomas, Stephen J; Lyons, Arthur G

    2014-01-01

    The endemicity of dengue fever (DF) and, consequently, sequelae of DF are increasing worldwide. The increases are largely a result of widespread international travel and the increased range of the mosquito vectors. US Army Special Operations Command (USASOC) personnel are at an increased risk of exposure to dengue based on their frequent deployments to and presence in dengue endemic areas worldwide. Repeated deployments to different endemic areas can increase the risk for developing the more serious sequelae of dengue: dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). Information about the seroprevalence rate of dengue in USASOC personnel, in particular, is lacking and is critical to assessing the risk, tailoring preventive medicine countermeasures, leveraging field diagnostics, and maintaining mission capability. In the first part of a two-part project to assess baseline seroprevalence in USASOC units, a random, unit-stratified sample of 500 anonymous serum specimens from personnel assigned to the highest-risk units in USASOC were screened for dengue using a microneutralization assay. Of the 500 specimens screened, 56 (11.2%) of 500 had neutralizing titers (NT) (MN₅₀≥10) against at least one DENV serotype. Subsequent sample titration resulted in 48 (85.7%) of 56 of the samples with NT (MN₅₀≥10) against at least one dengue serotype for an overall dengue exposure rate of 9.6% (48 of 500). The second part of the ongoing project, started in 2012, was a multicenter, serosurveillance project using predeployment and postdeployment sera collected from USASOC personnel deployed to South and Central America, Africa, and Southeast Asia. Preliminary results show a 13.2% (55 of 414) seropositivity rate. The significance of these findings as they relate to personal risk and operational impact is discussed. 2014.

  12. Initial results from 3D-DDTC detectors on p-type substrates

    Energy Technology Data Exchange (ETDEWEB)

    Zoboli, A., E-mail: zoboli@disi.unitn.i [Dipartimento di Ingegneria e Scienza dell' Informazione, Universita di Trento, and INFN, Sezione di Padova (Gruppo Collegato di Trento), Via Sommarive, 14, I-38100 Povo di Trento (Italy); Boscardin, M. [Fondazione Bruno Kessler, Centro per i Materiali e i Microsistemi, Via Sommarive, 18, I-38100 Povo di Trento (Italy); Bosisio, L. [Dipartimento di Fisica, Universita di Trieste, and INFN, Sezione di Trieste, Via A. Valerio, 2, I-34127 Trieste (Italy); Dalla Betta, G.-F. [Dipartimento di Ingegneria e Scienza dell' Informazione, Universita di Trento, and INFN, Sezione di Padova (Gruppo Collegato di Trento), Via Sommarive, 14, I-38100 Povo di Trento (Italy); Piemonte, C.; Ronchin, S.; Zorzi, N. [Fondazione Bruno Kessler, Centro per i Materiali e i Microsistemi, Via Sommarive, 18, I-38100 Povo di Trento (Italy)

    2010-01-11

    Owing to their superior radiation hardness compared to planar detectors, 3D detectors are one of the most promising technologies for the LHC upgrade foreseen in 2017. Fondazione Bruno Kessler has developed 3D Double-side Double-Type Column (3D-DDTC) detectors providing a technological simplifications with respect to a standard 3D process while aiming at comparable detector performance. We present selected results from the electrical characterization of 3D-DDTC structures from the second batch made on p-type substrates, supported also by TCAD simulations.

  13. Initial results with time series forecasting of TJ-II heliac waveforms

    International Nuclear Information System (INIS)

    Farias, G.; Dormido-Canto, S.; Vega, J.; Díaz, N.

    2015-01-01

    This article discusses about how to apply forecasting techniques to predict future samples of plasma signals during a discharge. One application of the forecasting could be to detect in real time anomalous behaviors in fusion waveforms. The work describes the implementation of three prediction techniques; two of them based on machine learning methods such as artificial neural networks and support vector machines for regression. The results have shown that depending on the temporal horizon, the predictions match the real samples in most cases with an error less than 5%, even more the forecasting of five samples ahead can reach accuracy over 90% in most signals analyzed.

  14. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Science.gov (United States)

    Denis, Max; Mehrmohammadi, Mohammad; Song, Pengfei; Meixner, Duane D; Fazzio, Robert T; Pruthi, Sandhya; Whaley, Dana H; Chen, Shigao; Fatemi, Mostafa; Alizad, Azra

    2015-01-01

    To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE) for classification of breast masses. CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF) beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results. Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s) in comparison to benign masses (3.65 ± 1.36 m/s). Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC), the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC). CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  15. Comb-push ultrasound shear elastography of breast masses: initial results show promise.

    Directory of Open Access Journals (Sweden)

    Max Denis

    Full Text Available To evaluate the performance of Comb-push Ultrasound Shear Elastography (CUSE for classification of breast masses.CUSE is an ultrasound-based quantitative two-dimensional shear wave elasticity imaging technique, which utilizes multiple laterally distributed acoustic radiation force (ARF beams to simultaneously excite the tissue and induce shear waves. Female patients who were categorized as having suspicious breast masses underwent CUSE evaluations prior to biopsy. An elasticity estimate within the breast mass was obtained from the CUSE shear wave speed map. Elasticity estimates of various types of benign and malignant masses were compared with biopsy results.Fifty-four female patients with suspicious breast masses from our ongoing study are presented. Our cohort included 31 malignant and 23 benign breast masses. Our results indicate that the mean shear wave speed was significantly higher in malignant masses (6 ± 1.58 m/s in comparison to benign masses (3.65 ± 1.36 m/s. Therefore, the stiffness of the mass quantified by the Young's modulus is significantly higher in malignant masses. According to the receiver operating characteristic curve (ROC, the optimal cut-off value of 83 kPa yields 87.10% sensitivity, 82.61% specificity, and 0.88 for the area under the curve (AUC.CUSE has the potential for clinical utility as a quantitative diagnostic imaging tool adjunct to B-mode ultrasound for differentiation of malignant and benign breast masses.

  16. Office and ambulatory blood pressure control with a fixed-dose combination of candesartan and hydrochlorothiazide in previously uncontrolled hypertensive patients: results of CHILI CU Soon

    Science.gov (United States)

    Mengden, Thomas; Hübner, Reinhold; Bramlage, Peter

    2011-01-01

    Background Fixed-dose combinations of candesartan 32 mg and hydrochlorothiazide (HCTZ) have been shown to be effective in clinical trials. Upon market entry we conducted a noninterventional study to document the safety and effectiveness of this fixed-dose combination in an unselected population in primary care and to compare blood pressure (BP) values obtained during office measurement (OBPM) with ambulatory blood pressure measurement (ABPM). Methods CHILI CU Soon was a prospective, noninterventional, noncontrolled, open-label, multicenter study with a follow-up of at least 10 weeks. High-risk patients aged ≥18 years with previously uncontrolled hypertension were started on candesartan 32 mg in a fixed-dose combination with either 12.5 mg or 25 mg HCTZ. OBPM and ABPM reduction and adverse events were documented. Results A total of 4131 patients (52.8% male) with a mean age of 63.0 ± 11.0 years were included. BP was 162.1 ± 14.8/94.7 ± 9.2 mmHg during office visits at baseline. After 10 weeks of candesartan 32 mg/12.5 mg or 25 mg HCTZ, mean BP had lowered to 131.7 ± 10.5/80.0 ± 6.6 mmHg (P good (r = 0.589 for systolic BP and r = 0.389 for diastolic BP during the day). Of those who were normotensive upon OBPM, 35.1% had high ABPM during the day, 49.3% were nondippers, and 3.4% were inverted dippers. Forty-nine adverse events (1.19%) were reported, of which seven (0.17%) were regarded as serious. Conclusion Candesartan 32 mg in a fixed-dose combination with either 12.5 mg or 25 mg HCTZ is safe and effective for further BP lowering irrespective of prior antihypertensive drug class not being able to control BP. PMID:22241950

  17. Twelve-month results of the rapid renal sympathetic denervation for resistant hypertension using the OneShotTM ablation system (RAPID) study.

    Science.gov (United States)

    Verheye, Stefan; Ormiston, John; Bergmann, Martin W; Sievert, Horst; Schwindt, Arne; Werner, Nikos; Vogel, Britta; Colombo, Antonio

    2015-02-01

    Renal denervation has emerged as a treatment option for patients with drug-resistant hypertension. This study was designed to assess the safety and effectiveness of the OneShotª Renal Denervation System. RAPID is a prospective, multicentre, single-arm study which enrolled 50 patients at 11 clinical sites in Europe and New Zealand. Eligible patients had an office systolic blood pressure (SBP) ≥160 mmHg and were on a stable regimen of ≥3 antihypertensive medications including a diuretic. The primary safety endpoints were acute procedural safety at discharge and chronic procedural safety at six months. The primary effectiveness endpoint was the rate of office SBP reduction ≥10 mmHg at six months compared to baseline. While not a predefined endpoint, change in 24-hour ambulatory BP was evaluated. The mean baseline office SBP and diastolic BP measurements were 181.6±20.8 and 95.5±15.5 mmHg, respectively. Patients were on a mean of 5.1 antihypertensive medications at baseline. The mean office BP decreased by -20/-8 mmHg (prenal artery injury or SAE/adverse device effects at six months. The results of the RAPID study demonstrate safe delivery of RF energy by the OneShot Renal Denervation System for renal sympathetic denervation and sustained efficacy, as evidenced by a significant reduction in office and 24-hour ABPM for six months, which was sustained up to 12 months. ClinicalTrials.gov Identifier: NCT01520506.

  18. Transcatheter closure of large patent ductus arteriosus with severe pulmonary arterial hypertension in adults: immediate and two-year follow-up results.

    Science.gov (United States)

    Zhang, Cao-Jin; Huang, Yi-Gao; Huang, Xin-Sheng; Huang, Tao; Huang, Wen-Hui; Xia, Chun-Li; Mo, Yu-Jing

    2012-11-01

    Transcatheter closure of patent ductus arteriosus (PDA) is a well established procedure and an accepted treatment modality for small to moderate-sized PDA. This study aimed to evaluate the immediate and follow-up results of transcatheter closure of large PDAs with severe pulmonary arterial hypertension (PAH) in adults. After a complete hemodynamic evaluation differentiating from the reversibility of severe PAH, transcatheter closure of PDA was performed. Patients were followed up clinically and echocardiographically at 24 hours, 1 month, 3 months, 6 months, 12 months and 24 months after occlusion. Twenty-nine patients had successful occlusion, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF) and fractional shortening (FS) significantly decreased immediately after occlusion ((106 ± 25) mmHg vs. (50 ± 14) mmHg, P closure, the signs and symptoms improved markedly in all 29 patients, and PDAs were completely closed and remained closed during the follow-up. Eighteen patients having different degrees of dyspnea were treated with angiotensin converting enzyme inhibitor (ACEI) and/or digoxin after occlusion. Nine patients whose pulmonary vascular resistence (PVR) > 6 Wood units accepted targeted PAH therapy. After 1 to 3 months of peroral drug therapy, their exercise tolerance improved from New York Heart Association (NYHA) class III-IV to NYHA class I. During follow-up, no latent arrhythmias were found, the left atrial diameter (LAD), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular mass index (LVMI) and pulmonary artery systolic pressure (PASP) decreased significantly (P closure of large PDA with severe PAH is feasible, effective, and safe in adults. Significant left ventricular systolic changes may occur after closure of large PDA, and left ventricular function usually recovers within a few months.

  19. Crystal habit modification of nickel-ferrite: development and results of initial laboratory testing

    International Nuclear Information System (INIS)

    Anderson, C.E.; Varrin, R.D.; Marks, C.; Barkatt, A.; Kim, K.; Fruzzetti, K.P.

    2010-01-01

    This paper documents the results of a laboratory test program conducted to assess the feasibility of using a new type of additive in the primary coolant of pressurized water reactors (PWRs) or to boiling water reactor (BWR) coolant. These additives, known as crystal habit modifiers (CHMs), could potentially be used to control the crystal habits, or shapes, that comprise primary deposits and crud. Similar additives are used throughout the chemical process industry to produce products with desirable crystalline structure, morphology, density, particle size, or surface area. Based on the successes of CHM technologies in other industries, CHMs may have the potential to alleviate problems associated with deposits in nuclear plants including axial offset anomaly (AOA). By controlling the habit of deposit materials, it may be possible to retard deposit formation, produce deposits with desirable properties (e.g., high friability, low or high porosity), or promote a preferred chemical composition or deposit structure that is more amenable to removal. Desirable properties that could be selected for include enhanced boiling efficiency, reduced surface affinity for boron, and resistance to consolidation. The results of this project demonstrate that crystal habit modification of nickel ferrite, a typical primary side deposit species, can be achieved by the addition of both inorganic and organic chemical species (CHMs). The most significant habit modification of nickel ferrite was observed with the addition of metal species (e.g., Zn, Cr) due to their incorporation into the crystal lattice of the oxide. Lesser degrees of modification were achieved with organic additives such as acetate. Specific CHM candidates that may have a beneficial effect on PWR operation are identified in this paper. In addition, this paper summarizes the refinement of several methods for synthesizing nickel ferrites under hydrothermal conditions that may benefit those interested in studying crud and

  20. Crystal habit modification of nickel-ferrite: development and results of initial laboratory testing

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, C.E.; Varrin, R.D.; Marks, C. [Dominion Engineering, Inc., Reston, Virginia (United States); Barkatt, A. [The Catholic Univ. of America, Dept. of Chemistry, Washington, District of Columbia (United States); Kim, K.; Fruzzetti, K.P. [Electric Power Research Inst., Palo Alto, California (United States)

    2010-07-01

    This paper documents the results of a laboratory test program conducted to assess the feasibility of using a new type of additive in the primary coolant of pressurized water reactors (PWRs) or to boiling water reactor (BWR) coolant. These additives, known as crystal habit modifiers (CHMs), could potentially be used to control the crystal habits, or shapes, that comprise primary deposits and crud. Similar additives are used throughout the chemical process industry to produce products with desirable crystalline structure, morphology, density, particle size, or surface area. Based on the successes of CHM technologies in other industries, CHMs may have the potential to alleviate problems associated with deposits in nuclear plants including axial offset anomaly (AOA). By controlling the habit of deposit materials, it may be possible to retard deposit formation, produce deposits with desirable properties (e.g., high friability, low or high porosity), or promote a preferred chemical composition or deposit structure that is more amenable to removal. Desirable properties that could be selected for include enhanced boiling efficiency, reduced surface affinity for boron, and resistance to consolidation. The results of this project demonstrate that crystal habit modification of nickel ferrite, a typical primary side deposit species, can be achieved by the addition of both inorganic and organic chemical species (CHMs). The most significant habit modification of nickel ferrite was observed with the addition of metal species (e.g., Zn, Cr) due to their incorporation into the crystal lattice of the oxide. Lesser degrees of modification were achieved with organic additives such as acetate. Specific CHM candidates that may have a beneficial effect on PWR operation are identified in this paper. In addition, this paper summarizes the refinement of several methods for synthesizing nickel ferrites under hydrothermal conditions that may benefit those interested in studying crud and

  1. Neonatal hypertension.

    Science.gov (United States)

    Sharma, Deepak; Farahbakhsh, Nazanin; Shastri, Sweta; Sharma, Pradeep

    2017-03-01

    Neonatal hypertension (HT) is a frequently under reported condition and is seen uncommonly in the intensive care unit. Neonatal HT has defined arbitrarily as blood pressure more than 2 standard deviations above the base as per the age or defined as systolic BP more than 95% for infants of similar size, gestational age and postnatal age. It has been diagnosed long back but still is the least studied field in neonatology. There is still lack of universally accepted normotensive data for neonates as per gestational age, weight and post-natal age. Neonatal HT is an important morbidity that needs timely detection and appropriate management, as it can lead to devastating short-term effect on various organs and also poor long-term adverse outcomes. There is no consensus yet about the treatment guidelines and majority of treatment protocols are based on the expert opinion. Neonate with HT should be evaluated in detail starting from antenatal, perinatal, post-natal history, and drug intake by neonate and mother. This review article covers multiple aspects of neonatal hypertension like definition, normotensive data, various etiologies and methods of BP measurement, clinical features, diagnosis and management.

  2. Longitudinal predictors of health-related quality of life in middle-aged and older adults with hypertension: results of a population-based study.

    Science.gov (United States)

    Maatouk, Imad; Wild, Beate; Herzog, Wolfgang; Wesche, Daniela; Schellberg, Dieter; Schöttker, Ben; Müller, Heiko; Rothenbacher, Dietrich; Stegmaier, Christa; Brenner, Hermann

    2012-07-01

    The aim of the study was to assess the longitudinal association between cardiovascular risk factors including albuminuria and other variables (e.g. awareness of hypertension, number of types of antihypertensive drugs, comorbidity), and health-related quality of life (HRQOL) in a large cohort of patients with hypertension, over a follow-up period of 5 years. Nine thousand nine hundred and fifty-three participants of the ESTHER (Epidemiologische Studie zu Chancen der Verhütung, Früherkennung und optimierten Therapie chronischer Erkrankungen) study - a population-based cohort study of middle-aged and older adults aged 50-74 years at baseline - were recruited by general practitioners (GPs) in 2000-2002 and included in the follow-up (2005-2007). HRQOL at baseline and follow-up was measured using the Short-Form General Health Survey (SF-12). Mental component scores (MCS) and physical component scores (PCS) were calculated. Multiple linear regression models were used to determine longitudinal predictors of HRQOL at follow-up. Four thousand, two hundred and three patients with hypertension (98.2%) responded to the SF-12 both at baseline and after 5 years and were therefore included in the study. Smoking status, BMI, diabetes, macroalbuminuria, comorbid diseases, history of depression, and lower HRQOL at baseline predicted lower PCS at the 5-year follow-up. Lower MCS after 5 years was predicted by smoking status, dyslipidaemia, a reported history of depression, and HRQOL at baseline. No significant association was detected between awareness of hypertension and any HRQOL component score after 5 years. Macroalbuminuria and other variables related to increased cardiovascular risk have a negative impact on PCS. Suggestions of a link of treatment and awareness of hypertension with HRQOL from previous cross-sectional studies are not supported by our longitudinal findings.

  3. Tablets in Education. Results from the Initiative ETiE, for Teaching Plants to Primary School Students

    Science.gov (United States)

    Fokides, Emmanuel; Atsikpasi, Pinelopi

    2017-01-01

    The study presents the results from the first phase of the initiative Emerging Technologies in Education. At this stage, we examined the learning outcomes from the use of tablets and an application as content delivery methods for teaching plants' parts, reproduction types and organs, photosynthesis, and respiration. The project lasted for four…

  4. Initial Results on Neutralized Drift Compression Experiments (NDCX-IA) for High Intensity Ion Beam

    CERN Document Server

    Roy, Prabir K; Baca, David; Bieniosek, Frank; Coleman, Joshua E; Davidson, Ronald C; Efthimion, Philip; Eylon, Shmuel; Gilson, Erik P; Grant Logan, B; Greenway, Wayne; Henestroza, Enrique; Kaganovich, Igor D; Leitner, Matthaeus; Rose, David; Sefkow, Adam; Sharp, William M; Shuman, Derek; Thoma, Carsten H; Vanecek, David; Waldron, William; Welch, Dale; Yu, Simon

    2005-01-01

    Ion beam neutralization and compression experiments are designed to determine the feasibility of using compressed high intensity ion beams for high energy density physics (HEDP) experiments and for inertial fusion power. To quantitatively ascertain the various mechanisms and methods for beam compression, the Neutralized Drift Compression Experiment (NDCX) facility is being constructed at Lawrence Berkeley National Laboratory (LBNL). In the first compression experiment, a 260 KeV, 25 mA, K+ ion beam of centimeters size is radially compressed to a mm size spot by neutralization in a meter-long plasma column and beam peak current is longitudinally compressed by an induction velocity tilt core. Instrumentation, preliminary results of the experiments, and practical limits of compression are presented. These include parameters such as emittance, degree of neutralization, velocity tilt time profile, and accuracy of measurements (fast and spatially high resolution diagnostic) are discussed.

  5. Summary of initial results from the GSFC fluxgate magnetometer on Pioneer 11

    Science.gov (United States)

    Acuna, M. H.; Ness, N. F.

    1975-01-01

    The main magnetic field of Jupiter was measured by the Fluxgate Magnetometer on Pioneer 11 and analysis reveals it to be relatively more complex than expected. In a centered spherical harmonic representation with a maximum order of n = 3 (designated GSFC model 04), the dipole term (with opposite polarity to the Earth's) has a moment of 4.28 Gauss x (Jupiter radius cubed), tilted by 9.6 deg towards a system 111 longitude of 232. The quadrupole and octupole moments are significant, 24% and 21% of the dipole moment respectively, and this leads to deviations of the planetary magnetic field from a simple offset tilted dipole for distances smaller than three Jupiter radii. The GSFC model shows a north polar field strength of 14 Gauss and a south polar field strength of 10.4 Gauss. Enhanced absorption effects in the radiation belts may be predicted as a result of field distortion.

  6. Data processing and initial results of Chang'e-3 lunar penetrating radar

    Science.gov (United States)

    Su, Yan; Fang, Guang-You; Feng, Jian-Qing; Xing, Shu-Guo; Ji, Yi-Cai; Zhou, Bin; Gao, Yun-Ze; Li, Han; Dai, Shun; Xiao, Yuan; Li, Chun-Lai

    2014-12-01

    To improve our understanding of the formation and evolution of the Moon, one of the payloads onboard the Chang'e-3 (CE-3) rover is Lunar Penetrating Radar (LPR). This investigation is the first attempt to explore the lunar subsurface structure by using ground penetrating radar with high resolution. We have probed the subsurface to a depth of several hundred meters using LPR. In-orbit testing, data processing and the preliminary results are presented. These observations have revealed the configuration of regolith where the thickness of regolith varies from about 4 m to 6 m. In addition, one layer of lunar rock, which is about 330 m deep and might have been accumulated during the depositional hiatus of mare basalts, was detected.

  7. Data processing and initial results of Chang'e-3 lunar penetrating radar

    International Nuclear Information System (INIS)

    Su Yan; Feng Jian-Qing; Xing Shu-Guo; Li Han; Dai Shun; Xiao Yuan; Li Chun-Lai; Fang Guang-You; Ji Yi-Cai; Zhou Bin; Gao Yun-Ze

    2014-01-01

    To improve our understanding of the formation and evolution of the Moon, one of the payloads onboard the Chang'e-3 (CE-3) rover is Lunar Penetrating Radar (LPR). This investigation is the first attempt to explore the lunar subsurface structure by using ground penetrating radar with high resolution. We have probed the subsurface to a depth of several hundred meters using LPR. In-orbit testing, data processing and the preliminary results are presented. These observations have revealed the configuration of regolith where the thickness of regolith varies from about 4 m to 6 m. In addition, one layer of lunar rock, which is about 330 m deep and might have been accumulated during the depositional hiatus of mare basalts, was detected

  8. Using Empirical Data to Estimate Potential Functions in Commodity Markets: Some Initial Results

    Science.gov (United States)

    Shen, C.; Haven, E.

    2017-12-01

    This paper focuses on estimating real and quantum potentials from financial commodities. The log returns of six common commodities are considered. We find that some phenomena, such as the vertical potential walls and the time scale issue of the variation on returns, also exists in commodity markets. By comparing the quantum and classical potentials, we attempt to demonstrate that the information within these two types of potentials is different. We believe this empirical result is consistent with the theoretical assumption that quantum potentials (when embedded into social science contexts) may contain some social cognitive or market psychological information, while classical potentials mainly reflect `hard' market conditions. We also compare the two potential forces and explore their relationship by simply estimating the Pearson correlation between them. The Medium or weak interaction effect may indicate that the cognitive system among traders may be affected by those `hard' market conditions.

  9. Byggmeister Test Home: Analysis and Initial Results of Cold Climate Wood-Framed Home Retrofit

    Energy Technology Data Exchange (ETDEWEB)

    Gates, C.

    2013-01-01

    BSC seeks to further the energy efficiency market for New England area retrofit projects by supporting projects that are based on solid building science fundamentals and verified implementation. With the high exposure of energy efficiency and retrofit terminology being used in the general media at this time, it is important to have evidence that measures being proposed will in fact benefit the homeowner through a combination of energy savings, improved durability, and occupant comfort. There are several basic areas of research to which the technical report for these test homes can be expected to contribute. These include the combination of measures that is feasible, affordable and acceptable to homeowners as well as expectations versus results. Two Byggmeister multi-family test homes in Massachusetts are examined with the goal of providing case studies that could be applied to other similar New England homes.

  10. Initial experience with fecal microbiota transplantation in Clostridium difficile infection: transplant protocol and preliminary results

    Directory of Open Access Journals (Sweden)

    Ana Ponte

    2015-07-01

    Full Text Available Background and aims: Clostridium difficile infection (CDI constitutes an important cause of antibiotic-associated diarrhea. Recurrence after first-line treatment with antibiotics is high and fecal microbiota transplantation (FMT may be effective for refractory and recurrent CDI. This series aims to describe the efficacy of FMT in the treatment of refractory and recurrent CDI. Methods: A prospectively recorded single-centre case series of patients with persistent or recurrent CDI treated with FMT between June 2014 and March 2015 was analyzed. Primary and secondary outcomes were defined as resolution of diarrhea without recurrence of CDI within 2 months after one or more FMT, respectively. A descriptive analysis was performed. Results: 8 FMT were performed in 6 patients, 3 with refractory CDI and 3 with recurrent CDI. The median age of recipients was 71 years and 66.7% were women. One FMT was delivered through colonoscopy and the remaining 87.5% through esophagogastroduodenoscopy. One upper FMT was excluded due to recurrence of CDI after antibiotic exposure for a respiratory infection. The overall cure rate of FMT was total with lower route and 83.3% with upper route. Primary cure rate was achieved in 83.3% of patients and secondary cure rate was achieved in all patients. Median time to resolution of diarrhea after FMT was 1 day and no complications were reported during follow-up. Conclusion: FMT appears to constitute a safe and effective approach in the management of refractory and recurrent CDI. Difference between primary and secondary cure rates may result of insufficient restoration of intestinal microbiota with a single FMT.

  11. Lunar Reconnaissance Orbiter K-Band (26 GHz) Signal Analysis: Initial Study Results

    Science.gov (United States)

    Morabito, D. D.; Heckman, D.

    2017-11-01

    Lower frequency telemetry bands are becoming more limited in bandwidth due to increased competition between flight projects and other entities. Higher frequency bands offer significantly more bandwidth and hence the prospect of much higher data rates. Future or prospective flight projects considering higher frequency bands such as Ka-band (32 GHz) for deep-space and K-band (26 GHz) for near-Earth telemetry links are interested in past flight experience with available received data at these frequencies. Given that there is increased degradation due to the atmosphere at these higher frequencies, there is an effort to retrieve flight data of received signal strength to analyze performance under a variety of factors. Such factors include elevation angle, season, and atmospheric conditions. This article reports on the analysis findings of over 10 million observations of received signal strength of the Lunar Reconnaissance Orbiter (LRO) spacecraft collected between 2014 and 2017. We analyzed these data to characterize link performance over a wide range of weather conditions, season, and as a function of elevation angle. Based on this analysis, we have confirmed the safety of using a 3-dB margin for preflight planning purposes. These results suggest that a 3-dB margin with respect to adverse conditions will ensure a 98 to 99 percent data return under 95 percent weather conditions at 26 GHz (K-band), thus confirming expectations from link budget predictions. The results suggest that this margin should be applicable for all elevation angles above 10 deg. Thus, missions that have sufficient power for their desired data rates may opt to use 10 deg as their minimum elevation angle. Limitations of this study include climate variability and the fact that the observations require removal of hotbody noise in order to perform an adequate cumulative distribution function (CDF) analysis, which is planned for a future comprehensive study. Flight projects may use other link margins

  12. Initial Continuous Chemistry Results From The Roosevelt Island Ice Core (RICE)

    Science.gov (United States)

    Kjær, H. A.; Vallelonga, P. T.; Simonsen, M. F.; Neff, P. D.; Bertler, N. A. N.; Svensson, A.; Dahl-Jensen, D.

    2014-12-01

    The Roosevelt Island ice core (79.36° S, -161.71° W) was drilled in 2011-13 at the top of the Roosevelt Island ice dome, a location surrounded by the Ross ice shelf. The RICE ice core provides a unique opportunity to look into the past evolution of the West Antarctic Ice sheet. Further the site has high accumulation; 0.26 m of ice equivalent is deposited annually allowing annual layer determination for many chemical parameters. The RICE core was drilled to bedrock and has a total length of 763 metres. Preliminary results derived from water isotopes suggest that the oldest ice reaches back to the Eemian, with the last glacial being compressed in the bottom 60 metres. We present preliminary results from the RICE ice core including continuous measurements of acidity using an optical dye method, insoluble dust particles, conductivity and calcium. The core was analyzed at the New Zealand National Ice Core Research Facility at GNS Science in Wellington. The analytical set up used to determine climate proxies in the ice core was a modified version of the Copenhagen CFA system (Bigler et al., 2011). Key volcanic layers have been matched to those from the WAIS record (Sigl et al., 2013). A significant anti-correlation between acidity and calcium was seen in the Holocene part of the record. Due to the proximity to the ocean a large fraction of the calcium originates from sea salt and is in phase with total conductivity and sodium. In combination with the insoluble dust record, calcium has been apportioned into ocean-related and dust-related sources. Variability over the Holocene is presented and attributed to changing inputs of marine and dust aerosols.

  13. Imaging of patients with hippocampal sclerosis at 7 Tesla: initial results.

    Science.gov (United States)

    Breyer, Tobias; Wanke, Isabel; Maderwald, Stefan; Woermann, Friedrich G; Kraff, Oliver; Theysohn, Jens M; Ebner, Alois; Forsting, Michael; Ladd, Mark E; Schlamann, Marc

    2010-04-01

    Focal epilepsies potentially can be cured by neurosurgery; other treatment options usually remain symptomatic. High-resolution magnetic resonance (MR) imaging is the central imaging strategy in the evaluation of focal epilepsy. The most common substrate of temporal epilepsies is hippocampal sclerosis (HS), which cannot always be sufficiently characterized with current MR field strengths. Therefore, the purpose of our study was to demonstrate the feasibility of high-resolution MR imaging at 7 Tesla in patients with focal epilepsy resulting from a HS and to improve image resolution at 7 Tesla in patients with HS. Six patients with known HS were investigated with T1-, T2-, T2(*)-, and fluid-attenuated inversion recovery-weighted sequences at 7 Tesla with an eight-channel transmit-receive head coil. Total imaging time did not exceed 90 minutes per patient. High-resolution imaging at 7 Tesla is feasible and reveals high resolution of intrahippocampal structures in vivo. HS was confirmed in all patients. The maximum non-interpolated in-plane resolution reached 0.2 x 0.2 mm(2) in T2(*)-weighted images. The increased susceptibility effects at 7 Tesla revealed identification of intrahippocampal structures in more detail than at 1.5 Tesla, but otherwise led to stronger artifacts. Imaging revealed regional differences in hippocampal atrophy between patients. The scan volume was limited because of specific absorption rate restrictions, scanning time was reasonable. High-resolution imaging at 7 Tesla is promising in presurgical epilepsy imaging. "New" contrasts may further improve detection of even very small intrahippocampal structural changes. Therefore, further investigations will be necessary to demonstrate the potential benefit for presurgical selection of patients with various lesion patterns in mesial temporal epilepsies resulting from a unilateral HS. Copyright 2010 AUR. Published by Elsevier Inc. All rights reserved.

  14. Experimental warming delays autumn senescence in a boreal spruce bog: Initial results from the SPRUCE experiment

    Science.gov (United States)

    Richardson, Andrew; Furze, Morgan; Aubrecht, Donald; Milliman, Thomas; Nettles, Robert; Krassovski, Misha; Hanson, Paul

    2016-04-01

    August through December. These patterns can also be seen in other daily images recorded at the site since January 2012. Air warming treatments at SPRUCE began in August 2015, and had a substantial influence on autumn senescence of the plant community, as a whole, within each chamber. Generally, vegetation in the warmed chambers stayed green longer than that in the unwarmed chambers. We characterized the seasonality by fitting a sigmoid curve to the Gcc time series data, and we used the autumn half-maximum date of the sigmoid as an indicator of the timing of senescence. We found a strong linear relationship between senescence date and temperature treatment (r2 = 0.71,n = 10). Overall, senescence was delayed by 3.5 ± 0.7 days per 1° C of warming. Thus, although photoperiod is widely believed to be the key trigger for autumn senescence, our results do not indicate that the autumn response to warming is in any way constrained by day length. The SPRUCE experiment is planned to running through 2025. Looking forward, we anticipate that different results may be obtained in year 2 of the SPRUCE experiment if warming treatments result in earlier spring onset, and increased evapotranspiration during spring and early summer, leading to drought conditions by late summer.

  15. [The department budget, in the context of the hospital global budget. Initial results in general medicine].

    Science.gov (United States)

    Besançon, F

    1984-02-23

    In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

  16. Quantification of renal allograft perfusion using arterial spin labeling MRI: initial results.

    Science.gov (United States)

    Lanzman, Rotem S; Wittsack, Hans-Jörg; Martirosian, Petros; Zgoura, Panagiota; Bilk, Philip; Kröpil, Patric; Schick, Fritz; Voiculescu, Adina; Blondin, Dirk

    2010-06-01

    To quantify renal allograft perfusion in recipients with stable allograft function and acute decrease in allograft function using nonenhanced flow-sensitive alternating inversion recovery (FAIR)-TrueFISP arterial spin labeling (ASL) MR imaging. Following approval of the local ethics committee, 20 renal allograft recipients were included in this study. ASL perfusion measurement and an anatomical T2-weighted single-shot fast spin-echo (HASTE) sequence were performed on a 1.5-T scanner (Magnetom Avanto, Siemens, Erlangen, Germany). T2-weighted MR urography was performed in patients with suspected ureteral obstruction. Patients were assigned to three groups: group a, 6 patients with stable allograft function over the previous 4 months; group b, 7 patients with good allograft function who underwent transplantation during the previous 3 weeks; group c, 7 allograft recipients with an acute deterioration of renal function. Mean cortical perfusion values were 304.8 +/- 34.4, 296.5 +/- 44.1, and 181.9 +/- 53.4 mg/100 ml/min for groups a, b and c, respectively. Reduction in cortical perfusion in group c was statistically significant. Our results indicate that ASL is a promising technique for nonenhanced quantification of cortical perfusion of renal allografts. Further studies are required to determine the clinical value of ASL for monitoring renal allograft recipients.

  17. Initial communication survey results for the Hanford Environmental Dose Reconstruction Project

    International Nuclear Information System (INIS)

    Beck, D.M.

    1991-03-01

    To support the public communication efforts of the Technical Steering Panel of the Hanford Environmental Dose Reconstruction (HEDR) Project, a public survey was conducted. The survey was intended to provide information about the public's knowledge and interest in the project and the best ways to communicate project results. Questions about the project were included as part of an omnibus survey conducted by Washington State University. The survey was conducted by phone to Washington State residents in the spring of 1990. This report gives the HEDR-related questions and summary data of responses. Questions associated with the HEDR Project were grouped into four categories: knowledge of the HEDR Project; interest in the project; preferred ways of receiving information about the project (including public information meetings, a newsletter mailed to homes, presentations to civic groups in the respondent's community, a computer bulletin board respondent could access with a modem, information displays at public buildings and shopping malls, and an information video sent to respondent); and level of concern over past exposure from Hanford operations. Questions abut whom state residents are most likely to trust about radiation issues were also part of the omnibus survey, and responses are included in this report

  18. Functional magnetic resonance imaging (fMRI) for fetal oxygenation during maternal hypoxia: initial results

    International Nuclear Information System (INIS)

    Wedegaertner, U.; Adam, G.; Tchirikov, M.; Schroeder, H.; Koch, M.

    2002-01-01

    Purpose: To investigate the potential of fMRI to measure changes in fetal tissue oxygenation during acute maternal hypoxia in fetal lambs. Material and Methods: Two ewes carrying singleton fetuses (gestational age 125 and 131 days) underwent MR imaging under inhalation anesthesia. BOLD imaging of the fetal brain, liver and myocardium was performed during acute maternal hypoxia (oxygen replaced by N 2 O). Maternal oxygen saturation and heart rate were monitored by a pulse-oxymeter attached to the maternal tongue. Results: Changes of fetal tissue oxygenation during maternal hypoxia were clearly visible with BOLD MRI. Signal intensity decreases were more distinct in liver and heart (∝40%) from control than in the fetal brain (∝10%). Conclusions: fMRI is a promising diagnostic tool to determine fetal tissue oxygenation and may open new opportunities in monitoring fetal well being in high risk pregnancies complicated by uteroplacentar insufficiency. Different signal changes in liver/heart and brain may reflect a centralization of the fetal blood flow. (orig.) [de

  19. Resonant Frequency Control For the PIP-II Injector Test RFQ: Control Framework and Initial Results

    Energy Technology Data Exchange (ETDEWEB)

    Edelen, A. L. [Colorado State U.; Biedron, S. G.; Milton, S. V.; Bowring, D.; Chase, B. E.; Edelen, J. P.; Nicklaus, D.; Steimel, J.

    2016-12-16

    For the PIP-II Injector Test (PI-Test) at Fermilab, a four-vane radio frequency quadrupole (RFQ) is designed to accelerate a 30-keV, 1-mA to 10-mA, H- beam to 2.1 MeV under both pulsed and continuous wave (CW) RF operation. The available headroom of the RF amplifiers limits the maximum allowable detuning to 3 kHz, and the detuning is controlled entirely via thermal regulation. Fine control over the detuning, minimal manual intervention, and fast trip recovery is desired. In addition, having active control over both the walls and vanes provides a wider tuning range. For this, we intend to use model predictive control (MPC). To facilitate these objectives, we developed a dedicated control framework that handles higher-level system decisions as well as executes control calculations. It is written in Python in a modular fashion for easy adjustments, readability, and portability. Here we describe the framework and present the first control results for the PI-Test RFQ under pulsed and CW operation.

  20. Quantification of renal allograft perfusion using arterial spin labeling MRI: initial results

    International Nuclear Information System (INIS)

    Lanzman, Rotem S.; Wittsack, Hans-Joerg; Bilk, Philip; Kroepil, Patric; Blondin, Dirk; Martirosian, Petros; Schick, Fritz; Zgoura, Panagiota; Voiculescu, Adina

    2010-01-01

    To quantify renal allograft perfusion in recipients with stable allograft function and acute decrease in allograft function using nonenhanced flow-sensitive alternating inversion recovery (FAIR)-TrueFISP arterial spin labeling (ASL) MR imaging. Following approval of the local ethics committee, 20 renal allograft recipients were included in this study. ASL perfusion measurement and an anatomical T2-weighted single-shot fast spin-echo (HASTE) sequence were performed on a 1.5-T scanner (Magnetom Avanto, Siemens, Erlangen, Germany). T2-weighted MR urography was performed in patients with suspected ureteral obstruction. Patients were assigned to three groups: group a, 6 patients with stable allograft function over the previous 4 months; group b, 7 patients with good allograft function who underwent transplantation during the previous 3 weeks; group c, 7 allograft recipients with an acute deterioration of renal function. Mean cortical perfusion values were 304.8 ± 34.4, 296.5 ± 44.1, and 181.9 ± 53.4 mg/100 ml/min for groups a, b and c, respectively. Reduction in cortical perfusion in group c was statistically significant. Our results indicate that ASL is a promising technique for nonenhanced quantification of cortical perfusion of renal allografts. Further studies are required to determine the clinical value of ASL for monitoring renal allograft recipients. (orig.)

  1. A web application for moderation training: Initial results of a randomized clinical trial1

    Science.gov (United States)

    Hester, Reid K.; Delaney, Harold D.; Campbell, William; Handmaker, Nancy

    2009-01-01

    Eighty four heavy drinkers who responded to a newspaper recruitment ad were randomly assigned to receive either: a) training in a moderate drinking protocol via an Internet-based program (www.moderatedrinking.com) and use of the online resources of Moderation Management (MM) (www.moderation.org) or b) use of the online resources of MM alone. Follow-ups are being conducted at 3, 6, and 12 months. Results of the recently completed 3 month follow-up (86% follow-up) indicated both groups significantly reduced their drinking based on these variables: standard drinks per week; percent days abstinent; and mean BAC per drinking day. Both groups also significantly reduced their alcohol-related problems. Relative to the control group the experimental group had better outcomes on percent days abstinent and log Drinks per Drinking Day. These short-term outcome data provide evidence for the effectiveness of both the moderate drinking web application and of the resources available online at MM in helping heavy drinkers reduce their drinking and alcohol-related problems. PMID:19339137

  2. Initial results from a prototype whole-body photon-counting computed tomography system.

    Science.gov (United States)

    Yu, Z; Leng, S; Jorgensen, S M; Li, Z; Gutjahr, R; Chen, B; Duan, X; Halaweish, A F; Yu, L; Ritman, E L; McCollough, C H

    X-ray computed tomography (CT) with energy-discriminating capabilities presents exciting opportunities for increased dose efficiency and improved material decomposition analyses. However, due to constraints imposed by the inability of photon-counting detectors (PCD) to respond accurately at high photon flux, to date there has been no clinical application of PCD-CT. Recently, our lab installed a research prototype system consisting of two x-ray sources and two corresponding detectors, one using an energy-integrating detector (EID) and the other using a PCD. In this work, we report the first third-party evaluation of this prototype CT system using both phantoms and a cadaver head. The phantom studies demonstrated several promising characteristics of the PCD sub-system, including improved longitudinal spatial resolution and reduced beam hardening artifacts, relative to the EID sub-system. More importantly, we found that the PCD sub-system offers excellent pulse pileup control in cases of x-ray flux up to 550 mA at 140 kV, which corresponds to approximately 2.5×10 11 photons per cm 2 per second. In an anthropomorphic phantom and a cadaver head, the PCD sub-system provided image quality comparable to the EID sub-system for the same dose level. Our results demonstrate the potential of the prototype system to produce clinically-acceptable images in vivo .

  3. The Mediterranean Moored Multi-sensor Array (M3A: system development and initial results

    Directory of Open Access Journals (Sweden)

    K. Nittis

    Full Text Available Operational forecasting of ocean circulation and marine ecosystem fluctuations requires multi-parametric real-time measurements of physical and biochemical properties. The architecture of a system that is able to provide such measurements from the upper-thermocline layers of the Mediterranean Sea is described here. The system was developed for the needs of the Mediterranean Forecasting System and incorporates state-of-the-art sensors for optical and chemical measurements in the upper 100 m and physical measurements down to 500 m. Independent moorings that communicate via hydro-acoustic modems are hosting the sensors. The satellite data transfer and the large autonomy allow for the operation of the system in any open-ocean site. The system has been in pre-operational use in the Cretan Sea since January 2000. The results of this pilot phase indicate that multi-parametric real-time observations with the M3A system are feasible, if a consistent maintenance and re-calibration program is followed. The main limitations of the present configuration of M3A are related: (a to bio-fouling that primarily affects the turbidity and secondarily affects the other optical sensors, and (b to the limited throughput of the currently used satellite communication system.

    Key words. Atmospheric composition and structure (instruments and techniques. Oceanography: general (ocean prediction Oceanography: physical (upper ocean process

  4. Diffusion tensor imaging and tractography for assessment of renal allograft dysfunction - initial results

    Energy Technology Data Exchange (ETDEWEB)

    Hueper, Katja; Gutberlet, M.; Rodt, T.; Wacker, F.; Galanski, M.; Hartung, D. [Institute for Diagnostic and Interventional Radiology, Hannover Medical School - Germany, Hannover (Germany); Gwinner, W. [Clinic for Nephrology, Hannover Medical School - Germany, Hannover (Germany); Lehner, F. [Clinic for General, Abdominal and Transplant Surgery, Hannover Medical School - Germany, Hannover (Germany)

    2011-11-15

    To evaluate MR diffusion tensor imaging (DTI) as non-invasive diagnostic tool for detection of acute and chronic allograft dysfunction and changes of organ microstructure. 15 kidney transplanted patients with allograft dysfunction and 14 healthy volunteers were examined using a fat-saturated echo-planar DTI-sequence at 1.5 T (6 diffusion directions, b = 0, 600 s/mm{sup 2}). Mean apparent diffusion coefficient (ADC) and mean fractional anisotropy (FA) were calculated separately for the cortex and for the medulla and compared between healthy and transplanted kidneys. Furthermore, the correlation between diffusion parameters and estimated GFR was determined. The ADC in the cortex and in the medulla were lower in transplanted than in healthy kidneys (p < 0.01). Differences were more distinct for FA, especially in the renal medulla, with a significant reduction in allografts (p < 0.001). Furthermore, in transplanted patients a correlation between mean FA in the medulla and estimated GFR was observed (r = 0.72, p < 0.01). Tractography visualized changes in renal microstructure in patients with impaired allograft function. Changes in allograft function and microstructure can be detected and quantified using DTI. However, to prove the value of DTI for standard clinical application especially correlation of imaging findings and biopsy results is necessary. (orig.)

  5. Initial results of the quality control in 11 computed tomography scanners at Curitiba

    International Nuclear Information System (INIS)

    Kodlulovich, S; Oliveira, L.; Jakubiak, R.R.; Miquelin, C.A.

    2008-01-01

    The aim of this study was to evaluate the image quality of 11 scanners installed in public and private centers of Curitiba, Brazil. This sample represents 30% of the CT scanners in the city so far. The ACR CT accreditation phantom was used to verify the accomplishment of the scanners performance to the international quality requirements. The results indicate that efforts should be concentrated in the maintenance of the equipments and specific training of the technicians. Most of the scanners have showed some non-conformity. In 27,5% of the sample the positioning requirement wasn't accomplished. The CT number accuracy evaluation showed that in 72,3 % of the scanners the CT numbers were out of the tolerance range, reaching values 35% greater than the limit. The low contrast resolution criteria weren't accomplished in 9% of the scanners. The main concern is that there isn't a specific program to evaluate the image quality of the CT scanners neither to estimate the CT doses in the procedures. (author)

  6. Longitudinal Study of the Impacts of a Climate Change Curriculum on Undergraduate Student Learning: Initial Results

    Directory of Open Access Journals (Sweden)

    Kristin C. Burkholder

    2017-05-01

    Full Text Available The present study assesses the efficacy of a semester-long undergraduate sustainability curriculum designed from a systems approach. The three-course curriculum, which incorporated environmental science and ethics courses along with an integrative course using a community-based learning pedagogy, was intended to provide students with experience using knowledge and skills from distinct disciplines in a holistic way in order to address the complex problems of the human acceptance of and response to anthropogenic climate change. In the fall of 2013, 23 of the 24 sophomore general education students enrolled in the three courses were surveyed at the beginning and end of the semester; 17 of those same students completed the survey again in the spring of 2016, their senior year. Results, which focus on the 17 students who continued to participate through their senior year, were analyzed with quantitative and qualitative methodologies. The pre/post data from the surveys demonstrated significant improvement in climate literacy, certainty, concern and urgency over the course of the semester; the senior data indicated that those improvements were largely retained. The study also suggests that the nine-credit curriculum improved transferable skills such as interdisciplinary thinking, self-confidence and public speaking. A qualitative analysis of three student cases, informed by a focus group (n = 7 of seniors along with other sources of information, suggested retention of such transferable skills, and, in some cases, deeper involvement in climate and sustainability action.

  7. The Mediterranean Moored Multi-sensor Array (M3A: system development and initial results

    Directory of Open Access Journals (Sweden)

    K. Nittis

    2003-01-01

    Full Text Available Operational forecasting of ocean circulation and marine ecosystem fluctuations requires multi-parametric real-time measurements of physical and biochemical properties. The architecture of a system that is able to provide such measurements from the upper-thermocline layers of the Mediterranean Sea is described here. The system was developed for the needs of the Mediterranean Forecasting System and incorporates state-of-the-art sensors for optical and chemical measurements in the upper 100 m and physical measurements down to 500 m. Independent moorings that communicate via hydro-acoustic modems are hosting the sensors. The satellite data transfer and the large autonomy allow for the operation of the system in any open-ocean site. The system has been in pre-operational use in the Cretan Sea since January 2000. The results of this pilot phase indicate that multi-parametric real-time observations with the M3A system are feasible, if a consistent maintenance and re-calibration program is followed. The main limitations of the present configuration of M3A are related: (a to bio-fouling that primarily affects the turbidity and secondarily affects the other optical sensors, and (b to the limited throughput of the currently used satellite communication system. Key words. Atmospheric composition and structure (instruments and techniques. Oceanography: general (ocean prediction Oceanography: physical (upper ocean process

  8. "Know Your Status": results from a novel, student-run HIV testing initiative on college campuses.

    Science.gov (United States)

    Milligan, Caitlin; Cuneo, C Nicholas; Rutstein, Sarah E; Hicks, Charles

    2014-08-01

    Know Your Status (KYS), a novel, student-run program offered free HIV-testing at a private university (PU) and community college (CC). Following completion of surveys of risk behaviors/reasons for seeking testing, students were provided with rapid, oral HIV-testing. We investigated testing history, risk behaviors, and HIV prevalence among students tested during the first three years of KYS. In total, 1408 tests were conducted, 5 were positive: 4/408 CC, 1/1000 PU (1% vs. 0.1%, p=0.01). Three positives were new diagnoses, all black men-who-have-sex-with-men (MSM). Over 50% of students were tested for the first time and 59% reported risk behaviors. CC students were less likely to have used condoms at last sex (a surrogate for risk behavior) compared to PU (OR 0.73, CI [0.54, 0.98]). Race, sexual identity, and sex were not associated with condom use. These results demonstrate that KYS successfully recruited large numbers of previously untested, at-risk students, highlighting the feasibility and importance of testing college populations.

  9. Dual energy CT intracranial angiography: image quality, radiation dose and initial application results

    International Nuclear Information System (INIS)

    Chai Xue; Zhang Longjiang; Lu Guangming; Zhou Changsheng

    2009-01-01

    Objective: To assess the clinical value of dual-energy intracranial CT angiography (CTA). Methods: Forty-one patients suspected of intracranial vascular diseases underwent dual-energy intracranial CT angiography, and 41 patients who underwent conventional subtraction CT were enrolled as the control group. Image quality of intracranial and skull base vessels and radiation dose between dual-energy CTA and conventional subtraction CTA were compared using two independent sample nonparametric test and independent-samples t test, respectively. Prevalence and size of lesions detected by dual-energy CTA and digital subtraction CTA were compared using paired-samples t test and Spearman correlative analysis. Results: The percentage of image quality scored 5 was 70.7% (29/41) for dual-energy CTA and 75.6% (31/41) for conventional subtraction CTA. There was no significant difference between the two groups (Z= -0.455, P=0.650). Image quality of vessels at the skull base in conventional subtraction CTA was superior to that in dual-energy CTA, especially for the petrosal and syphon segment (Z=-4.087, P=0.000). Radiation exposure of dual energy CTA and conventional CTA were (396.54±17.43) and (1090.95±114.29) mGy·cm respectively. Radiation exposure was decreased by 64% (t=-38.52, P=0.000) by dual energy CTA compared with conventional subtraction CTA. Out of the 41 patients, 19 patients were diagnosed as intracranial aneurysm, 2 patients as arteriovenous malformation (AVM), 3 patients with Moya-moya's disease, and the remaining 17 patients with negative results. Nine patients with intracranial aneurysm, 2 patients with AVM, 3 patients with Moya-moya's disease, and 2 patients with negative findings underwent DSA or operation, with concordant findings from both techniques. Diameter of aneurysm neck, long axis and minor axis by dual-energy CTA was (2.90±1.61), (5.23±1.68) and (3.83±1.69) mm, respectively; Diameter of aneurysm neck, long axis and minor axis by DSA was (2.95±1

  10. Arterial spin labelling perfusion MRI of breast cancer using FAIR TrueFISP: Initial results

    International Nuclear Information System (INIS)

    Buchbender, S.; Obenauer, S.; Mohrmann, S.; Martirosian, P.; Buchbender, C.; Miese, F.R.; Wittsack, H.J.; Miekley, M.; Antoch, G.; Lanzman, R.S.

    2013-01-01

    Aim: To assess the feasibility of an unenhanced, flow-sensitive, alternating inversion recovery-balanced steady-state free precession (FAIR TrueFISP) arterial spin labelling (ASL) magnetic resonance imaging (MRI) technique for quantification of breast cancer perfusion. Materials and methods: Eighteen untreated breast tumour patients (mean age 53 ± 17 years, range 30–68 years) and four healthy controls (mean age 51 ± 14 years, range 33–68 years) were enrolled in this study and were imaged using a clinical 1.5 T MRI machine. Perfusion measurements were performed using a coronal single-section ASL FAIR TrueFISP technique in addition to a routine breast MRI examination. T1 relaxation time of normal breast parenchyma was determined in four healthy volunteers using the variable flip angle approach. The definitive diagnosis was obtained at histology after biopsy or surgery and was available for all patients. Results: ASL perfusion was successfully acquired in 13 of 18 tumour patients and in all healthy controls. The mean ASL perfusion of invasive ductal carcinoma tissue was significantly higher (88.2 ± 39.5 ml/100 g/min) compared to ASL perfusion of normal breast parenchyma (24.9 ± 12.7 ml/100 g/min; p < 0.05) and invasive lobular carcinoma (30.5 ± 4.3 ml/100 g/min; p < 0.05). No significant difference was found between the mean ASL perfusion of normal breast parenchyma and invasive lobular carcinoma tissue (p = 0.97). Conclusion: ASL MRI enables quantification of breast cancer perfusion without the use of contrast material. However, its impact on diagnosis and therapy management of breast tumours has to be evaluated in larger patient studies

  11. Plans for longitudinal and transverse neutralized beam compression experiments, and initial results from solenoid transport experiments

    International Nuclear Information System (INIS)

    Seidl, P.A.; Armijo, J.; Baca, D.; Bieniosek, F.M.; Coleman, J.; Davidson, R.C.; Efthimion, P.C.; Friedman, A.; Gilson, E.P.; Grote, D.; Haber, I.; Henestroza, E.; Kaganovich, I.; Leitner, M.; Logan, B.G.; Molvik, A.W.; Rose, D.V.; Roy, P.K.; Sefkow, A.B.; Sharp, W.M.; Vay, J.L.; Waldron, W.L.; Welch, D.R.; Yu, S.S.

    2007-01-01

    This paper presents plans for neutralized drift compression experiments, precursors to future target heating experiments. The target-physics objective is to study warm dense matter (WDM) using short-duration (∼1 ns) ion beams that enter the targets at energies just above that at which dE/dx is maximal. High intensity on target is to be achieved by a combination of longitudinal compression and transverse focusing. This work will build upon recent success in longitudinal compression, where the ion beam was compressed lengthwise by a factor of more than 50 by first applying a linear head-to-tail velocity tilt to the beam, and then allowing the beam to drift through a dense, neutralizing background plasma. Studies on a novel pulse line ion accelerator were also carried out. It is planned to demonstrate simultaneous transverse focusing and longitudinal compression in a series of future experiments, thereby achieving conditions suitable for future WDM target experiments. Future experiments may use solenoids for transverse focusing of un-neutralized ion beams during acceleration. Recent results are reported in the transport of a high-perveance heavy ion beam in a solenoid transport channel. The principal objectives of this solenoid transport experiment are to match and transport a space-charge-dominated ion beam, and to study associated electron-cloud and gas effects that may limit the beam quality in a solenoid transport system. Ideally, the beam will establish a Brillouin-flow condition (rotation at one-half the cyclotron frequency). Other mechanisms that potentially degrade beam quality are being studied, such as focusing-field aberrations, beam halo, and separation of lattice focusing elements

  12. Sequential Blood Filtration for Extracorporeal Circulation: Initial Results from a Proof-of-Concept Prototype

    Science.gov (United States)

    Herbst, Daniel P.

    2014-01-01

    Abstract: Micropore filters are used during extracorporeal circulation to prevent gaseous and solid particles from entering the patient’s systemic circulation. Although these devices improve patient safety, limitations in current designs have prompted the development of a new concept in micropore filtration. A prototype of the new design was made using 40-μm filter screens and compared against four commercially available filters for performance in pressure loss and gross air handling. Pre- and postfilter bubble counts for 5- and 10-mL bolus injections in an ex vivo test circuit were recorded using a Doppler ultrasound bubble counter. Statistical analysis of results for bubble volume reduction between test filters was performed with one-way repeated-measures analysis of variance using Bonferroni post hoc tests. Changes in filter performance with changes in microbubble load were also assessed with dependent t tests using the 5- and 10-mL bolus injections as the paired sample for each filter. Significance was set at p < .05. All filters in the test group were comparable in pressure loss performance, showing a range of 26–33 mmHg at a flow rate of 6 L/min. In gross air-handling studies, the prototype showed improved bubble volume reduction, reaching statistical significance with three of the four commercial filters. All test filters showed decreased performance in bubble volume reduction when the microbubble load was increased. Findings from this research support the underpinning theories of a sequential arterial-line filter design and suggest that improvements in microbubble filtration may be possible using this technique. PMID:26357790

  13. CT enteroclysis in the diagnosis of obscure gastrointestinal bleeding: initial results

    International Nuclear Information System (INIS)

    Jain, T.P.; Gulati, M.S.; Makharia, G.K.; Bandhu, S.; Garg, P.K.

    2007-01-01

    Aim: To evaluate the usefulness of computed tomography (CT) enteroclysis in patients with obscure gastrointestinal (GI) bleeding. Materials and methods: In a prospective study, CT enteroclysis was performed in 21 patients (median age 50 years; range 13-71 years) with obscure GI bleeding in which the source of the bleeding could not be detected despite the patient having undergone both upper GI endoscopic and colonoscopic examinations. The entire abdomen and pelvis was examined in the arterial and venous phases using multisection CT after distending the small intestine with 2 l of 0.5% methylcellulose as a neutral enteral contrast medium and the administration of 150 ml intravenous contrast medium. Results: Adequate distension of the small intestine was achieved in 20 of the 21 (95.2%) patients. Potential causes of GI bleeding were identified in 10 of the 21 (47.6%) patients using CT enteroclysis. The cause of the bleeding could be detected nine of 14 (64.3%) patients with overt, obscure GI bleeding. However, for patients with occult, obscure GI bleeding, the cause of the bleeding was identified in only one of the seven (14.3%) patients. The lesions identified by CT enteroclysis included small bowel tumours (n = 2), small bowel intussusceptions (n = 2), intestinal tuberculosis (n = 2), and vascular lesions (n = 3). All vascular lesions were seen equally well in both the arterial and venous phases. Conclusions: The success rate in detection of the cause of bleeding using CT enteroclysis was 47.6% in patients with obscure GI bleeding. The diagnostic yield was higher in patients with overt, obscure GI bleeding than in those with occult obscure GI bleeding

  14. Current discharge management of acute coronary syndromes: baseline results from a national quality improvement initiative.

    Science.gov (United States)

    Wai, A; Pulver, L K; Oliver, K; Thompson, A

    2012-05-01

    Evidence-practice gaps exist in the continuum of care for patients with acute coronary syndromes (ACS), particularly at hospital discharge. We aimed to describe the methodology and baseline results of the Discharge Management of Acute Coronary Syndromes (DMACS) project, focusing on the prescription of guideline-recommended medications, referral to cardiac rehabilitation and communication between the hospital, patient and their primary healthcare professionals. DMACS employed Drug Use Evaluation methodology involving data collection, evaluation and feedback, and targeted educational interventions. Adult patients with ACS discharged during a 4-month period were eligible to participate. Data were collected (maximum 50 patients) at each site through an inpatient medical record review, a general practitioner (GP) postal/fax survey conducted 14 days post discharge and a patient telephone survey 3 months post discharge. Forty-nine hospitals participated in the audit recruiting 1545 patients. At discharge, 57% of patients were prescribed a combination of antiplatelet agent(s), beta-blocker, statin and angiotensin-converting enzyme inhibitor and/or angiotensin II-antagonist. At 3 months post discharge, 48% of patients reported using the same combination. Some 67% of patients recalled being referred to cardiac rehabilitation; of these, 33% had completed the programme. In total, 83% of patients had a documented ACS management plan at discharge. Of these, 90% included a medication list, 56% a chest pain action plan and 54% risk factor modification advice. Overall, 65% of GPs rated the quality of information received in the discharge summary as 'very good' to 'excellent'. The findings of our baseline audit showed that despite the robust evidence base and availability of national guidelines, the management of patients with ACS can be improved. These findings will inform a multifaceted intervention strategy to improve adherence to guidelines for the discharge management of

  15. Initial quality performance results using a phantom to simulate chest computed radiography

    Directory of Open Access Journals (Sweden)

    Muhogora Wilbroad

    2011-01-01

    Full Text Available The aim of this study was to develop a homemade phantom for quantitative quality control in chest computed radiography (CR. The phantom was constructed from copper, aluminium, and polymenthylmethacrylate (PMMA plates as well as Styrofoam materials. Depending on combinations, the literature suggests that these materials can simulate the attenuation and scattering characteristics of lung, heart, and mediastinum. The lung, heart, and mediastinum regions were simulated by 10 mm x 10 mm x 0.5 mm, 10 mm x 10 mm x 0.5 mm and 10 mm x 10 mm x 1 mm copper plates, respectively. A test object of 100 mm x 100 mm and 0.2 mm thick copper was positioned to each region for CNR measurements. The phantom was exposed to x-rays generated by different tube potentials that covered settings in clinical use: 110-120 kVp (HVL=4.26-4.66 mm Al at a source image distance (SID of 180 cm. An approach similar to the recommended method in digital mammography was applied to determine the CNR values of phantom images produced by a Kodak CR 850A system with post-processing turned off. Subjective contrast-detail studies were also carried out by using images of Leeds TOR CDR test object acquired under similar exposure conditions as during CNR measurements. For clinical kVp conditions relevant to chest radiography, the CNR was highest over 90-100 kVp range. The CNR data correlated with the results of contrast detail observations. The values of clinical tube potentials at which CNR is the highest are regarded to be optimal kVp settings. The simplicity in phantom construction can offer easy implementation of related quality control program.

  16. Initial Results With Image-guided Cochlear Implant Programming in Children.

    Science.gov (United States)

    Noble, Jack H; Hedley-Williams, Andrea J; Sunderhaus, Linsey; Dawant, Benoit M; Labadie, Robert F; Camarata, Stephen M; Gifford, René H

    2016-02-01

    Image-guided cochlear implant (CI) programming can improve hearing outcomes for pediatric CI recipients. CIs have been highly successful for children with severe-to-profound hearing loss, offering potential for mainstreamed education and auditory-oral communication. Despite this, a significant number of recipients still experience poor speech understanding, language delay, and, even among the best performers, restoration to normal auditory fidelity is rare. Although significant research efforts have been devoted to improving stimulation strategies, few developments have led to significant hearing improvement over the past two decades. Recently introduced techniques for image-guided CI programming (IGCIP) permit creating patient-customized CI programs by making it possible, for the first time, to estimate the position of implanted CI electrodes relative to the nerves they stimulate using CT images. This approach permits identification of electrodes with high levels of stimulation overlap and to deactivate them from a patient's map. Previous studies have shown that IGCIP can significantly improve hearing outcomes for adults with CIs. The IGCIP technique was tested for 21 ears of 18 pediatric CI recipients. Participants had long-term experience with their CI (5 mo to 13 yr) and ranged in age from 5 to 17 years old. Speech understanding was assessed after approximately 4 weeks of experience with the IGCIP map. Using a two-tailed Wilcoxon signed-rank test, statistically significant improvement (p < 0.05) was observed for word and sentence recognition in quiet and noise, as well as pediatric self-reported quality-of-life (QOL) measures. Our results indicate that image guidance significantly improves hearing and QOL outcomes for pediatric CI recipients.

  17. Contrast-enhanced 3D MRI of lung perfusion in children with cystic fibrosis - initial results

    International Nuclear Information System (INIS)

    Eichinger, Monika; Puderbach, Michael; Zuna, Ivan; Kauczor, Hans-Ulrich; Fink, Christian; Gahr, Julie; Mueller, Frank-Michael; Ley, Sebastian; Plathow, Christian; Tuengerthal, Siegfried

    2006-01-01

    This paper is a feasibility study of magnetic resonance imaging (MRI) of lung perfusion in children with cystic fibrosis (CF) using contrast-enhanced 3D MRI. Correlation assessment of perfusion changes with structural abnormalities. Eleven CF patients (9 f, 2 m; median age 16 years) were examined at 1.5 T. Morphology: HASTE coronal, transversal (TR/TE/α/ST: 600 ms/28 ms/180 /6 mm), breath-hold 18 s. Perfusion: Time-resolved 3D GRE pulse sequence (FLASH, TE/TR/α: 0.8/1.9 ms/40 ), parallel imaging (GRAPPA, PAT 2). Twenty-five data sets were acquired after intravenous injection of 0.1 mmol/kg body weight of gadodiamide, 3-5 ml/s. A total of 198 lung segments were analyzed by two radiologists in consensus and scored for morphological and perfusion changes. Statistical analysis was performed by Mantel-Haenszel chi-square test. Results showed that perfusion defects were observed in all patients and present in 80% of upper, and 39% of lower lobes. Normal lung parenchyma showed homogeneous perfusion (86%, P<0.0001). Severe morphological changes led to perfusion defects (97%, P<0.0001). Segments with moderate morphological changes showed normal (53%) or impaired perfusion (47%). In conclusion, pulmonary perfusion is easy to judge in segments with normal parenchyma or severe changes. In moderately damaged segments, MRI of lung perfusion may help to better assess actual functional impairment. Contrast-enhanced 3D MRI of lung perfusion has the potential for early vascular functional assessment and therapy control in CF patients. (orig.)

  18. Multi-voxel MR spectroscopic imaging of the brain: utility in clinical setting-initial results

    International Nuclear Information System (INIS)

    Parmar, Hemant; Lim, Tchoyoson C.C.; Yin Hong; Chua, Violet; Khin, Lay-Wai; Raidy, Tom; Hui, Francis

    2005-01-01

    Background and purpose: Compared to single voxel methods, MR spectroscopic imaging (MRSI) of the brain provides metabolic information with improved anatomical coverage and spectral resolution, but may be difficult to perform in the clinical setting. We evaluate the factors influencing spectral quality in MRSI using a semi-automated method, focussing on lipid contamination, and phase correction errors related to magnetic field inhomogeneity. Methods: We retrospectively analysed MRSI studies planned by radiologists and radiographers. Two-dimensional MRSI studies using point-resolved spectroscopy (PRESS) localisation, at long echo time (135 or 144 ms) were acquired on a 1.5 T scanner. Studies that contained lipid contamination and abnormally inverted spectra were reviewed and the latter correlated with anatomic location at the base of skull, and with the area of the region of interest (ROI) studied. Results: Of 128 consecutive MRSI studies, six showed abnormal inverted spectra, of which four were acquired at the base of skull. Multivariate logistic regression analysis showed that study location at the base of skull, but not larger ROI, was a significant predictor for the risk of being affected by inverted spectra (RR for base of skull: 11.76, 95% CI: 1.86-74.18, P = 0.009. RR for area of ROI: 3.68, 95% CI: 0.57-23.67, P = 0.170). Seven studies showed lipid contamination; all were in close proximity to the overlying scalp. Conclusion: Using a semi-automated acquisition and post-processing method, MRSI can be successfully applied in the clinical setting. However, care should be taken to avoid regions of high magnetic field inhomogeneity at the base of skull, and lipid contamination in voxels prescribed near the scalp

  19. Field data collection of miscellaneous electrical loads in Northern California: Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Greenblatt, Jeffery B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Pratt, Stacy [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Willem, Henry [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Claybaugh, Erin [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Desroches, Louis-Benoit [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Beraki, Bereket [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Nagaraju, Mythri [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Price, Sarah K. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.; Young, Scott J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division. Energy Analysis and Environmental Impacts Dept.

    2013-02-25

    This report describes efforts to measure energy use of miscellaneous electrical loads (MELs) in 880 San Francisco Bay Area homes during the summer of 2012. Ten regions were selected for metering: Antioch, Berkeley, Fremont, Livermore, Marin County (San Rafael, Novato, Fairfax, and Mill Valley), Oakland/Emeryville, Pleasanton, Richmond, San Leandro, and Union City. The project focused on three major categories of devices: entertainment (game consoles, set-top boxes, televisions and video players), home office (computers, monitors and network equipment), and kitchen plug-loads (coffee/espresso makers, microwave ovens/toaster ovens/toasters, rice/slow cookers and wine chillers). These categories were important to meter because they either dominated the estimated overall energy use of MELs, are rapidly changing, or there are very little energy consumption data published. A total of 1,176 energy meters and 143 other sensors were deployed, and 90% of these meters and sensors were retrieved. After data cleaning, we obtained 711 valid device energy use measurements, which were used to estimate, for a number of device subcategories, the average time spent in high power, low power and “off” modes, the average energy use in each mode, and the average overall energy use. Consistent with observations made in previous studies, we find on average that information technology (IT) devices (home entertainment and home office equipment) consume more energy (15.0 and 13.0 W, respectively) than non-IT devices (kitchen plug-loads; 4.9 W). Opportunities for energy savings were identified in almost every device category, based on the time spent in various modes and/or the power levels consumed in those modes. Future reports will analyze the collected data in detail by device category and compare results to those obtained from prior studies.

  20. The Vermont oxford neonatal encephalopathy registry: rationale, methods, and initial results

    Science.gov (United States)

    2012-01-01

    Background In 2006, the Vermont Oxford Network (VON) established the Neonatal Encephalopathy Registry (NER) to characterize infants born with neonatal encephalopathy, describe evaluations and medical treatments, monitor hypothermic therapy (HT) dissemination, define clinical research questions, and identify opportunities for improved care. Methods Eligible infants were ≥ 36 weeks with seizures, altered consciousness (stupor, coma) during the first 72 hours of life, a 5 minute Apgar score of ≤ 3, or receiving HT. Infants with central nervous system birth defects were excluded. Results From 2006–2010, 95 centers registered 4232 infants. Of those, 59% suffered a seizure, 50% had a 5 minute Apgar score of ≤ 3, 38% received HT, and 18% had stupor/coma documented on neurologic exam. Some infants experienced more than one eligibility criterion. Only 53% had a cord gas obtained and only 63% had a blood gas obtained within 24 hours of birth, important components for determining HT eligibility. Sixty-four percent received ventilator support, 65% received anticonvulsants, 66% had a head MRI, 23% had a cranial CT, 67% had a full channel encephalogram (EEG) and 33% amplitude integrated EEG. Of all infants, 87% survived. Conclusions The VON NER describes the heterogeneous population of infants with NE, the subset that received HT, their patterns of care, and outcomes. The optimal routine care of infants with neonatal encephalopathy is unknown. The registry method is well suited to identify opportunities for improvement in the care of infants affected by NE and study interventions such as HT as they are implemented in clinical practice. PMID:22726296

  1. Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI-Initial results

    Energy Technology Data Exchange (ETDEWEB)

    Fan Li [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China)], E-mail: fanli0930@163.com; Liu Shiyuan [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China); Sun Fei [GE Healthcare China (China)], E-mail: Fei.sun@med.ge.com; Xiao Xiangsheng [Department of Radiology, ChangZheng Hospital Affiliated to Second Military Medical University, No. 415 Fengyang Road, Shanghai 200003 (China)], E-mail: lizhaobin79@163.com

    2009-04-15

    Objective: The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Materials and methods: Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. Results: One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P > 0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Conclusion: Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

  2. Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI-Initial results

    International Nuclear Information System (INIS)

    Fan Li; Liu Shiyuan; Sun Fei; Xiao Xiangsheng

    2009-01-01

    Objective: The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Materials and methods: Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. Results: One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P > 0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Conclusion: Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

  3. CT enteroclysis in the diagnosis of obscure gastrointestinal bleeding: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Jain, T.P. [Department ofRadiodiagnosis, All India Institute of Medical Sciences, New Delhi (India); Gulati, M.S. [Department of Imaging, Queen Elizabeth Hospital NHS Trust, London (United Kingdom); Makharia, G.K. [Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi (India)]. E-mail: govindmakharia@aiims.ac.in; Bandhu, S. [Department ofRadiodiagnosis, All India Institute of Medical Sciences, New Delhi (India); Garg, P.K. [Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi (India)

    2007-07-15

    Aim: To evaluate the usefulness of computed tomography (CT) enteroclysis in patients with obscure gastrointestinal (GI) bleeding. Materials and methods: In a prospective study, CT enteroclysis was performed in 21 patients (median age 50 years; range 13-71 years) with obscure GI bleeding in which the source of the bleeding could not be detected despite the patient having undergone both upper GI endoscopic and colonoscopic examinations. The entire abdomen and pelvis was examined in the arterial and venous phases using multisection CT after distending the small intestine with 2 l of 0.5% methylcellulose as a neutral enteral contrast medium and the administration of 150 ml intravenous contrast medium. Results: Adequate distension of the small intestine was achieved in 20 of the 21 (95.2%) patients. Potential causes of GI bleeding were identified in 10 of the 21 (47.6%) patients using CT enteroclysis. The cause of the bleeding could be detected nine of 14 (64.3%) patients with overt, obscure GI bleeding. However, for patients with occult, obscure GI bleeding, the cause of the bleeding was identified in only one of the seven (14.3%) patients. The lesions identified by CT enteroclysis included small bowel tumours (n = 2), small bowel intussusceptions (n = 2), intestinal tuberculosis (n = 2), and vascular lesions (n = 3). All vascular lesions were seen equally well in both the arterial and venous phases. Conclusions: The success rate in detection of the cause of bleeding using CT enteroclysis was 47.6% in patients with obscure GI bleeding. The diagnostic yield was higher in patients with overt, obscure GI bleeding than in those with occult obscure GI bleeding.

  4. [The magnetotherapy of hypertension patients].