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Sample records for intensity factor solutions

  1. Full-range stress intensity factor solutions for clamped SENT specimens

    International Nuclear Information System (INIS)

    Zhu, Xian-Kui

    2017-01-01

    Single edge notched tension (SENT) specimen with clamped ends has been receiving increasing attention worldwide as a low-constraint specimen to measure less-conservative fracture toughness of pipeline steels in the oil and gas industry. Several SENT test methods were developed, but the solutions of stress intensity factor K used are different. The existing K solutions are thus reviewed and evaluated in this paper for the clamped SENT specimens, and then a full-range analytical solution of K is developed as a function of full-range crack sizes (a/W) and specimen aspect ratios (H/W). From this result, a simple closed-form solution of K is obtained particularly for H/W = 10, as used by the current SENT toughness test methods. The proposed full-range K solutions are validated using different numerical results and error analyses, and thus can be used generally to meet the needs of different SENT testing for determination of fatigue crack growth rate or fracture toughness in the low-constraint conditions. - Highlights: • The stress intensity factor K solutions were reinvestigated for clamped SENT specimens. • A general, full-range analytical solution of K was obtained for H/W≥3 with accuracy of 0.25%. • The corrected K solution obtained previously for BS 8571 was shown accurate for crack sizes of a/W≤0.925. • The actual valid ranges of three FEA results of K were redefined. • A simple closed-form solution of K was proposed for clamped SENT specimens with H/W = 10.

  2. New stress intensity factor solutions for an elliptical crack in a plate

    International Nuclear Information System (INIS)

    Delliou, P.L.; Barthelet, B.

    2005-01-01

    Crack assessment in engineering structures relies first on accurate evaluation of the stress intensity factors. In recent years, a large work has been conducted in France by the Atomic Energy Commission to develop influence coefficients for surface cracks in pipes. However, the problem of embedded cracks in plates (and pipes) which is also of practical importance has not received so much attention. Presently, solutions for elliptical cracks are available either in infinite solid with a polynomial distribution of normal loading or in plate, but restricted to constant or linearly varying tension. This paper presents the work conducted at EDF R and D to obtain influence coefficients for plates containing an elliptical crack with a wide range of the parameters : relative size (2a/t ratio), shape (a/c ratio) and free surface proximity (a/d ratio where d is the distance from the center of the ellipse to the closest free surface). These coefficients were developed through extensive 3D finite element calculations : 200 geometrical configurations were modeled, each containing from 18000 to 26000 nodes. The limiting case of the tunnel crack (a/c = 0) was also analyzed with 2D finite element calculation (50 geometrical configurations). The accuracy of the results was checked by comparison with analytical solutions for infinite solids and, when possible, with solutions for finite-thickness plates (generally loaded in constant tension). (authors)

  3. Analytical Solution for Stress Field and Intensity Factor in CSTBD under Mixed Mode Conditions

    Directory of Open Access Journals (Sweden)

    Najaf Ali Ghavidel

    2014-06-01

    Full Text Available Considering the fact that rocks fail faster under tensile stress, rock tensile strength is of greatimportance in applications such as blasting, rock fragmentation, slope stability, hydraulic fracturing,caprock integrity, and geothermal energy extraction. There are two direct and indirect methods tomeasure tensile strength. Since direct methods always encompass difficulties in test setup, indirectmethods, specifically the Brazilian test, have often been employed for tensile strength measurement.Tensile failure is technically attributed to crack propagation in rock. Fracture mechanics hassignificant potential for the determination of crack behaviour as well as propagation pattern. To applyBrazilian tests, cracked disc geometry has been suggested by the International Society for RockMechanics ISRM. Accordingly, a comprehensive study is necessary to evaluate stress field and stressintensity factor (SIF around the crack in the centre of the specimen. In this paper, superpositionprinciple is employed to solve the problem of cracked straight-through Brazilian disc (CSTBD, usingtwo methods of dislocation and complex stress function. Stress field and SIF in the vicinity of thecrack tip are then calculated. With the proposed method, the magnitude of critical load for crackinitiation in structures can be predicted. This method is valid for any crack of any arbitrary length andangle. In addition, numerical modelling has been carried out for the Brazilian disc. Finally, theanalytical solution has been compared with numerical modelling results showing the same outcomefor both methods.

  4. Calculation of Stress Intensity Factor KⅠ Using the Exact Solution in an Infinitely Deep Crack in a Half-Plane

    Energy Technology Data Exchange (ETDEWEB)

    An, Deuk Man [Pusan Nat’l Univ., Busan (Korea, Republic of)

    2017-01-15

    In this study, we develop the exact field of modeⅠin an infinitely deep crack in a half-plane. Using this field, we obtain the exact stress intensity factor KⅠ. From the tractions on the crack faces induced by exact field, we calculate the stress intensity factor of this field. We compare the results with the stress intensity factor calculated using Bueckner’s weight function formula and that calculated by using Tada’s formula listed in “The Stress Analysis of Cracks Handbook” It was found that Bueckner’s formula yields accurate results. However, the results obtained using Tada’s formula exhibit inaccurate behavior.

  5. Stress Intensity Factor Extraction from the Enriched Partition of Unity Solution for a Cracked Linear Elastic Medium

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Won-Tak [Gachon University, Seongnam (Korea, Republic of)

    2017-02-15

    The stress intensity factor is a useful tool for predicting material failure and describing the stress states of brittle materials. We present a technique to calculate the stress intensity factor for a linear elasticity problem on a cracked domain with an enriched partition of unity method. We use a particular partition of unity function, which is piecewise polynomial and has wide flat-top region. The flat-top area in the partition of unity function helps the displacements and the stress fields in the vicinity of the crack tip to be accurately represented, even with a coarse background mesh. Among other methods for calculating the stress intensity factor, we find that the direct extraction method is the most accurate and efficient one given a relatively coarse background mesh for the enriched partition of unity method.

  6. The Pursuit of K: Reflections on the Current State-of-the-Art in Stress Intensity Factor Solutions for Practical Aerospace Applications

    Science.gov (United States)

    CraigMcClung, R.; Lee, Yi-Der; Cardinal, Joseph W.; Guo, Yajun

    2012-01-01

    The elastic stress intensity factor (SIF, commonly denoted as K) is the foundation of practical fracture mechanics (FM) analysis for aircraft structures. This single parameter describes the first-order effects of stress magnitude and distribution as well as the geometry of both structure/component and crack. Hence, the calculation of K is often the most significant step in fatigue analysis based on FM. This presentation will provide several reflections on the current state-of-the-art in SIF solution methods used for practical aerospace applications, including a brief historical perspective, descriptions of some recent and ongoing advances, and comments on some remaining challenges. Newman and Raju made significant early contributions to practical structural analysis by developing closed-form SIF equations for surface and corner cracks in simplified geometries, often based on empirical fits of finite element (FE) solutions. Those solutions (and others like them) were sometimes revised as new analyses were conducted or limitations discovered. The foundational solutions have exhibited striking longevity, despite the relatively "coarse" FE models employed many decades ago. However, in recent years, the accumulation of different generations of solutions for the same nominal geometry has led to some confusion (which solution is correct?), and steady increases in computational capabilities have facilitated the discovery of inaccuracies in some (not all!) of the legacy solutions. Some examples of problems and solutions are presented and discussed, including the challenge of maintaining consistency with legacy design applications. As computational power has increased, the prospect of calculating large numbers of SIF solutions for specific complex geometries with advanced numerical methods has grown more attractive. Fawaz and Andersson, for example, have been generating literally millions of new SIF solutions for different combinations of multiple cracks under simplified

  7. Simple quantification of ultrasonic intensity using aqueous solution of phenolphthalein.

    Science.gov (United States)

    Rong, L; Kojima, Y; Koda, S; Nomura, H

    2001-01-01

    Aqueous phenolphthalein solution under sonication was investigated for use as a chemical dosimeter. The fading time of aqueous phenolphthalein solution under sonication depended on the concentration of phenolphthalein and the pH values of solutions. The fading time was correlated to the ultrasonic intensity in a reaction vessel that is estimated on the basis of decomposition of porphyrin. The relation between the fading time and the ultrasonic intensity for different frequencies is expressed by a single curve. From these results, it is indicated that aqueous solutions of phenolphthalein is useful for simple quantification of ultrasonic intensity for practical use, and one can regard it as one of the ultrasonic intensity indicators.

  8. Accuracy of Determining Stress Intensity Factors in Some Numerical Programs

    Directory of Open Access Journals (Sweden)

    M. Vorel

    2001-01-01

    Full Text Available At present, there are many programs for numerical analysis of cracks, in particular for determining stress intensity factors. Analyses of a single-edge cracked beam and flat plate with a semielliptical surface crack are presented in this study to examine the accuracy and applicability of the Franc2d and Franc3d programs. Further numerical computations of the MARC program and analytical solutions of stress intensity factors were included to compare the results with each other. For this purpose MARC was equipped with special user procedures. The influence of mesh fineness on the results was also investigated in all programs. The distributions of the stress intensity factors show good agreement in quality. The maximum deviations from the analytical solutions are 9.7 %. With greater numbers of elements programs Franc2d and Franc3d showed some instability, which currently reduces the usefulness and reliability of these promising tools for engineering applications.

  9. A review and assessment of the stress-intensity factors for surface cracks

    Science.gov (United States)

    Newman, J. C., Jr.

    1979-01-01

    The stress-intensity factor solutions proposed for a surface crack in a finite plate subjected to uniform tension are reviewed. Fourteen different solutions obtained over the past 16 years using approximate analytical methods, experimental methods, and engineering estimates are compared. The accuracy of the various solutions is assessed by correlating fracture data on surface-cracked tension specimens made of a brittle epoxy material. Fracture of the epoxy material was characterized by a constant value of stress-intensity factor as failure. Thus, the correctness of various solutions is judged by the variations in the stress-intensity factors at failure. The solutions were ranked in order of minimum standard deviation. The highest ranking solutions correlated 95% of data analyzed within + or - 10% whereas the lowest ranking solutions correlated 95% of data analyzed within + or - 20%. Some solutions could be applied to all data considered, whereas others were limited with respect to crack shapes and crack sizes that could be analyzed.

  10. Stress intensity factors and weight functions for cracks in front of notches

    International Nuclear Information System (INIS)

    Fett, T.

    1993-12-01

    The knowledge of stress intensity factors for cracks at notch roots is important for the fracture mechanical treatment of real components. Stress intensity factor solutions are available only for special notches and externally applied loads. For the treatment of more complex loadings as thermal stresses near the notch root the weight function is needed in addition. In the first part of this report weight functions for cracks in front of internal notches are derived from stress intensity factor solutions under external loading available in the literature. The second part deals with cracks in front of edge notches. Limit cases of stress intensity factors are derived which allow to estimate stress intensity factors for cracks in front of internal elliptical notches with arbitrary aspect ratio of the ellipse and for external notches. (orig.) [de

  11. REDUCING THE INTENSITY OF TAKEAWAY PULVERIZED COAL BY USING SPECIAL SOLUTION

    Directory of Open Access Journals (Sweden)

    M. M. Biliaiev

    2017-04-01

    Full Text Available Purpose. The article is aimed: 1 to develop the coal coating solution in open railway cars or to cover coal piles to minimize the coal dust losses; 2 creating a mathematical model of the process of the solution feeding to the surface of coal. Methodology. To solve this problem, it was developed a special solution containing cheap industrial wastes and semiproducts of chemical industries. It was conducted a physical experiment to assess the intensity of coal dust loss when using the developed solution. A mathematical model based on the use of the motion equations of the ideal fluid and mass transfer was developed. The developed numerical models are the basis of the application program package created for assessing the quality of processing the coal surface by special solution. Findings. The results of the conducted physical experiment to assess the magnitude of the coal dust loss on the model of the coal pile in the processing of its surface with a special solution and without processing are presented in the article. It is shown that the application of the proposed solution for surface processing of coal can significantly reduce the coal dust loss. This makes it possible to reduce the amount of economic losses and reduce the level of air dust pollution in work areas. The results of computational experiments carried out on the basis of the constructed numerical models are presented in the article. Originality. Authors proposed a new solution for the coal surface processing in order to minimize the removal of pulverized coal from the coal pile, which substantially reduces the coal losses. There were created numerical models to take into account the relevant factors influencing the solution dispersion process in the atmosphere from coal processing in gondola cars. Practical value. Solution, proposed in the article has a low price, because it can be created on the basis of industrial production wastes. Application of this solution can significantly

  12. Numerical Determination of Crack Opening and Closure Stress Intensity Factors

    DEFF Research Database (Denmark)

    Ricardo, Luiz Carlos Hernandes

    2009-01-01

    The present work shows the numerical determination of fatigue crack opening and closure stress intensity factors of a C(T) specimen under variable amplitude loading using a finite element method. A half compact tension C(T) specimen, assuming plane stress constraint was used by finite element met...

  13. Fatigue in Intensive Care Nurses and Related Factors.

    Science.gov (United States)

    Çelik, Sevim; Taşdemir, Nurten; Kurt, Aylin; İlgezdi, Ebru; Kubalas, Özge

    2017-10-01

    Fatigue negatively affects the performance of intensive care nurses. Factors contributing to the fatigue experienced by nurses include lifestyle, psychological status, work organization and sleep problems. To determine the level of fatigue among nurses working in intensive care units and the related factors. This descriptive study was conducted with 102 nurses working in intensive care units in the West Black Sea Region of Turkey. Data were collected between February and May 2014 using a personal information form, the Visual Analogue Scale for Fatigue (VAS-F), the Hospital Anxiety and Depression Scale and the Pittsburg Sleep Quality Index. The intensive care nurses in the study were found to be experiencing fatigue. Significant correlations were observed between scores on the VAS-F Fatigue and anxiety (p=0.01), depression (p=0.002), and sleep quality (p<0.001). Anxiety, depression and quality of sleep were significantly affected by the intensive care nurses' levels of fatigue. These results can be of benefit in taking measures which may be used to reduce fatigue in nurses, especially the fatigue related to work organization and social life.

  14. Soft solution synthesis and intense visible photoluminescence of lamellar zinc oxide hybrids

    International Nuclear Information System (INIS)

    Sağlam, Özge

    2013-01-01

    Graphical abstract: -- In this study, we demonstrate the synthesis of layered zinc oxide films intercalated with dodecyl sulphate ions by a simple soft solution process. The presence of potassium (K + ) and lithium (Li + ) ions in the precursor solution of layered zinc hydroxide resulted in lamellar hybrid zinc oxide films instead of layered zinc hydroxides. On the other hand, the addition of nickel phthalocyanine induces zinc hydroxide host layers which exhibit an intense blue emission. This is also promoted by K + and Li + ions

  15. Kinetic study of COS with tertiary alkanolamine solutions 1. Experiments in an intensely stirred batch reactor

    NARCIS (Netherlands)

    Littel, R.J.; Littel, R.J.; Versteeg, Geert; van Swaaij, Willibrordus Petrus Maria

    1992-01-01

    The reaction between COS and various tertiary alkanolamines in aqueous solutions has been studied in an intensely stirred batch reactor. Experiments for TEA, DMMEA, and DEMEA were carried out at 303 K the reaction between COS and aqueous MDEA has been studied at temperaturm ranging from 293 to 323

  16. Kinetic Study of COS with Tertiary Alkanolamine Solutions. 1. Experiments in an Intensely Stirred Batch Reactor

    NARCIS (Netherlands)

    Littel, Rob J.; Versteeg, Geert F.; Swaaij, Wim P.M. van

    1992-01-01

    The reaction between COS and various tertiary alkanolamines in aqueous solutions has been studied in an intensely stirred batch reactor. Experiments for TEA, DMMEA, and DEMEA were carried out at 303 K; the reaction between COS and aqueous MDEA has been studied at temperatures ranging from 293 to 323

  17. [Factors causing stress in patients in intensive care units].

    Science.gov (United States)

    Pérez de Ciriza, A; Otamendi, S; Ezenarro, A; Asiain, M C

    1996-01-01

    Intensive care units have been considered stress generating areas. Knowing the causes why this happens will allow us to take specific measures to prevent or minimize it. This study has been performed with the aim to identify stress raising factors, as they are perceived by intensive care patients. The study has been performed in 49 patients most of whom were being attended in postoperatory control. The valuation of the degree of stress was performed using the "Scale of Environmental Stressors in Intensive Care" by Ballard in 1981, modified and adapted to our environment, with a result of 43 items distributed in six groups; Immobilization, Isolation, Deprivation of sleep, Time-spacial disorientation, Sensorial deprivation and overestimulation, and depersonalization and loss of autocontrol. The level of stress perceived by patients was low. The factors considered as most stressing were those related to physical aspects; presence of tubes in nose and mouth, impossibility to sleep and presence of noise, whereas those less stressing referred to Nursing attention. We conclude that patients perceive ICU as a little stressing place in spite of the excessive noise, remark the presence of invasive tubes and the difficulty to sleep as the most stressing factors, and in the same way, express a high degree of satisfaction about the attention received.

  18. Postoperative delirium in intensive care patients: risk factors and outcome.

    Science.gov (United States)

    Veiga, Dalila; Luis, Clara; Parente, Daniela; Fernandes, Vera; Botelho, Miguela; Santos, Patricia; Abelha, Fernando

    2012-07-01

    Postoperative delirium (POD) in Surgical Intensive Care patients is an important independent outcome determinant. The purpose of our study was to evaluate the incidence and determinants of POD. Prospective cohort study conducted during a period of 10 months in a Post-Anesthesia Care Unit (PACU) with five intensive care beds. All consecutive adult patients submitted to major surgery were enrolled. Demographic data, perioperative variables, length of stay (LOS) and the mortality at PACU, hospital and at 6-months follow-up were recorded. Postoperative delirium was evaluated using the Intensive Care Delirium Screening Checklist (ICDSC). Descriptive analyses were conducted and the Mann-Whitney test, Chi-square test or Fisher's exact test were used for comparisons. Logistic regression analysis evaluated the determinants of POD with calculation of odds ratio (OR) and its confidence interval 95% (95% CI). There were 775 adult PACU admissions and 95 patients had exclusion criteria. Of the remaining 680 patients, 128 (18.8%) developed POD. Independent determinants of POD identified were age, ASA-PS, emergency surgery and total amount of fresh frozen plasma administered during surgery. Patients with delirium had higher mortality rates, were more severely ill and stayed longer at the PACU and in the hospital. POD was an independent risk factor for hospital mortality There was a high incidence of delirium had a high incidence in intensive care surgical patients. POD was associated with worse severity of disease scores, longer LOS in hospital, and in PACU and higher mortality rates. The independent risk factors for POD were age, ASAPS, emergency surgery and the amount of plasma administered during surgery. Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

  19. Weight functions for the determination of stress intensity factor and T-stress for edge-cracked plates with built-in ends

    International Nuclear Information System (INIS)

    Li, J.; Wang, X.; Tan, C.L.

    2004-01-01

    This paper presents the weight functions for the determination of the stress intensity factor and T-stress solutions for edge-cracked plates with built-in ends under complex stress distributions. First, a compliance analysis approach is used to calculate stress intensity factor and T-stress for edge cracks in finite width plates with built-in ends with uniform or linear stress distributions acting on the crack face. The results serve as the reference solutions for the next step in which the approaches of deriving weight functions from reference stress intensity factor and T-stress solutions developed for stress boundary conditions are extended to obtain the corresponding weight functions for edge-cracked plates with built-in ends. Finite element analysis is conducted to validate the derived solutions. The weight functions derived are suitable for obtaining stress intensity factors and T-stress solutions under any complex stress field

  20. Evaluation of stress intensity factors due to welding residual stresses for circumferential cracked pipes

    International Nuclear Information System (INIS)

    Oh, Chang-Young; Kim, Yun-Jae; Oh, Young-Jin; Kim, Jong-Sung; Song, Tae-Kwang; Kim, Yong-Beum

    2013-01-01

    To investigate the applicability of existing methods to estimate stress intensity factors due to welding residual stresses, comparisons with finite element (FE) solutions are made for two types of generic welding residual stress profiles, generated by simulating repair welds. It is found that fitting residual stresses over the crack depth using third-order polynomials gives good estimates of stress intensity factors but fitting over the entire thickness can result in inaccurate estimates even with fourth-order polynomials. Noting that welding residual stresses are often determined from FE analyses, linearization of residual stresses to estimate stress intensity factors is proposed. Comparison with FE solutions shows good agreements. -- Highlights: ► Applicability of K estimation methods is investigated for welding residual stresses. ► Two types of generic residual stress profiles with repair welds are considered. ► Fitting residual stresses over the crack depth gives good estimates of K. ► A method to estimate K by linearising residual stress profiles is proposed

  1. Energy intensive industry for Alaska. Volume I: Alaskan cost factors; market factors; survey of energy-intensive industries

    Energy Technology Data Exchange (ETDEWEB)

    Swift, W.H.; Clement, M.; Baker, E.G.; Elliot, D.C.; Jacobsen, J.J.; Powers, T.B.; Rohrmann, C.A.; Schiefelbein, G.L.

    1978-09-01

    The Alaskan and product market factors influencing industry locations in the state are discussed and a survey of the most energy intensive industries was made. Factors external to Alaska that would influence development and the cost of energy and labor in Alaska are analyzed. Industries that are likely to be drawn to Alaska because of its energy resources are analyzed in terms of: the cost of using Alaska energy resources in Alaska as opposed to the Lower 48; skill-adjusted wage and salary differentials between relevant Alaskan areas and the Lower 48; and basic plant and equipment and other operating cost differentials between relevant Alaskan areas and the Lower 48. Screening and evaluation of the aluminum metal industry, cement industry, chlor-alkali industry, lime industry, production of methanol from coal, petroleum refining, and production of petrochemicals and agrichemicals from North Slope natural gas for development are made.

  2. Factors associated with mortality in a neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Flávia Emília Cavalcante Valença Fernandes

    2017-05-01

    Full Text Available Aims: To describe the factors associated with mortality of newborns hospitalized in a Neonatal Intensive Care Unit in the period from 2012 to 2015. Methods: This was a descriptive, quantitative study of secondary data, correlated with the causes of death and hospitalization according to classification by ICD-10.  The categorical variables were presented in absolute and relative frequencies, with measurements of central tendency and dispersion. Evaluation of the factors associated with neonatal death was made by the logit model of analysis with correction of robust errors by the statistical program Stata 12.0, considering values of p<0.05 and interval of confidence of 95%.  Results: Of the 563 newborns, 58.6% were of the male sex; 89.0% were early newborns, 73.0% were premature. 181 newborns died (32.3%. The main causes of hospitalization were: difficulties during birth, conditions of birth and immaturity (45.0%, pathologies associated with the respiratory system (21.1%, congenital malformations (9.7%. The main causes of death were: septicemia of the NB (40.4%, respiratory discomfort of the NB (22.4%. The significant associations for mortality were the use of ventilatory supports: Mechanical Ventilation (p=0.001, Hallo (p=0.000, CPAP (p=0.000, VNI (p=0.005. Conclusions: The major risk factors for neonatal mortality were associated with septicemia and use of mechanical ventilation.

  3. Stress intensity factor for multiple cracks in half plane elasticity

    Science.gov (United States)

    Elfakhakhre, N. R. F.; Nik long, N. M. A.; Eshkuvatov, Z. K.

    2017-01-01

    The multiple cracks problem in an elastic half-plane is formulated into singular integral equation using the modified complex potential with free traction boundary condition. A system of singular integral equations is obtained with the distribution dislocation function as unknown, and the traction applied on the crack faces as the right hand terms. With the help of the curved length coordinate method and Gauss quadrature rule, the resulting system is solved numerically. The stress intensity factor (SIF) can be obtained from the unknown coefficients. Numerical examples exhibit that our results are in good agreement with the previous works, and it is found that the SIF increase as the cracks approaches the boundary of half plane.

  4. Readmission to medical intensive care units: risk factors and prediction.

    Science.gov (United States)

    Jo, Yong Suk; Lee, Yeon Joo; Park, Jong Sun; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon-Taek; Cho, Young-Jae

    2015-03-01

    The objectives of this study were to find factors related to medical intensive care unit (ICU) readmission and to develop a prediction index for determining patients who are likely to be readmitted to medical ICUs. We performed a retrospective cohort study of 343 consecutive patients who were admitted to the medical ICU of a single medical center from January 1, 2008 to December 31, 2012. We analyzed a broad range of patients' characteristics on the day of admission, extubation, and discharge from the ICU. Of the 343 patients discharged from the ICU alive, 33 (9.6%) were readmitted to the ICU unexpectedly. Using logistic regression analysis, the verified factors associated with increased risk of ICU readmission were male sex [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.29-8.48], history of diabetes mellitus (OR 3.03, 95% CI 1.29-7.09), application of continuous renal replacement therapy during ICU stay (OR 2.78, 95% CI 0.85-9.09), white blood cell count on the day of extubation (OR 1.13, 95% CI 1.07-1.21), and heart rate just before ICU discharge (OR 1.03, 95% CI 1.01-1.06). We established a prediction index for ICU readmission using the five verified risk factors (area under the curve, 0.76, 95% CI 0.66-0.86). By using specific risk factors associated with increased readmission to the ICU, a numerical index could be established as an estimation tool to predict the risk of ICU readmission.

  5. Risk factors for candidemia in pediatric intensive care unit patients.

    Science.gov (United States)

    Ağın, Hasan; Devrim, Ilker; Işgüder, Rana; Karaarslan, Utku; Kanık, Esra; Günay, Ilker; Kışla, Miray; Aydın, Sultan; Gülfidan, Gamze

    2014-11-01

    To determine the risk factors for developing candida infections in pediatric intensive care unit (PICU). The present study was conducted as a case-control study and included the population of patients who were admitted to PICU during the period of March 2010-March 2011. During the study period, a total of 57 patients in PICU had candidemia, 4 cases were excluded due to their PICU stay less than 48 h and one due to the insufficient data. The most commonly isolated Candida species was C. albicans, followed by C. parapsilosis. The median duration of hospitalization in PICU was higher (22.0 d) in candidemia patients compared to control group (13.5 d) (p = 0.037). The patients with candidemia had higher rates of presence of mechanical ventilation, presence of central venous catheter, and being under total parenteral nutrition; compared to the control group. The longer PICU durations, mechanical ventilation, central venous catheter, total parenteral nutrition were the associated factors. Although trials for predicitive models or scoring systems for development of candidemia have been performed; more future studies were required for practical usage in clinics settings in order to prevent candidemia.

  6. A plastic stress intensity factor approach to turbine disk structural integrity assessment

    Directory of Open Access Journals (Sweden)

    V. Shlyannikov

    2016-07-01

    Full Text Available This study based on a new fracture mechanics parameter is concerned with assessing the integrity of cracked steam turbine disk which operate under startup-shutdown cyclic loading conditions. Damage accumulation and growth in service have occurred on the inner surface of slot fillet of key. In order to determine elastic-plastic fracture mechanics parameters full-size stress-strain state analysis of turbine disk was performed for a quote-elliptical part-through cracks under considering loading conditions. As a result distributions of elastic and plastic stress intensity factors along crack front in slot fillet of key of turbine disk depending on surface crack form are defined. An engineering approach to the prediction of carrying capacity of cracked turbine disk which is sensitive to the loading history at maintenance is proposed. The predictions of the rate of crack growth and residual lifetime of steam turbine disk are compared for elastic and elastic-plastic solutions. It is shown that the previously proposed elastic crack growth models provide overestimate the lifetime with respect to the present one. An advantage to use the plastic stress intensity factor to characterize the fracture resistance as the self-dependent unified parameter for a variety of turbine disk configurations rather than the magnitude of the elastic stress intensity factors alone is discussed.

  7. Dosimetric comparison of intensity-modulated solutions for intact prostate cancer

    Energy Technology Data Exchange (ETDEWEB)

    Neill, Cory J., E-mail: coryjneill@gmail.com

    2014-01-01

    The purpose of this study is intended to investigate the implementation of a modified class solution for intact prostate intensity-modulated radiation therapy (IMRT). The class solution uses 2 additional optimization structures intended to increase target conformity and decrease unnecessary dose to healthy tissue. A total of 10 randomly selected intact prostate IMRT patients were chosen for this retrospective study. Each of the original IMRT plans was compared with a modified class solution. The class solution implemented 2 additional optimization structures. The 95{sub O}PT was intended to increase target conformity, and the Avoidance{sub 3}780 was intended to reduce normal tissue. Each plan was evaluated for minimum, maximum, and mean doses to the target. Additionally, mean normal tissue dose, total monitor units (MUs), and segments were investigated. Conformity index and normal healthy index were also compared. All comparisons were evaluated using a paired t-test using GraphPad software. Evaluations of MUs; segments; minimum, maximum, mean target doses; mean normal tissue dose; and conformity index did not demonstrate a significant difference between the modified class solution and the original plans. However, evaluation of healthy tissue conformity index indicated a significant difference. Overall, 70% of the original plans failed to demonstrate a satisfactory score (< 0.6) of properly sparing normal healthy tissue, whereas 70% of the modified plans exhibited a satisfactory score (> 0.6). Most (90%) of the modified plans demonstrated a greater number of segments than the compared original plan. A modified class solution provides a good starting point for planning intact prostate cancer. The addition of the Avoidance{sub 3}780 structure increases the healthy tissue conformity index score.

  8. Quantification of Fracture Interaction Using Stress Intensity Factor Variation Maps

    Science.gov (United States)

    Thomas, Robin N.; Paluszny, Adriana; Zimmerman, Robert W.

    2017-10-01

    Accurate and flexible models of fracture interaction are sought after in the fields of mechanics and geology. Stress intensity factors (SIFs) quantify the energy concentrated at the fracture tips and are perturbed from their isolated values when two fractures are close to one another. Using a three-dimensional finite element fracture mechanics code to simulate static fractures in tension and compression, interaction effects are examined. SIF perturbations are characterized by introducing three interaction measures: the circumferential and maximum SIF perturbation provide the "magnitude" of the effect of interaction, and the amplification to shielding ratio quantifies the balance between increased and decreased SIFs along the tip. These measures are used to demonstrate the change in interaction with fracture separation and to find the separation at which interaction becomes negligible. Interaction maps are constructed by plotting the values of the interaction measures for a static fracture as a second fracture is moved around it. These maps are presented for several common fracture orientations in tension. They explore interaction by highlighting regions in which growth is more likely to occur and where fractures will grow into nonplanar geometries. Interaction maps can be applied to fracture networks with multiple discontinuities to analyze the effect of geometric variations on fracture interaction.

  9. The stress intensity factor for the double cantilever beam

    Science.gov (United States)

    Fichter, W. B.

    1983-01-01

    Fourier transforms and the Wiener-Hopf technique are used in conjunction with plane elastostatics to examine the singular crack tip stress field in the double cantilever beam (DCB) specimen. In place of the Dirac delta function, a family of functions which duplicates the important features of the concentrated forces without introducing unmanageable mathematical complexities is used as a loading function. With terms of order h-squared/a-squared retained in the series expansion, the dimensionless stress intensity factor is found to be K (h to the 1/2)/P = 12 to the 1/2 (a/h + 0.6728 + 0.0377 h-squared/a-squared), in which P is the magnitude of the concentrated forces per unit thickness, a is the distance from the crack tip to the points of load application, and h is the height of each cantilever beam. The result is similar to that obtained by Gross and Srawley by fitting a line to discrete results from their boundary collocation analysis.

  10. Helical Oligonaphthodioxepins Showing Intense Circularly Polarized Luminescence (CPL) in Solution and in the Solid State.

    Science.gov (United States)

    Takaishi, Kazuto; Yamamoto, Takahiro; Hinoide, Sakiko; Ema, Tadashi

    2017-07-12

    A series of oligonaphthodioxepins was synthesized, revealing a helically arranged octamer, (R,R,R,R,R,R,R)-3, which showed intense circularly polarized luminescence (CPL) both in solution and in the solid state. The fluorescence quantum yields (Φ FL ) in solution and in the solid state were 0.90 and 0.22, respectively, and the g lum values in solution and in the solid state were +2.2×10 -3 and +7.0×10 -3 , respectively. This is one of the highest solid-state CPL g lum values yet reported. The high Φ FL and g lum values were due to the rigidity, as well as to the fact that (R,R,R,R,R,R,R)-3 was a non-planar molecule. Moreover, (R,R,R,R,R,R,R)-3 was highly stable both chemically and stereochemically. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  11. Global Sourcing, Technology, and Factor Intensity: Firm-level Relationships

    OpenAIRE

    TOMIURA Eiichi

    2007-01-01

    This paper empirically examines how technology and capital intensity are related with the firm's global sourcing decision. Firm-level data are derived from a survey covering all manufacturing industries in Japan without any firm-size threshold. Firms are disaggregated by their make-or-buy decision (in-house or outsourcing) and by their choice of sourcing location (offshore or domestic). Capital-intensive or R&D-intensive firms tend to source in-house from their FDI affiliates rather than outs...

  12. ANALYSING FACTORS INFLUENCING ENERGY INTENSITY OF INDIAN CEMENT INDUSTRY

    OpenAIRE

    Hena Oak

    2018-01-01

    India is a fast growing economy, with a considerable dependence on energy resources. Energy resources mainly comprise of fossil fuels that are highly emission intensive. In order to move towards sustainable development, it is important to reduce emissions. Since a sizable amount of emissions gets generated from the use of energy resources, it is essential to use energy more efficiently and reduce energy intensity. In India the industrial sector is the biggest consumer of energy and hence ener...

  13. Calcium and potassium contents in nutrient solution on Phoma leaf spot intensity in coffee seedlings

    Directory of Open Access Journals (Sweden)

    Aricléia de Moraes Catarino

    Full Text Available ABSTRACT Coffee is one of the main export commodities of Brazilian agribusiness. Phoma leaf spot [Phoma tarda (Stewart Boerema & Bollen] is one of the most important coffee fungal diseases in Brazil. Therefore, this study aimed to evaluate the intensity of Phoma leaf spot in coffee seedlings supplied with different rates of Ca+2 and K+. The study was conducted under controlled conditions in a growth chamber, at the Department of Phytopathology - UFLA, from February 2010 to December 2011. The assay was repeated twice under the same conditions. The nutrient solutions consisted of five concentrations of K+ (3, 4, 5, 6, 7 mmol L-1 and Ca+2 (2, 4, 6, 8 and 10 mmol L-1. The experiment was arranged in a randomized block design, with 25 treatments and three replicates, with two plants per plot. The areas under incidence progress curve (AUIPC and severity (AUSPC were calculated. At the lowest rate of Ca2+ (2 mmol L-1 and highest K+ (6 and 7 mmol L-1, approximately, the AUIPC was the smallest. For the AUSPC, the lowest rates of Ca+2 and K+ resulted in the lowest severities. Supply of Ca+2 and K+ in nutrient solution reduced AUIPC and AUSPC of Phoma leaf spot, and these nutrients can be recommended for the management of the disease.

  14. Automation of the solution type of intensity modulated radiation therapy with direct planning neoplastic breast lesions

    International Nuclear Information System (INIS)

    Fuente Rosales, Liset De La; Larrinaga Cortina, Eduardo Francisco

    2009-01-01

    Breast cancer ranks first among the lesions malignancies involving the Cuban women and the second in mortality only surpassed by lung injury. The breast-conserving surgery is becoming less appeal, with an increase in the choice of radiotherapy to the breast operated, and the surgical bed. Intensity Modulated Radiation Therapy, IMRT has demonstrated better results in the dose distribution for irradiation dimensional treatment breast shaping, 3DCRT. We developed a MATLAB application to obtain the solution type to direct planning IMRT for breast neoplasm. The technique was implemented in the Planning System Treatment Plus Theraplan v3.8 and Precise1 ELEKTA linear accelerator. Static segments are constructed for each portal of incidence and Excel files are exported as the positions of the blades. The technique was validated with a patient, which he performed a radiographic study of computerized axial tomography planning purposes. The standard solution built is consistent with those reported internationally and consists of a segment type and at least two segments of type B. The assignment of the relative weights of the segments is done manually by trial and error procedure, with the general rule of 90% by weight assigned to segment A and the remaining 10% divided equally between B-type segments IMRT breast obtained in a dose 17% homogeneity better than 3DCRT and reduced the average dose in the lung ipsilateral 15%. (author)

  15. Thermal stress intensity factor for an axial crack in a clad cylinder

    International Nuclear Information System (INIS)

    Kuo, An Yu; Deardorf, A.F.; Riccardella, P.C.

    1993-01-01

    Many clad pressure vessels have been found to have cracks running through the inside surface cladding and into the base material. Although Young's moduli and Poisson's ratios of the clad and base materials are about the same for most of the industrial applications, coefficients of thermal expansion of the two dissimilar materials, clad and base materials, are usually quite different. For example, low alloy ferritic steel is a common base material for reactor pressure vessels (RPV) and the vessels are usually clad with austenitic stainless steel. Young's moduli for the low alloy steel and stainless steel at 350 F are 29,000 ksi and 28,000 ksi, respectively, while their coefficients of thermal expansion are 7.47x10 -6 in/in and 9.50x10 -6 in/in-degree F, respectively. The mismatch in coefficients of thermal expansion will cause high residual thermal stress even when the entire vessel is at a uniform temperature. This residual stress is one of the primary reasons why so many cracks have been found in the cladded components. In performing reactor pressure vessel integrity evaluation, such as computing probability of brittle fracture of the RPV, it is necessary to calculate stress intensity factors for cracks, which initiate from the clad material and run into the base metal. This paper presents a convenient method of calculating stress intensity factor for an axial crack emanating from the inside surface of a cladded cylinder under thermal loading. A J-integral like line integral was derived and used to calculate the stress intensity factors from finite element stress solutions of the problem

  16. Calculation of intensity factors using weight function theory for a transversely isotropic piezoelectric material

    International Nuclear Information System (INIS)

    Son, In Ho; An, Deuk Man

    2012-01-01

    In fracture mechanics, the weight function can be used for calculating stress intensity factors. In this paper, a two dimensional electroelastic analysis is performed on a transversely isotropic piezoelectric material with an open crack. A plane strain formulation of the piezoelectric problem is solved within the Leknitskii formalism. Weight function theory is extended to piezoelectric materials. The stress intensity factors and electric displacement intensity factor are calculated by the weight function theory

  17. [Risk factors and prognostic factors in nosocomial pneumonia outside the intensive care units setting].

    Science.gov (United States)

    Barreiro-López, Bienvenido; Tricas, Josep Maria; Mauri, Elisabeth; Quintana, Salvador; Garau, Javier

    2005-11-01

    Nosocomial pneumonia (NP) is the second most frequent cause of hospital-acquired infection and is associated with elevated morbidity and mortality rates, particularly in intensive care units (ICU). The objectives of this study were to determine the incidence, risk factors and prognostic factors of NP acquired outside the ICU. A prospective case-control study was performed. All NP cases were acquired outside the ICU, and each case was paired with a control subject matched for gender, age, date of admission and hospitalization area. Epidemiological, clinical and microbiological data were obtained from cases and controls, and the risk factors and prognostic factors for NP were established. During the study period a total of 67 cases of NP outside the ICU were diagnosed. Estimated incidence was 3.35 cases/1,000 admissions. Mean age of the patients was 70 +/- 13 years and 48 of them were men. On multivariate analysis adjusted for confounding factors, bronchoaspiration, previous surgery and steroids were significantly associated with the development of NP. Mortality attributable to NP was 27%. The existence of an ultimately or rapidly fatal underlying condition and the presence of leukocytosis or leukopenia were associated with poor prognosis. The incidence of NP outside the ICU setting is low. Measures to reduce bronchoaspiration and judicial steroid use are necessary to decrease the risk of acquiring NP and to improve the prognosis.

  18. Factors influencing the establishment of knowledge-intensive ventures

    DEFF Research Database (Denmark)

    Madsen, Henning; Neergaard, Helle; Ulhøi, John Parm

    2008-01-01

    , a deeper understanding of various mechanisms on which knowledge-intensive entrepreneurship hinges is needed. This paper investigates how the make-up of financial, human and social capital impacts on entrepreneurial action.   Methodology: Based on a longitudinal study using both structured survey and in......-depth interview techniques, this research addresses the role and importance of financial capital, human capital and social capital in the organizational genesis and early growth of entrepreneurial activities.   Findings: Financial capital remains the most critical asset in the entrepreneurial process. However...

  19. Intensive monitoring of forest ecosystems in Europe; 2: atmospheric deposition and its impacts on soil solution chemistry

    NARCIS (Netherlands)

    Vries, de W.; Reinds, G.J.; Vel, E.M.

    2003-01-01

    In order to gain a better understanding of the effects of air pollution and other stress factors on forests, a Pan-European programme for intensive and continuous monitoring of forest ecosystems has been implemented in 1994. Results of this intensive monitoring programme presented in this paper are

  20. Prevalence and intensity of intestinal parasitic infections and factors ...

    African Journals Online (AJOL)

    The factors established to be independently associated with presence of intestinal parasitic infection were: age 11-15 years P<0.001, use of plain water for hand washing P<0.05, eating food without spoon P<0.05, consuming raw vegetables P<0.001, untrimmed finger nails P<0.001 and source of drinking water [river ...

  1. High resolution time-intensity recording with synchronized solution delivery system for the human dynamic taste perception.

    Science.gov (United States)

    Goto, Tazuko K; Yeung, Andy Wai Kan; Suen, Justin Long Kiu; Fong, Barry Siu Keung; Ninomiya, Yuzo

    2015-04-30

    Time-intensity sensory evaluation of human taste perception is useful to know the feedback of a taste stimulus from tongue. However, it has not been profiled together with reaction time under the constant stimulating tongue in high time resolution. We first made intra-oral device to deliver taste solution to anterior, lateral and posterior tongue in standardized condition. Second, we developed a time-intensity sensory evaluation meter linked to synchronized taste solution delivery system. Time-intensity profiles were recorded in higher temporal resolution than our past study. Third, we analyzed the corrected taste quality reaction time from raw sensory perception data, and following sensory evaluation profile. The new method acquired taste sensory evaluation data with 1 ms temporal resolution and found the reaction timing was 908 ms, the corrected taste quality reaction time was 712 ms, maximum intensity was 3.47, and corrected time to reach maximum intensity was 1312 ms. The coefficient of variation ranged from 0.007 to 0.236 indicating low variance. Time-intensity sensory evaluation in this study did not sacrifice the feature of raw data. The relative comparison of time-intensity sensory profile among subjects will be available in this system in future study, while it was still difficult to define the absolute value of reaction time. Our method could gather real-time feedback for the time-intensity sensory evaluation of a taste stimulus under the standardized stimulating tongue. This could be useful for establishing database of time-intensity sensory profiles for comparison of delicate taste perceptions. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Investigation of molecular size of transcription factor TFIIE in solution.

    Science.gov (United States)

    Itoh, Yoshiyuki; Unzai, Satoru; Sato, Mamoru; Nagadoi, Aritaka; Okuda, Masahiko; Nishimura, Yoshifumi; Akashi, Satoko

    2005-11-15

    Human general transcription factor IIE (TFIIE), a component of a transcription preinitiation complex associated with RNA polymerase II, was characterized by size-exclusion chromatography, mass spectrometry, analytical ultracentrifugation, and small-angle X-ray scattering (SAXS). Recombinant human TFIIE was purified to homogeneity and shown to contain equimolar amounts of TFIIEalpha (50 kDa) and TFIIEbeta (35 kDa) by SDS-PAGE. In the analysis of size-exclusion chromatography of the purified sample, as already reported, TFIIE was shown to be a 170-kDa alpha(2)beta(2) heterotetramer. However, by using electrospray ionization mass spectrometry the purified sample gave the molecular mass of 84,152 +/- 5, indicating that TFIIE is an alphabeta heterodimer but not a heterotetramer. Analytical ultracentrifugation experiment of TFIIE provided that only a single component with the molecular mass of ca. 80,000 existed in solution, also suggesting an alphabeta heterodimer. In addition, its extraordinarily rod-like molecular shape was confirmed by SAXS. It is likely that the rod-like molecular shape of TFIIE has misled larger molecular size in size-exclusion chromatography, which was calibrated by globular proteins. It is demonstrated that TFIIE exists as a heterodimer under our present conditions in solution, although two molecules of heterodimer might be required for the formation of the preinitiation complex with RNA polymerase II for starting the transcription process. (c) 2005 Wiley-Liss, Inc.

  3. Particle swarm optimizer for weighting factor selection in intensity-modulated radiation therapy optimization algorithms.

    Science.gov (United States)

    Yang, Jie; Zhang, Pengcheng; Zhang, Liyuan; Shu, Huazhong; Li, Baosheng; Gui, Zhiguo

    2017-01-01

    In inverse treatment planning of intensity-modulated radiation therapy (IMRT), the objective function is typically the sum of the weighted sub-scores, where the weights indicate the importance of the sub-scores. To obtain a high-quality treatment plan, the planner manually adjusts the objective weights using a trial-and-error procedure until an acceptable plan is reached. In this work, a new particle swarm optimization (PSO) method which can adjust the weighting factors automatically was investigated to overcome the requirement of manual adjustment, thereby reducing the workload of the human planner and contributing to the development of a fully automated planning process. The proposed optimization method consists of three steps. (i) First, a swarm of weighting factors (i.e., particles) is initialized randomly in the search space, where each particle corresponds to a global objective function. (ii) Then, a plan optimization solver is employed to obtain the optimal solution for each particle, and the values of the evaluation functions used to determine the particle's location and the population global location for the PSO are calculated based on these results. (iii) Next, the weighting factors are updated based on the particle's location and the population global location. Step (ii) is performed alternately with step (iii) until the termination condition is reached. In this method, the evaluation function is a combination of several key points on the dose volume histograms. Furthermore, a perturbation strategy - the crossover and mutation operator hybrid approach - is employed to enhance the population diversity, and two arguments are applied to the evaluation function to improve the flexibility of the algorithm. In this study, the proposed method was used to develop IMRT treatment plans involving five unequally spaced 6MV photon beams for 10 prostate cancer cases. The proposed optimization algorithm yielded high-quality plans for all of the cases, without human

  4. Threshold intensity factors as lower boundaries for crack propagation in ceramics

    Directory of Open Access Journals (Sweden)

    Walter Per-Ole

    2004-11-01

    Full Text Available Abstract Background Slow crack growth can be described in a v (crack velocity versus KI (stress intensity factor diagram. Slow crack growth in ceramics is attributed to corrosion assisted stress at the crack tip or at any pre-existing defect in the ceramic. The combined effect of high stresses at the crack tip and the presence of water or body fluid molecules (reducing surface energy at the crack tip induces crack propagation, which eventually may result in fatigue. The presence of a threshold in the stress intensity factor, below which no crack propagation occurs, has been the subject of important research in the last years. The higher this threshold, the higher the reliability of the ceramic, and consequently the longer its lifetime. Methods We utilize the Irwin K-field displacement relation to deduce crack tip stress intensity factors from the near crack tip profile. Cracks are initiated by indentation impressions. The threshold stress intensity factor is determined as the time limit of the tip stress intensity when the residual stresses have (nearly disappeared. Results We determined the threshold stress intensity factors for most of the all ceramic materials presently important for dental restorations in Europe. Of special significance is the finding that alumina ceramic has a threshold limit nearly identical with that of zirconia. Conclusion The intention of the present paper is to stress the point that the threshold stress intensity factor represents a more intrinsic property for a given ceramic material than the widely used toughness (bend strength or fracture toughness, which refers only to fast crack growth. Considering two ceramics with identical threshold limits, although with different critical stress intensity limits, means that both ceramics have identical starting points for slow crack growth. Fast catastrophic crack growth leading to spontaneous fatigue, however, is different. This growth starts later in those ceramic materials

  5. Transient Stress Intensity Factors of Functionally Graded Hollow Cylinders with Internal Circumferential Cracks

    Directory of Open Access Journals (Sweden)

    Iman Eshraghi

    Full Text Available Abstract In this paper, transient thermomechanical stress intensity factors for functionally graded cylinders with complete internal circumferential cracks are obtained using the weight function method. The finite difference method is used to calculate the time dependent temperature distribution and thermal stresses along the cylinder thickness. Furthermore, finite element analysis is performed to determine the weight function coefficients and to investigate the accuracy of the predicted stress intensity factors from the weight functions. Variation of the stress intensity factors with time and effects of the material gradation on the results are investigated, as well. It is shown that the proposed technique can be used to accurately predict transient thermomechanical stress intensity factors for functionally graded cylinders with arbitrary material gradation.

  6. Numerical Evaluation of Stress Intensity Factors (Ki) J-Integral Approach

    National Research Council Canada - National Science Library

    Riveros, Guillermo A

    2006-01-01

    The purpose of this Coastal and Hydraulics Engineering Technical Note (CHETN) is to describe the numerical evaluation of the stress intensity factors using the J-integral approach (Rice 1968a, 1968b...

  7. On the bounds for the stress intensity factor in laminated composites

    Science.gov (United States)

    Erdogan, F.; Gupta, G. D.

    1973-01-01

    An attempt was made to calculate the upper and lower bound for the stress intensity factor when crack tips are in the primary laminate, the buffer strips, and at the interfaces. The tests were made on boron-epoxy composites.

  8. Factors affecting experiences of intensive care patients in Turkey: patient outcomes in critical care setting.

    Science.gov (United States)

    Demir, Yurdanur; Korhan, Esra Akin; Eser, Ismet; Khorshid, Leyla

    2013-07-01

    To determine the factors affecting a patient's intensive care experience. The descriptive study was conducted at an intensive care unit in the Aegean Region of Turkey, and comprised 158 patients who spent at least 48 hours at the unit between June and November 2009. A questionnaire form and the Intensive Care Experience Scale were used as data collection tools. SPSS 11.5 was used for statistical analysis of the data. Of the total, 86 (54.4%) patients related to the surgical unit, while 72 (45.5%) spent time at the intensive care unit. Most of the subjects (n=113; 71.5%) reported that they constantly experienced pain during hospitalisation. Patients receiving mechanical ventilation support and patients reporting no pain had significantly higher scores on the intensive care experience scale. Patients who reported pain remembered their experiences less than those having no pain. Interventions are needed to make the experiences of patients in intensive care more positive.

  9. Application of the virtual crack closure technique to calculate stress intensity factors for through cracks with an oblique elliptical crack front

    NARCIS (Netherlands)

    Fawaz, S.

    1998-01-01

    Fractographic observations on fatigue tested 2024 T3 clad aluminium riveted lap-splice joints indicate oblique fronts after the initial surface or corner crack at a rivet hole has penetrated through the sheet thichness. No stress intensity factor solutions are available for this geometry subjected

  10. A New Displacement-based Approach to Calculate Stress Intensity Factors With the Boundary Element Method

    Directory of Open Access Journals (Sweden)

    Marco Gonzalez

    Full Text Available Abstract The analysis of cracked brittle mechanical components considering linear elastic fracture mechanics is usually reduced to the evaluation of stress intensity factors (SIFs. The SIF calculation can be carried out experimentally, theoretically or numerically. Each methodology has its own advantages but the use of numerical methods has become very popular. Several schemes for numerical SIF calculations have been developed, the J-integral method being one of the most widely used because of its energy-like formulation. Additionally, some variations of the J-integral method, such as displacement-based methods, are also becoming popular due to their simplicity. In this work, a simple displacement-based scheme is proposed to calculate SIFs, and its performance is compared with contour integrals. These schemes are all implemented with the Boundary Element Method (BEM in order to exploit its advantages in crack growth modelling. Some simple examples are solved with the BEM and the calculated SIF values are compared against available solutions, showing good agreement between the different schemes.

  11. Innovative solutions: sample financial management business plan: neurosurgical intensive care unit.

    Science.gov (United States)

    Villanueva-Baldonado, Analiza; Barrett-Sheridan, Shirley E

    2010-01-01

    This article describes one institution's intention to implement a financial management business plan for a neurosurgical intensive care unit in a level I trauma center. The financial objective of this proposed business plan includes a service increase in the patient population requiring critical care in a way that will help control costs.

  12. Plannig strategy for radiotherapic treatment oa patients with prosthetic hip. Solution of intensity

    International Nuclear Information System (INIS)

    Puertolas Hernandez, J. R.; Iriondo Igerabide, U.; Lozano Flores, F. J.; Pino Leon, C.; Larretxea Etxarri, R.

    2013-01-01

    The intensity modulated radiation therapy (IMRT) can offer better plans, defining the prosthesis as critical structure that limit the dose. In our case, in the last year we have made five planning hip replacement cases, and one case with two prostheses (bilateral). We are introducing the strategy we use to carry out these planning. (Author)

  13. The first example of intensive luminescence of LMCT state based on metal complexes in solution

    International Nuclear Information System (INIS)

    Lukova, G.V.; Vasil'ev, V.P.; Smirnov, V.A.; Huhn, W.

    2007-01-01

    A bridge complex rac-C 6 H 10 (IndH 4 ) 2 ZrC 2 , featuring a unique long-living luminescence in liquid solutions at 20 deg C, has been prepared for the first time by catalytic hydrogenation of bis-indinyl complex C 6 H 10 (Ind) 2 Zr 2 Cl 2 . It has been identified that quantum yields of luminescence of the complex solutions at room temperature are the greatest ones for the known compounds possessing emission states of charge transfer from ligand to metal. Linear correlations of quantum yield of metal complex luminescence in a solution with steric features of the solvent molecules have been detected for the first time [ru

  14. Stress intensity factors and weight functions for the edge cracked plate calculated by the boundary collocation method

    International Nuclear Information System (INIS)

    Fett, T.

    1990-09-01

    The determination of stress intensity factors for cracks exposed to arbitrary stress distribution according to the weight function method calls for knowledge of the crack opening displacements and stress intensity factor for a reference load case. The determination of these variables by means of the Boundary Collocation Method (BCM) is discussed by the example of the drawn plate with an edge crack. After derivation of the formulas for evaluation the influence is studied of the relative crack depth and the plate length on the stress intensity factor, and the results are compared with data from the literature. The crack opening displacement field is determined from the stress function established by the Boundary Collocation Method and the fracture mechanical weight function is calculated from it. The results are compared with an analytical weight function obtained on the basis of approximative crack opening displacement fields. A formula is indicated for the weight function which covers the total range from a/W=0 to a/W=1. This formula is the result of BCM computations made up to a/W=0.8 for a relative plate length of a/H > 1.5 and applies to the limit case a/W=1 known from the analysis. Finally the Boundary Collocation Method is used to calculate the mode II stress intensity factors for shear loaded plates with an edge crack. The results of the computations are compared with solutions proposed in the literature. For the edge crack loaded with constant shear stresses, which act on the crack surfaces, a numerical formula is given of the geometric function. Values applicable to the weight function are determined from the crack opening displacements. (orig.) [de

  15. A comparative study on the influential factors of China's provincial energy intensity

    International Nuclear Information System (INIS)

    Yang, Guangfei; Li, Wenli; Wang, Jianliang; Zhang, Dongqing

    2016-01-01

    China has become the largest energy consumer worldwide, and it is important to study the energy intensity to realize the sustainable development goal of China. This paper focuses on investigating the influential factors of China's energy intensity using provincial-level panel data from 1985 to 2012. More specifically, we try to identify which factor is relatively more important to pay attention to. A novel approach based on evolutionary computation is proposed to intelligently mine the intrinsic relations between observed phenomena and to let the important factors automatically emerge from the discovered nonlinear models. However, due to China's vast territory and significant heterogeneities, this approach may fail to examine some detailed or hidden information when analyzing the country as a whole. Instead, we concentrate on the provincial level because the provinces play vital roles in reducing energy intensity in China. From our analytical results, the main findings are as follows: (1) the Total Population is the most important influential factor across China's provinces, while the Energy Price Index has the least impact; and (2) the provinces could be naturally classified into four categories based on the primary factors emerged from data, and such classification could reveal more about the true underlying features of each area. - Highlights: • Identify the important factors of China's energy intensity by symbolic regression. • Analyze China's energy intensity using provincial-level panel data from 1985 to 2012. • Intelligently investigate nonlinear models and the emergence of important factors. • The Total Population is discovered to be the most important influential factor. • Provinces are naturally classified into four categories by the influential factors.

  16. Analysis of stress intensity factor for a Griffith crack opened under constant pressure in a plate with temperature dependent properties

    International Nuclear Information System (INIS)

    Hata, Toshiaki

    1982-01-01

    Recently, the research on the thermal stress of structural materials has become important with the progress of nuclear reactor technology. In the case of large temperature gradient, the change of the physical properties of materials must be taken into account. The thermal stress analysis for the things with cracks taking the temperature dependence of properties into account has scarcely been carried out. In this report, the general method of solution of three-dimensional problems using perturbation method and the extension of thermo-elastic displacement potential method is shown for the case in which Young's modulus changes according to the exponential function of temperature. Moreover, using this method, the effect of the temperature dependence of properties on the stress intensity factor of the cracks subjected to internal pressure in a strip exposed to linear thermal flow was clarified. In the analysis, Young's modulus, the coefficient of linear thermal expansion and thermal conductivity were assumed to be dependent on temperature. The method of solution, the analysis of stress intensity factor considering the change of properties due to temperature, and the numerical calculation for a square plate with a crack are explained. (Kako, I.)

  17. Development of a numerical method for determination of stress intensity factor into the members with cracks

    Directory of Open Access Journals (Sweden)

    В.В. Астанін

    2010-01-01

    Full Text Available  The linear fracture mechanics methods were applied for implementation a principle called safe damage. The problem of stress intensity coefficients determination was considered and a numerical method for their calculation was proposed. An application of the method for structure members with damages and cracks was shown. The analysis of stress-strain states for plates and strips with cracks were fulfilled. The values of stress intensity coefficients К1 for bodies in different configuration were determined based on solution of proper boundary problems and comparison obtained results with known solutions was  carried out. Several options of points location at determination displacements fields on crack surface were analyzed.

  18. Effects of high-intensity training on cardiovascular risk factors in pre- and postmenopausal women

    DEFF Research Database (Denmark)

    Mandrup Jensen, Camilla Maria; Egelund, Jon; Nyberg, Michael Permin

    2017-01-01

    and cardiovascular disease in late pre- and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training. METHODS: A 3-month high-intensity aerobic training intervention, involving healthy, non-obese, late pre- (n=40) and early postmenopausal (n=39) women....... A three month intervention of high-intensity aerobic training reduces risk factors for type 2 diabetes and cardiovascular disease to a similar extent in late pre- and early postmenopausal women.......BACKGROUND: Menopause is associated with increased risk of cardiovascular disease and the causal factors have been proposed to be the loss of estrogen and the subsequent alterations of the hormonal milieu. However, which factors that contribute to the deterioration of cardio-metabolic health...

  19. Factors Influencing Patients' Sleep in the Intensive Care Unit: Perceptions of Patients and Clinical Staff.

    Science.gov (United States)

    Ding, Qinglan; Redeker, Nancy S; Pisani, Margaret A; Yaggi, Henry K; Knauert, Melissa P

    2017-07-01

    Multiple factors are believed to contribute to disruption of patients' sleep and negatively affect clinical outcomes in the intensive care unit. Achieving restorative sleep for critically ill patients remains a challenge. To explore the perceptions and beliefs of staff, patients, and surrogates regarding the environmental and nonenvironmental factors in the medical intensive care unit that affect patients' sleep. This qualitative study included 24 medical intensive care unit staff (7 physicians, 5 respiratory therapists, 10 nurses, and 2 patient-care assistants), 8 patients, and 6 patient surrogates. Semistructured interviews were conducted, and qualitative analysis of content was used to code, categorize, and identify interview themes. Interview responses revealed 4 themes with related subthemes: (1) The overnight medical intensive care unit environment does affect sleep, (2) nonenvironmental factors such as difficult emotions and anxiety also affect sleep, (3) respondents' perceptions about sleep quality in the medical intensive care unit were highly variable, and (4) suggestions for sleep improvement included reassuring patients and care-clustering strategies. Results of this study suggest that environment is not the only factor influencing patients' sleep. Decreases in environmental sources of disturbance are necessary but not sufficient for sleep improvement. Guideline-recommended clustered care is needed to provide adequate sleep opportunity, but patients' emotions and anxiety also must be addressed. ©2017 American Association of Critical-Care Nurses.

  20. Factors That Influence Running Intensity in Interchange Players in Professional Rugby League.

    Science.gov (United States)

    Delaney, Jace A; Thornton, Heidi R; Duthie, Grant M; Dascombe, Ben J

    2016-11-01

    Rugby league coaches adopt replacement strategies for their interchange players to maximize running intensity; however, it is important to understand the factors that may influence match performance. To assess the independent factors affecting running intensity sustained by interchange players during professional rugby league. Global positioning system (GPS) data were collected from all interchanged players (starters and nonstarters) in a professional rugby league squad across 24 matches of a National Rugby League season. A multilevel mixed-model approach was employed to establish the effect of various technical (attacking and defensive involvements), temporal (bout duration, time in possession, etc), and situational (season phase, recovery cycle, etc) factors on the relative distance covered and average metabolic power (P met ) during competition. Significant effects were standardized using correlation coefficients, and the likelihood of the effect was described using magnitude-based inferences. Superior intermittent running ability resulted in very likely large increases in both relative distance and P met . As the length of a bout increased, both measures of running intensity exhibited a small decrease. There were at least likely small increases in running intensity for matches played after short recovery cycles and against strong opposition. During a bout, the number of collision-based involvements increased running intensity, whereas time in possession and ball time out of play decreased demands. These data demonstrate a complex interaction of individual- and match-based factors that require consideration when developing interchange strategies, and the manipulation of training loads during shorter recovery periods and against stronger opponents may be beneficial.

  1. Further studies on stress intensity factors of semi-elliptical cracks in pressurized cylinders

    International Nuclear Information System (INIS)

    Kobayashi, A.S.; Emery, A.F.; Love, W.J.; Jain, A.

    1979-01-01

    The authors have used, in the past, the three-dimensional stress intensity magnification factor, Msub(KS), for a semi-elliptical surface crack in a flat plate with a curvature correction factor, Msub(C), to estimate the stress intensity magnification factor, Msub(K) = Msub(C) x Msub(KS), for unpressurized and pressurized inner semi-elliptical cracks and unpressurized outer semi-elliptical cracks in pressurized and thermally shocked cylinders. Recent papers by Atluri/Kathiresan, Welliot/Labbens/Pellissier-Tanon and McGowan/Raymund, however, showed that while this plate analogy with curvature correction provided reasonable estimates of the stress intensity factors at the deepest crack penetration, it underestimated the stress intensity factors at the cylindrical surface. The source of this discrepancy was traced to the curvature correction factor Msub(C), which was re-evaluated for various crack configurations and cylindrical geometries studied. Using the updated Msub(C) together with the previously derived Msub(KS), stress intensity factor magnification factor, Msub(K), was rederived for: (1) Pressurized and unpressurized inner semi-elliptical cracks of two crack aspects ratios of b/a = 0.2 and 0.98 at crack depth of b/(Rsub(o)-Rsub(i)) = 0.4, 0.6, and 0.8 in pressurized cylinders with outside-to-inside radius ratios of Rsub(o)/Rsub(i) = 3/2, 5/4, 7/6, and 10/9. (2) Unpressurized outer semi-elliptical cracks of two crack aspect ratios of b/a = 0.2 and 0.98 at crack depths of b/(Rsub(o)-Rsub(i)) = 0.4, 0.6, and 0.8 in pressurized cylinders with outside-to-inside radius ratio of Rsub(o)/Rsub(i) = 3/2, 5/4, 7/6, and 10/9. (orig.)

  2. Validation of surface crack stress intensity factors of a tubular K-joint

    International Nuclear Information System (INIS)

    Lie, S.T.; Lee, C.K.; Chiew, S.P.; Shao, Y.B.

    2005-01-01

    Tubular K-joints are encountered widely in offshore structures, and the prediction of damaged joints depends very much on the accuracy of stress intensity factor solutions (SIFs). No parametric equations and very few results have been proposed and published in the literature for estimating the SIFs of any K-joints subjected to complex loading conditions. In this paper, a mesh generation method proposed previously for the Y-joint and T-joint has been extended to the K-joint. This method is realized by dividing the K-joint into several sub-zones with each zone consisting of different types of elements and mesh densities. This method has a distinct advantage of controlling the mesh quality, and most importantly the aspect ratio of the elements along the crack front. When the mesh of all the sub-zones has been generated automatically and completely, they are merged to form the complete model. The two most commonly used methods, namely the J-integral and displacement extrapolation, are used to evaluate the SIF values along the crack front of a typical K-joint. To validate the accuracy of these computed SIFs, a full-scale K-joint specimen was tested to failure under fatigue loading conditions. The standard alternating current potential drop (ACPD) technique was used to monitor the rate of crack propagation of the surface crack located at the hot spot stress region. Using the given material parameters C and m, the experimental SIFs were deduced, and they are found to be in good agreement with the computed SIFs obtained from the generated models. Hence, the proposed finite element models are both efficient and reliable

  3. High thermoelectric power factor from multilayer solution-processed organic films

    Science.gov (United States)

    Zuo, Guangzheng; Andersson, Olof; Abdalla, Hassan; Kemerink, Martijn

    2018-02-01

    We investigate the suitability of the "sequential doping" method of organic semiconductors for thermoelectric applications. The method consists of depositing a dopant (F4TCNQ) containing solution on a previously cast semiconductor (P3HT) thin film to achieve high conductivity, while preserving the morphology. For very thin films (˜25 nm), we achieve a high power factor around 8 μW/mK-2 with a conductivity over 500 S/m. For the increasing film thickness, conductivity and power factor show a decreasing trend, which we attribute to the inability to dope the deeper parts of the film. Since thick films are required to extract significant power from thermoelectric generators, we developed a simple additive technique that allows the deposition of an arbitrary number of layers without significant loss in conductivity or power factor that, for 5 subsequent layers, remain at ˜300 S/m and ˜5 μW/mK-2, respectively, whereas the power output increases almost one order of magnitude as compared to a single layer. The efficient doping in multilayers is further confirmed by an increased intensity of (bi)polaronic features in the UV-Vis spectra.

  4. Total Factor Productivity and Energy Intensity in Indian Manufacturing: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Santosh Kumar Sahu

    2011-01-01

    Full Text Available The objective of the paper is to estimate the transcendental logarithmic production function and further study the determinants of total factor productivity (TFP of Indian manufacturing industries. The estimation of TFP is based on four inputs model, where apart from labour and capital, material and energy are the other two inputs. The findings of the paper suggest that labour and material inputs play major role as compared to the capital and energy input. Age of the firm, ownership, energy intensity, embodied and disembodied technology imports, research and development and exports were considered as the possible determinants of the TFP in the second stage regression. The finding of the estimates suggest that age of the firm, export intensity and disembodied technology import are positively related to the TFP, where ownership, energy intensity, embodied technology import and R&D intensity are negatively related to the TFP of the firms for Indian manufacturing.

  5. Elasticity of population growth with respect to the intensity of biotic or abiotic driving factors.

    Science.gov (United States)

    Lee, Charlotte T

    2017-04-01

    Demographic analysis can elucidate how driving factors, such as climate or species interactions, affect populations. One important question is how growth would respond to future changes in the mean intensity of a driving factor or in its variability, such as might be expected in a fluctuating and shifting climate. Here I develop an approach to computing new stochastic elasticities to address this question. The linchpin of this novel approach is the multidimensional demographic difference that expresses how a population responds to change in the driving factor between two discrete levels of intensity. I use this difference to design a perturbation matrix that links data from common empirical sampling schemes with rigorous theory for stochastic elasticities. Although the starting point is a difference, the products of this synthesis are true derivatives: they are elasticity with respect to the mean intensity of a driving factor, and elasticity with respect to variability in a driving factor. Applying the methods to published data, I demonstrate how these new elasticities can shed light on growth rate response within and at the boundary of the previously observed range of the driving factor, thus helpfully indicating nonlinearity in the observed and in the potential future response. The stochastic approach simplifies in a fixed environment, yielding a compact formula for deterministic elasticity to a driving factor. © 2017 by the Ecological Society of America.

  6. Expanding Continuous Quality Improvement Capacity in the Medical Intensive Care Unit: Prehealth Volunteers as a Solution.

    Science.gov (United States)

    Priest, Kelsey C; Lobingier, Hannah; McCully, Nancy; Lombard, Jackie; Hansen, Mark; Uchiyama, Makoto; Hagg, Daniel S

    2016-01-01

    Health care delivery systems are challenged to support the increasing demands for improving patient safety, satisfaction, and outcomes. Limited resources and staffing are common barriers for making significant and sustained improvements. At Oregon Health & Science University, the medical intensive care unit (MICU) leadership team faced internal capacity limitations for conducting continuous quality improvement, specifically for the implementation and evaluation of the mobility portion of an evidence-based care bundle. The MICU team successfully addressed this capacity challenge using the person power of prehealth volunteers. In the first year of the project, 52 trained volunteers executed an evidence-based mobility intervention for 305 critically ill patients, conducting more than 200 000 exercise repetitions. The volunteers contributed to real-time evaluation of the project, with the collection of approximately 26 950 process measure data points. Prehealth volunteers are an untapped resource for effectively expanding internal continuous quality improvement capacity in the MICU and beyond.

  7. Risk factors for nosocomial infections in selected neonatal intensive care units in Colombia, South America.

    Science.gov (United States)

    Rojas, Mario A; Efird, Meica M; Lozano, Juan M; Bose, Carl L; Rojas, María X; Rondón, Martín A; Ruiz, Gloria; Piñeros, Juan G; Rojas, Catherine; Robayo, Guillermo; Hoyos, Angela; Gosendi, Maria H; Cruz, Hernan; O'Shea, Michael; Leon, Angela

    2005-08-01

    This study was designed to identify risk factors for nosocomial infections among infants admitted into eight neonatal intensive care units in Colombia. Knowledge of modifiable risk factors could be used to guide the design of interventions to prevent the problem. Data were collected prospectively from eight neonatal units. Nosocomial infection was defined as culture-proven infection diagnosed after 72 hours of hospitalization, resulting in treatment with antibiotics for >3 days. Associations were expressed as odds ratios. Logistic regression was used to adjust for potential confounders. From a total of 1504 eligible infants, 80 were treated for 127 episodes of nosocomial infection. Logistic regression analysis identified the combined exposure to postnatal steroids and H2-blockers, and use of oral gastric tubes for enteral nutrition as risk factors significantly associated with nosocomial infection. Nosocomial infections in Colombian neonatal intensive care units were associated with modifiable risk factors including use of postnatal steroids and H2-blockers.

  8. Factors associated with pain intensity and physical limitations after lateral ankle sprains

    NARCIS (Netherlands)

    Briet, Jan Paul; Houwert, Roderick M.; Hageman, Michiel G J S; Hietbrink, Falco; Ring, David C.; Verleisdonk, Egbert Jan J M

    2016-01-01

    Background Swelling, tenderness, and ecchymosis don't correlate with time to functional recovery in patients with a lateral ankle sprain. It is established that psychosocial factors such as symptoms of depression and low pain self-efficacy correlate with pain intensity and magnitude of limitations

  9. The Multi-state Latent Factor Intensity Model for Credit Rating Transitions

    NARCIS (Netherlands)

    Koopman, S.J.; Lucas, A.; Monteiro, A.

    2008-01-01

    A new empirical reduced-form model for credit rating transitions is introduced. It is a parametric intensity-based duration model with multiple states and driven by exogenous covariates and latent dynamic factors. The model has a generalized semi-Markov structure designed to accommodate many of the

  10. Stress intensity factor analysis of friction sliding at discontinuity interfaces and junctions

    CSIR Research Space (South Africa)

    Phan, AV

    2003-12-01

    Full Text Available A stress intensity factor (SIF) analysis for two dimensional fractures with frictional contact (crack friction) is presented. This analysis is carried out using the symmetric-Galerkin boundary element method, and a modified quarter-point crack tip...

  11. Measurement and interpretation of threshold stress intensity factors for steels in high-pressure hydrogen gas.

    Energy Technology Data Exchange (ETDEWEB)

    Dadfarnia, Mohsen (University of Illinois at Urbana-Champaign, Urbana, IL); Nibur, Kevin A.; San Marchi, Christopher W.; Sofronis, Petros (University of Illinois at Urbana-Champaign, Urbana, IL); Somerday, Brian P.; Foulk, James W., III; Hayden, Gary A. (CP Industries, McKeesport, PA)

    2010-07-01

    Threshold stress intensity factors were measured in high-pressure hydrogen gas for a variety of low alloy ferritic steels using both constant crack opening displacement and rising crack opening displacement procedures. The sustained load cracking procedures are generally consistent with those in ASME Article KD-10 of Section VIII Division 3 of the Boiler and Pressure Vessel Code, which was recently published to guide design of high-pressure hydrogen vessels. Three definitions of threshold were established for the two test methods: K{sub THi}* is the maximum applied stress intensity factor for which no crack extension was observed under constant displacement; K{sub THa} is the stress intensity factor at the arrest position for a crack that extended under constant displacement; and K{sub JH} is the stress intensity factor at the onset of crack extension under rising displacement. The apparent crack initiation threshold under constant displacement, K{sub THi}*, and the crack arrest threshold, K{sub THa}, were both found to be non-conservative due to the hydrogen exposure and crack-tip deformation histories associated with typical procedures for sustained-load cracking tests under constant displacement. In contrast, K{sub JH}, which is measured under concurrent rising displacement and hydrogen gas exposure, provides a more conservative hydrogen-assisted fracture threshold that is relevant to structural components in which sub-critical crack extension is driven by internal hydrogen gas pressure.

  12. Trading Dynamics in the Foreign Exchange Market: A Latent Factor Panel Intensity Approach

    DEFF Research Database (Denmark)

    Nolte, Ingmar; Voev, Valeri

    2011-01-01

    We develop a panel intensity framework for the analysis of complex trading activity datasets containing detailed information on individual trading actions in different securities for a set of investors. A feature of the model is the presence of a time varying latent factor, which captures...

  13. Posttraumatic Stress Disorder's Frequency and Intensity Ratings Are Associated with Factor Structure Differences in Military Veterans

    Science.gov (United States)

    Elhai, Jon D.; Palmieri, Patrick A.; Biehn, Tracey L.; Frueh, B. Christopher; Magruder, Kathryn M.

    2010-01-01

    We examined possible differences in the factor structure of posttraumatic stress disorder (PTSD) on the basis of whether frequency or intensity symptom response formats were used to assess PTSD. Participants included 669 veterans recruited from an epidemiological study of four Veterans Affairs Medical Centers' primary care clinics in the…

  14. Novel Desaturation Cell to Quantify Gushing Intensity: A Preliminary Study on Model Solutions

    Czech Academy of Sciences Publication Activity Database

    Novák, Pavel; Poštulková, Michaela; Růžička, Marek; Brányik, T.

    2015-01-01

    Roč. 73, č. 2 (2015), s. 185-189 ISSN 0361-0470 R&D Projects: GA MŠk(CZ) LD13018 Institutional support: RVO:67985858 Keywords : gushing * desaturation cell * gushing matrix Subject RIV: EI - Biotechnology ; Bionics Impact factor: 0.492, year: 2015

  15. Accurate solutions of Colebrook-White's friction factor formulae ...

    African Journals Online (AJOL)

    Estimations of friction factor (Ff) in pipeline systems and fluid transport are essential ingredients in engineering fields and processes. In this paper explicit friction factor formulae (Fff) were proposed and evaluated with an aim of developing error free Fff. General Fff that relate Ff, Reynolds number (Re) and relative roughness ...

  16. Travelling wave solutions for some time-delayed equations through factorizations

    International Nuclear Information System (INIS)

    Fahmy, E.S.

    2008-01-01

    In this work, we use factorization method to find explicit particular travelling wave solutions for the following important nonlinear second-order partial differential equations: The generalized time-delayed Burgers-Huxley, time-delayed convective Fishers, and the generalized time-delayed Burgers-Fisher. Using the particular solutions for these equations we find the general solutions, two-parameter solution, as special cases

  17. [Risk factors for nosocomial infection in a level III Neonatal Intensive Care Unit].

    Science.gov (United States)

    García, Heladia; Torres-Gutiérrez, Javier; Peregrino-Bejarano, Leoncio; Cruz-Castañeda, Marco Antonio

    2015-01-01

    Nosocomial infections are a major and a frequent problem in neonatal intensive care units and increase morbidity, mortality, and costs. The objective of this study was to identify the risk factors associated with nosocomial infections in a neonatal intensive care unit. Nested case control study. Records from patients were registered: gestational age, sex, birth weight, central venous catheter and other devices, congenital malformations, surgeries, mechanical ventilation, steroid use, H2 blockers, length of stay in neonatal intensive care unit, type of infection, and etiological agent. We studied 188 cases with nosocomial infections and 192 controls without nosocomial infections. The most frequent infection was sepsis (34.8%) and coagulase negative Staphylococcus was the principal etiological agent (37.2%). The risk factors associated with nosocomial infection were central venous catheter (OR: 7.3; 95% CI: 2.3-22.8), duration of neonatal intensive care unit stay>14 days (OR: 3.4; 95% CI: 1.7-6.7), H2 blockers (OR: 2.3; 95% CI: 1.2-4.2), number of surgeries≥2 (OR: 3; 95% CI: 1.1-7.9) and mechanical ventilation>7 days (OR: 2.1; 95% CI: 1.1-4.2). Some risk factors associated to nosocomial infections in this study are similar to those found previously, with the exception of the number of surgeries that was not reported in previous studies.

  18. Influence of Urbanization Factors on Surface Urban Heat Island Intensity: A Comparison of Countries at Different Developmental Phases

    Directory of Open Access Journals (Sweden)

    Yaoping Cui

    2016-07-01

    Full Text Available Urbanization is a global problem with demographic trends. The urban heat island plays a dominant role in local climate systems. Despite existing efforts to understand the impacts of multiple urbanization factors on the urban heat island globally, very little is known about the attribution of urban heat island magnitude to urbanization in different locations or developmental phases. In this study, based on global land surface temperature data, urban spatial domain data, gross domestic product (GDP, and population data, we analyzed the influence of multiple urbanization factors on global surface urban heat island intensity (SUHII. We also tentatively compared the abovementioned factors between different regions across the globe, especially between China and the USA, the largest countries that are experiencing or have experienced rapid urbanization in recent decades. The results showed that global SUHII had remarkable spatial heterogeneity due to the geographical and socioeconomic variation between cities. There was a significant correlation between SUHII and population as well as GDP in global cities. Moreover, this study suggested that the impacts of population on SUHII might be stronger in the early stages of urbanization, and the GDP factor would become a critical factor at a certain development level. The urban area also had non-ignorable impacts on SUHII, while the correlation between SUHII and urban shape was relatively weak. All these may imply that the best approach to slow down SUHII is to find other solutions, e.g., optimize the spatial configuration of urban internal landscapes, when the urbanization reaches a high level.

  19. accurate solutions of colebrook- white's friction factor formulae

    African Journals Online (AJOL)

    HOD

    modeling of Fff using numerical methods and Microsoft Excel Solver are better tools for estimating Ff in pipeline flow problems. Keywords: Friction factor, MSC; AIC; Reynolds number; Engineering Field; pipe flow, statistical methods. 1. INTRODUCTION. In pipeline systems, various parameters are involved in pipe network ...

  20. Conflict at Higher Education Institutions: Factors and Solutions for Yemen

    Science.gov (United States)

    Muthanna, Abdulghani; Sang, Guoyuan

    2018-01-01

    This is a qualitative case study focusing on reporting the dynamics that cause conflicts between academics and administrators in higher education in Yemen. Drawing upon a critical review of two policy documents, observational research and in-depth interviews with 59 administrators and academics, the article presents the key factors for conflict in…

  1. Confining pressure effects on stress intensity factors: A 3D finite ...

    African Journals Online (AJOL)

    Revue Synthèse N° 19, Décembre 2008. M.R.M. Aliha et al. 33. Confining pressure effects on stress intensity factors: A 3D finite element analysis. M.R.M. Aliha, M.R. Ayatollahi et M.M.S. Mousavi. Fatigue and Fracture Lab., Department of Mechanical Engineering,. Iran University of Science and Technology, Narmak, Tehran, ...

  2. Factors Affecting the Neonatal Intensive Care Unit Stay Duration in Very Low Birth Weight Premature Infants

    OpenAIRE

    Niknajad, Akram; Ghojazadeh, Morteza; Sattarzadeh, Niloufar; Bashar Hashemi, Fazileh; Dezham Khoy Shahgholi, Farid

    2012-01-01

    Introduction: Improved survival of very low birth weight (VLBW) premature infants requires urgent intensive care, professional nursing and medical care. On the other hand, long hospital stay period imposes emotional and economic burdens on the family and society. Therefore, it is necessary to clarify the most important factors affecting their hospitalization duration to lessen unwanted outcomes of premature birth and to eliminate or relieve the problems. Methods: In a descri...

  3. The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit

    OpenAIRE

    Zhang, Shumin; Sun, Xiaofeng; Lei, Yan

    2017-01-01

    The study was aimed to investigate the pathogens distribution and risk factors for PICC-related bloodstream infection in intensive care unit (ICU) patients. 402 patients placed with PICC in ICU were recruited in the study. The microbiological characteristics of PICC-related infection were investigated by Vitek 2 Compact automated microbial system. Antibiotics sensitivity was performed with disk diffusion and minimum inhibitory concentration (MIC) methods. Multivariate logistic and cox analyse...

  4. The maximum possible stress intensity factor for a crack in an unknown residual stress field

    International Nuclear Information System (INIS)

    Coules, H.E.; Smith, D.J.

    2015-01-01

    Residual and thermal stress fields in engineering components can act on cracks and structural flaws, promoting or inhibiting fracture. However, these stresses are limited in magnitude by the ability of materials to sustain them elastically. As a consequence, the stress intensity factor which can be applied to a given defect by a self-equilibrating stress field is also limited. We propose a simple weight function method for determining the maximum stress intensity factor which can occur for a given crack or defect in a one-dimensional self-equilibrating stress field, i.e. an upper bound for the residual stress contribution to K I . This can be used for analysing structures containing defects and subject to residual stress without any information about the actual stress field which exists in the structure being analysed. A number of examples are given, including long radial cracks and fully-circumferential cracks in thick-walled hollow cylinders containing self-equilibrating stresses. - Highlights: • An upper limit to the contribution of residual stress to stress intensity factor. • The maximum K I for self-equilibrating stresses in several geometries is calculated. • A weight function method can determine this maximum for 1-dimensional stress fields. • Simple MATLAB scripts for calculating maximum K I provided as supplementary material.

  5. Factors Associated with Fatality during the Intensive Phase of Anti-Tuberculosis Treatment

    Science.gov (United States)

    Casals, M.; Caminero, J. A.; García-García, J. M.; Jiménez-Fuentes, M. A.; Medina, J. F.; Millet, J. P.; Ruiz-Manzano, J.; Caylá, J.

    2016-01-01

    Objective To determine the case-fatality rate (CFR) at the end of the intensive phase of tuberculosis (TB) treatment, and factors associated with fatality. Methods TB patients diagnosed between 2006 and 2013 were followed-up during treatment. We computed the CFR at the end of the intensive phase of TB treatment, and the incidence of death per 100 person-days (pd) of follow-up. We performed survival analysis using the Kaplan-Meier method and Cox regression, and calculate hazard ratios (HR) and 95% confidence intervals (CI). Results A total of 5,182 patients were included, of whom 180 (3.5%) died; 87 of these deaths (48.3%) occurred during the intensive phase of treatment, with a CFR of 1.7%. The incidence of death was 0.028/100 pd. The following factors were associated with death during the intensive phase: being >50 years (HR = 36.9;CI:4.8–283.4); being retired (HR = 2.4;CI:1.1–5.1); having visited the emergency department (HR = 3.1;CI:1.2–7.7); HIV infection (HR = 3.4;CI:1.6–7.2); initial standard treatment with 3 drugs (HR = 2.0;CI:1.2–3.3) or non-standard treatments (HR = 2.68;CI:1.36–5.25); comprehension difficulties (HR = 2.8;CI:1.3–6.1); and smear-positive sputum (HR = 2.3-CI:1.0–4.8). Conclusion There is a non-negligible CFR during the intensive phase of TB, whose reduction should be prioritised. The CFR could be a useful indicator for evaluating TB programs. PMID:27487189

  6. Alternate Solution to Generalized Bernoulli Equations via an Integrating Factor: An Exact Differential Equation Approach

    Science.gov (United States)

    Tisdell, C. C.

    2017-01-01

    Solution methods to exact differential equations via integrating factors have a rich history dating back to Euler (1740) and the ideas enjoy applications to thermodynamics and electromagnetism. Recently, Azevedo and Valentino presented an analysis of the generalized Bernoulli equation, constructing a general solution by linearizing the problem…

  7. The potential etiologic factors influencing tinnitus intensity in patients with temporomandibular disorders.

    Science.gov (United States)

    Demirkol, Nermin; Demirkol, Mehmet; Usumez, Aslihan; Sari, Fatih; Akcaboy, Cihan

    2017-08-30

    To investigate the potential relationships between the intensity of tinnitus associated with temporomandibular disorders (TMD) and potential etiologic factors, including age, gender, freeway space, sleep bruxism (SB), joint clicking, and headache. The sample was comprised of 90 patients without any hearing loss, as confirmed by otorhinolaryngology, who self-reported subjective tinnitus and simultaneous TMD, based on the Research Diagnostic Criteria for TMD (RDC/TMD). The results showed a positive, weak correlation between the intensity of tinnitus and age (r = 0.225, p = 0.033). The presence of SB and headache were seen in higher proportions in the present sample, at 75.5% (n = 68) and 66.6% (n = 60), respectively. In a population of patients with subjective tinnitus and TMD, no significant associations were found between tinnitus intensity and age, freeway space, SB, clicking presence, and headache, though gender did show a weak correlation with tinnitus intensity.

  8. Analysis of contributing factors associated to related patients safety incidents in Intensive Care Medicine.

    Science.gov (United States)

    Martín Delgado, M C; Merino de Cos, P; Sirgo Rodríguez, G; Álvarez Rodríguez, J; Gutiérrez Cía, I; Obón Azuara, B; Alonso Ovies, Á

    2015-01-01

    To explore contributing factors (CF) associated to related critical patients safety incidents. SYREC study pos hoc analysis. A total of 79 Intensive Care Departments were involved. The study sample consisted of 1.017 patients; 591 were affected by one or more incidents. The CF were categorized according to a proposed model by the National Patient Safety Agency from United Kingdom that was modified. Type, class and severity of the incidents was analyzed. A total 2,965 CF were reported (1,729 were associated to near miss and 1,236 to adverse events). The CF group more frequently reported were related patients factors. Individual factors were reported more frequently in near miss and task related CF in adverse events. CF were reported in all classes of incidents. The majority of CF were reported in the incidents classified such as less serious, even thought CF patients factors were associated to serious incidents. Individual factors were considered like avoidable and patients factors as unavoidable. The CF group more frequently reported were patient factors and was associated to more severe and unavoidable incidents. By contrast, individual factors were associated to less severe and avoidable incidents. In general, CF most frequently reported were associated to near miss. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  9. Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

    Directory of Open Access Journals (Sweden)

    Valerie J. Ehlers

    2013-02-01

    Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviewswere conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

  10. Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

    Directory of Open Access Journals (Sweden)

    Valerie J. Ehlers

    2013-02-01

    Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit (MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviews were conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% (n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

  11. Modifiable risk factors for mechanical ventilator-associated pneumonia in intensive care

    Directory of Open Access Journals (Sweden)

    Raquel de Mendonça Nepomuceno

    2014-01-01

    Full Text Available Backgound and Objectives: Ventilator-associated pneumonia is a pulmonary infection that occurs 48 to 72 hours after endotracheal intubation and institution of mechanical ventilation, being considered one of the most feared adverse effects of intensive care therapy. Its incidence affects 10-30% of patients as an important cause of morbidity and mortality, of which mortality rate can exceed 25%. Modifiable risk factors are seen as crucial in decision-making for its treatment and prevention. Thus, the modifiable risk factors for pneumonia associated with invasive mechanical ventilation in patients admitted to the intensive care unit were described. Methods: This is a literature review carried out at Lilacs, SciELO, MEDLINE and Bdenf databases, to collect and summarize publications and subsequently, critically evaluate the risk factors for ventilator-associated pneumonia. Results: The inappropriate or indiscriminate use of antibiotics, lack of knowledge about the microbiota of the ICU and non compliance of the team regarding preventive measures predominated. Conclusion: Professionals must be made aware of the identified risk factors in order to carry out direct actions with short-term impact in the prevention and effective control of ventilator-associated pneumonia.

  12. On the existence of an unambiguous solution in factor analysis of dynamic studies

    International Nuclear Information System (INIS)

    Samal, M.; Surova, H.; Penicka, P.; Marikova, E.; Dienstbier, Z.; Karny, M.

    1989-01-01

    Achievement of an unambiguous solution in factor analysis of dynamic radionuclide studies depends on constraints reflecting the known properties of factors. The constraints should be tight enough to prevent ambiguity but sufficiently general in order to ensure the data-based derivation of factors. In dynamic scintigraphy, the non-negativity of factors is their essential property which is implied by the physical nature of measured quantities. Considering factors as the images of compartments in the distribution space of a radiopharmaceutical (i.e. performing the factor analysis in the spatial domain), a powerful additional constraint can be applied. This constraint is based on the presence of segments in the image matrix where the subtotal number of compartments is projected. Using this constraint, the existence of physiologically related unique solution in factor analysis can be proved providing the number of factors is chosen properly. (author)

  13. Parametric oscillators from factorizations employing a constant-shifted Riccati solution of the classical harmonic oscillator

    Energy Technology Data Exchange (ETDEWEB)

    Rosu, H.C., E-mail: hcr@ipicyt.edu.mx [IPICyT, Instituto Potosino de Investigacion Cientifica y Tecnologica, Apdo Postal 3-74 Tangamanga, 78231 San Luis Potosi, S.L.P. (Mexico); Khmelnytskaya, K.V. [Universidad Autonoma de Queretaro, Centro Universitario, Cerro de las Campanas s/n, C.P. 76010 Santiago de Queretaro, Qro. (Mexico)

    2011-09-19

    We determine the kind of parametric oscillators that are generated in the usual factorization procedure of second-order linear differential equations when one introduces a constant shift of the Riccati solution of the classical harmonic oscillator. The mathematical results show that some of these oscillators could be of physical nature. We give the solutions of the obtained second-order differential equations and the values of the shift parameter providing strictly periodic and antiperiodic solutions. We also notice that this simple problem presents parity-time (PT) symmetry. Possible applications are mentioned. -- Highlights: → A particular Riccati solution of the classical harmonic oscillator is shifted by a constant. → Such a solution is used in the factorization brackets to get different equations of motion. → The properties of the parametric oscillators obtained in this way are examined.

  14. The Comparison of Chlorhexidine Solution and Swab With Toothbrush and Toothpaste Effect on Preventing Oral Lesions in Hospitalized Patients in Intensive Care Unit

    OpenAIRE

    Estaji, Zahra; Alinejad, Mohammad; Rakhshani, Mohammad Hassan; Rad, Mojtaba

    2015-01-01

    Background: Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth. Methods: In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target...

  15. Influence of local meshing size on stress intensity factor of orthopedic lag screw

    Science.gov (United States)

    Husain, M. N.; Daud, R.; Basaruddin, K. S.; Mat, F.; Bajuri, M. Y.; Arifin, A. K.

    2017-09-01

    Linear elastic fracture mechanics (LEFM) concept is generally used to study the influence of crack on the performance of structures. In order to study the LEFM concept on damaged structure, the usage of finite element analysis software is implemented to do the simulation of the structure. Mesh generation is one of the most crucial procedures in finite element method. For the structure that crack or damaged, it is very important to determine the accurate local meshing size at the crack tip of the crack itself in order to get the accurate value of stress intensity factor, KI. Pre crack will be introduced to the lag screw based on the von mises' stress result that had been performed in previous research. This paper shows the influence of local mesh arrangement on numerical value of the stress intensity factor, KI obtained by the displacement method. This study aims to simulate the effect of local meshing which is the singularity region on stress intensity factor, KI to the critical point of failure in screw. Five different set of wedges meshing size are introduced during the simulation of finite element analysis. The number of wedges used to simulate this research is 8, 10, 14, 16 and 20. There are three set of numerical equations used to validate the results which are brown and srawley, gross and brown and Tada equation. The result obtained from the finite element software (ANSYS APDL) has a positive agreement with the numerical analysis which is Brown and Srawley compared to other numerical formula. Radius of first row size of 0.014 and singularity element with 14 numbers of wedges is proved to be the best local meshing for this study.

  16. Determination of Stress Intensity Factor Value for Chevron-Notched Specimens – Pilot Study

    Directory of Open Access Journals (Sweden)

    Sobek Jakub

    2017-12-01

    Full Text Available The description of material behavior is one of important information for its application in civil engineering. One area is covering fracture mechanical properties. For evaluation of the fracture toughness values, the knowledge of calibration curve is important. The paper is aimed on the numerical modelling of the test specimens with a chevron notch serving as an initiator of the stress distribution at the crack tip. The three-point bending test configuration with a chevron notch is used for the simulation given by plane model with different layer width of cross section part and output is given by the value of the stress intensity factor KI for tension loading mode.

  17. Admission factors associated with intensive care unit readmission in critically ill oncohematological patients: a retrospective cohort study.

    Science.gov (United States)

    Rodrigues, Cinthia Mendes; Pires, Ellen Maria Campos; Feliciano, Jorge Patrick Oliveira; Vieira, Jose Mauro; Taniguchi, Leandro Utino

    2016-01-01

    The purpose of our study was to determine the admission factors associated with intensive care unit readmission among oncohematological patients. Retrospective cohort study using an intensive care unit database from a tertiary oncological center. The participants included 1,872 critically ill oncohematological patients who were admitted to the intensive care unit from January 2012 to December 2014 and who were subsequently discharged alive. We used univariate and multivariate analysis to identify the admission risk factors associated with later intensive care unit readmission. One hundred seventy-two patients (9.2% of 1,872 oncohematological patients discharged alive from the intensive care unit) were readmitted after intensive care unit discharge. The readmitted patients were sicker compared with the non-readmitted group and had higher hospital mortality (32.6% versus 3.7%, respectively; p intensive care unit readmission were male sex (OR: 1.5, 95% CI: 1.07 - 2.12; p = 0.019), emergency surgery as the admission reason (OR: 2.91, 95%CI: 1.53 - 5.54; p = 0.001), longer hospital length of stay before intensive care unit transfer (OR: 1.02, 95%CI: 1.007 - 1.035; p = 0.003), and mechanical ventilation (OR: 2.31, 95%CI: 1.57 - 3.40; p intensive care unit readmission, most of which are not amenable to interventions. The identification of risk factors at intensive care unit discharge might be a promising approach.

  18. The Excess Heat Factor: A Metric for Heatwave Intensity and Its Use in Classifying Heatwave Severity

    Directory of Open Access Journals (Sweden)

    John R. Nairn

    2014-12-01

    Full Text Available Heatwaves represent a significant natural hazard in Australia, arguably more hazardous to human life than bushfires, tropical cyclones and floods. In the 2008/2009 summer, for example, many more lives were lost to heatwaves than to that summer’s bushfires which were among the worst in the history of the Australian nation. For many years, these other forms of natural disaster have received much greater public attention than heatwaves, although there are some signs of change. We propose a new index, called the excess heat factor (EHF for use in Australian heatwave monitoring and forecasting. The index is based on a three-day-averaged daily mean temperature (DMT, and is intended to capture heatwave intensity as it applies to human health outcomes, although its usefulness is likely to be much broader and with potential for international applicability. The index is described and placed in a climatological context in order to derive heatwave severity. Heatwave severity, as characterised by the climatological distribution of heatwave intensity, has been used to normalise the climatological variation in heatwave intensity range across Australia. This methodology was used to introduce a pilot national heatwave forecasting service for Australia during the 2013/2014 summer. Some results on the performance of the service are presented.

  19. The acute effect of moderate intensity aquatic exercise on coagulation factors in haemophiliacs.

    Science.gov (United States)

    Beltrame, Luis Gustavo Normanton; Abreu, Laurinda; Almeida, Jussara; Boullosa, Daniel Alexandre

    2015-05-01

    The objective of this cross-sectional study was to analyse the acute effect of aquatic exercise on haemostasis in persons with haemophilia. Ten adult haemophiliacs (8 type A, 2 type B) familiarized with aquatic training performed a 20-min exercise session in a swimming pool at an intensity of ~70% maximum heart rate (HR). Blood samples were collected immediately after the training session. The haemostatic parameters selected for analyses were factor VIII (FVIII), prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen. There were unclear effects of the exercise bout on FVIII and APTT, with a possibly beneficial effect on PT (-11·4%; 90% confidence interval: -26·1;3·3%), and a trivial change on fibrinogen levels. It was found an association between the mean rise in HR during exercise and the decrement in PT after exercise (r = 0·729; P = 0·026). The greater changes were observed in the patients diagnosed with a moderate level of haemophilia. It is concluded that a short bout of moderate intensity of aquatic exercise may have a positive influence on PT in adults with haemophilia with greater changes in those individuals exhibiting a greater rise in HR during exercise. This may be an important issue to the haemostatic control of haemophiliacs in clinical settings. Further studies are warranted for testing the influence of different aquatic exercise intensities on haemostasis. © 2014 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  20. A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Yang Su-Pen

    2013-01-01

    Full Text Available Abstract Background The incidence of fungal healthcare-associated infection (HAI has increased in a major teaching hospital in the northern part of Taiwan over the past decade, especially in the intensive care units (ICUs. The purpose of this study was to determine the factors that were responsible for the outbreak and trend in the ICU. Methods Surveillance fungal cultures were obtained from “sterile” objects, antiseptic solutions, environment of infected patients and hands of medical personnel. Risk factors for comparison included age, gender, admission service, and total length of stay in the ICU, Acute Physiology and Chronic Health Evaluation (APACHE II scores at admission to the ICU, main diagnosis on ICU admission, use of invasive devices, receipt of hemodialysis, total parenteral nutrition (TPN use, history of antibiotic therapy before HAI or during ICU stay in no HAI group, and ICU discharge status (ie, dead or alive. Univariable analysis followed by multiple logistic regression analysis was performed to identify the independent risk factors for ICU fungal HAIs and ICU mortality. Results There was a significant trend in ICU fungal HAIs from 1998 to 2009 (P Candida albicans (27.3%, Candida tropicalis (6.6%, Candida glabrata (6.6%, Candida parapsilosis (1.9%, Candida species (0.8%, and other fungi (1.9%. Candida albicans accounted for 63% of all Candida species. Yeasts were found in the environment of more heavily infected patients. The independent risk factors (P P  Conclusions There was a secular trend of an increasing number of fungal HAIs in our ICU over the past decade. Patients with ICU fungal HAIs had a significantly higher mortality rate than did patients without ICU HAIs. Total parenteral nutrition was a significant risk factor for all types of ICU fungal HAIs, and its use should be monitored closely.

  1. Risk factors for pressure ulcer development in Intensive Care Units: A systematic review.

    Science.gov (United States)

    Lima Serrano, M; González Méndez, M I; Carrasco Cebollero, F M; Lima Rodríguez, J S

    Pressure ulcers represent a significant problem for patients, professionals and health systems. Their reported incidence and prevalence are significant worldwide. Their character iatrogenic states that its appearance is preventable and its incidence is an indicator of scientific and technical quality both in primary care and specialized care. The aim of this review was to identify risk factors associated with the occurrence of pressure ulcers in critically ill patients. The PRISMA Declaration recommendations have been followed and adapted to studies identifying risk factors. A qualitative systematic review of primary studies has been performed and a search was conducted of the PubMed, The Cochrane Library, Scopus and Web of Science databases. Methodological limitations in observational studies have been considered. From 200 references, 17 fulfilled the eligibility criteria. These studies included 19,363 patients admitted to intensive care units. Six studies were classified as high quality and 11 were classified as moderate quality. Risk factors that emerged as predictive of pressure ulcers development more frequently included age, length of ICU stay, diabetes, time of MAP <60-70mmHg, mechanical ventilation, length of mechanical ventilation, intermittent haemodialysis or continuous veno-venous haemofiltration therapy, vasopressor support, sedation and turning. There is no single factors which can explain the occurrence of pressure ulcers. Rather, it is an interplay of factors that increase the probability of its development. Copyright © 2016 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  2. [Analysis of risk factors of ventilator-associated pneumonia in an intensive care unit].

    Science.gov (United States)

    Wang, Juan; Li, De-Xian; Yu, Chao-Xian; Huang, Su; Liang, Yan-Qiong

    2016-05-01

    To explore the risk factors of ventilator-associated pneumonia (VAP) in patients admitted in an intensive care unit (ICU) for pulmonary tuberculosis (TB). The clinical data of 143 patients admitted in the ICU at our center between January, 2014 and June, 2015 were reviewed. The patients with VAP and those without VAP were analyzed for risk factors of VAP in the setting of an ICU for pulmonary TB and compared for the duration of ventilation and hospital stay. The patients with pulmonary TB showed a significantly higher incidence of VAP in the ICU than those without TB. Univariate analysis suggested that the occurrence of VAP was significantly correlated with the duration of mechanical ventilation, invasive examination, pulmonary tuberculosis, lung structure changes, use of multiple antibiotics, diabetes, tracheal incision, indwelling gastric tube, APACHE II score, and coma (Prisk factors for VAP (Prisk of VAP with a high mortality rate as the result of multiple interacting risk factors. Pulmonary TB, prolonged mechanical ventilation, an APACHE II score >15, invasive operation, and use of multiple antibiotics are all independent risk factors for VAP in tuberculosis ICU.

  3. [Contact precautions in intensive care units: facilitating and inhibiting factors for professionals' adherence].

    Science.gov (United States)

    Oliveira, Adriana Cristina; Cardoso, Clareci Silva; Mascarenhas, Daniela

    2010-03-01

    The objective of this study was to identify facilitating and limiting factors for professionals' compliance with contact precautions in an intensive care unit of a general hospital. This cross-sectional study was performed from May to October 2007, using a semi-structured questionnaire for data collection. Participants were 102 professionals, as follows: nursing technician (54.9%), nurse (12.7%), preceptor physician (10.8%), apprentice physiotherapist (8.8%), preceptor physiotherapist (7.8%) and resident physician (4.9%). The limiting factors for compliance with hand cleansing were forgetting, lack of knowledge, distance from sink, skin irritation, and lack of materials. The use of scrubs presented the most difficulty (45%) because they were not available at the shower box, were inappropriately stored, and due to the heat and collective use. Glove use was the practice most easily conducted in everyday practice. Results show the need to implement precaution measures to minimize the dissemination of resistant microorganisms.

  4. Predisposing risk factors for delirium in living donor liver transplantation patients in intensive care units.

    Directory of Open Access Journals (Sweden)

    Szu-Han Wang

    Full Text Available BACKGROUND: Delirium is one of the main causes of increased length of intensive care unit (ICU stay among patients who have undergone living donor liver transplantation (LDLT. We aimed to evaluate risk factors for delirium after LDLT as well as to investigate whether delirium impacts the length of ICU and hospital stay. METHODS: Seventy-eight patients who underwent LDLT during the period January 2010 to December 2012 at a single medical center were enrolled. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU scale was used to diagnose delirium. Preoperative, postoperative, and hematologic factors were included as potential risk factors for developing delirium. RESULTS: During the study period, delirium was diagnosed in 37 (47.4% patients after LDLT. The mean onset of symptoms occurred 7.0±5.5 days after surgery and the mean duration of symptoms was 5.0±2.6 days. The length of stay in the ICU for patients with delirium (39.8±28.1 days was significantly longer than that for patients without delirium (29.3±19.0 days (p<0.05. Risk factors associated with delirium included history of alcohol abuse [odds ratio (OR = 6.40, 95% confidence interval (CI: 1.85-22.06], preoperative hepatic encephalopathy (OR = 4.45, 95% CI: 1.36-14.51, APACHE II score ≥16 (OR = 1.73, 95% CI: 1.71-2.56, and duration of endotracheal intubation ≥5 days (OR = 1.81, 95% CI: 1.52-2.23. CONCLUSIONS: History of alcohol abuse, preoperative hepatic encephalopathy, APACHE II scores ≥16 and endotracheal intubation ≥5 days were predictive of developing delirium in the ICU following liver transplantation surgery and were associated with increased length of ICU and hospital stay.

  5. Decisions to initiate involuntary commitment: the role of intensive community services and other factors.

    Science.gov (United States)

    McGarvey, Elizabeth Lloyd; Leon-Verdin, MaGuadalupe; Wanchek, Tanya Nicole; Bonnie, Richard J

    2013-02-01

    This study examined the predictors of actions to initiate involuntary commitment of individuals experiencing a mental health crisis. Emergency services clinicians throughout Virginia completed a questionnaire following each face-to-face evaluation of individuals experiencing a mental health crisis. Over a one-month period in 2007, a total of 2,624 adults were evaluated. Logistic hierarchical multiple regression was used to analyze the relationship between demographic, clinical, and service-related variables and outcomes of the emergency evaluations. Several factors predicted 84% of the actions taken to initiate involuntary commitment. These included unavailability of alternatives to hospitalization, such as temporary housing or residential crisis stabilization; evaluation of the client in a hospital emergency room or police station or while in police custody; current enrollment in treatment; and clinical factors related to the commitment criteria, including risk of self-harm or harm to others, acuity and severity of the crisis, and current drug abuse or dependence. A lack of intensive community-based treatment and support in lieu of hospitalization accounted for a significant portion of variance in actions to initiate involuntary commitment. Comprehensive community services and supports for individuals experiencing mental health crises may reduce the rate of involuntary hospitalization. There is a need to enrich intensive community mental health services and supports and to evaluate the impact of these enhancements on the frequency of involuntary mental health interventions.

  6. [Risk factors for neonatal pulmonary hemorrhage in the neonatal intensive care unit of a municipal hospital].

    Science.gov (United States)

    Fan, Jie; Hei, Ming-Yan; Huang, Xi-Lin; Li, Xiao-Ping

    2017-03-01

    To investigate the risk factors for neonatal pulmonary hemorrhage (NPH) in the neonatal intensive care unit (NICU) of a municipal hospital, and to provide a basis for the early identification and treatment of NPH. A total of 112 neonates who were admitted to the NICU of Shaoyang Central Hospital of Hunan Province and diagnosed with NPH were enrolled as the case group. A nested case-control method was used to select, as a control group (n=224), the neonates who underwent the treatment with an assisted mechanical ventilator and did not experience pulmonary hemorrhage. Univariate analysis and unconditional logistic regression analysis were used to identify the high risk factors for NPH. The univariate analysis showed that compared with the control group, the case group had significantly higher incidence rates of gestational diabetes and cholestasis in mothers, cesarean delivery, gestational age <34 weeks, 5-minute Apgar score ≤5, birth weight <2 500 g, heart failure and disseminated intravascular coagulation (DIC) before the development of NPH, partial pressure of oxygen/fraction of inspired oxygen (oxygenation index, OI) ≤100, and a reduction in mean platelet volume. The multivariate logistic regression analysis showed that DIC, heart failure, and OI ≤100 were independent risk factors for NPH (OR=33.975, 3.975, 1.818 respectively; P<0.05). Heart failure, OI ≤100, and DIC are risk factors for the development of NPH in the NICU of the municipal hospital.

  7. The microbiological characteristics and risk factors for PICC-related bloodstream infections in intensive care unit.

    Science.gov (United States)

    Zhang, Shumin; Sun, Xiaofeng; Lei, Yan

    2017-11-08

    The study was aimed to investigate the pathogens distribution and risk factors for PICC-related bloodstream infection in intensive care unit (ICU) patients. 402 patients placed with PICC in ICU were recruited in the study. The microbiological characteristics of PICC-related infection were investigated by Vitek 2 Compact automated microbial system. Antibiotics sensitivity was performed with disk diffusion and minimum inhibitory concentration (MIC) methods. Multivariate logistic and cox analyses were performed to identify the risk factors for PICC-related infection in ICU patients. 38 PICC-related infection cases were observed, and its morbidity was 9.45%. The morbidity was significantly higher in power PICC cases than that in common PICC cases. Gram-positive bacteria might be responsible for the major infection cases, followed by gram-negative bacteria, and fungi. Drug sensitivity analyses indicated that gram-negative bacteria showed low resistance to carbapenems antibiotics, and Cefperazone/sulbactam. The gram-positive bacterial exhibited sensitive to Teicoplanin and Vancomycin. The isolated fungi showed low resistance to the commonly used antifungal antibiotics. Multivariate analyses demonstrated that power PICC, high Charison scores, diabetes mellitus, double lumens triple lumens were risk factors for PICC-related infections among ICU patients. Power PICC, high Charison scores, diabetes mellitus, multi-lumens are risk factors for PICC-related bloodstream infection in ICU patients.

  8. Prognostic factors in pediatric sepsis study, from the Spanish Society of Pediatric Intensive Care.

    Science.gov (United States)

    Vila Pérez, David; Jordan, Iolanda; Esteban, Elisabeth; García-Soler, Patricia; Murga, Vega; Bonil, Vanesa; Ortiz, Irene; Flores, Carlos; Bustinza, Amaya; Cambra, Francisco Jose

    2014-02-01

    Sepsis and septic shock represent up to 30% of admitted patients in pediatric intensive care units, with a mortality that can exceed 10%. The objective of this study is to determine the prognostic factors for mortality in sepsis. Multicenter prospective descriptive study with patients (aged 7 days to 18 years) admitted to the pediatric intensive care units for sepsis, between January 2011 and April 2012. Data from 136 patients were collected. Eighty-seven were male (63.9%). The median age was a year and a half (P25-75 0.3-5.5 years). In 41 cases (30.1%), there were underlying diseases. The most common etiology was Neisseria meningitidis (31 cases, 22.8%) followed by Streptococcus pneumoniae (16 patients, 11.8%). Seventeen cases were fatal (12.5%). In the statistical analysis, the factors associated with mortality were nosocomial infection (P = 0.004), hypotension (P <0.001) and heart and kidney failure (P < 0.001 and P = 0.004, respectively). The numbers of leukocytes, neutrophils and platelets on admission were statistically lower in the group that died (P was 0.006, 0.013 and <0.001, respectively). Multivariate analysis showed that multiple organ failure, neutropenia, purpura or coagulopathy and nosocomial infection were independent risk factors for increased mortality (odds ratio: 17, 4.9, 9 and 9.2, respectively). Patients with sepsis and multiorgan failure, especially those with nosocomial infection or the presence of neutropenia or purpura, have a worse prognosis and should be monitored and treated early.

  9. Incidence and factors related to delirium in an intensive care unit.

    Science.gov (United States)

    Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

    2016-01-01

    To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium. Of the total 149 patients in the sample, 69 (46.3%) presented delirium during ICU stay, whose mean age, severity of illness and length of ICU stay were statistically higher. The factors related to delirium were: age, midazolam, morphine and propofol. Results showed high incidence of ICU delirium associated with older age, use of sedatives and analgesics, emphasizing the need for relevant nursing care to prevent and identify early, patients presenting these characteristics. Identificar a incidência de delirium, comparar as características demográficas e clínicas dos pacientes com e sem delirium e verificar os fatores relacionados ao delirium em pacientes internados em Unidade de Terapia Intensiva (UTI). Coorte prospectiva, cuja amostra foi constituída de pacientes internados em UTI de um hospital universitário. Variáveis demográficas, clínicas e da avaliação com o Confusion Assessment Method for Intensive Care Unit para identificação de delirium foram processadas para análise univariada, e regressão logística para identificar fatores relacionados à ocorrência do delirium. Do total de 149 pacientes da amostra, 69 (46,3%) apresentaram delirium durante a internação na UTI, observando-se que a média da idade, o índice de gravidade e o tempo de permanência nas UTI foram estatisticamente maiores. Os fatores relacionados ao delirium foram: idade, midazolam, morfina e propofol. Os

  10. Salivary nerve growth factor response to intense stress: effect of sex and body mass index.

    Science.gov (United States)

    Taylor, Marcus K; Laurent, Heidemarie K; Larson, Gerald E; Rauh, Mitchell J; Hiller Lauby, Melissa D; Granger, Douglas A

    2014-05-01

    Ample evidence links stress to psychiatric and neurological disease. Although many studies examine stress hormone secretion and receptor activity, exciting new developments signify a shift in focus to neuromodulatory systems influencing neuronal development, survival, and neuroplasticity. The purpose of this study was to characterize salivary nerve growth factor (sNGF) responses to intense stress exposure in healthy military members undergoing survival training. A second purpose was to explore effects of age, sex, education, and body mass index (BMI). One hundred sixteen military members (80% male) were studied before, during, and 24 h after a stressful mock-captivity exercise. sNGF was measured at all three time points. Reactivity, recovery, and residual elevation of sNGF were computed. General linear modeling with repeated measures evaluated effect of stress exposure, as well as the roles of age, sex, education, and BMI. sNGF increased 137% from baseline to intense stress. During recovery, sNGF remained elevated an average of 67% above baseline (i.e., residual elevation). Men showed greater sNGF reactivity than women quantified by larger absolute T1-T2Δ (+148.1 pg/mL vs. +64.9 pg/mL, peducation were shown. This study shows substantial reactivity and residual elevation of sNGF in response to intense stress exposure in healthy humans. Further research is needed to refine the sNGF assay, fully characterize the sNGF stress response, delineate correlates and mechanisms, and validate therapeutic applications. Published by Elsevier Ltd.

  11. [Pneumocystis jiroveci pneumonia: Clinical characteristics and mortality risk factors in an Intensive Care Unit].

    Science.gov (United States)

    Solano L, M F; Alvarez Lerma, F; Grau, S; Segura, C; Aguilar, A

    2015-01-01

    To describe the epidemiological characteristics of the population with Pneumocystis jiroveci (P. jiroveci) pneumonia, analyzing risk factors associated with the disease, predisposing factors for admission to an intensive care unit (ICU), and prognostic factors of mortality. A retrospective observational study was carried out, involving a cohort of patients consecutively admitted to a hospital in Spain from 1 January 2007 to 31 December 2011, with a final diagnosis of P. jiroveci pneumonia. The ICU and hospitalization service of Hospital del Mar, Barcelona (Spain). We included 36 patients with pneumonia due to P. jiroveci. Of these subjects, 16 required ICU admission (44.4%). The average age of the patients was 41.3 ± 12 years, and 23 were men (63.9%). A total of 86.1% had a history of human immunodeficiency virus (HIV) infection, and the remaining 13.9% presented immune-based disease subjected to immunosuppressive therapy. Risk factors associated to hospital mortality were age (51.8 vs. 37.3 years, P=.002), a higher APACHE score upon admission (17 vs. 13 points, P=.009), the need for invasive mechanical ventilation (27.8% vs. 11.1%, P=.000), requirement of vasoactive drugs (25.0% vs. 11.1%, P=.000), fungal coinfection (22.2% vs. 11.1%, P=.001), pneumothorax (16.7% vs. 83.3%, P=.000) and admission to the ICU (27.8% vs. 72.2% P=.000). The high requirement of mechanical ventilation and vasoactive drugs associated with fungal coinfection and pneumothorax in patients admitted to the ICU remain as risk factors associated with mortality in patients with P. jiroveci pneumonia. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  12. An assessment of ventilator-associated pneumonias and risk factors identified in the Intensive Care Unit.

    Science.gov (United States)

    Karatas, Mevlut; Saylan, Sedat; Kostakoglu, Ugur; Yilmaz, Gurdal

    2016-01-01

    Ventilator-associated pneumonia (VAP) is a significant cause of hospital-related infections, one that must be prevented due to its high morbidity and mortality. The purpose of this study was to evaluate the incidence and risk factors in patients developing VAP in our intensive care units (ICUs). This retrospective cohort study involved in mechanically ventilated patients hospitalized for more than 48 hours. VAP diagnosed patients were divided into two groups, those developing pneumonia (VAP(+)) and those not (VAP(-)).\\. We researched 1560 patients in adult ICUs, 1152 (73.8%) of whom were mechanically ventilated. The MV use rate was 52%. VAP developed in 15.4% of patients. The VAP rate was calculated as 15.7/1000 ventilator days. Mean length of stay in the ICU for VAP(+) and VAP(-) patients were (26.7±16.3 and 18.1±12.7 days (p<0.001)) and mean length of MV use was (23.5±10.3 and 12.6±7.4 days (p<0.001)). High APACHE II and Charlson co-morbidity index scores, extended length of hospitalization and MV time, previous history of hospitalization and antibiotherapy, reintubation, enteral nutrition, chronic obstructive pulmonary disease, cerebrovascular disease, diabetes mellitus and organ failure were determined as significant risk factors for VAP. The mortality rate in the VAP(+) was 65.2%, with 23.6% being attributed to VAP. VAPs are prominent nosocomial infections that can cause considerable morbidity and mortality in ICUs. Patient care procedures for the early diagnosis of patients with a high risk of VAP and for the reduction of risk factors must be implemented by providing training concerning risk factors related to VAP for ICU personnel, and preventable risk factors must be reduced to a minimum.

  13. Fast sweeping algorithm for accurate solution of the TTI eikonal equation using factorization

    KAUST Repository

    bin Waheed, Umair

    2017-06-10

    Traveltime computation is essential for many seismic data processing applications and velocity analysis tools. High-resolution seismic imaging requires eikonal solvers to account for anisotropy whenever it significantly affects the seismic wave kinematics. Moreover, computation of auxiliary quantities, such as amplitude and take-off angle, rely on highly accurate traveltime solutions. However, the finite-difference based eikonal solution for a point-source initial condition has an upwind source-singularity at the source position, since the wavefront curvature is large near the source point. Therefore, all finite-difference solvers, even the high-order ones, show inaccuracies since the errors due to source-singularity spread from the source point to the whole computational domain. We address the source-singularity problem for tilted transversely isotropic (TTI) eikonal solvers using factorization. We solve a sequence of factored tilted elliptically anisotropic (TEA) eikonal equations iteratively, each time by updating the right hand side function. At each iteration, we factor the unknown TEA traveltime into two factors. One of the factors is specified analytically, such that the other factor is smooth in the source neighborhood. Therefore, through the iterative procedure we obtain accurate solution to the TTI eikonal equation. Numerical tests show significant improvement in accuracy due to factorization. The idea can be easily extended to compute accurate traveltimes for models with lower anisotropic symmetries, such as orthorhombic, monoclinic or even triclinic media.

  14. SOLUTIONING

    Directory of Open Access Journals (Sweden)

    Maria de Hoyos Guajardo, Ph.D. Candidate, M.Sc., B.Eng.

    2004-11-01

    Full Text Available The theory that is presented below aims to conceptualise how a group of undergraduate students tackle non-routine mathematical problems during a problem-solving course. The aim of the course is to allow students to experience mathematics as a creative process and to reflect on their own experience. During the course, students are required to produce a written ‘rubric’ of their work, i.e., to document their thoughts as they occur as well as their emotionsduring the process. These ‘rubrics’ were used as the main source of data.Students’ problem-solving processes can be explained as a three-stage process that has been called ‘solutioning’. This process is presented in the six sections below. The first three refer to a common area of concern that can be called‘generating knowledge’. In this way, generating knowledge also includes issues related to ‘key ideas’ and ‘gaining understanding’. The third and the fourth sections refer to ‘generating’ and ‘validating a solution’, respectively. Finally, once solutions are generated and validated, students usually try to improve them further before presenting them as final results. Thus, the last section deals with‘improving a solution’. Although not all students go through all of the stages, it may be said that ‘solutioning’ considers students’ main concerns as they tackle non-routine mathematical problems.

  15. Analysis of Factors Influencing the Development of Xerostomia during Intensity-Modulated Radiotherapy

    Science.gov (United States)

    Randall, Ken; Stevens, Jason; Yepes, Juan Fernando; Randall, Marcus E.; Kudrimoti, Mahesh; Feddock, Jonathan; Xi, Jing; Kryscio, Richard J.; Miller, Craig S.

    2013-01-01

    OBJECTIVES Factors influencing xerostomia during intensity-modulated radiation therapy (IMRT) were assessed. METHODS A 6-week study of 32 head and neck cancer (HNC) patients was performed. Subjects completed the Xerostomia Inventory (XI) and provided stimulated saliva (SS) at baseline, week two and at end of IMRT. Influence of SS flow rate (SSFR), calcium and mucin 5b (MUC5b) concentrations and radiation dose on xerostomia was determined. RESULTS HNC subjects experienced mean SSFR decline of 36% by visit two (N=27; p=0.012) and 57% by visit three (N=20; p=0.0004), Concentrations of calcium and MUC5b increased, but not significantly during IMRT (p>0.05). Xerostomia correlated most with decreasing salivary flow rate as determined by Spearman correlations (pxerostomia. PMID:23523462

  16. INVESTIGATING THE COLLECTIVE ONLINE purchase PHENOMENON: FACTORS AFFECTING THE SHOPPING INTENSITY

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    Everton Roberto Comin

    2014-04-01

    Full Text Available The collective online shopping is a recent phenomenon in Brazil whose objective is to sell products and services for a minimum number of consumers. This study aims to investigate whether the intensity of collective online shopping is influenced by the aspects consumer interest in online collective shopping, impulse buying and insecurity. The data collection was based on a questionnaire with closed questions with multiple choices and a 5-point Likert scale.The final sample is composed of 143 respondents. Data was analyzed through the following statistic techniques: exploratory data analysis, exploratory factor analysis, reliability analysis, and logistic regression. The results suggest that people more interest in collective shopping are more likely to make collective shopping. People who feel greater insecurity in navigating the website is less likely to make collective shopping. It was observed that there is no a positive relationship between impulse shopping and collective purchasing. Some limitations include the number of constructs and sample characteristics.

  17. Stress intensity factors of eccentric cracks in bi-materials plate under mode I loading

    Energy Technology Data Exchange (ETDEWEB)

    Ismail, A. E. [Faculty of Mechanical and Manufacturing Engineering, Universiti Tun Hussein Onn Malaysia, 86400 Batu Pahat, Johor (Malaysia)

    2015-05-15

    Bi-material plates were generally used to joint electronic devices or mechanical components requiring dissimilar materials to be attached. During services, mechanical failure can be occurred due to the formation of cracks at the interfacial joint or away from the centre. Generally, linear elastic fracture mechanics approach is used to characterize these cracks based on stress intensity factors (SIF). Based on the literature survey, the SIFs for the central cracks were easily available. However, the SIFs for eccentric cracks were difficult to obtain. Therefore, this paper presented the SIFs for eccentric cracks subjected to mode I tension loading. Three important parameters were used such as relative crack depth, a/L, relative offset distance, b/L and elastic mismatch, E{sub 1}/E{sub 2} or α. It was found that such parameters significantly affected the characteristic of SIFs and it was depend on the location of cracks.

  18. Structure discrimination for the C-terminal domain of Escherichia coli trigger factor in solution

    International Nuclear Information System (INIS)

    Yao Yong; Bhabha, Gira; Kroon, Gerard; Landes, Mindy; Dyson, H. Jane

    2008-01-01

    NMR measurements can give important information on solution structure, without the necessity for a full-scale solution structure determination. The C-terminal protein binding domain of the ribosome-associated chaperone protein trigger factor is composed of non-contiguous parts of the polypeptide chain, with an interpolated prolyl isomerase domain. A construct of the C-terminal domain of Escherichia coli trigger factor containing residues 113-149 and 247-432, joined by a Gly-Ser-Gly-Ser linker, is well folded and gives excellent NMR spectra in solution. We have used NMR measurements on this construct, and on a longer construct that includes the prolyl isomerase domain, to distinguish between two possible structures for the C-terminal domain of trigger factor, and to assess the behavior of the trigger factor C-terminal domain in solution. Two X-ray crystal structures, of intact trigger factor from E. coli (Ferbitz et al., Nature 431:590-596, 2004), and of a truncated trigger factor from Vibrio cholerae (Ludlam et al., Proc Natl Acad Sci USA 101:13436-13441, 2004) showed significant differences in the structure of the C-terminal domain, such that the two structures could not be superimposed. We show using NMR chemical shifts and long range nuclear Overhauser effects that the secondary and tertiary structure of the E. coli C-terminal domain in solution is consistent with the crystal structure of the E. coli trigger factor and not with the V. cholerae protein. Given the similarity of the amino acid sequences of the E. coli and V. cholerae proteins, it appears likely that the structure of the V. cholerae protein has been distorted as a result of truncation of a 44-amino acid segment at the C-terminus. Analysis of residual dipolar coupling measurements shows that the overall topology of the solution structure is completely inconsistent with both structures. Dynamics analysis of the C-terminal domain using T 1 , T 2 and heteronuclear NOE parameters show that the protein is

  19. Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study.

    Science.gov (United States)

    Ballve, Ladislao Pablo Diaz; Dargains, Nahuel; Inchaustegui, José García Urrutia; Bratos, Antonella; Percaz, Maria de Los Milagros; Ardariz, Cesar Bueno; Cagide, Sabrina; Balestrieri, Carolina; Gamarra, Claudio; Paz, Dario; Rotela, Eliana; Muller, Sebastian; Bustos, Fernando; Castro, Ricard Aranda; Settembrino, Esteban

    2017-01-01

    This paper sought to determine the accumulated incidence and analyze the risk factors associated with the development of weakness acquired in the intensive care unit and its relationship to inspiratory weakness. We conducted a prospective cohort study at a single center, multipurpose medical-surgical intensive care unit. We included adult patients who required mechanical ventilation ≥ 24 hours between July 2014 and January 2016. No interventions were performed. Demographic data, clinical diagnoses, the factors related to the development of intensive care unit -acquired weakness, and maximal inspiratory pressure were recorded. Of the 111 patients included, 66 developed intensive care unit -acquired weakness, with a cumulative incidence of 40.5% over 18 months. The group with intensive care unit-acquired weakness were older (55.9 ± 17.6 versus 45.8 ± 16.7), required more mechanical ventilation (7 [4 - 10] days versus 4 [2 - 7.3] days), and spent more time in the intensive care unit (15.5 [9.2 - 22.8] days versus 9 [6 - 14] days). More patients presented with delirium (68% versus 39%), hyperglycemia > 3 days (84% versus 59%), and positive balance > 3 days (73.3% versus 37%). All comparisons were significant at p 5 days as independent predictors of intensive care unit-acquired weakness. Low maximal inspiratory pressure was associated with intensive care unit-acquired weakness (p intensive care unit-acquired weakness. The intensive care unit acquired weakness is a condition with a high incidence in our environment. The development of intensive care unit-acquired weakness was associated with age, delirium, hyperglycemia, and mechanical ventilation > 5 days. The maximum inspiratory pressure value of ≥ 36cmH2O was associated with a high diagnostic value to exclude the presence of intensive care unit -acquired weakness.

  20. Factors Affecting Dissolution Resistance of AC Anodizing Al in Sodium Carbonate Solution

    International Nuclear Information System (INIS)

    Abou-Krisha, M.

    2001-01-01

    Studies were performed to determine the effect of different factors on the properties and so the dissolution resistance of the anodic film of Al. Conductance and thermometric measurements were applied to evaluate the dissolution rate. The effect of applied AC voltage concentration of sodium carbonate solution, the anodization time and the temperature of sodium carbonate solutions show a parallel increase in the dissolution resistance of studied Al in hydrochloride acid. The results show that films formed by sodium carbonate solution were of porous type and have pronounced high resistance. Scanning electron microscope and x-ray diffraction further examined the films. The anodic and cathodic behavior and the effect of the scanning rate on the polarization of Al in sodium carbonate solution were studied. The regression analysis was applied to all results. (Author)

  1. First outbreak with MRSA in a Danish neonatal intensive care unit: risk factors and control procedures.

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    Benedicte Grenness Utke Ramsing

    Full Text Available INTRODUCTION: The purpose of the study was to describe demographic and clinical characteristics and outbreak handling of a large methicillin-resistant Staphylococcus aureus (MRSA outbreak in a neonatal intensive care unit (NICU in Denmark June 25(th-August 8(th 2008, and to identify risk factors for MRSA transmission. METHODS: Data were collected retrospectively from medical records and the Danish Neobase database. All MRSA isolates obtained from neonates, relatives and NICU health care workers (HCW as well as environmental cultures were typed. RESULTS: During the 46 day outbreak period, 102 neonates were admitted to the two neonatal wards. Ninety-nine neonates were subsequently sampled, and 32 neonates (32% from 25 families were colonized with MRSA (spa-type t127, SCCmec V, PVL negative. Thirteen family members from 11 of those families (44% and two of 161 HCWs (1% were colonized with the same MRSA. No one was infected. Five environmental cultures were MRSA positive. In a multiple logistic regression analysis, nasal Continuous Positive Airway Pressure (nCPAP treatment (p = 0.006 and Caesarean section (p = 0.016 were independent risk factors for MRSA acquisition, whereas days of exposure to MRSA was a risk factors in the unadjusted analysis (p = 0.04. CONCLUSIONS: MRSA transmission occurs with high frequency in the NICU during hospitalization with unidentified MRSA neonates. Caesarean section and nCPAP treatment were identified as risk factors for MRSA colonization. The MRSA outbreak was controlled through infection control procedures.

  2. Country-specific factors for the development of household smart grid solutions

    DEFF Research Database (Denmark)

    Christensen, Toke Haunstrup; Ascarza, Ainhoa; Throndsen, William

    The report provides an overview of relevant country-specific factors in relation to understanding the context of the development of smart grid solutions in Spain, Norway and Denmark (e.g. main characteristics of the energy system) and describes the current status of activities in relation to smart...

  3. Factors associated with admission to the intensive care unit in patients undergoing nephrectomy

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    L.D. Carrillo-Córdova

    2017-10-01

    Full Text Available Background: At present, there is no known risk factor analysis in patients undergoing nephrectomy secondary to lithiasis that favor their entry into the intensive care unit. There is no consensus in methods that report post-surgical complications. As a consequence, the reported incidence of complications in renal surgery ranges from 2% to 54%, regardless of the surgical approach. Methodology: A total of 58 patients with diagnosis of renal exclusion confirmed by renal scintigraphy, and lithiasis, were submitted to simple nephrectomy by a group of expert surgeons. A total of 58 patients were evaluated. Descriptive statistics were measured for the demographic variables. Inferential statistics were evaluated in quantitative variables using the Student's T test, with a p < 0.005. Chi square test was used for the qualitative variables. Results: When the multivariate analysis was carried out between the variables: age, weight, height, diabetes mellitus, systemic hypertension, smoking, abscess and transfusion, it was not possible to identify correlation between these and the development of complications or admission to the intensive care unit. However, when assessing by logistic regression the relationship between transfusing a patient and developing complications, a positive relationship was found with a p = 0.003, and an OR 13.45 CI [2.4–72]. Patients who suffered complications required a longer stay in the intensive care unit (p = 0.002. Conclusions: It was observed that patients with comorbidities such as hypertension, diabetes mellitus and anemia are more likely to require handling per unit of intensive care, even greater in those requiring transsurgical transfusion. Because there are not enough studies that relate the different risk factors that require intensive care unit management, a risk classification or transsurgical transfusion indications in these patients cannot yet be mentioned. Resumen: Antecedentes: En la

  4. Risk factors for the incidence of delirium in cerebrovascular patients in a Neurosurgery Intensive Care Unit: A prospective study.

    Science.gov (United States)

    Wang, Jun; Ji, Yuanyuan; Wang, Ning; Chen, Wenjin; Bao, Yuehong; Qin, Qinpu; Xiao, Qian; Li, Shulan

    2018-01-01

    To explore the incidence of delirium in cerebrovascular patients admitted in our Neurosurgery Intensive Care Unit and analyse the risk factors leading to delirium. Delirium is one of the most common mental disorders in general hospitals, but the incidence of different kinds of diseases and studies varies. Cerebrovascular patients in our Neurosurgery Intensive Care Unit are high-risk groups for delirium; identifying risk factors for delirium and taking early interventions are crucial for patient prognosis. A prospective study. A convenience sampling method was used to collect data from 128 patients in the Neurosurgery Intensive Care Unit of Xuanwu Hospital, Capital Medical University, Beijing, China, between May 2016-January 2017. Researchers used Confusion Assessment Method for the Intensive Care Unit (Chinese version) to assess each patient's delirium statement twice a day at regular times. We also collected other independent data variables and followed up the short-term clinical outcomes daily. On the basis of Confusion Assessment Method for the Intensive Care Unit evaluation, patients were divided into a delirium group and a nondelirium group. The prevalence of delirium among the 128 patients was 42.2%. Multivariate analysis showed that severity of illness, fever, the use of physical restraints and sleep deprivation were independent predictors of delirium in cerebrovascular patients in the Neurosurgery Intensive Care Unit. Cerebrovascular patients in the Neurosurgery Intensive Care Unit with a critical condition, fever or use of physical restraints or experiencing sleep deprivation were more prone to delirium. Cerebrovascular patients in the Neurosurgery Intensive Care Unit showed a high incidence of delirium. There are many risk factors leading to delirium, some of which are independent predictors of intensive care delirium. Patients with delirium will suffer various adverse effects upon their short-term clinical outcomes. Therefore, nurses should pay close

  5. Round Robin Analyses on Stress Intensity Factors of Inner Surface Cracks in Welded Stainless Steel Pipes

    Directory of Open Access Journals (Sweden)

    Chang-Gi Han

    2016-12-01

    Full Text Available Austenitic stainless steels (ASSs are widely used for nuclear pipes as they exhibit a good combination of mechanical properties and corrosion resistance. However, high tensile residual stresses may occur in ASS welds because postweld heat treatment is not generally conducted in order to avoid sensitization, which causes a stress corrosion crack. In this study, round robin analyses on stress intensity factors (SIFs were carried out to examine the appropriateness of structural integrity assessment methods for ASS pipe welds with two types of circumferential cracks. Typical stress profiles were generated from finite element analyses by considering residual stresses and normal operating conditions. Then, SIFs of cracked ASS pipes were determined by analytical equations represented in fitness-for-service assessment codes as well as reference finite element analyses. The discrepancies of estimated SIFs among round robin participants were confirmed due to different assessment procedures and relevant considerations, as well as the mistakes of participants. The effects of uncertainty factors on SIFs were deducted from sensitivity analyses and, based on the similarity and conservatism compared with detailed finite element analysis results, the R6 code, taking into account the applied internal pressure and combination of stress components, was recommended as the optimum procedure for SIF estimation.

  6. Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit

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    Ana Carolina Vieira Costa Fernandes Távora

    Full Text Available This study was designed to describe the epidemiology and risk factors for nosocomial infection (NI in a Brazilian neonatal intensive care unit (NICU. This study was a retrospective cohort from January to December, 2003. All neonates admitted to the NICU. Infection surveillance was conducted according to the NNIS, CDC. Chi-square test and logistic regression model were performed for statistical analyses. The study was conducted at a public, tertiary referral NICU of a teaching hospital in the Northeast of Brazil. A total of 948 medical records were reviewed. Overall NI incidence rate was 34%. The main neonatal NI was bloodstream infection (68.1%, with clinical sepsis accounting for 47.2%, and pneumonia was the second most common NI (8.6%. Multivariate analysis identified seven independent risk factors for NIs: birth weight, exposure to parenteral nutrition, percutaneous catheter, central venous catheter or mechanical ventilation, abruptio placentae and mother's sexually transmitted disease (STD. Neonates from mothers with STD or abruptio placentae, those weighing less than 1,500 g at birth or those who used invasive devices were at increased risk for acquiring NI.

  7. Risk factors for ventilator-associated pneumonia in neonatal intensive care unit patients.

    Science.gov (United States)

    Kawanishi, Fumiko; Yoshinaga, Masami; Morita, Michiyo; Shibata, Yuriko; Yamada, Tomoyuki; Ooi, Yukimasa; Ukimura, Akira

    2014-10-01

    Ventilator-associated pneumonia (VAP) is a serious complication in neonatal patients on mechanical ventilation. The objective of this study was to examine the incidence and risk factors associated with VAP, particularly in every 7-day versus every 14-day ventilator circuit changes, in a neonatal intensive care unit (NICU). Seventy-one neonates hospitalized in the NICU were enrolled. First, the neonates were divided into groups with and without VAP. On univariate logistic regression analyses, prolonged mechanical ventilation, frequent re-intubation, low gestational age, and low birth weight (BW) were significant risk factors for VAP development. After adjustments for other variables, only BW <626 g was a significant independent predictor for VAP in NICU infants. Second, to examine the effect of the frequency of changing ventilator circuits on the incidence of VAP, circuit changes were compared between the every 7-day group and the every 14-day group. The incidence of VAP per 1000 ventilator days was 9.66 for the every 7-day group and 8.08 for the every 14-day group, and there was no significant difference between the 2 groups. BW <626 g was a significant independent predictor of VAP, and decreasing the frequency of ventilator circuit changes from every 7 days to 14 days had no adverse effect on the VAP rate in the NICU. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Factors related to dimensions of grief intensity among African-American women after pregnancy loss.

    Science.gov (United States)

    Van, Paulina; Meleis, Afaf

    2010-12-01

    Grief is a normal response after pregnancy loss. Potentially, prolonged periods of grief can have a negative impact on physical or mental health. African-American women experience pregnancy loss at rates that are at least twice the rate of any other racial or ethnic group. However, the research literature on pregnancy loss has failed to include representative samples of African-American women or to explore and describe adequately their unique experiences after pregnancy loss. The purpose of this study was to examine the factors that are related to grief intensity after pregnancy loss (i.e., miscarriage, ectopic pregnancy, or fetal death) among African-American women. The results presented in this paper are components of a larger study in which the grief and coping experiences of African-American women following pregnancy loss were examined, using both quantitative and qualitative analysis. Eighty-six (N = 86) African-American women with a self-reported history ofinvoluntary pregnancy loss were recruited using a variety of culturally sensitive methods. The women completed three instruments: the Perinatal Grief Scale-Short Form (PGS-S), the Women's Role Integration Protocol (WRIP), and a personal profile tool designed specifically for the study. Pearson correlations were computed using pairwise deletion. Four models were tested using hierarchical multiple regression. Age and level of role integration were recurring predictors of the various dimensions of grief as measured by the PGS-S. Being older and reporting more major role satisfaction contributed to having less grief intensity after pregnancy loss. It is proposed that women with a history of pregnancy loss be assessed for residual grieving across their life span. Future explorations should address two main areas: specific interpersonal relations that facilitate grief management and the partners' experiences after pregnancy loss.

  9. Effect of different tillage intensity on yields and yield-forming factors in winter wheat

    Directory of Open Access Journals (Sweden)

    Martin Houšť

    2012-01-01

    Full Text Available The paper presents results of a study on application of minimum tillage technologies when growing winter wheat. Experiments were performed in the sugar-beet-growing region with loamy chernozem within the period of 2005–2009. Aanalysed and evaluated were effects of different methods of soil processing on yield-forming factors in stands of winter wheat grown after three different preceding crops (i.e. alfalfa, maize for silage and pea. Evaluated were the following four variants of tillage: (1 conventional ploughing to the depth of 0.22 m (Variant 1; (2 ploughing to the depth of 0.15 m (Variant 2; (3 direct sowing into the untilled soil (Variant 3, and (4 shallow tillage to the depth of 0.10 m (Variant 4.The effect of different tillage intensity on winter wheat yields was statistically non-significant after all forecrops. After alfalfa, the highest and the lowest average yields were recorded in Variant 2 (i.e. with ploughing to the depth of 0.15 m and Variant 3 (direct sowing into the untilled soil, respectively. After maize grown for silage, higher yields were obtained in Variant 2 and Variant 1 (conventional ploughing while in Variants 4 and 3 the obtained yields were lower. When growing winter wheat after pea as a preceding crop, the highest and the lowest average yields were recorded after direct sowing (Variant 3 and in Variant 1 (i.e. ploughing to the depth of 0.22 m, respectively. Results of studies on effect of different tillage technologies on yields of winter wheat crops indicate that under the given pedological and climatic conditions it is possible to apply methods of reduced tillage intensity. However, the choice of the corresponding technology must be performed with regard to the type of preceding crop.

  10. DIGITAL SOLUTION FOR FAST EVALUATION OF THE POWER FACTOR IN POWER NETWORKS

    Directory of Open Access Journals (Sweden)

    Adrian Gligor

    2017-06-01

    Full Text Available Power quality evaluation involves measurements and determinations of some power quality indicators. One of these indicators is represented by the power factor. The importance of the power factor as an indicator of power quality, both theoretical and practical, implies its determination or direct measurement as a necessity, especially in industrial environments where the optimization of energy costs is a primary target. Considering these, the determination of this power quality indicator implies multiple or sophisticated measurement tools. As a result, the present paper aims to present a solution for an easier evaluation of the power factor. The proposed solution can be integrated in numerical control systems for reactive power monitoring or in supervision and control systems in order to extend the applicability for the automatic power factor improvement. The proposed solution is characterized by simplicity and a low cost of implementation, representing an effective learning tool in the professional training in the electricity field. The configuration of the measurement circuit was designed to allow the measurement of a wide range of the power factor, starting from the case of inductive consumers to the case of capacitive consumers, noting that in the case of strongly deformed regimes the results shows significant deviations from the expected ones fact that is extensively exposed and motivated in the paper.

  11. TAM-based external factors related to ERP solutions acceptance in organizations

    Directory of Open Access Journals (Sweden)

    Simona Zabukovsek

    2013-01-01

    Full Text Available To improve the efficiency and effectiveness of ERP solutions use, understanding of critical success factors of ERP solutions assimilation in organizations is crucial. The technology acceptance model (TAM proposed by Davis (1989 has been the most widely used model for researching user acceptance and usage of IT/IS. The purpose of this paper is to extend the original TAM with groups of external factors which impact actual ERP system use. First, we focus on ERP system use in companies’ maturity phase. Second, we expose and examine three groups of external factors which influence ERP usage. The model was empirically tested using data collected from a survey of ERP users in 44 organizations. Survey data have been collected from ERP users who have been exposed to an ERP system which has operated for more than one year. The proposed research model was analyzed using the PLS approach.

  12. Comparison of Brain-Derived Neurotrophic Factor (BDNF and Insulin-like Growth Factor 1 (IGF-1 Responses to Different Endurance Training Intensities in Runner Men

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    M. Habibian

    2017-04-01

    Full Text Available Aims: Blood neurotrophins, such as Brain-Derived Neurotrophic Factor (BDNF and Insulin-like Growth Factor 1 (IGF-1, mediate exercise- induced health benefits in humans. The purpose of this study was to compare the response of BDNF and IGF-1 to different endurance training intensities in runner men. Materials & Methods: In this semi-experimental study with pre-test-posttest design in 2015, 10 people of male runners from Gorgan were selected through purposeful and accessible sampling. The endurance training protocol was 6 km running with moderate (70-75% of heart rate reserve or severe (80-85% of heart rate reserve intensity, which was performed within a week's interval. Fasting blood samples were collected before and immediately after both acute training sessions and serum levels of BDNF and IGF-1 were measured by ELISA and radioimmunoassay enzyme. Data were analyzed by SPSS 20 software using independent t-test and paired t-test. Findings: Both acute endurance training significantly increased serum levels of BDNF and IGF-1 in runners, but high intensity endurance exercises increased BDNF levels in comparison with moderate intensity (p0.05. Conclusion: Serum BDNF response in endurance athletes is affected by the intensity of exercise, so that the effect of high intensity endurance training on BDNF levels is greater than moderate intensity exercise, but the response of IGF-1 to acute endurance training is independent of the intensity of exercise.

  13. Orographic cyclogenesis in a saturated atmosphere and intense precipitation: baroclinic modal solutions under the joint action of localized mountains and humidity

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    A. Speranza

    1997-06-01

    Full Text Available In this paper we analyse the nature of orographic cyclogenesis in a saturated atmosphere by means of a simplified model based on the analysis of linear modal solutions.The space structure of fastest growing modal solutions suggests that three different scales of axtratropical atmospheric motion may simultaneously be activated in a single, growing, unstable mode: the orographic modulation of growing baroclinic modes extending, as we know from the classical modal theory of orographic cyclogenesis, from the scale typical of the primary, extra-tropical cyclone to the scale of the secondary, orographic cyclone, is also characterized by the (smaller scale associated with strong ascending motion in a saturated atmosphere. Since ascending motion can be associated with intense precipitation, this result is important in view of its potential consequences both on the ability to achieve a good forecast of intense precipitation events in the Mediterranean and on the refinement of the theory of orographic cyclogenesis.

  14. A new plastic correction for the stress intensity factor of an under-clad defect in a PWR vessel subjected to a pressurised thermal shock

    International Nuclear Information System (INIS)

    Marie, S.; Nedelec, M.

    2007-01-01

    For the assessment of an under-clad defect in a vessel subjected to a cold pressurised thermal shock, plasticity is considered through the amplification β of the elastic stress intensity factor K I in the ferritic part of the vessel. An important effort has been made recently by CEA to improve the analytical tools in the frame of R and D activities funded by IRSN. The current solution in the French RSE-M code has been developed from fitted F.E. calculation results. A more physical solution is proposed in this paper. This takes into account two phenomena: the amplification of the elastic K I due to plasticity in the cladding and a plastic zone size correction in the ferritic part. The first correction has been established by representing the cladding plasticity by an imposed displacement on the crack faces at the interface between the cladding and the ferritic vessel. The corresponding elastic stress intensity factor is determined from the elastic plane strain asymptotic solution for the opening displacement. Plasticity in the ferritic steel is considered through a classical plastic zone size correction. The application of the solution to axisymmetric defects is first checked. The case of semi-elliptical defects is also investigated. For the correction determined at the interface between the cladding and the ferritic vessel, an amplification of the correction proposed for the deepest point is determined from a fitting of the 3D F.E. calculation results. It is also shown that the proposition of RSE-M, which consists in applying the same β correction at the deepest point and the interface point is not suitable. The applicability to a thermal shock, eventually combined with an internal pressure has been verified. For the deepest point, the proposed correction leads to similar results to the RSE-M method, but presents an extended domain of validity (no limits on the crack length are imposed)

  15. Impact of high-intensity concurrent training on cardiovascular risk factors in persons with multiple sclerosis - pilot study.

    Science.gov (United States)

    Keytsman, Charly; Hansen, Dominique; Wens, Inez; O Eijnde, Bert

    2017-10-27

    High-intensity concurrent training positively affects cardiovascular risk factors. Because this was never investigated in multiple sclerosis, the present pilot study explored the impact of this training on cardiovascular risk factors in this population. Before and after 12 weeks of high-intense concurrent training (interval and strength training, 5 sessions per 2 weeks, n = 16) body composition, resting blood pressure and heart rate, 2-h oral glucose tolerance (insulin sensitivity, glycosylated hemoglobin, blood glucose and insulin concentrations), blood lipids (high- and low-density lipoprotein, total cholesterol, triglyceride levels) and C-reactive protein were analyzed. Twelve weeks of high-intense concurrent training significantly improved resting heart rate (-6%), 2-h blood glucose concentrations (-13%) and insulin sensitivity (-24%). Blood pressure, body composition, blood lipids and C-reactive protein did not seem to be affected. Under the conditions of this pilot study, 12 weeks of concurrent high-intense interval and strength training improved resting heart rate, 2-h glucose and insulin sensitivity in multiple sclerosis but did not affect blood C-reactive protein levels, blood pressure, body composition and blood lipid profiles. Further, larger and controlled research investigating the effects of high-intense concurrent training on cardiovascular risk factors in multiple sclerosis is warranted. Implications for rehabilitation High-intensity concurrent training improves cardiovascular fitness. This pilot study explores the impact of this training on cardiovascular risk factors in multiple sclerosis. Despite the lack of a control group, high-intense concurrent training does not seem to improve cardiovascular risk factors in multiple sclerosis.

  16. Phase retrieval using radiation and matter-wave fields: Validity of Teague's method for solution of the transport-of-intensity equation

    International Nuclear Information System (INIS)

    Schmalz, Jelena A.; Gureyev, Timur E.; Paganin, David M.; Pavlov, Konstantin M.

    2011-01-01

    Although originally developed for coherent paraxial scalar electromagnetic radiation in the visible-light regime, phase retrieval using the transport-of-intensity equation has been successfully applied to a range of paraxial radiation and matter-wave fields. Such applications include using electron wave fields to quantitatively image magnetic skyrmions and spin ices, propagation-based phase-contrast imaging using cold neutrons and hard x-rays, and visible-light refractive imaging of the projected column density of cold-atom clouds. Teague's method for phase retrieval using the transport-of-intensity equation, which renders the phase of a paraxial complex wave indirectly measurable via the existence of a conserved current, has been applied to a broad variety of situations which include all of the experiments described above. However, these applications have been undertaken without a thorough analysis of the underlying validity of the method. Here we derive sufficient conditions for the phase-retrieval solution provided by Teague's method to coincide with the true phase of the paraxial radiation or matter-wave field. We also present a sufficient condition guaranteeing that the discrepancy between the true phase function and that reconstructed using Teague's solution is small. These conditions demonstrate that, in most practical cases, for phase-amplitude retrieval using the transport-of-intensity equation, the Teague solution is very close to the exact solution. However, we also describe a counter example in the context of phase-amplitude retrieval using hard x-rays, in which the relative root-mean-square difference between the exact solution and that obtained using Teague's method is 9%. These findings clarify the foundations of one of the most widely applied methods for propagation-based phase retrieval of both paraxial matter and radiation wave fields and define a region for its applicability.

  17. Risk factors for slowly resolving pneumonia in the intensive care unit.

    Science.gov (United States)

    Li, Meiling; Liu, Jialin; Tan, Ruoming; Liu, Zhaojun; Yin, Jianyong; Qu, Hongping

    2016-10-01

    Slowly resolving pneumonia (SRP) poses early challenges for identification and medical expense for clinicians in intensive care units (ICUs); to date, the literature has been very limited in this regard. This was a retrospective and cohort-based study in the ICU of a university-affiliated hospital in Shanghai. Medical records of pneumonia patients in the ICU between April 2008 and February 2011were reviewed retrospectively to evaluate the risk factors for SRP. In all, 106 pneumonia patients in the ICU were identified as immune-competent with a diagnosis of bacterial pneumonia. There were 62 (58.49%) patients who showed SRP and their radiographic infiltrations were completely resolved between 5 weeks and 8 weeks. Multivariate logistic regression analysis demonstrated that initial treatment with an inappropriate antibiotic, multilobar infiltration, and a high CURB-65 score were independent risk factors for SRP, with odds ratio (OR) values of 8.338 [95% confidence interval (CI) 2.117-32.848], 11.184 (95% CI 2.526-49.514), and 2.329 (95% CI 1.172-4.626), respectively. The length of the ICU stay in the SRP group was twice as long as that of the normally resolving pneumonia (NRP) group (62.27 ± 73.73 vs. 32.25 ± 23, p = 0.002). The 28-day and 60-day mortality rates in the SRP group were 17.74% and 25.81%, respectively. In addition, the 60-day mortality rate was significantly higher in the SRP group than the NRP group (25.81% vs. 6.82%, respectively; p = 0.012). Moreover, SRP was an independent risk factor for 60-day mortality (OR 5.687, 95% CI 1.334-24.240). Treatment with an inappropriate antibiotic, multilobar infiltration, and a high CURB-65 score were independent risk factors for SRP. Copyright © 2014. Published by Elsevier B.V.

  18. Environmental factors influencing biological rhythms in newborns: From neonatal intensive care units to home.

    Science.gov (United States)

    Bueno, Clarissa; Menna-Barreto, Luiz

    2016-01-01

    Photic and non-photic environmental factors are suggested to modulate the development of circadian rhythms in infants. Our aim is to evaluate the development of biological rhythms (circadian or ultradian) in newborns in transition from Neonatal Intensive Care Units (NICU) to home and along the first 6 months of life, to identify masking and entraining environment factors along development. Ten newborns were evaluated in their last week inside the NICU and in the first week after being delivered home; 6 babies were also followed until 6 months of corrected age. Activity, recorded with actimeters, wrist temperature and observed sleep and feeding behavior were recorded continuously along their last week inside the NICU and in the first week at home and also until 6 months of corrected age for the subjects who remained in the study. Sleep/wake and activity/rest cycle showed ultradian patterns and the sleep/wake was strongly influenced by the 3 h feeding schedule inside the NICU, while wrist temperature showed a circadian pattern that seemed no to be affected by environmental cycles. A circadian rhythm emerges for sleep/wake behavior in the first week at home, whereas the 3 h period vanishes. Both activity/rest and wrist temperature presented a sudden increase in the contribution of the circadian component immediately after babies were delivered home, also suggesting a masking effect of the NICU environment. We found a positive correlation of postconceptional age and the increase in the daily component of activity and temperature along the following 6 months, while feeding behavior became arrhythmic.

  19. Incidence of and Risk Factors for Mastoiditis after Intensity Modulated Radiotherapy in Nasopharyngeal Carcinoma.

    Directory of Open Access Journals (Sweden)

    Ji-Jin Yao

    Full Text Available To report the incidence of and risk factors for mastoiditis after intensity-modulated radiotherapy (IMRT in nasopharyngeal carcinoma (NPC.Retrospective analysis of pretreatment and follow-up magnetic resonance imaging (MRI data for 451 patients with NPC treated with IMRT at a single institution. The diagnosis of mastoiditis was based on MRI; otomastoid opacification was rated as Grade 0 (none, 1 (mild, 2 (moderate or 3 (severe by radiologists blinded to clinical outcome. This study mainly focused on severe mastoiditis; patients were divided into three groups: the G0M (Grade 0 mastoiditis before treatment group, G1-2M (Grade 1 to 2 mastoiditis before treatment group and G3M (Grade 3 mastoiditis before treatment group. The software SAS9.3 program was used to analyze the data.For the entire cohort, the incidence of Grade 3 mastoiditis was 20% before treatment and 31%, 19% and 17% at 3, 12 and 24 months after radiotherapy, respectively. In the G0M group, the incidence of severe mastoiditis was 0% before treatment and 23%, 15% and 13% at 3, 12 and 24 months after radiotherapy, respectively. Multivariate analysis revealed T category (OR=0.68, 95% CI = 0.469 to 0.984, time (OR=0.668, 95% CI = 0.59 to 0.757 and chemotherapy (OR=0.598, 95% CI = 0.343 to 0.934 were independent factors associated with severe mastoiditis in the G0M group after treatment.Mastoiditis, as diagnosed by MRI, occurs as a progressive process that regresses and resolves over time in patients with NPC treated using IMRT.

  20. Factors influencing the prescription of intensive combination treatment strategies for early rheumatoid arthritis.

    Science.gov (United States)

    Meyfroidt, S; van Hulst, L; De Cock, D; Van der Elst, K; Joly, J; Westhovens, R; Hulscher, M; Verschueren, P

    2014-01-01

    Despite the availability and demonstrated effectiveness of intensive combination treatment strategies (ICTS) for early rheumatoid arthritis (RA), a discrepancy seems to exist between theoretical evidence and actual prescription in daily practice. The purpose of this study was to explore and identify the factors influencing the prescription of ICTS. This study involved rheumatologists and nurses participating in the Care for Rheumatoid Arthritis (CareRA) trial, a multicentre randomized controlled trial (RCT) comparing different ICTS for early RA with conventional disease-modifying anti-rheumatic drugs (DMARDs) plus step-down glucocorticoids (GCs). A qualitative study was carried out using individual semi-structured interviews. Each interview was recorded, transcribed literally, and analysed thematically. In addition, observations at outpatient clinics were used to clarify the interpretation of the results. We interviewed 26 rheumatologists and six nurses and observed five outpatient visits. Identified facilitators included available scientific evidence, personal faith in treatment strategy, staff support, and low treatment costs. Rheumatologists had no doubts about the value of methotrexate (MTX) but some questioned the value of combination strategy, others the effectiveness and/or the dosage of individual compounds. Additional barriers for prescribing ICTS included need for patient education, fear for patients' preconceptions, concerns about applicability to the individual patient, difficulties with breaking routine, interference with organizational structures and processes, time constraints, and lack of financial support. A heterogeneous set of factors highlights the complexity of prescribing ICTS for early RA in daily clinical practice. Future improvement strategies should stimulate the facilitators while at the same time addressing the barriers. The generalizability of these findings to other health care systems needs further examination.

  1. Stress Intensity Factors of Slanted Cracks in Bi-Material Plates

    Science.gov (United States)

    Ismail, Al Emran; Azhar Kamarudin, Kamarul; Nor, Nik Hisyamudin Muhd

    2017-10-01

    In this study, the stress intensity factors (SIF) of slanted cracks in bi-material plates subjected to mode I loading is numerically solved. Based on the literature survey, tremendous amount of research works are available studying the normal cracks in both similar and dissimilar plates. However, lack of SIF behavior for slanted cracks especially when it is embedded in bi-material plates. The slanted cracks are then modelled numerically using ANSYS finite element program. Two plates of different in mechanical properties are firmly bonded obliquely and then slanted edge cracks are introduced at the lower inclined edge. Isoparametric singular element is used to model the crack tip and the SIF is determined which is based on the domain integral method. Three mechanical mismatched and four slanted angles are used to model the cracks. According to the present results, the effects of mechanical mismatch on the SIF for normal cracks are not significant. However, it is played an important role when slanted angles are introduced. It is suggested that higher SIF can be obtained when the cracks are inclined comparing with the normal cracks. Consequently, accelerating the crack growth at the interface between two distinct materials.

  2. The Incidence And Risk Factors Nosocomial Pneumonia In A Neuromedical Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Devragudi TS

    2001-01-01

    Full Text Available This retrospective study examined the incidence and factors influencing the occurrence of nonsocomial pneumonia (NP in a neuromedical intensive care unit (NICU. Of the 57 patients admitted to the NICU over one year, 26% developed nosocomial pneumonia. It was observed that the infected patients were significantly older than the noninfected (43+15 vs 22+18 years; p<0.001, had a longer NICU stay (33+31 vs 18+18 days: p=0.05 and needed longer duration of mechanical ventilation (20+25 vs 9 + 12 days: P<0.05. Patients with neuromuscular diseases had a trend towards higher incidence of NP than those with encephalopathy and therapeutic interventions such as plasmapheresis, blood transfusion and inotropic therapy did not influence the incidence of nosocomial pneumonia. The NICU mortality was not significantly influenced by nosocomial pneumonia. Pseudomonas aerugenosa was the predominant organism responsible for pneumonia. Nine percent of the tracheobronchial isolates were resistant to the routinely-tested antibiotics. In conclusion, nosocornial pneumonia is a common complication in a NICU and while it increases the duration of NICU stay, mortality appears to be uninfluenced.

  3. Analysis of factors influencing admission to intensive care following convulsive status epilepticus in children.

    LENUS (Irish Health Repository)

    Tirupathi, Sandya

    2012-02-01

    OBJECTIVES: To identify clinical features and therapeutic decisions that influence admission to the Intensive Care unit (ICU) in children presenting with convulsive status epilepticus (CSE). METHODS: We evaluated 47 admissions with status epilepticus to a tertiary paediatric hospital A&E over a three year period (2003-2006). Following initial management 23 episodes required admission to ICU and 24 were managed on a paediatric ward. We compared clinical, demographic data and compliance with our CSE protocol between the ICU and ward groups. RESULTS: Median age at presentation in the ICU group was 17 months (range 3 months-11 years) compared to 46 months in the ward group (range 3 months-10 years). Fifty per cent of patients in both groups had a previous history of seizures. Median duration of pre-hospital seizure activity was 30 min in both groups. More than two doses of benzodiazepines were given as first line medication in 62% of the ICU group and 33% of the ward group. Among children admitted to ICU with CSE, 26% had been managed according to the CSE protocol, compared to 66% of children who were admitted to a hospital ward. Febrile seizures were the most common aetiology in both groups. CONCLUSION: Younger age at presentation, administration of more than two doses of benzodiazepines and deviation from the CSE protocol appear to be factors which influence admission of children to ICU. Recognition of pre-hospital administration of benzodiazepines and adherence to therapeutic guidelines may reduce the need for ventilatory support in this group.

  4. Health Facility Graduation from Donor-Supported Intensive Technical Assistance and Associated Factors in Zambia.

    Science.gov (United States)

    Koni, Phillip; Chishinga, Nathaniel; Nyirenda, Lameck; Kasonde, Prisca; Nsakanya, Richard; Welsh, Michael

    2015-01-01

    The FHI360-led Zambia Prevention Care and Treatment partnership II (ZPCT II) with funding from United States Agency for International Development, supports the Zambian Ministry of Health in scaling up HIV/AIDS services. To improve the quality of HIV/AIDS services, ZPCT II provides technical assistance until desired standards are met and districts are weaned-off intensive technical support, a process referred to as district graduation. This study describes the graduation process and determines performance domains associated with district graduation. Data were collected from 275 health facilities in 39 districts in 5 provinces of Zambia between 2008 and 2012. Performance in technical capacity, commodity management, data management and human resources domains were assessed in the following services areas: HIV counselling and testing and prevention of mother to child transmission, antiretroviral therapy/clinical care, pharmacy and laboratory. The overall mean percentage score was calculated by obtaining the mean of mean percentage scores for the four domains. Logistic regression models were used to obtain odds ratios (OR) and 95% confidence intervals (CI) for the domain mean percentage scores in graduated versus non-graduated districts; according to rural-urban, and province strata. 24 districts out of 39 graduated from intensive donor supported technical assistance while 15 districts did not graduate. The overall mean percentage score for all four domains was statistically significantly higher in graduated than non-graduated districts (93.2% versus 91.2%, OR = 1.34, 95%CI:1.20-1.49); including rural settings (92.4% versus 89.4%, OR = 1.43,95%CI:1.24-1.65). The mean percentage score in human resource domain was statistically significantly higher in graduated than non-graduated districts (93.6% versus 71.6%, OR = 5.81, 95%CI: 4.29-7.86) and in both rural and urban settings. QA/QI tools can be used to assess performance at health facilities and determine readiness for

  5. Risk factors for mortality in children with pneumonia admitted to the pediatric intensive care unit.

    Science.gov (United States)

    Koh, Jia Wen Janine Cynthia; Wong, Judith Ju-Ming; Sultana, Rehena; Wong, Petrina Poh Chen; Mok, Yee Hui; Lee, Jan Hau

    2017-08-01

    To describe the epidemiology of children with severe pneumonia and identify risk factors for poor outcomes. We conducted a retrospective study of children admitted to pediatric intensive care unit (PICU) from 2010 to 2014 with a diagnosis of pneumonia. Clinical microbiological, ventilation and other pertinent PICU data were collected. Primary outcome was PICU mortality. Univariate and multivariate logistic regression model were used to identify risk factors for mortality. Severe pneumonia consisted of 237/3539 (6.7%) of PICU admissions. Of these, 162/237 (68.4%) required mechanical ventilation. 32/237 (13.5%) patients died. The majority of patients had no organisms identified 82/237 (34.6%). A sole bacterial or viral pathogen was identified in 48/237 (20.1%) and 41/237 (17.9%) patients, respectively. Patients with viral pneumonias were more likely to develop acute respiratory distress syndrome compared to other etiologies (7/41[17.1%] vs 8/196 [4.0%]; P = 0.006). Bacterial pneumonias were associated with lung abscess (4/48 [8.3%] vs 2/189 [1.5%]; P = 0.016) and necrotizing pneumonia (18/48 [37.5%] vs 15/189 [7.9%]; P 1 respiratory pathogens isolated) occurred in 62/237 (26.2%) patients and were associated a higher rate of mechanical ventilation, and decreased ventilator and PICU free days. After adjusting for severity of illness, risk factors for mortality were: hospital acquired pneumonia (HAP) (aOR: 2.92 [95%CI 1.15, 7.40]; P = 0.024) and bacteremia (aOR: 5.03 [95%CI 1.77, 14.35]; P = 0.003). Severe pediatric pneumonia accounts for a significant number of PICU admissions and is associated with significant mortality risk. The presence of co-morbidities, HAP and bacteremia were early prognostic variables independently associated with poor clinical outcomes. © 2017 Wiley Periodicals, Inc.

  6. Factors influencing the incidence of sinusitis in nasopharyngeal carcinoma patients after intensity-modulated radiation therapy.

    Science.gov (United States)

    Su, Yan-xia; Liu, Lan-ping; Li, Lei; Li, Xu; Cao, Xiu-juan; Dong, Wei; Yang, Xin-hua; Xu, Jin; Yu, Shui; Hao, Jun-fang

    2014-12-01

    The aim of the study was to investigate the incidence of sinusitis in nasopharyngeal carcinoma (NPC) patients before and after intensity-modulated radiation therapy (IMRT) and to analyze factors associated with the incidence of sinusitis following IMRT. We retrospectively analyzed 283 NPC patients who received IMRT in our hospital from March 2009 to May 2011. The diagnostic criteria for sinusitis are based on computed tomography (CT) or magnetic resonance imaging (MRI) findings. CT or MRI scans were performed before and after IMRT to evaluate the incidence of sinusitis. Factors influencing the incidence of sinusitis were analyzed by log-rank univariate and logistic multivariate analyses. Among the 283 NPC patients, 128 (45.2 %) suffered from sinusitis before radiotherapy. The incidence rates of sinusitis in patients with T1, T2, T3, and T4 NPC before radiotherapy were 22.6, 37.5, 46.8, and 61.3 %, respectively (χ 2 = 14.548, p = 0.002). Among the 155 NPC patients without sinusitis before radiotherapy, the incidence rates of sinusitis at the end of radiotherapy and at 1, 3, 6, 9, 12, and 18 months after radiotherapy were 32.9, 43.2, 61.3, 68.4, 73.5, 69.7, and 61.3 %, respectively (χ 2 = 86.461, p < 0.001). Univariate analysis showed that T stage, invasion of the nasal cavity, nasal irrigation, and radiation dose to the nasopharynx were associated with the incidence of sinusitis in NPC patients after IMRT (p = 0.003, 0.006, 0.002, and 0.020). Multivariate analysis showed that T stage, invasion of the nasal cavity, and nasal irrigation were influential factors for the incidence of sinusitis in NPC patients after IMRT (p = 0.002, 0.002, and 0.000). There was a higher incidence of sinusitis with higher T stage among NPC patients before radiotherapy, and the incidence of sinusitis in NPC patients after IMRT was high (45.2 %). The incidence of sinusitis increased rapidly within the first 3 months after IMRT, and the number of sinusitis cases peaked at 6-9 months after

  7. Study on the relationship between stress intensity factor and J integral for mixed mode crack with arbitrary inclination based on SBFEM

    International Nuclear Information System (INIS)

    Zhu, C L; Li, J B; Lin, G; Zhong, H

    2010-01-01

    The J integral and the stress intensity factor (SIF) K are both important research objects of fracture mechanics, and are often employed to establish criteria for crackpropagation. The relationship between them has always been a research hotspot. In this paper, the SIF can be obtained conveniently by the scaled boundary finite element method (SBFEM) due to the fact that analytical solution can be obtained along the radial direction for stress singularity problems. The J integral can be solved analytically using the formulae between J and K for mixed mode crack with arbitrary inclination in elastic materials. Moreover, the J integral values obtained by this method are more accurate and convenient than by its definition. Factors that affect the accuracy of SIF and J integral, such as the distance between the crack and outer boundary, size of the discretized elements and partition of the domain into super-elements, are examined.

  8. Risk Factors for Voriconazole-Associated Hepatotoxicity in Patients in the Intensive Care Unit.

    Science.gov (United States)

    Wang, Yan; Wang, Taotao; Xie, Jiao; Yang, Qianting; Zheng, Xiaowei; Dong, Weihua; Xing, Jianfeng; Wang, Xue; Dong, Yalin

    2016-07-01

    To determine the incidence of hepatotoxicity in critically ill patients who were treated with voriconazole and to identify potential risk factors for voriconazole-associated hepatotoxicity in these patients. Single-center prospective observational study. Intensive care unit (ICU) in a university-affiliated hospital in Xi'an, China. Sixty-three adults, admitted to the ICU between January 2010 and July 2015, who had an ICU length of stay longer than 3 days, had received voriconazole treatment for at least 3 days, and had at least one trough voriconazole plasma concentration (VPC) measurement. All patients received CYP2C19 genotyping and were evaluated for the development of hepatotoxicity by assessing liver function tests performed before, during, and after voriconazole therapy. Hepatotoxicity was classified according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) grade scores and was defined as a CTCAE grade score that had increased by at least 2 grade scores over the baseline score. Hepatotoxicity occurred in 12 (19%) of the 63 patients. Characteristics of the patients who developed hepatotoxicity were compared with those of the patients who did not develop hepatotoxicity by univariate and multivariate Cox regression analyses. In the univariate analysis, Acute Physiology and Chronic Health Evaluation II score, invasive fungal infection classification, CYP2C19 genotype, and trough VPC were identified as the variables, and they were subsequently combined in the multivariate regression analysis. Multivariate Cox regression analysis revealed that hepatotoxicity was independently associated with trough VPC (hazard ratio 1.76, p<0.001). The relationships between trough VPCs and probability of hepatotoxicity were explored by using logistic regression analysis, and a target VPC upper limit of 4 mg/L was identified. The Kaplan-Meier method for the cumulative incidence of hepatotoxicity showed a significant difference between patients

  9. The effect of broken stringers on the stress intensity factor for a uniformly stiffened sheet containing a crack

    Science.gov (United States)

    Poe, C. C., Jr.

    1973-01-01

    A linear elastic stress analysis was made of a centrally cracked sheet stiffened by riveted, uniformly spaced and sized stringers. The stress intensity factor for the sheet and the load concentration factor for the most highly loaded stringer were determined for various numbers of broken stringers. A broken stringer causes the stress intensity factor to be very high when the crack tip is near the broken stringer, but causes little effect when the crack tip extends beyond several intact stringers. A broken stringer also causes an increase in the load concentration factor of the adjacent stringers. The calculated residual strengths and fatigue-crack-growth lives of a stiffened aluminum sheet with a broken stringer were only slightly less than a sheet with all intact stringers, and were still much higher than those of an unstiffened sheet.

  10. Prognostic factors for intervention effect on neck/shoulder symptom intensity and disability among female computer workers

    NARCIS (Netherlands)

    Larsman, Pernilla; Sandsjö, Leif; Kadefors, Roland; Voerman, Gerlienke; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

    2009-01-01

    Introduction It has been suggested that treatments may be more effective when they are matched to patient characteristics. This study aimed at investigating potential prognostic factors for clinically relevant improvement in symptom intensity and symptom-related disability among employees with

  11. Intense intermittent exercise provides weak stimulus for vascular endothelial growth factor secretion and capillary growth in skeletal muscle

    DEFF Research Database (Denmark)

    Høier, Birgitte; Passos, Madla; Bangsbo, Jens

    2013-01-01

    capillarization in the muscle but abolished the exercise induced increase in mRNA for several angiogenic factors, increased the eNOS protein levels, lowered TSP-1 protein levels in muscle but increased interstitial TSP-1 protein levels. We conclude that intense intermittent exercise provides a weak stimulus...

  12. Prognostic factors for intervention effect on neck/shoulder symptom intensity and disability among female computer workers.

    NARCIS (Netherlands)

    Larsman, P.; Sandsjo, L.; Kadefors, R.; Voerman, G.E.; Vollenbroek-Hutten, M.M.; Hermens, H.

    2009-01-01

    INTRODUCTION: It has been suggested that treatments may be more effective when they are matched to patient characteristics. This study aimed at investigating potential prognostic factors for clinically relevant improvement in symptom intensity and symptom-related disability among employees with

  13. Effects of distance from center of a weld to fixed end on residual stress and stress intensity factor of a piping weld. Evaluation of SCC growth under residual stress field. Report 1

    International Nuclear Information System (INIS)

    Miyazaki, Katsumasa; Numata, Masanori; Saito, Koichi; Mochizuki, Masahito

    2006-01-01

    The fixed conditions of butt welds between straight pipe and valve or pump in the actual piping system are different from those of straight pipes. However, the effect of fixed condition on the residual stress and the stress intensity factor for evaluation of structural integrity of cracked piping was not clear. In this study, the finite element analyses were conducted by considering the differences in the distance from the center of weld to the fixed end L to clarify the effect of fixed condition on the residual stress and the stress intensity factor. For the 600 A piping, the axial residual stress distribution was not affected by the distance L. Furthermore, the stress intensity factor of circumferential crack under the residual stress field with fixed condition could be estimated by using the existing simplified solution for piping. (author)

  14. Clinical Competence and Its Related Factors of Nurses in Neonatal Intensive Care Units.

    Science.gov (United States)

    Mirlashari, Jila; Qommi, Robabeh; Nariman, Shahin; Bahrani, Nasser; Begjani, Jamaloddin

    2016-12-01

    Introduction: Clinical competence of nurses working in the neonatal intensive care units together with advancements in medical science and technology increased the survival rate of newborns that need specialized care. To ensure the quality of care and provide the safety of patients, evaluating the clinical competence of nurses seems necessary. This study aimed to evaluate the clinical competence of nurses in the neonatal intensive care units. Methods: In this cross-sectional study, 117 nurses working in the neonatal intensive care units of the hospitals affiliated to Tehran University of Medical Sciences were selected by census method. The research tool was Development of Competency Inventory for Registered Nurses questionnaire which completed by self-assessment. The mean clinical competence scores of participants categorized into 3 levels: weak: 273. Data were analyzed by SPSS version 13 using the Pearson correlation coefficient, t-test and Chi-square test. Results: The highest levels of competence were related to critical thinking and research attitude and interpersonal relationships, and the lowest level was related to training and mentoring. There was a direct statistically significant relationship between marital status, employment status, level of interest in working in the neonatal intensive-care units and the clinical competence of nurses. Conclusion: Since the clinical competence of nurses in the Neonatal Intensive Care Units is vital, some variables such as interest in the nursing profession, employment status, the neonatal intensive theoretical and practical training courses and the amount of overtime working hours should be taken into consideration.

  15. Intensive wave power and steel quenching 3-D model for cylindrical sample. Time direct and reverse formulations and solutions

    Directory of Open Access Journals (Sweden)

    Buikis Andris

    2017-01-01

    Full Text Available In this paper we develop mathematical models for three dimensional hyperbolic heat equations (wave equation or telegraph equation with inner source power and construct their analytical solutions for the determination of the initial heat flux for cylindrical sample. As additional conditions the temperature and heat flux at the end time are given. In some cases we give expression of wave energy. In some cases we give expression of wave energy. Some solutions of time inverse problems are obtained in the form of first kind Fredholm integral equation, but others has been obtained in closed analytical form as series. We viewed both direct and inverse problems at the time. For the time inverse problem we use inversion in the time argument.

  16. Comparison of Risk Factors in Necrotizing Enterocolitis among Infants in Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2013-08-01

    Full Text Available Purpose: Necrotizing enterocolitis is one of the important problems of premature infants. The incidence is about 1-5% in infants followed in neonatal care units and inversely related to gestational age and birth weight. Materials and Methods: In this study, 31 infants with necrotizing enterocolitis and 31 infants with similar gestational age and birth weight as control group hospitalized in Cukurova University Neonatal Care Unit between 1 January 2001-31 January 2004 were evaluated. Results: The incidence of necrotizing enterocolitis in this period was 1.4 (31/2214 admission. Mean gestational age was 30.5  3.2 weeks (25-36, mean birth weight was 1331  384 (730-2150 grams while 71% was younger than 32 gestational weeks and 67.7% was under 1500 grams. The signs of NEC were detected at a mean of 11.2  10. (2-38 days. Twenty-six (83.9% were being fed at the time of the necrotizing enterocolitis signs appeared. According to the Walsh and Kliegman classification, 19 (61.3% infants were in stage 1 (17 were 1a, 2 were 1b; 3 (9.6% infants were in stage 2a, 9 (%29.1 infants were in stage 3 (7 were in 3b. Blood culture was positive in 7 (%22.6 infants with predominance of gram negative microorganisms (5 infants. Eleven (%35.5 infants were exitus, 12 were discharged. Hypoxia, respiratory distress syndrome, intraventricular hemorrhage and umbilical catheterization were significant risk factors in necrotizing enterocolitis . Thrombocytopenia, leucopenia and high C-reactive protein levels were significantly high in necrotizing enterocolitis group. Breast feeding is significantly high in control group. Conclusion: Necrotizing enterocolitis, is a leading cause of morbidity and mortality in neonatal intensive care units. Early breast feeding with small amounts, increasing amount of milk slowly, antenatal steroids, caring hygiene rules can prevent the development of it. [Cukurova Med J 2013; 38(4.000: 642-647

  17. A basic helix-loop-helix transcription factor DvIVS determines flower color intensity in cyanic dahlia cultivars.

    Science.gov (United States)

    Ohno, Sho; Deguchi, Ayumi; Hosokawa, Munetaka; Tatsuzawa, Fumi; Doi, Motoaki

    2013-08-01

    The study was aimed to identify the factors that regulate the intensity of flower color in cyanic dahlia (Dahlia variabilis), using fifteen cultivars with different color intensities in their petals. The cultivars were classified into three groups based on their flavonoid composition: ivory white cultivars with flavones; purple and pink cultivars with flavones and anthocyanins; and red cultivars with flavones, anthocyanins, and chalcones. Among the purple, pink, and ivory white cultivars, an inverse relationship was detected between lightness, which was used as an indicator for color intensity and anthocyanin content. A positive correlation was detected between anthocyanin contents and the expression of some structural genes in the anthocyanin synthesis pathway that are regulated by DvIVS, a basic helix-loop-helix transcription factor. A positive correlation between anthocyanin content and expression of DvIVS was also found. The promoter region of DvIVS was classified into three types, with cultivars carrying Type 1 promoter exhibited deep coloring, those carrying Type 2 and/or Type 3 exhibited pale coloring, and those carrying Type 1 and Type 2 and/or Type 3 exhibited medium coloring. The transcripts of the genes from these promoters encoded full-length predicted proteins. These results suggested that the genotype of the promoter region in DvIVS is one of the key factors determining the flower color intensity.

  18. Crack edge collocation for the direct computation of stress intensity factors using the displacement discontinuity method

    CSIR Research Space (South Africa)

    Napier, JAL

    2002-09-01

    Full Text Available The numerical solution of problems relating to crack fracture and failure can be accomplished using the displacement discontinuity boundary element method. This paper presents an extension to the normal formulation of this method to enable stress...

  19. Ultrasound assisted destruction of estrogen hormones in aqueous solution: Effect of power density, power intensity and reactor configuration

    International Nuclear Information System (INIS)

    Suri, Rominder P.S.; Nayak, Mohan; Devaiah, Uthappa; Helmig, Edward

    2007-01-01

    There are many reports documenting the adverse effects, such as feminization of fish, of estrogen hormones in the environment. One of the major sources of these compounds is from municipal wastewater effluents. The biological processes at municipal wastewater treatment plants cannot completely remove these compounds. This paper discusses the use of ultrasound to destroy estrogen compounds in water. The study examines the effect of ultrasound power density and power intensity on the destruction of various estrogen compounds which include: 17α-estradiol, 17β-estradiol, estrone, estriol, equilin, 17α-dihydroequilin, 17α-ethinyl estradiol and norgestrel. These tests were conducted in single component batch and flow through reactors using 0.6, 2 and 4 kW ultrasound sources. The sonolysis process produced 80-90% destruction of individual estrogens at initial concentration of 10 μg/L within 40-60 min of contact time. First order rate constants for the individual compounds under different conditions are presented. The estrogen degradation rates increase with increase in power intensity. However, the energy efficiency of the reactor was higher at lower power density. The 4 kW ultrasound reactor was more energy efficient compared to the 0.6 and 2 kW sonicators

  20. Cytokine measurements and possible interference from heterophilic antibodies--problems and solutions experienced with rheumatoid factor

    DEFF Research Database (Denmark)

    Bartels, Else Marie; Ribel-Madsen, Søren

    2013-01-01

    these. Some antibodies, such as heterophilic and human anti-animal antibodies, are able to interfere with all immunoassays, but the immunometric techniques are most prone to serious interference from this source. Another type, rheumatoid factor (RF) is a composite of different autoimmune antibodies...... which can be present in both blood and synovial fluid. RF is present in some arthritic diseases as well as in some other medical conditions. When present, especially RF IgM is known to interfere with the immunometric measurements. A possible and affordable solution to diminish this interference is PEG...

  1. Factors influencing hydroquinone degradation in aqueous solution using a modified microelectrolysis method.

    Science.gov (United States)

    Li, Tong; Li, Tingting; Xiong, Houfeng; Zou, Donglei

    2015-01-01

    The discharge of hydroquinone (HQ), an important chemical raw material, to natural waters poses different ecological threats to aquatic organisms. In this study, we investigated the removal performance of traditional and modified microelectrolysis methods in aqueous solutions. The traditional microelectrolysis packing was modified by adding manganese (Mn), zinc (Zn), and copper (Cu) powder as additives. The factors affecting the removal performance of HQ, such as catalytic metal type, mass fraction of additive, reaction time, and initial pH, were examined. The results showed that the Mn modified packing exhibited the best performance compared to Zn and Cu powder. The removal rate of HQ using Mn modified packing can reach 94% after 4 h. In addition, 9% of Mn packing has a higher removal rate than other mass fractions. The acidic solution pH shows a more favorable degradation than a neutral and alkaline solution. The intermediates of HQ degradation by modified microelectrolysis were identified and then the pathway of HQ degradation was proposed. Our result indicates that Mn as catalytic metal holds promising potential to enhance HQ removal in water using the microelectrolysis method.

  2. Factorized implicit solution technique for calculation of flow in reactor components

    International Nuclear Information System (INIS)

    Sargis, D.A.; Chilukuri, R.; Stuhmiller, J.H.

    1987-01-01

    A factorized implicit finite difference scheme (FIST) for solving the three-dimensional, time-dependent Navier-Stokes equations is presented in this paper. The overall solution strategy and treatment of interequation coupling is similar to the well-known implicit continuous fluid Eulerian (ICE) and SMAC procedures. However, several features of the implicit FIST algorithm enable use of large time steps in contrast to the ICE scheme. The FIST method of integrating the momentum equations is best described as an extension of the Peaceman-Rachford alternating direction implicit (ADI) scheme. The Peaceman-Rachford ADI scheme was developed for the unsteady heat (diffusion) equation. The innovative feature of the FIST algorithm lies in implicit treatment of both advection and diffusion terms. The FIST scheme is an efficient of integrating the unsteady Navier-Stokes equations. The advantage of the FIST algorithm over fully implicit schemes is that FIST requires simultaneous solution of only simple-line tridiagonal matrix equations. Fully implicit algorithms, on the other hand, generally require solution of a large system of coupled algebraic equations at each time step

  3. ECONOMIC EFFICIENCY OF THE USE OF TECHNOLOGIES OF INTENSIVE SMALL-VOLUME LIGHT – CULTURE IN WITH NUTRIENT SOLUTIONS BASED ON COMMERCIALLY AVAILABLE FERTILIZERS

    Directory of Open Access Journals (Sweden)

    L. M. Anikina

    2016-01-01

    Full Text Available In conditions of maintenance of environment parameters for plant growth, the use of nutrient solutions prepared with non-deficient fertilizers is an effective method of reducing the cost of vegetable production. The article examines economic prospects of the use of technologies of small-volume (0,15 — 0,3 l./per plant the intensity of light-culture of plants in nutrient solutions, prepared on the basis of industrially produced fertilizers ‘Rastvorin A’, ‘Akvarin’, ‘Agricola’ and ‘Kemira Lux’, which are recommended for leafy crops. ‘Knop’ solution as one of the most effective for intensive technologies of the light-culture of leafy crops was used as a control. The object of study was a lettuce, cultivar ‘Tayphun’ and parsley cultivar ‘Bogatyr’. Plants were grown under different levels of light irradiance. Light during the growing period for both species was for 12 hours, the temperature was maintained at 20-22C° in the day and 18-20C° at night, air humidity between 60-65%. The duration of the vegetation period is 25 days. As a result of the study, it was shown that the productivity of lettuce cultivar ‘Typhun’ and parsley cultivar ‘Bogatyr’ that were grown on nutrient solutions ‘Agricola’ and ‘Rastvorin’ was very high. The content of nitrates for all cases was not extended more than the MCL. The highest productivity in the range of irradiance between 60 and 40 watts has been observed in lettuce plants of cultivar ‘Typhoon’, grown under light-culture system with the use of nutrient solutions ‘Akvarin’ and ‘Agricola’. Thus, the study carried out has showed that nutrient solutions ‘Akvarin’, ‘Agricola’ and ‘Rastvorin’ can be recommended for cultivation of leafy crops under condition of changeable light irradiation.

  4. Factors Affecting Code Status in a University Hospital Intensive Care Unit

    Science.gov (United States)

    Van Scoy, Lauren Jodi; Sherman, Michael

    2013-01-01

    The authors collected data on diagnosis, hospital course, and end-of-life preparedness in patients who died in the intensive care unit (ICU) with "full code" status (defined as receiving cardiopulmonary resuscitation), compared with those who didn't. Differences were analyzed using binary and stepwise logistic regression. They found no…

  5. Long-term trends in direct and indirect household energy intensities: a factor in dematerialisation?

    International Nuclear Information System (INIS)

    Vringer, K.; Blok, K.

    2000-01-01

    Dematerialisation is assumed to contribute significantly to the alleviation of environmental problems. One of the possible causes of dematerialisation is a change in the consumption patterns of households. The aim of this article is to analyse changes in consumption patterns of Dutch households in the period between 1948 to 1996 in order to discover whether these changes have influenced the energy intensity of society. Due to the rise in consumption, the total household energy requirement per capita grew on average by 2.4 per cent per year over a period of 48 years (this figure ignores efficiency changes in the supplying sectors). In the same period the total energy intensity of households fluctuated but on average changed from 5.6 to 6.3 MJ/NLG, an increase of 0.25 per cent per year. If we exclude the direct energy consumption we find a slight decline in the indirect energy intensity, namely from 3.8 to 3.6 MJ/NLG ( - 0.14 per cent per year). No significant trends to a lower energy intensity are found and there is no indication of dematerialisation of the consumption patterns. If governments pursue a policy of sustainable development they have to take into account the fact that dematerialisation of the consumption pattern does not seem to be an autonomous process. (author)

  6. Brief Report: Incidence of and Risk Factors for Autistic Disorder in Neonatal Intensive Care Unit Survivors.

    Science.gov (United States)

    Matsuishi, Toyojiro; Yamashita, Yushiro; Ohtani, Yasuyo; Ornitz, Edward; Kuriya, Norikazu; Murakami, Yoshihiko; Fukuda, Seiichi; Hashimoto, Takeo; Yamashita, Fumio

    1999-01-01

    Analysis of the incidence of autistic disorder (AD) among 5,271 children in a neonatal intensive care unit in Japan found that 18 children were later diagnosed with AD, an incidence more than twice as high as previously reported. Children with AD had a significantly higher history of the meconium aspiration syndrome than the controls. (Author/DB)

  7. Factors determining the patients' care intensity for surgeons and surgical nurses: a conjoint analysis

    NARCIS (Netherlands)

    van Oostveen, Catharina J.; Vermeulen, Hester; Nieveen van Dijkum, Els J. M.; Gouma, Dirk J.; Ubbink, Dirk T.

    2015-01-01

    Surgeons and nurses sometimes perceive a high workload on the surgical wards, which may influence admission decisions and staffing policy. This study aimed to explore the relative contribution of various patient and care characteristics to the perceived patients' care intensity and whether

  8. Exploring item and higher order factor structure with the Schmid-Leiman solution: syntax codes for SPSS and SAS.

    Science.gov (United States)

    Wolff, Hans-Georg; Preising, Katja

    2005-02-01

    To ease the interpretation of higher order factor analysis, the direct relationships between variables and higher order factors may be calculated by the Schmid-Leiman solution (SLS; Schmid & Leiman, 1957). This simple transformation of higher order factor analysis orthogonalizes first-order and higher order factors and thereby allows the interpretation of the relative impact of factor levels on variables. The Schmid-Leiman solution may also be used to facilitate theorizing and scale development. The rationale for the procedure is presented, supplemented by syntax codes for SPSS and SAS, since the transformation is not part of most statistical programs. Syntax codes may also be downloaded from www.psychonomic.org/archive/.

  9. Factors determining the patients' care intensity for surgeons and surgical nurses: a conjoint analysis.

    Science.gov (United States)

    van Oostveen, Catharina J; Vermeulen, Hester; Nieveen van Dijkum, Els J M; Gouma, Dirk J; Ubbink, Dirk T

    2015-09-18

    Surgeons and nurses sometimes perceive a high workload on the surgical wards, which may influence admission decisions and staffing policy. This study aimed to explore the relative contribution of various patient and care characteristics to the perceived patients' care intensity and whether differences exist in the perception of surgeons and nurses. We invited surgeons and surgical nurses in the Netherlands for a conjoint analysis study through internet and e-mail invitations. They rated 20 virtual clinical scenarios regarding patient care intensity on a 10-point Likert scale. The scenarios described patients with 5 different surgical conditions: cholelithiasis, a colon tumor, a pancreas tumor, critical leg ischemia, and an unstable vertebral fracture. Each scenario presented a mix of 13 different attributes, referring to the patients' condition, physical symptoms, and admission and discharge circumstances. A total of 82 surgeons and 146 surgical nurses completed the questionnaire, resulting in 4560 rated scenarios, 912 per condition. For surgeons, 6 out of the 13 attributes contributed significantly to care intensity: age, polypharmacy, medical diagnosis, complication level, ICU-stay and ASA-classification, but not multidisciplinary care. For nurses, the same six attributes contributed significantly, but also BMI, nutrition status, admission type, patient dependency, anxiety or delirium during hospitalization, and discharge type. Both professionals ranked 'complication level' as having the highest impact. The differences between surgeons and nurses on attributes contributing to care intensity may be explained by differences in professional roles and daily work activities. Surgeons have a medical background, including technical aspects of their work and primary focus on patient curation. However, nurses are focused on direct patient care, i.e., checking vital functions, stimulating self-care and providing woundcare. Surgeons and nurses differ in their perception of

  10. On stability of exponential cosmological solutions with non-static volume factor in the Einstein-Gauss-Bonnet model

    International Nuclear Information System (INIS)

    Ivashchuk, V.D.

    2016-01-01

    A (n + 1)-dimensional gravitational model with Gauss-Bonnet term and a cosmological constant term is considered. When ansatz with diagonal cosmological metrics is adopted, the solutions with an exponential dependence of the scale factors, a i ∝ exp(v i t), i = 1,.., n, are analyzed for n > 3. We study the stability of the solutions with non-static volume factor, i.e. K(v) = sum k=1 n v k ≠ 0. We prove that under a certain restriction R imposed solutions with K(v) > 0 are stable, while solutions with K(v) < 0 are unstable. Certain examples of stable solutions are presented. We show that the solutions with v 1 = v 2 = v 3 = H > 0 and zero variation of the effective gravitational constant are stable if the restriction R is obeyed. (orig.)

  11. On stability of exponential cosmological solutions with non-static volume factor in the Einstein-Gauss-Bonnet model

    Energy Technology Data Exchange (ETDEWEB)

    Ivashchuk, V.D. [VNIIMS, Center for Gravitation and Fundamental Metrology, Moscow (Russian Federation); Peoples' Friendship University of Russia (RUDN University), Institute of Gravitation and Cosmology, Moscow (Russian Federation)

    2016-08-15

    A (n + 1)-dimensional gravitational model with Gauss-Bonnet term and a cosmological constant term is considered. When ansatz with diagonal cosmological metrics is adopted, the solutions with an exponential dependence of the scale factors, a{sub i} ∝ exp(v{sup i}t), i = 1,.., n, are analyzed for n > 3. We study the stability of the solutions with non-static volume factor, i.e. K(v) = sum {sub k=1}{sup n} v{sup k} ≠ 0. We prove that under a certain restriction R imposed solutions with K(v) > 0 are stable, while solutions with K(v) < 0 are unstable. Certain examples of stable solutions are presented. We show that the solutions with v{sup 1} = v{sup 2} = v{sup 3} = H > 0 and zero variation of the effective gravitational constant are stable if the restriction R is obeyed. (orig.)

  12. Provincial carbon intensity abatement potential estimation in China: A PSO–GA-optimized multi-factor environmental learning curve method

    International Nuclear Information System (INIS)

    Yu, Shiwei; Zhang, Junjie; Zheng, Shuhong; Sun, Han

    2015-01-01

    This study aims to estimate carbon intensity abatement potential in China at the regional level by proposing a particle swarm optimization–genetic algorithm (PSO–GA) multivariate environmental learning curve estimation method. The model uses two independent variables, namely, per capita gross domestic product (GDP) and the proportion of the tertiary industry in GDP, to construct carbon intensity learning curves (CILCs), i.e., CO 2 emissions per unit of GDP, of 30 provinces in China. Instead of the traditional ordinary least squares (OLS) method, a PSO–GA intelligent optimization algorithm is used to optimize the coefficients of a learning curve. The carbon intensity abatement potentials of the 30 Chinese provinces are estimated via PSO–GA under the business-as-usual scenario. The estimation reveals the following results. (1) For most provinces, the abatement potentials from improving a unit of the proportion of the tertiary industry in GDP are higher than the potentials from raising a unit of per capita GDP. (2) The average potential of the 30 provinces in 2020 will be 37.6% based on the emission's level of 2005. The potentials of Jiangsu, Tianjin, Shandong, Beijing, and Heilongjiang are over 60%. Ningxia is the only province without intensity abatement potential. (3) The total carbon intensity in China weighted by the GDP shares of the 30 provinces will decline by 39.4% in 2020 compared with that in 2005. This intensity cannot achieve the 40%–45% carbon intensity reduction target set by the Chinese government. Additional mitigation policies should be developed to uncover the potentials of Ningxia and Inner Mongolia. In addition, the simulation accuracy of the CILCs optimized by PSO–GA is higher than that of the CILCs optimized by the traditional OLS method. - Highlights: • A PSO–GA-optimized multi-factor environmental learning curve method is proposed. • The carbon intensity abatement potentials of the 30 Chinese provinces are estimated by

  13. Effect of Couple Stresses on the Stress Intensity Factors for Two Parallel Cracks in an Infinite Elastic Medium under Tension

    Directory of Open Access Journals (Sweden)

    Shouetsu Itou

    2012-01-01

    Full Text Available Stresses around two parallel cracks of equal length in an infinite elastic medium are evaluated based on the linearized couple-stress theory under uniform tension normal to the cracks. Fourier transformations are used to reduce the boundary conditions with respect to the upper crack to dual integral equations. In order to solve these equations, the differences in the displacements and in the rotation at the upper crack are expanded through a series of functions that are zero valued outside the crack. The unknown coefficients in each series are solved in order to satisfy the boundary conditions inside the crack using the Schmidt method. The stresses are expressed in terms of infinite integrals, and the stress intensity factors can be determined using the characteristics of the integrands for an infinite value of the variable of integration. Numerical calculations are carried out for selected crack configurations, and the effect of the couple stresses on the stress intensity factors is revealed.

  14. Transverse shear effects on the stress-intensity factor for a circumferentially cracked, specially orthotropic cylindrical shell

    Science.gov (United States)

    Delale, F.; Erdogan, F.

    1977-01-01

    The problem of a cylindrical shell containing a circumferential through crack is considered by taking into account the effect of transverse shear deformations. The formulation is given for a specially orthotropic material within the confines of a linearized shallow shell theory. The particular theory used permits the consideration of all five boundary conditions regarding moment and stress resultants on the crack surface. Consequently, aside from multiplicative constants representing the stress intensity factors, the membrane and bending components of the asymptotic stress fields near the crack tip are found to be identical. The stress intensity factors are calculated separately for a cylinder under a uniform membrane load, and that under a uniform bending moment. Sample results showing the nature of the out-of-plane crack surface displacement and the effect of the Poisson's ratio are presented.

  15. Simulation Analysis of the Mutual Influence of the Stress Intensity Factor on the Multiple Blisters Caused by Hydrogen Induced Damage

    Science.gov (United States)

    Ji, Congwei; Zhang, Shaojie; Wang, Hehui

    2018-03-01

    Hydrogen blisters are taken as the research object by using the finite element software ABAQUS. The stress intensity factors of blister cracks are numerically calculated at varying depths and different edge distances for established three-dimensional finite element models of single-blister and double-blisters, respectively. The mutual influence of the stress intensity factors of the multiple blisters is obtained. It shows that the blister crack is easier to expand when the crack is closer to inner wall of the cylinder. What’s more, the crack growth rate increases firstly and then decreases as the increasing of the distance between two blisters cracks. The investigated result is of great reference value for predicting the trend of blister crack growth.

  16. [Severe complications of orotracheal intubation in the Intensive Care Unit: An observational study and analysis of risk factors].

    Science.gov (United States)

    Badia, M; Montserrat, N; Serviá, L; Baeza, I; Bello, G; Vilanova, J; Rodríguez-Ruiz, S; Trujillano, J

    2015-01-01

    A study is made to determine the characteristics of endotracheal intubation (ETI) procedures performed in an Intensive Care Unit, and to describe the associated severe complications and related risk factors. A prospective cohort study involving a 2-year period was carried out. The combined clinical/surgical Intensive Care Unit in a secondary university hospital. All ETIs carried out by intensivists were included. None. We analyzed the data associated with the patient, the procedure and the postoperative complications after intubation. The study of risk factors was performed using multiple logistic regression analysis. Seventy-six percent of the ETIs were performed immediately. Most of them were carried out by Intensive Care Units residents (60%). A total of 34% of the procedures had severe complications, including respiratory (16%) or hemodynamic (5%) disorders, or both (10%). Three patients died (1%), and 2% of the subjects experienced cardiac arrest. Logistic regression analysis identified the following independent risk factors for complications: age (OR 1.1; 95% CI: 1.1-1.2), systolic blood pressure≤90mmHg (OR 3.0; 95% CI: 1.4-6.4) and SpO2≤90% (OR 4.4; 95% CI: 2.3-8.1) prior to intubation, the presence of secretions (OR 2.2; 95% CI: 1.1-4.6), and the need for more than one ETI attempt (OR 3.5; 95% CI: 1.4-8.7). ETI in Intensive Care Unit patients is associated with respiratory and hemodynamic complications. The independent risk factors associated with the development of complications were advanced age, hypotension and previous hypoxemia, the presence of secretions, and the need for more than one ETI attempt. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  17. Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer

    OpenAIRE

    Zhao, Yaqin; Chen, Lu; Zhang, Shu; Wu, Qiang; Jiang, Xiaoqin; Zhu, Hong; Wang, Jin; Li, Zhiping; Xu, Yong; Zhang, Ying Jie; Bai, Sen; Xu, Feng

    2015-01-01

    Background Radiation pneumonitis (RP) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). This study aims to analyze clinical or dosimetric factors associated with RP, and provides data for radiotherapy planning. Methods We reviewed 68 postoperative esophageal cancer patients who were treated with radiothera...

  18. The effect of several intact or broken stringers of the stress intensity factor in a cracked sheet

    Science.gov (United States)

    Arin, K.

    1976-01-01

    The stringers which are continuously attached to the plate and placed perpendicular to the crack may be partially debonded due to high stress concentrations. Since the stringers may even break under excessive loading conditions, both intact and broken stringers are considered to investigate the effect of rupture. The continuity of displacements along the bond lines leads to an integral equation which is solved to give the shear stress distribution in the adhesive and the stress intensity factors at the crack tips.

  19. Risk factors for pressure injury development in critically ill patients in the intensive care unit: a systematic review protocol.

    Science.gov (United States)

    Coyer, Fiona; Tayyib, Nahla

    2017-03-20

    Pressure injuries (PIs) create a significant burden in the health care system. Up to 49% of critically ill patients develop PIs. Identifying and understanding potential risk factors is essential to the provision of effective targeted prevention strategies to mitigate risk. The objectives of this review are to identify patient-centred clinical factors that may be associated with PI development in the adult intensive care environment and to determine the effect size of the relationship between identified factors and PI development in this unique population. The review will follow the PRISMA reporting guidelines for systematic reviews. Electronic databases (Cochrane; PubMed/MEDLINE; CINAHL (EBSCOhost); Embase; Scopus; PsycINFO; Proquest; Networked Digital Library of Theses and Dissertations; Australian Digital Theses Program, Grey literature, Google scholar, and Clinical Trial Registries) will be systematically searched. A suite of search terms will identify articles that have examined the patient-centred risk factors for PI development in adult intensive care units. The search strategy will be designed to retrieve studies published since inception to 2016 in English language. Quality of the studies will be assessed by using an assessment framework designed to appraise quality in prognostic studies and methodological considerations in the analysis and publication of observational studies. Screening, study selection process, and data extraction will be undertaken by two independent reviewers. Disagreement will be resolved by discussion and, if required, a third independent reviewer. Clinical and methodological heterogeneity across studies will be assessed and, if possible, meta-analyses will be performed. The evidence synthesis arising from this review will identify person-centred risk factors that are associated with PI development among critically ill patients in intensive care. Findings from this review will demonstrate potential patient risk factors that may

  20. Factors affecting the anthelmintic efficacy of papaya latex in vivo: host sex and intensity of infection.

    Science.gov (United States)

    Luoga, Wenceslaus; Mansur, Fadlul; Lowe, Ann; Duce, Ian R; Buttle, David J; Behnke, Jerzy M

    2015-07-01

    The development of plant-derived cysteine proteinases, such as those in papaya latex, as novel anthelmintics requires that the variables affecting efficacy be fully evaluated. Here, we conducted two experiments, the first to test for any effect of host sex and the second to determine whether the intensity of the worm burden carried by mice would influence efficacy. In both experiments, we used the standard C3H mouse reference strain in which papaya latex supernatant (PLS) consistently shows >80 % reduction in Heligmosomoides bakeri worm burdens, but to broaden the perspective, we also included for comparison mice of other strains that are known to respond more poorly to treatment with papaya latex. Our results confirmed that there is a strong genetic influence affecting efficacy of PLS in removing adult worm burdens. However, there was no effect of host sex on efficacy (C3H and NIH) and no effect of infection intensity (C3H and BALB/c). These results offer optimism that plant-derived cysteine proteinases (CPs), such as these from papaya latex, can function as effective anthelmintics, with neither host sex nor infection intensity presenting further hurdles to impede their development for future medicinal and veterinary usage.

  1. [Systemic candidiasis in medical intensive care unit: analysis of risk factors and the contribution of colonization index].

    Science.gov (United States)

    Massou, S; Ahid, S; Azendour, H; Bensghir, M; Mounir, K; Iken, M; Lmimouni, B E; Balkhi, H; Drissi Kamili, N; Haimeur, C

    2013-06-01

    Description of the epidemiological and clinical characteristics of the patients introducing risk factors of invasive candidiasis. Analysis of risk factors for candidiasis invasive and evaluation of the contribution of colonization index (CI) in the diagnosis of the systematic candidiasis in medical intensive care. Prospective observational study (October 2007 to October 2009). The selected patients present risk factors of system IC candidiasis with an infectious syndrome or clinical signs suggestive of Candida infection and hospitalized more than 48 hours in medical intensive care unit. Pittet's colonization index was calculated at admission and then once a week added to a blood culture. Patients were classified according to level of evidence of Candida infection and the degree of colonization (CIcandidiasis. In multivariate analysis, the corticosteroid therapy was associated with a high colonisation (IC ≥ 0.5) and neutropenia with a high risk of systemic candidiasis. The positive predictive value of CI was 26%. The negative predictive value was 98%, the sensitivity and specificity was 93% and 48% respectively. CI has the advantage to provide a quantified data of the patient's situation in relation to the colonization. But, it isn't helpful with patients having an invasive candidiasis in medical intensive care unit. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  2. Explicit Solutions for the (2 + 1-Dimensional Jaulent–Miodek Equation Using the Integrating Factors Method in an Unbounded Domain

    Directory of Open Access Journals (Sweden)

    Rahma Sadat

    2018-03-01

    Full Text Available In this work, we prove that the integrating factors can be used as a reduction method. Analytical solutions of the Jaulent–Miodek (JM equation are obtained using integrating factors as an extension of a recent work where, through hidden symmetries, the JM was reduced to ordinary differential equations (ODEs. Some of these ODEs had no quadrature. We here derive several new solutions for these non-solvable ODEs.

  3. Polynomial-time solution of prime factorization and NP-complete problems with digital memcomputing machines

    Science.gov (United States)

    Traversa, Fabio L.; Di Ventra, Massimiliano

    2017-02-01

    We introduce a class of digital machines, we name Digital Memcomputing Machines, (DMMs) able to solve a wide range of problems including Non-deterministic Polynomial (NP) ones with polynomial resources (in time, space, and energy). An abstract DMM with this power must satisfy a set of compatible mathematical constraints underlying its practical realization. We prove this by making a connection with the dynamical systems theory. This leads us to a set of physical constraints for poly-resource resolvability. Once the mathematical requirements have been assessed, we propose a practical scheme to solve the above class of problems based on the novel concept of self-organizing logic gates and circuits (SOLCs). These are logic gates and circuits able to accept input signals from any terminal, without distinction between conventional input and output terminals. They can solve boolean problems by self-organizing into their solution. They can be fabricated either with circuit elements with memory (such as memristors) and/or standard MOS technology. Using tools of functional analysis, we prove mathematically the following constraints for the poly-resource resolvability: (i) SOLCs possess a global attractor; (ii) their only equilibrium points are the solutions of the problems to solve; (iii) the system converges exponentially fast to the solutions; (iv) the equilibrium convergence rate scales at most polynomially with input size. We finally provide arguments that periodic orbits and strange attractors cannot coexist with equilibria. As examples, we show how to solve the prime factorization and the search version of the NP-complete subset-sum problem. Since DMMs map integers into integers, they are robust against noise and hence scalable. We finally discuss the implications of the DMM realization through SOLCs to the NP = P question related to constraints of poly-resources resolvability.

  4. Site of deposition and factors affecting clearance of aerosolized solute from canine lungs

    International Nuclear Information System (INIS)

    Rizk, N.W.; Luce, J.M.; Hoeffel, J.M.; Price, D.C.; Murray, J.F.

    1984-01-01

    The influence of several factors on lung solute clearance using aerosolized /sup 99m/Tc-diethylenetriaminepentaacetate was determined. The authors used a jet nebulizer-plate separator-balloon system to generate particles with an activity median aerodynamic diameter of 1.1 μm, administered the aerosol in a standard fashion, and determined clearance half times (t/sub 1/2/) with a gamma-scintillation camera. The following serial studies were performed in five anesthetized, paralyzed, intubated, mechanically ventilated dogs: (1) control, with ventilatory frequency (f) = 15 breaths/min and tidal volume (V/sub T/) = 15 ml/kg during solute clearance; (2) repeat control, for reproducibility; (3) increased frequency, with f = 25 breaths/min and V/sub T/ = 10 ml/kg; (4) positive end-expiratory pressure (PEEP) of 10 cmH 2 O; (5) unilateral pulmonary arterial occlusion (PAO); and (6) bronchial arterial occlusion (BAO). Control t/sub 1/2/ was 25 +/- 5 min and did not change in the repeat control, increased frequency, or BAO experiments. PEEP markedly decreased t/sub 1/2/ to 13 +/- 3 min (P < 0.01), and PAO increased it to 37 +/- 6 min (P < 0.05). We conclude that clearance from the lungs by our method is uninfluenced by increased frequency, increases markedly with PEEP, and depends on pulmonary, not bronchial, blood flow

  5. Risk factors, characteristics, and outcomes of candidemia in an adult intensive care unit in Turkey.

    Science.gov (United States)

    Tukenmez Tigen, Elif; Bilgin, Huseyin; Perk Gurun, Hande; Dogru, Arzu; Ozben, Beste; Cerikcioglu, Nilgun; Korten, Volkan

    2017-06-01

    Thirty-six patients with candidemia and 37 control patients were included consecutively to determine the characteristics of candidemia episodes. The patients with candidemia had higher mortality with higher Sequential Organ Failure Assessment scores and frequency of use of a central venous catheter, total parenteral nutrition, and broad-spectrum antibiotics; chronic renal failure with replacement therapy; and longer stay in an intensive care unit. Candida albicans was the predominant species followed by Candida glabrata, Candida tropicalis, and Candida parapsilosis. All isolates of C glabrata were itraconazole-resistant. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Analysis of Factors Affecting Stress Solution at Concrete Gravity Dam Heel

    Science.gov (United States)

    Hung, Vu Hoang; Quoc Cong, Trinh; Tongchun, Li

    2010-05-01

    Along with Vietnam's development, various hydraulic constructions including concrete gravity dams have been being built. In some of these dams, the fractures occurred at the heel of the dams are even in small and media dams. There are various reasons cause the factures at dam heel but the main reason is the stress states at dam heel are not determined correctly while designing dam. In this paper, several factors affecting stress solution at concrete gravity dam heel such as element mesh size, crack joints of upstream foundation, execution process are investigated by using finite element model of Banve concrete gravity dam. This work is very significant when the more high concrete gravity dams will be constructed in Vietnam year after year.

  7. Analyses of factors affecting nickel ferrite nanoparticles synthesis in ultrasound-assisted aqueous solution ball milling.

    Science.gov (United States)

    Yuan, Zhuang; Chen, Zhen-hua; Chen, Ding; Kang, Zhi-tao

    2015-01-01

    Ball milling experiments were conducted with and without ultrasound wave assistance in deionized water using NiCO3·2Ni(OH)2·4H2O as raw materials. In the reaction process of NiFe2O4 prepared by ultrasound-assisted aqueous solution ball milling, some influencing factors including raw materials, ultrasonic frequency, ball to powder ratio and liquid level were changed. Samples were characterized by X-ray diffraction, fluorescence measurements and electroconductivity detections. The results indicate that more hydroxyl radicals and ions can be generated under the coupling effect of ultrasonic and ball milling. The fluorescence measurements and electroconductivity detections also reflect the reaction speed, allowing for optimal parameters to be determined. Copyright © 2014 Elsevier B.V. All rights reserved.

  8. Rectangular Full Packed Format for Cholesky's Algorithm: Factorization, Solution, and Inversion

    DEFF Research Database (Denmark)

    Gustavson, Fred G.; Wasniewski, Jerzy; Dongarra, Jack J

    2010-01-01

    of the storage space but provide high performance via the use of Level 3 BLAS. Standard packed format arrays fully utilize storage (array space) but provide low performance as there is no Level 3 packed BLAS. We combine the good features of packed and full storage using RFPF to obtain high performance via using...... Level 3 BLAS as RFPF is a standard full-format representation. Also, RFPF requires exactly the same minimal storage as packed the format. Each LAPACK full and/or packed triangular, symmetric, and Hermitian routine becomes a single new RFPF routine based on eight possible data layouts of RFPF. This new...... RFPF routine usually consists of two calls to the corresponding LAPACK full-format routine and two calls to Level 3 BLAS routines. This means no new software is required. As examples, we present LAPACK routines for Cholesky factorization, Cholesky solution, and Cholesky inverse computation in RFPF...

  9. Carbapenem-resistant Klebsiella pneumoniae colonization in pediatric and neonatal intensive care units: risk factors for progression to infection.

    Science.gov (United States)

    Akturk, Hacer; Sutcu, Murat; Somer, Ayper; Aydın, Derya; Cihan, Rukiye; Ozdemir, Aslı; Coban, Asuman; Ince, Zeynep; Citak, Agop; Salman, Nuran

    2016-01-01

    Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. A retrospective case-control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010-December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients' medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6±1.9 days (median: 7 days, range: 2-38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n=15, 62.5%), ventilator-associated pneumonia (n=4, 16.6%), ventriculitis (n=2, 8.3%), intraabdominal infections (n=2, 8.3%), and urinary tract infection (n=1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7-37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2-40.1), neutropenia (OR: 13.8; 95% CI: 3

  10. A data-derived safety (uncertainty) factor for the intense sweetener, saccharin.

    Science.gov (United States)

    Renwick, A G

    1993-01-01

    An increased incidence of bladder cancer is found when male rats are fed high dietary concentrations of sodium saccharin (3% or more) from birth. This toxicity has been used as the basis for the development of a data-derived safety factor. Such an effect would attract an extra factor (10-fold) for nature of toxicity and in the absence of other data would result in a high overall safety factor. However the extensive mechanistic database on sodium saccharin allows an assessment of the potential relevance of the effect for humans. In addition the effect is only seen under specific conditions in rats, i.e. largely with the sodium salt and with a commercial rat diet. The effect is not related to the concentration of saccharin in the rat urine or bladder so that toxicokinetic considerations are simplified. The extensive animal database allows the determination of data-derived factors for inter-species differences in both toxicokinetics and toxicodynamics. Based on this analysis an overall safety factor of 50 (which includes the factor of 10 for severity of effect) would appear appropriate at the present time. This factor, and the ADI which would result from its application, are consistent with the absence of an association between the consumption of artificial sweeteners and bladder cancer in humans.

  11. Investigating the relationship between demographic and occupational factors with the intensity of nurse legs varicose veins in Amol hospitals

    Directory of Open Access Journals (Sweden)

    M. Mahbobi

    2010-04-01

    Full Text Available Background and aims   varicose of lower limbs is one of the most common injuries which is caused and intensified by the job activities through passing the time and can cause the person and the society to bear the high cost. This study has been done in order to investigate the relationship between the demographic and occupational factors with the lower limb varicose severity of the   nurses in Amol hospital.     Methods   This cross-sectional study was conducted through on 203 nurses in Amol hospitals. Questionnaire was used to collect the required information. It was completed through interview and physical examination based on the standard CEAP forms.     Results   145 of the subjects were female. 73.9% of the nurses had varicose with different levels  (CI95%: 77- 65. Female gender, age, BMI (OR =1.21, regular exercise (OR =0.31, family history, weight, and overtime between job factors (OR =1.01, years of service, standing (OR  =2.3 and sitting in the ward had significant relationship with the varicose intensity.     Conclusion   It seems that the necessary training to reduce disability and treatment expenses to adjust risk factors and prevention of inducing varicose is essential according to the high number of the nurses who have lower varicose veins with different intensities and the effect of lots of demographic and occupational factors.  

  12. Development Instruments Through Confirmatory Factor Analysis (CFA) in Appropriate Intensity Assessment

    OpenAIRE

    Ari Saptono

    2017-01-01

    The research aims to develop the valid and reliable measurement instruments of entrepreneurship intention in vocational secondary school students. Multi stage random sampling was used as the technique to determine sample (300 respondents). The research method used research and development with confirmatory factor analysis (CFA). Result of confirmatory factor analysis (CFA) at the second order with robust maximum likelihood method shows that valid and reliable instrument with the acquisition v...

  13. Factors limiting performance in a multitone intensity-discrimination task: disentangling non-optimal decision weights and increased internal noise.

    Directory of Open Access Journals (Sweden)

    Daniel Oberfeld

    Full Text Available To identify factors limiting performance in multitone intensity discrimination, we presented sequences of five pure tones alternating in level between loud (85 dB SPL and soft (30, 55, or 80 dB SPL. In the "overall-intensity task", listeners detected a level increment on all of the five tones. In the "masking task", the level increment was imposed only on the soft tones, rendering the soft tones targets and loud tones task-irrelevant maskers. Decision weights quantifying the importance of the five tone levels for the decision were estimated using methods of molecular psychophysics. Compatible with previous studies, listeners placed higher weights on the loud tones than on the soft tones in the overall-intensity condition. In the masking task, the decisions were systematically influenced by the to-be-ignored loud tones (maskers. Using a maximum-likelihood technique, we estimated the internal noise variance and tested whether the internal noise was higher in the alternating-level five-tone sequences than in sequences presenting only the soft or only the loud tones. For the overall-intensity task, we found no evidence for increased internal noise, but listeners applied suboptimal decision weights. These results are compatible with the hypothesis that the presence of the loud tones does not impair the precision of the representation of the intensity of the soft tones available at the decision stage, but that this information is not used in an optimal fashion due to a difficulty in attending to the soft tones. For the masking task, in some cases our data indicated an increase in internal noise. Additionally, listeners applied suboptimal decision weights. The maximum-likelihood analyses we developed should also be useful for other tasks or other sensory modalities.

  14. Burnout and stress amongst interns in Irish hospitals: contributing factors and potential solutions.

    Science.gov (United States)

    Hannan, E; Breslin, N; Doherty, E; McGreal, M; Moneley, D; Offiah, G

    2017-10-09

    The transition from medical school to internship can be daunting for newly qualified doctors. High rates of stress and burnout have been reported, with negative impacts on patient care and physician wellbeing. We surveyed interns in our hospital group to evaluate rates of stress and burnout, as well as identify the causative factors and propose potential solutions to these. A hundred and one interns working in four different hospitals over a 2-year period were invited to participate in an anonymous survey. The survey collected basic demographic details and surveyed aspects of mental health using the burnout scale, Maslach Burnout Inventory (MBI) and the stress scale and 12-item General Health Questionnaire (GHQ-12). Interns were also asked to rate a variety of workplace factors on a Likert scale based on the degree of stress caused. Finally, they were surveyed on their awareness of support services available to them. Our results showed that 37% of interns met the criteria for psychological distress, high levels of emotional exhaustion, high depersonalisation and a low sense of personal accomplishment were reported in 55.4, 51.5 and 41.6%, respectively. Inadequate preparation for practice, financial worries, poor role definition and sleep deprivation were reported as significant stressors. Most were unaware of available support services and expressed interest in leaving Ireland after internship. Burnout and stress are significant problems amongst doctors in Irish hospitals. Ensuring better preparation for clinical practice and awareness of support services is vital to tackle this issue.

  15. The Comparison of Chlorhexidine Solution and Swab With Toothbrush and Toothpaste Effect on Preventing Oral Lesions in Hospitalized Patients in Intensive Care Unit.

    Science.gov (United States)

    Estaji, Zahra; Alinejad, Mohammad; Hassan Rakhshani, Mohammad; Rad, Mojtaba

    2015-10-20

    Maintaining of oral hygiene has been known as one of the basic tasks of nurses working at intensive care unit. This study aimed to compare the effectiveness of chlorhexidine solution with toothbrush in prevention of oral lesions or ulcers in the different parts of the mouth. In this clinical trial study, research Society included patients hospitalized with endotracheal tube since the arrival time in intensive care unit. In this study, 30 patients were selected with target-based approach and equally divided into two groups through the permutation blocking method for oral care toothbrush and toothpaste and using chlorhexidine and swab. The modified form of Beck Oral Assessment Scale (BOAS) and MPS were used to obtain needed information. Data were analyzed by means of R software (version 3.0.2) and also multiple logistic regressions in the confidence level of 95%. This study indicated an association between using toothbrush and the oral health level (OR: 1.52). In different parts of the mouth, there was no difference between two groups in prevention of lesions in gums, lips and tongue while, this was significant in relation to plaque, mucus and teeth with an odd ratio of 3.94 for teeth and 2.75 for mucus . In comparison, there was an association between implying chlorhexidine and saliva health level. (OR: 2.046). This survey showed that using toothbrush has a noticeable impact on declining oral lesions in varied parts of the mouth.

  16. Factor Analysis with EM Algorithm Never Gives Improper Solutions when Sample Covariance and Initial Parameter Matrices Are Proper

    Science.gov (United States)

    Adachi, Kohei

    2013-01-01

    Rubin and Thayer ("Psychometrika," 47:69-76, 1982) proposed the EM algorithm for exploratory and confirmatory maximum likelihood factor analysis. In this paper, we prove the following fact: the EM algorithm always gives a proper solution with positive unique variances and factor correlations with absolute values that do not exceed one,…

  17. Fission products determination in high activity waste solution by wavelength dispersive X-ray fluorescence spectral interference correction by intensity ratio

    International Nuclear Information System (INIS)

    Sato, I.M.

    1988-01-01

    Fission products Se, Rb, Y, Zr, Mo, Ru, Rh, Pd, Te, Cd, Cs, Ba, La, Ce, Pr, Nd, Sm, Eu and Gd were determined in simulated high activity radioactive waste solution by wavelength dispersive X-ray fluorescence spectrometry without chemical separation. Thin layer technique was employed for the sample preparation. For the L spectral lines, the absorption effect was verified by Rasberry-Heinrich, Lucas Tooth-Pyne and Lachance-Trail relations. This effect was quantified and corrected accordingly. The spectral interferences of Kα and/or Lα lines of Y, Zr, Mo, La, Ce, Pr, Nd, Sm, Eu and Gd elements were eliminated by the intensity ratio method. The overlapping of up to three analytical lines was corrected by applying this method. The concentration influence of the interfering element on the intensity ratio values as well the efficiency of the correction method were investigated in order to assure that no systematic or residual error, resulting from the correction, affect the actual fluorescent intensity determination. The results is compared with the data obtained from measurements of free lines of spectral interference and also with those obtained by the linear equation system. Fission products determination presented a precision in the range of 0.1 to 5.0% and an accuracy of up to ± 7.0% the results are compared with those obtained by neutron activation analysis and inductively coupled plasma - atomic emission spectrometry. Leaching data, when radioactive waste is incorporated in cement matrix, were attempted by X-ray fluorescence technique. For two years leaching period, leaching rate and diffusion coefficient data of cesium were determined. The results obtained agree with those obtained by γ-spectromety. (author) [pt

  18. Risk Factors for Pelvic Insufficiency Fractures in Locally Advanced Cervical Cancer Following Intensity Modulated Radiation Therapy

    DEFF Research Database (Denmark)

    Ramlov, Anne; Pedersen, Erik Morre; Røhl, Lisbeth

    2017-01-01

    PURPOSE: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC). METHODS AND MATERIALS: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin...

  19. INTENSITY STATISTICS AND NORMALIZED STRUCTURE FACTORS FOR CRYSTALS WITH AN INCOMMENSURATE ONE-DIMENSIONAL MODULATION

    NARCIS (Netherlands)

    LAM, EJW; BEURSKENS, PT; VANSMAALEN, S

    1993-01-01

    An analytical expression is derived for the probability density function (p.d.f.) of X-ray structure-factor amplitudes of a crystal with an incommensurate one-dimensional modulation. The influence of the (3+1)-dimensional superspace symmetry is taken into account. It is shown that, in first-order

  20. [Burnout-associated factors in anesthesia and intensive care medicine. 2009 survey of the French Society of anesthesiology and intensive care].

    Science.gov (United States)

    Mion, G; Libert, N; Journois, D

    2013-03-01

    To assess factors related to burnout in anesthesia and intensive care. National prospective observational study. Questionnaire posted on the French Society of anesthesia website from 3rd June 2009 to 27th August 2009: Maslach Burnout Inventory (MBI), Fast Alcohol Consumption Evaluation (FACE) and The Harvard National Depression Screening Day Scale (HANDS) scales and questions to assess health, work and personal life. One thousand six hundred and three questionnaires returned: 1091 anesthetists (67.6%), 241 intensivists (14.9%), 204 nurses (12.6%), emergency physicians (2.8%), supervisor nurses (0.9%). Seven hundred and sixty three in a university hospital (47.3%), 259 in a regional hospital (16.1%), 405 in a private structure (25.1%), 71 in a non-lucrative private structure (4.4%), 75 in a military hospital (4.6%). Rest of safety: 69.2% of institutions. Depression: 38.7%. Drug or chemicals addicted: 10.6%. Alcohol addicts: 10.6%. Among them, 62.3% of individuals were in burnout. Burnout was linked to fragmented sleep (Pburnout intended more frequently to leave the profession (Pburnout: quality of work, of personal life, of fatigue, depression, conflicts with colleagues and patients, regretting the choice of specialty. This study of the largest cohort of anesthesia personnel performed in France detects a high proportion of burnout. It highlights links with tensors that may constitute possibilities of prevention of the burnout syndrome. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  1. Some Factors Hindering Acceptance of Three Gamification Solutions in Motivation Systems, in Small and Medium Enterprises

    Directory of Open Access Journals (Sweden)

    Jacek WOŹNIAK

    2017-12-01

    Full Text Available Gamification, understood as a use of chosen game mechanisms for motivating actors in non-game contexts, is increasingly popular and has become one of the “hot topics” of managerial practice and science. Despite its widespread use in HRM, several barriers preventing its progress in certain types of organizations have been identified. Small and medium enterprises (SMEs, where employees are not accustomed to formal procedures are a specific example, as gamification is based on formal procedures. The goal of the text is to analyze employees’ opinions concerning the incorporation of chosen gaming mechanisms into their motivation systems, to check if not being accustomed to formal procedures is a barrier. Beside “typical” SMEs where the entrepreneur is present, direct relations within a team are also characteristic of company departments which achieve their goals almost without contact with the rest of the organization – as in the case of a discount stores chain. The study bases on two samples to check if being accustomed to formal procedures in the small team facilitates acceptance of gamification. Two questionnaires (one on a sample of 100 employees of a discount store chain, and the second on 73 “typical” SME employees asked respondents to declare their preferences for different types of rewards in motivation systems, including readiness to be involved in two gamification-type solutions: based on (i lotteries, or (ii BLAP gaming with non-material and material prizes. The effects of chosen factors: psychological (risk aversion and situational (dissatisfaction with current incentive system on the perception of two different ways of incorporating gamification into motivational systems, were analyzed. The results show that dissatisfaction with the current incentive system and not being risk-averse favor accepting the incorporation of gamification solutions into motivational systems. The responses of discount store employees and SME

  2. Risk factors for mortality in patients admitted to intensive care units with pneumonia.

    Science.gov (United States)

    Li, Guowei; Cook, Deborah J; Thabane, Lehana; Friedrich, Jan O; Crozier, Tim M; Muscedere, John; Granton, John; Mehta, Sangeeta; Reynolds, Steven C; Lopes, Renato D; Francois, Lauzier; Freitag, Andreas P; Levine, Mitchell A H

    2016-07-11

    Despite the high mortality in patients with pneumonia admitted to an ICU, data on risk factors for death remain limited. In this secondary analysis of PROTECT (Prophylaxis for Thromboembolism in Critical Care Trial), we focused on the patients admitted to ICU with a primary diagnosis of pneumonia. The primary outcome for this study was 90-day hospital mortality and the secondary outcome was 90-day ICU mortality. Cox regression model was conducted to examine the relationship between baseline and time-dependent variables and hospital and ICU mortality. Six hundred sixty seven patients admitted with pneumonia (43.8 % females) were included in our analysis, with a mean age of 60.7 years and mean APACHE II score of 21.3. During follow-up, 111 patients (16.6 %) died in ICU and in total, 149 (22.3 %) died in hospital. Multivariable analysis demonstrated significant independent risk factors for hospital mortality including male sex (hazard ratio (HR) = 1.5, 95 % confidence interval (CI): 1.1 - 2.2, p-value = 0.021), higher APACHE II score (HR = 1.2, 95 % CI: 1.1 - 1.4, p-value risk of death in the ICU. In this study using data from a multicenter thromboprophylaxis trial, we found that male sex, higher APACHE II score on admission, chronic heart failure, and dialysis were independently associated with risk of hospital mortality in patients admitted to ICU with pneumonia. While high illness severity score, presence of a serious comorbidity (heart failure) and need for an advanced life support (dialysis) are not unexpected risk factors of mortality, male sex might necessitate further exploration. More studies are warranted to clarify the effect of these risk factors on survival in critically ill patients admitted to ICU with pneumonia. ClinicalTrials.gov Identifier: NCT00182143 .

  3. Pediatric burns mortality risk factors in a developing country’s tertiary burns intensive care unit

    Science.gov (United States)

    Agbenorku, Pius; Agbenorku, Manolo; Fiifi-Yankson, Papa Kwesi

    2013-01-01

    Aim: This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. Methods: The data for the three years retrospective study (May 2009 – April 2012) was obtained from the pediatric burn admissions records and patients’ folders of the Reconstructive Plastic Surgery & Burns Unit (RPSBU), Komfo Anokye Teaching Hospital (KATH), Ghana. Data retrieved included: Demographic features, Total Burned Surface Area (TBSA) incurred; Aetiology of burns; Duration of the admission; Outcome of admission; Part of the body affected and Cost incurred. Ethical approval for this study was obtained from the KNUST-SMS/KATH Committee on Human Research, Publications and Ethics. Data analyses were performed with SPSS 17.0 version. Results: Information on 197 patients was completely retrieved for the study. Burns mortality rate for the study was identified to be 21.3% (N=42). The mean age of the 42 dead patients was 3.7±0.3 years, ranging from 0-13 years, while, males (54.8%, N= 23) outnumbered females (45.2%, N=19). The TBSA burned interquartile range was 48%. In terms of etiology of burns Scald (73.8%, N=31) was the commonest cause of injury. Mortality risk factors identified were Age 36% (P=0.028) and Inhalation injury (P=0.040). Conclusion: Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana’s RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana. PMID:23875121

  4. Development Instruments Through Confirmatory Factor Analysis (CFA in Appropriate Intensity Assessment

    Directory of Open Access Journals (Sweden)

    Ari Saptono

    2017-06-01

    Full Text Available The research aims to develop the valid and reliable measurement instruments of entrepreneurship intention in vocational secondary school students. Multi stage random sampling was used as the technique to determine sample (300 respondents. The research method used research and development with confirmatory factor analysis (CFA. Result of confirmatory factor analysis (CFA at the second order with robust maximum likelihood method shows that valid and reliable instrument with the acquisition value of loading factor is more than 0.5 (> 0,5 and a significance value of t is more than 1,96 (> 1,96. Reliability test results shows that the value of the combined construct reliability (CR of 0.97and a variance value extract (VE to 0.52 is greater than the limit of acceptance CR ≥ 0.70 and VE ≥ 0.50. The conclusion of the measurement instruments of entrepreneurship intention with three dimensions and 31 items met the standards of validity and reliability in accordance with the instrument development process.

  5. On stable exponential cosmological solutions with non-static volume factor in the Einstein-Gauss-Bonnet model

    International Nuclear Information System (INIS)

    Ivashchuk, V D; Ernazarov, K K

    2017-01-01

    A ( n + 1)-dimensional gravitational model with cosmological constant and Gauss-Bonnet term is studied. The ansatz with diagonal cosmological metrics is adopted and solutions with exponential dependence of scale factors: a i ∼ exp ( v i t ), i = 1, …, n , are considered. The stability analysis of the solutions with non-static volume factor is presented. We show that the solutions with v 1 = v 2 = v 3 = H > 0 and small enough variation of the effective gravitational constant G are stable if certain restriction on ( v i ) is obeyed. New examples of stable exponential solutions with zero variation of G in dimensions D = 1 + m + 2 with m > 2 are presented. (paper)

  6. Solution structure of human insulin-like growth factor 1: A nuclear magnetic resonance and restrained molecular dynamics study

    International Nuclear Information System (INIS)

    Cooke, R.M.; Harvey, T.S.; Campbell, I.D.

    1991-01-01

    The solution structure of human insulin-like growth factor 1 has been investigated with a combination of nuclear magnetic resonance and restrained molecular dynamics methods. The results show that the solution structure is similar to that of insulin, but minor differences exist. The regions homologous to insulin are well-defined, while the remainder of the molecular exhibits greater disorder. The resultant structures have been used to visualize the sites for interaction with a number of physiologically important protein

  7. Pulmonary embolism in intensive care unit: Predictive factors, clinical manifestations and outcome

    Directory of Open Access Journals (Sweden)

    Bahloul Mabrouk

    2010-01-01

    Full Text Available Objective : To determine predictive factors, clinical and demographics characteristics of patients with pulmonary embolism (PE in ICU, and to identify factors associated with poor outcome in the hospital and in the ICU. Methods : During a four-year prospective study, a medical committee of six ICU physicians prospectively examined all available data for each patient in order to classify patients according to the level of clinical suspicion of pulmonary thromboembolism. During the study periods, all patients admitted to our ICU were classified into four groups. The first group includes all patients with confirmed PE; the second group includes some patients without clinical manifestations of PE; the third group includes patients with suspected and not confirmed PE and the fourth group includes all patients with only deep vein thromboses (DVTs without suspicion of PE. The diagnosis of PE was confirmed either by a high-probability ventilation/perfusion (V/Q scan or by a spiral computed tomography (CT scan showing one or more filling defects in the pulmonary artery or in its branches. The diagnosis was also confirmed by echocardiography when a thrombus in the pulmonary artery was observed. Results : During the study periods, 4408 patients were admitted in our ICU. The diagnosis of PE was confirmed in 87 patients (1.9%. The mean delay of development of PE was 7.8 ± 9.5 days. On the day of PE diagnosis, clinical examination showed that 50 patients (57.5% were hypotensive, 63 (72.4% have SIRS, 15 (17.2% have clinical manifestations of DVT and 71 (81.6% have respiratory distress requiring mechanical ventilation. In our study, intravenous unfractionated heparin was used in 81 cases (93.1% and low molecular weight heparins were used in 4 cases (4.6%. The mean ICU stay was 20.2 ± 25.3 days and the mean hospital stay was 25.5 ± 25 days. The mortality rate in ICU was 47.1% and the in-hospital mortality rate was 52.9%. Multivariate analysis showed that

  8. Computation of stress intensity factors for nozzle corner cracks by various finite element procedures

    International Nuclear Information System (INIS)

    Broekhoven, M.J.G.

    1975-01-01

    The present study aims at deriving accurate K-factors for a series of 5 elliptical nozzle corner cracks of increasing size by various finite element procedures, using a three-level recursive substructuring scheme to perform the computations in an economic way on an intermediate size computer (IBM 360/65 system). A nozzle on a flat plate has been selected for subsequent experimental verification, this configuration being considered an adequate simulation of a nozzle on a shallow shell. The computations have been performed with the ASKA finite element system using mainly HEXEC-27 (incomplete quartic) elements. The geometry has been subdivided into 5 subnets with a total of 3515 nodal points and 6250 unknowns, two main nets and one hyper net. Each crack front is described by 11 nodal points and all crack front nodes are inserted in the hyper net, which allows for the realization of the successive crack geometries by changing only a relatively small hyper net (615 to 725 unknowns). Output data have been interpreted in terms of K-factors by the global energy method, the displacement method and the stress method. Besides, a stiffness derivative procedure, recently developed at Brown University, which takes full advantage of the finite element formulation to calculate local K-factors, has been applied. Finally it has been investigated whether sufficiently accurate results can be obtained by analyzing a considerably smaller part than one half of the geometry (as strictly required by symmetry considerations), using fixed boundary conditions derived from a far cheaper analysis of the uncracked structure

  9. Risk factors for acute kidney injury in a pediatric intensive care unit: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Lina María Serna-Higuita

    2017-04-01

    Full Text Available Resumen ANTECEDENTES La incidencia de la lesión renal aguda en la población pediátrica, al igual que los factores de riesgo asociados a esta complicación, no se conocen con certeza. OBJETIVOS Este estudio tuvo como objetivo determinar la incidencia de lesión renal aguda en la población pediátrica críticamente enferma del Hospital Pablo Tobón Uribe en el período 2010-2014, e identificar factores de riesgo para su aparición. MÉTODOS Cohorte retrospectiva en la que se evaluaron los pacientes menores de 14 años, admitidos en las unidades de cuidados intensivos y de cuidados intermedios pediátricos. La lesión renal aguda se definió según la clasificación Kidney Disease Improving Global Outcomes, KDIGO. RESULTADOS En total 382 pacientes fueron evaluados, de los cuales 11,5% presentaron lesión renal aguda (tasa de incidencia 0,99 persona por día. En el análisis de regresión logística multivariada, los valores de plaquetas (Odds ratio: 2,947; intervalo de confianza 95%: 1,276-6,805 y el uso de vasopresores (Odds ratio: 4,601; intervalo de confianza 95%: 1,665-2,710 fueron identificados como factores de riesgo para lesión renal aguda. La estancia hospitalaria, al igual que la mortalidad en los pacientes con lesión renal aguda, fue significativamente mayor al compararla con el grupo sin esta patología (19 días versus 5 días y 3,7 días-persona versus 0,32 días-persona respectivamente. CONCLUSIONES La lesión renal aguda en los pacientes pediátricos que ingresan a los servicios de cuidados intensivos e intermedios pediátricos, se presenta en un porcentaje significativo. A su vez, esta complicación aumenta la estancia hospitalaria y la mortalidad. Los valores bajos de plaquetas y el uso de soporte vasopresor, fueron factores de riesgo independientes para el desarrollo de lesión renal aguda.

  10. Risk Factors for Pelvic Insufficiency Fractures in Locally Advanced Cervical Cancer Following Intensity Modulated Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ramlov, Anne, E-mail: anraml@rm.dk [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Pedersen, Erik Morre; Røhl, Lisbeth [Department of Radiotherapy, Aarhus University Hospital, Aarhus (Denmark); Worm, Esben [Department of Medical Physics, Aarhus University Hospital, Aarhus (Denmark); Fokdal, Lars; Lindegaard, Jacob Chr. [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Tanderup, Kari [Department of Oncology, Aarhus University Hospital, Aarhus (Denmark); Department of Medical Physics, Aarhus University Hospital, Aarhus (Denmark)

    2017-04-01

    Purpose: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC). Methods and Materials: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin and underwent external beam radiation therapy with 45 Gy in 25 fractions (node-negative patients) or 50 Gy in 25 fractions with a simultaneous integrated boost of 60 Gy in 30 fractions (node-positive patients). Pulsed dose rate magnetic resonance imaging guided adaptive brachytherapy was given in addition. Follow-up magnetic resonance imaging was performed routinely at 3 and 12 months after the end of treatment or based on clinical indication. PIF was defined as a fracture line with or without sclerotic changes in the pelvic bones. D{sub 50%} and V{sub 55Gy} were calculated for the os sacrum and jointly for the os ileum and pubis. Patient- and treatment-related factors including dose were analyzed for correlation with PIF. Results: The median follow-up period was 25 months. The median age was 50 years. In 20 patients (20%), a median of 2 PIFs (range, 1-3 PIFs) were diagnosed; half were asymptomatic. The majority of the fractures were located in the sacrum (77%). Age was a significant risk factor (P<.001), and the incidence of PIF was 4% and 37% in patients aged ≤50 years and patients aged >50 years, respectively. Sacrum D{sub 50%} was a significant risk factor in patients aged >50 years (P=.04), whereas V{sub 55Gy} of the sacrum and V{sub 55Gy} of the pelvic bones were insignificant (P=.33 and P=.18, respectively). A dose-effect curve for sacrum D{sub 50%} in patients aged >50 years showed that reduction of sacrum D{sub 50%} from 40 Gy{sub EQD2} to 35 Gy{sub EQD2} reduces PIF risk from 45% to 22%. Conclusions: PIF is common after treatment of LACC and is mainly seen in patients aged >50 years. Our data indicate that PIFs are not related to lymph node

  11. An Analytical Model for the Identification of the Threshold of Stress Intensity Factor Range for Crack Growth

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    Marzio Grasso

    2017-01-01

    Full Text Available The value of the stress intensity factor (SIF range threshold ΔKth for fatigue crack growth (FCG depends highly on its experimental identification. The identification and application of ΔKth are not well established as its determination depends on various factors including experimental, numerical, or analytical techniques used. A new analytical model which can fit the raw FCG experimental data is proposed. The analytical model proposed is suitable to fit with high accuracy the experimental data and is capable of estimating the threshold SIF range. The comparison between the threshold SIF range identified with the model proposed and those found in the literature is also discussed. ΔKth identified is found to be quite accurate and consistent when compared to the literature with a maximum deviation of 5.61%. The accuracy with which the analytical model is able to fit the raw data is also briefly discussed.

  12. Bradykinin-mediated angioedema: factors associated with admission to an intensive care unit, a multicenter study.

    Science.gov (United States)

    Javaud, Nicolas; Floccard, Bernard; Gontier, Florian; Lapostolle, Frédéric; Boccon-Gibod, Isabelle; Martin, Ludovic; Amarger, Stéphanie; Boumedienne, Abdalia; Boubaya, Marouane; Asfar, Pierre; Coppere, Brigitte; Ollivier, Yann; Bouillet, Laurence; Adnet, Frédéric; Fain, Olivier

    2016-06-01

    Bradykinin-mediated angioedema is characterized by transient attacks of localized edema of subcutaneous or submucosal tissues and can be life-threatening when involving the upper airways. The aim of this study was to determine the features of acute attacks that might be associated with admission to an ICU. We carried out a retrospective, multicenter, observational study in consecutive patients attending one of six reference centers in France for acute bradykinin-mediated angioedema attacks. Patients had been hospitalized for an acute episode at least once previously. Acute attacks requiring ICU admission were compared with acute attacks that had not required ICU admission. Overall, 118 acute attacks in 31 patients were analyzed (10 patients with hereditary angioedema, 19 patients with angiotensin-converting enzyme inhibitor-induced angioedema, and two patients with acquired C1-inhibitor deficiency angioedema). In multivariate analysis, upper airway involvement, corticosteroid, and C1-inhibitor concentrate administration were associated with ICU admission. Seven episodes (18%) needed airway protection. The evolution was favorable in 38 of 39 attacks warranting ICU admission: patients were able to get out of the service (mean ICU stay 4±5 days). One death was observed by asphyxiation because of laryngeal swelling. Upper airway involvement is an independent risk factor for ICU admission. Corticosteroid use, which is an ineffective treatment, and C1-inhibitor concentrate use are factors for ICU admission. The presence of upper airway involvement should be a warning signal that the attack may be severe.

  13. [Risk factors related with ventilator-associated pneumonia in a neonatal intensive care therapy].

    Science.gov (United States)

    Romo-Gamboa, Juan Pablo; Sandoval-Pérez, Bertha Alicia; Rodríguez-López, Ana Bertha; Torres-González, Marco Antonio; Barrera-de León, Juan Carlos

    2017-01-01

    Ventilator-associated pneumonia (VAP) represents the second cause of nosocomial infections and it is associated with greater morbility, duration of mechanical ventilation (MV), and hospital stay. The objective was to determine factors related with VAP in neonates. Analytical transversal study including newborns admitted already intubated with at least 48 hours of MV or who were intubated in Neonatal Therapy. VAP was defined according to the criteria of the Centers for Disease Control and Prevention: "those patients submitted to MV during at least 48 hours". We used inferential statistics for statistical analysis (chi squared, Mann-Whitney U test, and Kaplan-Meier estimator). 82 neonates were studied, out of which 27 developed VAP (33%). The median time to develop pneumonia was 6 days (range 5-11). The most commonly isolated germ was Escherichia coli (27%). Statistically significant variables were gestational age (p = 0.05), and the use of antacids at admission (p = 0.007). Patients with pneumonia had longer hospital stay (p = 0.001) and time with MV (p = 0.002). Of all the patients, 22 neonates died (27%), of which nine patients had VAP. Risk factors for VAP in neonates include lower gestational age, the use of antacids, and prolonged MV.

  14. Structural features of Fab fragments of rheumatoid factor IgM-RF in solution

    Energy Technology Data Exchange (ETDEWEB)

    Volkov, V. V., E-mail: vvo@ns.crys.ras.ru [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation); Lapuk, V. A. [Russian Academy of Sciences, Zelinskii Institute of Organic Chemistry (Russian Federation); Shtykova, E. V.; Stepina, N. D.; Dembo, K. A.; Sokolova, A. V.; Amarantov, S. V. [Russian Academy of Sciences, Shubnikov Institute of Crystallography (Russian Federation); Timofeev, V. P. [Russian Academy of Sciences, Engelhardt Institute of Molecular Biology (Russian Federation); Ziganshin, R. Kh. [Russian Academy of Sciences, Shemyakin Ovchinnikov Institute of Bioorganic Chemistry (Russian Federation); Varlamova, E. Yu. [Russian Academy of Medical Sciences, Hematology Research Center (Russian Federation)

    2008-05-15

    The structural features of the Fab fragments of monoclonal (Waldenstroem's disease) immunoglobulin M (IgM) and rheumatoid immunoglobulin M (IgM-RF) were studied by a complex of methods, including small-angle X-ray scattering (SAXS), electron spin resonance (ESR), and mass spectrometry (MS). The Fab-RF fragment was demonstrated to be much more flexible in the region of interdomain contacts, the molecular weights and the shapes of the Fab and Fab-RF macromolecules in solution being only slightly different. According to the ESR data, the rotational correlation time for a spin label introduced into the peptide sequence for Fab is twice as large as that for Fab-RF (21{+-}2 and 11{+-}1 ns, respectively), whereas the molecular weights of these fragments differ by only 0.5% (mass-spectrometric data), which correlates with the results of molecular-shape modeling by small-angle X-ray scattering. The conclusion about the higher flexibility of the Fab-RF fragment contributes to an understanding of the specificity of interactions between the rheumatoid factor and the antigens of the own organism.

  15. Structural features of Fab fragments of rheumatoid factor IgM-RF in solution

    International Nuclear Information System (INIS)

    Volkov, V. V.; Lapuk, V. A.; Shtykova, E. V.; Stepina, N. D.; Dembo, K. A.; Sokolova, A. V.; Amarantov, S. V.; Timofeev, V. P.; Ziganshin, R. Kh.; Varlamova, E. Yu.

    2008-01-01

    The structural features of the Fab fragments of monoclonal (Waldenstroem's disease) immunoglobulin M (IgM) and rheumatoid immunoglobulin M (IgM-RF) were studied by a complex of methods, including small-angle X-ray scattering (SAXS), electron spin resonance (ESR), and mass spectrometry (MS). The Fab-RF fragment was demonstrated to be much more flexible in the region of interdomain contacts, the molecular weights and the shapes of the Fab and Fab-RF macromolecules in solution being only slightly different. According to the ESR data, the rotational correlation time for a spin label introduced into the peptide sequence for Fab is twice as large as that for Fab-RF (21±2 and 11±1 ns, respectively), whereas the molecular weights of these fragments differ by only 0.5% (mass-spectrometric data), which correlates with the results of molecular-shape modeling by small-angle X-ray scattering. The conclusion about the higher flexibility of the Fab-RF fragment contributes to an understanding of the specificity of interactions between the rheumatoid factor and the antigens of the own organism.

  16. Risk factors for ventilator-associated pneumonia in the neonatal intensive care unit: a meta-analysis of observational studies.

    Science.gov (United States)

    Tan, Bin; Zhang, Fan; Zhang, Xian; Huang, Ya-Ling; Gao, Yu-Shuang; Liu, Xiao; Li, Ying-Li; Qiu, Jing-Fu

    2014-04-01

    Ventilator-associated pneumonia (VAP) is a common and serious problem among mechanically ventilated patients in intensive care units (ICU), especially for the newborn. However, limited literatures have been reviewed to synthesize the finding of previous papers to investigate the risk factors for VAP although it has been a serious complication of mechanical ventilation (MV) with a high morbidity and mortality in the newborn. We performed this meta-analysis to extend previous knowledge for developing VAP prevention strategies by identifying the potential risk factors related to VAP in the neonatal intensive care unit (NICU). The relevant literatures published up to July 2013 were searched in the databases of PubMed, Cochrane Central Register of Controlled Trials, Embase, and Web of Science. Three reviewers screened those literatures and extracted data according to the inclusion and exclusion criteria independently. A total of eight studies including 370 cases and 1,071 controls were identified. Ten risk factors were found to be related to neonatal VAP which were listed as follows in order by odds ratios (ORs): length of stay in NICU (OR 23.45), reintubation (OR 9.18), enteral feeding (OR 5.59), mechanical ventilation (OR 4.04), transfusion (OR 3.32), low birth weight (OR 3.16), premature infants (OR 2.66), parenteral nutrition (OR 2.30), bronchopulmonary dysplasia (OR 2.21), and tracheal intubation (OR 1.12). We identified ten variables as independent risk factors for the development of VAP: length of stay in NICU, reintubation, enteral feeding, mechanical ventilation, transfusion, low birth weight, premature infants, parenteral nutrition, bronchopulmonary dysplasia, and tracheal intubation. Due to several limitations in the present study, further large and well-designed studies are needed to confirm the conclusion.

  17. Experimental and numerical determination of critical stress intensity factor of aluminum curved thin sheets under tensile stress

    Energy Technology Data Exchange (ETDEWEB)

    Heidarvand, Majid; Soltani, Naser; Hajializadeh, Farshid [University of Tehran, Tehran (Iran, Islamic Republic of)

    2017-05-15

    We determined the fracture toughness of aluminum curved thin sheets using tensile stress tests and finite element method. We applied Linear elastic fracture mechanics (LEFM) and Feddersen procedure to evaluate stress intensity factor of the samples with central wire-cut cracks and fatigue cracks with different lengths to investigate the notch radius effect. Special fixture design was utilized to establish uniform stress distribution at the crack zone. Less than 9 % difference was found between the wire-cut and the fatigue cracked samples. Since generating central fatigue crack with different lengths required so much effort, wire-cut cracked samples were used to determine critical stress intensity factor. Finite element analysis was also performed on one-quarter of the specimen using both the singular Borsum elements and the regular isoparametric elements to further investigate fracture toughness of the samples. It was observed that the singular elements presented better results than the isoparametric ones. A slight difference was also found between the results obtained from finite element method using singular elements and the experimental results.

  18. Study on the Influence Factors of the Luminous Intensity of the Long Afterglow Luminous Paints

    Directory of Open Access Journals (Sweden)

    Zhao Su

    2016-01-01

    Full Text Available In order to extend the time afterglow luminous powder, enhancement the brightness of luminous paint, this study explore affect long afterglow energy storage luminous paints brightness of the main factors. Luminous paints were prepared with rare earth aluminate long afterglow luminescent powder, first is luminous powder surface modification, then investigate the influence of light emitting powder content, calcium carbonate, titanium dioxide, nano alumina and other fillers on the luminescent properties of the paints. It was concluded that the water resistance of the luminescent powder is better and the brightness can be improved after the modification of anhydrous alcohol. The addition of nano-alumina can improve the brightness of the system, and can effectively enhance the hardness of the paints. In the paints, the two kinds of components of carbonate and titanium dioxide have little effect on the luminescent brightness of the painting.

  19. Factors modifying the response of large animals to low-intensity radiation exposure

    Science.gov (United States)

    Page, N. P.; Still, E. T.

    1972-01-01

    In assessing the biological response to space radiation, two of the most important modifying factors are dose protraction and dose distribution to the body. Studies are reported in which sheep and swine were used to compare the hematology and lethality response resulting from radiation exposure encountered in a variety of forms, including acute (high dose-rate), chronic (low dose-rate), combinations of acute and chronic, and whether received as a continuous or as fractionated exposure. While sheep and swine are basically similar in response to acute radiation, their sensitivity to chronic irradiation is markedly different. Sheep remain relatively sensitive as the radiation exposure is protracted while swine are more resistant and capable of surviving extremely large doses of chronic irradiation. This response to chronic irradiation correlated well with changes in radiosensitivity and recovery following an acute, sublethal exposure.

  20. Colonization With Methicillin-Resistant Staphylococcus aureus Upon Intensive Care Unit Admission: Incidence and Risk Factors

    Directory of Open Access Journals (Sweden)

    Abbasi

    2016-08-01

    Full Text Available Background Since earlier identification of methicillin-resistant Staphylococcus aureus (MRSA-colonized patients could be helpful for reducing the overall frequency of S. aureus infections, the investigation of persons colonized with MRSA is considered to be a key component of MRSA infection prevention programs, particularly among ICU patients. Objectives The aim of the present study was to evaluate the prevalence of nasal and extra-nasal carriers of MRSA and risk factors associated with MRSA colonization among adult patients admitted to the ICU. Methods In a cross-sectional study, 164 adult patients who were admitted to the ICU of a teaching hospital were screened for nasal and extra-nasal carriage of MRSA. In addition, the ICU-hospitalized patients were evaluated for MRSA acquisition during their ICU stay. Results Out of the 164 patients admitted to the ICU, 12 (7.3% patients were methicillin-susceptible Staphylococcus aureus (MSSA carriers, and 12 (7.3% patients carried MRSA. Four (16.6% patients were colonized at single or multiple extra-nasal sites based on negative nares screening. Of the 15 remaining patients hospitalized at the ICU, one (6.7% patient acquired MRSA. The patients colonized with MRSA had more advanced ages (P = 0.008, longer hospital stays before being transferred to the ICU (P > 0.001, more underlying diseases with chronic obstructive pulmonary disease (COPD (P = 0.028, and had undergone surgery (P = 0.003. Patients transferred from the surgical wards to the ICU were found to have significantly higher carriage rates of MRSA (P = 0.041. Conclusions The prevalence of MRSA colonization upon ICU admission at our hospital was relatively high, and routine MRSA screening is suggested, especially for patients who have certain risk factors. In addition, extra-nasal MRSA screenings upon ICU admission will help in the early detection of MRSA.

  1. The effects of aerobic exercise intensity and duration on levels of brain-derived neurotrophic factor in healthy men.

    Science.gov (United States)

    Schmolesky, Matthew T; Webb, David L; Hansen, Rodney A

    2013-01-01

    This study examined the combined effects of aerobic exercise intensity and duration on serum brain-derived neurotrophic factor (sBDNF) levels in healthy human adult males aged 18-25 years. Forty five participants were randomly assigned to one of six exercise conditions based on varying intensity (80% or 60% of heart rate reserve, or control) and duration (20 or 40 min). Vigorous (80% heart rate reserve, "Vig") and moderate (60% heart rate reserve, "Mod") exercise was carried out on cycle ergometers. Control subjects remained seated and at rest during the exercise period. Pre- and post-exercise blood draws were conducted and sBDNF measured. Physical exercise caused an average ~ 32% increase in sBDNF levels relative to baseline that resulted in concentrations that were 45% higher than control conditions. Comparing the six conditions, sBDNF levels rose consistently among the four exercise conditions (Vig20 = 26.38 ± 34.89%, Vig40 = 28.48 ± 19.11%, Mod20 = 41.23 ± 59.65%, Mod40 = 30.16 ± 72.11%) and decreased consistently among the controls (Con20 = -14.48 ± 16.50, Con40 = -10.51 ± 26.78). Vig conditions had the highest proportion of subjects that experienced a significant (? 10%) increase in sBDNF levels, followed by Mod and control conditions. An analysis of modeled sBDNF integrals (area under the curve) demonstrated substantially greater values for Vig40 and Mod40 conditions compared to Vig20 and Mod20 conditions. Collectively, these results demonstrate that neither duration (20 vs. 40 min) nor intensity (60 vs. 80% HR reserve) significantly affects the benefits of exercise if only the sBDNF increase at a single post-exercise time point is considered. However, when comparing either the probability of achieving a significant BDNF gain or the integral (i.e. the volume of circulating BDNF over time) the Vig40 condition offers maximal benefits. Thus, we conclude that the future study of aerobic exercise effects on BDNF-mediated neuroprotection should take the

  2. Factors leading to self-extubation of endotracheal tubes in the intensive care unit.

    Science.gov (United States)

    Huang, Yuan-Ting

    2009-01-01

    To discuss the factors leading to self-extubation of endotracheal tubes (ETTs) and explore the differences between the groups of patients who did and did not self-remove their ETTs. Self-extubation of ETTs has been reported to occur in 4.2% of severely ill patients and is associated with adverse medical effects. A case-control study. One hundred and thirty-nine subjects were recruited from a teaching hospital in southern Taiwan based on purposive sampling. The rate of self-extubation of ETTs was 6.4%. Analysis of the two groups demonstrated that significant variables were identified and fell into three categories: (1) the department to which the patient was admitted (p self-extubation of the ETT. Among the 44 patients who had self-extubation of their ETT, 28 met the criteria to be extubated, 70% and 81.8% of whom were not sedated, and self-extubation of their ETT was conscious of the act. Of the patients who attempted to self-remove their ETT, 80% were successful and 93.2% did not incur any adverse medical effects. The medical doctor and nurse should fully evaluate a patient's oxygenation status, decrease the length of the extubation training session for patients and extubate patients promptly when extubation criteria are met. Adopting a proactive approach to patient extubation will improve the overall quality of care.

  3. High versus Moderate Intensity Running Exercise to Impact Cardiometabolic Risk Factors: The Randomized Controlled RUSH-Study

    Directory of Open Access Journals (Sweden)

    Wolfgang Kemmler

    2014-01-01

    Full Text Available Aerobic exercise positively impacts cardiometabolic risk factors and diseases; however, the most effective exercise training strategies have yet to be identified. To determine the effect of high intensity (interval training (HI(IT versus moderate intensity continuous exercise (MICE training on cardiometabolic risk factors and cardiorespiratory fitness we conducted a 16-week crossover RCT with partial blinding. Eighty-one healthy untrained middle-aged males were randomly assigned to two study arms: (1 a HI(IT-group and (2 a sedentary control/MICE-group that started their MICE protocol after their control status. HI(IT focused on interval training (90 sec to 12 min >85–97.5% HRmax intermitted by active recovery (1–3 min at 65–70% HRmax, while MICE consisted of continuous running at 65–75% HRmax. Both exercise groups progressively performed 2–4 running sessions/week of 35 to 90 min/session; however, protocols were adjusted to attain similar total work (i.e., isocaloric conditions. With respect to cardiometabolic risk factors and cardiorespiratory fitness both exercise groups demonstrated similar significant positive effects on MetS-Z-Score (HI(IT: -2.06±1.31, P=.001 versus MICE: -1.60±1.77, P=.001 and (relative VO2max (HI(IT: 15.6±9.3%, P=.001 versus MICE: 10.6 ± 9.6%, P=.001 compared with the sedentary control group. In conclusion, both exercise programs were comparably effective for improving cardiometabolic indices and cardiorespiratory fitness in untrained middle-aged males.

  4. Touristic resources and factor intensity: Dominant factor content of trade in tourism. The case of the municipalities of Buenos Aires, Argentina

    Directory of Open Access Journals (Sweden)

    Natalia Porto

    2016-01-01

    Full Text Available The aim of this paper is to quantify one of the characteristics of the production function of the tourism sector in the province of Buenos Aires: the dominant factor content of their touristic resources, one simplified concept which shows the factors of production incorporated in goods. For its estimation and the touristic characterization of the different municipalities of the province, the following elements are used: the inventory of touristic resources of 134 municipalities of the province; their classification into the five categories listed by OEA; and the factor intensity of each category. One interesting result is that most municipalities with high touristic GDP show a dominant factor content of capital, the implication being that comparative advantage in the Province of Buenos Aires in Argentina is based on contemporary technical, scientific and artistic work. It may be concluded that there is place to exploit tourism in Argentina, what points to the need to accompany them with a correct design of public policies.

  5. Interprofessional care in intensive care settings and the factors that impact it: results from a scoping review of ethnographic studies.

    Science.gov (United States)

    Paradis, Elise; Leslie, Myles; Gropper, Michael A; Aboumatar, Hanan J; Kitto, Simon; Reeves, Scott

    2013-12-01

    At the heart of safe cultures are effective interactions within and between interprofessional teams. Critical care clinicians see severely ill patients who require coordinated interprofessional care. In this scoping review, we asked: "What do we know about processes, relationships, organizational and contextual factors that shape the ability of clinicians to deliver interprofessional care in adult ICUs?" Using the 5-stage process established by Levac et al. (2010), we reviewed 981 abstracts to identify ethnographic articles that shed light on interprofessional care in the intensive care unit. The quality of selected articles is assessed using best practices in ethnographic research; their main insights evaluated in light of an interprofessional framework developed by Reeves et al (Interprofessional Teamwork for Health and Social Care. San Francisco, CA: Wiley-Blackwell; 2010). Overall, studies were of mixed quality, with an average (SD) score of 5.8 out of 10 (1.77). Insights into intensive care unit cultures include the importance of paying attention to workflow, the nefarious impact of hierarchical relationships, the mixed responses to protocols imposed from the top down, and a general undertheorization of sex and race. This review highlights several lessons for safe cultures and argues that more needs to be known about the context of critical care if quality and safety interventions are to succeed. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Can socioeconomic factors account for "atypical" correlations between timing, peak velocity, and intensity of adolescent growth in Taiwanese girls?

    Science.gov (United States)

    Floyd, B.

    2000-01-01

    This study uses longitudinal height records of girls in two urban and one rural area in Taiwan. Individual height records were modeled with the Preece-Baines Model 1 (PB1) function to test two related hypotheses: 1) Taiwanese students who experienced a relatively stable, affluent growth environment from an early age, as judged from parental education and stability of residence type, will have a pattern of correlations for the timing and intensity of the growth spurt similar to those of European and American females; and 2) those students whose parents gained the wherewithal to move from single-story to multi-story dwellings while they were in primary school will have the most atypical patterns. The extent to which these and other sociodemographic factors influence pubertal spurt velocities and increments of adolescent growth were explored as well using multiple regression analyses. Results support the view that rapid socioeconomic change in Taiwan influenced the relationship between the timing and intensity of adolescent growth in stature. Children in the more stable environments in both urban areas had patterns of correlations typical of population samples from developed countries. The most atypical correlations in both areas were found among those who likely experienced the greatest improvement in socioeconomic status during primary school. These represent positive values previously unreported in the literature. Differences in amounts of growth, though in accord with these patterns, were quite small. Am. J. Hum. Biol. 12:102-117, 2000. Copyright 2000 Wiley-Liss, Inc.

  7. Acute high-intensity exercise-induced cognitive enhancement and brain-derived neurotrophic factor in young, healthy adults.

    Science.gov (United States)

    Hwang, Jungyun; Brothers, R Matthew; Castelli, Darla M; Glowacki, Elizabeth M; Chen, Yen T; Salinas, Mandy M; Kim, Jihoon; Jung, Yeonhak; Calvert, Hannah G

    2016-09-06

    Acute exercise can positively impact cognition. The present study examined the effect of acute high-intensity aerobic exercise on prefrontal-dependent cognitive performance and brain-derived neurotrophic factor (BDNF). Fifty-eight young adults were randomly assigned to one of two experimental groups: (a) an acute bout of high-intensity exercise (n=29) or (b) a non-exercise control (n=29). Participants in the exercise group improved performance on inhibitory control in Stroop interference and on cognitive flexibility in Trail Making Test (TMT) Part-B compared with participants in the control group and increased BDNF immediately after exercise. There was a significant relationship between BDNF and TMT Part-B on the pre-post change following exercise. These findings provide support for the association between improved prefrontal-dependent cognitive performance and increased BDNF in response to acute exercise. We conclude that the changes in BDNF concentration may be partially responsible for prefrontal-dependent cognitive functioning following an acute bout of exercise. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Microbiology and prognostic factors of hospital- and community-acquired aspiration pneumonia in respiratory intensive care unit.

    Science.gov (United States)

    Wei, Chaojie; Cheng, Zhenshun; Zhang, Li; Yang, Jiong

    2013-10-01

    Incidence of aspiration pneumonia in hospital-acquired pneumonia and community-acquired pneumonia is high; however, many features of this disease remain imprecise. Our objective was to characterize the microbial etiology and their antibiotic resistance and to determine the prognostic factors in aspiration pneumonia among patients admitted to a respiratory intensive care unit (RICU). A prospective survey was conducted in 112 patients exhibiting hospital-or community-acquired aspiration pneumonia in the RICU of a provincial general hospital from 2010-2012. Bronchoalveolar lavage sampling was collected, and then followed by standard culture and drug-sensitive test. Risk factors were analyzed by multivariate logistic analysis. One hundred twenty-eight strains were isolated in 94 patients, gram-negative bacilli (57.8%) was the predominant cultured microorganism, followed by fungus (28.9%) and gram-positive cocci (13.3%). The 5 main isolated bacteria demonstrated high and multiantibiotic resistance. The crude overall mortality was 43.8%, 50%, and 40%, respectively, in hospital- and community-acquired aspiration pneumonia group. Multivariate logistic analysis identified age older than 65 years, use of inotropic support, and ineffective initial therapy as independent risk factors of poor outcome. The predominant pathogenic bacteria of aspiration pneumonia in patients admitted to an RICU were antibiotic-resistant bacteria, and effective initial supportive management secured better prognosis. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  9. Low income and living alone are risk factors for admission to the intensive care unit with sepsis

    DEFF Research Database (Denmark)

    Storm, Line

    . There was no significant association between educational level and the risk of admission to the ICU with sepsis. Conclusion: Individuals either living alone or having a low income had significantly higher odds of ICU admission with sepsis. The results indicate that this patient group needs specific attention when......Background: A recent study showed significantly higher risk of bacteremia among individuals with low socioeconomic status. No studies have focused on socioeconomic status as a risk factor for intensive care unit (ICU) admission with sepsis. We hypothesize that individuals with low socioeconomic...... were matched on sex, age and area of residence (Central Region Denmark) to 9-10 controls per patient (3,869) retrieved from the background population through Statistics Denmark. Socioeconomic status was defined as highest accomplished educational level, yearly income (based on yearly tax declaration...

  10. A new analytical method for stress intensity factors based on insitu measurement of crack deformation under biaxial tension

    International Nuclear Information System (INIS)

    Wang, J.G.; Ju, D.Y.; Sun, M.J.; Li, S.L.

    2011-01-01

    A new approach for the calculation of stress intensity factors (SIF) for isotropic and orthotropic materials under biaxial tension loading was proposed in this paper. In order to determine SIF from the full-field displacement data, an asymptotic expansion of the crack tip displacement field was performed. The deforming shape and surface residual stress of the crack tip was obtained at the early extended stage of the loading process by using optical microscope and X-ray diffraction measurement. During this stage, a modified Dugdale Model, which takes into account the coupled effect at the crack tip, was proposed for the open displacement of the crack tip. In this paper, the SIFs of two types of silicon steel sheet with isotropic and orthotropic properties were calculated using the modified Dugdale Model based on the biaxial tension experimental data. From the results, it was found that analysis using the modified Dugdale Model is an effective way to evaluate SIF under biaxial stress.

  11. The effect of creep damage formulation on crack tip fields, creep stress intensity factor and crack growth assessments

    Directory of Open Access Journals (Sweden)

    V. Shlyannikov

    2017-07-01

    Full Text Available Fields of stress, strain rate and process zone of a mode I creep crack growth are analyzed by employing damage evolution equations. Damage models for fracture of process zone represented by stress based formulation. Two expressions are presented to describe the stress-sensitive nature of multiaxial rupture behavior. Both damage free and defective creeping solids have been studied. The variation of creep stress and the crack-tip governing parameter in the form of creep In-integral with time and the evolution of creep damage were analyzed by using the FE-model. The effect of the introduced creep stress intensity factor as a function of creep time through the continuum damage mechanics of the creep crack growth are discussed in detail.

  12. Risk factors for bronchopulmonary dysplasia in five Portuguese neonatal intensive care units Factores de risco de displasia broncopulmonar em cinco unidades portuguesas de cuidados intensivos neonatais

    Directory of Open Access Journals (Sweden)

    Hercília Guimarães

    2010-06-01

    Full Text Available The pathogenesis of bronchopulmonary dysplasia (BPD is clearly multifactorial. Specific pathogenic risk factors are prematurity, respiratory distress, oxygen supplementation, mechanical ventilation (MV, inflammation, patent ductus arteriosus (PDA, etc. Aim: To evaluate BPD prevalence and to identify risk factors for BPD in five Portuguese Neonatal Intensive Care Units in order to develop better practices the management of these newborns. Material and methods: 256 very low birth weight infants with gestational age (GA 0.30 (85 vs 5 days, respectively in BPD and no BPD patients, pA displasia broncopulmonar (DBP é multifactorial. Prematuridade, doença da membrana hialina, oxigénio, ventilação mecânica, inflamação e canal arterial são alguns dos factores na sua patogénese. Objectivo: Avaliar a prevalência da DBP e seus factores de risco em cinco unidades portuguesas, para implementar boas práticas no tratamento deste doentes. Material e métodos: 256 recém-nascidos (RN com idade gestacional (IG 0,30 (85 vs 5 dias, respectivamente nos doentes com e sem DBP, p<0,001. Comentários: Os factores de risco de DBP mais relevantes foram o baixo peso, a doença da membrana hialina grave, a duração da ventilação mecânica e da oxigenoterapia e a sépsis. A implementação das boas práticas para reduzir a lesão pulmonar nos RN deve ser dirigida para melhorar as práticas que reduzem estes factores de risco.

  13. Effects of grazing intensity and environmental factors on species composition and diversity in typical steppe of Inner Mongolia, China.

    Science.gov (United States)

    Ren, Haiyan; Schönbach, Philipp; Wan, Hongwei; Gierus, Martin; Taube, Friedhelm

    2012-01-01

    In the present study, we aim to analyze the effect of grazing, precipitation and temperature on plant species dynamics in the typical steppe of Inner Mongolia, P.R. China. By uncoupling biotic and abiotic factors, we provide essential information on the main drivers determining species composition and species diversity. Effects of grazing by sheep were studied in a controlled experiment along a gradient of seven grazing intensities (from ungrazed to very heavily grazed) during six consecutive years (2005-2010). The results show that plant species composition and diversity varied among years but were little affected by grazing intensity, since the experimental years were much dryer than the long term average, the abiotic constraints may have overridden any grazing effect. Among-year differences were predominantly determined by the abiotic factors of precipitation and temperature. Most of the variation in species dynamics and coexistence between C3 and C4 species was explained by seasonal weather conditions, i.e. precipitation and temperature regime during the early-season (March-June) were most important in determining vegetation dynamics. The dominant C3 species Stipa grandis was highly competitive in March-June, when the temperature levels were low and rainfall level was high. In contrast, the most common C4 species Cleistogenes squarrosa benefited from high early-season temperature levels and low early-season rainfall. However, biomass of Stipa grandis was positively correlated with temperature in March, when effective mean temperature ranges from 0 to 5°C and thus promotes vernalization and vegetative sprouting. Our results suggest that, over a six-year term, it is temporal variability in precipitation and temperature rather than grazing that determines vegetation dynamics and species co-existence of grazed steppe ecosystems. Furthermore, our data support that the variability in the biomass of dominant species, rather than diversity, determine ecosystem

  14. Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population.

    Science.gov (United States)

    Mörtberg, Ewa; Reuterskiöld, Lena; Tillfors, Maria; Furmark, Tomas; Öst, Lars-Göran

    2017-06-01

    Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n = 180) and in a normal population (n = 614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.

  15. Researches on the stability of porphyra-334 solution and its influence factors

    Science.gov (United States)

    Zhang, Zhaohui; Gao, Xin; Yuri, Tashiro; Shingo, Matsukawa; Hiroo, Ogawa

    2004-10-01

    The stability of porphyra-334 in solutions of different pH values at different temperatures was studied. In high acidic conditions, below pH3, the absorption maximum, λmax, of porphyra-334 shows hypsochromic shift towards lower wavelength and the absorbance also has a light decrease. In high alkaline conditions of over pH12, the absorbance of porphyra-334 decreases and an unknown compound with a peak maximum at 225 nm appears. The peak height of the unknown compound increases with the decrease of absorbance of porphyra-334. This might be related to the decomposition of porphyra-334. At room temperature, porphyra-334 solutions, except high alkaline solutions, are stable. Increasing the temperature, especially higher than 60°C, promotes the decomposition of porphyra-334 and causes the absorbance decrease both in basic and acidic solutions.

  16. Effect of Exercise Intensity on Neurotrophic Factors and Blood-Brain Barrier Permeability Induced by Oxidative-Nitrosative Stress in Male College Students.

    Science.gov (United States)

    Roh, Hee-Tae; Cho, Su-Youn; Yoon, Hyung-Gi; So, Wi-Young

    2017-06-01

    We investigated the effects of aerobic exercise intensity on oxidative-nitrosative stress, neurotrophic factor expression, and blood-brain barrier (BBB) permeability. Fifteen healthy men performed treadmill running under low-intensity (LI), moderate-intensity (MI), and high-intensity (HI) conditions. Blood samples were collected immediately before exercise (IBE), immediately after exercise (IAE), and 60 min after exercise (60MAE) to examine oxidative-nitrosative stress (reactive oxygen species [ROS]; nitric oxide [NO]), neurotrophic factors (brain-derived neurotrophic factor [BDNF]; nerve growth factor [NGF]), and blood-brain barrier (BBB) permeability (S-100β; neuron-specific enolase). ROS concentration significantly increased IAE and following HI (4.9 ± 1.7 mM) compared with that after LI (2.8 ± 1.4 mM) exercise (p exercise (p exercise (p exercise (p exercise (p .05). Moderate- and/or high-intensity exercise may induce higher oxidative-nitrosative stress than may low-intensity exercise, which can increase peripheral neurotrophic factor levels by increasing BBB permeability.

  17. Incidence and Risk Factors of Retinopathy of Prematurity in Two Neonatal Intensive Care Units in North and South China

    Science.gov (United States)

    Chen, Yi; Xun, Deng; Wang, Ya-Cong; Wang, Bin; Geng, Shao-Hui; Chen, Hui; Li, Yan-Tao; Li, Xiao-Xin

    2015-01-01

    Background: To investigate the incidence and risk factors of retinopathy of prematurity (ROP) in two Neonatal Intensive Care Units in North and South of China, respectively. Methods: We studied data concerning 472 infants with gestational age (GA) ≤34 weeks or birth weight (BW) ≤2000 g who were admitted to the Zhujiang Hospital of Southern Medical University and the Fourth Hospital of Shijiazhuang between January 1, 2011 and December 31, 2011. Clinical information about perinatal neonates was collected and was confirmed by reviewing medical charts. The incidence and severity of ROP were assessed in the screened population. Main outcome measures are the incidence and severity of ROP. The relationship of clinical risk factors and the development of ROP were analyzed. Results: The overall incidence of ROP was 12.7%, and the overall incidence of type 1 ROP was 2.3%; 9.4% of infants in Zhujiang Hospital had ROP compared to 15.0% infants in the Fourth Hospital of Shijiazhuang developed ROP, and the difference is statistically significant. ROP was significantly associated with GA (odds ratio [OR]: 0.77 [0.62–0.95], P = 0.015), BW (OR: 0.998 [0.996–0.999], P = 0.008), maternal supplemental oxygen administration before and during delivery (OR: 4.27 [1.21–15.10], P = 0.024) and preeclampsia (OR: 6.07 [1.73–21.36] P = 0.005). The risk factors for ROP are different in two hospitals. In Zhujiang Hospital, BW is the independent risk factors for ROP while GA, BW and preeclampsia in the Fourth Hospital in Shijiazhuang Conclusions: Retinopathy of prematurity incidence is different based on area. Incidence of ROP is still high in China. More efforts need to prevent ROP. PMID:25836612

  18. Epidemiology and risk factors for severe respiratory syncytial virus infections requiring pediatric intensive care admission in Hong Kong children.

    Science.gov (United States)

    Leung, T F; Lam, D S Y; Miu, T Y; Hon, K L; Chau, C S K; Ku, S W; Lee, R S Y; Chow, P Y; Chiu, W K; Ng, D K K

    2014-04-01

    Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in young children. However, there are limited data on severe RSV infection requiring pediatric intensive care unit (PICU) admission. This retrospective study described features of RSV-associated PICU admissions in Hong Kong and investigated factors for mortality and duration of PICU stay. Children with laboratory-confirmed RSV infection and admitted to the PICUs of all eight government hospitals in Hong Kong between January 2009 and June 2011 were identified from computerized auditing systems and PICU databases. RSV in respiratory samples was detected by direct immunofluorescence and/or viral culture. The relationships between mortality and PICU duration and demographic and clinical factors were analyzed. A total of 118 (2.4 %) PICU admissions were identified among 4,912 RSV-positive pediatric cases in all hospitals. Sixty-five (55.6 %) patients were infants. PICU admissions were higher between October and March. Eight (6.8 %) patients died, but only two were infants. RSV-associated mortality was related to prior sick contact, presence of older siblings, neurodevelopmental conditions, chromosomal and genetic diseases, and bacterial co-infections, but none was significant following logistic regression analyses (odds ratio 9.36, 95 % confidence interval 0.91-96.03 for prior sick contact, p = 0.060). Chronic lung disease was the only risk factor for the duration of PICU admission (β = 0.218, p = 0.017). The majority of RSV-infected children do not require PICU support. There is winter seasonality for RSV-associated PICU admission in Hong Kong. Prior sick contact is the only risk factor for RSV-associated mortality, whereas the presence of chronic lung disease is associated with longer PICU stay. The current risk-based approach of RSV prophylaxis may not be effective in reducing severe RSV infections.

  19. Prognostic factors associated with mortality in patients with severe trauma: from prehospital care to the Intensive Care Unit.

    Science.gov (United States)

    González-Robledo, J; Martín-González, F; Moreno-García, M; Sánchez-Barba, M; Sánchez-Hernández, F

    2015-10-01

    To identify factors related to mortality in adult trauma patients, analyzing the clinical, epidemiological and therapeutic characteristics at the pre-hospital levels, in the Emergency Care Department and in Intensive Care. A retrospective, longitudinal descriptive study was carried out. Statistical analysis was performed using SPSS, MultBiplot and data mining methodology. Adult multiple trauma patients admitted to the Salamanca Hospital Complex (Spain) from 2006 to 2011. Demographic variables, clinical, therapeutic and analytical data from the injury site to ICU admission. Evolution from ICU admission to hospital discharge. A total of 497 patients with a median age of 45.5 years were included. Males predominated (76.7%). The main causes of injury were traffic accidents (56.1%), precipitation (18.4%) and falls (11%). The factors with the strongest association to increased mortality risk (P 65 years (OR 3.15), head injuries (OR 3.1), pupillary abnormalities (OR 113.88), level of consciousness according to the Glasgow Coma Scale ≤ 8 (OR 12.97), and serum lactate levels > 4 mmol/L (OR 9.7). The main risk factors identified in relation to the prognosis of trauma patients are referred to the presence of head injuries. Less widely known statistical techniques such as data mining or MultBiplot also underscore the importance of other factors such as lactate concentration. Trauma registries help assess the healthcare provided, with a view to adopting measures for improvement. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  20. LINDA - a solution-focused low-intensity intervention aimed at improving health behaviors of young females: a cluster-randomized controlled trial.

    Science.gov (United States)

    Valve, Päivi; Lehtinen-Jacks, Susanna; Eriksson, Tiina; Lehtinen, Matti; Lindfors, Pirjo; Saha, Marja-Terttu; Rimpelä, Arja; Anglé, Susanna

    2013-11-04

    We aimed to develop and evaluate the effectiveness of an individualized, long-term support lifestyle counseling approach in promoting healthy physical activity, improving dietary and sleeping behaviors, and preventing weight gain in young females. The counseling approach's intensity was designed to be low enough to be implementable in primary health care. Young women (n = 3,059, age at baseline 17-21 years) attending a population-based human papilloma virus vaccination trial (clinicaltrials.gov identifier: NCT00122681) in 15 vaccination centers in different communities across Finland, were cluster-randomized into intervention and control arms of the LINDA intervention. Both intervention and control arms received counseling on sexual health and contraception from the study nurses as part of the vaccination trial. Additionally, the LINDA intervention arm (n = 1,537) received a 20-minute individualized lifestyle counseling session followed by further support at the six-monthly follow-up visits of the vaccination trial, in total for 1.5-2.5 years.The LINDA solution-focused brief therapy intervention focused on healthy physical activity, and dietary and sleeping behaviors, based on the needs and interests of the participants. Anthropometrics were measured, and data on health-related behaviors were collected using self-report questionnaires at baseline and after the intervention at 1.5-2.5 years. In the intervention arm, 37% vs. 31% in the control arm made an overall improvement in their health behaviors concerning physical activity, meal regularity and/or earlier bedtime (NNT = 18, 95% CI = 11-50). The per-protocol analysis further revealed that 30% of those who actually received lifestyle change support on healthy physical activity behaviors improved their physical activity level vs. 23% in the control group (NNT = 15, 95% CI = 9-38). Respectively, 36% of those who received support on healthy sleeping behaviors went to sleep earlier before school-/work-days after the

  1. Factors associated with death or intensive care unit admission due to pandemic 2009 influenza A (H1N1) infection.

    Science.gov (United States)

    Tabarsi, Payam; Moradi, Ahmadreza; Marjani, Majid; Baghaei, Parvaneh; Hashemian, Seyed Mohammadreza Hashemian; Nadji, Seyed Alireza; Fakharian, Atefeh; Mansouri, Davood; Masjedi, Mohammadreza; Velayati, Aliakbar

    2011-04-01

    In preparation for pandemic HINI or H1N1 influenza (H1N1) it is necessary to identify factors associated with mortality of patients with HINI and hospital admissions to intensive care unit (ICU) of patients diagnosed in 2009 with HINI. To describe the clinical and epidemiological features associated with 2009 HIN1 mortality and ICU patient admissions to Masih Daneshvari Teaching Hospital, Iran. A retrospective cross-sectional study was conducted among patients with mortality and admissions to ICU with confirmed HINI. Demographic, clinical, laboratory, radiological findings, and epidemiologic data were abstracted from medical records, using a standardized datasheet. From June through December 2009, 20 out of the 46 confirmed hospitalized patients with confirmed H1NI were admitted to the ICU and 7 (15%) died. Among various variables, opium inhalation (P = 0.01), having productive cough, hemoptysis, chest pain, confusion, and loss of consciousness were significantly related to ICU admission (P < 0.05). Pleural effusion (P = 0.006), elevated liver enzymes, as well as CPK and LDH level were significantly relevant to ICU admission (P < 0.05). Delayed antiviral treatment was more common among patients who died and the elderly. Patients who were admitted to ICU with confirmed H1N1 included the following risk factors: delayed initiation of antiviral therapy, history of opium inhalation and symptoms including; productive cough, hemoptysis, chest pain, confusion, and loss of consciousness. The mortality rate in the study population was high but compares favorably with other recent published studies.

  2. Predictive factors for acute radiation pneumonitis in postoperative intensity modulated radiation therapy and volumetric modulated arc therapy of esophageal cancer.

    Science.gov (United States)

    Zhao, Yaqin; Chen, Lu; Zhang, Shu; Wu, Qiang; Jiang, Xiaoqin; Zhu, Hong; Wang, Jin; Li, Zhiping; Xu, Yong; Zhang, Ying Jie; Bai, Sen; Xu, Feng

    2015-01-01

    Radiation pneumonitis (RP) is a common side reaction in radiotherapy for esophageal cancer. There are few reports about RP in esophageal cancer patients receiving postoperative intensity modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). This study aims to analyze clinical or dosimetric factors associated with RP, and provides data for radiotherapy planning. We reviewed 68 postoperative esophageal cancer patients who were treated with radiotherapy at the West China Hospital from October 2010 to November 2012 to identify any correlation between the clinical or dosimetric parameters and acute radiation pneumonitis (ARP) or severe acute radiation pneumonitis (SARP) by t-test, chi-square test, and logistic regression analysis. Of the 68 patients, 33 patients (48.5%) developed ARP, 13 of which (19.1%) developed SARP. Of these 33 patients, 8 (11.8%), 12 (17.6%), 11 (16.2%), and 2 (2.9%) patients were grade 1, 2, 3, and 4 ARP, respectively. Univariate analysis showed that lung infection during radiotherapy, use of VMAT, mean lung dose (MLD), and dosimetric parameters (e.g. V20, V30) are significantly correlated with RP. Multivariate analysis found that lung infection during radiotherapy, MLD ≥ 12 Gy, and V30 ≥ 13% are significantly correlated with an increased risk of RP. Lung infection during radiotherapy and low radiation dose volume distribution were predictive factors associated with RP and should be accounted for during radiation planning.

  3. Incidence and Risk Factors for Delirium among Mechanically Ventilated Patients in an African Intensive Care Setting: An Observational Multicenter Study

    Directory of Open Access Journals (Sweden)

    Arthur Kwizera

    2015-01-01

    Full Text Available Aim. Delirium is common among mechanically ventilated patients in the intensive care unit (ICU. There are little data regarding delirium among mechanically ventilated patients in Africa. We sought to determine the burden of delirium and associated factors in Uganda. Methods. We conducted a multicenter prospective study among mechanically ventilated patients in Uganda. Eligible patients were screened daily for delirium using the confusional assessment method (CAM-ICU. Comparisons were made using t-test, chi-squares, and Fisher’s exact test. Predictors were assessed using logistic regression. The level of statistical significance was set at P<0.05. Results. Of 160 patients, 81 (51% had delirium. Median time to onset of delirium was 3.7 days. At bivariate analysis, history of mental illness, sedation, multiorgan dysfunction, neurosurgery, tachypnea, low mean arterial pressure, oliguria, fevers, metabolic acidosis, respiratory acidosis, anaemia, physical restraints, marital status, and endotracheal tube use were significant predictors. At multivariable analysis, having a history of mental illness, sedation, respiratory acidosis, higher PEEP, endotracheal tubes, and anaemia predicted delirium. Conclusion. The prevalence of delirium in a young African population is lower than expected considering the high mortality. A history of mental illness, anaemia, sedation, endotracheal tube use, and respiratory acidosis were factors associated with delirium.

  4. Progression of itching intensity and expression of growth factor proteins in skin of people suffering from atopic dermatitis under the influence of ultraviolet phototherapy

    Directory of Open Access Journals (Sweden)

    A. A. Kubanova

    2015-01-01

    Full Text Available Study of progression of itching intensity and expression of growth factor proteins in skin of people suffering from atopic dermatitis under the influence of narrowband (311Nm phototherapy. Material and methods. 30 patients with atopic dermatitis were treated by using narrowband (311Nm phototherapy. SCORAD index was used to assess the severity of the clinical responses. Itching intensity was assessed using visual analogue scale. Expression of growth factor of nerves, semaphorine-3A, amphiregulin, and PGP9.5, a protein marker for nerve fibers, was investigated by means of indirect immunofluorescence. Results. Increased expression level of nerves growth factor, decreased expression level of semaphorine-3A, and increase in the number, average length and luminous intensity of PGP9.5+ -nerve fibers were found in the patients’ epidermis. Course of narrowband (311 Nm phototherapy resulted in a decrease of the severity of the disease and itching intensity, and semaphorine-3A expression increase, reduction of number and average length of nerve fibers in the epidermis. A direct correlation relationship between the itching intensity and expression level of nerve growth factor, number and average length of PGP9.5+ -nerve fibers in the epidermis as well as an inverse correlation relationship between itching intensity and expression level of semaphorine-3A in the epidermis were found. Conclusion. Treating patients suffering from atopic dermatitis with narrowband (311 Nm phototherapy leads to a decrease of the itching intensity associated with a decreased intensity of innervation of the epidermis. This decrease in course of phototherapy is facilitated by decrease of nerve growth factor expression level and increase of semaphorine-3A expression.

  5. Level and Intensity of Early Intervention Services for Infants and Toddlers with Disabilities: The Impact of Child, Family, System, and Community-Level Factors on Service Provision

    Science.gov (United States)

    Hallam, Rena A.; Rous, Beth; Grove, Jaime; LoBianco, Tony

    2009-01-01

    Data from a statewide billing and information system for early intervention are used to examine the influence of multiple factors on the level and intensity of services provided in a state early intervention system. Results indicate that child and family factors including entry age, gestational age, Medicaid eligibility, access to third party…

  6. Impact of the Weld Geometry on the Stress Intensity Factor of the Welded T-Joint Exposed to the Tensile Force and the Bending Moment

    Directory of Open Access Journals (Sweden)

    Djoković Jelena M.

    2015-12-01

    Full Text Available In this paper it is analyzed the welded T-joint exposed to the axial tensile force and the bending moment, for determining the impact of the weld geometry on the fracture mechanics parameters. The stress intensity factor was calculated analytically, based on the concept of the linear elastic fracture mechanics (LEFM, by application of the Mathematica® programming routine. The presence of the weld was taken into account through the corresponding correction factors. The results show that increase of the size of the triangular welds leads to decrease of the stress intensity factor, while the SIF increases with increase of the welds’ width. The ratio of the two welded plates’ thicknesses shows that plate thicknesses do not exhibit significant influence on the stress intensity factor behavior.

  7. "Usability of data integration and visualization software for multidisciplinary pediatric intensive care: a human factors approach to assessing technology".

    Science.gov (United States)

    Lin, Ying Ling; Guerguerian, Anne-Marie; Tomasi, Jessica; Laussen, Peter; Trbovich, Patricia

    2017-08-14

    Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks. Twenty-two participants, consisting of bedside intensive care physicians, nurses, and respiratory therapists, tested the T3™ interface in a simulation laboratory setting. Twenty tasks were performed with a true-to-setting, fully functional, prototype, populated with physiological and therapeutic intervention patient data. Primary data visualization was time series and secondary visualizations were: 1) shading out-of-target values, 2) mini-trends with exaggerated maxima and minima (sparklines), and 3) bar graph of a 16-parameter indicator. Task completion was video recorded and assessed using a use error rating scale. Usability issues were classified in the context of task and type of clinician. A severity rating scale was used to rate potential clinical impact of usability issues. Time series supported tracking a single parameter but partially supported determining patient trajectory using multiple parameters. Visual pattern overload was observed with multiple parameter data streams. Automated data processing using shading and sparklines was often ignored but the 16-parameter data reduction algorithm, displayed as a persistent bar graph, was visually intuitive. However, by selecting or automatically processing data, triggering aids distorted the raw data that clinicians use regularly. Consequently, clinicians could not rely on new data representations because they did not know how they were

  8. Short-Term High- and Moderate-Intensity Training Modifies Inflammatory and Metabolic Factors in Response to Acute Exercise

    Directory of Open Access Journals (Sweden)

    Fabio Santos Lira

    2017-10-01

    Full Text Available Purpose: To compare the acute and chronic effects of high intensity intermittent training (HIIT and steady state training (SST on the metabolic profile and inflammatory response in physically active men.Methods: Thirty recreationally active men were randomly allocated to a control group (n = 10, HIIT group (n = 10, or SST group (n = 10. For 5 weeks, three times per week, subjects performed HIIT (5 km 1-min at 100% of maximal aerobic speed interspersed by 1-min passive recovery or SST (5 km at 70% of maximal aerobic speed while the control group did not perform training. Blood samples were collected at fasting (~12 h, pre-exercise, immediately post, and 60 min post-acute exercise session (pre- and post-5 weeks training. Blood samples were analyzed for glucose, non-ester fatty acid (NEFA, and cytokine (IL-6, IL-10, and TNF-α levels through a three-way analysis (group, period, and moment of measurement with repeated measures in the second and third factors.Results: The results showed an effect of moment of measurement (acute session with greater values to TNF-α and glucose immediately post the exercise when compared to pre exercise session, independently of group or training period. For IL-6 there was an interaction effect for group and moment of measurement (acute session the increase occurred immediately post-exercise session and post-60 min in the HIIT group while in the SST the increase was observed only 60 min post, independently of training period. For IL-10, there was an interaction for training period (pre- and post-training and moment of measurement (acute session, in which in pre-training, pre-exercise values were lower than immediately and 60 min post-exercise, in post-training period pre-exercise values were lower than immediately post-exercise and immediately post-exercise lower than 60 min post, it was also observed that values immediately post-exercise were lower pre- than post-training, being all results independently of intensity

  9. Central Nervous System Depressants Poisoning and Ventilator Associated Pneumonia: An Underrated Risk Factor at the Toxicological Intensive Care Unit.

    Science.gov (United States)

    Hashemian, Morteza; Talaie, Haleh; Akbarpour, Samaneh; Mahdavinejad, Arezou; Mozafari, Naser

    2016-01-01

    Ventilator-Associated Pneumonia (VAP) is the main cause of nosocomial infection at intensive care units (ICUs), which causes high mortality and morbidity. The objective of the present survey was to identify the VAP risk and prognostic factors among poisoned patients, who were admitted to the toxicological ICU (TICU), especially central nervous system (CNS) depressants due to their prevalence and importance. A case-control study was conducted at the Loghman Hakim hospital between March 2013 and March 2014. Among 300 poisoned patients with mechanical ventilator ≥ 48 hours, 150 patients, who had developed microbiologically-confirmed VAP were considered as the VAP group and 150 without VAP were defined as the control group. The following data were collected; age, gender, type of poisoning, glasgow coma score, Acute physiology and chronic health evaluation (APACHE) II score, length of hospital stay, previous antibiotic use, microbial culture of the trachea, body temperature, leukocyte count, and patients' outcome. Based on the type of poisoning, patients were divided into three groups including: opioid, CNS depressants and others. All data were expressed as means (SD) for continuous variables and frequencies for categorical variables. Logistic regression was used to determine the relationship between risk factors and VAP. The mean age of the patients was 33.9 ± 14.3 years. The probable VAP incidence and mortality were 22% and 18.6%, respectively. The rate of CNS depressant versus opioid use (odds ratio, 3.74; P depressant was an important risk factor for VAP among poisoned patients. Hypoventilation due to CNS depression can lead to VAP. The APACHE II and length of hospital stay were shown as independent predictors of VAP and mortality among these patients.

  10. The five-factor model of personality, work stress and professional quality of life in neonatal intensive care unit nurses.

    Science.gov (United States)

    Barr, Peter

    2018-02-14

    The study aim was to determine the direct and indirect relations of the five-factor model of personality traits and work stress with professional quality of life in neonatal nurses. Neonatal intensive care nursing has positive and negative effects on neonatal nurses' psychological well-being. Although individual and situational factors interact to influence professional quality of life, there have been few studies of these relationships in neonatal nurses. A cross-sectional study conducted in 2016. Self-report questionnaires were used to measure professional quality of life (burnout, secondary traumatic stress and compassion satisfaction), five-factor model of personality traits (neuroticism, agreeableness, extraversion, conscientiousness and openness) and work stress (role ambiguity, role conflict and role overload). One hundred and forty (34%) of 405 eligible neonatal nurses provided the data. After controlling for work stress, neuroticism and agreeableness were related to burnout, neuroticism was related to secondary traumatic stress, and extraversion was related to compassion satisfaction. Work stress controlled for personality traits was related to burnout and secondary traumatic stress, but not to compassion satisfaction. Neuroticism moderated the effect of work stress on secondary traumatic stress and agreeableness and openness moderated the effect of work stress on compassion satisfaction. Work stress mediated the effect of neuroticism and extraversion on burnout and the effects of extraversion and conscientiousness on compassion satisfaction. Strategies to reduce work stress may not lessen burnout and secondary traumatic stress or increase compassion satisfaction in neonatal nurses who are prone to high neuroticism, low agreeableness and low extraversion. © 2018 John Wiley & Sons Ltd.

  11. Surveillance of ventilator-associated pneumonia in a neonatal intensive care unit: characteristics, risk factors, and outcome.

    Science.gov (United States)

    Afjeh, Seyyed Abolfazl; Sabzehei, Mohammad Kazem; Karimi, Abdollah; Shiva, Farideh; Shamshiri, Ahmad Reza

    2012-09-01

    This study determined the incidence, characteristics, risk factors, and outcomes of ventilator-associated pneumonia (VAP) in newborns hospitalized in a Neonatal Intensive Care Unit (NICU) in Tehran, Iran. A prospective cohort study was carried out in the NICU of Mahdieh Hospital over a period of one year, from December 2008 to November 2009, on all neonates mechanically ventilated for more than 48 hours. VAP was diagnosed in accordance with the CDC definition of nosocomial pneumonias for patients younger than 12 months. Risk factors relevant to the development of VAP were studied. Multiple logistic and Cox regression analysis were performed to determine independent predictors for VAP and survival rate, respectively. There were 81 neonates enrolled. VAP occurred in 14 (17.3%), at a rate of 11.6/1000 days on the ventilator. Gram negative bacteria were the predominant etiologic agents. The most common bacterial isolates from the endotracheal aspirate were E. coli (21.4%), Klebsiella (21.4%), and Pseudomonas (14.1%). The only VAP predictor was sputum [odds ratio (OR) = 5.11, P = 0.02]. Mortality rate for VAP was 2/14 (14.3%). Duration of mechanical ventilation [hazard ratio (HR) = 0.96, P = 0.01], birth weight (HR = 0.81, P < 0.001), and purulent tracheal aspirate (HR = 0.25, P < 0.006) were independent predictors of overall survival. VAP occurs at a significant rate in mechanically ventilated newborns. Additional studies are needed to accurately determine the incidence and risk factors in order to develop effective preventive and therapeutic protocols.

  12. Incidence and Risk Factors for Intensive Care Unit–related Post-traumatic Stress Disorder in Veterans and Civilians

    Science.gov (United States)

    Jackson, James C.; Morandi, Alessandro; Girard, Timothy D.; Hughes, Christopher G.; Thompson, Jennifer L.; Kiehl, Amy L.; Elstad, Mark R.; Wasserstein, Mitzi L.; Goodman, Richard B.; Beckham, Jean C.; Chandrasekhar, Rameela; Dittus, Robert S.; Ely, E. Wesley; Pandharipande, Pratik P.

    2016-01-01

    Rationale: The incidence and risk factors of post-traumatic stress disorder (PTSD) related to the intensive care unit (ICU) experience have not been reported in a mixed veteran and civilian cohort. Objectives: To describe the incidence and risk factors for ICU-related PTSD in veterans and civilians. Methods: This is a prospective, observational, multicenter cohort enrolling adult survivors of critical illness after respiratory failure and/or shock from three Veterans Affairs and one civilian hospital. After classifying those with/without preexisting PTSD (i.e., PTSD before hospitalization), we then assessed all subjects for ICU-related PTSD at 3 and 12 months post hospitalization. Measurements and Main Results: Of 255 survivors, 181 and 160 subjects were assessed for ICU-related PTSD at 3- and 12-month follow-up, respectively. A high probability of ICU-related PTSD was found in up to 10% of patients at either follow-up time point, whether assessed by PTSD Checklist Event-Specific Version (score ≥ 50) or item mapping using the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). In the multivariable regression, preexisting PTSD was independently associated with ICU-related PTSD at both 3 and 12 months (P < 0.001), as was preexisting depression (P < 0.03), but veteran status was not a consistent independent risk factor for ICU-related PTSD (3-month P = 0.01, 12-month P = 0.48). Conclusions: This study found around 1 in 10 ICU survivors experienced ICU-related PTSD (i.e., PTSD anchored to their critical illness) in the year after hospitalization. Preexisting PTSD and depression were strongly associated with ICU-related PTSD. PMID:26735627

  13. A factorization for $Z \\times Z$-matrices yielding solutions of Toda-type hierarchies

    NARCIS (Netherlands)

    Helminck, G.F.

    2004-01-01

    In this paper one considers the problem of finding solutions to a number of Toda-type hierarchies. All of them are associated with a commutative subalgebra of the $k \\times k$-matrices. The first one is formulated in terms of upper triangular $\\mathbb{Z} \\times \\mathbb{Z}$-matrices, the second one

  14. A factorization for Z x Z-matrices yielding solutions of Toda-type hierarchies

    NARCIS (Netherlands)

    Helminck, G.F.

    2005-01-01

    In this paper one considers the problem of finding solutions to a number of Toda-type hierarchies. All of them are associated with a commutative subalgebra of the k×k-matrices. The first one is formulated in terms of upper triangular ℤ×ℤ-matrices, the second one in terms of lower triangular ones and

  15. Solubility of concrete in acid solution as a determinant factor in the ...

    African Journals Online (AJOL)

    The need exists for early assessment of strength of concrete in modem reinforced concrete construction to minimise losses. Possibility of using solubility of concrete in acid solutions to carry out its strength assessment was investigated. Standard concrete cubes were cast and cured for different days. At each curing day, a set ...

  16. Solution of elliptic partial differential equations by fast Poisson solvers using a local relaxation factor. 2: Two-step method

    Science.gov (United States)

    Chang, S. C.

    1986-01-01

    A two-step semidirect procedure is developed to accelerate the one-step procedure described in NASA TP-2529. For a set of constant coefficient model problems, the acceleration factor increases from 1 to 2 as the one-step procedure convergence rate decreases from + infinity to 0. It is also shown numerically that the two-step procedure can substantially accelerate the convergence of the numerical solution of many partial differential equations (PDE's) with variable coefficients.

  17. Effects of Antiseptic Solutions Commonly Used in Dentistry on Bone Viability, Bone Morphology, and Release of Growth Factors.

    Science.gov (United States)

    Sawada, Kosaku; Fujioka-Kobayashi, Masako; Kobayashi, Eizaburo; Schaller, Benoit; Miron, Richard J

    2016-02-01

    Antiseptic solutions are commonly used in dentistry for a number of sterilization procedures, including harvesting of bone chips, irrigation of extraction sockets, and sterilization of osteonecrotic bone. Despite its widespread use, little information is available regarding the effects of various antiseptic solutions on bone cell viability, morphology, and the release of growth factors. The antiseptic solutions included 1) 0.5% povidone iodine (PI), 2) 0.2% chlorhexidine diguluconate (CHX), 3) 1% hydrogen peroxide (H2O2), and 4) 0.25% sodium hypochlorite (HYP). Bone samples collected from porcine mandibular cortical bone were rinsed in the antiseptic solutions for 10 minutes and assessed for cell viability using an MTS assay and protein release of transforming growth factor (TGF-β1), bone morphogenetic protein 2 (BMP2), vascular endothelial growth factor (VEGF), interleukin (IL)-1β, and receptor activator of nuclear factor κB ligand (RANKL) using an enzyme-linked immunosorbent assay at 15 minutes and 4 hours after rinsing. After antiseptic rinsing, changes to the surface protein content showed marked alterations, with an abundant protein layer remaining on CHX-rinsed bone samples. The amount of surface protein content gradually decreased in the following order: CHX, H2O2, PI, and HYP. A similar trend was also observed for the relative cell viability from within bone samples after rinsing, with up to 6 times more viable cells found in the CHX-rinsed bone samples than in the HYP- and PI-rinsed samples. An analysis of the growth factors found that both HYP and PI had significantly lower VEGF and TGF-β1 protein release from bone samples at 15 minutes and 4 hours after rinsing compared with CHX and H2O2. A similar trend was observed for RANKL and IL-1β protein release, although no change was observed for BMP2. The results from the present study have demonstrated that antiseptic solutions present with very different effects on bone samples after 10 minutes of

  18. Solution structure of human insulin-like growth factor II; recognition sites for receptors and binding proteins.

    OpenAIRE

    Terasawa, H; Kohda, D; Hatanaka, H; Nagata, K; Higashihashi, N; Fujiwara, H; Sakano, K; Inagaki, F

    1994-01-01

    The three-dimensional structure of human insulin-like growth factor II was determined at high resolution in aqueous solution by NMR and simulated annealing based calculations. The structure is quite similar to those of insulin and insulin-like growth factor I, which consists of an alpha-helix followed by a turn and a strand in the B-region and two antiparallel alpha-helices in the A-region. However, the regions of Ala1-Glu6, Pro31-Arg40 and Thr62-Glu67 are not well-defined for lack of distanc...

  19. Water, Sanitation and Hygiene (WASH) and environmental risk factors for soil-transmitted helminth intensity of infection in Timor-Leste, using real time PCR.

    Science.gov (United States)

    Campbell, Suzy J; Nery, Susana V; Wardell, Rebecca; D'Este, Catherine A; Gray, Darren J; McCarthy, James S; Traub, Rebecca J; Andrews, Ross M; Llewellyn, Stacey; Vallely, Andrew J; Williams, Gail M; Clements, Archie C A

    2017-03-01

    No investigations have been undertaken of risk factors for intensity of soil-transmitted helminth (STH) infection in Timor-Leste. This study provides the first analysis of risk factors for intensity of STH infection, as determined by quantitative PCR (qPCR), examining a broad range of water, sanitation and hygiene (WASH) and environmental factors, among communities in Manufahi District, Timor-Leste. A baseline cross-sectional survey of 18 communities was undertaken as part of a cluster randomised controlled trial, with additional identically-collected data from six other communities. qPCR was used to assess STH infection from stool samples, and questionnaires administered to collect WASH, demographic, and socioeconomic data. Environmental information was obtained from open-access sources and linked to infection outcomes. Mixed-effects multinomial logistic regression was undertaken to assess risk factors for intensity of Necator americanus and Ascaris infection. 2152 participants provided stool and questionnaire information for this analysis. In adjusted models incorporating WASH, demographic and environmental variables, environmental variables were generally associated with infection intensity for both N. americanus and Ascaris spp. Precipitation (in centimetres) was associated with increased risk of moderate-intensity (adjusted relative risk [ARR] 6.1; 95% confidence interval [CI] 1.9-19.3) and heavy-intensity (ARR 6.6; 95% CI 3.1-14.1) N. americanus infection, as was sandy-loam soil around households (moderate-intensity ARR 2.1; 95% CI 1.0-4.3; heavy-intensity ARR 2.7; 95% CI 1.6-4.5; compared to no infection). For Ascaris, alkaline soil around the household was associated with reduced risk of moderate-intensity infection (ARR 0.21; 95% CI 0.09-0.51), and heavy-intensity infection (ARR 0.04; 95% CI 0.01-0.25). Few WASH risk factors were significant. In this high-prevalence setting, strong risk associations with environmental factors indicate that anthelmintic

  20. Factors associated with death or intensive care unit admission due to pandemic 2009 influenza A (H1N1 infection

    Directory of Open Access Journals (Sweden)

    Tabarsi Payam

    2011-01-01

    Full Text Available Background : In preparation for pandemic HINI or H1N1 influenza (H1N1 it is necessary to identify factors associated with mortality of patients with HINI and hospital admissions to intensive care unit (ICU of patients diagnosed in 2009 with HINI. Objectives : To describe the clinical and epidemiological features associated with 2009 HIN1 mortality and ICU patient admissions to Masih Daneshvari Teaching Hospital, Iran. Methods : A retrospective cross-sectional study was conducted among patients with mortality and admissions to ICU with confirmed HINI. Demographic, clinical, laboratory, radiological findings, and epidemiologic data were abstracted from medical records, using a standardized datasheet. Results : From June through December 2009, 20 out of the 46 confirmed hospitalized patients with confirmed H1NI were admitted to the ICU and 7 (15% died. Among various variables, opium inhalation (P = 0.01, having productive cough, hemoptysis, chest pain, confusion, and loss of consciousness were significantly related to ICU admission (P < 0.05. Pleural effusion (P = 0.006, elevated liver enzymes, as well as CPK and LDH level were significantly relevant to ICU admission (P < 0.05. Delayed antiviral treatment was more common among patients who died and the elderly. Discussion : Patients who were admitted to ICU with confirmed H1N1 included the following risk factors: delayed initiation of antiviral therapy, history of opium inhalation and symptoms including; productive cough, hemoptysis, chest pain, confusion, and loss of consciousness. The mortality rate in the study population was high but compares favorably with other recent published studies.

  1. Action of acoustical oscillations and hydrodynamic factors on the chemical activity of iodne in solution

    International Nuclear Information System (INIS)

    Nikolaev, L.A.; Fadeev, G.N.

    1984-01-01

    Investigation results on the effect of acoustic oscillations within the frequency range of 1-500 Hz on aqueous iodine solutions and dark blue iodide-starch complex have been presented. Experiments were carried out within the range of action of acoustical and hydrodynamic oscillations without visual formation of bubbles. Form of kinetic dependences corresponds to the first order reaction in respect to iodine. Sharp increase of solution electric conductivity and noticeable increase of medium acidity were observed after the action of oscillations. It has been shown that low-frequency oscillations strengthen iodine hydrolysis and lead to iodate atom formation. Effect of oscillations with 25-30 Hz upon the iodide-starch complex results in the complex destruction, i. e. iodide atom chains removal out of clathrate starch cavities. Formation of iodide-starch complexes is promoted under the action of 250 Hz frequency, as such oscillations lead to the change of starch structure, but do not effect upon iodide

  2. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-01-01

    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  3. Standard test method for determining a threshold stress intensity factor for environment-assisted cracking of metallic materials

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2003-01-01

    1.1 This test method covers the determination of the environment-assisted cracking threshold stress intensity factor parameters, KIEAC and KEAC, for metallic materials from constant-force testing of fatigue precracked beam or compact fracture specimens and from constant-displacement testing of fatigue precracked bolt-load compact fracture specimens. 1.2 This test method is applicable to environment-assisted cracking in aqueous or other aggressive environments. 1.3 Materials that can be tested by this test method are not limited by thickness or by strength as long as specimens are of sufficient thickness and planar size to meet the size requirements of this test method. 1.4 A range of specimen sizes with proportional planar dimensions is provided, but size may be variable and adjusted for yield strength and applied force. Specimen thickness is a variable independent of planar size. 1.5 Specimen configurations other than those contained in this test method may be used, provided that well-established stress ...

  4. Community-acquired Clostridium difficile: Epidemiology, Ribotype, Risk Factors, Hospital and Intensive Care Unit Outcomes, and Current and Emerging Therapies.

    Science.gov (United States)

    Ofori, Emmanuel; Ramai, Daryl; Dhawan, Monica; Mustafa, Fareeza; Gasperino, James; Reddy, Madhavi

    2018-01-30

    The epidemiological landscape of Clostridium difficile infection (CDI) has changed over the past 30 years. To review studies of CDI in the community setting. Electronic databases including PubMed, MEDLINE, Embase, Google Scholar, Scopus, ClinicalTrials.gov, and Cochrane Databases were searched for human studies performed between 2000 and 2017 that assessed the epidemiology, risk factors, ribotypes, hospital and intensive care unit outcomes, and management of community-acquired CDI. We also manually searched references to identify additional relevant studies. In total, 39 articles met our inclusion criteria. The incidence of community acquired CDI has almost doubled in the past decade. Approximately half of all cases of CDI are attributed to community origin. Individuals who are younger, female, in the presence of infants, frequently use proton pump inhibitors or specific classes of antibiotics, or live near farms and livestock are at higher risk for community-acquired CDI. Additionally, about 40% of all community-acquired cases require hospitalization, where severity has been linked to hypervirulent ribotypes 027 and 078 with poor outcomes. Emerging data on treatment paradigms have led to the revision of clinical guidelines and two potential vaccines in phase three clinical trials. However, ribotype specific response to current treatment strategies is lacking. Community-acquired CDI represents a growing public health threat and burden on healthcare systems. A multidisciplinary approach will be required to stem the tides. Copyright © 2018. Published by Elsevier Ltd.

  5. Ecoefficiency of Intensive Agricultural Production and Its Influencing Factors in China: An Application of DEA-Tobit Analysis

    Directory of Open Access Journals (Sweden)

    Heyuan You

    2016-01-01

    Full Text Available The excessive use of inputs per unit of agricultural land poses a great threat to ecological sustainability. Using an input-oriented data envelopment analysis (DEA model, this study analyzes ecoefficiency of intensive agricultural production in 31 provinces in China. The results show that the total efficiency of only six provinces can be considered fully efficient and that scale efficiencies are generally lower than technical efficiencies. Then, the spatial distribution of ecoefficiency is analyzed. The findings demonstrate that the provinces whose ecoefficiencies are maximal are primarily located in western China. The technical efficiencies in the western region are better than those in the eastern and middle regions. Imperfect scale efficiencies are distributed across all three regions. Furthermore, using the Tobit model, an analysis of the factors that influence ecoefficiency shows that the variables of farmland area per capita (FA, income per capita (IC, population per household (PH, and population burden coefficient (PB have statistically significant impacts on total efficiency. The distinct effects of the variables on total efficiency are caused by their differential effects on technical efficiency and scale efficiency. Finally, suitable policies designed to improve ecoefficiency are proposed according to the local circumstances of each of the three regions.

  6. Acute bacterial meningitis in the intensive care unit and risk factors for adverse clinical outcomes: retrospective study.

    Science.gov (United States)

    Fernandes, D; Gonçalves-Pereira, J; Janeiro, S; Silvestre, J; Bento, L; Póvoa, P

    2014-06-01

    Bacterial meningitis constitutes a medical emergency. Its burden has driven from childhood to the elderly and the immunocompromised population. However, the admission of patients with bacterial meningitis to the intensive care unit (ICU) has been sparsely approached, as have the prognostic factors associated with an adverse clinical outcome. We performed a retrospective analysis during a 7-year period of patients older than 18 years admitted to 2 polyvalent ICUs. Clinical, demographic, and outcome data were collected to evaluate its clinical impact on the outcome of patients with acute bacterial meningitis. We identified 65 patients with the diagnosis of acute bacterial meningitis (mean Acute Physiology and Chronic Health Evaluation II, 23; hospital mortality, 40%). Upon clinical presentation, their most frequent signs were fever (84%), seizures (21.5%), and a low Glasgow Coma Scale (GCS) score (GCSbacterial meningitis admitted to ICU had substantial morbidity and mortality. Those with low GCS or absence of fever have a particularly high risk of an adverse outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors.

    Science.gov (United States)

    Toohey, Kellie; Pumpa, Kate L; Arnolda, Leonard; Cooke, Julie; Yip, Desmond; Craft, Paul S; Semple, Stuart

    2016-01-01

    The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group ( n  = 8) or the continuous low to moderate intensity training group ( n  = 8) group for 36 sessions (12 weeks) of supervised exercise. The low-volume high-intensity interval training (LVHIIT) group performed 7 × 30 s intervals (≥85% maximal heart rate) and the continuous low to moderate intensity training (CLMIT) group performed continuous aerobic training for 20 min (≤55% maximal heart rate) on a stationary bike or treadmill. Significant improvements (time) were observed for 13 of the 23 dependent variables (ES 0.05-0.61, p  ≤ 0.05). An interaction effect was observed for six minute walk test (18.53% [32.43-4.63] ES 0.50, p  ≤ 0.01) with the LVHIIT group demonstrating greater improvements. These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT); it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

  8. A pilot study examining the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular risk factors in cancer survivors

    Directory of Open Access Journals (Sweden)

    Kellie Toohey

    2016-10-01

    Full Text Available Purpose The aim of this study was to evaluate the effects of low-volume high-intensity interval training and continuous low to moderate intensity training on quality of life, functional capacity and cardiovascular disease risk factors in cancer survivors. Methods Cancer survivors within 24 months post-diagnosis were randomly assigned into the low-volume high-intensity interval training group (n = 8 or the continuous low to moderate intensity training group (n = 8 group for 36 sessions (12 weeks of supervised exercise. The low-volume high-intensity interval training (LVHIIT group performed 7 × 30 s intervals (≥85% maximal heart rate and the continuous low to moderate intensity training (CLMIT group performed continuous aerobic training for 20 min (≤55% maximal heart rate on a stationary bike or treadmill. Results Significant improvements (time were observed for 13 of the 23 dependent variables (ES 0.05–0.61, p ≤ 0.05. An interaction effect was observed for six minute walk test (18.53% [32.43–4.63] ES 0.50, p ≤ 0.01 with the LVHIIT group demonstrating greater improvements. Conclusion These preliminary findings suggest that both interventions can induce improvements in quality of life, functional capacity and selected cardiovascular disease risk factors. The LVHIIT program was well tolerated by the participants and our results suggest that LVHIIT is the preferred modality to improve fitness (6MWT; it remains to be seen which intervention elicits the most clinically relevant outcomes for patients. A larger sample size with a control group is required to confirm the significance of these findings.

  9. Prevalence and intensity of fleas parasitizing an isolated population of screaming hairy armadillo in Buenos Aires province, Argentina: host-related factors and temporal dynamics.

    Science.gov (United States)

    Ezquiaga, M Cecilia; Abba, Agustín M; Cassini, Guillermo H; Lareschi, Marcela

    2017-11-01

    Fleas (Siphonaptera) of an isolated population of Chaetophractus vellerosus (Mammalia: Xenarthra) from Magdalena (Buenos Aires province) were studied, and their presence was associated with host-related factors (age, sex, weight, size, and physical condition) and temporal dynamics (seasonality and year). Three species of fleas were identified: Polygenis (Polygenis) platensis (Rhopalopsyllidae), Tunga penetrans (Tungidae), and Pulex irritans (Pulicidae). Prevalences were significant for year, season, and physical condition. Intensities were significantly different for year, physical condition, and weight. The intensities of fleas were higher in 2009 than in other years, probably because of lower rainfall than the annual average leading to extremely dry climatic conditions in 2008. Intensities decreased in individuals with major body weight and increased in individuals with poor physical condition. In this study, the dynamics of the flea community associated with an armadillo population is analyzed for the first time taking into account host-related factors and temporal dynamics, and also how these factors influence the community.

  10. Structure of Rosenberg’s Self-Esteem Scale: Three-factor solution

    Czech Academy of Sciences Publication Activity Database

    Blatný, Marek; Urbánek, Tomáš; Osecká, Terezie

    2006-01-01

    Roč. 48, č. 4 (2006), s. 371-378 ISSN 0039-3320 Institutional research plan: CEZ:AV0Z70250504 Keywords : Rosenberg Self - Esteem Scale * confirmatory factor analysis * adolescents Subject RIV: AN - Psychology Impact factor: 0.410, year: 2006

  11. The role of burnout syndrome as a mediator for the effect of psychosocial risk factors on the intensity of musculoskeletal disorders: a structural equation modeling approach.

    Science.gov (United States)

    Gholami, Tahereh; Pahlavian, Ahmad Heidari; Akbarzadeh, Mahdi; Motamedzade, Majid; Moghaddam, Rashid Heidari

    2016-01-01

    This study examined the hypothesis that burnout syndrome mediates effects of psychosocial risk factors and intensity of musculoskeletal disorders (MSDs) among hospital nurses. The sample was composed of 415 nurses from various wards across five hospitals of Iran's Hamedan University of Medical Sciences. Data were collected through three questionnaires: job content questionnaire, Maslach burnout inventory and visual analogue scale. Results of structural equation modeling with a mediating effect showed that psychosocial risk factors were significantly related to changes in burnout, which in turn affects intensity of MSDs.

  12. An I-integral method for crack-tip intensity factor variation due to domain switching in ferroelectric single-crystals

    Science.gov (United States)

    Yu, Hongjun; Wang, Jie; Shimada, Takahiro; Wu, Huaping; Wu, Linzhi; Kuna, Meinhard; Kitamura, Takayuki

    2016-09-01

    In the present study, an I-integral method is established for solving the crack-tip intensity factors of ferroelectric single-crystals. The I-integral combined with the phase field model is successfully used to investigate crack-tip intensity factor variations due to domain switching in ferroelectricity subjected to electromechanical loadings, which exhibits several advantages over previous methods based on small-scale switching. First, the shape of the switching zone around a crack tip is predicted by the time-dependent Ginzburg-Landau equation, which does not require preset energy-based switching criterion. Second, the I-integral can directly solve the crack-tip intensity factors and decouple the crack-tip intensity factors of different modes based on superimposing an auxiliary state onto an actual state. Third, the I-integral is area-independent, namely, the I-integral is not affected by the integral area size, the polarization distributions, or domain walls. This makes the I-integral applicable to large-scale domain switching. To this end, the electro-elastic field intensity factors of an impermeable crack in PbTiO3 ferroelectric single crystals are evaluated under electrical, mechanical, and combined loading. The intensity factors obtained by the I-integral agree well with those obtained by the extrapolation technique. From numerical results, the following conclusions can be drawn with respect to fracture behavior of ferroelectrics under large-scale switching. Under displacement controlled mechanical loading, the stress intensity factors (SIFs) decrease monotonically due to the domain switching process, which means a crack tip shielding or effective switching-induced toughening occurs. If an external electric field is applied, the electric displacement intensity factor (EDIF) increases in all cases, i.e., the formed domain patterns enhance the electric crack tip loading. The energy release rate, expressed by the crack-tip J-integral, is reduced by the domain

  13. Study of Characteristics, risk factors and outcome for Ventilator Associated Pneumonia in Neonatal Intensive Care Unit patient

    Directory of Open Access Journals (Sweden)

    Mehdi Moradi

    2013-09-01

    Full Text Available Background: Ventilator Associated Pneumonia (VAP, developing in mechanically ventilated patients after 48 hours of mechanical ventilation, is the second most common nosocomial infection. Therefore, there is a vital need to study the etiology and risk factors associated with VAP in neonates.Methods: Neonates admitted to neonatal intensive care unit (NICU, over a period of one year and who required mechanical ventilation for more than 48 hours were enrolled consecutively into the study. Semi-quantitative assay of endotracheal aspirate was used for microbiological diagnoses of VAP. 105CFU/ml was taken as the cut off between evidence of pathological infection and colonization. The primary outcome measure was the development of VAP. Secondary outcome measures were length of mechanical ventilation, NICU length of stay, hospital cost, and death.Results: Thirty eight patients were enrolled (58% were boys and 42% were girls. 42% of neonates developed VAP. The most common VAP organisms identified were Acinetobacter baumanni (43%. On multiple regression analysis, duration of mechanical ventilation was associated with VAP (P=0.00. Patients with VAP had greater need for mechanical ventilation (18.7 vs 6 median days, longer NICU length of stay (39 vs 21.5 median days and higher total median hospital costs (79.5 vs 52 million rials than those without VAP. The mortality rate was not different between two groups.Conclusion: In mechanically ventilated neonates, those with VAP had a prolonged need for mechanical ventilation, a longer NICU stay, and a higher hospital costs. Longer mechanical ventilation was associated with an increased risk of developing VAP in these patients. Developing of VAP didn’t increase mortality in patients.

  14. ENVIRONMENTAL INNOVATIVE BUSINESS SOLUTIONS AS A STRATEGIC FACTOR OF ECONOMIC SECURITY ISSUES

    Directory of Open Access Journals (Sweden)

    A. S. Senin

    2016-01-01

    Full Text Available The relevance of this work lies in the fact that it attempts to disclose the key theoretical and practical issues of economic security solutions, taking into account the problems of global transformations taking place in the global economy. As part of the article we have been studied various aspects that characterize global economic, environmental trends that will shape the future of modern civilization. The article also addresses the problem of exit from the raw model of the economy, the formation of economic mechanisms that take into account environmental costs, proposed internalization of environmental externalities.The purpose/goal. The purpose of this article and its main task is to systematize the areas of environmentally oriented development of economic entities, as well as the determination of the list of key provisions of environmental policies, which will ensure the further socio-economic development of Russia in line with the green economy.Methods. In this article, based on content analysis of theoretical and empirical basic conceptual provisions of economic security were formulated in the context of eco-oriented production, the transition to which world civilization is currently implementing. It was concluded that the economic, energy, environmental and social issues of sustainable development of modern civilization is directly linked, so the transition to ecooriented production is possible, firstly, it provided aggressive reduction of production and wasteful use of traditional hydrocarbon resources, and, secondly, on the condition of rational replacement of traditional energy sources with renewable energy.Results. This article outlines the basic solutions that can be used to provide environmentally responsible operation and development of Russian business and corporate structures. Also offered in the basic decisions that are to be included in the national environmental policy as a major incentive for the further transition to a

  15. Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical-epidemiological profile and risk factors for mortality.

    Science.gov (United States)

    Nóbrega, Marcus Vinícius Dantas da; Reis, Ricardo Coelho; Aguiar, Isabel Cristina Veras; Queiroz, Timóteo Vasconcelos; Lima, Ana Claudia Feitosa; Pereira, Eanes Delgado Barros; Ferreira, Raquel Feijó de Araújo

    2016-01-01

    Tetanus, an acute infectious disease, is highly prevalent worldwide, especially in developing countries. Due to respiratory failure and hemodynamic instability associated with dysautonomia, severe cases require intensive care, but little has been published regarding the management in the Intensive Care Unit. To draw a 10-year clinical-epidemiological profile of Intensive Care Unit patients with severe tetanus, observe their evolution in the Intensive Care Unit and identify risk factors for mortality. In this retrospective study, we used a standardized questionnaire to collect information from the records of patients with severe tetanus admitted to the intensive care unit of a referral hospital for infectious and contagious diseases in Northeastern Brazil. The initial sample included 144 patients, of whom 29 were excluded due to incomplete information, leaving a cohort of 115 subjects. The average age was 49.6±15.3 years, most patients had no (or incomplete) vaccination against tetanus, and most were male. The main intensive care-related complications were pneumonia (84.8%) and dysautonomia (69.7%). Mortality (44.5%) was higher than expected from the mean APACHE II score (11.8), with shock/multiple organ failure as the main cause of death (72.9%). The independent factors most predictive of mortality were APACHE II score, dysautonomia, continuous neuromuscular blockade and age. A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population. Copyright © 2016 Sociedade Brasileira de Infectologia. All rights reserved.

  16. Resistance in gram-negative bacilli in a cardiac intensive care unit in India: Risk factors and outcome

    Directory of Open Access Journals (Sweden)

    Pawar Mandakini

    2008-01-01

    Full Text Available The objective of this study was to compare the risk factors and outcome of patients with preexisting resistant gram-negative bacilli (GNB with those who develop sensitive GNB in the cardiac intensive care unit (ICU. Of the 3161 patients ( n = 3,161 admitted to the ICU during the study period, 130 (4.11% developed health care-associated infections (HAIs with GNB and were included in the cohort study. Pseudomonas aeruginosa (37.8% was the most common organism isolated followed by Klebsiella species (24.2%, E. coli (22.0%, Enterobacter species (6.1%, Stenotrophomonas maltophilia (5.7%, Acinetobacter species (1.3%, Serratia marcescens (0.8%, Weeksella virosa (0.4% and Burkholderia cepacia (0.4%. Univariate analysis revealed that the following variables were significantly associated with the antibiotic-resistant GNB: females ( P = 0.018, re-exploration ( P = 0.004, valve surgery ( P = 0.003, duration of central venous catheter ( P < 0.001, duration of mechanical ventilation ( P < 0.001, duration of intra-aortic balloon counter-pulsation ( P = 0.018, duration of urinary catheter ( P < 0.001, total number of antibiotic exposures prior to the development of resistance ( P < 0.001, duration of antibiotic use prior to the development of resistance ( P = 0.014, acute physiology and age chronic health evaluation score (APACHE II, receipt of anti-pseudomonal penicillins (piperacillin-tazobactam ( P = 0.002 and carbapenems ( P < 0.001. On multivariate analysis, valve surgery (adjusted OR = 2.033; 95% CI = 1.052-3.928; P = 0.035, duration of mechanical ventilation (adjusted OR = 1.265; 95% CI = 1.055-1.517; P = 0.011 and total number of antibiotic exposure prior to the development of resistance (adjusted OR = 1.381; 95% CI = 1.030-1.853; P = 0.031 were identified as independent risk factors for HAIs in resistant GNB. The mortality rate in patients with resistant GNB was significantly higher than those with sensitive GNB (13.9% vs. 1.8%; P = 0.03. HAI with

  17. Low intensity pulsed ultrasound enhanced mesenchymal stem cell recruitment through stromal derived factor-1 signaling in fracture healing.

    Directory of Open Access Journals (Sweden)

    Fang-Yuan Wei

    Full Text Available Low intensity pulsed ultrasound (LIPUS has been proven effective in promoting fracture healing but the underlying mechanisms are not fully depicted. We examined the effect of LIPUS on the recruitment of mesenchymal stem cells (MSCs and the pivotal role of stromal cell-derived factor-1/C-X-C chemokine receptor type 4 (SDF-1/CXCR4 pathway in response to LIPUS stimulation, which are essential factors in bone fracture healing. For in vitro study, isolated rat MSCs were divided into control or LIPUS group. LIPUS treatment was given 20 minutes/day at 37 °C for 3 days. Control group received sham LIPUS treatment. After treatment, intracellular CXCR4 mRNA, SDF-1 mRNA and secreted SDF-1 protein levels were quantified, and MSCs migration was evaluated with or without blocking SDF-1/CXCR4 pathway by AMD3100. For in vivo study, fractured 8-week-old young rats received intracardiac administration of MSCs were assigned to LIPUS treatment, LIPUS+AMD3100 treatment or vehicle control group. The migration of transplanted MSC to the fracture site was investigated by ex vivo fluorescent imaging. SDF-1 protein levels at fracture site and in serum were examined. Fracture healing parameters, including callus morphology, micro-architecture of the callus and biomechanical properties of the healing bone were investigated. The in vitro results showed that LIPUS upregulated SDF-1 and CXCR4 expressions in MSCs, and elevated SDF-1 protein level in the conditioned medium. MSCs migration was promoted by LIPUS and partially inhibited by AMD3100. In vivo study demonstrated that LIPUS promoted MSCs migration to the fracture site, which was associated with an increase of local and serum SDF-1 level, the changes in callus formation, and the improvement of callus microarchitecture and mechanical properties; whereas the blockade of SDF-1/CXCR4 signaling attenuated the LIPUS effects on the fractured bones. These results suggested SDF-1 mediated MSCs migration might be one of the

  18. Evaluations of Effective Factors on Efficiency Zinc Oxides Nanoparticles in Cadmium Removal from Aqueous Solution

    Directory of Open Access Journals (Sweden)

    MH Ehrampoush

    2014-09-01

    Results: The results indicated that the adsorption process is affected by different parameters such as initial pollutant concentrations, adsorbent dose, pH, and contact time and Cadmiumremoval efficiency increases with increasing adsorbent dose and reaction time and decreases with increasing initial concentration of Cadmium. Therefore, it is observed that by raising the initial Cadmium concentration, the adsorption rate increases. The maximum efficiency of adsorptionin pH=7amounted to 89.6%. Conclusion: It is concluded that Zinc Oxide nanoparticles have proper efficiency in removal of Cadmium from aqueous solutions and can be used in the treatment of wastewater that contains ion Cadmium. However, its efficiency is deeply dependent on ion strength and the interaction of other metals in wastewater.

  19. Investigation of factors affecting the stability of lysozyme spray dried from ethanol-water solutions

    DEFF Research Database (Denmark)

    Ji, Shuying; Thulstrup, Peter Waaben; Mu, Huiling

    2017-01-01

    Formulation composition and processing conditions can be adjusted to enhance the structural integrity as well as the bioactivity of proteins in the spray drying process. In this study, lysozyme was chosen as a model pharmaceutical protein to study these aspects when spray drying from water......-ethanol mixtures. The effect of formulation additives (trehalose, Tween 20 and phosphate-buffered saline) and processing conditions (inlet temperature and storage time of lysozyme in the feed solution before the spray drying process) on the protein bioactivity was investigated. The results showed...... that the bioactivities of spray dried lysozyme with these additives were about 5-10% higher than that without additives. The bioactivity of the spray dried lysozyme was found to increase with a decrease in the inlet temperature from 130°C to 80°C, with similar findings when shortening the storage time of the feed...

  20. Influence of environment factors on humidity conditions of selected external wall solutions in a heated building

    Science.gov (United States)

    Kaczmarek, Anna

    2017-10-01

    Contemporary single-family houses in Poland are often built during 3 quarters of a year (spring to autumn) are usually settled in a winter season. It is a special case when exploitation humidity coincides with technological one, causing unfavourable humidity conditions during the first years of exploitation. In consequence, thermal parameters of partitions differ from those assumed in the project. In construction stage the humidity state of a wall stabilizes as a result of water: associated with storage, entered technologically during wall construction and plastering, coming from rainfall. Thermo-insulation materials are built-in at dry state. During erection and exploitation of a building their thermal conductivity is changing depending on humidity conditions. According to building rules, construction humidity should be removed from a partition before the building transfer to usage, because it lowers the thermal partition insulation ability and increases air humidity of building interior. Walls are plastered and insulated in condition of simultaneous presence of atmospheric and technological humidity which cause special humidity condition during first years of exploitation. As a consequence, heating costs are substantially higher. In this article the results of simulation are shown performed with WUFI ®PRO 5 software, which was intended to define the time necessary for reaching the stabilised humidity in selected solutions of two-layer walls applied in a heated building. In the research performed, the partition orientation along geographic directions, short and long wave radiation, and environment humidity (air humidity, driving rain) coincidence with technological humidity in assumed wall solutions were taken into account.

  1. Uncertainty in positive matrix factorization solutions for PAHs in surface sediments of the Yangtze River Estuary in different seasons.

    Science.gov (United States)

    Liu, Ruimin; Men, Cong; Yu, Wenwen; Xu, Fei; Wang, Qingrui; Shen, Zhenyao

    2018-01-01

    To examine the variabilities of source contributions in the Yangtze River Estuary (YRE), the uncertainty based on the positive matrix factorization (PMF) was applied to the source apportionment of the 16 priority PAHs in 120 surface sediment samples from four seasons. Based on the signal-to-noise ratios, the PAHs categorized as "Bad" might drop out of the estimation of bootstrap. Next, the spatial variability of residuals was applied to determine which species with non-normal curves should be excluded. The median values from the bootstrapped solutions were chosen as the best estimate of the true factor contributions, and the intervals from 5th to 95th percentile represent the variability in each sample factor contribution. Based on the results, the median factor contributions of wood grass combustion and coke plant emissions were highly correlated with the variability (R 2  = 0.6797-0.9937) in every season. Meanwhile, the factor of coal and gasoline combustion had large variability with lower R 2 values in every season, especially in summer (0.4784) and winter (0.2785). The coefficient of variation (CV) values based on the Bootstrap (BS) simulations were applied to indicate the uncertainties of PAHs in every factor of each season. Acy, NaP and BgP always showed higher CV values, which suggested higher uncertainties in the BS simulations, and the PAH with the lowest concentration among all PAHs usually became the species with higher uncertainties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Latent Constructs of the Static-99R and Static-2002R: A Three-Factor Solution.

    Science.gov (United States)

    Brouillette-Alarie, Sébastien; Babchishin, Kelly M; Hanson, R Karl; Helmus, Leslie-Maaike

    2016-02-01

    The most commonly used risk assessment tools for predicting sexual violence focus almost exclusively on static, historical factors (e.g., characteristics of prior offences). Consequently, they are assumed to be unable to directly inform the selection of treatment targets or evaluate change. In this article, we argue that this limitation can be mitigated by using latent variable models as a framework to link historical risk factors to the psychological characteristics of offenders. Accordingly, we conducted a factor analysis of the 13 nonredundant items from the two most commonly used risk tools for sexual offenders (Static-99R and Static-2002R) to identify the psychological information contained in these tools. Three factors were identified: (a) persistence/paraphilia, a construct related to sexual criminality, especially of the pedophilic type; (b) youthful stranger aggression, a construct centered on young age and offence seriousness; and (c) general criminality, a construct that reflected the diversity and magnitude of criminal careers. These constructs predicted sexual recidivism with similar accuracy, but only youthful stranger aggression and general criminality predicted nonsexual recidivism. These results indicate that risk tools for sexual violence are multidimensional, and support a shift from a focus on atheoretical risk markers to the assessment of psychologically meaningful constructs. © The Author(s) 2015.

  3. General solution of an exact correlation function factorization in conformal field theory

    International Nuclear Information System (INIS)

    Simmons, Jacob J H; Kleban, Peter

    2009-01-01

    The correlation function factorization with K a boundary operator product expansion coefficient, is known to hold for certain scaling operators at the two-dimensional percolation point and in a few other cases. Here the correlation functions are evaluated in the upper half-plane (or any conformally equivalent region) with x 1 and x 2 arbitrary points on the real axis, and z an arbitrary point in the interior. This type of result is of interest because it is both exact and universal, relates higher-order correlation functions to lower-order ones and has a simple interpretation in terms of cluster or loop probabilities in several statistical models. This motivated us to use the techniques of conformal field theory to determine the general conditions for its validity. Here, we discover that either (see display) factorizes in this way for any central charge c, generalizing previous results. In particular, the factorization holds for either FK (Fortuin–Kasteleyn) or spin clusters in the Q-state Potts models; it also applies to either the dense or dilute phases of the O(n) loop models. Further, only one other non-trivial set of highest-weight operators (in an irreducible Verma module) factorizes in this way. In this case the operators have negative dimension (for c<1) and do not seem to have a physical realization

  4. DNA binding by the plant-specific NAC transcription factors in crystal and solution

    DEFF Research Database (Denmark)

    Welner, Ditte Hededam; Lindemose, Søren; Grossmann, J. Günter

    2012-01-01

    NAC (NAM/ATAF/CUC) plant transcription factors regulate essential processes in development, stress responses and nutrient distribution in important crop and model plants (rice, Populus, Arabidopsis), which makes them highly relevant in the context of crop optimization and bioenergy production...

  5. The Effect of Financial Factors on the Performance of New Venture Companies in High Tech and Knowledge-Intensive Industries: An Empirical Study in Denmark

    DEFF Research Database (Denmark)

    Bøllingtoft, Anne; Ulhøi, John Parm; Madsen, Henning

    2003-01-01

    This paper addresses important financial aspects during the formation of knowledge-intensive entrepreneurship. A number of ex ante derived hypotheses are submitted to an empirical test to identify and explain some of the key financial factors affecting the survival and first preliminary growth...

  6. Dose intensity of standard adjuvant CMF with granulocyte colony-stimulating factor for premenopausal patients with node-positive breast cancer

    NARCIS (Netherlands)

    deGraaf, H; Willemse, PHB; Bong, SB; Piersma, H; Tjabbes, T; vanVeelen, H; Coenen, JLLM; deVries, EGE

    1996-01-01

    The effects of granulocyte colony-stimulating factor (G-CSF) on total dose and dose intensity of standard oral adjuvant CMF (cyclophosphamide, methotrexate, and 5-fluorouracil) chemotherapy were studied in premenopausal patients with node-positive breast cancer. Treatment consisted of standard CMF

  7. Evaluation Of Finite Element Mesh Arrangements And Stress Intensity Factor Calculation Methods For Opening Mode Fracture Of Cracked-Cemented Materials

    Directory of Open Access Journals (Sweden)

    Hamid R. Nikraz

    2007-01-01

    Full Text Available Fracture mechanics is a branch of mechanics, which deals with the cracked body. Every construction material that currently in use inevitably is not flawless. The pre-existing crack may grow to cause structure failure due to low stress, which acts to a structure. Stress intensity factor (K is a single parameter in fracture mechanics, which can be used to examine if a crack, would propagate in a cracked structure under particular loading condition. Finite element method is used to analyze the cracked body to provide the displacements data around the crack tip (at quarter point elements due to load prescribed, for stress intensity factor determination. Two methods of stress intensity factor calculation, Quarter Point Displacement Technique (QPDT and Displacement Correlation Technique (DCT, were evaluated. A series of standard fracture testing were undertaken to provide the fracture load data (Pf, which coupled with the stress intensity factor analytical formula to calculate fracture toughness. The results showed that under a particular mesh arrangement, the result of finite element analysis could deviate from the analytical formula calculation result. The QPDT method is suitable for compact tension specimen but DCT seemed to be not. For cracked beam analysis, the QPDT and DCT calculations were in good agreement with the analytical formula as long as coupled with the appropriate mesh arrangement around the crack tip.

  8. Patients with severe accidental tetanus admitted to an intensive care unit in Northeastern Brazil: clinical–epidemiological profile and risk factors for mortality

    Directory of Open Access Journals (Sweden)

    Marcus Vinícius Dantas da Nóbrega

    2016-09-01

    Conclusion: A high mortality rate was observed in our cohort of Intensive Care Unit patients with severe tetanus and a number of risk factors for mortality were identified. Our results provide important insights for the development of intervention protocols capable of reducing complications and mortality in this patient population.

  9. Interpersonal violence on college campuses: understanding risk factors and working to find solutions.

    Science.gov (United States)

    Littleton, Heather

    2014-10-01

    This commentary discusses the contributions of Drs. Antonia Abbey and Catherine Kaukinen to our understanding of risk factors for sexual and physical aggression among college students. Major contributions of their work are outlined. These include Abbey's contributions to our understanding of trajectories of sexually aggressive behavior among college men, risk factors for engaging in sexual aggression among men, and the role of alcohol in sexual aggression. In addition, Kaukinen's work has increased our understanding of the frequency of violence in college dating relationships as well as the association of violent relationships with health risk behaviors. Directions for future research are also outlined including a need to identify trajectories of violence risk as well as a need to understand the complex interrelationships among health risk behaviors and interpersonal violence. Finally, implications for practice and university policy are discussed, including a focus on the development of effective preventive strategies and proactive responses to violence. © The Author(s) 2014.

  10. Sources, factors, mechanisms and possible solutions to pollutants in marine ecosystems.

    Science.gov (United States)

    Mostofa, Khan M G; Liu, Cong-Qiang; Vione, Davide; Gao, Kunshan; Ogawa, Hiroshi

    2013-11-01

    Algal toxins or red-tide toxins produced during algal blooms are naturally-derived toxic emerging contaminants (ECs) that may kill organisms, including humans, through contaminated fish or seafood. Other ECs produced either naturally or anthropogenically ultimately flow into marine waters. Pharmaceuticals are also an important pollution source, mostly due to overproduction and incorrect disposal. Ship breaking and recycle industries (SBRIs) can also release various pollutants and substantially deteriorate habitats and marine biodiversity. Overfishing is significantly increasing due to the global food crisis, caused by an increasing world population. Organic matter (OM) pollution and global warming (GW) are key factors that exacerbate these challenges (e.g. algal blooms), to which acidification in marine waters should be added as well. Sources, factors, mechanisms and possible remedial measures of these challenges to marine ecosystems are discussed, including their eventual impact on all forms of life including humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Stochastic conditional intensity processes

    DEFF Research Database (Denmark)

    Bauwens, Luc; Hautsch, Nikolaus

    2006-01-01

    In this article, we introduce the so-called stochastic conditional intensity (SCI) model by extending Russell’s (1999) autoregressive conditional intensity (ACI) model by a latent common dynamic factor that jointly drives the individual intensity components. We show by simulations that the propos...... for a joint latent factor and show that its inclusion allows for an improved and more parsimonious specification of the multivariate intensity process...

  12. Sources, factors, mechanisms and possible solutions to pollutants in marine ecosystems

    International Nuclear Information System (INIS)

    Mostofa, Khan M.G.; Liu, Cong-Qiang; Vione, Davide; Gao, Kunshan; Ogawa, Hiroshi

    2013-01-01

    Algal toxins or red-tide toxins produced during algal blooms are naturally-derived toxic emerging contaminants (ECs) that may kill organisms, including humans, through contaminated fish or seafood. Other ECs produced either naturally or anthropogenically ultimately flow into marine waters. Pharmaceuticals are also an important pollution source, mostly due to overproduction and incorrect disposal. Ship breaking and recycle industries (SBRIs) can also release various pollutants and substantially deteriorate habitats and marine biodiversity. Overfishing is significantly increasing due to the global food crisis, caused by an increasing world population. Organic matter (OM) pollution and global warming (GW) are key factors that exacerbate these challenges (e.g. algal blooms), to which acidification in marine waters should be added as well. Sources, factors, mechanisms and possible remedial measures of these challenges to marine ecosystems are discussed, including their eventual impact on all forms of life including humans. -- Review of sources, factors, mechanisms and possible remedial measures of key pollutants (contaminants, toxins, ship breaking, overfishing) in marine ecosystems

  13. Risk factors and characterization of Plasmodium vivax-associated admissions to pediatric intensive care units in the Brazilian Amazon.

    Directory of Open Access Journals (Sweden)

    Ellen Fátima Caetano Lança

    Full Text Available BACKGROUND: Plasmodium vivax is responsible for a significant proportion of malaria cases worldwide and is increasingly reported as a cause of severe disease. The objective of this study was to characterize severe vivax disease among children hospitalized in intensive care units (ICUs in the Western Brazilian Amazon, and to identify risk factors associated with disease severity. METHODS AND FINDINGS: In this retrospective study, clinical records of 34 children, 0-14 years of age hospitalized in the 11 public pediatric and neonatal ICUs of the Manaus area, were reviewed. P. falciparum monoinfection or P. falciparum/P. vivax mixed infection was diagnosed by microscopy in 10 cases, while P. vivax monoinfection was confirmed in the remaining 24 cases. Two of the 24 patients with P. vivax monoinfection died. Respiratory distress, shock and severe anemia were the most frequent complications associated with P. vivax infection. Ninety-one children hospitalized with P. vivax monoinfections but not requiring ICU were consecutively recruited in a tertiary care hospital for infectious diseases to serve as a reference population (comparators. Male sex (p = 0.039, age less than five years (p = 0.028, parasitemia greater than 500/mm(3 (p = 0.018, and the presence of any acute (p = 0.023 or chronic (p = 0.017 co-morbidity were independently associated with ICU admission. At least one of the WHO severity criteria for malaria (formerly validated for P. falciparum was present in 23/24 (95.8% of the patients admitted to the ICU and in 17/91 (18.7% of controls, making these criteria a good predictor of ICU admission (p = 0.001. The only investigated criterion not associated with ICU admission was hyperbilirubinemia (p = 0.513]. CONCLUSIONS: Our study points to the importance of P. vivax-associated severe disease in children, causing 72.5% of the malaria admissions to pediatric ICUs. WHO severity criteria demonstrated good sensitivity in

  14. Investigating The Factors Impacting On The Development & Deployment Of ITS Solutions In Developing Countries

    DEFF Research Database (Denmark)

    Adjin, Daniel Michael Okwabi; Tadayoni, Reza; Tsivor, Kenneth

    2013-01-01

    This paper investigates the factors that affect the development and deployment of Intelligent Transportation System (ITS) in developing countries (i.e., countries with transitional economies). Some observations on the drivers, barriers, current status and the way forward are presented. There are ......This paper investigates the factors that affect the development and deployment of Intelligent Transportation System (ITS) in developing countries (i.e., countries with transitional economies). Some observations on the drivers, barriers, current status and the way forward are presented...... in these countries. The main bottlenecks to deploying ITS applications in developing countries include: insufficient understanding of the potentials of ITS and its benefits due to lack of education and awareness, lack of financial resources, lack of technical support, difficulties in integrating ITS applications...... with existing transportation infrastructures and lack of co-operation between the stakeholders involved. The Methodology for this study was qualitative exploratory research design approach. The main method employed was reviews of related research studies, journal articles, desk top publications focused...

  15. Organizational factors in design and implementation of technological and organizational solutions in the nuclear industry

    International Nuclear Information System (INIS)

    Macchi, L.; Reiman, T.; Savioja, P.; Kahlbom, U.; Rollenhagen, C.

    2012-02-01

    Design is often found as one of the contributing factors in accident in the nuclear industry. The design of new technological systems and organisational structures has to take into account and be driven by the future users' needs and has to consider how their role and work practices within the organisation will be affected. The SADE project explores to which extend the concepts of safety culture and resilience engineering can contribute to the prevention of design errors when no hindsight data are available. In 2011, the SADE project focused on gathering experience and clarifying the current issues and challenges related to the design process. During 2011 seventeen interviews have been conducted in Finland and Sweden to identify some of the major challenges the nuclear industry is currently facing. At the same time a literature review has been conducted to establish a sound common theoretical ground. This progress report presents some of the relevant theoretical findings and preliminary results from the interviews. (Author)

  16. Organizational factors in design and implementation of technological and organizational solutions in the nuclear industry

    Energy Technology Data Exchange (ETDEWEB)

    Macchi, L.; Reiman, T.; Savioja, P. (VTT Technical Research Centre of Finland (Finland)); Kahlbom, U. (Risk Pilot AB, Stockholm (Sweden)); Rollenhagen, C. (Vattenfall (Sweden))

    2012-03-15

    Design is often found as one of the contributing factors in accident in the nuclear industry. The design of new technological systems and organisational structures has to take into account and be driven by the future users' needs and has to consider how their role and work practices within the organisation will be affected. The SADE project explores to which extend the concepts of safety culture and resilience engineering can contribute to the prevention of design errors when no hindsight data are available. In 2011, the SADE project focused on gathering experience and clarifying the current issues and challenges related to the design process. During 2011 seventeen interviews have been conducted in Finland and Sweden to identify some of the major challenges the nuclear industry is currently facing. At the same time a literature review has been conducted to establish a sound common theoretical ground. This progress report presents some of the relevant theoretical findings and preliminary results from the interviews. (Author)

  17. RISK FACTORS FOR HEARING LOSS IN PATIENTS TREATED WITH INTENSITY-MODULATED RADIOTHERAPY FOR HEAD-AND-NECK TUMORS

    NARCIS (Netherlands)

    Zuur, Charlotte L.; Simis, Yvonne J.; Lamers, Emmy A.; Hart, Augustinus A.; Dreschler, Wouter A.; Balm, Alfons J.; Rasch, Coen R.

    2009-01-01

    Purpose: Radiotherapy (RT) is a common treatment of head-and-neck carcinoma. The objective of this study was to perform a prospective multivariate assessment of the dose-effect relationship between intensity-modulated RT and hearing loss. Methods and Materials: Pure tone audiometry at 0.250-16 kHz

  18. Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation

    NARCIS (Netherlands)

    C. Schmid (Christoph); M. Labopin (Myriam); A. Nagler (Arnon); D. Niederwieser (Dietger); L. Castagna (Luca); R. Tabrizi (Reza); M. Stadler (Michael); J. Kuball (Jürgen); J.J. Cornelissen (Jan); J. Vorlicek (Jiri); G. Socié (Gerard); M. Falda (M.); L. Vindelov (Lars); P. Ljungman (Per); G. Jackson (Graham); N. Kröger (Nicolaus); A. Rank (Andreas); E. Polge (Emmanuelle); V. Rocha (Vanderson); M. Mohty (Mohamad)

    2012-01-01

    textabstractBecause information on management and outcome of AML relapse after allogeneic hematopoietic stem cell transplantation (HSCT) with reduced intensity conditioning (RIC) is scarce, a retrospective registry study was performed by the Acute LeukemiaWorking Party of EBMT. Among 2815 RIC

  19. Treatment, risk factors, and outcome of adults with relapsed AML after reduced intensity conditioning for allogeneic stem cell transplantation

    DEFF Research Database (Denmark)

    Schmid, Christoph; Labopin, Myriam; Nagler, Arnon

    2012-01-01

    Since information on management and outcome of adults with AML relapsing after allogeneic hematopoietic stem cell transplantation with reduced intensity conditioning (RIC HSCT) is scarce, a retrospective registry study was performed by the Acute Leukemia Working Party of EBMT. Among 2815 RIC tran...

  20. Low intensity radiation in diapazone of high frequency as factor of the survival modification of differentiated plant cells

    International Nuclear Information System (INIS)

    Tordiya, N.V.

    2005-01-01

    The combined effect of low intensity electromagnetic emission in high frequency range (EMI HF) and ionizing radiation on survival of the differential cells of high plant water Elodea canadensis is investigated. It was established, that EMI HF is radioprotective modification of the radiation injury of plant cell

  1. Neuromuscular and biomechanical factors codetermine the solution to motor redundancy in rhythmic multijoint arm movement.

    Science.gov (United States)

    de Rugy, Aymar; Riek, Stephan; Oytam, Yalchin; Carroll, Timothy J; Davoodi, Rahman; Carson, Richard G

    2008-08-01

    How the CNS deals with the issue of motor redundancy remains a central question for motor control research. Here we investigate the means by which neuromuscular and biomechanical factors interact to resolve motor redundancy in rhythmic multijoint arm movements. We used a two-df motorized robot arm to manipulate the dynamics of rhythmic flexion-extension (FE) and supination-pronation (SP) movements at the elbow-joint complex. Participants were required to produce rhythmic FE and SP movements, either in isolation, or in combination (at the phase relationship of their choice), while we recorded the activity of key bi-functional muscles. When performed in combination, most participants spontaneously produced an in-phase pattern of coordination in which flexion is synchronised with supination. The activity of the Biceps Brachii (BB), the strongest arm muscle which also has the largest moment arms in both flexion and supination was significantly higher for FE and SP performed in combination than in isolation, suggesting optimal exploitation of the mechanical advantage of this muscle. In a separate condition, participants were required to produce a rhythmic SP movement while a rhythmic FE movement was imposed by the motorized robot. Simulations based upon a musculoskeletal model of the arm demonstrated that in this context, the most efficient use of the force-velocity relationship of BB requires that an anti-phase pattern of coordination (flexion synchronized with pronation) be produced. In practice, the participants maintained the in-phase behavior, and BB activity was higher than for SP performed in isolation. This finding suggests that the neural organisation underlying the exploitation of bifunctional muscle properties, in the natural context, constrains the system to maintain the "natural" coordination pattern in an altered dynamic environment, even at the cost of reduced biomechanical efficiency. We suggest an important role for afference from the imposed movement

  2. Element and Crack Geometry Sensitivities of Finite Element Analysis Results of Linear Elastic Stress Intensity Factor for Surface Cracked Straight Pipes

    International Nuclear Information System (INIS)

    Ryu, Dongil; Bae, Kyungdong; Je, Jinho; An, Joonghyok; Kim, Yongbeum

    2013-01-01

    This study provides the elastic stress intensity factors, K, for circumferential and longitudinal surface cracked straight pipes under single or combined loads of internal pressure, bending, and torsion based on three-dimensional (3a) finite element (FE) analyses. FE results are compared with two different types of defect assessment codes (API-579-1 and RUC-MR A106) to prove the accuracy of the FE results and the differences between the codes. Through the 3a FE analysis, it is found that the stress intensity factors are sensitive to the number of elements, which they were believed to not be sensitive to because of path independence. Differences were also found between the FE analysis results for crack defining methods and the results obtained by two different types of defect assessment codes

  3. Factors influencing when intensive care unit nurses go to the bedside to investigate patient related alarms: A descriptive qualitative study.

    Science.gov (United States)

    Despins, Laurel A

    2017-12-01

    This study examines what prompts the intensive care unit (ICU) nurse to go to the patient's bedside to investigate an alarm and the influences on the nurse's determination regarding how quickly this needs to occur. A qualitative descriptive design guided data collection and analysis. Individual semi-structured interviews were conducted. Thematic analysis guided by the Patient Risk Detection Theoretical Framework was applied to the data. Four specialty intensive care units in an academic medical center. ICU nurses go the patient's bedside in response to an alarm to catch patient deterioration and avert harm. Their determination of the immediacy of patient risk and their desire to prioritize their bedside investigations to true alarms influences how quickly they proceed to the bedside. Ready visual access to physiological data and waveform configurations, experience, teamwork, and false alarms are important determinants in the timing of ICU nurses' bedside alarm investigations. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Spectrophotometric determination of acidity constant of some indicators in various micellar media solutions by rank annihilation factor analysis

    Science.gov (United States)

    Niazi, Ali; Zolgharnein, Javad; Davoodabadi, Mohammad Reza

    2008-07-01

    Rank annihilation factor analysis (RAFA) was used to the spectrophotometric studies of the acidity constant of methyl orange, methyl red and methyl violet in water and different micellar solutions at 25 °C and an ionic strength of 0.1 M. When the acidity constants (surfactant concentration dependent acidity constant) acts as an optimizing object, and simply combined with the pure spectrum of acidic and basic forms, the rank of original data matrix can be reduced. The residual standard deviation (R.S.D.) of the residual matrix after bi-linearization of the background matrix is regarded as the evaluation function. Results show that the acidity constant of these indicators are influenced as the percentages of neutral, cationic and anionic surfactant such as Triton X-100 (poly(oxyethylene)(9.5) p-(1,1,3,3-tetramethyl), sodiumdodecylsulfate (SDS) and cethyltrimethylammonium (CTAB), respectively, added to the solution of these reagents. Also, RAFA is an efficient chemometrics algorithm for completely analysis of acid-base equilibrium systems by spectrophotometric method. Effects of surfactant on acidity constant and absorption spectra are also discussed.

  5. Effect of Atorvastatin intensive therapy on the serum inflammatory factors, platelet activity and fibrinolytic activity in patients with acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Xiao-Li Zhu

    2016-05-01

    Full Text Available Objective: To observe the effect of Atorvastatin intensive therapy on the serum inflammatory factors, platelet activity and fibrinolytic activity in patients with acute coronary syndrome (ACS. Methods: A total of 92 patients with ACS were randomly divided into observation group (47 cases and control group (45 cases. The control group was given Atorvastatin (10mg/d based on the conventional therapy, while the observation group was given Atorvastatin at an intensive dose (40 mg/d based on the conventional therapy. Half a month later, the changes of IL-6, IL-8, hs-CRP, TNF-α, TXB2, GMP-140, PAI-1 and t-PA were observed and compared between the two groups. Results: After treatment, the inflammatory factors (IL-6, IL-8, hs-CRP and TNF-α and the indicators of platelet activity (TXB2, GMP-140 and PAI-1 were obviously decreased, while the indicator of fibrinolytic activity (t-PA was apparently increased in the two groups. Besides, the amplitudes of change referring to these indicators in the observation group were bigger than those in the control group after treatment, and the differences were statistically significant. Conclusion: The intensive therapy with the administration of Atorvastatin at a dose of 40 mg/d was better than the conventional therapy (Atorvastatin: 10 mg/d in aspects of reducing inflammatory factors, inhibiting platelet activity and correcting the high coagulation state of fibrinolytic system.

  6. Fundamental solutions in piezoelectricity. Penny-shaped crack solution

    International Nuclear Information System (INIS)

    Dyka, Ewa; Rogowski, Bogdan

    2006-01-01

    The problem of electroelasticity for piezoelectric materials is considered. For axially symmetric states three potentials are introduced, which determine the displacements, the electric potentials, the stresses, the components of the electric field vector and the electric displacements in a piezoelectric body. These fundamental solutions are utilized to solve the penny-shaped crack problem. Two cases of boundary-value problems are considered, namely the permeable and impermeable crack boundary conditions. Exact solutions are obtained for elastic and electric fields. The main results are the stress intensity factor for singular stress and the electric displacement intensity factor. The numerical results are presented graphically to show the influence of applied mechanical and electrical loading on the analyzed quantities and to clarify the effect of anisotropy of piezoelectric materials. It is show that the influence of anisotropy of the materials on these fields is significant

  7. Constraining the factor analytical solutions obtained from multiple-year receptor modeling of ambient PM2.5 data from five speciation sites in Ontario, Canada

    Science.gov (United States)

    Sofowote, Uwayemi M.; Su, Yushan; Dabek-Zlotorzynska, Ewa; Rastogi, Ankit K.; Brook, Jeff; Hopke, Philip K.

    2015-05-01

    Rotational ambiguity in factor analyses leads to solutions that are not always consistent with reality. The inherent non-negativity constraints in positive matrix factorization (PMF) help to prevent factor solutions from becoming overly unrealistic, but they are not sufficient to prevent unwanted rotations that could manifest in factors that should have similar compositions varying across multiple sites. The Canadian National Air Pollution Surveillance (NAPS) network operates five fine particulate matter (PM2.5) speciation sites in Ontario. Data from these sites from 2005 to 2010 were subjected to PMF to obtain factors representing sources of particulate matter. Eight factors were found to be common across these sites. These factors had profiles that varied greatly from one site to the other, suggesting that the PMF solutions were impacted by some rotational ambiguity. New features in the EPA PMF V5 program allow the use of a priori information to impose mathematical constraints that guide the evolution of the factor solutions. These constraints reduce the rotational space. In situations where major emissions sources are known and located in the neighborhood of receptors, or emissions inventories and literature source profiles exist, it is easy to use these profiles to force the factor solutions to conform to the expected signatures. In our case, reported source profiles were neither available nor applicable due to the large spatial span of potential sources and receptor sites. This work describes how such constraints can be generated and used in these complex situations. The fundamental principle explored in this work is the concept of 'stiffness' of PMF solutions to identify the desirable non-rotating factors.

  8. Change processes in couple therapy: an intensive case analysis of one couple using a common factors lens.

    Science.gov (United States)

    Blow, Adrian J; Morrison, Nancy C; Tamaren, Karen; Wright, Kristin; Schaafsma, Melanie; Nadaud, Alison

    2009-07-01

    The article describes a research study that explored the process of how change occurred for one distressed couple and a specific therapist in a naturalistic setting. Quantitative and qualitative data were collected on the couple at multiple points in the therapy. A research team comprised of five members met regularly to analyze the data and collectively they arrived at a theory of change for the couple posttherapy. Conclusions are made related to how change occurred for the couple with an emphasis on the role of extratherapeutic events, client motivational factors, the therapeutic alliance, hope and expectancy factors, therapist factors, specific techniques and interventions, and other surprise factors that contributed to change.

  9. Intensity of cervical inflammatory reaction as a risk factor for recurrence of carcinoma of the uterine cervix in stages IB and IIA

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    José Humberto Tavares Guerreiro Fregnani

    Full Text Available CONTEXT AND OBJECTIVE: Inflammatory reaction intensity has been indicated as a possible recurrence risk factor in carcinoma of the uterine cervix. Some authors observed greater risk with weak inflammatory reaction, while others described the opposite. This study aimed to evaluate risk factors for initial-stage uterine cervix carcinoma recurrence (IB and IIA, considering inflammatory reaction intensity. DESIGN AND SETTING: Retrospective cohort at Hospital do Câncer A. C. Camargo. METHODS: 289 patients with diagnosed uterine cervix carcinoma (stages IB and IIA who underwent radical surgery between 1980 and 1999 were studied. Data were collected from medical records. Histological sections from tumors and lymph nodes could be reviewed in 247 cases. Five-year disease-free survival rates were calculated using the Kaplan-Meier method and curves were compared using the log-rank test. Cox's proportional-hazards model was used for multivariate analysis. Recurrence risk was estimated using hazard ratios (HR. RESULTS: Forty-three recurrences were found. Multivariate analysis identified the following independent recurrence risk factors: number of metastatic pelvic lymph nodes (one lymph node: HR = 3.3 [1.3-8.3]; two or three: HR = 5.3 [1.5-18.6]; four or more: HR = 7.6 [1.7-33.2], tumor invasion depth (deepest third: HR = 2.1 [1.1-4.1] and inflammatory reaction intensity in the uterine cervix (absent or slight: HR = 2.5 [1.1-5.7]. CONCLUSION: This study identified that absent or slight inflammatory reaction was an independent risk factor for recurrence. The other risk factors were the number of metastatic pelvic lymph nodes and invasion of the deepest third of the uterine cervix.

  10. Prevalence and risk factor's analysis of bovine brucellosis in peri-urban areas under intensive system of production in Gujarat, India

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    M. D. Patel

    2014-07-01

    Full Text Available Aim: A study on surveillance of bovine brucellosis in dairy herds of peri-urban areas under intensive system of production was carried out by milk-ELISA. Various risk factors were identified having significant association with occurrence of bovine brucellosis in dairy herds of peri-urban areas. Materials and Methods: Five randomly selected peri-uban areas of six cities of Gujarat were included in the present study. Five randomly selected dairy herds under intensive system of production from each selected peri-urban area were included for further investigation. In total, 199 bulk and 582 individual milk samples were screened by milk-ELISA. Forty three different risk factors were identified and grouped into four major categories as general characteristics of farms, introduction of infection to farms, management systems of farms and exposure of disease. Further, their distribution and association with prevalence of bovine brucellosis was studied. Results: The overall herd and animal prevalence in peri-urban areas was 33.70 and 11.90%, respectively. Out of 11 risk factors on general characteristics of dairy farms, only five (herd size, type of animals, type of breed, age of owner and knowledge gained by owners showed significant (p<0.05 association with occurrence of bovine brucellosis. None of risk factors on introduction of infection to farms (n=6 and management systems of farms (n=11 was found significantly associated with occurrence of brucellosis. Among risk factors on exposure of disease (n=15, history of abortion, retention of placenta, still birth and metritis/endometritis showed significant (p<0.05 association with prevalence of bovine brucellosis. Conclusion: It was concluded that prevalence of bovine brucellosis in dairy herds under intensive system of production in peri-urban areas of Gujarat was comparatively higher than reported overall prevalence of brucellosis. Risk factors like larger herd in close confinement without adequate sheds

  11. Overview of non-invasive factors (low level laser and low intensity pulsed ultrasound) accelerating tooth movement during orthodontic treatment.

    Science.gov (United States)

    Jawad, Mohammed Mahmood; Husein, Adam; Alam, Mohammad Khursheed; Hassan, Rozita; Shaari, Rumaizi

    2014-01-01

    The need for orthodontic treatment is increasing all the time. As the treatment is time consuming ranging from a year to several years, any method of reducing the period of treatment and increasing the quality of the tissue will be beneficial to patients. The use of non-invasive techniques such as low level laser therapy and low intensity pulsed ultasound in accelerating orthodontic tooth movement are promising. Thus, this overview study will help to generate more understanding about the background information and the possible applications of them in daily orthodontics, depending on previous literature searching for reviews and original research articles.

  12. Radiology clinical synopsis: a simple solution for obtaining an adequate clinical history for the accurate reporting of imaging studies on patients in intensive care units

    International Nuclear Information System (INIS)

    Cohen, Mervyn D.; Alam, Khurshaid

    2005-01-01

    Lack of clinical history on radiology requisitions is a universal problem. We describe a simple Web-based system that readily provides radiology-relevant clinical history to the radiologist reading radiographs of intensive care unit (ICU) patients. Along with the relevant history, which includes primary and secondary diagnoses, disease progression and complications, the system provides the patient's name, record number and hospital location. This information is immediately available to reporting radiologists. New clinical information is immediately entered on-line by the radiologists as they are reviewing images. After patient discharge, the data are stored and immediately available if the patient is readmitted. The system has been in routine clinical use in our hospital for nearly 2 years. (orig.)

  13. The influence of demographic and psychosocial factors on the intensity of pain among chronic patients receiving home-based nursing care

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    T Antony

    2016-01-01

    Full Text Available Aim: To determine the influence of the demographic and the psychosocial factors on the intensity of pain manifestation among the chronic ill patients. Materials and Methods: A descriptive, cross-sectional study was carried out among 328 chronic patients under home-based nursing care in Southern State of Kerala, India, from July to August 2015. Each patient was interviewed during a scheduled home visit by a trained health professional. The translated version of the assessment tool questionnaire "Medical Outcome Study-Short Form Health Survey" was used for the data collection. Results: Sixty-four (19.5% out of 328 patients reported pain as one of the primary symptoms of their disease. The percentage of the patients who were suffering from pain increases with the improvements in both the educational level and the monthly income (P = 0.002 and 0.019, respectively. The social interaction with the relatives and other community members was significantly related to pain manifestation (P = 0.013. A higher degree of social interaction was associated with lower pain intensity (P = 0.019. Conclusion: The results of this study showed that certain demographic and psychosocial factors carry a significant level of influence on the pain manifestation and its intensity among the chronic patients. Hence, improvements in education, economic status, and psychosocial support should be considered for the management of the chronic patients.

  14. Effect of high- versus low-intensity supervised aerobic and resistance training on modifiable cardiovascular risk factors in type 2 diabetes; the Italian Diabetes and Exercise Study (IDES.

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    Stefano Balducci

    Full Text Available BACKGROUND: While current recommendations on exercise type and volume have strong experimental bases, there is no clear evidence from large-sized studies indicating whether increasing training intensity provides additional benefits to subjects with type 2 diabetes. OBJECTIVE: To compare the effects of moderate-to-high intensity (HI versus low-to-moderate intensity (LI training of equal energy cost, i.e. exercise volume, on modifiable cardiovascular risk factors. DESIGN: Pre-specified sub-analysis of the Italian Diabetes and Exercise Study (IDES, a randomized multicenter prospective trial comparing a supervised exercise intervention with standard care for 12 months (2005-2006. SETTING: Twenty-two outpatient diabetes clinics across Italy. PATIENTS: Sedentary patients with type 2 diabetes assigned to twice-a-week supervised progressive aerobic and resistance training plus exercise counseling (n = 303. INTERVENTIONS: Subjects were randomized by center to LI (n = 142, 136 completed or HI (n = 161, 152 completed progressive aerobic and resistance training, i.e. at 55% or 70% of predicted maximal oxygen consumption and at 60% or 80% of predicted 1-Repetition Maximum, respectively, of equal volume. MAIN OUTCOME MEASURE(S: Hemoglobin (Hb A(1c and other cardiovascular risk factors; 10-year coronary heart disease (CHD risk scores. RESULTS: Volume of physical activity, both supervised and non-supervised, was similar in LI and HI participants. Compared with LI training, HI training produced only clinically marginal, though statistically significant, improvements in HbA(1c (mean difference -0.17% [95% confidence interval -0.44,0.10], P = 0.03, triglycerides (-0.12 mmol/l [-0.34,0.10], P = 0.02 and total cholesterol (-0.24 mmol/l [-0.46, -0.01], P = 0.04, but not in other risk factors and CHD risk scores. However, intensity was not an independent predictor of reduction of any of these parameters. Adverse event rate was similar in HI and LI subjects

  15. Cellular Levels of Signaling Factors Are Sensed by β-actin Alleles to Modulate Transcriptional Pulse Intensity

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    Alon Kalo

    2015-04-01

    Full Text Available The transcriptional response of β-actin to extra-cellular stimuli is a paradigm for transcription factor complex assembly and regulation. Serum induction leads to a precisely timed pulse of β-actin transcription in the cell population. Actin protein is proposed to be involved in this response, but it is not known whether cellular actin levels affect nuclear β-actin transcription. We perturbed the levels of key signaling factors and examined the effect on the induced transcriptional pulse by following endogenous β-actin alleles in single living cells. Lowering serum response factor (SRF protein levels leads to loss of pulse integrity, whereas reducing actin protein levels reveals positive feedback regulation, resulting in elevated gene activation and a prolonged transcriptional response. Thus, transcriptional pulse fidelity requires regulated amounts of signaling proteins, and perturbations in factor levels eliminate the physiological response, resulting in either tuning down or exaggeration of the transcriptional pulse.

  16. Stress-intensity factors for a wedge-loaded edge crack in a semi-infinite strip

    Science.gov (United States)

    Erodogan, F.; Terada, H.

    1977-01-01

    The problem of a semi infinite strip containing an edge crack is considered. It is assumed that the strip is loaded by a frictionless rigid wedge pressed into the crack. The resulting crack contact problem is formulated in terms of a system of singular integral equations. The behavior of the solution near the singular points is studied in detail. A series of numerical examples are given and the results are compared with those obtained by the method of boundary collocation and by the simple beam theory.

  17. Hepatoprotective Effect of Quercetin on Endoplasmic Reticulum Stress and Inflammation after Intense Exercise in Mice through Phosphoinositide 3-Kinase and Nuclear Factor-Kappa B

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    Yuhan Tang

    2016-01-01

    Full Text Available The mechanisms underlying intense exercise-induced liver damage and its potential treatments remain unclear. We explored the hepatoprotection and mechanisms of quercetin, a naturally occurring flavonoid, in strenuous exercise-derived endoplasmic reticulum stress (ERS and inflammation. Intense exercise (28 m/min at a 5° slope for 90 min resulted in the leakage of aminotransferases in the BALB/C mice. The hepatic ultrastructural malformations and oxidative stress levels were attenuated by quercetin (100 mg/kg·bw. Intense exercise and thapsigargin- (Tg- induced ERS (glucose-regulated protein 78, GRP78 and inflammatory cytokines levels (IL-6 and TNF-α were decreased with quercetin. Furthermore, quercetin resulted in phosphoinositide 3-kinase (PI3K induction, Ca2+ restoration, and blockade of the activities of Jun N-terminal kinase (JNK, activating transcription factor 6 (ATF6 and especially NF-κB (p65 and p50 nuclear translocation. A PI3K inhibitor abrogated the protection of quercetin on ERS and inflammation of mouse hepatocytes. SP600125 (JNK inhibitor, AEBSF (ATF6 inhibitor, and especially PDTC (NF-κB inhibitor enhanced the quercetin-induced protection against Tg stimulation. Collectively, intense exercise-induced ERS and inflammation were attenuated by quercetin. PI3K/Akt activation and JNK, ATF6, and especially NF-κB suppression were involved in the protection. Our results highlight a novel preventive strategy for treating ERS and inflammation-mediated liver damage induced by intense exercise using natural phytochemicals.

  18. Opportunities and limiting factors of intensive vegetable farming in malaria endemic Côte d'Ivoire.

    Science.gov (United States)

    Girardin, Olivier; Dao, Daouda; Koudou, Benjamin G; Essé, Clémence; Cissé, Guéladio; Yao, Tano; N'Goran, Eliézer K; Tschannen, Andreas B; Bordmann, Gérard; Lehmann, Bernard; Nsabimana, Christian; Keiser, Jennifer; Killeen, Gerry F; Singer, Burton H; Tanner, Marcel; Utzinger, Jürg

    2004-01-01

    Poverty reduction policies guide development strategies. In economies that depend heavily on agriculture, in the face of rapid population growth, innovative approaches are required to satisfy food needs, increase household welfare and alleviate poverty. Irrigated agriculture is an important strategy to enhance crop production, but it must be well tailored to specific socio-ecological settings, as otherwise, it might increase the burden of water-related parasitic diseases and delay economic advance. The purpose of this study is to assess and quantify the effect of ill health, particularly malaria, on the performance of farm activity, with an emphasis on drip-irrigated vegetable farming in rural Côte d'Ivoire. Vegetable yields and revenues were monitored among 12 farmers and linked with longitudinal medical and entomological surveys. Over the course of 10 months, farmers were classified as sick, on average, for 14-15 days, with malaria accounting for 8-9 days (58%), confirming that malaria is the most important disease in this setting. There was a large heterogeneity among farmers, with malaria-related work losses ranging between 0 and 26 days. Work absenteeism correlated with overall yields and revenues. During a single cabbage production cycle, those farmers who were prescribed sick because of malaria for more than 2 days (mean: 4.2 days) had 47% lower yields and 53% lower revenues than farmers who missed a maximum of 2 days (mean: 0.3 days). This is consequential in an intensive cropping system, where substitutes for qualified workers are not readily available. We conclude that mitigating the burden of malaria is an important step towards reducing the vulnerability of people engaged in intensive agricultural production. This calls for targeted interventions to facilitate agriculture-based rural development that might spur social and economic development and reduce inequities in sub-Saharan Africa.

  19. Risk Factors for Hearing Loss in Patients Treated With Intensity-Modulated Radiotherapy for Head-and-Neck Tumors

    International Nuclear Information System (INIS)

    Zuur, Charlotte L.; Simis, Yvonne J.; Lamers, Emmy A.; Hart, Augustinus A.; Dreschler, Wouter A.; Balm, Alfons J.; Rasch, Coen R.

    2009-01-01

    Purpose: Radiotherapy (RT) is a common treatment of head-and-neck carcinoma. The objective of this study was to perform a prospective multivariate assessment of the dose-effect relationship between intensity-modulated RT and hearing loss. Methods and Materials: Pure tone audiometry at 0.250-16 kHz was obtained before and after treatment in 101 patients (202 ears). All patients received full-course intensity-modulated RT (range, 56-70 Gy), with a median cochlear dose of 11.4 Gy (range, 0.2-69.7). Results: Audiometry was performed 1 week before and a median of 9 weeks (range, 1-112) after treatment. The mean hearing deterioration at pure tone average air-conduction 1-2-4 kHz was small (from 28.6 dB HL to 30.1 dB HL). However, individual patients showed clinically significant hearing loss, with 10-dB threshold shift incidences of 13% and 18% at pure tone averages air-conduction 1-2-4 kHz and 8-10-12.5 kHz, respectively. Post-treatment hearing capability was unfavorable in the case of greater inner ear radiation doses (p <0.0001), unfavorable baseline hearing capability (p <0.0001), green-eyed patients (p <0.0001), and older age (p <0.0001). Using multivariate analysis, a prediction of individual hearing capabiltity after treatment was made. Conclusion: RT-induced hearing loss in the mean population is modest. However, clinically significant hearing loss was observed in older patients with green eyes and unfavorable pretreatment hearing. In these patients, the intended radiation dose may be adjusted according to the proposed predictive model, aiming to decrease the risk of ototoxicity.

  20. Predictive Factors for Delayed Extubation in the Intensive Care Unit after Coronary Artery Bypass Grafting; A Southern Iranian Experience

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    Shahrbanoo Shahbazi

    2012-12-01

    Full Text Available Background: Early extubation is implemented in cardiothoracic units worldwide for its advantages such as decreased mortality, morbidity, and hospitalization costs. We conducted a retrospective study to evaluate potential factors which may affect extubation time. Methods: The records of 334 eligible patients who underwent elective coronary artery bypass grafting (CABG in 2008 in Kowsar Hospital in Shiraz, southern Iran were evaluated to find the factors that can affect the extubation time. The patients were divided to early (equal or less than 6 hours and late extubation groups. The patients’ demographic data and operative variables were extracted from the records. We excluded patients with difficult intubation, severe acid base disturbance, neurological problems, and cardiovascular instability; and those who used intra-aortic balloon pump, had underwent emergency operation, or had another concomitant surgery. Results: Multiple logistic regressions comparing age, sex, number of grafts, ejection fraction, pump time, hematocrit, number of risk factors, and number of inotropic drugs, identified only age as a predictor of delayed extubation (odds ratio=1.07, CI 95%=1.04-1.10, P<0.001. Also, in both studied groups the men to women ratio was higher (P<0.05.Conclusion: Although in our study age was the only predictive factor for delayed extubation, a comprehensive study including preoperative, perioperative, and postoperative factors is recommended in our area.

  1. Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study

    Science.gov (United States)

    2013-01-01

    Background The provision of Intensive Care (IC) can lead to a health care provider’s physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. Methods A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Results Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. Conclusions A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results

  2. Burnout in intensive care units - a consideration of the possible prevalence and frequency of new risk factors: a descriptive correlational multicentre study.

    Science.gov (United States)

    Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António Manuel; Carvalho, Ana Sofia

    2013-10-31

    The provision of Intensive Care (IC) can lead to a health care provider's physical, psychological and emotional exhaustion, which may develop into burnout. We notice the absence of specific studies regarding this syndrome in Portuguese Intensive Care Units (ICUs). Our main objective is to study the incidence and risk factors of burnout in Portuguese ICUs. A self-fulfilment questionnaire containing 3 items: (i) socio-demographic data of the study population; (ii) experiences in the workplace; (iii) Maslach Burnout Inventory (MBI) - was applied to evaluate the influence of distinct factors on the prevalence of burnout among physicians and nurses working in ICUs. Three hundred professionals (82 physicians and 218 nurses) from ten ICUs were included in the study, out of a total of 445 who were eligible. There was a high rate of burnout among professionals working in Portuguese ICUs, with 31% having a high level of burnout. However, when burnout levels among nurses and physicians were compared, no significant difference was found. Using multivariate analysis, we identified gender as being a risk factor, where female status increases the risk of burnout. In addition, higher levels of burnout were associated with conflicts and ethical decision making regarding withdrawing treatments. Having a temporary work contract was also identified as a risk factor. Conversely, working for another service of the same health care institution acts as a protective factor. A high rate of burnout was identified among professionals working in Portuguese ICUs. This study highlights some new risk factors for burnout (ethical decision making, temporary work contracts), and also protective ones (maintaining activity in other settings outside the ICU) that were not previously reported. Preventive and interventive programmes to avoid and reduce burnout syndrome are of paramount importance in the future organization of ICUs and should take the above results into account.

  3. Effect of host-related factors on the intensity of liver fibrosis in patients with chronic hepatitis C virus infection

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    Costa Luciano Bello

    2002-01-01

    Full Text Available There is increasing interest in the identification of factors associated with liver disease progression in patients infected with hepatitis C virus (HCV. We assessed host-related factors associated with a histologically advanced stage of this disease and determined the rate of liver fibrosis progression in HCV-infected patients. We included patients submitted to liver biopsy, who were anti-HCV and HCV RNA positive, who showed a parenteral risk factor (blood transfusion or intravenous drug use, and who gave information about alcohol consumption.Patients were divided into two groups for analysis: group 1 - grades 0 to 2; group 2 - grades 3 to 4. The groups were compared in terms of sex, age at the time of infection, estimated duration of infection and alcoholism. The rate of fibrosis progression (index of fibrosis was determined based on the relationship between disease stage and duration of infection (years. Logistic regression analysis revealed that age at the time of infection (P or = 40 years (median = 0.47. The main factors associated with a more rapid fibrosis progression were age at the time of infection and the estimated duration of infection. Patients who acquired HCV after 40 years of age showed a higher rate of fibrosis progression.

  4. Effect of Intense Lifestyle Modification and Cardiac Rehabilitation on Psychosocial Cardiovascular Disease Risk Factors and Quality of Life

    Science.gov (United States)

    Aldana, Steven G.; Whitmer, William R.; Greenlaw, Roger; Avins, Andrew L.; Thomas, Dean; Salberg, Audrey; Greenwell, Andrea; Lipsenthal, Lee; Fellingham, Gill W.

    2006-01-01

    This study examined the effect of the Ornish Program for Reversing Heart Disease and cardiac rehabilitation(CR) on psychosocial risk factors and quality of life in patients with confirmed coronary artery disease. Participants had previously undergone a revascularization procedure. The 84 patients self-selected to participate in the Ornish Program…

  5. Determination of the stress intensity factor (Ksub(I)) for a ceack-containing model subjected to tensile stress normal to the crack

    International Nuclear Information System (INIS)

    Nunez, C.; Molleda, F.; Carbajo, F.A.

    1981-01-01

    A theoretic-experimental method is described in this article for determination of the stress intensity factor at the tip of a crack made in a material when a load coplanar to the crack and perpendicular to it is applied. A photoelastic transmision method was used for the experiment. The backing model for the crack was made of a material capable of presenting bi-refrigerance when subjected to a stress condition. Formulae for the maximum shearing stress of the material starting from the stress functions ratified by the experiment have been obtained. (author)

  6. Risk Factors for Mortality in 272 Patients With Lung Transplant: A Multicenter Analysis of 7 Intensive Care Units.

    Science.gov (United States)

    Rello, Jordi; Bello, Irene; de Vicente, Rosario; Hermira Anchuelo, Ana; Ballesteros, Maria Ángeles; Iranzo, Reyes; Rellán, Luzdivina; Riera, Jordi; Robles, Juan Carlos

    2017-08-01

    One-year survival in lung transplant is around 85%, but this figure has not increased in recent years, in spite of technical improvements. Retrospective, multicenter cohort study. Data from 272 eligible adults with lung transplant were recorded at 7 intensive care units (ICU) in Spain in 2013. The objective was to identify variables that might help to guide future clinical interventions in order to reducethe risk of death in the postoperative period. One patient (0.3%) died in the operating room and 27 (10%) within 90 days. Twenty (7.4%) died within 28 days, after a median of 14 ICU days. Grade 3 pulmonary graft dysfunction was documented in 108 patients, of whom 21 died, compared with 6 out of 163 without pulmonary graft dysfunction (P60yr (OR: 2.91) and SOFA>8 (OR: 2.53) as independent predictors of 90-day mortality. At ICU admission, higher median procalcitonin (1.6 vs 0.6) and lower median PaO2/FiO2 (200 vs 280mmHg) were significantly associated with mortality. Graft dysfunction remains a significant problem in lung transplant. Early ICU interventions in patients with severe hypoxemia or high procalcitonin are crucial in order to lower mortality. Copyright © 2017 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Phase II intensive monitored cardiac rehabilitation for coronary artery disease and coronary risk factors--a six-session protocol.

    Science.gov (United States)

    Fletcher, B J; Thiel, J; Fletcher, G F

    1986-04-01

    To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal MET level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or myocardial infarction. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs.

  8. Host morphophysiological conditions and environment abiotic factors correlate with bat flies (Streblidae prevalence and intensity in Artibeus Leach, 1821 (Phyllostomidae

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    Priscilla Maria Peixoto Patrício

    2016-04-01

    Full Text Available ABSTRACT: The aim of this study was to correlate Streblidae parasitism rates with temperature and humidity as well as sex, age and reproductive condition of Artibeus bats. Streblidae specimens were collected during two years in the Tinguá Biological Reserve and in two areas inside buffer zone, located in Nova Iguaçu, Rio de Janeiro State and preserved as wet specimens. The abundance of Streblidae species parasitizing Artibeus was analyzed, and no differences were found between them. However, the number of females parasitizing Artibeus fimbriatus was higher. Moreover, regarding sex, Artibeus females were more parasitized, particularly A. fimbriatus and A. lituratus. There was no correlation between mean intensity of infestation and body mass index of Artibeus species, even when correlated to abiotic data. This study contributes to better understand the parasitism on Artibeus by Streblidae, and based on results, it is clear that Streblidae show no preferences in terms of reproductive condition, body size, age, sex, temperature and humidity in parasitizing Artibeus species.

  9. Oropharyngeal flora in patients admitted to the medical intensive care unit: clinical factors and acid suppressive therapy.

    Science.gov (United States)

    Frandah, Wesam; Colmer-Hamood, Jane; Mojazi Amiri, Hoda; Raj, Rishi; Nugent, Kenneth

    2013-05-01

    Acid suppression therapy in critically ill patients significantly reduces the incidence of stress ulceration and gastrointestinal (GI) bleeding; however, recent studies suggest that proton pump inhibitors (PPIs) increase the risk of pneumonia. We wanted to test the hypothesis that acid suppressive therapy promotes alteration in the bacterial flora in the GI tract and leads to colonization of the upper airway tract with pathogenic species, potentially forming the biological basis for the observed increased incidence of pneumonia in these patients. This was a prospective observational study on patients (adults 18 years or older) admitted to the medical intensive care unit (MICU) at a tertiary care centre. Exclusion criteria included all patients with a diagnosis of pneumonia at admission, with infection in the upper airway, or with a history of significant dysphagia. Oropharyngeal cultures were obtained on day 1 and days 3 or 4 of admission. We collected data on demographics, clinical information, and severity of the underlying disease using APACHE II scores. There were 110 patients enrolled in the study. The mean age was 49±16 years, 50 were women, and the mean APACHE II score was 9.8 ± 6.5. Twenty per cent of the patients had used a PPI in the month preceding admission. The first oropharyngeal specimen was available in 110 cases; a second specimen at 72-96 h was available in 68 cases. Seventy-five per cent of the patients admitted to the MICU had abnormal flora. In multivariate logistic regression, diabetes mellitus and PPI use were associated with abnormal oral flora on admission. Chronic renal failure and a higher body mass index reduced the frequency of abnormal oral flora on admission. Most critically ill patients admitted to our MICU have abnormal oral flora. Patients with diabetes and a history of recent PPI use are more likely to have abnormal oral flora on admission.

  10. Infection with multidrug-resistant gram-negative bacteria in a pediatric oncology intensive care unit: risk factors and outcomes.

    Science.gov (United States)

    Costa, Patrícia de Oliveira; Atta, Elias Hallack; Silva, André Ricardo Araújo da

    2015-01-01

    This study aimed at evaluating the predictors and outcomes associated with multidrug-resistant gram-negative bacterial (MDR-GNB) infections in an oncology pediatric intensive care unit (PICU). Data were collected relating to all episodes of GNB infection that occurred in a PICU between January of 2009 and December of 2012. GNB infections were divided into two groups for comparison: (1) infections attributed to MDR-GNB and (2) infections attributed to non-MDR-GNB. Variables of interest included age, gender, presence of solid tumor or hematologic disease, cancer status, central venous catheter use, previous Pseudomonas aeruginosa infection, healthcare-associated infection, neutropenia in the preceding 7 days, duration of neutropenia, length of hospital stay before ICU admission, length of ICU stay, and the use of any of the following in the previous 30 days: antimicrobial agents, corticosteroids, chemotherapy, or radiation therapy. Other variables included initial appropriate antimicrobial treatment, definitive inadequate antimicrobial treatment, duration of appropriate antibiotic use, time to initiate adequate antibiotic therapy, and the 7- and 30-day mortality. Multivariate logistic regression analyses showed significant relationships between MDR-GNB and hematologic diseases (odds ratio [OR] 5.262; 95% confidence interval [95% CI] 1.282-21.594; p=0.021) and healthcare-associated infection (OR 18.360; 95% CI 1.778-189.560; p=0.015). There were significant differences between MDR-GNB and non-MDR-GNB patients for the following variables: inadequate initial empirical antibiotic therapy, time to initiate adequate antibiotic treatment, and inappropriate antibiotic therapy. Hematologic malignancy and healthcare-associated infection were significantly associated with MDR-GNB infection in this sample of pediatric oncology patients. Copyright © 2015 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  11. Characteristics and risk factors of candidemia in pediatric intensive care unit of a tertiary care children's hospital in Egypt.

    Science.gov (United States)

    Hegazi, Moustafa; Abdelkader, Alaa; Zaki, Maysaa; El-Deek, Basem

    2014-05-14

    This study was conducted to determine characteristics of Candida colonization and candidemia in the pediatric intensive care unit (PICU) of a tertiary care children's hospital. Patients between 6 months and 15 years of age consecutively admitted to the PICU of Mansoura University Children's Hospital in Mansoura, Egypt, during one year period, were evaluated for Candida colonization and candidemia. Susceptibility of Candida species isolated from blood to fluconazole and amphotericin B was determined by Etest. Sixty-six patients without prior fluconazole prophylaxis had 88 episodes of candidemia, representing 19% of all cases with blood stream infections (BSIs). Candida albicans (CA) and non-albicans Candida (NAC) species accounted for 40% and 60% of candidemia episodes respectively. C. parapsilosis, C. tropicalis, and C. glabrata accounted for 25%, 17%, and 8% of NAC candidemias respectively. Fluconazole resistance was detected in 11.4% and 18.9% of CA and NAC isolates respectively. Of the fluconazole resistant NAC isolates, four were C. krusei. Amphotericin B resistance was detected in 17% of NAC isolates. Candida colonization was detected in 78.8% of patients. Compared to CA candidemia, higher risk for NAC candidemia was associated with age older than 1 year, Candida isolation from endotracheal tube (ETT) and from central venous catheter. Mortality rate was 42.4%, attributable mortality of candidemia was 16.7%. Regression analysis showed that the most significant independent predictors of death were ETT and mechanical ventilation (MV), MV longer than 7 days, and candiduria. This study presents important epidemiological features of Candida BSIs in a non-neonatal population.

  12. Patient-related factors and circumstances surrounding decisions to forego life-sustaining treatment, including intensive care unit admission refusal.

    Science.gov (United States)

    Reignier, Jean; Dumont, Romain; Katsahian, Sandrine; Martin-Lefevre, Laurent; Renard, Benoit; Fiancette, Maud; Lebert, Christine; Clementi, Eva; Bontemps, Frederic

    2008-07-01

    To assess decisions to forego life-sustaining treatment (LST) in patients too sick for intensive care unit (ICU) admission, comparatively to patients admitted to the ICU. Prospective observational cohort study. A medical-surgical ICU. Consecutive patients referred to the ICU during a one-yr period. None. Of 898 triaged patients, 147 were deemed too well to benefit from ICU admission. Decisions to forego LST were made in 148 of 666 (22.2%) admitted patients and in all 85 patients deemed too sick for ICU admission. Independent predictors of decisions to forego LST at ICU refusal rather than after ICU admission were: age; underlying disease; living in an institution; preexisting cognitive impairment; admission for medical reasons; and acute cardiac failure, acute central neurologic illness, or sepsis. Hospital mortality after decisions to forego LST was not significantly different in refused and admitted patients (77.5% vs. 86.5%; p = .1). Decisions to forego LST were made via telephone in 58.8% of refused patients and none of the admitted patients. Nurses caring for the patient had no direct contact with the ICU physicians for 62.3% of the decisions in refused patients, whereas meetings between nurses and physicians occurred in 70.3% of decisions to forego LST in the ICU. Patients or relatives were involved in 28.2% of decisions to forego LST at ICU refusal compared with 78.4% of decisions to forego LST in ICU patients (p refused patients (vs. none of admitted patients) and were associated with less involvement of nurses and relatives compared with decisions in admitted patients. Further work is needed to improve decisions to forego LST made under the distinctive circumstances of triage.

  13. Data-intensive science

    CERN Document Server

    Critchlow, Terence

    2013-01-01

    Data-intensive science has the potential to transform scientific research and quickly translate scientific progress into complete solutions, policies, and economic success. But this collaborative science is still lacking the effective access and exchange of knowledge among scientists, researchers, and policy makers across a range of disciplines. Bringing together leaders from multiple scientific disciplines, Data-Intensive Science shows how a comprehensive integration of various techniques and technological advances can effectively harness the vast amount of data being generated and significan

  14. INCIDENCE, OUTCOME AND RISK FACTORS FOR SEPSIS--A TWO YEAR RETROSPECTIVE STUDY AT SURGICAL INTENSIVE CARE UNIT OF A TEACHING HOSPITAL IN PAKISTAN.

    Science.gov (United States)

    Asghar, All; Hashmi, Madiha; Rashid, Saima; Khan, Fazal Hameed

    2016-01-01

    Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scares. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan. Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013. Two hundred and twenty-nine patients met the inclusion criteria. Average age of the patients was 46.35 ± 18.23 years (16-85), mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 15.92 ± 8.13 and males were 67.6%. Median length of ICU stay was 4 [IQR 5]. 43% patients fulfilled the criteria of sepsis at the time of admission to the SICU and incidence of severe sepsis/septic shock was 35%. Abdominal sepsis was the most frequent source of infection (57.5%). The overall intensive care unit mortality was 32.31% but the mortality of sepsis-group was 51.15% as compared to 17.7% of the non- sepsis group. Stepwise logistic regression model showed that increasing age, female gender, non-operative admission, admission under general surgery and co-morbidities like ischaemic heart disease and chronic kidney disease were significant predictors of sepsis. The incidence of sepsis and severe sepsis/septic shock, on admission to SICU is high and mortality of the sepsis group is nearly three times the mortality of the non-sepsis group.

  15. Incidence, outcome and risk factors for sepsis - a two year retrospective study at surgical intensive care unit of a teaching hospital in Pakistan

    International Nuclear Information System (INIS)

    Asghar, A.; Hashmi, M.; Rashid, S.; Khan, F.H.

    2016-01-01

    Background: Sepsis is amongst the leading causes of admission to the intensive care units and is associated with a high mortality. However, data from developing countries is scarse. Aim of conducting this study was to determine the incidence, outcome and risk factors for sepsis on admission to surgical intensive care unit (SICU) of a teaching hospital in Pakistan. Methods: Two year retrospective observational study included all consecutive adult admissions to the surgical intensive care unit (SICU) of a University Hospital, from January 2012 to December 2013. Results: Two hundred and twenty-nine patients met the inclusion criteria. Average age of the patients was 46.35±18.23 years (16-85), mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score was 15.92±8.13 and males were 67.6 percentage. Median length of ICU stay was 4 [IQR 5]. 43 percentage patients fulfilled the criteria of sepsis at the time of admission to the SICU and incidence of severe sepsis/septic shock was 35 percentage. Abdominal sepsis was the most frequent source of infection (57.5 percentage). The overall intensive care unit mortality was 32.31 percentage but the mortality of sepsis-group was 51.15 percentage as compared to 17.7 percentage of the non-sepsis group. Stepwise logistic regression model showed that increasing age, female gender, non-operative admission, admission under general surgery and co-morbidities like ischaemic heart disease and chronic kidney disease were significant predictors of sepsis. Conclusion: The incidence of sepsis and severe sepsis/septic shock, on admission to SICU is high and mortality of the sepsis group is nearly three times the mortality of the non-sepsis group. (author)

  16. Investigating the relationship between demographic and occupational factors with the intensity of nurse legs varicose veins in Amol hospitals

    OpenAIRE

    M. Mahbobi; M. Ghorbani; Z. Beheshti; AA. Haghdoost; H. Sharif Nia

    2010-01-01

    Background and aims   varicose of lower limbs is one of the most common injuries which is caused and intensified by the job activities through passing the time and can cause the person and the society to bear the high cost. This study has been done in order to investigate the relationship between the demographic and occupational factors with the lower limb varicose severity of the   nurses in Amol hospital.     Methods   This cross-sectional study was conducted through on 203 nurses in Amol h...

  17. Risk factors for the development of post-traumatic stress disorder and coping strategies in mothers and fathers following infant hospitalisation in the neonatal intensive care unit.

    Science.gov (United States)

    Aftyka, Anna; Rybojad, Beata; Rosa, Wojciech; Wróbel, Aleksandra; Karakuła-Juchnowicz, Hanna

    2017-12-01

    The aim of this study was to identify the potential risk factors for the development of post-traumatic stress disorder in mothers and fathers following infant hospitalisation in the neonatal intensive care unit. The development of neonatal intensive care units has increased the survival rate of infants. However, one of the major parental problems is post-traumatic stress disorder. An observational study covered 125 parents (72 mothers and 53 fathers) of infants aged 3-12 months who were hospitalised in the neonatal intensive care unit during the neonatal period. Third-referral neonatal intensive care unit. Several standardised and self-reported research tools were used to estimate the level of post-traumatic stress symptoms (Impact Event Scale-Revised), perceived stress (Perceived Stress Scale) and coping strategies (COPE Inventory). The respondents also completed a Parent and Infant Characteristic Questionnaire. The mothers and fathers did not differ in their parental and infant characteristics. Post-traumatic stress disorder was present in 60% of the mothers and 47% of the fathers. Compared to the fathers, the mothers felt greater stress (p = .020) and presented a higher severity of post-traumatic stress disorder (p post-traumatic stress disorder in the mothers. In the fathers, an Apgar test at 1 min after birth (p = .030) and a partner's post-traumatic stress disorder (p = .038) were related to post-traumatic stress disorder. The mothers compared to the fathers were more likely to use strategies such as: positive reinterpretation and growth, focusing on and venting of emotions, instrumental social support, religious coping and acceptance. In the fathers, the predictors included an Apgar score at 1 min after birth, a lack of congenital anomalies in the child and mental disengagement. Risk factors for post-traumatic stress disorder, as well as coping strategies, differ in women compare to men. Knowledge of risk factors for post-traumatic stress disorder

  18. Correlation between expressions of hypoxia -inducible factor (HIF-1α, blood vessels density, cell proliferation, and apoptosis intensity in canine fibromas and fibrosarcomas

    Directory of Open Access Journals (Sweden)

    Madej Janusz A.

    2014-03-01

    Full Text Available The study aimed to demonstrate the expression of hypoxia-inducible factor (HIF-1α in soft tissue mesenchymal tumours (fibroma and fibrosarcoma in dogs. An attempt was made to correlate the obtained results with density of blood vessels (expression of von Willebrand Factor, vWF, expression of Ki-67 proliferation antigen, and with intensity of apoptosis in studied tumours. The study was performed on paraffin sections of 15 fibromas and 40 fibrosarcomas sampled from 55 female dogs aged 6 to 16 years. Immunohistochemical staining against HIF-1α, vWF, and Ki-67 was performed. Apoptosis was detected with the use of TUNEL reaction. A significantly higher HIF-1α expression was noted in fibrosarcomas in comparison to fibromas (P < 0.0001. HIF-1α expression in fibromas manifested strong positive correlation with tumour vascularity (r = 0.67, P = 0.007. Moreover, HIF-1α expression in fibrosarcomas manifested a moderate positive correlation with tumour malignancy grade (r = 0.44, P = 0.004, tumour vascularity (r = 0.52, P < 0.001, Ki-67 antigen expression (r = 0.42; P = 0.007, and TUNELpositive cells (r = 0.37, P = 0.017. Expression of HIF-1α was detected in 86.7% of fibroma type tumours and in 100% of fibrosarcomas. In all studied tumours expression of HIF-1α manifested positive correlation with the density of blood vessels, and in fibrosarcomas it correlated also with malignancy grade, intensity of Ki-67 expression, and with intensity of apoptosis in tumour cells.

  19. Project of integrity assessment of flawed components with structural discontinuity (IAF). Data book for estimation stress intensity factor. Surface crack on ICM housing for penetration in reactor vessel

    International Nuclear Information System (INIS)

    2012-12-01

    The project of Integrity Assessment of Flawed Components with Structural Discontinuity (IAF) was entrusted to Japan Power Engineering and Inspection Corporation (JAPEIC) from Nuclear and Industrial Safety Agency (NISA) and started from FY 2001. And then, it was taken over to Japan Nuclear Energy Safety Organization (JNES) which was established in October 2003 and carried out until FY 2007. In the IAF project, weld joints between nickel based alloys and low alloy steels around penetrations in reactor vessel, safe-end of nozzles and shroud supports were selected from among components and pipe arrangements in nuclear power plants, where high residual stresses were generated due to welding and complex structure. Residual stresses around of the weld joints were estimated by finite element analysis method (FEM) with a general modeling method, then the reasonability and the conservativeness was evaluated. In addition, for postulated surface crack of stress corrosion cracking (SCC), a simple calculation method of stress intensity factor (K) required to estimate the crack growth was proposed and the effectiveness was confirmed. JNES compiled results of the IAF project into Data Books of Residual Stress Analysis of Weld Joint, and Data Book of Simplified Stress Intensity Factor Calculation for Penetration of Reactor as typical Structure Discontinuity, respectively. Data Books of Residual Stress Analysis in Weld Joint. 1. Butt Weld Joint of Small Diameter Cylinder (4B Sch40) (JNES-RE-2012-0005), 2. Dissimilar Metal Weld Joint in Safe End (One-Side Groove Joint (JNES-RE-2012-0006), 3. Dissimilar Metal Weld Joint in Safe End (Large Diameter Both-Side Groove Joint) (JNES-RE-2012-0007), 4. Weld Joint around Penetrations in Reactor Vessel (Insert Joint) (JNES-RE-2012-0008), 5. Weld Joint in Shroud Support (H8, H9, H10 and H11 Welds) (JNES-RE-2012-0009), 6. Analysis Model of Dissimilar Metal Weld Joint Applied Post Weld Heat Treatment (PWHT) (JNES-RE-2012-0010). Data Book of

  20. Entrepreneurship in the knowledge-intensive sector: Influential factors at the start-up and early growth phase

    DEFF Research Database (Denmark)

    Madsen, Henning; Neergaard, Helle; Fisker, Sannie

    The importance of SMEs for economic growth and employment has long been recognised, although the entrepreneurial activity in SMEs has not been understood all that well. In the light of this, a better understanding of entrepreneurs and their local environment might be helpful, since these are usua......The importance of SMEs for economic growth and employment has long been recognised, although the entrepreneurial activity in SMEs has not been understood all that well. In the light of this, a better understanding of entrepreneurs and their local environment might be helpful, since...... these are usually key factors in the discovery and exploitation of new opportunities. In order to research this situation into more details, a framework taking into account aspects of social, human and financial capita has been developed. Therefore, the purpose of this paper is to address the influence...

  1. Solution structure of CCP modules 10-12 illuminates functional architecture of the complement regulator, factor H.

    Science.gov (United States)

    Makou, Elisavet; Mertens, Haydyn D T; Maciejewski, Mateusz; Soares, Dinesh C; Matis, Ilias; Schmidt, Christoph Q; Herbert, Andrew P; Svergun, Dmitri I; Barlow, Paul N

    2012-12-14

    The 155-kDa plasma glycoprotein factor H (FH), which consists of 20 complement control protein (CCP) modules, protects self-tissue but not foreign organisms from damage by the complement cascade. Protection is achieved by selective engagement of FH, via CCPs 1-4, CCPs 6-8 and CCPs 19-20, with polyanion-rich host surfaces that bear covalently attached, activation-specific, fragments of complement component C3. The role of intervening CCPs 9-18 in this process is obscured by lack of structural knowledge. We have concatenated new high-resolution solution structures of overlapping recombinant CCP pairs, 10-11 and 11-12, to form a three-dimensional structure of CCPs 10-12 and validated it by small-angle X-ray scattering of the recombinant triple-module fragment. Superimposing CCP 12 of this 10-12 structure with CCP 12 from the previously solved CCP 12-13 structure yielded an S-shaped structure for CCPs 10-13 in which modules are tilted by 80-110° with respect to immediate neighbors, but the bend between CCPs 10 and 11 is counter to the arc traced by CCPs 11-13. Including this four-CCP structure in interpretation of scattering data for the longer recombinant segments, CCPs 10-15 and 8-15, implied flexible attachment of CCPs 8 and 9 to CCP 10 but compact and intimate arrangements of CCP 14 with CCPs 12, 13 and 15. Taken together with difficulties in recombinant production of module pairs 13-14 and 14-15, the aberrant structure of CCP 13 and the variability of 13-14 linker sequences among orthologues, a structural dependency of CCP 14 on its neighbors is suggested; this has implications for the FH mechanism. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Correlation between risk factors during the neonatal period and appearance of retinopathy of prematurity in preterm infants in neonatal intensive care units in Alexandria, Egypt

    Directory of Open Access Journals (Sweden)

    Abdel Hadi AM

    2013-05-01

    Full Text Available Ahmed Mahmoud Abdel Hadi, Islam Shereen HamdyDepartment of Ophthalmology, Alexandria University Hospital, Alexandria, EgyptBackground: This study aimed to identify the main risk factors for development of retinopathy of prematurity (ROP in neonatal intensive care units in Alexandria, Egypt, from January 2010 to January 2012.Methods: A prospective cohort study was undertaken in infants weighing < 1250 g and maternal postmenstrual age < 32 weeks if there was concern about prolonged exposure to oxygen. The main clinical outcomes were occurrence of any stage of ROP and in particular severe ROP. Perinatal variables considered were: birth weight, gestational age, gender, method of ventilation (nasal continuous airway pressure or intermittent mechanical ventilation, packed red blood cell and/or plasma transfusion, occurrence of sepsis, neonatal indirect hyperbilirubinemia, intraventricular hemorrhage, and patent ductus arteriosus. After obtaining informed consent from the parents, infants at risk were examined for ROP using indirect ophthalmoscopy, ie, RetCam II fundus photography.Results: The study included 152 infants of mean gestational age 31.02 weeks and mean birth weight 1.229 kg. Seventy-two cases (47.5% were male and 80 cases (52.5% were female. Of the cases screened, 100 (65.6% had no ROP, 52 had ROP of any stage (34.4%, and 27 (18% had stage 1, five (3.3% had stage 2, 17 (11.5% had stage 3, and three (1.6% had stage 4 disease. No infants had stage 5 ROP. Of all our cases with ROP, 15 (28.6% had prethreshold disease type 1 that required treatment, comprising 9.8% of all cases screened for ROP. Using stepwise logistic regression analysis, all risk factors studied were found to be significantly associated with the development of ROP, except for neonatal indirect hyperbilirubinemia. Severity of ROP was inversely proportional to birth weight and gestational age.Conclusion: ROP occurred in 34.4% of all infants screened in the neonatal intensive

  3. Malaria among rice farming communities in Kilangali village, Kilosa district, Central Tanzania: prevalence, intensity and associated factors.

    Science.gov (United States)

    Mazigo, Humphrey D; Rumisha, Susan F; Chiduo, Mercy G; Bwana, Veneranda M; Mboera, Leonard E G

    2017-07-05

    Malaria remains the most important cause of morbidity and mortality in Tanzania. However, its prevalence varies from area to area depending on various ecological, socio-economic and health system factors. This study was carried out to determine malaria prevalence and associated factors among rice farming communities in the Kilangali village of Kilosa District in Central Tanzania. A cross-sectional study was conducted in May 2015, involving randomly selected persons living in the six sub-villages of the Kilangali village, namely Mlegeni, Kisiwani, Makuruwili, Kwamtunga, Upogoroni and Chamwino. A finger prick blood sample was obtained for diagnosis of malaria infection using Giemsa-stained thick smears and a rapid malaria diagnostic test. Study participants were also screened for haemoglobin levels and a total of 570 children aged ≤ 12 years of age were examined for spleen enlargement using the palpation method. A total of 1154 persons were examined for malaria infection with mean age of 21.9 ± 19.69 years. The overall malaria prevalence was 14.2% and 17.5% based on microscopic examination and rapid diagnostic test, respectively. Plasmodium falciparum accounted for the majority (89%) of the malaria infections. The overall geometrical mean parasite density was 20.5 parasites/μL (95% CI: 14.6-28.8). Malaria prevalence and parasitaemia was highest among individuals living in the Mlegeni (23.9%) and Makuruwili (24.4%) sub-villages. Among the children examined for splenomegaly, 2.98% (17/570) had it. The overall prevalence of anaemia was 34.6%. Malaria infection was associated with the age groups of 1-10 years (aOR = 4.41, 95% CI: 1.96-9.93, P < 0.001) and 11-20 years (aOR = 6.68, 95% CI: 2.91-15.37, P < 0.001); and mild anaemia (aOR = 1.71, 95% CI: 1.11-2.62, P < 0.014) and moderate anaemia (aOR = 1.55, 95% CI: 1.01-2.39, P < 0.045). Malaria was found at the study setting and its prevalence varied according to the demographic

  4. Incidence of and risk factors for infection or colonization of vancomycin-resistant enterococci in patients in the intensive care unit.

    Directory of Open Access Journals (Sweden)

    Sung-Ching Pan

    Full Text Available The prevalence of vancomycin-resistant enterococci (VRE colonization or infection in the hospital setting has increased globally. Many previous studies had analysed the risk factors for acquiring VRE, based on cross-sectional studies or prevalent cases. However, the actual incidence of and risk factors for VRE remain unclear. The present study was conducted in order to clarify the incidence of and risk factors for VRE in the intensive care unit (ICU. From 1(st April 2008 to 31(st March 2009, all patients admitted to a surgical ICU (SICU were put on active surveillance for VRE. The surveillance cultures, obtained by rectal swab, were taken on admission, weekly while staying in the SICU, and on discharge from the SICU. A total of 871 patients were screened. Among them, 34 were found to carry VRE before their admission to the SICU, and 47 acquired VRE during their stay in the SICU, five of whom developed VRE infections. The incidence of newly acquired VRE during ICU stay was 21.9 per 1000 patient-days (95% confidence interval [CI], 16.4-29.1. Using multivariate analysis by logistic regression, we found that the length of ICU stay was an independent risk factor for new acquisition of VRE. In contrast, patients with prior exposure to first-generation cephalosporin were significantly less likely to acquire VRE. Strategies to reduce the duration of ICU stay and prudent usage of broad-spectrum antibiotics are the keys to controlling VRE transmission.

  5. Effects of resistance training combined with moderate-intensity endurance or low-volume high-intensity interval exercise on cardiovascular risk factors in patients with coronary artery disease.

    Science.gov (United States)

    Currie, Katharine D; Bailey, Kaitlyn J; Jung, Mary E; McKelvie, Robert S; MacDonald, Maureen J

    2015-11-01

    To determine the effects of resistance training combined with either moderate-intensity endurance or low-volume high-intensity interval training on cardiovascular risk profiles in patients with coronary artery disease. Factorial repeated-measures study design. Nineteen patients were randomized into moderate-intensity endurance (n = 10) or high-intensity interval (n = 9) groups, and attended 2 supervised exercise sessions a week for 6-months. The first 3-months involved exclusive moderate-intensity endurance or high-intensity interval exercise, after which progressive resistance training was added to both groups for the remaining 3-months. Fitness (VO(2)peak), blood pressure and heart rate, lipid profiles and health related quality of life assessments were performed at pretraining, 3 and 6-months training. VO(2)peak increased from pretraining to 3-months in both groups (moderate-intensity endurance: 19.8 ± 7.3 vs. 23.2 ± 7.4 ml kg(-1)min(-1); high-intensity interval: 21.1 ± 3.3 vs. 26.4 ± 5.2 ml kg(-1)min(-1), pexercise, while all remaining indices were unchanged. Low-volume high-intensity interval exercise did not elicit improvements in lipids or health related quality of life. Blood pressures and heart rates were unchanged with training in both groups. Findings from our pilot study suggest improvements in fitness occur within the first few months of training in patients with coronary artery disease, after which the addition of resistance training to moderate-intensity endurance and high-intensity interval exercise elicited no further improvements. Given the importance of resistance training in cardiac rehabilitation, additional research is required to determine its effectiveness when combined with high-intensity interval exercise. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  6. Prevalence, risk factors, clinical course, and outcome of acute kidney injury in Chinese intensive care units: a prospective cohort study.

    Science.gov (United States)

    Wen, Ying; Jiang, Li; Xu, Yuan; Qian, Chuan-yun; Li, Shu-sheng; Qin, Tie-he; Chen, Er-zhen; Lin, Jian-dong; Ai, Yu-hang; Wu, Da-wei; Wang, Yu-shan; Sun, Ren-hua; Hu, Zhen-jie; Cao, Xiang-yuan; Zhou, Fa-chun; He, Zhen-yang; Zhou, Li-hua; An, You-zhong; Kang, Yan; Ma, Xiao-chun; Yu, Xiang-you; Zhao, Ming-yan; Xi, Xiu-ming; DU, Bin

    2013-12-01

    Acute kidney injury (AKI) has been recognized as a major healthcare problem affecting millions of patients worldwide. However, epidemiologic data concerning AKI in China are still lacking. The objectives of this study were to characterize AKI defined by RIFLE criteria, assess the association with hospital mortality, and evaluate the impact of AKI in the context of other risk factors. This prospective multicenter observational study enrolled 3,063 consecutive patients from 1 July 2009 to 31 August 2009 in 22 ICUs across mainland China. We excluded patients who were admitted for less than 24 hours (n = 1623), younger than 18 years (n = 127), receiving chronic hemodialysis (n = 29), receiving renal transplantation (n = 1) and unknown reasons (n = 28). There were 1255 patients in the final analysis. AKI was diagnosed and classified according to RIFLE criteria. There were 396 patients (31.6%) who had AKI, with RIFLE maximum class R, I, and F in 126 (10.0%), 91 (7.3%), and 179 (14.3%) patients, respectively. Renal function deteriorated in 206 patients (16.4%). In comparison with non AKI patients, patients in the risk class on ICU admission were more likely to progress to the injury class (odds ratio (OR) 3.564, 95% confidence interval (CI) 1.706 - 7.443, P = 0.001], while patients in the risk class (OR 5.215, 95% CI 2.798-9.719, P patients in Chinese ICUs. In comparison with non-AKI patients, patients with RIFLE class R or class I on ICU admission were more susceptibility to progression to class I or class F. The RIFLE criteria were robust and correlated well with clinical deterioration and mortality.

  7. Molecular near-field antenna effect in resonance hyper-Raman scattering: Intermolecular vibronic intensity borrowing of solvent from solute through dipole-dipole and dipole-quadrupole interactions

    International Nuclear Information System (INIS)

    Shimada, Rintaro; Hamaguchi, Hiro-o

    2014-01-01

    We quantitatively interpret the recently discovered intriguing phenomenon related to resonance Hyper-Raman (HR) scattering. In resonance HR spectra of all-trans-β-carotene (β-carotene) in solution, vibrations of proximate solvent molecules are observed concomitantly with the solute β-carotene HR bands. It has been shown that these solvent bands are subject to marked intensity enhancements by more than 5 orders of magnitude under the presence of β-carotene. We have called this phenomenon the molecular-near field effect. Resonance HR spectra of β-carotene in benzene, deuterated benzene, cyclohexane, and deuterated cyclohexane have been measured precisely for a quantitative analysis of this effect. The assignments of the observed peaks are made by referring to the infrared, Raman, and HR spectra of neat solvents. It has been revealed that infrared active and some Raman active vibrations are active in the HR molecular near-field effect. The observed spectra in the form of difference spectra (between benzene/deuterated benzene and cyclohexane/deuterated cyclohexane) are quantitatively analyzed on the basis of the extended vibronic theory of resonance HR scattering. The theory incorporates the coupling of excited electronic states of β-carotene with the vibrations of a proximate solvent molecule through solute–solvent dipole–dipole and dipole–quadrupole interactions. It is shown that the infrared active modes arise from the dipole–dipole interaction, whereas Raman active modes from the dipole–quadrupole interaction. It is also shown that vibrations that give strongly polarized Raman bands are weak in the HR molecular near-field effect. The observed solvent HR spectra are simulated with the help of quantum chemical calculations for various orientations and distances of a solvent molecule with respect to the solute. The observed spectra are best simulated with random orientations of the solvent molecule at an intermolecular distance of 10 Å

  8. Molecular near-field antenna effect in resonance hyper-Raman scattering: Intermolecular vibronic intensity borrowing of solvent from solute through dipole-dipole and dipole-quadrupole interactions

    Energy Technology Data Exchange (ETDEWEB)

    Shimada, Rintaro; Hamaguchi, Hiro-o, E-mail: hhama@nctu.edu.tw [Department of Applied Chemistry and Institute of Molecular Science, National Chiao Tung University, 1001 University Road, Hsinchu 30010, Taiwan (China)

    2014-05-28

    We quantitatively interpret the recently discovered intriguing phenomenon related to resonance Hyper-Raman (HR) scattering. In resonance HR spectra of all-trans-β-carotene (β-carotene) in solution, vibrations of proximate solvent molecules are observed concomitantly with the solute β-carotene HR bands. It has been shown that these solvent bands are subject to marked intensity enhancements by more than 5 orders of magnitude under the presence of β-carotene. We have called this phenomenon the molecular-near field effect. Resonance HR spectra of β-carotene in benzene, deuterated benzene, cyclohexane, and deuterated cyclohexane have been measured precisely for a quantitative analysis of this effect. The assignments of the observed peaks are made by referring to the infrared, Raman, and HR spectra of neat solvents. It has been revealed that infrared active and some Raman active vibrations are active in the HR molecular near-field effect. The observed spectra in the form of difference spectra (between benzene/deuterated benzene and cyclohexane/deuterated cyclohexane) are quantitatively analyzed on the basis of the extended vibronic theory of resonance HR scattering. The theory incorporates the coupling of excited electronic states of β-carotene with the vibrations of a proximate solvent molecule through solute–solvent dipole–dipole and dipole–quadrupole interactions. It is shown that the infrared active modes arise from the dipole–dipole interaction, whereas Raman active modes from the dipole–quadrupole interaction. It is also shown that vibrations that give strongly polarized Raman bands are weak in the HR molecular near-field effect. The observed solvent HR spectra are simulated with the help of quantum chemical calculations for various orientations and distances of a solvent molecule with respect to the solute. The observed spectra are best simulated with random orientations of the solvent molecule at an intermolecular distance of 10 Å.

  9. Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands

    Science.gov (United States)

    Freidl, Gudrun S.; Spruijt, Ineke T.; Borlée, Floor; Smit, Lidwien A. M.; van Gageldonk-Lafeber, Arianne B.; Heederik, Dick J. J.; Yzermans, Joris; van Dijk, Christel E.; Maassen, Catharina B. M.; van der Hoek, Wim

    2017-01-01

    Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20–72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a questionnaire on respiratory health, lifestyle and other items. We retrieved additional information for 2,426/2,494 (97%) participants from electronic medical records (EMR) from general practitioners. The outcome was self-reported, physician-diagnosed pneumonia or pneumonia recorded in the EMR in the previous three years. Livestock license data was used to determine exposure to livestock. We quantified associations between livestock exposures and pneumonia using odds ratios adjusted for participant characteristics and comorbidities (aOR). The three-year cumulative frequency of pneumonia was 186/2,426 (7.7%). Residents within 2,000m of a farm with at least 50 goats had an increased risk of pneumonia, which increased the closer they lived to the farm (2,000m aOR 1.9, 95% CI 1.4–2.6; 500m aOR 4.4, 95% CI 2.0–9.8). We found no significant associations between exposure to other farm animals and pneumonia. However, when conducting sensitivity analyses using pneumonia outcome based on EMR only, we found a weak but statistically significant association with presence of a poultry farm within 1,000m (aOR: 1.7, 95% CI 1.1–2.7). Living close to goat and poultry farms still constitute risk factors for pneumonia. Individuals with pneumonia were not more often seropositive for Coxiella burnetii, indicating that results are not explained by Q fever. We strongly recommend identification of pneumonia causes by the use of molecular diagnostics and investigating the role of non

  10. Livestock-associated risk factors for pneumonia in an area of intensive animal farming in the Netherlands.

    Science.gov (United States)

    Freidl, Gudrun S; Spruijt, Ineke T; Borlée, Floor; Smit, Lidwien A M; van Gageldonk-Lafeber, Arianne B; Heederik, Dick J J; Yzermans, Joris; van Dijk, Christel E; Maassen, Catharina B M; van der Hoek, Wim

    2017-01-01

    Previous research conducted in 2009 found a significant positive association between pneumonia in humans and living close to goat and poultry farms. However, as this result might have been affected by a large goat-related Q fever epidemic, the aim of the current study was to re-evaluate this association, now that the Q-fever epidemic had ended. In 2014/15, 2,494 adults (aged 20-72 years) living in a livestock-dense area in the Netherlands participated in a medical examination and completed a questionnaire on respiratory health, lifestyle and other items. We retrieved additional information for 2,426/2,494 (97%) participants from electronic medical records (EMR) from general practitioners. The outcome was self-reported, physician-diagnosed pneumonia or pneumonia recorded in the EMR in the previous three years. Livestock license data was used to determine exposure to livestock. We quantified associations between livestock exposures and pneumonia using odds ratios adjusted for participant characteristics and comorbidities (aOR). The three-year cumulative frequency of pneumonia was 186/2,426 (7.7%). Residents within 2,000m of a farm with at least 50 goats had an increased risk of pneumonia, which increased the closer they lived to the farm (2,000m aOR 1.9, 95% CI 1.4-2.6; 500m aOR 4.4, 95% CI 2.0-9.8). We found no significant associations between exposure to other farm animals and pneumonia. However, when conducting sensitivity analyses using pneumonia outcome based on EMR only, we found a weak but statistically significant association with presence of a poultry farm within 1,000m (aOR: 1.7, 95% CI 1.1-2.7). Living close to goat and poultry farms still constitute risk factors for pneumonia. Individuals with pneumonia were not more often seropositive for Coxiella burnetii, indicating that results are not explained by Q fever. We strongly recommend identification of pneumonia causes by the use of molecular diagnostics and investigating the role of non-infectious agents

  11. Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: A multi regression and logistic analysis.

    Science.gov (United States)

    Rezende, Márcia; Loguercio, Alessandro D; Kossatz, Stella; Reis, Alessandra

    2016-02-01

    The aim of this study was to identify predictor factors associated with the whitening outcome and risk and intensity of bleaching-induced tooth sensitivity from pooled data of 11 clinical trials of dental bleaching performed by the same research group. The individual patient data of several published and ongoing studies about dental bleaching was collected and retrospectively analyzed. At the patient-level, independent variables (bleaching techniques [at-home and in-office protocols], sex, age and baseline tooth color in shade guide unit [SGU]) as well as dependent variables (color change in shade guide units (ΔSGU), color change in the CIEL*a*b* system (ΔE), risk and intensity of TS in a visual analog scale) were collected. Multivariable linear regression and multivariable logistic regression models were carried out using backward elimination whenever the p-values were higher than 0.05. A significant relationship between baseline color and age on color change estimates was detected (pwhitening degree of 0.07 for the final ΔSGU and 0.69 for the ΔE. The bleaching technique was shown to be a significant predictor of ΔSGU (prisk of TS for at-home bleaching was 51% (95% CI 41.4-60.6) and for the in-office 62.9% (95% CI 56.9-67.3). Younger patients with darker teeth reach a higher degree of whitening. Patient with darker teeth and submitted to at-home bleaching presents lower risk and intensity of TS. The baseline color of the teeth and the patient's age is directly related to the effectiveness of dental bleaching and TS. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. The relationship among pressure ulcer risk factors, incidence and nursing documentation in hospital-acquired pressure ulcer patients in intensive care units.

    Science.gov (United States)

    Li, Dan

    2016-08-01

    To explore the quality/comprehensiveness of nursing documentation of pressure ulcers and to investigate the relationship between the nursing documentation and the incidence of pressure ulcers in four intensive care units. Pressure ulcer prevention requires consistent assessments and documentation to decrease pressure ulcer incidence. Currently, most research is focused on devices to prevent pressure ulcers. Studies have rarely considered the relationship among pressure ulcer risk factors, incidence and nursing documentation. Thus, a study to investigate this relationship is needed to fill this information gap. A retrospective, comparative, descriptive, correlational study. A convenience sample of 196 intensive care units patients at the selected medical centre comprised the study sample. All medical records of patients admitted to intensive care units between the time periods of September 1, 2011 through September 30, 2012 were audited. Data used in the analysis included 98 pressure ulcer patients and 98 non-pressure ulcer patients. The quality and comprehensiveness of pressure ulcer documentation were measured by the modified European Pressure Ulcer Advisory Panel Pressure Ulcers Assessment Instrument and the Comprehensiveness in Nursing Documentation instrument. The correlations between quality/comprehensiveness of pressure ulcer documentation and incidence of pressure ulcers were not statistically significant. Patients with pressure ulcers had longer length of stay than patients without pressure ulcers stay. There were no statistically significant differences in quality/comprehensiveness scores of pressure ulcer documentation between dayshift and nightshift. This study revealed a lack of quality/comprehensiveness in nursing documentation of pressure ulcers. This study demonstrates that staff nurses often perform poorly on documenting pressure ulcer appearance, staging and treatment. Moreover, nursing documentation of pressure ulcers does not provide a complete

  13. Matrix metalloproteinase, tissue inhibitor of metalloproteinase and transforming growth factor-beta 1 in frozen shoulder, and their changes as response to intensive stretching and supervised neglect exercise.

    Science.gov (United States)

    Lubis, Andri Maruli Tua; Lubis, Vita Kurniati

    2013-07-01

    Frozen shoulder is characterized with thickening and contracture of joint capsular. The mechanism of this disorder is not yet clear, however, some proteins have been related to frozen shoulder. This study was to compare the serum levels of proteins related to frozen shoulder, such as matrix metalloproteinase (MMP), tissue inhibitor of metalloproteinase (TIMP) and transforming growth factor-beta (TGF-β) between frozen shoulder and normal subjects; and before and after physical exercise active stretching and gentle thawing in frozen shoulder patients. Serum levels of MMP-1, MMP-2, TIMP-1, TIMP-2, and TGF-β1 was measured from frozen shoulder and normal subjects by using ELISA. Functional assessment of shoulder joint in frozen shoulder patients was based on abbreviated Constant score. Frozen shoulder patients were randomly divided into intensive stretching and supervised neglect groups. Abbreviated Constant score and serum samples of frozen shoulder patients were evaluated at baseline, week-6, and week-12 after exercise, while only baseline serum samples of control were measured. MMP/TIMP ratio was calculated from the total sum of MMP-1 and MMP-2 levels divided by the total sum of TIMP-1 and TIMP-2 levels. Baseline MMP-1 and MMP-2 levels were significantly lower, while TIMP-1, TIMP-2, and TGF-β1 levels were significantly higher in frozen shoulder group than in control. Increased MMPs and decreased TIMPs were significantly greater after intensive stretching than after supervised neglect exercise. Abbreviated Constant score improvement was significantly higher in intensive stretching group than in supervised neglect group. Serum levels of MMP-1, MMP-2, TIMP-1, TIMP-2, and TGF-β1 may be associated to frozen shoulder. Active stretching can improve frozen shoulder better than supervised neglect, as demonstrated by the improvement of Constant score.

  14. Soft Factors, Smooth Transport? The role of safety climate and team processes in reducing adverse events during intrahospital transport in intensive care.

    Science.gov (United States)

    Latzke, Markus; Schiffinger, Michael; Zellhofer, Dominik; Steyrer, Johannes

    2017-11-15

    Intrahospital patient transports (IHTs) in intensive care involve an appreciable risk of adverse events (AEs). Research on determinants of AE occurrence during IHT has hitherto focused on patient, transport, and intensive care unit (ICU) characteristics. By contrast, the role of "soft" factors, although arguably relevant for IHTs and a topic of interest in general health care settings, has not yet been explored. The study aims at examining the effect of safety climate and team processes on the occurrence of AE during IHT and whether team processes mediate the effect of safety climate. Data stem from a noninterventional, observational multicenter study in 33 ICUs (from 12 European countries), with 858 transports overall recorded during 28 days. AEs include medication errors, dislodgments, equipment failures, and delays. Safety climate scales were taken from the "Patient Safety Climate in Healthcare Organizations" (short version), team processes scales from the "Leiden Operating Theatre and Intensive Care Safety" questionnaire. Patient condition was assessed with NEMS (Nine Equivalents of Nursing Manpower Use Score). All other variables could be directly observed. Hypothesis testing and assessment of effects rely on bivariate correlations and binomial logistic multilevel models (with ICU as random effect). Both safety climate and team processes are comparatively important determinants of AE occurrence, also when controlling for transport-, staff-, and ICU-related variables. Team processes partially mediate the effect of safety climate. Patient condition and transport duration are consistently related with AE occurrence, too. Unlike most patient, transport, and ICU characteristics, safety climate and team processes are basically amenable to managerial interventions. Coupled with their considerable effect on AE occurrence, this makes pertinent endeavors a potentially promising approach for improving patient safety during IHT. Although literature suggests that safety

  15. Liquid-Liquid Phase Separation in a Dual Variable Domain Immunoglobulin Protein Solution: Effect of Formulation Factors and Protein-Protein Interactions.

    Science.gov (United States)

    Raut, Ashlesha S; Kalonia, Devendra S

    2015-09-08

    Dual variable domain immunoglobulin proteins (DVD-Ig proteins) are large molecules (MW ∼ 200 kDa) with increased asymmetry because of their extended Y-like shape, which results in increased formulation challenges. Liquid-liquid phase separation (LLPS) of protein solutions into protein-rich and protein-poor phases reduces solution stability at intermediate concentrations and lower temperatures, and is a serious concern in formulation development as therapeutic proteins are generally stored at refrigerated conditions. In the current work, LLPS was studied for a DVD-Ig protein molecule as a function of solution conditions by measuring solution opalescence. LLPS of the protein was confirmed by equilibrium studies and by visually observing under microscope. The protein does not undergo any structural change after phase separation. Protein-protein interactions were measured by light scattering (kD) and Tcloud (temperature that marks the onset of phase separation). There is a good agreement between kD measured in dilute solution with Tcloud measured in the critical concentration range. Results indicate that the increased complexity of the molecule (with respect to size, shape, and charge distribution on the molecule) increases contribution of specific and nonspecific interactions in solution, which are affected by formulation factors, resulting in LLPS for DVD-Ig protein.

  16. Factors affecting the implementation of complex and evolving technologies: multiple case study of intensity-modulated radiation therapy (IMRT in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Bak Kate

    2011-07-01

    Full Text Available Abstract Background Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT in publicly funded cancer centres and identifies facilitating or impeding factors. Methods A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders. Results Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1 leadership, 2 training, expertise and standardization, 3 collaboration, 4 resources, and 5 resistance to change. Conclusion A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.

  17. Factors affecting the implementation of complex and evolving technologies: multiple case study of intensity-modulated radiation therapy (IMRT) in Ontario, Canada.

    Science.gov (United States)

    Bak, Kate; Dobrow, Mark J; Hodgson, David; Whitton, Anthony

    2011-07-31

    Research regarding the decision to adopt and implement technological innovations in radiation oncology is lacking. This is particularly problematic since these technologies are often complex and rapidly evolving, requiring ongoing revisiting of decisions regarding which technologies are the most appropriate to support. Variations in adoption and implementation decisions for new radiation technologies across cancer centres can impact patients' access to appropriate and innovative forms of radiation therapy. This study examines the key steps in the process of adopting and implementing intensity modulated radiation therapy (IMRT) in publicly funded cancer centres and identifies facilitating or impeding factors. A multiple case study design, utilizing document analysis and key informant interviews was employed. Four cancer centres in Ontario, Canada were selected and interviews were conducted with radiation oncologists, medical physicists, radiation therapists, and senior administrative leaders. Eighteen key informants were interviewed. Overall, three centres made fair to excellent progress in the implementation of IMRT, while one centre achieved only limited implementation as of 2009. Key factors that influenced the extent of IMRT implementation were categorized as: 1) leadership, 2) training, expertise and standardization, 3) collaboration, 4) resources, and 5) resistance to change. A framework for the adoption and implementation of complex and evolving technologies is presented. It identifies the key factors that should be addressed by decision-makers at specific stages of the adoption/implementation process.

  18. Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India.

    Science.gov (United States)

    Dasgupta, Sugata; Das, Soumi; Chawan, Neeraj S; Hazra, Avijit

    2015-01-01

    The increased morbidity and mortality associated with nosocomial infections in the intensive care unit (ICU) is a matter of serious concern today. To determine the incidence of nosocomial infections acquired in the ICU, their risk factors, the causative pathogens and the outcome in a tertiary care teaching hospital. This was a prospective observational study conducted in a 12 bedded combined medical and surgical ICU of a medical college hospital. The study group comprised 242 patients admitted for more than 48 h in the ICU. Data were collected regarding severity of the illness, primary reason for ICU admission, presence of risk factors, presence of infection, infecting agent, length of ICU and hospital stay, and survival status and logistic regression analysis was done. The nosocomial infection rate was 11.98% (95% confidence interval 7.89-16.07%). Pneumonia was the most frequently detected infection (62.07%), followed by urinary tract infections and central venous catheter associated bloodstream infections. Prior antimicrobial therapy, urinary catheterization and length of ICU stay were found to be statistically significant risk factors associated with nosocomial infection. Nosocomial infection resulted in a statistically significant increase in length of ICU and hospital stay, but not in mortality. Nosocomial infections increase morbidity of hospitalized patients. These findings can be utilized for planning nosocomial infection surveillance program in our setting.

  19. Simultaneous analysis of residual stress and stress intensity factor in a resist after UV-nanoimprint lithography based on electron moiré fringes

    International Nuclear Information System (INIS)

    Wang, Qinghua; Kishimoto, Satoshi

    2012-01-01

    In this study, the residual stress in a resist (PAK01) film and the stress intensity factor (SIF) of an induced crack are simultaneously estimated during ultraviolet nanoimprint lithography (UV-NIL) based on electron moiré fringes. A micro grid in a triangular arrangement on the resist film fabricated by UV-NIL is directly used as the model grid. Electron moiré fringes formed by the interference between the fabricated grid and the electron scan beam are used to measure the displacement distribution around the tip of a crack induced by the residual stress in the resist. The SIF of the crack is estimated using a displacement extrapolation method. The residual strain fields and the corresponding residual stress in the resist film far from the crack are determined and analyzed. This method is effective for evaluating the grid quality fabricated by the UV-NIL technique. (paper)

  20. Ethical decision making in intensive care units: a burnout risk factor? Results from a multicentre study conducted with physicians and nurses.

    Science.gov (United States)

    Teixeira, Carla; Ribeiro, Orquídea; Fonseca, António M; Carvalho, Ana Sofia

    2014-02-01

    Ethical decision making in intensive care is a demanding task. The need to proceed to ethical decision is considered to be a stress factor that may lead to burnout. The aim of this study is to explore the ethical problems that may increase burnout levels among physicians and nurses working in Portuguese intensive care units (ICUs). A quantitative, multicentre, correlational study was conducted among 300 professionals. The most crucial ethical decisions made by professionals working in ICU were related to communication, withholding or withdrawing treatments and terminal sedation. A positive relation was found between ethical decision making and burnout in nurses, namely, between burnout and the need to withdraw treatments (p=0.032), to withhold treatments (p=0.002) and to proceed to terminal sedation (p=0.005). This did not apply to physicians. Emotional exhaustion was the burnout subdimension most affected by the ethical decision. The nurses' lack of involvement in ethical decision making was identified as a risk factor. Nevertheless, in comparison with nurses (6%), it was the physicians (34%) who more keenly felt the need to proceed to ethical decisions in ICU. Ethical problems were reported at different levels by physicians and nurses. The type of ethical decisions made by nurses working in Portuguese ICUs had an impact on burnout levels. This did not apply to physicians. This study highlights the need for education in the field of ethics in ICUs and the need to foster inter-disciplinary discussion so as to encourage ethical team deliberation in order to prevent burnout.

  1. Clinical characteristics, prevalence, and factors related to delirium in children of 5 to 14 years of age admitted to intensive care.

    Science.gov (United States)

    Ricardo Ramirez, C; Álvarez Gómez, M L; Agudelo Vélez, C A; Zuluaga Penagos, S; Consuegra Peña, R A; Uribe Hernández, K; Mejía Gil, I C; Cano Londoño, E M; Elorza Parra, M; Franco Vásquez, J G

    2018-03-09

    To evaluate the clinical characteristics, prevalence and factors associated with delirium in critical patients from 5 to 14 years of age. An analytical, cross-sectional observational study was made. Delirium was assessed with the Pediatric-Confusion Assessment Method for the Intensive Care Unit (pCAM-ICU) and motor classification was established with the Delirium Rating Scale Revised-98. A pediatric Intensive Care Unit. All those admitted over a one-year period were assessed during the first 24-72h, or when possible in deeply sedated patients. Patients in stupor or coma, with severe communication difficulty, subjected to deep sedation throughout admission, and those with denied consent. Twenty-nine of the 156 assessed patients suffered delirium (18.6%) and 55.2% were hypoactive. The neurocognitive alterations evaluated by the pCAM-ICU were similar in the three motor groups. Intellectual disability (OR=17.54; 95%CI: 3.23-95.19), mechanical ventilation (OR=18.80; 95%CI: 4.29-82.28), liver failure (OR=54.88; 95%CI: 4.27-705.33), neurological disease (OR=4.41; 95%CI: 1.23-15.83), anticholinergic drug use (OR=3.23; 95%CI: 1.02-10.26), different psychotropic agents (OR=4.88; 95%CI: 1.42-16.73) and tachycardia (OR=4.74; 95%CI: 1.21-18.51) were associated to delirium according to the logistic regression analysis. The frequency of delirium and hypoactivity was high. It is therefore necessary to routinely evaluate patients with standardized instruments. All patients presented with important neurocognitive alterations. Several factors related with the physiopathology of delirium were associated to the diagnosis; some of them are modifiable through the rationalization of medical care. Copyright © 2018 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  2. Tumour necrosis factor inhibitors versus combination intensive therapy with conventional disease modifying anti-rheumatic drugs in established rheumatoid arthritis: TACIT non-inferiority randomised controlled trial.

    Science.gov (United States)

    Scott, David L; Ibrahim, Fowzia; Farewell, Vern; O'Keeffe, Aidan G; Walker, David; Kelly, Clive; Birrell, Fraser; Chakravarty, Kuntal; Maddison, Peter; Heslin, Margaret; Patel, Anita; Kingsley, Gabrielle H

    2015-03-13

    To determine whether intensive combinations of synthetic disease modifying drugs can achieve similar clinical benefits at lower costs to high cost biologics such as tumour necrosis factor inhibitors in patients with active rheumatoid arthritis resistant to initial methotrexate and other synthetic disease modifying drugs. Open label pragmatic randomised multicentre two arm non-inferiority trial over 12 months. 24 rheumatology clinics in England. Patients with rheumatoid arthritis who were eligible for treatment with tumour necrosis factor inhibitors according to current English guidance were randomised to either the tumour necrosis factor inhibitor strategy or the combined disease modifying drug strategy. Biologic strategy: start tumour necrosis factor inhibitor; second biologic in six month for non-responders. Alternative strategy: start combination of disease modifying drugs; start tumour necrosis factor inhibitors after six months in non-responders. reduction in disability at 12 months measured with patient recorded heath assessment questionnaire (range 0.00-3.00) with a 0.22 non-inferiority margin for combination treatment versus the biologic strategy. quality of life, joint damage, disease activity, adverse events, and costs. Intention to treat analysis used multiple imputation methods for missing data. 432 patients were screened: 107 were randomised to tumour necrosis factor inhibitors and 101 started taking; 107 were randomised to the combined drug strategy and 104 started taking the drugs. Initial assessments were similar; 16 patients were lost to follow-up (seven with the tumour necrosis factor inhibitor strategy, nine with the combined drug strategy); 42 discontinued the intervention but were followed-up (19 and 23, respectively). The primary outcome showed mean falls in scores on the health assessment questionnaire of -0.30 with the tumour necrosis factor inhibitor strategy and -0.45 with the alternative combined drug strategy. The difference between

  3. The triggering factors of the Móafellshyrna debris slide in northern Iceland: Intense precipitation, earthquake activity and thawing of mountain permafrost.

    Science.gov (United States)

    Sæmundsson, Þorsteinn; Morino, Costanza; Helgason, Jón Kristinn; Conway, Susan J; Pétursson, Halldór G

    2018-04-15

    On the 20th September 2012, a large debris slide occurred in the Móafellshyrna Mountain in the Tröllaskagi peninsula, central north Iceland. Our work describes and discusses the relative importance of the three factors that may have contributed to the failure of the slope: intense precipitation, earthquake activity and thawing of ground ice. We use data from weather stations, seismometers, witness reports and field observations to examine these factors. The slide initiated after an unusually warm and dry summer followed by a month of heavy precipitation. Furthermore, the slide occurred after three seismic episodes, whose epicentres were located ~60km NNE of Móafellshyrna Mountain. The main source of material for the slide was ice-rich colluvium perched on a topographic bench. Blocks of ice-cemented colluvium slid and then broke off the frontal part of the talus slope, and the landslide also involved a component of debris slide, which mobilized around 312,000-480,000m 3 (as estimated from field data and aerial images of erosional morphologies). From our analysis we infer that intense precipitation and seismic activity prior to the slide are the main preparatory factors for the slide. The presence of ice-cemented blocks in the slide's deposits leads us to infer that deep thawing of ground ice was likely the final triggering factor. Ice-cemented blocks of debris have been observed in the deposits of two other recent landslides in northern Iceland, in the Torfufell Mountain and the Árnesfjall Mountain. This suggests that discontinuous mountain permafrost is degrading in Iceland, consistent with the decadal trend of increasing atmospheric temperature in Iceland. This study highlights a newly identified hazard in Iceland: landslides as a result of ground ice thaw. Knowledge of the detailed distribution of mountain permafrost in colluvium on the island is poorly constrained and should be a priority for future research in order to identify zones at risk from this

  4. Factors associated with catheter-associated urinary tract infections and the effects of other concomitant nosocomial infections in intensive care units.

    Science.gov (United States)

    Temiz, Ekrem; Piskin, Nihal; Aydemir, Hande; Oztoprak, Nefise; Akduman, Deniz; Celebi, Guven; Kokturk, Furuzan

    2012-05-01

    Catheter-associated urinary tract infections (CAUTIs) are the most common nosocomial infections in intensive care units (ICUs). The objectives of this study were to describe the incidence, aetiology, and risk factors of CAUTIs in ICUs and to determine whether concomitant nosocomial infections alter risk factors. Between April and October 2008, all adult catheterized patients admitted to the ICUs of Zonguldak Karaelmas University Hospital were screened daily, and clinical and microbiological data were collected for each patient. Two hundred and four patients were included and 85 developed a nosocomial infection. Among these patients, 22 developed a CAUTI alone, 38 developed a CAUTI with an additional nosocomial infection, either concomitantly or prior to the onset of the CAUTI, and 25 developed nosocomial infections at other sites. The CAUTI rate was 19.02 per 1000 catheter-days. A Cox proportional hazard model showed that in the presence of other site nosocomial infections, immune suppression (hazard ratio (HR) 3.73, 95% CI 1.47-9.46; p = 0.006), previous antibiotic usage (HR 2.06, 95% CI 1.11-3.83; p = 0.023), and the presence of a nosocomial infection at another site (HR 1.82, 95% CI 1.04-3.20; p = 0.037) were the factors associated with the acquisition of CAUTIs with or without a nosocomial infection at another site. When we excluded the other site nosocomial infections to determine if the risk factors differed depending on the presence of other nosocomial infections, female gender (HR 2.67, 95% CI 1.03-6.91; p = 0.043) and duration of urinary catheterization (HR 1.07 (per day), 95% CI 1.01-1.13; p = 0.019) were found to be the risk factors for the acquisition of CAUTIs alone. Our results showed that the presence of nosocomial infections at another site was an independent risk factor for the acquisition of a CAUTI and that their presence alters risk factors.

  5. Assessment of risk factors related to healthcare-associated methicillin-resistant Staphylococcus aureus infection at patient admission to an intensive care unit in Japan

    Directory of Open Access Journals (Sweden)

    Ogura Hiroshi

    2011-11-01

    Full Text Available Abstract Background Healthcare-associated methicillin-resistant Staphylococcus aureus (HA-MRSA infection in intensive care unit (ICU patients prolongs ICU stay and causes high mortality. Predicting HA-MRSA infection on admission can strengthen precautions against MRSA transmission. This study aimed to clarify the risk factors for HA-MRSA infection in an ICU from data obtained within 24 hours of patient ICU admission. Methods We prospectively studied HA-MRSA infection in 474 consecutive patients admitted for more than 2 days to our medical, surgical, and trauma ICU in a tertiary referral hospital in Japan. Data obtained from patients within 24 hours of ICU admission on 11 prognostic variables possibly related to outcome were evaluated to predict infection risk in the early phase of ICU stay. Stepwise multivariate logistic regression analysis was used to identify independent risk factors for HA-MRSA infection. Results Thirty patients (6.3% had MRSA infection, and 444 patients (93.7% were infection-free. Intubation, existence of open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission, were detected as independent prognostic indicators. Patients with intubation or open wound comprised 96.7% of MRSA-infected patients but only 57.4% of all patients admitted. Conclusions Four prognostic variables were found to be risk factors for HA-MRSA infection in ICU: intubation, open wound, treatment with antibiotics, and steroid administration, all occurring within 24 hours of ICU admission. Preemptive infection control in patients with these risk factors might effectively decrease HA-MRSA infection.

  6. Risk factors for infection and/or colonisation with extended-spectrum β-lactamase-producing bacteria in the neonatal intensive care unit: a meta-analysis.

    Science.gov (United States)

    Li, Xuan; Xu, Xuan; Yang, Xianxian; Luo, Mei; Liu, Pin; Su, Kewen; Qing, Ying; Chen, Shuai; Qiu, Jingfu; Li, Yingli

    2017-11-01

    Extended-spectrum β-lactamase (ESBL)-producing bacteria are an important cause of healthcare-associated infections in the neonatal intensive care unit (NICU). The aim of this meta-analysis was to identify risk factors associated with infection and/or colonisation with ESBL-producing bacteria in the NICU. Electronic databases were searched for relevant studies published from 1 January 2000 to 1 July 2016. The literature was screened and data were extracted according to the inclusion and exclusion criteria. The Z-test was used to calculate the pooled odds ratio (OR) of the risk factors. ORs and their 95% confidence intervals were used to determine the significance of the risk. A total of 14 studies, including 746 cases and 1257 controls, were identified. Thirteen risk factors were determined to be related to infection and/or colonisation with ESBL-producing bacteria in the NICU: birthweight [standardised mean difference (SMD) = 1.17]; gestational age (SMD = 1.36); Caesarean delivery (OR = 1.76); parenteral nutrition (OR = 7.51); length of stay in the NICU (SMD = 0.72); mechanical ventilation (OR = 4.8); central venous catheter use (OR = 2.85); continuous positive airway pressure (OR = 5.0); endotracheal intubation (OR = 2.82); malformations (OR = 2.89); previous antibiotic use (OR = 6.72); ampicillin/gentamicin (OR = 2.31); and cephalosporins (OR = 6.0). This study identified risk factors for infection and/or colonisation with ESBL-producing bacteria in the NICU, which may provide a theoretical basis for preventive measures and targeted interventions. Copyright © 2017 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  7. SIMULTANEOUS ABSORPTION AND DESORPTION WITH REVERSIBLE 1ST-ORDER CHEMICAL-REACTION - ANALYTICAL SOLUTION AND NEGATIVE ENHANCEMENT FACTORS

    NARCIS (Netherlands)

    WINKELMAN, JGM; BEENACKERS, AACM

    The problem of ps absorption accompanied by a first-order reversible reaction, producing a volatile reaction product, is considered. A general analytical solution is developed for the film model, resulting in explicit relations for the concentration profiles in the film and for the mass transfer

  8. Costs and risk factors for ventilator-associated pneumonia in a Turkish University Hospital's Intensive Care Unit: A case-control study

    Directory of Open Access Journals (Sweden)

    Serin Simay

    2004-04-01

    Full Text Available Abstract Background Ventilator-associated pneumonia (VAP which is an important part of all nosocomial infections in intensive care unit (ICU is a serious illness with substantial morbidity and mortality, and increases costs of hospital care. We aimed to evaluate costs and risk factors for VAP in adult ICU. Methods This is a-three year retrospective case-control study. The data were collected between 01 January 2000 and 31 December 2002. During the study period, 132 patients were diagnosed as nosocomial pneumonia of 731 adult medical-surgical ICU patients. Of these only 37 VAP patients were assessed, and multiple nosocomially infected patients were excluded from the study. Sixty non-infected ICU patients were chosen as control patients. Results Median length of stay in ICU in patients with VAP and without were 8.0 (IQR: 6.5 and 2.5 (IQR: 2.0 days respectively (P Conclusion Respiratory failure, coma, depressed consciousness, enteral feeding and length of stay are independent risk factors for developing VAP. The cost of VAP is approximately five-fold higher than non-infected patients.

  9. Invasive candidiasis in intensive care units in China: Risk factors and prognoses of Candida albicans and non-albicans Candida infections.

    Science.gov (United States)

    Gong, Xiaoying; Luan, Ting; Wu, Xingmao; Li, Guofu; Qiu, Haibo; Kang, Yan; Qin, Bingyu; Fang, Qiang; Cui, Wei; Qin, Yingzhi; Li, Jianguo; Zang, Bin

    2016-05-01

    To investigate the risk factors and prognoses of patients with invasive Candida albicans and non-albicans Candida (NAC) infection in intensive care units (ICUs) in China. Between November 2009 and April 2011, we performed a prospective study of critically ill patients with invasive Candida infection from 67 ICUs across China to compare the risk factors and mortality between patients with C albicans and NAC infection. There were 306 patients with proven invasive Candida; 244 cases (a total 389 Candida isolates) were sent to laboratory for strain identification (C albicans, 40.1%; NAC, 59.9%). More patients admitted for surgery or trauma had NAC infection than C albicans infection. C albicans infection was more common in patients with subclavian vein catheters or peritoneal drainage tubes. Compared with patients with C albicans infection, patients with NAC infection had longer antifungal therapy (P albicans remains the most common pathogen in candidiasis in critical care patients. However, the number of NAC infections exceeded C albicans infections. Compared with patients with C albicans infection, patients with NAC infection had heavier disease burdens. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Temporal lobe injury after re-irradiation of locally recurrent nasopharyngeal carcinoma using intensity modulated radiotherapy: clinical characteristics and prognostic factors.

    Science.gov (United States)

    Liu, Shuai; Lu, Taixiang; Zhao, Chong; Shen, Jingxian; Tian, Yunming; Guan, Ying; Zeng, Lei; Xiao, Weiwei; Huang, Shaomin; Han, Fei

    2014-09-01

    Temporal lobe injury (TLI) is a debilitating complication after radiotherapy for nasopharyngeal carcinoma (NPC), especially in patients who suffer treatment relapses and receive re-irradiation. We explored the clinical characteristics and prognostic factors of TLI in locally recurrent NPC (rNPC) patients after re-irradiation using intensity modulated radiotherapy (IMRT). A total of 454 temporal lobes (TLs) from 227 locally rNPC patients were reviewed. The clinical characteristics of TLI were analyzed. In the two radiotherapy courses, the equivalent dose in 2 Gy per fraction (EQD2) for the TLs was recalculated to facilitate comparison of the individual data. The median follow-up time was 31 (range, 3-127) months. After re-irradiation using IMRT, 31.3 % (71/227) of patients developed TLI. The median latency of TLI was 15 (range, 4-100) months. Univariate and multivariate analysis showed that the interval time (IT) between the two courses of radiotherapy and the summation of the maximum doses of the two radiotherapy courses (EQD2 - ∑max) were independent factors influencing TLI. The 5-year incidence of TLI for an IT ≤26 or >26 months was 35.9 and 53.7 % respectively (p = 0.024). The median maximum doses delivered to the injured TLs were significantly higher than was the case for the uninjured TLs after two courses of radiotherapy (135.3 and 129.8 Gy, respectively: p 2-year interval was found to be relatively safe.

  11. Influenza in hospitalized children in Ireland in the pandemic period and the 2010/2011 season: risk factors for paediatric intensive-care-unit admission.

    LENUS (Irish Health Repository)

    Rebolledo, J

    2013-11-11

    SUMMARY Influenza causes significant morbidity and mortality in children. This study\\'s objectives were to describe influenza A(H1N1)pdm09 during the pandemic, to compare it with circulating influenza in 2010\\/2011, and to identify risk factors for severe influenza defined as requiring admission to a paediatric intensive care unit (PICU). Children hospitalized with influenza during the pandemic were older, and more likely to have received antiviral therapy than children hospitalized during the 2010\\/2011 season. In 2010\\/2011, only one child admitted to a PICU with underlying medical conditions had been vaccinated. The risk of severe illness in the pandemic was higher in females and those with underlying conditions. In 2010\\/2011, infection with influenza A(H1N1)pdm09 compared to other influenza viruses was a significant risk factor for severe disease. An incremental relationship was found between the number of underlying conditions and PICU admission. These findings highlight the importance of improving low vaccination uptake and increasing the use of antivirals in vulnerable children.

  12. Patients Hospitalized in General Wards via the Emergency Department: Early Identification of Predisposing Factors for Death or Unexpected Intensive Care Unit Admission—A Historical Prospective

    Directory of Open Access Journals (Sweden)

    Thierry Boulain

    2014-01-01

    Full Text Available Background. To identify, upon emergency department (ED admission, predictors of unexpected death or unplanned intensive care/high dependency units (ICU/HDU admission during the first 15 days of hospitalization on regular wards. Methods. Prospective cohort study in a medical-surgical adult ED in a teaching hospital, including consecutive patients hospitalized on regular wards after ED visit, and identification of predictors by logistic regression and Cox proportional hazards model. Results. Among 4,619 included patients, 77 (1.67% target events were observed: 32 unexpected deaths and 45 unplanned transfers to an ICU/HDU. We identified 9 predictors of the target event including the oxygen administration on the ED, unknown current medications, and use of psychoactive drug(s. All predictors put the patients at risk during the first 15 days of hospitalization. A logistic model for hospital mortality prediction (death of all causes still comprised oxygen administration on the ED, unknown current medications, and the use of psychoactive drug(s as risk factors. Conclusion. The “use of oxygen therapy on the ED,” the “current use of psychoactive drug(s”, and the “lack of knowledge of current medications taken by the patients” were important predisposing factors to severe adverse events during the 15 days of hospitalization on regular wards following the ED visit.

  13. Fatores de risco para óbito em Unidade de Terapia Intensiva Neonatal Risk factors for death in the Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Luiz Fernando C. Nascimento

    2009-06-01

    Full Text Available OBJETIVO:Estimar fatores de risco para óbito durante internação em uma Unidade de Terapia Intensiva Neonatal (UTIN por modelo logístico hierarquizado. MÉTODOS: Trata-se de estudo observacional, analítico e longitudinal com recém-nascidos internados na UTIN de um hospital universitário, no período de janeiro/2000 a dezembro/2003. A variável dependente foi óbito intra-hospitalar e as independentes foram variáveis antenatais, perinatais e pós-natais. Criou-se um modelo hierarquizado em três níveis. Realizada a análise bivariada, foram incluídas no modelo as que apresentavam pOBJECTIVE:To estimate the risk factors for mortality during hospitalization in a Neonatal Intensive Care Unit (NICU using a hierarchical logistic model. METHODS:This longitudinal, observational and analytical study enrolled newborns admitted to the NICU from January/2001 to December/2003. The outcome analyzed was in-hospital death and the independent variables were prenatal, perinatal and postnatal factors. A hierarchical model with three levels was built. The variables with p<0.20 by bivariated analysis were included in the model and, after adjustment at the same level, variables with p<0.05 were maintained in the logistic model. Statistic analysis was performed by SPSS.10, software that estimated the accuracy of the model, adopting significance as p<0.05. RESULTS: Among 367 newborns included, 69 (18.8% died during hospital stay. The following risk factors comprised the hierarchical model of logistic regression and were significantly associated with death among the studied neonates: previous stillbirth, being first or second child, Apgar at five minutes below 7, preterm newborn and use of mechanical ventilation. This model had 86.9% of accuracy. CONCLUSIONS: The model obtained in this study has variables of the three hierarchical levels and might be used in Neonatal Intensive Care Units that share the same characteristic of the unit herein studied.

  14. The Three-Dimensional Solution Structure of the Src Homology Domain-2 of the Growth Factor Receptor-Bound Protein-2

    International Nuclear Information System (INIS)

    Senior, Mary M.; Frederick, Anne F.; Black, Stuart; Murgolo, Nicholas J.; Perkins, Louise M.; Wilson, Oswald; Snow, Mark E.; Wang Yusen

    1998-01-01

    A set of high-resolution three-dimensional solution structures of the Src homology region-2 (SH2) domain of the growth factor receptor-bound protein-2 was determined using heteronuclear NMR spectroscopy. The NMR data used in this study were collected on a stable monomeric protein solution that was free of protein aggregates and proteolysis. The solution structure was determined based upon a total of 1439 constraints, which included 1326 nuclear Overhauser effect distance constraints, 70 hydrogen bond constraints, and 43 dihedral angle constraints. Distance geometry-simulated annealing calculations followed by energy minimization yielded a family of 18 structures that converged to a root-mean-square deviation of 1.09 A for all backbone atoms and 0.40 A for the backbone atoms of the central β-sheet. The core structure of the SH2 domain contains an antiparallel β-sheet flanked by two parallel α-helices displaying an overall architecture that is similar to other known SH2 domain structures. This family of NMR structures is compared to the X-ray structure and to another family of NMR solution structures determined under different solution conditions

  15. [Comparision of risk factors and pathogens in patients with early- and late-onset ventilator-associated pneumonia in intensive care unit].

    Science.gov (United States)

    Liang, Y J; Li, Z L; Wang, L; Liu, B Y; Ding, R Y; Ma, X C

    2017-10-01

    Objective: To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU). Methods: This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital, China Medical University from Jan 2012 to Jun 2016. Subjects were classified by ventilator status: early-onset VAP (VAP) or late-onset VAP (≥ 5 d ventilation, L-VAP). Potential risk factors and pathogen were evaluated. Results: A total of 4 179 patients in adult ICU were screened, 3 989 (95.5%) of whom were mechanically ventilated, 962 patients with mechanical ventilation time ≥ 48 h. VAP developed in 142 patients. E-VAP and L-VAP had different potential risk factors based on statistical analysis.Independent risk factors for E-VAP included male ( OR =1.825, 95% CI 1.006-3.310), chronic obstructive pulmonary disease (COPD; OR =3.746, 95% CI 1.795-7.818), emergency intubation ( OR =1.932, 95% CI 1.139-3.276), aspiration ( OR =3.324, 95% CI 1.359-8.130). Whereas independent risk factors for L-VAP were coma ( OR =2.335, 95% CI 1.300-4.194), renal dysfunction ( OR =0.524, 95% CI 0.290-0.947), emergency intubation ( OR =2.184, 95% CI 1.334-3.574). Mortality in E-VAP and L-VAP group were both higher than the non-VAP group[30.2%(19/63)vs 19.8%(162/820), P =0.044; 29.1%(23/79) vs 19.8%(162/820), P =0.046]. The pathogens isolated from early-onset versus late-onset VAP were not significantly different between groups, which the most common ones were acinetobacter baumannii, pseudomonas aeruginosa and klebsiella pneumoniae. Conclusion: E-VAP and L-VAP have different risk factors, however related pathogens are similar. Different specific preventive strategies are suggested based on different onset of VAP.

  16. Pain Intensity, Interference, and Medication Use After Spinal Cord Injury: Association With Risk of Mortality After Controlling for Socioeconomic and Other Health Factors.

    Science.gov (United States)

    Krause, James S; Cao, Yue; Clark, Jillian M R

    2017-12-01

    To identify the association of pain intensity, pain interference, and pain medication use with risk of mortality after spinal cord injury, controlling for demographic, injury, socioeconomic, and health factors. Prospective cohort study. Academic medical center. All participants (N=2535) had traumatic spinal cord injury of at least 1-year duration at enrollment, with noncomplete recovery (American Spinal Injury Association Impairment Scale grades A-D). Mortality status was obtained for 2535 individuals, and 335 were deceased as of 2014. Not applicable. Mortality status as of December 31, 2014, identified by the National Death Index. Preliminary bivariate analyses indicated that deceased participants were more likely to be older at injury, have more years postinjury, be men, and have a severe injury, low income, less education, and poorer health indicators. The final Cox model indicated that those who used pain medication daily were 51% more likely to be deceased at follow-up (hazard ratio [HR], 1.51). Pain intensity and pain interference were not statistically significant. Nonchronic pressure ulcer was related to 67% higher mortality risk (HR, 1.67), and chronic pressure ulcer was related to 122% higher risk (HR, 2.22). Other health indicators also increased the risk of mortality from 43% to 73%, including hospitalization (HR, 1.54), depression (HR, 1.43), and amputation (HR, 1.73). Prescription pain medication use appears to have a direct association with mortality, beyond that associated with other characteristics, and should become a strong focus of prevention efforts. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. Lack of exercise of "moderate to vigorous" intensity in people with low levels of physical activity is a major discriminant for sociodemographic factors and morbidity.

    Directory of Open Access Journals (Sweden)

    José A Serrano-Sánchez

    Full Text Available The aim is to examine the differences between participation at low and zero moderate to vigorous physical activity (MVPA in relation to their trends and associations with known socio-demographic and health factors. We hypothesised that the number of people at zero MVPA level could be rising despite a parallel increase in the population meeting the recommended MVPA level. We also hypothesised that graded associations of sociodemographic and health factors exist across MVPA levels.Two independent population-based samples (n = 4320 [2004] and n = 2176 [1997], were recruited with a stratified and random sampling procedure and interviewed at home by professional interviewers. The MVPA was assessed by validated questionnaire. The participants were classified into three MVPA levels: zero, low and recommended MVPA. The trend of each MVPA level was analysed with the standardized prevalence ratios. Correlates of low and zero MVPA levels were examined using multinomial logistic regression.The population at zero and recommended MVPA levels rose between 1997-2004 by 12% (95% CI, 5-20% and 7% (95% CI,-4-19% respectively, while the population at low MVPA level decreased. At zero MVPA level, associative patterns were observed with sociodemographic and health factors which were different when compared to the population at low MVPA level.Despite the slight increase of population meeting the recommended MVPA level, a higher trend of increase was observed at zero MVPA level. Both recommended and low MPVA levels increased their participation by absorbing participants from the low MVPA level. The sociodemographic profile of those with low MVPA was more similar to the population at recommended MVPA than at zero MVPA level. Methodological implications about the combination of light and moderate-intensity PA could be derived. The prevention of decline in actual low MVPA could change the trend of increase in the population at zero MVPA level, particularly among

  18. Intensive care unit admission after endovascular aortic aneurysm repair is primarily determined by hospital factors, adds significant cost, and is often unnecessary.

    Science.gov (United States)

    Hicks, Caitlin W; Alshaikh, Husain N; Zarkowsky, Devin; Bostock, Ian C; Nejim, Besma; Malas, Mahmoud B

    2018-04-01

    A large proportion of endovascular aortic aneurysm repair (EVAR) patients are routinely admitted to the intensive care unit (ICU) for postoperative observation. In this study, we aimed to describe the factors associated with ICU admission after EVAR and to compare the outcomes and costs associated with ICU vs non-ICU observation. All patients undergoing elective infrarenal EVAR in the Premier database (2009-2015) were included. Patients were stratified as ICU vs non-ICU admission according to location on postoperative day 0. Both patient-level (sociodemographics, comorbidities) and hospital-level (teaching status, hospital size, geographic location) factors were analyzed using univariate and multivariable logistic regression to determine factors associated with ICU vs non-ICU admission. Overall outcomes and hospital costs were compared between groups. Overall, 8359 patients underwent elective EVAR during the study period, including 4791 (57.3%) ICU and 3568 (42.7%) non-ICU admissions. Patients admitted to ICU were more frequently nonwhite and had more comorbidities, including congestive heart failure, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, and hypertension, than non-ICU patients (all, P postoperative adverse events, ICU admission after EVAR cost $1475 (95% confidence interval, $768-2183) more than non-ICU admission (P postoperative ICU admission is more closely associated with hospital practice patterns than with individual patient risk. Routine ICU admission after EVAR adds significant cost without reducing failure to rescue or in-hospital mortality. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  19. Sound intensity

    DEFF Research Database (Denmark)

    Crocker, Malcolm J.; Jacobsen, Finn

    1998-01-01

    This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique.......This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique....

  20. Sound Intensity

    DEFF Research Database (Denmark)

    Crocker, M.J.; Jacobsen, Finn

    1997-01-01

    This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique.......This chapter is an overview, intended for readers with no special knowledge about this particular topic. The chapter deals with all aspects of sound intensity and its measurement from the fundamental theoretical background to practical applications of the measurement technique....

  1. Ba{sub 2.2}Ca{sub 0.8}Mg{sub 4}F{sub 14}, a new ''solid solution stabilized'' matrix for an intense blue phosphor

    Energy Technology Data Exchange (ETDEWEB)

    Kubel, F.; Pantazi, M. [TU Vienna, Inst. of Chemical Technologies and Analytics, Getreidemarkt 9, 164-SC, 1060 Vienna (Austria); Hagemann, H. [Departement de Chimie Physique, Universite de Geneve, 30, quai E.Ansermet, 1211 Geneva 4 (Switzerland)

    2011-09-15

    Barium calcium magnesium fluoride (Ba{sub 2}(Ba{sub x}Ca{sub 1-x})Mg{sub 4}F{sub 14}, x=0.19-0.26) has been synthesized at 850 C from precursors prepared by the solution precipitation method. Single crystals with composition of Ba{sub 2.200(2)}Ca{sub 0.800(2)}Mg{sub 4}F{sub 14}were obtained after prolonged heating. Lattice parameters from single crystal data are a = 12.4203(8) and c = 7.4365(5) A [tetragonal, space group P4{sub 2}/mnm (No. 136)]. They increase with increasing barium concentration within a given stability window. The structure is built of a network of MgF{sub 6} octahedra forming a pyrochlore related channel system and isolated fluorine ions. Within the channels, heavy alkaline earth ions are located. The wide channel is filled with off-center positioned barium ions. The channel with a narrow cross section hosts both ions, Ca{sup 2+}and Ba{sup 2+}. The structure is isotypic with Pb{sub 3}Nb{sub 4}O{sub 12}F{sub 2} but has a different coordination around Ba/Ca and Pb, respectively. Doped with {proportional_to}1% Eu(II), the compound shows intense blue luminescence under UV activation. (copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  2. A regularized matrix factorization approach to induce structured sparse-low-rank solutions in the EEG inverse problem

    DEFF Research Database (Denmark)

    Montoya-Martinez, Jair; Artes-Rodriguez, Antonio; Pontil, Massimiliano

    2014-01-01

    We consider the estimation of the Brain Electrical Sources (BES) matrix from noisy electroencephalographic (EEG) measurements, commonly named as the EEG inverse problem. We propose a new method to induce neurophysiological meaningful solutions, which takes into account the smoothness, structured...... matrix and the squared Frobenius norm of the latent source matrix. We develop an alternating optimization algorithm to solve the resulting nonsmooth-nonconvex minimization problem. We analyze the convergence of the optimization procedure, and we compare, under different synthetic scenarios...

  3. Factors responsible for the aggregation behavior of hydrophobic polyelectrolyte PEA in aqueous solution studied by molecular dynamics simulations.

    Science.gov (United States)

    Sappidi, Praveenkumar; Natarajan, Upendra

    2017-08-01

    Self-association (i.e. interchain aggregation) behavior of atactic poly(ethacrylic acid) PEA in dilute aqueous solution as function of degree-of-neutralization by Na + counter-ions (i.e. charge fraction f) was investigated by molecular dynamics simulations. Aggregation is found to occur in the range 0≤f≤0.7 in agreement with experimental results compared at specified polymer concentration C p =0.36mol/l in dilute solution. The macromolecular solution was characterized and analysed for radius-of-gyration, torsion angle distribution, inter and intra-molecular hydrogen bonds, radial distribution functions of intermolecular and inter-atomic pairs, inter-chain contacts and solvation enthalpy. The PEA chains form aggregate through attractive inter-chain interaction via hydrogen bonding, in the range fenthalpy. The PEA solvation enthalpy becomes increasingly favorable with increase in f. The transition enthalpy change, in going from uncharged (acid) state to fully charged state (f=1) is unfavorable towards aggregate formation. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Versatile application of indirect Fourier transformation to structure factor analysis: from X-ray diffraction of molecular liquids to small angle scattering of protein solutions.

    Science.gov (United States)

    Fukasawa, Toshiko; Sato, Takaaki

    2011-02-28

    We highlight versatile applicability of a structure-factor indirect Fourier transformation (IFT) technique, hereafter called SQ-IFT. The original IFT aims at the pair distance distribution function, p(r), of colloidal particles from small angle scattering of X-rays (SAXS) and neutrons (SANS), allowing the conversion of the experimental form factor, P(q), into a more intuitive real-space spatial autocorrelation function. Instead, SQ-IFT is an interaction potential model-free approach to the 'effective' or 'experimental' structure factor to yield the pair correlation functions (PCFs), g(r), of colloidal dispersions like globular protein solutions for small-angle scattering data as well as the radial distribution functions (RDFs) of molecular liquids in liquid diffraction (LD) experiments. We show that SQ-IFT yields accurate RDFs of liquid H(2)O and monohydric alcohol reflecting their local intermolecular structures, in which q-weighted structure function, qH(q), conventionally utilized in many LD studies out of necessity of performing direct Fourier transformation, is no longer required. We also show that SQ-IFT applied to theoretically calculated structure factors for uncharged and charged colloidal dispersions almost perfectly reproduces g(r) obtained as a solution of the Ornstein-Zernike (OZ) equation. We further demonstrate the relevance of SQ-IFT in its practical applications, using SANS effective structure factors of lysozyme solutions reported in recent literatures which revealed the equilibrium cluster formation due to coexisting long range electrostatic repulsion and short range attraction between the proteins. Finally, we present SAXS experiments on human serum albumin (HSA) at different ionic strength and protein concentration, in which we discuss the real space picture of spatial distributions of the proteins via the interaction potential model-free route.

  5. Confirmatory factor analysis of the Eating Disorder Examination-Questionnaire: A comparison of five factor solutions across vegan and omnivore participants.

    Science.gov (United States)

    Heiss, Sydney; Boswell, James F; Hormes, Julia M

    2018-03-13

    The Eating Disorder Examination-Questionnaire (EDE-Q) is a valid and reliable measure of eating-related pathology, but its factor structure has proven difficult to replicate. Given differences in dietary patterns in vegans compared to omnivores, proper measurement of eating disorder symptoms is especially important in studies of animal product avoiders. This study compared goodness-of-fit of five alternative models of the EDE-Q in vegans (i.e., individuals refraining from all animal products, n = 318) and omnivores (i.e., individuals not restricting intake of animal products, n = 200). Confirmatory factor analyses were used to compare fit indices of the original four-factor model of the EDE-Q, along with alternative three-, two-, full one-, and brief one-factor models. No model provided adequate fit of the data in either sample of respondents. The fit of the brief one-factor model was the closest to acceptable in omnivores, but did not perform as well in vegans. Indicators of fit were comparable in vegans and omnivores across all other models. Our data confirm difficulties in replicating the proposed factor structure of the EDE-Q, including in vegans. More research is needed to determine the suitability of the EDE-Q for quantifying eating behaviors, including in those abstaining from animal products. © 2018 Wiley Periodicals, Inc.

  6. Influence of the environmental factors on the intensity of the oxygen, ammonium, and phosphate metabolism in the agar-containing seaweed Ahnfeltia tobuchiensis (Ahnfeltiales, Rhodophyta)

    Science.gov (United States)

    Cherbadgy, I. I.; Sabitova, L. I.

    2011-02-01

    A complex study of the influence of various environmental factors on the rate of the oxygen (MO 2), ammonium (MNH 4), and phosphate (MPO 4) metabolism in Ahnfeltia tobuchiensis has been carried out in situ in the Izmena Bay of Kunashir Island. The following environmental factors have been included into the investigation: the photosynthetically active radiation (PAR); the ammonium (NH4); the phosphate (PO4); and the tissue content of carbon (C), nitrogen (N), phosphorus (P), and chlorophyll a (Chl). The population of agar-containing seaweed A. tobuchiensis forms a layer with a thickness up to 0.5 m, which occupies about 23.3 km2; the population's biomass is equal to 125000 tons. The quantitative assessment of the organic matter production and nutrient consumption during the oxygen metabolism (MO 2) has been carried out for the whole population. It has been shown that the daily rate depends on the PAR intensity, the seawater concentrations of PO4 and NH4, and the tissue content of N and P ( r 2 = 0.78, p < 0.001). The daily NH4 consumption averages 0.21 μmol/(gDW h) and depends on the NH4 and O2 concentrations in the seawater and on the C and Chl a content in the algal tissues ( r 2 = 0.64, p < 0.001). The daily PO4 consumption averages 0.01 μmol/(gDW h) and depends on the NH4 concentration in the seawater and on the P content in the algal tissues ( r 2 = 0.40, p < 0.001).

  7. Stress intensity factor at the tip of cladding incipient crack in RIA-simulating experiments for high-burnup PWR fuels

    International Nuclear Information System (INIS)

    Udagawa, Yutaka; Suzuki, Motoe; Sugiyama, Tomoyuki; Fuketa, Toyoshi

    2009-01-01

    RIA-simulating experiments for high-burnup PWR fuels have been performed in the NSRR, and the stress intensity factor K 1 at the tip of cladding incipient crack has been evaluated in order to investigate its validity as a PCMI failure threshold under RIA conditions. An incipient crack depth was determined by observation of metallographs. The maximum hydride-rim thickness in the cladding of the test fuel rod was regarded as the incipient crack depth in each test case. Hoop stress in the cladding periphery during the pulse power transient was calculated by the RANNS code. K 1 was calculated based on crack depth and hoop stress. According to the RANNS calculation, PCMI failure cases can be divided into two groups: failure in the elastic phase and failure in the plastic phase. In the former case, elastic deformation was predominant around the incipient crack at failure time. K 1 is available only in this case. In the latter, plastic deformation was predominant around the incipient crack at failure time. Failure in the elastic phase never occurred when K 1 was less than 17 MPa m 1/2 . For failure in the plastic phase, the plastic hoop strain of the cladding periphery at failure time clearly showed a tendency to decrease with incipient crack depth. The combination of K 1 , for failure in the elastic phase, and plastic hoop strain at failure, for failure in the plastic phase, can be an effective index of PCMI failure under RIA conditions. (author)

  8. On the effect of temperature on the threshold stress intensity factor of delayed hydride cracking in light water reactor fuel cladding

    Energy Technology Data Exchange (ETDEWEB)

    Holston, Anna-MariaAlvarez; Stjarnsater, Johan [Studsvik Nuclear AB, Nykoping (Sweden)

    2017-06-15

    Delayed hydride cracking (DHC) was first observed in pressure tubes in Canadian CANDU reactors. In light water reactors, DHC was not observed until the late 1990s in high-burnup boiling water reactor (BWR) fuel cladding. In recent years, the focus on DHC has resurfaced in light of the increased interest in the cladding integrity during interim conditions. In principle, all spent fuel in the wet pools has sufficient hydrogen content for DHC to operate below 300°C. It is therefore of importance to establish the critical parameters for DHC to operate. This work studies the threshold stress intensity factor (K{sub IH}) to initiate DHC as a function of temperature in Zry-4 for temperatures between 227°C and 315°C. The experimental technique used in this study was the pin-loading testing technique. To determine the K{sub IH}, an unloading method was used where the load was successively reduced in a stepwise manner until no cracking was observed during 24 hours. The results showed that there was moderate temperature behavior at lower temperatures. Around 300°C, there was a sharp increase in K{sub IH} indicating the upper temperature limit for DHC. The value for K{sub IH} at 227°C was determined to be 2.6 ± 0.3 MPa √m.

  9. FACTORS AFFECTING THE REMOVAL OF A BASIC AND AN AZO DYE FROM ARTIFICIAL SOLUTIONS BY ADSORPTION USING ACTIVATED CARBON

    Directory of Open Access Journals (Sweden)

    H Albroomi

    2014-10-01

    Full Text Available Decolourisation of wastewater, particularly from textile industries, is one of the major environmental concerns these days. Current methods for removing dyes from wastewater are costly and cannot effectively be used to treat wide range of such wastewater. This work describes the use of commercial available granular activated carbon (GAC as an efficient adsorbent material for dyes removal. Aqueous solutions of various basic dye Methylene Blue (MB and azo-dye Tartrazine with concentrations 5-20 mg l–1 and 10-100 mg l–1, respectively, were shaken with certain amount of GAC to determine the adsorption capacity and removal efficiencies. The effects of adsorbent dose, initial pH, initial dye concentration, agitation speed and contact time on dyes removal efficiencies have been studied. Maximum dye concentration was removed from the solution within 60-90 min after the beginning of every experiment. Adsorption parameters were found to fit well into Langmuir and Freundlich adsorption isotherms models with correlation coefficient (R2 > 0.99 in the concentration range of MB and TZ studied.

  10. Analysis of the major factors of influence on the conditions of the intensity modulated radiation therapy planning optimization in head and neck

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dae Sup [International ST. Mary' s Hospital, Seoul (Korea, Republic of); Yoon, In Ha; Lee, Woo Seok; Back, Geum Mun [Dept. of Radiation Oncology, Asan Medical Center, Seoul (Korea, Republic of)

    2014-06-15

    To derive the most appropriate factors by considering the effects of the major factors when applied to the optimization algorithm, thereby aiding the effective designing of a ideal treatment plan. The eclipse treatment planning system(Eclipse 10.0, Varian, USA) was used in this study. The PBC (Pencil Beam Convolution) algorithm was used for dose calculation, and the DVO (Dose Volume Optimizer 10.0.28) Optimization algorithm was used for intensity modulated radiation therapy. The experimental group consists of patients receiving intensity modulated radiation therapy for the head and neck cancer and dose prescription to two planned target volume was 2.2 Gy and 2.0 Gy simultaneously. Treatment plan was done with inverse dose calculation methods utilizing 6 MV beam and 7 fields. The optimal algorithm parameter of the established plan was selected based on volume dose-priority(Constrain), dose fluence smooth value and the impact of the treatment plan was analyzed according to the variation of each factors. Volume dose-priority determines the reference conditions and the optimization process was carried out under the condition using same ratio, but different absolute values. We evaluated the surrounding normal organs of treatment volume according to the changing conditions of the absolute values of the volume dose-priority. Dose fluence smooth value was applied by simply changing the reference conditions (absolute value) and by changing the related volume dose-priority. The treatment plan was evaluated using Conformal Index, Paddick's Conformal Index, Homogeneity Index and the average dose of each organs. When the volume dose-priority values were directly proportioned by changing the absolute values, the CI values were found to be different. However PCI was 1.299±0.006 and HI was 1.095±0.004 while D5%/D95% was 1.090±1.011. The impact on the prescribed dose were similar. The average dose of parotid gland decreased to 67.4, 50.3, 51.2, 47.1 Gy when the absolute

  11. Long-term effect of intensive lifestyle intervention on cardiovascular risk factors in patients with diabetes in real-world clinical practice: a 5-year longitudinal study.

    Science.gov (United States)

    Hamdy, Osama; Mottalib, Adham; Morsi, Amr; El-Sayed, Nuha; Goebel-Fabbri, Ann; Arathuzik, Gillian; Shahar, Jacqueline; Kirpitch, Amanda; Zrebiec, John

    2017-01-01

    We evaluated long-term impact of sustained weight loss versus weight regain on cardiovascular risk factors in real-world clinical practice. We evaluated 129 obese patients with diabetes enrolled in Weight Achievement and Intensive Treatment (Why WAIT) program, a 12-week clinical model of intensive lifestyle intervention. After 1 year, we divided participants into group A, who maintained <7% weight loss (47.3%) and group B (52.7%), who maintained ≥7% weight loss. We continued to follow them for a total of 5 years. The total cohort lost 23.8 lbs (-9.7%) at 12 weeks and maintained -16.2 lbs (-6.4%) at 5 years (p<0.001). Group A maintained -8.4 lbs (-3.5%) and group B maintained -23.1 lbs (-9.0%) at 5 years. In group A, A1C decreased from 7.5±1.3% to 6.7±0.9% at 12 weeks but increased to 7.7±1.4% at 1 year and 8.0±1.9% at 5 years. In group B, A1C decreased from 7.4±1.2% to 6.4±0.9% at 12 weeks and rose to 6.8±1.2% at 1 year and 7.3±1.5% at 5 years. Despite weight regain, group A maintained improvement in low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol with worsening of serum triglycerides and no change in blood pressure (BP). Group B maintained improvement in lipid profile for 5 years and had significantly lower BP for 18 months. Weight reduction in patients with diabetes can be maintained for 5 years and is predicted by patients' ability to maintain ≥7% weight loss at 1 year. A1C and triglycerides deteriorate with weight regain, while other lipid improvements are maintained. Sustained weight loss is associated with significantly lower A1C for 5 years and lowers BP for 18 months. NCT01937845.

  12. Partitioning the contributions of mega-, macro- and meiofauna to benthic metabolism on the upper continental slope of New Zealand: Potential links with environmental factors and trawling intensity

    Science.gov (United States)

    Leduc, Daniel; Pilditch, Conrad A.; Nodder, Scott D.

    2016-02-01

    Understanding and predicting change in deep-sea benthic ecosystem function remains a major challenge. Here, we conducted analyses combining data on the abundance and biomass of benthic fauna and sediment community oxygen consumption (SCOC) on New Zealand's continental margin to estimate and compare the contributions of meio-, macro-, and megafauna to total benthic metabolism and identify potential links with environmental factors and trawling intensity. We focussed on two regions in close proximity-the high surface primary productivity Chatham Rise and low surface productivity Challenger Plateau. Mean megafauna biomass was twenty times greater on Chatham Rise than Challenger Plateau, likely reflecting differences in food supply between the two regions; this contrast in megafaunal biomass was mainly due to differences in mean body weight rather than abundance. Meio- and macrofauna made similar contributions to SCOC and together accounted for 12% of benthic metabolism on average. In contrast, the estimated contribution of megafauna never exceeded 1.5%. Significant positive correlations between faunal respiration and food availability indicate a link between food supply and benthic community function. Our analyses also show that fauna made a greater contribution to SCOC in conditions of high food availability, and that microorganisms (i.e., the proportion of SCOC not accounted for by the fauna) tended to be more dominant at sites with low food availability. These findings provide support for the concept that large organisms are more strongly affected by a reduction in food resources than small organisms, which in turn underlies one of the most widely described patterns in the deep-sea benthos, i.e., the reduction in organism body size with depth. Because metabolism in deep-sea sediments is typically dominated by microorganisms and small fauna, the absence of a relationship between bottom trawling intensity and the respiration of benthic fauna in the present study may

  13. Human factors and technology environment in multinational project: problems and solutions; Factores humanos y entorno tecnologico en proyectos multinacionales: dificultades y soluciones

    Energy Technology Data Exchange (ETDEWEB)

    Jardi Besa, X.; Munoz Cervantes, A.

    2012-07-01

    At the onset of nuclear projects in Spain, there was an import of nuclear technology. In a second phase, there was a transfer of technology. Subsequently, there was an adaptation of the technology. In this evolution, comparable to that of other countries, were involved several countries, overcoming the difficulties of human factors involved. The current nuclear projects multinationals have a new difficulty: the different industrial technological environments. This paper will address the organizational challenges of multinational engineering projects, in the type of project and the human factors of the participating companies.

  14. Main critical factors affecting the welfare of beef cattle and veal calves raised under intensive rearing systems in Italy: a review

    Directory of Open Access Journals (Sweden)

    Flaviana Gottardo

    2010-01-01

    Full Text Available This review describes the principal causes of poor welfare in beef cattle and veal calves raised in intensive husbandry systems in Italy. Nowadays there are no specific regulations in force for beef cattle welfare. However, a document produced in 2001 by the Scientific Committee on Animal Health and Animal Welfare of the European Commission on Health and Consumer Protection identified the main causes of inadequate welfare levels in the different cattle rearing systems in Europe. In Italy and in the Po Valley in particular, the beef cattle farms are mainly finishing units characterised by animals kept at high density in multiple pens and fed high starch diets. Under these rearing conditions the limited space allowance is one of the most important issues impairing animal welfare. Other risk factors for poor welfare related to the housing structures are type of floor, space at the manger, number of water dispensers and lack of specific moving and handling facilities. Microclimatic conditions can be critical especially during the summer season when cattle can experience heat stress. The feeding plan adopted in the Italian beef farms may be another factor negatively affecting the welfare of these animals due to the low content of long fibre roughage which increases the risk of metabolic acidosis. In the veal calf rearing systems there has been a mandatory introduction of the new system of production according to the European Council Directives 91/629/EEC and 97/2/EC. Farms had to adopt group housing and to provide calves with an increasing amount of fibrous feed in addition to the all-liquid diet. Despite this specific legislation, several risk factors for calves’ welfare can still be identified. Some of them are related to the housing system (type of floor, air quality, feed and water supply equipment and lack of loading facilities and some others to the feeding plan (type and amount of roughage, quality of milk replacers. Recent studies have

  15. Factores que influyen sobre la aparición de infecciones hospitalarias en los pacientes de cuidados intensivos Factors influencing hospital infection in patients in the intensive care unit

    Directory of Open Access Journals (Sweden)

    Aurora Llanos-Méndez

    2004-06-01

    Full Text Available Objetivo: La acumulación de factores de riesgo en los pacientes atendidos en el hospital es uno de los elementos que condicionan el aumento de la infección nosocomial y su mayor frecuencia en las unidades de cuidados intensivos (UCI. Nuestro objetivo es la identificación de los factores de riesgo de la infección nosocomial en la UCI de nuestro hospital. Métodos: Se efectuó un estudio de cohortes prospectivo sobre los 1.134 pacientes ingresados, al menos durante 24 h en dicha UCI durante el año 2001. El seguimiento de los pacientes prosiguió 48 h tras el alta del paciente de la unidad. Los factores de riesgo se identificaron mediante un análisis multivariable de regresión de Cox. Resultados: Los factores de riesgo intrínsecos integrantes del modelo son el diagnóstico principal que motivó el ingreso del paciente en la unidad, la presencia de traumatismo craneoencefálico y la insuficiencia renal. Las técnicas invasivas que se asocian de forma independiente a la infección nosocomial son, de mayor a menor riesgo, el sondaje urinario, la traqueostomía, la ventilación mecánica, la inserción de un catéter de Swan-Ganz y la nutrición parenteral. Conclusiones: Si bien la mayor fuerza de asociación se encuentra entre los factores de riesgo endógenos, ya que son poco modificables, habrá que orientar las propuestas de mejora hacia los siguientes factores exógenos: ventilación mecánica, traqueostomía, sondaje urinario, catéter de Swan-Ganz y nutrición parenteral.Objective: The accumulation of risk factors in hospitalized patients is one of the elements contributing to the increase in the frequency of nosocomial infection in the intensive care unit (ICU. Our aim was to identify nosocomial infection risk factors in the ICU of our hospital. Methods: We performed a prospective cohort study of 1134 patients admitted to the ICU for at least 24 hours in 2001. The patients were followed-up for 48 hours after leaving the ICU

  16. The removal of an anionic red dye from aqueous solutions using chitosan beads-The role of experimental factors on adsorption using a full factorial design

    International Nuclear Information System (INIS)

    Cestari, Antonio R.; Vieira, Eunice F.S.; Mota, Jackeline A.

    2008-01-01

    A factorial design was employed to evaluate the quantitative removal of an anionic red dye from aqueous solutions on epichlorohydrin-cross-linked chitosan. The experimental factors and their respective levels studied were the initial dye concentration in solution (25 or 600 mg L -1 ), the absence or the presence of the anionic surfactant sodium dodecylbenzenesulfonate (DBS) and the adsorption temperature (25 or 55 deg. C). The adsorption parameters were analyzed statistically using modeling polynomial equations. The results indicated that increasing the dye concentration from 25 to 600 mg L -1 increases the dye adsorption whereas the presence of DBS increases it. The principal effect of temperature did not show a high statistical significance. The factorial results also demonstrate the existence of statistically significant binary interactions of the experimental factors. The adsorption thermodynamic parameters, namely Δ ads H, Δ ads G and Δ ads S, were determined for all the factorial design results. Exothermic and endothermic values were found in relation to the Δ ads H. The positive Δ ads S values indicate that entropy is a driving force for adsorption. The Δ ads G values are significantly affected by an important synergistic effect of the factors and not by the temperature changes alone

  17. Solution structure of the cytohesin-1 (B2–1) Sec7 domain and its interaction with the GTPase ADP ribosylation factor 1

    Science.gov (United States)

    Betz, Stephen F.; Schnuchel, Arndt; Wang, Hong; Olejniczak, Edward T.; Meadows, Robert P.; Lipsky, Brian P.; Harris, Edith A. S.; Staunton, Donald E.; Fesik, Stephen W.

    1998-01-01

    Cytohesin-1 (B2–1) is a guanine nucleotide exchange factor for human ADP ribosylation factor (Arf) GTPases, which are important for vesicular protein trafficking and coatamer assembly in the cell. Cytohesin-1 also has been reported to promote cellular adhesion via binding to the β2 integrin cytoplasmic domain. The solution structure of the Sec7 domain of cytohesin-1, which is responsible for both the protein’s guanine nucleotide exchange factor function and β2 integrin binding, was determined by NMR spectroscopy. The structure consists of 10 α-helices that form a unique tertiary fold. The binding between the Sec7 domain and a soluble, truncated version of human Arf-1 was investigated by examining 1H-15N and 1H-13C chemical shift changes between the native protein and the Sec7/Arf-1 complex. We show that the binding to Arf-1 occurs through a large surface on the C-terminal subdomain that is composed of both hydrophobic and polar residues. Structure-based mutational analysis of the cytohesin-1 Sec7 domain has been used to identify residues important for binding to Arf and for mediating nucleotide exchange. Investigations into the interaction between the Sec7 domain and the β2 integrin cytoplasmic domain suggest that the two proteins do not interact in the solution phase. PMID:9653114

  18. Effects of acute treadmill running at different intensities on activities of serotonin and corticotropin-releasing factor neurons, and anxiety- and depressive-like behaviors in rats.

    Science.gov (United States)

    Otsuka, Tomomi; Nishii, Ayu; Amemiya, Seiichiro; Kubota, Natsuko; Nishijima, Takeshi; Kita, Ichiro

    2016-02-01

    Accumulating evidence suggests that physical exercise can reduce and prevent the incidence of stress-related psychiatric disorders, including depression and anxiety. Activation of serotonin (5-HT) neurons in the dorsal raphe nucleus (DRN) is implicated in antidepressant/anxiolytic properties. In addition, the incidence and symptoms of these disorders may involve dysregulation of the hypothalamic-pituitary-adrenal axis that is initiated by corticotropin-releasing factor (CRF) neurons in the hypothalamic paraventricular nucleus (PVN). Thus, it is possible that physical exercise produces its antidepressant/anxiolytic effects by affecting these neuronal activities. However, the effects of acute physical exercise at different intensities on these neuronal activation and behavioral changes are still unclear. Here, we examined the activities of 5-HT neurons in the DRN and CRF neurons in the PVN during 30 min of treadmill running at different speeds (high speed, 25 m/min; low speed, 15m/min; control, only sitting on the treadmill) in male Wistar rats, using c-Fos/5-HT or CRF immunohistochemistry. We also performed the elevated plus maze test and the forced swim test to assess anxiety- and depressive-like behaviors, respectively. Acute treadmill running at low speed, but not high speed, significantly increased c-Fos expression in 5-HT neurons in the DRN compared to the control, whereas high-speed running significantly enhanced c-Fos expression in CRF neurons in the PVN compared with the control and low-speed running. Furthermore, low-speed running resulted in decreased anxiety- and depressive-like behaviors compared with high-speed running. These results suggest that acute physical exercise with mild and low stress can efficiently induce optimal neuronal activation that is involved in the antidepressant/anxiolytic effects. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Preparation and properties of chitosan-metal complex: Some factors influencing the adsorption capacity for dyes in aqueous solution.

    Science.gov (United States)

    Rashid, Sadia; Shen, Chensi; Yang, Jing; Liu, Jianshe; Li, Jing

    2018-04-01

    Chitosan-metal complexes have been widely studied in wastewater treatment, but there are still various factors in complex preparation which are collectively responsible for improving the adsorption capacity need to be further studied. Thus, this study investigates the factors affecting the adsorption ability of chitosan-metal complex adsorbents, including various kinds of metal centers, different metal salts and crosslinking degree. The results show that the chitosan-Fe(III) complex prepared by sulfate salts exhibited the best adsorption efficiency (100%) for various dyes in very short time duration (10min), and its maximum adsorption capacity achieved 349.22mg/g. The anion of the metal salt which was used in preparation played an important role to enhance the adsorption ability of chitosan-metal complex. SO 4 2- ions not only had the effect of crosslinking through electrostatic interaction with amine group of chitosan polymer, but also could facilitate the chelation of metal ions with chitosan polymer during the synthesis process. Additionally, the pH sensitivity and the sensitivity of ionic environment for chitosan-metal complex were analyzed. We hope that these factors affecting the adsorption of the chitosan-metal complex can help not only in optimizing its use but also in designing new chitosan-metal based complexes. Copyright © 2017. Published by Elsevier B.V.

  20. Effect of genetic and nongenetic factors on chemical composition of individual milk samples from dromedary camels (Camelus dromedarius) under intensive management.

    Science.gov (United States)

    Nagy, P; Fábri, Zs N; Varga, L; Reiczigel, J; Juhász, J

    2017-11-01

    The aims of the present study were to monitor the changes in gross chemical composition of individual dromedary camel milk over a 5-yr period, to provide reference values, and to determine the effect of genetic and nongenetic factors influencing camel milk composition under intensive management. A total of 1,528 lactating dromedary camels were included in the study. Animals were fed a constant diet and were milked twice a day in a herringbone parlor. Milk samples were collected at monthly intervals using a sampling device and then fat, protein, lactose, total solids (TS), and solids-nonfat (SNF) concentrations of raw camel milk were determined with an automatic milk analyzer. For each milk sample, production parameters were recorded and quantities (grams) of milk constituents were calculated. The overall mean quantity and fat, protein, lactose, SNF, and TS concentrations of the morning milk were 4.0 kg, 2.58%, 2.95%, 4.19%, 8.08%, and 10.46%, respectively. Milk quantity showed a positive correlation with lactose and a negative correlation with all other components. Parity exerted a strong effect on all milk parameters. Primiparous dromedaries (n = 60) produced less milk with higher concentrations of components than did multiparous animals (n = 1,468). Milk composition varied among the 7 breeds tested, but none of the genotypes was found to be superior to the others in this respect. We detected a significant, yet small calf sex-biased difference in milk yield and composition. Stage of lactation and season strongly influenced milk yield and all milk components. We also found a significant interaction between month postpartum (mPP) and month of the year. The concentration of all milk components decreased from 1 to 5 mPP. Later, lactose concentration and quantity continued to decrease parallel with decreasing milk production. The concentration of other components showed a temporary increase in mid lactation, from 6 to 11 mPP, and in late lactation, from 18 to 23 m

  1. The relationship between moderate-to-vigorous intensity physical activity and insulin resistance, insulin-like growth factor (IGF-1)-system 1, leptin and weight change in healthy women during pregnancy and after delivery

    NARCIS (Netherlands)

    van der Wijden, C.L.; Delemarre-van de Waal, H.A.; van Mechelen, W.; van Poppel, M.N.M.

    2015-01-01

    Context Child bearing is considered to be a significant risk factor for developing overweight and obesity. Physical activity might influence weight change via hormonal changes. Objective To test the hypothesis that higher levels of moderateto- vigorous intensity physical activity (MVPA) are

  2. Diarréia nosocomial em unidade de terapia intensiva: incidência e fatores de risco Nosocomial diarrhea in the intensive care unit: incidence and risk factors

    Directory of Open Access Journals (Sweden)

    Sérvulo Luiz Borges

    2008-06-01

    Full Text Available RACIONAL: Diarréia nosocomial parece ser comum em unidades de terapia intensiva, embora sua epidemiologia seja pouco documentada em nosso meio. OBJETIVO: Determinar a incidência e fatores de risco de diarréia entre pacientes adultos internados em unidade de terapia intensiva. MÉTODOS: Foram incluídos prospectivamente 457 pacientes no período entre outubro de 2005 e outubro de 2006. Dados demográficos, clínicos e bioquímicos, bem como aspecto e número de evacuações eram registrados diariamente até a saída do paciente do setor. RESULTADOS: Diarréia ocorreu em 135 (29,5% pacientes, durando em média 5,4 dias. O tempo do seu início em relação à internação foi de 17,8 dias e casos similares de diarréia no mesmo período foram registrados em 113 (83,7% pacientes. A mortalidade hospitalar foi maior nos pacientes com diarréia do que naqueles sem esta intercorrência. Na análise multivariada através de modelo de regressão logística, apenas o número de antibióticos (OR 1,65; IC 95% = 1,39-1,95 e o número de dias de antibioticoterapia (OR 1,16; IC 95% = 1,12-1,20 associaram-se estatisticamente com a ocorrência de diarréia. Cada dia de acréscimo a mais da antibioticoterapia aumentou em 16% o risco de diarréia (IC 12% a 20%, enquanto a adição de um antibiótico a mais ao esquema antimicrobiano aumentou as chances de ocorrência de diarréia em 65% (IC 39% a 95%. CONCLUSÃO: A incidência de diarréia nosocomial na unidade de terapia intensiva é elevada (29,5%. Os principais fatores de risco para sua ocorrência foram número de antibióticos prescritos e duração da antibioticoterapia. Além das precauções entéricas, a prescrição judiciosa e limitada de antimicrobianos, provavelmente reduzirá a ocorrência de diarréia neste setor.BACKGROUND: Nosocomial diarrhea seems to be common at intensive care units, although its epidemiology be poorly documented in Brazil. AIM: To determine the incidence and risk factors of

  3. Towards higher intensities

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Over the past 2 weeks, commissioning of the machine protection system has advanced significantly, opening up the possibility of higher intensity collisions at 3.5 TeV. The intensity has been increased from 2 bunches of 1010 protons to 6 bunches of 2x1010 protons. Luminosities of 6x1028 cm-2s-1 have been achieved at the start of fills, a factor of 60 higher than those provided for the first collisions on 30 March.   The recent increase in LHC luminosity as recorded by the experiments. (Graph courtesy of the experiments and M. Ferro-Luzzi) To increase the luminosity further, the commissioning crews are now trying to push up the intensity of the individual proton bunches. After the successful injection of nominal intensity bunches containing 1.1x1011 protons, collisions were subsequently achieved at 450 GeV with these intensities. However, half-way through the first ramping of these nominal intensity bunches to 3.5 TeV on 15 May, a beam instability was observed, leading to partial beam loss...

  4. Effectiveness of intense, activity-based physical therapy for individuals with spinal cord injury in promoting motor and sensory recovery: is olfactory mucosa autograft a factor?

    Science.gov (United States)

    Larson, Cathy A; Dension, Paula M

    2013-01-01

    Rehabilitation for individuals with spinal cord injury (SCI) is expanding to include intense, activity-based, out-patient physical therapy (PT). The study's primary purposes were to (i) examine the effectiveness of intense PT in promoting motor and sensory recovery in individuals with SCI and (ii) compare recovery for individuals who had an olfactory mucosa autograft (OMA) with individuals who did not have the OMA while both groups participated in the intense PT program. Prospective, non-randomized, non-blinded, intervention study. Using the American Spinal Injury Association examination, motor and sensory scores for 23 (7 OMA, 6 matched control and 10 other) participants were recorded. Mean therapy dosage was 137.3 total hours. The participants' total, upper and lower extremity motor scores improved significantly while sensory scores did not improve during the first 60 days and from initial to discharge examination. Incomplete SCI or paraplegia was associated with greater motor recovery. Five of 14 participants converted from motor-complete to motor-incomplete SCI. Individuals who had the OMA and participated in intense PT did not have greater sensory or greater magnitude or rate of motor recovery as compared with participants who had intense PT alone. This study provides encouraging evidence as to the effectiveness of intense PT for individuals with SCI. Future research is needed to identify the optimal therapy dosage and specific therapeutic activities required to generate clinically meaningful recovery for individuals with SCI including those who elect to undergo a neural recovery/regenerative surgical procedure and those that elect intense therapy alone.

  5. Patterns of admission and factors associated with neonatal mortality among neonates admitted to the neonatal intensive care unit of University of Gondar Hospital, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Demisse AG

    2017-05-01

    Full Text Available Abayneh Girma Demisse, Fentahun Alemu, Mahlet Abayneh Gizaw, Zemene Tigabu School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Introduction: The neonatal period is a highly vulnerable time for an infant completing many of the physiologic adjustments required for life outside the uterus. As a result, there are high rates of morbidity and mortality. The three major causes of mortality in developing countries include prematurity, infection, and perinatal asphyxia. The aim of this study was to identify the patterns of neonatal admission and factors associated with mortality among neonates admitted at the Neonatal Intensive Care Unit (NICU of University of Gondar Hospital.Materials and methods: A retrospective cross-sectional study was conducted among all admitted neonates in the NICU of University of Gondar referral hospital from December 1, 2015 to August 31, 2016. Information was extracted retrospectively during admission from patient records and death certificates, using a pretested questionnaire. The data were entered and analyzed using SPSS version 20, and p-values <0.05 were considered statistically significant.Results: A total of 769 neonates was included in the study. There were 448 (58.3% male neonates, and 398 (51.8% neonates were rural residents. More than two-thirds of the 587 deliveries (76.3% were performed in tertiary hospitals. Neonatal morbidity included hypothermia 546 (71%, sepsis 522 (67.9%, prematurity 250 (34.9%, polycythemia 242 (31.5%, hypoglycemia 142 (18.5, meconium aspiration syndrome 113 (14.7%, and perinatal asphyxia 96 (12.5%. The overall mortality was 110 (14.3%; 95% confidence interval [CI]: 11.9–16.9 of which 69 (62.7% deaths occurred in the first 24 hours of age. In the multivariate analysis, mortality was associated with perinatal asphyxia (adjusted odds ratio [AOR]: 5.97; 95% CI: 3.06–11.64, instrumental delivery (AOR: 2.99; 95% CI: 1.08–8.31, and early onset

  6. High-intensity interval training (HIIT) increases insulin-like growth factor-I (IGF-I) in sedentary aging men but not masters' athletes: an observational study.

    Science.gov (United States)

    Herbert, Peter; Hayes, Lawrence D; Sculthorpe, Nicholas; Grace, Fergal M

    2017-03-01

    The aim of this investigation was to examine the impact high-intensity interval training (HIIT) on serum insulin-like growth factor-I (IGF-I) in active compared with sedentary aging men. 22 lifetime sedentary (SED; 62 ± 2 years) and 17 masters' athletes (LEX; 60 ± 5 years) were recruited to the study. As HIIT requires preconditioning exercise in sedentary cohorts, the study required three assessment phases; enrollment (phase A), following preconditioning exercise (phase B), and post-HIIT (phase C). Serum IGF-I was determined by electrochemiluminescent immunoassay. IGF-I was higher in LEX compared to SED at baseline (p = 0.007, Cohen's d = 0.91), and phase B (p = 0.083, Cohen's d = 0.59), with only a small difference at C (p = 0.291, Cohen's d = 0.35). SED experienced a small increase in IGF-I following preconditioning from 13.1 ± 4.7 to 14.2 ± 6.0 μg·dl -1 (p = 0.376, Cohen's d = 0.22), followed by a larger increase post-HIIT (16.9 ± 4.4 μg·dl -1 ), which was significantly elevated compared with baseline (p = 0.002, Cohen's d = 0.85), and post-preconditioning (p = 0.005, Cohen's d = 0.51). LEX experienced a trivial changes in IGF-I from A to B (18.2 ± 6.4 to 17.2 ± 3.7 μg·dl -1 [p = 0.538, Cohen's d = 0.19]), and a small change post-HIIT (18.4 ± 4.1 μg·dl -1 [p = 0.283, Cohen's d = 0.31]). Small increases were observed in fat-free mass in both groups following HIIT (p HIIT with preconditioning exercise abrogates the age associated difference in IGF-I between SED and LEX, and induces small improvements in fat-free mass in both SED and LEX.

  7. Determination of neutron buildup factor using analytical solution of one-dimensional neutron diffusion equation in cylindrical geometry

    International Nuclear Information System (INIS)

    Fernandes, Julio Cesar L.; Vilhena, Marco Tullio; Borges, Volnei; Bodmann, Bardo Ernest

    2011-01-01

    The principal idea of this work, consist on formulate an analytical method to solved problems for diffusion of neutrons with isotropic scattering in one-dimensional cylindrical geometry. In this area were develop many works that study the same problem in different system of coordinates as well as cartesian system, nevertheless using numerical methods to solve the shielding problem. In view of good results in this works, we starting with the idea that we can represent a source in the origin of the cylindrical system by a Delta Dirac distribution, we describe the physical modeling and solved the neutron diffusion equation inside of cylinder of radius R. For the case of transport equation, the formulation of discrete ordinates S N consists in discretize the angular variables in N directions and in using a quadrature angular set for approximate the sources of scattering, where the Diffusion equation consist on S 2 approximated transport equation in discrete ordinates. We solved the neutron diffusion equation with an analytical form by the finite Hankel transform. Was presented also the build-up factor for the case that we have neutron flux inside the cylinder. (author)

  8. Determination of neutron buildup factor using analytical solution of one-dimensional neutron diffusion equation in cylindrical geometry

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Julio Cesar L.; Vilhena, Marco Tullio, E-mail: julio.lombaldo@ufrgs.b, E-mail: vilhena@pq.cnpq.b [Universidade Federal do Rio Grande do Sul (DMPA/UFRGS), Porto Alegre, RS (Brazil). Dept. de Matematica Pura e Aplicada. Programa de Pos Graduacao em Matematica Aplicada; Borges, Volnei; Bodmann, Bardo Ernest, E-mail: bardo.bodmann@ufrgs.b, E-mail: borges@ufrgs.b [Universidade Federal do Rio Grande do Sul (PROMEC/UFRGS), Porto Alegre, RS (Brazil). Programa de Pos-Graduacao em Engenharia Mecanica

    2011-07-01

    The principal idea of this work, consist on formulate an analytical method to solved problems for diffusion of neutrons with isotropic scattering in one-dimensional cylindrical geometry. In this area were develop many works that study the same problem in different system of coordinates as well as cartesian system, nevertheless using numerical methods to solve the shielding problem. In view of good results in this works, we starting with the idea that we can represent a source in the origin of the cylindrical system by a Delta Dirac distribution, we describe the physical modeling and solved the neutron diffusion equation inside of cylinder of radius R. For the case of transport equation, the formulation of discrete ordinates S{sub N} consists in discretize the angular variables in N directions and in using a quadrature angular set for approximate the sources of scattering, where the Diffusion equation consist on S{sub 2} approximated transport equation in discrete ordinates. We solved the neutron diffusion equation with an analytical form by the finite Hankel transform. Was presented also the build-up factor for the case that we have neutron flux inside the cylinder. (author)

  9. Factors influencing degradation of trichloroethylene by sulfide-modified nanoscale zero-valent iron in aqueous solution.

    Science.gov (United States)

    Dong, Haoran; Zhang, Cong; Deng, Junmin; Jiang, Zhao; Zhang, Lihua; Cheng, Yujun; Hou, Kunjie; Tang, Lin; Zeng, Guangming

    2018-02-07

    Sulfide-modified nanoscale zero-valent iron (S/NZVI) has been considered as an efficient material to degrade trichloroethylene (TCE) in groundwater. However, some critical factors influencing the dechlorination of TCE by S/NZVI have not been investigated clearly. In this study, the effects of Fe/S molar ratio, initial pH, dissolved oxygen and particle aging on TCE dechlorination by S/NZVI (using dithionite as sulfidation reagent) were studied. Besides, the feasibility of reactivation of the aged-NZVI by sulfidation treatment was looked into. The results show that the Fe/S molar ratio and initial pH significantly influenced the TCE dechlorination, and a higher TCE dechlorination was observed at Fe/S molar ratio of ∼60 under alkaline condition. Spectroscopic analyses demonstrate that the enhanced TCE dechlorination was associated with the presence of FeS on the surface of S/NZVI. Dissolved oxygen had little effect on TCE dechlorination by S/NZVI, revealing that the FeS layer could be able to alleviate the surface passivation of NZVI caused by oxidation. Aging of S/NZVI up to 10-20 d only slightly decreased the dechlorination efficiency of TCE. Although an obvious drop in dechorination efficiency was observed for the S/NZVI aged for 30 d, it still exhibited a higher reactivity than the bare NZVI. This indicates that sulfidation of NZVI did prolong its lifetime. Additionally, sulfidation treatment was used to reactivate the aged NZVI, and the results show that the reactivated NZVI even had higher reactivity than the fresh NZVI, suggesting that sulfidation treatment would be a promising method to reactivate the aged NZVI. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Effects of Radiosterilization on Sealed Aqueous Solutions

    International Nuclear Information System (INIS)

    Pandula, E.L.; Farkas, E.; Rácz, I.

    1967-01-01

    For aqueous solutions sensitive to heat,and in connection with the use of plastic ampoules, the need for applying radiosterilization is growing. Studying the possibilities of radiosterilization, experiments were made with the following: 0.1% atropine, 1.0% morphine, and 2% lidocain in aqueous solutions. The aim of the work was to establish whether the active ingredients of the injections suffer decomposition or not, to study the factors influencing the degradation and, furthermore, to make attempts to prevent decomposition. The samples were irradiated by 420 Ci 60 Co γ-radiation source. The applied doses were 1 to 2.5 Mrad, with a 10 4 to 2.5 x 10 5 rad/h dose intensity. After irradiation the change in colour, pH-value, concentration and UV-spectra were studied. Changes of the last three types were found. Studying the factors influencing decomposition it has been found that the degree of degradation was increased by the increase of radiation dose, increase of concentration, decrease of dose intensity, and increase of oxygen content in the atmosphere over the solution. Attempts were made to prevent degradation. Solutions were prepared with sulphite, ascorbic acid, and AET, and some measure of success was achieved, especially with the sulphite addition. (author)

  11. The Effect of a Three-Month Intensive Intermittent Training on Plasma Chemerin and some Factors Related to Body Composition on Overweight Males

    Directory of Open Access Journals (Sweden)

    MJ pourvaghar

    2015-08-01

    Results: Results showed that three-month of high-intensity interval training of running had a significant effect on decreasing the plasma chemerin levels, body weight, body fat percentage, BMI (P=0/0001, and WHR (P=0/012 in the experimental group compared to control group. Significant differences were observed for within group (P≤0/05. Conclusion: It seemed that three-month of high-intensity interval training as a non-invasive and non-pharmaceutical way could have a positive effect on reducing the levels of chemerin and some anthropometric indicators associated with obesity and overweight.

  12. Treating stimuli as a random factor in social psychology: a new and comprehensive solution to a pervasive but largely ignored problem.

    Science.gov (United States)

    Judd, Charles M; Westfall, Jacob; Kenny, David A

    2012-07-01

    Throughout social and cognitive psychology, participants are routinely asked to respond in some way to experimental stimuli that are thought to represent categories of theoretical interest. For instance, in measures of implicit attitudes, participants are primed with pictures of specific African American and White stimulus persons sampled in some way from possible stimuli that might have been used. Yet seldom is the sampling of stimuli taken into account in the analysis of the resulting data, in spite of numerous warnings about the perils of ignoring stimulus variation (Clark, 1973; Kenny, 1985; Wells & Windschitl, 1999). Part of this failure to attend to stimulus variation is due to the demands imposed by traditional analysis of variance procedures for the analysis of data when both participants and stimuli are treated as random factors. In this article, we present a comprehensive solution using mixed models for the analysis of data with crossed random factors (e.g., participants and stimuli). We show the substantial biases inherent in analyses that ignore one or the other of the random factors, and we illustrate the substantial advantages of the mixed models approach with both hypothetical and actual, well-known data sets in social psychology (Bem, 2011; Blair, Chapleau, & Judd, 2005; Correll, Park, Judd, & Wittenbrink, 2002). PsycINFO Database Record (c) 2012 APA, all rights reserved

  13. Persistence of clones of coagulase-negative staphylococci among premature neonates in neonatal intensive care units: two-center study of bacterial genotyping and patient risk factors

    NARCIS (Netherlands)

    C.L. Vermont (Clementien); N.G. Hartwig (Nico); A. Fleer; P. de Man (Peter); R. de Groot (Ronald); A.F. van Belkum (Alex); H.A. Verbrugh (Henri); J.N. van den Anker (John)

    1998-01-01

    textabstractFrom 1 January 1995 until 1 January 1996, we studied the molecular epidemiology of blood isolates of coagulase-negative staphylococci (CoNS) in the Neonatal Intensive Care Units (NICUs) of the Sophia Children's Hospital (SCH; Rotterdam, The Netherlands) and the

  14. Factors Influencing the Effective Use of Technology for Teaching and Learning: Lessons Learned from the SEIR-TEC Intensive Site Schools. 2nd Edition.

    Science.gov (United States)

    Byrom, Elizabeth; Bingham, Margaret

    From 1995 to 2000, the SouthEast Initiatives Regional Technology in Education Consortium (SEIR-TEC) provided technical assistance and professional development to 12 schools, referred to as intensive sites. Typically, this effort entailed a member of the SEIR-TEC staff spending three or four days per month working with teachers and administrators…

  15. Fatores associados à carga de trabalho de enfermagem em Unidade de Terapia Intensiva Factores asociados a la carga de trabajo de enfermería en Unidad de Terapia Intensiva Factors associated with nursing workload in adult intensive care units

    Directory of Open Access Journals (Sweden)

    Leilane Andrade Gonçalves

    2007-12-01

    Full Text Available Os objetivos desta pesquisa foram analisar a carga de trabalho de enfermagem e os fatores associados a ela, no primeiro dia de internação dos pacientes na Unidade de Terapia Intensiva (UTI. Trata-se de um estudo retrospectivo, de corte transversal e com abordagem quantitativa, realizado em abril de 2002 e outubro de 2004. Os dados foram extraídos de um banco de dados que reuniu informações de 5 UTIs de dois hospitais privados e a amostra foi constituída por 214 pacientes adultos que permaneceram no mínimo 24 horas na UTI. A média do escore total do Nursing Activities Score (NAS foi de 69,9% e mediana de 68,0%. Verificou-se, segundo a mediana, que 109 (50,9% indivíduos tiveram alta carga de trabalho de enfermagem e 105 (49,1% baixa carga. Observou-se também que a gravidade, a idade do paciente e o tipo de tratamento não foram fatores associados à demanda de trabalho de enfermagem.Los objetivos de esta pesquisa fueron analizar la carga de trabajo de enfermería y los factores asociados a ella, en el primer día de internación de los pacientes en la Unidad de Terapia Intensiva (UTI. Se trata de un estudio retrospectivo, de corte transversal y con abordaje cuantitativa, realizado en abril de 2002 y octubre de 2004. Los datos fueron extraídos de un banco de datos que reunió informaciones de 5 UTIs de dos hospitales particulares y la muestra fue constituida por 214 pacientes adultos que permanecieron en el mínimo de 24 horas en la UTI. La media de escore total del Nursing Activities Store (NAS fue de 69,9% y mediana de 68,0%. Se verificó, según la mediana, que 109 (50,9% individuos tuvieron alta carga de trabajo de enfermería y 105 (49,1% baja carga. Se observó también que la gravedad, la edad del paciente y el tipo de tratamiento no fueron factores asociados a la demanda de trabajo de enfermería.This study was aimed both at analyzing the nursing workload on the first day of admission of patients in Intensive Care Units (ICUs and

  16. Plannig strategy for radiotherapic treatment oa patients with prosthetic hip. Solution of intensity; Estrategia para la planificacion de tratamientos radioterapicos de pacientes con protesis de cader. Solucion de intensidad modulada

    Energy Technology Data Exchange (ETDEWEB)

    Puertolas Hernandez, J. R.; Iriondo Igerabide, U.; Lozano Flores, F. J.; Pino Leon, C.; Larretxea Etxarri, R.

    2013-07-01

    The intensity modulated radiation therapy (IMRT) can offer better plans, defining the prosthesis as critical structure that limit the dose. In our case, in the last year we have made five planning hip replacement cases, and one case with two prostheses (bilateral). We are introducing the strategy we use to carry out these planning. (Author)

  17. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data.

    Science.gov (United States)

    Hallowell, Sunny G; Rogowski, Jeannette A; Spatz, Diane L; Hanlon, Alexandra L; Kenny, Michael; Lake, Eileen T

    2016-01-01

    Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Cross sectional analysis combining nurse survey data with infant discharge data. A national sample of neonatal intensive care units (N=97), nurses (N=5614) and very low birth weight infants (N=6997). Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on "any human milk") and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (pmilk (pmilk at discharge (p=.056). A 1 SD increase (7%) in the fraction of infants who received breastfeeding support was associated with an eight percentage point increase in the fraction of infants discharged on human milk (pmilk. Investments by nurse administrators to improve work environments and support educational preparation of nursing staff may ensure that the most vulnerable infants have the best

  18. Intensidad del síndrome climatérico y su relación con algunos factores socioambientales Climateric syndrome intensity and its relation to some socio-environmental factors

    Directory of Open Access Journals (Sweden)

    Margeris Yanes Calderón

    2009-12-01

    con la satisfacción de sus necesidades básicas, tienen una mayor incidencia de síndrome climatérico leve o asintomático.Introduction: Expressions like …I am in the menopause, I am old, and the problem is that I am in the climateric or it is the age change… are very common in the multidisciplinary consultation of climateric and menopause of "Ana Betancourt" University Polyclinic of Playa municipality. It was the reason to make this research, avoiding the biomedical approach with which the climateric period has been approached until nowadays moving forward to a medical-social approach. Objective: To determine how the socioenvironmental factors influence on the climateric syndrome intensity. Methods: A cross-sectional and descriptive study was conducted in 192 climateric women seen in three medical consulting rooms from "Ana Betancourt" University Polyclinic of the Playa municipality from Ciudad de La Habana from June, 2006 to May, 2007. Results: Slight climateric syndrome was present in the 42,28% of study women, and those with a high schooling level have a major incidence of the asymptomatic climateric syndrome or slight; there was a close relation among the women presenting with a moderate climateric syndrome and the dysfunctional familiar performance; the workers women have a trend to present a less intensive climateric syndrome stayed by more than 33% of them, thus demonstrating that more than 30% women with a proper satisfaction of its basic needs and a good resident hygienic environment, have the greater incidence of the asymptomatic climateric syndrome or slight closely related to sociocultural and economic features of study health areas. Conclusions: Women with a higher schooling level, with conjugal stability and working link being part also of functional or moderately functional families and with a good resident hygienic environment in correspondence with satisfaction of their basic needs, have a higher incidence of slight climateric syndrome or

  19. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... activity: relative intensity and absolute intensity. Relative Intensity The level of effort required by a person to do an activity. When using relative intensity, people pay attention to how physical activity affects their heart rate ...

  20. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Compartir For more help with what counts as aerobic activity, watch this video: Windows Media Player, 4: ... ways to understand and measure the intensity of aerobic activity: relative intensity and absolute intensity. Relative Intensity ...

  1. Factors associated with infant feeding of human milk at discharge from neonatal intensive care: Cross-sectional analysis of nurse survey and infant outcomes data

    Science.gov (United States)

    Hallowell, Sunny G.; Rogowski, Jeannette A.; Spatz, Diane L.; Hanlon, Alexandra L.; Kenny, Michael; Lake, Eileen T.

    2016-01-01

    Context Nurses are principal caregivers in the neonatal intensive care unit and support mothers to establish and sustain a supply of human milk for their infants. Whether an infant receives essential nutrition and immunological protection provided in human milk at discharge is an issue of health care quality in this setting. Objectives To examine the association of the neonatal intensive care unit work environment, staffing levels, level of nurse education, lactation consultant availability, and nurse-reported breastfeeding support with very low birth weight infant receipt of human milk at discharge. Design and setting Cross sectional analysis combining nurse survey data with infant discharge data. Participants A national sample of neonatal intensive care units (N = 97), nurses (N = 5614) and very low birth weight infants (N = 6997). Methods Sequential multivariate linear regression models were estimated at the unit level between the dependent variable (rate of very low birth weight infants discharged on “any human milk”) and the independent variables (nurse work environment, nurse staffing, nursing staff education and experience, lactation consultant availability, and nurse-reported breastfeeding support). Results The majority of very low birth weight infants (52%) were discharged on formula only. Fewer infants (42%) received human milk mixed with fortifier or formula. Only 6% of infants were discharged on exclusive human milk. A 1 SD increase (0.25) in the Practice Environment Scale of the Nursing Work Index composite score was associated with a four percentage point increase in the fraction of infants discharged on human milk (p nurses with a bachelor’s degree in nursing was associated with a three percentage point increase in the fraction infants discharged on human milk (p care units with better work environments, better educated nurses, and more infants who receive breastfeeding support by nurses have higher rates of very low birth weight infants

  2. Intensities of Mobility

    DEFF Research Database (Denmark)

    Bissell, David; Vannini, Phillip; Jensen, Ole B.

    2017-01-01

    This paper explores the intensities of long-distance commuting journeys in order to understand how bodily sensibilities become attuned to the regular mobilities which they undertake. More people are travelling farther to and from work than ever before, owing to a variety of factors which relate...... to complex social and geographical dynamics of transport, housing, lifestyle, and employment. Yet, the experiential dimensions of long-distance commuting have not received the attention that they deserve within research on mobilities. Drawing from fieldwork conducted in Australia, Canada, and Denmark...... this paper aims to further develop our collective understanding of the experiential particulars of long-distance workers or ‘supercommuters’. Rather than focusing on the extensive dimensions of mobilities that are implicated in broad social patterns and trends, our paper turns to the intensive dimensions...

  3. Evolution in space and time of two interacting intensities

    International Nuclear Information System (INIS)

    Wilhelmsson, H.

    1977-01-01

    The basic nonlinear coupled equations describing the interaction between two intensities (or two populations) are discussed. Analytic solutions are deduced for the evolution in space and time of initially given perturbations of the equilibrium intensities. (Auth.)

  4. Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions

    Directory of Open Access Journals (Sweden)

    Dzodzomenyo Mawuli

    2011-05-01

    Full Text Available Abstract Background The ability of many countries to achieve national health goals such as the Millennium Development Goals remains hindered by inadequate and poorly distributed health personnel, including doctors. The distribution of doctors in Ghana is highly skewed, with a majority serving in two major metropolitan areas (Accra and Kumasi, and inadequate numbers in remote and rural districts. Recent policies increasing health worker salaries have reduced migration of doctors out of Ghana, but made little difference to distribution within the country. This qualitative study was undertaken to understand how practicing doctors and medical leaders in Ghana describe the key factors reducing recruitment and retention of health professionals into remote areas, and to document their proposed policy solutions. Methods In-depth interviews were carried out with 84 doctors and medical leaders, including 17 regional medical directors and deputy directors from across Ghana, and 67 doctors currently practicing in 3 regions (Greater Accra, Brong Ahafo, and Upper West; these 3 regions were chosen to represent progressively more remote distances from the capital of Accra. Results and discussion All participants felt that rural postings must have special career or monetary incentives given the loss of locum (i.e. moonlighting income, the higher workload, and professional isolation of remote assignments. Career 'death' and prolonged rural appointments were a common fear, and proposed policy solutions focused considerably on career incentives, such as guaranteed promotion or a study opportunity after some fixed term of service in a remote or hardship area. There was considerable stress placed on the need for rural doctors to have periodic contact with mentors through rural rotation of specialists, or remote learning centers, and reliable terms of appointment with fixed end-points. Also raised, but given less emphasis, were concerns about the adequacy of clinical

  5. Key factors leading to reduced recruitment and retention of health professionals in remote areas of Ghana: a qualitative study and proposed policy solutions.

    Science.gov (United States)

    Snow, Rachel C; Asabir, Kwesi; Mutumba, Massy; Koomson, Elizabeth; Gyan, Kofi; Dzodzomenyo, Mawuli; Kruk, Margaret; Kwansah, Janet

    2011-05-21

    The ability of many countries to achieve national health goals such as the Millennium Development Goals remains hindered by inadequate and poorly distributed health personnel, including doctors. The distribution of doctors in Ghana is highly skewed, with a majority serving in two major metropolitan areas (Accra and Kumasi), and inadequate numbers in remote and rural districts. Recent policies increasing health worker salaries have reduced migration of doctors out of Ghana, but made little difference to distribution within the country. This qualitative study was undertaken to understand how practicing doctors and medical leaders in Ghana describe the key factors reducing recruitment and retention of health professionals into remote areas, and to document their proposed policy solutions. In-depth interviews were carried out with 84 doctors and medical leaders, including 17 regional medical directors and deputy directors from across Ghana, and 67 doctors currently practicing in 3 regions (Greater Accra, Brong Ahafo, and Upper West); these 3 regions were chosen to represent progressively more remote distances from the capital of Accra. All participants felt that rural postings must have special career or monetary incentives given the loss of locum (i.e. moonlighting income), the higher workload, and professional isolation of remote assignments. Career 'death' and prolonged rural appointments were a common fear, and proposed policy solutions focused considerably on career incentives, such as guaranteed promotion or a study opportunity after some fixed term of service in a remote or hardship area. There was considerable stress placed on the need for rural doctors to have periodic contact with mentors through rural rotation of specialists, or remote learning centers, and reliable terms of appointment with fixed end-points. Also raised, but given less emphasis, were concerns about the adequacy of clinical equipment in remote facilities, and remote accommodations. In

  6. Gaussian processes for prediction in intensive care

    OpenAIRE

    Guiza Grandas, Fabian; Ramon, Jan; Blockeel, Hendrik

    2006-01-01

    In this paper we present the use of Gaussian Processes for regression in the application of prediction in Intensive Care. We propose a preliminary solution to predicting the evolution of a patient's state during his stay in intensive care by means of defined patient specific characteristics.

  7. WSSV risk factors related to water physico-chemical properties and microflora in semi-intensive P .monodon culture ponds in the Philippines

    NARCIS (Netherlands)

    Tendencia Alapide, E.; Bosma, R.H.; Verreth, J.A.J.

    2010-01-01

    Whitespot syndrome virus, WSSV, is the most important among the shrimp diseases. One of the suggested WSSV risk factors is the occurrence of stress since stressors could compromise the shrimp defence system thus increasing the risk of WSSV infection. Stressors are usually related to the

  8. The Evolution of and Risk Factors for Neck Muscle Atrophy and Weakness in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy

    Science.gov (United States)

    Zhang, Lu-Lu; Mao, Yan-Ping; Zhou, Guan-Qun; Tang, Ling-Long; Qi, Zhen-Yu; Lin, Li; Yao, Ji-Jin; Ma, Jun; Lin, Ai-Hua; Sun, Ying

    2015-01-01

    Abstract The aim of this study was to investigate the evolution of sternocleidomastoid muscle (SCM) atrophy in nasopharyngeal carcinoma (NPC) patients following intensity-modulated radiotherapy (IMRT), and the relationship between SCM atrophy and neck weakness. Data were retrospectively analyzed from 223 biopsy-proven NPC patients with no distant metastasis who underwent IMRT with or without chemotherapy. The volume of SCM was measured on pretreatment magnetic resonance imaging (MRI), and MRIs were conducted 1, 2, and 3 years after the completion of IMRT. Change in SCM volume was calculated and classified using the late effects of normal tissues–subjective, objective, management, and analytic system. The grade of neck muscle weakness, classified by the Common Terminology Criteria for Adverse Events V 3.0, was measured 3 years after the completion of IMRT. The average SCM atrophy ratio was −10.97%, −18.65%, and −22.25% at 1, 2, and 3 years postirradiation, respectively. Multivariate analysis indicated N stage and the length of time after IMRT were independent prognostic variables. There were significant associations between the degree of SCM atrophy and neck weakness. Radical IMRT can cause significant SCM atrophy in NPC patients. A more advanced N stage was associated with more severe SCM atrophy, but no difference was observed between N2 and N3. SCM atrophy progresses over time during the 3 years following IMRT. Grade of SCM atrophy is significantly associated with neck weakness. PMID:26252307

  9. Viscosity Solution

    OpenAIRE

    Camilli, Fabio; Prados, Emmanuel

    2011-01-01

    International audience; Viscosity solution is a notion of weak solution for a class of partial differential equations of Hamilton-Jacobi type. The range of applications of the notions of viscosity solution and Hamilton-Jacobi equations is enormous, including common class of partial differential equations such as evolutive problems and problems with boundary conditions, equations arising in optimal control theory, differential games, second-order equations arising in stochastic optimal control...

  10. Cholestasis sepsis at neonatology ward and neonatal Intensive Care Unit Cipto Mangunkusumo Hospital 2007 : incidence, mortality rate and associated risk factors

    Directory of Open Access Journals (Sweden)

    Kadim S. Bachtiar

    2008-06-01

    Full Text Available Cholestatic jaundice represents serious pathological condition. Septic-cholestasis is a kind of hepato-cellular cholestasis that occured during or after sepsis caused by biliary flow obstruction. This is a cohort study from February to June 2007 on neonatal sepsis patients at Neonatology ward Department of Child Health Faculty of Medicine University of Indonesia-Cipto Mangunkusumo General National Hospital. Aim of this study is to find out the incidence of intrahepatic cholestasis in neonatal sepsis, associated risk factors, and mortality rate in neonatal cholestasis-sepsis. From 138 neonatal sepsis patients, the incidence of intrahepatic cholestasis is 65.9%. None of the risk factors tested in this study showed statistically significant result. Mortality rate of neonatal cholestasis-sepsis is 52.8%. (Med J Indones 2008; 17: 107-13Keywords: cholestasis intrahepatic, neonatal sepsis, cholestasis sepsis, conjugated hyperbilirubinemia

  11. Effects of a 10-Day Intensive Health Promotion Program Combining Diet and Physical Activity on Body Composition, Physical Fitness, and Blood Factors of Young Adults: A Randomized Pilot Study.

    Science.gov (United States)

    Lee, Kyoung Soon; Lee, Jae Koo; Yeun, Young Ran

    2017-04-11

    BACKGROUND A lifestyle characterized by poor eating habits and physical inactivity is a risk factor for multiple lifestyle diseases in young adults. This study assessed the effects of implementing an intensive 10-day health promotion program combining diet and physical activities on body composition, physical fitness, and biochemical parameters of young adults. MATERIAL AND METHODS In this randomized pilot study, 30 female undergraduate students were randomly allocated to an intervention and a control group. The health promotion program consisted of unlimited amounts of vegetarian food; aerobic, flexibility, and strength exercises (3 hours/day); lectures on health (3 hours/day); massage practice (2 hours/day); and healthy cooking practice (1 hour/day). The effects of the intervention were analyzed using the Mann-Whitney U test and the Wilcoxon signed-rank test. RESULTS The intensive 10-day health promotion program significantly reduced body weight, body mass index, triglyceride, total cholesterol, low-density lipoprotein cholesterol, blood glucose, and the homeostasis model assessment of insulin resistance. At the same time, participants demonstrated increased back muscle, leg muscle, and grip strength; waist and shoulder flexibility; balance; and cardiorespiratory endurance. CONCLUSIONS The intensive 10-day health promotion program is a viable intervention for improving body composition, physical fitness, glycemic control, and blood lipid levels in young adults.

  12. Extending the charge-flipping method towards structure solution from incomplete data sets

    Czech Academy of Sciences Publication Activity Database

    Palatinus, Lukáš; Steurer, W.; Chapuis, G.

    2007-01-01

    Roč. 40, - (2007), s. 456-462 ISSN 0021-8898 Institutional research plan: CEZ:AV0Z10100521 Keywords : ab initio structure solution * density modification * maximum entropy method * intensity extrapolation Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 3.629, year: 2007

  13. Data Analysis Of Small Angle X-Ray Solution Scattering And Its ...

    African Journals Online (AJOL)

    Small Angle X-ray Scattering analysis was used for the study of the protein, Human Tumour Necrosis Factor (TNF) homogeneously dispersed in solution. The experiment consisted in sending a well collimated beam of synchrotron radiation of wavelength, λ through the sample and measuring the variation of the intensity as a ...

  14. Factors Associated With the Increasing Rates of Discharges Directly Home From Intensive Care Units-A Direct From ICU Sent Home Study.

    Science.gov (United States)

    Lau, Vincent I; Priestap, Fran A; Lam, Joyce N H; Ball, Ian M

    2018-02-01

    To evaluate the relationship between rates of discharge directly to home (DDH) from the intensive care unit (ICU) and bed availability (ward and ICU). Also to identify patient characteristics that make them candidates for safe DDH and describe transfer delay impact on length of stay (LOS). Retrospective cohort study of all adult patients who survived their stay in our medical-surgical-trauma ICU between April 2003 and March 2015. Median age was 49 years (interquartile range [IQR]: 33.5-60.4), and the majority of the patients were males (54.8%). Median number of preexisting comorbidities was 5 (IQR: 2-7) diagnoses. Discharge directly to home increased from 28 (3.1% of all survivors) patients in 2003 to 120 (12.5%) patients in 2014. The mean annual rate of DDH was between 11% and 12% over the last 6 years. Approximately 62% (n = 397) of patients waited longer than 4 hours for a ward bed, with a median delay of 2.0 days (IQR: 0.5-4.7) before being DDH. There was an inverse correlation between ICU occupancy and DDH rates ( r P = -.55, P DDH rates ( r s = -.055, P = .64, 95% CI = -0.25 to 0.21). The DDH rates have been increasing over time at our institution and were inversely correlated with ICU bed occupancy but were not associated with ward occupancy. The DDH patients are young, have few comorbidities on admission, and few discharge diagnoses, which are usually reversible single system problems with low disease burden. Transfers to the ward are delayed in a majority of cases, leading to increased ICU LOS and likely increased overall hospital LOS as well.

  15. Factors associated with inter-institutional variations in sepsis rates of very-low-birth-weight infants in 34 Malaysian neonatal intensive care units.

    Science.gov (United States)

    Boo, Nem-Yun; Cheah, Irene Guat-Sim

    2016-03-01

    This study aimed to determine whether patient loads, infant status on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis rates in very-low-birth-weight (VLBW) infants in the Malaysian National Neonatal Registry (MNNR). This was a retrospective study of 3,880 VLBW (≤ 1,500 g) infants admitted to 34 neonatal intensive care units (NICUs) in the MNNR. Sepsis was diagnosed in symptomatic infants with positive blood culture. Sepsis developed in 623 (16.1%) infants; 61 (9.8%) had early-onset sepsis (EOS) and 562 (90.2%) had late-onset sepsis (LOS). The median EOS rate of all NICUs was 1.0% (interquartile range [IQR] 0%, 2.0%). Compared with NICUs reporting no EOS (n = 14), NICUs reporting EOS (n = 20) had significantly higher patient loads (total live births, admissions, VLBW infants, outborns); more mothers with a history of abortions, and antenatal steroids and intrapartum antibiotic use; more infants requiring resuscitation procedures at birth; higher rates of surfactant therapy, pneumonia and insertion of central venous catheters. The median LOS rate of all NICUs was 14.5% (IQR 7.8%, 19.2%). Compared with NICUs with LOS rates below the first quartile (n = 8), those above the third quartile (n = 8) used less intrapartum antibiotics, and had significantly bigger and more mature infants, more outborns, as well as a higher number of sick infants requiring ventilator support and total parenteral nutrition. Patient loads, resuscitation at birth, status of infants on admission and treatment interventions were significantly associated with inter-institutional variations in sepsis. Copyright: © Singapore Medical Association.

  16. Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer. Factors for cardiac sparing and clinical outcomes

    International Nuclear Information System (INIS)

    Chen Jenny Lingyu; Cheng Jason Chiahsien; Kuo Sunghsin; Chan Hsingmin; Chen Yuhsuan; Huang Yusen

    2013-01-01

    Since December 2009, after breast-conserving surgery for Stage 0-I cancer of the left breast, 21 women with relatively pendulous breasts underwent computed tomography prone and supine simulations. The adjuvant radiotherapy was 50 Gy in 25 fractions to the left breast alone. Four plans-conventional wedged tangents and forward intensity-modulated radiotherapy (fIMRT) in supine and prone positions-were generated. fIMRT generated better homogeneity in both positions. Prone position centralized the breast tissue by gravity and also shortened the breast width which led to better conformity in both planning techniques. Prone fIMRT significantly reduced doses to left lung, Level I and Level II axilla. The mean cardiac doses did not differ between positions. Among the four plans, prone fIMRT produced the best target dosimetry and normal organ sparing. In subgroup analysis, patients with absolute breast depth >7 cm in the prone position or breast depth difference >3 cm between positions had significant cardiac sparing with prone fIMRT. Sixteen patients with significant cardiac sparing in prone position were treated using prone fIMRT and the others using supine fIMRT. All patients received a supine electron tumor bed boost of 10 Gy in 5 fractions. No patients developed Grade 2 or worse acute or late toxicities. There was no difference in the number of segments or beams, monitor units, treatment time, or positioning reproducibility between prone and supine positions. At a median follow-up time of 26.8 months, no locoregional or distant recurrence or death was noted. (author)

  17. Prevalence and risk factors for development of hemorrhagic gastro-intestinal disease in veterinary intensive care units in the United Kingdom.

    Science.gov (United States)

    Swann, James W; Maunder, Christina L; Roberts, Emma; McLauchlan, Gerard; Adamantos, Sophie

    2016-05-01

    To determine the prevalence of hemorrhagic gastro-intestinal (GI) disease developing in dogs and cats admitted for management of non-GI disease in veterinary intensive care units (ICUs). Retrospective study of animals presented between October 2012 and July 2013. Three ICUs located in veterinary teaching hospitals in the United Kingdom. Dogs (n = 272) and cats (n = 94) were consecutively enrolled from 3 ICUs if they were hospitalized in the unit for at least 24 hours. Cases were excluded if they had hemorrhagic GI disease in the 48-hour period before presentation or in the 24-hour period after admission. Cases were also excluded if they suffered skull fracture, epistaxis, or hemoptysis, if they underwent surgical procedures of the GI or upper respiratory tracts, or if they were presented for management of GI disease. Hemorrhagic GI disease was observed in dogs at all 3 units, but at different rates (Center 1: 10.3%, Center 2: 4.8%, Center 3: 2.2%). Hemorrhagic GI disease was not observed in cats at any of the participating centers. Construction of a multivariable logistic regression model revealed that serum albumin concentration, administration of prophylactic gastro-protectant drugs, and institution were significantly associated with the development of hemorrhagic GI disease in dogs. Development of hemorrhagic GI disease and placement of a feeding tube were significantly associated with mortality during the period of hospitalization in dogs. Thirty-seven (13.6%) dogs and 12 (12.8%) cats died or were euthanized while hospitalized, with a higher mortality rate (42.1%) in dogs with hemorrhagic GI disease. Hemorrhagic GI disease does develop in dogs hospitalized for management of non-GI disease, but this phenomenon was not observed in cats. Development of hemorrhagic GI disease appeared to have a significant impact on survival in veterinary ICUs. © Veterinary Emergency and Critical Care Society 2015.

  18. NTCP models for patient-rated xerostomia and sticky saliva after treatment with intensity modulated radiotherapy for head and neck cancer: The role of dosimetric and clinical factors

    International Nuclear Information System (INIS)

    Beetz, Ivo; Schilstra, Cornelis; Schaaf, Arjen van der; Heuvel, Edwin R. van den; Doornaert, Patricia; Luijk, Peter van; Vissink, Arjan; Laan, Bernard F.A.M. van der; Leemans, Charles R.; Bijl, Henk P.; Christianen, Miranda E.M.C.; Steenbakkers, Roel J.H.M.; Langendijk, Johannes A.

    2012-01-01

    Purpose: The purpose of this multicentre prospective study was to develop multivariable logistic regression models to make valid predictions about the risk of moderate-to-severe patient-rated xerostomia (XER M6 ) and sticky saliva 6 months (STIC M6 ) after primary treatment with intensity modulated radiotherapy (IMRT) with or without chemotherapy for head and neck cancer (HNC). Methods and materials: The study population was composed of 178 consecutive HNC patients treated with IMRT. All patients were included in a standard follow up programme in which acute and late side effects and quality of life were prospectively assessed, prior to, during and after treatment. The primary endpoints were XER M6 and STIC M6 as assessed by the EORTC QLQ-H and N35 after completing IMRT. Organs at risk (OARs) potentially involved in salivary function were delineated on planning-CT, including the parotid, submandibular and sublingual glands and the minor glands in the soft palate, cheeks and lips. Patients with moderate-to-severe xerostomia or sticky saliva, respectively, at baseline were excluded. The optimal number of variables for a multivariate logistic regression model was determined using a bootstrapping method. Results: Eventually, 51.6% of the cases suffered from XER M6 . The multivariate analysis showed that the mean contralateral parotid gland dose and baseline xerostomia (none vs. a bit) were the most important predictors for XER M6 . For the multivariate NTCP model, the area under the receiver operating curve (AUC) was 0.68 (95% CI 0.60–0.76) and the discrimination slope was 0.10, respectively. Calibration was good with a calibration slope of 1.0. At 6 months after IMRT, 35.6% of the cases reported STIC M6 . The mean contralateral submandibular gland dose, the mean sublingual dose and the mean dose to the minor salivary glands located in the soft palate were most predictive for STIC M6 . For this model, the AUC was 0.70 (95% CI 0.61–0.78) and the discrimination slope

  19. A difference-matrix metaheuristic for intensity map segmentation in step-and-shoot IMRT delivery.

    Science.gov (United States)

    Gunawardena, Athula D A; D'Souza, Warren D; Goadrich, Laura D; Meyer, Robert R; Sorensen, Kelly J; Naqvi, Shahid A; Shi, Leyuan

    2006-05-21

    At an intermediate stage of radiation treatment planning for IMRT, most commercial treatment planning systems for IMRT generate intensity maps that describe the grid of beamlet intensities for each beam angle. Intensity map segmentation of the matrix of individual beamlet intensities into a set of MLC apertures and corresponding intensities is then required in order to produce an actual radiation delivery plan for clinical use. Mathematically, this is a very difficult combinatorial optimization problem, especially when mechanical limitations of the MLC lead to many constraints on aperture shape, and setup times for apertures make the number of apertures an important factor in overall treatment time. We have developed, implemented and tested on clinical cases a metaheuristic (that is, a method that provides a framework to guide the repeated application of another heuristic) that efficiently generates very high-quality (low aperture number) segmentations. Our computational results demonstrate that the number of beam apertures and monitor units in the treatment plans resulting from our approach is significantly smaller than the corresponding values for treatment plans generated by the heuristics embedded in a widely use commercial system. We also contrast the excellent results of our fast and robust metaheuristic with results from an 'exact' method, branch-and-cut, which attempts to construct optimal solutions, but, within clinically acceptable time limits, generally fails to produce good solutions, especially for intensity maps with more than five intensity levels. Finally, we show that in no instance is there a clinically significant change of quality associated with our more efficient plans.

  20. A difference-matrix metaheuristic for intensity map segmentation in step-and-shoot IMRT delivery

    International Nuclear Information System (INIS)

    Gunawardena, Athula D A; D'Souza, Warren D; Goadrich, Laura D; Meyer, Robert R; Sorensen, Kelly J; Naqvi, Shahid A; Shi, Leyuan

    2006-01-01

    At an intermediate stage of radiation treatment planning for IMRT, most commercial treatment planning systems for IMRT generate intensity maps that describe the grid of beamlet intensities for each beam angle. Intensity map segmentation of the matrix of individual beamlet intensities into a set of MLC apertures and corresponding intensities is then required in order to produce an actual radiation delivery plan for clinical use. Mathematically, this is a very difficult combinatorial optimization problem, especially when mechanical limitations of the MLC lead to many constraints on aperture shape, and setup times for apertures make the number of apertures an important factor in overall treatment time. We have developed, implemented and tested on clinical cases a metaheuristic (that is, a method that provides a framework to guide the repeated application of another heuristic) that efficiently generates very high-quality (low aperture number) segmentations. Our computational results demonstrate that the number of beam apertures and monitor units in the treatment plans resulting from our approach is significantly smaller than the corresponding values for treatment plans generated by the heuristics embedded in a widely use commercial system. We also contrast the excellent results of our fast and robust metaheuristic with results from an 'exact' method, branch-and-cut, which attempts to construct optimal solutions, but, within clinically acceptable time limits, generally fails to produce good solutions, especially for intensity maps with more than five intensity levels. Finally, we show that in no instance is there a clinically significant change of quality associated with our more efficient plans

  1. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... videos Here are some ways to understand and measure the intensity of aerobic activity: relative intensity and ... The talk test is a simple way to measure relative intensity. In general, if you're doing ...

  2. A Field Intensive Approach to Understanding Relationships Between Vegetation, Landscape, and Management Factors and Their Effects on Stream Sediment and Nutrient Delivery in the Lake Tahoe Basin

    Science.gov (United States)

    Meidav, J. S.; Barbour, M. G.

    2008-12-01

    Understanding how management and vegetation type affect watershed factors is an important issue worldwide and key to connecting upland and downstream resource conservation. This work evaluated the connections between stream sediment and nutrient (nitrogen and phosphorus) constituents with land management and vegetation factors within the highest sediment yield watershed of the Lake Tahoe Basin (CA-NV), Blackwood Creek. Among plant community types, sub-watersheds with the highest amount of riparian/wetland vegetated areas were linked with the highest sediment and nutrient filtering capacity. Riparian/wetland areas appeared to act as a sink for sediment and nutrients during the peak flow period, while being a source area during base flow, corroborating other studies on disturbance effects on the hydrograph. Separating the watershed effects of forest species density and basal area from past management activities (e.g. logging and mining) proved equivocal on a sub-watershed scale. As the magnitude of landscape management impacts increased, the effects of peak flows on sediment and nutrient yield increased. Within more disturbed watersheds, the inorganic fraction of sediment and phosphorus dominated transport, which implicated in- and near-channel sources and features as having disproportionate effects on sub-watershed scale sediment and nutrient delivery. Without employing catchment-wide treatments or a priori linear models, the methods employed discerned that small particle sources, linked to lake clarity loss, are positively connected to the inorganic fraction and riparian, near-channel, sand deposits while manifesting a negative correlation with in-channel clay. Linking channel morphology and riparian and upland vegetation restoration (structure and process) in tandem will be important as efforts continue in the restoration of Lake Tahoe's ecological health.

  3. Sky view factor analysis of street canyons and its implication for urban heat island intensity : a GIS-based methodology applied in Hong Kong

    Energy Technology Data Exchange (ETDEWEB)

    Chen, L.; Ng, E. [Chinese Univ. of Hong Kong (China). Dept. of Architecture

    2009-07-01

    This paper reported on a study that examined the influence of building density and geometry on the microclimate in Hong Kong. In particular, it examined the sky view factor (SVF) that refers to the obstruction of the sky by built-up urban areas and the delay of surface cooling during clear, calm nights. In radiation budget models, the sky view factor (SVF) indicates the ratio of the radiation received (or emitted) by a planar surface to the radiation emitted (or received) by the entire hemispheric environment. It measures the percentage of radiation penetrated into the urban canopy layer (UCL). SVF is a dimensionless value ranging from 0 to 1 where 0 indicates that the sky is completely obstructed and the outgoing long-wave radiation is trapped within the urban canyons, and 1 means the sky is completely open and the radiation emits freely outside the UCL. Urban heat island (UHI) occurs when the difference in cooling rates between urban built-up areas and rural surroundings result in a nocturnal temperature difference between urban and rural areas. A GIS-based computer program was developed for calculating continuous SVF values in the entire urban environment. A map of SVF values was generated to derive an overall pattern of how Hong Kong's unique building bulk characteristics and UHI are related. The results can be used as a prognostic approach for categorizing Hong Kong's urban area for planning concerns for high dense sub-tropical cities.It was concluded that the GIS approach opens up new horizon for large scale urban geometry simulation. Integration with other whole building simulation methods such as computational fluid dynamics (CFD) is expected to provide more comprehensive understanding of the relation between climatic data and building form. 16 refs., 1 tab., 9 figs.

  4. Six-year trend analysis of nosocomial candidemia and risk factors in two intensive care hospitals in Mato Grosso, midwest region of Brazil.

    Science.gov (United States)

    Hoffmann-Santos, Hugo Dias; Paula, Claudete Rodrigues; Yamamoto, Ana Caroline Akeme; Tadano, Tomoko; Hahn, Rosane C

    2013-12-01

    We conducted this cross-sectional retrospective study using clinical and laboratory data from two tertiary hospitals in Cuiabá, Mato Grosso, Brazil, in order to explore the risk factors and estimate mortality, prevalence and lethality of candidemia between 2006 and 2011. A total of 130 episodes of candidemia were identified. The prevalence of candidemia was 1.8 per 1,000 admissions, the mortality rate was 0.9 per 1,000 admissions, and the lethality was 49.2 %. The main agent in this population was Candida parapsilosis (n = 50), followed by C. albicans (n = 45). Comparison between the numbers of episodes in the two triennia revealed that the non-albicans group grew by 48.2 %. The distribution of yeast species of Candida per hospital unit revealed that C. albicans was more prevalent than C. parapsilosis in the adult ICU and C. parapsilosis was more prevalent than C. albicans in the neonatal ICU. Patients remained hospitalized for an average of 53.5 days. Central venous catheters, parenteral nutrition and age were the variables that proved to be independent in the multivariate analysis and that maintained a statistically significant association with the incidence of death in patients with candidemia. The annual prevalence of candidemia showed a significant increase in the second triennium (2009-2011) compared with the first (2006-2008) probably due to increased exposure to risk factors: central venous catheter, H2 blockers, nutrition parenteral corticosteroids and mean hospital duration.

  5. Solution preparation

    International Nuclear Information System (INIS)

    Seitz, M.G.

    1982-01-01

    Reviewed in this statement are methods of preparing solutions to be used in laboratory experiments to examine technical issues related to the safe disposal of nuclear waste from power generation. Each approach currently used to prepare solutions has advantages and any one approach may be preferred over the others in particular situations, depending upon the goals of the experimental program. These advantages are highlighted herein for three approaches to solution preparation that are currently used most in studies of nuclear waste disposal. Discussion of the disadvantages of each approach is presented to help a user select a preparation method for his particular studies. Also presented in this statement are general observations regarding solution preparation. These observations are used as examples of the types of concerns that need to be addressed regarding solution preparation. As shown by these examples, prior to experimentation or chemical analyses, laboratory techniques based on scientific knowledge of solutions can be applied to solutions, often resulting in great improvement in the usefulness of results

  6. Multipolar Solutions

    OpenAIRE

    Quevedo, Hernando

    2012-01-01

    A class of exact solutions of the Einstein-Maxwell equations is presented which contains infinite sets of gravitoelectric, gravitomagnetic and electromagnetic multipole moments. The multipolar structure of the solutions indicates that they can be used to describe the exterior gravitational field of an arbitrarily rotating mass distribution endowed with an electromagnetic field. The presence of gravitational multipoles completely changes the structure of the spacetime because of the appearance...

  7. Schistosoma mansoni and soil-transmitted helminths among preschool-aged children in Chuahit, Dembia district, Northwest Ethiopia: prevalence, intensity of infection and associated risk factors

    Directory of Open Access Journals (Sweden)

    Agersew Alemu

    2016-05-01

    Full Text Available Abstract Background Intestinal schistosomiasis and soil-transmitted helminthiasis are the major public health problems globally. Compared with any other age group, pre-school aged children and school-aged children are the most exposed. There are few studies showing the burden of intestinal schistosomiasis, and soil-transmitted helminthiasis among pre-school aged children in Ethiopia. Hence, this study aimed to assess the prevalence of schistosoma mansoni and soil-transmitted helminths and associated risk factors among preschool aged children of Chuahit and surrounding Kebeles, Northwest Ethiopia. Methods A community based cross sectional study was conducted from February 2 to March 27 2015. Four hundred one preschool-aged children were included in the study by using two stage cluster sampling technique. Pretested structured questionnaire was employed to collected data via face-to-face interview technique. A single stool specimen was collected, and a portion of the sample was processed by Kato Katz method. Results Of the total children, 141 (35.2 % harbored one or more intestinal helminthes. Schistosoma mansoni was found in 45 (11.2 % of preschool age children. Ascaris lumbricoides was the predominant isolate, 77 (19.2 % followed by S. mansoni, 45 (11.2 %. The least parasites isolated were Tania species, 2 (0.5 %. After adjusting for other variables, being mothers who did not have the habit of washing hands after toilet (AOR = 7.3, 95%CI: 2.97–17.95, being occupationally housewife mothers (AOR = 8.9, 95%CI: 2.27–25.4, using protected spring water as a main family source of water (AOR = 3.9, 95%CI: 1.2–12.3 and child habit of not wearing shoe (AOR = 1.91, 95%CI: 1.01–3.64 were significantly associated with high prevalence of soil-transmitted helminthiasis among preschool-age children in Chuahit. Conclusion The current study showed that relatively higher level of STH and S. mansoni among preschool-aged children in

  8. Factores que influyen sobre la aparición de infecciones hospitalarias en los pacientes de cuidados intensivos Factors influencing hospital infection in patients in the intensive care unit

    OpenAIRE

    Aurora Llanos-Méndez; Carmen Díaz-Molina; José Luis Barranco-Quintana; Visitación García-Ortúzar; Rafael Fernández-Crehuet

    2004-01-01

    Objetivo: La acumulación de factores de riesgo en los pacientes atendidos en el hospital es uno de los elementos que condicionan el aumento de la infección nosocomial y su mayor frecuencia en las unidades de cuidados intensivos (UCI). Nuestro objetivo es la identificación de los factores de riesgo de la infección nosocomial en la UCI de nuestro hospital. Métodos: Se efectuó un estudio de cohortes prospectivo sobre los 1.134 pacientes ingresados, al menos durante 24 h en dicha UCI durante el a...

  9. Factors controlling the chemical composition of colloidal and dissolved fractions in soil solutions and the mobility of trace elements in soils

    Science.gov (United States)

    Gangloff, Sophie; Stille, Peter; Schmitt, Anne-Désirée; Chabaux, François

    2016-09-01

    The objectives of this study were to determine the processes and physico-chemical conditions that affect the composition of the soil solutions of a forest soil and to elucidate their impact on the transport of major and trace elements through the colloidal (0.2 μm to 5 kDa) and dissolved (soil. All experiments were performed with soil solutions obtained using lysimeter plates situated on an experimental spruce parcel of the Strengbach catchment (Northeastern France). The surface samples filtered at 0.2 μm facilitated the examination of the influence of litter decomposition on the chemical composition of the upper soil solutions. The impact of the soils biogeochemical conditions (pH, moisture, temperature, oxic or anoxic conditions) on litter decomposition was also examined. More particularly, the increase in NH4+ and NO2- compounds in some of the soil solutions points to denitrification processes in an anoxic environment. Thus, under anoxic conditions, the soil solution is enriched in Ca, P, Mn and Zn, whereas under oxic conditions it is enriched in Al and Fe. The physico-chemical conditions are more seasonally dependent in the upper soil horizons than in the deeper ones and have an impact on the variability of the chemical composition of the soil solutions. The colloidal and dissolved fractions of the soil solutions were obtained by tangential flow ultra-filtration. The experimental results reveal that nutrients, such as NO3- and P, are primarily in the dissolved fraction and consequently bioavailable; secondary minerals may be dissolved and/or precipitate in the colloidal fraction, such as pyromorphite (Pb5(PO4)3(OH, Cl, F)). The results further indicate that microbial activity influences the composition of the colloidal and dissolved fractions, and possibly enriches the colloidal fraction in Ca, Mn and P, diminishes the concentrations of Pb, V, Cr and Fe in the dissolved fraction, and changes the structure of organic carbon (OC). These results are important

  10. A pilot study on peritraumatic dissociation and coping styles as risk factors for posttraumatic stress, anxiety and depression in parents after their child's unexpected admission to a Pediatric Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2009-10-01

    Full Text Available Abstract Aim To study the prevalence of posttraumatic stress disorder (PTSD, anxiety and depression in parents three months after pediatric intensive care treatment of their child and examine if peritraumatic dissocation and coping styles are related to these mental health problems. Methods This is a prospective cohort study and included parents of children unexpectedly admitted to the Pediatric Intensive Care Unit (PICU from January 2006 to March 2007. At three months follow-up parents completed PTSD (n = 115, anxiety and depression (n = 128 questionnaires. Immediately after discharge, parents completed peritraumatic dissocation and coping questionnaires. Linear regression models with generalized estimating equations examined risk factors for mental health problems. Results Over 10% of the parents were likely to meet criteria for PTSD and almost one quarter for subclinical PTSD. Respectively 15% to 23% of the parents reported clinically significant levels of depression and anxiety. Peritraumatic dissocation was most strongly associated with PTSD, anxiety as well as depression. Avoidance coping was primarily associated with PTSD. Conclusion A significant number of parents have mental health problems three months after unexpected PICU treatment of their child. Improving detection and raise awareness of mental health problems is important to minimize the negative effect of these problems on parents' well-being.

  11. Analysis of clinical and dosimetric factors associated with severe acute radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent chemotherapy and intensity-modulated radiotherapy.

    Science.gov (United States)

    Shi, Anhui; Zhu, Guangying; Wu, Hao; Yu, Rong; Li, Fuhai; Xu, Bo

    2010-05-12

    To evaluate the association between the clinical, dosimetric factors and severe acute radiation pneumonitis (SARP) in patients with locally advanced non-small cell lung cancer (LANSCLC) treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT). We analyzed 94 LANSCLC patients treated with concurrent chemotherapy and IMRT between May 2005 and September 2006. SARP was defined as greater than or equal 3 side effects and graded according to Common Terminology Criteria for Adverse Events (CTCAE) version 3.0. The clinical and dosimetric factors were analyzed. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between clinical, dosimetric factors and SARP. Median follow-up was 10.5 months (range 6.5-24). Of 94 patients, 11 (11.7%) developed SARP. Univariate analyses showed that the normal tissue complication probability (NTCP), mean lung dose (MLD), relative volumes of lung receiving more than a threshold dose of 5-60 Gy at increments of 5 Gy (V5-V60), chronic obstructive pulmonary disease (COPD) and Forced Expiratory Volume in the first second (FEV1) were associated with SARP (p 4.2% and NTCP 50% were 5.7% and 29.2%, respectively (p < 0.01). NTCP value and V10 are the useful indicators for predicting SARP in NSCLC patients treated with concurrent chemotherapy and IMRT.

  12. Risk factors of multidrug-resistant, extensively drug-resistant and pandrug-resistant Acinetobacter baumannii ventilator-associated pneumonia in a Medical Intensive Care Unit of University Hospital in Thailand.

    Science.gov (United States)

    Inchai, Juthamas; Liwsrisakun, Chalerm; Theerakittikul, Theerakorn; Chaiwarith, Romanee; Khositsakulchai, Weerayut; Pothirat, Chaicharn

    2015-08-01

    Ventilator-associated pneumonia (VAP) caused by Acinetobacter baumannii remains a significant cause of morbidity and mortality. Increasing antimicrobial resistance influences the selection of antibiotic treatment especially pandrug-resistant A. baumannii. A retrospective cohort study was conducted in the Medical Intensive Care Unit to identify the risk factors of VAP caused by multidrug-resistant A. baumannii (MDR-AB), extensively drug-resistant A. baumannii (XDR-AB) and pandrug-resistant A. baumannii (PDR-AB). All 337 adult patients with confirmed A. baumannii VAP were included. The incidence of MDR-AB, XDR-AB and PDR-AB were 72 (21.4%), 220 (65.3%) and 12 (3.6%), respectively. The risk factor for MDR-AB was prior use of carbapenems (OR 5.20; 95% CI 1.41-19.17). Risk factors for XDR-AB were the prior use of carbapenems (OR, 6.30; 95% CI, 1.80-21.97) and a high Sequential Organ Failure Assessment (SOFA) score (OR 1.35; 95% CI 1.07-1.71). In PDR-AB, the risk factors were the prior use of colistin (OR, 155.95; 95% CI, 8.00-3041.98), carbapenems (OR, 12.84; 95% CI, 1.60-103.20) and a high Simplified Acute Physiology Score (SAPS II) (OR 1.10; 95% CI 1.01-1.22). In conclusion, previous exposure to antibiotics and severity of VAP were risk factors of drug-resistant A. baumannii. Judicious use of carbapenems and colistin is recommended to prevent the antimicrobial-resistant strains of this organism. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  13. High-intensity interval training or continuous training, combined or not with fasting, in obese or overweight women with cardiometabolic risk factors: study protocol for a randomised clinical trial.

    Science.gov (United States)

    De Lorenzo, Andrea; Van Bavel, Diogo; de Moraes, Roger; Tibiriça, Eduardo V

    2018-04-28

    Physical inactivity and increased caloric intake play important roles in the pathophysiology of obesity. Increasing physical activity and modifying eating behaviours are first-line interventions, frequently hampered by lack of time to exercise and difficulties in coping with different diets. High-intensity interval training (HIIT) may be a time-efficient method compared with moderate-intensity continuous training (CT). Conversely, diets with a fasting component may be more effective than other complex and restrictive diets, as it essentially limits caloric intake to a specified period without major diet composition changes. Therefore, the combination of HIIT and fasting may provide incremental benefits in terms of effectiveness and time efficiency in obese and sedentary populations. The aim of this study is to determine the effect of HIIT versus CT, combined or not with fasting, on microcirculatory function, cardiometabolic parameters, anthropometric indices, cardiorespiratory fitness and quality of life in a population of sedentary overweight or obese women with cardiometabolic risk factors. Sedentary women aged 30-50 years, with a body mass index ≥25 kg/m 2 and cardiometabolic risk factors, will be randomised to HIIT performed in the fasting state, HIIT performed in the fed state, CT in the fasting state or CT in the fed state. Cardiometabolic parameters, anthropometric indices, cardiorespiratory fitness, quality of life and microvascular function (cutaneous capillary density and microvascular reactivity evaluated by laser speckle contrast imaging) will be evaluated before initiation of the interventions and 16 weeks thereafter. The trial complies with the Declaration of Helsinki and has been approved by the local ethics committee (Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil). All patients provide written informed consent before enrolment and randomisation. The study's results will be disseminated to the healthcare community by publications and

  14. Intensity Frontier Instrumentation

    Energy Technology Data Exchange (ETDEWEB)

    Kettell S.; Rameika, R.; Tshirhart, B.

    2013-09-24

    The fundamental origin of flavor in the Standard Model (SM) remains a mystery. Despite the roughly eighty years since Rabi asked “Who ordered that?” upon learning of the discovery of the muon, we have not understood the reason that there are three generations or, more recently, why the quark and neutrino mixing matrices and masses are so different. The solution to the flavor problem would give profound insights into physics beyond the Standard Model (BSM) and tell us about the couplings and the mass scale at which the next level of insight can be found. The SM fails to explain all observed phenomena: new interactions and yet unseen particles must exist. They may manifest themselves by causing SM reactions to differ from often very precise predictions. The Intensity Frontier (1) explores these fundamental questions by searching for new physics in extremely rare processes or those forbidden in the SM. This often requires massive and/or extremely finely tuned detectors.

  15. Scenarios of future energy intensities

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In this chapter, the authors present scenarios of potential change in energy intensities in the OECD countries and in the Soviet Union. These scenarios are meant to illustrate how intensities might evolve over the next 20 years given different conditions with respect to energy prices, energy-efficiency policies, and other key factors. Changes in intensity will also be affected by the rates of growth and stock turnover in each sector. They have not tried to forecast how activity levels and structure will evolve. However, the OECD scenarios assume a world in which GDP averages growth in the 2-3%/year range, with some differences among countries. For the Soviet Union, the degree and pace of intensity decline will be highly dependent on the success of the transition to a market economy; each scenario explicitly envisions a different degree of success. They have not constructed comparable scenarios for the developing countries. The scenarios presented in this chapter do not predict what will happen in the future. They believe, however, that they illustrate a plausible set of outcomes if energy prices, policies, programs, and other factors evolve as described in each case. With higher energy prices and vigorous policies and programs, intensities in the OECD countries in 2010 could be nearly 50% less on average than the level where trends seem to be point. In the former Soviet Union, a combination of rapid, successful economic reform and extra effort to improve energy efficiency might result in average intensity being nearly 40% less than in a slow reform case. And in the LDCs, a mixture of sound policies, programs, and energy pricing reform could also lead to intensities being far lower than they would be otherwise. 8 refs., 10 figs., 1 tab

  16. Smart street lighting solution for remote rural areas of India

    Science.gov (United States)

    Hajra, Debdyut

    2017-09-01

    Though many smart street lighting solutions is available for urban areas, comparatively fewer solutions exist for rural areas. In the recent times, village streets have been illuminated with artificial lights as a part of rural development drive undertaken by the governments of respective countries. But, vehicle and pedestrian traffic is quite low through village roads. Hence, if light remains on all night long on such roads, then there is a huge wastage of energy. This calls for solutions to reduce this energy loss in an efficient manner. There are a lot of factors which must be kept in mind while designing solutions. Many villages lack the proper infrastructure to support new technologies. Communication facilities are limited, lack of local technically skilled labor, lack of security, etc. After evaluating these opportunities and challenges, an attempt has been made to devise a smart street lighting solution tailored for remote rural areas in India. One part of the solution discusses how intensity of the LED street lights can be varied according to the ambient lighting conditions using sensors and LED switching in LED matrix. An artificial intelligence (AI) has also been modelled to identify traffic conditions using PIR sensors and object identification through image processing and independently control the lights. It also tracks the performance and status of each light. It would send this data and necessary notifications to a distant control center for human evaluation. This solution is also applicable for other rural areas throughout the world.

  17. Polymer solutions

    Science.gov (United States)

    Krawczyk, Gerhard Erich [Bremen, DE; Miller, Kevin Michael [West Dundee, IL

    2011-07-26

    There is provided a method of making a polymer solution comprising polymerizing one or more monomer in a solvent, wherein said monomer comprises one or more ethylenically unsaturated monomer that is a multi-functional Michael donor, and wherein said solvent comprises 40% or more by weight, based on the weight of said solvent, one or more multi-functional Michael donor.

  18. Solution Prototype

    DEFF Research Database (Denmark)

    Efeoglu, Arkin; Møller, Charles; Serie, Michel

    2013-01-01

    environment. The solution prototype that is composed from blending product and service prototype has particular impacts on the dualism of DSR’s “Build” and “Evaluate”. Since the mix between product and service prototyping can be varied, there is a demand for a more agile and iterative framework. Van de Ven...

  19. Podcast solutions

    CERN Document Server

    Geoghegan, Michael W

    2005-01-01

    Podcasting is the art of recording radio show style audio tracks, then distributing them to listeners on the Web via podcasting software such as iPodder. From downloading podcasts to producing a track for fun or profit, ""Podcast Solutions"" covers the entire world of podcasting with insight, humor, and the unmatched wisdom of experience.

  20. Analysis of clinical and dosimetric factors associated with severe acute radiation pneumonitis in patients with locally advanced non-small cell lung cancer treated with concurrent chemotherapy and intensity-modulated radiotherapy

    Directory of Open Access Journals (Sweden)

    Xu Bo

    2010-05-01

    Full Text Available Abstract Background To evaluate the association between the clinical, dosimetric factors and severe acute radiation pneumonitis (SARP in patients with locally advanced non-small cell lung cancer (LANSCLC treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT. Methods We analyzed 94 LANSCLC patients treated with concurrent chemotherapy and IMRT between May 2005 and September 2006. SARP was defined as greater than or equal 3 side effects and graded according to Common Terminology Criteria for Adverse Events (CTCAE version 3.0. The clinical and dosimetric factors were analyzed. Univariate and multivariate logistic regression analyses were performed to evaluate the relationship between clinical, dosimetric factors and SARP. Results Median follow-up was 10.5 months (range 6.5-24. Of 94 patients, 11 (11.7% developed SARP. Univariate analyses showed that the normal tissue complication probability (NTCP, mean lung dose (MLD, relative volumes of lung receiving more than a threshold dose of 5-60 Gy at increments of 5 Gy (V5-V60, chronic obstructive pulmonary disease (COPD and Forced Expiratory Volume in the first second (FEV1 were associated with SARP (p p = 0.001 and V10 (p = 0.015 were the most significant factors associated with SARP. The incidences of SARP in the group with NTCP > 4.2% and NTCP ≤4.2% were 43.5% and 1.4%, respectively (p 50% were 5.7% and 29.2%, respectively (p Conclusions NTCP value and V10 are the useful indicators for predicting SARP in NSCLC patients treated with concurrent chemotherapy and IMRT.

  1. Bounding Theorems for Stress Intensity Factors.

    Science.gov (United States)

    1981-07-22

    are o 0 0 0 ciJi ij 2 ii ij ikl aij (26) 0 u (x) a ui 2 ux) u(x) Cii x1 It now follows from virtual work that -S Ta ui2dS + ui2d - - a 1 Cu0 2 dV (27...Expressing the admissible stresses and the re- lated strains by (13) and using the principle of virtual work for the vo- lume V2 it can be shown, as in

  2. Thiazol-4-one derivatives from the reaction of monosubstituted thioureas with maleimides: structures and factors determining the selectivity and tautomeric equilibrium in solution

    Directory of Open Access Journals (Sweden)

    Alena S. Pankova

    2016-11-01

    Full Text Available 2-(Alkyl(arylaminothiazol-4(5H-ones can regioselectively be prepared from monoalkyl(arylthioureas and maleimides. In solution, the former heterocycles exist in a tautomeric equilibrium with 2-(alkyl(aryliminothiazolidin-4-ones and the substituent on the exocyclic nitrogen atom governs the ratio of these tautomers. Isomers with the alkyl group in the endocyclic position can be obtained from N-methyl(ethylthioureas. 2D NMR spectroscopy and DFT calculations rationalize experimental results.

  3. Iowa Intensive Archaeological Survey

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This shape file contains intensive level archaeological survey areas for the state of Iowa. All intensive Phase I surveys that are submitted to the State Historic...

  4. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... for a breath. Absolute Intensity The amount of energy used by the body per minute of activity. ... or vigorous-intensity based upon the amount of energy used by the body while doing the activity. ...

  5. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... using relative intensity, people pay attention to how physical activity affects their heart rate and breathing. The talk test is a simple way to measure relative intensity. ...

  6. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Older Adults Overcoming Barriers Measuring Physical Activity Intensity Target Heart Rate & Estimated Maximum Heart Rate Perceived Exertion ( ... a heavy backpack Other Methods of Measuring Intensity Target Heart Rate and Estimated Maximum Heart Rate Perceived ...

  7. Intensive Care Unit Delirium

    Directory of Open Access Journals (Sweden)

    Yongsuk Kim

    2015-05-01

    Full Text Available Delirium is described as a manifestation of acute brain injury and recognized as one of the most common complications in intensive care unit (ICU patients. Although the causes of delirium vary widely among patients, delirium increases the risk of longer ICU and hospital length of stay, death, cost of care, and post-ICU cognitive impairment. Prevention and early detection are therefore crucial. However, the clinical approach toward delirium is not sufficiently aggressive, despite the condition’s high incidence and prevalence in the ICU setting. While the underlying pathophysiology of delirium is not fully understood, many risk factors have been suggested. As a way to improve delirium-related clinical outcome, high-risk patients can be identified. A valid and reliable bedside screening tool is also needed to detect the symptoms of delirium early. Delirium is commonly treated with medications, and haloperidol and atypical antipsychotics are commonly used as standard treatment options for ICU patients although their efficacy and safety have not been established. The approaches for the treatment of delirium should focus on identifying the underlying causes and reducing modifiable risk factors to promote early mobilization.

  8. Rainfed intensive crop systems

    DEFF Research Database (Denmark)

    Olesen, Jørgen E

    2014-01-01

    This chapter focuses on the importance of intensive cropping systems in contributing to the world supply of food and feed. The impact of climate change on intensive crop production systems is also discussed.......This chapter focuses on the importance of intensive cropping systems in contributing to the world supply of food and feed. The impact of climate change on intensive crop production systems is also discussed....

  9. The relationship between moderate-to-vigorous intensity physical activity and insulin resistance, insulin-like growth factor (IGF-1)-system 1, leptin and weight change in healthy women during pregnancy and after delivery.

    Science.gov (United States)

    van der Wijden, Carla L; Delemarre-van de Waal, Henriette A; van Mechelen, Willem; van Poppel, Mireille N M

    2015-01-01

    Childbearing is considered to be a significant risk factor for developing overweight and obesity. Physical activity might influence weight change via hormonal changes. To test the hypothesis that higher levels of moderate-to-vigorous intensity physical activity (MVPA) are positively associated with maternal insulin sensitivity and reduce IGF-1, IGFBP-3, leptin levels, bodyweight gain/retention and birth weight. In healthy nulliparous women, weight measurements were carried out and blood was collected during pregnancy in the 15th, 25th and 35th week, and after delivery at 6, 26 and 52 weeks. At 15 and 35 weeks of pregnancy and 26 weeks postpartum, MVPA was measured using accelerometers. In linear regression models, the relationship between MVPA below or above the median with metabolic and weight outcomes was assessed, adjusted for maternal BMI, age and smoking. Moderate-to-vigorous intensity physical activity (MVPA) decreased significantly during pregnancy, but was very low already in early pregnancy. Insulin resistance and leptin levels increased during pregnancy and decreased significantly after delivery (all P insulin, IGFBP-3 and BMI were significantly lower at 15 weeks of pregnancy in women with MVPA above the median compared to those with MVPA below the median. After 15 weeks of pregnancy, no significant associations were observed between hormonal levels and MVPA. MVPA was neither related to weight retention, nor to birth weight. Except in early pregnancy, MPVA was not related to metabolic outcomes. In addition, MVPA during pregnancy was not related to weight retention or birth weight. © 2014 John Wiley & Sons Ltd.

  10. Topical Recombinant Human Epidermal Growth Factor for Oral Mucositis Induced by Intensive Chemotherapy with Hematopoietic Stem Cell Transplantation: Final Analysis of a Randomized, Double-Blind, Placebo-Controlled, Phase 2 Trial.

    Directory of Open Access Journals (Sweden)

    Ji-Won Kim

    Full Text Available The aim of this study was to evaluate the efficacy and safety of recombinant human epidermal growth factor (rhEGF oral spray for oral mucositis (OM induced by intensive chemotherapy with hematopoietic stem cell transplantation. In this phase 2 study, patients were randomized to either rhEGF (50 microg/mL or placebo in a 1:1 ratio. The primary endpoint was incidence of National Cancer Institute (NCI grade ≥2 OM. A total of 138 patients were enrolled in this study. In the intention-to-treat analysis, rhEGF did not reduce the incidence of NCI grade ≥2 OM (p = 0.717 nor reduce its duration (p = 0.725. Secondary endpoints including the day of onset and duration of NCI grade ≥2 OM, the incidence of NCI grade ≥3 OM and its duration, and patient-reported quality of life were also similar between the two groups. In the per-protocol analysis, however, the duration of opioid analgesic use was shorter in the rhEGF group (p = 0.036, and recipients in the rhEGF group required a lower cumulative dose of opioid analgesics than those in the placebo group (p = 0.046, among patients with NCI grade ≥2 OM. Adverse events were mild and transient. This study found no evidence to suggest that rhEGF oral spray reduces the incidence of OM. However, further studies are needed to investigate the effect of rhEGF on OM-induced pain reduction after intensive chemotherapy.

  11. Healthcare-Associated Infections in Pediatric and Neonatal Intensive Care Units: Impact of Underlying Risk Factors and Antimicrobial Resistance on 30-Day Case-Fatality in Italy and Brazil.

    Science.gov (United States)

    Folgori, Laura; Bernaschi, Paola; Piga, Simone; Carletti, Michaela; Cunha, Filippe Pirrone; Lara, Paulo Henrique Rodriguez; de Castro Peixoto, Nicholas Cafieiro; Alves Guimarães, Bárbara Gomes; Sharland, Mike; Araujo da Silva, André Ricardo; Ciofi Degli Atti, Marta

    2016-11-01

    OBJECTIVES To describe trends in the epidemiology of healthcare-associated Infections (HAIs) in pediatric/neonatal intensive care units (ICUs) and to evaluate risk factors and impact of multidrug resistance in children admitted to ICUs. DESIGN Multicenter, retrospective, cohort study with a nested case-control study conducted from January 1, 2010, through December 31, 2014. SETTING Three tertiary care pediatric hospitals in Italy and Brazil with a total of 103 ICU beds. PATIENTS Inclusion criteria were admission to ICU during the study period, age at onset less than 18 years, and microbiologically confirmed HAI. RESULTS A total of 538 HAIs in 454 children were included; 93.3% of patients had comorbidities. Bloodstream infections were the leading pattern (45.4%). The cumulative incidence of HAI was 3.6/100 ICU admissions and the crude 30-day fatality rate was 5.7/1,000 admissions. The most frequently isolated pathogens were Enterobacteriaceae, followed by Pseudomonas aeruginosa and Staphylococcus aureus. Forty-four percent of isolates were multidrug-resistant (MDR). Two multivariate logistic regressions were performed. Factors independently associated with an MDR-HAI were country, previous antibiotics, transplantation, major surgery, and colonization by an MDR strain. Factors independently associated with 30-day case fatality were country, previous transplantation, fungal infection, bloodstream infection, lower respiratory tract infection, and infection caused by MDR strains. CONCLUSIONS Infection control and prevention can limit the spread of MDR strains and improve outcomes. Targeted surveillance programs collecting neonatal and pediatric HAI/bloodstream infection data and outcomes would allow global benchmarking. The next step is to identify methods to monitor key HAIs and integrate these into affordable intervention programs. Infect Control Hosp Epidemiol 2016;1-8.

  12. Factors affecting the equilibrium constant of homolysis of complexes with metal-carbon σ bonds in aqueous solutions. Pulse radiolysis studies

    International Nuclear Information System (INIS)

    Meyerstein, D.; Ben-Gurion Univ. of the Negev, Beersheba

    1989-01-01

    Pulse-Radiolysis is a powerful technique for the determination of the equilibrium constants of the homolytic cleavage of metal-carbon σ bonds in aqueous solutions. In most systems studied the observed reaction is: L m-1 M (n+1) -R + L ↔ ML m. n + ·R. Therefore the results do not enable a direct determination of the metal-carbon bond dissociation energies. The results obtained indicate that these equilibrium constants are not directly related to the redox potential of either L .m M (n) or of ·R, or to the activation energies for the homolytic cleavage of a family of similarly substituted ethanes. (author)

  13. Full dimensional Franck-Condon factors for the acetylene tilde{{A}} 1Au—{tilde{X}} {^1Σ _g^+} transition. I. Method for calculating polyatomic linear—bent vibrational intensity factors and evaluation of calculated intensities for the gerade vibrational modes in acetylene

    Science.gov (United States)

    Park, G. Barratt

    2014-10-01

    Franck-Condon vibrational overlap integrals for the tilde{A} {^1A_u}—{tilde{X}} {^1Σ _g^+} transition in acetylene have been calculated in full dimension in the harmonic normal mode basis. The calculation uses the method of generating functions first developed for polyatomic Franck-Condon factors by Sharp and Rosenstock [J. Chem. Phys. 41(11), 3453-3463 (1964)], and previously applied to acetylene by Watson [J. Mol. Spectrosc. 207(2), 276-284 (2001)] in a reduced-dimension calculation. Because the transition involves a large change in the equilibrium geometry of the electronic states, two different types of corrections to the coordinate transformation are considered to first order: corrections for axis-switching between the Cartesian molecular frames and corrections for the curvilinear nature of the normal modes at large amplitude. The angular factor in the wavefunction for the out-of-plane component of the trans bending mode, ν _4^' ' }, is treated as a rotation, which results in an Eckart constraint on the polar coordinates of the bending modes. To simplify the calculation, the other degenerate bending mode, ν _5^' ' }, is integrated in the Cartesian basis and later transformed to the constrained polar coordinate basis, restoring the conventional v and l quantum numbers. An updated tilde{A}-state harmonic force field obtained recently in the R. W. Field research group is evaluated. The results for transitions involving the gerade vibrational modes are in qualitative agreement with experiment. Calculated results for transitions involving ungerade modes are presented in Paper II of this series [G. B. Park, J. H. Baraban, and R. W. Field, "Full dimensional Franck-Condon factors for the acetylene tilde{A} {^1A_u}—{tilde{X}} {^1Σ _g^+} transition. II. Vibrational overlap factors for levels involving excitation in ungerade modes," J. Chem. Phys. 141, 134305 (2014)].

  14. Dimensional t-factor variation and increase of stability of the ferroelectric state in (Na0.5Bi0.5TiO3-based solid solutions

    Directory of Open Access Journals (Sweden)

    V. M. Ishchuk

    2017-10-01

    Full Text Available The influence of the B-site ion substitutions in (1−x(Bi1∕2Na1∕2TiO3–xBaTiO3 system of solid solutions on the relative stability of the antiferroelectric (AFE and ferroelectric (FE phases has been studied. The ions of zirconium, tin, and (In0.5Nb0.5, (Fe0.5Nb0.5, (Al0.5V0.5 ion complexes have been used as substituting elements. An increase in the concentration of the substituting ion results in a near linear variation in the size of the crystal lattice cell. Along with the cell size variation, a change in the relative stability of the AFE and FE phases takes place according to the changes of the tolerance factor of the solid solution. An increase in the tolerance factor leads to the increase in the temperature of the FE–AFE phase transition, and vice versa. Obtained results indicate the way for raising the temperature of the FE–AFE phase transition in (Bi1∕2Na1∕2TiO3-based solid solutions.

  15. Energy intensities: Prospects and potential

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In the previous chapter, the author described how rising activity levels and structural change are pushing toward higher energy use in many sectors and regions, especially in the developing countries. The extent to which more activity leads to greater energy use will depend on the energy intensity of end-use activities. In this chapter, the author presents an overview of the potential for intensity reductions in each sector over the next 10-20 years. It is not the author's intent to describe in detail the various technologies that could be employed to improve energy efficiency, which has been done by others (see, for example, Lovins ampersand Lovins, 1991; Goldembert et al., 1987). Rather, he discusses the key factors that will shape future energy intensities in different parts of the world, and gives a sense for the changes that could be attained if greater attention were given to accelerate efficiency improvement. The prospects for energy intensities, and the potential for reduction, vary among sectors and parts of the world. In the majority of cases, intensities are tending to decline as new equipment and facilities come into use and improvements are made on existing stocks. The effect of stock turnover will be especially strong in the developing countries, where stocks are growing at a rapid pace, and the Former East Bloc, where much of the existing industrial plant will eventually be retired and replaced with more modern facilities. While reductions in energy intensity are likely in most areas, there is a large divergence between the technical and economic potential for reducing energy intensities and the direction in which present trends are moving. In the next chapter, the author presents scenarios that illustrate where trends are pointing, and what could be achieved if improving energy efficiency were a focus of public policies. 53 refs., 4 figs., 2 tabs

  16. Decolorization of azo dye C.I. Reactive Black 5 by ozonation in aqueous solution: influencing factors, degradation products, reaction pathway and toxicity assessment.

    Science.gov (United States)