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Sample records for injury tolerance criteria

  1. Neck injury tolerance under inertial loads in side impacts.

    Science.gov (United States)

    McIntosh, Andrew S; Kallieris, Dimitrios; Frechede, Bertrand

    2007-03-01

    Neck injury remains a major issue in road safety. Current side impact dummies and side impact crashworthiness assessments do not assess the risk of neck injury. These assessments are limited by biofidelity and knowledge regarding neck injury criteria and tolerance levels in side impacts. Side impact tests with PMHS were performed at the Heidelberg University in the 1980s and 1990s to improve primarily the understanding of trunk dynamics, injury mechanisms and criteria. In order to contribute to the definition of human tolerances at neck level, this study presents an analysis of the head/neck biomechanical parameters that were measured in these tests and their relationship to neck injury severity. Data from 15 impact tests were analysed. Head accelerations, and neck forces and moments were calculated from 9-accelerometer array head data, X-rays and anthropometric data. Statistically significant relationships were observed between resultant head acceleration and neck force and neck injury severity. The average resultant head acceleration for AIS 2 neck injuries was 112 g, while resultant neck force was 4925 N and moment 241 Nm. The data compared well to other test data on cadavers and volunteers. It is hoped that the paper will assist in the understanding of neck injuries and the development of tolerance criteria.

  2. Neck injury criteria and certification procedure for side-facing aircraft seats

    NARCIS (Netherlands)

    Philippens, M.M.G.M.; Forbes, P.A.; Wismans, J.S.H.M.; DeWeese, R.; Moorcroft, D.

    2011-01-01

    This report documents research started in 2002 that identified the potential need for explicit neck injury criteria and tolerances for certification of side-facing seats in aircraft. Laboratory sled tests with full-body postmortem human subjects proved that there is a substantial risk for serious

  3. Biomechanics of side impact: injury criteria, aging occupants, and airbag technology.

    Science.gov (United States)

    Yoganandan, Narayan; Pintar, Frank A; Stemper, Brian D; Gennarelli, Thomas A; Weigelt, John A

    2007-01-01

    This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. This is followed by a survey of various experimental models used in the development of injury criteria and tolerance limits. The effects of fragility of the elderly coupled with physiological changes (e.g., visual, musculoskeletal) that may lead to an abnormal seating position (termed out-of-position) especially for the driving population are discussed. Fundamental biomechanical parameters such as thoracic, abdominal and pelvic forces; upper and lower spinal and sacrum accelerations; and upper, middle and lower chest deflections under various initial impacting conditions are evaluated. Secondary variables such as the thoracic trauma index and pelvic acceleration (currently adopted in the United States Federal Motor Vehicle Safety Standards), peak chest deflection, and viscous criteria are also included in the survey. The importance of performing research studies with specific focus on out-of-position scenarios of the elderly and using the most commonly available torso side airbag as the initial contacting condition in lateral impacts for occupant injury assessment is emphasized.

  4. 45 CFR 1308.16 - Eligibility criteria: Traumatic brain injury.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Eligibility criteria: Traumatic brain injury. 1308... DISABILITIES Health Services Performance Standards § 1308.16 Eligibility criteria: Traumatic brain injury. A child is classified as having traumatic brain injury whose brain injuries are caused by an external...

  5. Development of brain injury criteria (BrIC).

    Science.gov (United States)

    Takhounts, Erik G; Craig, Matthew J; Moorhouse, Kevin; McFadden, Joe; Hasija, Vikas

    2013-11-01

    Rotational motion of the head as a mechanism for brain injury was proposed back in the 1940s. Since then a multitude of research studies by various institutions were conducted to confirm/reject this hypothesis. Most of the studies were conducted on animals and concluded that rotational kinematics experienced by the animal's head may cause axonal deformations large enough to induce their functional deficit. Other studies utilized physical and mathematical models of human and animal heads to derive brain injury criteria based on deformation/pressure histories computed from their models. This study differs from the previous research in the following ways: first, it uses two different detailed mathematical models of human head (SIMon and GHBMC), each validated against various human brain response datasets; then establishes physical (strain and stress based) injury criteria for various types of brain injury based on scaled animal injury data; and finally, uses Anthropomorphic Test Devices (ATDs) (Hybrid III 50th Male, Hybrid III 5th Female, THOR 50th Male, ES-2re, SID-IIs, WorldSID 50th Male, and WorldSID 5th Female) test data (NCAP, pendulum, and frontal offset tests) to establish a kinematically based brain injury criterion (BrIC) for all ATDs. Similar procedures were applied to college football data where thousands of head impacts were recorded using a six degrees of freedom (6 DOF) instrumented helmet system. Since animal injury data used in derivation of BrIC were predominantly for diffuse axonal injury (DAI) type, which is currently an AIS 4+ injury, cumulative strain damage measure (CSDM) and maximum principal strain (MPS) were used to derive risk curves for AIS 4+ anatomic brain injuries. The AIS 1+, 2+, 3+, and 5+ risk curves for CSDM and MPS were then computed using the ratios between corresponding risk curves for head injury criterion (HIC) at a 50% risk. The risk curves for BrIC were then obtained from CSDM and MPS risk curves using the linear relationship

  6. Commensal Lactobacillus Controls Immune Tolerance during Acute Liver Injury in Mice

    Directory of Open Access Journals (Sweden)

    Nobuhiro Nakamoto

    2017-10-01

    Full Text Available Summary: Gut-derived microbial antigens trigger the innate immune system during acute liver injury. During recovery, regulatory immunity plays a role in suppressing inflammation; however, the precise mechanism underlying this process remains obscure. Here, we find that recruitment of immune-regulatory classical dendritic cells (cDCs is crucial for liver tolerance in concanavalin A-induced acute liver injury. Acute liver injury resulted in enrichment of commensal Lactobacillus in the gut. Notably, Lactobacillus activated IL-22 production by gut innate lymphoid cells and raised systemic IL-22 levels. Gut-derived IL-22 enhanced mucosal barrier function and promoted the recruitment of regulatory cDCs to the liver. These cDCs produced IL-10 and TGF-β through TLR9 activation, preventing further liver inflammation. Collectively, our results indicate that beneficial gut microbes influence tolerogenic immune responses in the liver. Therefore, modulation of the gut microbiota might be a potential option to regulate liver tolerance. : Nakamoto et.al. find that Lactobacillus accumulates in the gut and activates IL-22 production by innate lymphoid cells during acute liver injury. Gut-derived IL-22 contributes to liver tolerance via induction of regulatory DCs. Keywords: immune tolerance, dendritic cell, innate lymphoid cell, acute liver injury, interleukin-10, interleukin-22, microbiota, dysbiosis

  7. Human Injury Criteria for Underwater Blasts.

    Directory of Open Access Journals (Sweden)

    Rachel M Lance

    Full Text Available Underwater blasts propagate further and injure more readily than equivalent air blasts. Development of effective personal protection and countermeasures, however, requires knowledge of the currently unknown human tolerance to underwater blast. Current guidelines for prevention of underwater blast injury are not based on any organized injury risk assessment, human data or experimental data. The goal of this study was to derive injury risk assessments for underwater blast using well-characterized human underwater blast exposures in the open literature. The human injury dataset was compiled using 34 case reports on underwater blast exposure to 475 personnel, dating as early as 1916. Using severity ratings, computational reconstructions of the blasts, and survival information from a final set of 262 human exposures, injury risk models were developed for both injury severity and risk of fatality as functions of blast impulse and blast peak overpressure. Based on these human data, we found that the 50% risk of fatality from underwater blast occurred at 302±16 kPa-ms impulse. Conservatively, there is a 20% risk of pulmonary injury at a kilometer from a 20 kg charge. From a clinical point of view, this new injury risk model emphasizes the large distances possible for potential pulmonary and gut injuries in water compared with air. This risk value is the first impulse-based fatality risk calculated from human data. The large-scale inconsistency between the blast exposures in the case reports and the guidelines available in the literature prior to this study further underscored the need for this new guideline derived from the unique dataset of actual injuries in this study.

  8. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria.

    Science.gov (United States)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    2016-06-01

    More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when a person can start playing again. These criteria need to be critically evaluated, in an attempt to reduce recurrence rates and optimize RTP. To carry out a systematic review of the literature on (1) definitions of RTP used in hamstring research and (2) criteria for RTP after hamstring injuries. Systematic review. Seven databases (PubMed, EMBASE/MEDLINE, CINAHL, PEDro, Cochrane, SPORTDiscus, Scopus) were searched for articles that provided a definition of, or criteria for, RTP after hamstring injury. There were no limitations on the methodological design or quality of articles. Content analysis was used to record and analyze definitions and criteria for RTP after hamstring injury. Twenty-five papers fulfilled inclusion criteria, of which 13 provided a definition of RTP and 23 described criteria to support the RTP decision. "Reaching the athlete's pre-injury level" and "being able to perform full sport activities" were the primary content categories used to define RTP. "Absence of pain", "similar strength", "similar flexibility", "medical staff clearance", and "functional performance" were core themes to describe criteria to support the RTP decision after hamstring injury. Only half of the included studies provided some definition of RTP after hamstring injury, of which reaching the athlete's pre-injury level and being able to perform full sport activities were the most important. A wide variety of criteria are used to support the RTP decision, none of which have been validated. More research is needed to reach a consensus on the definition of RTP and to provide validated RTP criteria to facilitate hamstring injury management and reduce hamstring injury recurrence. PROSPERO

  9. Development and Validation of Quality Criteria for Providing Patient- and Family-centered Injury Care.

    Science.gov (United States)

    Boyd, Jamie M; Burton, Rachael; Butler, Barb L; Dyer, Dianne; Evans, David C; Felteau, Melissa; Gruen, Russell L; Jaffe, Kenneth M; Kortbeek, John; Lang, Eddy; Lougheed, Val; Moore, Lynne; Narciso, Michelle; Oxland, Peter; Rivara, Frederick P; Roberts, Derek; Sarakbi, Diana; Vine, Karen; Stelfox, Henry T

    2017-08-01

    The aim of this study was to develop and evaluate the content validity of quality criteria for providing patient- and family-centered injury care. Quality criteria have been developed for clinical injury care, but not patient- and family-centered injury care. Using a modified Research AND Development Corporation (RAND)/University of California, Los Angeles (UCLA) Appropriateness Methodology, a panel of 16 patients, family members, injury and quality of care experts serially rated and revised criteria for patient- and family-centered injury care identified from patient and family focus groups. The criteria were then sent to 384 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. A total of 46 criteria were rated and revised by the panel over 4 rounds of review producing 14 criteria related to clinical care (n = 4; transitions of care, pain management, patient safety, provider competence), communication (n = 3; information for patients/families; communication of discharge plans to patients/families, communication between hospital and community providers), holistic care (n = 4; patient hygiene, kindness and respect, family access to patient, social and spiritual support) and end-of-life care (n = 3; decision making, end-of-life care, family follow-up). Medical directors, managers, or coordinators representing 254 trauma centers (66% response rate) rated 12 criteria to be important (95% of responses) for patient- and family-centered injury care. Fewer centers rated family access to the patient (80%) and family follow-up after patient death (65%) to be important criteria. Fourteen-candidate quality criteria for patient- and family-centered injury care were developed and shown to have content validity. These may be used to guide quality improvement practices.

  10. Forearm interosseous membrane trauma: MRI diagnostic criteria and injury patterns

    Energy Technology Data Exchange (ETDEWEB)

    McGinley, Joseph C. [Stanford University Medical Center, Department of Radiology, Stanford, CA (United States); Roach, Neil [Hospital of the University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Hopgood, Brendon C. [Albert Einstein Medical Center, Department of Surgery, Philadelphia, PA (United States); Limmer, Karl [Temple University School of Medicine, Philadelphia, PA (United States); Kozin, Scott H. [Shriners Hospital for Children, Temple University and Pediatric Hand and Upper Extremity Surgeon, Philadelphia, PA (United States)

    2006-05-15

    Define criteria for interosseous membrane (IOM) injury diagnosis using MRI, and characterize patterns of IOM disruption following forearm trauma. Our hypothesis is that most IOM injuries occur along the ulnar insertion, and MRI should be obtained following forearm trauma to assess IOM competency. Sixteen cadaver forearms were subjected to longitudinal impact trauma. Prior to and following injury, MR images were examined by a board-certified musculoskeletal radiologist using pre-defined criteria for determining IOM integrity. Each specimen was dissected and the viability/pattern of injury examined. The MRI and dissection results were compared using a double-blinded methodology. Eight of the 16 specimens demonstrated IOM trauma. Seven specimens demonstrated complete IOM disruption from the ulnar insertion, and one revealed a mid-substance tear with intact origin and insertion. The dorsal oblique bundle was disrupted in four specimens. MRI analysis identified IOM injury in seven of the eight forearms. The injury location was correctly identified in six specimens when compared to dissection observations. MRI determination of IOM injury demonstrated a positive predictive value of 100%, a negative predictive value of 89%, a sensitivity of 87.5% and a specificity of 100%. (orig.)

  11. Forearm interosseous membrane trauma: MRI diagnostic criteria and injury patterns

    International Nuclear Information System (INIS)

    McGinley, Joseph C.; Roach, Neil; Hopgood, Brendon C.; Limmer, Karl; Kozin, Scott H.

    2006-01-01

    Define criteria for interosseous membrane (IOM) injury diagnosis using MRI, and characterize patterns of IOM disruption following forearm trauma. Our hypothesis is that most IOM injuries occur along the ulnar insertion, and MRI should be obtained following forearm trauma to assess IOM competency. Sixteen cadaver forearms were subjected to longitudinal impact trauma. Prior to and following injury, MR images were examined by a board-certified musculoskeletal radiologist using pre-defined criteria for determining IOM integrity. Each specimen was dissected and the viability/pattern of injury examined. The MRI and dissection results were compared using a double-blinded methodology. Eight of the 16 specimens demonstrated IOM trauma. Seven specimens demonstrated complete IOM disruption from the ulnar insertion, and one revealed a mid-substance tear with intact origin and insertion. The dorsal oblique bundle was disrupted in four specimens. MRI analysis identified IOM injury in seven of the eight forearms. The injury location was correctly identified in six specimens when compared to dissection observations. MRI determination of IOM injury demonstrated a positive predictive value of 100%, a negative predictive value of 89%, a sensitivity of 87.5% and a specificity of 100%. (orig.)

  12. Selection of tolerable risk criteria for dam safety decision making

    International Nuclear Information System (INIS)

    Nielsen, N.M.; Hartford, D.N.D.; MacDonald, T.F.

    1994-01-01

    Risk assessment has received increasing attention in recent years as a means of aiding decision making on dams by providing systematic and rational methods for dealing with risk and uncertainty. Risk assessment is controversial and decisions affecting risk to life are the most controversial. Tolerable criteria, based on the risks that society is prepared to accept in order to avoid excessive costs, set bounds within which risk-based decisions may be made. The components of risk associated with dam safety are addressed on an individual basis and criteria established for each component, thereby permitting flexibility in the balance between component risk and avoiding the problems of placing a monetary value on life. The guiding principle of individual risk is that dams do not impose intolerable risks on any individual. A risk to life of 1 in 10 4 per annum is generally considered the maximum tolerable risk. When considering societal risk, the safety of a dam should be proportional to the consequences of its failure. Risks of financial losses beyond the corporation's ability to finance should be so low as to be considered negligible. 17 refs., 3 figs

  13. The 1997 American Diabetes Association criteria versus the 1985 World Health Organization criteria for the diagnosis of abnormal glucose tolerance : poor agreement in the Hoorn Study

    NARCIS (Netherlands)

    de Vegt, F; Dekker, J M; Stehouwer, C D; Nijpels, G; Bouter, L M; Heine, R J

    1998-01-01

    OBJECTIVE: Recently, the American Diabetes Association (ADA) introduced new diagnostic criteria. These new criteria are based on fasting plasma glucose levels, avoiding the burdensome oral glucose tolerance test (OGTT). We compared the 1997 ADA criteria with the 1985 World Health Organization (WHO)

  14. Role of age and injury mechanism on cervical spine injury tolerance from head contact loading.

    Science.gov (United States)

    Yoganandan, Narayan; Chirvi, Sajal; Voo, Liming; Pintar, Frank A; Banerjee, Anjishnu

    2018-02-17

    The objective of this study was to determine the influence of age and injury mechanism on cervical spine tolerance to injury from head contact loading using survival analysis. This study analyzed data from previously conducted experiments using post mortem human subjects (PMHS). Group A tests used the upright intact head-cervical column experimental model. The inferior end of the specimen was fixed, the head was balanced by a mechanical system, and natural lordosis was removed. Specimens were placed on a testing device via a load cell. The piston applied loading at the vertex region. Spinal injuries were identified using medical images. Group B tests used the inverted head-cervical column experimental model. In one study, head-T1 specimens were fixed distally, and C7-T1 joints were oriented anteriorly, preserving lordosis. Torso mass of 16 kg was added to the specimen. In another inverted head-cervical column study, occiput-T2 columns were obtained, an artificial head was attached, T1-T2 was fixed, C4-C5 disc was maintained horizontal in the lordosis posture, and C7-T1 was unconstrained. The specimens were attached to the drop test carriage carrying a torso mass of 15 kg. A load cell at the inferior end measured neck loads in both studies. Axial neck force and age were used as the primary response variable and covariate to derive injury probability curves using survival analysis. Group A tests showed that age is a significant (P < .05) and negative covariate; that is, increasing age resulted in decreasing force for the same risk. Injuries were mainly vertebral body fractures and concentrated at one level, mid-to-lower cervical spine, and were attributed to compression-related mechanisms. However, age was not a significant covariate for the combined data from group B tests. Both group B tests produced many soft tissue injuries, at all levels, from C1 to T1. The injury mechanism was attributed to mainly extension. Multiple and noncontiguous injuries occurred

  15. Biomechanics of side impact: Injury criteria, aging occupants, and airbag technology

    OpenAIRE

    Yoganandan, Narayan; Pintar, Frank A.; Stemper, Brian D.; Gennarelli, Thomas A.; Weigelt, John A.

    2006-01-01

    This paper presents a survey of side impact trauma-related biomedical investigations with specific reference to certain aspects of epidemiology relating to the growing elderly population, improvements in technology such as side airbags geared toward occupant safety, and development of injury criteria. The first part is devoted to the involvement of the elderly by identifying variables contributing to injury including impact severity, human factors, and national and international field data. T...

  16. Review of the efficacy and tolerability of the diclofenac epolamine topical patch 1.3% in patients with acute pain due to soft tissue injuries.

    Science.gov (United States)

    Kuehl, Kerry S

    2010-06-01

    The diclofenac epolamine topical patch 1.3% (DETP) was approved by the US Food and Drug Administration in January 2007 for the treatment of soft tissue injuries such as strains, sprains, and contusions, although it has been available for many years in >40 countries worldwide. The aim of this study was to review the efficacy and tolerability of the DETP in relieving acute pain caused by soft tissue injuries. The MEDLINE, Derwent Drug File, BIOSIS, and EMBASE databases were searched for literature published between 1984 and October 30, 2009, in any language, using the terms diclofenac epolamine patch, diclofenac hydroxyethylpyrrolidine patch, and FLECTOR Patch. Clinical studies of the efficacy and/or tolerability of the DETP in patients with acute pain due to soft tissue injuries or localized periarticular disorders were included. Efficacy studies that enrolled patients with other medical conditions were excluded, except for reports that focused on tolerability, which were included to supplement tolerability data. The bibliographies of included studies were reviewed manually for relevant articles based on inclusion and exclusion criteria, and the manufacturer was contacted for additional relevant postmarketing surveillance information and presentations from scientific meetings. The search identified 6 placebo-controlled clinical studies, 1 active-comparator-controlled clinical study, and 1 open-label comparator clinical study of the efficacy and tolerability of the DETP in patients with soft tissue injuries. Three studies reported on tolerability. Primary analyses among the 8 studies reported DETP-associated reductions in spontaneous pain from baseline, assessed using a visual analog scale, ranging from 26% to 88% on day 7 and 56% to 61% on day 14. The use of the DETP was associated with significantly greater reductions in pain scores compared with a placebo patch (2 studies) on day 7 (88% vs 74%; P = 0.001) and day 14 (56.5% vs 46.8%; P = 0.001) and compared with

  17. Admission Physiology Criteria After Injury on the Battlefield Predict Medical Resource Utilization and Patient Mortality

    National Research Council Canada - National Science Library

    Eastridge, Brian J; Owsley, Jimmie; Sebesta, James; Beekley, Alec; Wade, Charles; Wildzunas, Robert; Rhee, Peter; Holcomb, John

    2006-01-01

    .... We hypothesized that easily measurable admission physiologic criteria and injury site as well as injury severity calculated after diagnostic evaluation or surgical intervention, would be strongly...

  18. Research progress of immune tolerance in the treatment of brain injury

    Directory of Open Access Journals (Sweden)

    Hua YAN

    2014-08-01

    Full Text Available Due to its special anatomical structures and immune pathophysiological mechanisms, brain damage repair is greatly different from damage repair of other systems. Secondary brain injury and inflammation are closely related. As a "double-edged sword", inflammation scavenges hazardous substances on the early stage of injury, but has side effects on normal brain tissue. The use of immunosuppressive therapy or hypothermia can inhibit immune injury, but the presence of reduced immunity may result in infection and tumorigenesis in the long term. Only reducing the autoimmune attack against brain tissue without affecting other immune capacity of the body will be optimized solution, and this paper will make a review on the research of immune tolerance in the treatment of brain injury with optimized program. doi: 10.3969/j.issn.1672-6731.2014.08.017

  19. A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC).

    Science.gov (United States)

    Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

    2015-01-01

    Injuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

  20. Liver Transplantation in the Mouse: Insights Into Liver Immunobiology, Tissue Injury and Allograft Tolerance

    Science.gov (United States)

    Yokota, Shinichiro; Yoshida, Osamu; Ono, Yoshihiro; Geller, David A.; Thomson, Angus W.

    2016-01-01

    The surgically-demanding mouse orthotopic liver transplant model was first described in 1991. It has proved a powerful research tool for investigation of liver biology, tissue injury, the regulation of alloimmunity and tolerance induction and the pathogenesis of specific liver diseases. Liver transplantation in mice has unique advantages over transplantation of the liver in larger species, such as the rat or pig, since the mouse genome is well-characterized and there is much greater availability of both genetically-modified animals and research reagents. Liver transplant experiments using various transgenic or gene knockout mice has provided valuable mechanistic insights into the immuno- and pathobiology of the liver and the regulation of graft rejection and tolerance over the past 25 years. The molecular pathways identified in regulation of tissue injury and promotion of liver transplant tolerance provide new potential targets for therapeutic intervention to control adverse inflammatory responses/ immune-mediated events in the hepatic environment and systemically. Conclusion: Orthotopic liver transplantation in the mouse is a valuable model for gaining improved insights into liver biology, immunopathology and allograft tolerance that may result in therapeutic innovation in liver and other diseases. PMID:26709949

  1. Return to play criteria after hamstring muscle injury in professional football: a Delphi consensus study.

    Science.gov (United States)

    Zambaldi, Mattia; Beasley, Ian; Rushton, Alison

    2017-08-01

    Hamstring muscle injury (HMI) is the most common injury in professional football and has a high re-injury rate. Despite this, there are no validated criteria to support return to play (RTP) decisions. To use the Delphi method to reach expert consensus on RTP criteria after HMI in professional football. All professional football clubs in England (n=92) were invited to participate in a 3-round Delphi study. Round 1 requested a list of criteria used for RTP decisions after HMI. Responses were independently collated by 2 researchers under univocal definitions of RTP criteria. In round 2 participants rated their agreement for each RTP criterion on a 1-5 Likert Scale. In round 3 participants re-rated the criteria that had reached consensus in round 2. Descriptive statistics and Kendall's coefficient of concordance enabled interpretation of consensus. Participation rate was limited at 21.7% (n=20), while retention rate was high throughout the 3 rounds (90.0%, 85.0%, 90.0%). Round 1 identified 108 entries with varying definitions that were collated into a list of 14 RTP criteria. Rounds 2 and 3 identified 13 and 12 criteria reaching consensus, respectively. Five domains of RTP assessment were identified: functional performance, strength, flexibility, pain and player's confidence. The highest-rated criteria were in the functional performance domain, with particular importance given to sprint ability. This study defined a list of consensually agreed RTP criteria for HMI in professional football. Further work is now required to determine the validity of the identified criteria. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. A conceptual framework for a sports knee injury performance profile (SKIPP and return to activity criteria (RTAC

    Directory of Open Access Journals (Sweden)

    David Logerstedt

    2015-10-01

    Full Text Available ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and safe to return to sport. A system centered on specific indicators that can be used to develop a comprehensive profile to monitor rehabilitation progression and to establish return to activity criteria is recommended to clear athletes to begin a progressive and systematic approach to activities and sports. Integration of a sports knee injury performance profile with return to activity criteria can guide clinicians in facilitating an athlete's safe return to sport, prevention of subsequent injury, and life-long knee joint health.

  3. A Multifactorial, Criteria-based Progressive Algorithm for Hamstring Injury Treatment.

    Science.gov (United States)

    Mendiguchia, Jurdan; Martinez-Ruiz, Enrique; Edouard, Pascal; Morin, Jean-Benoît; Martinez-Martinez, Francisco; Idoate, Fernando; Mendez-Villanueva, Alberto

    2017-07-01

    Given the prevalence of hamstring injuries in football, a rehabilitation program that effectively promotes muscle tissue repair and functional recovery is paramount to minimize reinjury risk and optimize player performance and availability. This study aimed to assess the concurrent effectiveness of administering an individualized and multifactorial criteria-based algorithm (rehabilitation algorithm [RA]) on hamstring injury rehabilitation in comparison with using a general rehabilitation protocol (RP). Implementing a double-blind randomized controlled trial approach, two equal groups of 24 football players (48 total) completed either an RA group or a validated RP group 5 d after an acute hamstring injury. Within 6 months after return to sport, six hamstring reinjuries occurred in RP versus one injury in RA (relative risk = 6, 90% confidence interval = 1-35; clinical inference: very likely beneficial effect). The average duration of return to sport was possibly quicker (effect size = 0.34 ± 0.42) in RP (23.2 ± 11.7 d) compared with RA (25.5 ± 7.8 d) (-13.8%, 90% confidence interval = -34.0% to 3.4%; clinical inference: possibly small effect). At the time to return to sport, RA players showed substantially better 10-m time, maximal sprinting speed, and greater mechanical variables related to speed (i.e., maximum theoretical speed and maximal horizontal power) than the RP. Although return to sport was slower, male football players who underwent an individualized, multifactorial, criteria-based algorithm with a performance- and primary risk factor-oriented training program from the early stages of the process markedly decreased the risk of reinjury compared with a general protocol where long-length strength training exercises were prioritized.

  4. Proposed diagnosis criteria for inflicted head injury of children younger than two years of age

    International Nuclear Information System (INIS)

    Fujiwara, Takeo; Okuyama, Makiko; Matsumoto, Tsutomu; Aritaki, Kentarou; Yotani, Nobuyuki; Miyasaka, Mikiko; Nishina, Sachiko

    2008-01-01

    It is difficult to distinguish whether children's head injuries are due to physical abuse or unintentional accidents. However, in the literature, medical findings specific to infant physical abuse were identified. Thus, we developed diagnostic criteria for inflicted head injury (IHI) and assessed its validity. Subjects were collected from all patients who were less than two years old when they visited National Center for Child Health (NCCHD) and Development and underwent head CT scan to assess head trauma from March 1, 2002 to December 31, 2005. Diagnostic criteria for IHI were developed based on definitions of Duhaime et al (1992) and Reece et al (2001). Validity of diagnosis criteria was assessed by comparing the official report to the Child Guidance Center (CGC) from NCCHD to the disposition decided by the CGC. Two-hundred and sixty cases were collected and diagnosed. There was a 86.5% match of the number of cases which were diagnosed as IHI or non-IHI using the IHI diagnostic criteria with official reports to CGC from NCCHD. Among the cases which were diagnosed as presumptive IHI and also reported to the CGC, 20 cases (83.3%) were regarded as abused cases by the CGC. The diagnostic criteria for IHI were valid and would be useful for pediatricians not to condone inflicted head injury. (author)

  5. Applying the Quebec Task Force criteria as a frame of reference for studies of whiplash injuries

    NARCIS (Netherlands)

    Versteegen, GJ; van Es, FD; Kingma, J; Meijler, WJ; ten Duis, HJ

    Research prior to 1995 showed a diversity of either inclusion or exclusion criteria (or both) for diagnosing whiplash injury. As a consequence, the Quebec Task Force (QTF) developed expert-based criteria, which may be considered as a the 'new' gold standard. Here, we examined the inclusion criteria

  6. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients

    Directory of Open Access Journals (Sweden)

    John Tran

    2016-05-01

    Full Text Available Introduction: The National Emergency X-radiography Utilization Study (NEXUS criteria are used extensively in emergency departments to rule out C-spine injuries (CSI in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. Methods: This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. Results: We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101. The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4% cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100] with a negative predictive value of 100 (98.7-100. Conclusion: Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  7. Prospective Validation of Modified NEXUS Cervical Spine Injury Criteria in Low-risk Elderly Fall Patients.

    Science.gov (United States)

    Tran, John; Jeanmonod, Donald; Agresti, Darin; Hamden, Khalief; Jeanmonod, Rebecca K

    2016-05-01

    The National Emergency X-radiography Utilization Study (NEXUS) criteria are used extensively in emergency departments to rule out C-spine injuries (CSI) in the general population. Although the NEXUS validation set included 2,943 elderly patients, multiple case reports and the Canadian C-Spine Rules question the validity of applying NEXUS to geriatric populations. The objective of this study was to validate a modified NEXUS criteria in a low-risk elderly fall population with two changes: a modified definition for distracting injury and the definition of normal mentation. This is a prospective, observational cohort study of geriatric fall patients who presented to a Level I trauma center and were not triaged to the trauma bay. Providers enrolled non-intoxicated patients at baseline mental status with no lateralizing neurologic deficits. They recorded midline neck tenderness, signs of trauma, and presence of other distracting injury. We enrolled 800 patients. One patient fall event was excluded due to duplicate enrollment, and four were lost to follow up, leaving 795 for analysis. Average age was 83.6 (range 65-101). The numbers in parenthesis after the negative predictive value represent confidence interval. There were 11 (1.4%) cervical spine injuries. One hundred seventeen patients had midline tenderness and seven of these had CSI; 366 patients had signs of trauma to the face/neck, and 10 of these patients had CSI. Using signs of trauma to the head/neck as the only distracting injury and baseline mental status as normal alertness, the modified NEXUS criteria was 100% sensitive (CI [67.9-100]) with a negative predictive value of 100 (98.7-100). Our study suggests that a modified NEXUS criteria can be safely applied to low-risk elderly falls.

  8. Return to Play After Hamstring Injuries: A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    N. van der Horst (Nick); S. van de Hoef (Sander); G. Reurink (Gustaaf); B.M.A. Huisstede (Bionka); F.J.G. Backx (Frank)

    2016-01-01

    textabstractBackground: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to

  9. Return to Play After Hamstring Injuries : A Qualitative Systematic Review of Definitions and Criteria

    NARCIS (Netherlands)

    van der Horst, Nick; van de Hoef, Sander; Reurink, Gustaaf; Huisstede, Bionka; Backx, Frank

    BACKGROUND: More than half of the recurrent hamstring injuries occur within the first month after return-to-play (RTP). Although there are numerous studies on RTP, comparisons are hampered by the numerous definitions of RTP used. Moreover, there is no consensus on the criteria used to determine when

  10. A conceptual framework for a sports knee injury performance profile (SKIPP) and return to activity criteria (RTAC)

    OpenAIRE

    Logerstedt, David; Arundale, Amelia; Lynch, Andrew; Snyder-Mackler, Lynn

    2015-01-01

    ABSTRACTInjuries to the knee, including intra-articular fractures, ligamentous ruptures, and meniscal and articular cartilage lesions, are commonplace within sports. Despite advancements in surgical techniques and enhanced rehabilitation, athletes returning to cutting, pivoting, and jumping sports after a knee injury are at greater risk of sustaining a second injury. The clinical utility of objective criteria presents a decision-making challenge to ensure athletes are fully rehabilitated and ...

  11. CTGF/CCN2 Postconditioning Increases Tolerance of Murine Hearts towards Ischemia-Reperfusion Injury.

    Science.gov (United States)

    Kaasbøll, Ole Jørgen; Moe, Ingvild Tronstad; Ahmed, Mohammad Shakil; Stang, Espen; Hagelin, Else Marie Valbjørn; Attramadal, Håvard

    2016-01-01

    Previous studies of ischemia-reperfusion injury (IRI) in hearts from mice with cardiac-restricted overexpression of CCN2 have shown that CCN2 increases tolerance towards IRI. The objectives of this study were to investigate to what extent post-ischemic administration of recombinant human CCN2 (rhCCN2) would limit infarct size and improve functional recovery and what signaling pathways are involved. Isolated mice hearts were perfused ad modum Langendorff, subjected to no-flow, global ischemia, and subsequently, exposed to mammalian cell derived, full-length (38-40kDa) rhCCN2 (250 nM) or vehicle during the first 15 min of a 60 min reperfusion period. Post-ischemic administration of rhCCN2 resulted in attenuation of infarct size from 58 ± 4% to 34 ± 2% (p concentration-dependent increase of cardiac phospho-GSK3β (serine-9) contents. We demonstrate that post-ischemic administration of rhCCN2 increases the tolerance of ex vivo-perfused murine hearts to IRI. Mechanistically, this postconditioning effect of rhCCN2 appeared to be mediated by activation of the reperfusion injury salvage kinase pathway as demonstrated by sensitivity to PI3 kinase inhibition and increased CCN2-induced phosphorylation of GSK3β (Ser-9). Thus, the rationale for testing rhCCN2-mediated post-ischemic conditioning of the heart in more complex models is established.

  12. Return to play after hamstring injuries in football (soccer): a worldwide Delphi procedure regarding definition, medical criteria and decision-making.

    Science.gov (United States)

    van der Horst, Nick; Backx, Fjg; Goedhart, Edwin A; Huisstede, Bionka Ma

    2017-11-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify RTP consultation and responsibilities after hamstring injury. The study used the Delphi procedure. The results of a systematic review were used as a starting point for the Delphi procedure. Fifty-eight experts in the field of hamstring injury management selected by 28 FIFA Medical Centres of Excellence worldwide participated. Each Delphi round consisted of a questionnaire, an analysis and an anonymised feedback report. After four Delphi rounds, with more than 83% response for each round, consensus was achieved that RTP should be defined as 'the moment a player has received criteria-based medical clearance and is mentally ready for full availability for match selection and/or full training'. The experts reached consensus on the following criteria to support the RTP decision: medical staff clearance, absence of pain on palpation, absence of pain during strength and flexibility testing, absence of pain during/after functional testing, similar hamstring flexibility, performance on field testing, and psychological readiness. It was also agreed that RTP decisions should be based on shared decision-making, primarily via consultation with the athlete, sports physician, physiotherapist, fitness trainer and team coach. The consensus regarding aspects of RTP should provide clarity and facilitate the assessment of when RTP is appropriate after hamstring injury, so as to avoid or reduce the risk of injury recurrence because of a premature RTP. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Return to play after hamstring injuries in football (soccer) : A worldwide Delphi procedure regarding definition, medical criteria and decision-making

    NARCIS (Netherlands)

    Van Der Horst, Nick; Backx, F. J.G.; Goedhart, Edwin A.; Huisstede, Bionka M.A.

    2017-01-01

    There are three major questions about return to play (RTP) after hamstring injuries: How should RTP be defined? Which medical criteria should support the RTP decision? And who should make the RTP decision? The study aimed to provide a clear RTP definition and medical criteria for RTP and to clarify

  14. 29 CFR 1904.4 - Recording criteria.

    Science.gov (United States)

    2010-07-01

    ... criteria. (Needlestick and sharps injury cases, tuberculosis cases, hearing loss cases, medical removal... Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR RECORDING AND REPORTING OCCUPATIONAL INJURIES AND ILLNESSES Recordkeeping Forms and Recording Criteria § 1904.4...

  15. Thresholds and Tolerance of Physical Pain Among Young Adults Who Self-Injure

    Directory of Open Access Journals (Sweden)

    Katrina McCoy

    2010-01-01

    Full Text Available Prevalence rates of nonsuicidal self-injury among college students range from 17% to 38%. Research indicates that individuals with borderline personality disorder who self-injure sometimes report an absence of pain during self-injury. Furthermore, self-injury in the absence of pain has been associated with more frequent suicide attempts. The present study examined pain thresholds and tolerance among 44 college students (11 who engaged in self-injury and 33 who did not. Pain thresholds and tolerance were measured using an algometer pressure device that was used to produce pain in previous laboratory research. Participants who engaged in self-injury had a higher pain tolerance than those who did not. In addition, participants who engaged in self-injury rated the pain as less intense than participants who did not. ANCOVAs revealed that depression was associated with pain rating and pain tolerance.

  16. Thoracic injury rule out criteria and NEXUS chest in predicting the risk of traumatic intra-thoracic injuries: A diagnostic accuracy study.

    Science.gov (United States)

    Safari, Saeed; Radfar, Fatemeh; Baratloo, Alireza

    2018-05-01

    This study aimed to compare the diagnostic accuracy of NEXUS chest and Thoracic Injury Rule out criteria (TIRC) models in predicting the risk of intra-thoracic injuries following blunt multiple trauma. In this diagnostic accuracy study, using the 2 mentioned models, blunt multiple trauma patients over the age of 15 years presenting to emergency department were screened regarding the presence of intra-thoracic injuries that are detectable via chest x-ray and screening performance characteristics of the models were compared. In this study, 3118 patients with the mean (SD) age of 37.4 (16.9) years were studied (57.4% male). Based on TIRC and NEXUS chest, respectively, 1340 (43%) and 1417 (45.4%) patients were deemed in need of radiography performance. Sensitivity, specificity, and positive and negative predictive values of TIRC were 98.95%, 62.70%, 21.19% and 99.83%. These values were 98.61%, 59.94%, 19.97% and 99.76%, for NEXUS chest, respectively. Accuracy of TIRC and NEXUS chest models were 66.04 (95% CI: 64.34-67.70) and 63.50 (95% CI: 61.78-65.19), respectively. TIRC and NEXUS chest models have proper and similar sensitivity in prediction of blunt traumatic intra-thoracic injuries that are detectable via chest x-ray. However, TIRC had a significantly higher specificity in this regard. Copyright © 2018 Elsevier Ltd. All rights reserved.

  17. The state of head injury biomechanics: past, present, and future part 2: physical experimentation.

    Science.gov (United States)

    Goldsmith, Werner; Monson, Kenneth L

    2005-01-01

    This presentation is the continuation of the article published in Critical Reviews of Biomedical Engineering, 29(5-6), 2001. That issue contained topics dealing with components and geometry of the human head, classification of head injuries, some early experimental studies, and tolerance considerations. It then dealt with head motion and load characterization, investigations during the period from 1939 to 1966, injury causation and early modeling efforts, the 1966 Head Injury Conference and its sequels, mechanical properties of solid tissues, fluid characterization, and early investigation of the mechanical properties of cranial materials. It continued with a description of the systematic investigations of solid cranial components and structural properties since 1966, fetal cranial properties, analytical head modeling, and numerical solutions of head injury. The paper concluded with experimental dynamic loading of human living and cadaver heads, dynamic loading of surrogate heads, and head injury mechanics. This portion of the paper describes physical head injury experimentation involving animals, primarily primates, human cadavers, volunteers, and inanimate physical models. In order to address the entire domain of head injury biomechanics in the two-part survey, it was intended that this information be supplemented by discussions of head injury tolerance and criteria, automotive and sports safety considerations, and the design of protective equipment, but Professor Goldsmith passed away before these sections could be completed. It is nevertheless anticipated that this attenuated installment will provide, in conjunction with the first part of the survey, a valuable resource for students and practitioners of head injury biomechanics.

  18. CTGF/CCN2 Postconditioning Increases Tolerance of Murine Hearts towards Ischemia-Reperfusion Injury.

    Directory of Open Access Journals (Sweden)

    Ole Jørgen Kaasbøll

    Full Text Available Previous studies of ischemia-reperfusion injury (IRI in hearts from mice with cardiac-restricted overexpression of CCN2 have shown that CCN2 increases tolerance towards IRI. The objectives of this study were to investigate to what extent post-ischemic administration of recombinant human CCN2 (rhCCN2 would limit infarct size and improve functional recovery and what signaling pathways are involved.Isolated mice hearts were perfused ad modum Langendorff, subjected to no-flow, global ischemia, and subsequently, exposed to mammalian cell derived, full-length (38-40kDa rhCCN2 (250 nM or vehicle during the first 15 min of a 60 min reperfusion period.Post-ischemic administration of rhCCN2 resulted in attenuation of infarct size from 58 ± 4% to 34 ± 2% (p < 0.001 which was abrogated by concomitant administration of the PI3 kinase inhibitor LY294002 (45 ± 3% vs. 50 ± 3%, ns. In congruence with reduction of infarct size rhCCN2 also improved recovery of left ventricular developed pressure (p < 0.05. Western blot analyses of extracts of ex vivo-perfused murine hearts also revealed that rhCCN2 evoked concentration-dependent increase of cardiac phospho-GSK3β (serine-9 contents.We demonstrate that post-ischemic administration of rhCCN2 increases the tolerance of ex vivo-perfused murine hearts to IRI. Mechanistically, this postconditioning effect of rhCCN2 appeared to be mediated by activation of the reperfusion injury salvage kinase pathway as demonstrated by sensitivity to PI3 kinase inhibition and increased CCN2-induced phosphorylation of GSK3β (Ser-9. Thus, the rationale for testing rhCCN2-mediated post-ischemic conditioning of the heart in more complex models is established.

  19. Public tolerance to defoliation and flower distortion in a public horticulture garden.

    Science.gov (United States)

    Sadof, Clifford S; Sclar, D Casey

    2002-04-01

    Surveys of visitor and grower perception of live potted plant quality were conducted in various locations in a large public display garden. Canna lily, Canna x generalis L.H.Bailey, was used to examine effects of defoliation by Japanese beetle, Popillia japonica Newman, on public perception. Chrysanthemums, Chrysanthemum x morifolium Ramat., were used to identify visitor and grower tolerance to flower distortion caused by western flower thrips, Frankliniella occidentalis (Pergande), on single and multiple flowered plants. On average, the maximum amount of defoliation or flower distortion tolerated by any respondent was low (< or = 10% for canna and < or = 25% for chrysanthemum). The level of acceptable injury was influenced by factors intrinsic to both the respondents and the plants themselves. Tolerance to injury was negatively associated with the risk aversion of the respondents. Visitors were less tolerant of injury on plants they considered for purchase than those that they would view at the garden. Similarly, grower tolerance was lower than that of visitors because producing substandard plants could put their professional reputation at risk. Factors that distracted visitor attention (e.g., presence of flowers and higher levels of background injury) increased their tolerance to plant injury. Visitors tolerated greater levels of flower distortion on multiple flowering chrysanthemum than on those with single flowers. We suggest that tolerance to insect pests can be increased by designing plantings that distract viewers from injured plant parts.

  20. [Definition of hospital discharge, serious injury and death from traffic injuries].

    Science.gov (United States)

    Pérez, Katherine; Seguí-Gómez, María; Arrufat, Vita; Barberia, Eneko; Cabeza, Elena; Cirera, Eva; Gil, Mercedes; Martín, Carlos; Novoa, Ana M; Olabarría, Marta; Lardelli, Pablo; Suelves, Josep Maria; Santamariña-Rubio, Elena

    2014-01-01

    Road traffic injury surveillance involves methodological difficulties due, among other reasons, to the lack of consensus criteria for case definition. Police records have usually been the main source of information for monitoring traffic injuries, while health system data has hardly been used. Police records usually include comprehensive information on the characteristics of the crash, but often underreport injury cases and do not collect reliable information on the severity of injuries. However, statistics on severe traffic injuries have been based almost exclusively on police data. The aim of this paper is to propose criteria based on medical records to define: a) "Hospital discharge for traffic injuries", b) "Person with severe traffic injury", and c) "Death from traffic injuries" in order to homogenize the use of these sources. Copyright © 2014. Published by Elsevier Espana.

  1. Padova Charter on personal injury and damage under civil-tort law : Medico-legal guidelines on methods of ascertainment and criteria of evaluation.

    Science.gov (United States)

    Ferrara, Santo Davide; Baccino, Eric; Boscolo-Berto, Rafael; Comandè, Giovanni; Domenici, Ranieri; Hernandez-Cueto, Claudio; Gulmen, Mete Korkut; Mendelson, George; Montisci, Massimo; Norelli, Gian Aristide; Pinchi, Vilma; Ranavaya, Mohammed; Shokry, Dina A; Sterzik, Vera; Vermylen, Yvo; Vieira, Duarte Nuno; Viel, Guido; Zoja, Riccardo

    2016-01-01

    Compensation for personal damage, defined as any pecuniary or non-pecuniary loss causally related to a personal injury under civil-tort law, is strictly based on the local jurisdiction and therefore varies significantly across the world. This manuscript presents the first "International Guidelines on Medico-Legal Methods of Ascertainment and Criteria of Evaluation of Personal Injury and Damage under Civil-Tort Law". This consensus document, which includes a step-by-step illustrated explanation of flow charts articulated in eight sequential steps and a comprehensive description of the ascertainment methodology and the criteria of evaluation, has been developed by an International Working Group composed of juridical and medico-legal experts and adopted as Guidelines by the International Academy of Legal Medicine (IALM).

  2. Development of a more fish-tolerant turbine runner, advanced hydropower turbine project

    International Nuclear Information System (INIS)

    Cook, T.C.; Hecker, G.E.

    1997-02-01

    Alden Research Laboratory, Inc. (ARL) and Northern Research and Engineering Corporation (NREC) conducted a research program to develop a turbine runner which will minimize fish injury and mortality at hydroelectric projects. ARL?NREC have developed a runner shape which minimizes the number of blade leading edges, reduces the pressure versus time and the velocity versus distance gradients within the runner, minimizes or eliminates the clearance between the runner and runner housing, and maximizes the size of the flow passages, all with minimal penalty on turbine efficiency. An existing pump impeller provided the starting point for developing the fish tolerant turbine runner. The Hidrostal pump is a single bladed combined screw/centrifugal pump which has been proven to transport fish with minimal injury. The focus of the ARL/NREC research project was to develop a new runner geometry which is effective in downstream fish passage and hydroelectric power generation. A flow of 1,000 cfs and a head in the range of 75 ft to 100 ft were selected for conceptual design of the new runner. Conceptual design of the new runner began with a re-evaluation of studies which have been previously conducted to identify probable sources of injury to fish passing through hydraulic turbines. Criteria relative to hydraulic characteristics which are favorable for fish passage were prepared based on a reassessment of the available information. Important criteria used to develop the new runner design included low pressure change rates, minimum absolute pressures, and minimum shear. Other criteria which are reflected in the runner design are a minimum number of blades (only two), minimum total length of leading edges, and large flow passages. 86 figs., 5 tabs

  3. SU-E-T-179: Clinical Impact of IMRT Failure Modes at Or Near TG-142 Tolerance Criteria Levels

    Energy Technology Data Exchange (ETDEWEB)

    Faught, J Tonigan; Balter, P; Johnson, J; Kry, S; Court, L; Stingo, F; Followill, D [UT MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: Quantitatively assess the clinical impact of 11 critical IMRT dose delivery failure modes. Methods: Eleven step-and-shoot IMRT failure modes (FMs) were introduced into twelve Pinnacle v9.8 treatment plans. One standard and one highly modulated plan on the IROC IMRT phantom and ten previous H&N patient treatment plans were used. FMs included physics components covered by basic QA near tolerance criteria levels (TG-142) such as beam energy, MLC positioning, and MLC modeling. Resultant DVHs were compared to those of failure-free plans and the severity of plan degradation was assessed considering PTV coverage and OAR and normal tissue tolerances and used for FMEA severity scoring. Six of these FMs were physically simulated and phantom irradiations performed. TLD and radiochromic film results are used for comparison to treatment planning studies. Results: Based on treatment planning studies, the largest clinical impact from the phantom cases was induced by 2 mm systematic MLC shift in one bank with the combination of a D95% target under dose near 16% and OAR overdose near 8%. Cord overdoses of 5%–11% occurred with gantry angle, collimator angle, couch angle, MLC leaf end modeling, and MLC transmission and leakage modeling FMs. PTV coverage and/or OAR sparing was compromised in all FMs introduced in phantom plans with the exception of CT number to electron density tables, MU linearity, and MLC tongue-and-groove modeling. Physical measurements did not entirely agree with treatment planning results. For example, symmetry errors resulted in the largest physically measured discrepancies of up to 3% in the PTVs while a maximum of 0.5% deviation was seen in the treatment planning studies. Patient treatment plan study results are under analysis. Conclusion: Even in the simplistic anatomy of the IROC phantom, some basic physics FMs, just outside of TG-142 tolerance criteria, appear to have the potential for large clinical implications.

  4. Re-irradiation tolerance in the rat spinal cord

    International Nuclear Information System (INIS)

    Shun Wong, C.; Poon, J.K.; Hill, R.P.

    1993-01-01

    The influence of the level of initial radiation damage on the long term recovery and re-irradiation tolerance in the rat spinal cord was investigated. Rats were irradiated with 0, 10, 20, 30 and 36 daily fractions of 2.15 Gy initially representing 0, 25, 50, 75 and 90% of cord tolerance. After an interval of 20 weeks, retreatments were given using graded single doses of X-ray. The end-point was paralysis of the forelimbs due to white matter necrosis. Latent times to paralysis were inversely proportional to the level of initial injury and retreatment doses. The retreatment ED 50 s were 19.0, 17.0, 15.7, 14.0 and 11.8 Gy for the control animals and animals irradiated initially with 10. 20, 30 and 36 fractions of 2.15 Gy respectively. Using the extrapolated response dose (ERD) concept, α/β of 3.0 Gy, the retreatment of ED 50 s in % ERD were 81, 70, 58 and 42% after initial doses of 25, 50, 75 and 90% ERD respectively. The level of initial injury appeared to influence the proportion of residual injury. For an initial injury of 25 and 90% of ERD, the respective residual injury was 74 and 65% of the initial damage; for an initial injury of 50 and 75% ERD, the residual injury decreased to 59 and 57% respectively. It is concluded that there was significant long-term recovery in the rat spinal cord, and that the level of initial radiation damage influenced both the treatment tolerance and the time expression of injury. (author). tabs

  5. Radiation injury to the nervous system

    International Nuclear Information System (INIS)

    Gutin, P.H.; Leibel, S.A.; Sneline, G.E.

    1991-01-01

    This book is designed to describe to the radiation biologist, radiation oncologist, neurologist, neurosurgeon, medical oncologist, and neuro-oncologist, the current state of knowledge about the tolerance of the nervous system to various kinds of radiation, the mechanisms of radiation injury, and how nervous system tolerance and injury are related to the more general problem of radiation damage to normal tissue of all types. The information collected here should stimulate interest in and facilitate the growing research effort into radiation injury to the nervous system

  6. Development of statewide geriatric patients trauma triage criteria.

    Science.gov (United States)

    Werman, Howard A; Erskine, Timothy; Caterino, Jeffrey; Riebe, Jane F; Valasek, Tricia

    2011-06-01

    The geriatric population is unique in the type of traumatic injuries sustained, physiological responses to those injuries, and an overall higher mortality when compared to younger adults. No published, evidence-based, geriatric-specific field destination criteria exist as part of a statewide trauma system. The Trauma Committee of the Ohio Emergency Medical Services (EMS) Board sought to develop specific criteria for geriatric trauma victims. A literature search was conducted for all relevant literature to determine potential, geriatric-specific, field-destination criteria. Data from the Ohio Trauma Registry were used to compare elderly patients, defined as age >70 years, to all patients between the ages of 16 to 69 years with regards to mortality risk in the following areas: (1) Glasgow Coma Scale (GCS) score; (2) systolic blood pressure (SBP); (3) falls associated with head, chest, abdominal or spinal injury; (4) mechanism of injury; (5) involvement of more than one body system as defined in the Barell matrix; and (6) co-morbidities and motor vehicle collision with one or more long bone fracture. For GCS score and SBP, those cut-off points with equal or greater risk of mortality as compared to current values were chosen as proposed triage criteria. For other measures, any criterion demonstrating a statistically significant increase in mortality risk was included in the proposed criteria. The following criteria were identified as geriatric-specific criteria: (1) GCS score trauma; (2) SBP trauma. In addition, these data suggested that elderly patients with specific co-morbidities be given strong consideration for evaluation in a trauma center. The state of Ohio is the first state to develop evidence-based geriatric-specific field-destination criteria using data from its state-mandated trauma registry. Further analysis of these criteria will help determine their effects on over-triage and under-triage of geriatric victims of traumatic injuries and the impact on the

  7. Tolerance-like innate immunity and spleen injury: a novel discovery via the weekly administrations and consecutive injections of PEGylated emulsions

    Directory of Open Access Journals (Sweden)

    Wang L

    2014-08-01

    Full Text Available Long Wang,* Chunling Wang,* Jiao Jiao, Yuqing Su, Xiaobo Cheng, Zhenjun Huang, Xinrong Liu, Yihui DengCollege of Pharmacy, Shenyang Pharmaceutical University, Shenyang, People’s Republic of China*These authors contributed equally to this workAbstract: There has been an increasing interest in the study of the innate immune system in recent years. However, few studies have focused on whether innate immunity can acquire tolerance. Therefore, in this study, we investigated tolerance in the innate immune system via the consecutive weekly and daily injections of emulsions modified with polyethylene glycol (PEG, referred to as PEGylated emulsions (PE. The effects of these injections of PE on pharmacokinetics and biodistribution were studied in normal and macrophage-depleted rats. Additionally, we evaluated the antigenic specificity of immunologic tolerance. Immunologic tolerance against PE developed after 21 days of consecutive daily injections or the fourth week of PE administration. Compared with a single administration, it was observed that the tolerant rats had a lower rate of PE clearance from the blood, which was independent of the stress response. In addition, weekly PE injections caused injury to the spleen. Furthermore, the rats tolerant to PEs with the methoxy group (-OCH3 of PEG, failed to respond to the PEs with a different terminal group of PEG or to non-PEG emulsions. Innate immunity tolerance was induced by PE, regardless of the mode of administration. Further study of this mechanism suggested that monocytes play an essential role in the suppression of innate immunity. These findings provide novel insights into the understanding of the innate immune system.Keywords: immunologic tolerance, innate immune system, pharmacokinetics, biodistribution, antigenic specificity

  8. Effective selection criteria for screening drought tolerant recombinant inbred lines of sunflower

    Directory of Open Access Journals (Sweden)

    Abdi Nishtman

    2013-01-01

    Full Text Available In this study, seventy two sunflower recombinant inbred lines were tested for their yielding ability under both water-stressed and well-watered states. The inbred lines were evaluated in a rectangular 8´9 lattice design with two replications in both well-watered and water-stressed conditions, separately. Eight drought tolerance indices including stability tolerance index (STI, mean productivity (MP, geometric mean productivity (GMP, harmonic mean (HM, stress susceptibility index (SSI, tolerance index (TOL, yield index (YI and yield stability index (YSI were calculated based on grain yield for every genotype. Results showed the highest values of mean productivity (MP index, geometric mean productivity (GMP, yield index (YI, harmonic mean (HM and stress tolerance index (STI indices for ‘C134a’ inbred line and least values of stress susceptibility index (SSI and tolerance (TOL for C61 inbred line. According to correlation of indices with yield performance under both drought stress and non-stress states and principle component analysis, indices including HM, MP, GMP and STI could properly distinguish drought tolerant sunflower inbred lines with high yield performance under both states. Cluster analysis of inbred lines using Ys, Yp and eight indices, categorized them into four groups including 19, 6, 26 and 19 inbred lines.

  9. Linking fish tolerance to water quality criteria for the assessment of environmental flows: A practical method for streamflow regulation and pollution control.

    Science.gov (United States)

    Zhao, Changsen; Yang, Shengtian; Liu, Junguo; Liu, Changming; Hao, Fanghua; Wang, Zhonggen; Zhang, Huitong; Song, Jinxi; Mitrovic, Simon M; Lim, Richard P

    2018-05-15

    The survival of aquatic biota in stream ecosystems depends on both water quantity and quality, and is particularly susceptible to degraded water quality in regulated rivers. Maintenance of environmental flows (e-flows) for aquatic biota with optimum water quantity and quality is essential for sustainable ecosystem services, especially in developing regions with insufficient stream monitoring of hydrology, water quality and aquatic biota. Few e-flow methods are available that closely link aquatic biota tolerances to pollutant concentrations in a simple and practical manner. In this paper a new method was proposed to assess e-flows that aimed to satisfy the requirements of aquatic biota for both the quantity and quality of the streamflow by linking fish tolerances to water quality criteria, or the allowable concentration of pollutants. For better operation of water projects and control of pollutants discharged into streams, this paper presented two coefficients for streamflow adjustment and pollutant control. Assessment of e-flows in the Wei River, the largest tributary of the Yellow River, shows that streamflow in dry seasons failed to meet e-flow requirements. Pollutant influx exerted a large pressure on the aquatic ecosystem, with pollutant concentrations much higher than that of the fish tolerance thresholds. We found that both flow velocity and water temperature exerted great influences on the pollutant degradation rate. Flow velocity had a much greater influence on pollutant degradation than did the standard deviation of flow velocity. This study provides new methods to closely link the tolerance of aquatic biota to water quality criteria for e-flow assessment. The recommended coefficients for streamflow adjustment and pollutant control, to dynamically regulate streamflow and control pollutant discharge, are helpful for river management and ecosystems rehabilitation. The relatively low data requirement also makes the method easy to use efficiently in developing

  10. Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

    Directory of Open Access Journals (Sweden)

    José Raimundo Araújo de Azevedo

    2010-06-01

    Full Text Available OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52% of the patients and was associated with a higher mortality (39.4% compared with those who did not have AKI (8.2% (p60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.

  11. Criteria for Performing Cranial Computed Tomography for Chinese Patients With Mild Traumatic Brain Injury: Canadian Computed Tomography Head Rule or New Orleans Criteria?

    Science.gov (United States)

    Yang, Xiao-Feng; Meng, Yuan-Yuan; Wen, Liang; Wang, Hao

    2017-09-01

    Computed tomography (CT) provides the primary diagnostic evidence for traumatic brain injury (TBI), but few positive traumatic findings are discovered in patients with mild TBI. In China, there are no existing criteria for selecting patients with mild TBI to undergo CT, and almost all of these patients undergo cranial CT in the emergency department. This retrospective study was performed to evaluate the necessity of cranial CT among patients with mild TBI, as well as the feasibility of 2 popular criteria (Canadian CT head rule [CCHR] and New Orleans Criteria [NOC]) in China. Patients with mild TBI who underwent cranial CT within 24 hours of the trauma were included in our institute. Two neurosurgeons reviewed the CT images independently to identify positive CT findings. The sensitivity and specificity of CCHR and NOC for positive CT findings related to TBI were analyzed. Finally, this study included 625 patients. Positive CT findings related to TBI were discovered in 13.12% (82/625) of these patients on cranial CT, and 6.88% (43/625) of them were admitted to the hospital for further management. Ultimately, 11 patients (1.76%, 11/625) underwent neurosurgery. In this study, the sensitivities of both the CCHR and NOC were 100%, but the specificity of CCHR was 43.36% and that of NOC was 33.12%. Based on our study, both CCHR and NOC have high sensitivity for the detection of positive CT findings related to head trauma in patients with mild TBI.

  12. Human Injury Criteria for Underwater Blasts

    Science.gov (United States)

    2014-09-08

    further underscored the need for this new guideline based on injury data. Conference Name: Personal Armour Systems Symposium Conference Date...29.  Cole, R., Underwater Explosion. (Dover Publications, Inc ., New York, N.Y., 1948) 30.  Nakahara, M., Nagayama, K, Mori, Y, Japanese Journal...Abstract of the Undersea and Hyperbaric Medical Society, Inc . Annual Scientific Meeting, (1976).

  13. LAPAROSCOPIC MANAGEMENT OF RETROPERITONEAL INJURIES IN PENETRATING ABDOMINAL INJURIES.

    Science.gov (United States)

    Mosai, F

    2017-09-01

    Laparoscopy in penetrating abdominal injuries is now accepted and practiced in many modern trauma centres. However its role in evaluating and managing retroperitoneal injuries is not yet well established. The aim of this study was to document our experience in using laparoscopy in a setting of penetrating abdominal injuries with suspected retroperitoneal injury in haemodynamically stable patients. A retrospective descriptive study of prospectively collected data from a trauma unit at Dr George Mukhari Academic Hospital (DGMAH) was done. All haemodynamically stable patients with penetrating abdominal injury who were offered laparoscopy from January 2012 to December 2015 were reviewed and those who met the inclusion criteria were analysed. A total of 284 patients with penetrating abdominal injuries were reviewed and 56 met the inclusion criteria and were analysed. The median age was 30.8 years (15-60 years) and males constituted 87.5% of the study population. The most common mechanism of injury was penetrating stab wounds (62.5%). Forty-five patients (80.3%) were managed laparoscopically, of these n=16 (28.5%) had retroperitoneal injuries that required surgical intervention. The most commonly injured organ was the colon (19.6%). The conversion rate was 19.6% with most common indication for conversion been active bleeding (14%). The complication rate was 7.14% (N=4) and were all Clavien-Dindo grade 3. There were no recorded missed injuries and no mortality. The positive outcomes documented in this study with no missed injuries and absence of mortality suggests that laparoscopy is a feasible option in managing stable patients with suspected retroperitoneal injuries.

  14. Ischemic Tolerance of the Brain and Spinal Cord: A Review.

    Science.gov (United States)

    Yunoki, Masatoshi; Kanda, Takahiro; Suzuki, Kenta; Uneda, Atsuhito; Hirashita, Koji; Yoshino, Kimihiro

    2017-11-15

    Ischemic tolerance is an endogenous neuroprotective phenomenon induced by sublethal ischemia. Ischemic preconditioning (IPC), the first discovered form of ischemic tolerance, is widely seen in many species and in various organs including the brain and the spinal cord. Ischemic tolerance of the spinal cord is less familiar among neurosurgeons, although it has been reported from the viewpoint of preventing ischemic spinal cord injury during aortic surgery. It is important for neurosurgeons to have opportunities to see patients with spinal cord ischemia, and to understand ischemic tolerance of the spinal cord as well as the brain. IPC has a strong neuroprotective effect in animal models of ischemia; however, clinical application of IPC for ischemic brain and spinal diseases is difficult because they cannot be predicted. In addition, one drawback of preconditioning stimuli is that they are also capable of producing injury with only minor changes to their intensity or duration. Numerous methods to induce ischemic tolerance have been discovered that vary in their timing and the site at which short-term ischemia occurs. These methods include ischemic postconditioning (IPoC), remote ischemic preconditioning (RIPC), remote ischemic perconditioning (RIPerC) and remote ischemic postconditioning (RIPoC), which has had a great impact on clinical approaches to treatment of ischemic brain and spinal cord injury. Especially RIPerC and RIPoC to induce spinal cord tolerance are considered clinically useful, however the evidence supporting these methods is currently insufficient; further experimental or clinical research in this area is thus necessary.

  15. Establishing soil loss tolerance: an overview

    Directory of Open Access Journals (Sweden)

    Costanza Di Stefano

    2016-09-01

    Full Text Available Soil loss tolerance is a criterion for establishing if a soil is potentially subjected to erosion risk, productivity loss and if a river presents downstream over-sedimentation or other off-site effects are present at basin scale. At first this paper reviews the concept of tolerable soil loss and summarises the available definitions and the knowledge on the recommended values and evaluating criteria. Then a threshold soil loss value, at the annual temporal scale, established for limiting riling was used for defining the classical soil loss tolerance. Finally, some research needs on tolerable soil loss are listed.

  16. Stress tolerance and stress-induced injury in crop plants measured by chlorophyll fluorescence in vivo: chilling, freezing, ice cover, heat, and high light.

    Science.gov (United States)

    Smillie, R M; Hetherington, S E

    1983-08-01

    The proposition is examined that measurements of chlorophyll fluorescence in vivo can be used to monitor cellular injury caused by environmental stresses rapidly and nondestructively and to determine the relative stress tolerances of different species. Stress responses of leaf tissue were measured by F(R), the maximal rate of the induced rise in chlorophyll fluorescence. The time taken for F(R) to decrease by 50% in leaves at 0 degrees C was used as a measure of chilling tolerance. This value was 4.3 hours for chilling-sensitive cucumber. In contrast, F(R) decreased very slowly in cucumber leaves at 10 degrees C or in chilling-tolerant cabbage leaves at 0 degrees C. Long-term changes in F(R) of barley, wheat, and rye leaves kept at 0 degrees C were different in frost-hardened and unhardened material and in the latter appeared to be correlated to plant frost tolerance. To simulate damage caused by a thick ice cover, wheat leaves were placed at 0 degrees C under N(2). Kharkov wheat, a variety tolerant of ice encapsulation, showed a slower decrease in F(R) than Gatcher, a spring wheat. Relative heat tolerance was also indicated by the decrease in F(R) in heated leaves while changes in vivo resulting from photoinhibition, ultraviolet radiation, and photobleaching can also be measured.

  17. Geriatric-specific triage criteria are more sensitive than standard adult criteria in identifying need for trauma center care in injured older adults.

    Science.gov (United States)

    Ichwan, Brian; Darbha, Subrahmanyam; Shah, Manish N; Thompson, Laura; Evans, David C; Boulger, Creagh T; Caterino, Jeffrey M

    2015-01-01

    We evaluate the sensitivity of Ohio's 2009 emergency medical services (EMS) geriatric trauma triage criteria compared with the previous adult triage criteria in identifying need for trauma center care among older adults. We studied a retrospective cohort of injured patients aged 16 years or older in the 2006 to 2011 Ohio Trauma Registry. Patients aged 70 years or older were considered geriatric. We identified whether each patient met the geriatric and the adult triage criteria. The outcome measure was need for trauma center care, defined by surrogate markers: Injury Severity Score greater than 15, operating room in fewer than 48 hours, any ICU stay, and inhospital mortality. We calculated sensitivity and specificity of both triage criteria for both age groups. We included 101,577 patients; 33,379 (33%) were geriatric. Overall, 57% of patients met adult criteria and 68% met geriatric criteria. Using Injury Severity Score, for older adults geriatric criteria were more sensitive for need for trauma center care (93%; 95% confidence interval [CI] 92% to 93%) than adult criteria (61%; 95% CI 60% to 62%). Geriatric criteria decreased specificity in older adults from 61% (95% CI 61% to 62%) to 49% (95% CI 48% to 49%). Geriatric criteria in older adults (93% sensitivity, 49% specificity) performed similarly to the adult criteria in younger adults (sensitivity 87% and specificity 44%). Similar patterns were observed for other outcomes. Standard adult EMS triage guidelines provide poor sensitivity in older adults. Ohio's geriatric trauma triage guidelines significantly improve sensitivity in identifying Injury Severity Score and other surrogate markers of the need for trauma center care, with modest decreases in specificity for older adults. Copyright © 2014 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

  18. Prevalence and Diagnostic Performance of Isolated and Combined NEXUS Chest CT Decision Criteria.

    Science.gov (United States)

    Raja, Ali S; Mower, William R; Nishijima, Daniel K; Hendey, Gregory W; Baumann, Brigitte M; Medak, Anthony J; Rodriguez, Robert M

    2016-08-01

    The use of chest computed tomography (CT) to evaluate emergency department patients with adult blunt trauma is rising. The NEXUS Chest CT decision instruments are highly sensitive identifiers of adult blunt trauma patients with thoracic injuries. However, many patients without injury exhibit one of more of the criteria so cannot be classified "low risk." We sought to determine screening performance of both individual and combined NEXUS Chest CT criteria as predictors of thoracic injury to inform chest CT imaging decisions in "non-low-risk" patients. This was a secondary analysis of data on patients in the derivation and validation cohorts of the prospective, observational NEXUS Chest CT study, performed September 2011 to May 2014 in 11 Level I trauma centers. Institutional review board approval was obtained at all study sites. Adult blunt trauma patients receiving chest CT were included. The primary outcome was injury and major clinical injury prevalence and screening performance in patients with combinations of one, two, or three of seven individual NEXUS Chest CT criteria. Across the 11 study sites, rates of chest CT performance ranged from 15.5% to 77.2% (median = 43.6%). We found injuries in 1,493/5,169 patients (28.9%) who had chest CT; 269 patients (5.2%) had major clinical injury (e.g., pneumothorax requiring chest tube). With sensitivity of 73.7 (95% confidence interval [CI] = 68.1 to 78.6) and specificity of 83.9 (95% CI = 83.6 to 84.2) for major clinical injury, abnormal chest-x-ray (CXR) was the single most important screening criterion. When patients had only abnormal CXR, injury and major clinical injury prevalences were 60.7% (95% CI = 52.2% to 68.6%) and 12.9% (95% CI = 8.3% to 19.4%), respectively. Injury and major clinical injury prevalences when any other single criterion alone (other than abnormal CXR) was present were 16.8% (95% CI = 15.2% to 18.6%) and 1.1% (95% CI = 0.1% to 1.8%), respectively. Injury and major clinical injury prevalences

  19. Long term (>1 year) postpartum glucose tolerance status among Indian women with history of Gestational Diabetes Mellitus (GDM) diagnosed by IADPSG criteria.

    Science.gov (United States)

    Goyal, Alpesh; Gupta, Yashdeep; Kalaivani, Mani; Sankar, M Jeeva; Kachhawa, Garima; Bhatla, Neerja; Gupta, Nandita; Tandon, Nikhil

    2018-05-24

    To determine prevalence of long term dysglycemia and its risk factors among women with history of GDM diagnosed using IADPSG criteria at a tertiary care hospital in North India. Women with GDM diagnosed between 2012 and 2016 were invited. Socio-demographic, anthropometric, medical data were collected and 75 gm OGTT with serum insulin estimation, HbA1c and fasting lipid profile were done at the hospital visit. Women (N = 267) were tested at 32.5 (±4.6) years of age and at a median (q 25- q 75 ) of 20 (12-44) months following the index delivery. Dysglycemia was found in 57.7% by ADA criteria [Diabetes in 10.5% and prediabetes in 47.2%]. Risk factors for cardiovascular disease were significantly more prevalent among these women. On multivariable analysis, HOMA-IR correlated positively, while insulinogenic index correlated negatively with postpartum dysglycemia. This is possibly the first long term (>1 year) glucose tolerance outcome study in South Asian women with history of GDM diagnosed by IADPSG criteria, which demonstrates significantly elevated risk of postpartum dysglycemia. While the IADPSG criteria identify women with a lower future conversion to diabetes compared with previous criteria, prediabetes conversion remains high, thereby offering an opportunity to intervene early and prevent progression to future diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Hamstring Muscle Injuries, a Rehabilitation Protocol Purpose.

    Science.gov (United States)

    Valle, Xavier; L Tol, Johannes; Hamilton, Bruce; Rodas, Gil; Malliaras, Peter; Malliaropoulos, Nikos; Rizo, Vicenc; Moreno, Marcel; Jardi, Jaume

    2015-12-01

    Hamstring acute muscle injuries are prevalent in several sports including AFL football (Australian Football League), sprinting and soccer, and are often associated with prolonged time away from sport. In response to this, research into prevention and management of hamstring injury has increased, but epidemiological data shows no decline in injury and re-injury rates, suggesting that rehabilitation programs and return to play (RTP) criteria have to be improved. There continues to be a lack of consensus regarding how to assess performance, recovery and readiness to RTP, following hamstring strain injury. The aim of this paper was to propose rehabilitation protocol for hamstring muscle injuries based on current basic science and research knowledge regarding injury demographics and management options. Criteria-based (subjective and objective) progression through the rehabilitation program will be outlined along with exercises for each phase, from initial injury to RTP.

  1. Selection criteria for drought tolerance at the vegetative phase in ...

    African Journals Online (AJOL)

    Aghomotsegin

    2016-05-18

    May 18, 2016 ... evaluated in a pot experiment conducted in a screen house facility and in the field at the Teaching ... development of drought tolerant maize genotypes by ... good stay green characteristic, and high scores for plant aspect and.

  2. Freezing and low temperature photoinhibition tolerance in cultivated potato and potato hybrids

    Directory of Open Access Journals (Sweden)

    M.M. SEPPÄNEN

    2008-12-01

    Full Text Available Four Solanum tuberosum L. cultivars (Nicola, Pito, Puikula, Timo and somatic hybrids between freezing tolerant S. commersonii and freezing sensitive S. tuberosum were evaluated for their tolerance to freezing and low temperature photoinhibition. Cellular freezing tolerance was studied using ion leakage tests and the sensitivity of the photosynthetic apparatus to freezing and high light intensity stress by measuring changes in chlorophyll fluorescence (FV/FM and oxygen evolution. Exposure to high light intensities after freezing stress increased frost injury significantly in all genotypes studied. Compared with S. tuberosum cultivars, the hybrids were more tolerant both of freezing and intense light stresses. In field experiments the mechanism of frost injury varied according to the severity of night frosts. During night frosts in 1999, the temperature inside the potato canopy was significantly higher than at ground level, and did not fall below the lethal temperature for potato cultivars (from -2.5 to -3.0°C. As a result, frost injury developed slowly, indicating that damage occurred to the photosynthetic apparatus. However, as the temperature at ground level and inside the canopy fell below -4°C, cellular freezing occurred and the canopy was rapidly destroyed. This suggests that in the field visual frost damage can follow from freezing or non-freezing temperatures accompanied with high light intensity. Therefore, in an attempt to improve low temperature tolerance in potato, it is important to increase tolerance to both freezing and chilling stresses.

  3. Proposed Diagnostic Criteria for the DSM-5 of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

    Directory of Open Access Journals (Sweden)

    Tina In-Albon

    2013-01-01

    Full Text Available Nonsuicidal self-injury (NSSI is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls. Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

  4. Coronary heart disease is not significantly linked to acute kidney injury identified using Acute Kidney Injury Group criteria.

    Science.gov (United States)

    Yayan, Josef

    2012-01-01

    Patients with unstable angina or myocardial infarction are at risk of acute kidney injury, which may be aggravated by the iodine-containing contrast agent used during coronary angiography; however, the relationship between these two conditions remains unclear. The current study investigated the relationship between acute kidney injury and coronary heart disease prior to coronary angiography. All patients were evaluated after undergoing coronary angiography in the cardiac catheterization laboratory of the Vinzentius Hospital in Landau, Germany, in 2011. The study group included patients with both acute coronary heart disease and acute kidney injury (as defined according to the classification of the Acute Kidney Injury Group); the control group included patients without acute coronary heart disease. Serum creatinine profiles were evaluated in all patients, as were a variety of demographic and health characteristics. Of the 303 patients examined, 201 (66.34%) had coronary artery disease. Of these, 38 (18.91%) also had both acute kidney injury and acute coronary heart disease prior to and after coronary angiography, and of which in turn 34 (16.91%) had both acute kidney injury and acute coronary heart disease only prior to the coronary angiography. However, the occurrence of acute kidney injury was not significantly related to the presence of coronary heart disease (P = 0.95, Chi-square test). The results of this study indicate that acute kidney injury is not linked to acute coronary heart disease. However, physicians should be aware that many coronary heart patients may develop kidney injury while hospitalized for angiography.

  5. Supraclassical consequence relations: Tolerating rare counterexamples

    CSIR Research Space (South Africa)

    Labuschagne, W

    2013-12-01

    Full Text Available We explore a family of supraclassical consequence relations obtained by varying the criteria according to which counterexamples to classical entailment may be deemed tolerable. This provides a different perspective on the rational consequence...

  6. Establishing soil loss tolerance: an overview

    OpenAIRE

    Costanza Di Stefano; Vito Ferro

    2016-01-01

    Soil loss tolerance is a criterion for establishing if a soil is potentially subjected to erosion risk, productivity loss and if a river presents downstream over-sedimentation or other off-site effects are present at basin scale. At first this paper reviews the concept of tolerable soil loss and summarises the available definitions and the knowledge on the recommended values and evaluating criteria. Then a threshold soil loss value, at the annual temporal scale, established for limiting rilin...

  7. Definition of tolerable soil erosion values

    Directory of Open Access Journals (Sweden)

    G. Sparovek

    1997-09-01

    Full Text Available Although the criteria for defining erosion tolerance are well established, the limits generally used are not consistent with natural, economical and technological conditions. Rates greater than soil formation can be accepted only until a minimum of soil depth is reached, provided that they are not associated with environmental hazard or productivity losses. A sequence of equations is presented to calculate erosion tolerance rates through time. The selection of equation parameters permits the definition of erosion tolerance rates in agreement with environmental, social and technical needs. The soil depth change that is related to irreversible soil degradation can be calculated. The definition of soil erosion tolerance according to these equations can be used as a guideline for sustainable land use planning and is compatible with expert systems.

  8. ATLANTIC-DIP: raised maternal body mass index (BMI) adversely affects maternal and foetal outcomes in glucose tolerant women classified using International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria

    LENUS (Irish Health Repository)

    Dennedy, MC

    2011-09-15

    Background and aims: Raised maternal body mass index (BMI), in association with hyperglycaemia is associated with adverse pregnancy outcome. Whether BMI has an independent effect on adverse pregnancy outcome is not clear. We aimed to investigate the effects of raised maternal BMI on pregnancy outcome in glucose tolerant women, classified using the IADPSG criteria.\\r\

  9. SALINITY TOLERANCE OF SEVERAL RICE GENOTYPES AT SEEDLING STAGE

    Directory of Open Access Journals (Sweden)

    Heni Safitri

    2018-01-01

    Full Text Available Salinity is one of the most serious problems in rice cultivation. Salinity drastically reduced plant growth and yield, especially at seedling stage. Several rice genotypes have been produced, but their tolerance to salinity has not yet been evaluated. The study aimed to evaluate salinity tolerance of rice genotypes at seedling stage. The glasshouse experiment was conducted at Cimanggu Experimental Station, Bogor, from April to May 2013. Thirteen rice genotypes and two check varieties, namely Pokkali (salt tolerant and IR29 (salt sensitive were tested at seedling stage. The experiment was arranged in a randomized complete block design with three replications and two factors, namely the levels of NaCl (0 and 120 mM and 13 genotypes of rice. Rice seedlings were grown in the nutrient culture (hydroponic supplemented with NaCl at different levels. The growth and salinity injury levels of the genotypes were recorded periodically. The results showed that salinity level of 120 mM NaCl reduced seedling growth of all rice genotypes, but the tolerant ones were survived after 14 days or until the sensitive check variety died. Based on the visual injury symptoms on the leaves, five genotypes, i.e. Dendang, Inpara 5, Inpari 29, IR77674-3B-8-2-2-14-4-AJY2, and IR81493-BBB-6-B- 2-1-2 were tolerant to 120 mM salinity level, while Inpara 4 was comparable to salt sensitive IR29. Hence, Inpara 4 could be used as a salinity sensitive genotype for future research of testing tolerant variety. Further evaluation is needed to confirm their salinity tolerance under field conditions. 

  10. Aircraft Crash Survival Design Guide. Volume 2. Aircraft Crash Environment and Human Tolerance

    Science.gov (United States)

    1980-01-01

    a whipping action’of the head, and often, impact of the upper torso on the legs, resulting in chest, head, and neck injuries . Head injuries due to...K., at al., COMPARATIVE TOLERANCE FOR CEREBRAL CONCUSSION BY HEAD IMPACT AND WHIPLASH INJURY IN PRIMATES , 1970 International Automobile Safety...FROM HEAD IMPACT AND WHIPLASH IN PRIMATES , Journal of Biomechanics, Vol. 4, 1971, pp. 13-21. 18. Goldsmith, W., BIOMECHANICS OF HEAD INJURY , In

  11. Evaluation of drought tolerance in different growth stages of maize ...

    African Journals Online (AJOL)

    In order to find the best drought tolerant inbred lines, experiment was performed at the Agricultural College of Islamic Azad University, Shoushtar Branch, Iran during ... Data analysis revealed that the MP, GMP and STI indices were the more accurate criteria for selection of drought tolerant and high yielding inbred lines.

  12. Development of acceptance criteria and damage tolerance analyzes of the ductile iron insert

    International Nuclear Information System (INIS)

    Dillstroem, Peter; Alverlind, Lars; Andersson, Magnus

    2010-01-01

    SKB intends to qualify a test system for detection and sizing of defects deemed to be relevant to the ductile iron insert. In support of this qualification, a damage tolerance analysis indicating the current qualification targets, given assumed damage and failure modes. This report describes the damage tolerance analyzes of different types of defects that are considered relevant of the ductile iron insert. The results are reported separately for each test area (zone) and type of insert (BWRs and PWRs)

  13. Salt tolerance in wheat - an overview. (abstract)

    International Nuclear Information System (INIS)

    Ashraf, M.

    2005-01-01

    Considerable efforts have been made during the past few years to overcome the problem of salinity through the development of salt tolerant lines of important crop species using screening, breeding and molecular biology techniques. In view of considerable importance of spring wheat as a major staple food crop of many countries, plant scientists have directed there attention to identify and develop salt tolerant genotypes that can be of direct use on salt-affected soils. Although considerable progress in understanding individual phenomenon and genes involved in plant response to salinity stress has been made over the past few years, underlying physiological mechanisms producing salt tolerant plants is still unclear. It has been suggested that salt tolerance of plants could be improved by defining genes or characters. Twenty years ago, it was suggested that genes located on the D genome of bread wheat confer salinity tolerance to hexaploid wheat by reducing Na/sup +/ accumulation in the leaf tissue and increasing discrimination in favour of K/sup +/. However, recently, low Na/sup +/ accumulation and high K/sup +/Na/sup +/ discrimination, of similar magnitude to bread wheat, in several selections of durum wheat has been observed, supporting the notion that salt tolerance is controlled by multiple genes, which are distributed throughout the entire set of chromosomes. In addition, various physiological selection criteria such as compatible osmolytes (glycinebetaine, proline, trehalose, mannitol etc.), antioxidants, carbon discrimination, high K/sup +//Na/sup +/ ratio etc. have been discussed. Although tolerance to salinity is known to have a multigenic inheritance, mediated by a large number of genes, knowledge of heritability and the genetic mode of salinity tolerance is still lacking because few studies have yet been conducted in these areas. Indeed, genetic information is lagging behind the physiological information. Modern methods such as recombinant DNA technology

  14. Explanation of diagnostic criteria for radiation-induced nervous system disease

    International Nuclear Information System (INIS)

    Xing Zhiwei; Jiang Enhai

    2012-01-01

    National occupational health standard-Diagnostic Criteria for Radiation-Induced Nervous System Disease has been issued and implemented by the Ministry of health. This standard contained three independent criteria of the brain, spinal cord and peripheral nerve injury. These three kinds of disease often go together in clinic,therefore,the three diagnostic criteria were merged into radioactive nervous system disease diagnostic criteria for entirety and maneuverability of the standard. This standard was formulated based on collection of the clinical practice experience, extensive research of relevant literature and foreign relevant publications. It is mainly applied to diagnosis and treatment of occupational radiation-induced nervous system diseases, and to nervous system diseases caused by medical radiation exposure as well. In order to properly implement this standard, also to correctly deal with radioactive nervous system injury, the main contents of this standard including dose threshold, clinical manifestation, indexing standard and treatment principle were interpreted in this article. (authors)

  15. Multi-scale mechanics of traumatic brain injury

    NARCIS (Netherlands)

    Cloots, R.J.H.

    2011-01-01

    Traumatic brain injury (TBI) can be caused by road traffic, sports-related or other types of accidents and often leads to permanent health issues or even death. For a good prevention or diagnosis of TBI, brain injury criteria are used to assess the probability of brain injury as a result of a

  16. Adverse fetal outcome in road accidents: Injury mechanism study and injury criteria development in a pregnant woman finite element model.

    Science.gov (United States)

    Auriault, F; Thollon, L; Pérès, J; Behr, M

    2016-12-01

    This study documents the development of adverse fetal outcome predictors dedicated to the analysis of road accidents involving pregnant women. To do so, a pre-existing whole body finite element model representative of a 50th percentile 26 weeks pregnant woman was used. A total of 8 accident scenarios were simulated with the model positioned on a sled. Each of these scenarios was associated to a risk of adverse fetal outcome based on results from real car crash investigations involving pregnant women from the literature. The use of airbags and accidents involving unbelted occupants were not considered in this study. Several adverse fetal outcome potential predictors were then evaluated with regard to their correlation to this risk of fetal injuries. Three predictors appeared strongly correlated to the risk of adverse fetal outcome: (1) the intra uterine pressure at the placenta fetal side area (r=0.92), (2) the fetal head acceleration (HIC) (r=0.99) and (3) area of utero-placental interface over a strain threshold (r=0.90). Finally, sensitivity analysis against slight variations of the simulation parameters was performed and assess robustness of these criteria. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. Head injury predictors in sports trauma--a state-of-the-art review.

    Science.gov (United States)

    Fernandes, Fábio A O; de Sousa, Ricardo J Alves

    2015-08-01

    Head injuries occur in a great variety of sports. Many of these have been associated with neurological injuries, affecting the central nervous system. Some examples are motorsports, cycling, skiing, horse riding, mountaineering and most contact sports such as football, ice and field hockey, soccer, lacrosse, etc. The outcome of head impacts in these sports can be very severe. The worst-case scenarios of permanent disability or even death are possibilities. Over recent decades, many In recent decades, a great number of head injury criteria and respective thresholds have been proposed. However, the available information is much dispersed and a consensus has still not been achieved regarding the best injury criteria or even their thresholds. This review paper gives a thorough overview of the work carried out by the scientific community in the field of impact biomechanics about head injuries sustained during sports activity. The main goal is to review the head injury criteria, as well as their thresholds. Several are reviewed, from the predictors based on kinematics to the ones based on human tissue thresholds. In this work, we start to briefly introduce the head injuries and their mechanisms commonly seen as a result of head trauma in sports. Then, we present and summarize the head injury criteria and their respective thresholds. © IMechE 2015.

  18. CO2-assimilation and chlorophyll fluorescence as indirect selection criteria for host tolerance against Striga

    NARCIS (Netherlands)

    Rodenburg, Jonne; Bastiaans, Lammert; Schapendonk, Ad. H. C. M.; van der Putten, Peter E. L.; van Ast, Aad; Dingemanse, Niels J.; Haussmann, Bettina I. G.

    Striga hermonthica (Del.) Benth. is a parasitic weed on tropical cereals causing serious yield losses in Africa. The use of host crop varieties with improved resistance and tolerance against this parasite is a key component of an integrated control strategy. Breeding for tolerance is however

  19. Comparison of Three Prehospital Cervical Spine Protocols for Missed Injuries

    Directory of Open Access Journals (Sweden)

    Rick Hong

    2014-07-01

    Full Text Available Introduction: We wanted to compare 3 existing emergency medical services (EMS immobilization protocols: the Prehospital Trauma Life Support (PHTLS, mechanism-based; the Domeier protocol (parallels the National Emergency X-Radiography Utilization Study [NEXUS] criteria; and the Hankins’ criteria (immobilization for patients 65 years, those with altered consciousness, focal neurologic deficit, distracting injury, or midline or paraspinal tenderness.To determine the proportion of patients who would require cervical immobilization per protocol and the number of missed cervical spine injuries, had each protocol been followed with 100% compliance. Methods: This was a cross-sectional study of patients ≥18 years transported by EMS post-traumatic mechanism to an inner city emergency department. Demographic and clinical/historical data obtained by physicians were recorded prior to radiologic imaging. Medical record review ascertained cervical spine injuries. Both physicians and EMS were blinded to the objective of the study. Results: Of 498 participants, 58% were male and mean age was 48 years. The following participants would have required cervical spine immobilization based on the respective protocol: PHTLS, 95.4% (95% CI: 93.1-96.9%; Domeier, 68.7% (95% CI: 64.5-72.6%; Hankins, 81.5% (95% CI: 77.9-84.7%. There were 18 cervical spine injuries: 12 vertebral fractures, 2 subluxations/dislocations and 4 spinal cord injuries. Compliance with each of the 3 protocols would have led to appropriate cervical spine immobilization of all injured patients. In practice, 2 injuries were missed when the PHTLS criteria were mis-applied. Conclusion: Although physician-determined presence of cervical spine immobilization criteria cannot be generalized to the findings obtained by EMS personnel, our findings suggest that the mechanism-based PHTLS criteria may result in unnecessary cervical spine immobilization without apparent benefit to injured patients. PHTLS

  20. Urinary tract injuries in laparoscopic hysterectomy: a systematic review.

    Science.gov (United States)

    Adelman, Marisa R; Bardsley, Tyler R; Sharp, Howard T

    2014-01-01

    The aim of this review was to estimate the incidence of urinary tract injuries associated with laparoscopic hysterectomy and describe the long-term sequelae of these injuries and the impact of early recognition. Studies were identified by searching the PubMed database, spanning the last 10 years. The key words "ureter" or "ureteral" or "urethra" or "urethral" or "bladder" or "urinary tract" and "injury" and "laparoscopy" or "robotic" and "gynecology" were used. Additionally, a separate search was done for "routine cystoscopy" and "gynecology." The inclusion criteria were published articles of original research referring to urologic injuries occurring during either laparoscopic or robotic surgery for gynecologic indications. Only English language articles from the past 10 years were included. Studies with less than 100 patients and no injuries reported were excluded. No robotic series met these criteria. A primary search of the database yielded 104 articles, and secondary cross-reference yielded 6 articles. After reviewing the abstracts, 40 articles met inclusion criteria and were reviewed in their entirety. Of those 40 articles, 3 were excluded because of an inability to extract urinary tract injuries from total injuries. Statistical analysis was performed using a generalized linear mixed effects model. The overall urinary tract injury rate for laparoscopic hysterectomy was 0.73%. The bladder injury rate ranged from 0.05% to 0.66% across procedure types, and the ureteral injury rate ranged from 0.02% to 0.4% across procedure type. In contrast to earlier publications, which cited unacceptably high urinary tract injury rates, laparoscopic hysterectomy appears to be safe regarding the bladder and ureter. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  1. Treatment of surgical brain injury by immune tolerance induced by intrathymic and hepatic portal vein injection of brain antigens.

    Science.gov (United States)

    Yang, Weijian; Liu, Yong; Liu, Baolong; Tan, Huajun; Lu, Hao; Wang, Hong; Yan, Hua

    2016-08-24

    Surgical brain injury (SBI) defines complications induced by intracranial surgery, such as cerebral edema and other secondary injuries. In our study, intrathymic and hepatic portal vein injection of allogeneic myelin basic protein (MBP) or autogeneic brain cell suspensions were administered to a standard SBI model. Serum pro-inflammatory IL-2, anti-inflammatory IL-4 concentrations and the CD4(+)T/CD8(+)T ratio were measured at 1, 3, 7, 14 and 21 d after surgery to verify the establishment of immune tolerance. Furthermore, we confirmed neuroprotective effects by evaluating neurological scores at 1, 3, 7, 14 and 21 d after SBI. Anti-Fas ligand (FasL) immunohistochemistry and TUNEL assays of brain sections were tested at 21 d after surgery. Intrathymic injections of MBP or autogeneic brain cell suspensions functioned by both suppressing secondary inflammatory reactions and improving prognoses, whereas hepatic portal vein injections of autogeneic brain cell suspensions exerted a better effect than MBP. Intrathymic and hepatic portal vein injections of MBP had equal effects on reducing secondary inflammation and improving prognoses. Otherwise, hepatic portal vein injections of autogeneic brain cell suspensions had better outcomes than intrathymic injections of autogeneic brain cell suspensions. Moreover, the benefit of injecting antigens into the thymus was outweighed by hepatic portal vein injections.

  2. Debris Motion and Injury Relationships in All Hazard Environments

    Science.gov (United States)

    1976-07-01

    reaction, limit of voluntary tolerance, injury threshold, LD5 0 value, limit of survival, etc. Our current state of knowledge concerning human impact...of-the-art review of "Human Impact Tolerance" up to approximately August 1970. Snyder concludes that current knowledge on human tolerance to impact...children and adults, suicides, high divers, skiers etc. have occurred and are reported in the literature (Refs. 19, 20, 21). With the objective of

  3. The research into head injury criteria dependence on car speed

    Directory of Open Access Journals (Sweden)

    L. Pelenytė-Vyšniauskienė

    2007-12-01

    Full Text Available There are many ways of car collisions which depend on car motion modes before and after crashes, speed, kinds of baskets, their heights, weights and rigidity. The machinery of the occupant’s movement at the moment of the crash is even more diffi cult. In order to find out precisely the chance of body injury, it is important to measure not only parameters that were mentioned above but also occupant’s height, weight, age, position of sitting, condition of body, whether there was any protection system used. The largest number of car crashes happen at the moment of frontal crash. This article’s aim is to analyse the types of frontal crashes and their repartition, to diagnose what part in occupant’s safety the protection system’s use takes, and also to analyse head injury coefficient dependence on car speed and show critical injuries and fatality limits in cases when driver is driving with no seat-belts in and while the car is without airbag. The research is done at the moment of ideal frontal crash by simulating distance from the occupant body to the wheel in diff erent types of baskets.

  4. Plant Tolerance: A Unique Approach to Control Hemipteran Pests.

    Science.gov (United States)

    Koch, Kyle G; Chapman, Kaitlin; Louis, Joe; Heng-Moss, Tiffany; Sarath, Gautam

    2016-01-01

    Plant tolerance to insect pests has been indicated to be a unique category of resistance, however, very little information is available on the mechanism of tolerance against insect pests. Tolerance is distinctive in terms of the plant's ability to withstand or recover from herbivore injury through growth and compensatory physiological processes. Because plant tolerance involves plant compensatory characteristics, the plant is able to harbor large numbers of herbivores without interfering with the insect pest's physiology or behavior. Some studies have observed that tolerant plants can compensate photosynthetically by avoiding feedback inhibition and impaired electron flow through photosystem II that occurs as a result of insect feeding. Similarly, the up-regulation of peroxidases and other oxidative enzymes during insect feeding, in conjunction with elevated levels of phytohormones can play an important role in providing plant tolerance to insect pests. Hemipteran insects comprise some of the most economically important plant pests (e.g., aphids, whiteflies), due to their ability to achieve high population growth and their potential to transmit plant viruses. In this review, results from studies on plant tolerance to hemipterans are summarized, and potential models to understand tolerance are presented.

  5. 40 CFR 180.960 - Polymers; exemptions from the requirement of a tolerance.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Polymers; exemptions from the... From Tolerances § 180.960 Polymers; exemptions from the requirement of a tolerance. Residues resulting from the use of the following substances, that meet the definition of a polymer and the criteria...

  6. Delamination tolerance studies in laminated composite panels

    Indian Academy of Sciences (India)

    Abstract. Determination of levels of tolerance in delaminated composite panels is an important issue in composite structures technology. The primary intention is to analyse delaminated composite panels and estimate Strain. Energy Release Rate (SERR) parameters at the delamination front to feed into acceptability criteria.

  7. Factors Predictive of Symptomatic Radiation Injury After Linear Accelerator-Based Stereotactic Radiosurgery for Intracerebral Arteriovenous Malformations

    International Nuclear Information System (INIS)

    Herbert, Christopher; Moiseenko, Vitali; McKenzie, Michael; Redekop, Gary; Hsu, Fred; Gete, Ermias; Gill, Brad; Lee, Richard; Luchka, Kurt; Haw, Charles; Lee, Andrew; Toyota, Brian; Martin, Montgomery

    2012-01-01

    Purpose: To investigate predictive factors in the development of symptomatic radiation injury after treatment with linear accelerator–based stereotactic radiosurgery for intracerebral arteriovenous malformations and relate the findings to the conclusions drawn by Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC). Methods and Materials: Archived plans for 73 patients who were treated at the British Columbia Cancer Agency were studied. Actuarial estimates of freedom from radiation injury were calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used for analysis of incidence of radiation injury. Log–rank test was used to search for dosimetric parameters associated with freedom from radiation injury. Results: Symptomatic radiation injury was exhibited by 14 of 73 patients (19.2%). Actuarial rate of symptomatic radiation injury was 23.0% at 4 years. Most patients (78.5%) had mild to moderate deficits according to Common Terminology Criteria for Adverse Events, version 4.0. On univariate analysis, lesion volume and diameter, dose to isocenter, and a V x for doses ≥8 Gy showed statistical significance. Only lesion diameter showed statistical significance (p 5 cm 3 and diameters >30 mm were significantly associated with the risk of radiation injury (p 12 also showed strong association with the incidence of radiation injury. Actuarial incidence of radiation injury was 16.8% if V 12 was 3 and 53.2% if >28 cm 3 (log–rank test, p = 0.001). Conclusions: This study confirms that the risk of developing symptomatic radiation injury after radiosurgery is related to lesion diameter and volume and irradiated volume. Results suggest a higher tolerance than proposed by QUANTEC. The widely differing findings reported in the literature, however, raise considerable uncertainties.

  8. Factors Predictive of Symptomatic Radiation Injury After Linear Accelerator-Based Stereotactic Radiosurgery for Intracerebral Arteriovenous Malformations

    Energy Technology Data Exchange (ETDEWEB)

    Herbert, Christopher, E-mail: cherbert@bccancer.bc.ca [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC (Canada); Moiseenko, Vitali [Department of Medical Physics, British Columbia Cancer Agency, Vancouver, BC (Canada); McKenzie, Michael [Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver, BC (Canada); Redekop, Gary [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Hsu, Fred [Department of Radiation Oncology, British Columbia Cancer Agency, Abbotsford, BC (Canada); Gete, Ermias; Gill, Brad; Lee, Richard; Luchka, Kurt [Department of Medical Physics, British Columbia Cancer Agency, Vancouver, BC (Canada); Haw, Charles [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Lee, Andrew [Department of Neurosurgery, Royal Columbian Hospital, New Westminster, BC (Canada); Toyota, Brian [Division of Neurosurgery, Vancouver General Hospital, University of British Columbia, Vancouver, BC (Canada); Martin, Montgomery [Department of Medical Imaging, British Columbia Cancer Agency, Vancouver, BC (Canada)

    2012-07-01

    Purpose: To investigate predictive factors in the development of symptomatic radiation injury after treatment with linear accelerator-based stereotactic radiosurgery for intracerebral arteriovenous malformations and relate the findings to the conclusions drawn by Quantitative Analysis of Normal Tissue Effects in the Clinic (QUANTEC). Methods and Materials: Archived plans for 73 patients who were treated at the British Columbia Cancer Agency were studied. Actuarial estimates of freedom from radiation injury were calculated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards models were used for analysis of incidence of radiation injury. Log-rank test was used to search for dosimetric parameters associated with freedom from radiation injury. Results: Symptomatic radiation injury was exhibited by 14 of 73 patients (19.2%). Actuarial rate of symptomatic radiation injury was 23.0% at 4 years. Most patients (78.5%) had mild to moderate deficits according to Common Terminology Criteria for Adverse Events, version 4.0. On univariate analysis, lesion volume and diameter, dose to isocenter, and a V{sub x} for doses {>=}8 Gy showed statistical significance. Only lesion diameter showed statistical significance (p < 0.05) in a multivariate model. According to the log-rank test, AVM volumes >5 cm{sup 3} and diameters >30 mm were significantly associated with the risk of radiation injury (p < 0.01). The V{sub 12} also showed strong association with the incidence of radiation injury. Actuarial incidence of radiation injury was 16.8% if V{sub 12} was <28 cm{sup 3} and 53.2% if >28 cm{sup 3} (log-rank test, p = 0.001). Conclusions: This study confirms that the risk of developing symptomatic radiation injury after radiosurgery is related to lesion diameter and volume and irradiated volume. Results suggest a higher tolerance than proposed by QUANTEC. The widely differing findings reported in the literature, however, raise considerable uncertainties.

  9. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    Energy Technology Data Exchange (ETDEWEB)

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S. (Pennsylvania State University College of Medicine, Hershey (United States))

    1992-09-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years.

  10. Prospective validation of criteria, including age, for safe, nonsurgical management of the ruptured spleen

    International Nuclear Information System (INIS)

    Smith, J.S. Jr.; Wengrovitz, M.A.; DeLong, B.S.

    1992-01-01

    One hundred twelve cases of blunt splenic rupture were prospectively entered (October 1987-October 1991) into surgical or nonsurgical management groups using these criteria for the nonsurgical group: hemodynamic stability-age less than 55 years-CT scan appearance of grade I, II, or III injury-absence of concomitant injuries precluding abdominal assessment+absence of other documented abdominal injuries. All ages were included and AAST injury scaling was used. Patients were grouped from the trauma room. The surgical treatment group included 66 patients (49 splenectomies, 17 splenorraphies). These patients were generally older and more severely injured, required more transfused blood, and a longer ICU stay. The nonsurgical group included 46 patients with 33 older than 14 years. There were 3 patients over the age of 55 years inappropriately included in this group, and nonsurgical therapy failed in all three. Statistical analysis (chi 2) showed that more splenic injuries were observed and more spleens were saved with these criteria applied prospectively compared with a previous retrospective series in the same institution. The series had a success rate of 93%, and validates the criteria used for safe, nonsurgical management of the ruptured spleen and adds a new criterion: a maximum age of 55 years

  11. Reality check on girth weld defect acceptance criteria

    Energy Technology Data Exchange (ETDEWEB)

    Brust, Bud; Kalyanam, Suresh; Shim, Do-Jun; Wilkowski, Gery [Engineering Mechanics Corporation of Columbus, Columbus, OH, (United States)

    2010-07-01

    Girth weld defect tolerance criteria for pipeline construction has evolved with time. Recently, ERPG recommended a new Tier 2 girth weld defect acceptance criterion. This paper described the new development on girth weld defect acceptance criteria. The inherent conservatisms of alternative girth weld defect acceptance criteria from the 2007 API 1104 Appendix A, CSA Z662 Appendix K, are compared to those from the proposed EPRG Tier 2 criteria. It is found that the API and CSA codes have the same empirical limit-load criteria. As well, there are conservatisms in the proposed EPRG Tier 2. The results showed that there are various reasons why large amounts of conservatism in the allowable flaw lengths in the CSA Appendix K,2007 API 1104 Appendix A, and proposed EPRG Tier 2 girth weld defect criterion exist. Small conservatisms on failure stress can result in large conservatisms in flaw size.

  12. Strong dietary restrictions protect Drosophila against anoxia/reoxygenation injuries.

    Directory of Open Access Journals (Sweden)

    Paul Vigne

    Full Text Available Reoxygenation of ischemic tissues is a major factor that determines the severity of cardiovascular diseases. This paper describes the consequences of anoxia/reoxygenation (A/R stresses on Drosophila, a useful, anoxia tolerant, model organism.Newly emerged adult male flies were exposed to anoxic conditions (<1% O2 for 1 to 6 hours, reoxygenated and their survival was monitored.A/R stresses induced a transient increase in mortality which peaked at the time of reoxygenation. Then flies recovered low mortality rates similar to those of control flies. A/R induced mortality was strongly dependent on dietary conditions during the 48 h that preceded anoxia. Well fed flies were anoxia sensitive. Strong dietary restrictions and starvation conditions protected flies against A/R injuries. The tolerance to anoxia was associated to large decreases in glycogen, protein, and ATP contents. During anoxia, anoxia tolerant flies produced more lactate, less phosphate and they maintained more stable ATP levels than anoxia sensitive flies. Moderate dietary restrictions, which increased the longevity of normoxic flies, did not promote resistance to A/R stresses. Diet dependent A/R injuries were still observed in sigma loss of function mutants and they were insensitive to dietary rapamycin or resveratrol. AICAR (5-aminoimidazole-4-carboxamide-1-beta-D-ribose-furanoside, an activator AMP kinase decreased A/R injuries. Mutants in the insulin signalling pathway were more anoxia tolerant in a fed state.Long A/R stresses induce a transient increase in mortality in Drosophila. This mortality is highly dependent on dietary conditions prior to the stress. Strong dietary restrictions and starvation conditions protect flies against A/R injuries, probably by inducing a major remodelling of energy metabolism. The results also indicate that mechanistically different responses develop in response to dietary restrictions of different strengths. AMP kinase and the insulin signalling

  13. Newly Identified Wild Rice Accessions Conferring High Salt Tolerance Might Use a Tissue Tolerance Mechanism in Leaf

    Science.gov (United States)

    Prusty, Manas R.; Kim, Sung-Ryul; Vinarao, Ricky; Entila, Frederickson; Egdane, James; Diaz, Maria G. Q.; Jena, Kshirod K.

    2018-01-01

    Cultivated rice (Oryza sativa L.) is very sensitive to salt stress. So far a few rice landraces have been identified as a source of salt tolerance and utilized in rice improvement. These tolerant lines primarily use Na+ exclusion mechanism in root which removes Na+ from the xylem stream by membrane Na+ and K+ transporters, and resulted in low Na+ accumulation in shoot. Identification of a new donor source conferring high salt tolerance is imperative. Wild relatives of rice having wide genetic diversity are regarded as a potential source for crop improvement. However, they have been less exploited against salt stress. Here, we simultaneously evaluated all 22 wild Oryza species along with the cultivated tolerant lines including Pokkali, Nona Bokra, and FL478, and sensitive check varieties under high salinity (240 mM NaCl). Based on the visual salt injury score, three species (O. alta, O. latifolia, and O. coarctata) and four species (O. rhizomatis, O. eichingeri, O. minuta, and O. grandiglumis) showed higher and similar level of tolerance compared to the tolerant checks, respectively. All three CCDD genome species exhibited salt tolerance, suggesting that the CCDD genome might possess the common genetic factors for salt tolerance. Physiological and biochemical experiments were conducted using the newly isolated tolerant species together with checks under 180 mM NaCl. Interestingly, all wild species showed high Na+ concentration in shoot and low concentration in root unlike the tolerant checks. In addition, the wild-tolerant accessions showed a tendency of a high tissue tolerance in leaf, low malondialdehyde level in shoot, and high retention of chlorophyll in the young leaves. These results suggest that the wild species employ tissue tolerance mechanism to manage salt stress. Gene expression analyses of the key salt tolerance-related genes suggested that high Na+ in leaf of wild species might be affected by OsHKT1;4-mediated Na+ exclusion in leaf and the following Na

  14. Tolerance Levels of Roadside Trees to Air Pollutants Based on Relative Growth Rate and Air Pollution Tolerance Index

    Directory of Open Access Journals (Sweden)

    SULISTIJORINI

    2008-09-01

    Full Text Available Motor vehicles release carbon monoxide, nitrogen dioxide, sulphur dioxide, and particulate matters to the air as pollutants. Vegetation can absorb these pollutants through gas exchange processes. The objective of this study was to examine the combination of the relative growth rate (RGR and physiological responses in determining tolerance levels of plant species to air pollutants. Physiological responses were calculated as air pollution tolerance index (APTI. Eight roadside tree species were placed at polluted (Jagorawi highway and unpolluted (Sindangbarang field area. Growth and physiological parameters of the trees were recorded, including plant height, leaf area, total ascorbate, total chlorophyll, leaf-extract pH, and relative water content. Scoring criteria for the combination of RGR and APTI method was given based on means of the two areas based on two-sample t test. Based on the total score of RGR and APTI, Lagerstroemia speciosa was categorized as a tolerant species; and Pterocarpus indicus, Delonix regia, Swietenia macrophylla were categorized as moderately tolerant species. Gmelina arborea, Cinnamomum burmanii, and Mimusops elengi were categorized as intermediate tolerant species. Lagerstroemia speciosa could be potentially used as roadside tree. The combination of RGR and APTI value was better to determinate tolerance level of plant to air pollutant than merely APTI method.

  15. Critical temperature: A quantitative method of assessing cold tolerance

    Science.gov (United States)

    D.H. DeHayes; M.W., Jr. Williams

    1989-01-01

    Critical temperature (Tc), defined as the highest temperature at which freezing injury to plant tissues can be detected, provides a biologically meaningful and statistically defined assessment of the relative cold tolerance of plant tissues. A method is described for calculating critical temperatures in laboratory freezing studies that use...

  16. Exertional Tolerance Assessments After Mild Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Quatman-Yates, Catherine; Bailes, Anna; Constand, Sara; Sroka, Mary Claire; Nissen, Katharine; Kurowski, Brad; Hugentobler, Jason

    2018-05-01

    To review the literature to identify and summarize strategies for evaluating responses to physical exertion after mild traumatic brain injury (mTBI) for clinical and research purposes. PubMed and EBSCOhost through December 31, 2016. Two independent reviewers selected studies based on the following criteria: (1) inclusion of participants with mTBI/concussion, (2) use of a measurement of physiological or psychosomatic response to exertion, (3) a repeatable description of the exertion protocol was provided, (4) a sample of at least 10 participants with a mean age between 8 and 65 years, and (5) the article was in English. The search process yielded 2685 articles, of which 14 studies met the eligibility requirements. A quality assessment using a checklist was conducted for each study by 2 independent study team members and verified by a third team member. Data were extracted by one team member and verified by a second team member. A qualitative synthesis of the studies revealed that most protocols used a treadmill or cycle ergometer as the exercise modality. Protocol methods varied across studies including differences in initial intensity determination, progression parameters, and exertion duration. Common outcome measures were self-reported symptoms, heart rate, and blood pressure. The strongest evidence indicates that exertional assessments can provide important insight about mTBI recovery and should be administered using symptoms as a guide. Additional studies are needed to verify optimal modes and protocols for post-mTBI exertional assessments. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Family function and its relationship to injury severity and psychiatric outcome in children with acquired brain injury: a systematized review.

    Science.gov (United States)

    Lax Pericall, Maria Teresa; Taylor, Eric

    2014-01-01

    The psychological and psychiatric outcome of children with acquired brain injury is influenced by many variables. A review was undertaken to clarify the contribution of family function, how it relates to injury severity, and what particular aspects of family function influence psychological outcome in this group. A systematized review of the literature of studies published between 1970 and 2012 from OvidMedline, PsychoInfo, PsycARTICLES, and Cochrane was undertaken focusing on family function, injury severity, and psychiatric outcome. Thirty-six papers met the inclusion criteria. Injury severity was linked to the development of organic personality change. Family function before injury, measured by the Family Assessment Device or the Clinical Rating Scale, had a statistically significant effect on general psychological functioning in six out of eight studies. Family function had a significant effect for oppositional defiant disorder and secondary attention-deficit-hyperactivity disorder. The effects of family function may differ depending on the age of the child and the severity of the injury. Some styles of parenting moderated recovery. After injury, family function was related to the child's contemporaneous psychiatric symptoms. The level of evidence for these papers was 3 or 4 (Oxford Centre for Evidence-based Medicine criteria). Screening for some aspects of family functioning before injury and family function during the rehabilitation phase may identify children at risk of psychiatric disorders. © 2013 Mac Keith Press.

  18. An FMEA evaluation of intensity modulated radiation therapy dose delivery failures at tolerance criteria levels.

    Science.gov (United States)

    Faught, Jacqueline Tonigan; Balter, Peter A; Johnson, Jennifer L; Kry, Stephen F; Court, Laurence E; Stingo, Francesco C; Followill, David S

    2017-11-01

    The objective of this work was to assess both the perception of failure modes in Intensity Modulated Radiation Therapy (IMRT) when the linac is operated at the edge of tolerances given in AAPM TG-40 (Kutcher et al.) and TG-142 (Klein et al.) as well as the application of FMEA to this specific section of the IMRT process. An online survey was distributed to approximately 2000 physicists worldwide that participate in quality services provided by the Imaging and Radiation Oncology Core - Houston (IROC-H). The survey briefly described eleven different failure modes covered by basic quality assurance in step-and-shoot IMRT at or near TG-40 (Kutcher et al.) and TG-142 (Klein et al.) tolerance criteria levels. Respondents were asked to estimate the worst case scenario percent dose error that could be caused by each of these failure modes in a head and neck patient as well as the FMEA scores: Occurrence, Detectability, and Severity. Risk probability number (RPN) scores were calculated as the product of these scores. Demographic data were also collected. A total of 181 individual and three group responses were submitted. 84% were from North America. Most (76%) individual respondents performed at least 80% clinical work and 92% were nationally certified. Respondent medical physics experience ranged from 2.5 to 45 yr (average 18 yr). A total of 52% of individual respondents were at least somewhat familiar with FMEA, while 17% were not familiar. Several IMRT techniques, treatment planning systems, and linear accelerator manufacturers were represented. All failure modes received widely varying scores ranging from 1 to 10 for occurrence, at least 1-9 for detectability, and at least 1-7 for severity. Ranking failure modes by RPN scores also resulted in large variability, with each failure mode being ranked both most risky (1st) and least risky (11th) by different respondents. On average MLC modeling had the highest RPN scores. Individual estimated percent dose errors and severity

  19. Effects of knee injury primary prevention programs on anterior cruciate ligament injury rates in female athletes in different sports: a systematic review.

    Science.gov (United States)

    Michaelidis, Michael; Koumantakis, George A

    2014-08-01

    Anterior Cruciate Ligament (ACL) injury is frequently encountered in sports. To analyze the effects of ACL injury prevention programs on injury rates in female athletes between different sports. A comprehensive literature search was performed in September 2012 using Pubmed Central, Science Direct, CINAHL, PEDro, Cochrane Library, SCOPUS, SPORTDiscus. The key words used were: 'anterior cruciate ligament', 'ACL', 'knee joint', 'knee injuries', 'female', 'athletes', 'neuromuscular', 'training', 'prevention'. The inclusion criteria applied were: (1) ACL injury prevention training programs for female athletes; (2) Athlete-exposure data reporting; (3) Effect of training on ACL incidence rates for female athletes. 13 studies met the inclusion criteria. Three training programs in soccer and one in handball led to reduced ACL injury incidence. In basketball no effective training intervention was found. In season training was more effective than preseason in ACL injury prevention. A combination of strength training, plyometrics, balance training, technique monitoring with feedback, produced the most favorable results. Comparing the main components of ACL injury prevention programs for female athletes, some sports-dependent training specificity issues may need addressing in future studies, related primarily to the individual biomechanics of each sport but also their most effective method of delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Application of a Framework to Assess the Usefulness of Alternative Sepsis Criteria.

    Science.gov (United States)

    Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Gesten, Foster; Klompas, Michael; Levy, Mitchell; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Warren, David K; Watson, R Scott; Angus, Derek C

    2016-03-01

    The current definition of sepsis is life-threatening, acute organ dysfunction secondary to a dysregulated host response to infection. Criteria to operationalize this definition can be judged by six domains of usefulness (reliability, content, construct and criterion validity, measurement burden, and timeliness). The relative importance of these six domains depends on the intended purpose for the criteria (clinical care, basic and clinical research, surveillance, or quality improvement [QI] and audit). For example, criteria for clinical care should have high content and construct validity, timeliness, and low measurement burden to facilitate prompt care. Criteria for surveillance or QI/audit place greater emphasis on reliability across individuals and sites and lower emphasis on timeliness. Criteria for clinical trials require timeliness to ensure prompt enrollment and reasonable reliability but can tolerate high measurement burden. Basic research also tolerates high measurement burden and may not need stability over time. In an illustrative case study, we compared examples of criteria designed for clinical care, surveillance and QI/audit among 396,241 patients admitted to 12 academic and community hospitals in an integrated health system. Case rates differed four-fold and mortality three-fold. Predictably, clinical care criteria, which emphasized timeliness and low burden and therefore used vital signs and routine laboratory tests, had the greater case identification with lowest mortality. QI/audit criteria, which emphasized reliability and criterion validity, used discharge information and had the lowest case identification with highest mortality. Using this framework to identify the purpose and apply domains of usefulness can help with the evaluation of existing sepsis diagnostic criteria and provide a roadmap for future work.

  1. Protection for Thorax Injury Severity in 90° Lateral Collision

    Directory of Open Access Journals (Sweden)

    Dimitrios Kallieris

    1996-01-01

    Full Text Available The thoracic trauma index (TTI and the viscous criterion (VC are injury criteria intended for the prediction of torso injury severity. The criteria were assessed in two series of experiments: 90° (lateral car to car collisions and controlled left trunk impacts against either a rigid or padded wall. Forty-two belt restrained human cadavers in the age range 18–65 years, located in the near-side front passenger seat, were used. The impact velocity was between 40 and 60 km/h. Left and right side impacts were simulated using standard or modified car side structures. With the second series of experiments, the left side of each subject was impacted under one of two different test conditions: 24 km/h rigid wall or 32 km/h padded wall. The thorax deformation was evaluated through the double integration of the accelerated difference at the fourth and eight ribs, near and far side. Deformation maxima of 6–138 mm (mean 69 mm, VC values of 0.3–4.7 m/s (mean 1.6 m/s, and TTI values of 85–252 (mean 63 occurred. Torso abbreviated injury severity (AIS values were between 0 and 5. Statistical analyses showed a stronger influence of age on injury severity than the injury criteria or biomechanical responses in the two series of experiments. The TTI showed the highest correlation with thoracic AIS and the number of rib fractures, while VC was the better predictor of abdominal AIS. The results are discussed critically and the strength and robustness of the injury criteria analyzed.

  2. Aerobic capacity, orthostatic tolerance, and exercise perceptions at discharge from inpatient spinal cord injury rehabilitation.

    Science.gov (United States)

    Pelletier, Chelsea A; Jones, Graham; Latimer-Cheung, Amy E; Warburton, Darren E; Hicks, Audrey L

    2013-10-01

    To describe physical capacity, autonomic function, and perceptions of exercise among adults with subacute spinal cord injury (SCI). Cross-sectional. Two inpatient SCI rehabilitation programs in Canada. Participants (N=41; mean age ± SD, 38.9 ± 13.7y) with tetraplegia (TP; n=19), high paraplegia (HP; n=8), or low paraplegia (LP; n=14) completing inpatient SCI rehabilitation (mean ± SD, 112.9 ± 52.5d postinjury). Not applicable. Peak exercise capacity was determined by an arm ergometry test. As a measure of autonomic function, orthostatic tolerance was assessed by a passive sit-up test. Self-efficacy for exercise postdischarge was evaluated by a questionnaire. There was a significant difference in peak oxygen consumption and heart rate between participants with TP (11.2 ± 3.4;mL·kg(-1)·min(-1) 113.9 ± 19.7 beats/min) and LP (17.1 ± 7.5 mL·kg(-1)·min(-1); 142.8 ± 22.7 beats/min). Peak power output was also significantly lower in the TP group (30.0 ± 6.9W) compared with the HP (55.5 ± 7.56W) and LP groups (62.5 ± 12.2W). Systolic blood pressure responses to the postural challenge varied significantly between groups (-3.0 ± 33.5 mmHg in TP, 17.8 ± 14.7 mmHg in HP, 21.6 ± 18.7 mmHg in LP). Orthostatic hypotension was most prevalent among participants with motor complete TP (73%). Results from the questionnaire revealed that although participants value exercise and see benefits to regular participation, they have low confidence in their abilities to perform the task of either aerobic or strengthening exercise. Exercise is well tolerated in adults with subacute SCI. Exercise interventions at this stage should focus on improving task-specific self-efficacy, and attention should be made to blood pressure regulation, particularly in individuals with motor complete TP. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Isolation of mutations affecting the development of freezing tolerance in Arabidopsis thaliana (L.) Heynh.

    Science.gov (United States)

    Warren, G; McKown, R; Marin, A L; Teutonico, R

    1996-08-01

    We screened for mutations deleterious to the freezing tolerance of Arabidopsis thaliana (L.) Heynh. ecotype Columbia. Tolerance was assayed by the vigor and regrowth of intact plants after cold acclimation and freezing. From a chemically mutagenized population, we obtained 13 lines of mutants with highly penetrant phenotypes. In 5 of these, freezing sensitivity was attributable to chilling injury sustained during cold acclimation, but in the remaining 8 lines, the absence of injury prior to freezing suggested that they were affected specifically in the development of freezing tolerance. In backcrosses, freezing sensitivity from each line segregated as a single nuclear mutation. Complementation tests indicated that the 8 lines contained mutations in 7 different genes. The mutants' freezing sensitivity was also detectable in the leakage of electrolytes from frozen leaves. However, 1 mutant line that displayed a strong phenotype at the whole-plant level showed a relatively weak phenotype by the electrolyte leakage assay.

  4. MR imaging of posterior cruciate ligament injuries

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Nobuyuki [Tsukuba Univ., Ibaraki (Japan). Hospital; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

    2001-07-01

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  5. MR imaging of posterior cruciate ligament injuries

    International Nuclear Information System (INIS)

    Takahashi, Nobuyuki; Niitsu, Mamoru; Itai, Yuji; Sato, Motohiro; Kujiraoka, Yuka; Ikeda, Kotaro; Kanamori, Akihiro

    2001-01-01

    Posterior cruciate ligament (PCL) injuries are less frequent than anterior cruciate ligament (ACL) injuries, but are presumably more common than once thought. Thirty-nine patients with PCL injuries identified on MR images were studied. The criteria for PCL injury were complete tear, partial tear, and avulsion fracture. The approximate site of a partial tear was categorized as proximal, midsubstance, distal, or combination. Fourteen patients (35.9%) had complete tears of the PCL, 21 patients (53.8%) had partial tears, and four patients (10.3%) had avulsion fractures. A total of 12 patients (30.7%) had isolated PCL injuries, while the remaining 27 patients demonstrated evidence of other coexistent knee injuries, such as meniscal tears and ligamentous injuries. Of coexistent knee injuries, meniscal tears (18 patients, 46.2%) were most often seen. (author)

  6. Development of biological criteria for the design of advanced hydropower turbines

    Energy Technology Data Exchange (ETDEWEB)

    Cada, Glenn F. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Coutant, Charles C. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Whitney, Richard R. [Leavenworth, WA (United States)

    1997-03-01

    A review of the literature related to turbine-passage injury mechanisms suggests the following biological criteria should be considered in the design of new turbines: (1) pressure; (2) cavitation; (3) shear and turbulence; and (4) mechanical injury. Based on the study’s review of fish behavior in relation to hydropower facilities, it provides a number of recommendations to guide both turbine design and additional research.

  7. Proposed diagnostic criteria for internet addiction.

    Science.gov (United States)

    Tao, Ran; Huang, Xiuqin; Wang, Jinan; Zhang, Huimin; Zhang, Ying; Li, Mengchen

    2010-03-01

    The objective of this study was to develop diagnostic criteria for internet addiction disorder (IAD) and to evaluate the validity of our proposed diagnostic criteria for discriminating non-dependent from dependent internet use in the general population. This study was conducted in three stages: the developmental stage (110 subjects in the survey group; 408 subjects in the training group), where items of the proposed diagnostic criteria were developed and tested; the validation stage (n = 405), where the proposed criteria were evaluated for criterion-related validity; and the clinical stage (n = 150), where the criteria and the global clinical impression of IAD were evaluated by more than one psychiatrist to determine inter-rater reliability. The proposed internet addiction diagnostic criteria consisted of symptom criterion (seven clinical symptoms of IAD), clinically significant impairment criterion (functional and psychosocial impairments), course criterion (duration of addiction lasting at least 3 months, with at least 6 hours of non-essential internet usage per day) and exclusion criterion (exclusion of dependency attributed to psychotic disorders). A diagnostic score of 2 + 1, where the first two symptoms (preoccupation and withdrawal symptoms) and at least one of the five other symptoms (tolerance, lack of control, continued excessive use despite knowledge of negative effects/affects, loss of interests excluding internet, and use of the internet to escape or relieve a dysphoric mood) was established. Inter-rater reliability was 98%. Our findings suggest that the proposed diagnostic criteria may be useful for the standardization of diagnostic criteria for IAD.

  8. Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football

    DEFF Research Database (Denmark)

    Thorborg, Kristian; Krommes, Kasper Kühn; Esteve, Ernest

    2017-01-01

    Objective To investigate the effect of FIFA injury prevention programmes in football (FIFA 11 and FIFA 11+). Design Systematic review and meta-analysis. Eligibility criteria for selecting studies Randomised controlled trials comparing the FIFA injury prevention programmes with a control (no or sham...... intervention) among football players. Data sources MEDLINE via PubMed, EMBASE via OVID, CINAHL via Ebsco, Web of Science, SportDiscus and Cochrane Central Register of Controlled Trials, from 2004 to 14 March 2016. Results 6 cluster-randomised controlled trials had assessed the effect of FIFA injury prevention...... programmes compared with controls on the overall football injury incidence in recreational/subelite football. These studies included 2 specific exercise-based injury prevention programmes: FIFA 11 (2 studies) and FIFA 11+ (4 studies). The primary analysis showed a reduction in the overall injury risk ratio...

  9. Semi-lethal high temperature and heat tolerance of eight Camellia species

    OpenAIRE

    He, XY; Ye, H; Ma, JL; Zhang, RQ; Chen, GC; Xia, YY

    2012-01-01

    Annual leaf segments of eight Camellia species were used to study the heat tolerance by an electrical conductivity method, in combination with a Logistic equation to ascertain the semi-lethal high temperature by fitting the cell injury rate curve. Te relationship between the processing temperature and the cell injury rate in Camellia showed a typical "S" shaped curve, following the Logistic model. Te correlation coeficient was above 0.95. Te semi-lethal high temperature LT50 of the eight Came...

  10. 45 Gy - tolerance dose spinal cord - dogma or the facts?

    International Nuclear Information System (INIS)

    Maciejewski, B.; Hliniak, A.; Danczak-Ginalska, Z.; Meder, M.; Skolyszewski, J.; Reinfuss, M.; Korzeniowski, S.; Peszynski, J.; Jassem, J.

    1993-01-01

    Dose of 45 Gy as a tolerance dose for spinal cord was questioned based on review of clinical data. Some data show that for conventional fractionation with the dose per fraction of less than 2.0 Gy spinal cord tolerance dose may arise up to 50-55 Gy. This was the base for round-table discussion and the importance of clinical and physical risk factors of postirradiation spinal cord injury was discussed and previous diseases of spinal cord, size of dose per fraction and length of irradiated spinal cord were pointed out as high risk factors. It was concluded that from clinical point of view there is no reason and on need to verify and to increase tolerance dose for spinal cord. (author)

  11. Blast wave injury prediction models for complex scenarios

    NARCIS (Netherlands)

    Teland, J.A.; Doormaal, J.C.A.M. van

    2012-01-01

    Blast waves from explosions can cause lethal injuries to humans. Development of injury criteria has been ongoing for many years, but with the main focus on free field conditions. However, with terrorist actions as a new threat, explosions in urban areas have become of much more interest. Urban areas

  12. Comparison of Prevalence and Outcomes of Pediatric Acute Respiratory Distress Syndrome Using Pediatric Acute Lung Injury Consensus Conference Criteria and Berlin Definition.

    Science.gov (United States)

    Gupta, Samriti; Sankar, Jhuma; Lodha, Rakesh; Kabra, Sushil K

    2018-01-01

    Our objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria and Berlin definitions. We screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU) over a 3-year period (2015-2017) for presence of any respiratory difficulty at admission or during PICU stay. We applied both PALICC and Berlin criteria to these patients. Data collection included definition and outcome related variables. Data were compared between the "PALICC only group" and the "Berlin with or without PALICC" group using Stata 11. Of a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. A total of 61 children (prevalence 9.9%; 95% CI: 7.8-12.4) fulfilled the definition of acute respiratory distress syndrome (ARDS) with either of the two criteria. While 60 children (98%) fulfilled PALICC criteria, only 26 children (43%) fulfilled Berlin definition. There was moderate agreement between the two definitions (Kappa: 0.51; 95% CI: 0.40-0.62; observed agreement 85%). Greater proportion of patients had severe ARDS in the "Berlin with or without PALICC group" as compared to the "PALICC only" group (50 vs. 19%). There was no difference between the groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days) or mortality [51.4 vs. 57.7%: RR (95% CI): 0.99 (0.64-1.5)]. In comparison to Berlin definition, the PALICC criteria identified more number of patients with ARDS. Proportion with severe ARDS and complications was greater in the "Berlin with or without PALICC" group as compared to the "PALICC only" group. There were no differences in clinical outcomes between the groups.

  13. Internet gaming disorder: Inadequate diagnostic criteria wrapped in a constraining conceptual model.

    Science.gov (United States)

    Starcevic, Vladan

    2017-06-01

    Background and aims The paper "Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field" by Kuss, Griffiths, and Pontes (in press) critically examines the DSM-5 diagnostic criteria for Internet gaming disorder (IGD) and addresses the issue of whether IGD should be reconceptualized as gaming disorder, regardless of whether video games are played online or offline. This commentary provides additional critical perspectives on the concept of IGD. Methods The focus of this commentary is on the addiction model on which the concept of IGD is based, the nature of the DSM-5 criteria for IGD, and the inclusion of withdrawal symptoms and tolerance as the diagnostic criteria for IGD. Results The addiction framework on which the DSM-5 concept of IGD is based is not without problems and represents only one of multiple theoretical approaches to problematic gaming. The polythetic, non-hierarchical DSM-5 diagnostic criteria for IGD make the concept of IGD unacceptably heterogeneous. There is no support for maintaining withdrawal symptoms and tolerance as the diagnostic criteria for IGD without their substantial revision. Conclusions The addiction model of IGD is constraining and does not contribute to a better understanding of the various patterns of problematic gaming. The corresponding diagnostic criteria need a thorough overhaul, which should be based on a model of problematic gaming that can accommodate its disparate aspects.

  14. Ice hockey injuries.

    Science.gov (United States)

    Benson, Brian W; Meeuwisse, Willem H

    2005-01-01

    This article reviews the distribution and determinants of injuries reported in the pediatric ice hockey literature, and suggests potential injury prevention strategies and directions for further research. Thirteen electronic databases, the ISI Web of Science, and 'grey literature' databases were searched using a combination of Medical Subject Headings and text words to identify potentially relevant articles. The bibliographies of selected studies were searched to identify additional articles. Studies were selected for review based on predetermined inclusion and exclusion criteria. A comparison between studies on this topic area was difficult due to the variability in research designs, definition of injury, study populations, and measurements used to assess injury. The majority of injuries were sustained during games compared with practices. The two most commonly reported injuries were sprains/strains and contusions. Players competing at the Minor hockey, High School, and Junior levels of competition sustained most of their injuries to the upper extremity, head, and lower extremity, respectively. The primary mechanism of injury was body checking, followed by stick and puck contact. The frequency of catastrophic eye injuries has been significantly reduced with the world-wide mandation of full facial protection for all Minor hockey players. Specific hockey-related injury risk factors are poorly delineated and rarely studied among pediatric ice hockey players leaving large gaps in the knowledge of appropriate prevention strategies. Risk management strategies should be focused at avoiding unnecessary foreseeable risk, and controlling the risks inherent to the sport. Suggestions for injury prevention and future research are discussed.

  15. Criteria for nonoperative management of blunt splenic trauma

    Directory of Open Access Journals (Sweden)

    Sarmast Shoushtary MH

    2009-02-01

    Full Text Available "nBackground: Although nonoperative management is as an alternative method for surgery in the management of blunt splenic trauma, there are many contraversies in criteria for appropriate selection of the best method of management in patients. This study was conducted to find clinical and diagnostic criteria for selection of patients for surgery. "nMethods: One hundred and one patients with blunt splenic injury entered in our prospective observational and cross sectional study. Patients with unstable hemodyna-mics and obvious abdominal symptoms underwent emergency splenectomy was performed. In stable patients, abdominal and pelvic CT scan with IV contrast was performed. Patients with stable hemodynamics who lack obvious abdominal symptoms, admitted in ICU ward. Patients' demographics, blood pressure changes, hemoglobin concertration, severity of trauma with injury severity score (ISS scoring system, CT scan findings, amount of blood transfusion; Hospitalization time and mechanism of injury were recorded. "nResults: From 101 patients, 61(60.3% underwent early laparotomy. 40 patients were planned for conservative management. In 30 patients (29.7% nonoperative management was successful. In 10 patients (9.9% This management failed and they underwent surgery. Hypotension, hemoglobin concentration dropping more than one episode and blood transfusion requirement more than one time, increased the risk of operation. Higher ISS number and ISS≥16 had a direct relation with operative management. In patients who underwent early laparotomy CT grade of injury was higher. CT findings correlated well with laparotomy findings. "nConclusion: Nonoperative management was successful in 75% of selected patients. With correct selection of patients and concerning to homodynamic status, hemoglobin concentration changes and injury severity score in conjunction with CT findings, we can use this management in greater number of patients.

  16. Blunt Cerebrovascular Injuries: Advances in Screening, Imaging, and Management Trends.

    Science.gov (United States)

    Nagpal, P; Policeni, B A; Bathla, G; Khandelwal, A; Derdeyn, C; Skeete, D

    2017-10-12

    Blunt cerebrovascular injury is a relatively uncommon but sometimes life-threatening injury, particularly in patients presenting with ischemic symptoms in that vascular territory. The decision to pursue vascular imaging (generally CT angiography) is based on clinical and imaging findings. Several grading scales or screening criteria have been developed to guide the decision to pursue vascular imaging, as well as to recommend different treatment options for various injuries. The data supporting many of these guidelines and options are limited however. The purpose of this article is to review and compare these scales and criteria and the data supporting clinical efficacy and to make recommendations for future research in this area. © 2017 by American Journal of Neuroradiology.

  17. Endotoxin tolerance does not limit mild ischemia-reperfusion injury in humans in vivo.

    NARCIS (Netherlands)

    Draisma, A.; Goeij, M. de; Wouters, C.W.; Riksen, N.P.; Oyen, W.J.G.; Rongen, G.A.P.J.M.; Boerman, O.C.; Deuren, M. van; Hoeven, J.G. van der; Pickkers, P.

    2009-01-01

    Animal studies have shown that previous exposure to lipopolysaccharide (LPS) can limit ischemia-reperfusion injury. We tested whether pretreatment with LPS also protects against ischemia-reperfusion injury in humans in vivo. Fourteen volunteers received bolus injections of incremental dosages of LPS

  18. Does Mechanism of Injury Predict Trauma Center Need?

    Science.gov (United States)

    Lerner, E. Brooke; Shah, Manish N.; Cushman, Jeremy T.; Swor, Robert; Guse, Clare E.; Brasel, Karen; Blatt, Alan; Jurkovich, Gregory J.

    2011-01-01

    Objective To determine the predictive value of the Mechanism of Injury step of the American College of Surgeon’s Field Triage Decision Scheme for determining trauma center need. Methods EMS providers caring for injured adult patients transported to the regional trauma center in 3 midsized communities over two years were interviewed upon ED arrival. Included was any injured patient, regardless of injury severity. The interview collected patient physiologic condition, apparent anatomic injury, and mechanism of injury. Using the 1999 Scheme, patients who met the physiologic or anatomic steps were excluded. Patients were considered to need a trauma center if they had non-orthopedic surgery within 24 hours, intensive care unit admission, or died prior to hospital discharge. Data were analyzed by calculating positive likelihood ratios (+LR) and 95% confidence intervals (CI) for each mechanism of injury criteria. Results 11,892 provider interviews were conducted. Of those, 1was excluded because outcome data were not available and 2,408 were excluded because they met the other steps of the Field Triage Decision Scheme. Of the remaining 9,483 cases, 2,363 met one of the mechanism of injury criteria, 204 (9%) of which needed the resources of a trauma center. Criteria with a +LR ≥5 were death of another occupant in the same vehicle (6.8; CI:2.7–16.7), fall >20 ft.(5.2; CI:2.4–11.3), and motor vehicle crash (MVC) extrication >20 minutes (5.0; CI:3.2–8.0). Criteria with a +LR between 2 and 12 inches (3.7; CI:2.6–5.3), ejection (3.2; CI:1.3–8.2), and deformity >20 inches (2.3; CI:1.7–3.0). The criteria with a +LR 40 mph (1.9; CI:1.5–2.2), pedestrian/bicyclist struck >5mph (1.2; CI:1.0–1.5), bicyclist/pedestrian thrown or run over (1.2; CI:0.9–1.6), motorcycle crash >20mph (1.1; CI:0.96–1.3), rider separated from motorcycle (1.0; CI:0.9–1.2), and MVC rollover (1.0; CI:0.7–1.5). Conclusion Death of another occupant, fall distance, and extrication time

  19. Using Dynamic Response Index (DRI) as a spinal injury predictor

    CSIR Research Space (South Africa)

    Ahmed, Rayeesa

    2014-09-01

    Full Text Available , moments and accelerations on an occupant are measured using an Anthropomorphic Testing Device (ATD). These measurements are then correlated to injury criteria which determine the probability of injury. Seats are typically evaluated in terms of probability...

  20. Iso-effect tables for tolerance of irradiated normal human tissues

    International Nuclear Information System (INIS)

    Cohen, L.; Creditor, M.

    1983-01-01

    Available literature on a radiation injury to human tissues (lung, brain, kidney and intestine) was surveyed. A parameter search program (RAD3) was used to derive best-fitting cell kinetic parameters, on the assumption that radiation injury arises from depletion of parenchymal cells in the irradiated organs. From these parameters iso-effect tables were constructed for a wide range of treatment schedules, including daily treatment as well as fractionation at longer intervals, for each tissue. The tables provide a set of limiting doses, above which the risk of radiation injury becomes substantial. Tolerance limits and dose-time-factors were substantially different in the four tissues. It is concluded that computed iso-effect tables provide a more reliable guide to treatment than conventional time-dose equations

  1. The tissue injury and repair in cancer radiotherapy

    International Nuclear Information System (INIS)

    Matsuzawa, Taiju

    1975-01-01

    One of the difficulties in cancer radiotherapy arises from the fact that the tissue tolerance dose is much smaller than the tumor lethal dose. In our opinion the former depends upon the tolerance of the endothelial cell of the blood vessel in the normal tissue. In this introduction, a new concept regarding the estimation of tissue radiosensitivity was described, and the possible significance of the mode of radiation injury and the repair capability of normal tissue in the cancer radiotheraphy was discussed. (author)

  2. Tolerance of the brain and spinal cord to conventional irradiation

    International Nuclear Information System (INIS)

    Leibel, S.A.; Sheline, G.E.

    1991-01-01

    In this paper, the authors discuss the clinical features and time-dose relations associated with radiation injury of the brain and spinal cord. Limits of radiation tolerance have not been well defined. In general, the literature on central nervous system (CNS) injury is anecdotal and incomplete. Relevant information such as total dose at the site of injury, size and number of treatment fractions, overall treatment time, radiation field arrangement, and volume treated is often omitted. Therefore, it is difficult to formulate firm conclusions regarding the risk of radiation injury and its association with any given set of therapeutic approaches and patient characteristics. The material presented in this chapter is based on conventional photon and gamma irradiation, and does not apply to large single dose fractions used in stereotaxic small-field external irradiation (radiosurgery) or to other forms of ionizing radiation such as neutrons or heavy particles

  3. SALT TOLERANCE OF CROP PLANTS

    Directory of Open Access Journals (Sweden)

    Hamdia, M. A

    2010-09-01

    Full Text Available Several environmental factors adversely affect plant growth and development and final yield performance of a crop. Drought, salinity, nutrient imbalances (including mineral toxicities and deficiencies and extremes of temperature are among the major environmental constraints to crop productivity worldwide. Development of crop plants with stress tolerance, however, requires, among others, knowledge of the physiological mechanisms and genetic controls of the contributing traits at different plant developmental stages. In the past 2 decades, biotechnology research has provided considerable insights into the mechanism of biotic stress tolerance in plants at the molecular level. Furthermore, different abiotic stress factors may provoke osmotic stress, oxidative stress and protein denaturation in plants, which lead to similar cellular adaptive responses such as accumulation of compatible solutes, induction of stress proteins, and acceleration of reactive oxygen species scavenging systems. Recently, the authores try to improve plant tolerance to salinity injury through either chemical treatments (plant hormones, minerals, amino acids, quaternary ammonium compounds, polyamines and vitamins or biofertilizers treatments (Asymbiotic nitrogen-fixing bacteria, symbiotic nitrogen-fixing bacteria and mycorrhiza or enhanced a process used naturally by plants to minimise the movement of Na+ to the shoot, using genetic modification to amplify the process, helping plants to do what they already do - but to do it much better."

  4. Injury Rate and Patterns Among CrossFit Athletes.

    Science.gov (United States)

    Weisenthal, Benjamin M; Beck, Christopher A; Maloney, Michael D; DeHaven, Kenneth E; Giordano, Brian D

    2014-04-01

    CrossFit is a type of competitive exercise program that has gained widespread recognition. To date, there have been no studies that have formally examined injury rates among CrossFit participants or factors that may contribute to injury rates. To establish an injury rate among CrossFit participants and to identify trends and associations between injury rates and demographic categories, gym characteristics, and athletic abilities among CrossFit participants. Descriptive epidemiology study. A survey was conducted, based on validated epidemiologic injury surveillance methods, to identify patterns of injury among CrossFit participants. It was sent to CrossFit gyms in Rochester, New York; New York City, New York; and Philadelphia, Pennsylvania, and made available via a posting on the main CrossFit website. Participants were encouraged to distribute it further, and as such, there were responses from a wide geographical location. Inclusion criteria included participating in CrossFit training at a CrossFit gym in the United States. Data were collected from October 2012 to February 2013. Data analysis was performed using Fisher exact tests and chi-square tests. A total of 486 CrossFit participants completed the survey, and 386 met the inclusion criteria. The overall injury rate was determined to be 19.4% (75/386). Males (53/231) were injured more frequently than females (21/150; P = .03). Across all exercises, injury rates were significantly different (P CrossFit was approximately 20%. Males were more likely to sustain an injury than females. The involvement of trainers in coaching participants on their form and guiding them through the workout correlates with a decreased injury rate. The shoulder and lower back were the most commonly injured in gymnastic and power lifting movements, respectively. Participants reported primarily acute and fairly mild injuries.

  5. [Penetrant injuries of colon--our experience].

    Science.gov (United States)

    Lazović, R; Krivokapić, Z; Dobricanin, V

    2010-01-01

    In attemption to determine the place of primary repair in management of colon injuries, an open, non randomized clinical study was performed. Retrospective (RS) group of 62 patients according to exclusion criteria by Stone (S/F) and Flint (F1) was managed by one or two stage surgical procedure. Prospective (PR) group of 34 patients was managed using one stage repair non-selectively: two stage procedures were performed in 3 cases of advanced peritonitis and multi-segmental lacerations with impaired circulation of colon. In RS group 36 patients were managed by primary repair and in PR group, 31 were managed by primary repair. Both groups were of similar age/sex. Indexes of trauma severity were similar (TS, ISS, PATI). The latent time was shorter in PR group. Associated injuries to other body regions and abdominal organs were similar in both groups. S/F criteria and Flint grading in both (RS vs. PR) groups were similar. Comparison of attempted and successful primary repairs justifies the more liberal use of primary repair in early management of colon injuries.

  6. Injury Incidence and Patterns Among Dutch CrossFit Athletes.

    Science.gov (United States)

    Mehrab, Mirwais; de Vos, Robert-Jan; Kraan, Gerald A; Mathijssen, Nina M C

    2017-12-01

    CrossFit is a strength and conditioning program that has gained widespread recognition, with 11,000 affiliated gyms worldwide. The incidence of injuries during CrossFit training is poorly analyzed. To investigate the incidence of injuries for persons participating in CrossFit. Risk factors for injury and injury mechanisms were also explored through athlete demographics and characteristics. Descriptive epidemiology study. A questionnaire that focused on injury incidence in CrossFit in the past year and included data on athlete demographics and characteristics was distributed to all 130 CrossFit gyms in the Netherlands and was also available online in active Facebook groups. Data were collected from July 2015 to January 2016. Inclusion criteria consisted of age ≥18 years and training at a registered CrossFit gym in the Netherlands. A total of 553 participants completed the survey. Univariable and multivariable generalized linear mixed models were used to identify potential risk factors for injury. A total of 449 participants met the inclusion criteria. Of all respondents, 252 athletes (56.1%) sustained an injury in the preceding 12 months. The most injured body parts were the shoulder (n = 87, 28.7%), lower back (n = 48, 15.8%), and knee (n = 25, 8.3%). The duration of participation in CrossFit significantly affected the injury incidence rates (CrossFit was 56.1%. The most frequent injury locations were the shoulder, lower back, and knee. A short duration of participation (<6 months) was significantly associated with an increased risk for injury.

  7. Involvement of Polyamines in the Chilling Tolerance of Cucumber Cultivars

    Science.gov (United States)

    Shen, Wenyun; Nada, Kazuyoshi; Tachibana, Shoji

    2000-01-01

    The possible involvement of polyamines (PAs) in the chilling tolerance of cucumber (Cucumis sativus L. cv Jinchun No. 3 and cv Suyo) was investigated. Plants with the first expanded leaves were exposed to 3°C or 15°C in the dark for 24 h (chilling), and then transferred to 28°C/22°C under a 12-h photoperiod for another 24 h (rewarming). Chilling-tolerant cv Jinchun No. 3 showed a marked increase of free spermidine (Spd) in leaves, once during chilling and again during rewarming. Putrescine increased significantly during rewarming, but the increase of spermine was slight. Any of these PAs did not increase in chilling-sensitive cv Suyo during either period. PA-biosynthetic enzyme activities appear to mediate these differences between cultivars. Pretreatment of Spd to cv Suyo prevented chill-induced increases in the contents of hydrogen peroxide in leaves and activities of NADPH oxidases and NADPH-dependent superoxide generation in microsomes and alleviated chilling injury. Pretreatment of methylglyoxal-bis-(guanylhydrazone), a PA biosynthesis inhibitor, to chilled cv Jinchun No. 3 prevented Spd increase and enhanced microsomal NADPH oxidase activity and chilling injury. The results suggest that Spd plays important roles in chilling tolerance of cucumber, probably through prevention of chill-induced activation of NADPH oxidases in microsomes. PMID:10982456

  8. Medical Injury Identification Using Hospital Discharge Data

    National Research Council Canada - National Science Library

    Layde, Peter M; Meurer, Linda N; Guse, Clare; Meurer, John R; Yang, Hongyan; Laud, Prakash; Kuhn, Evelyn M; Brasel, Karen J; Hargarten, Stephen W

    2005-01-01

    .... The development, validation, and testing of screening criteria for medical injury was based on International Classification of Disease code discharge diagnoses using 2001 patient data from Wisconsin hospitals...

  9. Food safety assurance systems: Microbiological testing, sampling plans, and microbiological criteria

    NARCIS (Netherlands)

    Zwietering, M.H.; Ross, T.; Gorris, L.G.M.

    2014-01-01

    Microbiological criteria give information about the quality or safety of foods. A key component of a microbiological criterion is the sampling plan. Considering: (1) the generally low level of pathogens that are deemed tolerable in foods, (2) large batch sizes, and (3) potentially substantial

  10. Biomechanics Associated with Patellofemoral Pain and ACL Injuries in Sports.

    Science.gov (United States)

    Weiss, Kaitlyn; Whatman, Chris

    2015-09-01

    Knee injuries are prevalent among a variety of competitive sports and can impact an athlete's ability to continue to participate in their sport or, in the worst case, end an athlete's career. The aim was to evaluate biomechanics associated with both patellofemoral pain syndrome (PFPS) and anterior cruciate ligament (ACL) injuries (in sports involving landing, change in direction, or rapid deceleration) across the three time points frequently reported in the literature: pre-injury, at the time of injury, and following injury. A search of the literature was conducted for research evaluating biomechanics associated with ACL injury and PFPS. The Web of Science, SPORTDiscus, EBSCO, PubMed, and CINAHL databases, to March 2015, were searched, and journal articles focused on ACL injuries and PFPS in sports that met the inclusion criteria were reviewed. The search methodology was created with the intent of extracting case-control, case, and cohort studies of knee injury in athletic populations. The search strategy was restricted to only full-text articles published in English. These articles were included in the review if they met all of the required selection criteria. The following inclusion criteria were used: (1) The study must report lower extremity biomechanics in one of the following settings: (a) a comparison of currently injured and uninjured participants, (b) a prospective study evaluating risk factors for injury, or (c) a study reporting on the injury event itself. (2) The study must include only currently active participants who were similar at baseline (i.e. healthy, high school level basketball players currently in-season) and include biomechanical analysis of either landing, change in direction, or rapid deceleration. (3) The study must include currently injured participants. The studies were graded on the basis of quality, which served as an indication of risk of bias. An adapted version of the 'Strengthening the Reporting of Observational Studies in

  11. A longitudinal exploration of pain tolerance and participation in contact sports.

    Science.gov (United States)

    Thornton, Claire; Sheffield, David; Baird, Andrew

    2017-07-01

    Athletes who choose to engage in contact sports do so with the knowledge that participation will bring pain in the form of contact with others, injury, and from exertion. Whilst athletes who play contact sports have been shown to have higher pain tolerance than those who do not, it is unclear whether this is a result of habituation over time, or as a result of individual differences at the outset. The aim was to compare pain responses over an athletic season in athletes who participated in contact sport and those who disengaged from it. One hundred and two new contact athletes completed measures of cold and ischaemic pain tolerance, perceived pain intensity, pain bothersomeness, pain coping styles and attendance at the start, middle (4 months) and end (8 months) of their season. The athletes were drawn from martial arts, rugby and American football. Cluster analysis placed 47 athletes into a participating category and 55 into a non-participating cluster. Participating athletes had higher ischaemic pain tolerance at the start (r=0.27, p=0.05), middle (r=0.41, pdirect coping, catastrophized less about injury pain and also found contact pain to be less bothersome physically and psychologically compared to non-participating athletes. Participating athletes were more tolerant of ischaemic pain at the end of the season compared to the start (r=0.28, p=0.04). Conversely non-participating athletes became significantly less tolerant to both pain stimuli by the end of the season (cold pressor; r=0.54, psports become less pain tolerant of experimental pain, possibly a result of catastrophizing. The results suggest that athletes who commit to contact sports find pain less bothersome over time, possibly as a result of experience and learning to cope with pain. Athletes who continue to participate in contact sports have a higher pain tolerance, report less bothersomeness and have higher direct coping than those who drop out. In addition, tolerance to ischaemic pain increased

  12. A SQUID Bootstrap Circuit with a Large Parameter Tolerance

    International Nuclear Information System (INIS)

    Zhang Guo-Feng; Kong Xiang-Yan; Xie Xiao-Ming; Zhang Yi; Krause Hans-Joachim; Offenhäusser Andreas

    2013-01-01

    The voltage biased (SQUID) bootstrap circuit (SBC) was recently introduced as an effective means to reduce the preamplifier noise contribution. We analyze the tolerances of the SBC noise suppression performance to spreads in SQUID and SBC circuit parameters. It is found that the tolerance to spread mainly caused by the integrated circuit fabrication process could be extended by a one-time adjustable current feedback. A helium-cooled niobium SQUID with a loop inductance of 350 pH is employed to experimentally verify the analysis. From this work, design criteria for fully integrated SBC devices with a high yield can be derived

  13. Radiation-induced heart injury

    International Nuclear Information System (INIS)

    Suzuki, Yoshihiko; Niibe, Hideo

    1975-01-01

    In order to identify radiation-induced heart injury and to differentiate it from heart disease, an attempt was made to clarify post-irradiation heart injury by investigating the histological changes which occur during the internal between the irradiation and the time of demonstrable histological changes. A study was made of 83 autopsies in which most of the primary neoplasms were breast cancers, lung cancers and mediastinal tumors. In 43 of these autopsies the heart had been irradiated. Sixty eight dd-strain mice were also used for microautoradiographic study. Histological changes in the heart were observed in 27 of the 43 cases receiving irradiation. The limit of the tolerance dose to the heart for indicating histological changes was 1220 ret in humans. The latent period without histological changes was 2.7 months after initiation of radiation therapy. Greater heart injury was observed after re-irradiation or after the combined therapy of radiation and chemotherapy especially mitomycin (MMC). The histological findings after treatment with MMC were similar to those of radiation-induced heart injury. Results of the study indicate that the damage is secondary to radiation-induced changes of the vascula connective tissue. (Evans, G.)

  14. Safe-life and damage-tolerant design approaches for helicopter structures

    Science.gov (United States)

    Reddick, H. K., Jr.

    1983-01-01

    The safe-life and damage-tolerant design approaches discussed apply to both metallic and fibrous composite helicopter structures. The application of these design approaches to fibrous composite structures is emphasized. Safe-life and damage-tolerant criteria are applied to all helicopter flight critical components, which are generally categorized as: dynamic components with a main and tail rotor system, which includes blades, hub and rotating controls, and drive train which includes transmission, and main and interconnecting rotor shafts; and the airframe, composed of the fuselage, aerodynamic surfaces, and landing gear.

  15. Acid and bile tolerance of spore-forming lactic acid bacteria.

    Science.gov (United States)

    Hyronimus, B; Le Marrec, C; Sassi, A H; Deschamps, A

    2000-11-01

    Criteria for screening probiotics such as bile tolerance and resistance to acids were studied with 13 spore-forming lactic acid producing bacteria. Different strains of Sporolactobacillus, Bacillus laevolacticus, Bacillus racemilacticus and Bacillus coagulans grown in MRS broth were subjected to low pH conditions (2, 2.5 and 3) and increasing bile concentrations. Among these microorganisms, Bacillus laevolacticus DSM 6475 and all Sporolactobacillus strains tested except Sporolactobacillus racemicus IAM 12395, were resistant to pH 3. Only Bacillus racemilacticus and Bacillus coagulans strains were tolerant to bile concentrations over 0.3% (w/v).

  16. Late effects of radiation on the lumbar spinal cord of guinea pigs: Re-treatment tolerance

    International Nuclear Information System (INIS)

    Mason, K.A.; Withers, H.R.; Chiang, Chi-Shiun

    1993-01-01

    Using a guinea pig model of lumbar myelopathy, various factors affecting the tolerance of spinal cord to irradiation were assessed: (a) extent of initial injury; (b) time interval between priming and test doses; and (c) animal age at the time of initial radiation treatment. A 3 cm section of lumbar spinal cord of guinea pigs was irradiated with fractionated doses of 4.5 Gy gamma rays given as 9 fractions per week. Guinea pigs were primed with 9 x 4.5 Gy in 7 days which is 60% of the ED 50 for a continuous course of treatment. After 28 or 40 weeks, animal were retreated with 6-14 fractions of 4.5 Gy. Animals were observed for 2 years following the priming dose and both the incidence and latency of myelopathy recorded. Young adult guinea pigs (8 wk old) showed both a decreased radiation tolerance and latency compared to old individuals (40 wk old). At 28 or 40 wk after 9 x 4.5 Gy, only about 8% of the initial injury was remembered in young adult guinea pigs. The amount of residual injury was dependent on the initial damage as a proportion of the tolerance dose. The spinal cord shows a greater capacity for long-term recovery than generally appreciated and re-treatment doses clinically prescribed may be lower than necessary. 8 refs., 3 figs., 2 tabs

  17. Triage tools for detecting cervical spine injury in pediatric trauma patients

    NARCIS (Netherlands)

    Slaar, Annelie; Fockens, M. M.; Wang, Junfeng; Maas, Mario; Wilson, David J.; Goslings, J. Carel; Schep, Niels Wl; van Rijn, Rick R.

    2017-01-01

    Pediatric cervical spine injury (CSI) after blunt trauma is rare. Nonetheless, missing these injuries can have severe consequences. To prevent the overuse of radiographic imaging, two clinical decision tools have been developed: The National Emergency X-Radiography Utilization Study (NEXUS) criteria

  18. Comparison of Prevalence and Outcomes of Pediatric Acute Respiratory Distress Syndrome Using Pediatric Acute Lung Injury Consensus Conference Criteria and Berlin Definition

    Directory of Open Access Journals (Sweden)

    Samriti Gupta

    2018-04-01

    Full Text Available ObjectivesOur objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC criteria and Berlin definitions.MethodsWe screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU over a 3-year period (2015–2017 for presence of any respiratory difficulty at admission or during PICU stay. We applied both PALICC and Berlin criteria to these patients. Data collection included definition and outcome related variables. Data were compared between the “PALICC only group” and the “Berlin with or without PALICC” group using Stata 11.ResultsOf a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. A total of 61 children (prevalence 9.9%; 95% CI: 7.8–12.4 fulfilled the definition of acute respiratory distress syndrome (ARDS with either of the two criteria. While 60 children (98% fulfilled PALICC criteria, only 26 children (43% fulfilled Berlin definition. There was moderate agreement between the two definitions (Kappa: 0.51; 95% CI: 0.40–0.62; observed agreement 85%. Greater proportion of patients had severe ARDS in the “Berlin with or without PALICC group” as compared to the “PALICC only” group (50 vs. 19%. There was no difference between the groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days or mortality [51.4 vs. 57.7%: RR (95% CI: 0.99 (0.64–1.5].ConclusionIn comparison to Berlin definition, the PALICC criteria identified more number of patients with ARDS. Proportion with severe ARDS and complications was greater in the “Berlin with or without PALICC” group as compared to the “PALICC only” group. There were no differences in clinical outcomes between the groups.

  19. Post-load hyperglycaemia and diagnostic criteria for diabetes

    Institute of Scientific and Technical Information of China (English)

    Qing Qiao

    2008-01-01

    The evolution of 2 h post-load glucose tolerance test for diagnosis of diabetes and its clinical implication was reviewed and discussed.Post-load hyperglycemia is a risk factor for both micro-and macro-vascular diseases.According to its relationship with retinopathy,the current cut-off values for diabetes was defined since 1979.Recently,strong evidence has shown that post-load hyperglycemia is also an important risk factor for cardiovascular disease(CVD),the relation is linear and no a threshold was found.There are large discrepancies between fasting and 2 h glucose criteria in the classification of diabetes and impaired glucose tolerance(IGT)/impaired fasting glucose(IFG).For early diagnosis and intervention administrating a 2 h OGTT to suspect individuals is necessary.

  20. Child abuse. Non-accidental head injury

    International Nuclear Information System (INIS)

    Klee, Dirk; Schaper, Joerg

    2011-01-01

    Knowledge of the radiological appearances that are the result of child abuse is an integral part of prevention of further, potentially life-threatening, injury. Radiologists must have un understanding of typical injury patterns of the skeletal system, visceral and intra-cranial structures, which should ideally be ordered chronologically. Necessary radiological investigations follow guidelines with specific criteria that are pointed out in this review. In equivocal cases of abuse, the opinion of a second (paediatric) radiologist should be sought. (orig.)

  1. A video analysis of head injuries satisfying the criteria for a head injury assessment in professional Rugby Union: a prospective cohort study.

    Science.gov (United States)

    Tucker, Ross; Raftery, Martin; Fuller, Gordon Ward; Hester, Ben; Kemp, Simon; Cross, Matthew J

    2017-08-01

    Concussion is the most common match injury in professional Rugby Union, accounting for 25% of match injuries. The primary prevention of head injuries requires that the injury mechanism be known so that interventions can be targeted to specifically overall incidence by focusing on characteristics with the greatest propensity to cause a head injury. 611 head injury assessment (HIA) events in professional Rugby Union over a 3-year period were analysed, with specific reference to match events, position, time and nature of head contact. 464 (76%) of HIA events occur during tackles, with the tackler experiencing a significantly greater propensity for an HIA than the ball carrier (1.40 HIAs/1000 tackles for the tackler vs 0.54 HIAs/1000 tackles for the ball carrier, incidence rate ratio (IRR) 2.59). Propensity was significantly greater for backline players than forwards (IRR 1.54, 95% CI 1.28 to 1.84), but did not increase over the course of the match. Head to head contact accounted for the most tackler HIAs, with the greatest propensity. By virtue of its high propensity and frequency, the tackle should be the focus for interventions that may include law change and technique education. A specific investigation of the characteristics of the tackle is warranted to refine the approach to preventative strategies. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Severe Juxtahepatic Venous Injury: Survival after Prolonged Hepatic Vascular Isolation Without Shunting

    Directory of Open Access Journals (Sweden)

    J. E. J. Krige

    1990-01-01

    Full Text Available Survival following major juxtahepatic venous injury is rare in blunt liver trauma despite the use of intracaval shunting. Prolonged liver arterial inflow control, total hepatic venous isolation and lobectomy without shunting was used in a patient to repair a combined vena caval and hepatic venous injury after blunt liver injury. An extended period of normothermic hepatic ischemia was tolerated. Early recognition of retrohepatic venous injury and temporary liver packing to control bleeding and correct hypovolemia are essential before caval occlusion. Hepatic vascular isolation without shunting is an effective simple alternative technique allowing major venous repair in complex liver trauma.

  3. The pattern and prevalence of vertebral artery injury in patients with cervical spine fractures

    Directory of Open Access Journals (Sweden)

    Farzanah Ismail

    2013-06-01

    Method: A retrospective review of patients who had undergone CTA of the vertebral arteries was undertaken. Reports were reviewed to determine which patients met the inclusion criteria of having had both cervical spine fractures and CTA of the vertebral arteries. Images of patients who met the inclusion criteria were analysed by a radiologist. Results: The prevalence of vertebral artery injury was 33%. Four out of the 11 patients who had vertebral artery injury, had post-traumatic spasm of the artery, with associated thrombosis or occlusion of the vessel. In terms of blunt carotid vertebral injury (BCVI grading, most of the patients sustained grade IV injuries. Four patients who had vertebral artery injury had fractures of the upper cervical vertebrae, i.e. C1 to C3. Fifteen transverse process fractures were associated with vertebral artery injury. No vertebral artery injury was detected in patients who had facet joint subluxations. Conclusion: Patients with transverse process fractures of the cervical spine and upper cervical vertebral body fractures should undergo CTA to exclude vertebral artery injury.

  4. A Case Report of Mania and Psychosis Five Months after Traumatic Brain Injury Successfully Treated Using Olanzapine

    Directory of Open Access Journals (Sweden)

    Giordano F. Cittolin-Santos

    2017-01-01

    Full Text Available Background. There are few published pharmacologic trials for the treatment of acute mania following traumatic brain injury (TBI. To our knowledge, we present the first case report of an individual being treated and stabilized with olanzapine monotherapy for this condition. Case Presentation. We describe the case of a 53-year-old African American male admitted to an inpatient psychiatric hospital with one month of behavioral changes including irritability, decreased need for sleep, hyperverbal speech, hypergraphia, and paranoia five months after TBI. Using Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5 criteria, he was diagnosed with bipolar disorder due to traumatic brain injury, with manic features. He was serially evaluated with clinical rating scales to measure symptom severity. The Young Mania Rating Scale (YMRS score upon admission was 31, and the Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS score was initially 9. After eight days of milieu treatment and gradual titration of olanzapine to 15 mg nightly, his symptoms completely abated, with YMRS and CRDPSS scores at zero on the day of discharge. Conclusion. Olanzapine was effective and well tolerated for the treatment of mania following TBI.

  5. Public 'in'tolerance of technological hazards and risk policy

    International Nuclear Information System (INIS)

    Simmons, P.; Walker, G.; Irwin, A.; Wynne, B.

    1998-01-01

    Full text of publication follows: it has been recognised that the notion that there is an 'acceptable' level of risk to the public from technological hazards is in many cases inappropriate. UK government policy on major industrial hazards is informed by the principle of 'tolerability' of risk (TOR). In the paper we examine this principle and how it relates to the views of people who live day-to-day with such hazards. The analysis of public views is based on the results of a Q-method study carried out in the course of recent research funded by the UK Health and Safety Executive. The Q-method study distinguishes between different bases of public toleration - and lack of toleration - of risk. The study found lack a toleration to be based on a single cluster of factors, whereas the bases for public toleration of risk were far more differentiated. The results are outlined in the paper. In the concluding section of the paper we examine the implications of these results for policy, in particular for the application of the TOR principle when setting risk criteria. (authors)

  6. Boarding Injuries: The Long and the Short of It

    Science.gov (United States)

    Fabian, Leslie A.; Thygerson, Steven M.; Merrill, Ray M.

    2014-01-01

    As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P skateboarders (P skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population. PMID:24660063

  7. Injury incidence in hip hop dance.

    Science.gov (United States)

    Ojofeitimi, S; Bronner, S; Woo, H

    2012-06-01

    Hip hop dance has rapidly become a popular international art form. There is limited information on injury patterns in this population. The purpose of this study was to determine injury incidence and patterns among three groups of hip hop dancers. Three hundred and twelve intermediate, advanced, and expert hip hop dancers were recruited at battles, dance conferences, clubs, and on dance related web sites within the United States and internationally. A Web-based survey was conducted over a 6-month period. Inclusion criteria included intermediate and advanced level dancers over the age of 13. Dancers were divided into three main categories: Breakers, Popper/Lockers, and New Schoolers. Separate analysis of variances were used to compare injury pattern differences between groups. Two hundred and thirty-two dancers reported a total of 738 injuries. Five hundred and six of these (sustained by 205 dancers) were time-loss (TL) injuries. Annual injury incidence was 237% (162% involving TL). Lower extremity injuries were 52% and upper extremity injuries 32% of total injuries. Breakers had a higher injury incidence compared with Popper/Lockers, and New Schoolers. Hip hop dancers report injury rates that are higher than other dance forms but similar to gymnastics. These dancers should be educated concerning injury prevention, biomechanics, and use of protective equipment. © 2010 John Wiley & Sons A/S.

  8. Paediatric cervical spine injury but NEXUS negative

    OpenAIRE

    Maxwell, Melanie J; Jardine, Andrew D

    2007-01-01

    Cervical spine injuries in paediatric patients following trauma are extremely rare. The National Emergency X‐Radiography Utilization Study (NEXUS) guidelines are a set of clinical criteria used to guide physicians in identifying trauma patients requiring cervical spine imaging. It is validated for use in children. A case of a child who did not fulfil the NEXUS criteria for imaging but was found to have a cervical spine fracture is reported.

  9. Plant plasma membrane proteomics for improving cold tolerance

    Directory of Open Access Journals (Sweden)

    Daisuke eTakahashi

    2013-04-01

    Full Text Available Plants are always exposed to various stresses. We have focused on freezing stress, which causes serious problems for agricultural management. When plants suffer freeze-induced damage, the plasma membrane is thought to be the primary site of injury because of its central role in regulation of various cellular processes. Cold tolerant species, however, adapt to such freezing conditions by modifying cellular components and functions (cold acclimation. One of the most important adaptation mechanisms to freezing is alteration of plasma membrane compositions and functions. Advanced proteomic technologies have succeeded in identification of many candidates that may play roles in adaptation of the plasma membrane to freezing stress. Proteomics results suggest that adaptations of plasma membrane functions to low temperature are associated with alterations of protein compositions during cold acclimation. Some of proteins identified by proteomic approaches have been verified their functional roles in freezing tolerance mechanisms further. Thus, accumulation of proteomic results in the plasma membrane is of importance for application to molecular breeding efforts to increase cold tolerance in crops.

  10. Occupational injury among migrant workers in China: a systematic review

    Science.gov (United States)

    Fitzgerald, Simon; Chen, Xin; Qu, Hui; Sheff, Mira Grice

    2017-01-01

    Objectives This review considers the state of occupational injury surveillance and prevention among migrant workers in China and suggests areas of focus for future research on the topic. Methods Bibliographic databases were searched for qualitative and quantitative studies on surveillance of and interventions to prevent occupational injury among migrant workers in mainland China. Additional abstracts were identified from the citations of relevant articles from the database search. Studies fitting the inclusion criteria were evaluated, and findings were extracted and summarised. Results The search uncovered 726 studies in the English-language databases searched, and 3109 in the Chinese database. This article analyses a total of 19 research articles that fit the inclusion criteria with qualitative or quantitative data on occupational injury surveillance and prevention of migrant workers in China. Despite evidence of the vulnerability of migrant workers in the workplace, there is little systematic surveillance of occupational injury and few evaluated interventions. Conclusions Migrant workers account for a disproportionate burden of occupational injury morbidity and mortality in China. However, data are inconsistent and inadequate to detail injury incidence or to evaluate interventions. The following are suggestions to decrease injury incidence among migrants: strengthen the national system of occupational injury surveillance; focus surveillance and interventions on high-risk occupations employing migrants such as construction, manufacturing and small mining operations; improve occupational safety training and access to appropriate safety equipment; evaluate recent changes in occupational health and safety and evaluate outcome of multi-party interventions to reduce occupational injury among migrant workers. PMID:23710065

  11. A new classification for cervical vertebral injuries: influence of CT

    International Nuclear Information System (INIS)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L.

    2000-01-01

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  12. Head injury: audit of a clinical guideline to justify head CT

    International Nuclear Information System (INIS)

    Haydon, Nicholas B.

    2013-01-01

    Head injury causes significant morbidity and mortality, and there is contention about which patients to scan. The UK National Health Service Clinical Guideline (CG) 56 provides criteria for selecting patients with clinically important brain injury who may benefit from a head CT scan, while minimising the radiation and economic burden of scanning patients without significant injury. This study aims to audit the documentation of the use of these guidelines in a busy UK trauma hospital and discusses the comparison with an Australian (New South Wales (NSW) ) head injury guideline. A retrospective cohort study of 480 patients presenting with head injury to the emergency department over 2 months was performed. The patient notes were assessed for documentation of each aspect of the clinical guidelines. Criteria were established to assess the utilisation of the CG 56. A database of clinical data was amalgamated with the head CT scan results for each patient. For the UK CG 56, 73% of the criteria were documented, with the least documented being 'signs of basal skull fracture' and 'amnesia of events'. Thirty-two per cent of patients received head CT and of these, 24% (37 patients) were reported to have pathology. Twenty-four patients underwent head CT without clinical justification being documented, none of which had reported pathology on CT. The study shows that the head injury guidelines are not being fully utilised at a major UK trauma hospital, resulting in 5% of patients being exposed to ionising radiation without apparent documented clinical justification. The NSW guideline has distinct differences to the CG 56, with a more complex algorithm and an absence of specific time frames for head CT completion. The results suggest a need for further education and awareness of head injury clinical guidelines.

  13. Self-injurious behavior in anorexia nervosa.

    Science.gov (United States)

    Favaro, A; Santonastaso, P

    2000-08-01

    Recent reports have postulated the existence of two different types of self-injurious behavior: impulsive and compulsive. The aim of the present study is to analyze the dimensionality of self-injurious behavior and to study the link between self-injurious behavior and clinical features in anorexia nervosa. The study involved 236 consecutive patients with anorexia nervosa, diagnosed by DSM-IV criteria. Subjects were evaluated by means of a semistructured interview and self-reported questionnaires, such as the Eating Disorders Inventory and Hopkins Symptom Checklist. A principal component analysis was used to study the dimensionality of different types of self-injurious behavior, including purging. Our findings confirm the distinction between impulsive and compulsive self-injurious behavior. The dimensions appear to be represented as a continuum in both the anorexia nervosa diagnostic subgroups. A third distinct dimension emerged that included self-induced vomiting and laxative/diuretics abuse. Childhood sexual abuse and anxiety significantly predict the presence of impulsive self-injury, whereas obsessionality and age predict compulsive self-injury. The coexistence of a positive score on both dimensions of self-injurious behavior was the strongest predictor of treatment dropout. The present study highlights the importance of self-injurious behavior; it should be given due consideration in future outcome studies on anorexia nervosa

  14. Biochemical leaf traits as indicators of tolerance potential in tree species from the Brazilian Atlantic Forest against oxidative environmental stressors.

    Science.gov (United States)

    Brandão, Solange E; Bulbovas, Patricia; Lima, Marcos E L; Domingos, Marisa

    2017-01-01

    The tolerance potential against the oxidative injury in native plants from forest ecosystems affected by environmental stressors depends on how efficiently they keep their pro-oxidant/antioxidant balance. Great variations in plant tolerance are expected, highlighting the higher relevance of measuring biochemical leaf trait indicators of oxidative injury in species with similar functions in the forest than in single species. The use of this functional approach seems very useful in the Brazilian Atlantic Forest because it still holds high plant diversity and was the focus of this study. We aimed at determining the tolerance potential of tree species from the Atlantic Forest remnants in SE Brazil against multiple oxidative environmental stressors. We assumed that pioneer tree species are more tolerant against oxidative stress than non-pioneer tree species and that their tolerance potential vary spatially in response to distinct combined effects of oxidative environmental stressors. The study was carried out in three Atlantic Forest remnants, which differ in physiognomy, species composition, climatic characteristics and air pollution exposure. Leaves of three pioneer and three non-pioneer species were collected from each forest remnant during wet (January 2015) and dry periods (June 2015), for analyses of non-enzymatic and enzymatic antioxidants and oxidative injury indicators. Both hypotheses were confirmed. The pioneer tree species displayed biochemical leaf traits (e.g. high levels of ascorbic acid, glutathione and carotenoids and lower lipid peroxidation) that indicate their higher potential tolerance against oxidative environmental stressors than non-pioneer species. The biochemical leaf traits of both successional groups of species varied between the forest remnants, in response to a linear combination of oxidative environmental stressors, from natural (relative humidity and temperature) and anthropogenic sources (ozone and nitrogen dioxide). Copyright © 2016

  15. Progesterone for Acute Traumatic Brain Injury: A Systematic Review of Randomized Controlled Trials.

    Directory of Open Access Journals (Sweden)

    Yunhui Zeng

    Full Text Available To evaluate the efficacy and safety of progesterone administrated in patients with acute traumatic brain injury (TBI.PubMed/MEDLINE, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL, Clinicaltrials.gov, ISRCTN registry and WHO International Clinical Trials Registry Platform (ICTRP were searched for randomized controlled trials (RCTs comparing progesterone and placebo administrated in acute TBI patients. The primary outcome was mortality and the secondary outcomes were unfavorable outcomes and adverse events. A meta-analysis was conducted to evaluate the efficacy and safety of progesterone administrated in patients with acute TBI.A total of 6 studies met inclusion criteria, involving 2,476 patients. The risk of bias was considered to be low in 4 studies but high in the other 2 studies. The results of meta-analysis indicated progesterone did not reduce the mortality (RR = 0.83, 95% CI = 0.57-1.20 or unfavorable outcomes (RR = 0.89, 95% CI = 0.78-1.02 of acute TBI patients in comparison with placebo. Sensitivity analysis yielded consistent results. Progesterone was basically safe and well tolerated in TBI patients with the exception of increased risk of phlebitis or thrombophlebitis (RR = 3.03, 95% CI = 1.96-4.66.Despite some modest bias, present evidence demonstrated that progesterone was well tolerated but did not reduce the mortality or unfavorable outcomes of adult patients with acute TBI.

  16. MANAGEMENT OF SPLENIC INJURY AFTER BLUNT INJURY TO ABDOMEN

    Directory of Open Access Journals (Sweden)

    J. Bharath Prakash Reddy

    2016-07-01

    Full Text Available BACKGROUND The spleen is an important organ in the body’s immune system. It is the most frequently injured organ in blunt abdominal trauma. 1 Over the past several decades, diagnosis and management of splenic trauma has been evolved. The conservative, operative approach has been challenged by several reports of successful non-operative management aided by the power of modern diagnostic imaging. The aim of our prospective study was to compare non-operative management with surgery for cases of splenic injury. METHODS We conducted a prospective study of patients admitted with blunt splenic injury to our regional hospital over a three-year period (2012-2015. Haemodynamic status upon admission, FAST examination, computed tomography 2 grade of splenic tear, presence and severity of associated injuries have been taken into account to determine the treatment of choice. Therapeutic options were classified into non-operative and splenectomy. RESULTS Over a 3-year period, 24 patients were admitted with blunt splenic injury. Sixteen patients were managed operatively and eight patients non-operatively. 3,4 Non-operative management failed in one patient due to continued bleeding. The majority of grades I, II, and III splenic injuries were managed non-operatively and grades IV and V were managed operatively. Blood transfusion requirement was significantly higher among the operative group, but the operative group had a significantly longer hospital stay. Among those managed non-operatively (median age 24.5 years, a number of patients were followed up with CT scans with significant radiation exposure and unknown longterm consequences. CONCLUSION In our experience, NOM is the treatment of choice for grade I, II and III blunt splenic injuries. Splenectomy was the chosen technique in patients who met exclusion criteria for NOM, as well as for patients with grade IV and V injury.

  17. Possible new roles for tolerable risk mediators

    International Nuclear Information System (INIS)

    O'Riordan, T.

    1989-01-01

    In his report on the Sizewell B Inquiry, the Inspector, Sir Frank Layfield, Q.C. introduced the term ''tolerable risk''. He regarded this as a better concept than the much abused and mis-interpreted phrase ''acceptable risk''. The application of tolerable risk implies that, even after regulation and incorporation of appropriate design safety criteria, there will always be a residual risk over which elements of the public will remain uneasy. They may tolerate, but they do not accept. They only tolerate because they have come to trust the process by which safety is assessed and delivered. This interpretation also implies that no safety target, the central theme of this meeting, should ever be regarded as stable or final. Such targets should continually be argued about and subject to regular searching review. Above all, such targets need to be re-justified to a doubting public so that they can be assured that the safety delivery process, namely the principles and management methods to ensure safety levels are actually met, is accountable and open for them to inspect. Thus the ''tolerable zone'' of nuclear plant safety is the product of procedures not simply assessments. These procedures need to be robust and adaptable. They need to be able to incorporate diversity of viewpoints and have a capacity to enable all who are involved to learn from each other's viewpoints and experience. In short the safety determination process needs to be more participatory and creative. (author)

  18. A systematic review on the influence of pre-existing disability on sustaining injury.

    Science.gov (United States)

    Yung, A; Haagsma, J A; Polinder, S

    2014-01-01

    To systematically review studies measuring the influence of pre-existing disability on the risk of sustaining an injury. Systematic review. Electronic databases searched included Medline (Pubmed), ProQuest, Ovid and EMBASE. Studies (1990-2010) in international peer-reviewed journals were identified with main inclusion criteria being that the study assessed involvement of injury sustained by persons with and without pre-existing disability. Studies were collated by design and methods, and evaluation of results. Twenty-two studies met the inclusion criteria of our review. All studies found that persons with disabilities were at a significantly higher risk of sustaining injuries than those without. Persons with disability had a 30-450% increased odds (odds ratio 1.3-5.5) of sustaining injury compared to persons without disability. Among persons with pre-existing disability, the high risk groups of sustaining an injury are children and elderly. People with disabilities experience a higher risk to sustain an injury in comparison to the healthy population. There is a high need for large epidemiological studies of injury among persons with disability, to better address these unique risk profiles in order to prevent additional disability or secondary conditions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Simplification and transformation of ASTM F1292 measurement procedure for fall accident injury criteria.

    Science.gov (United States)

    Kato, Maki; Shimodaira, Yoshie; Sato, Takeshi; Iida, Hiromi

    2014-01-01

    Protecting children from injuries caused by fall accidents from playground equipment is important. Therefore, measures toward minimizing the risk of fall accident injuries are required. The risk of injury can be evaluated using ASTM F1292. In this test, G-max and the HIC are used to estimate the risk of injury. However, the measurement procedure is too complicated for application to a large number of installed equipment. F1292 requires simplified by reducing the number of phases, even with a small risk of loss in accuracy. With this in mind, this study proposes a shortened measurement procedure and a transformation equation to estimate the risk as same as F1292. As the result of experiments, it was revealed that G-max and the HIC values for both procedures linearly increase with drop height. The differences in outcomes between the regression equations of the standardized procedure and those of the shortened procedure can be used as a correction value. They can be added to the value measured by the shortened procedure. This suggests that the combination of the shortened procedure and transformation equation would be equivalent to F1292, with the advantage of being more easily and efficiently applied to the evaluation of installed playground equipment.

  20. MR imaging of muscle injuries; MRT von Muskelverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Woertler, Klaus [Technische Univ. Muenchen, Klinikum rechts der Isar (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2014-12-15

    Injuries to skeletal muscle are very common particularly in athletes. Besides ultrasound, MR imaging represents the most valuable imaging modality for diagnosis and grading of muscle lesions. This article reviews the examination technique and diagnostic criteria of acute and chronic lesions of skeletal muscle at MR imaging. In addition to the morphology of direct and indirect muscle injuries, MR findings in myositis ossificans and compartment syndrome are discussed as well.

  1. 29 CFR 1904.8 - Recording criteria for needlestick and sharps injuries.

    Science.gov (United States)

    2010-07-01

    ....1030). You must enter the case on the OSHA 300 Log as an injury. To protect the employee's privacy, you may not enter the employee's name on the OSHA 300 Log (see the requirements for privacy cases in... classification of the case on the OSHA 300 Log if the case results in death, days away from work, restricted work...

  2. A multiscale approach to blast neurotrauma modeling:Part II: Methodology for inducing blast injury to in vitro models

    Directory of Open Access Journals (Sweden)

    Gwen B. Effgen

    2012-02-01

    Full Text Available Due to the prominent role of improvised explosive devices (IEDs in wounding patterns of U.S. war-fighters in Iraq and Afghanistan, blast injury has risen to a new level of importance and is recognized to be a major cause of injuries to the brain. However, an injury risk-function for microscopic, macroscopic, behavioral, and neurological deficits has yet to be defined. While operational blast injuries can be very complex and thus difficult to analyze, a simplified blast injury model would facilitate studies correlating biological outcomes with blast biomechanics to define tolerance criteria. Blast-induced traumatic brain injury (bTBI results from the translation of a shock wave in air, such as that produced by an IED, into a pressure wave within the skull-brain complex. Our blast injury methodology recapitulates this phenomenon in vitro, allowing for control of the injury biomechanics via a compressed-gas shock tube used in conjunction with a custom-designed, fluid-filled receiver that contains the living culture. The receiver converts the air shock wave into a fast-rising pressure transient with minimal reflections, mimicking the intracranial pressure history in blast. We have developed an organotypic hippocampal slice culture model that exhibits cell death when exposed to a 530  17.7 kPa peak overpressure with a 1.026 ± 0.017 ms duration and 190 ± 10.7 kPa-ms impulse in-air. We have also injured a simplified in vitro model of the blood-brain barrier, which exhibits disrupted integrity immediately following exposure to 581  10.0 kPa peak overpressure with a 1.067 ms ± 0.006 ms duration and 222 ± 6.9 kPa-ms impulse in-air. To better prevent and treat bTBI, both the initiating biomechanics and the ensuing pathobiology must be understood in greater detail. A well-characterized, in vitro model of bTBI, in conjunction with animal models, will be a powerful tool for developing strategies to mitigate the risks of bTBI.

  3. The impaired myocardial ischemic tolerance in adult offspring of diabetic pregnancy is restored by maternal melatonin treatment.

    Science.gov (United States)

    Gao, Ling; Zhao, Yi-Chao; Liang, Yan; Lin, Xian-Hua; Tan, Ya-Jing; Wu, Dan-Dan; Li, Xin-Zhu; Ye, Bo-Zhi; Kong, Fan-Qi; Sheng, Jian-Zhong; Huang, He-Feng

    2016-10-01

    Diabetic pregnancy, with ever increasing prevalence, adversely affects embryogenesis and increases vasculometabolic disorder risks in adult offspring. However, it remains poorly understood whether maternal diabetes increases the offspring's susceptibility to heart injuries in adulthood. In this study, we observed that cardiac function and structure were comparable between adult offspring born to diabetic mice and their counterparts born to nondiabetic mice at baseline. However, in response to myocardial ischemia/reperfusion (MIR), diabetic mother offspring exhibited augmented infarct size, cardiac dysfunction, and myocardial apoptosis compared with control, in association with exaggerated activation of mitochondria- and endoplasmic reticulum (ER) stress-mediated apoptosis pathways and oxidative stress. Molecular analysis showed that the impaired myocardial ischemic tolerance in diabetic mother offspring was mainly attributable to blunted cardiac insulin receptor substrate (IRS)-1/Akt signaling. Furthermore, the effect of maternal melatonin administration on offspring's response to MIR was determined, and the results indicated that melatonin treatment in diabetic dams during pregnancy significantly improved the tolerance to MIR injury in their offspring, via restoring cardiac IRS-1/Akt signaling. Taken together, these data suggest that maternal diabetes predisposes offspring to augmented MIR injury in adulthood, and maternal melatonin supplementation during diabetic pregnancy may hold promise for improving myocardial ischemic tolerance in the offspring. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. [Salt stress tolerance of cucumber-grafted rootstocks].

    Science.gov (United States)

    Wang, Li-Ping; Sun, Jin; Guo, Shi-Rong; Liu, Shu-Ren; Liu, Chao-Jie; Tian, Jing

    2012-05-01

    Taking 4 different Cucurbita maxima x C. moschata rootstocks for cucumber (Cucumis sativus) as test materials, a solution culture experiment was conducted to study their growth and antioxidative enzyme activities under the stresses of Ca(NO3)2 and NaCl, with the salt stress tolerance of the rootstocks evaluated by subordinate function. At 30 mmol x L(-1) of Ca (NO3)2 or 45 mmol x L(-1) of NaCl, the growth of the rootstock seedlings was improved; but at 60 and 120 mmol x L(-1) of Ca(NO3)2 or 90 and 180 mmol x L(-1) of NaCl, the growth and the antioxidative systems of the seedlings were inhibited, and the salt injury index of 'Qingzhen No. 1' was the smallest, with the decrement of biomass and SOD, POD and CAT activities and the increment of relative conductance being significantly lower than those of the others. Under the stress of high concentration Ca(NO3)2, the SOD, POD and CAT activities of test rootstocks were higher, and the salt injury index and relative conductance were lower, as compared with those under high concentration NaCl, suggesting that the damage of Ca(NO3)2 stress to cucumber-grafted rootstock were smaller than that of NaCl stress. Among the 4 rootstocks, 'Qingzhen No. 1' had the strongest salt stress tolerance, followed by 'Zuomu Nangua', 'Fengyuan Tiejia', and 'Chaoba Nangua'.

  5. Evaluation report on the causal association between humidifier disinfectants and lung injury

    Directory of Open Access Journals (Sweden)

    Mina Ha

    2016-08-01

    Full Text Available OBJECTIVES As of November 2011, the Korean government recalled and banned humidifier disinfectants (HDs from the market, because four case-control studies and one retrospective epidemiological study proved the association between HDs and lung injury of unknown cause. The report reviewed the causal role of HDs in lung injury based on scientific evidences. METHODS A careful examination on the association between the HDs and lung injury was based on the criteria of causality inference by Hill and the US Surgeon General Expert Committee. RESULTS We found that all the evidences on the causality fulfilled the criteria (strength of association, consistency, specificity, temporality, biologic gradient, plausibility, coherence, experiment, analogy, consideration of alternative explanations, and cessation of exposure, which proved the unknown cause lung injury reported in 2011 was caused by the HDs. In particular, there was no single reported case of lung injury since the ban in selling HDs in November 2011 as well as before the HDs were sold in markets. CONCLUSIONS Although only a few epidemiological studies in Korea have evaluated the association between lung injury and the use of HDs, those studies contributed to proving the strong association between the use of the HDs and lung injury, based on scientific evidence.

  6. Tolerance of plants to air pollutants. Shokubutsu no taiki osen taisei

    Energy Technology Data Exchange (ETDEWEB)

    Kondo, N.; Saji, H. (National Institute for Environmental Studies, Tsukuba (Japan))

    1992-11-10

    Attempts have been made to improve tolerance of plants to air pollutants by changing activities in detoxifying enzymes against toxic substances attributable to air pollutants, through gene manipulation. An air pollutant, absorbed in a plant through its stomata, produces toxic substances in the cells and damages the organism. Detailed discussions were given on the following: Stoma opening action and reaction; injuries attributable to air pollutants and detoxifying metabolism systems; ethylene and toxic enzymes of secondary toxic substances in an organism; different detoxifying mechanisms and active enzymes; and activation of detoxifying enzymes using genes. Pollution tolerance in plants is governed by inherent plant natures and environmental conditions. Plants that have two opposing functions of emerging damages from toxicity and preventing them with detoxifying capability are controlled with a complex and delicate balance. Changing pollution tolerance in plants may be possible by manipulating genes, but the importance is to elucidate what the tolerating enzymes are, and obtain their genes. Genes that could be used are very few in number. Expectations are placed on the future development. 122 refs., 4 figs.

  7. Benefits of the maximum tolerated dose (MTD) and maximum tolerated concentration (MTC) concept in aquatic toxicology

    International Nuclear Information System (INIS)

    Hutchinson, Thomas H.; Boegi, Christian; Winter, Matthew J.; Owens, J. Willie

    2009-01-01

    There is increasing recognition of the need to identify specific sublethal effects of chemicals, such as reproductive toxicity, and specific modes of actions of the chemicals, such as interference with the endocrine system. To achieve these aims requires criteria which provide a basis to interpret study findings so as to separate these specific toxicities and modes of action from not only acute lethality per se but also from severe inanition and malaise that non-specifically compromise reproductive capacity and the response of endocrine endpoints. Mammalian toxicologists have recognized that very high dose levels are sometimes required to elicit both specific adverse effects and present the potential of non-specific 'systemic toxicity'. Mammalian toxicologists have developed the concept of a maximum tolerated dose (MTD) beyond which a specific toxicity or action cannot be attributed to a test substance due to the compromised state of the organism. Ecotoxicologists are now confronted by a similar challenge and must develop an analogous concept of a MTD and the respective criteria. As examples of this conundrum, we note recent developments in efforts to validate protocols for fish reproductive toxicity and endocrine screens (e.g. some chemicals originally selected as 'negatives' elicited decreases in fecundity or changes in endpoints intended to be biomarkers for endocrine modes of action). Unless analogous criteria can be developed, the potentially confounding effects of systemic toxicity may then undermine the reliable assessment of specific reproductive effects or biomarkers such as vitellogenin or spiggin. The same issue confronts other areas of aquatic toxicology (e.g., genotoxicity) and the use of aquatic animals for preclinical assessments of drugs (e.g., use of zebrafish for drug safety assessment). We propose that there are benefits to adopting the concept of an MTD for toxicology and pharmacology studies using fish and other aquatic organisms and the

  8. A new classification for cervical vertebral injuries: influence of CT

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H.; Brown, R.R.; Goldberg, A.L. [Department of Diagnostic Radiology, Allegheny University Hospitals, Allegheny General, Pittsburgh, PA (United States)

    2000-03-30

    Objective. Computed tomography (CT) has been demonstrated to be superior to radiography in identifying cervical vertebral injuries. However, many of these injuries may not be clinically significant, and require only minimal symptomatic and supportive treatment. It is therefore imperative that radiologists and spine surgeons have criteria for distinguishing between those injuries requiring surgical stabilization and those that do not. The authors propose a new classification of cervical vertebral injuries into two categories: major and minor.Design and patients. A data base, acquired on 1052 separate cervical injuries in 879 patients seen between 1983 and 1998, was reviewed. Four categories of injury based on mechanism [hyperflexion (four variants), hyperextension (two variants), rotary (two variants), and axial compression (five variants)] were identified. ''Major'' injuries are defined as having either radiographic or CT evidence of instability with or without associated localized or central neurologic findings, or have the potential to produce the latter. ''Minor'' injuries have no radiographic and/or CT evidence of instability, are not associated with neurologic findings, and have no potential to cause the latter.Results and conclusions. Cervical injury should be classified as ''major'' if the following radiographic and/or CT criteria are present: displacement of more than 2 mm in any plane, wide vertebral body in any plane, wide interspinous/interlaminar space, wide facet joints, disrupted posterior vertebral body line, wide disc space, vertebral burst, locked or perched facets (unilateral or bilateral), ''hanged man'' fracture of C2, dens fracture, and type III occipital condyle fracture. All other types of fractures may be considered ''minor''. (orig.)

  9. Sports-related injuries in athletes with disabilities.

    Science.gov (United States)

    Fagher, K; Lexell, J

    2014-10-01

    The number of athletes with disabilities participating in organized sports and the popularity of the Paralympic Games is steadily increasing around the world. Despite this growing interest and the fact that participation in sports places the athlete at risk for injury, there are few studies concerning injury patterns, risk factors, and prevention strategies of injuries in disabled athletes. In this systematic literature search and critical review, we summarize current knowledge of the epidemiology of sports-related injuries in disabled athletes and describe their characteristics, incidence, prevalence, and prevention strategies. The outcomes of interest were any injury, either an acute trauma or an overuse event. PubMed, EMBASE, CINAHL, and Google Scholar were systematically searched and 25 of 605 identified studies met the inclusion criteria. Lower extremity injuries were more common in walking athletes, whereas upper extremity injuries were more prevalent in wheelchair athletes. The methodologies and populations varied widely between the studies. Few studies were sports or disability specific, which makes it difficult to determine specific risk factors, and few studies reported injury severity and prevention of injuries. Further longitudinal, systematic sports and disability specific studies are needed in order to identify and prevent injuries in athletes with disabilities. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Screening of cotton (gossypium hirsutum l.) genotypes for heat tolerance

    International Nuclear Information System (INIS)

    Abro, S.; Khan, M.A.; Sial, M.A.

    2015-01-01

    Cotton yield is highly affected due to biotic (diseases and pests) and abiotic (heat, dought and salinity) Stresses. Among them, high temperature is the main environmental constraint which adversely reduces cotton yield and quality. High temperature above 36 degree C affects plant growth and development especially during reproductive phase. Present studies were carried out to assess the tolerance of fifty-eight newly evolved cotton genotypes to heat stresses, based on agronomic and physiological characteristics. The genotypes were screened in field conditions under two temperature regimes. The studies were conducted at experimental farm of Nuclear Institute of Agriculture, Tando Jam, Pakistan. The results showed that March sown crop experienced high temperature (i.e. > 44 degree C in May and June), which significantly affected crop growth and productivity. The genotypes were identified as heat-tolerant on the basis of relative cell injury percentage (RCI %), heat susceptibility index (HSI) values, boll retention and seed cotton yield (kg/ha). RCI level in cotton genotypes ranged from 39.0 to 86.0%. Out of 58, seventeen genotypes (viz.NIA-80, NIA-81, NIA-83, NIA-84, NIA-M-30, NIA-M31, NIA-HM-48, NIA-HM-327, NIA-H-32, NIA-HM-2-1, NIA-Bt1, NIA-Bt2, NIA-Perkh, CRIS-342, CRIS-134, NIAB-111 and check variety Sadori indicated high level of heat tolerance at both (heat-stressed and non-stressed) temperature regimes; as shown the lowest relative injury level and relatively heat resistant index (HSI<1) values. Such genotypes could be used as heattolerant genotypes under heat-stressed environments. (author)

  11. Directionality Between Tolerance of Deviance and Deviant Behavior is Age-Moderated in Chronically Stressed Youth

    OpenAIRE

    Ridenour, TY A.; Caldwell, Linda L.; Coatsworth, J. Douglas; Gold, Melanie A.

    2011-01-01

    Problem behavior theory posits that tolerance of deviance is an antecedent to antisocial behavior and substance use. In contrast, cognitive dissonance theory implies that acceptability of a behavior may increase after experiencing the behavior. Using structural equation modeling, this investigation tested whether changes in tolerance of deviance precede changes in conduct disorder criteria or substance use or vice versa, or if they change concomitantly. Two-year longitudinal data from 246 8- ...

  12. Validity of helicopter emergency medical services dispatch criteria for traumatic injuries: A systematic review

    NARCIS (Netherlands)

    A.N. Ringburg (Akkie); G. de Ronde (Gijs); S. Thomas (Siep); E.M.M. van Lieshout (Esther); P. Patka (Peter); I.B. Schipper (Inger)

    2009-01-01

    textabstractObjective. This review provides an overview of the validity of Helicopter Emergency Medical Services (HEMS) dispatch criteria for severely injured patients. Methods. A systematic literature search was performed. English written and peer-reviewed publications on HEMS dispatch criteria

  13. Atlantic Diabetes in Pregnancy (DIP): the prevalence and outcomes of gestational diabetes mellitus using new diagnostic criteria.

    LENUS (Irish Health Repository)

    O'Sullivan, E P

    2012-01-31

    AIMS\\/HYPOTHESIS: New diagnostic criteria for gestational diabetes mellitus (GDM) have recently been published. We wished to evaluate what impact these new criteria would have on GDM prevalence and outcomes in a predominantly European population. METHODS: The Atlantic Diabetes In Pregnancy (DIP) programme performed screening for GDM in 5,500 women with an oral glucose tolerance test at 24-28 weeks. GDM was defined according to the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria and compared with previous WHO criteria; maternal and neonatal adverse outcomes were prospectively recorded. RESULTS: Of the participants, 12.4% and 9.4% were diagnosed with GDM using IADPSG and WHO criteria, respectively. IADPSG GDM pregnancies were associated with a statistically significant increased incidence of adverse maternal outcomes (gestational hypertension, polyhydramnios and Caesarean section) and neonatal outcomes (prematurity, large for gestational age, neonatal unit admission, neonatal hypoglycaemia and respiratory distress). The odds ratio for the development of these adverse outcomes remained significant after adjustment for maternal age, body mass index and non-European ethnicity. Those women who were classified as having normal glucose tolerance by WHO criteria but as having GDM by IADPSG criteria also had significant adverse pregnancy outcomes. CONCLUSIONS\\/INTERPRETATION: GDM prevalence is higher when using newer IADPSG, compared with WHO, criteria, and these women and their offspring experience significant adverse pregnancy outcomes. Higher rates of GDM pose a challenge to healthcare systems, but improved screening provides an opportunity to attempt to reduce the associated morbidity for mother and child.

  14. A state-of-the-art multi-criteria model for drug benefit-risk analysis

    NARCIS (Netherlands)

    Tervonen, T.; Hillege, H.L.; Buskens, E.; Postmus, D.

    2010-01-01

    Drug benefit-risk analysis is based on firm clinical evidence related to various safety and efficacy outcomes, such as tolerability, treatment response, and adverse events. In this paper, we propose a new approach for constructing a supporting multi-criteria model that fully takes into account this

  15. Trauma team activation criteria in managing trauma patients at an emergency room in Thailand.

    Science.gov (United States)

    Wuthisuthimethawee, P

    2017-02-01

    Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled. Demographic data, physiologic parameters, ED length of stay (EDLOS), and the injury severity score (ISS) were recorded. Multiple logistic regression was used to determine the factors affecting 28-day mortality. Institutional review board approval was obtained from the Prince of Songkla University. A total of 80 patients (74 male and 6 female) were eligible with a mean age of 34.3 years old. Shock, penetrating torso injury, and pulse rate >120 beats per minute were the three most common criteria for trauma team consultation. At the ED, 9 patients (11.3 %) were non-survivors, 30 patients (37.5 %) needed immediate operation, and 41 patients (51.2 %) were admitted. All of the arrest patients died (p team activation criteria improved acute trauma care in the ED which was demonstrated by the decreased EDLOS and mortality rate. A high ISS is the sole parameter predicting mortality.

  16. Ring Avulsion Injuries: A Systematic Review.

    Science.gov (United States)

    Bamba, Ravinder; Malhotra, Gautam; Bueno, Reuben A; Thayer, Wesley P; Shack, R Bruce

    2018-01-01

    Ring avulsion injuries can range from soft tissue injury to complete amputation. Grading systems have been developed to guide treatment, but there is controversy with high-grade injuries. Traditionally, advanced ring injuries have been treated with completion amputation, but there is evidence that severe ring injuries can be salvaged. The purpose of this systematic review was to pool the current published data on ring injuries. A systematic review of the English literature published from 1980 to 2015 in PubMed and MEDLINE databases was conducted to identify patients who underwent treatment for ring avulsion injuries. Twenty studies of ring avulsion injuries met the inclusion criteria. There were a total of 572 patients reported with ring avulsion injuries. The Urbaniak class breakdown was class I (54 patients), class II (204 patients), and class III (314 patients). The average total arc of motion (TAM) for patients with a class I injury was 201.25 (n = 40). The average 2-point discrimination was 5.6 (n = 10). The average TAM for patients with a class II injury undergoing microsurgical revascularization was 187.0 (n = 114), and the average 2-point discrimination was 8.3 (n = 40). The average TAM for patients with a class III injury undergoing microsurgical revascularization was 168.2 (n = 170), and the average 2-point discrimination was 10.5 (n = 97). Ring avulsion injuries are commonly classified with the Urbaniak class system. Outcomes are superior for class I and II injuries, and there are select class III injuries that can be treated with replantation. Shared decision making with patients is imperative to determine whether replantation is appropriate.

  17. Analysis of natural variation in bermudagrass (Cynodon dactylon) reveals physiological responses underlying drought tolerance.

    Science.gov (United States)

    Shi, Haitao; Wang, Yanping; Cheng, Zhangmin; Ye, Tiantian; Chan, Zhulong

    2012-01-01

    Bermudagrass (Cynodon dactylon) is a widely used warm-season turfgrass and one of the most drought tolerant species. Dissecting the natural variation in drought tolerance and physiological responses will bring us powerful basis and novel insight for plant breeding. In the present study, we evaluated the natural variation of drought tolerance among nine bermudagrass varieties by measuring physiological responses after drought stress treatment through withholding water. Three groups differing in drought tolerance were identified, including two tolerant, five moderately tolerant and two susceptible varieties. Under drought stress condition, drought sensitive variety (Yukon) showed relative higher water loss, more severe cell membrane damage (EL), and more accumulation of hydrogen peroxide (H₂O₂) and malondialdehyde (MDA), while drought tolerant variety (Tifgreen) exhibited significantly higher antioxidant enzymes activities. Further results indicated that drought induced cell injury in different varieties (Yukon, SR9554 and Tifgreen) exhibited liner correlation with leaf water content (LWC), H₂O₂ content, MDA content and antioxidant enzyme activities. Additionally, Tifgreen plants had significantly higher levels of osmolytes (proline level and soluble sugars) when compared with Yukon and SR9554 under drought stress condition. Taken together, our results indicated that natural variation of drought stress tolerance in bermudagrass varieties might be largely related to the induced changes of water status, osmolyte accumulation and antioxidant defense system.

  18. ACR Appropriateness Criteria® rib fractures.

    Science.gov (United States)

    Henry, Travis S; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Parker, J Anthony; Ravenel, James G; Restrepo, Carlos Santiago; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D; Mohammed, Tan-Lucien H

    2014-11-01

    Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  19. Skin Autofluorescence Based Decision Tree in Detection of Impaired Glucose Tolerance and Diabetes

    NARCIS (Netherlands)

    Smit, Andries J.; Smit, Jitske M.; Botterblom, Gijs J.; Mulder, Douwe

    2013-01-01

    Aim: Diabetes (DM) and impaired glucose tolerance (IGT) detection are conventionally based on glycemic criteria. Skin autofluorescence (SAF) is a noninvasive proxy of tissue accumulation of advanced glycation endproducts (AGE) which are considered to be a carrier of glycometabolic memory. We

  20. Impact of desiccation and heat exposure stress on Salmonella tolerance to acidic conditions.

    Science.gov (United States)

    Richardson, Kurt E; Cox, Nelson A; Cosby, Douglas E; Berrang, Mark E

    2018-02-01

    In a recent study, the pH of commonly used Salmonella pre-enrichment media became acidic (pH 4.0 to 5.0) when feed or feed ingredients were incubated for 24 h. Acidic conditions have been reported to injure or kill Salmonella. In this study, cultures of four known feed isolates (S. montevideo, S. senftenberg, S. tennessee, and S. schwarzengrund) and four important processing plant isolates (S. typhimurium, S. enteritidis, S. infantis, and S. heidelberg) were grown on meat and bone meal and later subjected to desiccation and heat exposure to stress the microorganism. The impact of stress on the isolates ability to survive in acidic conditions ranging from pH 4.0 to 7.0 was compared to the non-stressed isolate. Cell injury was determined on xylose lysine tergitol 4 (XLT4) and cell death determined on nutrient agar (NA). When measured by cell death in non-stressed Salmonella, S. typhimurium was the most acid tolerant and S. heidelberg was the most acid sensitive whereas in stressed Salmonella, S. senftenberg was the most acid tolerant and S. tennessee was the most acid sensitive. The pH required to cause cell injury varied among isolates. With some isolates, the pH required for 50% cell death and 50% cell injury was similar. In other isolates, cell injury occurred at a more neutral pH. These findings suggest that the pH of pre-enrichment media may influence the recovery and bias the serotype of Salmonella recovered from feed during pre-enrichment.

  1. Nitrate Increased Cucumber Tolerance to Fusarium Wilt by Regulating Fungal Toxin Production and Distribution.

    Science.gov (United States)

    Zhou, Jinyan; Wang, Min; Sun, Yuming; Gu, Zechen; Wang, Ruirui; Saydin, Asanjan; Shen, Qirong; Guo, Shiwei

    2017-03-11

    Cucumber Fusarium wilt, induced by Fusarium oxysporum f. sp. cucumerinum (FOC), causes severe losses in cucumber yield and quality. Nitrogen (N), as the most important mineral nutrient for plants, plays a critical role in plant-pathogen interactions. Hydroponic assays were conducted to investigate the effects of different N forms (NH₄⁺ vs. NO₃ ‒ ) and supply levels (low, 1 mM; high, 5 mM) on cucumber Fusarium wilt. The NO₃ ‒ -fed cucumber plants were more tolerant to Fusarium wilt compared with NH₄⁺-fed plants, and accompanied by lower leaf temperature after FOC infection. The disease index decreased as the NO₃ ‒ supply increased but increased with the NH₄⁺ level supplied. Although the FOC grew better under high NO₃ - in vitro, FOC colonization and fusaric acid (FA) production decreased in cucumber plants under high NO₃ - supply, associated with lower leaf membrane injury. There was a positive correlation between the FA content and the FOC number or relative membrane injury. After the exogenous application of FA, less FA accumulated in the leaves under NO₃ - feeding, accompanied with a lower leaf membrane injury. In conclusion, higher NO₃ - supply protected cucumber plants against Fusarium wilt by suppressing FOC colonization and FA production in plants, and increasing the plant tolerance to FA.

  2. Mitigating the risk of musculoskeletal injury: A systematic review of the most effective injury prevention strategies for military personnel.

    Science.gov (United States)

    Wardle, Sophie L; Greeves, Julie P

    2017-11-01

    To update the current injury prevention strategy evidence base for making recommendations to prevent physical training-related musculoskeletal injury. We conducted a systematic review to update the evidence base on injury prevention strategies for military personnel. Literature was systematically searched and extracted from five databases, and reported according to PRISMA guidelines. Sixty one articles meeting the inclusion criteria and published during the period 2008-2015 were selected for systematic review. The retrieved articles were broadly categorised into six injury prevention strategies; (1) conditioning, (2) footwear modifications, (3) bracing, (4) physical activity volume, (5) physical fitness, and (6) leadership/supervision/awareness. The majority of retrieved articles (n=37 (of 61) evaluated or systematically reviewed a conditioning intervention of some nature. However, the most well-supported strategies were related to reducing physical activity volume and improving leadership/supervision/awareness of injuries and injury prevention efforts. Several injury prevention strategies effectively reduce musculoskeletal injury rates in both sexes, and many show promise for utility with military personnel. However, further evaluation, ideally with prospective randomised trials, is required to establish the most effective injury prevention strategies, and to understand any sex-specific differences in the response to these strategies. Copyright © 2017. Published by Elsevier Ltd.

  3. [Bony injuries of the thoracic cage in multiple trauma : Incidence, concomitant injuries, course and outcome].

    Science.gov (United States)

    Schulz-Drost, S; Oppel, P; Grupp, S; Krinner, S; Langenbach, A; Lefering, R; Mauerer, A

    2016-12-01

    Thoracic trauma is considered to be responsible for 25 % of fatalities in multiple trauma and is a frequent injury with an incidence of 50 %. In addition to organ injuries, severe injuries to the bony parts of the thorax also occur and these injuries are described very differently mostly based on single center data. The focus of this study was on a holistic presentation of the prevalence and the incidence of thoracic trauma in patients with multiple trauma from the data of the large collective of the TraumaRegister DGU® (TR-DGU) with the objective of an analysis of concomitant injuries, therapy options and outcome parameters. A retrospective analysis was carried out based on the data set of the TR-DGU from the years 2009-2013. Inclusion criteria were an injury severity scale (ISS) score ≥ 16 and primary admission to a trauma center but isolated craniocerebral injury was an exclusion criterium. Patients were separated into two groups: those with rib fractures (RF) and those with flail chest (FC). A total of 21,741 patients met the inclusion criteria including 10,474 (48.2 %) suffering from either RF or FC. The mean age was 49.8 ± 19.9 years in the RF group and 54.1 ± 18.2 years in the FC group. Approximately 25 % were female in both groups, 98.1 % were blunt force injuries and the median ISS was 28.0 ± 11.2 in RF and 35.1 ± 14.2 in FC. Shock, insertion of a chest tube, (multi) organ failure and fatality rates were significantly higher in the FC group as were concomitant thoracic injuries, such as pneumothorax and hemothorax. Sternal fractures without rib fractures were less common (3.8 %) than concomitant in the RF (10.1 %) and FC (14 %) groups, as were concomitant fractures of the clavicle and the scapula. Out of all patients 32.6 % showed fractures of the thoracolumbar spine, 26.5 % without rib fractures, 36.6-38.6 % with rib fractures or monolateral FC and 48.6 % concomitant to bilateral FC. Thoracotomy was carried

  4. [Ethical relativism and the modern concept of tolerance].

    Science.gov (United States)

    Laffitte, Jean

    2008-01-01

    History presents many examples of men and women who find themselves in a position of having to disobey civil law. The motives for such disobedience can only be founded on moral conscience, as influenced by other laws - immutable and recognized as true. The author studies the historical context of the appearance, during the Age of the Enlightenment, of a new concept: tolerance. Ceasing to represent the expression of the classical practical virtue of prudence, ideological tolerance achieves the rank of theoretical virtue. Such a pretension has a political in essence but also innumerable ethical consequences. An ideologically tolerant society is created. The author develops this paradoxical thesis according to which an ideologically tolerant society is not prepared to tolerate the idea that there might exist a truth for which to search. Today, we see a secularization of conscientious objection concerning two particular themes: military service and matters connected with the protection of human life. Examining the paradigmatic example of abortion, the author demonstrates how society is no longer capable of reflecting peacefully upon the question of the status of the embryo, for fear of questioning the legislative choice concerning its legalization. Thus, society no longer has the capability of confronting challenges connected to practices that are detrimental to the dignity of human life, the essential criteria that would allow it to face these matters having been declared outside the confines of future reflection.

  5. Radiation-induced heart injury. Radiopathological study

    Energy Technology Data Exchange (ETDEWEB)

    Suzuki, Y; Niibe, H [Gunma Univ., Maebashi (Japan). School of Medicine

    1975-11-01

    In order to identify radiation-induced heart injury and to differentiate it from heart disease, an attempt was made to clarify post-irradiation heart injury by investigating the histological changes which occur during the interval between the irradiation and the time of demonstrable histological changes. A study was made of 83 autopsies in which most of the primary neoplasms were breast cancers, lung cancers and mediastinal tumors. In 43 of these autopsies the heart had been irradiated. Sixty eight dd-strain mice were also used for microautoradiographic study. Histological changes in the heart were observed in 27 of the 43 cases receiving irradiation. The limit of the tolerance dose to the heart for indicating histological changes was 1220 ret in humans. The latent period without histological changes was 2.7 months after initiation of radiation therapy. Greater heart injury was observed after re-irradiation or after the combined therapy of radiation and chemotherapy especially mitomycin (MMC). The histological findings after treatment with MMC were similar to those of radiation-induced heart injury. Results of the study indicate that the damage is secondary to radiation-induced changes of the vascula connective tissue.

  6. Impaired glucose tolerance in patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Pradat, Pierre-Francois; Bruneteau, Gaelle; Gordon, Paul H; Dupuis, Luc; Bonnefont-Rousselot, Dominique; Simon, Dominique; Salachas, Francois; Corcia, Philippe; Frochot, Vincent; Lacorte, Jean-Marc; Jardel, Claude; Coussieu, Christiane; Le Forestier, Nadine; Lacomblez, Lucette; Loeffler, Jean-Philippe; Meininger, Vincent

    2010-01-01

    Our objectives were to analyse carbohydrate metabolism in a series of ALS patients and to examine potential association with parameters of lipid metabolism and clinical features. Glucose tolerance was assessed by the oral glucose tolerance test in 21 non-diabetic ALS patients and compared with 21 age- and sex-matched normal subjects. Lipids and lactate/pyruvate ratio, levels of pro-inflammatory cytokines (tumour necrosis factor-alpha and interleukin-6) and adipocytokines (leptin and adiponectin) were also measured in ALS patients. Mann-Whitney U-tests analysed continuous data and Fisher's exact tests assessed categorical data. Blood glucose determined 120 min after the glucose bolus was significantly higher in patients with ALS (7.41 mmol/l+/-1.68) compared to controls (6.05+/-1.44, p=0.006). ALS patients with impaired glucose tolerance (IGT) according to WHO criteria (n=7, 33%) were more likely to have elevated free fatty acids (FFA) levels compared to patients with normal glucose tolerance (0.77 nmol/l+/-0.30 vs. 0.57+/-0.19, p=0.04). IGT was not associated with disease duration or severity. In conclusion, patients with ALS show abnormal glucose tolerance that could be associated with increased FFA levels, a key determinant of insulin resistance. The origin of glucose homeostasis abnormalities in ALS may be multifactorial and deserves further investigation.

  7. Construction and evaluation of thoracic injury risk curves for a finite element human body model in frontal car crashes.

    Science.gov (United States)

    Mendoza-Vazquez, Manuel; Davidsson, Johan; Brolin, Karin

    2015-12-01

    There is a need to improve the protection to the thorax of occupants in frontal car crashes. Finite element human body models are a more detailed representation of humans than anthropomorphic test devices (ATDs). On the other hand, there is no clear consensus on the injury criteria and the thresholds to use with finite element human body models to predict rib fractures. The objective of this study was to establish a set of injury risk curves to predict rib fractures using a modified Total HUman Model for Safety (THUMS). Injury criteria at the global, structural and material levels were computed with a modified THUMS in matched Post Mortem Human Subjects (PMHSs) tests. Finally, the quality of each injury risk curve was determined. For the included PMHS tests and the modified THUMS, DcTHOR and shear stress were the criteria at the global and material levels that reached an acceptable quality. The injury risk curves at the structural level did not reach an acceptable quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Tolerance

    DEFF Research Database (Denmark)

    Tønder, Lars

    is linked to a different set of circumstances than the ones suggested by existing models in contemporary democratic theory. Reorienting the discussion of tolerance, the book raises the question of how to disclose new possibilities within our given context of affect and perception. Once we move away from......Tolerance: A Sensorial Orientation to Politics is an experiment in re-orientation. The book is based on the wager that tolerance exceeds the more prevalent images of self-restraint and repressive benevolence because neither precludes the possibility of a more “active tolerance” motivated...... by the desire to experiment and to become otherwise. The objective is to discuss what gets lost, conceptually as well as politically, when we neglect the subsistence of active tolerance within other practices of tolerance, and to develop a theory of active tolerance in which tolerance's mobilizing character...

  9. Correlations Between General Joint Hypermobility and Joint Hypermobility Syndrome and Injury in Contemporary Dance Students.

    Science.gov (United States)

    Ruemper, Alia; Watkins, Katherine

    2012-12-01

    The first objective of this study was to ascertain the prevalence of general joint hypermobility (GJH) and joint hypermobility syndrome (JHS) in BA Dance Theatre 1st and 3rd year students at a contemporary dance conservatory. The second objective was to determine the statistical correlation between GJH, JHS, and injury in this population. A total of 85 (female, N = 78; male, N = 7) contemporary dance students participated in the study. The Beighton score (with a forward flexion test modification) was used to determine GJH, and the Brighton criteria were used to verify JHS. Participants completed a self-reported injury questionnaire that included type of injury (physical complaint, medical diagnosis, or time-loss) and injury frequency. Statistical analysis (Pearson correlation) was used to correlate GJH, JHS, and frequency-of-injury scores. Overall, 69% of the students were found to have GJH, and 33% had JHS. A statistical correlation of r = + 0.331 (p dance students and suggests that screening programs should include the Brighton criteria to identify JHS in these dancers. Subsequent injury tracking and injury prevention programs would then provide data for further research in this area.

  10. Does EMS Perceived Anatomic Injury Predict Trauma Center Need?

    Science.gov (United States)

    Lerner, E. Brooke; Roberts, Jennifer; Guse, Clare E.; Shah, Manish N.; Swor, Robert; Cushman, Jeremy T.; Blatt, Alan; Jurkovich, Gregory J.; Brasel, Karen

    2013-01-01

    Objective Our objective was to determine the predictive value of the anatomic step of the 2011 Field Triage Decision Scheme for identifying trauma center need. Methods EMS providers caring for injured adults transported to regional trauma centers in 3 midsized communities were interviewed over two years. Patients were included, regardless of injury severity, if they were at least 18 years old and were transported by EMS with a mechanism of injury that was an assault, motor vehicle or motorcycle crash, fall, or pedestrian or bicyclist struck. The interview was conducted upon ED arrival and collected physiologic condition and anatomic injury data. Patients who met the physiologic criteria were excluded. Trauma center need was defined as non-orthopedic surgery within 24 hours, intensive care unit admission, or death prior to hospital discharge. Data were analyzed by calculating descriptive statistics including positive likelihood ratios (+LR) with 95% confidence intervals. Results 11,892 interviews were conducted. One was excluded because of missing outcome data and 1,274 were excluded because they met the physiologic step. EMS providers identified 1,167 cases that met the anatomic criteria, of which 307 (26%) needed the resources of a trauma center (38% sensitivity, 91% specificity, +LR 4.4; CI: 3.9 - 4.9). Criteria with a +LR ≥5 were flail chest (9.0; CI: 4.1 - 19.4), paralysis (6.8; CI: 4.2 - 11.2), two or more long bone fractures (6.3; CI: 4.5 - 8.9), and amputation (6.1; CI: 1.5 - 24.4). Criteria with a +LR >2 and <5 were penetrating injury (4.8; CI: 4.2 - 5.6), and skull fracture (4.8; CI: 3.0 - 7.7). Only pelvic fracture (1.9; CI: 1.3 - 2.9) had a +LR less than 2. Conclusions The anatomic step of the Field Triage Guidelines as determined by EMS providers is a reasonable tool for determining trauma center need. Use of EMS perceived pelvic fracture as an indicator for trauma center need should be re-evaluated. PMID:23627418

  11. A Survey on Common Injuries in Recreational Badminton Players

    Directory of Open Access Journals (Sweden)

    A Muttalib

    2009-11-01

    Full Text Available The aim of this descriptive study is to determine the incidence of injuries among recreational badminton players. We evaluated 86 recreational badminton players in the city of Malacca; 35 were excluded for fitting the exclusion criteria. The average recreational badminton player was 36.13 years old and had been playing badminton for the past 17.84 years at a frequency of 2.11 times per week. 39.21% of the recreational badminton players complained of recent injuries in relation to playing badminton. Our data showed that the most common injury sustained by recreational badminton players was pain and stiffness at the shoulder joint. None of the injuries sustained by the players in our data were serious enough to warrant any form of surgical intervention. We conclude that badminton is a sport of relatively low risk and that the majority of related injuries were chronic overuse injuries.

  12. A Fault-tolerable Control Scheme for an Open-frame Underwater Vehicle

    Directory of Open Access Journals (Sweden)

    Huang Hai

    2014-05-01

    Full Text Available Open-frame is one of the major types of structures of Remote Operated Vehicles (ROV because it is easy to place sensors and operations equipment onboard. Firstly, this paper designed a petri-based recurrent neural network (PRFNN to improve the robustness with response to nonlinear characteristics and strong disturbance of an open-frame underwater vehicle. A threshold has been set in the third layer to reduce the amount of calculations and regulate the training process. The whole network convergence is guaranteed with the selection of learning rate parameters. Secondly, a fault tolerance control (FTC scheme is established with the optimal allocation of thrust. Infinity-norm optimization has been combined with 2-norm optimization to construct a bi-criteria primal-dual neural network FTC scheme. In the experiments and simulation, PRFNN outperformed fuzzy neural networks in motion control, while bi-criteria optimization outperformed 2-norm optimization in FTC, which demonstrates that the FTC controller can improve computational efficiency, reduce control errors, and implement fault tolerable thrust allocation.

  13. Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review.

    Science.gov (United States)

    Kenny, Sarah J; Whittaker, Jackie L; Emery, Carolyn A

    2016-08-01

    Preprofessional dancers partake in rigorous training and have high injury prevalence. Attempts to identify risk factors for dance injuries have focused on a diversity of intrinsic and extrinsic factors. To identify and evaluate the evidence examining risk factors for musculoskeletal injury in preprofessional ballet and modern dancers. Fifteen electronic databases were systematically searched to October 2015. Studies selected met a priori inclusion criteria and investigated musculoskeletal injury risk factors in preprofessional (elite adolescent, student, young adult) ballet and modern dancers. Two reviewers independently assessed the quality and level of evidence using the Downs and Black (DB) criteria and a modified Oxford Centre of Evidence-Based Medicine 2009 model, respectively. Of 1364 potentially relevant studies, 47 were included and scored. Inconsistent injury definition and methodology precluded meta-analysis. The most common modifiable risk factors investigated were anthropometrics (ie, body mass index, adiposity), joint range of motion (ie, lower extremity), dance exposure (ie, years training, exposure hours) and age. The median DB score across studies was 8/33 (range 2-16). The majority of studies were classified as level 3 evidence and few considered risk factor inter-relationships. There is some level 2 evidence that previous injury and poor psychological coping skills are associated with increased injury risk. Because of the lack of high-quality studies, consensus regarding risk factors for musculoskeletal injury in preprofessional dancers remains difficult. There is a need for injury definition consensus and high-quality prospective studies examining the multifactorial relationship between risk factors and injury in preprofessional dance. 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. Analysis of Natural Variation in Bermudagrass (Cynodon dactylon) Reveals Physiological Responses Underlying Drought Tolerance

    Science.gov (United States)

    Cheng, Zhangmin; Ye, Tiantian; Chan, Zhulong

    2012-01-01

    Bermudagrass (Cynodon dactylon) is a widely used warm-season turfgrass and one of the most drought tolerant species. Dissecting the natural variation in drought tolerance and physiological responses will bring us powerful basis and novel insight for plant breeding. In the present study, we evaluated the natural variation of drought tolerance among nine bermudagrass varieties by measuring physiological responses after drought stress treatment through withholding water. Three groups differing in drought tolerance were identified, including two tolerant, five moderately tolerant and two susceptible varieties. Under drought stress condition, drought sensitive variety (Yukon) showed relative higher water loss, more severe cell membrane damage (EL), and more accumulation of hydrogen peroxide (H2O2) and malondialdehyde (MDA), while drought tolerant variety (Tifgreen) exhibited significantly higher antioxidant enzymes activities. Further results indicated that drought induced cell injury in different varieties (Yukon, SR9554 and Tifgreen) exhibited liner correlation with leaf water content (LWC), H2O2 content, MDA content and antioxidant enzyme activities. Additionally, Tifgreen plants had significantly higher levels of osmolytes (proline level and soluble sugars) when compared with Yukon and SR9554 under drought stress condition. Taken together, our results indicated that natural variation of drought stress tolerance in bermudagrass varieties might be largely related to the induced changes of water status, osmolyte accumulation and antioxidant defense system. PMID:23285294

  15. Primary repair of colon injuries: clinical study of nonselective approach.

    Science.gov (United States)

    Lazovic, Ranko G; Barisic, Goran I; Krivokapic, Zoran V

    2010-12-02

    This study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach. Two groups of patients were analyzed. Retrospective (RS) group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F) and Flint (Fl). In this group 18 patients were managed by primary repair. Prospective (PR) group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases. Groups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours). Stab wounds were more frequent in PR group (9:2), and iatrogenic lesions in RS group (6:2). Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar.In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days) deaths, with no evidence of anastomotic leakage. Results of this study justify more liberal use of primary repair in early management of colon injuries. Current Controlled Trials ISRCTN94682396.

  16. Radioimmunoassay of Plasma Insulin during Oral Glucose Tolerance Test in Thyrotoxicosis

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hong Kyu; Koh, Chang Soon; Lee, Mun Ho [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1971-03-15

    Blood glucose and immunoreactive insulin (IRI) were measured during oral glucose tolerance test in 15 thyrotoxic patients and 8 normal controls, to study the glucose metabolism in thyrotoxicosis. Following were the results;1) In thyrotoxicosis, there is noticed late rise and late fall of plasma IRI during oral glucose tolerance test, like as phenomenon of mild diabetes mellitus. 2) When the thyrotoxic patients were divided into normal and abnormal responsive groups after the level of blood glucose by Wilkerson Criteria, no significant difference in plasma IRI levels were noticed between two groups. 3) This result may be interpreted as relative deficiency of insulin secretion from panaceas and suggest genetically related defects.

  17. Cardiac arrhythmias associated with spinal cord injury

    DEFF Research Database (Denmark)

    Hector, Sven Magnus; Biering-Sørensen, Tor; Krassioukov, Andrei

    2013-01-01

    CONTEXT/OBJECTIVES: To review the current literature to reveal the incidence of cardiac arrhythmias and its relation to spinal cord injury (SCI). METHODS: Data source: MEDLINE database, 304 hits, and 32 articles were found to be relevant. The relevant articles all met the inclusion criteria: (1...

  18. Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union

    Science.gov (United States)

    Fuller, Colin W; Molloy, Michael G; Bagate, Christian; Bahr, Roald; Brooks, John H M; Donson, Hilton; Kemp, Simon P T; McCrory, Paul; McIntosh, Andrew S; Meeuwisse, Willem H; Quarrie, Kenneth L; Raftery, Martin; Wiley, Preston

    2007-01-01

    Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow‐up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non‐fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union. PMID:17452684

  19. Urinary Tract Injury in Gynecologic Laparoscopy for Benign Indication: A Systematic Review.

    Science.gov (United States)

    Wong, Jacqueline M K; Bortoletto, Pietro; Tolentino, Jocelyn; Jung, Michael J; Milad, Magdy P

    2018-01-01

    To perform a comprehensive literature review of the incidence, location, etiology, timing, management, and long-term sequelae of urinary tract injury in gynecologic laparoscopy for benign indication. A systematic review of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov was conducted. Four hundred thirty-three studies were screened for inclusion with 136 full-text articles reviewed. Ninety studies published between 1975 and 2015 met inclusion criteria, representing 140,444 surgeries. Articles reporting the incidence of urinary tract injury in gynecologic laparoscopy for benign indication were included. Exclusion criteria comprised malignancy, surgery by urogynecologists, research not in English, and insufficient data. A total of 458 lower urinary tract injuries were reported with an incidence of 0.33% (95% CI 0.30-0.36). Bladder injury (0.24%, 95% CI 0.22-0.27) was overall three times more frequent than ureteral injury (0.08%, 95% CI 0.07-0.10). Laparoscopic hysterectomy not otherwise specified (1.8%, 95% CI 1.2-2.6) and laparoscopically assisted vaginal hysterectomy (1.0%, 95% CI 0.9-1.2) had the highest rates of injury. Most ureteral injuries resulted from electrosurgery (33.3%, 95% CI 24.3-45.8), whereas most bladder injuries resulted from lysis of adhesions (23.3%, 95% CI 18.7-29.0). Ureteral injuries were most often recognized postoperatively (60%, 95% CI 47-76) and were repaired by open ureteral anastomosis (47.4%, 95% CI 36.3-61.9). In contrast, bladder injuries were most often recognized intraoperatively (85%, 95% CI 75-95) and were repaired by laparoscopic suturing (34.9%, 95% CI 29.2-41.7). The incidence of lower urinary tract injury in gynecologic laparoscopy for benign indication remains low at 0.33%. Bladder injury was three times more common than ureteral injury, although ureteral injuries were more often unrecognized intraoperatively and underwent open surgical repair. These risk estimates can assist gynecologic surgeons in effectively

  20. A CLINICAL STUDY ON BLUNT INJURY ABDOMEN

    Directory of Open Access Journals (Sweden)

    G. Kishore Babu

    2016-10-01

    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  1. Comparison of the New Adult Ventilator-Associated Event Criteria to the Centers for Disease Control and Prevention Pediatric Ventilator-Associated Pneumonia Definition (PNU2) in a Population of Pediatric Traumatic Brain Injury Patients.

    Science.gov (United States)

    Cirulis, Meghan M; Hamele, Mitchell T; Stockmann, Chris R; Bennett, Tellen D; Bratton, Susan L

    2016-02-01

    The new Centers for Disease Control and Prevention paradigm for ventilator-associated events is intended to simplify surveillance of infectious and noninfectious complications of mechanical ventilation in adults. We assessed the ventilator-associated events algorithm in pediatric patients. A retrospective observational cohort study. This single-center study took place in a PICU at an urban academic medical facility. Pediatric (ages 0-18 yr old) trauma patients with moderate-to-severe traumatic brain injury ventilated for greater than or equal to 2 days. We assessed for pediatric ventilator-associated pneumonia (as defined by current Centers for Disease Control and Prevention PNU2 guidelines), adult ventilator-associated events, and an experimental ventilator-associated events definition modified for pediatric patients. We compared ventilator-associated events to ventilator-associated pneumonia to calculate the test characteristics. Thirty-nine of 119 patients (33%) developed ventilator-associated pneumonia. Sensitivity of the adult ventilator-associated condition definition was 23% (95% CI, 11-39%), which increased to 56% (95% CI, 40-72%) using the modified pediatric ventilator-associated pneumonia criterion. Specificity reached 100% for both original and modified pediatric probable ventilator-associated pneumonia using ventilator-associated events criteria. Children who developed ventilator-associated pneumonia or ventilator-associated condition had similar baseline characteristics: age, mechanism of injury, injury severity scores, and use of an intracranial pressure monitor. Diagnosis of ventilator-associated pneumonia and ventilator-associated condition portended similarly unfavorable outcomes: longer median duration of ventilation, ICU and hospital length of stay, and more discharges to rehabilitation, home health, or nursing care compared with patients with no pulmonary complication. Both current and modified ventilator-associated events criteria have poor

  2. Chronic injuries of the cruciate ligaments

    International Nuclear Information System (INIS)

    Pricca, P.; Cecchini, A.; Vecchioni, G.; Mariani, P.M.; Tansini, A.; Ferrario, A.

    1988-01-01

    The high incidence of cruciate ligament injuries as a result of acute knee trauma with hemartrosis and abuse of diagnostic arthroscopies call for a suitable radiological imaging of the central pivot. Computed Arthrotomography (CAT) was used to examine the knee joint in 20 cases of clinically suspected chronic cruciate ligament injury. The images were correlated with arthroscopic and/or arthrotomic findings. Thirteen lesions of the anterior cruciate ligament (ACL) (65%) were found, plus 1 lesion of the posterior cruciate ligament (PCL) (5%), 2 associated lesions of ACL + PCL (10%), and 4 normal cases. Confirmation of pathology was available in all cases but one by arthroscopy and/or surgery. The central pivot diseases were classified as follows: absence, detachement, partial or complete tear. CAT findings of cruciate ligament injuries are emphasized and the role of the technique as compared to arthroscopy is discussed. CAT is useful in 3-D evaluation of central pivot and detection of different cruciate ligament injuries, with high sensitivity-specifity for ACL and high specifity-moderate sensitivity for PCL. In the evaluation of the chronic unstable knee, CAT is highly accurate and gives the surgeon useful information towards the planning of therapeutic procedures. CAT is almost non-invasive, well tolerated and easy to perform in out-patients, which make it a first-choice procedure in the screening of chronic ligament injuries

  3. A 2-Year Prospective Cohort Study of Overuse Running Injuries: The Runners and Injury Longitudinal Study (TRAILS).

    Science.gov (United States)

    Messier, Stephen P; Martin, David F; Mihalko, Shannon L; Ip, Edward; DeVita, Paul; Cannon, D Wayne; Love, Monica; Beringer, Danielle; Saldana, Santiago; Fellin, Rebecca E; Seay, Joseph F

    2018-05-01

    The National Center for Injury Prevention and Control, noting flaws in previous running injury research, called for more rigorous prospective designs and comprehensive analyses to define the origin of running injuries. To determine the risk factors that differentiate recreational runners who remain uninjured from those diagnosed with an overuse running injury during a 2-year observational period. Cohort study; Level of evidence, 2. Inclusion criteria were running a minimum of 5 miles per week and being injury free for at least the past 6 months. Data were collected at baseline on training, medical and injury histories, demographics, anthropometrics, strength, gait biomechanics, and psychosocial variables. Injuries occurring over the 2-year observation period were diagnosed by an orthopaedic surgeon on the basis of predetermined definitions. Of the 300 runners who entered the study, 199 (66%) sustained at least 1 injury, including 73% of women and 62% of men. Of the injured runners, 111 (56%) sustained injuries more than once. In bivariate analyses, significant ( P ≤ .05) factors at baseline that predicted injury were as follows: Short Form Health Survey-12 mental component score (lower mental health-related quality of life), Positive and Negative Affect Scale negative affect score (more negative emotions), sex (higher percentage of women were injured), and knee stiffness (greater stiffness was associated with injury); subsequently, knee stiffness was the lone significant predictor of injury (odds ratio = 1.18) in a multivariable analysis. Flexibility, quadriceps angle, arch height, rearfoot motion, strength, footwear, and previous injury were not significant risk factors for injury. The results of this study indicate the following: (1) among recreational runners, women sustain injuries at a higher rate than men; (2) greater knee stiffness, more common in runners with higher body weights (≥80 kg), significantly increases the odds of sustaining an overuse running

  4. Visual working memory is more tolerant than visual long-term memory.

    Science.gov (United States)

    Schurgin, Mark W; Flombaum, Jonathan I

    2018-05-07

    Human visual memory is tolerant, meaning that it supports object recognition despite variability across encounters at the image level. Tolerant object recognition remains one capacity in which artificial intelligence trails humans. Typically, tolerance is described as a property of human visual long-term memory (VLTM). In contrast, visual working memory (VWM) is not usually ascribed a role in tolerant recognition, with tests of that system usually demanding discriminatory power-identifying changes, not sameness. There are good reasons to expect that VLTM is more tolerant; functionally, recognition over the long-term must accommodate the fact that objects will not be viewed under identical conditions; and practically, the passive and massive nature of VLTM may impose relatively permissive criteria for thinking that two inputs are the same. But empirically, tolerance has never been compared across working and long-term visual memory. We therefore developed a novel paradigm for equating encoding and test across different memory types. In each experiment trial, participants saw two objects, memory for one tested immediately (VWM) and later for the other (VLTM). VWM performance was better than VLTM and remained robust despite the introduction of image and object variability. In contrast, VLTM performance suffered linearly as more variability was introduced into test stimuli. Additional experiments excluded interference effects as causes for the observed differences. These results suggest the possibility of a previously unidentified role for VWM in the acquisition of tolerant representations for object recognition. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  5. Boarding Injuries: The Long and the Short of It

    Directory of Open Access Journals (Sweden)

    Leslie A. Fabian

    2014-01-01

    Full Text Available As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU length of stay (LOS, Injury Severity Score (ISS, patient treatment options, disposition, and outcome were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI, and intracranial hemorrhage (ICH were significantly more common among longboard patients than skateboarders (P<0.0001. All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P<0.0001. Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

  6. Outcomes of a questionnaire survey on intracranial hypotension following minor head injury

    International Nuclear Information System (INIS)

    Dohi, Kenji; Aruga, Tohru; Abe, Toshiaki; Ogawa, Takeki; Onuma, Takehide; Katayama, Yoichi; Sakaki, Toshisuke; Shima, Katsuji; Hirakawa, Kimiyoshi

    2007-01-01

    Intracranial hypotension (IH) is a rare condition caused by leakage of cerebrospinal fluid (CSF). Recently, a small number of clinicians have proposed a new concept about IH following minor head injury. They suggest that many of their patients with IH can be successfully treated with epidural blood patch therapy. They also argue that some patients with post-traumatic cervical syndrome and general fatigue syndrome suffer from IH following minor head injury. Consequently, IH following minor head injury was widely recognized and dealt with as a social problem in Japan. On the other hand, pathophysiological aspects of the condition as well as the provisional criteria to describe this clinical entity remain to be elucidated. In 2006, the Japan Society of Neurotraumatology performed a questionnaire survey asking 44 hospitals belonging to trustees of this society about IH following minor head injury. This paper provides a report of the outcomes of this survey. The response rate to this questionnaire was 57% (25/44). Fifty-six percent of respondents did not have experience of IH following minor head injury. Moreover, respondents' criteria for describing this disease differed greatly, especially in the radiological examinations and symptoms for the diagnosis of this entity which showed significant variation. These problems might originate from the general features of this disease. With the exception of postural headache, the symptoms of this disease varied enormously. This wide range of symptoms confused with the pathophysiolosies of a great many similar conditions. As such, clarifications of the pathophysiological characteristics of IH following minor head injury, together with consensus on specific criteria to describe the condition, are required. In conclusion, the results of this survey revealed many serious scientific and social problems associated with the diagnosis and treatment of intracranial hypotension following minor head injury. Scientific study including the

  7. Time course of primary and secondary hyperalgesia after heat injury to the skin

    DEFF Research Database (Denmark)

    Møiniche, S; Dahl, J B; Kehlet, H

    1993-01-01

    the injury in any volunteer. These findings suggest post-injury development of secondary hyperalgesia to be a dynamic process, closely related in time to a peripheral nociceptive input, with reversal to normal when the peripheral lesion disappears. These observations may be relevant to the concept of "pre......We have examined the time course of, and relationship between, primary and secondary hyperalgesia after thermal injury to the skin in humans. Burn injuries (15 x 25 mm rectangular thermode, 49 degrees C, 5 min) were produced in eight healthy, unmedicated male volunteers, on the medial side...... of the right calf, on two occasions at least 8 days apart. Heat pain detection thresholds (HPDT), heat pain tolerance (HPT), mechanical pain detection threshold (MPDT) and the intensity of burn-injury induced erythema (skin erythema index, SEI) were assessed inside the burn injury. HPT was assessed only in one...

  8. Nitrate Increased Cucumber Tolerance to Fusarium Wilt by Regulating Fungal Toxin Production and Distribution

    Directory of Open Access Journals (Sweden)

    Jinyan Zhou

    2017-03-01

    Full Text Available Cucumber Fusarium wilt, induced by Fusarium oxysporum f. sp. cucumerinum (FOC, causes severe losses in cucumber yield and quality. Nitrogen (N, as the most important mineral nutrient for plants, plays a critical role in plant–pathogen interactions. Hydroponic assays were conducted to investigate the effects of different N forms (NH4+ vs. NO3‒ and supply levels (low, 1 mM; high, 5 mM on cucumber Fusarium wilt. The NO3‒-fed cucumber plants were more tolerant to Fusarium wilt compared with NH4+-fed plants, and accompanied by lower leaf temperature after FOC infection. The disease index decreased as the NO3‒ supply increased but increased with the NH4+ level supplied. Although the FOC grew better under high NO3− in vitro, FOC colonization and fusaric acid (FA production decreased in cucumber plants under high NO3− supply, associated with lower leaf membrane injury. There was a positive correlation between the FA content and the FOC number or relative membrane injury. After the exogenous application of FA, less FA accumulated in the leaves under NO3− feeding, accompanied with a lower leaf membrane injury. In conclusion, higher NO3− supply protected cucumber plants against Fusarium wilt by suppressing FOC colonization and FA production in plants, and increasing the plant tolerance to FA.

  9. PHYSIOLOGICAL AND BIOCHEMICAL MARKERS OF SALINITY TOLERANCE IN PLANTS

    Directory of Open Access Journals (Sweden)

    Mustafa YILDIZ

    2011-02-01

    Full Text Available Salt stress limits plant productivity in arid and semi arid regions. Salt stress causes decrease in plant growth by adversely affecting physiological processes, especially photosynthesis. Salinity tolerance is defined as the ability of plant to maintain normal rowth and development under salt conditions. Salt stress results in accumulation of low molecular weight compounds, termed compatible solutes, which do not interfere with the normal biochemical reactions. These compatible solutes such as carbohydrates, polyols, amino acids and amides, quaternary ammonium compounds, polyamines andsoluble proteins may play a crucial role in osmotic adjustment, protection of macromolecules, maintenance of cellular pH and detoxification of free radicals. On the other hand, plants subjected to environmental stresses such as salinity produce reactive oxygen species (ROS and these ROS are efficiently eliminated by antioxidant enzyme systems. In plant breeding studies, the use of some physiological and biochemical markers for improving the salt tolerance in plants is crucial. In this review, the possibility of using some physiological and biochemical markers as selection criteria for salt tolerance is discussed.

  10. Correlation between hypermobility score and injury rate in artistic gymnastics.

    Science.gov (United States)

    Bukva, Bojan; Vrgoč, Goran; Madić, Dejan; Sporiš, Goran; Trajković, Nebojša

    2018-01-10

    Generalized Joint Hypermobility (GJH) is suggested as a contributing factor for injuries in young athletes and adults. It is presumed that GJH causes decreased joint stability, thereby increasing the risk of joint and soft tissue injuries during sports activities. The aim of this study was to determine the correlation between the hypermobility rate (using the Beighton`s modification of the Carter-Wilkinson criteria of hypermobility) in gymnasts and injury rate, during the period of one year. This study observed 24 artistic gymnasts (11-26 years old), members of Qatar National Team in artistic gymnastics. We examined the Beighton joint hypermobility screen and a seasonal injury survey. The gymnasts characteristics (age, gender) and gymnastics characteristics (training per day and number of years in training artistic gymnastics) and its' relations to injury rate were also included. The most common injury was the lower back pain injury, followed by knee, shoulder, hip and ankle injuries. We found strong correlation of number of years gymnastics training and injury rate (p0.05). According to this study there is no correlation between GJH rate and injury rate in artistic gymnasts in Qatar. Total training period in gymnastics have greater contribution in injury rate.

  11. Radiation therapy tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1987-01-01

    To adequately plan acceptable dose distributions for radiation therapy treatments it is necessary to ensure that normal structures do not receive unacceptable doses. Acceptable doses are generally those that are below a stated tolerance dose for development of some level of complication. To support the work sponsored by the National Cancer Institute, data for the tolerance of normal tissues or organs to low-LET radiation has been compiled from a number of sources. These tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD 5 ) or 50% (TD 50 ) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represent doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same end point. 20 refs., 1 fig., 1 tab

  12. Emotional Intelligence in Patients with Spinal Cord Injury (SCI).

    Science.gov (United States)

    Saberi, Hooshang; Ghajarzadeh, Mahsa

    2017-05-01

    Spinal Cord Injury (SCI) is a devastating situation. Spinal Cord Injury affects functional, psychological and socioeconomic aspects of patients' lives. The ability to accomplish and explicate the one's own and other's feelings and emotions to spread over appropriate information for confirming thoughts and actions is defined as emotional intelligence (EI). The goal of this study was to evaluate depression and EI in SCI patients in comparison with healthy subjects. One-hundred-ten patients with SCI and 80 healthy subjects between Aug 2014 and Aug 2015 were enrolled. The study was conducted in Imam Hospital, Tehran, Iran. All participants were asked to fill valid and reliable Persian version Emotional Quotient inventory (EQ-i) and Beck Depression Inventory (BDI). All data were analyzed using SPSS. Data were presented as Mean±SD for continuous or frequencies for categorical variables. Continuous variables compared by means of independent sample t -test. P -values less than 0.05 were considered as significant. Mean age of patients was 28.7 and mean age of controls was 30.2 yr. Spinal cord injury in 20 (18.3%) were at cervical level, in 83 (75.4%) were thoracic and in 7 (6.3%) were lumbar. Mean values of independence, stress tolerance, self-actualization, emotional Self-Awareness, reality testing, Impulse Control, flexibility, responsibility, and assertiveness were significantly different between cases and controls. Mean values of stress tolerance, optimism, self-regard, and responsibility were significantly different between three groups with different injury level. Most scales were not significantly different between male and female cases. Emotional intelligence should be considered in SCI cases as their physical and psychological health is affected by their illness.

  13. Psychosocial consequences of mild traumatic brain injury in children

    DEFF Research Database (Denmark)

    Keightley, Michelle L; Côté, Pierre; Rumney, Peter

    2014-01-01

    OBJECTIVE: To synthesize the best available evidence regarding psychosocial consequences of mild traumatic brain injury (MTBI) in children. DATA SOURCES: MEDLINE, Embase, CINAHL, PsycINFO, and SPORTDiscus were searched (2001-2012). Inclusion criteria included published peer-reviewed reports...

  14. The Incidence of Postconcussion Syndrome Remains Stable Following Mild Traumatic Brain Injury in Children.

    Science.gov (United States)

    Barlow, Karen M; Crawford, Susan; Brooks, Brian L; Turley, Brenda; Mikrogianakis, Angelo

    2015-12-01

    Improving our knowledge about the natural history and persistence of symptoms following mild traumatic brain injury is a vital step in improving the provision of health care to children with postconcussion syndrome. The purposes of this study were to (1) determine the incidence and persistence of symptoms after mild traumatic brain injury and (2) ascertain whether Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptom criteria for postconcussion syndrome in adults are appropriate for use in children. A tertiary care pediatric emergency department was the setting for this study. This was a prospective observational follow-up cohort study of children (ages 2 to 18 years) with mild traumatic brain injury. Data were collected in person during the acute presentation, and subsequent follow-up was performed by telephone at 7-10 days and 1, 2, and 3 months postinjury. Postconcussion Symptom Inventory for parents and children was used. The DSM-IV diagnostic criteria for postconcussion syndrome were explored using receiver operating characteristic curve analysis. A total of 467 children (62.5% boys, median age 12.04, range 2.34-18.0) with mild traumatic brain injury participated. The median time until symptom resolution was 29.0 days (95% confidence intervals: 26.09-31.91). Three months after injury, 11.8% of children with mild traumatic brain injury remained symptomatic. Receiver operating curve characteristic analysis of the postconcussion syndrome criteria successfully classified symptomatic participants at three months postinjury; the adolescent receiver operating characteristic curve was excellent with the area under the curve being 0.928 (P children presenting to the emergency room with a mild traumatic brain injury remain symptomatic at 3 months postinjury. This is the first study to demonstrate stable incidence rates of postconcussion syndrome in children and that modified DSM-IV criteria can be used to successfully classify

  15. Role of Postmortem Multislice Computed Tomography Scan in Close Blunt Head Injury

    Directory of Open Access Journals (Sweden)

    Prijo Sidipratomo

    2014-08-01

    Full Text Available BACKGROUND: Conventional autopsy in Indonesia is not well accepted as it is contrary to religion and culture. New radiological imaging method such as multislice computed tomography (MSCT scan has potential to be a diagnostic tool in forensic pathology. The purpose of this study is to determine the ability of MSCT scan in finding abnormalities in close blunt head injury compared with autopsy. METHODS: This study used descriptive qualitative method. Postmortem cases in Department of Forensic Medicine and Radiology of Dr. Cipto Mangunkusumo Hospital were selected based on inclusion criteria. Then MSCT scan and autopsy were conducted. MSCT scan and autopsy results were compared and analyzed. RESULTS: There were 491 postmortem cases of blunt head injury. However, only 10 cases fulfilled inclusion criteria. Subarachnoid haemorrhages were identified 100% with MSCT scan and 80% with autopsy. Cerebral oedemas were identified 100% either with MSCT scan and autopsy. Subdural haemorrhages were identified 100% with MSCT scan, while 50% with autopsy. Multiple fractures were identified 80% with MSCT scan, while 40% with auto. CONCLUSIONS: MSCT scan showed a sensitive detection in finding abnormalities in close blunt head injury. Therefore it could be as an alternative choice of examination in close blunt head injury cases. KEYWORDS: multislice computed tomography scan, postmortem, blunt head injury, autopsy.

  16. Exercise-Based Interventions for Injury Prevention in Tackle Collision Ball Sports: A Systematic Review.

    Science.gov (United States)

    Sewry, Nicola; Verhagen, Evert; Lambert, Mike; van Mechelen, Willem; Viljoen, Wayne; Readhead, Clint; Brown, James

    2017-09-01

    The injury burden in collision sports is relatively high compared to other team sports. Therefore, participants in these sports would benefit by having effective injury prevention programs. Exercise-based interventions have successfully reduced injuries in soccer, but evidence on exercise-based interventions in tackle collision sports is limited. The objective of this review is to systematically examine the evidence of exercise-based intervention programs reducing injuries in tackle collision sports. PubMed, EBSCOHost, and Web of Science were searched for articles published between January 1995 and December 2015. The methodological quality was assessed using an adapted Cochrane Bone Joint and Muscle Trauma Group quality assessment tool. The inclusion criteria were (1) (randomized) control trials and observational studies; (2) sporting codes: American, Australian and Gaelic Football, rugby union, and rugby league; (3) participants of any age or sex; (4) exercise-based, prehabilitative intervention; and (5) primary outcome was injury rate or incidence (injury risk). The exclusion criteria were (1) unavailability of full-text; and (2) article unavailable in English. Nine studies with a total of 3517 participants were included in this review. Seven of these studies showed a significant decrease in injury risk. These studies included three sporting codes and various age groups, making it difficult to make inferences. The two highest methodological quality studies found no effect of an exercise-based intervention on injury risk. There is evidence that exercise-based injury preventions can be beneficial in reducing injury risk in collision sports, but more studies of high methodological quality are required.

  17. Urodynamic Bladder Patterns in Spinal Cord Injury Patients

    International Nuclear Information System (INIS)

    Aziz, T.; Khan, A. A.; Iqbal, S.; Aziz, U.; Jilani, S.; Ayyub, A.

    2017-01-01

    Objective: To determine the frequency of various neurogenic bladder patterns in patients with traumatic spinal cord injury presenting at Armed Forces Institute of Rehabilitation Medicine Rawalpindi based on urodynamic studies. Study Design: Descriptive cross sectional study. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi, from Jul 2014 to Jun 2016. Material and Methods: One hundred and forty traumatic spinal cord injury patients fulfilling the inclusion criteria were included both from indoor and outdoor departments through non-probability purposive sampling. Urodynamic studies were performed using the urodynamic equipment at urodynamic laboratory. Data were collected and recorded on specialized proforma by the principal investigator. Results: Among 140 study participants detrusor overactivity was found in 100 patients out of which 76 (76 percent) had thoracic level of injury, 20 (20 percent) had cervical level and 4 (4 percent) had lumbar level of injury. Detrusor areflexia was the bladder pattern in 40 patients out of which 26 (65 percent) had thoracic level of injury, 10 (25 percent) had cervical level, and 4 (10 percent) had lumbar level of injury. Conclusion: Detrusor overactivity was the commonest neurogenic bladder pattern among the traumatic spinal cord injury patients. (author)

  18. Prevention of Lower Extremity Injuries in Basketball

    Science.gov (United States)

    Taylor, Jeffrey B.; Ford, Kevin R.; Nguyen, Anh-Dung; Terry, Lauren N.; Hegedus, Eric J.

    2015-01-01

    Context: Lower extremity injuries are common in basketball, yet it is unclear how prophylactic interventions affect lower extremity injury incidence rates. Objective: To analyze the effectiveness of current lower extremity injury prevention programs in basketball athletes, focusing on injury rates of (1) general lower extremity injuries, (2) ankle sprains, and (3) anterior cruciate ligament (ACL) tears. Data Sources: PubMed, MEDLINE, CINAHL, SPORTDiscus, and the Cochrane Register of Controlled Trials were searched in January 2015. Study Selection: Studies were included if they were randomized controlled or prospective cohort trials, contained a population of competitive basketball athletes, and reported lower extremity injury incidence rates specific to basketball players. In total, 426 individual studies were identified. Of these, 9 met the inclusion criteria. One other study was found during a hand search of the literature, resulting in 10 total studies included in this meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 2. Data Extraction: Details of the intervention (eg, neuromuscular vs external support), size of control and intervention groups, and number of injuries in each group were extracted from each study. Injury data were classified into 3 groups based on the anatomic diagnosis reported (general lower extremity injury, ankle sprain, ACL rupture). Results: Meta-analyses were performed independently for each injury classification. Results indicate that prophylactic programs significantly reduced the incidence of general lower extremity injuries (odds ratio [OR], 0.69; 95% CI, 0.57-0.85; P basketball athletes. Conclusion: In basketball players, prophylactic programs may be effective in reducing the risk of general lower extremity injuries and ankle sprains, yet not ACL injuries. PMID:26502412

  19. Importance of liver biopsy findings in immunosuppression management: biopsy monitoring and working criteria for patients with operational tolerance.

    Science.gov (United States)

    2012-10-01

    Obstacles to morbidity-free long-term survival after liver transplantation (LT) include complications of immunosuppression (IS), recurrence of the original disease and malignancies, and unexplained chronic hepatitis and graft fibrosis. Many programs attempt to minimize chronic exposure to IS by reducing dosages and stopping steroids. A few programs have successfully weaned a highly select group of recipients from all IS without apparent adverse consequences, but long-term follow-up is limited. Patients subjected to adjustments in IS are usually followed by serial liver chemistry tests, which are relatively insensitive methods for detecting allograft damage. Protocol biopsy has largely been abandoned for hepatitis C virus-negative recipients, at least in part because of the inability to integrate routine histopathological findings into a rational clinical management algorithm. Recognizing a need to more precisely categorize and determine the clinical significance of findings in long-term biopsy samples, the Banff Working Group on Liver Allograft Pathology has reviewed the literature, pooled the experience of its members, and proposed working definitions for biopsy changes that (1) are conducive to lowering IS and are compatible with operational tolerance (OT) and (2) raise concern for closer follow-up and perhaps increased IS during or after IS weaning. The establishment of guidelines should help us to standardize analyses of the effects of various treatments and/or weaning protocols and more rigorously categorize patients who are assumed to show OT. Long-term follow-up using standardized criteria will help us to determine the consequences of lowering IS and to define and determine the incidence and robustness of OT in liver allografts. Copyright © 2012 American Association for the Study of Liver Diseases.

  20. Graded Aerobic Treadmill Testing in Adolescent Traumatic Brain Injury Patients.

    Science.gov (United States)

    Cordingley, Dean M; Girardin, Richard; Morissette, Marc P; Reimer, Karen; Leiter, Jeff; Russell, Kelly; Ellis, Michael J

    2017-11-01

    To examine the safety and tolerability of clinical graded aerobic treadmill testing in recovering adolescent moderate and severe traumatic brain injury (TBI) patients referred to a multidisciplinary pediatric concussion program. We completed a retrospective case series of two moderate and five severe TBI patients (mean age, 17.3 years) who underwent initial Buffalo Concussion Treadmill Testing at a mean time of 71.6 days (range, 55-87) postinjury. Six patients completed one graded aerobic treadmill test each and one patient underwent initial and repeat testing. There were no complications. Five initial treadmill tests were completely tolerated and allowed an accurate assessment of exercise tolerance. Two initial tests were terminated early by the treatment team because of neurological and cardiorespiratory limitations. As a result of testing, two patients were cleared for aerobic exercise as tolerated and four patients were treated with individually tailored submaximal aerobic exercise programs resulting in subjective improvement in residual symptoms and/or exercise tolerance. Repeat treadmill testing in one patient performed after 1 month of treatment with submaximal aerobic exercise prescription was suggestive of improved exercise tolerance. One patient was able to tolerate aerobic exercise following surgery for posterior glottic stenosis. Preliminary results suggest that graded aerobic treadmill testing is a safe, well tolerated, and clinically useful tool to assess exercise tolerance in appropriately selected adolescent patients with TBI. Future prospective studies are needed to evaluate the effect of tailored submaximal aerobic exercise prescription on exercise tolerance and patient outcomes in recovering adolescent moderate and severe TBI patients.

  1. Head injury causation scenarios for belted, rear-seated children in frontal impacts.

    Science.gov (United States)

    Bohman, Katarina; Arbogast, Kristy B; Bostrom, Ola

    2011-02-01

    Head injuries are the most common serious injuries sustained by children in motor vehicle crashes and are of critical importance with regard to long-term disability. There is a lack of understanding of how seat belt-restrained children sustain head injuries in frontal impacts. The aim of the study was to identify the AIS2+ head injury causation scenarios for rear-seated, belt-restrained children in frontal impacts, including the set of parameters contributing to the injury. In-depth crash investigations from two National Highway Traffic Safety Administration (NHTSA) databases, the National Automotive Sampling System-Crashworthiness Data System (NASS-CDS; 1997-2008) and the Crash Injury Research and Engineering Network (CIREN; 1996-2009), were collected and analyzed in detail. Selection criteria were all frontal impacts with principal direction of force (PDOF) of 11, 12, and 1 o'clock involving rear-seated, three-point belt-restrained, with or without booster cushion, children from 3 to 13 years with an AIS2+ head injury. Cases were analyzed using the BioTab method of injury causation assessment in order to systematically analyze the injury causation scenario for each case. There were 27 cases meeting the inclusion criteria, 19 cases with MAIS2 head injuries and 8 cases with MAIS3+ head injuries, including 2 fatalities. Three major injury causation scenarios were identified, including head contact with seatback (10 cases), head contact with side interior (7 cases,) and no evidence of head contact (9 cases). Head injuries with seatback or side interior contact typically included a PDOF greater than 10 degree (similar to the Insurance Institute for Highway Safety [IIHS] and EuroNCAP offset frontal testing) and vehicle maneuvers. For seatback contact, the vehicle's movements contributed to occupant kinematics inboard the vehicle, causing a less than optimal restraint of the torso and/or torso roll out of the shoulder belt. For side interior contact, the PDOF and

  2. Metabolic fate and evaluation of injury in rats and dogs following exposure to the hydrolysis products of uranium hexafluoride: implications for a bioassay program related to potential releases of uranium hexafluoride, July 1979-October 1981

    International Nuclear Information System (INIS)

    Morrow, P.E.; Leach, L.J.; Smith, F.A.

    1982-12-01

    This final report summarizes the experimental studies undertaken in rats and dogs in order to help provide adequate biological bases for quantifying and evaluating uranium hexafluoride (UF 6 ) exposures. Animals were administered the hydrolysis products of UF 6 by inhalation exposures, intratracheal instillations and intravenous injections. Attention was given to dose-effect relationships appropriate to the kidney, the unique site of subacute toxicity; to the rates of uranium excretion; and to uranium retention in renal tissue. These criteria were examined in both naive and multiply-exposed animals. The findings of these studies partly substantiate the ICRP excretion model for hexavalent uranium; generally provide a lower renal injury threshold concentration than implicit in the MPC for natural uranium; indicate distinctions in response (for example, uranium excretion) are based on exposure history; compare and evaluate various biochemical indices of renal injury; raise uncertainties about prevailing views of reversible renal injury, renal tolerance and possible hydrogen fluoride synergism with uranium effects; and reveal species differences in several areas, for example, renal retention of uranium. While these studies present some complicating features to extant bioassay practice, they nevertheless supply data supportive of the bioassay concept

  3. Primary repair of colon injuries: clinical study of nonselective approach

    Directory of Open Access Journals (Sweden)

    Krivokapic Zoran V

    2010-12-01

    Full Text Available Abstract Background This study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach. Methods Two groups of patients were analyzed. Retrospective (RS group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F and Flint (Fl. In this group 18 patients were managed by primary repair. Prospective (PR group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases. Results Groups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours. Stab wounds were more frequent in PR group (9:2, and iatrogenic lesions in RS group (6:2. Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar. In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days deaths, with no evidence of anastomotic leakage. Conclusions Results of this study justify more liberal use of primary repair in early management of colon injuries. Trial registration Current Controlled Trials ISRCTN94682396

  4. Tolerance of edible flowers to gamma irradiation

    International Nuclear Information System (INIS)

    Koike, Amanda C.R.; Araujo, Michel M.; Costa, Helbert S.F.; Almeida, Mariana C.; Villavicencio, Anna Lucia C.H.

    2011-01-01

    People have been eating flowers and using them in culinary creations for hundreds of years. Edible flowers are increasingly being used in meals as an ingredient in salads or garnish, entrees, drinks and desserts. The irradiation process is an alternative method that can be used in disinfestation of food and flowers, using doses that do not damage the product. The sensitivity of flowers to irradiation varies from species to species. In the present research was irradiated with doses up to 1 kGy some edible flowers to examine their physical tolerance to gamma-rays. Furthermore, high doses gamma irradiation causes petal withering, browning process and injury in edible flowers. (author)

  5. Tolerance of edible flowers to gamma irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Koike, Amanda C.R.; Araujo, Michel M.; Costa, Helbert S.F.; Almeida, Mariana C.; Villavicencio, Anna Lucia C.H., E-mail: ackoike@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP) Sao Paulo, SP (Brazil)

    2011-07-01

    People have been eating flowers and using them in culinary creations for hundreds of years. Edible flowers are increasingly being used in meals as an ingredient in salads or garnish, entrees, drinks and desserts. The irradiation process is an alternative method that can be used in disinfestation of food and flowers, using doses that do not damage the product. The sensitivity of flowers to irradiation varies from species to species. In the present research was irradiated with doses up to 1 kGy some edible flowers to examine their physical tolerance to gamma-rays. Furthermore, high doses gamma irradiation causes petal withering, browning process and injury in edible flowers. (author)

  6. Birth injuries to the epiphyseal cartilage

    International Nuclear Information System (INIS)

    Ekengren, K.; Bergdahl, S.; Ekstroem, G.

    1978-01-01

    A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography. (Auth.)

  7. 30 CFR 50.20-2 - Criteria-“Transfer to another job.”

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Criteria-âTransfer to another job.â 50.20-2 Section 50.20-2 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR ACCIDENTS..., Injuries, and Illnesses § 50.20-2 Criteria—“Transfer to another job.” “Transfer to another job” means...

  8. Child abuse. Non-accidental head injury; Kindesmisshandlung. Nicht akzidentelle Kopfverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Klee, Dirk; Schaper, Joerg [Universitaetsklinik Duesseldorf (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

    2011-12-15

    Knowledge of the radiological appearances that are the result of child abuse is an integral part of prevention of further, potentially life-threatening, injury. Radiologists must have un understanding of typical injury patterns of the skeletal system, visceral and intra-cranial structures, which should ideally be ordered chronologically. Necessary radiological investigations follow guidelines with specific criteria that are pointed out in this review. In equivocal cases of abuse, the opinion of a second (paediatric) radiologist should be sought. (orig.)

  9. The Relationship Between Muscular Strength and Dance Injuries: A Systematic Review.

    Science.gov (United States)

    Moita, João P; Nunes, Alexandre; Esteves, José; Oliveira, Raul; Xarez, Luis

    2017-03-01

    The physical demands placed on dancers put them at significant risk for injury, with rates similar to ones sustained by athletes in sports at the same level of performance. Muscle strength has been suggested to play a preventative role against injury in dancers. To systematically search and examine the available evidence on the protective role of muscle strength in dance injuries. Five electronic databases and two dance-specific science publications were screened up to September 2015. Study selection was based on a priori inclusion criteria on the relation between muscle strength components and injuries. Methodologic quality and level of evidence were assessed using the Downs and Black (DB) checklist and the Oxford Centre of Evidence-Based Medicine (OCEBM) 2011 model. From 186 titles found, only 8 studies met the inclusion criteria and were considered for review. Because of the significant heterogeneity of the included studies, meta-analysis was deemed inappropriate. The DB quality assessment results ranged from 18.7% to 75% (mean 42.3±16.9) and the OCEBM between 2b and 4. Some level 2b evidence from 2 studies suggested that pre-professional ballet dancers who get injured exhibit lower overall muscle strength scores on the lower extremity, and that lower extremity power gains may be associated with decreased bodily pain but not injury rate. Although there might be an association trend toward low muscle strength and dance injuries, the nature of that relation remains unclear, and presently the state of knowledge does not provide a solid basis for designing interventions for prevention.

  10. Analysis of Pregnancy Outcomes Using the New IADPSG Recommendation Compared with the Carpenter and Coustan Criteria in an Area with a Low Prevalence of Gestational Diabetes

    Directory of Open Access Journals (Sweden)

    Katrien Benhalima

    2013-01-01

    Full Text Available Aims. This paper aims to evaluate characteristics and pregnancy outcomes in women prior classified normal by Carpenter and Coustan criteria (old criteria and now gestational diabetes (GDM by the IADPSG criteria. Methods. Retrospective analysis of 6727 pregnancies is used. Using the old criteria, 222 had GDM (old GDM. Using the IADPSG criteria, 382 had GDM of which 160 had a normal glucose tolerance with the old criteria (new GDM. We compared the new GDM group with the old GDM group and women with normal glucose tolerance with both criteria (NGT group, 6345. Results. New GDM women were younger (31.6 ± 4.7 versus 33.3 ± 7.2 years, than old GDM women. Caesarean section was performed in 30.5% of new GDM, in 32.4% of old GDM (, and in 23.3% of NGT women (. Large for gestational age occurred in 10.8% of new GDM, in 13.8% of old GDM (, and in 9.0% of NGT women (. Shoulder dystocia occurred in 3.9% of new GDM, in 3.2% of old GDM (, and in 1.4% of NGT women (. Conclusion. Using the IADPSG criteria, more women are identified as having GDM, and these women carry an increased risk for adverse gestational outcome compared to women without GDM.

  11. Investigation of the THOR Anthropomorphic Test Device for Predicting Occupant Injuries during Spacecraft Launch Abort and Landing

    Directory of Open Access Journals (Sweden)

    Jeffrey T. Somers

    2014-03-01

    Full Text Available The objective of this study was to investigate new methods for predicting injury from expected spaceflight dynamic loads by leveraging a broader range of available information in injury biomechanics. Although all spacecraft designs were considered, the primary focus was the NASA Orion capsule, as the authors have the most knowledge and experience related to this design. The team defined a list of critical injuries and selected the Test Device for Human Occupant Restraint (THOR anthropomorphic test device (ATD as the basis for new standards and requirements. In addition, the team down selected the list of available injury metrics to the following: head injury criteria (HIC 15, kinematic rotational brain injury criteria (BRIC, neck axial tension and compression force, maximum chest deflection, lateral shoulder force and displacement, acetabular lateral force, thoracic spine axial compression force, ankle moments, and average distal forearm speed limits. The team felt that these metrics capture all of the injuries that might be expected by a seated crewmember during vehicle aborts and landings. Using previously determined injury risk levels for nominal and off-nominal landings, appropriate injury assessment reference values (IARVs were defined for each metric. Musculoskeletal deconditioning due to exposure to reduced gravity over time can affect injury risk during landing; therefore a deconditioning factor was applied to all IARVs. Although there are appropriate injury data for each anatomical region of interest, additional research is needed for several metrics to improve the confidence score.

  12. Rehabilitation and return to sport after hamstring strain injury

    Directory of Open Access Journals (Sweden)

    Lauren N. Erickson

    2017-09-01

    Full Text Available Hamstring strain injuries are common among sports that involve sprinting, kicking, and high-speed skilled movements or extensive muscle lengthening-type maneuvers with hip flexion and knee extension. These injuries present the challenge of significant recovery time and a lengthy period of increased susceptibility for recurrent injury. Nearly one third of hamstring strains recur within the first year following return to sport with subsequent injuries often being more severe than the original. This high re-injury rate suggests that athletes may be returning to sport prematurely due to inadequate return to sport criteria. In this review article, we describe the epidemiology, risk factors, differential diagnosis, and prognosis of an acute hamstring strain. Based on the current available evidence, we then propose a clinical guide for the rehabilitation of acute hamstring strains and an algorithm to assist clinicians in the decision-making process when assessing readiness of an athlete to return to sport.

  13. Therapeutic physical exercise in neural injury: friend or foe?

    Science.gov (United States)

    Park, Kanghui; Lee, Seunghoon; Hong, Yunkyung; Park, Sookyoung; Choi, Jeonghyun; Chang, Kyu-Tae; Kim, Joo-Heon; Hong, Yonggeun

    2015-12-01

    [Purpose] The intensity of therapeutic physical exercise is complex and sometimes controversial in patients with neural injuries. This review assessed whether therapeutic physical exercise is beneficial according to the intensity of the physical exercise. [Methods] The authors identified clinically or scientifically relevant articles from PubMed that met the inclusion criteria. [Results] Exercise training can improve body strength and lead to the physiological adaptation of skeletal muscles and the nervous system after neural injuries. Furthermore, neurophysiological and neuropathological studies show differences in the beneficial effects of forced therapeutic exercise in patients with severe or mild neural injuries. Forced exercise alters the distribution of muscle fiber types in patients with neural injuries. Based on several animal studies, forced exercise may promote functional recovery following cerebral ischemia via signaling molecules in ischemic brain regions. [Conclusions] This review describes several types of therapeutic forced exercise and the controversy regarding the therapeutic effects in experimental animals versus humans with neural injuries. This review also provides a therapeutic strategy for physical therapists that grades the intensity of forced exercise according to the level of neural injury.

  14. Transition of a Combined Toxic Gas Lethality Model to an Injury Model

    National Research Council Canada - National Science Library

    Stuhmiller, James

    1997-01-01

    Acute exposure to toxic gases under militarily relevant conditions differs dramatically from the long-term, low-dose exposure conditions for which most toxic gas injury criteria have been developed...

  15. Imperfect Gold Standards for Kidney Injury Biomarker Evaluation

    Science.gov (United States)

    Betensky, Rebecca A.; Emerson, Sarah C.; Bonventre, Joseph V.

    2012-01-01

    Clinicians have used serum creatinine in diagnostic testing for acute kidney injury for decades, despite its imperfect sensitivity and specificity. Novel tubular injury biomarkers may revolutionize the diagnosis of acute kidney injury; however, even if a novel tubular injury biomarker is 100% sensitive and 100% specific, it may appear inaccurate when using serum creatinine as the gold standard. Acute kidney injury, as defined by serum creatinine, may not reflect tubular injury, and the absence of changes in serum creatinine does not assure the absence of tubular injury. In general, the apparent diagnostic performance of a biomarker depends not only on its ability to detect injury, but also on disease prevalence and the sensitivity and specificity of the imperfect gold standard. Assuming that, at a certain cutoff value, serum creatinine is 80% sensitive and 90% specific and disease prevalence is 10%, a new perfect biomarker with a true 100% sensitivity may seem to have only 47% sensitivity compared with serum creatinine as the gold standard. Minimizing misclassification by using more strict criteria to diagnose acute kidney injury will reduce the error when evaluating the performance of a biomarker under investigation. Apparent diagnostic errors using a new biomarker may be a reflection of errors in the imperfect gold standard itself, rather than poor performance of the biomarker. The results of this study suggest that small changes in serum creatinine alone should not be used to define acute kidney injury in biomarker or interventional studies. PMID:22021710

  16. Diagnosis and treatment of radiation injuries

    International Nuclear Information System (INIS)

    Dalci, D.; Doerter, G.; Gueclue, I.

    2005-01-01

    This publication is the translation of IAEA Safety Reports Series No.2 ,Diagnosis and Treatment of Radiation Injuries. This report is directed at medical professionals who may be involved in the management of radiation injuries starting from the first few hours or days after an exposure of undefined severity. The principal aim of this publication is to provide guidelines to enable medical professionals to carry out prompt diagnostic measure and to offer emergency treatment. This report provides information in tabulated form on clinical criteria for dose assesment. Additionally, it discusses the appropriate dose-effect relationship in cases of external radiation involving either total body or local exposures, as well as internal contamination

  17. How effective are exercise-based injury prevention programmes for soccer players? : A systematic review.

    Science.gov (United States)

    van Beijsterveldt, A M C; van der Horst, Nick; van de Port, Ingrid G L; Backx, Frank J G

    2013-04-01

    The incidence of soccer (football) injuries is among the highest in sports. Despite this high rate, insufficient evidence is available on the efficacy of preventive training programmes on injury incidence. To systematically study the evidence on preventive exercise-based training programmes to reduce the incidence of injuries in soccer. The databases EMBASE/MEDLINE, PubMed, CINAHL, Cochrane Central Register of controlled trials, PEDro and SPORTDiscus™ were searched for relevant articles, from inception until 20 December 2011. The methodological quality of the included studies was assessed using the PEDro scale. The inclusion criteria for this review were (1) randomized controlled trials or controlled clinical trials; (2) primary outcome of the study is the number of soccer injuries and/or injury incidence; (3) intervention focusing on a preventive training programme, including a set of exercises aimed at improving strength, coordination, flexibility or agility; and (4) study sample of soccer players (no restrictions as to level of play, age or sex). The exclusion criteria were: (1) the article was not available as full text; (2) the article was not published in English, German or Dutch; and (3) the trial and/or training programme relates only to specific injuries and/or specific joints. To compare the effects of the different interventions, we calculated the incidence risk ratio (IRR) for each study. Six studies involving a total of 6,099 participants met the inclusion criteria. The results of the included studies were contradictory. Two of the six studies (one of high and one of moderate quality) reported a statistical significant reduction in terms of their primary outcome, i.e. injuries overall. Four of the six studies described an overall preventive effect (IRRbased programmes to prevent soccer injuries. Some reasons for the contradictory findings could be different study samples (in terms of sex and soccer type) in the included studies, differences between

  18. Neuromuscular training injury prevention strategies in youth sport: a systematic review and meta-analysis.

    Science.gov (United States)

    Emery, Carolyn A; Roy, Thierry-Olivier; Whittaker, Jackie L; Nettel-Aguirre, Alberto; van Mechelen, Willem

    2015-07-01

    Youth have very high participation and injury rates in sport. Sport is the leading cause of injury in youth. Sport injury reduces future participation in physical activity which adversely affects future health. Sport injury may lead to overweight/obesity and post-traumatic osteoarthritis. The objective of the systematic review and meta-analysis was to evaluate the efficacy of injury prevention neuromuscular training strategies in youth sport. Three electronic databases were systematically searched up to September 2014. Studies selected met the following criteria: original data; analytic prospective design; investigated a neuromuscular training prevention strategy intervention(s) and included outcomes for injury sustained during sport participation. Two authors assessed the quality of evidence using Downs and Black (DB) criteria. Meta-analyses including randomised controlled trials only (RCTs) to ensure study design homogeneity were completed for lower extremity and knee injury outcomes. Of 2504 potentially relevant studies, 25 were included. Meta-analysis revealed a combined preventative effect of neuromuscular training in reducing the risk of lower extremity injury (incidence rate ratio: IRR=0.64 (95% CI 0.49 to 0.84)). Though not statistically significant, the point estimate suggests a protective effect of such programmes in reducing the risk of knee injury (IRR=0.74 (95% CI 0.51 to 1.07)). There is evidence for the effectiveness of neuromuscular training strategies in the reduction of injury in numerous team sports. Lack of uptake and ongoing maintenance of such programmes is an ongoing concern. A focus on implementation is critical to influence knowledge, behaviour change and sustainability of evidence informed injury prevention practice. 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.

  19. Sleep disordered breathing in spinal cord injury: A systematic review.

    Science.gov (United States)

    Chiodo, Anthony E; Sitrin, Robert G; Bauman, Kristy A

    2016-07-01

    Spinal cord injury commonly results in neuromuscular weakness that impacts respiratory function. This would be expected to be associated with an increased likelihood of sleep-disordered breathing. (1) Understand the incidence and prevalence of sleep disordered breathing in spinal cord injury. (2) Understand the relationship between injury and patient characteristics and the incidence of sleep disordered breathing in spinal cord injury. (3) Distinguish between obstructive sleep apnea and central sleep apnea incidence in spinal cord injury. (4) Clarify the relationship between sleep disordered breathing and stroke, myocardial infarction, metabolic dysfunction, injuries, autonomic dysreflexia and spasticity incidence in persons with spinal cord injury. (5) Understand treatment tolerance and outcome in persons with spinal cord injury and sleep disordered breathing. Extensive database search including PubMed, Cochrane Library, CINAHL and Web of Science. Given the current literature limitations, sleep disordered breathing as currently defined is high in patients with spinal cord injury, approaching 60% in motor complete persons with tetraplegia. Central apnea is more common in patients with tetraplegia than in patients with paraplegia. Early formal sleep study in patients with acute complete tetraplegia is recommended. In patients with incomplete tetraplegia and with paraplegia, the incidence of sleep-disordered breathing is significantly higher than the general population. With the lack of correlation between symptoms and SDB, formal study would be reasonable. There is insufficient evidence in the literature on the impact of treatment on morbidity, mortality and quality of life outcomes.

  20. Distinct mechanisms underlying tolerance to intermittent and constant hypoxia in Drosophila melanogaster.

    Directory of Open Access Journals (Sweden)

    Priti Azad

    Full Text Available BACKGROUND: Constant hypoxia (CH and intermittent hypoxia (IH occur during several pathological conditions such as asthma and obstructive sleep apnea. Our research is focused on understanding the molecular mechanisms that lead to injury or adaptation to hypoxic stress using Drosophila as a model system. Our current genome-wide study is designed to investigate gene expression changes and identify protective mechanism(s in D. melanogaster after exposure to severe (1% O(2 intermittent or constant hypoxia. METHODOLOGY/PRINCIPAL FINDINGS: Our microarray analysis has identified multiple gene families that are up- or down-regulated in response to acute CH or IH. We observed distinct responses to IH and CH in gene expression that varied in the number of genes and type of gene families. We then studied the role of candidate genes (up-or down-regulated in hypoxia tolerance (adult survival for longer periods (CH-7 days, IH-10 days under severe CH or IH. Heat shock proteins up-regulation (specifically Hsp23 and Hsp70 led to a significant increase in adult survival (as compared to controls of P-element lines during CH. In contrast, during IH treatment the up-regulation of Mdr49 and l(208717 genes (P-element lines provided survival advantage over controls. This suggests that the increased transcript levels following treatment with either paradigm play an important role in tolerance to severe hypoxia. Furthermore, by over-expressing Hsp70 in specific tissues, we found that up-regulation of Hsp70 in heart and brain play critical role in tolerance to CH in flies. CONCLUSIONS/SIGNIFICANCE: We observed that the gene expression response to IH or CH is specific and paradigm-dependent. We have identified several genes Hsp23, Hsp70, CG1600, l(208717 and Mdr49 that play an important role in hypoxia tolerance whether it is in CH or IH. These data provide further clues about the mechanisms by which IH or CH lead to cell injury and morbidity or adaptation and survival.

  1. Imaging and diagnostic criteria for multiple sclerosis: are we there yet?

    International Nuclear Information System (INIS)

    Josey, Lawrence; Curley, Michael; Mousavi, Foroogh Jafari; Taylor, Bruce V.; Lucas, Robyn; Coulthard, Alan

    2012-01-01

    Excluding post traumatic injury, Multiple Sclerosis (MS) is the most common disabling neurological disorder of young adults. Although the effect on mortality is limited, the association of a young demographic and significant morbidity combine to make MS a devastating disease. Since MS was given its first detailed description in 1868, diagnostic criteria continue to evolve. Recently, there has been an international commitment to combine both clinical and paraclinical tests to arrive at an earlier diagnosis. Widespread acceptance of the use of MRI in diagnosis, monitoring and research has made the role of the radiologist more critical than ever in this disease. The primary diagnostic criteria for MS are the International Panel criteria, commonly referred to as the McDonald criteria and it is essential that the radiology community is aware of the work preceding these criteria, so that they are understood in the correct context and the importance acknowledged. Literature review utilising key word search to obtain the historical and current context of magnetic resonance imaging in the diagnosis of MS. A succinct description of the evolution of criteria for the diagnosis of MS. Radiologists must recognise that there are specific diagnostic criteria for MS that continue to evolve as a result of new research, improved technology and clinical experience and it is crucial that these criteria be applied in daily practice. It should be evident that diagnostic imaging criteria for MS will be most effective when combined with standardised MRI protocols such as those published by the international Consortium of Multiple Sclerosis Centres.

  2. Endorsement of DSM-IV dependence criteria among caffeine users.

    Science.gov (United States)

    Hughes, J R; Oliveto, A H; Liguori, A; Carpenter, J; Howard, T

    1998-10-01

    The purpose of this article is to determine whether some caffeine users endorse clinical indicators of dependence and abuse. We asked 162 randomly-selected caffeine users generic DSM-IV criteria for dependence, abuse, intoxication and withdrawal pertaining to their caffeine use in the last year via a structured telephone interview. The prevalence of endorsement of dependence items was 56% for strong desire or unsuccessful attempt to stop use, 50% for spending a great deal of time with the drug, 28% for using more than intended, 18% for withdrawal, 14% for using despite knowledge of harm, 8% for tolerance and 1% for foregoing activities to use. Seven percent of users met DSM-IV criteria for caffeine intoxication and, among those who had tried to stop caffeine permanently, 24% met DSM-IV research criteria for caffeine withdrawal. Test-retest interviews for dependency agreed in 29/30 cases (97%). Eight expert substance abuse clinicians agreed with self-endorsed caffeine dependence 91% of the time. Our results replicate earlier work and suggest that a substantial proportion of caffeine users exhibit dependence-like behaviors. Further studies are needed to determine whether such users exhibit a clinically significant syndrome of drug dependence.

  3. Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's Diagnostic and Statistical Manual formulation with implications for treatment.

    Science.gov (United States)

    Andrews, Christopher J; Reisner, Andrew D; Cooper, Mary Ann

    2017-09-01

    In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a systematic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM). The major neuropsychological consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a DSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

  4. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review.

    Science.gov (United States)

    Pfirrmann, Daniel; Herbst, Mark; Ingelfinger, Patrick; Simon, Perikles; Tug, Suzan

    2016-05-01

    The incidence of injury for elite youth and professional adult soccer players is an important concern, but the risk factors for these groups are different. To summarize and compare the injury incidences and injury characteristics of male professional adult and elite youth soccer players. We searched MEDLINE and Web of Science using the search terms elite, international, European, soccer, football, injury, injuries, epidemiology, incidence, prevalence, not female, not American football, and not rugby. We also used the search terms professional for studies on professional adult soccer players and high-level, soccer academy, youth, adolescent, and young for studies on elite youth soccer players. Eligible studies were published in English, had a prospective cohort design, and had a minimum study period of 6 months. To ensure that injury data were assessed in relationship to the athlete's individual exposure, we included only studies that reported on injuries and documented exposure volume. Two independent reviewers applied the selection criteria and assessed the quality of the studies. A total of 676 studies were retrieved from the literature search. Eighteen articles met the inclusion criteria: 6 for elite youth and 12 for professional adult soccer players. Injury rates were higher for matches than for training for both youth and adult players. Youth players had a higher incidence of training injuries than professionals. Efforts must be made to reduce the overall injury rate in matches. Therefore, preventive interventions, such as adequately enforcing rules and focusing on fair play, must be analyzed and developed to reduce match-related injury incidences. Reducing training injuries should be a particular focus for youth soccer players.

  5. Maximum concentrations at work and maximum biologically tolerable concentration for working materials 1991

    International Nuclear Information System (INIS)

    1991-01-01

    The meaning of the term 'maximum concentration at work' in regard of various pollutants is discussed. Specifically, a number of dusts and smokes are dealt with. The valuation criteria for maximum biologically tolerable concentrations for working materials are indicated. The working materials in question are corcinogeneous substances or substances liable to cause allergies or mutate the genome. (VT) [de

  6. Cold tolerance and photosystem function in a montane red spruce population: physiological relationships with foliar carbohydrates

    Science.gov (United States)

    P.G. Shaberg; G.R. Strimbeck; G.J. Hawley; D.H. DeHayes; J.B. Shane; P.F. Murakami; T.D. Perkins; J.R. Donnelly; B.L. Wong

    2000-01-01

    Red spruce (Picea rubens Sarg.) growing in northern montane forests of eastern North America appears to be distinctive with respect to at least two aspects of winter physiology. First, red spruce attains only a modest level of midwinter cold tolerance compared to other north temperate conifers and appears barely capable of avoiding freezing injury at...

  7. Drug-Induced Liver Injury Network Causality Assessment: Criteria and Experience in the United States

    Directory of Open Access Journals (Sweden)

    Paul H. Hayashi

    2016-02-01

    Full Text Available Hepatotoxicity due to drugs, herbal or dietary supplements remains largely a clinical diagnosis based on meticulous history taking and exclusion of other causes of liver injury. In 2004, the U.S. Drug-Induced Liver Injury Network (DILIN was created under the auspices of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases with the aims of establishing a large registry of cases for clinical, epidemiological and mechanistic study. From inception, the DILIN has used an expert opinion process that incorporates consensus amongst three different DILIN hepatologists assigned to each case. It is the most well-established, well-described and vigorous expert opinion process for DILI to date, and yet it is an imperfect standard. This review will discuss the DILIN expert opinion process, its strengths and weaknesses, psychometric performance and future.

  8. Cognitive, emotional and behavioral impairments following traumatic brain injury and the neuro-radiological diagnosis

    International Nuclear Information System (INIS)

    Shinoda, Jun; Asano, Yoshitaka

    2011-01-01

    Definition and diagnostic criteria in Japan of a high order brain functional impairment are explained and recent findings of the useful imaging for the criteria are discussed. The criteria of cognitive, emotional and behavioral impairments following brain injury (BI) defined by Ministry of Health, Labour and Welfare (MHLW) and National Rehabilitation Center for Persons with Disabilities contain 4 items of major symptoms, test findings, exclusion criteria and diagnosis. The criteria contain parts of diseases F04, F06 and F7 in ICD (International Classification of Diseases) 10, and conceivably correspond to such Western terms as the neuropsychological impairment, neurobehavioral impairment, cognitive disability and post-concussion syndrome. Head trauma is the major cause of BI and in the second item (test findings) of the diagnostic criteria above, imaging confirmation of the organic BI (mainly diffuse) is essential. For imaging technology of chronic diffuse injury, discussed are on findings of the structural MRI, diffusion tensor imaging (DTI), functional MRI; 18 F-fluorodeoxyglucose-positron emission tomography (FDG-PET); and single photon emission computed tomography (SPECT) with 99m Tc-ethyl-cysteinate dimmer and 123 I-iomazenil. Based on those findings, it is thought that the impairment of the high order brain functions by diffuse injury is caused by the dysfunction of the primarily injured region and by its consequent disorder of cingulated gyrus and frontal anterior medial region through disturbance of cerebral nerve transmission and control. It is also suggested that a part of the blast related mild traumatic BI in US ex-servicemen is caused by the light diffuse BI, which can only be identified by the fractional anisotropy-statistical parametric mapping image in DTI. Number of patients with the high order brain functional impairment is estimated to be about 300,000 in Japan, but only 1/3 of those are actually diagnosed to be of the disease. (T.T.)

  9. Genetically determined angiotensin converting enzyme level and myocardial tolerance to ischemia

    OpenAIRE

    Messadi, Erij; Vincent, Marie-Pascale; Griol-Charhbili, Violaine; Mandet, Chantal; Colucci, Juliana; Krege, John H.; Bruneval, Patrick; Bouby, Nadine; Smithies, Oliver; Alhenc-Gelas, François; Richer, Christine

    2010-01-01

    Angiotensin I-converting enzyme (ACE; kininase II) levels in humans are genetically determined. ACE levels have been linked to risk of myocardial infarction, but the association has been inconsistent, and the causality underlying it remains undocumented. We tested the hypothesis that genetic variation in ACE levels influences myocardial tolerance to ischemia. We studied ischemia-reperfusion injury in mice bearing 1 (ACE1c), 2 (ACE2c, wild type), or 3 (ACE3c) functional copies of the ACE gene ...

  10. Development of acceptance criteria and damage tolerance analyzes of the ductile iron insert; Framtagning av acceptanskriterier samt skadetaalighetsanalyser av segjaernsinsatsen

    Energy Technology Data Exchange (ETDEWEB)

    Dillstroem, Peter; Alverlind, Lars; Andersson, Magnus (Inspecta Technology AB (Sweden))

    2010-01-15

    SKB intends to qualify a test system for detection and sizing of defects deemed to be relevant to the ductile iron insert. In support of this qualification, a damage tolerance analysis indicating the current qualification targets, given assumed damage and failure modes. This report describes the damage tolerance analyzes of different types of defects that are considered relevant of the ductile iron insert. The results are reported separately for each test area (zone) and type of insert (BWRs and PWRs)

  11. A comparison of hydroponic and soil-based screening methods to identify salt tolerance in the field in barley

    Science.gov (United States)

    Tavakkoli, Ehsan; Fatehi, Foad; Rengasamy, Pichu; McDonald, Glenn K.

    2012-01-01

    Success in breeding crops for yield and other quantitative traits depends on the use of methods to evaluate genotypes accurately under field conditions. Although many screening criteria have been suggested to distinguish between genotypes for their salt tolerance under controlled environmental conditions, there is a need to test these criteria in the field. In this study, the salt tolerance, ion concentrations, and accumulation of compatible solutes of genotypes of barley with a range of putative salt tolerance were investigated using three growing conditions (hydroponics, soil in pots, and natural saline field). Initially, 60 genotypes of barley were screened for their salt tolerance and uptake of Na+, Cl–, and K+ at 150 mM NaCl and, based on this, a subset of 15 genotypes was selected for testing in pots and in the field. Expression of salt tolerance in saline solution culture was not a reliable indicator of the differences in salt tolerance between barley plants that were evident in saline soil-based comparisons. Significant correlations were observed in the rankings of genotypes on the basis of their grain yield production at a moderately saline field site and their relative shoot growth in pots at ECe 7.2 [Spearman’s rank correlation (rs)=0.79] and ECe 15.3 (rs=0.82) and the crucial parameter of leaf Na+ (rs=0.72) and Cl– (rs=0.82) concentrations at ECe 7.2 dS m−1. This work has established screening procedures that correlated well with grain yield at sites with moderate levels of soil salinity. This study also showed that both salt exclusion and osmotic tolerance are involved in salt tolerance and that the relative importance of these traits may differ with the severity of the salt stress. In soil, ion exclusion tended to be more important at low to moderate levels of stress but osmotic stress became more important at higher stress levels. Salt exclusion coupled with a synthesis of organic solutes were shown to be important components of salt

  12. Addiction and Engagement: An Explorative Study Toward Classification Criteria for Internet Gaming Disorder.

    Science.gov (United States)

    Lehenbauer-Baum, Mario; Klaps, Armin; Kovacovsky, Zuzana; Witzmann, Karolin; Zahlbruckner, Raphaela; Stetina, Birgit U

    2015-06-01

    The DSM-5 introduced Internet gaming disorder (IGD) as a condition needing more research. Proposed criteria include tolerance, preoccupation, deceiving, or continued excess despite psychosocial problems. However, studies suggest differences between addicted and engaged players. Therefore, this study investigated differences between engagement and addiction in a German-speaking sample of expert World of Warcraft players. Using an online-based questionnaire, 682 participants were surveyed (Mage=23.26 years; 84.9% male) from German-speaking areas. An adapted version of the "Asheron's call" questionnaire (which covers six addiction criteria, including salience, euphoria, and tolerance), the WHOQOL-BREF, the Gaming Motivation Scale, the BDI, the SPIN, and a brief version of the personality questionnaire BFI-10 were used. The average gamer in the sample played on level 87.93 and had been playing for 5.42 years. Addicted players had higher scores on the BDI and SPIN and significantly lower scores in all dimensions of quality of life. Addicted gamers played for 39.25 hours per week (engaged players: 11.93 hours per week) with significantly higher scores in items tapping achievement and immersion. There were differences regarding the BFI-10 in terms of "agreeableness," "conscientiousness," and "neuroticism." The results suggest that factors such as achievement and immersion set engaged and addicted users apart. Addiction seems to be significantly more connected to other psychopathologies such as depression and social anxiety. The results suggest that euphoria, tolerance, and cognitive salience should be handled with caution when it comes to a classification of IGD similar to (behavioral) addiction.

  13. Unintentional injury prevention and the role of occupational therapy in the Solomon Islands: an integrative review.

    Science.gov (United States)

    Daufanamae, Barbara U; Franklin, Richard C; Eagers, Jackie

    2016-01-01

    Unintentional injuries (injuries for which there is no evidence of a predetermined intent) are one of the leading causes of death worldwide, particularly in low- and middle-income countries (LMICs). Although evidence demonstrates unintentional injuries are preventable it is a public health challenge for many LMICs such as the Solomon Islands. Occupational therapists are well placed to contribute to injury prevention, as they have specialised skills to analyse the accessibility and safety of the environments within which people conduct their daily occupations. While the role of occupational therapy in unintentional injury prevention is well known in high-income countries, it is unfamiliar in LMICs, especially in the Solomon Islands. This integrative review aimed to explore the incidence of common unintentional injuries, and the burden in the Solomon Islands; and explore the potential role of occupational therapy in unintentional injury prevention in the Solomon Islands, based on current activities in LMICs. Articles were reviewed from six databases (Medline, CINAHL, OTDBase, OT Seeker, Scopus and PsychInfo). Five articles met the inclusion criteria for the first objective and 15 articles met the inclusion criteria for the second objective. These articles were thematically analysed where themes and codes associated with the research objectives were extracted and analysed. Unintentional injuries in the Solomon Islands reported in the literature included ocular trauma, falls from fruit trees and coconut palms, and road traffic crashes. Burden of injury reported was mostly associated with loss of productivity. Occupational therapists undertook rehabilitative, biomechanical, neurodevelopmental and educational roles in LMIC, focusing on tertiary and secondary injury prevention. This integrative review suggests that there is limited information regarding injury in the Solomon Islands. However, evidence is available in LMICs to suggest that occupational therapy services can

  14. Comparison of Two Multi-Criteria Decision Techniques for Eliciting Treatment Preferences in People with Neurological Disorders

    NARCIS (Netherlands)

    IJzerman, Maarten Joost; van Til, Janine Astrid; Snoek, Govert J.

    2008-01-01

    Objective: To present and compare two multi-criteria decision techniques (analytic hierarchy process [AHP] and conjoint analysis [CA]) for eliciting preferences in patients with cervical spinal cord injury (SCI) who are eligible for surgical augmentation of hand function, either with or without

  15. Soft tissue twisting injuries of the knee

    International Nuclear Information System (INIS)

    Magee, T.; Shapiro, M.

    2001-01-01

    Twisting injuries occur as a result of differential motion of different tissue types in injuries with some rotational force. These injuries are well described in brain injuries but, to our knowledge, have not been described in the musculoskeletal literature. We correlated the clinical examination and MR findings of 20 patients with twisting injuries of the soft tissues around the knee. Design and patients: We prospectively followed the clinical courses of 20 patients with knee injuries who had clinical histories and MR findings to suggest twisting injuries of the subcutaneous tissues. Patients with associated internal derangement of the knee (i.e., meniscal tears, ligamentous or bone injuries) were excluded from this study. MR findings to suggest twisting injuries included linear areas of abnormal dark signal on T1-weighted sequences and abnormal bright signal on T2-weighted or short tau inversion recovery (STIR) sequences and/or signal to suggest hemorrhage within the subcutaneous tissues. These MR criteria were adapted from those established for indirect musculotendinous junction injuries. Results: All 20 patients presented with considerable pain that suggested internal derangement on physical examination by the referring orthopedic surgeons. All presented with injuries associated with rotational force. The patients were placed on a course of protected weight-bearing of the affected extremity for 4 weeks. All patients had pain relief by clinical examination after this period of protected weight-bearing. Twisting injuries of the soft tissues can result in considerable pain that can be confused with internal derangement of the knee on physical examination. Soft tissue twisting injuries need to be recognized on MR examinations as they may be the cause of the patient's pain despite no MR evidence of internal derangement of the knee. The demonstration of soft tissue twisting injuries in a patient with severe knee pain but no documented internal derangement on MR

  16. Induction of ischemic tolerance as a promising treatment against diabetic retinopathy

    Institute of Scientific and Technical Information of China (English)

    Ruth E.Rosenstein; Diego C.Fernandez

    2014-01-01

    Diabetic retinopathy is a leading cause of acquired blindness, and it is the most common ischemic disorder of the retina. Available treatments are not very effective. Efforts to inhibit diabetic reti-nopathy have focused either on highly speciifc therapeutic approaches for pharmacologic targets or using genetic approaches to change expression of certain enzymes. However, it might be wise to choose innovative treatment modalities that act by multiple potential mechanisms. The resis-tance to ischemic injury, or ischemic tolerance, can be transiently induced by prior exposure to a non-injurious preconditioning stimulus. A complete functional and histologic protection against retinal ischemic damage can be achieved by previous preconditioning with non-damaging isch-emia. In this review, we will discuss evidence that supports that ischemic conditioning could help avert the dreaded consequences that results from retinal diabetic damage.

  17. Evaluation criteria for dialogue processes: key findings from RISCOM II

    International Nuclear Information System (INIS)

    Atherton, Elizabeth

    2003-01-01

    As part of Work Package 4 (undertaken by a consortium of partners from the United Kingdom) in the joint European project RISCOM II, work was undertaken on evaluation criteria for determining the success of dialogue processes; this note outlines its key findings as, in order to continue the development of dialogue processes, it is important to evaluate and learn from the experience of engaging with stakeholders. Criteria can be developed to evaluate how successful a process has been, these can range from very practical criteria relating to how well the process worked or be linked to more subjective criteria developed from the aims of the dialogue process itself. Some criteria are particularly relevant to dialogue processes that aim to encourage deliberation and the development of stakeholders' views through participation in the dialogue process: transparency, legitimacy, equality of access, 'being able to speak', a deliberative environment, openness of framing, developing insight into range of issues (new meanings are generated), inclusive and 'best' knowledge elicited, producing acceptable/tolerable and usable outcomes/decisions, improvement of trust and understanding between participants, developing a sense of shared responsibility and common good. Evaluation will incur a cost in terms of time and money, but will help practitioners to be able to develop processes that meet the needs of those who participate and improve the way that we try to engage people in the debate

  18. Effect of the Shrink Fit and Mechanical Tolerance on Reactor Coolant Pump Flywheel Integrity Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Donghak [Korea KHNP Central Research Institute, Daejeon (Korea, Republic of)

    2015-10-15

    Reactor coolant pump (RCP) flywheel should satisfy the RCP flywheel integrity criteria of the US NRC standard review plan (SRP) 5.4.1.1 and regulatory guide (RG) 1.14. Shrink-fit and rotational stresses should be calculated to evaluate the integrity. In this paper the effects of the shrink fit and mechanical tolerance on the RCP flywheel integrity evaluation are studied. The shrink fit should be determined by the joint release speed and the stresses in the flywheel will be increased by the shrink fit. The stress at the interface between the hub and the outer wheel shows the highest value. The effect of the mechanical tolerance should be considered for the stress evaluation. And the effect of the mechanical tolerance should be not considered to determine the joint release speed.

  19. Effect of the Shrink Fit and Mechanical Tolerance on Reactor Coolant Pump Flywheel Integrity Evaluation

    International Nuclear Information System (INIS)

    Kim, Donghak

    2015-01-01

    Reactor coolant pump (RCP) flywheel should satisfy the RCP flywheel integrity criteria of the US NRC standard review plan (SRP) 5.4.1.1 and regulatory guide (RG) 1.14. Shrink-fit and rotational stresses should be calculated to evaluate the integrity. In this paper the effects of the shrink fit and mechanical tolerance on the RCP flywheel integrity evaluation are studied. The shrink fit should be determined by the joint release speed and the stresses in the flywheel will be increased by the shrink fit. The stress at the interface between the hub and the outer wheel shows the highest value. The effect of the mechanical tolerance should be considered for the stress evaluation. And the effect of the mechanical tolerance should be not considered to determine the joint release speed

  20. Primary blast survival and injury risk assessment for repeated blast exposures.

    Science.gov (United States)

    Panzer, Matthew B; Bass, Cameron R Dale; Rafaels, Karin A; Shridharani, Jay; Capehart, Bruce P

    2012-02-01

    The widespread use of explosives by modern insurgents and terrorists has increased the potential frequency of blast exposure in soldiers and civilians. This growing threat highlights the importance of understanding and evaluating blast injury risk and the increase of injury risk from exposure to repeated blast effects. Data from more than 3,250 large animal experiments were collected from studies focusing on the effects of blast exposure. The current study uses 2,349 experiments from the data collection for analysis of the primary blast injury and survival risk for both long- and short-duration blasts, including the effects from repeated exposures. A piecewise linear logistic regression was performed on the data to develop survival and injury risk assessment curves. New injury risk assessment curves uniting long- and short-duration blasts were developed for incident and reflected pressure measures and were used to evaluate the risk of injury based on blast over pressure, positive-phase duration, and the number of repeated exposures. The risk assessments were derived for three levels of injury severity: nonauditory, pulmonary, and fatality. The analysis showed a marked initial decrease in injury tolerance with each subsequent blast exposure. This effect decreases with increasing number of blast exposures. The new injury risk functions showed good agreement with the existing experimental data and provided a simplified model for primary blast injury risk. This model can be used to predict blast injury or fatality risk for single exposure and repeated exposure cases and has application in modern combat scenarios or in setting occupational health limits. .Copyright © 2012 by Lippincott Williams & Wilkins

  1. Prevention of shoulder injuries in overhead athletes: a science-based approach

    Directory of Open Access Journals (Sweden)

    Ann M. Cools

    2015-10-01

    Full Text Available The shoulder is at high risk for injury during overhead sports, in particular in throwing or hitting activities, such as baseball, tennis, handball, and volleyball. In order to create a scientific basis for the prevention of recurrent injuries in overhead athletes, four steps need to be undertaken: (1 risk factors for injury and re-injury need to be defined; (2 established risk factors may be used as return-to-play criteria, with cut-off values based on normative databases; (3 these variables need to be measured using reliable, valid assessment tools and procedures; and (4 preventative training programs need to be designed and implemented into the training program of the athlete in order to prevent re-injury. In general, three risk factors have been defined that may form the basis for recommendations for the prevention of recurrent injury and return to play after injury: glenohumeral internal-rotation deficit (GIRD; rotator cuff strength, in particular the strength of the external rotators; and scapular dyskinesis, in particular scapular position and strength.

  2. Brain injury in sports.

    Science.gov (United States)

    Lloyd, John; Conidi, Frank

    2016-03-01

    Helmets are used for sports, military, and transportation to protect against impact forces and associated injuries. The common belief among end users is that the helmet protects the whole head, including the brain. However, current consensus among biomechanists and sports neurologists indicates that helmets do not provide significant protection against concussion and brain injuries. In this paper the authors present existing scientific evidence on the mechanisms underlying traumatic head and brain injuries, along with a biomechanical evaluation of 21 current and retired football helmets. The National Operating Committee on Standards for Athletic Equipment (NOCSAE) standard test apparatus was modified and validated for impact testing of protective headwear to include the measurement of both linear and angular kinematics. From a drop height of 2.0 m onto a flat steel anvil, each football helmet was impacted 5 times in the occipital area. Skull fracture risk was determined for each of the current varsity football helmets by calculating the percentage reduction in linear acceleration relative to a 140-g skull fracture threshold. Risk of subdural hematoma was determined by calculating the percentage reduction in angular acceleration relative to the bridging vein failure threshold, computed as a function of impact duration. Ranking the helmets according to their performance under these criteria, the authors determined that the Schutt Vengeance performed the best overall. The study findings demonstrated that not all football helmets provide equal or adequate protection against either focal head injuries or traumatic brain injuries. In fact, some of the most popular helmets on the field ranked among the worst. While protection is improving, none of the current or retired varsity football helmets can provide absolute protection against brain injuries, including concussions and subdural hematomas. To maximize protection against head and brain injuries for football players of

  3. Tolerance

    DEFF Research Database (Denmark)

    Tønder, Lars

    Tolerance: A Sensorial Orientation to Politics is an experiment in re-orientation. The book is based on the wager that tolerance exceeds the more prevalent images of self-restraint and repressive benevolence because neither precludes the possibility of a more “active tolerance” motivated by the d...... these alternatives by returning to the notion of tolerance as the endurance of pain, linking this notion to exemplars and theories relevant to the politics of multiculturalism, religious freedom, and free speech....

  4. How Do People Stop Non-Suicidal Self-Injury? A Systematic Review.

    Science.gov (United States)

    Mummé, Tess Alexandra; Mildred, Helen; Knight, Tess

    2017-07-03

    The current paper reviews extant quantitative and qualitative literature into how Non-Suicidal Self-Injury cessation occurs, and individuals' experiences of stopping. Specific search criteria utilizing a PRISMA format were used across 5 databases, which resulted in 454 papers being identified. After utilizing exclusion criteria and then review, nine of the 454 papers identified were retained for extensive synthesis and critique. Results from 8 of the identified papers indicated that both intra and inter personal factors can influence self-injury cessation. These include: family support, self-esteem, emotional regulation, and professional help. Only 1 paper articulated a cessation process, describing it as a procedural event of developing interpersonal strength, then implementing alternative coping strategies. Limitations and implications of the studies are reported, concluding that further research is warranted to inform effective prevention and treatment strategies to ameliorate this growing public health concern.

  5. Application of National Emergency X-Ray Utilizations Study low-risk c-spine criteria in high-risk geriatric falls.

    Science.gov (United States)

    Evans, Daniel; Vera, Luis; Jeanmonod, Donald; Pester, Jonathan; Jeanmonod, Rebecca

    2015-09-01

    We sought to validate National Emergency X-Radiography Utilizations Study low-risk cervical spine (C spine) criteria in a geriatric trauma population. We sought to determine whether patients' own baseline mental status (MS) could substitute for Glasgow Coma Scale (GCS) to meet the criteria "normal alertness." We further sought to refine the definition of "distracting injury." This is a retrospective review of geriatric fall patients presenting to a level 1 trauma center and triaged to the trauma bay. We queried our database from 2008 to 2013. Abstractors recorded GCS, deviation from baseline MS, midline neck tenderness, intoxication, focal deficit, signs of trauma, and presence of other injury. Patients were considered at baseline MS if specific documentation was present on the chart, or if their GCS was 15. Six hundred sixty elderly fall patients were trauma alerts during the study period. Seventeen were excluded for incomplete records/death before imaging, leaving 647. The median age was 81 (interquartile range, 74-87). Fifty patients (8.0%) had C spine or cord injury. Two hundred ninety-four (44.5%) had baseline MS (including GCS 13-15), no spine tenderness, no intoxication, and no focal neurologic deficit. Of these, 18 had C-spine injury. Using physical findings of head trauma as the only "distracting injury," no injury would have been missed (sensitivity, 100% [confidence interval, 91.1-100]; specificity, 14.2%). Our study suggests that National Emergency X-Radiography Utilizations Study can be safely applied in elderly fall patients who are at their personal baseline MS. Furthermore, our data support a more narrow definition of distracting injury to include only patients with signs of trauma to the head. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. The association of temporomandibular disorder pain with history of head and neck injury in adolescents.

    Science.gov (United States)

    Fischer, Dena J; Mueller, Beth A; Critchlow, Cathy W; LeResche, Linda

    2006-01-01

    To evaluate the risk of self-reported temporomandibular disorder (TMD) pain among adolescents in relation to previous head and/or neck injury. 3,101 enrollees (11 to 17 years of age) of a nonprofit integrated health-care system were interviewed by telephone. Two hundred four cases with self-reported TMD pain and 194 controls without self-reported TMD pain frequency-matched to the cases by age and gender completed standardized in-person interviews and physical examinations in which reports of previous head/neck injuries were recorded. Odds ratio (OR) estimates and 95% confidence intervals (CIs) of the relative risks of TMD pain associated with prior head and/or neck injuries were calculated using logistic regression. A greater proportion of subjects reporting TMD pain (36%) than controls (25%) had a history of head and/or neck injuries (OR = 1.8, 95% CI, 1.1-2.8). In a separate analysis, the presence of TMD based upon the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) was assessed in relation to prior head and/or neck injury. Cases reporting TMD pain and meeting the RDC/TMD criteria for myofascial pain and/or arthralgia or arthritis were 2.0 (CI, 1.0-3.8) times more likely to have had a prior head injury than were controls with neither self-reported nor RDC/TMD pain diagnoses. The results suggest a modest association of prior head injuries with both self-reported and clinically diagnosed TMD pain in adolescents.

  7. Injury rates and risk factors in competitive professional boxing.

    Science.gov (United States)

    Zazryn, Tsharni R; McCrory, Paul R; Cameron, Peter A

    2009-01-01

    To determine injury rates and risk factors for injury in a cohort of professional boxers. Retrospective cohort design reporting on data collected for a fight statistics database maintained by the Professional Boxing and Combat Sports Board of Victoria, Australia. Data were extracted for the years January 1997 through June 2005. Victoria, Australia. 545 professional boxers (age, 18 to 43 years) who participated in a total of 907 fights over the study period. Independent variables under investigation included age, gender, weight, bout exposure, and location of the bout (within or outside of the State of Victoria). Physician-reported acute boxing injuries occurring during bouts of any region or nature. 214 injuries were sustained over the 8.5 years, corresponding to an injury rate of 23.6 per 100 professional fights. The majority of these injuries were lacerations to the head and face. An increasing age and an increasing number of fights were both significant predictors of injury. Injury reduction strategies for professional boxing might include restrictions of eligibility to fight based on age and boxing bout exposure. Future research using prospective cohort designs and standardized injury definitions are needed to confirm these results. Greater mechanistic detail and more complete data entry are necessary to ensure that optimal injury prevention strategies can be developed and implemented. Upon confirmation of the results of this study, the Professional Boxing and Combat Sports Board of Victoria may consider different criteria upon which to sanction a fight.

  8. Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria.

    Science.gov (United States)

    Benjet, Corina; González-Herrera, Irene; Castro-Silva, Everardo; Méndez, Enrique; Borges, Guilherme; Casanova, Leticia; Medina-Mora, Maria Elena

    2017-06-01

    Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. [The forensic medical assessment of the results of a study of laryngeal injuries in blunt trauma to the neck].

    Science.gov (United States)

    Svetlakov, A V; Korenev, S A; Akishin, A N

    1997-01-01

    Presents the methodological principles and succession of examination of the basic formations of the larynx in cases with blunt injuries of the neck. Describes variants of anatomic structure of the sublingual bone and laryngeal cartilages influencing the morphology of injuries thereof. Offers differential diagnostic criteria of various mechanisms of fractures of the basic formations and recommendations on medical criminological assessment of laryngeal injuries.

  10. Organization of medical aid and treatment of victims of mass ionizing radiation injuries

    International Nuclear Information System (INIS)

    Gus'kova, A.K.; Burenin, P.I.; Barabanova, A.V.

    1987-01-01

    General organization points on medical aid and treatment of mass ionizing radiation injuries in population are presented. Characteristic of losses and structure of injuries induced by a nuclear explosion are given. Destructions in a town caused by a nuclear explosion and medical aid conditions for patients are analysed. Main information about structure of medical surveillance of civil defence and criteria of medical classification and evacuation of the injured are presented

  11. The tissue injury and repair in cancer radiotherapy. A concept of tissue architecture and radio sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Matsuzawa, T [Tohoku Univ., Sendai (Japan). Research Inst. for Tuberculosis, Leprosy and Cancer

    1975-06-01

    One of the difficulties in cancer radiotherapy arises from the fact that the tissue tolerance dose is much smaller than the tumor lethal dose. In our opinion the former depends upon the tolerance of the endothelial cell of the blood vessel in the normal tissue. In this introduction, a new concept regarding the estimation of tissue radiosensitivity was described, and the possible significance of the mode of radiation injury and the repair capability of normal tissue in the cancer radiotheraphy was discussed.

  12. Caregiver outcomes and interventions: a systematic scoping review of the traumatic brain injury and spinal cord injury literature.

    Science.gov (United States)

    Baker, Anne; Barker, Samantha; Sampson, Amanda; Martin, Clarissa

    2017-01-01

    To identify factors reported with negative and positive outcomes for caregivers of the traumatic brain injury and spinal cord injury cohorts, to investigate what interventions have been studied to support carers and to report what effectiveness has been found. Scoping systematic review. Electronic databases and websites were searched from 1990 to December 2015. Studies were agreed for inclusion using pre-defined criteria. Relevant information from included studies was extracted and quality assessment was completed. Data were synthesised using qualitative methods. A total of 62 studies reported caregiver outcomes for the traumatic brain injury cohort; 51 reported negative outcomes and 11 reported positive outcomes. For the spinal cord injury cohort, 18 studies reported caregiver outcomes; 15 reported negative outcomes and three reported positive outcomes. Burden of care was over-represented in the literature for both cohorts, with few studies looking at factors associated with positive outcomes. Good family functioning, coping skills and social support were reported to mediate caregiver burden and promote positive outcomes. A total of 21 studies further described interventions to support traumatic brain injury caregivers and four described interventions to support spinal cord injury caregivers, with emerging evidence for the effectiveness of problem-solving training. Further research is required to explore the effects of injury severity of the care recipient, as well as caregiver age, on the outcome of the interventions. Most studies reported negative outcomes, suggesting that barriers to caregiving have been established, but not facilitators. The interventions described to support carers are limited and require further testing to confirm their effectiveness.

  13. Vascular injury outcomes with screening implementation

    Directory of Open Access Journals (Sweden)

    James D. Weinberg, MD

    2017-09-01

    Full Text Available Blunt carotid and vertebral artery injuries (BCVI are generally viewed as rare events. Screening guidelines based on the Memphis and Denver data were put into place at Palmetto Health Richland in August of 2008. This study aims to look at the incidence of BCVI 2 years before the guidelines were put into place and then 2 years after. A total of 11,005 trauma patients presented during our study period. 98 patients were determined to have BCVI and met inclusion criteria: 21 in the Control group and 77 in the Screening group. A total of 16 deaths and 14 strokes were recorded in the study population. The odds of patients in the Screening group dying were 29% lower than that of a patient in the Control group [OR: 0.71, (95% CI: 0.20–2.50; p = 0.59], after adjusting for ISS. The odds of developing a stroke in the Screening group were 69% lower than the Control group [OR: 0.31 (0.09–1.08; p = 0.067]. These differences were not statistically significant. The increased BCVI incidence rate and decreased stroke and mortality rate following screening implementation further support the importance of having screening criteria for blunt vascular injury following trauma.

  14. Young Children's Acute Stress After a Burn Injury: Disentangling the Role of Injury Severity and Parental Acute Stress.

    Science.gov (United States)

    Haag, Ann-Christin; Landolt, Markus A

    2017-09-01

    Although injury severity and parental stress are strong predictors of posttraumatic adjustment in young children after burns, little is known about the interplay of these variables. This study aimed at clarifying mediation processes between injury severity and mother's, father's, and young child's acute stress. Structural equation modeling was used to examine the relationships between injury severity and parental and child acute stress. Parents of 138 burn-injured children (ages 1-4 years) completed standardized questionnaires on average 19 days postinjury. Sixteen children (11.7%) met Diagnostic and Statistical Manual of Mental Disorders, 5th edition, preschool criteria for posttraumatic stress disorder (excluding time criterion). The model revealed a significant mediation of maternal acute stress, with the effect of injury severity on a child's acute stress mediated by maternal acute stress. Paternal acute stress failed to serve as a mediating variable. Our findings confirm mothers' crucial role in the posttraumatic adjustment of young children. Clinically, mothers' acute stress should be monitored. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  15. Pre-symptomatic transcriptome changes during cold storage of chilling sensitive and resistant peach cultivars to elucidate chilling injury mechanisms

    OpenAIRE

    Puig, Clara Pons; Dagar, Anurag; Marti Ibanez, Cristina; Singh, Vikram; Crisosto, Carlos H; Friedman, Haya; Lurie, Susan; Granell, Antonio

    2015-01-01

    Background: Cold storage induces chilling injury (CI) disorders in peach fruit (woolliness/mealiness, flesh browning and reddening/bleeding) manifested when ripened at shelf life. To gain insight into the mechanisms underlying CI, we analyzed the transcriptome of 'Oded' (high tolerant) and 'Hermoza' (relatively tolerant to woolliness, but sensitive to browning and bleeding) peach cultivars at pre-symptomatic stages. The expression profiles were compared and validated with two previously analy...

  16. Tolerability and suitability of brief group mindfulness-oriented interventions in psychiatric inpatients: a pilot study.

    Science.gov (United States)

    Nikolitch, Katerina; Laliberté, Vincent; Yu, Ching; Strychowsky, Natalie; Segal, Marilyn; Looper, Karl J; Rej, Soham

    2016-09-01

    Mindfulness-oriented therapies have a positive impact on patients' overall well-being and alleviate many psychiatric conditions. However, little is known about their use in people with severe mental illness. We aimed to identify which clinical and sociodemographic factors are associated with suitability/tolerability of a brief group mindfulness-oriented therapy. This retrospective study examines pre-/post-data from 40 psychiatric inpatients who underwent one session of a 10-min mindfulness-oriented group intervention between January and March 2014. The main outcome was 'suitability for and tolerating the brief mindfulness-oriented group intervention'. We assessed potential correlates of the main outcome, including female gender, shorter hospitalisation, the absence of psychosis and good pre-morbid functioning. The intervention was well tolerated (92.5%) and 50% of patients met both of our relatively stringent suitability and tolerability criteria. Sociodemographic and clinical variables were not associated with suitability/tolerability. Tai chi was the most suitable/tolerable compared to body scan and mindful eating (76.5% vs. 35.7% vs. 22.2%, Fisher's exact p = 0.01, Bonferroni p mindfulness therapy interventions are very well tolerated and often suitable for acutely hospitalised psychiatric inpatients, including those with acute psychosis. Mindfulness-oriented intervention with an active component (e.g., tai chi, mindful walking) may potentially be best suited for this population.

  17. Analysis of injuries in long-distance triathletes.

    Science.gov (United States)

    Egermann, M; Brocai, D; Lill, C A; Schmitt, H

    2003-05-01

    Triathlon is an individual sport consisting of three disciplines - swimming, cycling and running. Triathlon has changed from a novel appearance to a very popular Olympic sport within the last fifteen years. Nevertheless, there is not sufficient data about injuries in triathlon. The aim of this retrospective survey was to investigate the incidence of injuries according to class of injuries, anatomical sites and disciplines. Relations to age, sex, performance level, training habits and medical care were analysed. Questionnaires were sent to all German speaking participants of the Ironman Europe 2000. With a response rate of 35 %, 656 questionnaires met the inclusion criteria. At least one injury was experienced by 74.8 % (95 %-CI: 71.3-78.1) of all respondents during their active time in triathlon. 51.1 % (95 %-CI: 47.2-55.0) suffered one or more contusion/skin-abrasions, 33.1 % (95 %-CI: 29.5-36.8) muscle-/tendon-injuries, 29.0 % (95 %-CI: 25.5-32.6) ligament-/capsule-injuries and 11.9 % (95 %-CI: 9.5-14.6) fractures. Most of the injuries happened during cycling (54.8 % [95 %-CI: 51.9-57.8]) within training sessions. 18.7 % (95 %-CI: 16.4-21.2) of all injuries occurred while the athletes were competing. Considering the low number of competition hours per year, the incidence of injuries during competition was higher than during training session. Significant relations were found considering the age, performance level and weekly training hours of the triathletes. Older athletes sustained more fractures (p = 0.024), high performance athletes suffered more contusions/abrasions (p = 0.003) and muscle-tendon-injuries (p = 0.001) and athletes with a large number of weekly training hours suffered more muscle-tendon-injuries (p = 0.014). To summarize, injuries in triathlon seem to be related to age, performance level and weekly training hours, but not to sex, presence of training coach and medical care.

  18. Heat Acclimation-Mediated Cross-Tolerance: Origins in within-Life Epigenetics?

    Directory of Open Access Journals (Sweden)

    Michal Horowitz

    2017-07-01

    Full Text Available The primary outcome of heat acclimation is increased thermotolerance, which stems from enhancement of innate cytoprotective pathways. These pathways produce “ON CALL” molecules that can combat stressors to which the body has never been exposed, via cross-tolerance mechanisms (heat acclimation-mediated cross-tolerance—HACT. The foundation of HACT lies in the sharing of generic stress signaling, combined with tissue/organ- specific protective responses. HACT becomes apparent when acclimatory homeostasis is achieved, lasts for several weeks, and has a memory. HACT differs from other forms of temporal protective mechanisms activated by exposure to lower “doses” of the stressor, which induce adaptation to higher “doses” of the same/different stressor; e.g., preconditioning, hormesis. These terms have been adopted by biochemists, toxicologists, and physiologists to describe the rapid cellular strategies ensuring homeostasis. HACT employs two major protective avenues: constitutive injury attenuation and abrupt post-insult release of help signals enhanced by acclimation. To date, the injury-attenuating features seen in all organs studied include fast-responding, enlarged cytoprotective reserves with HSPs, anti-oxidative, anti-apoptotic molecules, and HIF-1α nuclear and mitochondrial target gene products. Using cardiac ischemia and brain hypoxia models as a guide to the broader framework of phenotypic plasticity, HACT is enabled by a metabolic shift induced by HIF-1α and there are less injuries caused by Ca+2 overload, via channel or complex-protein remodeling, or decreased channel abundance. Epigenetic markers such as post-translational histone modification and altered levels of chromatin modifiers during acclimation and its decline suggest that dynamic epigenetic mechanisms controlling gene expression induce HACT and acclimation memory, to enable the rapid return of the protected phenotype. In this review the link between in vivo

  19. [Efficacy and tolerance of fenspiride in adult patients with acute respiratory tract infections].

    Science.gov (United States)

    Płusa, T; Nawacka, D

    1998-12-01

    Fenspiride is an antiinflammatory drug targeted for the respiratory tract. In our study clinical efficacy and tolerance of drug were evaluated in 392 adult patients with acute respiratory tract infections. According to clinical criteria all observed symptoms were classified as mild, moderate and severe. The most of observed patients were included into moderate symptom score. Cough and nose obturation were dominant symptoms. All noticed changes in the upper respiratory tract were decreased after fenspiride therapy in 7 days trial. In 168 observed patients systemic and in 60 local acting antibiotics were successfully applied. Excellent tolerance of fenspiride was documented in 59% and good tolerance --in 34% of patients. Observed adverse reactions were classified as mild and in 20 patients fenspiride was rejected. Authors suggest that fenspiride therapy is save and successful in patient with acute respiratory tract infection. Good results in patients with bronchitis in decreasing of bronchospasm indicate fenspiride as a good tool in bronchial infection.

  20. Molecular programs induced by heat acclimation confer neuroprotection against TBI and hypoxic insults via cross-tolerance mechanisms

    Directory of Open Access Journals (Sweden)

    Michal eHorowitz

    2015-07-01

    Full Text Available Neuroprotection following prolonged exposure to high ambient temperatures (heat acclimation HA develops via altered molecular programs such as cross-tolerance (Heat Acclimation -Neuroprotection Cross-Tolerance -HANCT. The mechanisms underlying cross-tolerance depend on enhanced on-demand protective pathways evolving during acclimation. The protection achieved is long lasting and limits the need for de novo recruitment of cytoprotective pathways upon exposure to novel stressors. Using mouse and rat acclimated phenotypes, we will focus on the impact of heat acclimation on Angiotensin II-AT2 receptors in neurogenesis and on HIF-1 as key mediators in spontaneous recovery and HANCT after traumatic brain injury (TBI. The neuroprotective consequences of heat acclimation on NMDA and AMPA receptors will be discussed using the global hypoxia model. A behavioral-molecular link will be crystallized. The differences between HANCT and consensus preconditioning will be reviewed.

  1. Iso-effect table for radiation tolerance of the human spinal cord

    International Nuclear Information System (INIS)

    Cohen, L.; Creditor, M.

    1981-01-01

    Available literature on radiation injury to the human spinal cord was collected into a comprehensive data set relating the incidence of myelopathy to dosage, number of fractions and total treatment time. The data was analyzed using a search program (RAD3) to derive best-fitting cell kinetic parameters on the assumption that radiation myelopathy arises from cellular depletion in the irradiated tissues. From these parameters iso-effect tables were constructed for a wide range of treatment schedules, including daily treatment as well as fractionation at longer intervals. The tables provide a set of limiting doses, above which the risk of radiation injury to the spinal cord becomes substantial. General application of NSD tolerance limits could lead to systematic overdosage of the spinal cord, especially with large individual fractions or short treatment times. We conclude that the computed iso-effect tables provide a more reliable clinical guide than conventional time-dose equations

  2. Risk factors and outcome of transfusion-related acute lung injury in the critically ill: A nested case-control study

    NARCIS (Netherlands)

    Vlaar, Alexander P. J.; Binnekade, Jan M.; Prins, David; van Stein, Danielle; Hofstra, Jorrit J.; Schultz, Marcus J.; Juffermans, Nicole P.

    2010-01-01

    Objectives: To determine the incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of critically ill patients. Design: In a retrospective cohort study, patients with transfusion-related acute lung injury were identified using the consensus criteria of acute lung

  3. Risk factors and outcome of transfusion-related acute lung injury in the critically ill : A nested case-control study

    NARCIS (Netherlands)

    Vlaar, Alexander P. J.; Binnekade, Jan M.; Prins, David; van Stein, Danielle; Hofstra, Jorrit J.; Schultz, Marcus J.; Juffermans, Nicole P.

    Objectives: To determine the incidence, risk factors, and outcome of transfusion-related acute lung injury in a cohort of critically ill patients. Design: In a retrospective cohort study, patients with transfusion-related acute lung injury were identified using the consensus criteria of acute lung

  4. A STUDY OF EPIDEMIOLOGY OF SPINE INJURY IN FALL FROM HEIGHT

    Directory of Open Access Journals (Sweden)

    Amel Antony

    2016-09-01

    Full Text Available BACKGROUND This study puts in a sincere effort to study the spinal cord injuries in cases of fall from height. This study is intended to help the fellow radiologists to identify and thus help the individuals to cut down the progression of the disease. Identifying the spinal trauma and its clinic - epidemiological aspects will help further the practicing clinicians. The study can also help in formulation of preventive measures and putting forward management protocols in cases of spinal injury. METHODS This study was done in the Department of Radiology, Travancore Medical College, Kollam. This study was done from June 2104 to march 2016. Thirty two cases were identified and were taken up for the study. INCLUSION CRITERIA Spinal injuries following fall from height. EXCLUSION CRITERIA 1. Other spinal pathologies were not considered for the study. 2. Diabetic patients were excluded. RESULTS In the present study male sex amounted to ninety percent which amounted to twenty nine cases of spinal injury followed by female sex which amounted to ten percent which amounted to three cases. The age wise distribution of cases showed that age group of twenty to forty years showed maximum number of cases which amounted to sixteen admissions followed by age group of forty to sixty years which amounted to seven cases followed by age group of zero to twenty years which amounted to five cases, followed by age group of more than sixty years which amounted to four cases. Based on approximate height from which the fall occurred seventeen cases fell from the height of more than twenty feet, followed by nine cases which fell from the height of ten to twenty feet and six cases fell from the height of less than ten feet. The CT scan showed that eighteen cases had displaced spinal fractures followed by forteen cases which had undisplaced spinal fractures. Cord injury was seen in six cases. Based on the level of spine injury twenty six cases had lumbar spine injury, eleven

  5. The tolerability of risk from nuclear power stations: a discussion of the HSE's guidelines

    International Nuclear Information System (INIS)

    Ryder, E.A.; Woods, P.B.

    1989-01-01

    The Health and Safety Executive's discussion document, ''The Tolerability of risk from nuclear power stations'', published just a year ago considers the concept of risk and the broad principles of risk assessment and proposes guidelines on the tolerable levels of individual and societal risks from normal operation and from accidents at nuclear power stations. This paper discusses how these guidelines might be applied in safety assessments so as to ensure an acceptable level of safety and considers some of the problems inherent in the estimation of risk from nuclear power stations. It shows how the tolerable risk levels of the Health and Safety Executive's document are related to the standards used by HM Nuclear Installations Inspectorate when licensing nuclear installations. Some of the uncertainties in the estimation of acceptable risk are discussed as are the acceptance criteria used by the Inspectorate in its assessments of both normal and accident situations. (author)

  6. Rehabilitation of discourse impairments after acquired brain injury

    Directory of Open Access Journals (Sweden)

    Gigiane Gindri

    Full Text Available ABSTRACT Language impairments in patients with acquired brain injury can have a negative impact on social life as well as on other cognitive domains. Discourse impairments are among the most commonly reported communication deficits among patients with acquired brain damage. Despite advances in the development of diagnostic tools for detecting such impairments, few studies have investigated interventions to rehabilitate patients presenting with these conditions. Objective: The aim of this study was to present a systematic review of the methods used in the rehabilitation of discourse following acquired brain injury. Methods: The PubMed database was searched for articles using the following keywords: "rehabilitation", "neurological injury", "communication" and "discursive abilities". Results: A total of 162 abstracts were found, but only seven of these met criteria for inclusion in the review. Four studies involved samples of individuals with aphasia whereas three studies recruited samples of individuals with traumatic brain injury. Conclusion: All but one article found that patient performance improved following participation in a discourse rehabilitation program.

  7. Neurologic Evaluation and Management of Perioperative Nerve Injury.

    Science.gov (United States)

    Watson, James C; Huntoon, Marc A

    2015-01-01

    Neurologic injury after regional anesthesia or pain medicine procedures is rare. Postprocedural neurologic deficits may create high levels of anxiety for the patient and practitioner, although most deficits are limited in severity and can be expected to fully resolve with time. Postoperative anesthesia-related neuraxial and peripheral nerve injuries are reviewed to define an efficient, structured approach to these complications. Emphasis is placed on acutely stratifying the urgency and scope of diagnostic testing or consultation necessity, initiating appropriate definitive treatments, and defining appropriate out-of-hospital follow-up and symptom management. Studies pertinent to the recognition, evaluation, and treatment of neurologic assessment of perioperative nerve injury and published since the last advisory on the topic are reviewed and a new structured algorithmic approach is proposed. The evolving literature on postoperative inflammatory neuropathies is reviewed to help define the clinical criteria and to identify patients who would benefit from early neurological evaluation. New sections review potential acute interventions to improve neurologic outcome and long-term management of neuropathic pain resulting from perioperative nerve injury.

  8. Defining pediatric traumatic brain injury using International Classification of Diseases Version 10 Codes: a systematic review.

    Science.gov (United States)

    Chan, Vincy; Thurairajah, Pravheen; Colantonio, Angela

    2015-02-04

    Although healthcare administrative data are commonly used for traumatic brain injury (TBI) research, there is currently no consensus or consistency on the International Classification of Diseases Version 10 (ICD-10) codes used to define TBI among children and youth internationally. This study systematically reviewed the literature to explore the range of ICD-10 codes that are used to define TBI in this population. The identification of the range of ICD-10 codes to define this population in administrative data is crucial, as it has implications for policy, resource allocation, planning of healthcare services, and prevention strategies. The databases MEDLINE, MEDLINE In-Process, Embase, PsychINFO, CINAHL, SPORTDiscus, and Cochrane Database of Systematic Reviews were systematically searched. Grey literature was searched using Grey Matters and Google. Reference lists of included articles were also searched for relevant studies. Two reviewers independently screened all titles and abstracts using pre-defined inclusion and exclusion criteria. A full text screen was conducted on articles that met the first screen inclusion criteria. All full text articles that met the pre-defined inclusion criteria were included for analysis in this systematic review. A total of 1,326 publications were identified through the predetermined search strategy and 32 articles/reports met all eligibility criteria for inclusion in this review. Five articles specifically examined children and youth aged 19 years or under with TBI. ICD-10 case definitions ranged from the broad injuries to the head codes (ICD-10 S00 to S09) to concussion only (S06.0). There was overwhelming consensus on the inclusion of ICD-10 code S06, intracranial injury, while codes S00 (superficial injury of the head), S03 (dislocation, sprain, and strain of joints and ligaments of head), and S05 (injury of eye and orbit) were only used by articles that examined head injury, none of which specifically examined children and

  9. Crafting tolerance

    DEFF Research Database (Denmark)

    Kirchner, Antje; Freitag, Markus; Rapp, Carolin

    2011-01-01

    Ongoing changes in social structures, orientation, and value systems confront us with the growing necessity to address and understand transforming patterns of tolerance as well as specific aspects, such as social tolerance. Based on hierarchical analyses of the latest World Values Survey (2005......–08) and national statistics for 28 countries, we assess both individual and contextual aspects that influence an individual's perception of different social groupings. Using a social tolerance index that captures personal attitudes toward these groupings, we present an institutional theory of social tolerance. Our...

  10. Development of Head Injury Assessment Reference Values Based on NASA Injury Modeling

    Science.gov (United States)

    Somers, Jeffrey T.; Melvin, John W.; Tabiei, Ala; Lawrence, Charles; Ploutz-Snyder, Robert; Granderson, Bradley; Feiveson, Alan; Gernhardt, Michael; Patalak, John

    2011-01-01

    NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA s proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA s context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach

  11. Tolerance doses for treatment planning

    International Nuclear Information System (INIS)

    Lyman, J.T.

    1985-10-01

    Data for the tolerance of normal tissues or organs to (low-LET) radiation has been compiled from a number of sources which are referenced at the end of this document. This tolerance dose data are ostensibly for uniform irradiation of all or part of an organ, and are for either 5% (TD 5 ) or 50% (TD 50 ) complication probability. The ''size'' of the irradiated organ is variously stated in terms of the absolute volume or the fraction of the organ volume irradiated, or the area or the length of the treatment field. The accuracy of these data is questionable. Much of the data represents doses that one or several experienced therapists have estimated could be safely given rather than quantitative analyses of clinical observations. Because these data have been obtained from multiple sources with possible different criteria for the definition of a complication, there are sometimes different values for what is apparently the same endpoint. The data from some sources shows a tendancy to be quantized in 5 Gy increments. This reflects the size of possible round off errors. It is believed that all these data have been accumulated without the benefit of 3-D dose distributions and therefore the estimates of the size of the volume and/or the uniformity of the irradiation may be less accurate than is now possible. 19 refs., 4 figs

  12. Frequency of impaired oral glucose tolerance test in high risk pregnancies for gestational diabetes mellitus

    International Nuclear Information System (INIS)

    Naheed, F.; Narijo, S.; Kammeruddin, K.

    2008-01-01

    To determine the frequency of impaired oral glucose tolerance test in high risk pregnancies for Gestational Diabetes Mellitus (GDM). A total of 50 high risk pregnancies for gestational diabetes mellitus were selected through outpatient department of obstetrics. Data was collected according to certain obstetric and non-obstetric risk factors for GDM as inclusion criteria through a designed proforma i.e. family history of diabetes, macrosomia (i.e, wt > 3.5 kg), abortions, grand multiparity, a sudden increase in weight (>1 kg/wk) during pregnancy, age > 35 years, early neonatal deaths/sudden IUDS, polyhydramnios, urogenital infections (vulvo-vaginal candidiasis and UTI), previous history of GDM, congenital abnormalities (with or without polyhydramnios) and multiple pregnancy. Oral glucose tolerance test was performed and analyzed according to American Diabetic Association criteria, 2004. The most frequent risk factors were family history of diabetes mellitus in 1st degree relative and large for dates babies in 18 patients. Similarly, high risk factors such as history of abortions and grand multiparity were present in 16 and 14 pregnant women respectively. Least common factors, which contributed for GDM, were polyhydramnios in 4 cases and perinatal mortality (due to congenital anomalies of foetus, intrauterine deaths or neonatal deaths) seen only in 5 cases. Overall impaired oral glucose tolerance test was found in 24%. Most patients had one (17%) or two risk factors commonly (23%). Only 2% had shown five or more risk factors. Oral glucose tolerance test is a useful diagnostic tool to detect GDM in high risk pregnancies, depending upon the high frequency of number of risk factors in each individual. (author)

  13. Hypoxia tolerance in reptiles, amphibians, and fishes: life with variable oxygen availability.

    Science.gov (United States)

    Bickler, Philip E; Buck, Leslie T

    2007-01-01

    The ability of fishes, amphibians, and reptiles to survive extremes of oxygen availability derives from a core triad of adaptations: profound metabolic suppression, tolerance of ionic and pH disturbances, and mechanisms for avoiding free-radical injury during reoxygenation. For long-term anoxic survival, enhanced storage of glycogen in critical tissues is also necessary. The diversity of body morphologies and habitats and the utilization of dormancy have resulted in a broad array of adaptations to hypoxia in lower vertebrates. For example, the most anoxia-tolerant vertebrates, painted turtles and crucian carp, meet the challenge of variable oxygen in fundamentally different ways: Turtles undergo near-suspended animation, whereas carp remain active and responsive in the absence of oxygen. Although the mechanisms of survival in both of these cases include large stores of glycogen and drastically decreased metabolism, other mechanisms, such as regulation of ion channels in excitable membranes, are apparently divergent. Common themes in the regulatory adjustments to hypoxia involve control of metabolism and ion channel conductance by protein phosphorylation. Tolerance of decreased energy charge and accumulating anaerobic end products as well as enhanced antioxidant defenses and regenerative capacities are also key to hypoxia survival in lower vertebrates.

  14. Injuries associated with police use of force.

    Science.gov (United States)

    Bozeman, William P; Stopyra, Jason P; Klinger, David A; Martin, Brian P; Graham, Derrel D; Johnson, James C; Mahoney-Tesoriero, Katherine; Vail, Sydney J

    2018-03-01

    Use of force [UOF] by police can result in serious injuries and fatalities. The risk of significant injuries associated with different force modalities is poorly defined. We sought to determine the incidence of police UOF and compare the likelihood of significant injury with different force modalities. A prospective multicenter observational study of all UOF incidents was conducted via mandatory UOF investigations at three mid-sized police agencies over a two year period. Expert physicians reviewed police and medical records to determine injury severity using a priori injury severity stratification criteria. There were 893 UOF incidents, representing a UOF rate of 0.086% of 1,041,737 calls for service (1 in 1167) and 0.78% of 114,064 criminal arrests(1 in 128). Suspects were primarily young (mean age, 31 years; range, 12-86 years) males (89%). The 1,399 force utilizations included unarmed physical force (n = 710, 51%), CEWs (504, 30%), chemical (88, 6.3%), canines (47, 3.4%), impact weapons (9, 0.6%), kinetic impact munitions (8, 0.6%), firearms (6, 0.4%), and other (27, 1.9%). Among 914 suspects, 898 (98%) sustained no or mild injury after police UOF. Significant (moderate or severe) injuries occurred in 16 (1.8%) subjects. Logistic regression analysis shows these are most associated with firearm and canine use. There was one fatality (0.1%) due to gunshots. No significant injuries occurred among 504 CEW uses (0%; 95% confidence interval, 0.0-0.9%). Of the 355 suspects transported to a medical facility, 78 (22%) were hospitalized. The majority of hospitalizations were unrelated to UOF (n = 59, 76%), whereas a minority (n = 19, 24%) were due to injuries related to police UOF. Police UOF is rare. When force is used officers most commonly rely on unarmed physical force and CEWs. Significant injuries are rare. Transport for medical evaluation is a poor surrogate for significant injury due to UOF. Epidemiological, level II.

  15. Moisture-tolerant resin-based sealant: A boon

    Directory of Open Access Journals (Sweden)

    Prasanna Kumar Bhat

    2013-01-01

    Full Text Available Background and Objectives: Pit and fissure sealants are highly effective in preventing occlusal caries. The present study clinically evaluated and compared the retention and development of caries when sealed with moisture-tolerant resin-based sealant, conventional resin-based sealant with and without a bonding agent, and Glass Ionomer Cement Sealant in young permanent teeth. Materials and Methods: A total of 80 healthy cooperative children aged 6-9 years who were at high caries risk with all four newly erupted permanent first molars were included in the study. Teeth were divided into 4 groups using a full-factorial design, and each of the molars was sealed with the four different sealant material. Evaluation of sealant retention and development of caries was performed at 6 and 12 months using Modified Simonsen′s criteria. The data obtained were tabulated and subjected to statistical analysis using Kruskal-Wallis Test and Mann-Whitney Test. Result and Conclusion: The result from the present study indicated that moisture-tolerant resin-based sealant could be successfully used as a pit and fissure sealant because its hydrophilic chemistry makes it less technique sensitive and simplifies the sealant application procedure.

  16. A Meta-Analysis of Soccer Injuries on Artificial Turf and Natural Grass

    Directory of Open Access Journals (Sweden)

    Jay H. Williams

    2013-01-01

    Full Text Available The goal of this investigation was to determine if playing or training on third-generation artificial turf (AT surfaces increases the incidence rate of injuries compared to natural grass (NG surfaces. This was accomplished by a meta-analysis performed on previously published research. Eight studies met the criteria of competitive soccer players, participation on both surfaces, and presentation of both exposure time and injury occurrence. Exposure time and injury incidence values were used to generate injury rate ratios (IRRs, AT/NG for all injuries as well as specific injuries. Subgroup analyses were also performed by condition (match or training, gender, and age (youth or adult. The overall IRR was 0.86 ( suggesting a lower injury risk on AT than NG. However, there was considerable heterogeneity between studies. Analyses of individual injuries and subgroups found that in many cases IRR values were significantly less than 1.0. In no case was the IRR significantly greater than 1.0. Based on this, it appears that the risk of sustaining an injury on AT under some conditions might be lowered compared to NG. However, until more is known about how issues such as altered playing styles affect injury incidence, it is difficult to make firm conclusions regarding the influence of AT on player safety.

  17. Definitions and methods of measuring and reporting on injurious falls in randomised controlled fall prevention trials: a systematic review

    Directory of Open Access Journals (Sweden)

    Schwenk Michael

    2012-04-01

    Full Text Available Abstract Background The standardisation of the assessment methodology and case definition represents a major precondition for the comparison of study results and the conduction of meta-analyses. International guidelines provide recommendations for the standardisation of falls methodology; however, injurious falls have not been targeted. The aim of the present article was to review systematically the range of case definitions and methods used to measure and report on injurious falls in randomised controlled trials (RCTs on fall prevention. Methods An electronic literature search of selected comprehensive databases was performed to identify injurious falls definitions in published trials. Inclusion criteria were: RCTs on falls prevention published in English, study population ≥ 65 years, definition of injurious falls as a study endpoint by using the terms "injuries" and "falls". Results The search yielded 2089 articles, 2048 were excluded according to defined inclusion criteria. Forty-one articles were included. The systematic analysis of the methodology applied in RCTs disclosed substantial variations in the definition and methods used to measure and document injurious falls. The limited standardisation hampered comparability of study results. Our results also highlight that studies which used a similar, standardised definition of injurious falls showed comparable outcomes. Conclusions No standard for defining, measuring, and documenting injurious falls could be identified among published RCTs. A standardised injurious falls definition enhances the comparability of study results as demonstrated by a subgroup of RCTs used a similar definition. Recommendations for standardising the methodology are given in the present review.

  18. Inflammation reduces physiological tissue tolerance in the development of work-related musculoskeletal disorders.

    Science.gov (United States)

    Barr, Ann E; Barbe, Mary F

    2004-02-01

    Work-related musculoskeletal disorders (MSDs) cause substantial worker discomfort, disability and loss of productivity. Due to the difficulty in analyzing the tissues of patients in the early stages of work-related MSD, there is controversy concerning the pathomechanisms of the development of these disorders. The pathophysiology of work-related MSD can be studied more easily in animal models. The purpose of this review is to relate theories of the development of tissue injury due to repeated motion to findings of recent investigations in animals that address the role of the inflammatory response in propagating tissue injury and contributing to chronic or recurring tissue injury. These tissue effects are related to behavioral indicators of discomfort and movement dysfunction with the aim of clarifying key time points for specific intervention approaches. The results from animal models of MSD are discussed in the light of findings in patients, whose tissues are examined at a much later phase of MSD development. Finally, a conceptual model of the potentially negative impact of inflammation on tissue tolerance is proposed along with suggestions for future research directions.

  19. Quantitative in vivo assessment of radiation injury of the liver using Gd-EOB-DTPA enhanced MRI: tolerance dose of small liver volumes

    Directory of Open Access Journals (Sweden)

    Pech Maciej

    2011-04-01

    Full Text Available Abstract Backround Hepatic radiation toxicity restricts irradiation of liver malignancies. Better knowledge of hepatic tolerance dose is favourable to gain higher safety and to optimize radiation regimes in radiotherapy of the liver. In this study we sought to determine the hepatic tolerance dose to small volume single fraction high dose rate irradiation. Materials and methods 23 liver metastases were treated by CT-guided interstitial brachytherapy. MRI was performed 3 days, 6, 12 and 24 weeks after therapy. MR-sequences were conducted with T1-w GRE enhanced by hepatocyte-targeted Gd-EOB-DTPA. All MRI data sets were merged with 3D-dosimetry data. The reviewer indicated the border of hypointensity on T1-w images (loss of hepatocyte function or hyperintensity on T2-w images (edema. Based on the volume data, a dose-volume-histogram was calculated. We estimated the threshold dose for edema or function loss as the D90, i.e. the dose achieved in at least 90% of the pseudolesion volume. Results At six weeks post brachytherapy, the hepatocyte function loss reached its maximum extending to the former 9.4Gy isosurface in median (i.e., ≥9.4Gy dose exposure led to hepatocyte dysfunction. After 12 and 24 weeks, the dysfunctional volume had decreased significantly to a median of 11.4Gy and 14Gy isosurface, respectively, as a result of repair mechanisms. Development of edema was maximal at six weeks post brachytherapy (9.2Gy isosurface in median, and regeneration led to a decrease of the isosurface to a median of 11.3Gy between 6 and 12 weeks. The dose exposure leading to hepatocyte dysfunction was not significantly different from the dose provoking edema. Conclusion Hepatic injury peaked 6 weeks after small volume irradiation. Ongoing repair was observed up to 6 months. Individual dose sensitivity may differ as demonstrated by a relatively high standard deviation of threshold values in our own as well as all other published data.

  20. Evaluating the Nintendo Wii for assessing return to activity readiness in youth with mild traumatic brain injury.

    Science.gov (United States)

    DeMatteo, Carol; Greenspoon, Dayna; Levac, Danielle; Harper, Jessica A; Rubinoff, Mandy

    2014-08-01

    Adolescents with mild traumatic brain injuries (MTBI) are at substantial risk for repeat injury if they return to activity too soon. Post-concussion symptoms and impaired balance are two factors that limit return to activity. Post-injury assessments that challenge activity tolerance and balance skills are needed to ensure readiness to return to activity. This cross-sectional study evaluated the Nintendo Wii as a measure of exertion (heart rate [HR], respiration rate [RR], and caloric expenditure) and balance testing for youth with MTBI in a clinical setting. Twenty-four youth with MTBI, ages 9-18, played six Wii games. The Bruininks-Oseretsky Test of Motor Proficiency 2nd edition (BOT-2) and the Community Balance and Mobility Scale (CBM) were used as balance indicators. The Wii Fit Running game demonstrated the highest caloric expenditure and HR (p = .010). Frequency counts of balance loss during Wii game play did not correlate with performance on the BOT-2 or the CBM. Type, number, and time since injury were predictive of balance performance on the CBM (p = .008). Findings provide preliminary evidence for the use of the Wii as an exertion challenge to evaluate tolerance for exercise post-concussion. Frequency count of balance loss during Wii game play, however, was not a valid measure of balance impairment post-MTBI.

  1. HYPNOBIRTHING INCREASE PAIN TOLERANCE AND ANXIETY IN ACTIVE PHASE LABOR

    Directory of Open Access Journals (Sweden)

    Nursalam Nursalam

    2017-07-01

    Full Text Available Introduction: The main problem of inpartu mother was a labour pain and anxiety. The etiology of labour pain has been determained by dilatation and cervic’s tickness. The objective of this study was to examine the effect of hypnobirthing relaxation on the pain tolerance and anxiety responses in labor. Method: A pre experimental static group comparison purposive sampling design was used in this study. Population were all pregnant women in age of pregnancies between 38 until 39 weeks at RSUD Wangaya Denpasar. There were 12 respondents who met to the inclusion criteria divided into 6 respondents were given hypnobirthing relaxation intervention and 6 respondents as the control group. The independent variable was hypnobirthing relaxation and dependent variables were tolerance of pain and anxiety responses. Data were collected by using observation and questionnaire, then data were analyzed by using Mann Whitney U Test with significance level p=0.05. Result: The result showed that hypnobirthing relaxation had an effect on the pain tolerance and anxiety responses (p=0.015. Discussion: It can be concluded that the hypnobirthing relaxation has an effect to increase the pain tolerance and to decrease anxiety responses in active phase of labour. It is recommended to the hospital that have an ante natal care to hypnobirthing relaxation technique. Further studies should measure the effect of hynobirthing relaxation on increasing of β-endorfin in active phase labour.

  2. Tolerance of Glyphosate-Resistant Maize to Glyphosate Plus MCPA Amine Is Influenced by Dose and Timing

    Directory of Open Access Journals (Sweden)

    Nader Soltani

    2015-01-01

    Full Text Available There is little information on tolerance of glyphosate-resistant maize to glyphosate plus MCPA amine as influenced by dose and timing under Ontario environmental conditions. A total of seven field trials were conducted at various locations in Ontario, Canada, in 2011–2013 to evaluate tolerance of field maize to tank mixes of glyphosate (900 g a.e./ha plus MCPA amine (79, 158, 315, 630, 1260, 2520, or 5040 g a.e./ha at either the 4- or 8-leaf stage. The predicted dose of MCPA amine that caused 5, 10, and 20% injury was 339, 751, and 1914 g a.e./ha when applied to 4-leaf maize but only 64, 140, and 344 g a.e./ha when applied to 8-leaf maize, respectively. The predicted dose of MCPA amine that caused 5, 10, and 20% reduction in shoot dry weight of maize was 488, 844, and 1971 g a.e./ha when applied to 4-leaf maize and only 14, 136, and 616 g a.e./ha when applied to 8-leaf maize, respectively. The predicted dose of MCPA amine that caused 5, 10, and 20% yield reduction was 2557, 4247, and >5040 g a.e./ha when applied to 4-leaf maize and 184, 441, and 1245 g a.e./ha when applied to 8-leaf maize, respectively. Based on these results, glyphosate plus MCPA amine applied at the manufacturer’s recommended dose of 630 g a.e./ha applied to 4-leaf maize has potential to cause injury but the injury is transient with no significant reduction in yield. However, when glyphosate plus MCPA amine is applied to 8-leaf maize it has the potential to cause significant injury and yield loss in maize.

  3. Compromise and Toleration

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    Political compromise is akin to toleration, since both consist of an "agreement to disagree." Compromise and toleration also share a predicament of being regarded as ambiguous virtues that require of us to accept something we actually regard as wrong. However, we misunderstand the nature, justifi...... in compromise are more stringent than those for being tolerated. Still, the limits of compromise cannot be drawn to narrowly if it is to remain its value as a form of agreement that respects and embodies the differences of opinion in society.......Political compromise is akin to toleration, since both consist of an "agreement to disagree." Compromise and toleration also share a predicament of being regarded as ambiguous virtues that require of us to accept something we actually regard as wrong. However, we misunderstand the nature......, justification, and limits of compromise if we see it merely as a matter of toleration. While toleration is mainly a matter of accepting citizens' equal right to co-existence as subjects to law, political compromise includes the parties in making law – it makes them co-authors of law. Toleration entails...

  4. A comparison of screening methods to identify waterlogging tolerance in the field in Brassica napus L. during plant ontogeny.

    Directory of Open Access Journals (Sweden)

    Xiling Zou

    Full Text Available Waterlogging tolerance is typically evaluated at a specific development stage, with an implicit assumption that differences in waterlogging tolerance expressed in these systems will result in improved yield performance in fields. It is necessary to examine these criteria in fields. In the present study, three experiments were conducted to screen waterlogging tolerance in 25 rapeseed (Brassica napus L. varieties at different developmental stages, such as seedling establishment stage and seedling stage at controlled environment, and maturity stage in the fields. The assessments for physiological parameters at three growth stages suggest that there were difference of waterlogging tolerance at all the development stages, providing an important basis for further development of breeding more tolerant materials. The results indicated that flash waterlogging restricts plant growth and growth is still restored after removal of the stress. Correlation analysis between waterlogging tolerance coefficient (WTC of yield and other traits revealed that there was consistency in waterlogging tolerance of the genotypes until maturity, and good tolerance at seedling establishment stage and seedling stage can guarantee tolerance in later stages. The waterlogging-tolerant plants could be selected using some specific traits at any stage, and selections would be more effective at the seedling establishment stage. Thus, our study provides a method for screening waterlogging tolerance, which would enable the suitable basis for initial selection of a large number of germplasm or breeding populations for waterlogging tolerance and help for verifying their potential utility in crop-improvement.

  5. Recognition and Toleration

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2010-01-01

    Recognition and toleration are ways of relating to the diversity characteristic of multicultural societies. The article concerns the possible meanings of toleration and recognition, and the conflict that is often claimed to exist between these two approaches to diversity. Different forms...... or interpretations of recognition and toleration are considered, confusing and problematic uses of the terms are noted, and the compatibility of toleration and recognition is discussed. The article argues that there is a range of legitimate and importantly different conceptions of both toleration and recognition...

  6. Teaching Tolerance? Associational Diversity and Tolerance Formation

    DEFF Research Database (Denmark)

    Rapp, Carolin; Freitag, Markus

    2015-01-01

    , a closer look is taken at how associational diversity relates to the formation of tolerance and the importance of associations as schools of tolerance are evaluated. The main theoretical argument follows contact theory, wherein regular and enduring contact in diverse settings reduces prejudice and thereby...

  7. Prevalence of Internet gaming disorder in German adolescents: diagnostic contribution of the nine DSM-5 criteria in a state-wide representative sample.

    Science.gov (United States)

    Rehbein, Florian; Kliem, Sören; Baier, Dirk; Mößle, Thomas; Petry, Nancy M

    2015-05-01

    Internet gaming disorder (IGD) is included as a condition for further study in Section 3 of the DSM-5. Nine criteria were proposed with a threshold of five or more criteria recommended for diagnosis. The aims of this study were to assess how the specific criteria contribute to diagnosis and to estimate prevalence rates of IGD based on DSM-5 recommendations. Large-scale, state-representative school survey using a standardized questionnaire. Germany (Lower Saxony). A total of 11 003 ninth-graders aged 13-18 years (mean = 14.88, 51.09% male). IGD was assessed with a DSM-5 adapted version of the Video Game Dependency Scale that covered all nine criteria of IGD. In total, 1.16% [95% confidence interval (CI) = 0.96, 1.36] of respondents were classified with IGD according to DSM-5 recommendations. IGD students played games for longer periods, skipped school more often, had lower grades in school, reported more sleep problems and more often endorsed feeling 'addicted to gaming' than their non-IGD counterparts. The most frequently reported DSM-5 criteria overall were 'escape adverse moods' (5.30%) and 'preoccupation' (3.91%), but endorsement of these criteria rarely related to IGD diagnosis. Conditional inference trees showed that the criteria 'give up other activities', 'tolerance' and 'withdrawal' were of key importance for identifying IGD as defined by DSM-5. Based on a state-wide representative school survey in Germany, endorsement of five or more criteria of DSM-5 internet gaming disorder (IGD) occurred in 1.16% of the students, and these students evidence greater impairment compared with non-IGD students. Symptoms related to 'give up other activities', 'tolerance' and 'withdrawal' are most relevant for IGD diagnosis in this age group. © 2015 Society for the Study of Addiction.

  8. Electroacupuncture pretreatment induces tolerance against focal cerebral ischemia through activation of canonical Notch pathway

    Directory of Open Access Journals (Sweden)

    Zhao Yu

    2012-09-01

    Full Text Available Abstract Background Electroacupuncture (EA pretreatment can induce the tolerance against focal cerebral ischemia. However, the underlying mechanisms have not been fully understood. Emerging evidences suggest that canonical Notch signaling may be involved in ischemic brain injury. In the present study, we tested the hypothesis that EA pretreatment-induced tolerance against focal cerebral ischemia is mediated by Notch signaling. Results EA pretreatment significantly enhanced Notch1, Notch4 and Jag1 gene transcriptions in the striatum, except Notch1 intracellular domain level, which could be increased evidently by ischemia. After ischemia and reperfusion, Hes1 mRNA and Notch1 intracellular domain level in ischemic striatum in EA pretreatment group were increased and reached the peak at 2 h and 24 h, respectively, which were both earlier than the peak achieved in control group. Intraventricular injection with the γ-secretase inhibitor MW167 attenuated the neuroprotective effect of EA pretreatment. Conclusions EA pretreatment induces the tolerance against focal cerebral ischemia through activation of canonical Notch pathway.

  9. Treatment of penetrating hepatic injuries: a retrospective analysis of 50 patients.

    Science.gov (United States)

    Gonullu, D; Koksoy, F N; Ilgun, S; Demiray, O; Yucel, O; Yucel, T

    2009-01-01

    The aim of this study was to determine the possibility of non-operative treatment via retrospective analysis of our patients. Fifty patients with penetrating hepatic injuries were examined retrospectively with respect to trauma scores, associated injuries, complications, and mortality parameters. Thirteen injuries were caused by firearms, whereas 37 injuries were caused by stab wounds. Forty-three patients (86%) underwent laparotomy and 7 patients (14%) were monitored by CT and clinical findings (nonoperative group, NO group). The laparotomies were evaluated as non-therapeutic in 11 patients (22%) (NTL group) and therapeutic in 32 patients (64%) (TL group). The morbidity and mortality rates were 40 and 10%, respectively. RTS and ISS scores of the nonsurviving and the surviving patients were significantly different. The rates of major venous, grade IV-V hepatic injuries, and gunshot wounds were significantly higher in the nonsurviving patients when compared to the surviving patients. Major venous and grade IV-V hepatic injuries were the primary factors determining mortality and these injuries generally occurred as a result of firearm injuries. NTL occurring at a rate of 22% would decrease to 2% if 'RTS <7' criteria was added to the hemodynamic instability and/or peritoneal irritation findings determining surgical candidacy. Copyright 2009 S. Karger AG, Basel.

  10. Expression of three sHSP genes involved in heat pretreatment-induced chilling tolerance in banana fruit.

    Science.gov (United States)

    He, Li-hong; Chen, Jian-ye; Kuang, Jian-fei; Lu, Wang-jin

    2012-07-01

    Banana fruit is highly susceptible to chilling injury. In previous research it was shown that heat pretreatment of banana fruit at 38 °C for 3 days before storage at a chilling temperature of 8 °C for 12 days prevented increases in visible chilling injury index, electrolyte leakage and malondialdehyde content and also decreases in lightness and chroma, indicating that heat pretreatment could effectively alleviate chilling injury of banana fruit. However, little is known about the role of small heat shock proteins (sHSPs) in postharvest chilling tolerance of banana fruit. In the present study, three cytosolic sHSP expression profiles in peel and pulp tissues of banana fruit during heat pretreatment and subsequent chilled storage (8 °C) were investigated in relation to heat pretreatment-induced chilling tolerance. Three full-length cDNAs of cytosolic sHSP genes, including two class I sHSP (CI sHSP) and one class II sHSP (CII sHSP) cDNAs, named Ma-CI sHSP1, Ma-CI sHSP2 and Ma-CII sHSP3 respectively, were isolated and characterised from harvested banana fruit. Accumulation of Ma-CI sHSP1 mRNA transcripts in peel and pulp tissues and Ma-CII sHSP3 mRNA transcripts in peel tissue increased during heat pretreatment. Expression of all three Ma-sHSP genes in peel and pulp tissues was induced during subsequent chilled storage. Furthermore, Ma-CI sHSP1 and Ma-CII sHSP3 mRNA transcripts in pulp tissue and Ma-CI sHSP2 mRNA transcripts in peel and pulp tissues were obviously enhanced by heat pretreatment at days 6 and 9 of subsequent chilled storage. These results suggested that heat pretreatment enhanced the expression of Ma-sHSPs, which might be involved in heat pretreatment-induced chilling tolerance of banana fruit. Copyright © 2012 Society of Chemical Industry.

  11. Use of car crashes resulting in fatal and serious injuries to analyze a safe road transport system model and to identify system weaknesses.

    Science.gov (United States)

    Stigson, Helena; Hill, Julian

    2009-10-01

    The objective of this study was to evaluate a model for a safe road transport system, based on some safety performance indicators regarding the road user, the vehicle, and the road, by using crashes with fatally and seriously injured car occupants. The study also aimed to evaluate whether the model could be used to identify system weaknesses and components (road user, vehicles, and road) where improvements would yield the highest potential for further reductions in serious injuries. Real-life car crashes with serious injury outcomes (Maximum Abbreviated Injury Scale 2+) were classified according to the vehicle's safety rating by Euro NCAP (European New Car Assessment Programme) and whether the vehicle was fitted with ESC (Electronic Stability Control). For each crash, the road was also classified according to EuroRAP (European Road Assessment Programme) criteria, and human behavior in terms of speeding, seat belt use, and driving under the influence of alcohol/drugs. Each crash was compared and classified according to the model criteria. Crashes where the safety criteria were not met in more than one of the 3 components were reclassified to identify whether all the components were correlated to the injury outcome. In-depth crash injury data collected by the UK On The Spot (OTS) accident investigation project was used in this study. All crashes in the OTS database occurring between 2000 and 2005 with a car occupant with injury rated MAIS2+ were included, for a total of 101 crashes with 120 occupants. It was possible to classify 90 percent of the crashes according to the model. Eighty-six percent of the occupants were injured when more than one of the 3 components were noncompliant with the safety criteria. These cases were reclassified to identify whether all of the components were correlated to the injury outcome. In 39 of the total 108 cases, at least two components were still seen to interact. The remaining cases were only related to one of the safety criteria

  12. Capabilities of Helmets for Preventing Head Injuries Induced by Ballistic Impacts

    Directory of Open Access Journals (Sweden)

    D.V. Balandin

    2004-01-01

    Full Text Available The limiting performance of ballistically loaded helmets designed to reduce head injuries is studied analytically. The projectile does not penetrate the helmet. This analysis evaluates the absolute minimum of the peak displacement of the helmet shell relative to the head, provided that criteria measuring the severity of head injuries lie within prescribed limits. Rather than optimize a specific design configuration, e.g. a viscoelastic foam liner, characteristics of a time-dependent force representing the helmet liner are calculated. The formulation reduces the limiting performance analysis to an optimal control problem.

  13. Mechanical tolerance stackup and analysis

    CERN Document Server

    Fischer, Bryan R

    2004-01-01

    BackgroundDimensioning and TolerancingTolerance Format and Decimal PlacesConverting Plus/Minus Dimensions and Tolerances into Equal Bilaterally Toleranced DimensionsVariation and Sources of VariationTolerance AnalysisWorst-case Tolerance StackupsStatistical Tolerance StackupsGeometric Dimensioning and Tolerancing (GD&T)Converting Plus/Minus Tolerancing to Positional Tolerancing and Projected Tolerance ZonesDiametral and Radial Tolerance StackupsSpecifying Material Condition Modifiers and Their Effect on Tolerance Stackups The Tolerance Stackup SketchThe Tolerance Stackup Report FormTolerance S

  14. Elastic Bandaging for Orthopedic- and Sports-Injury Prevention and Rehabilitation: A Systematic Review.

    Science.gov (United States)

    Fousekis, Konstantinos; Billis, Evdokia; Matzaroglou, Charalampos; Mylonas, Konstantinos; Koutsojannis, Constantinos; Tsepis, Elias

    2017-05-01

    Elastic bandages are commonly used in sports to treat and prevent sport injuries. To conduct a systematic review assessing the effectiveness of elastic bandaging in orthopedic- and sports-injury prevention and rehabilitation. The researchers searched the electronic databases MEDLINE, CINAHL, SPORTDiscus, EMBASE, and Physiotherapy Evidence Database (PEDro) with keywords elastic bandaging in combination, respectively, with first aid, sports injuries, orthopedic injuries, and sports injuries prevention and rehabilitation. Research studies were selected based on the use of the term elastic bandaging in the abstract. Final selection was made by applying inclusion and exclusion criteria to the full text. Studies were included if they were peer-reviewed clinical trials written in English on the effects of elastic bandaging for orthopedic-injury prevention and rehabilitation. Twelve studies met the criteria and were included in the final analysis. Data collected included number of participants, condition being treated, treatment used, control group, outcome measures, and results. Studies were critically analyzed using the PEDro scale. The studies in this review fell into 2 categories: studies in athletes (n = 2) and nonathletes (n = 10). All included trials had moderate to high quality, scoring ≥5 on the PEDro scale. The PEDro scores for the studies in athletes and nonathletes ranged from 5 to 6 out of 10 and from 5 to 8 out of 10, respectively. The quality of studies was mixed, ranging from higher- to moderate-quality methodological clinical trials. Overall, elastic bandaging can assist proprioceptive function of knee and ankle joint. Because of the moderate methodological quality and insufficient number of clinical trials, further effects of elastic bandaging could not be confirmed.

  15. Association analysis of salt tolerance in cowpea (Vigna unguiculata (L.) Walp) at germination and seedling stages.

    Science.gov (United States)

    Ravelombola, Waltram; Shi, Ainong; Weng, Yuejin; Mou, Beiquan; Motes, Dennis; Clark, John; Chen, Pengyin; Srivastava, Vibha; Qin, Jun; Dong, Lingdi; Yang, Wei; Bhattarai, Gehendra; Sugihara, Yuichi

    2018-01-01

    This is the first report on association analysis of salt tolerance and identification of SNP markers associated with salt tolerance in cowpea. Cowpea (Vigna unguiculata (L.) Walp) is one of the most important cultivated legumes in Africa. The worldwide annual production in cowpea dry seed is 5.4 million metric tons. However, cowpea is unfavorably affected by salinity stress at germination and seedling stages, which is exacerbated by the effects of climate change. The lack of knowledge on the genetic underlying salt tolerance in cowpea limits the establishment of a breeding strategy for developing salt-tolerant cowpea cultivars. The objectives of this study were to conduct association mapping for salt tolerance at germination and seedling stages and to identify SNP markers associated with salt tolerance in cowpea. We analyzed the salt tolerance index of 116 and 155 cowpea accessions at germination and seedling stages, respectively. A total of 1049 SNPs postulated from genotyping-by-sequencing were used for association analysis. Population structure was inferred using Structure 2.3.4; K optimal was determined using Structure Harvester. TASSEL 5, GAPIT, and FarmCPU involving three models such as single marker regression, general linear model, and mixed linear model were used for the association study. Substantial variation in salt tolerance index for germination rate, plant height reduction, fresh and dry shoot biomass reduction, foliar leaf injury, and inhibition of the first trifoliate leaf was observed. The cowpea accessions were structured into two subpopulations. Three SNPs, Scaffold87490_622, Scaffold87490_630, and C35017374_128 were highly associated with salt tolerance at germination stage. Seven SNPs, Scaffold93827_270, Scaffold68489_600, Scaffold87490_633, Scaffold87490_640, Scaffold82042_3387, C35069468_1916, and Scaffold93942_1089 were found to be associated with salt tolerance at seedling stage. The SNP markers were consistent across the three models and

  16. Role of microglia in neuropathic pain, postoperative pain, and morphine tolerance

    Science.gov (United States)

    Wen, Yeong-Ray; Tan, Ping-Heng; Cheng, Jen-Kun; Liu, Yen-Chin; Ji, Ru-Rong

    2011-01-01

    Management of chronic pain such as nerve injury-induced neuropathic pain associated with diabetic neuropathy, viral infection, and cancer is a real clinical challenge. Major surgeries such as breast and thoracic surgery, leg amputation, and coronary artery bypass surgery also lead to chronic pain in 10–50% of individuals after acute postoperative pain, in part due to surgery-induced nerve injury. Current treatments mainly focus on blocking neurotransmission in the pain pathway and have only resulted in limited success. Ironically, chronic opioid exposure may lead to paradoxical pain. Development of effective therapeutic strategies requires a better understanding of cellular mechanisms underlying the pathogenesis of neuropathic pain. An important progress in pain research points to important role of microglial cells in the development of chronic pain. Spinal cord microglia are strongly activated after nerve injury, surgical incision, and chronic opioid exposure. Increasing evidence suggests that under all these conditions the activated microglia not only exhibit increased expression of microglial markers CD11b and Iba1 but also display elevated phosphorylation of p38 MAP kinase. Inhibition of spinal cord p38 has been shown to attenuate neuropathic pain and postoperative pain, as well as morphine-induced antinociceptive tolerance. Activation of p38 in spinal microglia results in increased synthesis and release of the neurotrophin BDNF and the proinflammatory cytokines IL-1β, IL-6, and TNF-α. These microglia-released mediators can powerfully modulate spinal cord synaptic transmission, leading to increased excitability of dorsal horn neurons, i.e. central sensitization, in part via suppressing inhibitory synaptic transmission. We review the studies that support the pronociceptive role of microglia in conditions of neuropathic pain, post-surgical pain, and opioid tolerance. Some of these studies have been accomplished by four Taiwanese anesthesiologists who are also

  17. Low-temperature conditioning induces chilling tolerance in stored mango fruit.

    Science.gov (United States)

    Zhang, Zhengke; Zhu, Qinggang; Hu, Meijiao; Gao, Zhaoyin; An, Feng; Li, Min; Jiang, Yueming

    2017-03-15

    In this study, mango fruit were pre-treated with low-temperature conditioning (LTC) at 12°C for 24h, followed by refrigeration at 5°C for 25days before removal to ambient temperature (25°C) to investigate the effects and possible mechanisms of LTC on chilling injury (CI). The results showed that LTC effectively suppressed the development of CI in mango fruit, accelerated softening, and increased the soluble solids and proline content. Furthermore, LTC reduced electrolyte leakage, and levels of malondialdehyde, O 2 - and H 2 O 2 , maintaining membrane integrity. To reveal the molecular regulation of LTC on chilling tolerance in mango fruit, a C-repeat/dehydration-responsive element binding factor (CBF) gene, MiCBF1, was identified and its expression in response to LTC was examined using RT-qPCR. LTC resulted in a higher MiCBF1 expression. These findings suggest that LTC enhances chilling tolerance in mango fruit by inducing a series of physiological and molecular responses. Copyright © 2016 Elsevier Ltd. All rights reserved.

  18. Canadian CT head rule and New Orleans Criteria in mild traumatic brain injury: comparison at a tertiary referral hospital in Japan.

    Science.gov (United States)

    Mata-Mbemba, Daddy; Mugikura, Shunji; Nakagawa, Atsuhiro; Murata, Takaki; Kato, Yumiko; Tatewaki, Yasuko; Takase, Kei; Kushimoto, Shigeki; Tominaga, Teiji; Takahashi, Shoki

    2016-01-01

    We compared Canadian computed tomography (CT) head rule (CCHR) and New Orleans Criteria (NOC) in predicting important CT findings in patients with mild traumatic brain injury (TBI). We included 142 consecutive patients with mild TBI [Glasgow coma scale (GCS) 13-15] who showed at least one of the risk factors stated in the CCHR or the NOC. We introduced two scores: a Canadian from the CCHR and a New Orleans from the NOC. A patient's score represented a sum of the number of positive items. We examined the relationship between scores or items and the presence of important CT findings. Only the Canadian was significantly associated with important CT findings in multivariate analyses and showed higher area under the receiver operating characteristic curve (AUC) either in all 142 patients (GCS 13-15: P = 0.0130; AUC = 0.69) or in the 67 with a GCS = 15 (P = 0.0128, AUC = 0.73). Of items, ">60 years" or "≥65 years" included in either guideline was the strongest predictor of important CT finding, followed by "GCS < 15 after 2 h" included only in the CCHR. In a tertiary referral hospital in Japan, CCHR had higher performance than the NOC in predicting important CT findings.

  19. Tolerance to and cross tolerance between ethanol and nicotine.

    Science.gov (United States)

    Collins, A C; Burch, J B; de Fiebre, C M; Marks, M J

    1988-02-01

    Female DBA mice were subjected to one of four treatments: ethanol-containing or control diets, nicotine (0.2, 1.0, 5.0 mg/kg/hr) infusion or saline infusion. After removal from the liquid diets or cessation of infusion, the animals were challenged with an acute dose of ethanol or nicotine. Chronic ethanol-fed mice were tolerant to the effects of ethanol on body temperature and open field activity and were cross tolerant to the effects of nicotine on body temperature and heart rate. Nicotine infused animals were tolerant to the effects of nicotine on body temperature and rotarod performance and were cross tolerant to the effects of ethanol on body temperature. Ethanol-induced sleep time was decreased in chronic ethanol- but not chronic nicotine-treated mice. Chronic drug treatment did not alter the elimination rate of either drug. Chronic ethanol treatment did not alter the number or affinity of brain nicotinic receptors whereas chronic nicotine treatment elicited an increase in the number of [3H]-nicotine binding sites. Tolerance and cross tolerance between ethanol and nicotine is discussed in terms of potential effects on desensitization of brain nicotinic receptors.

  20. Injury in the national basketball association: a 17-year overview.

    Science.gov (United States)

    Drakos, Mark C; Domb, Benjamin; Starkey, Chad; Callahan, Lisa; Allen, Answorth A

    2010-07-01

    Injury patterns in elite athletes over long periods continue to evolve. The goal of this study was to review of the injuries and medical conditions afflicting athletes competing in the National Basketball Association (NBA) over a 17-year period. Descriptive epidemiological study. Injuries and player demographic information were reported by each team's athletic trainer. Criteria for reportable injuries were those that resulted in (1) physician referral, (2) a practice or game being missed, or (3) emergency care. The demographics, frequency of injury, time lost, and game exposures were tabulated, and game-related injury rates and 95% confidence intervals were calculated. A total of 1094 players appeared in the database 3843 times (3.3 ± 2.6 seasons). Lateral ankle sprains were the most frequent orthopaedic injury (n, 1658; 13.2%), followed by patellofemoral inflammation (n, 1493; 11.9%), lumbar strains (n, 999; 7.9%), and hamstring strains (n, 413; 3.3%). The most games missed were related to patellofemoral inflammation (n, 10 370; 17.5%), lateral ankle sprains (n, 5223; 8.8%), knee sprains (n, 4369; 7.4%), and lumbar strains (n, 3933; 6.6%). No correlations were found between injury rate and player demographics, including age, height, weight, and NBA experience. Professional athletes in the NBA experience a high rate of game-related injuries. Patellofemoral inflammation is the most significant problem in terms of days lost in competition, whereas ankle sprains are the most common injury. True ligamentous injuries of the knee were surprisingly rare. Importantly, player demographics were not correlated with injury rates. Further investigation is necessary regarding the consequences and sport-specific treatment of various injuries in NBA players. Knowledge of these injury patterns can help to guide treatments and provide more accurate guidelines for an athlete to return to play.

  1. High dose methylprednisolone in the management of acute spinal cord injury - a systematic review from a clinical perspective.

    Science.gov (United States)

    Short, D J; El Masry, W S; Jones, P W

    2000-05-01

    Systematic literature review for primary data using predefined inclusion, exclusion and validity criteria. Primary outcome measure was standardised neurological examination or neurological function. Secondary outcomes; acute mortality, early morbidity. To access the literature available to clinicians systematically and evaluate the evidence for an effect of high dose methylprednisolone (MPSS) on neurological improvement following acute spinal cord injury (ACSI). Information retrieval was based on Medline search (1966 through December 1999) using the strategy 'spinal cord injury' and 'methylprednisolone' (or 'dexamethasone') with no other restrictions. Primary data publications using high dose steroids given within 12 h following spinal cord injury and reporting outcome measures separately for steroid and non-steroid treated groups were selected. Evaluation followed the guides of Guyatt et al7 (for the Evidence Based Working Group in Canada). Studies with questionable validity were excluded. Level of evidence and treatment recommendation utilised the Canadian Task Force on the Periodic Health Examination criteria.6 Experimental spinal cord injury studies on larger animals were included; small mammal experiments were considered beyond evaluation. Three clinical trials and six cohort study publications were found to satisfy the review criteria. The evidence they provide supports 'the recommendation that the manoeuvre (high dose methylpredisolone) be excluded from consideration as an intervention for the condition'10 (acute spinal cord injury). Twelve larger animal publications were detailed. Validity and the functional significance of results was of concern in many. The weight of evidence lay with those studies demonstrating no definite effect of MPSS on functional outcome. In cat experiments with higher level cord damage, deaths in the MPSS treated groups were notable. The evidence produced by this systematic review does not support the use of high dose

  2. Posttraumatic stress disorder in patients with traumatic brain injury and amnesia for the event?

    Science.gov (United States)

    Warden, D L; Labbate, L A; Salazar, A M; Nelson, R; Sheley, E; Staudenmeier, J; Martin, E

    1997-01-01

    Frequency of DSM-III-R posttraumatic stress disorder (PTSD) was studied in 47 active-duty service members (46 male, 1 female; mean age 27 = 7) with moderate traumatic brain injury and neurogenic amnesia for the event. Patients had attained "oriented and cooperative" recovery level. When evaluated with a modified Present State Examination and other questions at various points from study entry to 24-month follow-up, no patients met full criteria for PTSD or met criterion B (reexperience); 6 (13%) met both C (avoidance) and D (arousal) criteria. Five of these 6 also had organic mood disorder, depressed type, and/or organic anxiety disorder. Posttraumatic amnesia following moderate head injury may protect against recurring memories and the development of PTSD. Some patients with neurogenic amnesia may develop a form of PTSD without the reexperiencing symptoms.

  3. Does generalized joint hypermobility predict joint injury in sport? A review.

    LENUS (Irish Health Repository)

    Donaldson, Peter R

    2012-02-01

    OBJECTIVE: To determine whether persons with generalized joint hypermobility have an increased risk of lower limb joint injury during sport. DATA SOURCES: PubMed, CINAHL, EMBASE, and SportDiscus were searched through February 2009, without language restrictions, using terms related to risk; hip, ankle, and knee injuries; and joint instability. Reference lists of included studies and relevant reviews were searched by hand. STUDY SELECTION: Selection criteria were peer-reviewed studies with a prospective design that used an objective scale to measure generalized joint hypermobility; the participants were engaged in sport activity, and the injury data were quantitative and based on diagnosis by a health professional, were self-reported, or resulted in time lost to athletic participation. The studies were screened by 1 researcher and checked by a second. Study methods were independently assessed by 2 investigators using the 6-point scale for prognostic studies developed by Pengel. Disagreements were resolved through discussion. Of 4841 studies identified, 18 met inclusion criteria. Of these, 8 were included in random-effects meta-analyses. DATA EXTRACTION: The data extracted by 2 reviewers included participant and sport characteristics and details of joint hypermobility and injury measurements. More detailed data for 4 investigations were obtained from the study authors. Where possible, hypermobility was defined as >\\/=4 of 9 points on the British Society of Rheumatology Scale (BSRS). MAIN RESULTS: Lower limb joint injuries (3 studies, 1047 participants) occurred in 14% of participants. Using the BSRS of joint hypermobility, any lower limb injury was not associated with hypermobility [odds ratio (OR), 1.43; 95% confidence interval (CI), 0.56-3.67]. Using the original authors\\' definitions, hypermobility was associated with risk of knee joint injuries (OR, 2.62; 95% CI, 1.04-6.58) in 5 studies. In 4 studies in which the BSRS could be used (1167 participants; incidence

  4. Successful Reinnervation of the Diaphragm After Intercostal to Phrenic Nerve Neurotization in Patients With High Spinal Cord Injury.

    Science.gov (United States)

    Nandra, Kulvir S; Harari, Martin; Price, Thea P; Greaney, Patrick J; Weinstein, Michael S

    2017-08-01

    Our objective in this study was to extend diaphragmatic pacing therapy to include paraplegic patients with high cervical spinal cord injuries between C3 and C5. Diaphragmatic pacing has been used in patients experiencing ventilator-dependent respiratory failure due to spinal cord injury as a means to reduce or eliminate the need for mechanical ventilation. However, this technique relies on intact phrenic nerve function. Recently, phrenic nerve reconstruction with intercostal nerve grafting has expanded the indications for diaphragmatic pacing. Our study aimed to evaluate early outcomes and efficacy of intercostal nerve transfer in diaphragmatic pacing. Four ventilator-dependent patients with high cervical spinal cord injuries were selected for this study. Each patient demonstrated absence of phrenic nerve function via external neck stimulation and laparoscopic diaphragm mapping. Each patient underwent intercostal to phrenic nerve grafting with implantation of a phrenic nerve pacer. The patients were followed, and ventilator dependence was reassessed at 1 year postoperatively. Our primary outcome was measured by the amount of time our patients tolerated off the ventilator per day. We found that all 4 patients have tolerated paced breathing independent of mechanical ventilation, with 1 patient achieving 24 hours of tracheostomy collar. From this study, intercostal to phrenic nerve transfer seems to be a promising approach in reducing or eliminating ventilator support in patients with C3 to C5 high spinal cord injury.

  5. Prevalence of chest trauma, associated injuries and mortality: a level I trauma centre experience.

    Science.gov (United States)

    Veysi, Veysi T; Nikolaou, Vassilios S; Paliobeis, Christos; Efstathopoulos, Nicolas; Giannoudis, Peter V

    2009-10-01

    A review of prospectively collected data in our trauma unit for the years 1998-2003 was undertaken. Adult patients who suffered multiple trauma with an Injury Severity Score (ISS) of >/=16, admitted to hospital for more than 72 hours and with sustained blunt chest injuries were included in the study. Demographic details including pre-hospital care, trauma history, admission vital signs, blood transfusions, details of injuries and their abbreviated injury scores (AIS), operations, length of intensive care unit and hospital stays, Injury Severity Score (ISS) and mortality were analysed. Fulfilling the inclusion criteria with at least one chest injury were 1,164 patients. The overall mortality reached 18.7%. As expected, patients in the higher AIS groups had both a higher overall ISS and mortality rate with one significant exception; patients with minor chest injuries (AIS(chest) = 1) were associated with mortality comparable to injuries involving an AIS(chest) = 3. Additionally, the vast majority of polytraumatised patients with an AIS(chest) = 1 died in ICU sooner than patients of groups 2-5.

  6. Effect of Obesity on Motor Functional Outcome of Rehabilitating Traumatic Brain Injury Patients.

    Science.gov (United States)

    Le, David; Shafi, Shahid; Gwirtz, Patricia; Bennett, Monica; Reeves, Rustin; Callender, Librada; Dunklin, Cynthia; Cleveland, Samantha

    2015-08-01

    The aim of this study was to determine the association between obesity and functional motor outcome of patients undergoing inpatient rehabilitation after traumatic brain injury. This retrospective study at an urban acute inpatient rehabilitation center screened data from 761 subjects in the Traumatic Brain Injury Model System who were admitted from January 2010 to September 2013. Inclusion criteria consisted of age of 18 years or older and an abnormal Functional Independence Measure motor score. Body mass index was used to determine obesity in the study population. Patients with a body mass index of 30.0 kg/m or greater were considered obese. A total of 372 subjects met the criteria for inclusion in the study. Of these, 54 (13.2%) were obese. Both obese and nonobese patients showed similar improvement in Functional Independence Measure motor score (mean [SD], 30.4 [12.8] for the obese patients, P = 0.115, and 27.3 [13.1] for the nonobese patients). The mean (SD) Functional Independence Measure motor scores at discharge for the obese and nonobese patients were 63.0 (12.6) and 62.3 (10.1) (P = 0.6548), respectively. Obesity had no adverse impact on motor functional outcomes of the traumatic brain injury patients who underwent inpatient rehabilitation. Therefore, obesity should not be considered an obstacle in inpatient rehabilitation after traumatic brain injury, if patients are able to participate in necessary therapy.

  7. Basic criteria for formation of growth twins in high stacking fault energy metals

    International Nuclear Information System (INIS)

    Yu, K. Y.; Zhang, X.; Bufford, D.; Chen, Y.; Liu, Y.; Wang, H.

    2013-01-01

    Nanotwinned metals received significant interest lately as twin boundaries may enable simultaneous enhancement of strength, ductility, thermal stability, and radiation tolerance. However, nanotwins have been the privilege of metals with low-to-intermediate stacking fault energy (SFE). Recent scattered studies show that nanotwins could be introduced into high SFE metals, such as Al. In this paper, we examine several sputter-deposited, (111) textured Ag/Al, Cu/Ni, and Cu/Fe multilayers, wherein growth twins were observed in Al, Ni, and face-centered cubic (fcc) Fe. The comparisons lead to two important design criteria that dictate the introduction of growth twins in high SFE metals. The validity of these criteria was then examined in Ag/Ni multilayers. Furthermore, another twin formation mechanism in high SFE metals was discovered in Ag/Ni system

  8. High-grade renal injuries are often isolated in sports-related trauma.

    Science.gov (United States)

    Patel, Darshan P; Redshaw, Jeffrey D; Breyer, Benjamin N; Smith, Thomas G; Erickson, Bradley A; Majercik, Sarah D; Gaither, Thomas W; Craig, James R; Gardner, Scott; Presson, Angela P; Zhang, Chong; Hotaling, James M; Brant, William O; Myers, Jeremy B

    2015-07-01

    Most high-grade renal injuries (American Association for Surgery of Trauma (AAST) grades III-V) result from motor vehicle collisions associated with numerous concomitant injuries. Sports-related blunt renal injury tends to have a different mechanism, a solitary blow to the flank. We hypothesized that high-grade renal injury is often isolated in sports-related renal trauma. We identified patients with AAST grades III-V blunt renal injuries from four level 1 trauma centres across the United States between 1/2005 and 1/2014. Patients were divided into "Sport" or "Non-sport" related groups. Outcomes included rates of hypotension (systolic blood pressure 110bpm), concomitant abdominal injury, and procedural/surgical intervention between sports and non-sports related injury. 320 patients met study criteria. 18% (59) were sports-related injuries with the most common mechanisms being skiing, snowboarding and contact sports (25%, 25%, and 24%, respectively). Median age was 24 years for sports and 30 years for non-sports related renal injuries (p=0.049). Males were more commonly involved in sports related injuries (85% vs. 72%, p=0.011). Median injury severity score was lower for sports related injuries (10 vs. 27, pinjury scale scores. Sports related trauma was more likely to be isolated without other significant injury (69% vs. 39% (psports and non-sports renal injuries (p=0.30). Sports injuries had lower transfusion (7% vs. 47%, psports vs. 18% non-sports, p=0.95). High-grade sports-related blunt renal trauma is more likely to occur in isolation without other abdominal or thoracic injuries and clinicians must have a high suspicion of renal injury with significant blows to the flank during sports activities. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Primary Blast Injury Criteria for Animal/Human TBI Models using Field Validated Shock Tubes

    Science.gov (United States)

    2017-09-01

    acute hemorrhage characterized by partial filling of small groups of alveoli by blood . 240 kPa: Mild multifocal pools of acute hemorrhage which...Neurotrauma, Blast TBI, Primary blast brain injury, Blast overpressure, Blood -brain barrier, Neuroinflammation, Oxidative stress, Neuroproteomics 16...stress, neuroinflammation and BBB damage as a result of blast overpressure in the acute phase (0, 4 and 24 hours post-exposure). Our group

  10. Temporomandibular disorders after whiplash injury: a controlled, prospective study.

    Science.gov (United States)

    Kasch, Helge; Hjorth, Tine; Svensson, Peter; Nyhuus, Lone; Jensen, Troels S

    2002-01-01

    Whiplash injury to the neck is often considered a significant risk factor for development of temporomandibular disorders (TMD), and has been proposed to produce internal derangements of the temporomandibular joint (TMJ). Few studies, however, have examined TMD-related pain in acute whiplash patients compared with a matched control group. The aim of the present study was to assess pain and sensorimotor function in the craniofacial region in an unselected group of patients sustaining a motor vehicle accident involving a rear collision. Prospectively, 19 acute whiplash patients exposed to a motor vehicle accident involving a rear collision participated in a study of TMD. The control group consisted of 20 age- and gender-matched ankle-injury patients. Participants were seen within 4 weeks and again at 6 months post-injury. The masticatory system was examined in accordance with the research diagnostic criteria. Participants underwent structured interviews, filled out the McGill Pain Questionnaire (MPQ), and had their masticatory system examined by a trained dentist, blinded to their diagnosis. Pain detection threshold (PDT) to pressure stimuli, and maximal voluntary occlusal force (MVOF) were obtained at each visit. One whiplash patient and 1 ankle-injury patient had jaw pain at the first visit. Palpation scores of the TMJ and the summated palpation scores only tended to be higher in patients sustaining a whiplash injury than in ankle-injury controls at the first visit. However, MPQ, TMD symptoms and signs, MVOF and PDT were not significantly different in whiplash-injury and ankle-injury patients after 4 weeks and 6 months. TMD pain after whiplash injury and ankle injury is rare, suggesting that whiplash injury is not a major risk factor for the development of TMD problems. Further studies are needed to identify which other factors may contribute to TMD pain.

  11. Tolerância de sementes de linhagens de milho à alta temperatura de secagem Tolerance of corn lines seeds to high drying temperature

    Directory of Open Access Journals (Sweden)

    Solange Carvalho Barrios Roveri José

    2004-10-01

    Full Text Available Cultivares tolerantes a altas temperaturas de secagem proporcionam redução no tempo de secagem, uma etapa crítica no sistema de produção de sementes de milho (Zea mays L.. Nesta pesquisa, foi avaliada a tolerância à alta temperatura de secagem de sementes de linhagens de milho, por meio de testes de germinação e vigor. As sementes foram colhidas manualmente em espigas com teor de água em torno de 35% e secas artificialmente à 45 C até atingirem 11% de teor de água. Em seguida, foram submetidas aos testes de primeira contagem e contagem final de germinação, envelhecimento acelerado, teste de frio sem solo e de condutividade elétrica. Houve diferenças significativas nos valores de germinação e vigor de sementes das diferentes linhagens, sendo então classificadas em tolerantes e intolerantes. Pelos resultados, conclui-se que a sensibilidade das sementes à injúria por secagem à alta temperatura é dependente da linhagem.High drying temperature tolerant cultivars provide a reduction in the drying period, a critical phase of the corn seeds (Zea mays L. production system. In this research the tolerance of corn lines seeds to high drying temperature was evaluated by the germination and vigor tests. Seeds were handpicked in ears with water content around 35% and dried artificially at 45ºC up to 11% water content. Then, the seeds were submitted to the first and final germination counting tests, accelerated aging, cold test without soil and electrical conductivity. There were significant differences in the germination and vigor values of seeds from different lines, being classified into tolerant and intolerant. The results permitted to conclude that sensitivity of seeds to high drying temperature injury depends on the lines.

  12. Barriers to return to work after burn injuries.

    Science.gov (United States)

    Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H

    2007-12-01

    To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.

  13. Reducing violent injuries: priorities for pediatrician advocacy.

    Science.gov (United States)

    Dolins, J C; Christoffel, K K

    1994-10-01

    A basic framework for developing an advocacy plan must systematically break down the large task of policy development implementation into manageable components. The basic framework described in detail in this paper includes three steps: Setting policy objectives by narrowing the scope of policy, by reviewing policy options, and by examining options against selected criteria. Developing strategies for educating the public and for approaching legislative/regulatory bodies. Evaluating the effectiveness of the advocacy action plan as a process and as an agent for change. To illustrate the variety of ways in which pediatricians can be involved in the policy process to reduce violent injuries among children and adolescents, we apply this systematic approach to three priority areas. Prohibiting the use of corporal punishment in schools is intended to curb the institutionalized legitimacy of violence that has been associated with future use of violence. Efforts to remove handguns from the environments of children and adolescents are aimed at reducing the numbers of firearm injuries inflicted upon and by minors. Comprehensive treatment of adolescent victims of assault is intended to decrease the reoccurrence of violent injuries.

  14. [Alleged assault in a forest: An unusual case of self-inflicted blunt injury].

    Science.gov (United States)

    Kunz, Sebastian Niko; Tutsch-Bauer, Edith

    2014-01-01

    The medico-legal assessment of potentially self-inflicted injuries is an important field of clinical forensic medicine. Compared with sharp force injuries, it is much more difficult to distinguish blunt injuries caused by another party from self-inflicted lesions. We present a case of a young female doctor, who was allegedly attacked by an unknown stranger during her evening walk in the woods. She claimed to have been hit repeatedly on the head and arms with a stone. During the forensic investigation, blunt injuries could be confirmed on her head and forearms. Based on the arrangement and intensity of the injuries, together with the result of a bloodstain pattern analysis of the weapon, the victim's statement could be disproved. After being confronted with the results of the investigation, the woman admitted to have inflicted the injuries herself. This case is an unusual and rare example of self-inflicted blunt injury. It shows that the criteria of self-inflicted injuries can also be applied to blunt trauma. However, due to the small number of cases, a high degree of caution is required from the forensic expert.

  15. Halovest treatment in traumatic cervical spine injury.

    Science.gov (United States)

    Razak, M; Basir, T; Hyzan, Y; Johari, Z

    1998-09-01

    This is a cross-sectional study on the use of halovest appliance in the Orthopaedic and Traumatology Department, Kuala Lumpur Hospital from June 1993 to September 1996. Fifty-three patients with cervical spine injuries were treated by halovest stabilization. Majority of cases was caused by motor-vehicle accident; others were fall from height at construction sites, fall at home, hit by falling object and assault. The injuries were Jefferson fracture of C1, odontoid fractures, hangman fractures, open spinous process fracture and fracture body of C2, and fracture, and fracture-dislocation of the lower cervical spines. Majority of patients had hospital stay less than 30 days. The use of the halovest ranges from 4 to 16 weeks and the healing rate was 96%. Two patients of lower cervical spine injury had redislocation and one of them was operated. There was one case of non-union of type II odontoid fracture and treated by posterior fusion. Other complications encountered during halovest treatment were minor. They were pin-site infection, pin-loosening, clamp loosening and neck pain or neck stiffness. This method of treatment enables patient to ambulate early and reduces hospital stay. We found that halovest is easy to apply, safe and tolerable to most of the patients.

  16. Restraint status improves the predictive value of motor vehicle crash criteria for pediatric trauma team activation.

    Science.gov (United States)

    Bozeman, Andrew P; Dassinger, Melvin S; Recicar, John F; Smith, Samuel D; Rettiganti, Mallikarjuna R; Nick, Todd G; Maxson, Robert T

    2012-12-01

    Most trauma centers incorporate mechanistic criteria (MC) into their algorithm for trauma team activation (TTA). We hypothesized that characteristics of the crash are less reliable than restraint status in predicting significant injury and the need for TTA. We identified 271 patients (age, <15 y) admitted with a diagnosis of motor vehicle crash. Mechanistic criteria and restraint status of each patient were recorded. Both MC and MC plus restraint status were evaluated as separate measures for appropriately predicting TTA based on treatment outcomes and injury scores. Improper restraint alone predicted a need for TTA with an odds ratios of 2.69 (P = .002). MC plus improper restraint predicted the need for TTA with an odds ratio of 2.52 (P = .002). In contrast, the odds ratio when using MC alone was 1.65 (P = .16). When the 5 MC were evaluated individually as predictive of TTA, ejection, death of occupant, and intrusion more than 18 inches were statistically significant. Improper restraint is an independent predictor of necessitating TTA in this single-institution study. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Prehospital plasma resuscitation associated with improved neurologic outcomes after traumatic brain injury.

    Science.gov (United States)

    Hernandez, Matthew C; Thiels, Cornelius A; Aho, Johnathon M; Habermann, Elizabeth B; Zielinski, Martin D; Stubbs, James A; Jenkins, Donald H; Zietlow, Scott P

    2017-09-01

    Trauma-related hypotension and coagulopathy worsen secondary brain injury in patients with traumatic brain injuries (TBIs). Early damage control resuscitation with blood products may mitigate hypotension and coagulopathy. Preliminary data suggest resuscitation with plasma in large animals improves neurologic function after TBI; however, data in humans are lacking. We retrospectively identified all patients with multiple injuries age >15 years with head injuries undergoing prehospital resuscitation with blood products at a single Level I trauma center from January 2002 to December 2013. Inclusion criteria were prehospital resuscitation with either packed red blood cells (pRBCs) or thawed plasma as sole colloid resuscitation. Patients who died in hospital and those using anticoagulants were excluded. Primary outcomes were Glasgow Outcomes Score Extended (GOSE) and Disability Rating Score (DRS) at dismissal and during follow-up. Of 76 patients meeting inclusion criteria, 53% (n = 40) received prehospital pRBCs and 47% (n = 36) received thawed plasma. Age, gender, injury severity or TBI severity, arrival laboratory values, and number of prehospital units were similar (all p > 0.05). Patients who received thawed plasma had an improved neurologic outcome compared to those receiving pRBCs (median GOSE 7 [7-8] vs. 5.5 [3-7], p plasma had improved functionality compared to pRBCs (median DRS 2 [1-3.5] vs. 9 [3-13], p plasma compared to pRBCs by both median GOSE (8 [7-8] vs. 6 [6-7], p plasma is associated with improved neurologic and functional outcomes at discharge and during follow-up compared to pRBCs alone. These preliminary data support the further investigation and use of plasma in the resuscitation of critically injured TBI patients. Therapeutic, level V.

  18. A critical review of "Internet addiction" criteria with suggestions for the future.

    Science.gov (United States)

    Van Rooij, Antonius J; Prause, Nicole

    2014-12-01

    In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted.

  19. ACR appropriateness criteria blunt chest trauma.

    Science.gov (United States)

    Chung, Jonathan H; Cox, Christian W; Mohammed, Tan-Lucien H; Kirsch, Jacobo; Brown, Kathleen; Dyer, Debra Sue; Ginsburg, Mark E; Heitkamp, Darel E; Kanne, Jeffrey P; Kazerooni, Ella A; Ketai, Loren H; Ravenel, James G; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D

    2014-04-01

    Imaging is paramount in the setting of blunt trauma and is now the standard of care at any trauma center. Although anteroposterior radiography has inherent limitations, the ability to acquire a radiograph in the trauma bay with little interruption in clinical survey, monitoring, and treatment, as well as radiography's accepted role in screening for traumatic aortic injury, supports the routine use of chest radiography. Chest CT or CT angiography is the gold-standard routine imaging modality for detecting thoracic injuries caused by blunt trauma. There is disagreement on whether routine chest CT is necessary in all patients with histories of blunt trauma. Ultimately, the frequency and timing of CT chest imaging should be site specific and should depend on the local resources of the trauma center as well as patient status. Ultrasound may be beneficial in the detection of pneumothorax, hemothorax, and pericardial hemorrhage; transesophageal echocardiography is a first-line imaging tool in the setting of suspected cardiac injury. In the blunt trauma setting, MRI and nuclear medicine likely play no role in the acute setting, although these modalities may be helpful as problem-solving tools after initial assessment. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  20. PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury.

    Science.gov (United States)

    Andersen, Tonny Elmose; Elklit, Ask; Brink, Ole

    2013-01-01

    The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which may cause persistent pain and medically unexplained symptoms after a whiplash injury. The present study examines attachment insecurity and PTSD symptoms as possible vulnerability factors in relation to high levels of pain and somatisation after sub-acute whiplash injury. Data were collected from 327 patients (women = 204) referred consecutively to the emergency unit after acute whiplash injury. Within 1-month post injury, patients answered a questionnaire regarding attachment insecurity, pain, somatisation, and PTSD symptoms. Multiple mediation analyses were performed to assess whether the PTSD symptom clusters mediated the association between attachment insecurity, pain, and somatisation. A total of 15% fulfilled the DSM-IV symptom cluster criteria for a possible PTSD diagnosis and 11.6% fulfilled the criteria for somatisation. PTSD increased the likelihood of belonging to the moderate-severe pain group three-fold. In relation to somatisation the likelihood of belonging to the group was almost increased four-fold. The PTSD symptom clusters of avoidance and hyperarousal mediated the association between the attachment dimensions, pain, and somatisation. Acknowledging that PTSD is part of the aetiology involved in explaining persistent symptoms after whiplash, may help sufferers to gain early and more suited treatment, which in turn may prevent the condition from becoming chronic.

  1. Remember Tolerance Differently

    DEFF Research Database (Denmark)

    Tønder, Lars

    2012-01-01

    This essay questions the linear conception of history which often accompanies the way contemporary democratic theory tends to disavow tolerance's discontinuities and remainders. In the spirit of Foucault's genealogy of descent, the idea is to develop a new sense of tolerance's history, not by inv......This essay questions the linear conception of history which often accompanies the way contemporary democratic theory tends to disavow tolerance's discontinuities and remainders. In the spirit of Foucault's genealogy of descent, the idea is to develop a new sense of tolerance's history......, not by invoking a critique external to contemporary democratic theory, but by witnessing the history of tolerance paraliptically, with an eye to what it obscures and yet presupposes....

  2. Exercise tolerance in asymptomatic patients with moderate-severe valvular heart disease and preserved ejection fraction.

    Science.gov (United States)

    Olaf, Schulz; Debora, Brala; Ricarda, Bensch; Gunnar, Berghöfer; Jochen, Krämer; Schimke, Ingolf; Halle, Martin; Jaffe, Allan

    2012-12-20

    For asymptomatic patients with moderate-severe valvular heart disease, in whom symptoms may be obscured, objective exercise tolerance measures are warranted for decisions concerning physical activities and surgical treatment. We compared 61 patients (39 with aortic stenosis, 22 with aortic or mitral regurgitation) to 23 controls without valvular heart disease but with indications for stress testing. All participants underwent cardiopulmonary function testing and dobutamine stress echocardiography. Blood was drawn before as well as after bicycle stress to assess high-sensitivity cardiac troponin T (hscTnT). Patients who underwent surgery were re-evaluated 1.5 ±0.9 years after the operation. Conventional bicycle test following guideline criteria revealed a pathologic result in 26% of the patients, whereas spiroergometry showed an objectively reduced exercise tolerance in 59%, reaching a prognostically relevant feature in 39%. Stress echocardiography detected a reduced systolic reserve in 33% and elevated filling pressures in 62%. These abnormalities were significantly less present in the control group (4, 17, 9, 9, 4% respectively, p valvular heart disease beyond stress-test criteria recommended in recent guidelines. High-sensitivity cardiac troponin I may be of additional value. Results of these tests presage post-operative function.

  3. Perioperative Care for Pediatric Patients With Penetrating Brain Injury: A Review.

    Science.gov (United States)

    Mikhael, Marco; Frost, Elizabeth; Cristancho, Maria

    2017-05-19

    Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury. PBI was one of the exclusion criteria in the second edition of guidelines for the acute medical management of severe TBI in infants, children, and adolescents that was published in 2012 (it is referred to as "pediatric guidelines" in this review). Many reviews of TBI do not differentiate between the mechanisms of injury. We present an overview of PBI, its presenting features, epidemiology, and causes as well as an analysis of case series and the conclusions that may be drawn from those and other studies. More clinical trials specific to penetrating head injuries in children, focusing mainly on pathophysiology and management, are needed. The term PBI is specific to penetrating injury only, whereas TBI, a more inclusive term, describes mainly, but not only, blunt injury.

  4. Induced tolerance from a sublethal insecticide leads to cross-tolerance to other insecticides.

    Science.gov (United States)

    Hua, Jessica; Jones, Devin K; Relyea, Rick A

    2014-04-01

    As global pesticide use increases, the ability to rapidly respond to pesticides by increasing tolerance has important implications for the persistence of nontarget organisms. A recent study of larval amphibians discovered that increased tolerance can be induced by an early exposure to low concentrations of a pesticide. Since natural systems are often exposed to a variety of pesticides that vary in mode of action, we need to know whether the induction of increased tolerance to one pesticide confers increased tolerance to other pesticides. Using larval wood frogs (Lithobates sylvaticus), we investigated whether induction of increased tolerance to the insecticide carbaryl (AChE-inhibitor) can induce increased tolerance to other insecticides that have the same mode of action (chlorpyrifos, malathion) or a different mode of action (Na(+)channel-interfering insecticides; permethrin, cypermethrin). We found that embryonic exposure to sublethal concentrations of carbaryl induced higher tolerance to carbaryl and increased cross-tolerance to malathion and cypermethrin but not to chlorpyrifos or permethrin. In one case, the embryonic exposure to carbaryl induced tolerance in a nonlinear pattern (hormesis). These results demonstrate that that the newly discovered phenomenon of induced tolerance also provides induced cross-tolerance that is not restricted to pesticides with the same mode of action.

  5. Descriptors used to define running-related musculoskeletal injury: a systematic review.

    Science.gov (United States)

    Yamato, Tiê Parma; Saragiotto, Bruno Tirotti; Hespanhol Junior, Luiz Carlos; Yeung, Simon S; Lopes, Alexandre Dias

    2015-05-01

    Systematic review. To systematically review the descriptors used to define running-related musculoskeletal injury and to analyze the implications of different definitions on the results of studies. Studies have developed their own definitions of running-related musculoskeletal injuries based on different criteria. This may affect the rates of injury, which can be overestimated or underestimated due to the lack of a standard definition. Searches were conducted in the Embase, PubMed, CINAHL, SPORTDiscus, LILACS, and SciELO databases, without limits on date of publication and language. Only articles that reported a definition of running-related injury were included. The definitions were classified according to 3 domains and subcategories: (1) presence of physical complaint (symptom, body system involved, region), (2) interruption of training or competition (primary sports involved, extent of injury, extent of limitation, interruption, period of injury), and (3) need for medical assistance. Spearman rank correlation was performed to evaluate the correlation between the completeness of definitions and the rates of injury reported in the studies. A total of 48 articles were included. Most studies described more than half of the subcategories, but with no standardization between the terms used within each category, showing that there is no consensus for a definition. The injury rates ranged between 3% and 85%, and tended to increase with less specific definitions. The descriptors commonly used by researchers to define a running-related injury vary between studies and may affect the rates of injuries. The lack of a standardized definition hinders comparison between studies and rates of injuries.

  6. Prevalence of type 2 diabetes mellitus and other abnormalities of carbohydrate metabolism depending on diagnostic criteria

    Directory of Open Access Journals (Sweden)

    Alexander Vasil'evich Dreval'

    2010-03-01

    Full Text Available Aim. To assess current criteria for type 2 diabetes mellitus. Materials and methods. This screening study involving 2,368 residents of two municipal districts of the Moscow region was designed to elucidate differencesin the prevalence of abnormalities of carbohydrate metabolism depending on diagnostic criteria (WHO and ADA. Results. The prevalence of early disorders of carbohydrate metabolism and DM2 among the adult population of Moscow region is 17,1 and 7,2 respectivelyusing WHO criteria and 40,0 and 5,9% by ADA criteria. Conclusion. Refusal to undergo OGTT during screening decreases detectability of early metabolic disorders by 28,8 and 6,1% using WHO and ADAcriteria respectively. When screening is aimed to diagnose DM2 alone, OGTT can be omitted in subjects with fasting plasma glucose level below4,7 mmol/l. If it is aimed to diagnose both DM2 and impaired glucose tolerance, OGTT is not needed in subjects with fasting plasma glucose levelbelow 4,2 mmol/l. The use of ?combined? diagnostic criteria (i.e. OGTT according to ADA, but not WHO significantly increases the prevalence ofmetabolic disorders from 24,9 to 48,8%.

  7. Dual hit lipopolysaccharide & oleic acid combination induced rat model of acute lung injury/acute respiratory distress syndrome

    Directory of Open Access Journals (Sweden)

    T N Hagawane

    2016-01-01

    Results: It was noted that the respiratory rate, and tumour necrosis factor-α (TNF-α levels were significantly higher at 4 h in the dual hit group as compared to LPS, OA and control groups. Interleukin-6 (IL-6 levels were significantly higher in the dual hit group as compared to LPS at 8 and 24 h, OA at 8 h and control (at all time intervals group. IL-1β levels were significantly higher in LPS and dual hit groups at all time intervals, but not in OA and control groups. The injury induced in dual hit group was earlier and more sustained as compared to LPS and OA alone. Interpretation & conclusions: The lung pathology and changes in respiration functions produced by the dual hit model were closer to the diagnostic criteria of ALI/ARDS in terms of clinical manifestations and pulmonary injury and the injury persisted longer as compared to LPS and OA single hit model. Therefore, the ARDS model produced by the dual hit method was closer to the diagnostic criteria of ARDS in terms of clinical manifestations and pulmonary injury.

  8. Current Use of Methylprednisolone for Acute Spinal Cord Injury by Spine Surgeons of Thailand

    Directory of Open Access Journals (Sweden)

    Sirichai Wilartratsami

    2016-07-01

    Full Text Available Objective: To determine current decision making in methylprednisolone succinate (MPS administration for acute spinal cord injury (ASCI treatment in Thailand. Methods: A questionnaire was sent to all orthopedic surgeons who attended the annual meeting of the Spine Society of Thailand 2016. The questionnaire had 3 parts of questions including demographic data, opinions in MPS use in general ASCI patients and patients who meet the exclusion criteria in NASCIS III study. Results: Fifty five respondents completed the survey (overall response rate was 27.1 % and there was 78.18% prescribe MPS to ASCI patients. Among them, 40 % prescribe according to NASCIS II and 55.6% NASCIS III. The main reasons for MPS administration are practice standard (38.6%, effectiveness (31.8% and liability issue (22.7%. In patients who met the exclusion criteria of NASCIS III, most respondents do not prescribe any steroids in patients who had age below 14 years old (42.2%, pregnancy (77.8%, severe underlying disease (72.7%, body weight more than 109 kg (40.9%, gunshot injury (59.1% and previous spinal cord injury (46.5%. Interestingly, there were 93.2% prescribed MPS to patients who sustained ACSI more than 8 hours. Conclusion: Because the institutional standard supported MPS use, most participants prescribed MPS in ASCI despite current clinical data from recent studies. Most participants who did not use MPS in patients had exclusion criteria of NASCIS III.

  9. Expression and significance of Bax protein in model of radiation injury in mouse skin

    International Nuclear Information System (INIS)

    Feng Yizhong; Mo Yahong

    2002-01-01

    Objective: The study is to find some valuable criteria for diagnosis and treatment of radiation injury in skin. Methods: The expression of Bax protein was studied by SP immunohistochemistry in 40 cases of model of radiation injury in mouse skin. Their relationship relating to radiation dose was also investigated. Results: The expression rates of Bax were 30%, 30%, 70%, 70% in 5 Gy group, 15 Gy group, 30 Gy group, 45 Gy group respectively. There was no significant correlation between the expression of Bax and radiation groups. Conclusions: The experiment shows that radiation can increase the expression of Bax protein which might be related to poor healing in radiation skin injury

  10. Musculoskeletal injuries and pain in dancers: a systematic review update.

    Science.gov (United States)

    Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David

    2012-01-01

    The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered.

  11. Activity-related summation of pain and functional disability in patients with whiplash injuries.

    Science.gov (United States)

    Sullivan, Michael J L; Larivière, Christian; Simmonds, Maureen

    2010-11-01

    This study investigated the relation between repetition-induced summation of activity-related pain (RISP) and indicators of functional disability in a sample of 62 individuals who had sustained whiplash injuries. Participants completed measures of pain severity, pain catastrophizing, fear of movement and depression prior to lifting a series of 36 weighted canisters. An index of RISP was computed as the increase in pain reported by participants over successive lifts of the weighted canisters. Measures of functional disability included physical lifting tolerance, self-reported disability and perceived work demands. Regression analyses revealed that the index of RISP accounted for significant variance in measures of lifting tolerance and perceived work demands, even when controlling for age, sex and pain severity. The index of RISP was also significantly correlated with pain catastrophizing and pain duration. The discussion addresses the mechanisms by which physiological and psychological factors might contribute to increases in pain during repeated physical activity. Discussion also addresses whether RISP might represent a risk factor for problematic recovery outcomes following whiplash injury. Copyright © 2010 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  12. The elderly patient with spinal injury: treat or transfer?

    Science.gov (United States)

    Barmparas, Galinos; Cooper, Zara; Haider, Adil H; Havens, Joaquim M; Askari, Reza; Salim, Ali

    2016-05-01

    The purpose of this investigation was to delineate whether elderly patients with spinal injuries benefit from transfers to higher level trauma centers. Retrospective review of the National Trauma Data Bank 2007 to 2011, including patients > 65 (y) with any spinal fracture and/or spinal cord injury from a blunt mechanism. Patients who were transferred to level I and II centers from other facilities were compared to those admitted and received their definitive treatment at level III or other centers. Of 3,313,117 eligible patients, 43,637 (1.3%) met inclusion criteria: 19,588 (44.9%) were transferred to level I-II centers, and 24,049 (55.1%) received definitive treatment at level III or other centers. Most of the patients (95.8%) had a spinal fracture without a spinal cord injury. Transferred patients were more likely to require an intensive care unit admission (48.5% versus 36.0%, P spinal cord injury (22.3% versus 21.0%, P elderly patients with spinal injuries to higher level trauma centers is not associated with improved survival. Future studies should explore the justifications used for these transfers and focus on other outcome measures such as functional status to determine the potential benefit from such practices. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Stimulant Use in the Management of Mild Traumatic Brain Injury: A Qualitative Literature Review.

    Science.gov (United States)

    Iaccarino, Mary Alexis; Philpotts, Lisa Liang; Zafonte, Ross; Biederman, Joseph

    2018-03-01

    Mild traumatic brain injury (mTBI) often presents with cognitive complaints including difficulty with attention and concentration. As these symptoms resemble those of ADHD, stimulants may be a potential treatment for mTBI. This review evaluates the literature on the use of stimulants for the treatment of mTBI. A systematic evaluation of the literature using six databases: Ovidmedline, Pubmed, psychINFO, CINAH, Embase, and Cochrane. Broad search terms were used and studies were included that evaluate the use of stimulant and stimulant-like medications in the mTBI population. Data extracted included stimulant type and dosing, symptoms targeted, outcomes, safety and tolerability, and if the study population had ADHD. Nine studies were identified that met the inclusion criteria. Immediate release methylphenidate and amantadine were used for treatment. Methylphenidate had some impact on attention, fatigue, and depression. However, due to the limited number of studies and heterogeneity of study populations, symptoms targeted, and outcome measures used, meaningful conclusions regarding the effect of stimulants in mTBI could not be made. No study evaluated for the presence of ADHD within the study population, despite stimulants being the mainstay treatment for ADHD. PProspective studies on the use of stimulants in mTBI, that evaluate participants for a diagnosis of ADHD, are needed.

  14. The impact of sharps injuries on student nurses: a systematic review.

    Science.gov (United States)

    Hambridge, Kevin; Nichols, Andrew; Endacott, Ruth

    2016-10-27

    The purpose of this review was to discover the impact of sharps injuries in the student nurse population. Much is known and reported about sharps injuries in registered nurses, but there has been a lack of published evidence regarding sharps injuries within the student nurse population. A systematic review of nursing, health and psychology databases was conducted. The limits set were publications between 1980 and 2014 in the English language. Studies were identified then, following a rigorous critical and quality appraisal with validated tools, were selected for the systematic review. A total of 40 articles met the inclusion criteria, reporting studies conducted in 18 countries. Psychological and physical impacts of sharps injuries in student nurses were reported, such as fear, anxiety and depression, although these impacts were not quantified using a validated instrument. The impact of sharps injuries can be severe, both psychological and physical. This systematic review shows that further research is needed into this, especially in under-researched areas such as the UK, to establish the impact of sharps injuries within this population. Further research would also aid the education and prevention of this harmful problem. The review also emphasises the psychological issues relating to sharps injuries, the impact these can have on individuals and the support and counselling that student nurses require after injury. These findings highlight the potential psychological issues that can result from sharps injuries in this population.

  15. The effects of smoking and nicotine ingestion on exercise heat tolerance.

    Science.gov (United States)

    Druyan, Amit; Atias, Danit; Ketko, Itay; Cohen-Sivan, Yoav; Heled, Yuval

    2017-03-01

    Smoking has a thermogenic effect and is associated with low physical performance. Nevertheless, a direct, quantitative effect of acute smoking on exercise heat tolerance has not been reported. Sixteen healthy young male volunteers, eight cigarette smokers, and eight non-smokers participated in the study. All subjects performed a maximal oxygen consumption test (VO2max) and a standardized heat tolerance test (HTT) after at least 12 h without smoking under the following conditions: no nicotine exposure, 10 min after nicotine exposure (2 mg nicotine lozenge), and 10 min after smoking two cigarettes (0.8 mg nicotine in each cigarette, smokers only). There was no significant effect of nicotine exposure on physiological performance and heat tolerance in the non-smokers group. In the smokers group, cigarette smoking, but not nicotine ingestion, resulted with higher heart rate (by 9±9 bpm) at the end of the HTT (psmoking and nicotine ingestion increased smokers' rectal temperature at the end of the HTT (by 0.24±0.16°C and 0.21±0.26°C, respectively, psmoking in the smokers group compared with no exposure (2.13±2.57 and 2.48±2.76, respectively, psmoking and nicotine ingestion increase the physiological strain during a HTT in smokers. Acute smoking may, therefore, increase heat intolerance and the risk to heat injuries.

  16. The interaction between freezing tolerance and phenology in temperate deciduous trees

    Directory of Open Access Journals (Sweden)

    Yann eVitasse

    2014-10-01

    Full Text Available Temperate climates are defined by a distinct temperature seasonality with large and often unpredictable weather during any of the four seasons. To thrive in such climates, trees have to withstand a cold winter and the stochastic occurrence of freeze events during any time of the year. The physiological mechanisms trees adopt to escape, avoid and tolerate freezing temperatures include a cold acclimation in autumn, a dormancy period during winter (leafless in deciduous trees, and the maintenance of a certain freezing tolerance during dehardening in early spring. The change from one phase to the next is mediated by complex interactions between temperature and photoperiod. This review aims at providing an overview of the interplay between phenology of leaves and species-specific freezing resistance. First, we address the long-term evolutionary responses that enabled temperate trees to tolerate certain low temperature extremes. We provide evidence that short term acclimation of freezing resistance plays a crucial role both in dormant and active buds, including re-acclimation to cold conditions following warm spells. This ability declines to almost zero during leaf emergence. Second, we show that the risk that native temperate trees encounter freeze injuries is low and is confined to spring and underline that this risk might be altered by climate warming depending on species-specific phenological responses to environmental cues.

  17. Genetic analysis of cold tolerance at the germination and booting stages in rice by association mapping.

    Directory of Open Access Journals (Sweden)

    Yinghua Pan

    Full Text Available Low temperature affects the rice plants at all stages of growth. It can cause severe seedling injury and male sterility resulting in severe yield losses. Using a mini core collection of 174 Chinese rice accessions and 273 SSR markers we investigated cold tolerance at the germination and booting stages, as well as the underlying genetic bases, by association mapping. Two distinct populations, corresponding to subspecies indica and japonica showed evident differences in cold tolerance and its genetic basis. Both subspecies were sensitive to cold stress at both growth stages. However, japonica was more tolerant than indica at all stages as measured by seedling survival and seed setting. There was a low correlation in cold tolerance between the germination and booting stages. Fifty one quantitative trait loci (QTLs for cold tolerance were dispersed across all 12 chromosomes; 22 detected at the germination stage and 33 at the booting stage. Eight QTLs were identified by at least two of four measures. About 46% of the QTLs represented new loci. The only QTL shared between indica and japonica for the same measure was qLTSSvR6-2 for SSvR. This implied a complicated mechanism of old tolerance between the two subspecies. According to the relative genotypic effect (RGE of each genotype for each QTL, we detected 18 positive genotypes and 21 negative genotypes in indica, and 19 positive genotypes and 24 negative genotypes in japonica. In general, the negative effects were much stronger than the positive effects in both subspecies. Markers for QTL with positive effects in one subspecies were shown to be effective for selection of cold tolerance in that subspecies, but not in the other subspecies. QTL with strong negative effects on cold tolerance should be avoided during MAS breeding so as to not cancel the effect of favorable QTL at other loci.

  18. Injury risk curves for the WorldSID 50th male dummy.

    Science.gov (United States)

    Petitjean, Audrey; Trosseille, Xavier; Petit, Philippe; Irwin, Annette; Hassan, Joe; Praxl, Norbert

    2009-11-01

    The development of the WorldSID 50th percentile male dummy was initiated in 1997 by the International Organisation for Standardisation (ISO/SC12/TC22/WG5) with the objective of developing a more biofidelic side impact dummy and supporting the adoption of a harmonised dummy into regulations. More than 45 organizations from all around the world have contributed to this effort including governmental agencies, research institutes, car manufacturers and dummy manufacturers. The first production version of the WorldSID 50th male dummy was released in March 2004 and demonstrated an improved biofidelity over existing side impact dummies. Full scale vehicle tests covering a wide range of side impact test procedures were performed worldwide with the WorldSID dummy. However, the vehicle safety performance could not be assessed due to lack of injury risk curves for this dummy. The development of these curves was initiated in 2004 within the framework of ISO/SC12/TC22/WG6 (Injury criteria). In 2008, the ACEA- Dummy Task Force (TFD) decided to contribute to this work and offered resources for a project manager to coordinate of the effort of a group of volunteer biomechanical experts from international institutions (ISO, EEVC, VRTC/NHTSA, JARI, Transport Canada), car manufacturers (ACEA, Ford, General Motors, Honda, Toyota, Chrysler) and universities (Wayne State University, Ohio State University, John Hopkins University, Medical College of Wisconsin) to develop harmonized injury risk curves. An in-depth literature review was conducted. All the available PMHS datasets were identified, the test configurations and the quality of the results were checked. Criteria were developed for inclusion or exclusion of PMHS tests in the development of the injury risk curves. Data were processed to account for differences in mass and age of the subjects. Finally, injury risk curves were developed using the following statistical techniques, the certainty method, the Mertz/Weber method, the

  19. Insights into the Molecular Events That Regulate Heat-Induced Chilling Tolerance in Citrus Fruits.

    Science.gov (United States)

    Lafuente, María T; Establés-Ortíz, Beatriz; González-Candelas, Luis

    2017-01-01

    Low non-freezing temperature may cause chilling injury (CI), which is responsible for external quality deterioration in many chilling-sensitive horticultural crops. Exposure of chilling-sensitive citrus cultivars to non-lethal high-temperature conditioning may increase their chilling tolerance. Very little information is available about the molecular events involved in such tolerance. In this work, the molecular events associated with the low temperature tolerance induced by heating Fortune mandarin, which is very sensitive to chilling, for 3 days at 37°C prior to cold storage is presented. A transcriptomic analysis reveals that heat-conditioning has an important impact favoring the repression of genes in cold-stored fruit, and that long-term heat-induced chilling tolerance is an active process that requires activation of transcription factors involved in transcription initiation and of the WRKY family. The analysis also shows that chilling favors degradation processes, which affect lipids and proteins, and that the protective effect of the heat-conditioning treatment is more likely to be related to the repression of the genes involved in lipid degradation than to the modification of fatty acids unsaturation, which affects membrane permeability. Another major factor associated with the beneficial effect of the heat treatment on reducing CI is the regulation of stress-related proteins. Many of the genes that encoded such proteins are involved in secondary metabolism and in oxidative stress-related processes.

  20. Insights into the Molecular Events That Regulate Heat-Induced Chilling Tolerance in Citrus Fruits

    Directory of Open Access Journals (Sweden)

    María T. Lafuente

    2017-06-01

    Full Text Available Low non-freezing temperature may cause chilling injury (CI, which is responsible for external quality deterioration in many chilling-sensitive horticultural crops. Exposure of chilling-sensitive citrus cultivars to non-lethal high-temperature conditioning may increase their chilling tolerance. Very little information is available about the molecular events involved in such tolerance. In this work, the molecular events associated with the low temperature tolerance induced by heating Fortune mandarin, which is very sensitive to chilling, for 3 days at 37°C prior to cold storage is presented. A transcriptomic analysis reveals that heat-conditioning has an important impact favoring the repression of genes in cold-stored fruit, and that long-term heat-induced chilling tolerance is an active process that requires activation of transcription factors involved in transcription initiation and of the WRKY family. The analysis also shows that chilling favors degradation processes, which affect lipids and proteins, and that the protective effect of the heat-conditioning treatment is more likely to be related to the repression of the genes involved in lipid degradation than to the modification of fatty acids unsaturation, which affects membrane permeability. Another major factor associated with the beneficial effect of the heat treatment on reducing CI is the regulation of stress-related proteins. Many of the genes that encoded such proteins are involved in secondary metabolism and in oxidative stress-related processes.

  1. Pattern of injuries suffered by the patients treated for alleged assault ...

    African Journals Online (AJOL)

    South African Family Practice ... In South Africa, violence plays a detrimental role in our daily lives, affecting almost everybody, directly or indirectly. ... From 29th October 1999 to 1st May 2000, the patients who attended for injuries due to alleged assault (interpersonal violence) and met the inclusion criteria were included in ...

  2. Workplace injuries in Fiji: a population-based study (TRIP 7).

    Science.gov (United States)

    Reddy, R; Kafoa, B; Wainiqolo, I; Kool, B; Gentles, D; McCaig, E; Ameratunga, S

    2013-06-01

    Workplace injury rates in low and middle-income countries are known to be high. Contemporary data on this topic from Pacific Island countries and territories are scant. To describe the epidemiology of fatal and hospitalized workplace injuries in Fiji using a population-based trauma registry. An analysis of data from a prospective population-based surveillance registry investigated the characteristics associated with workplace injuries resulting in death or hospital admission among people aged 15 years and older in Viti Levu, the largest island in the Republic of Fiji, from October 2005 to September 2006. Incidence rates were calculated using denominator data from the 2004-05 Fiji Employment Survey. One hundred and eighty-nine individuals met the study eligibility criteria (including nine deaths). This corresponded to annual injury-related hospitalization and death rates of 73.4 and 3.7 per 100 000 workers, respectively. Males accounted for 95% of injuries, and hospitalization rates were highest among those aged 15-29 years (33 per 100 000 workers). Fijian and Indian workers had similar rates of admission to hospital (38.3 and 31.8 per 100 000 workers, respectively). Fractures (40%) and 'cuts/bites/open wounds' (32%) were the commonest types of injury while 'being hit by a person or object' (34%), falls (27%) and 'cutting or piercing' injuries (27%) were the commonest mechanisms. Overall, 7% of injuries were deemed intentional. Acknowledging the likely underestimation of the overall burden of workplace injuries, these findings support the need to identify context-specific risk factors and effective approaches to preventing workplace injuries in Fiji.

  3. Effect of Mindfulness Based Stress Reduction (MBSR in Increasing Pain Tolerance and Improving the Mental Health of Injured Athletes

    Directory of Open Access Journals (Sweden)

    Warhel Asim Mohammed

    2018-05-01

    Full Text Available Literature indicates that injured athletes face both physical and psychological distress after they have been injured. In this study, a Mindfulness Based Stress Reduction (MBSR was utilised as an intervention for use during the period of recovery with injured athletes and, to the best of our knowledge, this is the first study using MBSR as an intervention for this purpose.Objective: The aim of this research was to investigate the role of MBSR practise in reducing the perception of pain and decreasing anxiety/stress, as well as increasing pain tolerance and mindfulness. An additional aim was to increase positive mood and decrease negative mood in injured athletes.Methods: The participants comprised of twenty athletes (male = 14; female = 6; age range = 21–36 years who had severe injuries, preventing their participation in sport for more than 3 months. Prior to their injury, the participants had trained regularly with their University teams and participated in official university championships. Both groups followed their normal physiotherapy treatment, but in addition, the intervention group practised mindfulness meditation for 8 weeks (one 90-min session/week. A Cold Pressor Test (CPT was used to assess pain tolerance. In contrast, the perception of pain was measured using a Visual Analogue Scale. Other measurements used were the Mindful Attention Awareness Scale (MAAS, Depression Anxiety and Stress Scale (DASS, and Profile of Mood States (POMS.Results: Our results demonstrated an increase in pain tolerance for the intervention group and an increase in mindful awareness for injured athletes. Moreover, our findings observed a promising change in positive mood for both groups. Regarding the Stress/Anxiety scores, our findings showed a notable decrease across sessions; however, no significant changes were observed in other main and interaction effects in both groups.Conclusion: Injured athletes can benefit from using mindfulness as part of the

  4. Determinants of Return to Play After the Nonoperative Management of Hamstring Injuries in Athletes: A Systematic Review.

    Science.gov (United States)

    Fournier-Farley, Camille; Lamontagne, Martin; Gendron, Patrick; Gagnon, Dany H

    2016-08-01

    It is important for clinicians to rely on suitable prognosis factors after hamstring injuries because of the high incidence of these injuries and time away from athletic activities. To summarize the current literature on factors that influence return to play after a hamstring injury in athletes. Systematic review. A computer-assisted literature search of CINAHL, MEDLINE, Embase, and EBM Reviews databases (and a manual search of the reference lists of all selected articles) was conducted using keywords related to hamstring injuries and return to play. The literature review criteria included (1) patients with an acute hamstring or posterior thigh injury; (2) a randomized controlled trial, cohort study, case-control study, case series, or prospective or retrospective design; (3) information on rehabilitation, physical therapy, clinical assessment, imaging techniques, and return to play; and (4) studies written in English or French. The search strategy identified 914 potential articles, of which 24 met the inclusion criteria. In terms of the clinical assessment, the following factors were associated with a longer recovery time: stretching-type injuries, recreational-level sports, structural versus functional injuries, greater range of motion deficit with the hip flexed at 90°, time to first consultation >1 week, increased pain on the visual analog scale, and >1 day to be able to walk pain free after the injury. As for magnetic resonance imaging studies, the following factors correlated with a longer recovery time: positive findings; higher grade of injury; muscle involvement >75%; complete transection; retraction; central tendon disruption of the biceps femoris; proximal tendon involvement; shorter distance to the ischial tuberosity; length of the hamstring injury; and depth, volume, and large cross-sectional area. With respect to ultrasound studies, the following factors were associated with a poor prognosis: large cross-sectional area, injury outside the

  5. Criteria to Extract High-Quality Protein Data Bank Subsets for Structure Users.

    Science.gov (United States)

    Carugo, Oliviero; Djinović-Carugo, Kristina

    2016-01-01

    It is often necessary to build subsets of the Protein Data Bank to extract structural trends and average values. For this purpose it is mandatory that the subsets are non-redundant and of high quality. The first problem can be solved relatively easily at the sequence level or at the structural level. The second, on the contrary, needs special attention. It is not sufficient, in fact, to consider the crystallographic resolution and other feature must be taken into account: the absence of strings of residues from the electron density maps and from the files deposited in the Protein Data Bank; the B-factor values; the appropriate validation of the structural models; the quality of the electron density maps, which is not uniform; and the temperature of the diffraction experiments. More stringent criteria produce smaller subsets, which can be enlarged with more tolerant selection criteria. The incessant growth of the Protein Data Bank and especially of the number of high-resolution structures is allowing the use of more stringent selection criteria, with a consequent improvement of the quality of the subsets of the Protein Data Bank.

  6. Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch.

    Science.gov (United States)

    Lionberger, David R; Brennan, Michael J

    2010-11-10

    The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP) in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs), diclofenac, and DETP in patients with acute soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical NSAIDs, diclofenac, diclofenac epolamine, acute pain, sports injury, soft tissue injury, strain, sprain, and contusion, and from citations in retrieved articles covering the years 1978-2008. Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5-1.9). In a limited number of comparisons, topical and oral NSAIDs provided comparable pain relief, but the use of topical agents produced lower plasma drug concentrations and fewer systemic adverse events (AEs). The physical-chemical properties of diclofenac epolamine make it well suited for topical use. In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days. Moreover, DETP displayed tolerability comparable with placebo; the most common AEs were pruritus and other application site reactions. Review of published literature suggests that DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing acute pain associated with strains, sprains, and contusions, and other localized painful conditions.

  7. Flooding tolerance in interspecific introgression lines containing chromosome segments from teosinte (Zea nicaraguensis) in maize (Zea mays subsp. mays)

    Science.gov (United States)

    Mano, Y.; Omori, F.

    2013-01-01

    Background and Aims Nicaraguan teosinte (Zea nicaraguensis), a species found in frequently flooded areas, provides useful germplasm for breeding flooding-tolerant maize (Z. mays subsp. mays). The objective of this study was to select flooding-tolerant lines using a library of introgression lines (ILs), each containing a chromosome segment from Z. nicaraguensis in the maize inbred line Mi29. Methods To produce the ILs, a single F1 plant derived from a cross between maize Mi29 and Z. nicaraguensis was backcrossed to Mi29 three times, self-pollinated four times and genotyped using simple sequence repeat markers. Flooding tolerance was evaluated at the seedling stage under reducing soil conditions. Key Results By backcrossing and selfing, a series of 45 ILs were developed covering nearly the entire maize genome. Five flooding-tolerant lines were identified from among the ILs by evaluating leaf injury. Among these, line IL#18, containing a Z. nicaraguensis chromosome segment on the long arm of chromosome 4, showed the greatest tolerance to flooding, suggesting the presence of a major quantitative trait locus (QTL) in that region. The presence of the QTL was verified by examining flooding tolerance in a population segregating for the candidate region of chromosome 4. There was no significant relationship between the capacity to form constitutive aerenchyma and flooding tolerance in the ILs, indicating the presence of other factors related to flooding tolerance under reducing soil conditions. Conclusions A flooding-tolerant genotype, IL#18, was identified; this genotype should be useful for maize breeding. In addition, because the chromosome segments of Z. nicaraguensis in the ILs cover nearly the entire genome and Z. nicaraguensis possesses several unique traits related to flooding tolerance, the ILs should be valuable material for additional QTL detection and the development of flooding-tolerant maize lines. PMID:23877074

  8. Flooding tolerance in interspecific introgression lines containing chromosome segments from teosinte (Zea nicaraguensis) in maize (Zea mays subsp. mays).

    Science.gov (United States)

    Mano, Y; Omori, F

    2013-10-01

    Nicaraguan teosinte (Zea nicaraguensis), a species found in frequently flooded areas, provides useful germplasm for breeding flooding-tolerant maize (Z. mays subsp. mays). The objective of this study was to select flooding-tolerant lines using a library of introgression lines (ILs), each containing a chromosome segment from Z. nicaraguensis in the maize inbred line Mi29. To produce the ILs, a single F1 plant derived from a cross between maize Mi29 and Z. nicaraguensis was backcrossed to Mi29 three times, self-pollinated four times and genotyped using simple sequence repeat markers. Flooding tolerance was evaluated at the seedling stage under reducing soil conditions. By backcrossing and selfing, a series of 45 ILs were developed covering nearly the entire maize genome. Five flooding-tolerant lines were identified from among the ILs by evaluating leaf injury. Among these, line IL#18, containing a Z. nicaraguensis chromosome segment on the long arm of chromosome 4, showed the greatest tolerance to flooding, suggesting the presence of a major quantitative trait locus (QTL) in that region. The presence of the QTL was verified by examining flooding tolerance in a population segregating for the candidate region of chromosome 4. There was no significant relationship between the capacity to form constitutive aerenchyma and flooding tolerance in the ILs, indicating the presence of other factors related to flooding tolerance under reducing soil conditions. A flooding-tolerant genotype, IL#18, was identified; this genotype should be useful for maize breeding. In addition, because the chromosome segments of Z. nicaraguensis in the ILs cover nearly the entire genome and Z. nicaraguensis possesses several unique traits related to flooding tolerance, the ILs should be valuable material for additional QTL detection and the development of flooding-tolerant maize lines.

  9. The work-related fatal injury study: numbers, rates and trends of work-related fatal injuries in New Zealand 1985-1994.

    Science.gov (United States)

    Feyer, A M; Langley, J; Howard, M; Horsburgh, S; Wright, C; Alsop, J; Cryer, C

    2001-01-26

    To determine the number and rates of work-related fatal injuries by employment status, occupation, industry, age and gender in New Zealand 1985-1994. Potential cases of work-related injury deaths of persons aged 15-84 years were identified from the national electronic mortality data files. Main exclusions were deaths due to suicide and deaths due to motor vehicle crashes. The circumstances of the deaths of each fatal incident meeting inclusion criteria were then reviewed directly from coronial files to determine work-relatedness. The rate of work-related fatal injury in New Zealand was 5.03/100000 workers per year for the study period. There was a significant decline in crude rate over the study period. However, this was in substantial part accounted for by changes in occupation and industry mix. Older workers, male workers, self-employed workers, and particular occupational groups, all had substantially elevated rates. Agricultural and helicopter pilots, forestry workers and fishery workers had the highest rates. Farmers, forestry workers, and fishery workers also had high numbers of deaths, together accounting for nearly 40% of all deaths. This study has demonstrated that work-related fatal injury remains a pressing problem for New Zealand. Several areas in urgent need of prevention efforts were highlighted.

  10. Psychological injury in victims of child sexual abuse: A meta-analytic review

    Directory of Open Access Journals (Sweden)

    Bárbara G. Amado

    2015-04-01

    Full Text Available In order to assess the effects of child/adolescent sexual abuse (CSA/ASA on the victim's probability of developingsymptoms of depression and anxiety, to quantify injury in populational terms, to establish theprobability of injury, and to determine the different effects of moderators on the severity of injury, a meta-analysis was performed. Given the abundant literature, only studies indexed in the scientific databaseof reference, the Web of Science, were selected. A total of 78 studies met the inclusion criteria: they measuredCSA/ASA victimization or injury in terms of depression or anxiety symptoms, measured the effectsize or included data for computing them, and provided a description of the sample. The results showedthat CSA/ASA victims suffered significant injury, generally of a medium effect size and generalizable, victimshad 70% more probabilities of suffering from injury, and clinical diagnosis was significantly a moreadequate measure of injury than symptoms. The probability of chronic injury (dysthymia was greaterthan developing more severe injury, i.e., major depressive disorder (MDD. In the category of anxiety disorders,injury was expressed with a higher probability in specific phobia. In terms of the victim's gender,females had significantly higher rates of developing a depressive disorder (DD and/or an anxiety disorder(AD, quantified in a 42% and 24% over the baseline, for a DD and AD respectively. As for the type of abuse,the meta-analysis revealed that abuse involving penetration was linked to severe injury, whereas abusewith no contact was associated to less serious injury. The clinical, social, and legal implications of the resultsare discussed.

  11. Strain-time cell death threshold for skeletal muscle in a tissue-engineered model system for deep tissue injury

    NARCIS (Netherlands)

    Gefen, A.; Nierop, van B.J.; Bader, D.L.; Oomens, C.W.J.

    2008-01-01

    Deep tissue injury (DTI) is a severe pressure ulcer that results from sustained deformation of muscle tissue overlying bony prominences. In order to understand the etiology of DTI, it is essential to determine the tolerance of muscle cells to large mechanical strains. In this study, a new

  12. Time line for noncopers to pass return-to-sports criteria after anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Hartigan, Erin H; Axe, Michael J; Snyder-Mackler, Lynn

    2010-03-01

    Randomized clinical trial. Determine effective interventions for improving readiness to return to sports postoperatively in patients with complete, unilateral, anterior cruciate ligament (ACL) rupture who do not compensate well after the injury (noncopers). Specifically, we compared the effects of 2 preoperative interventions on quadriceps strength and functional outcomes. The percentage of athletes who return to sports after ACL reconstruction varies considerably, possibly due to differential responses after acute ACL rupture and different management. Prognostic data for noncopers following ACL reconstruction is absent in the literature. Forty noncopers were randomly assigned to receive either progressive quadriceps strength-training exercises (STR group) or perturbation training in conjunction with strength-training exercises (PERT group) for 10 preoperative rehabilitation sessions. Postoperative rehabilitation was similar between groups. Data on quadriceps strength indices [(involved limb/uninvolved limb force) x 100], 4 hop score indices, and 2 self-report questionnaires were collected preoperatively and 3, 6, and 12 months postoperatively. Mann-Whitney U tests were used to compare functional differences between the groups. Chi-square tests were used to compare frequencies of passing functional criteria and reasons for differences in performance between groups postoperatively. Functional outcomes were not different between groups, except a greater number of patients in the PERT group achieved global rating scores (current knee function expressed as a percentage of overall knee function prior to injury) necessary to pass return-to-sports criteria 6 and 12 months after surgery. Mean scores for each functional outcome met return-to-sports criteria 6 and 12 months postoperatively. Frequency counts of individual data, however, indicated that 5% of noncopers passed RTS criteria at 3, 48% at 6, and 78% at 12 months after surgery. Functional outcomes suggest that a

  13. Importance of flexible bronchoscopy in decannulation of tracheostomy patients

    Directory of Open Access Journals (Sweden)

    Leonardo Brand Rodrigues

    Full Text Available OBJECTIVE: To evaluate the importance of flexible bronchoscopy in tracheostomy patients in the process of decannulation to assess the incidence and types of laryngotracheal injury and compare the presence of such lesions with clinical criteria used for decannulation. METHODS: We studied 51 tracheostomized patients aged between 19 and 87 years, with tracheal stent for a mean of 46 ± 28 days and with clinical criteria for decannulation. They were submitted to tracheostomy tube occlusion tolerance testfor 24 hours, and then to flexible bronchoscopy. We described and classified the diagnosed laryngotracheal changes. We compared the clinical criteria for decannulation indication with the bronchoscopy-diagnosed laryngotracheal injuries that contraindicated decannulation. We identified the factors that could interfere in decannulation and evaluated the importance of bronchoscopy as part of the process. RESULTS: Forty (80.4% patients had laryngotracheal alterations. Of the 40 patients considered clinically fit to decannulation, eight (20% (p = 0.0007 presented with laryngotracheal injuries at bronchoscopy that contraindicated the procedure. The most frequent laryngeal alteration was vocal cords lesion, in 15 (29% individuals, and granuloma, the most prevalent tracheal lesion, in 14 (27.5% patients. CONCLUSION: flexible bronchoscopy showed a large number of laryngotracheal injuries, the most frequent being the vocal cords injury in the larynx and the granuloma in the trachea, which contributed to increase the decannulation procedure safety.

  14. Paediatric trauma on the Last Frontier: an 11-year review of injury mechanisms, high-risk injury patterns and outcomes in Alaskan children

    Directory of Open Access Journals (Sweden)

    Christopher W. Snyder

    2014-08-01

    Full Text Available Background: Paediatric trauma system development in Alaska is complicated by a vast geographic coverage area, wide regional variations in environment and culture, and a lack of available published data. Objective: To provide a detailed description of paediatric trauma mechanisms, high-risk injury patterns and outcomes in Alaska. Design: This retrospective study included all children aged 17 years or younger in the State of Alaska Trauma Registry database admitted with traumatic injury between 2001 and 2011. Each injury record was reviewed individually and assigned a mechanism based on Centers for Disease Control E-codes. Geographic definitions were based on existing Emergency Medical Services regions. Mechanisms were compared by geographic region, patient demographics, injury characteristics and outcome. Subgroup analysis of fatal injuries was performed to identify causes of death. Results: Of 5,547 patients meeting inclusion criteria, the most common mechanisms of injury were falls (39%, motor vehicle collisions (10% and all-terrain vehicle (ATV accidents (9%. The overall case fatality rate was 2%. Mechanisms with the greatest risk of death were gunshot wounds (21%, pedestrians struck by motorized vehicles (9% and motor vehicle collisions (5%. These 3 mechanisms accounted for 15% of injuries but 60% of deaths in the overall cohort. Injury patterns involving combined central nervous system (CNS and torso injuries were unusual but especially lethal, occurring in 3% of patients but carrying a case fatality rate of 18%. Although the distribution of mechanisms was generally similar for each geographic region, ATV and snowmobile injuries were significantly more common in remote areas (23% remote vs. 7% non-remote, p < 0.0001. Conclusions: Mechanisms of paediatric trauma in Alaska have widely varying impacts on outcome and show some variation by region. Highest-risk mechanisms include gunshot wounds and motorized vehicle-related accidents. Prevention

  15. Approaches to Demonstrating the Reliability and Validity of Core Diagnostic Criteria for Chronic Pain.

    Science.gov (United States)

    Bruehl, Stephen; Ohrbach, Richard; Sharma, Sonia; Widerstrom-Noga, Eva; Dworkin, Robert H; Fillingim, Roger B; Turk, Dennis C

    2016-09-01

    The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy (AAPT) is designed to be an evidence-based multidimensional chronic pain classification system that will facilitate more comprehensive and consistent chronic pain diagnoses, and thereby enhance research, clinical communication, and ultimately patient care. Core diagnostic criteria (dimension 1) for individual chronic pain conditions included in the initial version of AAPT will be the focus of subsequent empirical research to evaluate and provide evidence for their reliability and validity. Challenges to validating diagnostic criteria in the absence of clear and identifiable pathophysiological mechanisms are described. Based in part on previous experience regarding the development of evidence-based diagnostic criteria for psychiatric disorders, headache, and specific chronic pain conditions (fibromyalgia, complex regional pain syndrome, temporomandibular disorders, pain associated with spinal cord injuries), several potential approaches for documentation of the reliability and validity of the AAPT diagnostic criteria are summarized. The AAPT is designed to be an evidence-based multidimensional chronic pain classification system. Conceptual and methodological issues related to demonstrating the reliability and validity of the proposed AAPT chronic pain diagnostic criteria are discussed. Copyright © 2016 American Pain Society. Published by Elsevier Inc. All rights reserved.

  16. Thioredoxin priming prolongs lung allograft survival by promoting immune tolerance.

    Directory of Open Access Journals (Sweden)

    Hanbo Hu

    Full Text Available Tolerance to allograft antigen is the major challenge and final goal of transplant medicine. Our previous study demonstrated that thioredoxin-1 (Trx priming of donor lung significantly protected allogeneic lung graft. To determine whether Trx priming of donor lung inhibits allograft rejection, extends allograft survival and induces immune tolerance, orthotopic left lung transplantation was performed from Lewis to Sprague-Dawley rats without immunosuppression. Donor lungs were primed with Trx at 4°C for 4 hr prior to transplantation. After up to 37 days post-transplantation, allograft lung morphology, recipient T cell and humoral alloantigen-specific immune responses were examined. We found that Trx-primed lungs exhibited much reduced acute rejection and associated lung injuries resulting in loss of graft functional area at 5-37 days post-transplant in contrast to the control groups. CD4+ T cells from the recipients with Trx-primed grafts responded to the stimulation of dendritic cells (DCs of donor origin, in contrast to DCs from the third party, with significantly reduced proliferation. Consistent with above findings, we observed that CD4+Foxp3+ regulatory T cells in spleen cells from the recipients with Trx-primed grafts were significantly increased compared to controls, and CD4+ T cells from the recipients with Trx-primed grafts produced much higher levels of immunosuppressive cytokine, IL-10 when stimulated with allogeneic donor DCs. In addition, humoral immune tolerance was also induced as there was no significant increase levels of serum antibodies against donor antigens in Trx-lung recipients when re-challenged with allogeneic donor antigens. Our results demonstrate that one-time Trx-priming of donor lung grafts prior to transplantation significantly prolongs the survival of the grafts through inducing or promoting cellular and humoral alloantigen-specific immune tolerance, which might be associated with the induction of

  17. Work injury management model and implication in Hong Kong: a literature review.

    Science.gov (United States)

    Chong, Cecilia Suk-Mei; Cheng, Andy Shu-Kei

    2010-01-01

    The objective of this review is to explore the work injury management models in literatures and the essential components in different models. The resulting information could be used to develop an integrated holistic model that could be applied in the work injury management system in Hong Kong. A keyword search of MEDLINE and CINAHL databases was conducted. A total of 68 studies related to the management of an injury were found within the above mentioned electronic database. Together with the citation tracking, there were 13 studies left for selection after the exclusion screening. Only 7 out of those 13 studies met the inclusion criteria for review. It is noticeable that the most important component in the injury management model in the reviewed literatures is early intervention. Because of limitations in Employees' Compensation Ordinance in Hong Kong, there is an impetus to have a model and practice guideline for work injury management in Hong Kong to ensure the quality of injury management services. At the end of this paper, the authors propose a work injury management model based on the employees' compensation system in Hong Kong. This model can be used as a reference for those countries adopting similar legislation as in Hong Kong.

  18. Developing predictive models for return to work using the Military Power, Performance and Prevention (MP3) musculoskeletal injury risk algorithm: a study protocol for an injury risk assessment programme.

    Science.gov (United States)

    Rhon, Daniel I; Teyhen, Deydre S; Shaffer, Scott W; Goffar, Stephen L; Kiesel, Kyle; Plisky, Phil P

    2018-02-01

    Musculoskeletal injuries are a primary source of disability in the US Military, and low back pain and lower extremity injuries account for over 44% of limited work days annually. History of prior musculoskeletal injury increases the risk for future injury. This study aims to determine the risk of injury after returning to work from a previous injury. The objective is to identify criteria that can help predict likelihood for future injury or re-injury. There will be 480 active duty soldiers recruited from across four medical centres. These will be patients who have sustained a musculoskeletal injury in the lower extremity or lumbar/thoracic spine, and have now been cleared to return back to work without any limitations. Subjects will undergo a battery of physical performance tests and fill out sociodemographic surveys. They will be followed for a year to identify any musculoskeletal injuries that occur. Prediction algorithms will be derived using regression analysis from performance and sociodemographic variables found to be significantly different between injured and non-injured subjects. Due to the high rates of injuries, injury prevention and prediction initiatives are growing. This is the first study looking at predicting re-injury rates after an initial musculoskeletal injury. In addition, multivariate prediction models appear to have move value than models based on only one variable. This approach aims to validate a multivariate model used in healthy non-injured individuals to help improve variables that best predict the ability to return to work with lower risk of injury, after a recent musculoskeletal injury. NCT02776930. 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/.

  19. STUDY OF ACUTE KIDNEY INJURY IN SNAKE BITE PATIENTS

    Directory of Open Access Journals (Sweden)

    Suma Dasaraju

    2017-04-01

    Full Text Available BACKGROUND Snake venom is well known to cause toxic damage to the kidneys (Schreiner and Maher, 1965. This study is an attempt to evaluate the snakebite-induced Acute Kidney Injury (AKI. MATERIALS AND METHODS 50 patients with snakebite-induced acute kidney injury were selected randomly and their clinical profile was assessed. Acute kidney injury was evaluated using noninvasive laboratory methods. Inclusion Criteria- 1. History of snakebite; 2. Presence of AKI. Exclusion Criteria- Pre-existing renal diseases, after establishing the diagnosis, patients were started on conservative treatment including ASV, blood/blood products and haemodialysis as required. RESULTS Out of 50 patients included in the study, majority of them were males (62% with mean age of presentation 43.8 ± 12.63 years. The mean interval between snakebite and presentation to hospital was 15.37 hours. In them, 98% patients presented with local signs of inflammation, 52% of patients presented with coagulation abnormality and 60% with decreased urine output. Comparison between good outcome (recovered from AKI and poor outcome (not recovered from AKI shows significant pvalue for ‘lapse of time in hours’ in presenting to the hospital after snakebite (p value 0.005 and ‘alternative treatment taken’ before coming to the hospital (p value 0.001. CONCLUSION Poisonous snakebites have common manifestations of cellulitis, abnormal coagulation profile and decreased urine output. Overall mortality due to snakebite-induced AKI is 6%. Patients who did not recover from AKI had lapse of time in presenting to the hospital and abnormal coagulation profile.

  20. Performance of primary repair on colon injuries sustained from low-versus high-energy projectiles.

    Science.gov (United States)

    Lazovic, Ranko; Radojevic, Nemanja; Curovic, Ivana

    2016-04-01

    Among various reasons, colon injuries may be caused by low- or high-energy firearm bullets, with the latter producing a temporary cavitation phenomenon. The available treatment options include primary repair and two-stage management, but recent studies have shown that primary repair can be widely used with a high success rate. This paper investigates the differences in performance of primary repair on these two types of colon injuries. Two groups of patients who sustained colon injuries due to single gunshot wounds, were retrospectively categorized based on the type of bullet. Primary colon repair was performed in all patients selected based on the inclusion and exclusion criteria (Stone and Fabian's criteria). An almost absolute homogeneity was attained among the groups in terms of age, latent time before surgery, and four trauma indexes. Only one patient from the low-energy firearm projectile group (4%) developed a postsurgical complication versus nine patients (25.8%) from the high-energy group, showing statistically significant difference (p = 0.03). These nine patients experienced the following postsurgical complications: pneumonia, abscess, fistula, suture leakage, and one multiorgan failure with sepsis. Previous studies concluded that one-stage primary repair is the best treatment option for colon injuries. However, terminal ballistics testing determined the projectile's path through the body and revealed that low-energy projectiles caused considerably lesser damage than their high-energy counterparts. Primary colon repair must be performed definitely for low-energy short firearm injuries but very carefully for high-energy injuries. Given these findings, we suggest that the treatment option should be determined based not only on the bullet type alone but also on other clinical findings. Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  1. Biochemical basis of drought tolerance in hybrid Populus grown under field production conditions. CRADA final report

    Energy Technology Data Exchange (ETDEWEB)

    Tschaplinski, T.J.; Tuskan, G.A. [Oak Ridge National Lab., TN (United States); Wierman, C. [Boise Cascade Corp., Wallula, WA (United States)

    1997-04-01

    The purpose of this cooperative effort was to assess the use of osmotically active compounds as molecular selection criteria for drought tolerance in Populus in a large-scale field trial. It is known that some plant species, and individuals within a plant species, can tolerate increasing stress associated with reduced moisture availability by accumulating solutes. The biochemical matrix of such metabolites varies among species and among individuals. The ability of Populus clones to tolerate drought has equal value to other fiber producers, i.e., the wood products industry, where irrigation is used in combination with other cultural treatments to obtain high dry weight yields. The research initially involved an assessment of drought stress under field conditions and characterization of changes in osmotic constitution among the seven clones across the six moisture levels. The near-term goal was to provide a mechanistic basis for clonal differences in productivity under various irrigation treatments over time.

  2. Functional brain study of chronic traumatic head injury

    International Nuclear Information System (INIS)

    Ceballos Alonso, Concepcion; Pelegrin Valero, Carmelo; Cordoba Diaz de Laspra, Elena

    2000-01-01

    Explosive aggressive behaviour is a significant clinical and medico-legal problem in patients suffering from head injury. However, experts in neuropsychiatry have proposed a specific category for this disorder: the o rganic aggressive syndrome: . The basic reason for proposing this diagnosis is that it describes the specificity of the violent conduct secondary to 'brain damage' with greater precision. Early diagnosis and treatment of the injury is critical. The impact of hnetium-99m-hexamethylpropuleneamine oxime (HMPAO) was examined for measuring brain damage in correlation to neuropsychological performance in patients with traumatic brain injury (TBI). We thus report the case of a twelve-year-old child with a history of CET, who presents with serious episodes of heteroaggressiveness and suggest the usefulness of single photon emission computerized tomography (SPECT) to establish the validity of this psychiatric diagnosis. The appearance of modern functional neuro-image techniques (SPECT) may help to increase the validity of clinical diagnoses in the field of psychiatry in general and of forensic psychiatry in particularly, as the related findings may be used as demarcation criteria to establish syndromic diagnoses (Au)

  3. Computed tomographic findings of splenic injury and correlation with treatment

    International Nuclear Information System (INIS)

    Kim, Dong Jin; Koh, Joo Yaul; Kim, Myung Soon; Hong, In Soo; Cho, Whi Youl; Sung, Ki Joon

    1990-01-01

    According to recently reported classification, 46 patients with blunt splenic trauma were evaluate preoperatively with computed tomography(CT). Injures were graded I through IV and describe as capsular or subcapsular disruptions without parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); injuries involving hilum(3 patients); and fragmentation(17 patients). Nineteen patients were managed conservatively and 27 patients were managed surgically. Twelve patients(47%) out of those with Type I or Type II were managed surgically including five hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries and unknown surgical criteria. On the other hand hemodynamically stable patients(25%) out of those with Type III or Type IV were managed surgically. The amount of hemoperitoneum was graded into small, moderate and large; small in three patients, moderate in 39 patients, and large in two patients. The amount of hemoperitoneum in patients with conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneum in patients with operative treatment was small in three patients, moderate in 23 patients and large in one patient. We concluded that CT was accurate method of determining the extent of splenic injury and evaluation of hemoperitoneum, but treatment choice should be based on the hemodynamic status of patients rather than the type of injury or the amount of hemoperitoneum by CT

  4. Computed tomographic findings of splenic injury and correlation with treatment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Jin; Koh, Joo Yaul; Kim, Myung Soon; Hong, In Soo; Cho, Whi Youl; Sung, Ki Joon [Yonsei University Wonju College of Medicine, Wonju (Korea, Republic of)

    1990-12-15

    According to recently reported classification, 46 patients with blunt splenic trauma were evaluate preoperatively with computed tomography(CT). Injures were graded I through IV and describe as capsular or subcapsular disruptions without parenchymal injury(3 patients); capsular and parenchymal injuries(23 patients); injuries involving hilum(3 patients); and fragmentation(17 patients). Nineteen patients were managed conservatively and 27 patients were managed surgically. Twelve patients(47%) out of those with Type I or Type II were managed surgically including five hemodynamically unstable patients and seven hemodynamically stable patients with associated injuries and unknown surgical criteria. On the other hand hemodynamically stable patients(25%) out of those with Type III or Type IV were managed surgically. The amount of hemoperitoneum was graded into small, moderate and large; small in three patients, moderate in 39 patients, and large in two patients. The amount of hemoperitoneum in patients with conservative treatment was moderate in 16 patients and large in one patient. And the amount of hemoperitoneum in patients with operative treatment was small in three patients, moderate in 23 patients and large in one patient. We concluded that CT was accurate method of determining the extent of splenic injury and evaluation of hemoperitoneum, but treatment choice should be based on the hemodynamic status of patients rather than the type of injury or the amount of hemoperitoneum by CT.

  5. Topical nonsteroidal anti-inflammatory drugs for the treatment of pain due to soft tissue injury: diclofenac epolamine topical patch

    Directory of Open Access Journals (Sweden)

    David R Lionberger

    2010-11-01

    Full Text Available David R Lionberger1, Michael J Brennan21Southwest Orthopedic Group, Houston, TX, USA; 2Department of Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The objective of this article is to review published clinical data on diclofenac epolamine topical patch 1.3% (DETP in the treatment of acute soft tissue injuries, such as strains, sprains, and contusions. Review of published literature on topical nonsteroidal anti-inflammatory drugs (NSAIDs, diclofenac, and DETP in patients with acute soft tissue injuries was included. Relevant literature was identified on MEDLINE using the search terms topical NSAIDs, diclofenac, diclofenac epolamine, acute pain, sports injury, soft tissue injury, strain, sprain, and contusion, and from citations in retrieved articles covering the years 1978–2008. Review of published, randomized clinical trials and meta-analyses shows that topical NSAIDs are significantly more effective than placebo in relieving acute pain; the pooled average relative benefit was 1.7 (95% confidence interval, 1.5–1.9. In a limited number of comparisons, topical and oral NSAIDs provided comparable pain relief, but the use of topical agents produced lower plasma drug concentrations and fewer systemic adverse events (AEs. The physical–chemical properties of diclofenac epolamine make it well suited for topical use. In patients with acute soft tissue injuries treated with DETP, clinical data report an analgesic benefit within hours of the first application, and significant pain relief relative to placebo within 3 days. Moreover, DETP displayed tolerability comparable with placebo; the most common AEs were pruritus and other application site reactions. Review of published literature suggests that DETP is generally safe and well tolerated, clinically efficacious, and a rational treatment option for patients experiencing acute pain associated with strains, sprains, and contusions, and other localized painful conditions

  6. New Insights on plant salt tolerance mechanisms and their potential use for breeding

    Directory of Open Access Journals (Sweden)

    Moez HANIN

    2016-11-01

    Full Text Available Soil salinization is a major threat to agriculture in arid and semi-arid regions, where water scarcity and inadequate drainage of irrigated lands severely reduce crop yield. Salt accumulation inhibits plant growth and reduces the ability to uptake water and nutrients, leading to osmotic or water-deficit stress. Salt is also causing injury of the young photosynthetic leaves and acceleration of their senescence, as the Na+ cation is toxic when accumulating in cell cytosol resulting in ionic imbalance and toxicity of transpiring leaves. To cope with salt stress, plants have evolved mainly two types of tolerance mechanisms based on either limiting the entry of salt by the roots, or controlling its concentration and distribution. Understanding the overall control of Na+ accumulation and functional studies of genes involved in transport processes, will provide a new opportunity to improve the salinity tolerance of plants relevant to food security in arid regions. A better understanding of these tolerance mechanisms can be used to breed crops with improved yield performance under salinity stress. Moreover, associations of cultures with nitrogen-fixing bactéria and arbuscular mycorrhizal fungi could serve as an alternative and sustainable strategy to increase crop yields in salt affected fields.

  7. Elbow, forearm, wrist, and hand injuries among sport rock climbers.

    Science.gov (United States)

    Holtzhausen, L M; Noakes, T D

    1996-07-01

    Sport rock climbing with its repetitive high-torque movements in gaining the ascent of a rock face or wall, often in steep overhanging positions, is associated with a unique distribution and form of upper limb injuries. In this article, we review the biomechanical aspects of sport rock climbing and the types of injuries commonly encountered in the forearm, wrist, and hand regions of elite sport rock climbers. Because elbow, forearm, wrist, and hand injuries predominate, representing 62% of the total injuries encountered, these anatomical areas have been selected for review. The predominant source of data are the published work of Bollen et al. The remaining sources were obtained through electronic search of the Medline and Current Contents Databases (last searched May 1995). German and French articles were included in the search criteria. Only studies dealing with acute soft tissue and overuse injuries amongst sport rock climbers were selected. Data were extracted directly from the sourced articles. The following injuries have been described in detail with regard to their presentation, diagnosis, treatment, and prevention amongst sport rock climbers: medial epicondylitis, brachialis tendonitis, biceps brachii tendonitis, ulnar collateral ligament sprain of the elbow, carpal tunnel syndrome, digital flexor tendon pulley sheath tears, interphalangeal joint effusions, fixed flexion deformities of the interphalangeal joints, and collateral ligament tears of the interphalangeal joints. Many of the injuries are specific to the handhold types used by the rock climber. Accurate diagnosis and effective treatment of these unique injuries will be facilitated by a wider understanding of the biomechanical aspects of rock climbing and an awareness of the patterns and incidence of injuries in this sport.

  8. Statistical modelling for recurrent events: an application to sports injuries.

    Science.gov (United States)

    Ullah, Shahid; Gabbett, Tim J; Finch, Caroline F

    2014-09-01

    Injuries are often recurrent, with subsequent injuries influenced by previous occurrences and hence correlation between events needs to be taken into account when analysing such data. This paper compares five different survival models (Cox proportional hazards (CoxPH) model and the following generalisations to recurrent event data: Andersen-Gill (A-G), frailty, Wei-Lin-Weissfeld total time (WLW-TT) marginal, Prentice-Williams-Peterson gap time (PWP-GT) conditional models) for the analysis of recurrent injury data. Empirical evaluation and comparison of different models were performed using model selection criteria and goodness-of-fit statistics. Simulation studies assessed the size and power of each model fit. The modelling approach is demonstrated through direct application to Australian National Rugby League recurrent injury data collected over the 2008 playing season. Of the 35 players analysed, 14 (40%) players had more than 1 injury and 47 contact injuries were sustained over 29 matches. The CoxPH model provided the poorest fit to the recurrent sports injury data. The fit was improved with the A-G and frailty models, compared to WLW-TT and PWP-GT models. Despite little difference in model fit between the A-G and frailty models, in the interest of fewer statistical assumptions it is recommended that, where relevant, future studies involving modelling of recurrent sports injury data use the frailty model in preference to the CoxPH model or its other generalisations. The paper provides a rationale for future statistical modelling approaches for recurrent sports injury. 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.

  9. Male Gametophytic Screening of Citrus Genotypes for Salt Stress Tolerance

    Directory of Open Access Journals (Sweden)

    A. Barandan

    2016-07-01

    Full Text Available Citrus species are classified as a sensitive group of trees to salt stress, but the levels of their sensitivity or tolerance to salt are different among cultivars. In order to evaluate the effects of salinity stress on pollen germination of some citrus cultivars, an experiment was performed in factorial, based on completely randomized design in three replications with Cleopatra mandarin (Citrus reshni and Poncirus trifoliata as tolerant and sensitive controls along with 13 genotypes. Pollen grains of these genotypes were cultured in media containing different levels of sodium chloride (0, 0.87, 1.6, 2.4, 3.1 dS/m along with 15% sucrose, 0.7% agar and 100 mg/L boric acid. In order to understand the biochemical responses of pollen grains to salt stress, they were cultured in liquid media with three levels of salinity (i.e. 0, 0.87 and 1.6 dS/m and then the amounts of total protein and enzyme activities of superoxide dismutase (SOD and ascorbate peroxidase (APX were evaluated. Significant differences of pollen germination (P ≤ 0.01 were observed in different salinity levels, but there were no significant differences in pollen tube growth. Pollen germination in Cleopatra was greater in comparison to Poncirus trifoliate, indicating that Cleopatra is a tolerant cultivar. The amounts of total protein and enzyme activities of SOD and APX were influenced by genotypes, salinity levels and their interactions (P ≤ 0.01. Considering the fastness and accuracy of this type of experiment, the evaluation of citrus pollen responses may, potentially, be hired as an initial screening criteria for detecting salt-sensitive varieties from the tolerant citrus ones.

  10. Selective Nonoperative Management of Penetrating Abdominal Solid Organ Injuries

    Science.gov (United States)

    Demetriades, Demetrios; Hadjizacharia, Pantelis; Constantinou, Costas; Brown, Carlos; Inaba, Kenji; Rhee, Peter; Salim, Ali

    2006-01-01

    Objective: To assess the feasibility and safety of selective nonoperative management in penetrating abdominal solid organ injuries. Background: Nonoperative management of blunt abdominal solid organ injuries has become the standard of care. However, routine surgical exploration remains the standard practice for all penetrating solid organ injuries. The present study examines the role of nonoperative management in selected patients with penetrating injuries to abdominal solid organs. Patients and Methods: Prospective, protocol-driven study, which included all penetrating abdominal solid organ (liver, spleen, kidney) injuries admitted to a level I trauma center, over a 20-month period. Patients with hemodynamic instability, peritonitis, or an unevaluable abdomen underwent an immediate laparotomy. Patients who were hemodynamically stable and had no signs of peritonitis were selected for further CT scan evaluation. In the absence of CT scan findings suggestive of hollow viscus injury, the patients were observed with serial clinical examinations, hemoglobin levels, and white cell counts. Patients with left thoracoabdominal injuries underwent elective laparoscopy to rule out diaphragmatic injury. Outcome parameters included survival, complications, need for delayed laparotomy in observed patients, and length of hospital stay. Results: During the study period, there were 152 patients with 185 penetrating solid organ injuries. Gunshot wounds accounted for 70.4% and stab wounds for 29.6% of injuries. Ninety-one patients (59.9%) met the criteria for immediate operation. The remaining 61 (40.1%) patients were selected for CT scan evaluation. Forty-three patients (28.3% of all patients) with 47 solid organ injuries who had no CT scan findings suspicious of hollow viscus injury were selected for clinical observation and additional laparoscopy in 2. Four patients with a “blush” on CT scan underwent angiographic embolization of the liver. Overall, 41 patients (27

  11. Correlating learning and memory improvements to long-term potentiation in patients with brain injury

    Institute of Scientific and Technical Information of China (English)

    Xingfu Peng; Qian Yu

    2008-01-01

    BACKGROUND:Brain injury patients often exhibit learning and memory functional deficits.Long-term potentiation(LTP)is a representative index for studying learning and memory cellular models; the LTP index correlates to neural plasticity. OBJECTIVE:This study was designed to investigate correlations of learning and memory functions to LTP in brain injury patients,and to summarize the research advancements in mechanisms underlying brain functional improvements after rehabilitation intervention. RETRIEVAL STRATEGY:Using the terms "brain injuries,rehabilitation,learning and memory,long-term potentiation",manuscripts that were published from 2000-2007 were retrieved from the PubMed database.At the same time,manuscripts published from 2000-2007 were also retrieved from the Database of Chinese Scientific and Technical Periodicals with the same terms in the Chinese language.A total of 64 manuscripts were obtained and primarily screened.Inclusion criteria:studies on learning and memory,as well as LTP in brain injury patients,and studies focused on the effects of rehabilitation intervention on the two indices; studies that were recently published or in high-impact journals.Exclusion criteria:repetitive studies.LITERATURE EVALUATION:The included manuscripts primarily focused on correlations between learning and memory and LTP,the effects of brain injury on learning and memory,as well as LTP,and the effects of rehabilitation intervention on learning and memory after brain injury.The included 39 manuscripts were clinical,basic experimental,or review studies. DATA SYNTHESIS:Learning and memory closely correlates to LTP.The neurobiological basis of learning and memory is central nervous system plasticity,which involves neural networks,neural circuits,and synaptic connections,in particular,synaptic plasticity.LTP is considered to be an ideal model for studying synaptic plasticity,and it is also a classic model for studying neural plasticity of learning and memory.Brain injury

  12. Evaluation gallbladder function in patients with spinal cord injury using 99Tcm-DISIDA hepatobiliary imaging

    International Nuclear Information System (INIS)

    Xia Changsuo; Li Hong; Hong Guangxiang

    2005-01-01

    Objective: To investigate gallbladder function in patients with spinal cord injury (SCI). Methods: Eighteen normal control subjects, 16 other traumatic control subjects and 46 SCI patients were include. Gallbladder function was quantitatively evaluated by 99 Tc m labeled imino-diacetic acid analogue (DISIDA) hepatobiliary imaging using two parameters as filling fraction (FF) and ejection fraction (EF). The gallbladder function of SCI patients was further analyzed according to age, sex, body weight, injury gradient (with ASIA criteria), cord injury level and the duration of injury. Results: 52% of SCI patients had abnormal FF and 59% with abnormal EF. Significantly decreased FF and EF values were found in SCI patients, especially in those who were female, severe and high-level injuries of spinal cord. Conclusion: With the use of quantitative 99 Tc m -DISIDA hepatobiliary imaging, significant impairment of the gallbladder function was found in SCI patients. (authors)

  13. Genetic engineering to develop salt tolerance in potato: a need of the present time scenario(abstract)

    International Nuclear Information System (INIS)

    Ikram ul Haq; Dahot, M.U.

    2005-01-01

    Of environmental stresses, salinity has negative impacts on agricultural yield throughout the world; affected production is 1% as compared to 3%. Soil salinity affects plant growth and development by way of osmotic stress, injurious effects of toxic Na/sup +/ and Cl/sup -/ ions and to some extent Cl/sup -/ and SO/sub 4//sup 2-/ of Mg//sup 2+/. The plant response to salinity consists of numerous processes that must function in coordination to alleviate both cellular hyper osmolarity and ion disequilibrium. However, cell biology and molecular genetics research is providing new insight into the plant response to salinity and is identifying genetic determinants involved in the salt tolerance. Recent confirmation (Arabidopsis thaliana) to salt tolerance determinants is that mediate cellular ion homeostasis. The transport systems facilitate cellular capacity to utilize Na/sup +/ for osmotic adjustment and growth and the role of the Salt-Overly-Sensitive (SOS) signal transduction pathway in the regulation of ion homeostasis and salt tolerance. The SOS signaling pathway regulates Na/sup +/ and K/sup +/ homeostasis, after Ca/sup 2+/ activation. Furthermore, overexpression of AtNHX1 enhances plant salt tolerance, presumably by increasing vacuolar Na/sup +//H/sup +/ compartmentalization that minimizes the toxic I. accumulation of the ion in the cytosol. The activation of SOS1 (Na/sup +/ efflux) and/or AtNHX1 (Na/sup +/ efflux) so by expression of such transporters enhances salt tolerance in plants. (author)

  14. Present of occupational accidents dimensions based on risk-injury affinity groups (case study, from1384 to 1393

    Directory of Open Access Journals (Sweden)

    Peyman Yari

    2017-03-01

    Full Text Available Background and aim: correspondence analysis method as the best method to optimize matrix functions that using the risk-injury matrix methods are analyzed. This method reduces the information contained in the risk-injury table and to determine the correlation between the variables in the matrix. The aim of this study is to present accidents and occupational hazards dimensions is dependent to risk-injury groups, using occupational accidents that can be managed. Method: in this study the reports of occupational accidents registered in the social security organization in a period of ten years from the beginning of 1384 until the end of 1393 ( 222,300 incidents were collected and type of Risk and injury related to any accident identified based on criteria, the International Labour Organization and classified in a risk-injury matrix (18 × 18. Using correspondence analysis of dimensions are identified individually, this dimensions Most indicate the most correlation between risk and injury that facilitate decision-making in the risk assessment companies are covered by Social Security.  Results: Hair criteria recommends dimensions with inertia higher than 0.2 are suitable for the study and interpretation of results, based on this study were obtained from the dimensions of inertia (eigenvalue greater than 0.2 include the dim1 ,dim2 ,dim3 to consider and the correlation between variables is obtained based on singular value (variable distance from the centeroid. (Singular value of dim1: 0.750, singular value of dimension 2: 0.647 and singular value dimension3: 0.521

  15. Drug-refractory aggression, self-injurious behavior, and severe tantrums in autism spectrum disorders: a chart review study.

    Science.gov (United States)

    Adler, Benjamin A; Wink, Logan K; Early, Maureen; Shaffer, Rebecca; Minshawi, Noha; McDougle, Christopher J; Erickson, Craig A

    2015-01-01

    Aggression, self-injurious behavior, and severe tantrums are impairing symptoms frequently experienced by individuals with autism spectrum disorders. Despite US Food and Drug Administration approval of two atypical antipsychotics targeting these symptoms in youth with autistic disorder, they remain frequently drug refractory. We define drug-refractory aggression, self-injurious behavior, and severe tantrums in people with autism spectrum disorders as behavioral symptoms requiring medication adjustment despite previous trials of risperidone and aripiprazole or previous trials of three psychotropic drugs targeting the symptom cluster, one of which was risperidone or aripiprazole. We reviewed the medical records of individuals of all ages referred to our clinic for autism spectrum disorder diagnostic evaluation, as well as pharmacotherapy follow-up notes for all people meeting autism spectrum disorder criteria, for drug-refractory symptoms. Among 250 consecutively referred individuals, 135 met autism spectrum disorder and enrollment criteria, and 53 of these individuals met drug-refractory symptom criteria. Factors associated with drug-refractory symptoms included age 12 years or older (p diagnosis of autistic disorder (p = 0.0139), and presence of intellectual disability (p = 0.0273). This pilot report underscores the significance of drug-refractory aggression, self-injurious behavior, and severe tantrums; suggests the need for future study clarifying factors related to symptom development; and identifies the need for focused treatment study of this impairing symptom domain. © The Author(s) 2014.

  16. Status report - The Canadian Hospitals Injury Reporting and Prevention Program: a dynamic and innovative injury surveillance system

    Directory of Open Access Journals (Sweden)

    J. Crain

    2016-06-01

    Full Text Available This status report on the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP, an emergency department-based injury and poisoning surveillance system, describes the result of migrating from a centralized data entry and coding process to a decentralized process, the web-based eCHIRPP system, in 2011. This secure system is improving the CHIRPP’s overall flexibility and timeliness, which are key attributes of an effective surveillance system. The integrated eCHIRPP platform enables near real-time data entry and access, has user-friendly data management and analysis tools, and allows for easier communication and connectivity across the CHIRPP network through an online collaboration centre. Current pilot testing of automated data monitoring and trend analysis tools—designed to monitor and flag incoming data according to predefined criteria (for example, a new consumer product—is revealing eCHIRPP’s potential for providing early warnings of new hazards, issues and trends.

  17. Assessing the Efficiency of Phenotyping Early Traits in a Greenhouse Automated Platform for Predicting Drought Tolerance of Soybean in the Field.

    Science.gov (United States)

    Peirone, Laura S; Pereyra Irujo, Gustavo A; Bolton, Alejandro; Erreguerena, Ignacio; Aguirrezábal, Luis A N

    2018-01-01

    Conventional field phenotyping for drought tolerance, the most important factor limiting yield at a global scale, is labor-intensive and time-consuming. Automated greenhouse platforms can increase the precision and throughput of plant phenotyping and contribute to a faster release of drought tolerant varieties. The aim of this work was to establish a framework of analysis to identify early traits which could be efficiently measured in a greenhouse automated phenotyping platform, for predicting the drought tolerance of field grown soybean genotypes. A group of genotypes was evaluated, which showed variation in their drought susceptibility index (DSI) for final biomass and leaf area. A large number of traits were measured before and after the onset of a water deficit treatment, which were analyzed under several criteria: the significance of the regression with the DSI, phenotyping cost, earliness, and repeatability. The most efficient trait was found to be transpiration efficiency measured at 13 days after emergence. This trait was further tested in a second experiment with different water deficit intensities, and validated using a different set of genotypes against field data from a trial network in a third experiment. The framework applied in this work for assessing traits under different criteria could be helpful for selecting those most efficient for automated phenotyping.

  18. Assessing the Efficiency of Phenotyping Early Traits in a Greenhouse Automated Platform for Predicting Drought Tolerance of Soybean in the Field

    Directory of Open Access Journals (Sweden)

    Laura S. Peirone

    2018-05-01

    Full Text Available Conventional field phenotyping for drought tolerance, the most important factor limiting yield at a global scale, is labor-intensive and time-consuming. Automated greenhouse platforms can increase the precision and throughput of plant phenotyping and contribute to a faster release of drought tolerant varieties. The aim of this work was to establish a framework of analysis to identify early traits which could be efficiently measured in a greenhouse automated phenotyping platform, for predicting the drought tolerance of field grown soybean genotypes. A group of genotypes was evaluated, which showed variation in their drought susceptibility index (DSI for final biomass and leaf area. A large number of traits were measured before and after the onset of a water deficit treatment, which were analyzed under several criteria: the significance of the regression with the DSI, phenotyping cost, earliness, and repeatability. The most efficient trait was found to be transpiration efficiency measured at 13 days after emergence. This trait was further tested in a second experiment with different water deficit intensities, and validated using a different set of genotypes against field data from a trial network in a third experiment. The framework applied in this work for assessing traits under different criteria could be helpful for selecting those most efficient for automated phenotyping.

  19. NKT cells are important mediators of hepatic ischemia-reperfusion injury.

    Science.gov (United States)

    Richards, James A; Wigmore, Stephen J; Anderton, Stephen M; Howie, Sarah E M

    2017-12-01

    IRI results from the interruption then reinstatement of an organ's blood supply, and this poses a significant problem in liver transplantation and resectional surgery. In this paper, we explore the role T cells play in the pathogenesis of this injury. We used an in vivo murine model of warm partial hepatic IRI, genetically-modified mice, in vivo antibody depletion, adoptive cell transfer and flow cytometry to determine which lymphocyte subsets contribute to pathology. Injury was assessed by measuring serum alanine aminotransfersase (ALT) and by histological examination of liver tissue sections. The absence of T cells (CD3εKO) is associated with significant protection from injury (p=0.010). Through a strategy of antibody depletion it appears that NKT cells (p=0.0025), rather than conventional T (CD4+ or CD8+) (p=0.11) cells that are the key mediators of injury. Our results indicate that tissue-resident NKT cells, but not other lymphocyte populations are responsible for the injury in hepatic IRI. Targeting the activation of NKT cells and/or their effector apparatus would be a novel approach in protecting the liver during transplantation and resection surgery; this may allow us to expand our current criteria for surgery. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Normal tissue tolerance to external beam radiation therapy: Esophagus; Dose de tolerance a l'irradiation des tissus sains: l'oesophage

    Energy Technology Data Exchange (ETDEWEB)

    Bera, G.; Pointreau, Y. [Clinique d' oncologie-radiotherapie, centre Henry-S.-Kaplan, hopital Bretonneau, CHU de Tours, 37 - Tours (France); Denis, F.; Dupuis, O. [Centre Jean-Bernard, clinique Victor-Hugo, 72 - Le-Mans (France); Orain, I. [Service d' anatomie et cytologie pathologiques, hopital Trousseau, CHU de Tours, 37 - Tours (France); Crehange, G. [Departement de radiotherapie, centre Georges-Francois-Leclerc, 21 - Dijon (France)

    2010-07-15

    The esophagus is a musculo-membranous tube through which food passes from the pharynx to the stomach. Due to its anatomical location, it can be exposed to ionizing radiation in many external radiotherapy indications. Radiation-induced esophageal mucositis is clinically revealed by dysphagia and odynophagia, and usually begins 3 to 4 weeks after the start of radiation treatment. With the rise of multimodality treatments (e.g., concurrent chemoradiotherapy, dose escalation and accelerated fractionation schemes), esophageal toxicity has become a significant dose-limiting issue. Understanding the predictive factors of esophageal injury may improve the optimal delivery of treatment plans. It may help to minimize the risks, hence increasing the therapeutic ratio. Based on a large literature review, our study describes both early and late radiation-induced esophageal injuries and highlights some of the predictive factors for cervical and thoracic esophagus toxicity. These clinical and dosimetric parameters are numerous but none is consensual. The large number of dosimetric parameters strengthens the need of an overall analysis of the dose/volume histograms. The data provided is insufficient to recommend their routine use to prevent radiation-induced esophagitis. Defining guidelines for the tolerance of the esophagus to ionizing radiation remains essential for a safe and efficient treatment. (authors)

  1. Fault Tolerant Feedback Control

    DEFF Research Database (Denmark)

    Stoustrup, Jakob; Niemann, H.

    2001-01-01

    An architecture for fault tolerant feedback controllers based on the Youla parameterization is suggested. It is shown that the Youla parameterization will give a residual vector directly in connection with the fault diagnosis part of the fault tolerant feedback controller. It turns out...... that there is a separation be-tween the feedback controller and the fault tolerant part. The closed loop feedback properties are handled by the nominal feedback controller and the fault tolerant part is handled by the design of the Youla parameter. The design of the fault tolerant part will not affect the design...... of the nominal feedback con-troller....

  2. MO-D-BRC-04: Multiple-Criteria Optimization Planning

    International Nuclear Information System (INIS)

    Donaghue, J.

    2016-01-01

    Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical

  3. MO-D-BRC-04: Multiple-Criteria Optimization Planning

    Energy Technology Data Exchange (ETDEWEB)

    Donaghue, J. [Akron General Medical Center (United States)

    2016-06-15

    Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented. The objectives of this session are: Understand differences among these three advanced planning tools Provide clinical assessments on the utility of the advanced planning tools Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs. Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical.

  4. Chest Injuries Associated with Head Injury

    African Journals Online (AJOL)

    Traumatic brain injury (TBI) is a common cause of mortality and severe morbidity. Although there have been significant advances in management, associated severe injuries, in particular chest injuries, remain a major challenge. Extracranial injuries, especially chest injuries increase mortality in patients with TBI in both short.

  5. Self-Injurious Behavior and Functional Analysis: Where Are the Descriptions of Participant Protections?

    Science.gov (United States)

    Weeden, Marc; Mahoney, Amanda; Poling, Alan

    2010-01-01

    This study examined the reporting of participant protections in studies involving functional analysis and self-injurious behavior and published from 1994 through 2008. Results indicated that session termination criteria were rarely reported and other specific participant safeguards were seldom described. The absence of such information in no way…

  6. Protocol for the verification of minimum criteria

    International Nuclear Information System (INIS)

    Gaggiano, M.; Spiccia, P.; Gaetano Arnetta, P.

    2014-01-01

    This Protocol has been prepared with reference to the provisions of article 8 of the Legislative Decree of May 26, 2000 No. 187. Quality controls of radiological equipment fit within the larger 'quality assurance Program' and are intended to ensure the correct operation of the same and the maintenance of that State. The pursuit of this objective guarantees that the radiological equipment subjected to those controls also meets the minimum criteria of acceptability set out in annex V of the aforementioned legislative decree establishing the conditions necessary to allow the functions to which each radiological equipment was designed, built and for which it is used. The Protocol is established for the purpose of quality control of radiological equipment of Cone Beam Computer Tomography type and reference document, in the sense that compliance with stated tolerances also ensures the subsistence minimum acceptability requirements, where applicable.

  7. Effects of storage temperature on the physiological characteristics and vegetative propagation of desiccation-tolerant mosses

    Science.gov (United States)

    Guo, Yuewei; Zhao, Yunge

    2018-02-01

    vegetative propagation of desiccation-tolerant mosses. A 40-day storage period caused cell injury. Our results suggest that storage temperature can enhance or suppress such injury and change the regenerative capacity of the three mosses. The data indicate that the suitable storage temperature is 4 °C for B. unguiculata and 17 °C for both D. vinealis and D. tectorum.

  8. Toleration out of respect?

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2013-01-01

    Under conditions of pluralism different cultures, interests or values can come into conflict, which raises the problem of how to secure peaceful co-existence. The idea of toleration historically emerged as an answer to this problem. Recently Rainer Forst has argued that toleration should not just...... be based on a modus vivendi designed to secure peaceful co-existence, but should be based on moral reasons. Forst therefore advances what he calls the ‘respect conception’ of toleration as an in itself morally desirable type of relationship, which is furthermore the only conception of toleration...... that avoids various so-called ‘paradoxes of toleration’. The paper first examines whether Forst’s respect conception can be applied descriptively to distinguish between actual patterns of behaviour and classify different acts of toleration. Then the focus is shifted to toleration out of respect as a normative...

  9. Simultaneous Improvement and Genetic Dissection of Salt Tolerance of Rice (Oryza sativa L. by Designed QTL Pyramiding

    Directory of Open Access Journals (Sweden)

    Yunlong Pang

    2017-07-01

    Full Text Available Breeding of multi-stress tolerant rice varieties with higher grain yields is the best option to enhance the rice productivity of abiotic stresses prone areas. It also poses the greatest challenge to plant breeders to breed rice varieties for such stress prone conditions. Here, we carried out a designed QTL pyramiding experiment to develop high yielding “Green Super Rice” varieties with significantly improved tolerance to salt stress and grain yield. Using the F4 population derived from a cross between two selected introgression lines, we were able to develop six mostly homozygous promising high yielding lines with significantly improved salt tolerance and grain yield under optimal and/or saline conditions in 3 years. Simultaneous mapping using the same breeding population and tunable genotyping-by-sequencing technology, we identified three QTL affecting salt injury score and leaf chlorophyll content. By analyzing 32M SNP data of the grandparents and graphical genotypes of the parents, we discovered 87 positional candidate genes for salt tolerant QTL. According to their functional annotation, we inferred the most likely candidate genes. We demonstrated that designed QTL pyramiding is a powerful strategy for simultaneous improvement and genetic dissection of complex traits in rice.

  10. The political limit of tolerance O limite político da tolerância

    Directory of Open Access Journals (Sweden)

    Joseph Yvon Thériault

    2008-06-01

    Full Text Available In the contemporary discussions about democracy modifications, tolerance has been frequently evoked in order to express the way by which the democracies respond to the new demands of plurality recognition. While drawing the general lines of the connection between tolerance and democracy, the present article intends to deepen the comprehension of tolerance’s places and limits inside the democracy. After that, the text should evaluate the reach of the contemporary use of tolerance. Keywords: Democracy. Tolerance. Political theory. National Identity. Nas discussões contemporâneas sobre as transformações da democracia, a tolerância é com freqüência evocada para expressar o modo pelo qual as democracias respondem às novas exigências de reconhecimento da pluralidade. Ao esboçar as linhas gerais da relação entre tolerância e democracia, o presente artigo pretende aprofundar a compreensão do lugar e dos limites da tolerância na democracia. Em um segundo momento, tratará de avaliar o alcance do uso contemporâneo da tolerância. Palavras-chave: Democracia. Tolerância. Teoria Política. Identidade Nacional.

  11. FAA/NASA International Symposium on Advanced Structural Integrity Methods for Airframe Durability and Damage Tolerance

    Energy Technology Data Exchange (ETDEWEB)

    Harris, C.E.

    1994-09-01

    International technical experts in durability and damage tolerance of metallic airframe structures were assembled to present and discuss recent research findings and the development of advanced design and analysis methods, structural concepts, and advanced materials. The symposium focused on the dissemination of new knowledge and the peer-review of progress on the development of advanced methodologies. Papers were presented on: structural concepts for enhanced durability, damage tolerance, and maintainability; new metallic alloys and processing technology; fatigue crack initiation and small crack effects; fatigue crack growth models; fracture mechanics failure, criteria for ductile materials; structural mechanics methodology for residual strength and life prediction; development of flight load spectra for design and testing; and advanced approaches to resist corrosion and environmentally assisted fatigue. Separate abstracts have been indexed for articles from this report.

  12. Tolerance in Drosophila

    OpenAIRE

    Atkinson, Nigel S.

    2009-01-01

    The set of genes that underlie ethanol tolerance (inducible resistance) are likely to overlap with the set of genes responsible for ethanol addiction. Whereas addiction is difficult to recognize in simple model systems, behavioral tolerance is readily identifiable and can be induced in large populations of animals. Thus, tolerance lends itself to analysis in model systems with powerful genetics. Drosophila melanogaster has been used by a variety of laboratories for the identification of genes...

  13. The epidemiology of sports-related injuries in older adults: a central European epidemiologic study.

    Science.gov (United States)

    Kammerlander, Christian; Braito, Matthias; Kates, Stephen; Jeske, Christian; Roth, Tobias; Blauth, Michael; Dallapozza, Christian

    2012-10-01

    The population is rapidly aging and remaining more active over the age of 65. An increasing number of sports related injuries in individuals 65 and older are thus anticipated. The aim of this study is to analyze the epidemiology of sports injuries in the age group aged 65 and older. Data from the medical records of adults aged 65 years and older who were treated for sports-related injuries at a level one trauma center between December 1994 and February 2008 was collected and statistically analyzed. A total of 2635 patients met our inclusion criteria. There were 1647 men (62.5%) and 988 women (37.5%) with a mean age of 70.9 years. The yearly number of injuries doubled during the study period (1996-2007). The most common mechanism of injury was a simple fall from standing height (69%). Nearly 75% of all injuries occurred during alpine skiing, cycling or mountain climbing. The median Injury Severity Score was 4. Minor injuries and wounds (40%) were recorded most commonly followed by fractures (27%), sprains, ligament injuries (19%) and injuries of muscles and tendons (6%). The most frequent diagnoses were minor injuries to the head and ligament injuries around the knee joint. Injuries to the upper extremities occurred in 33.7%, injuries to the lower extremities in 29.4% and injuries to the head occurred in 20% of the patients. Women sustained substantially more fractures than men. Adults aged 65 and older are remaining active in sports, which results in higher numbers of sports related injuries in this age group. Identification of type, mechanism and distribution of the injuries can help with the recognition of risk factors for injury. This may enable us to develop appropriate preventative measures to reduce the incidence, and morbidity of such injuries.

  14. Serious shoulder injuries in professional soccer: return to participation after surgery.

    Science.gov (United States)

    Hart, David; Funk, Lennard

    2015-07-01

    An evidence base for the management and prevention of shoulder injuries in soccer is lacking. The aim of this study was to demonstrate the type, mechanism and recovery time after surgery associated with serious shoulder injuries sustained in professional soccer to build an evidence base foundation. Fifty-two professional soccer players underwent shoulder surgery for injuries sustained during match play. Of these, 25 fulfilled the inclusion criteria. Data were collected for injury mechanism and type; clinical, radiological and surgical findings and procedures; and return to full participation. Subjects were all managed by the same surgeon. Labral injuries represented the most common injury type affecting 21 (84 %) subjects; two rotator cuff (8 %) and two combined labral/rotator cuff (8 %) injuries were less common. Fourteen (56 %) subjects sustained a high-energy trauma injury in a combined abduction and external rotation position. Six (24 %) subjects sustained a low-energy trauma mechanism in variable positions, while five (20 %) had a gradual onset of symptoms. Twenty-two (88 %) subjects reported a dislocation as a feature of their presentation. All of the subjects with high- and low-energy trauma mechanisms reported a dislocation occurring at the time of injury. Eight (32 %) subjects had sustained a previous significant shoulder injury to the ipsilateral side. Goalkeepers did not sustain low-energy trauma injuries. Outfield players returned to full participation in a mean time of 11.6 weeks, while goalkeepers did so in 11.1 weeks post-surgery. Return to participation time ranged from 7 to 24 weeks with a median of 11 weeks. Professional soccer players can expect a return to participation within 12 weeks post-surgery. The majority of serious shoulder injuries in soccer occur at a positional extreme of external rotation and abduction in high-energy situations, while a significant number occur in low-energy situations away from this position. Most serious shoulder

  15. Normal tissue tolerance to external beam radiation therapy: Esophagus

    International Nuclear Information System (INIS)

    Bera, G.; Pointreau, Y.; Denis, F.; Dupuis, O.; Orain, I.; Crehange, G.

    2010-01-01

    The esophagus is a musculo-membranous tube through which food passes from the pharynx to the stomach. Due to its anatomical location, it can be exposed to ionizing radiation in many external radiotherapy indications. Radiation-induced esophageal mucositis is clinically revealed by dysphagia and odynophagia, and usually begins 3 to 4 weeks after the start of radiation treatment. With the rise of multimodality treatments (e.g., concurrent chemoradiotherapy, dose escalation and accelerated fractionation schemes), esophageal toxicity has become a significant dose-limiting issue. Understanding the predictive factors of esophageal injury may improve the optimal delivery of treatment plans. It may help to minimize the risks, hence increasing the therapeutic ratio. Based on a large literature review, our study describes both early and late radiation-induced esophageal injuries and highlights some of the predictive factors for cervical and thoracic esophagus toxicity. These clinical and dosimetric parameters are numerous but none is consensual. The large number of dosimetric parameters strengthens the need of an overall analysis of the dose/volume histograms. The data provided is insufficient to recommend their routine use to prevent radiation-induced esophagitis. Defining guidelines for the tolerance of the esophagus to ionizing radiation remains essential for a safe and efficient treatment. (authors)

  16. Prediction of Glucose Tolerance without an Oral Glucose Tolerance Test

    Directory of Open Access Journals (Sweden)

    Rohit Babbar

    2018-03-01

    Full Text Available IntroductionImpaired glucose tolerance (IGT is diagnosed by a standardized oral glucose tolerance test (OGTT. However, the OGTT is laborious, and when not performed, glucose tolerance cannot be determined from fasting samples retrospectively. We tested if glucose tolerance status is reasonably predictable from a combination of demographic, anthropometric, and laboratory data assessed at one time point in a fasting state.MethodsGiven a set of 22 variables selected upon clinical feasibility such as sex, age, height, weight, waist circumference, blood pressure, fasting glucose, HbA1c, hemoglobin, mean corpuscular volume, serum potassium, fasting levels of insulin, C-peptide, triglyceride, non-esterified fatty acids (NEFA, proinsulin, prolactin, cholesterol, low-density lipoprotein, HDL, uric acid, liver transaminases, and ferritin, we used supervised machine learning to estimate glucose tolerance status in 2,337 participants of the TUEF study who were recruited before 2012. We tested the performance of 10 different machine learning classifiers on data from 929 participants in the test set who were recruited after 2012. In addition, reproducibility of IGT was analyzed in 78 participants who had 2 repeated OGTTs within 1 year.ResultsThe most accurate prediction of IGT was reached with the recursive partitioning method (accuracy = 0.78. For all classifiers, mean accuracy was 0.73 ± 0.04. The most important model variable was fasting glucose in all models. Using mean variable importance across all models, fasting glucose was followed by NEFA, triglycerides, HbA1c, and C-peptide. The accuracy of predicting IGT from a previous OGTT was 0.77.ConclusionMachine learning methods yield moderate accuracy in predicting glucose tolerance from a wide set of clinical and laboratory variables. A substitution of OGTT does not currently seem to be feasible. An important constraint could be the limited reproducibility of glucose tolerance status during a

  17. Inferior Alveolar Nerve Injury after Mandibular Third Molar Extraction: a Literature Review

    Directory of Open Access Journals (Sweden)

    Rafael Sarikov

    2014-12-01

    Full Text Available Objectives: The purpose of this study was to systematically review the comprehensive overview of literature data about injury to the inferior alveolar nerve after lower third molar extraction to discover the prevalence of injury, the risk factors, recovery rates, and alternative methods of treatment. Material and Methods: Literature was selected through a search of PubMed electronic databases. Articles from January 2009 to June 2014 were searched. English language articles with a minimum of 6 months patient follow-up and injury analysis by patient’s reporting, radiographic, and neurosensory testing were selected. Results: In total, 84 literature sources were reviewed, and 14 of the most relevant articles that are suitable to the criteria were selected. Articles were analyzed on men and women. The influence of lower third molar extraction (especially impacted on the inferior alveolar nerve was clearly seen. Conclusions: The incidence of injury to the inferior alveolar nerve after lower third molar extraction was about 0.35 - 8.4%. The injury of the inferior alveolar nerve can be predicted by various radiological signs. There are few risk factors that may increase the risk of injury to the nerve such as patients over the age of 24 years old, with horizontal impactions, and extraction by trainee surgeons. Recovery is preferable and permanent injury is very rare.

  18. The hemodynamic tolerability and feasibility of sustained low efficiency dialysis in the management of critically ill patients with acute kidney injury

    Directory of Open Access Journals (Sweden)

    Nisenbaum Rosane

    2010-11-01

    Full Text Available Abstract Background Minimization of hemodynamic instability during renal replacement therapy (RRT in patients with acute kidney injury (AKI is often challenging. We examined the relative hemodynamic tolerability of sustained low efficiency dialysis (SLED and continuous renal replacement therapy (CRRT in critically ill patients with AKI. We also compared the feasibility of SLED administration with that of CRRT and intermittent hemodialysis (IHD. Methods This cohort study encompassed four critical care units within a single university-affiliated medical centre. 77 consecutive critically ill patients with AKI who were treated with CRRT (n = 30, SLED (n = 13 or IHD (n = 34 and completed at least two RRT sessions were included in the study. Overall, 223 RRT sessions were analyzed. Hemodynamic instability during a given session was defined as the composite of a > 20% reduction in mean arterial pressure or any escalation in pressor requirements. Treatment feasibility was evaluated based on the fraction of the prescribed therapy time that was delivered. An interrupted session was designated if Results Hemodynamic instability occurred during 22 (56.4% SLED and 43 (50.0% CRRT sessions (p = 0.51. In a multivariable analysis that accounted for clustering of multiple sessions within the same patient, the odds ratio for hemodynamic instability with SLED was 1.20 (95% CI 0.58-2.47, as compared to CRRT. Session interruption occurred in 16 (16.3, 30 (34.9 and 11 (28.2 of IHD, CRRT and SLED therapies, respectively. Conclusions In critically ill patients with AKI, the administration of SLED is feasible and provides comparable hemodynamic control to CRRT.

  19. Epidemiology of injuries in elite taekwondo athletes: two Olympic periods cross-sectional retrospective study

    Science.gov (United States)

    Altarriba-Bartes, Albert; Drobnic, Franchek; Til, Lluís; Malliaropoulos, Nikolaos; Montoro, José Bruno; Irurtia, Alfredo

    2014-01-01

    Objective Taekwondo injuries differ according to the characteristics of the athletes and the competition. This analytical cross-sectional retrospective cohort study aimed to describe reported taekwondo injuries and to determine the prevalence, characteristics and possible risk factors for injuries sustained by athletes of the Spanish national team. In addition, we compared each identified risk factor—age, weight category, annual quarter, injury timing and competition difficulty level—with its relation to injury location and type. Settings Injury occurrences in taekwondo athletes of the Spanish national team during two Olympic periods at the High Performance Centre in Barcelona were analysed. Participants 48 taekwondo athletes (22 male, 26 female; age range 15–31 years) were studied; 1678 injury episodes occurred. Inclusion criteria were: (1) having trained with the national taekwondo group for a minimum of one sports season; (2) being a member of the Spanish national team. Results Independently of sex or Olympic period, the anatomical sites with most injury episodes were knee (21.3%), foot (17.0%), ankle (12.2%), thigh (11.4%) and lower leg (8.8%). Contusions (29.3%) and cartilage (17.6%) and joint (15.7%) injuries were the prevalent types of injury. Chronological age, weight category and annual quarter can be considered risk factors for sustaining injuries in male and female elite taekwondists according to their location and type (p≤0.001). Conclusions This study provides epidemiological information that will help to inform future injury surveillance studies and the development of prevention strategies and recommendations to reduce the number of injuries in taekwondo competition. PMID:24531455

  20. Novel Prunus rootstock somaclonal variants with divergent ability to tolerate waterlogging.

    Science.gov (United States)

    Pistelli, Laura; Iacona, Calogero; Miano, Dario; Cirilli, Marco; Colao, Maria Chiara; Mensuali-Sodi, Anna; Muleo, Rosario

    2012-03-01

    Plants require access to free water for nutrient uptake, but excess water surrounding the roots can be injurious or even lethal because it blocks the transfer of free oxygen between the soil and the atmosphere. Genetic improvement efforts in this study were focused on the increased tolerance in roots to waterlogging. Among a pool of clones generated in vitro from leaf explants of rootstock Mr.S.2/5 of Prunus cerasifera L., the S.4 clone was flood tolerant whereas the S.1 clone was sensitive. The S.4 clone formed adventitious roots on exposure to flooding. Moreover, the chlorophyll content and mitochondrial activity in the leaf and root, soluble sugar content, alcohol dehydrogenase activity and ethylene content were different between the clones. The sorbitol transporter gene (SOT1) was up-regulated during hypoxia, the alcohol dehydrogenase genes (ADH1 and ADH3) were up-regulated in the leaves and down-regulated in the roots of the S.4 clone during hypoxia, and the 1-aminocyclopropane-1-oxidase gene (ACO1) was up-regulated in the leaves and roots of the S.4 clone during hypoxia and down-regulated in the wild-type roots. In addition, in the S.4 root, hypoxia induced significant down-regulation of a glycosyltransferase-like gene (GTL), which has a yet-undefined role. Although the relevant variation in the S.4 genome has yet to be determined, genetic alteration clearly conferred a flooding-tolerant phenotype. The isolation of novel somaclonals with the same genomic background but with divergent tolerance to flooding may offer new insights in the elucidation of the genetic machinery of resistance to flooding and aid in the selection of new Prunus rootstocks to be used in various adverse environments.

  1. Current status of fluid biomarkers in mild traumatic brain injury

    Science.gov (United States)

    Kulbe, Jacqueline R.; Geddes, James W.

    2015-01-01

    Mild traumatic brain injury (mTBI) affects millions of people annually and is difficult to diagnose. Mild injury is insensitive to conventional imaging techniques and diagnoses are often made using subjective criteria such as self-reported symptoms. Many people who sustain a mTBI develop persistent post-concussive symptoms. Athletes and military personnel are at great risk for repeat injury which can result in second impact syndrome or chronic traumatic encephalopathy. An objective and quantifiable measure, such as a serum biomarker, is needed to aid in mTBI diagnosis, prognosis, return to play/duty assessments, and would further elucidate mTBI pathophysiology. The majority of TBI biomarker research focuses on severe TBI with few studies specific to mild injury. Most studies use a hypothesis-driven approach, screening biofluids for markers known to be associated with TBI pathophysiology. This approach has yielded limited success in identifying markers that can be used clinically, additional candidate biomarkers are needed. Innovative and unbiased methods such as proteomics, microRNA arrays, urinary screens, autoantibody identification and phage display would complement more traditional approaches to aid in the discovery of novel mTBI biomarkers. PMID:25981889

  2. Significance of radiographic abnormalities in patients with tibial stress injuries: correlation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Kijowski, Richard; Choi, James; Smet, Arthur de; Mukharjee, Rajat

    2007-01-01

    The objective was to correlate radiographic findings with magnetic resonance imaging (MRI) findings in patients with suspected tibial stress injuries in order to determine the significance of radiographic signs of stress injury in these individuals. The study group consisted of 80 patients with suspected tibial stress injuries who underwent a radiographic and MR examination of the tibia. Nineteen patients had bilateral involvement. Thus, a total of 99 tibias were evaluated. All radiographs and MR examinations were retrospectively reviewed, 1 month apart, in consensus by two musculoskeletal radiologists. The radiographs were reviewed without knowledge of the site of the clinical symptoms. Fisher's exact tests were used to determine the association between a positive radiograph and the presence of various MRI signs of a high-grade stress injury. There was a strong association between the presence of periosteal reaction on radiographs at the site of the clinical symptoms and a Fredericson grade 4 stress injury on MRI. The presence of periosteal reaction on radiographs at the site of clinical symptoms is predictive of a high-grade stress injury by MRI criteria. (orig.)

  3. Lactose tolerance tests

    Science.gov (United States)

    Hydrogen breath test for lactose tolerance ... Two common methods include: Lactose tolerance blood test Hydrogen breath test The hydrogen breath test is the preferred method. It measures the amount of hydrogen ...

  4. A critical review of “Internet addiction” criteria with suggestions for the future

    Science.gov (United States)

    VAN ROOIJ, ANTONIUS J.; PRAUSE, NICOLE

    2014-01-01

    Aims: In the last 5 years a deluge of articles on the topic of Internet addiction (IA) has proposed many candidate symptoms as evidence of this proposed disease. We critically reviewed the current approach to the measurement and identification of this new excessive behavior syndrome. Methods: Three popular models of IA were discussed: Griffith’s components model; Young’s Internet Addiction Test (IAT); and the criteria by Tao et al. (2010). We selected these models because they are widely cited and propose specific criteria for IA disorder. Our approach is not meant to provide an exhaustive review, but to discuss and critique the most salient trends in the field. Results: The models of Internet addiction share some criteria, including feeling a loss of control over Internet use; ensuing psychological, social, or professional conflict or problems; and preoccupation when not using the Internet. Other criteria inconsistently mentioned include: mood management, tolerance, withdrawal, and craving/anticipation. The models studied here share the assumption that the Internet can produce a qualitative shift to a diseased state in humans. Conclusions: We critically discussed the above criteria and concluded that the evidence base is currently not strong enough to provide support for an Internet addiction disorder. Future research areas are suggested: (1) Focusing on common impaired dimensions, (2) exploring neuroimaging as a model building tool, and (3) identifying shifts in the rewarding aspects of Internet use. Given the lack of consensus on the subject of Internet addiction, a focus on problem behaviors appears warranted. PMID:25592305

  5. Oral glucose tolerance test significantly impacts the prevalence of abnormal glucose tolerance among Indian women with polycystic ovary syndrome: lessons from a large database of two tertiary care centers on the Indian subcontinent.

    Science.gov (United States)

    Ganie, Mohd Ashraf; Dhingra, Atul; Nisar, Sobia; Sreenivas, Vishnubhatla; Shah, Zaffar Amin; Rashid, Aafia; Masoodi, Shariq; Gupta, Nandita

    2016-01-01

    To estimate the prevalence of abnormal glucose tolerance (AGT) among Indian women with polycystic ovary syndrome (PCOS) and analyze the role of oral glucose tolerance (OGTT) test on its estimation. Cross-sectional clinical study. Tertiary care center. A total of 2,014 women with PCOS diagnosed on the basis of the Rotterdam 2003 criteria were enrolled, and the data of 1,746 subjects were analyzed. In addition to recording clinical, biochemical, and hormone parameters, a 75 g OGTT was administered. Prevalence of AGT and impact of age, body mass index (BMI), family history, and OGTT on its prevalence. The mean age of subjects was 23.8 ± 5.3 years, with a mean BMI of 24.9 ± 4.4 kg/m(2). The overall prevalence of AGT was 36.3% (6.3% diabetes and 30% impaired fasting plasma glucose/impaired glucose tolerance) using American Diabetes Association criteria. The glucose intolerance showed a rising trend with advancing age (30.3%, 35.4%, 51%, and 58.8% in the second, third, fourth, and fifth decades, respectively) and increasing BMI. Family history of diabetes mellitus was present in 54.6% (953/1,746) subjects, and it did not correlate with any of the studied parameters except waist circumference and BMI. Sensitivity was better with 2-hour post-OGTT glucose values as compared with fasting plasma glucose, since using fasting plasma glucose alone would have missed the diagnosis in 107 (6.1%) subjects. We conclude that AGT is high among young Indian women with PCOS and that it is not predicted by family history of type 2 DM. OGTT significantly improves the detection rate of AGT among Indian women with PCOS. Copyright © 2016. Published by Elsevier Inc.

  6. A STUDY ON PATTERN OF INJURIES FOLLOWING RTA

    Directory of Open Access Journals (Sweden)

    Jiju George

    2016-09-01

    Full Text Available BACKGROUND Around three lakh accidents occur in India every year injuring upto 3,40,000 people. Injuries to the pedestrian occur as a result of acceleration process. There can be an abrasion, contusion, laceration or fracture. Injuries can be grouped as  Primary Impact Injuries: This is the first contact of vehicle over the victim’s body. It can be an abrasion or contusion and may bear the design of the part of vehicle which struck the victim. The part of the body involved depends upon the position of the victim or the dimension of the offending vehicle.  Secondary Impact Injuries: Following the primary impact the victim can be scooped up and the vehicle can impact over other parts of his body producing injuries.  Secondary Injuries: These occur when the victim is knocked down following impact. These injuries are as a result of the victim striking the ground or any other intervening object.  Crush Injuries: these are seen when the victim is run over by the vehicle. The severity depends upon the weight of the vehicle. 2 In this study a sincere effort has been put to study the different types of injuries produced in a victim of road traffic accident. This study is intended to help the fellow orthopaedicians to identify quickly and act accordingly and thus prevent the consequences. MATERIALS AND METHODS  The present study was done in the Department of Orthopaedics, Travancore Medical College at Kollam.  The present study was done from March 2015 to march 2016.  A total of 196 cases of RTA were admitted in our hospital during the study period.  Gender distribution, age distribution, type of road user, time of the day when accidents occurred, part of the body injured, types of fracture and injuries sustained that followed was checked.  Detailed clinical history and examination was done and simultaneously noted. INCLUSION CRITERIA Nonfatal injuries was taken up for the study. EXCLUSION CRITERIA Patients who succumbed to

  7. Boron nutrition and chilling tolerance of warm climate crop species.

    Science.gov (United States)

    Huang, Longbin; Ye, Zhengqian; Bell, Richard W; Dell, Bernard

    2005-10-01

    Field observations and glasshouse studies have suggested links between boron (B)-deficiency and leaf damage induced by low temperature in crop plants, but causal relationships between these two stresses at physiological, biochemical and molecular levels have yet to be explored. Limited evidence at the whole-plant level suggests that chilling temperature in the root zone restricts B uptake capacity and/or B distribution/utilization efficiency in the shoot, but the nature of this interaction depends on chilling tolerance of species concerned, the mode of low temperature treatment (abrupt versus gradual temperature decline) and growth conditions (e.g. photon flux density and relative humidity) that may exacerbate chilling stress. This review explores roles of B nutrition in chilling tolerance of continual root or transient shoot chills in crop species adapted to warm season conditions. It reviews current research on combined effects of chilling temperature (ranging from >0 to 20 degrees C) and B deficiency on growth and B nutrition responses in crop species differing in chilling tolerance. For subtropical/tropical species (e.g. cucumber, cassava, sunflower), root chilling at 10-17 degrees C decreases B uptake efficiency and B utilization in the shoot and increases the shoot : root ratio, but chilling-tolerant temperate species (e.g. oilseed rape, wheat) require much lower root chill temperatures (2-5 degrees C) to achieve the same responses. Boron deficiency exacerbates chilling injuries in leaf tissues, particularly under high photon flux density. Suggested mechanisms for B x chilling interactions in plants are: (a) chilling-induced reduction in plasmalemma hydraulic conductivity, membrane fluidity, water channel activity and root pressure, which contribute to the decrease in root hydraulic conductance, water uptake and associated B uptake; (b) chilling-induced stomatal dysfunction affecting B transport from root to shoot and B partitioning in the shoot; and (c) B

  8. Injury Characteristics of Low-Energy Lisfranc Injuries Compared With High-Energy Injuries.

    Science.gov (United States)

    Renninger, Christopher H; Cochran, Grant; Tompane, Trevor; Bellamy, Joseph; Kuhn, Kevin

    2017-09-01

    Lisfranc injuries result from high- and low-energy mechanisms though the literature has been more focused on high-energy mechanisms. A comparison of high-energy (HE) and low-energy (LE) injury patterns is lacking. The objective of this study was to report injury patterns in LE Lisfranc joint injuries and compare them to HE injury patterns. Operative Lisfranc injuries were identified over a 5-year period. Patient demographics, mechanism of injury, injury pattern, associated injuries, missed diagnoses, clinical course, and imaging studies were reviewed and compared. HE mechanism was defined as motor vehicle crash, motorcycle crash, direct crush, and fall from greater than 4 feet and LE mechanism as athletic activity, ground level twisting, or fall from less than 4 feet. Thirty-two HE and 48 LE cases were identified with 19.3 months of average follow-up. There were no differences in demographics or missed diagnosis frequency (21% HE vs 18% LE). Time to seek care was not significantly different. HE injuries were more likely to have concomitant nonfoot fractures (37% vs 6%), concomitant foot fractures (78% vs 4%), cuboid fractures (31% vs 6%), metatarsal base fractures (84% vs 29%), displaced intra-articular fractures (59% vs 4%), and involvement of all 5 rays (23% vs 6%). LE injuries were more commonly ligamentous (68% vs 16%), with fewer rays involved (2.7 vs 4.1). LE mechanisms were a more common cause of Lisfranc joint injury in this cohort. These mechanisms generally resulted in an isolated, primarily ligamentous injury sparing the lateral column. Both types had high rates of missed injury that could result in delayed treatment. Differences in injury patterns could help direct future research to optimize treatment algorithms. Level III, comparative series.

  9. CT should replace three-view radiographs as the initial screening test in patients at high, moderate, and low risk for blunt cervical spine injury: a prospective comparison.

    Science.gov (United States)

    Bailitz, John; Starr, Frederic; Beecroft, Matthew; Bankoff, Jon; Roberts, Roxanne; Bokhari, Faran; Joseph, Kimberly; Wiley, Dorian; Dennis, Andrew; Gilkey, Susan; Erickson, Paul; Raksin, Patricia; Nagy, Kimberly

    2009-06-01

    An estimated 10,000 Americans suffer cervical spine injuries each year. More than 800,000 cervical spine radiographs (CSR) are ordered annually. The human and healthcare costs associated with these injuries are enormous especially when diagnosis is delayed. Controversy exists in the literature concerning the diagnostic accuracy of CSR, with reported sensitivity ranging from 32% to 89%. We sought to compare prospectively the sensitivity of cervical CT (CCT) to CSR in the initial diagnosis of blunt cervical spine injury for patients meeting one or more of the NEXUS criteria. The study prospectively compared the diagnostic accuracy of CSR to CCT in consecutive patients evaluated for blunt trauma during 23 months at an urban, public teaching hospital and Level I Trauma Center. Inclusion criteria were adult patient, evaluated for blunt cervical spine injury, meeting one or more of the NEXUS criteria. All patients received both three-view CSR and CCT as part of a standard diagnostic protocol. Each CSR and CCT study was interpreted independently by a different radiology attending who was blinded to the results of the other study. Clinically significant injuries were defined as those requiring one or more of the following interventions: operative procedure, halo application, and/or rigid cervical collar. Of 1,583 consecutive patients evaluated for blunt cervical spine trauma, 78 (4.9%) patients received only CCT or CSR and were excluded from the study. Of the remaining 1,505 patients, 78 (4.9%) had evidence of a radiographic injury by CSR or CCT. Of these 78 patients with radiographic injury, 50 (3.3%) patients had clinically significant injuries. CCT detected all patients with clinically significant injuries (100% sensitive), whereas CSR detected only 18 (36% sensitive). Of the 50 patients, 15 were at high risk, 19 at moderate risk, and 16 at low risk for cervical spine injury according to previously published risk stratification. CSR detected clinically significant

  10. New results on the beam-loss criteria for heavy-ion accelerators

    International Nuclear Information System (INIS)

    Katrik, Peter; Hoffmann, Dieter H.H.; Mustafin, Edil; Strasik, Ivan; Pavlovic, Marius

    2015-01-01

    Activation of high-energy heavy-ion accelerators due to beam losses is a serious issue for accelerator parts like collimators, magnets, beam-lines, fragment separator targets, etc. The beam losses below 1 W/m are considered as tolerable for 'hands-on' maintenance in proton machines. In our previous studies, the FLUKA2008 code has been used for establishing a scaling law expanding the existing beam-loss tolerance for 1 GeV protons to heavy ions. This scaling law enabled specifying beam-loss criteria for projectile species from proton up to uranium at energies from 200 MeV/u up to 1 GeV/u. FLUKA2008 allowed nucleus-nucleus interactions down to 100 MeV/u only. In this work, we review our previous results and extend activation simulations to lower energies with the help of the new FLUKA version, namely FLUKA2011. It includes models for nucleus-nucleus interactions below 100 MeV/u. We also tried to expand the scaling law to lower energies. This, however, needs further studies, because the heavy-ion-induced nuclide composition starts deviating from the proton-induced nuclide composition at energies below 150 MeV/u. (authors)

  11. Do Susceptibility Weighted Imaging and Multi-Shot Echo Planar Imaging Optimally Demonstrate and Predict Outcome for Spinal Cord Injury

    Science.gov (United States)

    2017-03-27

    to manufacture, use, or sell any patented invention that may relate to them. Qualified requestors may obtain copies of this report from the...Spinal Injury Association (ASIA) impairment scale A, B, C, or D injury. Inclusion criteria were as follows: (a) age ≥ 18 years old, both genders , (b...morphology of cervical spine fracture. In addition, 15 neurologically intact healthy volunteers with comparable age and gender were recruited to

  12. The site of primary T cell activation is a determinant of the balance between intrahepatic tolerance and immunity.

    Science.gov (United States)

    Bowen, David G; Zen, Monica; Holz, Lauren; Davis, Thomas; McCaughan, Geoffrey W; Bertolino, Patrick

    2004-09-01

    Hepatic immunobiology is paradoxical: although the liver possesses unusual tolerogenic properties, it is also the site of effective immune responses against multiple pathogens and subject to immune-mediated pathology. The mechanisms underlying this dichotomy remain unclear. Following previous work demonstrating that the liver may act as a site of primary T cell activation, we demonstrate here that the balance between immunity and tolerance in this organ is established by competition for primary activation of CD8+ T cells between the liver and secondary lymphoid tissues, with the immune outcome determined by the initial site of activation. Using a transgenic mouse model in which antigen is expressed within both liver and lymph nodes, we show that while naive CD8+ T cells activated within the lymph nodes were capable of mediating hepatitis, cells undergoing primary activation within the liver exhibited defective cytotoxic function and shortened half-life and did not mediate hepatocellular injury. The implications of these novel findings may pertain not only to the normal maintenance of peripheral tolerance, but also to hepatic allograft tolerance and the immunopathogenesis of chronic viral hepatitis.

  13. IMRT QA: Selecting gamma criteria based on error detection sensitivity

    Energy Technology Data Exchange (ETDEWEB)

    Steers, Jennifer M. [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California 90048 and Physics and Biology in Medicine IDP, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California 90095 (United States); Fraass, Benedick A., E-mail: benedick.fraass@cshs.org [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California 90048 (United States)

    2016-04-15

    Purpose: The gamma comparison is widely used to evaluate the agreement between measurements and treatment planning system calculations in patient-specific intensity modulated radiation therapy (IMRT) quality assurance (QA). However, recent publications have raised concerns about the lack of sensitivity when employing commonly used gamma criteria. Understanding the actual sensitivity of a wide range of different gamma criteria may allow the definition of more meaningful gamma criteria and tolerance limits in IMRT QA. We present a method that allows the quantitative determination of gamma criteria sensitivity to induced errors which can be applied to any unique combination of device, delivery technique, and software utilized in a specific clinic. Methods: A total of 21 DMLC IMRT QA measurements (ArcCHECK®, Sun Nuclear) were compared to QA plan calculations with induced errors. Three scenarios were studied: MU errors, multi-leaf collimator (MLC) errors, and the sensitivity of the gamma comparison to changes in penumbra width. Gamma comparisons were performed between measurements and error-induced calculations using a wide range of gamma criteria, resulting in a total of over 20 000 gamma comparisons. Gamma passing rates for each error class and case were graphed against error magnitude to create error curves in order to represent the range of missed errors in routine IMRT QA using 36 different gamma criteria. Results: This study demonstrates that systematic errors and case-specific errors can be detected by the error curve analysis. Depending on the location of the error curve peak (e.g., not centered about zero), 3%/3 mm threshold = 10% at 90% pixels passing may miss errors as large as 15% MU errors and ±1 cm random MLC errors for some cases. As the dose threshold parameter was increased for a given %Diff/distance-to-agreement (DTA) setting, error sensitivity was increased by up to a factor of two for select cases. This increased sensitivity with increasing dose

  14. Evaluation of Drought Tolerance in Some Wheat Genotypes Based on Selection Indices

    Directory of Open Access Journals (Sweden)

    M Mohseni

    2016-02-01

    Full Text Available Introduction Wheat is a major crop among cereals and plays a vital role in the national economy of developing countries. Wheat (Triticum aestivum L. is one of the most important crops in terms of acreage and production rates in the world. This crop has an important role in the food supply. According to the FAO (2010 statistics report, the average wheat yield in Iran was 2136 kg ha-1, while the worldwide average yield was 3009 kg ha-1. Iran, with an average annual rainfall of 250 mm, is located in the world desert belt. Yield loss due to drought stress is likely higher than other stresses. Therefore, introducing plants with high production under both drought stress and non-stress conditions is highly regarded. Stress tolerance indices are used for screening drought tolerant varieties. Tolerance (TOL, mean productivity (MP, stress susceptibility index (SSI, geometric mean productivity (GMP, stress tolerance index (STI and modified STI (MSTI have been employed under various conditions. Fischer and Maurer (1978 explained that cultivars with an SSI less than a unit are stress tolerant, since their yield reduction under stress conditions is smaller than the mean yield reduction of all cultivars (Bruckner and Frohberg, 1987. Mean productivity, GMP, harmonic mean (HM and STI were reported as preferred criteria in selection of drought-tolerant barley genotypes by Baheri et al. (2003. Yield Index (YI proposed by Gavuzzi et al. (1997, was significantly correlated with stress yield which ranks cultivars on the basis of their yield under stress. The genotypes with a high Yield Stability Index (YSI are expected to have higher yield under both stress and non-stress conditions (Bouslama and Schapaugh, 1984. Mousavi et al (2008 introduced Stress Susceptibility Percentage Index (SSPI as a powerful index to select extreme tolerant genotypes with yield stability. Fischer and Wood (1979 suggested that relative drought index (RDI is a positive index for indicating

  15. Overexpression of GmDREB1 improves salt tolerance in transgenic wheat and leaf protein response to high salinity

    Directory of Open Access Journals (Sweden)

    Qiyan Jiang

    2014-04-01

    Full Text Available The transcription factor dehydration-responsive element binding protein (DREB is able to improve tolerance to abiotic stress in plants by regulating the expression of downstream genes involved in environmental stress resistance. The objectives of this study were to evaluate the salt tolerance of GmDREB1 transgenic wheat (Triticum aestivum L. and to evaluate its physiological and protein responses to salt stress. Compared with the wild type, the transgenic lines overexpressing GmDREB1 showed longer coleoptiles and radicles and a greater radicle number at the germination stage, as well as greater root length, fresh weight, and tiller number per plant at the seedling stage. The yield-related traits of transgenic lines were also improved compared with the wild type, indicating enhanced salt tolerance in transgenic lines overexpressing GmDREB1. Proteomics analysis revealed that osmotic- and oxidative-stress-related proteins were up-regulated in transgenic wheat leaves under salt stress conditions. Transgenic wheat had higher levels of proline and betaine and lower levels of malondialdehyde and relative electrolyte leakage than the wild type. These results suggest that GmDREB1 regulates the expression of osmotic- and oxidative-stress-related proteins that reduce the occurrence of cell injury caused by high salinity, thus improving the salt tolerance of transgenic wheat.

  16. FAA/NASA International Symposium on Advanced Structural Integrity Methods for Airframe Durability and Damage Tolerance, part 2

    Science.gov (United States)

    Harris, Charles E. (Editor)

    1994-01-01

    The international technical experts in the areas of durability and damage tolerance of metallic airframe structures were assembled to present and discuss recent research findings and the development of advanced design and analysis methods, structural concepts, and advanced materials. The principal focus of the symposium was on the dissemination of new knowledge and the peer-review of progress on the development of advanced methodologies. Papers were presented on the following topics: structural concepts for enhanced durability, damage tolerance, and maintainability; new metallic alloys and processing technology; fatigue crack initiation and small crack effects; fatigue crack growth models; fracture mechanics failure criteria for ductile materials; structural mechanics methodology for residual strength and life prediction; development of flight load spectra for design and testing; and corrosion resistance.

  17. Fault-tolerant computing systems

    International Nuclear Information System (INIS)

    Dal Cin, M.; Hohl, W.

    1991-01-01

    Tests, Diagnosis and Fault Treatment were chosen as the guiding themes of the conference. However, the scope of the conference included reliability, availability, safety and security issues in software and hardware systems as well. The sessions were organized for the conference which was completed by an industrial presentation: Keynote Address, Reconfiguration and Recover, System Level Diagnosis, Voting and Agreement, Testing, Fault-Tolerant Circuits, Array Testing, Modelling, Applied Fault Tolerance, Fault-Tolerant Arrays and Systems, Interconnection Networks, Fault-Tolerant Software. One paper has been indexed separately in the database. (orig./HP)

  18. Intolerant tolerance.

    Science.gov (United States)

    Khushf, G

    1994-04-01

    The Hyde Amendment and Roman Catholic attempts to put restrictions on Title X funding have been criticized for being intolerant. However, such criticism fails to appreciate that there are two competing notions of tolerance, one focusing on the limits of state force and accepting pluralism as unavoidable, and the other focusing on the limits of knowledge and advancing pluralism as a good. These two types of tolerance, illustrated in the writings of John Locke and J.S. Mill, each involve an intolerance. In a pluralistic context where the free exercise of religion is respected, John Locke's account of tolerance is preferable. However, it (in a reconstructed form) leads to a minimal state. Positive entitlements to benefits like artificial contraception or nontherapeutic abortions can legitimately be resisted, because an intolerance has already been shown with respect to those that consider the benefit immoral, since their resources have been coopted by taxation to advance an end that is contrary to their own. There is a sliding scale from tolerance (viewed as forbearance) to the affirmation of communal integrity, and this scale maps on to the continuum from negative to positive rights.

  19. Changes in bacillus thuringiensis tolerance levels due to hybridization of Bt-tolerant and susceptible silkworm populations

    International Nuclear Information System (INIS)

    Begumad, H.A.; Hassana, E.; Dingleb, J.; Alshehic, A.A.

    2012-01-01

    Males and females of a Bt-tolerant mulberry silkworm (Bombyx mori L.) population were crossed with females and males of a Bt-susceptible population, to produce Bt-tolerant silkworm hybrids, and to determine the expression of the Bt-tolerance pattern in the F 1 hybrids. It was observed that when a Bt-tolerant (42% larval mortality) female (BtT ) silkworm was crossed with a Bt-susceptible (85% larval mortality) male (BtS ), the resultant F 1 offspring showed lower levels of Bt-tolerance (87% larval mortality). On the other hand, when a Bt-tolerant male (BtT ) was crossed with a Bt-susceptible female (BtS ), the F 1 hybrid showed higher levels of Bt-tolerance (35% larval mortality) characteristic. The probit statistics showed that both hybrids expressed Bt-tolerance or susceptible levels similar to their male parents. These different patterns of Bt-tolerance in F 1 hybrids might be due to the transferring of a Bt-tolerant gene, from the parents to offspring, through the homozygotic male (ZZ) silkworm. (author)

  20. Suppressor cells in transplantation tolerance. I. Analysis of the suppressor status of neonatally and adoptively tolerized rats

    International Nuclear Information System (INIS)

    Dorsch, S.; Roser, B.

    1982-01-01

    The lymphocytes from neonatally tolerant rats which adoptively transfer tolerance to sublethally irradiated recipients do so by specifically suppressing the regeneration of alloreactivity which normally occurs after irradiation. Although tolerant cells will only partially suppress normal alloreactive cells when the two are mixed in near equivalent numbers, experiments in which the interval between injection of tolerant and normal cells into irradiated recipients was gradually extended, indicated that total suppression of normally alloreactive cells was achieved after 8 weeks of prior residence of tolerant cells in the adoptive host. Further evidence that tolerant cells would only suppress if present in excess of normal cells was obtained by reducing the tolerant cell population in tolerant donor rats by whole body irradiation. These animals then lost their ability to suppress normal alloreactive cells administered to them. The immune status of adoptively tolerized animals did not mimic that of the donors of the tolerant cells. Even where full tolerance, as measured by skin graft survival, failure to synthesize alloantibodies, and capacity to further transfer skin graft tolerance to secondary recipients, was evident the lymphocytes of these animals showed considerable graft-versus-host (GVH) reactivity. The persistence of tolerance through repeated adoptive transfers was correlated with the persistence of donor (chimeric) cells and the indicator skin graft on adoptive recipients only amplified tolerance expression where the inocula of tolerant cells given was weakly suppressive. Finally, removal of the minor population of chimeric cells from tolerant inocula using cytotoxic alloantisera abolished the capacity to transfer tolerance. These results imply an active role for chimeric cells which is best understood as an immune response involving proliferation driven by the idiotypes of the alloreceptors on host cells

  1. Risks and injuries in laser and high-frequency applications

    Science.gov (United States)

    Giering, K.; Philipp, Carsten M.; Berlien, Hans-Peter

    1995-01-01

    An analysis of injuries and risks using high frequency (HF) and lasers in medicine based on a literature search with MEDLINE was performed. The cases reported in the literature were classified according to the following criteria: (1) Avoidable in an optimal operational procedure. These kind of injuries are caused by a chain of unfortunate incidents. They are in principle avoidable by the 'right action at the right time' which presupposes an appropriate training of the operating team, selection of the optimal parameters for procedure and consideration of all safety instructions. (2) Avoidable, caused by malfunction of the equipment and/or accessories. The injuries classified into this group are avoidable if all safety regulations were fulfilled. This includes a pre-operational check-up and the use of medical lasers and high frequency devices only which meet the international safety standards. (3) Avoidable, caused by misuse/mistake. Injuries of this group were caused by an inappropriate selection of the procedure, wrong medical indication or mistakes during application. (4) Unavoidable, fateful. These injuries can be caused by risks inherent to the type of energy used, malfunction of the equipment and/or accessories though a pre-operational check-up was done. Some risks and complications are common to high frequency and laser application. But whereas these risks can be excluded easily in laser surgery there is often a great expenditure necessary or they are not avoidable if high frequency if used. No unavoidable risks due to laser energy occur.

  2. Suppressor cells in transplantation tolerance: I. analysis of the suppressor status of neonatally and adoptively tolerized rats

    International Nuclear Information System (INIS)

    Dorsch, S.; Roser, B.

    1982-01-01

    The lymphocytes from neonatally tolerant rats which adoptively transfer tolerance to sublethally irradiated recipients do so by specificallly suppressing the regeneration of alloreactivity which normally occurs after irradiation. Although tolerant cells will only partially suppress normal alloreactive cells when the two are mixed in near equivalent numbers, experiments in which the interval between injection of tolerant and normal cells into irradiated recipients was gradually extended, indicated that total suppression of normally alloreactive cells was achieved after 8 weeks of prior residence of tolerant cells in the adoptive host. Further evidence that tolerant cells would only suppress if present in excess of normal cells was obtained by reducing the tolerant cell populaton in tolerant donor rats by whole body irradiation. The persistence of tolerance through repeated adoptive transfers was correlated with the persistence of donor (chimeric) cells and the indicator skin graft on adoptive recipients only amplified tolerance expression where the inocula of tolerant cells given was weakly suppressive

  3. In vitro selection of induced mutants to salt-tolerance: Inducible gene regulation for salt tolerance

    Energy Technology Data Exchange (ETDEWEB)

    Winicov, I [Department of Microbiology and Biochemistry, Univ. of Nevada-Reno, Reno, NV (United States)

    1997-07-01

    A selection protocol to obtain salt tolerant calli, followed by regeneration and progeny-test of the regenerated plants for salt tolerance in rice was investigated. Callus cultures were initiated from salt-sensitive US elite rice lines and cv. `Pokkali`. Salt-tolerant cell lines were selected from these by a single step selection procedure. The selected salt-tolerant lines grew well on medium with {+-} 0.5% or 1% NaCl, while the parent lines occasionally survived, but did not grow at these salt concentrations. Plants were regenerated from these cell lines through different passages on medium containing salt. Seed was collected from the regenerated plants and salt tolerance of R2 seedlings was compared with those regenerated without salt selection. Salt-tolerance was measured by survival and productive growth of newly germinated seedlings in Hoagland solution with 0.3% and 0.5% NaCl for 4 weeks. Heritable improvement in salt tolerance was obtained in R2 seedlings from one plant regenerated after 5 months selection. Survival and growth of these seedlings was equivalent to that from `Pokkali` seedlings. These results show that cellular tolerance can provide salt-tolerance in rice plants. (author). 6 refs, 2 tabs.

  4. In vitro selection of induced mutants to salt-tolerance: Inducible gene regulation for salt tolerance

    International Nuclear Information System (INIS)

    Winicov, I.

    1997-01-01

    A selection protocol to obtain salt tolerant calli, followed by regeneration and progeny-test of the regenerated plants for salt tolerance in rice was investigated. Callus cultures were initiated from salt-sensitive US elite rice lines and cv. 'Pokkali'. Salt-tolerant cell lines were selected from these by a single step selection procedure. The selected salt-tolerant lines grew well on medium with ± 0.5% or 1% NaCl, while the parent lines occasionally survived, but did not grow at these salt concentrations. Plants were regenerated from these cell lines through different passages on medium containing salt. Seed was collected from the regenerated plants and salt tolerance of R2 seedlings was compared with those regenerated without salt selection. Salt-tolerance was measured by survival and productive growth of newly germinated seedlings in Hoagland solution with 0.3% and 0.5% NaCl for 4 weeks. Heritable improvement in salt tolerance was obtained in R2 seedlings from one plant regenerated after 5 months selection. Survival and growth of these seedlings was equivalent to that from 'Pokkali' seedlings. These results show that cellular tolerance can provide salt-tolerance in rice plants. (author). 6 refs, 2 tabs

  5. Chest and spine radiography abnormality in blunt chest trauma correlated with major vessel injury in an unselected patient population

    International Nuclear Information System (INIS)

    Fernandez, G.; Kadir, S.; Encarnacion, C.

    1989-01-01

    To assess the true incidence of major vessel injury, the authors retrospectively reviewed all arch aortograms obtained for blunt chest trauma (BCT) during a 24-month period beginning December 1986. Aortograms were correlated with preangiographic chest radiographic and operative findings. The goals of this review were to examine the usefulness of commonly employed screening criteria for aortography and determine whether thoracic spine fractures imply a decreased likelihood of aortic injury. One hundred twenty aortograms were obtained during this period. The incidence of aortic laceration was 6.7%, and 7.5% had brachiocerebral vascular injury. Only 51% of chest radiographs were suggestive of vascular injury. Two patients with subtle radiographic findings had aortic laceration. One patient with a burst fracture of T-4 had aortic laceration. The results of this review indicate the incidence of great vessel injury is as high as that of injury to the aorta itself and that the presence of spine fractures does not exclude vascular injury

  6. Om tolerance

    DEFF Research Database (Denmark)

    Huggler, Jørgen

    2007-01-01

    Begrebet tolerance og dets betydninger diskuteres med henblik på en tydeliggørelse af begrebets forbindelse med stat, religion, ytringsfrihed, skeptisk erkendelsesteori, antropologi og pædagogik.......Begrebet tolerance og dets betydninger diskuteres med henblik på en tydeliggørelse af begrebets forbindelse med stat, religion, ytringsfrihed, skeptisk erkendelsesteori, antropologi og pædagogik....

  7. Limb Symmetry Indexes Can Overestimate Knee Function After Anterior Cruciate Ligament Injury.

    Science.gov (United States)

    Wellsandt, Elizabeth; Failla, Mathew J; Snyder-Mackler, Lynn

    2017-05-01

    Study Design Prospective cohort. Background The high risk of second anterior cruciate ligament (ACL) injuries after return to sport highlights the importance of return-to-sport decision making. Objective return-to-sport criteria frequently use limb symmetry indexes (LSIs) to quantify quadriceps strength and hop scores. Whether using the uninvolved limb in LSIs is optimal is unknown. Objectives To evaluate the uninvolved limb as a reference standard for LSIs utilized in return-to-sport testing and its relationship with second ACL injury rates. Methods Seventy athletes completed quadriceps strength and 4 single-leg hop tests before anterior cruciate ligament reconstruction (ACLR) and 6 months after ACLR. Limb symmetry indexes for each test compared involved-limb measures at 6 months to uninvolved-limb measures at 6 months. Estimated preinjury capacity (EPIC) levels for each test compared involved-limb measures at 6 months to uninvolved-limb measures before ACLR. Second ACL injuries were tracked for a minimum follow-up of 2 years after ACLR. Results Forty (57.1%) patients achieved 90% LSIs for quadriceps strength and all hop tests. Only 20 (28.6%) patients met 90% EPIC levels (comparing the involved limb at 6 months after ACLR to the uninvolved limb before ACLR) for quadriceps strength and all hop tests. Twenty-four (34.3%) patients who achieved 90% LSIs for all measures 6 months after ACLR did not achieve 90% EPIC levels for all measures. Estimated preinjury capacity levels were more sensitive than LSIs in predicting second ACL injuries (LSIs, 0.273; 95% confidence interval [CI]: 0.010, 0.566 and EPIC, 0.818; 95% CI: 0.523, 0.949). Conclusion Limb symmetry indexes frequently overestimate knee function after ACLR and may be related to second ACL injury risk. These findings raise concern about whether the variable ACL return-to-sport criteria utilized in current clinical practice are stringent enough to achieve safe and successful return to sport. Level of Evidence

  8. The peer effect on pain tolerance.

    Science.gov (United States)

    Engebretsen, Solveig; Frigessi, Arnoldo; Engø-Monsen, Kenth; Furberg, Anne-Sofie; Stubhaug, Audun; de Blasio, Birgitte Freiesleben; Nielsen, Christopher Sivert

    2018-05-19

    Twin studies have found that approximately half of the variance in pain tolerance can be explained by genetic factors, while shared family environment has a negligible effect. Hence, a large proportion of the variance in pain tolerance is explained by the (non-shared) unique environment. The social environment beyond the family is a potential candidate for explaining some of the variance in pain tolerance. Numerous individual traits have previously shown to be associated with friendship ties. In this study, we investigate whether pain tolerance is associated with friendship ties. We study the friendship effect on pain tolerance by considering data from the Tromsø Study: Fit Futures I, which contains pain tolerance measurements and social network information for adolescents attending first year of upper secondary school in the Tromsø area in Northern Norway. Pain tolerance was measured with the cold-pressor test (primary outcome), contact heat and pressure algometry. We analyse the data by using statistical methods from social network analysis. Specifically, we compute pairwise correlations in pain tolerance among friends. We also fit network autocorrelation models to the data, where the pain tolerance of an individual is explained by (among other factors) the average pain tolerance of the individual's friends. We find a significant and positive relationship between the pain tolerance of an individual and the pain tolerance of their friends. The estimated effect is that for every 1 s increase in friends' average cold-pressor tolerance time, the expected cold-pressor pain tolerance of the individual increases by 0.21 s (p-value: 0.0049, sample size n=997). This estimated effect is controlled for sex. The friendship effect remains significant when controlling for potential confounders such as lifestyle factors and test sequence among the students. Further investigating the role of sex on this friendship effect, we only find a significant peer effect of male friends

  9. Fault-tolerant architecture: Evaluation methodology

    International Nuclear Information System (INIS)

    Battle, R.E.; Kisner, R.A.

    1992-08-01

    The design and reliability of four fault-tolerant architectures that may be used in nuclear power plant control systems were evaluated. Two architectures are variations of triple-modular-redundant (TMR) systems, and two are variations of dual redundant systems. The evaluation includes a review of methods of implementing fault-tolerant control, the importance of automatic recovery from failures, methods of self-testing diagnostics, block diagrams of typical fault-tolerant controllers, review of fault-tolerant controllers operating in nuclear power plants, and fault tree reliability analyses of fault-tolerant systems

  10. Abdominal pain in long-term spinal cord injury

    DEFF Research Database (Denmark)

    Finnerup, Nanna Brix; Faaborg, Pia Møller; Krogh, Klaus

    2008-01-01

    Objectives:To describe the prevalence and character of chronic abdominal pain in a group of patients with long-term spinal cord injury (SCI) and to assess predictors of abdominal pain.Study design:Postal survey.Setting:Members of the Danish Paraplegic Association.Methods:We mailed a questionnaire...... to 284 members of the Danish Paraplegic Association who met the inclusion criteria (member for at least 10 years). The questionnaire contained questions about cause and level of spinal injury, colorectal function and pain/discomfort.Results:Seventy percent returned the questionnaire (133 men and 70 women....../discomfort. There was no relation of abdominal pain to other types of pain.Conclusion:Chronic pain located in the abdomen is frequent in patients with long-term SCI. The delayed onset following SCI and the relation to constipation suggest that constipation plays an important role for this type of pain in the spinal cord injured....

  11. Abdominal pain in long-term spinal cord injury

    DEFF Research Database (Denmark)

    Finnerup, Nanna Brix; Faaborg, Pia Møller; Krogh, Klaus

    2008-01-01

    Objectives:To describe the prevalence and character of chronic abdominal pain in a group of patients with long-term spinal cord injury (SCI) and to assess predictors of abdominal pain.Study design:Postal survey.Setting:Members of the Danish Paraplegic Association.Methods:We mailed a questionnaire....../discomfort. There was no relation of abdominal pain to other types of pain.Conclusion:Chronic pain located in the abdomen is frequent in patients with long-term SCI. The delayed onset following SCI and the relation to constipation suggest that constipation plays an important role for this type of pain in the spinal cord injured....... to 284 members of the Danish Paraplegic Association who met the inclusion criteria (member for at least 10 years). The questionnaire contained questions about cause and level of spinal injury, colorectal function and pain/discomfort.Results:Seventy percent returned the questionnaire (133 men and 70 women...

  12. Taking the long view: a systematic review reporting long-term perspectives on child unintentional injury.

    Science.gov (United States)

    Mytton, Julie A; Towner, Elizabeth M L; Powell, Jane; Pilkington, Paul A; Gray, Selena

    2012-10-01

    The relative significance of child injury as a cause of preventable death has increased as mortality from infectious diseases has declined. Unintentional child injuries are now a major cause of death and disability across the world with the greatest burden falling on those who are most disadvantaged. A review of long-term data on child injury mortality was conducted to explore trends and inequalities and consider how data were used to inform policy, practice and research. The authors systematically collated and quality appraised data from publications and documents reporting unintentional child injury mortality over periods of 20 years or more. A critical narrative synthesis explored trends by country income group, injury type, age, gender, ethnicity and socioeconomic group. 31 studies meeting the inclusion criteria were identified of which 30 were included in the synthesis. Only six were from middle income countries and none were from low income countries. An overall trend in falling child injury mortality masked rising road traffic injury deaths, evidence of increasing vulnerability of adolescents and widening disparities within countries when analysed by ethnic group and socioeconomic status. Child injury mortality trend data from high and middle income countries has illustrated inequalities within generally falling trends. There is scope for greater use of existing trend data to inform policy and practice. Similar evidence from low income countries where the burden of injury is greatest is needed.

  13. Influence of upper extremity positioning on pain, paresthesia, and tolerance: advancing current practice.

    Science.gov (United States)

    Lester, Mark E; Hazelton, Jill; Dewey, William S; Casey, James C; Richard, Reginald

    2013-01-01

    Loss of upper extremity motion caused by axillary burn scar contracture is a major complication of burn injury. Positioning acutely injured patients with axillary burns in positions above 90° of shoulder abduction may improve shoulder motion and minimize scar contracture. However, these positions may increase injury risk to the nerves of the brachial plexus. This study evaluated the occurrence of paresthesias, pain, and positional intolerance in four shoulder abduction positions in healthy adults. Sixty men and women were placed in four randomly assigned shoulder abduction positions for up to 2 hours: 1) 90° with elbow extension (90 ABD); 2) 130° with elbow flexion at 110° (130 ABD); 3) 150° with elbow extension (150 ABD); and 4) 170° with elbow extension (170 ABD). Outcome measures were assessed at baseline and every 30 minutes and included the occurrence of upper extremity paresthesias, position comfort/tolerance, and pain. Transient paresthesias, lasting less than 3 minutes, occurred in all test positions in 10 to 37% of the cases. Significantly fewer subjects reported paresthesias in the 90 ABD position compared with the other positions (P < .01). Pain was reported more frequently in the 170° position (68%) compared with the other positions (P < .01). Positioning with the elbow flexed or in terminal extension is not recommended, regardless of the degree of shoulder abduction. Positioning patients in a position of 150° of shoulder abduction was shown to be safe and well tolerated. Consideration of positions above this range should be undertaken cautiously and only with strict monitoring in alert and oriented patients for short time periods.

  14. Improving Hybrid III injury assessment in steering wheel rim to chest impacts using responses from finite element Hybrid III and human body model.

    Science.gov (United States)

    Holmqvist, Kristian; Davidsson, Johan; Mendoza-Vazquez, Manuel; Rundberget, Peter; Svensson, Mats Y; Thorn, Stefan; Törnvall, Fredrik

    2014-01-01

    The main aim of this study was to improve the quality of injury risk assessments in steering wheel rim to chest impacts when using the Hybrid III crash test dummy in frontal heavy goods vehicle (HGV) collision tests. Correction factors for chest injury criteria were calculated as the model chest injury parameter ratios between finite element (FE) Hybrid III, evaluated in relevant load cases, and the Total Human Model for Safety (THUMS). This is proposed to be used to compensate Hybrid III measurements in crash tests where steering wheel rim to chest impacts occur. The study was conducted in an FE environment using an FE-Hybrid III model and the THUMS. Two impactor shapes were used, a circular hub and a long, thin horizontal bar. Chest impacts at velocities ranging from 3.0 to 6.0 m/s were simulated at 3 impact height levels. A ratio between FE-Hybrid III and THUMS chest injury parameters, maximum chest compression C max, and maximum viscous criterion VC max, were calculated for the different chest impact conditions to form a set of correction factors. The definition of the correction factor is based on the assumption that the response from a circular hub impact to the middle of the chest is well characterized and that injury risk measures are independent of impact height. The current limits for these chest injury criteria were used as a basis to develop correction factors that compensate for the limitations in biofidelity of the Hybrid III in steering wheel rim to chest impacts. The hub and bar impactors produced considerably higher C max and VC max responses in the THUMS compared to the FE-Hybrid III. The correction factor for the responses of the FE-Hybrid III showed that the criteria responses for the bar impactor were consistently overestimated. Ratios based on Hybrid III and THUMS responses provided correction factors for the Hybrid III responses ranging from 0.84 to 0.93. These factors can be used to estimate C max and VC max values when the Hybrid III is

  15. Recognition and Toleration

    DEFF Research Database (Denmark)

    Lægaard, Sune

    2010-01-01

    Recognition and toleration are ways of relating to the diversity characteristic of multicultural societies. The article concerns the possible meanings of toleration and recognition, and the conflict that is often claimed to exist between these two approaches to diversity. Different forms or inter...

  16. Spiral CT aortography: an efficient technique for the diagnosis of traumatic aortic injury

    International Nuclear Information System (INIS)

    Wicky, S.; Capasso, P.; Meuli, R.; Schnyder, P.; Fischer, A.; Segesser, L. von

    1998-01-01

    The objective of this study was to assess the efficiency of spiral CT (SCT) aortography for diagnosing acute aortic lesions in blunt thoracic trauma patients. Between October 1992 and June 1997, 487 SCT scans of the chest were performed on blunt thoracic trauma patients. To assess aortic injury, the following SCT criteria were considered: hemomediastinum, peri-aortic hematoma, irregular aspect of the aortic wall, aortic pseudodiverticulum, intimal flap and traumatic dissection. Aortic injury was diagnosed on 14 SCT examinations (2.9 %), five of the patients having had an additional digital aortography that confirmed the aortic trauma. Twelve subjects underwent surgical repair of the thoracic aorta, which in all but one case confirmed the aortic injury. Two patients died before surgery from severe brain lesions. The aortic blunt lesions were confirmed at autopsy. According to the follow-up of the other 473 patients, we are aware of no false-negative SCT examination. Our limited series shows a sensitivity of 100 % and specificity of 99.8 % of SCT aortography in the diagnosis of aortic injury. It is concluded that SCT aortagraphy is an accurate diagnostic method for the assessment of aortic injury in blunt thoracic trauma patients. (orig.)

  17. In vitro selection of salinity tolerant variants from triploid bermudagrass (Cynodon transvaalensis x C. dactylon) and their physiological responses to salt and drought stress.

    Science.gov (United States)

    Lu, Shaoyun; Peng, Xinxiang; Guo, Zhenfei; Zhang, Gengyun; Wang, Zhongcheng; Wang, Congying; Pang, Chaoshu; Fan, Zhen; Wang, Jihua

    2007-08-01

    A protocol was established for in vitro selection of salinity tolerant somaclonal variations from suspension cultured calli of triploid bermudagrass cv. TifEagle. To induce somaclonal variations the calli were subcultured for 18 months and were then subject to three-round selections for salt-tolerant calli by placing on solid medium containing 0.3 M NaCl for 10 days followed by a recovery for 2 weeks. The surviving calli were regenerated on regeneration medium containing 0.1 M NaCl. Three somaclonal variant lines (2, 71, and 77) were obtained and analyzed. The selected somaclonal lines showed higher relative growth and less injury than TifEagle under salt stress, indicating that they increased salt tolerance. In addition, they had higher relative water content and lower electrolyte leakage than TifEagle after withholding irrigatio