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Sample records for occurred severity ratings

  1. Pediatric Injuries at an Annual Motocross Competition: Rates and Severity.

    Science.gov (United States)

    Williams, Brendan A; McFadden, James P; Teurlings, Tyler L; Blakemore, Laurel C

    Pediatric motocross injuries occur frequently and with significant associated morbidity; however, data are limited regarding injury occurring during competition. North Central Florida hosts an annual motocross competition with numerous pediatric competitors. We sought to evaluate the rate and severity of injuries sustained at this event over a multiyear period. Our primary hypothesis was that motocross injury rates and severity in competition exceed that of other competitive sports in this age group. A retrospective review was performed to identify pediatric patients (17 and younger) presenting to a single Level 1 Trauma Center as a result of injury sustained at an annual motocross competition from 2009 to 2012. Demographic, diagnostic, and treatment data were collected including injuries, procedural interventions, and length of hospital stay. Rate, type, and severity of injury were evaluated and compared with established norms of other competitive sports in a similar age group. Over a 4-year period, 51 pediatric motocross competitors sustained 75 injuries. Injured riders were 14.2±2.51 years (range, 8 to 17 y) old and 92% (47/51) male. Forty (78%) patients sustained at least 1 orthopaedic injury and 17 (33%) patients suffered polytrauma. The majority of injuries occurred in the upper extremity (36%). Twenty-four (47%) patients required procedural intervention, 15 of which were operative. Thirty-nine (76%) patients necessitated surgical specialty care. Average injury severity score was 6.5 (1 to 75) and 1 death occurred. The injury rate for pediatric motocross riders in this study was 19.9 injuries per 1000 competitors. High rates of injury occur among pediatric patients in competitive motocross, exceeding those seen in other competitive sports in a comparable age group. Significant morbidity and at least 1 fatality were demonstrated in the group studied. The majority of patients suffer at least 1 orthopaedic injury and nearly all patients require pediatric

  2. Ventricular fibrillation occurring after atrioventricular node ablation despite minimal difference between pre- and post-ablation heart rates.

    Science.gov (United States)

    Squara, F; Theodore, G; Scarlatti, D; Ferrari, E

    2017-02-01

    We report the case of an 82-year-old man presenting with ventricular fibrillation (VF) occurring acutely after atrioventricular node (AVN) ablation. This patient had severe valvular cardiomyopathy, chronic atrial fibrillation (AF), and underwent prior to the AVN ablation a biventricular implantable cardiac defibrillator positioning. The VF was successfully cardioverted with one external electrical shock. What makes this presentation original is that the pre-ablation spontaneous heart rate in AF was slow (84 bpm), and that VF occurred after ablation despite a minimal heart rate drop of only 14 bpm. VF is the most feared complication of AVN ablation, but it had previously only been described in case of acute heart rate drop after ablation of at least 30 bpm (and more frequently>50 bpm). This case report highlights the fact that VF may occur after AVN ablation regardless of the heart rate drop, rendering temporary fast ventricular pacing mandatory whatever the pre-ablation heart rate. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  3. Clinical significance of exercise-induced left ventricular wall motion abnormality occurring at a low heart rate

    International Nuclear Information System (INIS)

    Kimchi, A.; Rozanski, A.; Fletcher, C.; Maddahi, J.; Swan, H.J.; Berman, D.S.

    1987-01-01

    We studied the relationship between the heart rate at the time of onset of exercise-induced wall motion abnormality and the severity of coronary artery disease in 89 patients who underwent exercise equilibrium radionuclide ventriculography as part of their evaluation for coronary artery disease. Segmental wall motion was scored with a five-point system (3 = normal; -1 = dyskinesis); a decrease of one score defined the onset of wall motion abnormality. The onset of wall motion abnormality at less than or equal to 70% of maximal predicted heart rate had 100% predictive accuracy for coronary artery disease and higher sensitivity than the onset of ischemic ST segment depression at similar heart rate during exercise: 36% (25 of 69 patients with coronary disease) vs 19% (13 of 69 patients), p = 0.01. Wall motion abnormality occurring at less than or equal to 70% of maximal predicted heart rate was present in 49% of patients (23 of 47) with critical stenosis (greater than or equal to 90% luminal diameter narrowing), and in only 5% of patients (2 of 42) without such severe stenosis, p less than 0.001. The sensitivity of exercise-induced wall motion abnormality occurring at a low heart rate for the presence of severe coronary artery disease was similar to that of a deterioration in wall motion by more than two scores during exercise (49% vs 53%) or an absolute decrease of greater than or equal to 5% in exercise left ventricular ejection fraction (49% vs 45%)

  4. Parent and Teacher Ratings of Communication among Children with Severe Disabilities and Visual Impairment/Blindness

    Science.gov (United States)

    Cascella, Paul W.; Trief, Ellen; Bruce, Susan M.

    2012-01-01

    Three trends emerged from independent parent and teacher ratings of receptive communication and expressive forms and functions among students with severe disabilities and visual impairment/blindness. Parents had higher ratings than teachers, receptive communication was rated the highest, and no skills occurred often. Implications are discussed for…

  5. A Randomized Controlled Trial of Family Intervention for Co-occurring Substance Use and Severe Psychiatric Disorders

    Science.gov (United States)

    Mueser, Kim T.; Glynn, Shirley M.; Cather, Corrine; Xie, Haiyi; Zarate, Roberto; Smith, Lindy Fox; Clark, Robin E.; Gottlieb, Jennifer D.; Wolfe, Rosemarie; Feldman, James

    2013-01-01

    Substance use disorders have a profound impact on the course of severe mental illnesses and on the family, but little research has evaluated the impact of family intervention for this population. To address this question, a randomized controlled trial was conducted comparing a brief (2–3 mo) Family Education (ED) program with a longer-term (9–18 mo) program that combined education with teaching communication and problem-solving skills, Family Intervention for Dual Disorders (FIDD). A total of 108 clients (77% schizophrenia-spectrum) and a key relative were randomized to either ED or FIDD and assessed at baseline and every 6 months for 3 years. Rates of retention of families in both programs were moderate. Intent-to-treat analyses indicated that clients in both programs improved in psychiatric, substance abuse, and functional outcomes, as did key relatives in knowledge of co-occurring disorders, burden, and mental health functioning. Clients in FIDD had significantly less severe overall psychiatric symptoms and psychotic symptoms and tended to improve more in functioning. Relatives in FIDD improved more in mental health functioning and knowledge of co-occurring disorders. There were no consistent differences between the programs in substance abuse severity or family burden. The findings support the utility of family intervention for co-occurring disorders, and the added benefits of communication and problem-solving training, but also suggest the need to modify these programs to retain more families in treatment in order to provide them with the information and skills they need to overcome the effects of these disorders. PMID:22282453

  6. Determinants of patient-rated and clinician-rated illness severity in schizophrenia.

    Science.gov (United States)

    Fervaha, Gagan; Takeuchi, Hiroyoshi; Agid, Ofer; Lee, Jimmy; Foussias, George; Remington, Gary

    2015-07-01

    The contribution of specific symptoms on ratings of global illness severity in patients with schizophrenia is not well understood. The present study examined the clinical determinants of clinician and patient ratings of overall illness severity. This study included 1,010 patients with a DSM-IV diagnosis of schizophrenia who participated in the baseline visit of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study conducted between January 2001 and December 2004 and who had available symptom severity, side effect burden, cognition, and community functioning data. Both clinicians and patients completed the 7-point Clinical Global Impressions-Severity of Illness scale (CGI-S), the primary measure of interest in the present study. Symptoms were rated using the Positive and Negative Syndrome Scale and the Calgary Depression Scale for Schizophrenia, and functional status with the Quality of Life Scale. Neurocognition, insight, and medication-related side effects were also evaluated. Clinicians rated illness severity significantly higher than patients (P negative, disorganized, and depressive symptoms, as well as functional outcome (all P values enhance patient engagement in care and improve outcomes. ClinicalTrials.gov identifier: NCT00014001. © Copyright 2014 Physicians Postgraduate Press, Inc.

  7. Effect of severity of illness on cesarean delivery rates in Washington State.

    Science.gov (United States)

    Hitti, Jane; Walker, Suzan; Benedetti, Thomas J

    2017-10-01

    , and geographic location within Washington. Hospital aggregate admission severity-of-illness score correlated with primary term singleton vertex cesarean delivery rate in all fiscal years (R 2 0.38-0.58, P cesarean rate. The slope of the regression line decreased during the study interval, suggesting that statewide decrease in primary term singleton vertex cesarean rate occurred across the range of severity of illness. Admission severity-of-illness score is strongly associated with the primary term singleton vertex cesarean delivery rate among hospitals in Washington State. Approximately 50% of variation in hospital primary term singleton vertex cesarean delivery rates appeared to be related to admission severity of illness. This relationship persisted over time despite a statewide decrease in cesarean delivery, suggesting that patient acuity will likely continue to contribute to hospital variation in cesarean delivery rates despite perinatal quality improvement efforts. The major implication of this study is that patient acuity should be considered when determining optimal cesarean delivery rates. High-acuity hospitals are likely to have high cesarean rates because they provide a specific role in serving regional needs. To hold these centers to an arbitrary benchmark may jeopardize the funding necessary to support regional safety net institutions. Copyright © 2017. Published by Elsevier Inc.

  8. Individual and collective dose rates from naturally-occurring radionuclides in seafood

    International Nuclear Information System (INIS)

    Pentreath, R.J.; Camplin, W.C.; Allington, D.J.

    1989-01-01

    Although seafoods are not a large item in the UK diet, they are of interest because of the above-average quantities of naturally-occurring radionuclides which they contain -particularly shellfish. The single most important contributor is 210 Po; studies have therefore been made to examine the contribution which this nuclide makes to the dose received, both collectively and to individual high-rate consumers of shellfish. (author)

  9. Relationship between the stuttering severity index and speech rate

    Directory of Open Access Journals (Sweden)

    Claudia Regina Furquim de Andrade

    Full Text Available CONTEXT: The speech rate is one of the parameters considered when investigating speech fluency and is an important variable in the assessment of individuals with communication complaints. OBJECTIVE: To correlate the stuttering severity index with one of the indices used for assessing fluency/speech rate. DESIGN: Cross-sectional study. SETTING: Fluency and Fluency Disorders Investigation Laboratory, Faculdade de Medicina da Universidade de São Paulo. PARTICIPANTS: Seventy adults with stuttering diagnosis. MAIN MEASUREMENTS: A speech sample from each participant containing at least 200 fluent syllables was videotaped and analyzed according to a stuttering severity index test and speech rate parameters. RESULTS: The results obtained in this study indicate that the stuttering severity and the speech rate present significant variation, i.e., the more severe the stuttering is, the lower the speech rate in words and syllables per minute. DISCUSSION AND CONCLUSION: The results suggest that speech rate is an important indicator of fluency levels and should be incorporated in the assessment and treatment of stuttering. This study represents a first attempt to identify the possible subtypes of developmental stuttering. DEFINITION: Objective tests that quantify diseases are important in their diagnosis, treatment and prognosis.

  10. A multivariate tobit analysis of highway accident-injury-severity rates.

    Science.gov (United States)

    Anastasopoulos, Panagiotis Ch; Shankar, Venky N; Haddock, John E; Mannering, Fred L

    2012-03-01

    Relatively recent research has illustrated the potential that tobit regression has in studying factors that affect vehicle accident rates (accidents per distance traveled) on specific roadway segments. Tobit regression has been used because accident rates on specific roadway segments are continuous data that are left-censored at zero (they are censored because accidents may not be observed on all roadway segments during the period over which data are collected). This censoring may arise from a number of sources, one of which being the possibility that less severe crashes may be under-reported and thus may be less likely to appear in crash databases. Traditional tobit-regression analyses have dealt with the overall accident rate (all crashes regardless of injury severity), so the issue of censoring by the severity of crashes has not been addressed. However, a tobit-regression approach that considers accident rates by injury-severity level, such as the rate of no-injury, possible injury and injury accidents per distance traveled (as opposed to all accidents regardless of injury-severity), can potentially provide new insights, and address the possibility that censoring may vary by crash-injury severity. Using five-year data from highways in Washington State, this paper estimates a multivariate tobit model of accident-injury-severity rates that addresses the possibility of differential censoring across injury-severity levels, while also accounting for the possible contemporaneous error correlation resulting from commonly shared unobserved characteristics across roadway segments. The empirical results show that the multivariate tobit model outperforms its univariate counterpart, is practically equivalent to the multivariate negative binomial model, and has the potential to provide a fuller understanding of the factors determining accident-injury-severity rates on specific roadway segments. Published by Elsevier Ltd.

  11. [Hospitalization rate in relation to severe complications of transrectal prostate biopsy: About 2715 patients biopsied].

    Science.gov (United States)

    Tamarelle, B; Perrin, P; Devonec, M; Paparel, P; Ruffion, A

    To identify hospitalizations directly related to a complication occurring within 30 days following a transrectal prostate biopsy (PBP). Overall hospitalization rates, mortality rates, potential predisposing factors for complications. Single-center study including all patients who underwent PBP between January 2005 and January 2012. Any hospitalization occurring within 30 days of the PBP for urgent motive was considered potentially attributable to biopsy. We identified the reason for hospitalization with direct complications (urinary infection or fever, rectal bleeding, bladder caillotage, retention) and indirect (underlying comorbidities decompensation) of the biopsy. The contributing factors were anticoagulant or antiplatelet treatment well as waning immunity factors (corticosteroid therapy, HIV, chemotherapy or immunodulateur). Among 2715 men who underwent PBP, there were 120 (4.4%) hospitalizations including 28 (1.03%) caused by the biopsy. Twenty-five (0.92%) were related to a direct complication of biopsy: 14 (56%) for urinary tract infection or fever including 1 hospitalization in intensive care, 5 (20%) for rectal bleeding which required several transfusions 1, 10 (40%) urinary retention and 3 (0.11%) for an indirect complication (2 coronary syndromes and 1 respiratory failure). Several direct complications were associated in 3 cases. Only two hospitalizations associated with rectal bleeding were taking an antiplatelet or anticoagulant. There was no association between hospitalization for urinary tract infections and a decreased immune status. The first death observed in our study occurred at D31 of pulmonary embolism (advanced metastatic patient with bladder cancer). Twenty (60.6%) patients urgently hospitalized did not have prostate cancer. Within this large sample of patients the overall rate of hospitalization due to the realization of a PBP was 1%. It has not been found predictive of complications leading to hospitalization. 4. Copyright © 2016

  12. Factors associated with DSM-5 severity level ratings for autism spectrum disorder.

    Science.gov (United States)

    Mazurek, Micah O; Lu, Frances; Macklin, Eric A; Handen, Benjamin L

    2018-02-01

    The newest edition of the Diagnostic and Statistical Manual of Mental Disorders (5th ed., DSM-5) introduced substantial changes to the diagnostic criteria for autism spectrum disorder, including new severity level ratings for social communication and restricted and repetitive behavior domains. The purpose of this study was to evaluate the use of these new severity ratings and to examine their relation to other measures of severity and clinical features. Participants included 248 children with autism spectrum disorder who received diagnostic evaluations at one of six Autism Treatment Network sites. Higher severity ratings in both domains were associated with younger age, lower intelligence quotient, and greater Autism Diagnostic Observation Schedule-Second Edition domain-specific symptom severity. Greater restricted and repetitive behavior severity was associated with higher parent-reported stereotyped behaviors. Severity ratings were not associated with emotional or behavioral problems. The new DSM-5 severity ratings in both domains were significantly associated with behavioral observations of autism severity but not with measures of other behavioral or emotional symptoms. However, the strong associations between intelligence quotient and DSM-5 severity ratings in both domains suggest that clinicians may be including cognitive functioning in their overall determination of severity. Further research is needed to examine clinician decision-making and interpretation of these specifiers.

  13. Does Anxiety Modify the Risk for, or Severity of, Conduct Problems Among Children With Co-Occurring ADHD: Categorical and Dimensional and Analyses.

    Science.gov (United States)

    Danforth, Jeffrey S; Doerfler, Leonard A; Connor, Daniel F

    2017-08-01

    The goal was to examine whether anxiety modifies the risk for, or severity of, conduct problems in children with ADHD. Assessment included both categorical and dimensional measures of ADHD, anxiety, and conduct problems. Analyses compared conduct problems between children with ADHD features alone versus children with co-occurring ADHD and anxiety features. When assessed by dimensional rating scales, results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety are at risk for more intense conduct problems. When assessment included a Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) diagnosis via the Schedule for Affective Disorders and Schizophrenia for School Age Children-Epidemiologic Version (K-SADS), results showed that compared with children with ADHD alone, those children with ADHD co-occurring with anxiety neither had more intense conduct problems nor were they more likely to be diagnosed with oppositional defiant disorder or conduct disorder. Different methodological measures of ADHD, anxiety, and conduct problem features influenced the outcome of the analyses.

  14. PERFORMANCE EVALUATION AND RISK AVERSION RATE FOR SEVERAL STOCK INDICES IN INDONESIA STOCK EXCHANGE

    Directory of Open Access Journals (Sweden)

    Robiyanto Robiyanto

    2017-03-01

    Full Text Available There are numerous stock indices in Indonesia Stock Exchange. Several of them are LQ-45, MBX, DBX, JII, SRI-KEHATI, PEFINDO-25, BISNIS-27, IDX-30 and KOMPAS-100. Unfortunately there are limi­ted researches which have been done to measure those indices performance specifically. The same condition also occurs on risk aversion level usage in Indonesia Stock Exchange, only few numbers of researches use this me­a­surement in the portfolio valuation. Based on that, this research measured the performance and risk aversion rate of those indices in Indonesia Stock Exchange. The results of this study were SRI-KEHATI becomes the best performer with the highest risk aversion rate, while Jakarta Islamic Index (JII produces the lowest positive per­formance with the lowest risk aversion rate. This finding shows that sharia stocks’ characters (i.e. usury free could give relieveness and convenience regardless its per­formance.

  15. [Nature and severity of oppositional defiant disorder and conduct disorder as they occur together or separately in children].

    Science.gov (United States)

    Lapalme, Mélanie; Déry, Michèle

    2009-09-01

    Co-occurring oppositional defiant disorder and conduct disorder symptoms are particularly common, which could be related to the greater severity (number and nature of symptoms) of each disorder. Our study aims to determine if oppositional defiant disorder and conduct disorder symptoms vary when they occur together or separately in children. Our study was conducted with 406 children (aged 6 to 13 years) divided in 4 groups (oppositional disorder only, conduct disorder only, oppositional disorder and conduct disorder, control) with no age or sex difference. Structured diagnostic interviews conducted with one parent and each child separately led to assessing the average number of symptoms for each disorder as well as the onset frequency of each symptom. When occurring together, oppositional disorder and conduct disorder appear more severe than when they occur separately, considering the number and nature of symptoms shown. Further, children with an oppositional disorder only or a conduct disorder only also have more frequent symptoms of the other disorder, compared with children in the control group. These results suggest taking into account, at the time of assessment and potential intervention, the presence of both disorders.

  16. The effect of coarse second-phase particles on the rate of grain refinement during severe deformation processing

    DEFF Research Database (Denmark)

    Apps, P.J.; Bowen, Jacob R.; Prangnell, P.B.

    2003-01-01

    The effect of second-phase particles on the rate of grain refinement during severe deformation processing has been investigated, by comparing the microstructure evolution in an AA8079 aluminium alloy, containing 2.5 vol.% of ~2 μm particles, with that in a high purity, single-phase, Al-0.13% Mg a...... by an effective strain of only five in the particle-containing alloy, compared to ten in the single-phase material. The mechanisms that contribute to this acceleration of the grain refinement process are discussed.......The effect of second-phase particles on the rate of grain refinement during severe deformation processing has been investigated, by comparing the microstructure evolution in an AA8079 aluminium alloy, containing 2.5 vol.% of ~2 μm particles, with that in a high purity, single-phase, Al-0.13% Mg...... alloy, deformed identically by ECAE to an effective strain of ten. The materials were analysed by high-resolution EBSD orientation mapping, which revealed that grain refinement occurred at a dramatically higher rate in the particle-containing alloy. A submicron grain structure could be achieved...

  17. Estimation of the prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia

    Science.gov (United States)

    Meza, Benjamin P.L.; Lohrke, Britta; Wilkinson, Robert; Pitman, John P.; Shiraishi, Ray W.; Bock, Naomi; Lowrance, David W.; Kuehnert, Matthew J.; Mataranyika, Mary; Basavaraju, Sridhar V.

    2014-01-01

    Background Acute transfusion reactions are probably common in sub-Saharan Africa, but transfusion reaction surveillance systems have not been widely established. In 2008, the Blood Transfusion Service of Namibia implemented a national acute transfusion reaction surveillance system, but substantial under-reporting was suspected. We estimated the actual prevalence and rate of acute transfusion reactions occurring in Windhoek, Namibia. Methods The percentage of transfusion events resulting in a reported acute transfusion reaction was calculated. Actual percentage and rates of acute transfusion reactions per 1,000 transfused units were estimated by reviewing patients’ records from six hospitals, which transfuse >99% of all blood in Windhoek. Patients’ records for 1,162 transfusion events occurring between 1st January – 31st December 2011 were randomly selected. Clinical and demographic information were abstracted and Centers for Disease Control and Prevention National Healthcare Safety Network criteria were applied to categorize acute transfusion reactions1. Results From January 1 – December 31, 2011, there were 3,697 transfusion events (involving 10,338 blood units) in the selected hospitals. Eight (0.2%) acute transfusion reactions were reported to the surveillance system. Of the 1,162 transfusion events selected, medical records for 785 transfusion events were analysed, and 28 acute transfusion reactions were detected, of which only one had also been reported to the surveillance system. An estimated 3.4% (95% confidence interval [CI]: 2.3–4.4) of transfusion events in Windhoek resulted in an acute transfusion reaction, with an estimated rate of 11.5 (95% CI: 7.6–14.5) acute transfusion reactions per 1,000 transfused units. Conclusion The estimated actual rate of acute transfusion reactions is higher than the rate reported to the national haemovigilance system. Improved surveillance and interventions to reduce transfusion-related morbidity and mortality

  18. Relationship between stuttering severity in children and their mothers’ speaking rate

    Directory of Open Access Journals (Sweden)

    Ali Dehqan

    Full Text Available CONTEXT AND OBJECTIVE: Stuttering is a complex disease that influences occupational, social, academic and emotional achievements. The aim of this study was to correlate the stuttering severity index with speaking rates of mothers and children. DESIGN AND SETTING: Cross-sectional study, at the child rehabilitation clinics of Tehran city. METHODS: 35 pairs of mothers and their children who stuttered were studied. There were 29 boys and six girls, of mean age 8.5 years (range: 5.1-12.0. Speech samples from the mother-child pairs were audiotaped for approximately 15 minutes, until a reciprocal verbal interaction had been obtained. This sample was then analyzed in accordance with a stuttering severity index test and speaking rate parameters. RESULTS: The research results outlined a significant relationship between the mothers’ speaking rate and their children’s stuttering severity. CONCLUSION: The results suggest that the mothers’ speaking rate should be incorporated in the assessment and treatment of stuttering.

  19. Variations in rates of severe perineal tears and episiotomies in 20 European countries

    DEFF Research Database (Denmark)

    Blondel, Béatrice; Alexander, Sophie; Bjarnadóttir, Ragnheiður I

    2016-01-01

    INTRODUCTION: Rates of severe perineal tears and episiotomies are indicators of obstetrical quality of care, but their use for international comparisons is complicated by difficulties with accurate ascertainment of tears and uncertainties regarding the optimal rate of episiotomies. We compared...... rates of severe perineal tears and episiotomies in European countries and analysed the association between these two indicators. MATERIAL AND METHODS: We used aggregate data from national routine statistics available in the Euro-Peristat project. We compared rates of severe (third- and fourth......-degree) tears and episiotomies in 2010 by mode of vaginal delivery (n = 20 countries), and investigated time trends between 2004 and 2010 (n = 9 countries). Statistical associations were assessed with Spearman's ranked correlations (rho). RESULTS: In 2010 in all vaginal deliveries, rates of severe tears ranged...

  20. Association of heart rate profile during exercise with the severity of coronary artery disease.

    Science.gov (United States)

    Cay, Serkan; Ozturk, Sezgin; Biyikoglu, Funda; Yildiz, Abdulkadir; Cimen, Tolga; Uygur, Belma; Tuna, Funda

    2009-05-01

    Coronary artery disease is the leading cause of morbidity and mortality around the world. Autonomic nervous system abnormalities are associated with coronary artery disease and its complications. Exercise stress tests are routinely used for the detection of the presence of coronary artery disease. In this study, we observed the association between heart rate profile during exercise and the severity of coronary artery disease. One hundred and sixty patients with abnormal exercise treadmill test (> or =1 mm horizontal or downsloping ST-segment depression; 119 men, 41 women; mean age = 57 +/- 9 years) were included in the study. Use of any drug affecting heart rate was not permitted. Resting heart rate before exercise, maximum heart rate during exercise, and resting heart rate after exercise (5 min later) were measured and two parameters were calculated: heart rate increment (maximum heart rate - resting heart rate before exercise) and heart rate decrement (maximum heart rate - resting heart rate after exercise). All patients underwent selective coronary angiography and subclassified into two groups according to stenotic lesion severity. Group 1 had at least 50% of stenotic lesion and group 2 had less than 50%. Patients in the first group had increased resting heart rate, decreased maximum heart rate, decreased heart rate increment, and decreased heart rate decrement compared with second group. All patients were classified into tertiles of resting heart rate, heart rate increment, and heart rate decrement level to evaluate whether these parameters were associated with severity of coronary artery stenosis in the study. The multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 21.888 (95% confidence interval 6.983-68.606) for the highest tertile of resting heart rate level compared with the lowest tertile. In addition, the multiple-adjusted odds ratio of the risk of severe coronary atherosclerosis was 20.987 (95% confidence interval 6

  1. Phenomena occuring in the reactor coolant system during severe core damage accidents

    International Nuclear Information System (INIS)

    Malinauskas, A.P.

    1990-01-01

    The reactor coolant system (RCS) of a nuclear power plant consists of the reactor pressure vessel and the piping and associated components that are required for the continuous circulation of the coolant which is used to maintain thermal equilibrium throughout the system. This paper discusses, how in the event of an accident, the RCS also serves as one of several barriers to the escape of radiotoxic material into the biosphere. The physical and chemical processes occurring within the RCS during normal operation of the reactor are relatively uncomplicated and are reasonably well understood. When the flow of coolant is properly adjusted, the thermal energy resulting from nuclear fission (or, in the shutdown mode, from radioactive decay processes) and secondary inputs, such as pumps, are exactly balanced by thermal losses through the RCS boundaries and to the various heat sinks that are employed to effect the conversion of heat to electrical energy. Because all of the heat and mass fluxes remain sensibly constant with time, mathematical descriptions of the thermophysical processes are relatively straightforward, even for boiling water reactor (BWR) systems. Although the coolant in a BWR does undergo phase changes, the phase boundaries remain well-defined and time-invariant

  2. Severe gastritis decreases success rate of Helicobacter pylori eradication.

    Science.gov (United States)

    Kalkan, Ismail Hakki; Sapmaz, Ferdane; Güliter, Sefa; Atasoy, Pınar

    2016-05-01

    In several studies, different risk factors other than antibiotic resistance have been documented with Helicobacter pylori eradication failure. We aimed in this study to investigate the relationship of gastric density of H. pylori, the occurrence/degree of gastric atrophy, and intestinal metaplasia (IM) with success rate of H. pylori eradication. Two hundred consecutive treatment naive patients who received bismuth containing standart quadruple treatment due to H. pylori infection documented by histopathological examination of two antral or two corpal biopsies entered this retrospective study. The updated Sydney system was used to grade the activity of gastritis, density of H. pylori colonization, atrophy, and IM. Stages III and IV of operative link for gastritis assessment (OLGA) or the operative link on gastric intestinal metaplasia assessment (OLGIM) stages was considered as severe gastritis. H. pylori eradication was determined via stool H. pylori antigen test performed 4 weeks after the end of therapy. The presence of gastric atrophy and IM was significantly higher in patients with eradication failure (p = 0.001 and 0.01, respectively). Severe gastritis (OLGA III-IV and OLGIM III-IV) rates were higher in eradication failure group. A multiple linear regression analysis showed that OLGA and OLGIM stages were to be independent risk factors for eradication failure (p = 0.03 and 0.01, respectively). Our results suggested that histopathologically severe gastritis may cause H. pylori eradication failure. In addition, we found that H. pylori density was not a risk factor for treatment failure in patients who receive quadruple treatment.

  3. Physical Activity in Individuals with Severe Mental Illness: Client versus Case Manager Ratings

    Science.gov (United States)

    Bezyak, Jill L.; Chan, Fong; Lee, Eun-Jeong; Catalano, Denise; Chiu, Chung-Yi

    2012-01-01

    The "Physical Activity Scale for Individuals With Physical Disabilities" was examined as a physical activity measure for people with severe mental illness. Case manager ratings were more closely related to body mass index than clients' ratings, challenging the accuracy of self-report physical activity measures for individuals with severe mental…

  4. Severe signal loss in diamond beam loss monitors in high particle rate environments by charge trapping in radiation-induced defects

    CERN Document Server

    Kassel, Florian; Dabrowski, Anne; de Boer, Wim

    2016-01-01

    The beam condition monitoring leakage (BCML) system is a beam monitoring device in the compact muon solenoid (CMS) experiment at the large hadron collider (LHC). As detectors 32 poly-crystalline (pCVD) diamond sensors are positioned in rings around the beam pipe. Here, high particle rates occur from the colliding beams scattering particles outside the beam pipe. These particles cause defects, which act as traps for the ionization, thus reducing the charge collection efficiency (CCE). However, the loss in CCE was much more severe than expected from low rate laboratory measurements and simulations, especially in single-crystalline (sCVD) diamonds, which have a low initial concentration of defects. The reason why in real experiments the CCE is much worse than in laboratory experiments is related to the ionization rate. At high particle rates the trapping rate of the ionization is so high compared with the detrapping rate, that space charge builds up. This space charge reduces locally the internal electric field,...

  5. Impact of severity of congenital heart diseases on university graduation rate among male patients.

    Science.gov (United States)

    Özcan, Emin Evren; Küçük, Alaattin

    2012-04-01

    This study examines university graduation rates among individuals with congenital heart disease (CHD) in comparison to their healthy peers. The effect of disease severity, type of surgery, and timing of surgery on graduation rate was also evaluated. One hundred forty-five male patients with CHD at military age were enrolled in the study between the dates of January 2005 and May 2007. Severity of disease was operationalised in term of initial diagnosis (According to classification of 32th ACC Bethesta Conference Task Force 1). University graduation rates of among two groups of CHD patients (mild disease (group 1) or moderate to severe disease (group 2)) are compared to each other and to healthy peers. Patients with CHD have reduced rates of participation in higher education compared with healthy individuals (13.1% vs 20.7%, p=0.01). Furthermore, this negative effect on education participation rate is independent of the severity of disease (group 1, 16.4%, p=0.01; group 2, 9.7%, pgraduation rate was relatively higher in patients with mild disease severity, no significant difference was found between the two patient groups (p=0.23). Having an operation does not effect graduation rate (p=0.58), however greater age at the time of operation increases the likelihood of graduation (p=0.02). Being born with CHD significantly reduces the chance of completing higher education. This negative impact on university graduation rate is independent of the severity of the disease. No negative effects of disease related surgery or subsequent corrective surgery on education were observed. Patients who were operated on later in life were more likely to complete university education. Mean operation age of this group corresponds to the typical age during the last year of elementary school in Turkey.

  6. Ratings of Severity of Life Events by Ninth-Grade Students.

    Science.gov (United States)

    Hutton, Jerry B.; And Others

    1987-01-01

    Special education, basic, and honors ninth-grade students (n=60) rated the severity of stress for each of the life events on the Source of Stress Inventory (Chandler, 1981). There was a significant positive relationship between the Chandler rankings (teachers and mental health workers) and the student rankings. (Author/NB)

  7. Impact of socioeconomic deprivation on rate and cause of death in severe mental illness.

    Science.gov (United States)

    Martin, Julie Langan; McLean, Gary; Park, John; Martin, Daniel J; Connolly, Moira; Mercer, Stewart W; Smith, Daniel J

    2014-09-12

    Socioeconomic status has important associations with disease-specific mortality in the general population. Although individuals with Severe Mental Illnesses (SMI) experience significant premature mortality, the relationship between socioeconomic status and mortality in this group remains under investigated. We aimed to assess the impact of socioeconomic status on rate and cause of death in individuals with SMI (schizophrenia and bipolar disorder) relative to the local (Glasgow) and wider (Scottish) populations. Cause and age of death during 2006-2010 inclusive for individuals with schizophrenia or bipolar disorder registered on the Glasgow Psychosis Clinical Information System (PsyCIS) were obtained by linkage to the Scottish General Register Office (GRO). Rate and cause of death by socioeconomic status, measured by Scottish Index of Multiple Deprivation (SIMD), were compared to the Glasgow and Scottish populations. Death rates were higher in people with SMI across all socioeconomic quintiles compared to the Glasgow and Scottish populations, and persisted when suicide was excluded. Differences were largest in the most deprived quintile (794.6 per 10,000 population vs. 274.7 and 252.4 for Glasgow and Scotland respectively). Cause of death varied by socioeconomic status. For those living in the most deprived quintile, higher drug-related deaths occurred in those with SMI compared to local Glasgow and wider Scottish population rates (12.3% vs. 5.9%, p = socioeconomic quintiles compared to the Glasgow and Scottish populations but was most marked in the most deprived quintiles when suicide was excluded as a cause of death. Further work assessing the impact of socioeconomic status on specific causes of premature mortality in SMI is needed.

  8. A Brief "DSM-IV"-Referenced Teacher Rating Scale for Monitoring Behavioral Improvement in ADHD and Co-Occurring Symptoms

    Science.gov (United States)

    Sprafkin, Joyce; Mattison, Richard E.; Gadow, Kenneth D.; Schneider, Jayne; Lavigne, John V.

    2011-01-01

    Objective: To examine the psychometric properties of the 30-item teacher's version of the Child and Adolescent Symptom Inventory Progress Monitor (CASI-PM-T), a "DSM-IV"-referenced rating scale for monitoring change in ADHD and co-occurring symptoms in youths receiving behavioral or pharmacological interventions. Method: Three separate studies…

  9. Pharyngeal Residue Severity Rating Scales Based on Fiberoptic Endoscopic Evaluation of Swallowing: A Systematic Review.

    Science.gov (United States)

    Neubauer, Paul D; Hersey, Denise P; Leder, Steven B

    2016-06-01

    Identification of pharyngeal residue severity located in the valleculae and pyriform sinuses has always been a primary goal during fiberoptic endoscopic evaluation of swallowing (FEES). Pharyngeal residue is a clinical sign of potential prandial aspiration making an accurate description of its severity an important but difficult challenge. A reliable, validated, and generalizable pharyngeal residue severity rating scale for FEES would be beneficial. A systematic review of the published English language literature since 1995 was conducted to determine the quality of existing pharyngeal residue severity rating scales based on FEES. Databases were searched using controlled vocabulary words and synonymous free text words for topics of interest (deglutition disorders, pharyngeal residue, endoscopy, videofluoroscopy, fiberoptic technology, aspiration, etc.) and outcomes of interest (scores, scales, grades, tests, FEES, etc.). Search strategies were adjusted for syntax appropriate for each database/platform. Data sources included MEDLINE (OvidSP 1946-April Week 3 2015), Embase (OvidSP 1974-2015 April 20), Scopus (Elsevier), and the unindexed material in PubMed (NLM/NIH) were searched for relevant articles. Supplementary efforts to identify studies included checking reference lists of articles retrieved. Scales were compared using qualitative properties (sample size, severity definitions, number of raters, and raters' experience and training) and psychometric analyses (randomization, intra- and inter-rater reliability, and construct validity). Seven articles describing pharyngeal residue severity rating scales met inclusion criteria. Six of seven scales had insufficient data to support their use as evidenced by methodological weaknesses with both qualitative properties and psychometric analyses. There is a need for qualitative and psychometrically reliable, validated, and generalizable pharyngeal residue severity rating scales that are anatomically specific, image

  10. Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample.

    Science.gov (United States)

    Dakanalis, Antonios; Alix Timko, C; Colmegna, Fabrizia; Riva, Giuseppe; Clerici, Massimo

    2018-04-01

    We examined the validity and utility of the DSM-5 severity ratings for anorexia nervosa (AN) in a clinical (treatment-seeking) sample (N = 273; 95.6% women). Participants classified with mild, moderate, severe, and extreme severity of AN based on their measured body mass index, differed significantly from each other in eating disorder features, putative maintenance factors, and illness-specific functional impairment (medium effect sizes). However, they were statistically indistinguishable in psychiatric-disorder comorbidity and distress, demographics, and age-of-AN onset. The implications of our findings, providing limited support for the DSM-5 severity ratings for AN, and directions for future research are outlined. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Naturally Occurring Peer Support through Social Media: The Experiences of Individuals with Severe Mental Illness Using YouTube

    Science.gov (United States)

    Naslund, John A.; Grande, Stuart W.; Aschbrenner, Kelly A.; Elwyn, Glyn

    2014-01-01

    Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain. PMID:25333470

  12. Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.

    Directory of Open Access Journals (Sweden)

    John A Naslund

    Full Text Available Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

  13. Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube.

    Science.gov (United States)

    Naslund, John A; Grande, Stuart W; Aschbrenner, Kelly A; Elwyn, Glyn

    2014-01-01

    Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer support. Peer support includes a system of mutual giving and receiving where individuals with severe mental illness can offer hope, companionship, and encouragement to others facing similar challenges. In this study we explore the phenomenon of individuals with severe mental illness uploading videos to YouTube, and posting and responding to comments as a form of naturally occurring peer support. We also consider the potential risks and benefits of self-disclosure and interacting with others on YouTube. To address these questions, we used qualitative inquiry informed by emerging techniques in online ethnography. We analyzed n = 3,044 comments posted to 19 videos uploaded by individuals who self-identified as having schizophrenia, schizoaffective disorder, or bipolar disorder. We found peer support across four themes: minimizing a sense of isolation and providing hope; finding support through peer exchange and reciprocity; sharing strategies for coping with day-to-day challenges of severe mental illness; and learning from shared experiences of medication use and seeking mental health care. These broad themes are consistent with accepted notions of peer support in severe mental illness as a voluntary process aimed at inclusion and mutual advancement through shared experience and developing a sense of community. Our data suggest that the lack of anonymity and associated risks of being identified as an individual with severe mental illness on YouTube seem to be overlooked by those who posted comments or uploaded videos. Whether or not this platform can provide benefits for a wider community of individuals with severe mental illness remains uncertain.

  14. A Study on Visibility Rating of Several Representative Web-Safe Colors

    Science.gov (United States)

    Saito, Daisuke; Saito, Keiichi; Notomi, Kazuhiro; Saito, Masao

    This paper presents the visibility ordering of several web-safe colors. The research of web site visibility is important because of the rapid dissemination of the World Wide Web. The combination of a foreground color and a background color is an important factor in providing sufficient visibility. Therefore, the rating of color combination visibility is necessary when developing accessible web sites. In this study, the visibility of several web-safe color combinations was examined using psychological methodology, i.e., a paired comparison. Eighteen chromatic web-safe colors were employed for visual stimuli. Nine students ranging from ages 21 to 29 (average 23.7) were recruited, and all were with normal color sensation. These nine subjects looked at two different colored characters simultaneously on the white background and were instructed to identify which one enabled them to see more clearly. In examining the relationship between the psychological rankings of the color combinations and the visual sensations, each color combination was first scored as to the visibility by Thurstone's paired comparisons technique. Secondly, the visual sensation was deduced by applying Weber-Fechner's law to the luminance of the foreground colors. As results, the luminance of a foreground color influenced the visibility; however the visibility rating is difficult only using the luminance of web-safe colors. These indicate that the chromaticity and chroma saturation are necessary in rating of chromatic web-safe color visibility.

  15. Does recall period have an effect on cancer patients' ratings of the severity of multiple symptoms?

    Science.gov (United States)

    Shi, Qiuling; Trask, Peter C; Wang, Xin Shelley; Mendoza, Tito R; Apraku, Winifred A; Malekifar, Maggie; Cleeland, Charles S

    2010-08-01

    Choosing an appropriate recall period for symptom assessment in a clinical trial is dependent on the design and purpose of the trial. To examine the effects of recall on symptom severity ratings by comparing ratings made using 24-hour and seven-day recall periods of the MD Anderson Symptom Inventory (MDASI). Forty-two patients in their third to eighth week of chemoradiation rated their symptoms using the MDASI on two separate occasions (T1 and T2), one week apart. At T1, patients were randomly assigned to rate symptoms using either a 24-hour or a seven-day recall. At T2, patients rated symptoms using the recall period not used at their first visit. Comparing the 24-hour and seven-day recall periods, the correlation coefficient for total symptom severity was 0.888. All correlation coefficients for symptom severity items were >0.7 except for distress (r=0.67). The percentages of moderate to severe symptoms (rated >or=5) were consistent for both recall periods, with no significant difference between recall periods in the prevalence of moderate to severe symptoms. Cronbach alpha coefficients for both 24-hour and seven-day recalls were >0.8. Symptoms from both recall periods were more severe for patients with poorer performance status. Twenty patients were cognitively debriefed; 70% thought that the seven-day recall was "more appropriate" for the MDASI, but 85% did not think that recall period would influence their answers. This study demonstrated that the MDASI in a seven-day recall format has psychometric properties consistent with the 24-hour recall version, which may promote its use in future cancer clinical trials and may inform the choice of recall period when symptoms are outcome measures. Copyright (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  16. The reliability of a severity rating scale to measure stuttering in an unfamiliar language.

    Science.gov (United States)

    Hoffman, Laura; Wilson, Linda; Copley, Anna; Hewat, Sally; Lim, Valerie

    2014-06-01

    With increasing multiculturalism, speech-language pathologists (SLPs) are likely to work with stuttering clients from linguistic backgrounds that differ from their own. No research to date has estimated SLPs' reliability when measuring severity of stuttering in an unfamiliar language. Therefore, this study was undertaken to estimate the reliability of SLPs' use of a 9-point severity rating (SR) scale, to measure severity of stuttering in a language that was different from their own. Twenty-six Australian SLPs rated 20 speech samples (10 Australian English [AE] and 10 Mandarin) of adults who stutter using a 9-point SR scale on two separate occasions. Judges showed poor agreement when using the scale to measure stuttering in Mandarin samples. Results also indicated that 50% of individual judges were unable to reliably measure the severity of stuttering in AE. The results highlight the need for (a) SLPs to develop intra- and inter-judge agreement when using the 9-point SR scale to measure severity of stuttering in their native language (in this case AE) and in unfamiliar languages; and (b) research into the development and evaluation of practice and/or training packages to assist SLPs to do so.

  17. Effect of context on respiratory rate measurement in identifying non-severe pneumonia in African children.

    Science.gov (United States)

    Muro, Florida; Mtove, George; Mosha, Neema; Wangai, Hannah; Harrison, Nicole; Hildenwall, Helena; Schellenberg, David; Todd, Jim; Olomi, Raimos; Reyburn, Hugh

    2015-06-01

    Cough or difficult breathing and an increased respiratory rate for their age are the commonest indications for outpatient antibiotic treatment in African children. We aimed to determine whether respiratory rate was likely to be transiently raised by a number of contextual factors in a busy clinic leading to inaccurate diagnosis. Respiratory rates were recorded in children aged 2-59 months presenting with cough or difficulty breathing to one of the two busy outpatient clinics and then repeated at 10-min intervals over 1 h in a quiet setting. One hundred and sixty-seven children were enrolled with a mean age of 7.1 (SD ± 2.9) months in infants and 27.6 (SD ± 12.8) months in children aged 12-59 months. The mean respiratory rate declined from 42.3 and 33.6 breaths per minute (bpm) in the clinic to 39.1 and 32.6 bpm after 10 min in a quiet room and to 39.2 and 30.7 bpm (P pneumonia. In a random effects linear regression model, the variability in respiratory rate within children (42%) was almost as much as the variability between children (58%). Changing the respiratory rates cut-offs to higher thresholds resulted in a small reduction in the proportion of non-severe pneumonia mis-classifications in infants. Noise and other contextual factors may cause a transient increase in respiratory rate and consequently misclassification of non-severe pneumonia. However, this effect is less pronounced in older children than infants. Respiratory rate is a difficult sign to measure as the variation is large between and within children. More studies of the accuracy and utility of respiratory rate as a proxy for non-severe pneumonia diagnosis in a busy clinic are needed. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  18. Parkinson's Impulse-Control Scale for the Severity Rating of Impulse-Control Behaviors in Parkinson's Disease: A Semistructured Clinical Assessment Tool.

    Science.gov (United States)

    Okai, David; Askey-Jones, Sally; Mack, Joel; Martin, Anne; Chaudhuri, Kallol Ray; Samuel, Michael; David, Anthony S; Brown, Richard G

    2016-01-01

    Impulse-control behaviors (ICBs) are increasingly recognized in Parkinson's disease (PD) as drug-related effects of dopaminergic mediation that occur in 15% to 35% of patients with PD. The authors describe the design and evaluation of a new, clinician-rated severity scale for the assessment of syndromal and subsyndromal forms of impulse-control disorders (ICDs), simple (punding) and complex (hobbyism) repetitive behaviors, and compulsive overuse of medication (dopamine dysregulation syndrome). The Parkinson's Impulse-Control Scale (PICS), the first PD-specific, semistructured interview to cover the full range of PD-related ICBs, is described along with initial evidence on its clinimetric properties including interrater reliability, discriminant validity and sensitivity to change. A convenience sample of PD patients with ICBs and those without were administered a semistructured interview (n = 92). The scale distinguished between those with and without clinically detected ICBs and between patients with syndromal ICD and subsyndromal ICB (receiver operating characteristic areas under the curve, 92%-95%). Cutoff values were suggested, and substantial agreement was reported on weighted kappa (Κ) values for clinician-clinician rating of severity (Κ = 0.92). Significant improvements were detected on the scale after a randomized controlled trial of cognitive-behavioral therapy and medication adjustment ( t [22] = 5.47; P < 0.001). The PICS appears to be a reliable measure of the full range of PD ICBs with good levels of interrater reliability. It may provide a useful measure to assess the severity of ICBs and monitor change in clinical and research settings; although, given the specialized centers used for recruitment of this sample, further psychometric evaluation is required.

  19. Late effects of post-high-dose-rate brachytherapy for oropharyngeal carcinoma: are they severer than post-low-dose-rate?

    International Nuclear Information System (INIS)

    Nose, T.; Koizumi, M.; Nishiyama, K.; Peiffert, D.; Lapeyre, M.; Hoffstetter, S.

    2004-01-01

    Background: late effects by high-dose-rate (HDR) brachytherapy have been believed severer than low-dose-rate (LDR) provided tumor control was constant. Local control of oropharyngeal carcinoma with HDR at Osaka Medical Center was comparable to LDR series from Centre Alexis Vautrin (82%, 79.5%, respectively). To assess the feasibility of HDR brachytherapy, the late effects were compared. Patients and methods: the data of 29 HDR and 24 LDR patients (median follow-up of 27 and 29.5 months, respectively; p = 0.89) were collected. The HDR schedule was 21 Gy/3.5 fractions/2 days following 46 Gy/23 fractions external beam, while 25 Gy/3 days following 50 Gy/25 fractions external beam was for LDR. Late changes were evaluated using RTOG/EORTC late morbidity scoring scheme. For subclinical late changes, mucosa chapter of Dische score was modified for brachytherapy. Scores were discussed through photos and were agreed on by authors. Late sequelae were estimated, by reviewing charts, concerning frequency, severity, and duration of mucosal damages (erosion and ulcer). Results: Late changes were of no difference (p = 0.12 for EORTC/RTOG, and p = 0.45, 0.47, 1.00, 0.12, 0.16, 0.95, 0.27, 0.21 for erythema, ulceration, edema, thinning, pallor, telangiectasia, mobility impairment of tongue/faucial pillars, respectively, of the modified Dische score). Late sequelae showed no differences (p = 0.90, 0.12, 0.40 for frequency, severity, duration, respectively, of mucosal damages). Conclusion: the late effects by HDR were not severer than by LDR. HDR oropharyngeal brachytherapy is as safe as LDR. (orig.)

  20. Phenomena occurring in the reactor coolant system during severe core damage accidents

    International Nuclear Information System (INIS)

    Malinauskas, A.P.

    1989-01-01

    The reactor coolant system (RCS) of a nuclear power plant consists of the reactor pressure vessel and the piping and associated components that are required for the continuous circulation of the coolant which is used to maintain thermal equilibrium throughout the system. In the event of an accident, the RCS also serves as one of several barriers to the escape of radiotoxic material into the biosphere. In contrast to normal operating conditions, severe core damage accidents are characterized by significant temporal and spatial variations in heat and mass fluxes, and by eventual geometrical changes within the RCS. Furthermore, the difficulties in describing the system in the severe accident mode are compounded by the occurrence of chemical reactions. These reactions can influence both the thermal and the mass transport behavior of the system. In addition, behavior of the reactor vessel internals and of materials released from the core region (especially the radioactive fission products) in the course of the accident likewise become of concern to the analyst. This report addresses these concerns. 9 refs., 1 tab

  1. Rates of Anovulation in Adolescents and Young Adults with Moderate to Severe Primary Dysmenorrhea and Those without Primary Dysmenorrhea.

    Science.gov (United States)

    Seidman, Laura C; Brennan, Kathleen M; Rapkin, Andrea J; Payne, Laura A

    2018-04-01

    To evaluate rates of presumptive anovulation in eumenorrheic adolescents and young adults with moderate to severe primary dysmenorrhea and those without primary dysmenorrhea. Participants completed luteinizing hormone surge ovulation predictor test kits. Anovulatory cycles were defined by never receiving a positive result before the next menstrual period; participants were grouped as anovulatory if they experienced at least 1 anovulatory cycle during study participation. Participants rated daily level of menstrual pain on a 0-10 numeric rating scale. A university-based clinical research laboratory. Thirty-nine adolescents and young adults (ages 16-24) with primary dysmenorrhea and 52 age-matched control girls. Rates of presumptive anovulation. One hundred sixty-eight cycles were monitored, 29.8% (N = 50) of which were anovulatory (37.1% [39/105] vs 17.5% [11/63] of cycles in control and dysmenorrhea groups, respectively). During study participation, control girls were significantly more likely to have had at least 1 anovulatory cycle than were girls with primary dysmenorrhea (44.2% [23/52] vs 17.9% [7/39] of participants, respectively; P dysmenorrhea group's maximum menstrual pain ratings did not differ between ovulatory and anovulatory cycles (4.77 and 4.36, respectively; P > .05). Our data support previous findings of increased rates of ovulation in primary dysmenorrhea. However, menstruation after anovulatory cycles can be as painful as menstruation after ovulatory cycles. These data support the idea that regular menses do not necessarily indicate that a normal ovulatory cycle has occurred. Previous implications that ovulation is necessary for the development of substantial menstrual pain are incomplete. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  2. Primary Ankle Arthrodesis for Severely Comminuted Tibial Pilon Fractures.

    Science.gov (United States)

    Al-Ashhab, Mohamed E

    2017-03-01

    Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score. [Orthopedics. 2017; 40(2):e378-e381.]. Copyright 2016, SLACK Incorporated.

  3. Radioisotopic measurement of glomerular filtration rate in severe chronic renal failure

    International Nuclear Information System (INIS)

    LaFrance, N.D.; Drew, H.H.; Walser, M.

    1988-01-01

    In order to determine the best method for routine measurement of glomerular filtration rate (GFR) in severe renal failure, we compared simultaneously the urinary clearances of [/sup 99m/Tc] diethylenetriaminepentaacetic acid (DTPA) (UD), [ 125 I]iothalamate (UI), 24-hr creatinine clearance (UC) and plasma clearance of [/sup 99m/Tc]DTPA (PD), based on three plasma samples. In 60 studies in 22 patients with serum creatinine values of 2 to 8 mg/dl, UD and UI were almost identical: UD = 0.358 +/- 0.976 UI +/- 0.87 ml/min, r = 0.990. However, PD overestimated UD by a large and variable extent: PD = 11.3 +/- 0.843 UD +/- 5.5 ml/min, r = 0.694, and was inconsistent in sequential measurements in individual patients. UC also overestimated urinary isotope clearance: UC = 4.2 + 0.95 UI +/- 3.9 ml/min, r = 0.865. Sequential measurements of GFR in five patients with severe but stable renal failure (mean GFR 5.9 ml/min) showed an average standard deviation of only 0.83 ml/min. Thus both UD and UI appear to be reliable and precise measures of GFR in severe renal failure

  4. Total retinal detachment occurring after minor head trauma.

    Science.gov (United States)

    Mircea, Pienaru; Ramona, Serban; Mircea, Filip; Andrei, Filip

    2015-01-01

    The objective of this article is to present the case of a patient with a severe decrease of visual acuity that occurred after an apparently minor head injury. Following the investigations, the patient was diagnosed with rhegmatogenous retinal detachment that was triggered by a fall from the same level and which occurred on a background of lattice degeneration. In this case, a minor trauma caused a severe complication because the patient had a contributing factor for the complication. The patient was operated and the end result was satisfactory.

  5. Prognostic value of lactate clearance in severe community acquired pneumonia

    OpenAIRE

    Mohamed, Kamel Abd Elaziz; Ahmed, Dief Abd Elgalil

    2014-01-01

    Introduction: Severe community acquired pneumonia (SCAP) occurs in approximately 18–36% of all CAP and the mortality rate could be as high as 67% in patients with SCAP. Several studies have described a correlation between baseline lactate concentration and mortality of ICU patients. Aim of the work: To follow lactate clearance after admission for 24 h which could be an indicator of outcome in severe community acquired pneumonia. Patients and methods: Forty-six consecutively admitted adu...

  6. Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006-2013.

    Science.gov (United States)

    Lipska, Kasia J; Yao, Xiaoxi; Herrin, Jeph; McCoy, Rozalina G; Ross, Joseph S; Steinman, Michael A; Inzucchi, Silvio E; Gill, Thomas M; Krumholz, Harlan M; Shah, Nilay D

    2017-04-01

    To examine temporal trends in utilization of glucose-lowering medications, glycemic control, and rate of severe hypoglycemia among patients with type 2 diabetes (T2DM). Using claims data from 1.66 million privately insured and Medicare Advantage patients with T2DM from 2006 to 2013, we estimated the annual 1 ) age- and sex-standardized proportion of patients who filled each class of agents; 2 ) age-, sex-, race-, and region-standardized proportion with hemoglobin A 1c (HbA 1c ) use increased for metformin (from 47.6 to 53.5%), dipeptidyl peptidase 4 inhibitors (0.5 to 14.9%), and insulin (17.1 to 23.0%) but declined for sulfonylureas (38.8 to 30.8%) and thiazolidinediones (28.5 to 5.6%; all P use of glucose-lowering drugs has changed dramatically among patients with T2DM. Overall glycemic control has not improved and remains poor among nearly a quarter of the youngest patients. The overall rate of severe hypoglycemia remains largely unchanged. © 2017 by the American Diabetes Association.

  7. Hot flashes severity, complementary and alternative medicine use, and self-rated health in women with breast cancer.

    Science.gov (United States)

    Chandwani, Kavita D; Heckler, Charles E; Mohile, Supriya G; Mustian, Karen M; Janelsins, Michelle; Peppone, Luke J; Bushunow, Peter; Flynn, Patrick J; Morrow, Gary R

    2014-01-01

    Hot flashes (HF) are a common distressing symptom in women with breast cancer (BC). Current pharmacologic options are moderately effective and are associated with bothersome side effects. Complementary and alternative medicine is commonly used by cancer patients. However, information on the association of hot flashes severity with such use and self-rated health is lacking. To examine the hot flashes severity in women with breast cancer and its association with complementary and alternative medicine use and self-rated health (SRH). Longitudinal multicenter study to assess information needs of cancer outpatients. Patients with a diagnosis of breast cancer who were scheduled to undergo chemotherapy and/or radiotherapy. Hot flashes severity (0 = not present and 10 = as bad as you can imagine), use of complementary and alternative medicine (yes/no), and self-rating of health (SRH) status post-treatment and six-months thereafter (1-5, higher score = better SRH). The majority of women with HF (mean age = 54.4 years) were Caucasian and married, with higher education, and 93% had received surgical treatment for BC. At the end of treatment, 79% women reported experiencing HF [mean severity = 5.87, standard deviation (SD) = 2.9]; significantly more severe HF were reported by younger women with poor SRH, poor performance status, and those reporting doing spiritual practices. At follow-up, 73% had HF (mean severity = 4.86, SD = 3.0), and more severe HF were reported by younger women with poor self-rated health who had undergone chemotherapy plus radiotherapy, used vitamins, and did not exercise. A high percentage of women experienced hot flashes at the end of treatment and at six-month follow-up. A significant association of hot flashes severity with spiritual practice, increased vitamin use, and reduced exercise emphasize the need for future studies to confirm the results. This can facilitate safe use of complementary and alternative medicine and favorable outcomes while

  8. Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport: A Descriptive Study of MRI-Confirmed Reinjuries

    NARCIS (Netherlands)

    Wangensteen, Arnlaug; Tol, Johannes L.; Witvrouw, Erik; van Linschoten, Robbart; Almusa, Emad; Hamilton, Bruce; Bahr, Roald

    2016-01-01

    Despite relatively high reinjury rates after acute hamstring injuries, there is a lack of detailed knowledge about where and when hamstring reinjuries occur, and studies including imaging-confirmed reinjuries are scarce. To investigate the location, radiological severity, and timing of reinjuries on

  9. Site of delivery contribution to black-white severe maternal morbidity disparity.

    Science.gov (United States)

    Howell, Elizabeth A; Egorova, Natalia N; Balbierz, Amy; Zeitlin, Jennifer; Hebert, Paul L

    2016-08-01

    The black-white maternal mortality disparity is the largest disparity among all conventional population perinatal health measures, and the mortality gap between black and white women in New York City has nearly doubled in recent years. For every maternal death, 100 women experience severe maternal morbidity, a life-threatening diagnosis, or undergo a life-saving procedure during their delivery hospitalization. Like maternal mortality, severe maternal morbidity is more common among black than white women. A significant portion of maternal morbidity and mortality is preventable, making quality of care in hospitals a critical lever for improving outcomes. Hospital variation in risk-adjusted severe maternal morbidity rates exists. The extent to which variation in hospital performance on severe maternal morbidity rates contributes to black-white disparities in New York City hospitals has not been studied. We examined the extent to which black-white differences in severe maternal morbidity rates in New York City hospitals can be explained by differences in the hospitals in which black and white women deliver. We conducted a population-based study using linked 2011-2013 New York City discharge and birth certificate datasets (n = 353,773 deliveries) to examine black-white differences in severe maternal morbidity rates in New York City hospitals. A mixed-effects logistic regression with a random hospital-specific intercept was used to generate risk-standardized severe maternal morbidity rates for each hospital (n = 40). We then assessed differences in the distributions of black and white deliveries among these hospitals. Severe maternal morbidity occurred in 8882 deliveries (2.5%) and was higher among black than white women (4.2% vs 1.5%, P rates among New York City hospitals ranged from 0.8 to 5.7 per 100 deliveries. White deliveries were more likely to be delivered in low-morbidity hospitals: 65% of white vs 23% of black deliveries occurred in hospitals in the lowest

  10. Illness severity, trait anxiety, cognitive impairment and heart rate variability in bipolar disorder.

    Science.gov (United States)

    Levy, Boaz

    2014-12-30

    Numerous studies have documented a significant association between symptom severity and cognitive functioning in bipolar disorder (BD). These findings advanced speculations about a potential link between the physiological stress associated with illness severity and cognitive dysfunction. To explore this hypothesis, the current study employed heart rate variability (HRV) as a physiological measure that is sensitive to the effects of chronic stress, and a scale of trait anxiety for assessing a psychological condition that is correlated with hyper sympathetic arousal. Analyses indicated that BD patients with High Illness Severity reported more symptoms of trait-anxiety (i.e., State Trait Anxiety Inventory), performed more poorly on a computerized neuropsychological battery (i.e., CNS Vital Signs), and exhibited a more constricted HRV profile (i.e., lower SDNN with elevated LF/HF ratio) than patients with Low Illness Severity. Illness severity was determined by a history of psychosis, illness duration, and number of mood episodes. A third group of healthy controls (n=22) performed better on the neuropsychological battery and exhibited a healthier HRV profile than the BD groups. This study provides preliminary evidence that illness severity and cognitive impairment in BD may be associated with state anxiety and neuro-cardiac alterations that are sensitive to physiological stress. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. The management of adults and children with moderate severity ...

    African Journals Online (AJOL)

    Moderate severity asthma occurs in approximately 10 to 15% of patients with chronic reversible airway obstruction and is de- fined by more than four daytime symptoms per week, more than four night time symptoms per month and peak expiratory flow rates of between 60 and 80% of predicted values. Currently ...

  12. PERFORMANCE EVALUATION AND RISK AVERSION RATE FOR SEVERAL STOCK INDICES IN INDONESIA STOCK EXCHANGE

    OpenAIRE

    Robiyanto Robiyanto

    2017-01-01

    There are numerous stock indices in Indonesia Stock Exchange. Several of them are LQ-45, MBX, DBX, JII, SRI-KEHATI, PEFINDO-25, BISNIS-27, IDX-30 and KOMPAS-100. Unfortunately there are limi­ted researches which have been done to measure those indices performance specifically. The same condition also occurs on risk aversion level usage in Indonesia Stock Exchange, only few numbers of researches use this me­a­surement in the portfolio valuation. Based on that, this research measured the perfor...

  13. Outcome of severe infections in afebrile neutropenic cancer patients

    Science.gov (United States)

    Mahkovic-Hergouth, Ksenija; Novakovic, Barbara Jezersek; Seruga, Bostjan

    2016-01-01

    Abstract Background In some neutropenic cancer patients fever may be absent despite microbiologically and/or clinically confirmed infection. We hypothesized that afebrile neutropenic cancer patients with severe infections have worse outcome as compared to cancer patients with febrile neutropenia. Patients and methods We retrospectively analyzed all adult cancer patients with chemotherapy-induced neutropenia and severe infection, who were admitted to the Intensive Care Unit at our cancer center between 2000 and 2011. The outcome of interest was 30-day in-hospital mortality rate. Association between the febrile status and in-hospital mortality rate was evaluated by the Fisher’s exact test. Results We identified 69 episodes of severe neutropenic infections in 65 cancer patients. Among these, 9 (13%) episodes were afebrile. Patients with afebrile neutropenic infection presented with hypotension, severe fatigue with inappetence, shaking chills, altered mental state or cough and all of them eventually deteriorated to severe sepsis or septic shock. Overall 30-day in-hospital mortality rate was 55.1%. Patients with afebrile neutropenic infection had a trend for a higher 30-day in-hospital mortality rate as compared to patients with febrile neutropenic infection (78% vs. 52%, p = 0.17). Conclusions Afebrile cancer patients with chemotherapy-induced neutropenia and severe infections might have worse outcome as compared to cancer patients with febrile neutropenia. Patients should be informed that severe neutropenic infection without fever can occasionally occur during cancer treatment with chemotherapy. PMID:27904453

  14. Gender-specific heart rate dynamics in severe intrauterine growth-restricted fetuses.

    Science.gov (United States)

    Gonçalves, Hernâni; Bernardes, João; Ayres-de-Campos, Diogo

    2013-06-01

    Management of intrauterine growth restriction (IUGR) remains a major issue in perinatology. The objective of this paper was the assessment of gender-specific fetal heart rate (FHR) dynamics as a diagnostic tool in severe IUGR. FHR was analyzed in the antepartum period in 15 severe IUGR fetuses and 18 controls, matched for gestational age, in relation to fetal gender. Linear and entropy methods, such as mean FHR (mFHR), low (LF), high (HF) and movement frequency (MF), approximate, sample and multiscale entropy. Sensitivities and specificities were estimated using Fisher linear discriminant analysis and the leave-one-out method. Overall, IUGR fetuses presented significantly lower mFHR and entropy compared with controls. However, gender-specific analysis showed that significantly lower mFHR was only evident in IUGR males and lower entropy in IUGR females. In addition, lower LF/(MF+HF) was patent in IUGR females compared with controls, but not in males. Rather high sensitivities and specificities were achieved in the detection of the FHR recordings related with IUGR male fetuses, when gender-specific analysis was performed at gestational ages less than 34 weeks. Severe IUGR fetuses present gender-specific linear and entropy FHR changes, compared with controls, characterized by a significantly lower entropy and sympathetic-vagal balance in females than in males. These findings need to be considered in order to achieve better diagnostic results. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Severe signal loss in diamond beam loss monitors in high particle rate environments by charge trapping in radiation-induced defects

    Energy Technology Data Exchange (ETDEWEB)

    Kassel, Florian; Boer, Wim de [Institute for Experimental Nuclear Physics (IEKP), KIT, Karlsruhe (Germany); Guthoff, Moritz; Dabrowski, Anne [CERN, Meyrin (Switzerland)

    2016-10-15

    The beam condition monitoring leakage (BCML) system is a beam monitoring device in the compact muon solenoid (CMS) experiment at the large hadron collider (LHC). As detectors 32 poly-crystalline (pCVD) diamond sensors are positioned in rings around the beam pipe. Here, high particle rates occur from the colliding beams scattering particles outside the beam pipe. These particles cause defects, which act as traps for the ionization, thus reducing the charge collection efficiency (CCE). However, the loss in CCE was much more severe than expected from low rate laboratory measurements and simulations, especially in single-crystalline (sCVD) diamonds, which have a low initial concentration of defects. After an integrated luminosity of a few fb{sup -1} corresponding to a few weeks of LHC operation, the CCE of the sCVD diamonds dropped by a factor of five or more and quickly approached the poor CCE of pCVD diamonds. The reason why in real experiments the CCE is much worse than in laboratory experiments is related to the ionization rate. At high particle rates the trapping rate of the ionization is so high compared with the detrapping rate, that space charge builds up. This space charge reduces locally the internal electric field, which in turn increases the trapping rate and recombination and hence reduces the CCE in a strongly non-linear way. A diamond irradiation campaign was started to investigate the rate-dependent electrical field deformation with respect to the radiation damage. Besides the electrical field measurements via the transient current technique (TCT), the CCE was measured. The experimental results were used to create an effective deep trap model that takes the radiation damage into account. Using this trap model, the rate-dependent electrical field deformation and the CCE were simulated with the software SILVACO TCAD. The simulation, tuned to rate-dependent measurements from a strong radioactive source, was able to predict the non-linear decrease of the

  16. Severe signal loss in diamond beam loss monitors in high particle rate environments by charge trapping in radiation-induced defects

    International Nuclear Information System (INIS)

    Kassel, Florian; Boer, Wim de; Guthoff, Moritz; Dabrowski, Anne

    2016-01-01

    The beam condition monitoring leakage (BCML) system is a beam monitoring device in the compact muon solenoid (CMS) experiment at the large hadron collider (LHC). As detectors 32 poly-crystalline (pCVD) diamond sensors are positioned in rings around the beam pipe. Here, high particle rates occur from the colliding beams scattering particles outside the beam pipe. These particles cause defects, which act as traps for the ionization, thus reducing the charge collection efficiency (CCE). However, the loss in CCE was much more severe than expected from low rate laboratory measurements and simulations, especially in single-crystalline (sCVD) diamonds, which have a low initial concentration of defects. After an integrated luminosity of a few fb -1 corresponding to a few weeks of LHC operation, the CCE of the sCVD diamonds dropped by a factor of five or more and quickly approached the poor CCE of pCVD diamonds. The reason why in real experiments the CCE is much worse than in laboratory experiments is related to the ionization rate. At high particle rates the trapping rate of the ionization is so high compared with the detrapping rate, that space charge builds up. This space charge reduces locally the internal electric field, which in turn increases the trapping rate and recombination and hence reduces the CCE in a strongly non-linear way. A diamond irradiation campaign was started to investigate the rate-dependent electrical field deformation with respect to the radiation damage. Besides the electrical field measurements via the transient current technique (TCT), the CCE was measured. The experimental results were used to create an effective deep trap model that takes the radiation damage into account. Using this trap model, the rate-dependent electrical field deformation and the CCE were simulated with the software SILVACO TCAD. The simulation, tuned to rate-dependent measurements from a strong radioactive source, was able to predict the non-linear decrease of the CCE in

  17. Radiochemical techniques for determining some naturally occurring radionuclides in marine environmental materials

    Energy Technology Data Exchange (ETDEWEB)

    Baker, C W [Ministry of Agriculture, Fisheries and Food, Lowestoft (UK). Fisheries Lab.

    1984-06-15

    The determination of some of the naturally-occurring, alpha-emitting radionuclides in marine environmental materials, is of interest for several reasons. Radium and radon nuclides are potentially useful as oceanographic tracers. Lead and thorium nuclides may be used to study sedimentation rates, mixing processes and bioturbation in sediments. Radium and polonium nuclides are incorporated into food chains and the data may provide a perspective against which to assess the significance, for marine organisms, of exposure to radiation in a marine radioactive waste disposal situation. This paper discusses the manner in which samples are taken, and the radiochemical methods which have been employed to measure the nuclides, together with some data produced.

  18. Estimating diversification rates for higher taxa: BAMM can give problematic estimates of rates and rate shifts.

    Science.gov (United States)

    Meyer, Andreas L S; Wiens, John J

    2018-01-01

    Estimates of diversification rates are invaluable for many macroevolutionary studies. Recently, an approach called BAMM (Bayesian Analysis of Macro-evolutionary Mixtures) has become widely used for estimating diversification rates and rate shifts. At the same time, several articles have concluded that estimates of net diversification rates from the method-of-moments (MS) estimators are inaccurate. Yet, no studies have compared the ability of these two methods to accurately estimate clade diversification rates. Here, we use simulations to compare their performance. We found that BAMM yielded relatively weak relationships between true and estimated diversification rates. This occurred because BAMM underestimated the number of rates shifts across each tree, and assigned high rates to small clades with low rates. Errors in both speciation and extinction rates contributed to these errors, showing that using BAMM to estimate only speciation rates is also problematic. In contrast, the MS estimators (particularly using stem group ages), yielded stronger relationships between true and estimated diversification rates, by roughly twofold. Furthermore, the MS approach remained relatively accurate when diversification rates were heterogeneous within clades, despite the widespread assumption that it requires constant rates within clades. Overall, we caution that BAMM may be problematic for estimating diversification rates and rate shifts. © 2017 The Author(s). Evolution © 2017 The Society for the Study of Evolution.

  19. Incidence of severe critical events in paediatric anaesthesia (APRICOT)

    DEFF Research Database (Denmark)

    Habre, Walid; Disma, Nicola; Virag, Katalin

    2017-01-01

    a relatively high rate of severe critical events during the anaesthesia management of children for surgical or diagnostic procedures in Europe, and a large variability in the practice of paediatric anaesthesia. These findings are substantial enough to warrant attention from national, regional, and specialist......BACKGROUND: Little is known about the incidence of severe critical events in children undergoing general anaesthesia in Europe. We aimed to identify the incidence, nature, and outcome of severe critical events in children undergoing anaesthesia, and the associated potential risk factors. METHODS...... 261 participating centres across 33 European countries. The primary endpoint was the occurence of perioperative severe critical events requiring immediate intervention. A severe critical event was defined as the occurrence of respiratory, cardiac, allergic, or neurological complications requiring...

  20. The QUANTEC criteria for parotid gland dose and their efficacy to prevent moderate to severe patient-rated xerostomia.

    Science.gov (United States)

    Beetz, Ivo; Steenbakkers, Roel J H M; Chouvalova, Olga; Leemans, Charles R; Doornaert, Patricia; van der Laan, Bernard F A M; Christianen, Miranda E M C; Vissink, Arjan; Bijl, Henk P; van Luijk, Peter; Langendijk, Johannes A

    2014-05-01

    Recently, the Quantitative Analysis of Normal Tissue Effect in the Clinic (QUANTEC) Group defined dose-volume constraints for the parotid glands to avoid severe xerostomia. The aim of this study was to determine if application of these QUANTEC criteria also protected against moderate-to-severe patient-rated xerostomia. The study population consisted of 307 head and neck cancer patients treated with primary (chemo)radiotherapy, either with 3D-CRT (56%) or with IMRT (44%). All patients participated in a standard follow-up program in which radiation-induced toxicity and quality of life were prospectively assessed. Patients who met the QUANTEC criteria were classified as low risk and otherwise as high risk. In total, 41% of the patients (treated with 3D-CRT and IMRT) were classified as low risk patients. In the group treated with 3D-CRT and IMRT, it was possible to meet the QUANTEC criteria in 47% and 32% of the patients, respectively. Sparing the parotid glands with IMRT was considerably more difficult in patients with lymph node metastases and in patients with nasopharyngeal and oropharyngeal tumours. Low risk patients reported significantly less moderate-to-severe xerostomia than high risk patients. However, the predicted risk of elderly patients and patients with pre-existing minor patient-rated xerostomia at baseline was > 20%, even when the QUANTEC criteria were met. Significantly lower rates of radiation-induced patient-rated xerostomia were found among low risk patients treated according to the QUANTEC criteria, but these criteria do not completely protect against xerostomia. Particularly in elderly patients and patients already suffering from minor xerostomia at baseline, the QUANTEC criteria do not sufficiently protect against persistent, moderate-to-severe patient-rated xerostomia.

  1. Are High-Severity Fires Burning at Much Higher Rates Recently than Historically in Dry-Forest Landscapes of the Western USA?

    Science.gov (United States)

    Baker, William L

    2015-01-01

    Dry forests at low elevations in temperate-zone mountains are commonly hypothesized to be at risk of exceptional rates of severe fire from climatic change and land-use effects. Their setting is fire-prone, they have been altered by land-uses, and fire severity may be increasing. However, where fires were excluded, increased fire could also be hypothesized as restorative of historical fire. These competing hypotheses are not well tested, as reference data prior to widespread land-use expansion were insufficient. Moreover, fire-climate projections were lacking for these forests. Here, I used new reference data and records of high-severity fire from 1984-2012 across all dry forests (25.5 million ha) of the western USA to test these hypotheses. I also approximated projected effects of climatic change on high-severity fire in dry forests by applying existing projections. This analysis showed the rate of recent high-severity fire in dry forests is within the range of historical rates, or is too low, overall across dry forests and individually in 42 of 43 analysis regions. Significant upward trends were lacking overall from 1984-2012 for area burned and fraction burned at high severity. Upward trends in area burned at high severity were found in only 4 of 43 analysis regions. Projections for A.D. 2046-2065 showed high-severity fire would generally be still operating at, or have been restored to historical rates, although high projections suggest high-severity fire rotations that are too short could ensue in 6 of 43 regions. Programs to generally reduce fire severity in dry forests are not supported and have significant adverse ecological impacts, including reducing habitat for native species dependent on early-successional burned patches and decreasing landscape heterogeneity that confers resilience to climatic change. Some adverse ecological effects of high-severity fires are concerns. Managers and communities can improve our ability to live with high-severity fire in

  2. Evaluation of safety ratings of roads based on frontal crashes with known crash pulse and injury outcome.

    Science.gov (United States)

    Stigson, H

    2009-06-01

    The objective in this study, using data from crashed cars fitted with on-board crash pulse recorders, was to present differences in average crash severity, distribution of crash severity, and injury outcomes, based on an independent safety rating of roads, also taking road type and speed limit into consideration. Furthermore, the objective was to evaluate differences in injury risk, based on the distribution of crash severity. The investigation included both frontal two-vehicle crashes and single-vehicle crashes with known injury outcome. In total, 209 real-world crashes involving cars fitted with crash pulse recorders were included. For all crashes, average mean acceleration and change of velocity of the vehicle acceleration pulse were measured and calculated. All crash spots were classified according to an independent road safety rating program (European Road Assessment Programme Road Protection Score), where the safety quality of roads is rated in relation to posted speed limits. The crash severity and injury outcome in crashes that occurred on roads with good safety ratings were compared with crashes on roads with poor safety ratings. The data were also divided into subcategories according to posted speed limit and road type, to evaluate whether there was a difference in crash severity and injury outcome within the categories. In total, crash severity was statistically significantly lower in crashes occurring on roads with good safety ratings than in crashes occurring on roads with poor safety ratings. It was found that crash severity and injury risk were lower on roads with good safety ratings with a speed limit of above 90 km/h compared with roads with poor safety ratings, irrespective of speed limit. On the other hand, crash severity was higher on roads with good safety ratings with speed limit of 70 km/h than on roads with poor safety ratings with the same speed limit. Though it was found that a higher speed limit resulted in higher crash severity on roads

  3. Severity of infection and seasonal variation of non-typhoid Salmonelle occurence in humans

    DEFF Research Database (Denmark)

    Gradel, K.O.; Dethlefsen, Claus; Schønheyder, H.C.

    2007-01-01

    Non-typhoid Salmonella infections may present as severe gastroenteritis necessitatinghospitalization and some patients become septic with bacteraemia. We hypothesized that theseasonal variation of non-typhoid Salmonella occurrence in humans diminishes with increasedseverity of infection. We...... examined the seasonal variation of non-typhoid Salmonella infections inthree patient groups with differing severity of infection: outpatients treated for gastroenteritis(n=1490); in-patients treated for gastroenteritis (n=492); and in-patients treated for bacteraemia(n=113). The study was population......-based and included all non-typhoid Salmonella patients ina Danish county from 1994 to 2003. A periodic regression model was used to compute thepeak-to-trough ratio for the three patient groups. The peak-to-trough ratios were 4·3 [95%confidence interval (CI) 3·6–5.0] for outpatients with gastroenteritis, 3·2 (95% CI...

  4. Scapular fracture: lower severity and mortality

    Directory of Open Access Journals (Sweden)

    Javad Salimi

    Full Text Available CONTEXT AND OBJECTIVE: The presence of scapular fracture is believed to be associated with high rates of other injuries and accompanying morbidities. The aim was to study injury patterns and their overall outcomes in patients with scapula fractures. DESIGN AND SETTING: Cross-sectional study of trauma patients treated at six general hospitals in Tehran. METHODS: One-year trauma records were obtained from six general hospitals Among these, forty-one had sustained a scapular fracture and were included in this study. RESULTS: Scapular fracture occurred predominantly among 20 to 50-year-old patients (78%. Road traffic accidents (RTAs were the main cause of injury (73.2%; 30/41. Pedestrians accounted for 46.7% (14/30 of the injuries due to RTAs. Falls were the next most common cause, accounting for seven cases (17.1%. Body fractures were the most common type of scapular fractures (80%. Eighteen patients (43.9% had isolated scapular fractures. Limb fracture was the most common associated injury, detected in 18 cases (43.9%. Three patients (7.3% had severe injuries (injury severity score, ISS > 16 which resulted in one death (2.4%. The majority of the patients were treated conservatively (87.8%. CONCLUSIONS: Patients with scapula fractures have more severe underlying chest injuries and clavicle fractures. However, this did not correlate with higher rates of injury severity score, intensive care unit admission or mortality.

  5. Relationship of suicide rates to economic variables in Europe

    DEFF Research Database (Denmark)

    Fountoulakis, Konstantinos N; Kawohl, Wolfram; Theodorakis, Pavlos N

    2014-01-01

    European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. RESULTS: There was a strong correlation between suicide rates and all economic indices except GPD per capita...... in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. CONCLUSIONS: Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support...

  6. Design study on dose evaluation method for employees at severe accident

    International Nuclear Information System (INIS)

    Yoshida, Yoshitaka; Irie, Takashi; Kohriyama, Tamio; Kudo, Seiichi; Nishimura, Kazuya

    2002-01-01

    If a severe accident occurs in a pressurized water reactor plant, it is required to estimate dose values of operators engaged in emergency such as accident management, repair of failed parts. However, it might be difficult to measure radiation dose rate during the progress of an accident, because radiation monitors are not always installed in areas where the emergency activities are required. In this study, we analyzed the transport of radioactive materials in case of a severe accident, investigated a method to obtain radiation dose rate in the plant from estimated radioactive sources, made up a prototype analyzing system from this design study, and then evaluated its availability. As a result, we obtained the following: (1) A new dose evaluation method was established to predict the radiation dose rate at any point in the plant during a severe accident scenario. (2) This evaluation of total dose including access route and time for emergency activities is useful for estimating radiation dose limit for these employee actions. (3) The radiation dose rate map is effective for identifying high radiation areas and for choosing a route with lower radiation dose rate. (author)

  7. Predicting severe winter coastal storm damage

    International Nuclear Information System (INIS)

    Hondula, David M; Dolan, Robert

    2010-01-01

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'-such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989-are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the losses along the North

  8. Predicting severe winter coastal storm damage

    Energy Technology Data Exchange (ETDEWEB)

    Hondula, David M; Dolan, Robert, E-mail: hondula@virginia.edu [Department of Environmental Sciences, University of Virginia, PO Box 400123, Charlottesville, VA 22903 (United States)

    2010-07-15

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'-such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989-are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the

  9. Predicting severe winter coastal storm damage

    Science.gov (United States)

    Hondula, David M.; Dolan, Robert

    2010-07-01

    Over the past 40 years residents of, and visitors to, the North Carolina coastal barrier islands have experienced the destructive forces of several 'named' extratropical storms. These storms have caused large-scale redistributions of sand and loss of coastal structures and infrastructure. While most of the population living on the islands are familiar with the wintertime storms, the damage and scars of the 'super northeasters'—such as the Ash Wednesday storm of 7 March 1962, and the Halloween storm of 1989—are slipping away from the public's memory. In this research we compared the damage zones of the 1962 Ash Wednesday storm, as depicted on aerial photographs taken after the storm, with photos taken of the same areas in 2003. With these high-resolution aerial photos we were able to estimate the extent of new development which has taken place along the Outer Banks of North Carolina since 1962. Three damage zones were defined that extend across the islands from the ocean landward on the 1962 aerial photos: (1) the zone of almost total destruction on the seaward edge of the islands where the storm waves break; (2) the zone immediately inland where moderate structural damage occurs during severe storms; and (3) the zone of flood damage at the landward margin of the storm surge and overwash. We considered the rate of coastal erosion, the rate of development, and increases in property values as factors which may contribute to changing the financial risk for coastal communities. In comparing the values of these four factors with the 1962 damage data, we produced a predicted dollar value for storm damage should another storm of the magnitude of the 1962 Ash Wednesday storm occur in the present decade. This model also provides an opportunity to estimate the rate of increase in the potential losses through time as shoreline erosion continues to progressively reduce the buffer between the development and the edge of the sea. Our data suggest that the losses along the

  10. Phonemic verbal fluency and severity of anxiety disorders in young children

    Directory of Open Access Journals (Sweden)

    Rudineia Toazza

    Full Text Available Abstract Introduction: Previous studies have implicated impaired verbal fluency as being associated with anxiety disorders in adolescents. Objectives: To replicate and extend previously reported evidence by investigating whether performance in phonemic verbal fluency tasks is related to severity of anxiety symptoms in young children with anxiety disorders. We also aim to investigate whether putative associations are independent from co-occurring attention deficit hyperactivity disorder (ADHD symptoms. Methods: Sixty children (6-12 years old with primary diagnoses of anxiety disorders participated in this study. Severity of symptoms was measured using clinician-based, parent-rated and self-rated validated scales. Verbal fluency was assessed using a simple task that measures the number of words evoked in 1-minute with the letter F, from which we quantified the number of isolated words, number of clusters (groups of similar words and number of switches (transitions between clusters and/or between isolated words. Results: There was a significant association between the number of clusters and anxiety scores. Further analysis revealed associations were independent from co-occurring ADHD symptoms. Conclusion: We replicate and extend previous findings showing that verbal fluency is consistently associated with severity in anxiety disorders in children. Further studies should explore the potential effect of cognitive training on symptoms of anxiety disorders.

  11. Depressive symptomatology in severe dementia in a European sample: prevalence, associated factors and prescription rate of antidepressants.

    Science.gov (United States)

    Giebel, Clarissa M; Sutcliffe, Caroline; Renom-Guiteras, Anna; Arve, Seija; Hallberg, Ingalill Rahm; Soto, Maria; Zabalegui, Adelaida; Hamers, Jan; Saks, Kai; Challis, David

    2015-04-01

    Depression is a common comorbid disorder of dementia. This study explores the prevalence of and factors associated with depressive symptomatology, and antidepressant prescription rates in severe dementia across eight European countries. In total, 414 people with severe dementia completed measures of cognition and quality of life (QoL), whilst carers completed proxy measures of activities of daily living (ADLs), depression, neuropsychiatric symptoms, QoL and comorbidity. Findings indicated that 30% of the sample had depression, whilst the highest and lowest prevalence of depression was reported in Germany and Finland, respectively. Lower QoL, the presence of pain and more frequent neuropsychiatric symptoms were associated with depressive symptomatology, whilst no significant relationship between impairment of ADLs, comorbidity, and depression emerged. Spain and Estonia had the highest and lowest rates of antidepressant prescribing, respectively, whilst Germany had the highest discrepancy between depressive symptomatology and prescription. The study highlights variations across countries in the prevalence of depressive symptomatology in severe dementia and prescription of antidepressants. Information about factors associated with depressive symptomatology may help to better identify and manage depression.

  12. Predictive Validity of the Columbia-Suicide Severity Rating Scale for Short-Term Suicidal Behavior

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Erlangsen, Annette; Teasdale, Thomas William

    2017-01-01

    adolescents (90.6% females) who participated at follow-up (85.9%) out of the 99 (49.7%) baseline respondents. All adolescents were recruited from a specialized suicide-prevention clinic in Denmark. Through multivariate logistic regression analyses, we examined whether baseline suicidal behavior predicted......Using the Columbia-Suicide Severity Rating Scale (C-SSRS), we examined the predictive and incremental predictive validity of past-month suicidal behavior and ideation for short-term suicidal behavior among adolescents at high risk of suicide. The study was conducted in 2014 on a sample of 85...... subsequent suicidal behavior (actual attempts and suicidal behavior of any type, including preparatory acts, aborted, interrupted and actual attempts; mean follow-up of 80.8 days, SD = 52.4). Furthermore, we examined whether suicidal ideation severity and intensity incrementally predicted suicidal behavior...

  13. Increasing rates of cerebral palsy across the severity spectrum in north-east England 1964-1993. The North of England Collaborative Cerebral Palsy Survey.

    Science.gov (United States)

    Colver, A F; Gibson, M; Hey, E N; Jarvis, S N; Mackie, P C; Richmond, S

    2000-07-01

    To report epidemiological trends in cerebral palsy including analyses by severity. Descriptive longitudinal study in north-east England. Every child with suspected cerebral palsy was examined by a developmental paediatrician to confirm the diagnosis. Severity of impact of disability was derived from a parent completed questionnaire already developed and validated for this purpose. All children with cerebral palsy, not associated with any known postneonatal insult, born 1964-1993 to mothers resident at the time of birth in the study area. Cerebral palsy rates by year, birth weight, and severity. Severity of 30% and above defines the more reliably ascertained cases; children who died before assessment at around 6 years of age are included in the most severe group (70% and above). 584 cases of cerebral palsy were ascertained, yielding a rate that rose from 1.68 per 1000 neonatal survivors during 1964-1968 to 2.45 during 1989-1993 (rise = 0.77; 95% confidence interval 0.2-1.3). For the more reliably ascertained cases there was a twofold increase in rate from 0.98 to 1.96 (rise = 0.98; 95% confidence interval 0.5-1.4). By birth weight, increases in rates were from 29.8 to 74.2 per 1000 neonatal survivors rate of cerebral palsy has risen in spite of falling perinatal and neonatal mortality rates, a rise that is even more pronounced when the mildest and least reliably ascertained are excluded. The effect of modern care seems to be that many babies rates, and to monitor changes in the distribution of severity.

  14. Why Does Bureaucratic Corruption Occur in the EU?

    DEFF Research Database (Denmark)

    Brandt, Urs Steiner; Svendsen, Gert Tinggaard

    2013-01-01

    Why does bureaucratic corruption occur in the EU system? Several examples suggest that bureaucratic corruption exists and that the Commission’s anti-fraud agency, OLAF, is not a fully independent authority. We thus develop a novel interpretation of the principalsupervisor-agent model to cope...... with non-independent anti-fraud units. This model shows that corruption is likely to occur when the expected value to the client from bribing the agent is larger than the expected value to the principal of truth-telling by the supervisor. Overall, this analysis points to the risks of flawed incentives...

  15. Maternal depression and co-occurring antisocial behaviour: testing maternal hostility and warmth as mediators of risk for offspring psychopathology.

    Science.gov (United States)

    Sellers, Ruth; Harold, Gordon T; Elam, Kit; Rhoades, Kimberly A; Potter, Robert; Mars, Becky; Craddock, Nick; Thapar, Anita; Collishaw, Stephan

    2014-01-01

    Disruption in the parent-child relationship is a commonly hypothesized risk factor through which maternal depression may increase risk for offspring psychopathology. However, maternal depression is commonly accompanied by other psychopathology, including antisocial behaviour. Few studies have examined the role of co-occurring psychopathology in depressed mothers. Using a longitudinal study of offspring of mothers with recurrent depression, we aimed to test whether maternal warmth/hostility mediated links between maternal depression severity and child outcomes, and how far direct and indirect pathways were robust to controls for co-occurring maternal antisocial behaviour. Mothers with a history of recurrent major depressive disorder and their adolescent offspring (9-17 years at baseline) were assessed three times between 2007 and 2010. Mothers completed questionnaires assessing their own depression severity and antisocial behaviour at Time 1 (T1). The parent-child relationship was assessed using parent-rated questionnaire and interviewer-rated 5-min speech sample at Time 2 (T2). Offspring symptoms of depression and disruptive behaviours were assessed using the Child and Adolescent Psychiatric Assessment at Time 3 (T3). Maternal hostility and warmth, respectively, mediated the association between maternal depression severity and risk for offspring psychopathology. However, the effects were attenuated when maternal antisocial behaviour was included in the analysis. In tests of the full theoretical model, maternal antisocial behaviour predicted both maternal hostility and low warmth, maternal hostility predicted offspring disruptive behaviour disorder symptoms, but not depression, and maternal warmth was not associated with either child outcome. Parenting interventions aimed at reducing hostility may be beneficial for preventing or reducing adolescent disruptive behaviours in offspring of depressed mothers, especially when depressed mothers report co-occurring

  16. Natural occurring radioactive substances. Vol. 1

    Energy Technology Data Exchange (ETDEWEB)

    Emara, A E [National Center for radiation Research and Technology Atomic Energy Authority, Cairo (Egypt)

    1996-03-01

    Naturally occurring radioactive substances produced by cosmic rays of those of terrestrial origin are surveyed. The different radioactive decay series are discussed. Special emphasis is given to the element radium as regards its properties and distribution in different environmental samples. The properties of naturally occurring k-40 and its distribution in different natural media are also outlined. Induced radionuclides which are formed as a result of the interaction of cosmic rays with the constituents of the atmosphere are mentioned. In this respect the intensity of natural background radiation and the dose at different locations and levels is surveyed. Some regions of exceptionally high radioactivity which result in high exposure rates are mentioned. Monazite deposits and water springs are mentioned in some detail. The Oklo phenomenon as a natural reactor is also discussed. 8 tabs.

  17. Natural occurring radioactive substances. Vol. 1

    International Nuclear Information System (INIS)

    Emara, A.E.

    1996-01-01

    Naturally occurring radioactive substances produced by cosmic rays of those of terrestrial origin are surveyed. The different radioactive decay series are discussed. Special emphasis is given to the element radium as regards its properties and distribution in different environmental samples. The properties of naturally occurring k-40 and its distribution in different natural media are also outlined. Induced radionuclides which are formed as a result of the interaction of cosmic rays with the constituents of the atmosphere are mentioned. In this respect the intensity of natural background radiation and the dose at different locations and levels is surveyed. Some regions of exceptionally high radioactivity which result in high exposure rates are mentioned. Monazite deposits and water springs are mentioned in some detail. The Oklo phenomenon as a natural reactor is also discussed. 8 tabs

  18. Key factors contributing to accident severity rate in construction industry in Iran: a regression modelling approach.

    Science.gov (United States)

    Soltanzadeh, Ahmad; Mohammadfam, Iraj; Moghimbeigi, Abbas; Ghiasvand, Reza

    2016-03-01

    Construction industry involves the highest risk of occupational accidents and bodily injuries, which range from mild to very severe. The aim of this cross-sectional study was to identify the factors associated with accident severity rate (ASR) in the largest Iranian construction companies based on data about 500 occupational accidents recorded from 2009 to 2013. We also gathered data on safety and health risk management and training systems. Data were analysed using Pearson's chi-squared coefficient and multiple regression analysis. Median ASR (and the interquartile range) was 107.50 (57.24- 381.25). Fourteen of the 24 studied factors stood out as most affecting construction accident severity (p<0.05). These findings can be applied in the design and implementation of a comprehensive safety and health risk management system to reduce ASR.

  19. Asthma Is More Severe in Older Adults

    Science.gov (United States)

    Dweik, Raed A.; Comhair, Suzy A.; Bleecker, Eugene R.; Moore, Wendy C.; Peters, Stephen P.; Busse, William W.; Jarjour, Nizar N.; Calhoun, William J.; Castro, Mario; Chung, K. Fan; Fitzpatrick, Anne; Israel, Elliot; Teague, W. Gerald; Wenzel, Sally E.; Love, Thomas E.; Gaston, Benjamin M.

    2015-01-01

    Background Severe asthma occurs more often in older adult patients. We hypothesized that the greater risk for severe asthma in older individuals is due to aging, and is independent of asthma duration. Methods This is a cross-sectional study of prospectively collected data from adult participants (N=1130; 454 with severe asthma) enrolled from 2002 – 2011 in the Severe Asthma Research Program. Results The association between age and the probability of severe asthma, which was performed by applying a Locally Weighted Scatterplot Smoother, revealed an inflection point at age 45 for risk of severe asthma. The probability of severe asthma increased with each year of life until 45 years and thereafter increased at a much slower rate. Asthma duration also increased the probability of severe asthma but had less effect than aging. After adjustment for most comorbidities of aging and for asthma duration using logistic regression, asthmatics older than 45 maintained the greater probability of severe asthma [OR: 2.73 (95 CI: 1.96; 3.81)]. After 45, the age-related risk of severe asthma continued to increase in men, but not in women. Conclusions Overall, the impact of age and asthma duration on risk for asthma severity in men and women is greatest over times of 18-45 years of age; age has a greater effect than asthma duration on risk of severe asthma. PMID:26200463

  20. Effect of Severe Winter Cold on the Photosynthetic Potentials of Three Co-occurring Evergreen Woody Species in a Mediterranean Forest, Catalonia (Spain)

    Science.gov (United States)

    Sperlich, Dominik; Gracia, Carlos; Peñuelas, Josep; Sabaté, Santi

    2013-04-01

    Evergreen tree species in the Mediterranean region have to cope with a wide range of environmental stress conditions from summer drought to winter cold. The winter period can lead to photoinhibition due to a combination of high solar irradiances and chilling temperatures which can reduce the light saturation point. However, Mediterranean winter mildness can lead periodically to favourable environmental conditions above the threshold for positive carbon balance benefitting evergreen woody species in contrast to winter deciduous species. The advantage of being able to photosynthesis all year round with a significant fraction in the winter month is compensating for the lower photosynthetic potentials during spring and summer in comparison to deciduous species. In this work, we investigated the physiological behaviour of three evergreen tree species (Quercus ilex, Pinus halepensis, Arbutus undeo) co-occurring in a natural and mature Mediterranean forest after a period of mild winter conditions and their response to a sudden period of intense cold weather. Therefore, we examined in each period the photosynthetic potentials by estimating the maximum carboxylation rate (Vcmax) and the maximum electron transport rate (Jmax) through gas exchange measurements. The results indicate that all species exhibited extraordinary high photosynthetic potentials during the first period of measurement as a response to the mild conditions. However, the sudden cold period affected negatively the photosynthetic potentials of Quercus ilex and A. unedo with reduction ranging between 37 to 45 %, whereas they were observed to be only insignificantly reduced in Pinus halepensis. Our results can be explained by previous classifications into photoinhibition-avoiding (P. halpensis) and photoinhibition-tolerant (Q. ilex, A. undeo) species on the basis of their susceptibility to dynamic photoinhibition (Martinez Ferri 2000). Photoinhibition tolerant species are characterised with a more dynamic

  1. Fission neutron damage rates and efficiencies in several metals

    International Nuclear Information System (INIS)

    Klabunde, C.E.; Coltman, R.R. Jr.

    1981-11-01

    Initial rates of resistivity-measured low-temperature damage production by fission-spectrum fast neutrons have been determined for 14 metals in the same very well characterized irradiation facility. Six of these metals were fcc, 5 bcc, and 3 hcp. Most were of quite high purity. Observed damage rates, after correction for all known extraneous resistivity-producing effects, were compared with rates predicted by the damage calculation code RECOIL, using parameters chosen from the literature. These parameters, effective displacement threshold energy, E/sub d/, and Frenkel-pair resistivity, rho/sub F/, were in many cases only best estimates, the further refinement of which may be aided by the present results. Damage efficiencies (measured/predicted rates) follow the same trends by crystal classes as seen in other fast-neutron studies

  2. Drop-out rate among patients treated with omalizumab for severe asthma: Literature review and real-life experience.

    Science.gov (United States)

    Caminati, M; Senna, G; Stefanizzi, G; Bellamoli, R; Longhi, S; Chieco-Bianchi, F; Guarnieri, G; Tognella, S; Olivieri, M; Micheletto, C; Festi, G; Bertocco, E; Mazza, M; Rossi, A; Vianello, A

    2016-08-25

    In patients with asthma, particularly severe asthma, poor adherence to inhaled drugs negatively affects the achievement of disease control. A better adherence rate is expected in the case of injected drugs, such as omalizumab, as they are administered only in a hospital setting. However, adherence to omalizumab has never been systematically investigated. The aim of this study was to review the omalizumab drop-out rate in randomized controlled trials (RCTs) and real-life studies. A comparative analysis was performed between published data and the Italian North East Omalizumab Network (NEONet) database. In RCTs the drop-out rate ranged from 7.1 to 19.4 %. Although the reasons for withdrawal were only occasionally reported, patient decision and adverse events were the most frequently reported causes. In real-life studies the drop-out rate ranged from 0 to 45.5 %. In most cases lack of efficacy was responsible for treatment discontinuation. According to NEONet data, 32 % of treated patients dropped out, with an increasing number of drop outs observed over time. Patient decision and lack of efficacy accounted for most treatment withdrawals. Treatment adherence is particularly crucial in patients with severe asthma considering the clinical impact of the disease and the cost of non-adherence. The risk of treatment discontinuation has to be carefully considered both in the experimental and real-life settings. Increased knowledge regarding the main reasons for patient withdrawal is important to improve adherence in clinical practice.

  3. True mean rate measuring system

    International Nuclear Information System (INIS)

    Eichenlaub, D.P.

    1980-01-01

    A digital radiation-monitoring system for nuclear power plants uses digital and microprocessor circuitry to enable rapid processing of pulse information from remote radiation monitors. The pulse rates are analyzed to determine whether new pulse-rate information is statisticaly the same as that previously received and to determine the best possible averaging time, which can be changed so that the statistical error remains below a specified level while the system response time remains short. Several data modules each process the pulse-rate information from several remote radiation monitors. Each data module accepts pulse data from each radiation monitor and measures the true average or mean pulse rate of events occurring with a Poisson distribution to determine the radiation level. They then develop digital output signals which indciate the respective radiation levels and which can be transmitted via multiplexer circuits for additional processing and display. The data modules can accept signals from remote control stations or computer stations via the multiplexer circuit to change operating thresholds and alarm levels in their memories. A check module scans the various data modules to determine whether the output signals are valid. It also acts as a redundant data module and will automatically replace an inoperative unit. (DN)

  4. Rates of Cervical Cancer Screening Among Women With Severe Mental Illness in the Public Health System.

    Science.gov (United States)

    James, Monique; Thomas, Melanie; Frolov, Latoya; Riano, Nicholas S; Vittinghoff, Eric; Schillinger, Dean; Newcomer, John W; Mangurian, Christina

    2017-08-01

    This study aimed to determine cervical cancer screening rates among women with severe mental illness. California Medicaid administrative records (2010-2011) for 31,308 women with severe mental illness were examined. Participants received specialty mental health services and were not dually eligible for Medicare. Poisson models assessed association between selected predictors and cervical cancer screening. Overall, 20.2% of women with severe mental illness received cervical cancer screening during the one-year period. Compared with white women, Asian women (adjusted risk ratio [ARR]=1.23), black women (ARR=1.10), and Hispanic women (ARR=1.11) (pWomen ages 28-37 were more likely than those ages 18-27 to have been screened (ARR=1.31, phealth care use was the strongest predictor of screening (ARR=3.07, pwomen in the sample were not regularly screened for cervical cancer. Cervical cancer screening for this high-risk population should be prioritized.

  5. Hydration rate of obsidian.

    Science.gov (United States)

    Friedman, I; Long, W

    1976-01-30

    The hydration rates of 12 obsidian samples of different chemical compositions were measured at temperatures from 95 degrees to 245 degrees C. An expression relating hydration rate to temperature was derived for each sample. The SiO(2) content and refractive index are related to the hydration rate, as are the CaO, MgO, and original water contents. With this information it is possible to calculate the hydration rate of a sample from its silica content, refractive index, or chemical index and a knowledge of the effective temperature at which the hydration occurred. The effective hydration temperature can be either measured or approximated from weather records. Rates have been calculated by both methods, and the results show that weather records can give a good approximation to the true EHT, particularly in tropical and subtropical climates. If one determines the EHT by any of the methods suggested, and also measures or knows the rate of hydration of the particular obsidian used, it should be possible to carry out absolute dating to +/- 10 percent of the true age over periods as short as several years and as long as millions of years.

  6. Outcomes After Orbital Atherectomy of Severely Calcified Left Main Lesions: Analysis of the ORBIT II Study.

    Science.gov (United States)

    Lee, Michael S; Shlofmitz, Evan; Shlofmitz, Richard; Sahni, Sheila; Martinsen, Brad; Chambers, Jeffrey

    2016-09-01

    The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. The ORBIT II trial was a prospective, multicenter clinical trial that enrolled 443 patients with severely calcified coronary lesions in the United States. The major adverse cardiac event (MACE) rate through 2 years post procedure, defined by cardiac death, myocardial infarction (CK-MB >3x upper limit of normal with or without a new pathologic Q-wave) and target-vessel revascularization, was compared in the LM and non-left main (NLM) groups. Among the 443 patients, a total of 10 underwent orbital atherectomy of protected LM artery lesions. At 2 years, there was no significant difference in the 2-year MACE rate in the LM and NLM groups (30.0% vs 19.1%, respectively; P=.36). Cardiac death was low in both groups (0% vs 4.4%, respectively; P=.99). Myocardial infarction occurred within 30 days in both groups (10.0% vs 9.7%, respectively; P=.99). Severe dissection, perforation, persistent slow flow, and persistent no reflow did not occur in the LM group. Abrupt closure occurred in 1 patient in the LM group. Orbital atherectomy for patients with heavily calcified LM coronary artery lesions is safe and feasible. Further studies are needed to assess the safety and efficacy of orbital atherectomy in patients with severely calcified LM artery lesions.

  7. Preferential flow occurs in unsaturated conditions

    Science.gov (United States)

    Nimmo, John R.

    2012-01-01

    Because it commonly generates high-speed, high-volume flow with minimal exposure to solid earth materials, preferential flow in the unsaturated zone is a dominant influence in many problems of infiltration, recharge, contaminant transport, and ecohydrology. By definition, preferential flow occurs in a portion of a medium – that is, a preferred part, whether a pathway, pore, or macroscopic subvolume. There are many possible classification schemes, but usual consideration of preferential flow includes macropore or fracture flow, funneled flow determined by macroscale heterogeneities, and fingered flow determined by hydraulic instability rather than intrinsic heterogeneity. That preferential flow is spatially concentrated associates it with other characteristics that are typical, although not defining: it tends to be unusually fast, to transport high fluxes, and to occur with hydraulic disequilibrium within the medium. It also has a tendency to occur in association with large conduits and high water content, although these are less universal than is commonly assumed. Predictive unsaturated-zone flow models in common use employ several different criteria for when and where preferential flow occurs, almost always requiring a nearly saturated medium. A threshold to be exceeded may be specified in terms of the following (i) water content; (ii) matric potential, typically a value high enough to cause capillary filling in a macropore of minimum size; (iii) infiltration capacity or other indication of incipient surface ponding; or (iv) other conditions related to total filling of certain pores. Yet preferential flow does occur without meeting these criteria. My purpose in this commentary is to point out important exceptions and implications of ignoring them. Some of these pertain mainly to macropore flow, others to fingered or funneled flow, and others to combined or undifferentiated flow modes.

  8. Examining the Relationship between Heart Rate and Problem Behavior: A Case Study of Severe Skin Picking in Prader-Willi Syndrome

    Science.gov (United States)

    Hall, Scott S.; Hammond, Jennifer L.; Hustyi, Kristin M.

    2013-01-01

    Few studies have examined the relationship between heart rate and self-injurious behavior (SIB) shown by individuals with IDD (intellectual and developmental disabilities). In this single-case study, we simultaneously monitored heart rate and activity levels during a functional analysis of severe skin picking behavior exhibited by a young man with…

  9. Evaluation of Lightning Jumps as a Predictor of Severe Weather in the Northeastern United States

    Science.gov (United States)

    Eck, Pamela

    Severe weather events in the northeastern United States can be challenging to forecast, given how the evolution of deep convection can be influenced by complex terrain and the lack of quality observations in complex terrain. To supplement existing observations, this study explores using lightning to forecast severe convection in areas of complex terrain in the northeastern United States. A sudden increase in lightning flash rate by two standard deviations (2sigma), also known as a lightning jump, may be indicative of a strengthening updraft and an increased probability of severe weather. This study assesses the value of using lightning jumps to forecast severe weather during July 2015 in the northeastern United States. Total lightning data from the National Lightning Detection Network (NLDN) is used to calculate lightning jumps using a 2sigma lightning jump algorithm with a minimum threshold of 5 flashes min-1. Lightning jumps are used to predict the occurrence of severe weather, as given by whether a Storm Prediction Center (SPC) severe weather report occurred 45 min after a lightning jump in the same cell. Results indicate a high probability of detection (POD; 85%) and a high false alarm rate (FAR; 89%), suggesting that lightning jumps occur in sub-severe storms. The interaction between convection and complex terrain results in a locally enhanced updraft and an increased probability of severe weather. Thus, it is hypothesized that conditioning on an upslope variable may reduce the FAR. A random forest is introduced to objectively combine upslope flow, calculated using data from the High Resolution Rapid Refresh (HRRR), flash rate (FR), and flash rate changes with time (DFRDT). The random forest, a machine-learning algorithm, uses pattern recognition to predict a severe or non-severe classification based on the predictors. In addition to upslope flow, FR, and DFRDT, Next-Generation Radar (NEXRAD) Level III radar data was also included as a predictor to compare its

  10. Severe maternal morbidity for 2004-2005 in the three Dublin maternity hospitals.

    LENUS (Irish Health Repository)

    Murphy, Cliona M

    2012-02-01

    OBJECTIVE: To assess the prevalence and causes of severe maternal morbidity in Dublin over a two year period from 2004 to 2005. STUDY DESIGN: A prospective cohort study from January 2004 to December 2005 was undertaken in the three large maternity hospitals in Dublin, which serve a population of 1.5 million people. All are tertiary referral centres for obstetrics and neonatology and have an annual combined delivery rate of circa 23,000 births. Cases of severe maternal morbidity were identified. A systems based classification was used. The primary cause of maternal morbidity and the number of events experienced per patient was recorded. RESULTS: We identified 158 women who fulfilled the definition for severe maternal morbidity, giving a rate of 3.2 per 1000 maternities. There were two maternal deaths during the time period giving mortality to morbidity ratio of 1:79. The commonest cause of severe morbidity was vascular dysfunction related to obstetric haemorrhage. Eclampsia comprised 15.4% of cases. Intensive care or coronary care admission occurred in 12% of cases. CONCLUSION: The prevalence of severe maternal morbidity in this population is 3.2\\/1000 maternities. Obstetric haemorrhage was the main cause of severe maternal morbidity.

  11. The dissolution rate of silicate glasses and minerals: an alternative model based on several activated complexes

    International Nuclear Information System (INIS)

    Berger, G.

    1997-01-01

    Most of the mineral reactions in natural water-rock systems progress at conditions close to the chemical equilibrium. The kinetics of these reactions, in particular the dissolution rate of the primary minerals, is a major constrain for the numerical modelling of diagenetic and hydrothermal processes. In the case of silicates, recent experimental studies have pointed out the necessity to better understand the elementary reactions which control the dissolution process. This article presents several models that have been proposed to account for the observed dissolution rate/chemical affinity relationships. The case of glasses (R7T7), feldspars and clays, in water, in near neutral pH aqueous solutions and in acid/basic media, are reviewed. (A.C.)

  12. Comparison of four statistical and machine learning methods for crash severity prediction.

    Science.gov (United States)

    Iranitalab, Amirfarrokh; Khattak, Aemal

    2017-11-01

    Crash severity prediction models enable different agencies to predict the severity of a reported crash with unknown severity or the severity of crashes that may be expected to occur sometime in the future. This paper had three main objectives: comparison of the performance of four statistical and machine learning methods including Multinomial Logit (MNL), Nearest Neighbor Classification (NNC), Support Vector Machines (SVM) and Random Forests (RF), in predicting traffic crash severity; developing a crash costs-based approach for comparison of crash severity prediction methods; and investigating the effects of data clustering methods comprising K-means Clustering (KC) and Latent Class Clustering (LCC), on the performance of crash severity prediction models. The 2012-2015 reported crash data from Nebraska, United States was obtained and two-vehicle crashes were extracted as the analysis data. The dataset was split into training/estimation (2012-2014) and validation (2015) subsets. The four prediction methods were trained/estimated using the training/estimation dataset and the correct prediction rates for each crash severity level, overall correct prediction rate and a proposed crash costs-based accuracy measure were obtained for the validation dataset. The correct prediction rates and the proposed approach showed NNC had the best prediction performance in overall and in more severe crashes. RF and SVM had the next two sufficient performances and MNL was the weakest method. Data clustering did not affect the prediction results of SVM, but KC improved the prediction performance of MNL, NNC and RF, while LCC caused improvement in MNL and RF but weakened the performance of NNC. Overall correct prediction rate had almost the exact opposite results compared to the proposed approach, showing that neglecting the crash costs can lead to misjudgment in choosing the right prediction method. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Evolution of cultural traits occurs at similar relative rates in different world regions.

    Science.gov (United States)

    Currie, Thomas E; Mace, Ruth

    2014-11-22

    A fundamental issue in understanding human diversity is whether or not there are regular patterns and processes involved in cultural change. Theoretical and mathematical models of cultural evolution have been developed and are increasingly being used and assessed in empirical analyses. Here, we test the hypothesis that the rates of change of features of human socio-cultural organization are governed by general rules. One prediction of this hypothesis is that different cultural traits will tend to evolve at similar relative rates in different world regions, despite the unique historical backgrounds of groups inhabiting these regions. We used phylogenetic comparative methods and systematic cross-cultural data to assess how different socio-cultural traits changed in (i) island southeast Asia and the Pacific, and (ii) sub-Saharan Africa. The relative rates of change in these two regions are significantly correlated. Furthermore, cultural traits that are more directly related to external environmental conditions evolve more slowly than traits related to social structures. This is consistent with the idea that a form of purifying selection is acting with greater strength on these more environmentally linked traits. These results suggest that despite contingent historical events and the role of humans as active agents in the historical process, culture does indeed evolve in ways that can be predicted from general principles.

  14. The Epidemiology of Severe Injuries Sustained by National Collegiate Athletic Association Student-Athletes, 2009–2010 Through 2014–2015

    Science.gov (United States)

    Kay, Melissa C.; Register-Mihalik, Johna K.; Gray, Aaron D.; Djoko, Aristarque; Dompier, Thomas P.; Kerr, Zachary Y.

    2017-01-01

    Context: Few researchers have described the incidence of the most severe injuries sustained by student-athletes at the collegiate level. Objective: To describe the epidemiology of severe injuries within 25 National Collegiate Athletic Association (NCAA) sports in the 2009–2010 through 2014–2015 academic years. Design: Descriptive epidemiology study. Setting: Aggregate injury and exposure data from 25 NCAA sports. Patients or Other Participants: Collegiate student-athletes in the 2009–2010 through 2014–2015 academic years. Main Outcome Measure(s): Injury data from the NCAA Injury Surveillance Program were analyzed. A severe injury (1) occurred during a sanctioned competition or practice, (2) required medical attention by an athletic trainer or physician, and (3) resulted in at least 21 days lost from sport activity or a premature end to the sport season. Injury counts, proportions, rates per 1000 athlete-exposures (AEs), rate ratios (RRs), and injury proportion ratios were reported with 95% confidence intervals (CIs). Results: A total of 3183 severe injuries were reported, for an injury rate of 0.66/1000 AEs. Wrestling had the highest severe injury rate (1.73/1000 AEs), followed by women's gymnastics (1.40/1000 AEs) and football (0.97/1000 AEs). Overall, the severe injury rate was higher in competition than in practice (RR = 4.25, 95% CI = 3.97, 4.56). Most severe injuries were reported during the regular season (69.3%, n = 2206); however, severe injury rates did not differ between the preseason and regular season (RR = 0.98, 95% CI = 0.91, 1.06). Common severely injured body parts were the knee (32.9%, n = 1047), lower leg/ankle/foot (22.5%, n = 715), and head/face/neck (11.2%, n = 358). Common severe injury diagnoses were sprains (32.9%, n = 1048), strains (16.9%, n = 538), and fractures (14.4%, n = 458). Common severe injury mechanisms were player contact (39.3%, n = 1251), noncontact (25.1%, n = 800), and surface contact (12.0%, n = 383). Conclusions

  15. The economic production lot size model with several production rates

    DEFF Research Database (Denmark)

    Larsen, Christian

    should be chosen in the interval between the demand rate and the production rate, which minimize unit production costs, and should be used in an increasing order. Then, given the production rates, we derive closed form solutions for the optimal runtimes as well as the minimum average cost. Finally we...

  16. A Systemic Review of Autologous Fat Grafting Survival Rate and Related Severe Complications

    Directory of Open Access Journals (Sweden)

    Nan-Ze Yu

    2015-01-01

    Full Text Available Objective: Clinical application of autologous fat grafting (AFG is quickly expanding. Despite the widely acceptance, long-term survival rate (SR of AFG remains a question not yet solved. Meanwhile, although rare, severe complications related to AFG including vision loss, stroke even death could be seen in the literature. Data Sources: A comprehensive research of PubMed database to June 2013 was performed according to guidelines of the American Society of Plastic Surgeons Fat Graft Task Force Assessment Methodology. Articles were screened using predetermined inclusion and exclusion criteria. Study Selection: Data collected included patient characteristics, surgical technique, donor site, recipient site, graft amount, and quantified measurement methods. Patient cohorts were pooled, and SR was calculated. All the severe complications were also summarized according to the different clinical characteristics. Results: Of 550 articles, 16 clinical articles and 10 animal studies met the inclusion criteria and provided quantified measurement methods. Totally, 596 patients were included. SR varied from 34% to 82% in breast and 30-83% in the facial area. Nude mice were applied to investigate human fat grafting SR (38.3-52.5% after 15 weeks. Rabbits were commonly used to study animal AFG SR (14.00-14.56% after 1-year. Totally, 21 severe complications were reported, including death (2, stroke (10, vision loss (11, 8 of which accompanied with stroke, sepsis (3, multiple abscess (1 and giant fat necrotic cyst (2. Ten of these complications happened within 10 years. Conclusions: There is no unified measurement method to evaluate fat graft SR until now and no clinical evidence to show better SR according to different donor and recipient cite. Body mass index change between pre- and postoperation may be the bias factor in evaluating fat SR. Fat embolisms of the ophthalmic artery and the middle cerebral artery are the most severe complication of AFG and still lack

  17. Predicted occurrence rate of severe transportation accidents involving large casks

    International Nuclear Information System (INIS)

    Dennis, A.W.

    1978-01-01

    A summary of the results of an investigation of the severities of highway and railroad accidents as they relate to the shipment of large radioactive materials casks is discussed. The accident environments considered are fire, impact, crash, immersion, and puncture. For each of these environments, the accident severities and their predicted frequencies of occurrence are presented. These accident environments are presented in tabular and graphic form to allow the reader to evaluate the probabilities of occurrence of the accident parameter severities he selects

  18. Our Treatment Approaches in Severe Maxillofacial Injuries Occurring After Failed Suicide Attempts Using Long-Barreled Guns.

    Science.gov (United States)

    Kucuker, Ismail; Şimşek, Tekin; Keles, Musa Kemal; Yosma, Engin; Aksakal, Ibrahim Alper; Demir, Ahmet

    2016-03-01

    Maxillofacial traumas with long-barreled guns may sometimes cause catastrophic results by means of smashing in facial structures. In these patients, reconstruction strategies of both fragmented/lost soft and hard tissues still remain controversial. In their clinic, the authors treated 5 patients with severely injured face after failed suicide attempt between 2008 and 2013. In this study, the authors aimed to present their clinical experiences on these severely injured maxillofacial gunshot traumas and offer a treatment algorithm to gain a result as possible as satisfactory in terms of functionality and appearance.

  19. Standardized error severity score (ESS) ratings to quantify risk associated with child restraint system (CRS) and booster seat misuse.

    Science.gov (United States)

    Rudin-Brown, Christina M; Kramer, Chelsea; Langerak, Robin; Scipione, Andrea; Kelsey, Shelley

    2017-11-17

    Although numerous research studies have reported high levels of error and misuse of child restraint systems (CRS) and booster seats in experimental and real-world scenarios, conclusions are limited because they provide little information regarding which installation issues pose the highest risk and thus should be targeted for change. Beneficial to legislating bodies and researchers alike would be a standardized, globally relevant assessment of the potential injury risk associated with more common forms of CRS and booster seat misuse, which could be applied with observed error frequency-for example, in car seat clinics or during prototype user testing-to better identify and characterize the installation issues of greatest risk to safety. A group of 8 leading world experts in CRS and injury biomechanics, who were members of an international child safety project, estimated the potential injury severity associated with common forms of CRS and booster seat misuse. These injury risk error severity score (ESS) ratings were compiled and compared to scores from previous research that had used a similar procedure but with fewer respondents. To illustrate their application, and as part of a larger study examining CRS and booster seat labeling requirements, the new standardized ESS ratings were applied to objective installation performance data from 26 adult participants who installed a convertible (rear- vs. forward-facing) CRS and booster seat in a vehicle, and a child test dummy in the CRS and booster seat, using labels that only just met minimal regulatory requirements. The outcome measure, the risk priority number (RPN), represented the composite scores of injury risk and observed installation error frequency. Variability within the sample of ESS ratings in the present study was smaller than that generated in previous studies, indicating better agreement among experts on what constituted injury risk. Application of the new standardized ESS ratings to installation

  20. Quantitative assessment for pneumoconiosis severity diagnosis using 3D CT images

    Science.gov (United States)

    Hino, Koki; Matsuhiro, Mikio; Suzuki, Hidenobu; Kawata, Yoshiki; Niki, Noboru; Kato, Katsuya; Kishimoto, Takumi; Ashizawa, Kazuto

    2018-02-01

    Pneumoconiosis is an occupational respiratory illness that occur by inhaling dust to the lungs. 240,000 participants are screened for diagnosis of pneumoconiosis every year in Japan. Radiograph is used for staging of severity rate in pneumoconiosis worldwide. CT imaging is useful for the differentiation of requirements for industrial accident approval because it can detect small lesions in comparison with radiograph. In this paper, we extracted lung nodules from 3D pneumoconiosis CT images by two manual processes and automatic process, and created a database of pneumoconiosis CT images. We used the database to analyze, compare, and evaluate visual diagnostic results of radiographs and quantitative assessment (number, size and volume) of lung nodules. This method was applied to twenty pneumoconiosis patients. Initial results showed that the proposed method can assess severity rate in pneumoconiosis quantitatively. This study demonstrates effectiveness on diagnosis and prognosis of pneumoconiosis in CT screening.

  1. BIRDNEST: Bayesian Inference for Ratings-Fraud Detection

    OpenAIRE

    Hooi, Bryan; Shah, Neil; Beutel, Alex; Gunnemann, Stephan; Akoglu, Leman; Kumar, Mohit; Makhija, Disha; Faloutsos, Christos

    2015-01-01

    Review fraud is a pervasive problem in online commerce, in which fraudulent sellers write or purchase fake reviews to manipulate perception of their products and services. Fake reviews are often detected based on several signs, including 1) they occur in short bursts of time; 2) fraudulent user accounts have skewed rating distributions. However, these may both be true in any given dataset. Hence, in this paper, we propose an approach for detecting fraudulent reviews which combines these 2 app...

  2. Filtering, control and fault detection with randomly occurring incomplete information

    CERN Document Server

    Dong, Hongli; Gao, Huijun

    2013-01-01

    This book investigates the filtering, control and fault detection problems for several classes of nonlinear systems with randomly occurring incomplete information. It proposes new concepts, including RVNs, ROMDs, ROMTCDs, and ROQEs. The incomplete information under consideration primarily includes missing measurements, time-delays, sensor and actuator saturations, quantization effects and time-varying nonlinearities. The first part of this book focuses on the filtering, control and fault detection problems for several classes of nonlinear stochastic discrete-time systems and

  3. Co-occurring woody species have diverse hydraulic strategies and mortality rates during an extreme drought: Belowground hydraulic failure during drought

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, Daniel M. [College of Natural Resources, University of Idaho, Moscow ID 83844 USA; Domec, Jean-Christophe [Bordeaux Sciences Agro, UMR INRA-ISPA 1391, Gradignan 33195 France; Nicholas School of the Environment, Duke University, Durham NC 27708 USA; Carter Berry, Z. [College of Natural Resources, University of Idaho, Moscow ID 83844 USA; Department of Natural Resources and the Environment, University of New Hampshire, Durham NH 03824 USA; Schwantes, Amanda M. [Nicholas School of the Environment, Duke University, Durham NC 27708 USA; McCulloh, Katherine A. [Department of Botany, University of Wisconsin-Madison, Madison WI 53705 USA; Woodruff, David R. [US Forest Service, Pacific Northwest Research Station, Corvallis OR 97331 USA; Wayne Polley, H. [Grassland, Soil & Water Research Laboratory USDA-Agricultural Research Service, Temple TX 76502 USA; Wortemann, Remí [INRA Nancy, UMR INRA-UL 1137 Ecologie et Ecophysiologie Forestières, Champenoux 54280 France; Swenson, Jennifer J. [Nicholas School of the Environment, Duke University, Durham NC 27708 USA; Scott Mackay, D. [Department of Geography, State University of New York, Buffalo NY 14261 USA; McDowell, Nate G. [Pacific Northwest National Laboratory, Richland WA 99352 USA; Jackson, Robert B. [Department of Earth System Science, Woods Institute for the Environment, and Precourt Institute for Energy, Stanford University, Stanford CA 94305 USA

    2018-01-29

    From 2011 to 2013, Texas experienced its worst drought in recorded history. This event provided a unique natural experiment to assess species-specific responses to extreme drought and mortality of four co-occurring woody species: Quercus fusiformis, Diospyros texana, Prosopis glandulosa and Juniperus ashei. We examined hypothesized mechanisms that could promote these species’ diverse mortality patterns using post-drought measurements on surviving trees coupled to retrospective process modeling. The species exhibited a wide range of gas exchange responses, hydraulic strategies, and mortality rates. Multiple proposed indices of mortality mechanisms were not consistent with the observed mortality patterns across species, including measures of iso/anisohydry, photosynthesis, carbohydrate depletion, and hydraulic safety margins. Large losses of growing season whole-tree conductance (driven by belowground losses of conductance), and shallower rooting depths, were associated with species that exhibited greater mortality. Based on this retrospective analysis, we suggest that species more vulnerable to drought were more likely to have succumbed to hydraulic failure belowground.

  4. Cross Time-Frequency Analysis for Combining Information of Several Sources: Application to Estimation of Spontaneous Respiratory Rate from Photoplethysmography

    Science.gov (United States)

    Peláez-Coca, M. D.; Orini, M.; Lázaro, J.; Bailón, R.; Gil, E.

    2013-01-01

    A methodology that combines information from several nonstationary biological signals is presented. This methodology is based on time-frequency coherence, that quantifies the similarity of two signals in the time-frequency domain. A cross time-frequency analysis method, based on quadratic time-frequency distribution, has been used for combining information of several nonstationary biomedical signals. In order to evaluate this methodology, the respiratory rate from the photoplethysmographic (PPG) signal is estimated. The respiration provokes simultaneous changes in the pulse interval, amplitude, and width of the PPG signal. This suggests that the combination of information from these sources will improve the accuracy of the estimation of the respiratory rate. Another target of this paper is to implement an algorithm which provides a robust estimation. Therefore, respiratory rate was estimated only in those intervals where the features extracted from the PPG signals are linearly coupled. In 38 spontaneous breathing subjects, among which 7 were characterized by a respiratory rate lower than 0.15 Hz, this methodology provided accurate estimates, with the median error {0.00; 0.98} mHz ({0.00; 0.31}%) and the interquartile range error {4.88; 6.59} mHz ({1.60; 1.92}%). The estimation error of the presented methodology was largely lower than the estimation error obtained without combining different PPG features related to respiration. PMID:24363777

  5. Cross Time-Frequency Analysis for Combining Information of Several Sources: Application to Estimation of Spontaneous Respiratory Rate from Photoplethysmography

    Directory of Open Access Journals (Sweden)

    M. D. Peláez-Coca

    2013-01-01

    Full Text Available A methodology that combines information from several nonstationary biological signals is presented. This methodology is based on time-frequency coherence, that quantifies the similarity of two signals in the time-frequency domain. A cross time-frequency analysis method, based on quadratic time-frequency distribution, has been used for combining information of several nonstationary biomedical signals. In order to evaluate this methodology, the respiratory rate from the photoplethysmographic (PPG signal is estimated. The respiration provokes simultaneous changes in the pulse interval, amplitude, and width of the PPG signal. This suggests that the combination of information from these sources will improve the accuracy of the estimation of the respiratory rate. Another target of this paper is to implement an algorithm which provides a robust estimation. Therefore, respiratory rate was estimated only in those intervals where the features extracted from the PPG signals are linearly coupled. In 38 spontaneous breathing subjects, among which 7 were characterized by a respiratory rate lower than 0.15 Hz, this methodology provided accurate estimates, with the median error {0.00; 0.98} mHz ({0.00; 0.31}% and the interquartile range error {4.88; 6.59} mHz ({1.60; 1.92}%. The estimation error of the presented methodology was largely lower than the estimation error obtained without combining different PPG features related to respiration.

  6. Co-Occurring Disorders

    Science.gov (United States)

    ... the mental health field. Alcohol and Drug Abuse, Addiction and Co-occurring Disorders: Co-occurring Disorders and ... 500 Montgomery Street, Suite 820 Alexandria, VA 22314 Phone (703) 684.7722 Toll Free (800) 969.6642 ...

  7. Parkinson's disease severity levels and MDS-Unified Parkinson's Disease Rating Scale.

    Science.gov (United States)

    Martínez-Martín, Pablo; Rodríguez-Blázquez, Carmen; Mario Alvarez; Arakaki, Tomoko; Arillo, Víctor Campos; Chaná, Pedro; Fernández, William; Garretto, Nélida; Martínez-Castrillo, Juan Carlos; Rodríguez-Violante, Mayela; Serrano-Dueñas, Marcos; Ballesteros, Diego; Rojo-Abuin, Jose Manuel; Chaudhuri, Kallol Ray; Merello, Marcelo

    2015-01-01

    Severity of PD is usually assessed by means of the motor and disability-based Hoehn and Yahr staging (HY), or clinician and patient global perceptions. Scores of more detailed assessments, as the MDS-UPDRS, have not been translated to a grading that allows assignment of score sections to severity levels. The objective of the present study is to determine cut-off points for PD severity levels based on the MDS-UPDRS. International, observational study. Applied assessments were: HY, MDS-UPDRS, Clinical Impression for Severity Index, and Clinical and Patient Global Impression of Severity. The coincidence in severity level (mild, moderate, severe) of at least two clinical classifications plus the patient's gradation was considered "the criterion of severity". Cut-off values for each MDS-UPDRS subscale was determined by triangulation of: 1) percentile 90 of the subscale total score; 2) receiver operating characteristic (ROC) analysis; and 3) ordinal logistic regression (OLR) model. Sample was composed of 452 consecutive PD patients without dementia, 55.3% males, age 65.1 ± 10.7 years and PD duration 8.7 ± 6.3 years. All HY stages were represented. The "criterion", classified 275 patients (60.8% of the sample) as: mild PD, 149 (54.2%); moderate, 82 (29.8%); and severe, 44 (16%). The following MDS-UPDRS cut-off points between mild/moderate and moderate/severe levels were found: Part 1: 10/11 and 21/22; Part 2: 12/13 and 29/30; Part 3: 32/33 and 58/59; and Part 4: 4/5 and 12/13. Cut-off points to classify PD patients as mild, moderate, or severe on the basis of their MDS-UPDRS scores are proposed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Factors affecting fall down rates of dead aspen (Populus tremuloides) biomass following severe drought in west-central Canada.

    Science.gov (United States)

    Ted Hogg, Edward H; Michaelian, Michael

    2015-05-01

    Increases in mortality of trembling aspen (Populus tremuloides Michx.) have been recorded across large areas of western North America following recent periods of exceptionally severe drought. The resultant increase in standing, dead tree biomass represents a significant potential source of carbon emissions to the atmosphere, but the timing of emissions is partially driven by dead-wood dynamics which include the fall down and breakage of dead aspen stems. The rate at which dead trees fall to the ground also strongly influences the period over which forest dieback episodes can be detected by aerial surveys or satellite remote sensing observations. Over a 12-year period (2000-2012), we monitored the annual status of 1010 aspen trees that died during and following a severe regional drought within 25 study areas across west-central Canada. Observations of stem fall down and breakage (snapping) were used to estimate woody biomass transfer from standing to downed dead wood as a function of years since tree death. For the region as a whole, we estimated that >80% of standing dead aspen biomass had fallen after 10 years. Overall, the rate of fall down was minimal during the year following stem death, but thereafter fall rates followed a negative exponential equation with k = 0.20 per year. However, there was high between-site variation in the rate of fall down (k = 0.08-0.37 per year). The analysis showed that fall down rates were positively correlated with stand age, site windiness, and the incidence of decay fungi (Phellinus tremulae (Bond.) Bond. and Boris.) and wood-boring insects. These factors are thus likely to influence the rate of carbon emissions from dead trees following periods of climate-related forest die-off episodes. © 2014 Her Majesty the Queen in Right of Canada Global Change Biology © 2014 John Wiley & Sons Ltd Reproduced with the permission of the Minister of Natural Resources Canada.

  9. Characteristics associated with clinical severity and inflammatory phenotype of naturally occurring virus-induced exacerbations of asthma in adults

    DEFF Research Database (Denmark)

    Bjerregaard, Asger; Laing, Ingrid A; Poulsen, Nadia

    2017-01-01

    BACKGROUND: In experimental studies viral infections have been shown to induce type 2 inflammation in asthmatics, but whether this is a feature of naturally occurring virus-induced asthma exacerbations is unknown. Thymic stromal lymphopoietin (TSLP) released from the airway epithelium in response...... occurring virus-induced exacerbations of asthma and whether TSLP is associated with this type 2 inflammation. METHODS: Patients presenting to hospital with acute asthma were examined during the exacerbation, and after 4 weeks recovery. The assessments included spirometry, FeNO and induced sputum...... in patients during virus-induced asthma exacerbations, to the same degree as non-viral exacerbations, and correlate negatively with FEV1. However, in virus-positive patients, high TSLP expression during exacerbation was associated with low sputum eosinophils, suggesting that the effect of TSLP in vivo...

  10. The rates of carbon cycling in several soils from AMS14C measurements of fractionated soil organic matter

    International Nuclear Information System (INIS)

    Trumbore, S.E.; Bonani, G.; Wolfli, W.

    1990-01-01

    14 C mean residence times (MRT) of fractionated organic matter are reported for three pre-bomb soil profiles. Comparisons of organic matter extracted with acid and base showed that the longest MRTs were associated with the non-acid-hydrolysable fraction. The MRT of organic matter in a soil layer represents a combination of the rates of several processes, including decay to CO 2 and transport out of the layer. In some instances (notably in the A horizon of the Podzol soil studied in this paper), the MRT is dominated by the rate of transport, rather than the rate of decay. Thus it is important to use the distribution and balance of carbon in the soil profile to assess the meaning of the MRT with respect to influencing atmospheric CO 2

  11. Descriptions of selected accidents that have occurred at nuclear reactor facilities

    Energy Technology Data Exchange (ETDEWEB)

    Bertini, H.W.

    1980-04-01

    This report was prepared at the request of the President's Commission on the Accident at Three Mile Island to provide the members of the Commission with some insight into the nature and significance of accidents that have occurred at nuclear reactor facilities in the past. Toward that end, this report presents a brief description of 44 accidents which have occurred throughout the world and which meet at least one of the severity criteria that were established.

  12. Descriptions of selected accidents that have occurred at nuclear reactor facilities

    International Nuclear Information System (INIS)

    Bertini, H.W.

    1980-04-01

    This report was prepared at the request of the President's Commission on the Accident at Three Mile Island to provide the members of the Commission with some insight into the nature and significance of accidents that have occurred at nuclear reactor facilities in the past. Toward that end, this report presents a brief description of 44 accidents which have occurred throughout the world and which meet at least one of the severity criteria that were established

  13. Calculation of mean outcrossing rates of non-Gaussian processes with stochastic input parameters - Reliability of containers stowed on ships in severe sea

    DEFF Research Database (Denmark)

    Nielsen, Ulrik Dam

    2010-01-01

    values is expected to occur, and the final result, the mean outcrossing rate, is obtained by summation. The derived procedure is illustrated by an example considering the forces in containers stowed on ships and, in particular, results are presented for the so-called racking failure in the containers...

  14. The National and Regional Prevalence Rates of Disability, Type, of Disability and Severity in Saudi Arabia-Analysis of 2016 Demographic Survey Data.

    Science.gov (United States)

    Bindawas, Saad M; Vennu, Vishal

    2018-02-28

    The prevalence of disability varies between countries ranging from less than 1% to up to 30% in some countries, thus, the estimated global disability prevalence is about 15%. However, it is unknown what the current estimate of disability and its types and severity are in Saudi Arabia. Thus, the objective of this study is to estimate national and regional prevalence rates of any disability, types of disability, and their severity among Saudi populations. Data on disability status were extracted from the national demographic survey conducted in 2016 as reported by the General Authority for Statistics, Saudi Arabia (N = 20,064,970). Prevalence rates per a population of 100,000 of any disability, type of disability, and its severity were calculated at the national level and in all 13 regions. Out of 20,064,970 Saudi citizens surveyed, 667,280 citizens reported disabilities, accounting for a prevalence rate of 3326 per a population of 100,000 (3.3%). Individuals aged 60 years and above (11,014) and males (3818) had a higher prevalence rate of disability compared with females (2813). The Tabuk region has the highest rate of reported disability, at 4.3%. The prevalence rates of extreme disabilities in mobility and sight were higher in Madinah (57,343) and Northern border (41,236) regions, respectively. In Saudi Arabia, more than half a million Saudi citizens (1 out of every 30 individuals) reported the presence of disability during the year 2016. A higher prevalence rate of disability was seen among those aged 60 years and above, and males. Targeted efforts are required at the national and regional levels to expand and improve rehabilitation and social services for all people with disabilities.

  15. Incidence of herpes zoster amongst adults varies by severity of immunosuppression.

    Science.gov (United States)

    Schröder, Carsten; Enders, Dirk; Schink, Tania; Riedel, Oliver

    2017-09-01

    We examined the incidence of herpes zoster in immunocompromised adults (≥18 years) with different severities of immunosuppression and assessed the prevalence of complications and of various kinds of healthcare resource utilisation. German claims data from more than ten million adults were used to calculate annual incidence rates of herpes zoster for the years 2006-2012 and to analyse the prevalence of complications, physician visits, hospitalisations, and antiviral and analgesic treatments using a cohort design. The analyses were stratified by age, sex, and severity of immunosuppression, defined by immunocompromising conditions and drug therapies. The incidence rate per 1000 person-years of herpes zoster was almost twice as high in immunocompromised patients (11.5 (95% confidence interval (CI): 11.4-11.6)) compared to immunocompetent subjects (5.9 (95% CI: 5.8-5.9)). The incidence rate was higher in highly immunocompromised patients (13.4 (95% CI: 13.2-13.6)) than in patients with a low severity of immunosuppression (10.0 (95% CI: 9.8-10.1)). These differences were observed for both sexes and in all age groups. Complications, outpatient physician visits, hospitalisations, and analgesic treatments occurred more frequently in immunocompromised patients as well. Our results show that immunocompromised individuals are affected by the disease in particular and that the burden of herpes zoster is highest in severely immunocompromised patients. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

  16. [Characterization of severe acute occupational poisoning accidents in China between 1989 and 2003].

    Science.gov (United States)

    Zhang, Min; Li, Tao; Wang, Huan-Qiang; Wang, Hong-Fei; Chen, Shu-Yang; Du, Xie-Yi; Zhang, Shuang; Qin, Jian

    2006-12-01

    To analyze severe acute occupational poisoning accidents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies. The data from the national occupational poisoning case reporting system were analyzed with descriptive methods. (1) There were 506 acute severe occupational poisoning accidents for 15 years with 4 657 workers poisoned. The total poisoning rate was 54.8%, and the total mortality was 16.5%. The average poisoning age was (31.9 +/- 9.8) years old and the average death age was (33.7 +/- 10.3) years old. The poisoning accidents occurred more in men than in women. (2) There were more than 112 chemicals which caused these poisoning accidents. Most of the accidents caused by hydrogen sulfide, carbon monoxide, benzene and homologs, metal and metalloid and carbon dioxide, and the types of chemicals varied in different types of industries. (3) The accidents mainly occurred in chemical industry, manufacture, water disposal industry, mining and construction industry, and the risk was higher in some jobs than others, such as cleanout, machine maintenance and repair, production, mine and digging. The accidents occurred more frequently from April to August each year. (1) The control over the severe acute occupational poisoning is urgent. (2) The trend of the characteristics of severe acute occupational poisoning accidents is centralized in the high risk industries, poisons and jobs. (3) The characteristics of the accidents varied in different types of industries. (4) It is the key point to strengthen the supervision on poisoning.

  17. Changes in the probability of co-occurring extreme climate events

    Science.gov (United States)

    Diffenbaugh, N. S.

    2017-12-01

    Extreme climate events such as floods, droughts, heatwaves, and severe storms exert acute stresses on natural and human systems. When multiple extreme events co-occur, either in space or time, the impacts can be substantially compounded. A diverse set of human interests - including supply chains, agricultural commodities markets, reinsurance, and deployment of humanitarian aid - have historically relied on the rarity of extreme events to provide a geographic hedge against the compounded impacts of co-occuring extremes. However, changes in the frequency of extreme events in recent decades imply that the probability of co-occuring extremes is also changing, and is likely to continue to change in the future in response to additional global warming. This presentation will review the evidence for historical changes in extreme climate events and the response of extreme events to continued global warming, and will provide some perspective on methods for quantifying changes in the probability of co-occurring extremes in the past and future.

  18. Severe childhood malnutrition

    DEFF Research Database (Denmark)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

    2017-01-01

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use...... the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...

  19. The tell-tale: what do heart rate; skin temperature and skin conductance reveal about emotions of people with severe and profound intellectual disabilities?

    Science.gov (United States)

    Vos, Pieter; De Cock, Paul; Munde, Vera; Petry, Katja; Van Den Noortgate, Wim; Maes, Bea

    2012-01-01

    Identifying emotions in people with severe and profound intellectual disabilities is a difficult challenge. Since self-reports are not available, behaviour is the most used source of information. Given the limitations and caveats associated with using behaviour as the sole source of information about their emotions, it is important to supplement behavioural information with information from another source. As it is accepted that emotions consist of language, behaviour and physiology, in this article we investigated if physiology could give information about the emotions of people with severe and profound intellectual disabilities. To this aim we tested hypotheses derived from the motivational model of Bradley, Codispoti, Cuthbert, and Lang (2001) about the relation between heart rate and the valence of emotions and between heart rate, skin conductance and skin temperature and behavioural expressions of emotions of people with severe and profound intellectual disability. We presented 27 participants with 4 staff-selected negative and 4 staff-selected positive stimuli. The situations were videotaped and their heart rate, skin conductance and skin temperature was measured. Each behaviour of the participant was coded using the observational method developed by Petry and Maes (2006). As hypothesized, we found a lower heart rate when participants were presented with negative stimuli than when they were presented with positive stimuli in the first 6s of stimuli presentation. Their skin temperature was higher for the expression of low intensity negative emotions compared to the expression of low intensity positive emotions. The results suggest that, as with people without disability, heart rate and skin temperature can give information about the emotions of persons with severe and profound ID. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Risk Factors Associated with Crash Severity on Low-Volume Rural Roads in Denmark

    DEFF Research Database (Denmark)

    Prato, Carlo Giacomo; Rasmussen, Thomas Kjær; Kaplan, Sigal

    2014-01-01

    Safety on low-volume rural roads is drawing attention due to the high fatality and severe injury rates in comparison with high-volume roads and the increasing awareness of sustainable rural development among policy makers. This study analyzes the risk factors associated with crash severity on low......-volume rural roads, including crash characteristics, driver attributes and behavior, vehicle type, road features, environmental conditions, distance from the nearest hospital, and zone rurality degree. The data consist of a set of crashes occurred on low-volume rural roads in Denmark between 2007 and 2011...... advantage in accommodating the ordered-response nature of severity while relaxing the proportional odds assumption. Model estimates and pseudoelasticities show that aggravated crash injury severity is significantly associated with (1) alcohol and failure to wear seatbelts, (2) involvement of vulnerable road...

  1. Percutaneous treatment of complications occurring during hemodialysis graft recanalization

    Energy Technology Data Exchange (ETDEWEB)

    Sofocleous, Constantinos T. E-mail: constant@pol.net; Schur, Israel; Koh, Elsie; Hinrichs, Clay; Cooper, Stanley G.; Welber, Adam; Brountzos, Elias; Kelekis, Dimitris

    2003-09-01

    Introduction/objective: To describe and evaluate percutaneous treatment methods of complications occurring during recanalization of thrombosed hemodialysis access grafts. Methods and materials: A retrospective review of 579 thrombosed hemodialysis access grafts revealed 48 complications occurring during urokinase thrombolysis (512) or mechanical thrombectomy (67). These include 12 venous or venous anastomotic ruptures not controlled by balloon tamponade, eight arterial emboli, 12 graft extravasations, seven small hematomas, four intragraft pseudointimal 'dissections', two incidents of pulmonary edema, one episode of intestinal angina, one procedural death, and one distant hematoma. Results: Twelve cases of post angioplasty ruptures were treated with uncovered stents of which 10 resulted in graft salvage allowing successful hemodialysis. All arterial emboli were retrieved by Fogarty or embolectomy balloons. The 10/12 graft extravasations were successfully treated by digital compression while the procedure was completed and the graft flow was restored. Dissections were treated with prolonged Percutaneous Trasluminal Angioplasty (PTA) balloon inflation. Overall technical success was 39/48 (81%). Kaplan-Meier Primary and secondary patency rates were 72 and 78% at 30, 62 and 73% at 90 and 36 and 67% at 180 days, respectively. Secondary patency rates remained over 50% at 1 year. There were no additional complications caused by these maneuvers. Discussions and conclusion: The majority of complications occurring during percutaneous thrombolysis/thrombectomy of thrombosed access grafts, can be treated at the same sitting allowing completion of the recanalization procedure and usage of the same access for hemodialysis.

  2. Co-occurring Attention Deficit Hyperactivity Disorder symptoms in adults affected by heroin dependence: Patients characteristics and treatment needs.

    Science.gov (United States)

    Lugoboni, Fabio; Levin, Frances Rudnick; Pieri, Maria Chiara; Manfredini, Matteo; Zamboni, Lorenzo; Somaini, Lorenzo; Gerra, Gilberto; Gruppo InterSert Collaborazione Scientifica Gics

    2017-04-01

    Attention Deficit Hyperactivity Disorder (ADHD) is a risk for substance use disorders. The aim of this study was to investigate the association between adult ADHD symptoms, opioid use disorder, life dysfunction and co-occurring psychiatric symptoms. 1057 heroin dependent patients on opioid substitution treatment participated in the survey. All patients were screened for adult ADHD symptoms using the Adult ADHD Self-Report Scale (ASRS-v1.1). 19.4% of the patients screened positive for concurrent adult ADHD symptoms status and heroin dependence. Education level was lower among patients with ADHD symptoms, but not significant with respect to non-ADHD patients. Patients with greater ADHD symptoms severity were less likely to be employed. A positive association was observed between ADHD symptoms status and psychiatric symptoms. Patients with ADHD symptoms status were more likely to be smokers. Patients on methadone had a higher rate of ADHD symptoms status compared to buprenorphine. Those individuals prescribed psychoactive drugs were more likely to have ADHD symptoms. In conclusion, high rate of ADHD symptoms was found among heroin dependent patients, particularly those affected by the most severe form of addiction. These individuals had higher rates of unemployment, other co-morbid mental health conditions, heavy tobacco smoking. Additional psychopharmacological interventions targeting ADHD symptoms, other than opioid substitution, is a public health need. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  3. Naturally occurring methyl salicylate glycosides.

    Science.gov (United States)

    Mao, Ping; Liu, Zizhen; Xie, Meng; Jiang, Rui; Liu, Weirui; Wang, Xiaohong; Meng, Shen; She, Gaimei

    2014-01-01

    As an important part of non steroids anti-inflammation drug (NSAIDs), salicylate has developed from natural substance salicylic acid to natrium salicylicum, to aspirin. Now, methyl salicylate glycoside, a new derivative of salicylic acid, is modified with a -COOH group integrated one methyl radical into formic ether, and a -OH linked with a monosaccharide, a disaccharide or a trisaccharide unit by glycosidic linkage. It has the similar pharmacological activities, anti-inflammatory, analgesic, antipyretic and antithrombotic as the previous salicylates' without resulting in serious side effects, particularly the gastrointestinal toxicity. Owing to the superiority of those significant bioactivities, methyl salicylate glycosides have became a hot research area in NSAIDs for several years. This paper compiles all 9 naturally occurring methyl salicylate glycosides, their distribution of the resource and pharmacological mechanism, which could contribute to the new drug discovery.

  4. Adaptive rate selection scheme for video transmission to resolve IEEE 802.11 performance anomaly

    Science.gov (United States)

    Tang, Guijin; Zhu, Xiuchang

    2011-10-01

    Multi-rate transmission may lead to performance anomaly in an IEEE 802.11 network. It will decrease the throughputs of all the higher rate stations. This paper proposes an adaptive rate selection scheme for video service when performance anomaly occurs. Considering that video has the characteristic of tolerance to packet loss, we actively drop several packets so as to select the rates as high as possible for transmitting packets. Experiment shows our algorithm can decrease the delay and jitter of video, and improve the system throughput as well.

  5. Comprehensive analysis of prognostic factors in hospitalized patients with pneumonia occurring outside hospital: Serum albumin is not less important than pneumonia severity assessment scale.

    Science.gov (United States)

    Miyazaki, Hiroyuki; Nagata, Nobuhiko; Akagi, Takanori; Takeda, Satoshi; Harada, Taishi; Ushijima, Shinichiro; Aoyama, Takashi; Yoshida, Yuji; Yatsugi, Hiroshi; Fujita, Masaki; Watanabe, Kentaro

    2018-08-01

    This study aimed to elucidate factors related to 30-day mortality of pneumonia occurring outside hospital by comprehensively analyzing data considered relevant to prognosis. Data considered relevant to prognosis were retrospectively examined from clinical charts and chest X-ray images of all patients with pneumonia occurring outside hospital admitted to our hospital from 2010 to 2016. The primary outcome was 30-day mortality. Data were collected from 534 patients (317 community-acquired pneumonia and 217 nursing- and healthcare associated pneumonia patients; 338 men (63.3%); mean age, 76.2 years-old). Eighty-three patients (9.9%) died from pneumonia within 30 days from the date of admission. The numbers of patients with pneumonia severity index (PSI) classes of I/II/III/IV/V and age, dehydration, respiratory failure, orientation disturbance, pressure (A-DROP) scores of 0/1/2/3/4/5 were 29/66/127/229/83, and 71/107/187/132/30/7, respectively. Mean (standard deviation) body mass index (BMI), serum albumin, blood procalcitonin, white blood cell and C-reactive protein were 20.00 (4.12) kg/m 2 , 3.16 (0.60) g/dL, 3.69 (13.15) ng/mL, 11559.4 (5656.9)/mm 3 , and 10.92 (8.75) mg/dL, respectively. Chest X-ray images from 152 patients exhibited a pneumonia shadow over a quarter of total lung field. Logistic regression analysis revealed that PSI class or A-DROP score, BMI, serum albumin, and extent of pneumonia shadow were related to 30-day mortality. Receiver operating characteristics curve analysis revealed that serum albumin was superior to PSI class or A-DROP score for predicting 30-day mortality. Serum albumin is not less important than PSI class or A-DROP score for predicting 30-day mortality in hospitalized patients with pneumonia occurring outside hospital. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  6. Analysis of hexcan failures occurring during the simulation of severe accidents in liquid metal cooled reactors

    International Nuclear Information System (INIS)

    Peppler, W.; Will, H.

    1988-01-01

    Under the SIMBATH programme the physical phenomena of transient material movement and relocation during severe LMFBR accidents are investigated out-of-pile. In most of the SIMBATH bundle experiments a failure of the wrapper was observed. From the safety point of view this has implications on the issue of propagation. By openings into the inter-subassembly gaps pressure relief and material release are possible. From the development of failure, based on measurements made during the simulation tests, and from post-experiment investigations three types of failure mode have been identified: Melt-through of the wrapper wall by a jet of hot material from a failing pin. This happened very early during the test. Sodium boiling in the annular bypass prior to failure has not been detected. Melt-through in the simulated fuel region by severe ablation due to local crust instability combined with intense heat input from the flowing melt. Melt-through in the simulated breeding regions close to blockages. This failure mode was always observed together with sodium gross boiling in the annular channel, i.e. reduced cooling of the wrapper wall. No mechanical failure was detected as a result of the stress concentration in the corners of the hexcan walls. The influence of the internal overpressure is restricted mainly to final break-through after severe ablation and drives the material motions after wrapper failure; it does not control wrapper wall failure in these experiments. (orig.)

  7. Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing

    Directory of Open Access Journals (Sweden)

    Wen-Yao Pan

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA is an independent cardiovascular risk factor to which autonomic nervous dysfunction has been reported to be an important contributor. Ninety subjects recruited from the sleep center of a single medical center were divided into four groups: normal snoring subjects without OSA (apnea hypopnea index, AHI < 5, n = 11, mild OSA (5 ≤ AHI < 15, n = 10, moderate OSA (15 ≤ AHI < 30, n = 24, and severe OSA (AHI ≥ 30, n = 45. Demographic (i.e., age, gender, anthropometric (i.e., body mass index, neck circumference, and polysomnographic (PSG data were recorded and compared among the different groups. For each subject, R-R intervals (RRI from 10 segments of 10-minute electrocardiogram recordings during non-rapid eye movement sleep at stage N2 were acquired and analyzed for heart rate variability (HRV and sample entropy using multiscale entropy index (MEI that was divided into small scale (MEISS, scale 1–5 and large scale (MEILS, scale 6–10. Our results not only demonstrated that MEISS could successfully distinguish normal snoring subjects and those with mild OSA from those with moderate and severe disease, but also revealed good correlation between MEISS and AHI with Spearman correlation analysis (r = −0.684, p < 0.001. Therefore, using the two parameters of EEG and ECG, MEISS may serve as a simple preliminary screening tool for assessing the severity of OSA before proceeding to PSG analysis.

  8. Reporting Severe Hypoglycemia in Type 1 Diabetes

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Thorsteinsson, Birger

    2017-01-01

    PURPOSE OF REVIEW: To describe potential factors influencing reporting of severe hypoglycemia in adult patients with type 1 diabetes and to analyze their effect on reported rates of severe hypoglycemia. RECENT FINDINGS: Reported rates of severe hypoglycemia defined as need for third party...... by partners report higher rates of severe hypoglycemia. There is a large variation between studies reporting incidence and prevalence of severe hypoglycemia in patients with type 1 diabetes, mainly explained by definition of severity, methods of reporting, and patient selection. These findings call...... hypoglycemia are 0.02-0.5 events per patient-year and 1-29%, respectively. When subjects with recurrent severe hypoglycemia in the past or suffering from impaired hypoglycemia awareness are excluded from participation in studies, lower rates are reported. Studies applying anonymous reporting or reporting...

  9. Variation in rates of severe retinopathy of prematurity among neonatal intensive care units in the Australian and New Zealand Neonatal Network

    OpenAIRE

    Darlow, B A; Hutchinson, J L; Simpson, J M; Henderson-Smart, D J; Donoghue, D A; Evans, N J

    2005-01-01

    Aim: To analyse variations in rates of severe retinopathy of prematurity (ROP) among neonatal intensive care units (NICUs) in the Australian and New Zealand Neonatal Network (ANZNN), adjusting for sampling variability and for case mix.

  10. 35% Good Outcome Rate in IV-tPA treated Patients with CTA Confirmed Severe Anterior Circulation Occlusive Stroke

    Science.gov (United States)

    González, R. Gilberto; Furie, Karen L.; Goldmacher, Gregory V.; Smith, Wade S.; Kamalian, Shervin; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Lev, Michael H.

    2015-01-01

    BACKGROUND AND PURPOSE To determine the effect of IV-tPA on outcomes in patients with severe major anterior circulation ischemic stroke. METHODS Prospectively, 649 acute stroke patients had admission NIH stroke scale scores (NIHSS), non-contrast CT, CT angiography (CTA), and 6-month outcome assessed using modified Rankin scale (mRS). IV-tPA treatment decisions were made prior to CTA, at the time of non-contrast CT scanning, as per routine clinical protocol. Severe symptoms were defined as NIHSS>10. Poor outcome was defined as mRS>2. Major occlusions were identified on CTA. Univariate and multivariate stepwise-forward logistic regression analyses of the full cohort were performed. RESULTS Of 649 patients, 188 (29%) presented with NIHSS>10, and 64/188 (34%) of these received IV-tPA. Admission NIHSS, large artery occlusion, and IV-tPA all independently predicted good outcomes, however a significant interaction existed between IV-tPA and occlusion (p10 patients with anterior circulation occlusion, twice the percentage had good outcomes if they received IV-tPA (17/49, 35%), than if they did not (13/77, 17%; p=0.031). The “number needed to treat” was 7 (95% CI = 3–60). CONCLUSIONS IV-tPA treatment resulted in significantly more good outcomes in severely symptomatic stroke patients with major anterior circulation occlusions. The 35% good outcome rate was similar to rates found in endovascular therapy trials. Vascular imaging may help in patient selection and stratification for trials of IV-thrombolytic and endovascular therapies. PMID:24003051

  11. Spatial clustering by disease severity among reported Rocky Mountain spotted fever cases in the United States, 2001-2005.

    Science.gov (United States)

    Adjemian, Jennifer Zipser; Krebs, John; Mandel, Eric; McQuiston, Jennifer

    2009-01-01

    Rocky Mountain spotted fever (RMSF) occurs throughout much of the United States, ranging in clinical severity from moderate to fatal infection. Yet, little is known about possible differences among severity levels across geographic locations. To identify significant spatial clusters of severe and non-severe disease, RMSF cases reported to Centers for Disease Control and Prevention (CDC) were geocoded by county and classified by severity level. The statistical software program SaTScan was used to detect significant spatial clusters. Of 4,533 RMSF cases reported, 1,089 hospitalizations (168 with complications) and 23 deaths occurred. Significant clusters of 6 deaths (P = 0.05, RR = 11.4) and 19 hospitalizations with complications (P = 0.02, RR = 3.45) were detected in southwestern Tennessee. Two geographic areas were identified in north-central North Carolina with unusually low rates of severity (P = 0.001, RR = 0.62 and P = 0.001, RR = 0.45, respectively). Of all hospitalizations, 20% were clustered in central Oklahoma (P = 0.02, RR = 1.43). Significant geographic differences in severity were observed, suggesting that biologic and/or anthropogenic factors may be impacting RMSF epidemiology in the United States.

  12. The impact of mild induced hypothermia on the rate of transfusion and the mortality in severely injured patients: a retrospective multi-centre study.

    Science.gov (United States)

    Jensen, Kai Oliver; Held, Leonhard; Kraus, Andrea; Hildebrand, Frank; Mommsen, Philipp; Mica, Ladislav; Wanner, Guido A; Steiger, Peter; Moos, Rudolf M; Simmen, Hans-Peter; Sprengel, Kai

    2016-10-06

    Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included. At hospital A, patients qualified for IH with age ≤70 years and a severe head injury with an abbreviated injury scale (AIS Head ) of ≥3. IH was defined as target core body temperature of 35 °C. Hypothermic patients were matched with two patients, one from hospital B and one from hospital C using age and AIS Head . The effect of IH on the transfusion rate, complications and mortality was quantified with 95 % confidence intervals (CI). Patients not treated with IH in hospital A and those from hospital B and C, who were not matched, were used to adjust the CI for the effect of inter-hospital therapy protocol differences. Mean age of patients in the IH-group (n = 43) was 35.7 years, mean ISS 30 points and sex distribution showed 83.7 % male. Mean age of matched patients in the normotherm-group (n = 86) was 36.7 years, mean ISS 33 points and there were 75.6 % males. For the hypothermic patients, we pointed out an estimate of mean difference for the number of transfused units of packed red blood cells as well as for mortality which does not indicate a decrease in the benefit gained by hypothermia. It is suggested that hypothermic patients tend to a higher rate of lung failure and thromboembolisms. Though tending to an increased rate of complications, there is no evidence for a difference in both; rate of transfusion and mortality in SIP. Mild IH as an option for

  13. Case report: Ribavirin and vitamin A in a severe case of measles.

    Science.gov (United States)

    Bichon, Amandine; Aubry, Camille; Benarous, Lucas; Drouet, Hortense; Zandotti, Christine; Parola, Philippe; Lagier, Jean-Christophe

    2017-12-01

    Despite a vaccine being widely available, measles continues to occur frequently, with sometimes lethal consequences. The mortality rate reaches 35% and measles represents 44% of the 1.4 million deaths which are due to preventable diseases. Severe forms of measles are reported, mainly in young, unvaccinated adults, and in specific populations. The risk factors for severe measles include no or incomplete vaccination and vitamin A deficiency. Apart from secondary measles-related infections, severe measles is mainly represented by neurological, respiratory, and digestive symptoms. Strengthening the hypothesis that there is a link between vitamin A deficiency and severe measles in this paper we report the case of a 25-year-old unvaccinated man hospitalized for severe and complicated measles. The evolution was good after administration of intramuscular vitamin A as well as intravenous ribavirin. Measles remains a fatal and serious disease. The early use of ribavirin and vitamin A shows significant improvements regarding morbimortality and should be systematic in severe cases. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  14. Kyphoplasty for severe osteoporotic vertebral compression fractures

    International Nuclear Information System (INIS)

    Bao Zhaohua; Wang Genlin; Yang Huilin; Meng Bin; Chen Kangwu; Jiang Weimin

    2010-01-01

    Objective: To evaluate the clininal efficacy of kyphoplasty for severe osteoporotic vertebral compression fractures. Methods: Forty-five patients with severe osteoporotic compressive fractures were treated by kyphoplasty from Jan 2005 to Jan 2009. The compressive rate of the fractured vertebral bodies was more than 75%. According to the morphology of the vertebral compression fracture bodies the unilateral or bilateral balloon kyphoplasty were selected. The anterior vertebral height was measured on a standing lateral radiograph at pre-operative, post-operative (one day after operation) and final follow-up time. A visual analog scale(VAS) and the Oswestry disability index (ODI) were chosen to evaluate pain status and functional activity. Results: The mean follow-up was for 21.7 months (in range from 18 to 48 months). The anterior vertebral body height of fracture vertebra was restored from preoperative (18.7 ± 3.1)% to postoperative (51.4 ± 2.3)%, the follow-up period (50.2 ± 2.7)%. There was a significant improvement between preoperative and postoperative values (P 0.05). The VAS was 8.1 ± 1.4 at preoperative, 2.6 ± 0.9 at postoperative, 2.1 ± 0.5 at final follow-up time; and the ODI was preoperative 91.1 ± 2.3, postoperative 30.7 ± 7.1, follow-up period 26.1 ± 5.1. There was statistically significant improvement in the VAS and ODI in the post-operative assessment compared with the pre-operative assessment (P 0.05). Asymptomatic cement leakage occurred in three cases. New vertebral fracture occurred in one case. Conclusion: The study suggests that balloon kyphoplasty is a safe and effective procedure in the treatment of severe osteoporotic vertebral compression fractures. (authors)

  15. Hamstring Reinjuries Occur at the Same Location and Early After Return to Sport: A Descriptive Study of MRI-Confirmed Reinjuries.

    Science.gov (United States)

    Wangensteen, Arnlaug; Tol, Johannes L; Witvrouw, Erik; Van Linschoten, Robbart; Almusa, Emad; Hamilton, Bruce; Bahr, Roald

    2016-08-01

    Despite relatively high reinjury rates after acute hamstring injuries, there is a lack of detailed knowledge about where and when hamstring reinjuries occur, and studies including imaging-confirmed reinjuries are scarce. To investigate the location, radiological severity, and timing of reinjuries on magnetic resonance imaging (MRI) compared with the index injury. Case series; Level of evidence, 4. A MRI scan was obtained ≤5 days after an acute hamstring index injury in 180 athletes, and time to return to sport (RTS) was registered. Athletes with an MRI-confirmed reinjury in the same leg ≤365 days after RTS were included. Categorical grading and standardized MRI parameters of the index injury and reinjury were scored by a single radiologist (with excellent intraobserver reliability). To determine the location of the reinjury, axial and coronal views of the index injury and reinjury were directly compared on proton density-weighted fat-suppressed images. In the 19 athletes included with reinjury, 79% of these reinjuries occurred in the same location within the muscle as the index injury. The median time to RTS after the index injury was 19 days (range, 5-37 days; interquartile range [IQR], 15 days). The median time between the index injury and reinjury was 60 days (range, 20-316 days; IQR, 131 days) and the median time between RTS after the index injury and the reinjury was 24 days (range, 4-311 days; IQR, 140 days). More than 50% of reinjuries occurred within 25 days (4 weeks) after RTS from the index injury and 50% occurred within 50 days after the index injury. All reinjuries with more severe radiological grading occurred in the same location as the index injury. The majority of the hamstring reinjuries occurred in the same location as the index injury, early after RTS and with a radiologically greater extent, suggesting incomplete biological and/or functional healing of the index injury. Specific exercise programs focusing on reinjury prevention initiated

  16. Non-thermal radio frequency and static magnetic fields increase rate of hemoglobin deoxygenation in a cell-free preparation.

    Directory of Open Access Journals (Sweden)

    David Muehsam

    Full Text Available The growing body of clinical and experimental data regarding electromagnetic field (EMF bioeffects and their therapeutic applications has contributed to a better understanding of the underlying mechanisms of action. This study reports that two EMF modalities currently in clinical use, a pulse-modulated radiofrequency (PRF signal, and a static magnetic field (SMF, applied independently, increased the rate of deoxygenation of human hemoglobin (Hb in a cell-free assay. Deoxygenation of Hb was initiated using the reducing agent dithiothreitol (DTT in an assay that allowed the time for deoxygenation to be controlled (from several min to several hours by adjusting the relative concentrations of DTT and Hb. The time course of Hb deoxygenation was observed using visible light spectroscopy. Exposure for 10-30 min to either PRF or SMF increased the rate of deoxygenation occurring several min to several hours after the end of EMF exposure. The sensitivity and biochemical simplicity of the assay developed here suggest a new research tool that may help to further the understanding of basic biophysical EMF transduction mechanisms. If the results of this study were to be shown to occur at the cellular and tissue level, EMF-enhanced oxygen availability would be one of the mechanisms by which clinically relevant EMF-mediated enhancement of growth and repair processes could occur.

  17. Does attenuated skin blood flow lower sweat rate and the critical environmental limit for heat balance during severe heat exposure?

    Science.gov (United States)

    Cramer, Matthew N; Gagnon, Daniel; Crandall, Craig G; Jay, Ollie

    2017-02-01

    What is the central question of this study? Does attenuated skin blood flow diminish sweating and reduce the critical environmental limit for heat balance, which indicates maximal heat loss potential, during severe heat stress? What is the main finding and its importance? Isosmotic hypovolaemia attenuated skin blood flow by ∼20% but did not result in different sweating rates, mean skin temperatures or critical environmental limits for heat balance compared with control and volume-infusion treatments, suggesting that the lower levels of skin blood flow commonly observed in aged and diseased populations may not diminish maximal whole-body heat dissipation. Attenuated skin blood flow (SkBF) is often assumed to impair core temperature (T c ) regulation. Profound pharmacologically induced reductions in SkBF (∼85%) lead to impaired sweating, but whether the smaller attenuations in SkBF (∼20%) more often associated with ageing and certain diseases lead to decrements in sweating and maximal heat loss potential is unknown. Seven healthy men (28 ± 4 years old) completed a 30 min equilibration period at 41°C and a vapour pressure (P a ) of 2.57 kPa followed by incremental steps in P a of 0.17 kPa every 6 min to 5.95 kPa. Differences in heat loss potential were assessed by identifying the critical vapour pressure (P crit ) at which an upward inflection in T c occurred. The following three separate treatments elicited changes in plasma volume to achieve three distinct levels of SkBF: control (CON); diuretic-induced isosmotic dehydration to lower SkBF (DEH); and continuous saline infusion to maintain SkBF (SAL). The T c , mean skin temperature (T sk ), heart rate, mean laser-Doppler flux (forearm and thigh; LDF mean ), mean local sweat rate (forearm and thigh; LSR mean ) and metabolic rate were measured. In DEH, a 14.2 ± 5.7% lower plasma volume resulted in a ∼20% lower LDF mean in perfusion units (PU) (DEH, 139 ± 23 PU; CON, 176 ± 22 PU; and SAL

  18. Comparison of associated features and drug treatment between co-occurring unipolar and bipolar disorders in depressed eating disorder patients.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Chang, Chin-Hao; Liao, Shih-Cheng; Chen, Hsi-Chung

    2017-02-27

    To examine the differences of associated characteristics and prescription drug use between co-occurring unipolar and bipolar disorders in patients with eating disorders (EDs). Patients with EDs and major depressive episode (MDE) were recruited from psychiatric outpatient clinics. They were interviewed and completed self-administered measures assessing eating and general psychopathology. The prescribed drugs at the index outpatient visit were recorded. Clinical characteristics and prescription drugs of groups with major depressive disorder (ED-MDD), MDE with lifetime mania (ED-BP I), and MDE with lifetime hypomania (ED-BP II) were compared. Continuous variables between groups were compared using generalized linear regression with adjustments of age, gender, and ED subtype for pair-wise comparisons. Multivariate logistic regression with adjustments of age, gender, and ED subtype was employed to estimate adjusted odds ratios with 95% confidence intervals between groups. Two hundred and twenty-seven patients with EDs had a current MDE. Among them, 17.2% and 24.2% experienced associated manic and hypomanic episodes, respectively. Bipolar I and II patients displayed significantly poorer weight regulation, more severe impulsivity and emotional lability, and higher rates of co-occurring alcohol use disorders than ED-MDD patients. ED-BP I patients were found to have the lowest IQ, poorest working memory, and the most severe depression, suicidality and functional impairment among all patients. Patients with ED-BP II shared affect and behavioral dysregulations with ED-BP I, but had less severe degrees of cognitive and functional impairments than ED-BP I. Patients with ED-BP I were significantly less likely than those in the ED-MDD and ED-BP II groups to be on antidepressant monotherapy, but a great rate (27%) of ED-BP I individuals taking antidepressant monotherapy had potential risk of mood switch during the course of treatment. Our study identified discriminative features

  19. Naturally Occurring Canine Invasive Urinary Bladder Cancer: A Complementary Animal Model to Improve the Success Rate in Human Clinical Trials of New Cancer Drugs

    Directory of Open Access Journals (Sweden)

    Christopher M. Fulkerson

    2017-01-01

    Full Text Available Genomic analyses are defining numerous new targets for cancer therapy. Therapies aimed at specific genetic and epigenetic targets in cancer cells as well as expanded development of immunotherapies are placing increased demands on animal models. Traditional experimental models do not possess the collective features (cancer heterogeneity, molecular complexity, invasion, metastasis, and immune cell response critical to predict success or failure of emerging therapies in humans. There is growing evidence, however, that dogs with specific forms of naturally occurring cancer can serve as highly relevant animal models to complement traditional models. Invasive urinary bladder cancer (invasive urothelial carcinoma (InvUC in dogs, for example, closely mimics the cancer in humans in pathology, molecular features, biological behavior including sites and frequency of distant metastasis, and response to chemotherapy. Genomic analyses are defining further intriguing similarities between InvUC in dogs and that in humans. Multiple canine clinical trials have been completed, and others are in progress with the aim of translating important findings into humans to increase the success rate of human trials, as well as helping pet dogs. Examples of successful targeted therapy studies and the challenges to be met to fully utilize naturally occurring dog models of cancer will be reviewed.

  20. Naturally Occurring Canine Invasive Urinary Bladder Cancer: A Complementary Animal Model to Improve the Success Rate in Human Clinical Trials of New Cancer Drugs.

    Science.gov (United States)

    Fulkerson, Christopher M; Dhawan, Deepika; Ratliff, Timothy L; Hahn, Noah M; Knapp, Deborah W

    2017-01-01

    Genomic analyses are defining numerous new targets for cancer therapy. Therapies aimed at specific genetic and epigenetic targets in cancer cells as well as expanded development of immunotherapies are placing increased demands on animal models. Traditional experimental models do not possess the collective features (cancer heterogeneity, molecular complexity, invasion, metastasis, and immune cell response) critical to predict success or failure of emerging therapies in humans. There is growing evidence, however, that dogs with specific forms of naturally occurring cancer can serve as highly relevant animal models to complement traditional models. Invasive urinary bladder cancer (invasive urothelial carcinoma (InvUC)) in dogs, for example, closely mimics the cancer in humans in pathology, molecular features, biological behavior including sites and frequency of distant metastasis, and response to chemotherapy. Genomic analyses are defining further intriguing similarities between InvUC in dogs and that in humans. Multiple canine clinical trials have been completed, and others are in progress with the aim of translating important findings into humans to increase the success rate of human trials, as well as helping pet dogs. Examples of successful targeted therapy studies and the challenges to be met to fully utilize naturally occurring dog models of cancer will be reviewed.

  1. The Paradox of Increasing Both Enrollment and Graduation Rates: Acknowledging Elephants in the Ivory Tower

    Science.gov (United States)

    Mulvenon, Sean W.; Robinson, Daniel H.

    2014-01-01

    The argument is made that increasing enrollments and graduation rates cannot occur while maintaining academic standards. Several U.S. universities are attempting to increase their enrollments to counter the financial difficulties created by a reduction in state support. These same universities are also under growing pressure from their state…

  2. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tward, Jonathan D., E-mail: Jonathan.Tward@hci.utah.edu [Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah (United States); Jarosek, Stephanie; Chu, Haitao [University of Minnesota, Minneapolis, Minnesota (United States); Thorpe, Cameron; Shrieve, Dennis C. [Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah (United States); Elliott, Sean [University of Minnesota, Minneapolis, Minnesota (United States)

    2016-08-01

    Purpose: Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Methods and Materials: Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results–Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Results: Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Conclusions: Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus

  3. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy

    International Nuclear Information System (INIS)

    Tward, Jonathan D.; Jarosek, Stephanie; Chu, Haitao; Thorpe, Cameron; Shrieve, Dennis C.; Elliott, Sean

    2016-01-01

    Purpose: Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Methods and Materials: Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results–Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Results: Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Conclusions: Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus

  4. Time Course and Accumulated Risk of Severe Urinary Adverse Events After High- Versus Low-Dose-Rate Prostate Brachytherapy With or Without External Beam Radiation Therapy.

    Science.gov (United States)

    Tward, Jonathan D; Jarosek, Stephanie; Chu, Haitao; Thorpe, Cameron; Shrieve, Dennis C; Elliott, Sean

    2016-08-01

    Severe urinary adverse events (UAEs) include surgical treatment of urethral stricture, urinary incontinence, and radiation cystitis. We compared the incidence of grade 3 UAEs, according to the Common Terminology Criteria for Adverse Events, after low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy, as well as after LDR plus external beam radiation therapy (EBRT) and HDR plus EBRT. Men aged >65 years with nonmetastatic prostate cancer were identified from the Surveillance, Epidemiology, and End Results-Medicare database who were treated with LDR (n=12,801), HDR (n=685), LDR plus EBRT (n=8518), or HDR plus EBRT (n=2392). The populations were balanced by propensity weighting, and the Kaplan-Meier incidence of severe UAEs was compared. Propensity-weighted Cox proportional hazards models were used to compare the adjusted hazard of UAEs. These UAEs were compared with those in a cohort of men not treated for prostate cancer. Median follow-up was 4.3 years. At 8 years, the propensity-weighted cumulative UAE incidence was highest after HDR plus EBRT (26.6% [95% confidence interval, 23.8%-29.7%]) and lowest after LDR (15.7% [95% confidence interval, 14.8%-16.6%]). The absolute excess risk over nontreated controls at 8 years was 1.9%, 3.8%, 8.4%, and 12.9% for LDR, HDR, LDR plus EBRT, and HDR plus EBRT, respectively. These represent numbers needed to harm of 53, 26, 12, and 8 persons, respectively. The additional risk of development of a UAE related to treatment for LDR, LDR plus EBRT, and HDR plus EBRT was greatest within the 2 years after treatment and then continued to decline over time. Beyond 4 years, the risk of development of a new severe UAE matched the baseline risk of the control population for all treatments. Toxicity differences were observed between LDR and HDR, but the differences did not meet statistical significance. However, combination radiation therapy (either HDR plus EBRT or LDR plus EBRT) increases the risk of severe UAEs compared with HDR

  5. Injury severity in delivery-motorcycle to vehicle crashes in the Seoul metropolitan area.

    Science.gov (United States)

    Chung, Younshik; Song, Tai-Jin; Yoon, Byoung-Jo

    2014-01-01

    More than 56% of motorcycles in Korea are used for the purpose of delivering parcels and food. Since such delivery requires quick service, most motorcyclists commit traffic violations while delivering, such as crossing the centerline, speeding, running a red light, and driving in the opposite direction down one-way streets. In addition, the fatality rate for motorcycle crashes is about 12% of the fatality rate for road traffic crashes, which is considered to be high, although motorcycle crashes account for only 5% of road traffic crashes in South Korea. Therefore, the objective of this study is to analyze the injury severity of vehicle-to-motorcycle crashes that have occurred during delivery. To examine the risk of different injury levels sustained under all crash types of vehicle-to-motorcycle, this study applied an ordered probit model. Based on the results, this study proposes policy implications to reduce the injury severity of vehicle-to-motorcycle crashes during delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Personality dimensions and service failure severity

    African Journals Online (AJOL)

    kirstam

    Dr L. Kruger is a senior lecturer in the Department of Marketing Management ... severity rather than possible individual consumer effects on service failure severity. ... When service failures occur, there is an imbalance in the relationship, because ... service recovery strategies may result in a successful recovery experience ( ...

  7. Early diagnosis of osteomyelitis occurred in the jaws

    International Nuclear Information System (INIS)

    Choi, Eun Sook; Na, Seung Mog; Lee, Un Gyeong; Koh, Kwang Joon

    1994-01-01

    Early diagnosis and treatment of osteomyelitis provide good prognosis and prevent severe complications. Therefore, it is important to early diagnose and treat before the bony changes are observed in conventional radiograms. Authors experienced three cases of early osteomyelitis, and scintigrams were useful to differentiate them from other diseases. The purpose of this report was to aid in the early diagnosis and treatment of osteomyelitis occurred in the jaws. The characteristic features were as follows: 1. In clinical examination, the patients complained mild pain and localized swelling in the jaws. 2. In radiographic findings, the conventional radiograms showed relatively mild bony change in the jaws. 3. The more severe periosteal reactions were observed in radiograms in children than in adult patient. 4. It showed marked increased uptake of radioisotopes in all scintigrams. 5. The three phase bone scanning were helpful to differentiate osteomyelitis from soft tissue diseases.

  8. The use of a low-cost gas-liquid flow meter to monitor severe slugging

    DEFF Research Database (Denmark)

    Andreussi, Paolo; Bonizzi, Marco; Ciandri, Paolo

    2017-01-01

    A very simple, low-cost gas-liquid flow meter that only employs conventional field instrumentation has been used to monitor severe slugging occurring at the exit of a vertical pipe. This meter was originally developed for conventional oil field applications [1] and is based on the readings...... method to monitor severe slugging by means of low cost instrumentation, in particular, by replacing a cumbersome instrument such as a gamma-densitometer with a differential pressure transmitter. In field operation, the multiphase orifice used in these experiments can be replaced by a calibrated control...... of a multiphase orifice and the pressure drops of the gas-liquid mixture flowing in a vertical section of the pipe. Liquid and gas flow rates have been determined by means of semi-empirical equations developed for the specific set of flow parameters (geometry, flow rates, physical properties) adopted in a series...

  9. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

    OpenAIRE

    Gupta, Natasha; Ahmed, Seema; Shaffer, Lemuel; Cavens, Paula; Blankstein, Josef

    2014-01-01

    Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term an...

  10. Severe Late Toxicities Following Concomitant Chemoradiotherapy Compared to Radiotherapy Alone in Cervical Cancer: An Inter-era Analysis

    International Nuclear Information System (INIS)

    Gondi, Vinai; Bentzen, Søren M.; Sklenar, Kathryn L.; Dunn, Emily F.; Petereit, Daniel G.; Tannehill, Scott P.; Straub, Margaret; Bradley, Kristin A.

    2012-01-01

    Purpose: To compare rates of severe late toxicities following concomitant chemoradiotherapy and radiotherapy alone for cervical cancer. Methods and Materials: Patients with cervical cancer were treated at a single institution with radiotherapy alone or concomitant chemoradiotherapy for curative intent. Severe late toxicity was defined as grade ≥3 vaginal, urologic, or gastrointestinal toxicity or any pelvic fracture, using Common Terminology Criteria for Adverse Events version 4.0 (CTCAE), occurring ≥6 months from treatment completion and predating any salvage therapy. Severe late toxicity rates were compared after adjusting for pertinent covariates. Results: At 3 years, probability of vaginal severe late toxicity was 20.2% for radiotherapy alone and 35.1% for concomitant chemoradiotherapy (P=.026). At 3 years, probability of skeletal severe late toxicity was 1.6% for radiotherapy alone and 7.5% for concomitant chemoradiotherapy (P=.010). After adjustment for case mix, concomitant chemoradiotherapy was associated with higher vaginal (hazard ratio [HR] 3.0, 95% confidence interval [CI], 1.7-5.2, P 50 was associated with higher vaginal (HR 1.8, 95% CI 1.1-3.0, P=.013) and skeletal (HR 5.7, 95% CI 1.2-27.0, P=.028) severe late toxicity. Concomitant chemoradiotherapy was not associated with higher gastrointestinal (P=.886) or urologic (unadjusted, P=.053; adjusted, P=.063) severe late toxicity. Conclusion: Compared to radiotherapy alone, concomitant chemoradiotherapy is associated with higher rates of severe vaginal and skeletal late toxicities. Other predictive factors include dilator compliance for severe vaginal late toxicity and age for severe vaginal and skeletal late toxicities.

  11. Redo buccal mucosa graft urethroplasty: success rate, oral morbidity and functional outcomes.

    Science.gov (United States)

    Rosenbaum, Clemens M; Schmid, Marianne; Ludwig, Tim A; Kluth, Luis A; Dahlem, Roland; Fisch, Margit; Ahyai, Sascha

    2016-11-01

    To determine the success rate, oral morbidity and functional outcomes of redo buccal mucosa graft urethroplasty (BMGU) for treatment of stricture recurrence after previous BMGU. We included 50 patients who underwent redo BMGU between February 2009 and September 2014. Patients' charts and non-validated questionnaires were reviewed. The primary endpoint was success rate, defined as stricture-free survival. Stricture recurrence was defined as any postoperative claims of catheterization, dilatation, urethrotomy or repeat urethroplasty, or a maximum urinary flow rate <15 mL/s, and a stricture was consecutively verified in a combined cysto-urethrogram or cystoscopy at annual follow-up visit. The secondary endpoint was oral morbidity. Additional endpoints were erectile function, urinary continence and patients' satisfaction. Redo BMGU was performed for bulbar (71.4%) or penile (28.6%) recurrent strictures. The mean (median; range) follow-up was 25.6 (15.5; 3-70) months. Stricture recurrence occurred in 18.0% of patients within a mean (median; range) of 13.8 (9.0; 3-36) months. Stricture-free survival at 12, 24 and 36 months was 91.2, 86.2 and 80.8%, respectively. The majority of the patients (97.0%) reported no or only mildly changed salivation or problems in opening of the mouth. Severe or very severe oral numbness occurred in 13.5% of patients. Oral problems in daily life were a moderate or severe burden to 13.6 and 2.7% of the patients, respectively, while 75.0% of the patients reported improved quality of life compared with preoperative status. The success rate and oral morbidity of redo BMGU are almost the same as outcomes of primary BMGU. Oral numbness was the most frequently reported oral disorder. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  12. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    Energy Technology Data Exchange (ETDEWEB)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki (Dept. of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan)), email: utsunomi@kumamoto-u.ac.jp; Awai, Kazuo (Dept. of Diagnostic Radiology, Graduate School of Biomedical Sciences, Hiroshima Univ., Hiroshima (Japan)); Funama, Yoshinori (Dept. of Medical Physics, Faculty of Life Sciences, Kumamoto Univ., Kumamoto (Japan))

    2011-06-15

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 +- 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m2) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 < =eGFR < 90, 45 < =eGFR < 60, 30 < =eGFR < 45 and eGFR < 30, respectively. Results Of the 6586 patients, 1.6%, 3.7%, 13.7%, and 54.2% were judged to present with severe, moderate-b, moderate-a, and mild RI, respectively. While moderate-b-to-severe RI was recorded in 133 (3.2%) of 4161 patients aged 70 years or less, it was observed in 218 (9.0%) of the 2425 patients who were 71 years or older. Among the 829 CVD patients, 9.9% manifested moderate-b-to-severe- and 73.0% mild-to-moderate-a RI. The corresponding rates were 4.4% and 68.9% for oncologic disease, 16.9% and 61.2% for DM, and 4.8% and 71.5% for CLD patients. By univariate analysis, there was a significant association between moderate-b-to-severe RI and the advanced age, CVD, DM, and non-oncologic disease. Multivariate analysis showed that the advanced age, DM, and non-oncologic disease were statistically associated with moderate-b-to-severe RI. Conclusion The incidence of RI of eGFR < 45mL/min/1.73 m2 at baseline was high in patients with advanced age, CVD and DM and

  13. Critical exploration of co-occurring Attention-Deficit/Hyperactivity Disorder, mood disorder and Substance Use Disorder.

    Science.gov (United States)

    Regnart, Judith; Truter, Ilse; Meyer, Anneke

    2017-06-01

    Co-occurring disorders (CODs) describe a Substance Use Disorder (SUD) accompanied by a comorbid psychiatric disorder. Attention-Deficit/Hyperactivity Disorder (ADHD) and mood disorders are common CODs with high prevalence rates in SUD populations. It is proposed that literature on a tri-condition presentation of ADHD, mood disorder and SUD is limited. Areas covered: A literature search was conducted using a keyword search on EBSCOhost. Initially 2 799 records were identified, however, only two articles included all three conditions occurring concurrently in individuals. CODs constitute a major concern due to their overarching burden on society as a whole. Diagnosis and treatment of such patients is challenging. There is evidence that dysfunction of dopamine in the brain reward circuitry impacts the development or symptomology of all three disorders. Disparity exists regarding whether ADHD or mood disorders are greater modifiers for increased SUD severity. However, it has been reported that poor functional capacity may have a greater influence than comorbidities on SUD development. Expert commentary: Challenges exist which confound the clear distinction of CODs, however, with greater emergence of adult ADHD its screening in SUD populations should become standard practice to establish data on multi-condition presentations with the ultimate goal of improving clinical outcomes.

  14. Increased rate of osteoporosis, low lean mass, and fragility fractures in COPD patients: association with disease severity.

    Science.gov (United States)

    Graumam, R Q; Pinheiro, M M; Nery, L E; Castro, C H M

    2018-03-21

    A very high rate of osteoporosis, fractures, and low lean mass was observed in patients with chronic obstructive pulmonary disease (COPD). Disease severity was associated with bone and muscle adverse outcomes, while age ≥ 63.5 years old, low lean mass, higher iPTH, and a T-score below - 2.5 were all associated with higher risk of fracture. Osteoporosis is frequently neglected in patients with COPD. We aimed at evaluating the rate of osteoporosis, fractures, and low lean mass in patients with COPD. Ninety-nine patients with COPD (53 women, 64.5 ± 9.6 years old, and 46 men, 65.9 ± 8.0 years old) underwent bone densitometry (DXA) with body composition analyses. Healthy individuals (N = 57) not exposed to tobacco matched by sex, age, and body mass index (BMI) were used as controls. Spirometry, routine laboratory workout, and conventional thoracolumbar radiography surveying for vertebral deformities were performed in all patients. Osteoporosis was found in 40.4% of the COPD patients against only 13.0% of the healthy controls (p = 0.001). Vertebral fractures were seen in 24.4% of the men and 22.0% of the women with COPD. Disease severity (GOLD 3 and 4) was significantly associated with higher risk of vitamin D deficiency (p = 0.032), lower BMD (both men and women at all sites), higher frequency of osteoporosis (in women at all sites), lower skeletal mass index, and higher rate of low lean mass (in both men and women) than healthy controls and COPD patients with milder disease (GOLD 1 and 2). Age was a main predictor of vertebral fractures (OR = 1.164 (1.078-9.297); p lean mass were associated with FEV 1% lean mass, high iPTH, and low bone mass were all significantly associated with fractures in COPD patients.

  15. Is earthquake rate in south Iceland modified by seasonal loading?

    Science.gov (United States)

    Jonsson, S.; Aoki, Y.; Drouin, V.

    2017-12-01

    Several temporarily varying processes have the potential of modifying the rate of earthquakes in the south Iceland seismic zone, one of the two most active seismic zones in Iceland. These include solid earth tides, seasonal meteorological effects and influence from passing weather systems, and variations in snow and glacier loads. In this study we investigate the influence these processes may have on crustal stresses and stressing rates in the seismic zone and assess whether they appear to be influencing the earthquake rate. While historical earthquakes in the south Iceland have preferentially occurred in early summer, this tendency is less clear for small earthquakes. The local earthquake catalogue (going back to 1991, magnitude of completeness M6+ earthquakes, which occurred in June 2000 and May 2008. Standard Reasenberg earthquake declustering or more involved model independent stochastic declustering algorithms are not capable of fully eliminating the aftershocks from the catalogue. We therefore inspected the catalogue for the time period before 2000 and it shows limited seasonal tendency in earthquake occurrence. Our preliminary results show no clear correlation between earthquake rates and short-term stressing variations induced from solid earth tides or passing storms. Seasonal meteorological effects also appear to be too small to influence the earthquake activity. Snow and glacier load variations induce significant vertical motions in the area with peak loading occurring in Spring (April-May) and maximum unloading in Fall (Sept.-Oct.). Early summer occurrence of historical earthquakes therefore correlates with early unloading rather than with the peak unloading or unloading rate, which appears to indicate limited influence of this seasonal process on the earthquake activity.

  16. A Rare Occurance with Epidermolysis Bullosa Disease: Dilated Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Derya Cimen

    2014-02-01

    Full Text Available Epidermolysis bullosa is a congenital and herediter vesiculobullous disease. Dystrophic form of this disease is characterized by severe malnutrition, failure to thrive, adhesions at fingers, joint contractures related with the formation of scar tissues, carcinoma of the skin, anemia, hipoalbuminemia, wound enfections and sepsis. Rarely, mortal dilated cardiomyopathy may occur in patients. In this report we present a 13 year-old pediatric patient with dilated cardiomyopathy, clinically diagnosed with Epidermolysis bullosa as well as a review of recent related literature.

  17. Fractures of the distal limb occuring under effective diagnostic anaethesia during equine lameness examination

    OpenAIRE

    Plückhahn, Nina

    2011-01-01

    Fractures of the distal limb occuring during present effect of diagnostic nerve blocks respective intraarticular anesthesia represent rare but severe complications in equine lameness examinations. Due to very poor prognosis most cases in this study resulted in euthanisation of the horse. Several reasons can be claimed to cause fractures. As for the above mentioned fact that total loss of the animal is common due to severity of the fracture, the most important reason is represented by undet...

  18. Where does “whichever occurs first” hold for preventive maintenance modelings?

    International Nuclear Information System (INIS)

    Zhao, Xufeng; Liu, Hu-Chen; Nakagawa, Toshio

    2015-01-01

    The purpose of this paper is to observe where the classical assumption “whichever occurs first” holds for preventive maintenance (PM) modelings. We firstly take up a bivariate maintenance policy where “whichever occurs first” and the newly proposed “whichever occurs last” are respectively used. Modification of PM performance is introduced into modelings to avoid interruptions of job executions, that is, PMs are done only at the end of working cycles. From the points of performability and maintenance cost, we secondly compare the optimized “first” and “last” policies in detail and find two critical points of comparisons analytically. Further, by comparing the “first” and “last” policies with the standard maintenance, modified PM costs are obtained to observe whether it is easy to save PM cost for “whichever occurs first”. For a trivariate maintenance policy, we thirdly propose an entirely new assumption “whichever occurs middle” and give another one model that considers both assumptions of “first” and “last”. We analyze maintenance probabilities for each model and then obtain directly their expected maintenance cost rates for further studies. - Highlights: • A bivariate maintenance policy based on “whichever occurs first” is improved. • Two comparisons of “whichever occurs first and last” are made. • Modified maintenance costs are obtained to observe which policy could save more costs. • New assumption “whichever occurs middle” for the trivariate maintenances is proposed. • One policy is modeled by considering both assumptions of “first” and “last”

  19. Drought occurence

    Science.gov (United States)

    John W. Coulston

    2007-01-01

    Why Is Drought Important? Drought is an important forest disturbance that occurs regularly in the Western United States and irregularly in the Eastern United States (Dale and others 2001). Moderate drought stress tends to slow plant growth while severedrought stress can also reduce photosynthesis (Kareiva and others 1993). Drought can also interact with...

  20. Establishing the severity of personality disorder.

    Science.gov (United States)

    Tyrer, P; Johnson, T

    1996-12-01

    The authors developed a simplified method of rating the severity of personality disorder. The new rating method is based on four levels of severity: no personality disorder, personality difficulty, simple personality disorder, and diffuse personality disorder. The new method was applied to different diagnostic systems and was then compared with an old rating system based on six severity levels. Data were derived from a longitudinal study in which 163 patients with anxiety and depressive disorders had initial assessments of personality status and were followed up over 2 years. Ratings of psychiatric symptoms were made by using the Comprehensive Psychopathological Rating Scale over this period. The results were analyzed with special attention to linear and quadratic trends. The new system was clinically useful in separating patients' initial assessments and outcomes. Patients with no personality disorder had the lowest initial symptom scores and the best outcomes, and those with diffuse personality disorder had the highest initial levels of symptoms and improved least over the 2 years. When the patients were separated by the old classification system, 72% of the variation between groups was accounted for by linear and quadratic trends; the comparable percentage was 97% when the patients were categorized by the new system. The new system of rating severity of personality disturbance is an improvement on existing methods and allows ratings to be made easily from DSM-IV and ICD-10.

  1. Detection of Influenza C Viruses Among Outpatients and Patients Hospitalized for Severe Acute Respiratory Infection, Minnesota, 2013-2016.

    Science.gov (United States)

    Thielen, Beth K; Friedlander, Hannah; Bistodeau, Sarah; Shu, Bo; Lynch, Brian; Martin, Karen; Bye, Erica; Como-Sabetti, Kathryn; Boxrud, David; Strain, Anna K; Chaves, Sandra S; Steffens, Andrea; Fowlkes, Ashley L; Lindstrom, Stephen; Lynfield, Ruth

    2018-03-19

    Existing literature suggests that influenza C typically causes mild respiratory tract disease. However, clinical and epidemiological data are limited. Four outpatient clinics and 3 hospitals submitted clinical data and respiratory specimens through a surveillance network for acute respiratory infection (ARI) from May 2013 through December 2016. Specimens were tested using multitarget nucleic acid amplification for 19-22 respiratory pathogens, including influenza C. Influenza C virus was detected among 59 of 10 202 (0.58%) hospitalized severe ARI cases and 11 of 2282 (0.48%) outpatients. Most detections occurred from December to March, 73% during the 2014-2015 season. Influenza C detections occurred among patients of all ages, with rates being similar between inpatients and outpatients. The highest rate of detection occurred among children aged 6-24 months (1.2%). Among hospitalized cases, 7 required intensive care. Medical comorbidities were reported in 58% of hospitalized cases and all who required intensive care. At least 1 other respiratory pathogen was detected in 40 (66%) cases, most commonly rhinovirus/enterovirus (25%) and respiratory syncytial virus (20%). The hemagglutinin-esterase-fusion gene was sequenced in 37 specimens, and both C/Kanagawa and C/Sao Paulo lineages were detected in inpatients and outpatients. We found seasonal circulation of influenza C with year-to-year variability. Detection was most frequent among young children but occurred in all ages. Some cases that were positive for influenza C, particularly those with comorbid conditions, had severe disease, suggesting a need for further study of the role of influenza C virus in the pathogenesis of respiratory disease.

  2. Hydatidiform mole: age-related clinical presentation and high rate of severe complications in older women.

    Science.gov (United States)

    Mangili, Giorgia; Giorgione, Veronica; Gentile, Cinzia; Bergamini, Alice; Pella, Francesca; Almirante, Giada; Candiani, Massimo

    2014-05-01

    The purpose of this study was to demonstrate differences in clinical presentation of hydatidiform mole between women ≥40 years and younger women. Retrospective study. A tertiary referral unit in northern Italy. Three hundred and sixty-five women with hydatidiform mole were divided into group A (Clinical presentation between groups A and B was analyzed, also considering partial hydatidiform mole and complete hydatidiform mole. Differences in clinical presentation according to woman's age. In group B the diagnosis of hydatidiform mole at ≥12 gestational weeks was more frequent (p presented with vaginal bleeding (p clinical features of hydatidiform mole in women ≥40 years are different from those seen in younger women. Failures in the early detection of hydatidiform mole in older women may expose them to a higher rate of severe complications. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

  3. Kidney Damage in Hemorrhagic Vasculitis Occurring in Childhood and Adulthood

    Directory of Open Access Journals (Sweden)

    O.V. Syniachenko

    2016-10-01

    Full Text Available Introduction. Nephropathy is diagnosed in 30–60 % of patients with hemorrhagic vasculitis (HV (Schönlein Henoch puprupa and occurred in each fourth of them in the onset of the disease and with the same incidence at first recurrence of the patho­logical process. In recent years, the relative and absolute number of patients with this form of glomerular disease significantly increased. According to the results of the kidney biopsy in children, Henoch glomerulonephritis (HGN is the most common variant of the secondary immunoglobulin (Ig A nephritis. The nature of the clinical course and morphological manifestations of the HGN in patients with HV, which began in childhood and adulthood, remains unexplored. This was the purpose and objectives of this study. Materials and methods. The study included 174 patients with HV (83 % of men and 47 % of women. In 92 cases, vasculitis debuted in children (on average in 12 years, and in 82 — in the adults (on average in 25 years. I, II and III degree of activity of pathological process are set at a ratio of 1 : 2 : 2. Seropositivity for high levels of IgA occurred in 40 % of cases, by the presence of rheumatoid factor — in 27 %. At the time of the survey, cutaneous syndrome was diagnosed in 68 % of patients in the form of urticarial, hemorrhagic, papule-nodular, papule-necro­tic, pustular-ulcerative, necrotic-ulcerative, nodose-ulcerative and polymorphic forms, and articular syndrome — in 48 %. In 24 cases, kidney biopsy was performed. Results. Renal disease was revealed in 71 % of patients with HV, while on the background of nephropathy the integral index of the severity of extrarenal patho­logy was significantly higher. According to the characteristics of the articular syndrome, patients with nephropathy and without it differed little among themselves. The severity of muscle syndrome has the impact on the development of the HV. In turn, renal pathology significantly influenced the development

  4. Environmental effects on growth phenology of co-occurring Eucalyptus species.

    Science.gov (United States)

    Rawal, Deepa S; Kasel, Sabine; Keatley, Marie R; Aponte, Cristina; Nitschke, Craig R

    2014-05-01

    Growth is one of the most important phenological cycles in a plant's life. Higher growth rates increase the competitive ability, survival and recruitment and can provide a measure of a plant's adaptive capacity to climate variability and change. This study identified the growth relationship of six Eucalyptus species to variations in temperature, soil moisture availability, photoperiod length and air humidity over 12 months. The six species represent two naturally co-occurring groups of three species each representing warm-dry and the cool-moist sclerophyll forests, respectively. Warm-dry eucalypts were found to be more tolerant of higher temperatures and lower air humidity than the cool-moist eucalypts. Within groups, species-specific responses were detected with Eucalyptus microcarpa having the widest phenological niche of the warm-dry species, exhibiting greater resistance to high temperature and lower air humidity. Temperature dependent photoperiodic responses were exhibited by all the species except Eucalyptus tricarpa and Eucalyptus sieberi, which were able to maintain growth as photoperiod shortened but temperature requirements were fulfilled. Eucalyptus obliqua exhibited a flexible growth rate and tolerance to moisture limitation which enables it to maintain its growth rate as water availability changes. The wider temperature niche exhibited by E. sieberi compared with E. obliqua and Eucalyptus radiata may improve its competitive ability over these species where winters are warm and moisture does not limit growth. With climate change expected to result in warmer and drier conditions in south-east Australia, the findings of this study suggest all cool-moist species will likely suffer negative effects on growth while the warm-dry species may still maintain current growth rates. Our findings highlight that climate driven shifts in growth phenology will likely occur as climate changes and this may facilitate changes in tree communities by altering inter

  5. Effect of continuous hemofiltration on internal environment and survival rate of severe heatstroke dogs with shock

    Directory of Open Access Journals (Sweden)

    Guang-ming CHEN

    2011-08-01

    Full Text Available Objective To explore the effect of continuous hemofiltration(CHF on internal environment and survival rate of severe heatstroke dogs with shock.Methods Sixteen healthy male dogs were randomly divided into heatshock group(HS group,n=8 and continuous hemofiltration group(CHF group,n=8.Severe heatstroke model was established by applying high temperature to whole body,and then the animals were removed from the heating cabin as soon as they presented manifestations of shock.Dogs of HS group were put into an ordinary environment,while dogs of CHF group received CHF treatment.The core temperature(Tc,mean arterial pressure(MAP,blood gas analysis,serum electrolytes and survival rate of dogs in two groups were observed.Results The time from heat exposure to shock was 107.0±28.5min and 111.4±22.2min in HS group and CHF group respectively(t=-0.354,P=0.729.The Tc in CHF group declined to normal level 15 to 30 minitues after CHF treatment,while the Tc in HS group remained at a level higher than that before heat exposure at 90min after shock.The Tc of two groups showed significant difference at each time point after shock(P < 0.01.The MAP of both groups was obviously lowered than that before heatstroke.The MAP of CHF group raised gradually 30 min after treatment,while the MAP of HS group rose very slowly,and it was significantly lower than that of CHF group at each time point after 45min(P < 0.05,P < 0.01.All the dogs in both groups manifested hyperventilation and respiratory alkalosis when shock appeared.After shock,respiratory alkalosis in HS group gradually became metabolic acidosis,with some animals manifested combined metabolic and respiratory acidosis because of respiratory decompensation,while the blood gas levels in CHF group recovered to normal gradually.The blood gas levels of two groups showed significant difference at each time point after shock(P < 0.05,P < 0.01.Hypernatremia,hyperchloraemia and hyperpotassaemia were found in all animals of both

  6. Slip, trip and fall accidents occurring during the delivery of mail.

    Science.gov (United States)

    Bentley, T A; Haslam, R A

    1998-12-01

    This study sought to identify causal factors for slip, trip and fall accidents occurring during the delivery of mail. Analysis of in-house data produced information about accident circumstances for 1734 fall cases. The most common initiating events in delivery falls were slips and trips. Slips most often occurred on snow, ice or grass, while trips tended to involve uneven pavements, obstacles and kerbs. Nearly one-fifth of falls occurred on steps, with step falls requiring longer absence from work than falls on the level. Half of all falls occurred during November-February and three-quarters of falls occurred between 7 and 9 a.m. Incidence rates for female employees were 50% higher than for their male colleagues. Accident-independent methods included interviews with safety personnel and managers, discussion groups with delivery employees, and a questionnaire survey of employees and managers. These techniques provided data on risk factors related to the task, behaviour, footwear and equipment. Arising from these accident-independent investigations, it is suggested that unsafe working practices, such as reading addresses while walking and taking shortcuts, increase the risk of falls. Organizational issues include management safety activities, training and equipment provision. Measures are discussed that might lead to a reduction in the incidence of delivery fall accidents.

  7. Validity of the American Board of Orthodontics Discrepancy Index and the Peer Assessment Rating Index for comprehensive evaluation of malocclusion severity.

    Science.gov (United States)

    Liu, S; Oh, H; Chambers, D W; Baumrind, S; Xu, T

    2017-08-01

    To assess the validity of the American Board of Orthodontics Discrepancy Index (ABO-DI) and Peer Assessment Rating (PAR) Index in evaluating malocclusion severity in Chinese orthodontic patients. A stratified random sample of 120 orthodontic patients based on Angle classification was collected from six university orthodontic centres. Sixty-nine orthodontists rated malocclusion severity on a five-point scale by assessing a full set of pre-treatment records for each case and listed reasons for their decision. Their judgement was then compared with ABO-DI and PAR scores determined by three calibrated examiners. Excellent interexaminer reliability of clinician judgement, ABO-DI and PAR index was demonstrated by the Intraclass Correlation Coefficient (rho= 0.995, 0.990 and 0.964, respectively). Both the ABO-DI and US-PAR index showed good correlation with clinician judgement (r=.700 and r=.707, respectively). There was variability among the different Angle classifications: the ABO-DI showed the highest correlation with clinician judgement in Class II patients (r=.780), whereas the US-PAR index showed the highest correlation with clinician judgement in Class III patients (r=.710). Both indices demonstrated the lowest correlations with clinician judgement in Class I patients. With strong interexaminer agreement, the panel consensus was used for validating the ABO-DI and US-PAR index for malocclusion severity. Overall, the ABO-DI and US-PAR index were reliable for measuring malocclusion severity with significantly variable weightings for different Angle classifications. Further modification of the indices for different Angle classification may be indicated. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Comparison of Percentage of Syllables Stuttered With Parent-Reported Severity Ratings as a Primary Outcome Measure in Clinical Trials of Early Stuttering Treatment.

    Science.gov (United States)

    Onslow, Mark; Jones, Mark; O'Brian, Sue; Packman, Ann; Menzies, Ross; Lowe, Robyn; Arnott, Simone; Bridgman, Kate; de Sonneville, Caroline; Franken, Marie-Christine

    2018-04-17

    This report investigates whether parent-reported stuttering severity ratings (SRs) provide similar estimates of effect size as percentage of syllables stuttered (%SS) for randomized trials of early stuttering treatment with preschool children. Data sets from 3 randomized controlled trials of an early stuttering intervention were selected for analyses. Analyses included median changes and 95% confidence intervals per treatment group, Bland-Altman plots, analysis of covariance, and Spearman rho correlations. Both SRs and %SS showed large effect sizes from pretreatment to follow-up, although correlations between the 2 measures were moderate at best. Absolute agreement between the 2 measures improved as percentage reduction of stuttering frequency and severity increased, probably due to innate measurement limitations for participants with low baseline severity. Analysis of covariance for the 3 trials showed consistent results. There is no statistical reason to favor %SS over parent-reported stuttering SRs as primary outcomes for clinical trials of early stuttering treatment. However, there are logistical reasons to favor parent-reported stuttering SRs. We conclude that parent-reported rating of the child's typical stuttering severity for the week or month prior to each assessment is a justifiable alternative to %SS as a primary outcome measure in clinical trials of early stuttering treatment.

  9. Predictors of Co-occurring Neurodevelopmental Disabilities in Children With Autism Spectrum Disorders.

    Science.gov (United States)

    Zauche, Lauren Head; Darcy Mahoney, Ashley E; Higgins, Melinda K

    Co-occurring neurodevelopmental disabilities (including cognitive and language delays and attention deficit hyperactivity disorder) affect over half of children with ASD and may affect later behavioral, language, and cognitive outcomes beyond the ASD diagnosis. However, no studies have examined predictors of co-occurring neurodevelopmental disabilities in children with ASD. This study investigated whether maternal sociodemographic, perinatal and neonatal factors are associated with co-occurring disabilities. This study involved a retrospective analysis of medical records for children diagnosed with ASD between 2009 and 2010 at an Autism Center in the southeast United States. Logistic regression was used to identify predictors of co-occurring neurodevelopmental disabilities. Of the 385 children in the sample, 61% had a co-occurring neurodevelopmental disability. Children whose mothers had less education (OR: 0.905), had never been married (OR: 1.803), or had bleeding during pregnancy (OR: 2.233) were more likely to have a co-occurring neurodevelopmental disability. Both preterm birth and African American race were associated with bleeding during pregnancy. Several maternal and perinatal risk factors for ASD were found to put children at risk for further diagnoses of co-occurring neurodevelopmental disabilities. While prematurity, a well-established risk factor for ASD, as well as maternal ethnicity was not found to increase the risk of a co-occurring disability, this study suggests that bleeding during pregnancy may moderate these relationships. Understanding maternal, perinatal, and neonatal risk factors may inform healthcare provider screening for ASD and co-occurring neurodevelopmental disabilities by helping providers recognize infants who present with multiple risk factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Percutaneous dilatational tracheostomy for ICU patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Guo Dongyuan

    2014-12-01

    Full Text Available 【Abstract】Objective: To sum up our experience in percutaneous dilatational tracheostomy (PDT in ICU patient with severe brain injury. Methods: Between November 2011 and April 2014, PDTs were performed on 32 severe brain injury patients in ICU by a team of physicians and intensivists. The success rate, effi cacy, safety, and complications including stomal infection and bleeding, paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, as well as clinically significant tracheal stenosis were carefully monitored and recorded respectively. Results: The operations took 4-15 minutes (mean 9.1 minutes±4.2 minutes. Totally 4 cases suffered from complications in the operations: 3 cases of stomal bleeding, and 1 case of intratracheal bloody secretion, but none required intervention. Paratracheal insertion, pneumothorax, pneumomediastinum, tracheal laceration, or clinically signifi cant tracheal stenosis were not found in PDT patients. There was no procedure-related death occurring during or after PDT. Conclusion: Our study demonstrats that PDT is a safe, highly effective, and minimally invasive procedure. The appropriate sedation and airway management perioperatively help to reduce complication rates. PDT should be performed or supervised by a team of physicians with extensive experience in this procedure, and also an intensivist with experience in diffi cult airway management. Key words: Brain injuries; Percutaneous dilatational tracheostomy; ICU

  11. Accident rates and types among self-employed private forest owners.

    Science.gov (United States)

    Lindroos, Ola; Burström, Lage

    2010-11-01

    Half of all Swedish forests are owned by private individuals, and at least 215,000 people work in these privately owned forest holdings. However, only lethal accidents are systematically monitored among self-employed forest workers. Therefore, data from the registries of the Swedish Work Environment Authority, the Labor Insurance Organization and the regional University Hospital in Umeå were gathered to allow us to perform a more in-depth assessment of the rate and types of accidents that occurred among private forest owners. We found large differences between the registries in the type and number of accidents that were reported. We encountered difficulties in defining "self-employed forest worker" and also in determining whether the accidents that did occur happened during work or leisure time. Consequently, the estimates for the accident rate that we obtained varied from 32 to > or = 4300 injured persons per year in Sweden, depending on the registry that was consulted, the definition of the sample population that was used, and the accident severity definition that was employed. Nevertheless, the different registries gave a consistent picture of the types of accidents that occur while individuals are participating in self-employed forestry work. Severe accidents were relatively common, as self-employed forestry work fatalities constituted 7% of the total number of fatalities in the work authority registry. Falling trees were associated with many of these fatal accidents as well as with accidents that resulted in severe non-fatal injuries. Thus, unsafe work methods appeared more related to the occurrence of an accident than the equipment that was being used at the time of the accident (e.g., a chainsaw). Improvement of the workers' skills should therefore be considered to be an important prevention measure that should be undertaken in this field. The challenges in improving the safety in these smallest of companies, which fall somewhere between the purview of

  12. Numerical Exploration of Kaldorian Interregional Macrodynamics: Enhanced Stability and Predominance of Period Doubling under Flexible Exchange Rates

    Directory of Open Access Journals (Sweden)

    Toichiro Asada

    2010-01-01

    Full Text Available We present a discrete two-regional Kaldorian macrodynamic model with flexible exchange rates and explore numerically the stability of equilibrium and the possibility of generation of business cycles. We use a grid search method in two-dimensional parameter subspaces, and coefficient criteria for the flip and Hopf bifurcation curves, to determine the stability region and its boundary curves in several parameter ranges. The model is characterized by enhanced stability of equilibrium, while its predominant asymptotic behavior when equilibrium is unstable is period doubling. Cycles are scarce and short-lived in parameter space, occurring at large values of the degree of capital movement β. By contrast to the corresponding fixed exchange rates system, for cycles to occur sufficient amount of trade is required together with high levels of capital movement. Rapid changes in exchange rate expectations and decreased government expenditure are factors contributing to the creation of interregional cycles. Examples of bifurcation and Lyapunov exponent diagrams illustrating period doubling or cycles, and their development into chaotic attractors, are given. The paper illustrates the feasibility and effectiveness of the numerical approach for dynamical systems of moderately high dimensionality and several parameters.

  13. Training effects of wheelchair dance on aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy rated to GMFCS level V.

    Science.gov (United States)

    Terada, Kyoko; Satonaka, Ayako; Terada, Yasuto; Suzuki, Nobuharu

    2017-10-01

    There were few studies about training effects of wheelchair dance on aerobic fitness in the bedridden individuals with severe cerebral palsy for whom the traditional maximal or submaximal exercise tests were not applicable. As the oxygen pulse (O2P), the oxygen uptake divided by the heart rate, is regarded to be a relative measure of stroke volume and the O2P correlates to peak oxygen uptake, we would be able to assess the training effects of wheelchair dance on aerobic fitness in those individuals measuring O2P. To study training effects of wheelchair dance on aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy. Pre-post study design. A laboratory and a community care center. Bedridden individuals with athetospastic cerebral palsy rated to Gross Motor Function Classification System (GMFCS) level V (N.=6). The O2P was compared between during the rest, the waltz, and the jive at the baseline, the 3rd, the 6th, and the 12th month of the intervention of wheelchair dance 6 to 15 minutes at a time, 2 days a week or more. Paired Student's t-test showed that O2P during the waltz and the jive was significantly increased compared with that during the rest at the 6th and the 12th month, and O2P during the jive was also significantly increased compared with that during the rest at the 3rd, the 6th, and the 12th month of the intervention period. This is the first study that shows wheelchair dance may possibly increase aerobic fitness in bedridden individuals with severe athetospastic cerebral palsy rated GMFCS level V. Future studies with a larger sample will be warranted to prove the claim.

  14. Co-occurring eating and psychiatric symptoms in Taiwanese college students: effects of gender and parental factors.

    Science.gov (United States)

    Tseng, Mei-Chih Meg; Gau, Susan Shur-Fen; Tseng, Wan-Ling; Hwu, Hai-Gwo; Lee, Ming-Been

    2014-03-01

    To test whether gender and parental factors moderate the relationships between symptoms of eating disorder (ED) and other psychiatric symptoms. A total of 5,015 new entrants completed several questionnaires and 541 individuals with ED symptoms were identified by the Adult Self-Report Inventory-4 that assessed a wide range of Diagnostic and Statistical Manual of Mental Disorders Fourth Edition psychopathology. The participants also reported on their parents' attitude toward them before their ages of 16. ED symptoms, female gender, less parental care, and more parental protection were associated with more severe co-occurring psychiatric symptoms. Gender and parental factors also demonstrated differential moderating effects on the relationships between ED and co-occurring psychiatric symptoms. Parenting counseling may be individualized to young adults with ED symptoms and different co-occurring psychiatric symptoms. © 2013 Wiley Periodicals, Inc.

  15. Severe forms of food allergy

    Directory of Open Access Journals (Sweden)

    Emanuel Sarinho

    2017-11-01

    Conclusion: Severe food allergy may occur in the form of anaphylaxis and food‐protein‐induced enterocolitis syndrome, which are increasingly observed in the pediatric emergency room; hence, pediatricians must be alert so they can provide the immediate diagnosis and treatment.

  16. Metabolic and Hormonal Determinants of Glomerular Filtration Rate and Renal Hemodynamics in Severely Obese Individuals

    Directory of Open Access Journals (Sweden)

    Edoardo Vitolo

    2016-10-01

    Full Text Available Objective: Renal function is often compromised in severe obesity. A true measurement of glomerular filtration rate (GFR is unusual, and how estimation formulae (EstForm perform in such individuals is unclear. We characterized renal function and hemodynamics in severely obese individuals, assessing the reliability of EstForm. Methods: We measured GFR (mGFR by iohexol plasma clearance, renal plasma flow (RPF by 123I-ortho-iodo-hippurate, basal and stimulated vascular renal indices, endothelium-dependent and -independent vasodilation using flow-mediated dilation (FMD as well as metabolic and hormonal profile in morbid, otherwise healthy, obese subjects. Results: Compared with mGFR, the better performing EstForm was CKD-EPI (5.3 ml/min/1.73 m2 bias by Bland-Altman analysis. mGFR was directly related with RPF, total and incremental glucose AUC, and inversely with PTH and h8 cortisol. Patients with mGFR below the median shown significantly higher PTH and lower vitamin D3. Basal or dynamic renal resistive index, FMD, pulse wave velocity were not related with mGFR. In an adjusted regression model, renal diameter and plasma flow remained related with mGFR (R2 = 0.67, accounting for 15% and 21% of mGFR variance, respectively. Conclusions: CKD-EPI formula should be preferred in morbid obesity; glucose increments during oral glucose tolerance test correlate with hyperfiltration; RPF and diameter are independent determinants of mGFR; slightly high PTH values, frequent in obesity, might influence mGFR.

  17. Predictors of ventricular tachyarrhythmia occurring late after intracardiac repair of tetralogy of Fallot: combination of QRS duration change rate and tricuspid regurgitation pressure gradient

    Science.gov (United States)

    Takahashi, Masashi; Sugimoto, Ai; Tsuchida, Masanori

    2017-01-01

    Background To determine potential predictors of ventricular tachyarrhythmia and sudden cardiac death (SCD) occurring late after repair of tetralogy of Fallot (TOF). Methods Since 1964, 415 patients had undergone total repair for TOF at Niigata University Hospital. Of these, 89 patients who were followed for more than 10 years at our institute were retrospectively reviewed. Results The mean follow-up period was 24.3 years. During the study period, one patient died of cerebral bleeding, and two patients had SCD. The overall survival rates at 20, 30, and 40 years were 100%, 94.6%, and 94.6%, respectively. Eight (9.0%) patients required re-intervention during the late period associated with right ventricular outflow (n=4), tricuspid valve (n=3), aortic valve (n=2), and others (n=2). Ten (11.2%) patients had a history of ventricular tachycardia (VT) or ventricular fibrillation (VF), and six underwent implantation of an implantable cardiac defibrillator. Multivariate analysis selected the change rate of QRS duration [ms/year; odds ratio (OR), 2.44; 95% confidence interval (CI): 1.28–4.65; P=0.007] and the pressure gradient at tricuspid valve regurgitation on echocardiography (OR, 1.12; 95% CI: 1.02–1.22; P=0.017) as risk factors for VT/VF or SCD. Trans-annular patch (TAP) repair was not an independent risk factor for ventricular arrhythmia. Conclusions The combination of rapid change rate of QRS duration and higher-pressure gradient at tricuspid regurgitation were risk factors for ventricular tachyarrhythmia late after TOF repair. Adequate surgical or catheter intervention for pressure and volume load in the right ventricle might decrease the prevalence of VT/VF and SCD. PMID:29312717

  18. Severe childhood malnutrition.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  19. Punctal Plug Retention Rates for the Treatment of Moderate to Severe Dry Eye: A Randomized, Double-Masked, Controlled Clinical Trial.

    Science.gov (United States)

    Brissette, Ashley R; Mednick, Zale D; Schweitzer, Kelly D; Bona, Mark D; Baxter, Stephanie A

    2015-08-01

    To compare retention rates of Super Flex (Eagle Vision, Memphis, Tennessee, USA; Softplug-Oasis Medical Inc, Glendora, California, USA) vs Parasol (Odyssey Medical, Memphis, Tennessee, USA; Beaver Visitec International, Waltham, Massachusetts, USA) punctal plugs. Randomized, double-masked, interventional controlled clinical trial. Institutional study at Hotel Dieu Hospital (Queen's University) of 50 eyes, from patients with moderate to severe dry eye. Each eye from eligible patients was separately randomized to receive Super Flex or Parasol punctal plugs. The main outcome measure was plug retention at 6 months. Secondary outcome measures included objective tests of Schirmer I (mm), tear meniscus height (mm), tear break-up time (s), inferior fluorescein corneal staining (National Eye Institute [NEI] scale), and average lissamine green conjunctival staining (NEI scale). Punctal plug retention was significantly different at 6 months (P = .011). Sixty-eight percent of Parasol plugs were retained compared to 32% of Super Flex plugs. Parasol plugs required less frequent artificial tear use at 6 months (P = .024). There was a statistically significant improvement in all secondary outcome measures (Schirmer, tear meniscus height, tear break-up time, fluorescein corneal staining) at 6 months within plug groups except conjunctival staining. There were no additional significant differences between groups and no plug complications reported. Punctal plugs improve symptoms of moderate to severe dry eye; however, retention rates differ significantly. These data will allow us to guide patient decision making for the safe and effective treatment of punctal plugs for moderate to severe dry eye. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. A study on radiographic repeat rate data of several hospitals in Jeddah

    International Nuclear Information System (INIS)

    Al-Malki, M.A.; Abulfaraj, W.H.; Bhuiyan, S.I.; Kinsara, A.A.

    2003-01-01

    Radiographic repeat rate data in diagnostic radiology in King Fahad Hospital (KFH), King Abdulaziz Hospital (KAH), and Maternity and Children Hospital (MCH) in Jeddah, Saudi Arabia, have been studied. The study provided valuable information to suggest preventive measures to reduce repeats. The variables included in the study are exposure techniques, examination types, total number of films used, number of films repeated, the film sizes, gender, the age groups of the patients, and reason for repetition. The total number of examinations in all three hospitals is 6001 using 8887 films on 5412 patients. The average repeat rate was 7.93%, where the individual hospital repeat rates were 9.57% in the MCH, 7.84% in KAH and 7.44% in KFH. The repeat rate for children and infants was found to be undesirable. The quality assurance (QA) programme can effectively reduce the unnecessary exposure and can identify the cause of the exposure. The overexposure, underexposure and position fault were the foremost contributors for repeats and constitute 32.91%, 28.94% and 22.98% of the total respectively. The QA study identified that human error and equipment malfunction are the major contributors to these causes of repeats. The highest repetition rate was for pelvis, 13.64%, followed by skull, 11.59%, and abdomen, 10.41%. It is estimated that the total area of wasted film in all three hospitals is 74.3 m 2 . As per the average repeat rate, the cost of repeat films in the entire kingdom per year has been projected to be about US$1.82 million (SR 6.83 million) in the government hospitals only. Based on the findings of this study a set of recommendations have been prescribed for the radiology department to reduce the repeat rate and to improve the safety culture. (author)

  1. A study on radiographic repeat rate data of several hospitals in Jeddah

    Energy Technology Data Exchange (ETDEWEB)

    Al-Malki, M.A.; Abulfaraj, W.H.; Bhuiyan, S.I.; Kinsara, A.A

    2003-07-01

    Radiographic repeat rate data in diagnostic radiology in King Fahad Hospital (KFH), King Abdulaziz Hospital (KAH), and Maternity and Children Hospital (MCH) in Jeddah, Saudi Arabia, have been studied. The study provided valuable information to suggest preventive measures to reduce repeats. The variables included in the study are exposure techniques, examination types, total number of films used, number of films repeated, the film sizes, gender, the age groups of the patients, and reason for repetition. The total number of examinations in all three hospitals is 6001 using 8887 films on 5412 patients. The average repeat rate was 7.93%, where the individual hospital repeat rates were 9.57% in the MCH, 7.84% in KAH and 7.44% in KFH. The repeat rate for children and infants was found to be undesirable. The quality assurance (QA) programme can effectively reduce the unnecessary exposure and can identify the cause of the exposure. The overexposure, underexposure and position fault were the foremost contributors for repeats and constitute 32.91%, 28.94% and 22.98% of the total respectively. The QA study identified that human error and equipment malfunction are the major contributors to these causes of repeats. The highest repetition rate was for pelvis, 13.64%, followed by skull, 11.59%, and abdomen, 10.41%. It is estimated that the total area of wasted film in all three hospitals is 74.3 m{sup 2}. As per the average repeat rate, the cost of repeat films in the entire kingdom per year has been projected to be about US$1.82 million (SR 6.83 million) in the government hospitals only. Based on the findings of this study a set of recommendations have been prescribed for the radiology department to reduce the repeat rate and to improve the safety culture. (author)

  2. Neighborhood Influences on Vehicle-Pedestrian Crash Severity.

    Science.gov (United States)

    Toran Pour, Alireza; Moridpour, Sara; Tay, Richard; Rajabifard, Abbas

    2017-12-01

    Socioeconomic factors are known to be contributing factors for vehicle-pedestrian crashes. Although several studies have examined the socioeconomic factors related to the location of the crashes, limited studies have considered the socioeconomic factors of the neighborhood where the road users live in vehicle-pedestrian crash modelling. This research aims to identify the socioeconomic factors related to both the neighborhoods where the road users live and where crashes occur that have an influence on vehicle-pedestrian crash severity. Data on vehicle-pedestrian crashes that occurred at mid-blocks in Melbourne, Australia, was analyzed. Neighborhood factors associated with road users' residents and location of crash were investigated using boosted regression tree (BRT). Furthermore, partial dependence plots were applied to illustrate the interactions between these factors. We found that socioeconomic factors accounted for 60% of the 20 top contributing factors to vehicle-pedestrian crashes. This research reveals that socioeconomic factors of the neighborhoods where the road users live and where the crashes occur are important in determining the severity of the crashes, with the former having a greater influence. Hence, road safety countermeasures, especially those focussing on the road users, should be targeted at these high-risk neighborhoods.

  3. Bioimpedance in Severely Malnourished Children

    DEFF Research Database (Denmark)

    Girma Nigatu, Tsinuel

    Worldwide severe acute malnutrition (SAM) affects millions of children and considerably contributes to under-five mortality, mainly in low-income settings. Among children with SAM, deaths occur largely in those with oedema and during early phase of treatment often aggravated by infection. Treatment...

  4. Clinical needs of in-treatment pregnant women with co-occurring disorders: implications for primary care.

    Science.gov (United States)

    Lee King, Patricia A; Duan, Lei; Amaro, Hortensia

    2015-01-01

    We investigated social vulnerability and behavioral health clinical profiles (symptom severity) of pregnant women with co-occurring disorders, defined as substance abuse, mental illness, and trauma at treatment entry compared to their nonpregnant counterparts and the role of interpersonal abuse in clinical presentation among pregnant women. Our objective was to provide primary health care providers with insight into the needs of pregnant patients with high behavioral health risks to serve them better during the critical window of opportunity for long-term impact. We conducted cross-sectional secondary analysis of baseline data from women enrolled in treatment programs in the Women, Co-occurring Disorders and Violence Study from nine sites across the United States. We used analysis of variance and Cochran-Mantel-Haenszel statistical analyses to compare means and frequencies of social vulnerability indicators and baseline Addiction Severity Index, Brief Symptom Inventory of mental health, and Posttraumatic Stress Diagnostic Scale scores between 152 pregnant and 2,577 nonpregnant women, and between pregnant women with and without current interpersonal abuse. Compared to nonpregnant women, pregnant women evidenced more social vulnerability but better behavioral health clinical profiles at treatment entry. Current interpersonal abuse was associated with increased mental health and trauma symptomatology but not with alcohol or drug abuse severity among pregnant women. The prenatal period is an important time for screening and intervention for factors such as social vulnerability and co-occurring disorders, known to affect pregnancy and infant outcomes; social and behavioral health services are particularly essential among pregnant women with co-occurring disorders.

  5. Helicopter type and accident severity in Helicopter Emergency Medical Services missions.

    Science.gov (United States)

    Hinkelbein, Jochen; Schwalbe, Mandy; Wetsch, Wolfgang A; Spelten, Oliver; Neuhaus, Christopher

    2011-12-01

    Whereas accident rates and fatal accident rates for Helicopter Emergency Medical Services (HEMS) were investigated sufficiently, resulting consequences for the occupants remain largely unknown. The present study aimed to classify HEMS accidents in Germany to prognosticate accident severity with regard to the helicopter model used. German HEMS accidents (1 Sept. 1970-31 Dec. 2009) were gathered as previously reported. Accidents were categorized in relation to the most severe injury, i.e., (1) no; (2) slight; (3) severe; and (4) fatal injuries. Only helicopter models with at least five accidents were analyzed to retrieve representative data. Prognostication was estimated by the relative percentage of each injury type compared to the total number of accidents. The model BO105 was most often involved in accidents (38 of 99), followed by BK117 and UH-1D. OfN = 99 accidents analyzed, N = 63 were without any injuries (63.6%), N = 8 resulted in minor injuries of the occupants (8.1%), and N = 9 in major injuries (9.1%). Additionally, N = 19 fatal accidents (19.2%) were registered. EC135 and BK1 17 had the highest incidence of uninjured occupants (100% vs. 88.2%) and the lowest percentage of fatal injuries (0% vs. 5.9%; all P > 0.05). Most fatal accidents occurred with the models UH-1D, Bell 212, and Bell 412. Use of the helicopter models EC135 and BK117 resulted in a high percentage of uninjured occupants. In contrast, the fatality rate was highest for the models Bell UH-I D, Bell 222, and Bell 412. Data from the present study allow for estimating accident risk in HEMS missions and prognosticating resulting fatalities, respectively.

  6. A severity rating system for evaluating stand-level balsam woolly adelgid (Hemiptera: Adelgidae) damage in two Abies species in western North America

    Science.gov (United States)

    Kathryn H. Hrinkevich; Robert A. Progar; David C. Shaw

    2016-01-01

    Severity rating systems are fundamental to understanding the impacts of disturbance agents in forest stands. The balsam woolly adelgid (BWA), Adelges piceae (Ratzeburg) (Hemiptera: Adelgidae), is an invasive forest pest in North America that infests and causes mortality in true fir, Abies spp. There is currently no single...

  7. Transcatheter embolization of pseudoaneurysms complicating acute severe pancreatitis

    International Nuclear Information System (INIS)

    Wu Hanping; Liang Huimin; Zheng Chuansheng; Feng Gansheng

    2005-01-01

    Objective: To evaluate the therapeutic roles of transcatheter embolization in patients with pseudoaneurysms complicating acute severe pancreatitis. Methods: Seven patients who suffered from pseudoaneurysms complicating acute severe pancreatitis received abdominal angiography and were treated with transcatheter embolization. The angiographic findings, complications related to the procedure and post- embolization, and rebleeding were observed. Results: The pseudoaneurysms developed at the splenic artery (n=5), right gastroepiploic artery (n=1), and left gastric artery (n=1), respectively. Findings of active bleeding were observed in 3 patients. Six of them were embolized with coils, and the bleedings were stopped immediately. Rebleeding occurred 14-60 days after the embolization in 3 patients, and in one of them, another pseudo aneurysm was observed in repeated angiography and was successfully treated by repeated embolization. No causes of bleeding were found in repeated angiography in the other 2 patients, who died from severe hemorrhage. One pseudo aneurysm was embolized with gelfoam granule. The gastrointestinal bleeding was not controlled and the patient died 3 days later. Procedure related complications occurred in 2 patients. One was celiac trunk rupture during angiography, the other was intima dissecting in splenic artery. Severe post procedure complications occurred in none of the patients. Conclusion: Transcatheter embolization is safe and relatively effective in the management of pseudoaneurysms complicating acute severe pancreatitis. (authors)

  8. System care improves trauma outcome: patient care errors dominate reduced preventable death rate.

    Science.gov (United States)

    Thoburn, E; Norris, P; Flores, R; Goode, S; Rodriguez, E; Adams, V; Campbell, S; Albrink, M; Rosemurgy, A

    1993-01-01

    A review of 452 trauma deaths in Hillsborough County, Florida, in 1984 documented that 23% of non-CNS trauma deaths were preventable and occurred because of inadequate resuscitation or delay in proper surgical care. In late 1988 Hillsborough County organized a County Trauma Agency (HCTA) to coordinate trauma care among prehospital providers and state-designated trauma centers. The purpose of this study was to review county trauma deaths after the inception of the HCTA to determine the frequency of preventable deaths. 504 trauma deaths occurring between October 1989 and April 1991 were reviewed. Through committee review, 10 deaths were deemed preventable; 2 occurred outside the trauma system. Of the 10 deaths, 5 preventable deaths occurred late in severely injured patients. The preventable death rate has decreased to 7.0% with system care. The causes of preventable deaths have changed from delayed or inadequate intervention to postoperative care errors.

  9. Case of severe intestinal complications caused by high dose-rate intracavitary irradiation for cervical cancer

    Energy Technology Data Exchange (ETDEWEB)

    Koga, Kenji; Nishikawa, Kiyoshi; Matsuki, Kazuhiko; Watanabe, Katsushi

    1987-02-01

    A 46-year-old woman with severe intestinal complication caused by high dose-rate intracavitary irradiation is reported. She received radiation treatment of stage IIb cervical cancer between July 24 and September 26, 1984: a dose of 2400 rad to a point A concurrently with 2000 rad to the parametrium following 4000 rad to the whole pelvis. Eight months later she developed diarrhea and bloody stool. Barium enema study revealed a stenosis at 20 to 25 cm from the anal ring and romanoscopy oozing coagula at the same site. On November 29, 1985 transverse colostomy was performed because of continuing bloody stool and abdominal pain. On January 30, 1986 resection of the ileum and ileostomy were done because of the ileum perforation located 26 cm apart from the ileum end. Some discussion on the causes of this complication are made, suggesting that short length of a tandem and deep location of ovoids influence its cause.

  10. Naturally occurring minichromosome platforms in chromosome engineering: an overview.

    Science.gov (United States)

    Raimondi, Elena

    2011-01-01

    Artificially modified chromosome vectors are non-integrating gene delivery platforms that can shuttle very large DNA fragments in various recipient cells: theoretically, no size limit exists for the chromosome segments that an engineered minichromosome can accommodate. Therefore, genetically manipulated chromosomes might be potentially ideal vector systems, especially when the complexity of higher eukaryotic genes is concerned. This review focuses on those chromosome vectors generated using spontaneously occurring small markers as starting material. The definition and manipulation of the centromere domain is one of the main obstacles in chromosome engineering: naturally occurring minichromosomes, due to their inherent small size, were helpful in defining some aspects of centromere function. In addition, several distinctive features of small marker chromosomes, like their appearance as supernumerary elements in otherwise normal karyotypes, have been successfully exploited to use them as gene delivery vectors. The key technologies employed for minichromosome engineering are: size reduction, gene targeting, and vector delivery in various recipient cells. In spite of the significant advances that have been recently achieved in all these fields, several unsolved problems limit the potential of artificially modified chromosomes. Still, these vector systems have been exploited in a number of applications where the investigation of the controlled expression of large DNA segments is needed. A typical example is the analysis of genes whose expression strictly depends on the chromosomal environment in which they are positioned, where engineered chromosomes can be envisaged as epigenetically regulated expression systems. A novel and exciting advance concerns the use of engineered minichromosomes to study the organization and dynamics of local chromatin structures.

  11. Nonlinear response of hail precipitation rate to environmental moisture content: A real case modeling study of an episodic midlatitude severe convective event

    Science.gov (United States)

    Li, Mingxin; Zhang, Fuqing; Zhang, Qinghong; Harrington, Jerry Y.; Kumjian, Matthew R.

    2017-07-01

    The dependence of hail production on initial moisture content in a simulated midlatitude episodic convective event occurred in northeast China on 10-11 June 2005 was investigated using the Weather Research and Forecasting (WRF) model with a double-moment microphysics scheme where both graupel and hail are considered. Three sensitivity experiments were performed by modifying the initial water vapor mixing ratio profile to 90% ("Q-10%"), 105% ("Q+5%"), and 110% ("Q+10%") of the initial conditions used for the control simulation. It was found that increasing the initial water vapor content caused the hail and total precipitation rates to increase during the first 5 h. The precipitation response to increasing water vapor content was monotonic for this first episode; however, for the event's second episode, the hail precipitation rate responds to the initial water vapor profile nonlinearly, while the total precipitation rate responds mostly monotonically. In particular, simulation Q+5% achieves the largest hail production rate while simulation Q+10% has the largest total precipitation rate. In contrast, during the second episode simulation Q-10% has the strongest vertical motion, produces the most cloud ice and snow, but has the lowest hail production. Analysis shows that increasing the initial moisture content directly increases the precipitation during the first episode, which subsequently induces a stronger, longer-lasting cold pool that limits the development of deep convection during the second episode.

  12. Assessment on Startup Ramp Rate and Threshold Power of OPR1000

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kiyoung; Kim, Yongbae; Cha, Gyunho; Kim, Yongdeog [Korea Hydro and Nuclear Power Co., Ltd., Daejeon (Korea, Republic of)

    2014-05-15

    This paper summarizes PCI assessment according to several startup ramp rates and threshold power assessment of OPR1000. The definition of threshold power is maximum value in power range that can increase startup ramp rate rapidly. FALCON code is used for PCI assessment and it is analyzed for once-burned fuel because it is the most sensitive to PCI failure. The objective of the PCI analysis is to assess the cladding stress state under various power ramp conditions at the peak power node location. The PCI analyses were conducted for the once-burned fuel from the start of the second cycle to plant power 100%. This paper presents both the PCI analysis according to startup ramp rates and threshold power assessment result like below. · The more startup ramp rate is increased, the more PCI failure probability is decreased in low power range (≤ 40%). · PCI failure is not occurred even though startup ramp rate is 10%/hr until the plant power reaches 55%.

  13. Assessment on Startup Ramp Rate and Threshold Power of OPR1000

    International Nuclear Information System (INIS)

    Kim, Kiyoung; Kim, Yongbae; Cha, Gyunho; Kim, Yongdeog

    2014-01-01

    This paper summarizes PCI assessment according to several startup ramp rates and threshold power assessment of OPR1000. The definition of threshold power is maximum value in power range that can increase startup ramp rate rapidly. FALCON code is used for PCI assessment and it is analyzed for once-burned fuel because it is the most sensitive to PCI failure. The objective of the PCI analysis is to assess the cladding stress state under various power ramp conditions at the peak power node location. The PCI analyses were conducted for the once-burned fuel from the start of the second cycle to plant power 100%. This paper presents both the PCI analysis according to startup ramp rates and threshold power assessment result like below. · The more startup ramp rate is increased, the more PCI failure probability is decreased in low power range (≤ 40%). · PCI failure is not occurred even though startup ramp rate is 10%/hr until the plant power reaches 55%

  14. TRUMP-BD: A computer code for the analysis of nuclear fuel assemblies under severe accident conditions

    International Nuclear Information System (INIS)

    Lombardo, N.J.; Marseille, T.J.; White, M.D.; Lowery, P.S.

    1990-06-01

    TRUMP-BD (Boil Down) is an extension of the TRUMP (Edwards 1972) computer program for the analysis of nuclear fuel assemblies under severe accident conditions. This extension allows prediction of the heat transfer rates, metal-water oxidation rates, fission product release rates, steam generation and consumption rates, and temperature distributions for nuclear fuel assemblies under core uncovery conditions. The heat transfer processes include conduction in solid structures, convection across fluid-solid boundaries, and radiation between interacting surfaces. Metal-water reaction kinetics are modeled with empirical relationships to predict the oxidation rates of steam-exposed Zircaloy and uranium metal. The metal-water oxidation models are parabolic in form with an Arrhenius temperature dependence. Uranium oxidation begins when fuel cladding failure occurs; Zircaloy oxidation occurs continuously at temperatures above 13000 degree F when metal and steam are available. From the metal-water reactions, the hydrogen generation rate, total hydrogen release, and temporal and spatial distribution of oxide formations are computed. Consumption of steam from the oxidation reactions and the effect of hydrogen on the coolant properties is modeled for independent coolant flow channels. Fission product release from exposed uranium metal Zircaloy-clad fuel is modeled using empirical time and temperature relationships that consider the release to be subject to oxidation and volitization/diffusion (''bake-out'') release mechanisms. Release of the volatile species of iodine (I), tellurium (Te), cesium (Ce), ruthenium (Ru), strontium (Sr), zirconium (Zr), cerium (Cr), and barium (Ba) from uranium metal fuel may be modeled

  15. TRUMP-BD: A computer code for the analysis of nuclear fuel assemblies under severe accident conditions

    Energy Technology Data Exchange (ETDEWEB)

    Lombardo, N.J.; Marseille, T.J.; White, M.D.; Lowery, P.S.

    1990-06-01

    TRUMP-BD (Boil Down) is an extension of the TRUMP (Edwards 1972) computer program for the analysis of nuclear fuel assemblies under severe accident conditions. This extension allows prediction of the heat transfer rates, metal-water oxidation rates, fission product release rates, steam generation and consumption rates, and temperature distributions for nuclear fuel assemblies under core uncovery conditions. The heat transfer processes include conduction in solid structures, convection across fluid-solid boundaries, and radiation between interacting surfaces. Metal-water reaction kinetics are modeled with empirical relationships to predict the oxidation rates of steam-exposed Zircaloy and uranium metal. The metal-water oxidation models are parabolic in form with an Arrhenius temperature dependence. Uranium oxidation begins when fuel cladding failure occurs; Zircaloy oxidation occurs continuously at temperatures above 13000{degree}F when metal and steam are available. From the metal-water reactions, the hydrogen generation rate, total hydrogen release, and temporal and spatial distribution of oxide formations are computed. Consumption of steam from the oxidation reactions and the effect of hydrogen on the coolant properties is modeled for independent coolant flow channels. Fission product release from exposed uranium metal Zircaloy-clad fuel is modeled using empirical time and temperature relationships that consider the release to be subject to oxidation and volitization/diffusion ( bake-out'') release mechanisms. Release of the volatile species of iodine (I), tellurium (Te), cesium (Ce), ruthenium (Ru), strontium (Sr), zirconium (Zr), cerium (Cr), and barium (Ba) from uranium metal fuel may be modeled.

  16. Naturally occurring BRCA2 alternative mRNA splicing events in clinically relevant samples

    DEFF Research Database (Denmark)

    Fackenthal, James D; Yoshimatsu, Toshio; Zhang, Bifeng

    2016-01-01

    patterns and thereby disrupt gene function. mRNA analyses are therefore among the tests used to interpret the clinical significance of some genetic variants. However, these could be confounded by the appearance of naturally occurring alternative transcripts unrelated to germline sequence variation...... to characterise the spectrum of naturally occurring BRCA2 mRNA alternate-splicing events. METHODS: mRNA was prepared from several blood and breast tissue-derived cells and cell lines by contributing ENIGMA laboratories. cDNA representing BRCA2 alternate splice sites was amplified and visualised using capillary...... or agarose gel electrophoresis, followed by sequencing. RESULTS: We demonstrate the existence of 24 different BRCA2 mRNA alternate-splicing events in lymphoblastoid cell lines and both breast cancer and non-cancerous breast cell lines. CONCLUSIONS: These naturally occurring alternate-splicing events...

  17. Gray Wolf (Canis lupus) dyad monthly association rates by demographic group.

    Science.gov (United States)

    Barber-Meyer, Shannon M.; Mech, L. David

    2015-01-01

    Preliminary data from GPS-collared wolves (Canis lupus) in the Superior National Forest of northeastern Minnesota indicated wolves had low association rates with packmates during summer. However, aerial-telemetry locations of very high frequency (VHF)-radioed wolves in this same area showed high associations among packmates during winter. We analyzed aerial-telemetry-location data from VHF-collared wolves in several packs (n=18 dyads) in this same area from 1994-2012 by month, and found lowest association rates occurred during June. While other studies have found low association among wolf packmates during summer, information on differences in association patterns depending on the wolf associates’ demographics is sparse. During May-July, association rates were greatest for breeding pairs, followed by sibling dyads, and lowest for parent– offspring dyads. Our findings improve our understanding of how individual wolf relationships affect monthly association rates. We highlight some important remaining questions regarding wolf packmate associations.

  18. Distributions of Autocorrelated First-Order Kinetic Outcomes: Illness Severity.

    Directory of Open Access Journals (Sweden)

    James D Englehardt

    Full Text Available Many complex systems produce outcomes having recurring, power law-like distributions over wide ranges. However, the form necessarily breaks down at extremes, whereas the Weibull distribution has been demonstrated over the full observed range. Here the Weibull distribution is derived as the asymptotic distribution of generalized first-order kinetic processes, with convergence driven by autocorrelation, and entropy maximization subject to finite positive mean, of the incremental compounding rates. Process increments represent multiplicative causes. In particular, illness severities are modeled as such, occurring in proportion to products of, e.g., chronic toxicant fractions passed by organs along a pathway, or rates of interacting oncogenic mutations. The Weibull form is also argued theoretically and by simulation to be robust to the onset of saturation kinetics. The Weibull exponential parameter is shown to indicate the number and widths of the first-order compounding increments, the extent of rate autocorrelation, and the degree to which process increments are distributed exponential. In contrast with the Gaussian result in linear independent systems, the form is driven not by independence and multiplicity of process increments, but by increment autocorrelation and entropy. In some physical systems the form may be attracting, due to multiplicative evolution of outcome magnitudes towards extreme values potentially much larger and smaller than control mechanisms can contain. The Weibull distribution is demonstrated in preference to the lognormal and Pareto I for illness severities versus (a toxicokinetic models, (b biologically-based network models, (c scholastic and psychological test score data for children with prenatal mercury exposure, and (d time-to-tumor data of the ED01 study.

  19. Exercise and severe major depression: effect on symptom severity and quality of life at discharge in an inpatient cohort.

    Science.gov (United States)

    Schuch, F B; Vasconcelos-Moreno, M P; Borowsky, C; Zimmermann, A B; Rocha, N S; Fleck, M P

    2015-02-01

    Exercise is a potential treatment for depression. However, few studies have evaluated the role of adjunct exercise in the treatment of severely major depressed inpatients. The goal of this study was to evaluate the effects of add-on exercise on the usual treatment of severely depressed inpatients. Fifty participants were randomized to an exercise (exercise + usual treatment) or a control (usual treatment) group. Twenty-five patients were randomly allocated to each group. The participants in the exercise group performed three sessions per week throughout the hospitalization period, with a goal dose of 16.5 kcal/kg/week plus the usual pharmacological treatment. Depressive symptoms and the Quality of Life (QoL) of the participants were assessed at the baseline, the second week, and discharge. A significant group × time interaction was found for depressive symptoms and the physical and psychological domains of QoL. Differences between groups occurred at the second week and discharge with respect to depressive symptoms and the physical and psychological domains of QoL. There was no difference in the remission rate at discharge (48% and 32% for the exercise and control group, respectively). An NNT of 6.25 was found. No significant baseline characteristics predict remission at discharge. Add-on exercise is an efficacious treatment for severely depressed inpatients, improving their depressive symptoms and QoL. Initial acceptance of exercise remains a challenge. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Assessment of radiological significance of naturally occurring radionuclides in soil and rock matrices around Kakrapar environment

    International Nuclear Information System (INIS)

    Patra, A.K.; Jaison, T.J.; Baburajan, A.; Hegde, A.G.

    2008-01-01

    The activity and gamma-absorbed dose rate due to the naturally occurring radionuclides in the terrestrial environment such as 238 U, 232 Th and 40 K were determined in soil and rock samples collected around Kakrapar Atomic Power Plant site, using gamma-ray spectrometry. The mean concentration levels measured in Kakrapar soil from naturally occurring radioisotopes such as 238 U, 232 Th and 40 K are lower than the corresponding global average values obtained in worldwide soil. The external hazard index (Hex) and absorbed gamma dose rate in air outdoors is observed to be 0.04-0.18 and 3.1-14.1 nGy h -1 , respectively. (authors)

  1. Naturally Occurring Peer Support through Social Media: The Experiences of Individuals with Severe Mental Illness Using YouTube

    NARCIS (Netherlands)

    Naslund, J.A.; Grande, S.W.; Aschbrenner, K.A.; Elwyn, G.

    2014-01-01

    Increasingly, people with diverse health conditions turn to social media to share their illness experiences or seek advice from others with similar health concerns. This unstructured medium may represent a platform on which individuals with severe mental illness naturally provide and receive peer

  2. Morbidity of severe obesity.

    Science.gov (United States)

    Kral, J G

    2001-10-01

    Although obesity is an easy diagnosis to make, its etiologies, pathophysiology, and symptomatology are extraordinarily complex. Progress in surgical technique and anesthesiological management has substantially improved the safety of performing operations on the severely obese in the last 20 years. These improvements have occurred more or less empirically, without a full understanding of etiology or pathophysiology, although this has advanced concomitantly with improvements in practice. This review has attempted to provide a framework to facilitate progress in the neglected areas of patient selection and choice of operation, in an effort to improve long-term outcome. Despite the disparate etiologies of obesity and its diverse comorbidities and complications, there are unifying interdependent pathogenetic mechanisms of great relevance to the practice of antiobesity surgery. The rate of eating, whether driven by HPA dysfunction, ambient stress, or related hereditary susceptibility factors including the increased energy demands of an expanded body fat mass, participates in a cycle that results in disordered satiety (see Fig. 3). This leads to substrate overload, causing extensive metabolic abnormalities such as atherogenesis, insulin resistance, thrombogenesis, and carcinogenesis. This interpretation of the pathophysiology of obesity ironically accords with the original meaning of the word obesity: "to overeat." The ultimate solution to the problem of obesity--preventing it--will not be forthcoming until the food industry is forced to lower production and change its marketing strategies, as the liquor and tobacco industries in the United States were compelled to do. This cannot occur until the large and fast-growing populations of industrialized nations become educated in the personal implications of the energy principle. Regardless of whether school curricula are modified to prioritize health education, the larger problems of cultural and economic change remain for

  3. Naturally occurring variants of human Α9 nicotinic receptor differentially affect bronchial cell proliferation and transformation.

    Directory of Open Access Journals (Sweden)

    Anna Chikova

    Full Text Available Isolation of polyadenilated mRNA from human immortalized bronchial epithelial cell line BEP2D revealed the presence of multiple isoforms of RNA coded by the CHRNA9 gene for α9 nicotinic acetylcholine receptor (nAChR. BEP2D cells were homozygous for the rs10009228 polymorphism encoding for N442S amino acid substitution, and also contained mRNA coding for several truncated isoforms of α9 protein. To elucidate the biologic significance of the naturally occurring variants of α9 nAChR, we compared the biologic effects of overexpression of full-length α9 N442 and S442 proteins, and the truncated α9 variant occurring due to a loss of the exon 4 sequence that causes frame shift and early termination of the translation. These as well as control vector were overexpressed in the BEP2D cells that were used in the assays of proliferation rate, spontaneous vs. tobacco nitrosamine 4-(methylnitrosamino-1-(3-pyridyl-1-butanone (NNK-induced cellular transformation, and tumorigenicity in cell culture and mice. Overexpression of the S442 variant significantly increased cellular proliferation, and spontaneous and NNK-induced transformation. The N442 variant significantly decreased cellular transformation, without affecting proliferation rate. Overexpression of the truncated α9 significantly decreased proliferation and suppressed cellular transformation. These results suggested that α9 nAChR plays important roles in regulation of bronchial cell growth by endogenous acetylcholine and exogenous nicotine, and susceptibility to NNK-induced carcinogenic transformation. The biologic activities of α9 nAChR may be regulated at the splicing level, and genetic polymorphisms in CHRNA9 affecting protein levels, amino acid sequence and RNA splicing may influence the risk for lung cancer.

  4. A clinician-administered severity rating scale for illness anxiety: development, reliability, and validity of the H-YBOCS-M.

    Science.gov (United States)

    Skritskaya, Natalia A; Carson-Wong, Amanda R; Moeller, James R; Shen, Sa; Barsky, Arthur J; Fallon, Brian A

    2012-07-01

    Clinician-administered measures to assess severity of illness anxiety and response to treatment are few. The authors evaluated a modified version of the hypochondriasis-Y-BOCS (H-YBOCS-M), a 19-item, semistructured, clinician-administered instrument designed to rate severity of illness-related thoughts, behaviors, and avoidance. The scale was administered to 195 treatment-seeking adults with DSM-IV hypochondriasis. Test-retest reliability was assessed in a subsample of 20 patients. Interrater reliability was assessed by 27 interviews independently rated by four raters. Sensitivity to change was evaluated in a subsample of 149 patients. Convergent and discriminant validity was examined by comparing H-YBOCS-M scores to other measures administered. Item clustering was examined with confirmatory and exploratory factor analyses. The H-YBOCS-M demonstrated good internal consistency, interrater and test-retest reliability, and sensitivity to symptom change with treatment. Construct validity was supported by significant higher correlations with scores on other measures of hypochondriasis than with nonhypochondriacal measures. Improvement over time in response to treatment correlated with improvement both on measures of hypochondriasis and on measures of somatization, depression, anxiety, and functional status. Confirmatory factor analysis did not show adequate fit for a three-factor model. Exploratory factor analysis revealed a five-factor solution with the first two factors consistent with the separation of the H-YBOCS-M items into the subscales of illness-related avoidance and compulsions. H-YBOCS-M appears to be valid, reliable, and appropriate as an outcome measure for treatment studies of illness anxiety. Study results highlight "avoidance" as a key feature of illness anxiety-with potentially important nosologic and treatment implications. © 2012 Wiley Periodicals, Inc.

  5. Validation of the CORB75 (confusion, oxygen saturation, respiratory rate, blood pressure, and age ≥ 75 years) as a simpler pneumonia severity rule.

    Science.gov (United States)

    Ochoa-Gondar, O; Vila-Corcoles, A; Rodriguez-Blanco, T; Hospital, I; Salsench, E; Ansa, X; Saun, N

    2014-04-01

    This study compares the ability of two simpler severity rules (classical CRB65 vs. proposed CORB75) in predicting short-term mortality in elderly patients with community-acquired pneumonia (CAP). A population-based study was undertaken involving 610 patients ≥ 65 years old with radiographically confirmed CAP diagnosed between 2008 and 2011 in Tarragona, Spain (350 cases in the derivation cohort, 260 cases in the validation cohort). Severity rules were calculated at the time of diagnosis, and 30-day mortality was considered as the dependent variable. The area under the receiver operating characteristic curves (AUC) was used to compare the discriminative power of the severity rules. Eighty deaths (46 in the derivation and 34 in the validation cohorts) were observed, which gives a mortality rate of 13.1 % (15.6 % for hospitalized and 3.3 % for outpatient cases). After multivariable analyses, besides CRB (confusion, respiration rate ≥ 30/min, systolic blood pressure AUC statistics for predicting mortality in the derivation and validation cohorts were 0.79 and 0.82, respectively. In the derivation cohort, a CORB75 score ≥ 2 showed 78.3 % sensitivity and 65.5 % specificity for mortality (in the validation cohort, these were 82.4 and 71.7 %, respectively). The proposed CORB75 scoring system has good discriminative power in predicting short-term mortality among elderly people with CAP, which supports its use for severity assessment of these patients in primary care.

  6. Study Of Severe Accident Phenomena In Nuclear Power Plant

    International Nuclear Information System (INIS)

    Sugiyanto; Antariksawan; Anhar, R.; Arifal

    2001-01-01

    Several phenomena that occurred in the light water reactor type of nuclear power plant during severe accident were studied. The study was carried out based on the results of severe accident researches in various countries. In general, severe accident phenomena can be classified into in-vessel phenomena, retention in the reactor coolant system, and ex-vessel phenomena. In-vessel retention has been recommended as a severe accident management strategy

  7. Stuttering Severity and Educational Attainment

    Science.gov (United States)

    O'Brian, Sue; Jones, Mark; Packman, Ann; Menzies, Ross; Onslow, Mark

    2011-01-01

    Purpose: This study investigated the relationship between self-reported stuttering severity ratings and educational attainment. Method: Participants were 147 adults seeking treatment for stuttering. At pretreatment assessment, each participant reported the highest educational level they had attained and rated their typical and worst stuttering…

  8. Pressure drop-flow rate curves for single-phase steam in Combustion Engineering type steam generator U-tubes during severe accidents

    Energy Technology Data Exchange (ETDEWEB)

    Fynan, Douglas A.; Ahn, Kwang-Il, E-mail: kiahn@kaeri.re.kr

    2016-12-15

    Highlights: • Pressure drop-flow rate curves for superheated steam in U-tubes were generated. • Forward flow of hot steam is favored in the longer and taller U-tubes. • Reverse flow of cold steam is favored in short U-tubes. • Steam generator U-tube bundle geometry and tube diameter are important. • Need for correlation development for natural convention heat transfer coefficient. - Abstract: Characteristic pressure drop-flow rate curves are generated for all row numbers of the OPR1000 steam generators (SGs), representative of Combustion Engineering (CE) type SGs featuring square bend U-tubes. The pressure drop-flow rate curves are applicable to severe accident natural circulations of single-phase superheated steam during high pressure station blackout sequences with failed auxiliary feedwater and dry secondary side which are closely related to the thermally induced steam generator tube rupture event. The pressure drop-flow rate curves which determine the recirculation rate through the SG tubes are dependent on the tube bundle geometry and hydraulic diameter of the tubes. The larger CE type SGs have greater variation of tube length and height as a function of row number with forward flow of steam favored in the longer and taller high row number tubes and reverse flow favored in the short low row number tubes. Friction loss, natural convection heat transfer coefficients, and temperature differentials from the primary to secondary side are dominant parameters affecting the recirculation rate. The need for correlation development for natural convection heat transfer coefficients for external flow over tube bundles currently not modeled in system codes is discussed.

  9. Risk factors for death in children during inpatient treatment of severe acute malnutrition

    DEFF Research Database (Denmark)

    Rytter, Maren Johanne Heilskov; Babirekere-Iriso, Esther; Namusoke, Hanifa

    2017-01-01

    BACKGROUND: Children who receive in-hospital treatment of severe acute malnutrition often have high mortality rates, and the reasons are not well understood. OBJECTIVE: We assessed risk factors for death in children who were treated for malnutrition in a hospital. DESIGN: In a prospective...... observational study of 120 children who were receiving in-hospital treatment of severe acute malnutrition in Uganda with therapeutic formulas F-75 and F-100, we collected data on symptoms, clinical findings, plasma markers of refeeding syndrome (electrolytes and phosphate), and acute phase reactants......% CI: 1.9, 13.3), which was an association that remained after adjustment for potential confounders (HR: 69.5; 95% CI: 7.0, 694.6). CONCLUSIONS: Refeeding syndrome may occur in children who are treated for malnutrition, even with moderately low plasma phosphate, and, in particular, in children...

  10. Co-Occurring Atomic Contacts for the Characterization of Protein Binding Hot Spots

    Science.gov (United States)

    Liu, Qian; Ren, Jing; Song, Jiangning; Li, Jinyan

    2015-01-01

    A binding hot spot is a small area at a protein-protein interface that can make significant contribution to binding free energy. This work investigates the substantial contribution made by some special co-occurring atomic contacts at a binding hot spot. A co-occurring atomic contact is a pair of atomic contacts that are close to each other with no more than three covalent-bond steps. We found that two kinds of co-occurring atomic contacts can play an important part in the accurate prediction of binding hot spot residues. One is the co-occurrence of two nearby hydrogen bonds. For example, mutations of any residue in a hydrogen bond network consisting of multiple co-occurring hydrogen bonds could disrupt the interaction considerably. The other kind of co-occurring atomic contact is the co-occurrence of a hydrophobic carbon contact and a contact between a hydrophobic carbon atom and a π ring. In fact, this co-occurrence signifies the collective effect of hydrophobic contacts. We also found that the B-factor measurements of several specific groups of amino acids are useful for the prediction of hot spots. Taking the B-factor, individual atomic contacts and the co-occurring contacts as features, we developed a new prediction method and thoroughly assessed its performance via cross-validation and independent dataset test. The results show that our method achieves higher prediction performance than well-known methods such as Robetta, FoldX and Hotpoint. We conclude that these contact descriptors, in particular the novel co-occurring atomic contacts, can be used to facilitate accurate and interpretable characterization of protein binding hot spots. PMID:26675422

  11. Implementation of hydrogen mitigation techniques during severe accidents in nuclear power plants

    International Nuclear Information System (INIS)

    1996-01-01

    Severe accidents in water-cooled reactors are low-probability events as the Emergency Core Cooling System (ECCS) has been designed and specific accident management measures have been implemented to prevent severe accidents from occurring. Should it not be possible to prevent a severe accident in a water-cooled reactor, a large amount of hydrogen could be generated, notably from the reaction between steam and zirconium at high fuel clad temperatures, but also from reactions of molten core debris with concrete, water radiolysis, and reactions of structural materials with steam. The rates and quantities of hydrogen produced depend on the particular severe accident scenario and also on the reactor type (e.g. mass of zirconium in the reactor core). Depending on assumptions made, and taking account of various uncertainties, release rates of hydrogen up to several kg/s have been calculated with total hydrogen mass releases ranging from 100 kg to more than 1,000 kg for large reactors. Hydrogen produced during a severe accident could burn close to the hydrogen source or would mix with the containment atmosphere and burn if flammable concentrations are attained and ignition sources are available (e.g., igniters, accidental sparks from electric equipment). If oxygen and ignition sources are present in the vicinity of the release, the hydrogen will ignite and it could burn as a standing flame at the release location, which is possible over a large range of jet exit diameters, jet velocities and environmental conditions. The hydrogen that will not burn close to the source will mix with steam and air and will transport in the containment building to increase global or local concentrations and to create possibly flammable conditions. If ignited at high enough hydrogen concentration, the mixture could burn as a deflagration, creating a transient pressure and temperature that could possibly challenge the containment integrity and equipment. In regions of higher hydrogen

  12. Impact of source terms on distances to which reactor accident consequences occur

    International Nuclear Information System (INIS)

    Ostmeyer, R.M.

    1982-01-01

    Estimates of the distances over which reactor accident consequences might occur are important for development of siting criteria and for emergency response planning. This paper summarizes the results of a series of CRAC2 calculations performed to estimate these distances. Because of the current controversy concerning the magnitude of source terms for severe accidents, the impact of source term reductions upon distance estimates is also examined

  13. Daily intakes of naturally occurring radioisotopes in typical Korean foods

    International Nuclear Information System (INIS)

    Choi, Min-Seok; Lin Xiujing; Lee, Sun Ah; Kim, Wan; Kang, Hee-Dong; Doh, Sih-Hong; Kim, Do-Sung; Lee, Dong-Myung

    2008-01-01

    The concentrations of naturally occurring radioisotopes ( 232 Th, 228 Th, 230 Th, 228 Ra, 226 Ra, and 40 K) in typical Korean foods were evaluated. The daily intakes of these radioisotopes were calculated by comparing concentrations in typical Korean foods and the daily consumption rates of these foods. Daily intakes were as follows: 232 Th, 0.00-0.23; 228 Th, 0.00-2.04; 230 Th, 0.00-0.26; 228 Ra, 0.02-2.73; 226 Ra, 0.01-4.37 mBq/day; and 40 K, 0.01-5.71 Bq/day. The total daily intake of the naturally occurring radioisotopes measured in this study from food was 39.46 Bq/day. The total annual internal dose resulting from ingestion of radioisotopes in food was 109.83 μSv/y, and the radioisotope with the highest daily intake was 40 K. These values were same level compiled in other countries

  14. Psychometric validation of the Columbia-Suicide Severity rating scale in Spanish-speaking adolescents.

    Science.gov (United States)

    Serrani Azcurra, Daniel

    2017-12-30

    Adolescent suicide is a major public health issue, and early and accurate detection is of great concern. There are many reliable instruments for this purpose, such as the Columbia-Suicide severity rating scale (C-SSRS), but no validation exists for Spanish speaking Latin American adolescents. To assess psychometric properties and cut-off scores of the C-SSRS in Spanish speaking adolescents. Exploratory assessment with principal component analysis (PCA) and Varimax rotation, and confirmatory analysis (CFA) were performed on two groups with 782 and 834 participants respectively (N=1616). Mean age was 24.8 years. A Receiver operator analysis was applied to distinguish between control and suicide-risk subgroups adolescents. Promax rotation yielded two 10-items factors, for suicide ideation and behavior respectively. C-SSRS was positively correlated with other suicide risk scales, such as Beck Depression Inventory-II, Suicidal Behaviors Questionnaire-Revised, or PHQ-9. Confirmatory factor analysis yielded a two-factor solution as the best goodness of fit model. C-SSRS showed adequate ability to detect suicide risk group with positive predictive value of 68.3%. ROC analyses showed cutoff scores of ≥ 6 and ≥ 4 for suicide ideation and behavior scales respectively. This research offers data supporting psychometric validity and reliability of C-SSRS in nonclinical Spanish-speaking students. Added benefits are flexible scoring and management easiness. This questionnaire yields data on distinct aspects of suicidality, being more parsimonious than separate administration of a bunch of questionnaires.

  15. Fe2+ oxidation rate drastically affect the formation and phase of secondary iron hydroxysulfate mineral occurred in acid mine drainage

    International Nuclear Information System (INIS)

    Huang Shan; Zhou Lixiang

    2012-01-01

    During the processes of secondary iron hydroxysulfate mineral formation, Fe 2+ ion was oxidized by the following three methods: (1) biooxidation treatment by Acidithiobacillus ferrooxidans (A. ferrooxidans); (2) rapid abiotic oxidation of Fe 2+ with H 2 O 2 (rapid oxidation treatment); (3) slow abiotic oxidation of Fe 2+ with H 2 O 2 (slow oxidation treatment). X-ray diffraction (XRD) patterns, element composition, precipitate weight and total Fe removal efficiency were analyzed. The XRD patterns and element composition of precipitates synthesized through the biooxidation and the slow oxidation treatments well coincide with those of potassium jarosite, while precipitates formed at the initial stage of incubation in the rapid oxidation treatment showed a similar XRD pattern to schwertmannite. With the ongoing incubation, XRD patterns and element composition of the precipitates that occurred in the rapid oxidation treatment were gradually close to those in the biooxidation and the slow oxidation treatments. Due to the inhibition of A. ferrooxidans itself and its extracellular polymeric substances (EPS) in aggregation of precipitates, the amount of precipitates and soluble Fe removal efficiency were lower in the biooxidation treatment than in the slow oxidation treatment. Therefore, it is concluded that Fe 2+ oxidation rate can greatly affect the mineral phase of precipitates, and slow oxidation of Fe 2+ is helpful in improving jarosite formation. - Highlights: ► Slow oxidation of Fe 2+ is helpful in jarosite formation. ► The already-formed schwertmannite can be gradually transformed to jarosite. ► Precipitates formation can be inhibited probably by EPS from A. ferrooxidans.

  16. A systematic review of technology-based interventions for co-occurring substance use and trauma symptoms.

    Science.gov (United States)

    Gilmore, Amanda K; Wilson, Sarah M; Skopp, Nancy A; Osenbach, Janyce E; Reger, Greg

    2017-09-01

    Introduction Technology-based mental health interventions are becoming increasingly common, and several have begun to target multiple outcomes in a single intervention. Recent developments in the treatment of co-occurring posttraumatic stress disorder and substance use disorder has led to the development and testing of technology-based interventions for these disorders. The current systematic review examined technology-based interventions designed to improve mental health outcomes among patients with co-occurring trauma symptoms and substance use. Methods Of 601 articles reviewed, 14 included a technology-based intervention for patients with these co-occurring problems. Results Seven of these studies provided preliminary evidence that technology-based interventions are likely to be efficacious in reducing either trauma symptoms or substance use. The seven remaining studies demonstrated that technology-based interventions for co-occurring trauma symptoms and substance use are feasible. Discussion This review suggests that technology-based interventions for co-occurring trauma symptoms and substance use are feasible, but more work is needed to assess efficacy using scientifically rigorous studies.

  17. Mycoplasma ovipneumoniae - A Primary Cause of Severe Pneumonia Epizootics in the Norwegian Muskox (Ovibos moschatus) Population

    DEFF Research Database (Denmark)

    Handeland, Kjell; Tengs, Torstein; Kokotovic, Branko

    2014-01-01

    The Norwegian muskox (Ovibos moschatus) population lives on the high mountain plateau of Dovre and originates from animals introduced from Greenland. In the late summers of 2006 and 2012, severe outbreaks of pneumonia with mortality rates of 25-30% occurred. During the 2012 epidemic high quality...... heavy consolidations primarily in the cranial parts of the lungs and it also identified one case of otitis media. Histologically, lung lesions were characterized as acute to subacute mixed exudative and moderately proliferative bronchoalveolar pneumonia. Immunohistochemical (IHC) examination revealed...

  18. Base Rates: Both Neglected and Intuitive

    Science.gov (United States)

    Pennycook, Gordon; Trippas, Dries; Handley, Simon J.; Thompson, Valerie A.

    2014-01-01

    Base-rate neglect refers to the tendency for people to underweight base-rate probabilities in favor of diagnostic information. It is commonly held that base-rate neglect occurs because effortful (Type 2) reasoning is required to process base-rate information, whereas diagnostic information is accessible to fast, intuitive (Type 1) processing…

  19. Using Logistic Regression To Predict the Probability of Debris Flows Occurring in Areas Recently Burned By Wildland Fires

    Science.gov (United States)

    Rupert, Michael G.; Cannon, Susan H.; Gartner, Joseph E.

    2003-01-01

    Logistic regression was used to predict the probability of debris flows occurring in areas recently burned by wildland fires. Multiple logistic regression is conceptually similar to multiple linear regression because statistical relations between one dependent variable and several independent variables are evaluated. In logistic regression, however, the dependent variable is transformed to a binary variable (debris flow did or did not occur), and the actual probability of the debris flow occurring is statistically modeled. Data from 399 basins located within 15 wildland fires that burned during 2000-2002 in Colorado, Idaho, Montana, and New Mexico were evaluated. More than 35 independent variables describing the burn severity, geology, land surface gradient, rainfall, and soil properties were evaluated. The models were developed as follows: (1) Basins that did and did not produce debris flows were delineated from National Elevation Data using a Geographic Information System (GIS). (2) Data describing the burn severity, geology, land surface gradient, rainfall, and soil properties were determined for each basin. These data were then downloaded to a statistics software package for analysis using logistic regression. (3) Relations between the occurrence/non-occurrence of debris flows and burn severity, geology, land surface gradient, rainfall, and soil properties were evaluated and several preliminary multivariate logistic regression models were constructed. All possible combinations of independent variables were evaluated to determine which combination produced the most effective model. The multivariate model that best predicted the occurrence of debris flows was selected. (4) The multivariate logistic regression model was entered into a GIS, and a map showing the probability of debris flows was constructed. The most effective model incorporates the percentage of each basin with slope greater than 30 percent, percentage of land burned at medium and high burn severity

  20. Reference Material IAEA 434: Naturally Occurring Radionuclides in Phosphogypsum

    International Nuclear Information System (INIS)

    2010-01-01

    Phosphogypsum is generated as a by-product of the phosphoric acid based fertilizer industry. The discharge of phosphogypsum on earth surface deposits is a potential source of enhanced natural radiation and heavy metals, and the resulting environmental impact should be considered carefully to ensure safety and compliance with environmental regulations. In addition, phosphogypsum can be used to make several building materials and it is used in agriculture as a conditioner to maintain soil productivity in areas where soils are poor and erode easily. A reliable determination of naturally occurring radionuclides in phosphogypsum is necessary to comply with the radiation protection and environmental regulations. The IAEA-434 will assist laboratories in the IAEA Member States in validating their analytical methods for the determination of naturally occurring radionuclides in phosphogypsum and to control the quality of the produced analytical results. Reference values for the massic activities and associated standard uncertainties were established for: Pb-210, Ra-226, Th-230, U-234 and U-238. During sample production and certification, the requirements for reference material production and certification as stated in ISO guides 34 and 35 were taken into account. This report summarizes the preparation and certification process

  1. Implementing Statewide Severe Maternal Morbidity Review: The Illinois Experience.

    Science.gov (United States)

    Koch, Abigail R; Roesch, Pamela T; Garland, Caitlin E; Geller, Stacie E

    2018-03-07

    Severe maternal morbidity (SMM) rates in the United States more than doubled between 1998 and 2010. Advanced maternal age and chronic comorbidities do not completely explain the increase in SMM or how to effectively address it. The Centers for Disease Control and Prevention and American College of Obstetricians and Gynecologists have called for facility-level multidisciplinary review of SMM for potential preventability and have issued implementation guidelines. Within Illinois, SMM was identified as any intensive or critical care unit admission and/or 4 or more units of packed red blood cells transfused at any time from conception through 42 days postpartum. All cases meeting this definition were counted during statewide surveillance. Cases were selected for review on the basis of their potential to yield insights into factors contributing to preventable SMM or best practices preventing further morbidity or death. If the SMM review committee deemed a case potentially preventable, it identified specific factors associated with missed opportunities and made actionable recommendations for quality improvement. Approximately 1100 cases of SMM were identified from July 1, 2016, to June 30, 2017, yielding a rate of 76 SMM cases per 10 000 pregnancies. Reviews were conducted on 142 SMM cases. Most SMM cases occurred during delivery hospitalization and more than half were delivered by cesarean section. Hemorrhage was the primary cause of SMM (>50% of the cases). Facility-level SMM review was feasible and acceptable in statewide implementation. States that are planning SMM reviews across obstetric facilities should permit ample time for translation of recommendations to practice. Although continued maternal mortality reviews are valuable, they are not sufficient to address the increasing rates of SMM and maternal death. In-depth multidisciplinary review offers the potential to identify factors associated with SMM and interventions to prevent women from moving along the

  2. Human error as the root cause of severe accidents at nuclear reactors

    International Nuclear Information System (INIS)

    Kovács Zoltán; Rýdzi, Stanislav

    2017-01-01

    A root cause is a factor inducing an undesirable event. It is feasible for root causes to be eliminated through technological process improvements. Human error was the root cause of all severe accidents at nuclear power plants. The TMI accident was caused by a series of human errors. The Chernobyl disaster occurred after a badly performed test of the turbogenerator at a reactor with design deficiencies, and in addition, the operators ignored the safety principles and disabled the safety systems. At Fukushima the tsunami risk was underestimated and the project failed to consider the specific issues of the site. The paper describes the severe accidents and points out the human errors that caused them. Also, provisions that might have eliminated those severe accidents are suggested. The fact that each severe accident occurred on a different type of reactor is relevant – no severe accident ever occurred twice at the same reactor type. The lessons learnt from the severe accidents and the safety measures implemented on reactor units all over the world seem to be effective. (orig.)

  3. Severe rectal complications after prostate brachytherapy

    International Nuclear Information System (INIS)

    Wallner, Kent; Sutlief, Stephen; Bergsagel, Carl; Merrick, Gregory S.

    2015-01-01

    Purpose: Some investigators have reported severe rectal complications after brachytherapy. Due to the low number of such events, their relationship to dosimetric parameters has not been well characterized. Methods and materials: A total of 3126 patients were treated with low dose rate brachytherapy from 1998 through 2010. 2464 had implant alone, and 313 had implant preceded by 44–46 Gy supplemental external beam radiation (EBRT). Post-implant dosimetry was based on a CT scan obtained on the day of implant, generally within 30 min of the procedure. Every patient’s record was reviewed for occurrence of rectal complications. Results: Eight of 2464 patients (0.32%) treated with brachytherapy alone developed a radiation-related rectal fistula. Average prostatic and rectal dose parameters were moderately higher for fistula patients than for patients without a severe rectal complication. For instance, the average R100 was 1.2 ± 0.75 cc for fistula patients, versus 0.37 ± 0.88 cc for non-fistula patients. However, the fistula patients’ values were well within the range of values for patients without a rectal complication. Four patients had some attempt at repair or reconstruction, but long-term functional outcomes were not favorable. Conclusions: Rectal fistulas are a very uncommon potential complication of prostate brachytherapy, which can occur even in the setting of acceptable day 0 rectal doses. Their occurrence is not easily explained by standard dosimetric or clinical factors

  4. Orbital Atherectomy for Treating De Novo Severely Calcified Coronary Narrowing (1-Year Results from the Pivotal ORBIT II Trial).

    Science.gov (United States)

    Généreux, Philippe; Lee, Arthur C; Kim, Christopher Y; Lee, Michael; Shlofmitz, Richard; Moses, Jeffrey W; Stone, Gregg W; Chambers, Jeff W

    2015-06-15

    Percutaneous coronary intervention of severely calcified lesions has historically been associated with major adverse cardiac event (MACE) rates as high as 30%. In the ORBIT II (Evaluate the Safety and Efficacy of OAS in Treating Severely Calcified Coronary Lesions) trial, treatment of de novo severely calcified lesions with the Diamondback 360° Coronary Orbital Atherectomy System (OAS) resulted in low rates of procedural and 30-day adverse ischemic events. The long-term results from this trial have not been reported. We sought to determine the 1-year outcomes after orbital atherectomy of severely calcified coronary lesions. ORBIT II was a single-arm trial enrolling 443 subjects at 49 US sites with severely calcified lesions usually excluded from randomized trials. OAS utilizes a centrifugal differential sanding mechanism of action for plaque modification prior to stent implantation. After OAS drug-eluting stents were implanted in 88.2% of the patients. The primary safety end point was 30-day MACE, the composite of cardiac death, myocardial infarction, or target vessel revascularization [TVR]. The present analysis reports the 1-year follow-up results from ORBIT II. One-year data were available in 433 of 443 patients (97.7%), with median follow-up time of 16.7 months. The 1-year MACE rate was 16.4%, including cardiac death (3.0%), myocardial infarction (9.7%), and target vessel revascularization (5.9%). The 1-year target lesion revascularization rate was 4.7%, and stent thrombosis occurred in 1 patient (0.2%). Independent predictors of 1-year MACE and target vessel revascularization were diameter stenosis at baseline and the use of bare-metal stents. In patients with severely calcified lesions who underwent percutaneous coronary intervention, the use of OAS was associated with low rates of 1-year adverse ischemic events compared with historical controls. This finding has important clinical implications for the selection of optimum treatment strategies for patients

  5. Severe Hypoglycemia Accompanied with Thyroid Crisis

    Directory of Open Access Journals (Sweden)

    Yuki Nakatani

    2012-01-01

    Full Text Available We report a 32-year-old Japanese women with severe hypoglycemia accompanied with thyroid crisis. She complained of dyspnea, general fatigue, and leg edema. She was diagnosed with hyperthyroidism with congestive heart failure and liver dysfunction. Soon after admission, sudden cardiopulmonary arrest occurred. She was then transferred to the intensive care unit. Her serum glucose level was 7 mg/dl. Intravenous glucose, hydrocortisone, diuretics, and continuous hemodiafiltration (CHDF saved her. We considered that hypoglycemia occurred due to heart failure and liver dysfunction due to thyroid crisis.

  6. Severe slugging in gas-liquid two-phase pipe flow

    NARCIS (Netherlands)

    Malekzadeh, R.

    2012-01-01

    transportation facilities. In an offshore oil and gas production facility, pipeline-riser systems are required to transport two-phase hydrocarbons from subsurface oil and gas wells to a central production platform. Severe slugs reaching several thousands pipe diameters may occur when transporting

  7. The observation and nursing of patients receiving interventional management for biliary complications occurred after liver transplantation

    International Nuclear Information System (INIS)

    Li Xiaohui; Zhu Kangshun; Lian Xianhui; Qiu Xuanying

    2009-01-01

    Objective: To discuss the perioperative nursing norm for patients who are suffering from biliary complications occurred after liver transplantation and who will receive interventional management to treat the complications. Methods: Interventional therapies were performed in 20 patients with biliary complications due to liver transplantation. The interventional procedures performed in 20 cases included percutaneous biliary drainage (n = 13), percutaneous biliary balloon dilatation (n = 5) and biliary stent implantation (n = 7). The clinical results were observed and analyzed. Results: Biliary tract complications occurred after liver transplantation were seen frequently. Proper interventional management could markedly improve the successful rate of liver transplantation and increase the survival rate of the patients. In accordance with the individual condition, proper nursing measures should be taken promptly and effectively. Conclusion: Conscientious and effective nursing can contribute to the early detection of biliary complications and, therefore, to improve the survival rate of both the transplanted liver and the patients. (authors)

  8. Severe hypoglycaemia in 1076 adult patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Pramming, Stig; Heller, Simon R

    2004-01-01

    BACKGROUND: Differences between studies in rates of severe hypoglycaemia in type 1 diabetic cohorts are common and poorly understood. The purpose of this study was to assess the frequency of severe hypoglycaemia in unselected patients treated in different secondary care centres and to evaluate...... the influence of risk markers, clinical setting and selection. METHODS: Cross-sectional Danish-British multicentre survey of 1076 consecutive adult patients with clinical type 1 diabetes who completed a detailed questionnaire on hypoglycaemia and related issues. Key variable was the self-reported rate of severe......, the rate of severe hypoglycaemia was 0.35 episodes/patient-year and only retinopathy was a significant risk marker together with state of awareness. CONCLUSION: Severe hypoglycaemia remains a significant clinical problem in type 1 diabetes. The rate of severe hypoglycaemia and the influence of risk markers...

  9. Fungi of genus Alternaria occurring on tomato

    Directory of Open Access Journals (Sweden)

    Joanna Marcinkowska

    2013-12-01

    Full Text Available Tomato early blight in central Poland was caused by Alternaria solani (A. porri f. sp., solani and A. alernata (A. tenuis. A. alternata was isolated more often than A. solani. All isolates of A. solani in controlled conditions killed tomato seedlings, while pathogenic isolates of A. alternata caused only slight seedling blight. In greenhouse tests A. solani proved to be strongly pathogenic for leaves and stems of tomato but A. alternata was weakly pathogenic. The latter species attacked only injured fruits while, A. solanicould penetrate through undamaged peel of fruits. Both of these species caused the same type of symptoms; the differences consisted only in intensification of disease symptoms. During 1974 and 1975 field tomatoes were moderately attacked by early blight. Thebest development of this disease occurred by the turn of August and September. Determinate variety 'New Yorker' was distinguished by more severe infection of stem parts of tomato whereas the fruits of a stock variety 'Apollo' were more strongly attacked.

  10. Uranium occurence in California near Bucaramanga (Columbia)

    International Nuclear Information System (INIS)

    Heider Polania, J.

    1980-01-01

    The mining district of California, Bucaramanga, is on the west side of the Cordillera Oriental in the Santander massif region. The oldest rocks of the area form a complex of metamorphites and migmatites of the predevonic age. Amphibolite various types of paragneiss and orthogneiss are represented. Several stages of metamorphism can be documented in some rocks, as well as double anatexis. Triassic to jurassic quarz diorites and leukogranites show wide distribution. Porphyric rocks of granodioritic to granitic composition, to which the uranium mineralization is mainly bonded, intruded into the sediments of the lower cretaceous. Atomic absorption spectral analyses were carried out for the elements Cu, Zn and Li, as well as the uranium contents of some samples using fluorimetry. Uranium is primarily bonded to pitch blende and coffinite. The latter mostly occur in fine distribution grown in quarz and belong to the most recent mineralization phase. Autunite, meta-autunite, torbernite, meta-torbernite, zeunerite, meta-zeunerite and meta uranocircite detected as secondary uranium minerals. (orig./HP) [de

  11. Improved Completion Rates and Characterization of Drug Reactions with an Intensive Chagas Disease Treatment Program in Rural Bolivia

    Science.gov (United States)

    Tornheim, Jeffrey A.; Lozano Beltran, Daniel F.; Gilman, Robert H.; Castellon, Mario; Solano Mercado, Marco A.; Sullca, Walter; Torrico, Faustino; Bern, Caryn

    2013-01-01

    Background Chagas disease treatment is limited by drug availability, adverse side effect profiles of available medications, and poor adherence. Methods Adult Chagas disease patients initiating 60-days of benznidazole were randomized to weekly or twice-weekly evaluations of medication adherence and screening for adverse drug events (ADEs). Mid-week evaluations employed phone-based evaluations. Adherence was measured by self-report, pill counts with intentional over-distribution, and Medication Event Monitoring Systems (MEMS). Prospective data were compared to historical controls treated with benznidazole at the same hospital. Results 162 prospective patients were compared to 172 historical patients. Pill counts correlated well with MEMS data (R = 0.498 for 7-day intervals, R = 0.872 for intervals >7 days). Treatment completion rates were higher among prospective than historical patients (82.1% vs. 65.1%), primarily due to lower abandonment rates. Rates of ADEs were lower among prospective than historical patients (56.8% vs. 66.9%). Twice-weekly evaluations increased identification of mild ADEs, prompting higher suspension rates than weekly evaluations. While twice-weekly evaluations identified ADEs earlier, they did not reduce incidence of moderate or severe ADEs. Many dermatologic ADEs were moderately severe upon presentation (35.6%), were not reduced by use of antihistamines, occurred among adult patients of all ages, and occurred throughout treatment, rather than the first few weeks alone. Conclusions Intensive management improved completion and identified more ADEs, but did not reduce moderate or severe ADEs. Risk of dermatologic ADEs cannot be reduced by selecting younger adults or monitoring only during the first few weeks of treatment. Pill counts and phone-based encounters are reliable tools for treatment programming in rural Bolivia. PMID:24069472

  12. The association between previous and future severe exacerbations of chronic obstructive pulmonary disease: Updating the literature using robust statistical methodology.

    Science.gov (United States)

    Sadatsafavi, Mohsen; Xie, Hui; Etminan, Mahyar; Johnson, Kate; FitzGerald, J Mark

    2018-01-01

    There is minimal evidence on the extent to which the occurrence of a severe acute exacerbation of COPD that results in hospitalization affects the subsequent disease course. Previous studies on this topic did not generate causally-interpretable estimates. Our aim was to use corrected methodology to update previously reported estimates of the associations between previous and future exacerbations in these patients. Using administrative health data in British Columbia, Canada (1997-2012), we constructed a cohort of patients with at least one severe exacerbation, defined as an episode of inpatient care with the main diagnosis of COPD based on international classification of diseases (ICD) codes. We applied a random-effects 'joint frailty' survival model that is particularly developed for the analysis of recurrent events in the presence of competing risk of death and heterogeneity among individuals in their rate of events. Previous severe exacerbations entered the model as dummy-coded time-dependent covariates, and the model was adjusted for several observable patient and disease characteristics. 35,994 individuals (mean age at baseline 73.7, 49.8% female, average follow-up 3.21 years) contributed 34,271 severe exacerbations during follow-up. The first event was associated with a hazard ratio (HR) of 1.75 (95%CI 1.69-1.82) for the risk of future severe exacerbations. This risk decreased to HR = 1.36 (95%CI 1.30-1.42) for the second event and to 1.18 (95%CI 1.12-1.25) for the third event. The first two severe exacerbations that occurred during follow-up were also significantly associated with increased risk of all-cause mortality. There was substantial heterogeneity in the individual-specific rate of severe exacerbations. Even after adjusting for observable characteristics, individuals in the 97.5th percentile of exacerbation rate had 5.6 times higher rate of severe exacerbations than those in the 2.5th percentile. Using robust statistical methodology that controlled

  13. A combined telemetry - tag return approach to estimate fishing and natural mortality rates of an estuarine fish

    Science.gov (United States)

    Bacheler, N.M.; Buckel, J.A.; Hightower, J.E.; Paramore, L.M.; Pollock, K.H.

    2009-01-01

    A joint analysis of tag return and telemetry data should improve estimates of mortality rates for exploited fishes; however, the combined approach has thus far only been tested in terrestrial systems. We tagged subadult red drum (Sciaenops ocellatus) with conventional tags and ultrasonic transmitters over 3 years in coastal North Carolina, USA, to test the efficacy of the combined telemetry - tag return approach. There was a strong seasonal pattern to monthly fishing mortality rate (F) estimates from both conventional and telemetry tags; highest F values occurred in fall months and lowest levels occurred during winter. Although monthly F values were similar in pattern and magnitude between conventional tagging and telemetry, information on F in the combined model came primarily from conventional tags. The estimated natural mortality rate (M) in the combined model was low (estimated annual rate ?? standard error: 0.04 ?? 0.04) and was based primarily upon the telemetry approach. Using high-reward tagging, we estimated different tag reporting rates for state agency and university tagging programs. The combined telemetry - tag return approach can be an effective approach for estimating F and M as long as several key assumptions of the model are met.

  14. A complex intervention to improve implementation of World Health Organization guidelines for diagnosis of severe illness in low-income settings: a quasi-experimental study from Uganda

    Directory of Open Access Journals (Sweden)

    Matthew J. Cummings

    2017-11-01

    Full Text Available Abstract Background To improve management of severely ill hospitalized patients in low-income settings, the World Health Organization (WHO established a triage tool called “Quick Check” to provide clinicians with a rapid, standardized approach to identify patients with severe illness based on recognition of abnormal vital signs. Despite the availability of these guidelines, recognition of severe illness remains challenged in low-income settings, largely as a result of infrequent vital sign monitoring. Methods We conducted a staggered, pre-post quasi-experimental study at four inpatient health facilities in western Uganda to assess the impact of a multi-modal intervention for improving quality of care following formal training on WHO “Quick Check” guidelines for diagnosis of severe illness in low-income settings. Intervention components were developed using the COM-B (“capability,” “opportunity,” and “motivation” determine “behavior” model and included clinical mentoring by an expert in severe illness care, collaborative improvement meetings with external support supervision, and continuous audits of clinical performance with structured feedback. Results There were 5759 patients hospitalized from August 2014 to May 2015: 1633 were admitted before and 4126 during the intervention period. Designed to occur twice monthly, collaborative improvement meetings occurred every 2–4 weeks at each site. Clinical mentoring sessions, designed to occur monthly, occurred every 4–6 months at each site. Audit and feedback reports were implemented weekly as designed. During the intervention period, there were significant increases in the site-adjusted likelihood of initial assessment of temperature, heart rate, blood pressure, respiratory rate, mental status, and pulse oximetry. Patients admitted during the intervention period were significantly more likely to be diagnosed with sepsis (4.3 vs. 0.4%, risk ratio 10.1, 95% CI 3.0–31

  15. Delay discounting, impulsiveness, and addiction severity in opioid-dependent patients.

    Science.gov (United States)

    Robles, Elias; Huang, B Emma; Simpson, Pippa M; McMillan, Donald E

    2011-12-01

    Individuals who abuse drugs show higher delay discounting (DD) rate and impulsiveness scores compared with controls; however, it is unclear if DD rate covaries with severity of the addiction or if an individual's discounting rate can be changed by effective substance abuse treatment. This study compared methadone maintenance treatment (MMT) patients (n = 30) who had not used illegal drugs for 2 years with drug-using MMT patients (n = 30) and controls (n = 25) in terms of addiction severity, DD rate, and impulsiveness. Methadone patients abstinent from illegal drugs scored significantly lower on a number of addiction severity measures than the drug-using methadone patients. In addition, both groups of MMT patients showed significantly higher rates of DD and impulsiveness than the control group; however, no differences in DD rate or impulsiveness were found between the groups of patients. Results suggest that DD rate and impulsiveness may not covary with indicators of addiction severity in MMT patients. Published by Elsevier Inc.

  16. How Often Does Deliberate Self-Harm Occur Relative to Each Suicide? A Study of Variations by Gender and Age

    Science.gov (United States)

    Hawton, Keith; Harriss, Louise

    2008-01-01

    Deliberate self-harm (DSH; i.e., nonfatal self-poisoning or self-injury) occurs much more frequently than suicide, yet there has been little detailed investigation of the comparative rates of DSH and suicide. We conducted a study of how rates of DSH relate to suicide rates across the life cycle by gender and by method of estimation of DSH rates,…

  17. ESTIMATION OF THE WANDA GLACIER (SOUTH SHETLANDS SEDIMENT EROSION RATE USING NUMERICAL MODELLING

    Directory of Open Access Journals (Sweden)

    Kátia Kellem Rosa

    2013-09-01

    Full Text Available Glacial sediment yield results from glacial erosion and is influenced by several factors including glacial retreat rate, ice flow velocity and thermal regime. This paper estimates the contemporary subglacial erosion rate and sediment yield of Wanda Glacier (King George Island, South Shetlands. This work also examines basal sediment evacuation mechanisms by runoff and glacial erosion processes during the subglacial transport. This is small temperate glacier that has seen retreating for the last decades. In this work, we examine basal sediment evacuation mechanisms by runoff and analyze glacial erosion processes occurring during subglacial transport. The glacial erosion rate at Wanda Glacier, estimated using a numerical model that consider sediment evacuated to outlet streams, ice flow velocity, ice thickness and glacier area, is 1.1 ton m yr-1.

  18. The optimal rating philosophy for the rating of SMEs

    NARCIS (Netherlands)

    Rikkers, F.; Thibeault, A.

    2007-01-01

    The objective of this research is to determine the optimal rating philosophy for the rating of SMEs, and to describe the consequences of the chosen philosophy on several related aspects. As to our knowledge, this is the first paper that studies the considerations of financial institutions on what

  19. Temperature fields occurring in dielectric capillaries for the transport of of ion beams

    International Nuclear Information System (INIS)

    Urbanovich, A.I.

    2012-01-01

    This paper presents the results of computing the temperature fields occurring in dielectric capillaries of glass for the transport of accelerated charged particles. It is shown that on the transport of ion beams with a power of several watts the capillary is heated intensively, whereas heat stresses may approach the lower bound associated with a real strength of glass. (authors)

  20. Contribution to the study of sedimentation rates in some french Polynesian lakes and lagoon

    International Nuclear Information System (INIS)

    Serra, C.; Poletiko, C.; Badie, C.

    1991-03-01

    210 Pb measurements using 210 Po deposition technique were performed in several marine and lacustrine sediments of French Polynesia to determine sedimentation rates in lakes and lagoons. Some results in terrigeneous sediments were acceptable and permit rate measurements; on the contrary other sediments, especially coral sands provided a 210 Pb/ 226 Ra disequilibrium (0.33 to 0.69). The occurring phenomena seem to be related to 222 Rn scavenging and geothermal endoupwelling which induces 226 Ra enhancement; this leads to the same 210 Pb/ 226 Ra disequilibrium as in deep ocean waters as described, for instance by Thomson and Turekian (1976) in an upwelling zone on Peru coasts [fr

  1. Effects of ion and electron screening on thermonuclear reaction rates

    International Nuclear Information System (INIS)

    Brady, L.R. Jr.

    1977-01-01

    The effects of screening by ions and electrons on thermonuclear reaction rates in stellar plasmas are considered. The enhancement of the reaction rate ranges from negligible to extremely large (on the order of 10 26 or greater). In order to calculate these effects, the potential about a given reacting nucleus is determined. First, Boltzmann-Vlasov and Poisson-Boltzmann equations are solved to yield a Yukawa potential. A suitable approximation to this potential is integrated in the action integral to give the barrier penetration. The screened reaction rate is then found by the saddle-point method. In developing a general formalism to calculate the screened reaction rate and the screening factor, effects due to the finite size of the nucleus are considered and found to be negligible. An expression for the screening factor for resonant reaction rates is also derived. A different and relatively simple approach, based on work of Stewart and Pyatt (1966), is used to find the barrier penetration from the action integral in two approximations: a modified Coulomb potential and a constant-shift potential. Screening factors are calculated for carbon burning at T 6 = 100 and T 6 = 400 for a wide range of densities and also for several examples in late stellar evolution. These screening factors are, for the most part, greater than those given by most others by a few percent at low density to 4 or more orders of magnitude at T 6 = 100 and rho = 10 10 g/cm 3 . Near the edge of the crystalline lattice region, however, they are significantly lower than those of some others. The increase in reaction rates for carbon burning indicates that carbon ignition may occur at lower densities than previously thought and may affect the density at which a supernova shock may occur

  2. Ohia forest decline: its spread and severity in Hawaii

    Science.gov (United States)

    Edwin Q. P. Petteys; Robert E. Burgan; Robert E. Nelson

    1975-01-01

    Ohia forest decline–its severity and rate of spread–was studied by aerial photographic techniques on a 197,000-acre (80,000-ha) portion of the island of Hawaii. In 1954, only 300 acres (121 ha) showed signs of severe decline; by 1972, the acreage of severely affected forest had increased to 85,200 acres (34,480 ha). Rate of decline and current severity were related to...

  3. The rate of urinary tract abnormalities and the functional state of kidneys in relation to the degree of connective tissue dysplasia in children

    Directory of Open Access Journals (Sweden)

    T. A. Kryganova

    2016-01-01

    Full Text Available The paper is devoted to the study of the rate of urinary tract abnormalities and kidney functions in children with mild, moderate, and severe connective tissue dysplasia. Severe connective tissue dysplasia was found to prevail in children with urinary tract abnormalities and to be characterized by a variety of urodynamic urinary tract abnormalities. Urinary system infection occurred equally frequently in both patient groups and its rate did not depend on the degree of the dysplasia. Some children with severe connective dysplasia were noted to have diminished renal filtration function. High-grade vesicoureteral reflux, tubular disorders as nocturias, and lowered urine osmolarity were more common in children with severe dysplasia. Hypertension was seen equally often in both patient groups, no matter what the degree of connective tissue dysplasia.

  4. Uranium occurence in nature: Geophysical prospecting, and its occurence in Syria

    International Nuclear Information System (INIS)

    Al-Haj Rasheed, Zaki

    1985-01-01

    A general idea about naturaly occured uranium minerals such as uranite, pechblende, carnotite, coffinit, and bronnerit is given. At the same time, different geophysical methods and detecting devices applied for uranium exploration have been demonstrated. Investigations and studies carried out in Syria point to a uranium content of 100 ppm in the exploited Syrian phosphorite. 1 fig., 1 tab

  5. CT-guided needle biopsy of lung lesions: A survey of severe complication based on 9783 biopsies in Japan

    International Nuclear Information System (INIS)

    Tomiyama, Noriyuki; Yasuhara, Yoshifumi; Nakajima, Yasuo; Adachi, Shuji; Arai, Yasuaki; Kusumoto, Masahiko; Eguchi, Kenji; Kuriyama, Keiko; Sakai, Fumikazu; Noguchi, Masayuki; Murata, Kiyoshi; Murayama, Sadayuki; Mochizuki, Teruhito; Mori, Kiyoshi; Yamada, Kozo

    2006-01-01

    Purpose: The aim of our study was to update the rate of severe complications following CT-guided needle biopsy in Japan via a mailed survey. Materials and methods: Postal questionnaires regarding CT-guided needle biopsy were sent out to multiple hospitals in Japan. The questions regarded: the total number and duration of CT-guided lung biopsies performed at each hospital, and the complication rates and numbers of pneumothorax, hemothorax, air embolism, tumor seeding, tension pneumothorax and other rare complications. Each severe complication was followed with additional questions. Results: Data from 9783 biopsies was collected from 124 centers. Pneumothorax was the most common complication, and occurred in 2412 (35%) of 6881 cases. A total of 39 (35%) hospitals reported 74 (0.75%) cases with severe complications. There were six cases (0.061%) with air embolism, six cases (0.061%) with tumor seeding at the site of the biopsy route, 10 cases (0.10%) with tension pneumothorax, six cases (0.061%) with severe pulmonary hemorrhage or hemoptysis, nine cases (0.092%) with hemothorax, and 27 cases (0.26%) with others, including heart arrest, shock, and respiratory arrest. From a total of 62 patients with severe complications, 54 patients (0.55%) recovered without sequela, however one patient (0.01%) recovered with hemiplegia due to cerebral infarction, and the remaining seven patients (0.07%) died. Conclusions: This is the first national study documenting severe complications with respect to CT-guided needle biopsy in Japan. The complication rate in Japan is comparable to internationally published figures. We believe this data will improve both clinicians as well as patients understanding of the risk versus benefit of CT-guided needle biopsy, resulting better decisions

  6. Transabdominal amnioinfusion to avoid fetal demise and intestinal damage in fetuses with gastroschisis and severe oligohydramnios.

    Science.gov (United States)

    Sapin, E; Mahieu, D; Borgnon, J; Douvier, S; Carricaburu, E; Sagot, P

    2000-04-01

    Despite dramatic improvement in survival rate for neonates with gastroschisis, significant postoperative morbidity and a low mortality rate still occur. Furthermore, even in recent publications, some fetal death has been reported. Does this mean that antenatal diagnosis of gastroschisis is a missed opportunity? In fact, decreased amniotic fluid (AF) volume is observed in some fetuses with gastroschisis. However, oligohydramnios is associated with an increased risk of fetal suffering. When severe oligohydramnios is observed, intrapartum amnioinfusion, to restore AF volume, may help avoid fetal complications. Two fetuses with gastroschisis and severe oligohydramnios were treated antenatally with amnioinfusion of saline solution. In one case, fetal heart beat decelerations were observed at 27 weeks' gestation among with the oligohydroamnios and serial transabdominal amnioinfusions were performed. In the second case, severe oligohydramnios was observed at 31, weeks and an amnioinfusion was performed. The 2 babies were delivered at 31 and 34 weeks, respectively. In both cases, exteriorized bowel was nearly normal at birth, and primary closure could be performed. Outcome was favorable, and they were discharged home on day 43 and day 54, respectively. Because fetuses with gastroschisis and oligohydramnios are part of a particular high-risk group, serial ultrasound examination and computerized fetal heart beat monitoring are necessary during the third trimester. In selected cases of gastroschisis associated with severe oligohydramnios, serial amnioinfusion may be required.

  7. Analysis of 90 cases of antithyroid drug-induced severe hepatotoxicity over 13 years in China.

    Science.gov (United States)

    Yang, Jun; Li, Lin-Fa; Xu, Qin; Zhang, Jun; Weng, Wan-Wen; Zhu, Yang-Jun; Dong, Meng-Jie

    2015-03-01

    Antithyroid drug (ATD)-induced severe hepatotoxicity is a rare but serious complication of ATD therapy. The characteristics of severe hepatotoxicity have been reported in only a small number of patients. Ninety patients with ATD-induced severe hepatotoxicity presenting during a 13 year period (2000-2013) who were about to undergo nuclear medicine therapy with (131)I from a sample of 8864 patients with hyperthyroidism were studied, and the outcomes were evaluated. The mean age of the patients with ATD-induced severe hepatotoxicity was 41.6±12.5 years (mean±standard deviation), and the female to male ratio was 2.2:1. The methimazole (MMI) dose given at the onset was 19.1±7.4 mg/day. The propylthiouracil (PTU) dose given at the onset was 212.8±105.0 mg/day. ATD-induced severe hepatotoxicity occurred in 63.3%, 75.6%, and 81.1% of patients within 4, 8, and 12 weeks of the onset of ATD therapy, respectively. The types of severe hepatotoxicity did not differ significantly between the MMI and PTU groups (p=0.188). The frequency of the cholestatic type in the MMI group (35.3%, 18/51) was higher than that in the PTU group (17.9%, 7/39), but these frequencies were not significantly different (p=0.069). The patients who were treated with (131)I received an average dose of 279.1±86.1 MBq (n=84). Therapy was successful in 60 of the 67 patients (89.6%). The success rate was equivalent (p=0.696) between the groups receiving MMI (91.7%, 33/36) and PTU (87.1%, 27/31). Severe hepatotoxicity tends to occur within the first three months after the onset of ATD therapy. The type of ATD-induced severe hepatotoxicity did not differ between the MMI and PTU groups. (131)I therapy is an effective treatment approach for patients with ATD-induced severe hepatotoxicity.

  8. Oxidation mechanisms occurring in wines

    OpenAIRE

    Oliveira, Carla Maria; Ferreira, António César Silva; Freitas, Victor De; Silva, Artur M. S.

    2011-01-01

    The present review aims to show the state of the art on the oxidation mechanisms occurring in wines, as well as the methods to monitor, classify and diagnose wine oxidation. Wine oxidation can be divided in enzymatic oxidation and non-enzymatic oxidation. Enzymatic oxidation almost entirely occurs in grape must and is largely correlated with the content of hydroxycinnamates, such as caffeoyltartaric acid and paracoumaroyltartaric acid, and flavan-3-ols. Non-enzymatic oxidation, al...

  9. Acylation of proteins with myristic acid occurs cotranslationally

    International Nuclear Information System (INIS)

    Wilcox, C.; Hu, J.S.; Olson, E.N.

    1987-01-01

    Several proteins of viral and cellular origin are acylated with myristic acid early during their biogenesis. To investigate the possibility that myristylation occurred cotranslationally, the BC 3 H1 muscle cell line, which contains a broad array of myristylated proteins, was pulse-labeled with [ 3 H]myristic acid. Nascent polypeptide chains covalently associated with transfer RNA were isolated subsequently by ion-exchange chromatography. [ 3 H]Myristate was attached to nascent chains through an amide linkage and was identified by thin-layer chromatography after its release from nascent chains by acid methanolysis. Inhibition of cellular protein synthesis with puromycin resulted in cessation of [ 3 H]myristate-labeling of nascent chains, in agreement with the dependence of this modification on protein synthesis in vivo. These data represent a direct demonstration that myristylation of proteins is a cotranslational modification

  10. Can false memory for critical lures occur without conscious awareness of list words?

    Science.gov (United States)

    Sadler, Daniel D; Sodmont, Sharon M; Keefer, Lucas A

    2018-02-01

    We examined whether the DRM false memory effect can occur when list words are presented below the perceptual identification threshold. In four experiments, subjects showed robust veridical memory for studied words and false memory for critical lures when masked list words were presented at exposure durations of 43 ms per word. Shortening the exposure duration to 29 ms virtually eliminated veridical recognition of studied words and completely eliminated false recognition of critical lures. Subjective visibility ratings in Experiments 3a and 3b support the assumption that words presented at 29 ms were subliminal for most participants, but were occasionally experienced with partial awareness by participants with higher perceptual awareness. Our results indicate that a false memory effect does not occur in the absence of conscious awareness of list words, but it does occur when word stimuli are presented at an intermediate level of visibility. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Reliability and validity of a tool to measure the severity of tongue thrust in children: the Tongue Thrust Rating Scale.

    Science.gov (United States)

    Serel Arslan, S; Demir, N; Karaduman, A A

    2017-02-01

    This study aimed to develop a scale called Tongue Thrust Rating Scale (TTRS), which categorised tongue thrust in children in terms of its severity during swallowing, and to investigate its validity and reliability. The study describes the developmental phase of the TTRS and presented its content and criterion-based validity and interobserver and intra-observer reliability. For content validation, seven experts assessed the steps in the scale over two Delphi rounds. Two physical therapists evaluated videos of 50 children with cerebral palsy (mean age, 57·9 ± 16·8 months), using the TTRS to test criterion-based validity, interobserver and intra-observer reliability. The Karaduman Chewing Performance Scale (KCPS) and Drooling Severity and Frequency Scale (DSFS) were used for criterion-based validity. All the TTRS steps were deemed necessary. The content validity index was 0·857. A very strong positive correlation was found between two examinations by one physical therapist, which indicated intra-observer reliability (r = 0·938, P reliability (r = 0·892, P validity of the TTRS. The TTRS is a valid, reliable and clinically easy-to-use functional instrument to document the severity of tongue thrust in children. © 2016 John Wiley & Sons Ltd.

  12. The burden of infection in severely injured trauma patients and the relationship with admission shock severity.

    Science.gov (United States)

    Cole, Elaine; Davenport, Ross; Willett, Keith; Brohi, Karim

    2014-03-01

    Infection following severe injury is common and has a major impact on patient outcomes. The relationship between patient, injury, and physiologic characteristics with subsequent infections is not clearly defined. The objective of this study was to characterize the drivers and burden of all-cause infection in critical care trauma patients. A prospective cohort study of severely injured adult patients admitted to critical care was conducted. Data were collected prospectively on patient and injury characteristics, baseline physiology, coagulation profiles, and blood product use. Patients were followed up daily for infectious episodes and other adverse outcomes while in the hospital. Three hundred patients (Injury Severity Score [ISS] >15) were recruited. In 48 hours or less, 29 patients (10%) died, leaving a cohort of 271. One hundred forty-one patients (52%) developed at least one infection. Three hundred four infections were diagnosed overall. Infection and noninfection groups were matched for age, sex, mechanism, and ISS. Infection rates were greater with any degree of admission shock and threefold higher in the most severely shocked cohort (p < 0.01). In multivariate analysis, base deficit (odds ratio [OR], 1.78, 95% confidence interval [CI], 1.48-1.94; p < 0.001) and lactate (OR, 1.36; 95% CI, 1.10-1.69; p = 0.05) were independently associated with the development of infection. Outcomes were significantly worse for the patients with infection. In multivariate logistic regression, infection was the only factor independently associated with multiple-organ failure (p < 0.001; OR, 15.4; 95% CI, 8.2-28.9; r = 0.402), ventilator-free days (p < 0.001; β, -4.48; 95% CI, -6.7 to -2.1; r = 0.245), critical care length of stay (p < 0.001; β, 13.2; 95% CI, 10.0-16.4; r = 0.466), and hospital length of stay (p < 0.001; β, 31.1; 95% CI, 24.0-38.2; r = 0.492). Infectious complications are a burden for severely injured patients and occur early in the critical care stay

  13. Reduced heart rate variability in social anxiety disorder: associations with gender and symptom severity.

    Directory of Open Access Journals (Sweden)

    Gail A Alvares

    Full Text Available BACKGROUND: Polyvagal theory emphasizes that autonomic nervous system functioning plays a key role in social behavior and emotion. The theory predicts that psychiatric disorders of social dysfunction are associated with reduced heart rate variability, an index of autonomic control, as well as social inhibition and avoidance. The purpose of this study was to examine whether heart rate variability was reduced in treatment-seeking patients diagnosed with social anxiety disorder, a disorder characterized by social fear and avoidance. METHODS: Social anxiety patients (n = 53 were recruited prior to receiving psychological therapy. Healthy volunteers were recruited through the University of Sydney and the general community and were matched by gender and age (n = 53. Heart rate variability was assessed during a five-minute recording at rest, with participants completing a range of self-report clinical symptom measures. RESULTS: Compared to controls, participants with social anxiety exhibited significant reductions across a number of heart rate variability measures. Reductions in heart rate variability were observed in females with social anxiety, compared to female controls, and in patients taking psychotropic medication compared to non-medicated patients. Finally, within the clinical group, we observed significant associations between reduced heart rate variability and increased social interaction anxiety, psychological distress, and harmful alcohol use. CONCLUSIONS: The results of this study confirm that social anxiety disorder is associated with reduced heart rate variability. Resting state heart rate variability may therefore be considered a marker for social approach-related motivation and capacity for social engagement. Additionally, heart rate variability may provide a useful biomarker to explain underlying difficulties with social approach, impaired stress regulation, and behavioral inhibition, especially in disorders associated with

  14. Approaches to proton single-event rate calculations

    International Nuclear Information System (INIS)

    Petersen, E.L.

    1996-01-01

    This article discusses the fundamentals of proton-induced single-event upsets and of the various methods that have been developed to calculate upset rates. Two types of approaches are used based on nuclear-reaction analysis. Several aspects can be analyzed using analytic methods, but a complete description is not available. The paper presents an analytic description for the component due to elastic-scattering recoils. There have been a number of studies made using Monte Carlo methods. These can completely describe the reaction processes, including the effect of nuclear reactions occurring outside the device-sensitive volume. They have not included the elastic-scattering processes. The article describes the semiempirical approaches that are most widely used. The quality of previous upset predictions relative to space observations is discussed and leads to comments about the desired quality of future predictions. Brief sections treat the possible testing limitation due to total ionizing dose effects, the relationship of proton and heavy-ion upsets, upsets due to direct proton ionization, and relative proton and cosmic-ray upset rates

  15. Severe hypoglycemia rates and associated costs among type 2 diabetics starting basal insulin therapy in the United States.

    Science.gov (United States)

    Ganz, Michael L; Wintfeld, Neil S; Li, Qian; Lee, Yuan-Chi; Gatt, Elyse; Huang, Joanna C

    2014-10-01

    To derive current real-world data on the rates and costs of severe hypoglycemia (SH) for people with type 2 diabetes mellitus (T2D) who have initiated basal insulin therapy and to examine differences in SH rates and costs stratified by history of prior SH events. We used a nation-wide electronic health records database that included encounter and laboratory data, as well as clinical notes, to estimate the rates and costs of SH events among adults with T2D who initiated basal insulin between 2008 and 2011. Unadjusted and regression-adjusted rates and quarterly costs were calculated for all patients as well as stratified by history of a SH event before starting basal insulin and history of a SH event during the basal insulin titration period. We identified 7235 incident cases of basal insulin use among patients with T2D who did not use insulin during the previous 12 months. Regression-adjusted incidence and total event rates were 10.36 and 11.21 per 100 patient-years, respectively. A history of SH events during the pre-index baseline and post-index titration periods were statistically significantly associated with both the incidence and total event rates (p history of previous SH or SH events during the titration period were not statistically significantly associated with costs. These results suggest that the real-world burden of SH is high among people with T2D who start using basal insulin and that history of previous SH events, both before starting insulin and during the insulin titration period, influences future SH. These results can also provide insights into interventions that can prevent or delay SH. These results should, however, be interpreted in light of the key limitations of our study: not all SH events may have been captured or coded in the database, data on filled prescriptions were not available, and the post-titration follow-up period could have been divided into time units other than quarters (3 month blocks) resulting in potentially different

  16. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity.

    Science.gov (United States)

    Roberts, Christine L; Ford, Jane B; Algert, Charles S; Bell, Jane C; Simpson, Judy M; Morris, Jonathan M

    2009-02-25

    Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI) developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH). We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000) suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3-5.3%). This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was entirely among women who experienced a PPH. Reducing or stabilising

  17. Trends in adverse maternal outcomes during childbirth: a population-based study of severe maternal morbidity

    Directory of Open Access Journals (Sweden)

    Algert Charles S

    2009-02-01

    Full Text Available Abstract Background Maternal mortality is too rare in high income countries to be used as a marker of the quality of maternity care. Consequently severe maternal morbidity has been suggested as a better indicator. Using the maternal morbidity outcome indicator (MMOI developed and validated for use in routinely collected population health data, we aimed to determine trends in severe adverse maternal outcomes during the birth admission and in particular to examine the contribution of postpartum haemorrhage (PPH. Methods We applied the MMOI to the linked birth-hospital discharge records for all women who gave birth in New South Wales, Australia from 1999 to 2004 and determined rates of severe adverse maternal outcomes. We used frequency distributions and contingency table analyses to examine the association between adverse outcomes and maternal, pregnancy and birth characteristics, among all women and among only those with PPH. Using logistic regression, we modelled the effects of these characteristics on adverse maternal outcomes. The impact of adverse outcomes on duration of hospital admission was also examined. Results Of 500,603 women with linked birth and hospital records, 6242 (12.5 per 1,000 suffered an adverse outcome, including 22 who died. The rate of adverse maternal outcomes increased from 11.5 in 1999 to 13.8 per 1000 deliveries in 2004, an annual increase of 3.8% (95%CI 2.3–5.3%. This increase occurred almost entirely among women with a PPH. Changes in pregnancy and birth factors during the study period did not account for increases in adverse outcomes either overall, or among the subgroup of women with PPH. Among women with severe adverse outcomes there was a 12% decrease in hospital days over the study period, whereas women with no severe adverse outcome occupied 23% fewer hospital days in 2004 than in 1999. Conclusion Severe adverse maternal outcomes associated with childbirth have increased in Australia and the increase was

  18. Severe Hypertriglyceridemia Induced Pancreatitis in Pregnancy

    Directory of Open Access Journals (Sweden)

    Natasha Gupta

    2014-01-01

    Full Text Available Acute pancreatitis caused by severe gestational hypertriglyceridemia is a rare complication of pregnancy. Acute pancreatitis has been well associated with gallstone disease, alcoholism, or drug abuse but rarely seen in association with severe hypertriglyceridemia. Hypertriglyceridemia may occur in pregnancy due to normal physiological changes leading to abnormalities in lipid metabolism. We report a case of severe gestational hypertriglyceridemia that caused acute pancreatitis at full term and was successfully treated with postpartum therapeutic plasma exchange. Patient also developed several other complications related to her substantial hypertriglyceridemia including preeclampsia, chylous ascites, retinal detachment, pleural effusion, and chronic pericarditis. This patient had no previous family or personal history of lipid abnormality and had four successful prior pregnancies without developing gestational hypertriglyceridemia. Such a severe hypertriglyceridemia is usually seen in patients with familial chylomicronemia syndromes where hypertriglyceridemia is exacerbated by the pregnancy, leading to fatal complications such as acute pancreatitis.

  19. Development and application of a radioactivity evaluation technique the to obtain radiation exposure dose of radioactivity evaluation technique when a severe accident occurs in the a power station of a severe accident. Accident management guidelines of knowledge-based maintenance

    International Nuclear Information System (INIS)

    Kawasaki, Ikuo; Yoshida, Yoshitaka

    2013-01-01

    As a One of the lessons learned from the nuclear accident at the Fukushima Daiichi Nuclear Power Stations of Tokyo Electric Power Company, the was the need for improvement of accident management guidelines is required. In this report study, we developed and applied a dose evaluation technique to evaluated the radiation dose in a nuclear power plant assuming three conditions: employees were evacuation evacuated at the time of a severe accident occurrence; operators carried out the accident management operation; of the operators, and the repair work was carried out for of the trouble damaged apparatuses in a the nuclear power plant using a dose evaluation system. The following knowledge findings were obtained and should to be reflected to in the knowledge base of the guidelines was obtained. (1) By making clearly identifying an areas beforehand becoming the that would receive high radiation doses at the time of a severe accident definitely beforehand, we can employees can be moved to the evacuation places through an areas having of low dose rate and it is also known it how much we long employees can safely stay in the evacuation places. (2) When they circulate CV containment vessel recirculation sump water is recirculated by for the accident management operation and the restoration of safety in the facilities, because the plumbing piping and the apparatuses become radioactive radioactivity sources, the dose evaluation of the shortest access route and detour access routes with should be made for effective the accident management operation is effective. Because the area where a dose rate rises changes which as safety apparatuses are restored, in consideration of a plant state, it is necessary to judge the rightness or wrongness of the work continuation from the spot radioactive dose of the actual apparatus area, with based on precedence of the need to restore with precedence, and to choose a system to be used for accident management. (author)

  20. Explanation and Analysis of the Reasons of Occurring Sedition in Kalila and Dimna

    Directory of Open Access Journals (Sweden)

    Mohammad Khodadadi

    2017-08-01

    Full Text Available Sedition is one of the political and social disorders in humankind societies. In case of occurring sedition, a society will involve in not only disturbance and chaos, but also it is possible to destroy the political system, so this factor is considered as severe threaten from creation and forming the political systems up to now. Most of the scientists considered the valuable book of Kalila and Dimna as political constitution which was written by Nasrollah Monshi and this important factor was expressed in different dimensions as evidenced by this statement. In this Article, it is attempted to be involved in explanation and analysis of the reasons of occurring the sedition such as jealousy, greed and avidity, aversion, pride and revenge in Kalila and Dimna.

  1. Music therapy can lower the heart rates of severely sick children.

    Science.gov (United States)

    Uggla, L; Bonde, L O; Svahn, B M; Remberger, M; Wrangsjö, B; Gustafsson, B

    2016-10-01

    Paediatric recipients of haematopoietic stem cell transplants (HSCT) are at increased risk of developing post-traumatic stress disorder (PTSD), and there is a need to identify interventions that can alleviate stress in this group. The aim of this study was to examine the previously unexplored effect of music therapy on children undergoing HSCT, by analysing physiological parameters and comparing them with a control group. We performed a randomised clinical pilot study of 24 patients up to the age of 16 undergoing HSCT at Karolinska University Hospital, Huddinge, Sweden. Music therapy, including expressive and receptive elements, was performed twice a week in the treatment group and compared to standard care in the control group. Physiological parameters were evaluated according to the hospital's protocols. The music therapy group had significantly reduced evening heart rates compared to the control group (p Music therapy significantly lowered the heart rate of children undergoing HSCT for at least four to eight hours, indicating reduced stress levels and potentially lowering the risk of developing PTSD. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Markers of disease severity are associated with malnutrition in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Jamie M Sheard

    Full Text Available OBJECTIVE: In Parkinson's disease (PD, commonly reported risk factors for malnutrition in other populations commonly occur. Few studies have explored which of these factors are of particular importance in malnutrition in PD. The aim was to identify the determinants of nutritional status in people with Parkinson's disease (PWP. METHODS: Community-dwelling PWP (>18 years were recruited (n = 125; 73M/52F; Mdn 70 years. Self-report assessments included Beck's Depression Inventory (BDI, Spielberger Trait Anxiety Inventory (STAI, Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT, Modified Constipation Assessment Scale (MCAS and Freezing of Gait Questionnaire (FOG-Q. Information about age, PD duration, medications, co-morbid conditions and living situation was obtained. Addenbrooke's Cognitive Examination (ACE-R, Unified Parkinson's Disease Rating Scale (UPDRS II and UPDRS III were performed. Nutritional status was assessed using the Subjective Global Assessment (SGA as part of the scored Patient-Generated Subjective Global Assessment (PG-SGA. RESULTS: Nineteen (15% were malnourished (SGA-B. Median PG-SGA score was 3. More of the malnourished were elderly (84% vs. 71% and had more severe disease (H&Y: 21% vs. 5%. UPDRS II and UPDRS III scores and levodopa equivalent daily dose (LEDD/body weight (mg/kg were significantly higher in the malnourished (Mdn 18 vs. 15; 20 vs. 15; 10.1 vs. 7.6 respectively. Regression analyses revealed older age at diagnosis, higher LEDD/body weight (mg/kg, greater UPDRS III score, lower STAI score and higher BDI score as significant predictors of malnutrition (SGA-B. Living alone and higher BDI and UPDRS III scores were significant predictors of a higher log-adjusted PG-SGA score. CONCLUSIONS: In this sample of PWP, the rate of malnutrition was higher than that previously reported in the general community. Nutrition screening should occur regularly in those with more severe disease and depression. Community

  3. Predictive validity of disability rating scale in determining functional outcome in patients with severe traumatic brain injury.

    Science.gov (United States)

    Deepika, Akhil; Devi, B Indira; Shukla, Dhaval

    2017-01-01

    Most patients with severe traumatic brain injury (TBI) are discharged when they have still not recovered completely. Many such patients are not available for follow up. We conducted this study to determine whether the condition at discharge from acute care setting, as assessed with disability rating scale (DRS), correlates with functional outcome at follow up. This study was conducted at a Neurosurgical intensive care unit (ICU) of a tertiary care referral center. This was a prospective observational study. Patients admitted to ICU with a diagnosis of severe TBI were enrolled for the study. On the day of discharge, all patients underwent DRS assessment. A final assessment was performed using Glasgow outcome scale extended (GOSE) at 6 months after discharge from the hospital. The correlation between the DRS scores at the time of discharge with DRS scores and GOSE categories at 6 months after discharge was determined using Spearman's rho correlation coefficient. A total of 88 patients were recruited for the study. The correlation coefficient of DRS at discharge for DRS at 6 months was 0.536 and for GOSE was -0.553. The area under the curve of DRS score at discharge for predicting unfavorable outcome and mortality at 6 months was 0.770 and 0.820, respectively. The predictive validity of DRS is fair to good in determining GOSE at follow-up. Pending availability of a more accurate outcome assessment tool, DRS at discharge can be used as a surrogate outcome for GOSE at follow up.

  4. Long-term impacts of mega-projects: the discount rate

    NARCIS (Netherlands)

    Koopmans, C.; Rietveld, P.; Priemus, H.; van Wee, B.

    2013-01-01

    In social cost-benefit analysis (SCBA), discount rates are used to convert costs and benefits that occur at different points in time, to present values that can be added and subtracted. Especially if important costs and benefits occur in the long term (more than say 30 years), the discount rate may

  5. Flare-up rate of single-visit endodontics.

    Science.gov (United States)

    Trope, M

    1991-01-01

    The purpose of the study was to compare the flare-up rate for single-visit endodontics among teeth without radiographic or clinical signs of apical periodontitis, those with radiographic or clinical signs of apical periodontitis not previously root-treated, and those with apical periodontitis where retreatment was performed. All teeth were instrumented to a predetermined minimum size with a 0.5 per cent solution of sodium hypochlorite being used as the irrigant. The root canal was obturated without regard to the presence or absence of symptoms or diagnosis of the apical condition. The patients were given written post-operative instructions and a prescription for 600 mg ibuprofen to be taken if mild to moderate pain developed. If severe pain and/or swelling developed, the patient was instructed to telephone immediately and was considered to have had a flare-up. Teeth without signs of apical periodontitis did not have any flare-ups. One flare-up occurred in 69 teeth with signs of apical periodontitis not previously root-treated. The majority of the flare-ups (3 of 22 teeth) occurred in teeth with signs of apical periodontitis requiring retreatment.

  6. 8 CFR 293.2 - Interest rate.

    Science.gov (United States)

    2010-01-01

    ... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Interest rate. 293.2 Section 293.2 Aliens... CASH RECEIVED TO SECURE IMMIGRATION BONDS § 293.2 Interest rate. The Secretary of the Treasury has determined that effective from date of deposit occurring after April 27, 1966, the interest rate shall be 3...

  7. Dynamics of leaf water relations components in co-occurring iso- and anisohydric conifer species

    Science.gov (United States)

    Frederick Meinzer; David Woodruff; Danielle Marias; Katherine McCulloh; Sanna Sevanto

    2014-01-01

    Because iso- and anisohydric species differ in stomatal regulation of the rate and magnitude of fluctuations in shoot water potential, they may be expected to show differences in the plasticity of their shoot water relations components, but explicit comparisons of this nature have rarely been made. We subjected excised shoots of co-occurring anisohydric Juniperus...

  8. Brief Report: Concurrent Validity of Autism Symptom Severity Measures

    Science.gov (United States)

    Reszka, Stephanie S.; Boyd, Brian A.; McBee, Matthew; Hume, Kara A.; Odom, Samuel L.

    2014-01-01

    The autism spectrum disorder (ASD) diagnostic classifications, according to the DSM-5, include a severity rating. Several screening and/or diagnostic measures, such as the autism diagnostic and observation schedule (ADOS), Childhood Autism Rating Scale (CARS) and social responsiveness scale (SRS) (teacher and parent versions), include an…

  9. A remote sensing-assisted risk rating study to predict oak decline and recovery in the Missouri Ozark Highlands, USA

    Science.gov (United States)

    Cuizhen Wang; Hong S. He; John M. Kabrick

    2008-01-01

    Forests in the Ozark Highlands underwent widespread oak decline affected by severe droughts in 1999-2000. In this study, the differential normalized difference water index was calculated to detect crown dieback. A multi-factor risk rating system was built to map risk levels of stands. As a quick response to drought, decline in 2000 mostly occurred in stands at low to...

  10. Depressive realism: effects of depression severity and interpretation time.

    Science.gov (United States)

    McKendree-Smith, N; Scogin, F

    2000-12-01

    This study examined the theory of depressive realism, which posits that depressed people often are more accurate in perceptions and judgments than nondepressed people. Two possible qualifications to this theory were examined: (1) severity of depression moderates the effect, and (2) length of processing time will impact the presence of bias in depressed people, that is, negative bias will develop over time. College students were presented with a bogus personality profile that actually consisted of items previously rated as neutral in desirability. Participants rated these profiles for desirability initially and then again three days later. Results indicated a significant effect of depression severity on desirability rating. Nondepressed and mildly depressed students found their profiles to be more positive than the moderately/severely depressed students, with both groups having scores in the positive range. However, those participants who were moderately/severely depressed showed a negative bias in their ratings. No support was found for the effect of different times of interpretation.

  11. Rates and limits of climatic change: Discussion of possible targets; Rates and limits of temperature, precipitation, and sea-level changes

    Energy Technology Data Exchange (ETDEWEB)

    Gleick, P H [Pacific Inst. for SiDES, Berkeley, CA (US); Sassin, W [Landl (AT)

    1990-10-01

    The rate of sea-level rise over the next century is likely to accelerate rapidly and exceed rates of rise experienced over the last several thousand years. Under these conditions, adverse effects on natural ecosystems such as coastal marshes and coral reef islands would be widely observable by 2050, and would be noticeable in vulnerable ecosystems by the year 2000, even under low sea-level rise scenario. Non-linearities and sudden events such as storm surges and a change in storm frequency and intensity could lead to damages even earlier. Similarly, change in temperature and precipitation patterns far greater than those experienced in the last 10000to 100000 years seem likely unless strong actions are taken soon. Rates of change in temperature, precipitation, and sea level over geologic time have often exceeded the rates expected over the next century from global warming. These large excursions, however, were often accompanied by dramatic changes in ecosystems and by large species extinctions, and they occurred when no human infrastructure existed. The adaptive abilities of natural ecosystems can be used to define targets of maximum rates of rise. For coral reef islands and coastal marshes, the maximum rate of accretion of materials is 10 to 15 mm/yr. At this rate, however, many reefs and marshes that accrete materials at slower rates will be inundated and destroyed. Average rates of accretion for marshes are lower - between 2 and 5 mm/yr, and between 5 and 10 mm/yr for coral reefs. Even at these lower rates, some ecosystem losses are to be expected. This information leads to a recommended target for the rate of sea-level rise of between 20 and 50 mm per decade, and a target for absolute sea-level rise of between 0.2 and 0.5 above the 1990 global mean sea level. (authors).

  12. General properties of grapevine viruses occurring in Hungary

    Directory of Open Access Journals (Sweden)

    Eszter Cseh

    2012-03-01

    Full Text Available The past fifty years important advances have been made in the field of grapevine virus research, including characterization of pathogens and control measurements. Still the occurrence of Grapevine fanleaf virus (GFLV, Arabis mosaic virus (ArMV, Tomato black ring virus (TBRV, Grapevine chrome mosaic virus (GCMV, Alfalfa mosaic virus (AMV, Grapevine Bulgarian latent virus (GBLV, Grapevine fleck virus (GFkV, Grapevine leafroll- associated viruses (GLRaV1-4, Grapevine virus A (GVA, Grapevine virus B (GVB and Grapevine rupestris stem pitting- associated virus (GRSPaV have been reported in Hungary and characterized by conventional methods as woody indexing, herbaceous indexing and serological methods. Among grapevine viruses the Grapevine line pattern virus (GLPV seems to be uncial; because it was reported only in Hungary. Causal agents of several grapevine diseases, like enation, vein necrosis and vein mosaic remained undiscovered. These virus-like diseases occurred only sporadically, without economic importance.

  13. Ice Thickness, Melting Rates and Styles of Activity in Ice-Volcano Interaction

    Science.gov (United States)

    Gudmundsson, M. T.

    2005-12-01

    In most cases when eruptions occur within glaciers they lead to rapid ice melting, jokulhlaups and/or lahars. Many parameters influence the style of activity and its impact on the environment. These include ice thickness (size of glacier), bedrock geometry, magma flow rate and magma composition. The eruptions that have been observed can roughly be divided into: (1) eruptions under several hundred meters thick ice on a relatively flat bedrock, (2) eruptions on flat or sloping bed through relatively thin ice, and (3) volcanism where effects are limitied to confinement of lava flows or melting of ice by pyroclastic flows or surges. This last category (ice-contact volcanism) need not cause much ice melting. Many of the deposits formed by Pleistocene volcanism in Iceland, British Columbia and Antarctica belong to the first category. An important difference between this type of activity and submarine activity (where pressure is hydrostatic) is that pressure at vents may in many cases be much lower than glaciostatic due to partial support of ice cover over vents by the surrounding glacier. Reduced pressure favours explosive activity. Thus the effusive/explosive transition may occur several hundred metres underneath the ice surface. Explosive fragmentation of magma leads to much higher rates of heat transfer than does effusive eruption of pillow lavas, and hence much higher melting rates. This effect of reduced pressure at vents will be less pronounced in a large ice sheet than in a smaller glacier or ice cap, since the hydraulic gradient that drives water away from an eruption site will be lower in the large glacier. This may have implications for form and type of eruption deposits and their relationship with ice thickness and glacier size.

  14. Can Exchange Rates Be Predicted?

    OpenAIRE

    Siriwutiset, Trin

    2007-01-01

    Foreign exchange rates produce significant impacts on both the macroeconomic and microeconomic scale. Countries� government and multinational companies have been seeking ways to stabilize the exchange rates for a few decades. However, there is no perfect consensus on methods to control and stabilize the exchange rates. In fact, there are several occasions in history where turbulence movements caused crisis in the economies. There are several factors that are identified by economis...

  15. Prevalence and outcome of severe malnutrition in children less than five-year-old in Omdurman Paediatric Hospital, Sudan.

    Science.gov (United States)

    Kanan, Shaza O H; Swar, Mohammed Osman

    2016-01-01

    This is a retrospective observational hospital-based study aimed to determine the prevalence and outcome of severe acute malnutrition in children less than five years admitted to Omdurman Paediatric Hospital during the period January 2014 to December 2014. Data was collected from patient's hospital records during the study period. Ethical approval and permission to access patients' record were obtained. A total of 593 children with severe malnutrition were identified; 305 of cases were male (51.4%) with a male: female ratio of 1:0.9. The mean age these children was 22.3 months. Children 36-59 months were least affected. 35.4% were classified as low socioeconomic class, 22.9% classified as an average class and there were no sufficient data to classify the remaining. The overall prevalence of severe malnutrition was 6.5%, and the general mortality rate was 2.4% while mortality rate among children with severe malnutrition was 9.3%. Among the 593 admitted children with malnutrition, 407 (68.6%) had marasmus, 141 (23.8%) had kwashiorkor and 45 (7.6%) had marasmic-kwashiorkor. The highest prevalence and mortality rate occurred in September. The most common clinical presentations were gastroenteritis, malaria, urinary tract infections, giardiasis, tuberculosis and AIDS. Only 10.8% of the admitted children were exclusively breast fed for the first three months. 33% were fully vaccinated. Overall 75.7% improved and discharged, 15% discharged against medical advice and 9.3% died. We concluded that prevalence and mortality among children with acute severe malnutrition at Omdurman paediatrics hospital were high, and the current management strategies require review to identify the causes. We recommended adopting policies to manage malnutrition in the community and hospitals.

  16. Severe neurological complications in association with Epstein-Barr virus infection

    NARCIS (Netherlands)

    Corssmit, E. P.; Leverstein-van Hall, M. A.; Portegies, P.; Bakker, P.

    1997-01-01

    Involvement of the nervous system in infectious mononucleosis is common. About 50% have headache on presentation. Neck stiffness without meningitis is a frequent finding. Severe neurological complications are rare though, occurring in fewer than 0.5%. We describe two patients with unusual and severe

  17. Inhibitor development and mortality in non-severe hemophilia A.

    Science.gov (United States)

    Eckhardt, C L; Loomans, J I; van Velzen, A S; Peters, M; Mauser-Bunschoten, E P; Schwaab, R; Mazzucconi, M G; Tagliaferri, A; Siegmund, B; Reitter-Pfoertner, S E; van der Bom, J G; Fijnvandraat, K

    2015-07-01

    The life expectancy of non-severe hemophilia A (HA) patients equals the life expectancy of the non-hemophilic population. However, data on the effect of inhibitor development on mortality and on hemophilia-related causes of death are scarce. The development of neutralizing factor VIII antibodies in non-severe HA patients may dramatically change their clinical outcome due to severe bleeding complications. We assessed the association between the occurrence of inhibitors and mortality in patients with non-severe HA. In this retrospective cohort study, clinical data and vital status were collected for 2709 non-severe HA patients (107 with inhibitors) who were treated between 1980 and 2011 in 34 European and Australian centers. Mortality rates for patients with and without inhibitors were compared. During 64,200 patient-years of follow-up, 148 patients died (mortality rate, 2.30 per 1000 person-years; 95% confidence interval (CI), 1.96-2.70) at a median age of 64 years (interquartile range [IQR], 49-76). In 62 patients (42%) the cause of death was hemophilia related. Sixteen inhibitor patients died at a median age of 71 years (IQR, 60-81). In ten patients the inhibitor was present at time of death; seven of them died of severe bleeding complications. The all-cause mortality rate in inhibitor patients was > 5 times increased compared with that for those without inhibitors (age-adjusted mortality rate ratio, 5.6). Inhibitor development in non-severe hemophilia is associated with increased mortality. High rates of hemophilia-related mortality in this study indicate that non-severe hemophilia is not mild at all and stress the importance of close follow-up for these patients. © 2015 International Society on Thrombosis and Haemostasis.

  18. Management of interest rate risk

    Directory of Open Access Journals (Sweden)

    Šabović Šerif

    2014-01-01

    Full Text Available Interest rate risk is one of the biggest and most dangerous risks that a bank is exposed to. When a change of interest rates occurs, the incomes of a bank based on credits and securities endure significant changes. Banks resources also endure some changes. The change of interest rates changes the value of the assets and liabilities of the bank and it's net and investment worth . The change of interest rates also affects bank's balance sheet, income sheet statement and bank's share capital.

  19. Surgical treatment of severe osteoporosis including new concept of advanced severe osteoporosis

    Directory of Open Access Journals (Sweden)

    Jin Hwan Kim

    2017-12-01

    Full Text Available Severe osteoporosis is classified as those with a bone mineral density (BMD T-score of −2.5 or lower, and demonstrate one or more of osteoporotic, low-trauma, fragility fractures. According to the general principle of surgical approach, patients with severe osteoporosis require not only more thorough pre- and postoperative treatment plans, but improvements in surgical fixtures and techniques such as the concept of a locking plate to prevent bone deformity and maximizing the blood flow to the fracture site by using a minimally invasive plate osteosynthesis. Arthroplasty is often performed in cases of displaced femoral neck fracture. Otherwise internal fixation for the goal of bone union is the generally accepted option for intertrochanteric, subtrochanteric, and femoral shaft fractures. Most of osteoporotic spine fracture is stable compression fracture, but vertebroplasty or kyphoplasty may be performed some selective patients. If neurological paralysis, severe spinal instability, or kyphotic deformity occurs, open decompression or fusion surgery may be considered. In order to overcome shortcomings of the World Health Organization definition of osteoporosis, we proposed a concept of ‘advanced severe osteoporosis,’ which is defined by the presence of proximal femur fragility fracture or two or more fragility fractures in addition to BMD T-score of −2.5 or less. In conclusion, we need more meticulous approach for surgical treatment of severe osteoporosis who had fragility fracture. In cases of advanced severe osteoporosis, we recommend more aggressive managements using parathyroid hormone and receptor activator of nuclear factor kappa-B ligand monoclonal antibody.

  20. Baseline incidence and severity of renal insufficiency evaluated by estimated glomerular filtration rates in patients scheduled for contrast-enhanced CT

    International Nuclear Information System (INIS)

    Utsunomiya, Daisuke; Yanaga, Yumi; Oda, Seitaro; Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Funama, Yoshinori

    2011-01-01

    Background Although pre-existing renal insufficiency (RI) is the most important risk factor for contrast-induced nephropathy (CIN), the background distribution of baseline renal function has not been investigated thoroughly in patients scheduled for contrast-enhanced CT. Purpose To investigate the incidence and severity of baseline RI evaluated by estimated glomerular filtration rates (eGFR) in patients who underwent contrast-enhanced CT at an academic center. Material and Methods A total of 6586 patients (3630 men and 2956 women; mean age 57.0 ± 11.9 years) who underwent contrast-enhanced CT between January and December 2008 were retrospectively studied. Of these, 829 had cardiovascular diseases (CVD), 5116 had oncologic diseases, 178 had diabetes mellitus (DM), and 1572 had chronic liver disease (CLD). The eGFR (mL/min/1.73 m 2 ) was calculated from their serum creatinine level. Mild, moderate-a, moderate-b, and severe RI were recorded at 60 2 at baseline was high in patients with advanced age, CVD and DM and in patients without oncologic disease

  1. Exchange rate policy under sovereign default risk

    OpenAIRE

    Schabert, Andreas

    2011-01-01

    We examine monetary policy options for a small open economy where sovereign default might occur due to intertemporal insolvency. Under interest rate policy and floating exchange rates the equilibrium is indetermined. Under a fixed exchange rate the equilibrium is uniquely determined and independent of sovereign default.

  2. Persistent and late occurring lesions in irradiated feet of rats: their clinical relevance

    International Nuclear Information System (INIS)

    Hopewell, J.W.

    1982-01-01

    Radiation-induced deformity, as characterized by tissue loss, has been investigated in rat feet. The acute epithelial response and the loss of deeper tissues occur concomitantly after irradiation. The greatest loss of tissue (severe deformity) was produced in feet where the healing of the epithelial reaction was greatly delayed. While deformity will clearly continue to ''persist'' after the acute reaction has healed it is misleading to refer to this lesion as ''late'' damage. A late-occurring lesion, not previously described in the literature, can be produced in the rat foot by high doses of radiation delivered in such a way that moist desquamation is avoided, i.e. by extending the total treatment time. Parallels are drawn between reactions in rodents and those in the skin of pig and man. (author)

  3. Severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2017-01-01

    BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...... for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. RESULTS: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections...

  4. Effects of ocean acidification on the dissolution rates of reef-coral skeletons

    Directory of Open Access Journals (Sweden)

    Robert van Woesik

    2013-11-01

    Full Text Available Ocean acidification threatens the foundation of tropical coral reefs. This study investigated three aspects of ocean acidification: (i the rates at which perforate and imperforate coral-colony skeletons passively dissolve when pH is 7.8, which is predicted to occur globally by 2100, (ii the rates of passive dissolution of corals with respect to coral-colony surface areas, and (iii the comparative rates of a vertical reef-growth model, incorporating passive dissolution rates, and predicted sea-level rise. By 2100, when the ocean pH is expected to be 7.8, perforate Montipora coral skeletons will lose on average 15 kg CaCO3 m−2 y−1, which is approximately −10.5 mm of vertical reduction of reef framework per year. This rate of passive dissolution is higher than the average rate of reef growth over the last several millennia and suggests that reefs composed of perforate Montipora coral skeletons will have trouble keeping up with sea-level rise under ocean acidification. Reefs composed of primarily imperforate coral skeletons will not likely dissolve as rapidly, but our model shows they will also have trouble keeping up with sea-level rise by 2050.

  5. Naturally occurring radionuclides in food

    International Nuclear Information System (INIS)

    Djujic, I.

    1995-01-01

    The naturally occurring radionuclides are the major source of radiation exposure to humans. The principal way of natural radiation exposure is the inhalation of 222 Rn decay products (about 85% of the total). The remainder is equally divided between internally deposited radionuclides, cosmic and terrestrial sources. In the present study, the content of 40 K, 210 Pb, 226 Ra, 230 Th, 232 Th and 238 U in representative food samples (milk, pork, beef, potatoes, wheat and corn flour) and samples of different food items that do not represent entire national production but provide interesting additional data for approximative calculation of naturally occurring radionuclide intake is presented. Daily weight of food eaten, participation of food groups, as well as daily intake by food of mentioned naturally occurring radionuclides in the Serbian diet was obtained on the base of house hold budget surveys. The result obtained for daily intake estimates in mBq for Serbian population are 78.1 ( 40 K), 38.2( 210 Pb), 52.3( 226 Ra), 2.0( 230 Th) and 12.5( 238 U). (author)

  6. Radiation and Radioactivity Levels Survey of Naturally Occurring Radioactive Materials (NORM) at PT Caltex Pacific Indonesia

    International Nuclear Information System (INIS)

    Bakri, Jusuf; Siregar, Roland

    2003-01-01

    PT Caltex Pacific Indonesia (CPI) is the largest oil company sharing contractor with Pertamina, located in Riau Province, Central Sumatera, employs about 6,800 employees and works together with 28,000 business partner employees. Currently CPI produces about 510,000 bbls crude oil. The production process mobilizes the naturally occurring radionuclides from deep reservoir rock that are deposited as Naturally Occurring Radioactive Materials (NORM) in well tubes, surface pipes, vessels and other processing equipment. NORM has a potential to be externally exposed during production process due to the accumulation of gamma emitting radionuclides and internal exposure to employees/business partners particularly during maintenance, sludge processing and decontamination of equipment. Understanding of the possible NORM hazards to human life, CPI initiated a NORM survey in order to obtain a clear picture of the magnitude of NORM in CPI operations. The survey has been conducted in 2001 and 2002 involved experts from Chevron Texaco USA, BATAN and BAPETEN Jakarta. The survey covered the determination of gamma exposure rates and the concentration of 238 U, 232 Th, 226 Ra, 228 Ra, 228 Th and 40 K in several samples taken from scale, sludge, tank bottom and sand. To safely management of NORM, the Industrial Health Team of Corporate Health, Environment and Safety in coordination with Training Center Team and BATAN have conducted a NORM training for Industrial Hygienist and employees exposed to NORM, developed Standard Operating Procedure for NORM Handling and Disposal and continuously performed NORM survey and mapping of all suspected areas. (author)

  7. Sarnet lecture notes on nuclear reactor severe accident phenomenology

    International Nuclear Information System (INIS)

    Trambauer, K.; Adroguer, B.; Fichot, F.; Muller, C.; Meyer, L.; Breitung, W.; Magallon, D.; Journeau, C.; Alsmeyer, H.; Housiadas, C.; Clement, B.; Ang, M.L.; Chaumont, B.; Ivanov, I.; Marguet, S.; Van Dorsselaere, J.P.; Fleurot, J.; Giordano, P.; Cranga, M.

    2008-01-01

    The 'Severe Accident Phenomenology Short Course' is part of the Excellence Spreading activities of the European Severe Accident Research NETwork of Excellence SARNET (project of the EURATOM 6. Framework programme). It was held at Cadarache, 9-13 January 2006. The course was divided in 14 lectures covering all aspects of severe accident phenomena that occur during a scenario. It also included lectures on PSA-2, Safety Assessment and design measures in new LWR plants for severe accident mitigation (SAM). This book presents the lecture notes of the Severe Accident Phenomenology Short Course and condenses the essential knowledge on severe accident phenomenology in 2008. (authors)

  8. Natural Transformation of Campylobacter jejuni Occurs Beyond Limits of Growth

    Science.gov (United States)

    Vegge, Christina S.; Brøndsted, Lone; Ligowska-Marzęta, Małgorzata; Ingmer, Hanne

    2012-01-01

    Campylobacter jejuni is a human bacterial pathogen. While poultry is considered to be a major source of food borne campylobacteriosis, C. jejuni is frequently found in the external environment, and water is another well-known source of human infections. Natural transformation is considered to be one of the main mechanisms for mediating transfer of genetic material and evolution of the organism. Given the diverse habitats of C. jejuni we set out to examine how environmental conditions and physiological processes affect natural transformation of C. jejuni. We show that the efficiency of transformation is correlated to the growth conditions, but more importantly that transformation occurs at growth-restrictive conditions as well as in the late stationary phase; hence revealing that growth per se is not required for C. jejuni to be competent. Yet, natural transformation of C. jejuni is an energy dependent process, that occurs in the absence of transcription but requires an active translational machinery. Moreover, we show the ATP dependent ClpP protease to be important for transformation, which possibly could be associated with reduced protein glycosylation in the ClpP mutant. In contrast, competence of C. jejuni was neither found to be involved in DNA repair following DNA damage nor to provide a growth benefit. Kinetic studies revealed that several transformation events occur per cell cycle indicating that natural transformation of C. jejuni is a highly efficient process. Thus, our findings suggest that horizontal gene transfer by natural transformation takes place in various habitats occupied by C. jejuni. PMID:23049803

  9. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder

    Science.gov (United States)

    Abdulkadir, Mohamed; Tischfield, Jay A.; King, Robert A.; Fernandez, Thomas V.; Brown, Lawrence W.; Cheon, Keun-Ah; Coffey, Barbara J.; de Bruijn, Sebastian F. T. M.; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L.; Grice, Dorothy E.; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G.; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D.; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L.; Openneer, Thaïra J. C.; Plessen, Kerstin J.; Rath, Judith J. G.; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A.; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H.; State, Matthew W.; Heiman, Gary A.; Hoekstra, Pieter J.; Dietrich, Andrea

    2016-01-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention–deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1,113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR=1.72) and morning sickness requiring medical attention (OR=2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR=1.07). Furthermore, neonatal complications were related to the presence (OR=1.46) and severity (b=2.27) of co-occurring OCD and also to ADHD severity (b=1.09). Delivery complications were only related to co-occurring OCD (OR=1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD. PMID:27494079

  10. Low glyphosate rates do not affect Citrus limonia (L.) Osbeck seedlings.

    Science.gov (United States)

    Gravena, Renan; Victoria Filho, Ricardo; Alves, Pedro Luis Ca; Mazzafera, Paulo; Gravena, Adriana R

    2009-04-01

    Glyphosate is used to control weeds in citrus orchards, and accidental spraying or wind drift onto the seedlings may cause growth arrest owing to metabolism disturbance. Two experiments were carried out to investigate the effect of non-lethal rates (0, 180, 360 and 720 g AI ha(-1)) of glyphosate on four-month-old 'Cravo' lime, Citrus limonia (L.) Osbeck, seedlings. Photosynthesis and the concentrations of shikimic acid, total free amino acids and phenolic acids were evaluated. Only transitory effects were observed in the contents of shikimate and total free amino acids. No visual effects were observed. The present study showed that glyphosate at non-lethal rates, which is very usual when accidental spraying or wind drift occurs in citrus orchard, did not cause severe metabolic damage in 'Cravo' lime seedlings. Copyright (c) 2009 Society of Chemical Industry.

  11. Study of 222Rn emanation levels present in naturally occurring radioactive materials - NORM

    International Nuclear Information System (INIS)

    Miranda, Marcia Valeria F.E. Sa; Crispim, Verginia Reis; Lima, Clara Teresa S.

    2009-01-01

    The presence of Naturally Occurring Radioactive Material (NORM), contaminating oil and gas installations, is usual in the petroleum industry, and can be severe enough to expose the workers to elevated levels of radiation. The segregation of contaminated residues although necessary, is still a problem without a satisfactory solution. Currently, the most practical and economic option for discarding this material is to stock it in areas of the installation with controlled access. Certain equipment used in the petroleum industry has scale and sludge that could be associated to important levels of radioactivity. Typically, the scales are mixtures of carbonate and sulphate minerals, such as barite (BaSO 4 ), that easily incorporate 226 Ra and 228 Ra in their structures. The objective of this work was to measure the emanations of the radon present in NORM samples, via diffusion chambers containing a nuclear track detector (CR-39). The images of α particle tracks emanated by 222 Rn registered on CR-39 were observed with a Nikon E400 optic microscope and captured by a Nikon Coolpix digital camera and then stored in a database, to later count the tracks using the computational program, Image Pro plus. Since the number of those tracks resulted proportional to the emanation rate of 222 Rn this methodology allowed the comparison of contamination levels in analyzed samples. (author)

  12. Model for GCR-particle fluxes in stony meteorites and production rates of cosmogenic nuclides

    International Nuclear Information System (INIS)

    Reedy, R.C.

    1984-01-01

    A model is presented for the differential fluxes of galactic-cosmic-ray (GCR) particles with energies above 1 MeV inside any spherical stony meteorite as a function of the meteorite's radius and the sample's depth. This model is based on the Reedy-Arnold equations for the energy-dependent fluxes of GCR particles in the moon and is an extension of flux parameters that were derived for several meteorites of various sizes. This flux is used to calculate the production rates of many cosmogenic nuclides as a function of radius and depth. The peak production rates for most nuclides made by the reactions of energetic GCR particles occur near the centers of meteorites with radii of 40 to 70 g cm -2 . Although the model has some limitations, it reproduces well the basic trends for the depth-dependent production of cosmogenic nuclides in stony meteorites of various radii. These production profiles agree fairly well with measurements of cosmogenic nuclides in meteorites. Some of these production profiles are different than those calculated by others. The chemical dependence of the production rates for several nuclides varies with size and depth. 25 references, 8 figures

  13. Neuropsychiatric aspects of severe brain injuries

    Directory of Open Access Journals (Sweden)

    O. S. Zaitsev

    2012-01-01

    Full Text Available The state-of-the-art of Russian neuropsychiatry and priority developments in different psychopathological syndromes in severe brain injuries are assessed. Many cognitive and emotional impairments are explained in terms of the idea on the organization of psychic activity over time. It is emphasized that to achieve the premorbid levels of an interhemispheric interaction and functional asymmetry of the cerebral hemispheres affords psychic activity recovery. The experience in investigating, classifying, and treating various mental disorders occurring after severe brain injuries is generalized. The basic principles of psychopharmacotherapy and rehabilitation of victims are stated.

  14. Managing Naturally Occurring Radioactive Materials In the Petroleum Industry in Egypt

    International Nuclear Information System (INIS)

    Bahsat, H.; Korany, Y.

    1999-01-01

    Naturally Occurring Radioactive Materials (NORM) have been known to be present in varying concentrations in hydrocarbon reservoirs. These NORM under certain reservoir conditions can reach hazardous contamination levels.the recognition of NORM as a potential source of contamination to oil and gas facilities has become widely spread and gained increased momentum from the industry. Some contamination levels may be sufficiently severe that maintenance and other personnel may be sufficiently severe that maintenance and other personnel may be exposed to hazardous concentrations. Health and environmental concerns regarding NORM have become an important safety issue in upstream petroleum industry in Egypt since the early 1990's when NORM have been detected in different gas and oil production facilities. In these facilities, radiation protection measures were taken to realize safe handling and disposal of NORM according to the applicable international standards. This paper describes the extent of the NORM contamination problem in Egypt and presents guidelines for dealing with NORM based on the latest scientific techniques and international experiences

  15. Appendix : airborne incidents : an econometric analysis of severity

    Science.gov (United States)

    2014-12-19

    This is the Appendix for Airborne Incidents: An Econometric Analysis of Severity Report. : Airborne loss of separation incidents occur when an aircraft breaches the defined separation limit (vertical and/or horizontal) with another aircraft or terrai...

  16. Surviving severe traumatic brain injury in Denmark

    DEFF Research Database (Denmark)

    Odgaard, Lene; Poulsen, Ingrid; Kammersgaard, Lars Peter

    2015-01-01

    PURPOSE: To identify all hospitalized patients surviving severe traumatic brain injury (TBI) in Denmark and to compare these patients to TBI patients admitted to highly specialized rehabilitation (HS-rehabilitation). PATIENTS AND METHODS: Patients surviving severe TBI were identified from...... severe TBI were admitted to HS-rehabilitation. Female sex, older age, and non-working status pre-injury were independent predictors of no HS-rehabilitation among patients surviving severe TBI. CONCLUSION: The incidence rate of hospitalized patients surviving severe TBI was stable in Denmark...

  17. Should Magnesium Sulphate Prophylaxis be Used in all Cases of Severe Preeclampsia?

    Directory of Open Access Journals (Sweden)

    Sohini Bhattacharya,

    2011-01-01

    Full Text Available A case control study, undertaken in the department of Obstetrics and Gynecology in a tertiary referral centre, was designed to administer standard dose of magnesium sulphate to 50 randomly selected severely preeclamptic women in labor (Group 1. 48 women who formed the control group did not receive the drug (Group 2. The admission – delivery interval, rate of Cesarean section showed no statistically significant difference. Four patients developed convulsions in Group 1 in contrast to twelve patients in Group 2. Efficacy of magnesium sulphate at preventing eclampsia was calculated as 68%. Mild respiratory depression occurred in two cases and oliguria in eight cases in Group 1. Both the conditions improved on suspending further doses of magnesium sulphate. No patient had post partum haemorrhage in Group 1 although 4% patients had it in Group 2. Neonatal outcome was comparable in both the groups. Hence magnesium sulphate may be regarded as a fairly safe and effective prophylactic agent for eclampsia when used in severe preeclampsia in labor.

  18. Induction of interleukin 1 by synthetic and naturally occurring muramyl peptides.

    Science.gov (United States)

    Dinarello, C A; Krueger, J M

    1986-10-01

    Like bacterial lipopolysaccharides (endotoxins), synthetic muramyl peptides (MPs) are thought to exert many of their biological effects by inducing the production of various mediators from host cells. Both synthetic muramyl dipeptide (MDP) and naturally occurring sleep factor (SF), which contains an MP structure, stimulate human monocytes to produce interleukin 1 (IL 1). IL 1 is a family of unique polypeptides that mediate a variety of host defense functions and possess several biological properties, many of which are shared with MPs. Endotoxins are potent inducers of IL 1, but polymyxin B, which blocks endotoxin's biological activities, has no effect on MP-induced IL 1 production. SF purified from human urine and SF isolated from the peritoneal fluid of patients undergoing chronic ambulatory peritoneal dialysis (CAPD) induce IL 1 when incubated with human mononuclear cells in vitro. SF from urine or CAPD fluid induces IL 1 production in the picrogram per milliliter range whereas synthetic MDP requires microgram per milliliter concentrations. Thus, both synthetic and naturally occurring MPs exert their biological effects, in part, by inducing IL 1.

  19. Expression of cytoskeletal and matrix genes following exposure to ionizing radiation: Dose-rate effects and protein synthesis requirements

    International Nuclear Information System (INIS)

    Woloschak, G.E.; Felcher, P.; Chang-Liu, Chin-Mei

    1992-01-01

    Experiments were designed to examine the effects of radiation dose-rate and of the protein synthesis inhibitor cycloheximide on expression of cytoskeletal elements (γ- and β-actin and α-tubulin) and matrix elements (fibronectin) in Syrian hamster embryo cells. Past work from our laboratory had already demonstrated optimum time points and doses for examination of radiation effects on accumulation of specific transcripts. Our results here demonstrated little effect of dose-rate for JANUS fission spectrum neutrons when comparing expression of either α-tubulin or fibronectin genes. Past work had already documented similar results for expression of actin transcripts. Effects of cycloheximide, however, revealed several interesting and novel findings: (1) Cycloheximide repressed accumulation of α-tubulin following exposure to high dose-rate neutrons or γ rays; this did not occur following similar low dose-rate exposure (2) Cycloheximide did not affect accumulation of mRNA for actin genes. Cycloheximide abrogated the moderate induction of fibronectin-mRNA which occurred following exposure to γ rays and high dose-rate neutrons. These results suggest a role for labile proteins in the maintenance of α-tubulin and fibronectin mRNA accumulation following exposure to ionizing radiation. In addition, they suggest that the cellular/molecular response to low dose-rate neutrons may be different from the response to high dose-rate neutrons

  20. How Often Do Thermally Excited 630.0 nm Emissions Occur in the Polar Ionosphere?

    Science.gov (United States)

    Kwagala, Norah Kaggwa; Oksavik, Kjellmar; Lorentzen, Dag A.; Johnsen, Magnar G.

    2018-01-01

    This paper studies thermally excited emissions in the polar ionosphere derived from European Incoherent Scatter Svalbard radar measurements from the years 2000-2015. The peak occurrence is found around magnetic noon, where the radar observations show cusp-like characteristics. The ionospheric, interplanetary magnetic field and solar wind conditions favor dayside magnetic reconnection as the dominant driving process. The thermal emissions occur 10 times more frequently on the dayside than on the nightside, with an average intensity of 1-5 kR. For typical electron densities in the polar ionosphere (2 × 1011 m-3), we find the peak occurrence rate to occur for extreme electron temperatures (>3000 K), which is consistent with assumptions in literature. However, for extreme electron densities (>5 × 1011 m-3), we can now report on a completely new population of thermal emissions that may occur at much lower electron temperatures (˜2300 K). The empirical atmospheric model (NRLMSISE-00) suggests that the latter population is associated with enhanced neutral atomic oxygen densities.

  1. Baseline performance and learning rate of conceptual and perceptual skill-learning tasks: the effect of moderate to severe traumatic brain injury.

    Science.gov (United States)

    Vakil, Eli; Lev-Ran Galon, Carmit

    2014-01-01

    Existing literature presents a complex and inconsistent picture of the specific deficiencies involved in skill learning following traumatic brain injury (TBI). In an attempt to address this difficulty, individuals with moderate to severe TBI (n = 29) and a control group (n = 29) were tested with two different skill-learning tasks: conceptual (i.e., Tower of Hanoi Puzzle, TOHP) and perceptual (i.e., mirror reading, MR). Based on previous studies of the effect of divided attention on these tasks and findings regarding the effect of TBI on conceptual and perceptual priming tasks, it was predicted that the group with TBI would show impaired baseline performance compared to controls in the TOHP task though their learning rate would be maintained, while both baseline performance and learning rate on the MR task would be maintained. Consistent with our predictions, overall baseline performance of the group with TBI was impaired in the TOHP test, while the learning rate was not. The learning rate on the MR task was preserved but, contrary to our prediction, response time of the group with TBI was slower than that of controls. The pattern of results observed in the present study was interpreted to possibly reflect an impairment of both the frontal lobes as well as that of diffuse axonal injury, which is well documented as being affected by TBI. The former impairment affects baseline performance of the conceptual learning skill, while the latter affects the overall slower performance of the perceptual learning skill.

  2. THE INJURY SEVERITY RATE DIFFERENCES IN PASSENGER CARS AND PICK UP TRUCKS RELATED TWO VEHICLE INVOLVED MOTOR VEHICLE CRASHES IN BRITISH COLUMBIA, CANADA

    Directory of Open Access Journals (Sweden)

    E.B.R. DESAPRIYA

    2004-01-01

    Full Text Available The effect of large vehicle involvement on motor vehicle crash (MVC rates and severity has long been a concern in MVC analysis literature. Injuries in drivers and occupants are related to several key factors: the mass of the case vehicle and mass of its collision partner and speed of case vehicle and collision partner at the time of the crash. Objective: To evaluate the relative risk of injury occurrence in collisions between picks up trucks (PU and passenger sedan cars (PS. Methods: Data from the Insurance Corporation of British Columbia (ICBC crash data base was used to determine MVC rates and injury occurrence. Descriptive characteristics of the injury location and injury type were analyzed comparing the Odds Ratios and chi-squares. Results: PS occupants received more injuries; Odds Ratio was 2.49 (95% confidence interval: 2.15–2.88. Conclusion: Occupants in PS which collide with PU were at twice the risk of injuries. Concussion, whiplash, lacerations and abrasion were more frequent in PS drivers and occupants than in PU drivers and occupants. Overall, PS drivers/occupants experienced greater injuries than PU drivers/occupants in PU-PS collisions. In this paper, results are shown as odds ratios comparing occupants injuries in PS (case group with occupant injuries in PU (control group.

  3. Survey of valve operator-related events occurring during 1978, 1979 and 1980

    International Nuclear Information System (INIS)

    Brown, E.J.; Ashe, F.S.

    1983-01-01

    The survey approach was to analyze several events and identify trends or patterns. The primary data source was licensee event reports (LERs) and consisted of 444 total valve operator events with 193 motor operator events which served as the basis for this study. The investigation revealed that motor-operated events could be grouped in three major categories which are torque switches, limit switches, and motors. The major findings are: (1) Torque switches do not appear to be a dominant cause of valve assembly inoperability. The reported information suggests torque switch events are an indication of symptomatic change with time in valve operability characteristics rather than a root cause of valve inoperability. (2) Repetitive problems are occurring with valve operators. It may occur on the same valve, a valve in similar service in a similar system, or a valve in similar service in a redundant train of the same system. (3) The plant operating staff objective appears to be a mode of finding measures to return inoperable equipment to operational status rather than to determine root causes of inoperability. (4) Motor burnout of valve motor operators has occurred quite frequently in High Pressure Coolant Injection (HPCI) and Reactor Core Isolation Cooling (RCIC) systems of BWR units. (orig./GL)

  4. Severe maternal morbidity in Zanzibar's referral hospital: Measuring the impact of in-hospital care.

    Directory of Open Access Journals (Sweden)

    Tanneke Herklots

    Full Text Available to analyse the impact of in-hospital care on severe maternal morbidity using WHO's near-miss approach in the low-resource, high mortality setting of Zanzibar's referral hospital.Mnazi Mmoja Hospital, a tertiary care facility, in Zanzibar, Tanzania.We identified all cases of morbidity and mortality in women admitted within 42 days after the end of pregnancy at Mnazi Mmoja Hospital in the period from April to October 2016. The severity of complications was classified using WHO's near-miss approach definitions: potentially life-threatening condition (PLTC, maternal near-miss (MNM or maternal death (MD. Quality of in-hospital care was assessed using the mortality index (MI defined as ratio between mortality and severe maternal outcome (SMO where SMO = MD + MNM, cause-specific case facility rates and comparison with predicted mortality based on the Maternal Severity Index model.5551 women were included. 569 (10.3% had a potentially life-threatening condition and 65 (1.2% a severe maternal outcome (SMO: 37 maternal near-miss cases and 28 maternal deaths. The mortality index was high at 0.43 and similar for women who developed a SMO within 12 hours of admission and women who developed a SMO after 12 hours. A standardized mortality ratio of 6.03 was found; six times higher than that expected in moderate maternal mortality settings given the same severity of cases. Obstetric haemorrhage was found to be the main cause of SMO. Ruptured uterus and admission to ICU had the highest case-fatality rates. Maternal death cases seemed to have received essential interventions less often.WHO's near-miss approach can be used in this setting. The high mortality index observed shows that in-hospital care is not preventing progression of disease adequately once a severe complication occurs. Almost one in two women experiencing life-threatening complications will die. This is six times higher than in moderate mortality settings.

  5. Spontaneous mutation rates and the rate-doubling dose

    International Nuclear Information System (INIS)

    Von Borstel, R.C.; Moustaccki, E.; Latarjet, R.

    1978-01-01

    The amount of radiation required to double the frequency of mutations or tumours over the rate of those that occur spontaneously is called the rate-doubling dose. An equivalent concept has been proposed for exposure to other environmental mutagens. The doubling dose concept is predicated on the assumption that all human populations have the same spontaneous mutation rate, and that this spontaneous mutation rate is known. It is now established for prokaryotes and lower eukaryotes that numerous genes control the spontaneous mutation rate, and it is likely that the same is true for human cells as well. Given that the accepted mode of evolution of human populatons is from small, isolated groups of individuals, it seems likely that each population would have a different spontaneous mutation rate. Given that a minimum of twenty genes control or affect the spontaneous mutation rate, and that each of these in turn is susceptible to spontaneously arising or environmentally induced mutations, it seems likely that every individual within a population (except for siblings from identical multiple births) will have a unique spontaneous mutation rate. If each individual in a population does have a different spontaneous mutation rate, the doubling dose concept, in rigorous terms, is fallacious. Therefore, as with other concepts of risk evaluation, the doubling dose concept is subject to criticism. Nevertheless, until we know individual spontaneous mutation rates with precision, and can evaluate risks based on this information, the doubling dose concept has a heuristic value and is needed for practical assessment of risks for defined populations. (author)

  6. Adulthood outcome of tic and obsessive-compulsive symptom severity in children with Tourette syndrome.

    Science.gov (United States)

    Bloch, Michael H; Peterson, Bradley S; Scahill, Lawrence; Otka, Jessica; Katsovich, Lily; Zhang, Heping; Leckman, James F

    2006-01-01

    Tourette syndrome (TS) is a childhood-onset neuropsychiatric disorder that is characterized by both motor and phonic tics. One half to two thirds of children with TS experience a reduction or complete resolution of tic symptoms during adolescence. At least one third of adults with TS have comorbid obsessive-compulsive disorder (OCD). To clarify the clinical course of tic and OCD symptoms in children with TS and determine if baseline clinical measurements in childhood are associated with future symptom severity in late adolescence and early adulthood. Prospective cohort study. Yale Child Study Center tic and OCD outpatient specialty clinic. Forty-six children with TS who received a structured clinical evaluation prior to age 14 years. Expert-rated tic and OCD symptom severity at follow-up interview an average of 7.6 years later (range, 3.8-12.8 years). Eighty-five percent of subjects reported a reduction in tic symptoms during adolescence. Only increased tic severity in childhood was associated with increased tic severity at follow-up. The average age at worst-ever tic severity was 10.6 years. Forty-one percent of patients with TS reported at one time experiencing at least moderate OCD symptoms. Worst-ever OCD symptoms occurred approximately 2 years later than worst-ever tic symptoms. Increased childhood IQ was strongly associated with increased OCD severity at follow-up. Obsessive-compulsive disorder symptoms in children with TS became more severe at a later age and were more likely to persist than tic symptoms.

  7. Antibody-mediated neutralization of Ebola virus can occur by two distinct mechanisms

    International Nuclear Information System (INIS)

    Shedlock, Devon J.; Bailey, Michael A.; Popernack, Paul M.; Cunningham, James M.; Burton, Dennis R.; Sullivan, Nancy J.

    2010-01-01

    Human Ebola virus causes severe hemorrhagic fever disease with high mortality and there is no vaccine or treatment. Antibodies in survivors occur early, are sustained, and can delay infection when transferred into nonhuman primates. Monoclonal antibodies (mAbs) from survivors exhibit potent neutralizing activity in vitro and are protective in rodents. To better understand targets and mechanisms of neutralization, we investigated a panel of mAbs shown previously to react with the envelope glycoprotein (GP). While one non-neutralizing mAb recognized a GP epitope in the nonessential mucin-like domain, the rest were specific for GP1, were neutralizing, and could be further distinguished by reactivity with secreted GP. We show that survivor antibodies, human KZ52 and monkey JP3K11, were specific for conformation-dependent epitopes comprising residues in GP1 and GP2 and that neutralization occurred by two distinct mechanisms; KZ52 inhibited cathepsin cleavage of GP whereas JP3K11 recognized the cleaved, fusion-active form of GP.

  8. Synthesis of the IRSN report on the issue of severe accidents which may occur on operating pressurised water nuclear reactors

    International Nuclear Information System (INIS)

    2008-01-01

    While containing other related documents (expert report, mail), this synthetic report analyses and comments some aspects of the assessment and treatment of severe accidents by EDF in its operating PWRs (pressurised water nuclear reactors). These aspects are: the EDF referential related to severe accidents (objectives of consequence limitation and prevention, long term management, probabilistic objectives, radiological objectives, expected performance of equipment and systems), the re-assessment of the 'S3 reference source term' which corresponds to a typical discharge (selection of representative scenarios, new approach based on waste categorization, the taking into account of various species, components and systems), the water management in the reactor tank (risks of explosion, of critical corium level, etc.), the strategy of an anticipated opening of the containment envelope venting-filtration device in order to avoid a core fusion, and the risk associated by a cesspool filling-in by debris

  9. COPD exacerbations by disease severity in England

    Directory of Open Access Journals (Sweden)

    Merinopoulou E

    2016-04-01

    Full Text Available Evie Merinopoulou,1 Mireia Raluy-Callado,1 Sreeram Ramagopalan,1 Sharon MacLachlan,1 Javaria Mona Khalid2 1Real-World Evidence, Evidera, 2Takeda Development Centre Europe Ltd, London, UK Objectives: Exacerbations of chronic obstructive pulmonary disease (COPD are associated with accelerated disease progression and are important drivers of health care resource utilization. The study aimed to quantify the rates of COPD exacerbations in England and assess health care resource utilization by severity categories according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2013.Methods: Data from the Clinical Practice Research Datalink linked to Hospital Episode Statistics were used to identify patients with a COPD diagnosis aged ≥40 years. Those with complete spirometric, modified Medical Research Council Dyspnea Scale information, and exacerbation history 12 months prior to January 1, 2011 (index date were classified into GOLD severity groups. Study outcomes over follow-up (up to December 31, 2013 were exacerbation rates and resource utilization (general practitioner visits, hospital admissions.Results: From the 44,201 patients in the study cohort, 83.5% were classified into severity levels GOLD A: 33.8%, GOLD B: 21.0%, GOLD C: 18.1%, and GOLD D: 27.0%. Mean age at diagnosis was 66 years and 52.0% were male. Annual exacerbation rates per person-year increased with severity, from 0.83 (95% confidence interval [CI]: 0.81–0.85 for GOLD A to 2.51 (95% CI: 2.47–2.55 for GOLD D. General practitioner visit rates per person-year also increased with severity, from 4.82 (95% CI: 4.74–4.93 for GOLD A to 7.44 (95% CI: 7.31–7.61 for GOLD D. COPD-related hospitalization rates per person-year increased from less symptoms (GOLD A: 0.28, GOLD C: 0.39 to more symptoms (GOLD B: 0.52, GOLD D: 0.84.Conclusion: Patients in the most severe category (GOLD D experienced nearly three times the number of exacerbations and COPD

  10. Left atrial volume and function in dogs with naturally occurring myxomatous mitral valve disease

    DEFF Research Database (Denmark)

    Höllmer, M.; Willesen, J. L.; Tolver, A.

    2017-01-01

    stroke volume increased, whereas LA reservoir and contractile function decreased with increasing disease severity. A maximal LA volume heart failure in dogs with chronic MMVD with a sensitivity of 96% and a specificity of 100......%. An active LA emptying fraction heart failure in dogs with chronic MMVD with a sensitivity of 77% and a specificity of 89% and a sensitivity of 82% and a specificity of 82%, respectively. CONCLUSION: Dogs with MMVD appear to have larger LA...... of cardiac compensation. Left atrial function in dogs with naturally occurring MMVD remains largely unexplored. The objective of this study was to evaluate LA volume and function in dogs with naturally occurring MMVD. ANIMALS: This prospective study included 205 client-owned dogs of different breeds, 114...

  11. Preliminary Development and Evaluation of Lightning Jump Algorithms for the Real-Time Detection of Severe Weather

    Science.gov (United States)

    Schultz, Christopher J.; Petersen, Walter A.; Carey, Lawrence D.

    2009-01-01

    Previous studies have demonstrated that rapid increases in total lightning activity (intracloud + cloud-to-ground) are often observed tens of minutes in advance of the occurrence of severe weather at the ground. These rapid increases in lightning activity have been termed "lightning jumps." Herein, we document a positive correlation between lightning jumps and the manifestation of severe weather in thunderstorms occurring across the Tennessee Valley and Washington D.C. A total of 107 thunderstorms were examined in this study, with 69 of the 107 thunderstorms falling into the category of non-severe, and 38 into the category of severe. From the dataset of 69 isolated non-severe thunderstorms, an average peak 1 minute flash rate of 10 flashes/min was determined. A variety of severe thunderstorm types were examined for this study including an MCS, MCV, tornadic outer rainbands of tropical remnants, supercells, and pulse severe thunderstorms. Of the 107 thunderstorms, 85 thunderstorms (47 non-severe, 38 severe) from the Tennessee Valley and Washington D.C tested 6 lightning jump algorithm configurations (Gatlin, Gatlin 45, 2(sigma), 3(sigma), Threshold 10, and Threshold 8). Performance metrics for each algorithm were then calculated, yielding encouraging results from the limited sample of 85 thunderstorms. The 2(sigma) lightning jump algorithm had a high probability of detection (POD; 87%), a modest false alarm rate (FAR; 33%), and a solid Heidke Skill Score (HSS; 0.75). A second and more simplistic lightning jump algorithm named the Threshold 8 lightning jump algorithm also shows promise, with a POD of 81% and a FAR of 41%. Average lead times to severe weather occurrence for these two algorithms were 23 minutes and 20 minutes, respectively. The overall goal of this study is to advance the development of an operationally-applicable jump algorithm that can be used with either total lightning observations made from the ground, or in the near future from space using the

  12. Blunt splenic injury and severe brain injury: a decision analysis and implications for care

    Science.gov (United States)

    Alabbasi, Thamer; Nathens, Avery B.; Tien, Col Homer

    2015-01-01

    Background The initial nonoperative management (NOM) of blunt splenic injuries in hemodynamically stable patients is common. In soldiers who experience blunt splenic injuries with concomitant severe brain injury while on deployment, however, NOM may put the injured soldier at risk for secondary brain injury from prolonged hypotension. Methods We conducted a decision analysis using a Markov process to evaluate 2 strategies for managing hemodynamically stable patients with blunt splenic injuries and severe brain injury — immediate splenectomy and NOM — in the setting of a field hospital with surgical capability but no angiography capabilities. We considered the base case of a 40-year-old man with a life expectancy of 78 years who experienced blunt trauma resulting in a severe traumatic brain injury and an isolated splenic injury with an estimated failure rate of NOM of 19.6%. The primary outcome measured was life expectancy. We assumed that failure of NOM would occur in the setting of a prolonged casualty evacuation, where surgical capability was not present. Results Immediate splenectomy was the slightly more effective strategy, resulting in a very modest increase in overall survival compared with NOM. Immediate splenectomy yielded a survival benefit of only 0.4 years over NOM. Conclusion In terms of overall survival, we would not recommend splenectomy unless the estimated failure rate of NOM exceeded 20%, which corresponds to an American Association for the Surgery of Trauma grade III splenic injury. For military patients for whom angiography may not be available at the field hospital and who require prolonged evacuation, immediate splenectomy should be considered for grade III–V injuries in the presence of severe brain injury. PMID:26100770

  13. Rate-Agnostic (Causal) Structure Learning.

    Science.gov (United States)

    Plis, Sergey; Danks, David; Freeman, Cynthia; Calhoun, Vince

    2015-12-01

    Causal structure learning from time series data is a major scientific challenge. Extant algorithms assume that measurements occur sufficiently quickly; more precisely, they assume approximately equal system and measurement timescales. In many domains, however, measurements occur at a significantly slower rate than the underlying system changes, but the size of the timescale mismatch is often unknown. This paper develops three causal structure learning algorithms, each of which discovers all dynamic causal graphs that explain the observed measurement data, perhaps given undersampling. That is, these algorithms all learn causal structure in a "rate-agnostic" manner: they do not assume any particular relation between the measurement and system timescales. We apply these algorithms to data from simulations to gain insight into the challenge of undersampling.

  14. Several unusual cases of child abuse.

    Science.gov (United States)

    Palmer, H; Weston, J T

    1976-10-01

    All childhood deaths which occurred in New Mexico during 1974 and 1975 were reviewed. Nine fatal instances of abuse were identified representing the entire spectrum of physical abuse: neglect, abuse in a single episode of injury, repetitive abuse, or sexual abuse. Several cases are summarized. These are unusual either in the distribution of pathologic findings or in the problems encountered in court presentation.

  15. The effect of altitude and climate on the suicide rates in Turkey.

    Science.gov (United States)

    Asirdizer, Mahmut; Kartal, Erhan; Etli, Yasin; Tatlisumak, Ertugrul; Gumus, Orhan; Hekimoglu, Yavuz; Keskin, Sıddık

    2018-02-01

    Suicide is one of the most important public health problems. There was an association between suicide and several factors such as psychiatric diseases and psychological characteristics, somatic illness, cultural, socioeconomic, familial, occupational and individual risk factors. Also, high altitude and climatic factors including high temperature, cloudiness, more sunshine and low rainfalls were defined as some of these risk factors in the literature. In this study, we aimed to investigate correlation between suicide rates and altitudes of all cities in Turkey and between suicide rates and climatic factors including Rainfall Activity Index, Winter Mean Temperatures, Summer Mean Temperatures and Temperature Difference between January and July previously defined by several authors in the broad series in Turkey. In Turkey, 29865 suicidal deaths occurred in 10 years period between 2006 and 2015. Of them, 21020 (70.4%) were males and 8845 (29.6%) were females. In this study, we found that high altitude above 1500 m, winter median temperature lower than -10 °C and hard temperature changes above 25 °C between winter and summer of settlements were important factors that affected on female suicide rates appropriate to knowledge which defined in previous studies. In conclusion, we suggested that the associations among suicide rates with altitudes and climate should be studied in wider series obtained from different countries for reaching more reliable results. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Severity of cerebral palsy and likelihood of adverse events after botulinum toxin A injections.

    Science.gov (United States)

    Swinney, Caitlyn M; Bau, Karen; Burton, Karen L Oakley; O'Flaherty, Stephen J; Bear, Natasha L; Paget, Simon P

    2018-05-01

    To determine the incidence of common adverse events after botulinum toxin A (BoNT-A) injections in children with cerebral palsy (CP) and to identify whether the severity of CP influences the incidence of adverse events. This was an observational study of patients attending a BoNT-A clinic at a tertiary paediatric hospital (2010-2014). Data examined included procedural adverse events at the time of injection and at follow-up. Systemic adverse events were defined as lower respiratory tract illnesses, generalized weakness, dysphagia, and death. Severity of CP was categorized by the Gross Motor Function Classification System (GMFCS). The relationships between GMFCS and adverse events were analysed using negative binomial regression models. In total, 591 children underwent 2219 injection episodes. Adverse events were reported during the procedure (130 [6%] injection episodes) and at follow-up (492 [22%] injection episodes). There were significantly increased rates of systemic adverse events in injection episodes involving children in GMFCS level IV (incidence rate ratio [IRR] 3.92 [95% confidence interval] 1.45-10.57]) and GMFCS level V (IRR 7.37 [95% confidence interval 2.90-18.73]; p<0.001). Adverse events after BoNT-A injections are common but mostly mild and self-limiting. Children in GMFCS levels IV and V are at increased risk of systemic adverse events. The relationship between CP severity and BoNT-A adverse events is complex and further research is required to better understand this relationship. Adverse events reported at the time of botulinum toxin A injection occurred in 6% of injection episodes. Adverse events were reported at follow-up in 22% of injection episodes. Children in Gross Motor Function Classification System (GMFCS) levels IV and V have increased rates of systemic adverse events. Children in GMFCS levels IV and V report less local weakness and pain. © 2018 Mac Keith Press.

  17. An analysis of severe air transport accidents

    International Nuclear Information System (INIS)

    McClure, J.D.; Luna, R.E.

    1989-01-01

    The objective of this paper is to analyze the severity of aircraft accidents that may involve the air transport of radioactive materials (RAM). One of the basic aims of this paper is to provide a numerical description of the severity of aircraft transport accidents so that the accident severity can be compared with the accident performance standards that are specified in IAEA Safety Series 6, the international packaging standards for the safe movement of RAM. The existing packaging regulations in most countries embrace the packaging standards developed by the IAEA. Historically, the packaging standards for Type B packages have been independent of the transport mode. That is, if the shipment occurs in a certified packaging, then the shipment can take place by any transport mode. In 1975, a legislative action occurred in the US Congress which led to the development of a package designed specifically for the air transport of plutonium. Changes were subsequently made to the US packaging regulations in 10CFR71 to incorporate the plutonium air transport performance standards. These standards were used to certify the air transport package for plutonium which is commonly referred to as PAT-1 (US NRC). The PAT-1 was certified by the US Nuclear Regulatory Commission in September 1978

  18. Eddy-current flow rate meter for measuring sodium flow rates

    International Nuclear Information System (INIS)

    Knaak, J.

    1976-01-01

    For safety reasons flow rate meters for monitoring coolant flow rates are inserted in the core of sodium-cooled fast breeder reactors. These are so-called eddy-current flow rate meters which can be mounted directly above the fuel elements. In the present contribution the principle of measurement, the mechanical construction and the circuit design of the flow rate measuring device are described. Special problems and their solution on developing the measuring system are pointed out. Finally, results of measurement and experience with the apparatus in several experiments are reported, where also further possibilities of application were tested. (orig./TK) [de

  19. Validation and simplification of Fournier's gangrene severity index.

    Science.gov (United States)

    Lin, Tsung-Yen; Ou, Chien-Hui; Tzai, Tzong-Shin; Tong, Yat-Ching; Chang, Chien-Chen; Cheng, Hong-Lin; Yang, Wen-Horng; Lin, Yung-Ming

    2014-07-01

    To validate the predictive value of Fournier's Gangrene Severity Index in patients with Fournier gangrene and to facilitate patient mortality risk-stratification by simplifying the Fournier's Gangrene Severity Index. From January 1989 to December 2011, 85 male patients with clinically-documented Fournier's gangrene undergoing intensive treatment and with complete medical records were recruited. The demographic information and nine parameters of Fournier's Gangrene Severity Index were compared between survivors and non-survivors. The parameters that showed a significant difference between the two groups were selected to generate a simplified scoring index. Of the 85 patients recruited, 16 patients died of the disease with mortality rate of 18.8%. The Fournier's Gangrene Severity Index score at initial diagnosis was significantly higher in non-survivors than in survivors. Of the nine parameters of Fournier's Gangrene Severity Index, the scores of serum creatinine level, hematocrit level and serum potassium level were significantly different between the two groups. However, the mean body temperatures, heart rate, respiration rate, white blood cell count, serum sodium and bicarbonate levels were non-significantly different. Of the 12 patients with chronic kidney disease or end-stage renal disease, 10 died of severe sepsis. A simplified scoring index including parameters of creatinine, hematocrit and potassium was generated, which provided sensitivity and specificity of 87% and 77% in predicting patient mortality, respectively. The predictive values of this simplified Fournier's Gangrene Severity Index were shown to be non-inferior to Fournier's Gangrene Severity Index in our patients. The simplified Fournier's Gangrene Severity Index is easy to use at initial diagnosis, and offers a way to compare outcomes in different clinical populations. © 2014 The Japanese Urological Association.

  20. Pre- and perinatal complications in relation to Tourette syndrome and co-occurring obsessive-compulsive disorder and attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Abdulkadir, Mohamed; Tischfield, Jay A; King, Robert A; Fernandez, Thomas V; Brown, Lawrence W; Cheon, Keun-Ah; Coffey, Barbara J; de Bruijn, Sebastian F T M; Elzerman, Lonneke; Garcia-Delgar, Blanca; Gilbert, Donald L; Grice, Dorothy E; Hagstrøm, Julie; Hedderly, Tammy; Heyman, Isobel; Hong, Hyun Ju; Huyser, Chaim; Ibanez-Gomez, Laura; Kim, Young Key; Kim, Young-Shin; Koh, Yun-Joo; Kook, Sodahm; Kuperman, Samuel; Lamerz, Andreas; Leventhal, Bennett; Ludolph, Andrea G; Madruga-Garrido, Marcos; Maras, Athanasios; Messchendorp, Marieke D; Mir, Pablo; Morer, Astrid; Münchau, Alexander; Murphy, Tara L; Openneer, Thaïra J C; Plessen, Kerstin J; Rath, Judith J G; Roessner, Veit; Fründt, Odette; Shin, Eun-Young; Sival, Deborah A; Song, Dong-Ho; Song, Jungeun; Stolte, Anne-Marie; Tübing, Jennifer; van den Ban, Els; Visscher, Frank; Wanderer, Sina; Woods, Martin; Zinner, Samuel H; State, Matthew W; Heiman, Gary A; Hoekstra, Pieter J; Dietrich, Andrea

    2016-11-01

    Pre- and perinatal complications have been implicated in the onset and clinical expression of Tourette syndrome albeit with considerable inconsistencies across studies. Also, little is known about their role in co-occurring obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder (ADHD) in individuals with a tic disorder. Therefore, we aimed to investigate the role of pre- and perinatal complications in relation to the presence and symptom severity of chronic tic disorder and co-occurring OCD and ADHD using data of 1113 participants from the Tourette International Collaborative Genetics study. This study included 586 participants with a chronic tic disorder and 527 unaffected family controls. We controlled for age and sex differences by creating propensity score matched subsamples for both case-control and within-case analyses. We found that premature birth (OR = 1.72) and morning sickness requiring medical attention (OR = 2.57) were associated with the presence of a chronic tic disorder. Also, the total number of pre- and perinatal complications was higher in those with a tic disorder (OR = 1.07). Furthermore, neonatal complications were related to the presence (OR = 1.46) and severity (b = 2.27) of co-occurring OCD and also to ADHD severity (b = 1.09). Delivery complications were only related to co-occurring OCD (OR = 1.49). We conclude that early exposure to adverse situations during pregnancy is related to the presence of chronic tic disorders. Exposure at a later stage, at birth or during the first weeks of life, appears to be associated with co-occurring OCD and ADHD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. A case of angiosarcoma of the breast occurring after radiotherapy

    International Nuclear Information System (INIS)

    Hakata, Hisafumi; Maeno, Yoshito; Tatsuoka, Toshihiko

    1995-01-01

    A case of angiosarcoma of the left breast occurring one month after radiotherapy following partial mastectomy for a cancer of the right breast is described. A 43-year-old woman underwent right partial mastectomy and axillary lymphnode dissection for a right breast cancer on February 23, 1993. Radiation therapy (total 50 grey) was given to the right breast for 3 weeks postoperatively. A small hemangioma appeared near the nipple of her left breast in the following month. On June 23, we excised the grain sized hemangioma and diagnosed as angiosarcoma. After her hesitating several months, she underwent left mastectomy because of some relapses appeared around her left breast on January 20, 1994. Now she is doing well without recurrence. Angiosarcoma of the breast is extremely rare in our country and only 20 cases have been seen in the Japanese literature. This case of angiosarcoma of the breast which occurred after radiotherapy is the first report of Stewart-Treves syndrome. Recent increasing use of radiotherapy following breast-sparing operation may contribute to an increase in occurrence of angiosarcoma. We should strictly follow up irradiated patients with breast cancer entertaining possible occurrence of angiosarcoma of the breast as well as that of the upper extremities. (author)

  2. Basal metabolic rate and the rate of senescence in the great tit

    NARCIS (Netherlands)

    Bouwhuis, Sandra; Sheldon, Ben C.; Verhulst, Simon; Koteja, Pawel

    1. Between-individual variation in rates of senescence has recently been found to relate to natal and early-life conditions in several natural populations. Mechanistic theories of senescence have predicted between-individual variation in basal metabolic rate (BMR) to also underlie such variation in

  3. Exploring variability among quality management system auditors when rating the severity of audit findings at a nuclear power plant

    Directory of Open Access Journals (Sweden)

    Simons, R. C.

    2017-05-01

    Full Text Available A reliable quality assurance (QA function in the nuclear environment is underpinned by the effective identification of risk, and by effective decision-making processes in relation to the risk identified. The need for competent auditors who are able to remain objective and independent at all times forms a critical component of this process. This exploratory study sought to determine reasons for the noted inconsistency among auditors when rating the severity of audit findings, and to provide recommendations to reduce this variability. The Delphi technique, a structured process to gather information from a panel of experts, was adopted to enable multiple iterations of qualitative and quantitative data collection and analysis, in an attempt to mimic the elements of a sequential exploratory strategy related to a mixed method methodology.

  4. Urban and rural mortality rates during heat waves in Berlin and Brandenburg, Germany

    International Nuclear Information System (INIS)

    Gabriel, Katharina M.A.; Endlicher, Wilfried R.

    2011-01-01

    In large cities such as Berlin, human mortality rates increase during intense heat waves. Analysis of relevant data from north-eastern Germany revealed that, during the heat waves that occurred between 1990 and 2006, health risks were higher for older people in both rural and urban areas, but that, during the two main heat waves within that 17-year period of time, the highest mortality rates were from the city of Berlin, and in particular from its most densely built-up districts. Adaptation measures will need to be developed, particularly within urban areas, in order to cope with the expected future intensification of heat waves due to global climate change. - Highlights: → Periods of heat stress enhance mortality rates in Berlin and Brandenburg. → Heat-related mortality is an urban as well as a rural problem. → During extreme events highest mortality rates can be found in the city centre. → Mortality rates correlate well with the distribution of sealed surfaces. → Health risks are higher for older than for younger people. - During periods of severe heat stress the pattern of mortality rates in Berlin and Brandenburg was found to correlate well with the distribution of sealed surfaces.

  5. Hazard rate for a two-channel protective system subject to a high demand rate

    International Nuclear Information System (INIS)

    Oliveira, L.F.; Youngblood, R.; Melo, P.F.F.

    1989-01-01

    A basic figure of merit associated with a protective system for an industrial plant is the number of accidents expected to occur in the plant within a given period of time, with the system installed. By definition, in a plant equipped with a protective system, an accident can only happen if an initiating event (a demand) occurs while the protective system is unavailable, that is, while it is in one of its possible failed states. This means that the hazard rate or accident frequency depends on the demand rate and on the unavailability of the protective systems. It has long been recognized that the demand rate influences the unavailability of the protective system, and practical expressions incorporating that effect have been developed for single-channel (Lees, 1982) and multi-channel (Kumamoto and Henley 1978) protective systems. The effect has also been incorporated into a Markovian treatment of a plant protection system (Papazoglou and Cho, 1985). In a previous paper (Oliveira and Netto, 1987) a Markovian approach was used to derive analytical expressions for the evaluation of the plant hazard rate for a single-channel protective system, properly accounting for the effects of the demand and the repair rates. In this paper the authors present an extension of that model to the case of a plant equipped with a two-channel protective system

  6. Dynamics of Severe and Non-Severe Invasive Pneumococcal Disease in Young Children in Israel Following PCV7/PCV13 Introduction.

    Science.gov (United States)

    Glikman, Daniel; Dagan, Ron; Barkai, Galia; Averbuch, Diana; Guri, Alex; Givon-Lavi, Noga; Ben-Shimol, Shalom

    2018-05-10

    The introduction of the pneumococcal conjugated vaccines (PCVs) resulted in a substantial reduction of invasive pneumococcal disease (IPD) rates. However, impact on non-severe IPD (mostly occult bacteremia) has not yet been fully elucidated.We assessed severe and non-severe IPD (SIPD and NSIPD, respectively) rate dynamics in children <5 years in Israel before and after PCV7/PCV13 implementation. A prospective, population-based, nationwide surveillance. All IPD episodes recorded from 1999 through 2015, were included. NSIPD was defined as IPD episodes without meningitis, pneumonia or mastoiditis in a child with a favorable outcome (not-hospitalized or hospitalized in a non-intensive care unit <5 days, without mortality). Three sub-periods were defined: pre-PCV (1999-2008), PCV7 (2010-2011) and PCV13 (2013-2015). Incidence rate ratios (IRRs) were calculated. Overall, 4,457 IPD episodes were identified; 3,398 (76.2%) SIPD, 1,022 (22.9%) NSIPD and 37 (0.8%) unknown. In 90% of NSIPD episodes, no focus was identified.In the PCV7 period, NSIPD rates significantly declined by 52%, while SIPD rates declined less prominently by 24%. Following PCV13 introduction, compared with the PCV7 period, NSIPD rates declined non-significantly by 17% while SIPD rates declined significantly further by an additional 53%. These trends resulted in overall reductions (comparing PCV13 and pre-PCV periods) of NSIPD and SIPD of 60% (IRR=0.4; 0.32-0.51) and 64% (IRR=0.36; 0.32-0.42), respectively. Following PCV7/PCV13 introduction, SIPD and NSIPD rates substantially declined, with differences in rate-dynamics, alluding to differences in serotype distribution between the two groups. Future surveillance is warranted when considering modification in treatment protocols for suspected occult bacteremia/NSIPD cases.

  7. The ecological importance of severe wildfires: some like it hot.

    Science.gov (United States)

    Hutto, Richard L

    2008-12-01

    Many scientists and forest land managers concur that past fire suppression, grazing, and timber harvesting practices have created unnatural and unhealthy conditions in the dry, ponderosa pine forests of the western United States. Specifically, such forests are said to carry higher fuel loads and experience fires that are more severe than those that occurred historically. It remains unclear, however, how far these generalizations can be extrapolated in time and space, and how well they apply to the more mesic ponderosa pine systems and to other forest systems within the western United States. I use data on the pattern of distribution of one bird species (Black-backed Woodpecker, Picoides arcticus) as derived from 16465 sample locations to show that, in western Montana, this bird species is extremely specialized on severely burned forests. Such specialization has profound implications because it suggests that the severe fires we see burning in many forests in the Intermountain West are not entirely "unnatural" or "unhealthy." Instead, severely burned forest conditions have probably occurred naturally across a broad range of forest types for millennia. These findings highlight the fact that severe fire provides an important ecological backdrop for fire specialists like the Black-backed Woodpecker, and that the presence and importance of severe fire may be much broader than commonly appreciated.

  8. Geological structure of strata and the occurence of gas outbursts

    Energy Technology Data Exchange (ETDEWEB)

    Koewing, K

    1977-10-20

    Geological conditions which may have an influence on gas outbursts are depth, rank, type of formation, tectonic stresses, and the petrological form of the neighboring rock. The risk of outbursts is greater if there are dirt bands in the seam, since the coal can slide on these. Tectonically disturbed zones in seams containing more than 9 cu m of gas per ton are especially dangerous. Tectonic stress is not necessarily an indication of the severity of outbursts. Gas and sandstone outbursts do not depend on tectonic disturbance; outburst-prone sandstones have a greater pore volume and lower strength than normal. Almost all outbursts from the floor occur where the strata immediately below are impervious to gas and sandstone is present lower down. (In German)

  9. When Does Premature Treatment Termination Occur? Examining Session-by-Session Dropout Among Clients with Gambling Disorder.

    Science.gov (United States)

    Pfund, Rory A; Peter, Samuel C; Whelan, James P; Meyers, Andrew W

    2018-06-01

    Premature termination challenges the successful outcomes of psychological treatments for gambling disorder. To date, research has primarily identified clients who are at particular risk for dropping out of treatment. A smaller but growing body of literature has investigated when dropout occurs. Typically, those studies have not considered improvement in psychological distress within their operationalizations of dropout and therefore may have misrepresented when dropout occurs. The current study examined when dropout occurs using an operationalization based on the criteria of attaining reliable change in a naturalistic sample of clients with gambling disorder, and the classification rates yielded from that operationalization were compared to the rates from a more common operationalization. Participants (n = 334) were clients meeting diagnostic criteria for gambling disorder at an outpatient private practice who completed a measure of psychological distress at baseline and prior to each subsequent treatment session. A survival analysis was conducted to determine temporal patterns of treatment dropout (i.e., clients who discontinued treatment before realizing reliable changes in psychological distress) and completion (i.e., clients who discontinued treatment after realizing reliable changes in distress) at each treatment session. Forty-nine percent of clients were classified as dropouts, and the majority of those clients did so in the first few sessions. The more common operationalization of dropout classified clients as dropouts when they had improved in their distress and clients as completers when they had not improved in their distress. Discussion centers on the implications of dropout occurring at various stages of treatment and future directions.

  10. Bone marrow transplantation in severe aplastic anemia and acute or chronic leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, U W; Mahmoud, H K; Beelen, D W; Hoffmann, W; Becher, R; Schmidt, C G; Bamberg, M; Quast, U; Haralambie, E; Linzenmeier, G

    1986-04-01

    In Essen 121 bone marrow transplantations were carried out. The indications were severe aplastic anemia, acute leukemia in relapse, acute leukemia in remission or chronic myeloid leukemia. The conditioning regimen consisted of cyclophosphamide or the combination of cyclophosphamide and total body irradiation. All patients were treated under strict gnotobiotic care. To mitigate the risk of CMV infections intravenous CMV-hyperimmunoglobulin and CMV-negative blood products have been applied routinely since two years. MTX was used as prophylaxis against GVH-disease. In case of severe aplastic anemia 13 patients (72%) are still alive with a median observation time of 24 months. In the prognostically unfavourable group of acute leukemia in relapse only one patient showed long term survival. In this patient leukemic relapse occurred six years after transplantation. The survival rate of AML patients grafted during the first remission is 55% with a median observation time of 40 months. For patients grafted in the first consecutive remission of ALL the survival rate is 42% with a maximal observation time of 29 months. Out of 37 patients grafted because of CML, eight were in an advanced stage of the disease. 13 patients are still alive, the maximal observation time is 37 months. The overall incidence of GVHD in patients at risk was 28% in aplastic anemia, 26% in AML, 9% in ALL and 63% in CML. In aplastic anemia no patient developed an interstitial pneumonia. In leukemia the risk of fatal interstitial pneumonia was 34%.

  11. Bone marrow transplantation in severe aplastic anemia and acute or chronic leukemia

    International Nuclear Information System (INIS)

    Schaefer, U.W.; Mahmoud, H.K.; Beelen, D.W.; Hoffmann, W.; Becher, R.; Schmidt, C.G.; Bamberg, M.; Quast, U.; Haralambie, E.; Linzenmeier, G.; Stollmann, B.; Grosse-Wilde, H.; Richter, H.J.; Hantschke, D.; Henneberg, K.; Luboldt, W.

    1986-01-01

    In Essen 121 bone marrow transplantations were carried out. The indications were severe aplastic anemia, acute leukemia in relapse, acute leukemia in remission or chronic myeloid leukemia. The conditioning regimen consisted of cyclophosphamide or the combination of cyclophosphamide and total body irradiation. All patients were treated under strict gnotobiotic care. To mitigate the risk of CMV infections intravenous CMV-hyperimmunoglobulin and CMV-negative blood products have been applied routinely since two years. MTX was used as prophylaxis against GVH-disease. In case of severe aplastic anemia 13 patients (72%) are still alive with a median observation time of 24 months. In the prognostically unfavourable group of acute leukemia in relapse only one patient showed long term survival. In this patient leukemic relapse occurred six years after transplantation. The survival rate of AML patients grafted during the first remission is 55% with a median observation time of 40 months. For patients grafted in the first consecutive remission of ALL the survival rate is 42% with a maximal observation time of 29 months. Out of 37 patients grafted because of CML, eight were in an advanced stage of the disease. 13 patients are still alive, the maximal observation time is 37 months. The overall incidence of GVHD in patients at risk was 28% in aplastic anemia, 26% in AML, 9% in ALL and 63% in CML. In aplastic anemia no patient developed an interstitial pneumonia. In leukemia the risk of fatal interstitial pneumonia was 34%. (orig.) [de

  12. Severe hemolytic disease of the newborn from anti-e.

    Science.gov (United States)

    McAdams, R M; Dotzler, S A; Winter, L W; Kerecman, J D

    2008-03-01

    Maternal antibody-mediated fetal red blood cell destruction secondary to non-D Rhesus (Rh) antibodies is a significant cause of hemolytic disease of the newborn (HDN). Here, we report a rare case of severe HDN associated with maternal antibody to Rh e. In addition to severe anemia, the infant developed thrombocytopenia, conjugated hyperbilirubinemia and cholelithiasis. Resolution of the infant's cholelithiasis occurred following treatment with ursodeoxycholic acid.

  13. Experiments on the lower plenum response during a severe accident

    International Nuclear Information System (INIS)

    Henry, Robert E.; Hammersley, Robert J.; Klopp, George T.; Merilo, Mati

    2004-01-01

    Severe accident evaluations for nuclear reactors consider the response when the core materials have been overheated sufficient to melt and change geometry. One possible consequence of this is that molten core debris could drain into the lower plenum, as occurred in the TMI-2 accident. Given this state, several physical processes need to be analyzed, i.e. the extent of debris particulation and cooling, the potential for thermal attack of lower plenum structures, the thermal transient of the RPV and the potential for external cooling of the RPV lower head. These are important and complex processes, the evaluations of which need to be guided by well founded experiments. To support the development of the MAAP codes, recent experiments have been performed on specific issues such as: 1. the response of lower head penetrations submerged in a high temperature melt, 2. the net steam generation rate when molten debris drains into the lower plenum, 3. the formation of a contact resistance when molten debris drains through water and contacts the RPV wall and 4. the potential for external cooling of the RPV lower head. This paper discusses these experiments and their results. More importantly, it discusses how these are used in formulating models to represent the lower plenum response in the MAAP codes. (author)

  14. Survey of environmental radiation dose rates in Tokushima prefecture

    International Nuclear Information System (INIS)

    Sakama, Minoru; Imura, Hiroyoshi; Akou, Natsuki; Takeuchi, Emi; Morihiro, Yukinori

    2004-01-01

    Survey of environmental radiation dose rates in Tokushima prefecture has been carried out using a portable NaI (Tl) scintillation survey meter and a CsI(Tl) pocket type one. To our knowledge, previous several surveys in Tokushima, for example by Abe et al. (1982) and Yoshino et al. (1991), have remained to report the environmental radiation dose rates merely about the major cities, that is Tokushima City and others along the Pacific. Up to now, there have been few efforts to survey the environmental radiation dose rates about mountain valleys in Tokushima. In this work, it is remarkable that we have for the first time made surveys of environmental radiation dose rates on the 6 routes across the Sanuki mountains and inside the pier of Onaruto Bridge, 'Naruto Uzu-no-michi', in the northern area of Tokushima. In the course of present surveys, the maximum value of the environmental radiation dose rates was 0.117±0.020 μGy/h at Higetouge in Sanuki City, and then it was found that the radiation dose rates across the Sanuki mountains tend to increase slightly with approaching Kagawa area from Tokushima one. Considering geological formation around the northern side of Sanuki mountains, there are mainly geological layers of granodiorite containing in the substantial amount of naturally occurring radionuclides, 40 K, U-series, and Th-series, than other geological rocks and it was found that the terrestrial gamma-rays have effect on the environmental radiation dose rates according to the geological formation. (author)

  15. A percutaneous drainage protocol for severe and moderately severe acute pancreatitis.

    Science.gov (United States)

    Sugimoto, Motokazu; Sonntag, David P; Flint, Greggory S; Boyce, Cody J; Kirkham, John C; Harris, Tyler J; Carr, Sean M; Nelson, Brent D; Barton, Joshua G; Traverso, L William

    2015-11-01

    According to the revised Atlanta classification, severe and moderately severe acute pancreatitis (AP) includes patients with pancreatic and peripancreatic collections with or without organ failure. These collections suggest the presence of pancreatic juice leakage. The aim of this study was to evaluate the efficacy of a percutaneous catheter drainage (PCD) protocol designed to control leakage and decrease disease severity. Among 663 patients with clinical AP, 122 were classified as moderately severe or severe AP (all had collections). The computed tomography severity index (CTSI) score was calculated. The indication for PCD was based on progressive clinical signs and symptoms. Drain patency, position, and need for additional drainage sites were assessed using CT scans and drain studies initially every 3 days using a proactive protocol. Drain fluid was examined for amylase concentration and microbiological culture. Clinicopathological variables for patients with and without PCD were compared. Since there was no mortality, we used prolonged drainage time to measure the success of PCD. Within the group treated with PCD, variables that resulted in prolonged drainage time were analyzed. PCD was used in 47/122 (39 %) patients of which 33/47 (70 %) had necrosis. PCD cases had a median CTSI of 8 and were classified as moderately severe AP (57 %) and severe AP (43 %). Inhospital mortality was zero. Surgical necrosectomy was not required for patients with necrosis. Independent risk factors for prolonged drainage time were persistent organ failure >48 h (P = 0.001), CTSI 8-10 (P = 0.038), prolonged duration of amylase-rich fluid in drains (P drainage fluid resulting in a mortality rate of zero.

  16. Severe and complicated malaria in KwaZulu-Natal

    African Journals Online (AJOL)

    predictors of poor outcome (95% confidence intervals. 1.53 - 91 .9, 2.74 - 100.0 ... cases of severe malaria occur among young children over the age of 6 ... southern distribution of the infection in Africa. Sharp" ... urinary tract and 8 of the chest.

  17. The dose-rate effect

    International Nuclear Information System (INIS)

    Steel, G.G.

    1989-01-01

    This paper presents calculations that illustrate two conclusions; for any particular cell type there will be a critical radius at which tumor control breaks down, and the radius at which this occurs is strongly dependent upon the low-dose-rate radiosensitivity of the cells

  18. Ultrathin needle (25G) aspiration lung biopsy: diagnostic accuracy and complication rates

    International Nuclear Information System (INIS)

    Oikonomou, A.; Matzinger, F.R.; Seely, J.M.; Dennie, C.J.; Macleod, P.J.

    2004-01-01

    The aim of this study was to evaluate the diagnostic accuracy and complication rate of 25-G fine-needle aspiration biopsy (FNAB) of the lung in patients with suspected malignant focal lesions and abnormal lung function. The 25-G FNAB was performed in 123 patients who underwent prebiopsy CT and pulmonary function tests. Retrospective evaluation included pulmonary function, cytology, size of the lesion, depth of location, presence of emphysema on CT, needle passes, pneumothorax and drainage. The final diagnosis (gold standard) was based on histopathology after surgical resection or follow-up and response to treatment. Sixty-one patients had normal lung function or mild impairment (group 1) and 62 had moderate or severe impairment (group 2). Pneumothorax occurred in 26 of 126 procedures (20.6%) with drainage needed in 11 (8.7%). In group 2 pneumothorax occurred in 19 of 63 procedures (30.15%) with drainage needed in 11 (17.5%). The sensitivity, specificity and diagnostic accuracy of cytology results were 93.6, 100 and 94.4%, respectively. FEV1 (p=0.014), FEV1/FVC (p=0.005), FEF25-75 (p=0.001), DLCO (p=0.013) and presence of emphysema on CT (p<0.001) correlated with pneumothorax (Students t test). The 25-G lung FNAB is accurate and safe in diagnosing malignancy in patients with severe lung functional abnormality. Patients with moderate to severe airway obstruction have a higher prevalence of pneumothorax than patients with mild or no functional impairment

  19. Naturally occurring radionuclides in pasture soil, feed ingredients and milk of dairy cattle

    Energy Technology Data Exchange (ETDEWEB)

    Turtiainen, T.; Kostiainen, E.; Solatie, D. [STUK-Radiation and Nuclear Safety Authority (Finland)

    2014-07-01

    Naturally occurring radionuclides are generally considered being respective part of the environment and hence no statutory monitoring of their levels are required in food products. Therefore, limited data are available on the naturally occurring radionuclides in food. Dairy products constitute a significant portion of Finnish diet (400-500 g/d) and hence it is reasonable to study radionuclide levels in milk in more detail. Contrary to caesium, strontium and iodine, few transfer coefficients are available in the literature for naturally occurring radionuclide transfer to cow's milk. The renaissance of mining industry in Finland has raised a question among the public about the baseline values of naturally occurring radionuclides in Finnish agricultural products. The objective of this study was to investigate naturally occurring radionuclides in the components of dairy cattle diet and milk and calculate their transfer to milk. This information is needed for regulating the permitted discharges to the environment and for setting up monitoring programs if any unplanned discharges are released. In modern dairy farming, cattle are fed a precise diet in order to maximize milk production and quality and to achieve cost-effectiveness. Therefore, several different components are found in dairy cattle's diet and pasture grass concentrations are not sufficient for calculating radionuclide transfer to cow's milk. In this study, we carried out comprehensive sampling at four dairy farms each representing different areas of natural radiation background. The pasture soils were characterized and measured for natural radioactivity. Samples were taken from cattle's total diet (including e.g. pasture grass, water, silage, mineral forage) and milk. Document available in abstract form only. (authors)

  20. Risk factors that predict severe injuries in university rugby sevens players.

    Science.gov (United States)

    Mirsafaei Rizi, Rezvan; Yeung, Simon S; Stewart, Nathan J; Yeung, Ella W

    2017-07-01

    To investigate injury incidence and the influence of physical fitness parameters on the risk of severe injuries in players on rugby sevens university teams. Prospective cohort study. Rugby players from three universities (N=104; 90M:14F; 20.6±1.9years) were recruited before the beginning of the season. Players underwent pre-season assessments of power, strength, speed, agility, endurance, stability, and flexibility. Throughout the season, rugby-related injury and exposure data were collected. Potential predictor variables were analyzed using Cox proportional regression model to identify risk factors associated with severe injuries (time loss>28days). Thirty-one injuries occurred during the rugby season. The match and training injury incidence rates were 59.3 injuries and 3.3 injuries per 1000 player-hours, respectively. Lower limb injuries were most common and most severe. The ankle joint was the most prevalent site of injury, and ligamentous injury was most common (48.4%). Nine severe injuries were sustained resulting in an average time loss of 51.3±14.6days. Female (hazard ratio [HR]=8.35; 95% confidence intervals [CI]=2.01-34.8), slower (HR=3.51; 95% CI=1.17-10.5), and less agile (HR=2.22; 95% CI=1.26-3.92) players as well as those with hip flexors tightness (HR=1.12; 95% CI=1.00-1.25) were at significantly greater risk for sustaining severe injuries. Limited studies are available on risk factors associated with amateur rugby players in the Sevens version. The development of gender-specific injury prevention measures that emphasize speed and agility training, and improve hip flexor extensibility may be important to reduce the risk of severe injuries. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Thermonuclear reaction rates. III

    International Nuclear Information System (INIS)

    Harris, M.J.; Fowler, W.A.; Caughlan, G.R.; Zimmerman, B.A.

    1983-01-01

    Stellar thermonuclear reaction rates are revised and updated, adding a number of new important reaction rates. Several reactions with large negative Q-values are included, and examples of them are discussed. The importance of the decay rates for Mg-26(p,n) exp 26 Al and Al-26(n,p) exp 26 Mg for stellar studies is emphasized. 19 references

  2. [How often does decreased consciousness of hypoglycaemia occur in children and adolescents with diabetes type 1 and what are its consequences?].

    Science.gov (United States)

    Peczyńska, Jadwiga; Urban, Mirosława; Głowińska, Barbara; Florys, Bozena

    2004-01-01

    The inability of the patient to recognize the risk of hypoglycemia is a very frequent phenomenon, but it is also often an underestimated complication in diabetes treated with insulin. The results of DCCT trial revealed that intensification in insulin therapy increases three-fold the risk of severe hypoglycaemia. Feeling the state of hypoglycaemia is the basic defensive mechanism in patients with diabetes type 1, making possible to start the self treatment. The decreased consciousness of hypoglycaemia makes limitations to intensive insulin therapy, which main aim is to stop later complications. THE AIM OF THE STUDY was to answer the questions: 1. How often does lack of consciousness of hypoglycaemia occur in children and adolescents with diabetes type 1. 2. What are the possible factors influencing appearance of hypoglycaemia. 3. Is lack of hypoglycaemia consciousness of a risk factor for severe hypoglycaemia. The study was carried out on 318 patients aged x=13.6 yrs (4-21), suffering from diabetes, mean 6.6 yrs (2-18). The study was retrospective taking into consideration the period from 1.01.1998 to 31.12.2002. In the analysis of the questionnaire assessing the occurrence of hypoglycaemia it was found that 82 patients (25.8%) have problems with feeling the state of hypoglycaemia. We analyzed the influence of time of lasting diabetes and we found that patients with a longer duration of the disease more frequently have problems with feeling hypoglycaemia, 57% patients with lack of hypoglycaemia consciousness have bad metabolic control of the disease. In the analyzed period, 64 incidences of severe hypoglycaemia in 48 patients (30 boys and 18 girls) were found. In patients with lack of consciousness of feeling hypoglycaemia the incidences of severe hypoglycaemia occurred ten times more frequently compared to patients who feel hypoglycaemia. Sleeping makes it impossible to perceive early symptoms of hypoglycaemia: in our patients 51 severe incidences (79.7%) occurred

  3. Committed effective dose from naturally occuring radionuclides in shellfish

    International Nuclear Information System (INIS)

    Khandaker, Mayeen Uddin; Wahib, Norfadira Binti; Amin, Yusoff Mohd.; Bradley, D.A.

    2013-01-01

    Recognizing their importance in the average Malaysian daily diet, the radioactivity concentrations in mollusc- and crustacean-based food have been determined for key naturally occuring radionuclides. Fresh samples collected from various maritime locations around peninsular Malaysia have been processed using standard procedures; the radionuclide concentrations being determined using an HPGe γ-ray spectrometer. For molluscs, assuming secular equilibrium, the range of activities of 238 U ( 226 Ra), 232 Th ( 228 Ra) and 40 K were found to be 3.28±0.35 to 5.34±0.52, 1.20±0.21 to 2.44±0.21 and 118±6 to 281±14 Bq kg −1 dry weight, respectively. The respective values for crustaceans were 3.02±0.57 to 4.70±0.52, 1.38±0.21 to 2.40±0.35 and 216±11 to 316±15 Bq kg −1 . The estimated average daily intake of radioactivity from consumption of molluscs are 0.37 Bq kg −1 for 238 U ( 226 Ra), 0.16 Bq kg −1 for 232 Th ( 228 Ra) and 18 Bq kg −1 for 40 K; the respective daily intake values from crustaceans are 0.36 Bq kg −1 , 0.16 Bq kg −1 and 23 Bq kg −1 . Associated annual committed effective doses from molluscs are estimated to be in the range 21.3 to 34.7 μSv for 226 Ra, 19.3 to 39.1 μSv for 228 Ra and 17.0 to 40.4 μSv for 40 K. For crustaceans, the respective dose ranges are 19.6 to 30.5 μSv, 22.0 to 38.4 μSv and 31.1 to 45.5 μSv, being some several times world average values. - Highlights: ► Activity concentrations of naturally occuring radionuclides were assessed for shellfish. ► 238 U, 232 Th, 40 K intake via shellfish showed several times higher than world averages. ► Committed effective doses due to the ingestions of 238 U, 232 Th, 40 K are the first report in Malaysia. ► Estimated committed effective dose also showed higher values than the world average

  4. Severe Pollution in China Amplified by Atmospheric Moisture

    NARCIS (Netherlands)

    Tie, Xuexi; Huang, Ru-Jin; Cao, Junji; Zhang, Qiang; Cheng, Yafang; Su, Hang; Chang, Di; Poeschl, Ulrich; Hoffmann, Thorsten; Dusek, Uli; Li, Guohui; Worsnop, Douglas R.; O'Dowd, Colin D.

    2017-01-01

    In recent years, severe haze events often occurred in China, causing serious environmental problems. The mechanisms responsible for the haze formation, however, are still not well understood, hindering the forecast and mitigation of haze pollution. Our study of the 2012-13 winter haze events in

  5. Risk factors for death in patients with severe asthma

    Directory of Open Access Journals (Sweden)

    Andréia Guedes Oliva Fernandes

    2014-08-01

    Full Text Available OBJECTIVE: To identify risk factors for death among patients with severe asthma. METHODS: This was a nested case-control study. Among the patients with severe asthma treated between December of 2002 and December of 2010 at the Central Referral Outpatient Clinic of the Bahia State Asthma Control Program, in the city of Salvador, Brazil, we selected all those who died, as well as selecting other patients with severe asthma to be used as controls (at a ratio of 1:4. Data were collected from the medical charts of the patients, home visit reports, and death certificates. RESULTS: We selected 58 cases of deaths and 232 control cases. Most of the deaths were attributed to respiratory causes and occurred within a health care facility. Advanced age, unemployment, rhinitis, symptoms of gastroesophageal reflux disease, long-standing asthma, and persistent airflow obstruction were common features in both groups. Multivariate analysis showed that male gender, FEV1 pre-bronchodilator < 60% of predicted, and the lack of control of asthma symptoms were significantly and independently associated with mortality in this sample of patients with severe asthma. CONCLUSIONS: In this cohort of outpatients with severe asthma, the deaths occurred predominantly due to respiratory causes and within a health care facility. Lack of asthma control and male gender were risk factors for mortality.

  6. Disciplinary responses to misconduct among female prison inmates with mental illness, substance use disorders, and co-occurring disorders.

    Science.gov (United States)

    Houser, Kimberly; Belenko, Steven

    2015-03-01

    Most female inmates have mental health, substance use, or co-occurring disorders (CODs), which can create greater difficulty adjusting to incarceration and higher rates of prison misconduct. The response of prison officials to institutional misbehaviors has important implications for female inmates' experiences while incarcerated, their likelihood of parole, and the clinical course of their condition. This article examined whether disciplinary actions are more severe for women with CODs. Data were provided by the Pennsylvania Department of Corrections for all female state prison inmates incarcerated between January 1, 2007, and July 30, 2009 (N = 2,279). The final sample of 211 women included those who had committed a minor misconduct during their incarceration. Disorder categories were created based on intake assessments, and multivariate models were estimated to determine the effect of disorder category on whether the prison imposed a severe or minor disciplinary response to the misconduct. The odds of receiving severe disciplinary responses to minor misconduct was significantly greater for women with CODs than those with the singular disorders of mental illness or substance abuse disorders, or those with no disorders. Findings suggest correctional institutions are responding in a punitive manner to the symptomatic manifestations of CODs in female inmates. These findings suggest the importance of screening instruments in correctional settings that assess for the presence of dual disorders. In addition, correctional administrators must implement training protocols for correctional officers and staff on the complexity of CODs and the ability to identify behavioral and emotional symptoms associated with this vulnerable subset of the offender population. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  7. Characteristics of schools in which fatal shootings occur.

    Science.gov (United States)

    de Apodaca, Roberto Flores; Brighton, Lauren M; Perkins, Ashley N; Jackson, Kiana N; Steege, Jessica R

    2012-04-01

    School-based violence, and fatal school shootings in particular, have gained increased attention in the media and psychological literature. Most reports have focused on the characteristics of perpetrators, but there is a growing awareness that school-related factors may also influence the occurrence of fatal school shootings. The current study examined several key characteristics of all schools where random (38) and targeted (96) fatal shootings occurred in the United States between 1966 and 2009. These were compared with a group (138) of schools randomly selected to represent the population of all schools in the United States. The size of a school's enrollment, urban or suburban locale, public funding, and predominantly non-white enrollment were positively associated with fatal shootings. Universities and colleges were disproportionately associated with random shootings and high schools with targeted ones. It was proposed that characteristics of schools that allow feelings of anonymity or alienation among students may help create environmental conditions associated with fatal school shootings. Implications for future research and interventions are considered.

  8. Rate Constants for the Reactions of Hydroxyl Radical with Several Alkanes, Cycloalkanes, and Dimethyl Ether

    Science.gov (United States)

    DeMore, W.; Bayes, K.

    1998-01-01

    Relative rate experiements were used to measure rate constants and temperature denpendencies of the reactions of OH with propane, n-butane, n-pentane, n-hexane, cyclopropane, cyclobutane, cyclopentane, and dimethyl ether.

  9. Tank Z-361 dose rate calculations

    International Nuclear Information System (INIS)

    Richard, R.F.

    1998-01-01

    Neutron and gamma ray dose rates were calculated above and around the 6-inch riser of tank Z-361 located at the Plutonium Finishing Plant. Dose rates were also determined off of one side of the tank. The largest dose rate 0.029 mrem/h was a gamma ray dose and occurred 76.2 cm (30 in.) directly above the open riser. All other dose rates were negligible. The ANSI/ANS 1991 flux to dose conversion factor for neutrons and photons were used in this analysis. Dose rates are reported in units of mrem/h with the calculated uncertainty shown within the parentheses

  10. Sleeve gastrectomy severe complications: is it always a reasonable surgical option?

    Science.gov (United States)

    Moszkowicz, David; Arienzo, Roberto; Khettab, Idir; Rahmi, Gabriel; Zinzindohoué, Franck; Berger, Anne; Chevallier, Jean-Marc

    2013-05-01

    Laparoscopic sleeve gastrectomy (LSG) is widely adopted but exposes serious complications. A retrospective database analysis was done to study LSG staple line complications in a tertiary referral university center with surgical ICU experienced in treatment of morbid obesity and complications. Twenty-two consecutive patients were referred between January 2004 and February 2012 with postoperative gastric leak or stenosis after LSG. Interventions consisted in the control of intra-abdominal and general sepsis; restoration of staple line continuity or revision of LSG; nutritional support; treatment of associated complications. Main outcome measures concerned success rates of therapeutic strategies, morbidity and mortality rates, LOS, and time to cure. Thirteen patients (59 %) were referred after failure of reoperation (seven fistula repairs were attempted). Three patients received emergency surgery in our center with transorificial intubation and jejunostomy formation. An endoscopic stent was tried in nine patients but failed in 84.6 % of cases within 20 days (1-161). Seven patients (32 %) necessitated total gastrectomy within 217 days (0-1,915 days) for conservative treatment failure. Procedures under general anesthesia were required in 41 % of cases, organ failure was found in 55 % of cases, and central venous device infection in 40 %. Mortality rate was 4.5 % (n = 1). Patients with unfavorable evolution of LSG complications (death or additional gastrectomy) had more previous bariatric procedure (82 % vs. 18 %, p = 0.003). Median time to cure was 310 days (9-546 days). LSG exposes severe complications occurring in patients with benign condition. Endoscopic stents entail high failure rate. Total gastrectomy is required in one third of the cases.

  11. HSMR : Comparing Death Rates Across UK Hospitals

    NARCIS (Netherlands)

    Ben Teeuwen; Thuy Ngo; Frans Nauta

    2011-01-01

    The Hospital Standardized Mortality Ratio (HSMR) is a measurement tool that shows hospitals’ death rates. The HSMR compares deaths that occur in hospitals with death ratios that one would normally expect based on patients’ diseases. It is used as a benchmark for adjusted hospital death rates. These

  12. Long-term outcomes of the Ross procedure in adults with severe aortic stenosis: single-centre experience with 20 years of follow-up.

    Science.gov (United States)

    Kalfa, David; Mohammadi, Siamak; Kalavrouziotis, Dimitri; Kharroubi, Mounir; Doyle, Daniel; Marzouk, Mohamed; Metras, Jacques; Perron, Jean

    2015-01-01

    The optimal prosthesis option for aortic valve replacement in adult patientsreplacement (n=190; 86%) or the subcoronary technique (n=31; 14%). There were 169 patients with bicuspid valves and 33 redo operations including previous aortic valve repair (n=6) and replacement (n=9) for severe AS. Demographic, preoperative, postoperative and longitudinal clinical and echocardiographic data were collected prospectively. The median and mean follow-up were 11.4 years (range: 1-20.1 years) and 10.1±5.9 years, respectively. The follow-up was complete in all patients. Kaplan-Meier actuarial survival analysis was performed to assess long-term survival, freedom from reoperation for autograft and/or homograft failure and freedom from autograft valve insufficiency. Cox regression risk analysis was performed to identify factors associated with autograft or homograft reoperations. The perioperative mortality rate was 0.9% (n=2). The incidence rate of early reoperation for bleeding was 5.9%. The actuarial survival rate at 10 and 15 years following surgery was 92.1 and 90.5%, respectively. Ross-related reoperations occurred in 21 patients during follow-up: autograft dysfunction (n=9), homograft dysfunction (n=6) and both (n=6). The rate of freedom from Ross-related reoperation was 94.7 and 87.7% at 10 and 15 years, respectively. The rate of freedom from reoperation for autograft failure was 97.6 and 91.5%, the rate of freedom from reoperation for homograft failure was 95.7 and 90.8%, and the rate of freedom from moderate or severe autograft regurgitation was 94.1 and 85.6% at 10 and 15 years, respectively. Compared with available aortic bioprosthetic alternatives in young adults with severe AS, the Ross procedure provides an excellent long-term option for patients with predominant severe AS who seek a durable operation without anticoagulation. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights

  13. Pathways to change: Use trajectories following trauma-informed treatment of women with co-occurring post-traumatic stress disorder and substance use disorders.

    Science.gov (United States)

    López-Castro, Teresa; Hu, Mei-Chen; Papini, Santiago; Ruglass, Lesia M; Hien, Denise A

    2015-05-01

    Despite advances towards integration of care for women with co-occurring substance use disorder (SUD) and post-traumatic stress disorder (PTSD), low abstinence rates following SUD/PTSD treatment remain the norm. The utility of investigating distinct substance use trajectories is a critical innovation in the detection and refining of effective interventions for this clinical population. The present study reanalysed data from the largest randomised clinical trial to date for co-occurring SUD and PTSD in women (National Drug Abuse Treatment Clinical Trials Network; Women and Trauma Study). Randomised participants (n = 353) received one of two interventions in addition to treatment as usual for SUD: (i) trauma-informed integrative treatment for PTSD/SUD; or (ii) an active control psychoeducation course on women's health. The present study utilised latent growth mixture models (LGMM) with multiple groups to estimate women's substance use patterns during the 12-month follow-up period. Findings provided support for three different trajectories of substance use in the post-treatment year: (i) consistently low likelihood and use frequency; (ii) consistently high likelihood and use frequency; and (iii) high likelihood and moderate use frequency. Covariate analyses revealed improvement in PTSD severity was associated with membership in a specific substance use trajectory, although receiving trauma-informed treatment was not. Additionally, SUD severity, age and after-care efforts were shown to be related to trajectory membership. Findings highlight the necessity of accounting for heterogeneity in post-treatment substance use, relevance of trauma-informed care in SUD recovery and benefits of incorporating methodologies like LGMM when evaluating SUD treatment outcomes. © 2015 Australasian Professional Society on Alcohol and other Drugs.

  14. Severe Hypertension Secondary to Renal Artery Stenosis and Cushing's Syndrome

    International Nuclear Information System (INIS)

    Al-Zahrani, Ali S.; Al-Hajjaj, Alya; Al-Watban, Jehad; Kanaan, Imaduddin

    2005-01-01

    We present an unusual patient who simultaneously had severe renal artery stenosis RAS and Cushings syndrome. The case highlights the difficulty of reaching a specific diagnosis of Cushings syndrome and the possible interaction between Cushings syndrome and some other concurrent illnesses that this patient had. A 37-year old man presented with severe hypertension HTN and uncontrolled diabetes mellitus DM without clear physical signs of Cushings syndrome. He was found to have severe osteoporosis, proximal myopathy, several cutaneous warts, tinea versicolor, and chronic viral hepatitis. Captopril-stimulated renal scan and renal artery angiogram revealed severe RAS. Partial balloon dilatation of RAS led to improvement in HTN. Unexpectedly, urine free cortisol 24 hour was found extremely high. Serum adrenocorticotropic hormone ACTH was also elevated and high dose dexamethasone suppression tests were inconclusive. Several imaging studies failed to localize the source of ACTH. Despite normal MRI of the pituitary gland, bilateral inferior petrosal sinus sampling IPSS localized the source of ACTH secretion to the right side of the pituitary gland and right anterior hemihypophysectomy resulted in cure of Cushings disease, HTN, DM, and tinea versicolor with significant improvement in cutaneous warts, osteoporosis, and chronic hepatitis. In conclusion, RAS and Cushings syndrome may occur together. Significant hypercortisolemia can occur without clear signs of Cushings syndrome. Controlling hypercortisolemia is of paramount importance when treating chronic infections in patients with Cushing's syndrome. (author)

  15. Determination of natural occurring radionuclides concentrations

    International Nuclear Information System (INIS)

    Stajic, J.; Markovic, V.; Krstic, D.; Nikezic, D.

    2011-01-01

    Tobacco smoke contains certain concentrations of naturally occurring radionuclides from radioactive chains of uranium and thorium - 214 Pb, 214 Bi, 228 Ac, 208 Tl, 226 Ra, 232 Th and 40 K. Inhaling of tobacco smoke leads to internal exposure of man. In order to estimate absorbed dose of irradiation it is necessary to determine concentrations of radionuclides present in the tobacco leaves. In this paper specific activities of naturally occurring radionuclides were measured in tobacco samples from cigarettes which are used in Serbia. [sr

  16. Measurement of soluble nuclide dissolution rates from spent fuel

    International Nuclear Information System (INIS)

    Wilson, C.N.; Gray, W.J.

    1990-01-01

    Gaining a better understanding of the potential release behavior of water-soluble radionuclides is the focus of new laboratory spent fuel dissolution studies being planned in support of the Yucca Mountain Project. Previous studies have suggested that maximum release rates for actinide nuclides, which account for most of the long-term radioactivity in spent fuel, should be solubility-limited and should not depend on the characteristics or durability of the spent fuel waste form. Maximum actinide concentrations should be sufficiently low to meet the NRC (Nuclear Regulatory Commission) annual release limits. Potential release rates for soluble nuclides such as 99 Tc, 135 Cs, 14 C and 129 I, which account for about 1-2% of the activity in spent fuel at 1,000 years, are less certain and may depend on processes such as oxidation of the fuel in the repository air environment. Dissolution rates for several soluble nuclides have been measured from spent fuel specimens using static and semi-static methods. However, such tests do not provide a direct measurement of fuel matrix dissolution rates that may ultimately control soluble-nuclide release rates. Flow-through tests are being developed as a potential supplemental method for determining the matrix component of soluble-nuclide dissolution. Advantages and disadvantages of both semi-static and flow-through methods are discussed. Tests with fuel specimens representing a range of potential fuel states that may occur in the repository, including oxidized fuel, are proposed. Preliminary results from flow-through tests with unirradiated UO 2 suggesting that matrix dissolution rates are very sensitive to water composition are also presented

  17. Asteroid rotation rates

    International Nuclear Information System (INIS)

    Binzel, R.P.; Farinella, P.

    1989-01-01

    Within the last decade the data base of asteroid rotation parameters (rotation rates and lightcurve amplitudes) has become sufficiently large to identify some definite rends and properties which can help us to interpret asteroid collisional evolution. Many significant correlations are found between rotation parameters and diameter, with distinct changes occurring near 125 km. The size range, which is also the diameter above which self-gravity may become important, perhaps represents a division between surviving primordial asteroids and collisional fragments. A Maxwellian is able to fit the observed rotation rate distributions of asteroids with D>125 km, implying that their rotation rates may be determined by collisional evolution. Asteroids with D<125 km show an excess of slow rotators and their non-Maxwellian distributions suggests that their rotation rates are more strongly influenced by other processes, such as the distribution resulting from their formation in catastrophic disruption events. Other correlations observed in the data set include different mean rotation rates for C, S and M type asteroids implying that their surface spectra are indicative of bulk properties

  18. Obsessive-compulsive personality disorder co-occurring with obsessive-compulsive disorder: Conceptual and clinical implications.

    Science.gov (United States)

    Starcevic, Vladan; Berle, David; Brakoulias, Vlasios; Sammut, Peter; Moses, Karen; Milicevic, Denise; Hannan, Anthony

    2013-01-01

    There are ongoing uncertainties in the relationship between obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD). This study aimed to test the proposition that OCPD may be a marker of severity of OCD by comparing groups of OCD individuals with and without OCPD on a number of variables. A total of 148 adults with a principal diagnosis of OCD were administered the Mini International Neuropsychiatric Interview, Yale-Brown Obsessive-Compulsive Scale, Sheehan Disability Scale, Vancouver Obsessional Compulsive Inventory and Symptom Checklist 90-Revised. Participants with a DSM-IV diagnosis of OCPD were compared with those without OCPD. Some 70 (47.3%) participants were diagnosed with OCPD. The groups of participants with and without OCPD did not differ significantly with respect to any of the demographic variables, clinician-rated severity of OCD, levels of disability and mean age of onset of OCD. All self-rated OCD symptom dimensions except for contamination and checking were significantly more prominent in participants with OCPD, as were all self-rated dimensions of psychopathology. Participants with OCPD had significantly more frequent hoarding compulsions and obsessions involving a need to collect and keep objects. Of Axis I disorders, only panic disorder was significantly more frequent in participants with OCPD than in those without OCPD. A high frequency of OCPD among individuals with OCD suggests a strong, although not necessarily a unique, relationship between the two conditions. This finding may also be a consequence of the blurring of the boundary between OCD and OCPD by postulating that hoarding and hoarding-like behaviours characterise both disorders. Results of this study do not support the notion that OCD with OCPD is a marker of clinician-rated severity of OCD. However, individuals with OCPD had more prominent OCD symptoms, they were more distressed and exhibited various other psychopathological phenomena more intensely

  19. Severe Accident Research Program plan update

    International Nuclear Information System (INIS)

    1992-12-01

    In August 1989, the staff published NUREG-1365, ''Revised Severe Accident Research Program Plan.'' Since 1989, significant progress has been made in severe accident research to warrant an update to NUREG-1365. The staff has prepared this SARP Plan Update to: (1) Identify those issues that have been closed or are near completion, (2) Describe the progress in our understanding of important severe accident phenomena, (3) Define the long-term research that is directed at improving our understanding of severe accident phenomena and developing improved methods for assessing core melt progression, direct containment heating, and fuel-coolant interactions, and (4) Reflect the growing emphasis in two additional areas--advanced light water reactors, and support for the assessment of criteria for containment performance during severe accidents. The report describes recent major accomplishments in understanding the underlying phenomena that can occur during a severe accident. These include Mark I liner failure, severe accident scaling methodology, source term issues, core-concrete interactions, hydrogen transport and combustion, TMI-2 Vessel Investigation Project, and direct containment heating. The report also describes the major planned activities under the SARP over the next several years. These activities will focus on two phenomenological issues (core melt progression, and fuel-coolant interactions and debris coolability) that have significant uncertainties that impact our understanding and ability to predict severe accident phenomena and their effect on containment performance SARP will also focus on severe accident code development, assessment and validation. As the staff completes the research on severe accident issues that relate to current generation reactors, continued research will focus on efforts to independently evaluate the capability of new advanced light water reactor designs to withstand severe accidents

  20. Measurement of the rates of reaction of the ground and metastable excited states of 02+, N0+ and 0+ with atmospheric gases at thermal energy

    International Nuclear Information System (INIS)

    Glosik, J.; Rakshit, A.B.; Twiddy, N.D.; Adams, N.G.; Smith, D.

    1978-01-01

    Thermal-energy reaction rate coefficients and product ion distributions have been measured for reactions of both the ground state and metastable electronic states of 0 2 + , N0 + and 0 + with several neutral species, using a selected-ion flow tube. In general the excited-ion reaction rates are fast, frequently approaching the Langevin limit. Collisional quenching occurs for the reactions of N0 + sup(star) with N 2 ,0 2 and H 2 and the quenching rates have been determined. The ion source also provided a substantial yield of doubly charged 0 2 permitting some measurements of reaction rates of 0 2 2+ . (author)

  1. Naturally Occurring Radioactive Materials (NORM)

    International Nuclear Information System (INIS)

    Gray, P.

    1997-01-01

    This paper discusses the broad problems presented by Naturally Occuring Radioactive Materials (NORM). Technologically Enhanced naturally occuring radioactive material includes any radionuclides whose physical, chemical, radiological properties or radionuclide concentration have been altered from their natural state. With regard to NORM in particular, radioactive contamination is radioactive material in an undesired location. This is a concern in a range of industries: petroleum; uranium mining; phosphorus and phosphates; fertilizers; fossil fuels; forestry products; water treatment; metal mining and processing; geothermal energy. The author discusses in more detail the problem in the petroleum industry, including the isotopes of concern, the hazards they present, the contamination which they cause, ways to dispose of contaminated materials, and regulatory issues. He points out there are three key programs to reduce legal exposure and problems due to these contaminants: waste minimization; NORM assesment (surveys); NORM compliance (training)

  2. Naturally Occurring Radioactive Materials (NORM)

    Energy Technology Data Exchange (ETDEWEB)

    Gray, P. [ed.

    1997-02-01

    This paper discusses the broad problems presented by Naturally Occuring Radioactive Materials (NORM). Technologically Enhanced naturally occuring radioactive material includes any radionuclides whose physical, chemical, radiological properties or radionuclide concentration have been altered from their natural state. With regard to NORM in particular, radioactive contamination is radioactive material in an undesired location. This is a concern in a range of industries: petroleum; uranium mining; phosphorus and phosphates; fertilizers; fossil fuels; forestry products; water treatment; metal mining and processing; geothermal energy. The author discusses in more detail the problem in the petroleum industry, including the isotopes of concern, the hazards they present, the contamination which they cause, ways to dispose of contaminated materials, and regulatory issues. He points out there are three key programs to reduce legal exposure and problems due to these contaminants: waste minimization; NORM assesment (surveys); NORM compliance (training).

  3. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

    Science.gov (United States)

    de Jonge, Ank; Mesman, Jeanette A J M; Manniën, Judith; Zwart, Joost J; van Dillen, Jeroen; van Roosmalen, Jos

    2013-06-13

    To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Cohort study using a linked dataset. Information on all cases of severe acute maternal morbidity in the Netherlands collected by the national study into ethnic determinants of maternal morbidity in the netherlands (LEMMoN study), 1 August 2004 to 1 August 2006, merged with data from the Netherlands perinatal register of all births occurring during the same period. 146 752 low risk women in primary care at the onset of labour. Severe acute maternal morbidity (admission to an intensive care unit, eclampsia, blood transfusion of four or more packed cells, and other serious events), postpartum haemorrhage, and manual removal of placenta. Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe acute maternal morbidity among planned primary care births was 2.0 per 1000 births. For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95% confidence interval 0.56 to 1.06), relative risk reduction 25.7% (95% confidence interval -0.1% to 53.5%), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5%, -6.8% to 7.9%), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8%, -6.1% to 11.8%). For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3%, 33.2% to 87.5%), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9%, 41.2% to 54.7%), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9%, 47.9% to 66.3%). Low risk

  4. Naturally-occurring alpha activity

    Energy Technology Data Exchange (ETDEWEB)

    Mayneord, W V

    1960-12-01

    In view of the difficulties of assessing the significance of man-made radioactivity it is important to study for comparison the background of natural radioactivity against which the human race has evolved and lives. It is also important to define the present levels of activity so that it will be possible to detect and study as quickly as possible any changes which may occur owing to the release into the environment of new radioactive materials. Moreover, by the study of the behaviour of natural radioactivity light may be shed upon that of the artificially produced isotopes and a number of analogies traced between the two groups. These concepts have led to studies of naturally-occurring radioactive materials alongside a programme of research into fission products in food, water and air, as well as studies of the metabolism of both sets of materials in the human body. Since the last report there has been a useful increase in our knowledge of natural radioactivity in the biosphere, and its levels relative to the new man-made activities. These studies have necessitated technical developments, particularly in the methods of measuring and identifying alpha-ray emitters, to which group many of the more important natural radioactive materials belong.

  5. Models for financial crisis detection in Indonesia based on bank deposits, real exchange rate and terms of trade indicators

    Science.gov (United States)

    Sugiyanto; Zukhronah, Etik; Nur Aini, Anis

    2017-12-01

    Several times Indonesia has experienced to face a financial crisis, but the crisis occurred in 1997 had a tremendous impact on the economy and national stability. The impact of the crisis fall the exchange rate of rupiah against the dollar so it is needed the financial crisis detection system. Some data of bank deposits, real exchange rate and terms of trade indicators are used in this paper. Data taken from January 1990 until December 2016 are used to form the models with three state. Combination of volatility and Markov switching models are used to model the data. The result suggests that the appropriate model for bank deposit and terms of trade is SWARCH (3,1), and for real exchange rates is SWARCH (3,2).

  6. Altered dopamine signaling in naturally occurring maternal neglect.

    Directory of Open Access Journals (Sweden)

    Stephen C Gammie

    2008-04-01

    Full Text Available Child neglect is the most common form of child maltreatment, yet the biological basis of maternal neglect is poorly understood and a rodent model is lacking.The current study characterizes a population of mice (MaD1 which naturally exhibit maternal neglect (little or no care of offspring at an average rate of 17% per generation. We identified a set of risk factors that can predict future neglect of offspring, including decreased self-grooming and elevated activity. At the time of neglect, neglectful mothers swam significantly more in a forced swim test relative to nurturing mothers. Cross-fostered offspring raised by neglectful mothers in turn exhibit increased expression of risk factors for maternal neglect and decreased maternal care as adults, suggestive of possible epigenetic contributions to neglect. Unexpectedly, offspring from neglectful mothers elicited maternal neglect from cross-fostered nurturing mothers, suggesting that factors regulating neglect are not solely within the mother. To identify a neurological pathway underlying maternal neglect, we examined brain activity in neglectful and nurturing mice. c-Fos expression was significantly elevated in neglectful relative to nurturing mothers in the CNS, particularly within dopamine associated areas, such as the zona incerta (ZI, ventral tegmental area (VTA, and nucleus accumbens. Phosphorylated tyrosine hydroxylase (a marker for dopamine production was significantly elevated in ZI and higher in VTA (although not significantly in neglectful mice. Tyrosine hydroxylase levels were unaltered, suggesting a dysregulation of dopamine activity rather than cell number. Phosphorylation of DARPP-32, a marker for dopamine D1-like receptor activation, was elevated within nucleus accumbens and caudate-putamen in neglectful versus nurturing dams.These findings suggest that atypical dopamine activity within the maternal brain, especially within regions involved in reward, is involved in naturally

  7. Impact of pavement conditions on crash severity.

    Science.gov (United States)

    Li, Yingfeng; Liu, Chunxiao; Ding, Liang

    2013-10-01

    Pavement condition has been known as a key factor related to ride quality, but it is less clear how exactly pavement conditions are related to traffic crashes. The researchers used Geographic Information System (GIS) to link Texas Department of Transportation (TxDOT) Crash Record Information System (CRIS) data and Pavement Management Information System (PMIS) data, which provided an opportunity to examine the impact of pavement conditions on traffic crashes in depth. The study analyzed the correlation between several key pavement condition ratings or scores and crash severity based on a large number of crashes in Texas between 2008 and 2009. The results in general suggested that poor pavement condition scores and ratings were associated with proportionally more severe crashes, but very poor pavement conditions were actually associated with less severe crashes. Very good pavement conditions might induce speeding behaviors and therefore could have caused more severe crashes, especially on non-freeway arterials and during favorable driving conditions. In addition, the results showed that the effects of pavement conditions on crash severity were more evident for passenger vehicles than for commercial vehicles. These results provide insights on how pavement conditions may have contributed to crashes, which may be valuable for safety improvement during pavement design and maintenance. Readers should notice that, although the study found statistically significant effects of pavement variables on crash severity, the effects were rather minor in reality as suggested by frequency analyses. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Factors involved in the identification of stuttering severity in a foreign language.

    Science.gov (United States)

    Cosyns, Marjan; Einarsdóttir, Jóhanna T; Van Borsel, John

    2015-01-01

    Speech-language pathologists nowadays are more and more confronted with clients who speak a language different from their own mother tongue. The assessment of persons who speak a foreign language poses particular challenges. The present study investigated the possible role and interplay of factors involved in the identification of stuttering severity in a foreign language. Nineteen speech-language pathologists from five different countries (i.e. Iceland, Sweden, Norway, Finland, and Belgium) rated stuttering severity of speech samples featuring persons who stutter speaking Icelandic, Swedish, Norwegian, or Dutch. Additionally, they were asked to score how easy they found it to rate the samples. Accuracy of rating stuttering severity in another language appeared to be foremost determined by the client's stuttering severity, while experienced ease of rating stuttering severity was essentially related to closeness of the language of the clinician to that of the client and familiarity of the clinician with the client's language. Stuttering measurement training programmes in different languages are needed.

  9. Estimating NHL Scoring Rates

    OpenAIRE

    Buttrey, Samuel E.; Washburn, Alan R.; Price, Wilson L.; Operations Research

    2011-01-01

    The article of record as published may be located at http://dx.doi.org/10.2202/1559-0410.1334 We propose a model to estimate the rates at which NHL teams score and yield goals. In the model, goals occur as if from a Poisson process whose rate depends on the two teams playing, the home-ice advantage, and the manpower (power-play, short-handed) situation. Data on all the games from the 2008-2009 season was downloaded and processed into a form suitable for the analysis. The model...

  10. Differences in life-history and ecological traits between co-occurring Panulirus spiny lobsters (Decapoda, Palinuridae).

    Science.gov (United States)

    Briones-Fourzán, Patricia

    2014-01-01

    Coexistence of closely related species may be promoted by niche differentiation or result from interspecific trade-offs in life history and ecological traits that influence relative fitness differences and contribute to competitive inequalities. Although insufficient to prove coexistence, trait comparisons provide a first step to identify functional differences between co-occurring congeneric species in relation to mechanisms of coexistence. Here, a comparative review on life history and ecological traits is presented for two pairs of co-occurring species of spiny lobsters in the genus Panulirus: Panulirusgracilis and Panulirusinflatus from the Eastern Central Pacific region, and Panulirusargus and Panulirusguttatus from the Caribbean region. Panulirusgracilis and Panulirusinflatus have similar larval, postlarval, and adult sizes and a similar diet, but differ in degree of habitat specialization, fecundity, and growth rate. However, little is known on behavioral traits of these two species that may influence their competitive abilities and susceptibility to predators. The more abundant information on Panulirusargus and Panulirusguttatus shows that these two species differ more broadly in degree of habitat specialization, larval, postlarval and adult sizes, diet, fecundity, growth rate, degree of sociality, defense mechanisms, susceptibility to predators, and chemical ecology, suggesting a greater degree of niche differentiation between Panulirusargus and Panulirusguttatus than between Panulirusgracilis and Panulirusinflatus. Whether the substantial niche differentiation and apparent interspecific trade-offs between Panulirusargus and Panulirusguttatus relative to Panulirusgracilis and Panulirusinflatus reflect an earlier divergence of the former pair of species in the evolution of the genus constitutes an intriguing hypothesis. However, whether or not post-divergence evolution of each species pair occurred in sympatry remains uncertain.

  11. Effects of strain rate, stress condition and environment on iodine embrittlement of Ziracloy-2

    International Nuclear Information System (INIS)

    Une, K.

    1979-01-01

    Iodine stress corrosion cracking (SCC) susceptibility of Zircaloy became higher with decreasing strain rate. Critical strain rate, below which high SCC severity was observed, substantially depended on Zircaloy stress condition. This strain rate (7 x 10 -3 min -1 ) under plane strain condition was about 3.5 times as fast as that (2 x 10 -3 min -1 ) under uniaxial condition. The maximum iodine embrittlement in Zircaloy was found in stress ratio α (axial/tangential stress) range of 0.5 to 0.7. No embrittlement occurred at α = infinity because of its texture effect. The SCC fracture stresses were about 39 kg/mm 2 for unirradiated and stress-relieved material, and about 34 kg/mm 2 for recrystallized material, whose ratios to yield strength of each material were 0.8 and 1.2. Impurity gases of oxygen and moisture in the iodine had the effects of reducing Zircaloy SCC susceptibility. Stress-relieved material was more sensitive to environmental impurities than recrystallized material

  12. Industry Television Ratings for Violence, Sex, and Substance Use.

    Science.gov (United States)

    Gabrielli, Joy; Traore, Aminata; Stoolmiller, Mike; Bergamini, Elaina; Sargent, James D

    2016-09-01

    To examine whether the industry-run television (TV) Parental Guidelines discriminate on violence, sexual behavior, alcohol use, and smoking in TV shows, to assess their usefulness for parents. Seventeen TV shows (323 episodes and 9214 episode minutes) across several TV show rating categories (TVY7, TVPG, TV14, and TVMA) were evaluated. We content-coded the episodes, recording seconds of each risk behavior, and we rated the salience of violence in each one. Multilevel models were used to test for associations between TV rating categories and prevalence of risk behaviors across and within episodes or salience of violence. Every show had at least 1 risk behavior. Violence was pervasive, occurring in 70% of episodes overall and for 2.3 seconds per episode minute. Alcohol was also common (58% of shows, 2.3 seconds per minute), followed by sex (53% of episodes, 0.26 seconds per minute), and smoking (31% of shows, 0.54 seconds per minute). TV Parental Guidelines did not discriminate prevalence estimates of TV episode violence. Although TV-Y7 shows had significantly less substance use, other categories were poor at discriminating substance use, which was as common in TV-14 as TV-MA shows. Sex and gory violence were the only behaviors demonstrating a graded increase in prevalence and salience for older-child rating categories. TV Parental Guidelines ratings were ineffective in discriminating shows for 3 out of 4 behaviors studied. Even in shows rated for children as young as 7 years, violence was prevalent, prominent, and salient. TV ratings were most effective for identification of sexual behavior and gory violence. Copyright © 2016 by the American Academy of Pediatrics.

  13. Severe cold lower limbs in patients with Parkinson’s disease during the summer

    Directory of Open Access Journals (Sweden)

    Hiroshi Kataoka

    2016-11-01

    Full Text Available Parkinson’s disease (PD is frequently associated with vasomotor symptoms such as distal cold limbs or sensitivity to cold. Coldness of the lower limbs (COL usually occurs in winter and is often accompanied by pain, potentially causing difficulty in walking or standing. A standard dopaminergic treatment for such symptoms is yet to be established. We describe two patients with PD, who had severe COL during summer. For example, the patients wore many pairs of socks or used heating appliances in the summer. Severe COL can occur in summertime and can be intolerable or unpleasant, since it can worsen disability. The treatment with a dopamine agonist did not sufficiently decrease the severity of COL.

  14. Peak heart rate decreases with increasing severity of acute hypoxia

    DEFF Research Database (Denmark)

    Lundby, C; Araoz, M; Van Hall, Gerrit

    2001-01-01

    , 459, and 404 mmHg) in a hypobaric chamber and while breathing 9% O(2) in N(2). These conditions were equivalent to altitudes of 3300, 4300, 5300, and 6300 m above sea level, respectively. At 4300 m, maximal exercise was also repeated after 4 and 8 h. Peak heart rate (HR) decreased from 191 (182......-202) (mean and range) at sea level to 189 (179-200), 182 (172-189), 175 (166-183), and 165 (162-169) in the acute hypoxic conditions. Peak HR did not decrease further after 4 and 8 h at 4300 m compared to the acute exposure at this altitude. Between barometric pressures of 518 and 355 mmHg (approximately...... 3300 and 6300 m), peak HR decreased linearly: peak HR(hypobaria) = peak HR(sea level) - 0.135 x [hypobaria(3100) - hypobaria (mmHg)]; or peak HR(altitude) = peak HR(sea level) - 0.15 x (altitude - 3100 m). This corresponds to approximately 1-beat x min(-1) reduction in peak HR for every 7-mmHg decrease...

  15. Motor vehicle and pedestrian collisions: burden of severe injury on major versus neighborhood roads.

    Science.gov (United States)

    Rothman, Linda; Slater, Morgan; Meaney, Christopher; Howard, Andrew

    2010-02-01

    To determine whether the severity of injuries sustained by pedestrians involved in motor vehicle collisions varies by road type and age. All police-reported pedestrian motor vehicle collisions in the city of Toronto, Canada, between January 1, 2000, and December 31, 2005, were analyzed. Geographic Information Systems software was used to determine whether the collisions occurred on major or neighborhood roads. Age-specific estimates of the burden of pedestrian collisions are presented. Odds ratios and 95 percent confidence intervals were calculated to examine age-specific relationships between injury severity and road type. A second analysis comparing the distribution of severe injury location between age groups was also performed. The majority of collisions involved adults (68%), although elderly pedestrians were overrepresented in fatal collisions (49%). Severe and fatal collisions involving working-age and elderly adult pedestrians were more likely on major roads. Odds of severe injury occurring on a major road were 1.36 (95% CI: 1.17-1.57) times higher for adults ages 18 to 64, and 1.55 (95% CI: 1.22-1.99) times higher for elderly aged 65+. By contrast, severe injuries among children were more common on neighborhood roads, with odds of severe injury on a major road of 0.64 (95% CI: 0.37-1.1) for children aged 5 to 9. Among children under 9, 64-67 percent of hospitalized or fatal injuries occurred on neighborhood roads, a marked difference from the distribution of such injuries in adults or the elderly, for whom only 29-30 percent of hospitalized or fatal injuries occurred on neighborhood roads (chi-square = 52.6, p roads alone will not make child pedestrians safer. Pedestrian interventions specific to children and focused on neighborhood roads must be considered in urban centers like Toronto.

  16. Outcome of severely injured trauma patients at a designated trauma centre in the Hong Kong Special Administrative Region.

    Science.gov (United States)

    Leung, Ka Kit Gilberto; Ho, Wendy; Tong, King Hung Daniel; Yuen, Wai Key

    2010-05-20

    The Hong Kong Special Administrative Region (HKSAR) of the People's Republic of China (PRC) has seen significant changes in its trauma service over the last ten years including the implementation of a regional trauma system. The author's institution is one of the five trauma centres designated in 2003. This article reports our initial clinical experience. A prospective single-centre trauma registry from January 2004 to December 2008 was reviewed. The primary clinical outcome measure was hospital mortality. The Trauma and Injury Severity Score (TRISS) methodology was used for bench-marking with the North America Major Trauma Outcome Study (MTOS) database. There were 1451 patients. The majority (83.9%) suffered from blunt injury. The overall mortality rate was 7.8%. Severe injury, defined as the Injury Severity Score > 15, occurred in 22.5% of patients, and was associated with a mortality rate of 31.6%. A trend of progressive improvement was noted. The M-statistic was 0.99, indicating comparable case-mix with the MTOS. The Z- and W-statistics of each individual year revealed fewer, but not significantly so, number of survivors than expected. Trauma centre designation was feasible in the HKSAR and was associated with a gradual improvement in patient care. Trauma system implementation may be considered in regions equipped with the necessary socio-economic and organizational set-up.

  17. Naturally occurring Vpr inhibitors from medicinal plants of Myanmar.

    Science.gov (United States)

    Win, Nwet Nwet; Ngwe, Hla; Abe, Ikuro; Morita, Hiroyuki

    2017-10-01

    Human immunodeficiency virus type-1 (HIV-1) is a lentiviral family member that encodes the retroviral Gag, Pol, and Env proteins, along with six additional accessory proteins, Tat, Rev, Vpu, Vif, Nef, and Vpr. The currently approved anti-HIV drugs target the Pol and Env encoded proteins. However, these drugs are only effective in reducing viral replication. Furthermore, the drugs' toxicities and the emergence of drug-resistant strains have become serious worldwide problems. Resistance eventually arises to all of the approved anti-HIV drugs, including the newly approved drugs that target HIV integrase (IN). Drug resistance likely emerges because of spontaneous mutations that occur during viral replication. Therefore, new drugs that effectively block other viral components must be developed to reduce the rate of resistance and suppress viral replication with little or no long-term toxicity. The accessory proteins may expand treatment options. Viral protein R (Vpr) is one of the promising drug targets among the HIV accessory proteins. However, the search for inhibitors continues in anti-HIV drug discovery. In this review, we summarize the naturally occurring compounds discovered from two Myanmar medicinal plants as well as their structure-activity relationships. A total of 49 secondary metabolites were isolated from Kaempferia pulchra rhizomes and Picrasama javanica bark, and the types of compounds were identified as isopimarane diterpenoids and picrasane quassinoids, respectively. Among the isolates, 7 diterpenoids and 15 quassinoids were found to be Vpr inhibitors lacking detectable toxicity, and their potencies varied according to their respective functionalities.

  18. The use of naturally occurring selectively isolated bacteria for inhibiting paraffin deposition

    International Nuclear Information System (INIS)

    Lazar, I.; Voicu, A.; Dobrota, S.; Petrisor, I.G.; Stefanescu, M.; Sandulescu, L.; Nicolescu, C.; Mucenica, D.

    1999-01-01

    One of the most severe problems at any oil fields producing paraffinic oils is that of paraffin depositions. Romania which has a long experience in oil production is also faced with this problem in many oil fields. The microbial treatment, based on the activity of naturally occurring, selectively isolated bacteria, is already proved as an effective alternative to conventional methods to prevent and remove paraffin damage. Using such kind of bacterial products, exciting results for inhibiting paraffin depositions have been obtained. In this paper results concerning the naturally occurring bacteria selectively isolated from hydrocarbon polluted sites as well as from paraffinic oils, semi-solid and solid paraffin depositions are presented. After a laboratory screening, 15 bacterial strains (BS 1-15), three bacterial consortia (BC 1-3) and a Special Bacterial Consortium (SBC1) were selected. For the selection of bacterial consortia, the classical enrichment culture method has been used. The Special Bacterial Consortium resulted from a mixture of BS 1-15 and BC 1-3 following the steps of the classical enrichment culture method. The BS 1-15, BC 1-3 and SBC1 have been tested for their performances in producing biosurfactants and biosolvents as well as for hydrocarbon utilisation. The SBC1 has been tested for its ability in degradation of hydrocarbons contained in several types of paraffinic or non-paraffinic oils, and then for inhibiting paraffin deposition on a 'flow equipment' using two types of paraffinic oils. The SBC1 has been also tested for degradation of hydrocarbons contained in semi-solid and solid paraffin depositions. The results obtained could support further applications to prevent and control paraffin depositions

  19. The use of naturally occurring selectively isolated bacteria for inhibiting paraffin deposition

    Energy Technology Data Exchange (ETDEWEB)

    Lazar, I.; Voicu, A.; Dobrota, S.; Petrisor, I.G.; Stefanescu, M.; Sandulescu, L. [Institute of Biology of the Romanian Academy, Spl. Independentei 296, Bucharest (Romania); Nicolescu, C.; Mucenica, D. [PETROSTAR Ploiesti, Bdul Bucuresti 35, Ploiesti (Romania)

    1999-01-01

    One of the most severe problems at any oil fields producing paraffinic oils is that of paraffin depositions. Romania which has a long experience in oil production is also faced with this problem in many oil fields. The microbial treatment, based on the activity of naturally occurring, selectively isolated bacteria, is already proved as an effective alternative to conventional methods to prevent and remove paraffin damage. Using such kind of bacterial products, exciting results for inhibiting paraffin depositions have been obtained. In this paper results concerning the naturally occurring bacteria selectively isolated from hydrocarbon polluted sites as well as from paraffinic oils, semi-solid and solid paraffin depositions are presented. After a laboratory screening, 15 bacterial strains (BS 1-15), three bacterial consortia (BC 1-3) and a Special Bacterial Consortium (SBC1) were selected. For the selection of bacterial consortia, the classical enrichment culture method has been used. The Special Bacterial Consortium resulted from a mixture of BS 1-15 and BC 1-3 following the steps of the classical enrichment culture method. The BS 1-15, BC 1-3 and SBC1 have been tested for their performances in producing biosurfactants and biosolvents as well as for hydrocarbon utilisation. The SBC1 has been tested for its ability in degradation of hydrocarbons contained in several types of paraffinic or non-paraffinic oils, and then for inhibiting paraffin deposition on a `flow equipment` using two types of paraffinic oils. The SBC1 has been also tested for degradation of hydrocarbons contained in semi-solid and solid paraffin depositions. The results obtained could support further applications to prevent and control paraffin depositions

  20. Interpersonal traits change as a function of disease type and severity in degenerative brain diseases.

    Science.gov (United States)

    Sollberger, Marc; Neuhaus, John; Ketelle, Robin; Stanley, Christine M; Beckman, Victoria; Growdon, Matthew; Jang, Jung; Miller, Bruce L; Rankin, Katherine P

    2011-07-01

    Different degenerative brain diseases result in distinct personality changes as a result of divergent patterns of brain damage; however, little is known about the natural history of these personality changes throughout the course of each disease. To investigate how interpersonal traits change as a function of degenerative brain disease type and severity. Using the Interpersonal Adjective Scales, informant ratings of retrospective premorbid and current scores for dominance, extraversion, warmth and ingenuousness were collected annually for 1 to 4 years on 188 patients (67 behavioural variant frontotemporal dementia (bvFTD), 40 semantic dementia (SemD), 81 Alzheimer's disease (AD)) and 65 older healthy controls. Using random coefficient models, interpersonal behaviour scores at very mild, mild or moderate-to-severe disease stages were compared within and between patient groups. Group-level changes from premorbid personality occurred as a function of disease type and severity, and were apparent even at a very mild disease stage (Clinical Dementia Rating=0.5) for all three diseases. Decreases in interpersonal traits were associated with emotional affiliation (ie, extraversion, warmth and ingenuousness) and more rigid interpersonal behaviour differentiated bvFTD and SemD patients from AD patients. Specific changes in affiliative interpersonal traits differentiate degenerative brain diseases even at a very mild disease stage, and patterns of personality change differ across bvFTD, SemD and AD with advancing disease. This study describes the typical progression of change of interpersonal traits in each disease, improving the ability of clinicians and caregivers to predict and plan for symptom progression.

  1. Outcomes after asystole events occurring during wearable defibrillator-cardioverter use.

    Science.gov (United States)

    Liang, Jackson J; Bianco, Nicole R; Muser, Daniele; Enriquez, Andres; Santangeli, Pasquale; D'Souza, Benjamin A

    2018-04-26

    To examine whether wearable cardioverter defibrillator (WCD) alarms for asystole improve patient outcomes and survival. All asystole episodes recorded by the WCD in 2013 were retrospectively analyzed from a database of device and medical record documentation and customer call reports. Events were classified as asystole episodes if initial presenting arrhythmia was asystole (< 10 beats/minor ≥ 5 s pause). Survival was defined as recovery at the scene or arrival to a medical facility alive, or not requiring immediate medical attention. Episodes occurring in hospitals, nursing homes, or ambulances were considered to be under medical care. Serious asystole episodes were defined as resulting in unconsciousness, hospital transfer, or death. Of the total 51933 patients having worn the WCD in 2013, there were 257 patients (0.5%) who had asystole episodes and comprised the study cohort. Among the 257 patients (74% male, median age 69 years), there were 264 asystole episodes. Overall patient survival was 42%. Most asystoles were considered "serious" ( n = 201 in 201 patients, 76%), with a 26% survival rate. All 56 patients with "non-serious" asystole episodes survived. Being under medical care was associated with worse survival of serious asystoles. Among acute survivors, 20% later died during WCD use (a median 4 days post asystole episode). Of the 86 living patients at the end of WCD use period, 48 (56%) received ICD/pacemaker and 17 (20%) improved their condition. Survival rates after asystole in patients with WCD are higher than historically reported survival rates. Those under medical care at time of asystole exhibited lower survival.

  2. Pathogenic triad in bacterial meningitis: pathogen invasion, NF-κB activation and leukocyte transmigration that occur at the Blood-Brain Barrier

    Directory of Open Access Journals (Sweden)

    Sheng-He eHuang

    2016-02-01

    Full Text Available Bacterial meningitis remains the leading cause of disabilities worldwide. This life-threatening disease has a high mortality rate despite the availability of antibiotics and improved critical care. The interactions between bacterial surface components and host defense systems that initiate bacterial meningitis have been studied in molecular and cellular detail over the past several decades. Bacterial meningitis commonly exhibits triad hallmark features (THFs: pathogen penetration, nuclear factor-kappaB (NF-B activation in coordination with type 1 interferon (IFN signaling and leukocyte transmigration that occur at the blood-brain barrier (BBB, which consists mainly of brain microvascular endothelial cells (BMEC. This review outlines the progression of these early inter-correlated events contributing to the central nervous system (CNS inflammation and injury during the pathogenesis of bacterial meningitis. A better understanding of these issues is not only imperative to elucidating the pathogenic mechanism of bacterial meningitis, but may also provide the in-depth insight into the development of novel therapeutic interventions against this disease.

  3. Co-occurring mental illness, substance use disorders, and antisocial personality disorder among clients of forensic mental health services.

    Science.gov (United States)

    Ogloff, James R P; Talevski, Diana; Lemphers, Anthea; Wood, Melisa; Simmons, Melanie

    2015-03-01

    Despite the number of studies investigating co-occurring disorders, and more recently, co-occurring disorders and criminal offending, few studies have considered samples from forensic mental health services. The present study was conducted to investigate the relationship between mental illness, substance use disorders, antisocial personality disorder, and offending. The prevalence of co-occurring disorders was investigated in 130 male offenders who had contact with the statewide forensic mental health service in Victoria, Australia. Offense histories and severity of offending were compared among participants diagnosed with a single mental illness (or no mental illness), co-occurring mental illness and substance use, and co-occurring disorders plus antisocial personality disorder. The majority of participants had co-occurring mental and substance use disorders; a significant minority met the criteria for antisocial personality disorder. Participants with co-occurring mental illness and substance use disorders, and those who had an additional diagnosis of antisocial personality disorder, were responsible for more serious and frequent offending than those with mental illness alone. Forensic mental health services must take into account the effect that co-occurring disorders have on clients' functioning and offending. Those who work with people with psychiatric disabilities and co-occurring substance use disorders must ensure that the substance disorders are addressed to help ensure recovery from the mental illness and to reduce the likelihood of offending. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

  4. Predictors of residential treatment retention among individuals with co-occurring substance abuse and mental health disorders.

    Science.gov (United States)

    Choi, Sam; Adams, Susie M; MacMaster, Samuel A; Seiters, John

    2013-01-01

    A significant number of individuals with co-occurring substance abuse and mental health disorders do not engage, stay, and/or complete residential treatment. The purpose of this study is to identify factors during the initial phase of treatment which predict retention in private residential treatment for individuals with co-occurring substance use and mental health disorders. The participants were 1,317 individuals with co-occurring substance abuse and mental health disorders receiving treatment at three residential treatment centers located in Memphis, TN, Malibu, CA, and Palm Springs, CA. Bivariate analysis and logistic regression were utilized to identify factors that predict treatment retention at 30 days. The findings indicate a variety of factors including age, gender, types of drug, Addiction Severity Index Medical and Psychiatric scores, and readiness to change. These identified factors could be incorporated into pretreatment assessments, so that programs can initiate preventive measures to decrease attrition and improve treatment outcomes.

  5. A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale.

    Science.gov (United States)

    Walker, Stephen L; Sales, Anna M; Butlin, C Ruth; Shah, Mahesh; Maghanoy, Armi; Lambert, Saba M; Darlong, Joydeepa; Rozario, Benjamin Jewel; Pai, Vivek V; Balagon, Marivic; Doni, Shimelis N; Hagge, Deanna A; Nery, José A C; Neupane, Kapil D; Baral, Suwash; Sangma, Biliom A; Alembo, Digafe T; Yetaye, Abeba M; Hassan, Belaynesh A; Shelemo, Mohammed B; Nicholls, Peter G; Lockwood, Diana N J

    2017-07-01

    We wished to validate our recently devised 16-item ENLIST ENL Severity Scale, a clinical tool for measuring the severity of the serious leprosy associated complication of erythema nodosum leprosum (ENL). We also wished to assess the responsiveness of the ENLIST ENL Severity Scale in detecting clinical change in patients with ENL. Participants, recruited from seven centres in six leprosy endemic countries, were assessed using the ENLIST ENL Severity Scale by two researchers, one of whom categorised the severity of ENL. At a subsequent visit a further assessment using the scale was made and both participant and physician rated the change in ENL using the subjective categories of "Much better", "somewhat better", "somewhat worse" and "much worse" compared with "No change" or "about the same". 447 participants were assessed with the ENLIST ENL Severity Scale. The Cronbach alpha of the scale and each item was calculated to determine the internal consistency of the scale. The ENLIST ENL Severity Scale had good internal consistency and this improved following removal of six items to give a Cronbach's alpha of 0.77. The cut off between mild ENL and more severe disease was 9 determined using ROC curves. The minimal important difference of the scale was determined to be 5 using both participant and physician ratings of change. The 10-item ENLIST ENL Severity Scale is the first valid, reliable and responsive measure of ENL severity and improves our ability to assess and compare patients and their treatments in this severe and difficult to manage complication of leprosy. The ENLIST ENL Severity Scale will assist physicians in the monitoring and treatment of patients with ENL. The ENLIST ENL Severity Scale is easy to apply and will be useful as an outcome measure in treatment studies and enable the standardisation of other clinical and laboratory ENL research.

  6. A simple algebraic cancer equation: calculating how cancers may arise with normal mutation rates

    Directory of Open Access Journals (Sweden)

    Shibata Darryl

    2010-01-01

    Full Text Available Abstract Background The purpose of this article is to present a relatively easy to understand cancer model where transformation occurs when the first cell, among many at risk within a colon, accumulates a set of driver mutations. The analysis of this model yields a simple algebraic equation, which takes as inputs the number of stem cells, mutation and division rates, and the number of driver mutations, and makes predictions about cancer epidemiology. Methods The equation [p = 1 - (1 - (1 - (1 - udkNm ] calculates the probability of cancer (p and contains five parameters: the number of divisions (d, the number of stem cells (N × m, the number of critical rate-limiting pathway driver mutations (k, and the mutation rate (u. In this model progression to cancer "starts" at conception and mutations accumulate with cell division. Transformation occurs when a critical number of rate-limiting pathway mutations first accumulates within a single stem cell. Results When applied to several colorectal cancer data sets, parameter values consistent with crypt stem cell biology and normal mutation rates were able to match the increase in cancer with aging, and the mutation frequencies found in cancer genomes. The equation can help explain how cancer risks may vary with age, height, germline mutations, and aspirin use. APC mutations may shorten pathways to cancer by effectively increasing the numbers of stem cells at risk. Conclusions The equation illustrates that age-related increases in cancer frequencies may result from relatively normal division and mutation rates. Although this equation does not encompass all of the known complexity of cancer, it may be useful, especially in a teaching setting, to help illustrate relationships between small and large cancer features.

  7. Increased strength of concrete subject to high loading rates

    International Nuclear Information System (INIS)

    Curbach, M.

    1987-01-01

    Within the scope of this work various problems are discussed which occur in connection with concrete under high tensile loading rates (e.g. when a plane crashes on a nuclear power plant very high loads occur which act only for a very short time). Particularly the causes for the already frequently noticed increases in strength with increasing loading rates are investigated and also the question whether this increased strength can be taken into account when dimensioning a construction. (MM) [de

  8. Autism Spectrum Disorder and Co-occurring Substance Use Disorder – A Systematic Review

    Directory of Open Access Journals (Sweden)

    Espen Ajo Arnevik

    2016-01-01

    Full Text Available Objective Patients with co-occurring autism spectrum disorders (ASD and substance use disorder (SUD require special attention from clinical services. Screening for this co-occurrence is not generally an integral part of routine clinical assessments, and failure to identify and understand this group of patients may contribute to a worsening of their symptoms and/or an increase in drug abuse. Thus, there is a need to review the evidence base on patients with co-occurring ASD and SUD in order to enhance clinical practice and future research. Methods We reviewed all identified papers on patients with co-occurring ASD and SUD. The focus of the review was on epidemiology, patient characteristics, function of drug use, and the effect of current interventions. Results A total of 18 papers were included in the analysis. Eleven papers were based on epidemiological studies, although only one study reported the prevalence of ASD in an SUD population. Two papers explored the role of personality, three papers studied subgroups of individuals serving prison for violent or sexual crimes, and one paper explored the function of drugs in the ASD patient group. There were no studies testing specific treatment interventions. Conclusions In most of the treatment settings studied, there were relatively few patients with co-occurring ASD and SUD, but due to differences in study samples it was difficult to establish a general prevalence rate. The one consistent finding was the lack of focused treatment studies. There is clearly a need for research on interventions that take account of the special needs of this patient group.

  9. Distribution of naturally occurring radionuclides in soils of the southern districts of Bangladesh

    International Nuclear Information System (INIS)

    Chowdhury, M. I.; Kamal, M.; Alam, M. N.; Yeasmin, S.; Mostafa, M. N.

    2006-01-01

    The activity concentrations of naturally occurring radioactive materials in soil samples of an elevated radiation background area of nine southern districts of Bangladesh were determined using gamma-ray spectrometry with an aim of evaluating the environmental radioactivity. The outdoor and indoor external effective dose rates and the radiation hazard indices from the soil activity were evaluated with an aim of minimising the harmful effects of ionising radiation to the population of the area concerned. The activity of 137 Cs was measured and observed in some of the locations. (authors)

  10. [Measurement of regional cerebral metabolism rate of glucose in patients with Alzheimer's disease in different levels of severity].

    Science.gov (United States)

    Xiao, Shi-fu; Cao, Qiu-yun; Xue, Hai-bo; Liu, Yong-chang; Zuo, Chuan-tao; Jiang, Kai-da; Zhang, Ming-yuan

    2005-11-09

    To measure the changes of regional cerebral metabolism rate of glucose (rCMRglc) in patients with Alzheimer's disease (AD) and explore their value to diagnosis of AD. 10 patients with AD who met the diagnostic criteria of DSM-IV and 10 normal controls (NC) were assessed with (18)F-2-fluoro-deoxy-D-glucose positron emission tomography (PET). The two groups were matched in age, gender and education. The mean total scores of the mini-mental status examination (MMSE) were 16.5 +/- 6.1 for AD and 28.7 +/- 1.6 for NC. The mean total memory quotient of Wechsler Memory Scales (MQ) were 32.3 +/- 19.6 for AD and 93.1 +/- 9.0 for NC. Comparing to NC, the AD groups showed statistically significant decline of rCMRglc in frontal lobe, temporal lobe and the hippocampal formation with decreased rates ranged from 3.3% to 28.4% (P upper and middle frontal gyri, middle temporal gyrus, orbital gyrus and anterior cingulate gyrus, in which areas the metabolism decreased over 20% compared to NC. The hypo-metabolism was correlated to the severity of dementia. Discriminant analysis demonstrated that the variables of right inferior temporal gyrus, left upper temporal gyrus, left hippocampus and right insular lobe were entered into the discriminant functions and the total discriminant accuracy reached 100%. (18)F-FDG PET is a very sensitive tool in measurement of the changes of rCMRglc in patients with AD. The findings show a frontal-temporal type of metabolism in AD patients and suggest that hypo-metabolism in hippocampal formation and temporal lobe is helpful in early detection of AD.

  11. Face Validity of the Single Work Ability Item: Comparison with Objectively Measured Heart Rate Reserve over Several Days

    Science.gov (United States)

    Gupta, Nidhi; Jensen, Bjørn Søvsø; Søgaard, Karen; Carneiro, Isabella Gomes; Christiansen, Caroline Stordal; Hanisch, Christiana; Holtermann, Andreas

    2014-01-01

    Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR) among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74) aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD)” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005), but not among females (R = 0.11, P = 0.431). In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI) = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16), and a significant interaction between work ability, %HRR and gender was observed (P = 0.03). Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated. PMID:24840350

  12. Face Validity of the Single Work Ability Item: Comparison with Objectively Measured Heart Rate Reserve over Several Days

    Directory of Open Access Journals (Sweden)

    Nidhi Gupta

    2014-05-01

    Full Text Available Purpose: The purpose of this study was to investigate the face validity of the self-reported single item work ability with objectively measured heart rate reserve (%HRR among blue-collar workers. Methods: We utilized data from 127 blue-collar workers (Female = 53; Male = 74 aged 18–65 years from the cross-sectional “New method for Objective Measurements of physical Activity in Daily living (NOMAD” study. The workers reported their single item work ability and completed an aerobic capacity cycling test and objective measurements of heart rate reserve monitored with Actiheart for 3–4 days with a total of 5,810 h, including 2,640 working hours. Results: A significant moderate correlation between work ability and %HRR was observed among males (R = −0.33, P = 0.005, but not among females (R = 0.11, P = 0.431. In a gender-stratified multi-adjusted logistic regression analysis, males with high %HRR were more likely to report a reduced work ability compared to males with low %HRR [OR = 4.75, 95% confidence interval (95% CI = 1.31 to 17.25]. However, this association was not found among females (OR = 0.26, 95% CI 0.03 to 2.16, and a significant interaction between work ability, %HRR and gender was observed (P = 0.03. Conclusions: The observed association between work ability and objectively measured %HRR over several days among male blue-collar workers supports the face validity of the single work ability item. It is a useful and valid measure of the relation between physical work demands and resources among male blue-collar workers. The contrasting association among females needs to be further investigated.

  13. Naturally Occurring Nrf2 Activators: Potential in Treatment of Liver Injury

    Directory of Open Access Journals (Sweden)

    Ravirajsinh N. Jadeja

    2016-01-01

    Full Text Available Oxidative stress plays a major role in acute and chronic liver injury. In hepatocytes, oxidative stress frequently triggers antioxidant response by activating nuclear erythroid 2-related factor 2 (Nrf2, a transcription factor, which upregulates various cytoprotective genes. Thus, Nrf2 is considered a potential therapeutic target to halt liver injury. Several studies indicate that activation of Nrf2 signaling pathway ameliorates liver injury. The hepatoprotective potential of naturally occurring compounds has been investigated in various models of liver injuries. In this review, we comprehensively appraise various phytochemicals that have been assessed for their potential to halt acute and chronic liver injury by enhancing the activation of Nrf2 and have the potential for use in humans.

  14. Co-occurring symptoms of attention deficit hyperactivity disorder (ADHD) in a population-based sample of adolescents screened for depression.

    Science.gov (United States)

    Lundervold, Astri J; Hinshaw, Stephen P; Sørensen, Lin; Posserud, Maj-Britt

    2016-02-25

    Depression is common in adolescents, with a gender bias towards girls. Symptoms associated with attention deficit hyperactivity disorder (ADHD) tend to co-occur in depressed adolescents. This may be related to common features between the two symptom domains, but co-occurring ADHD symptoms may also inflate the severity of depression. The present study investigates the frequency and influence of ADHD symptoms co-occurring with depression in a gender balanced population-based sample of Norwegian adolescents. A sample of 9614 adolescents (16-19 years) completed a questionnaire including the short version of the Mood and Feelings Questionnaire (sMFQ) and the Adult ADHD Self-Report Scale (ASRS), with items reflecting symptoms associated with depression and ADHD, respectively. The sMFQ sum score was used as a proxy for severity of depression, and adolescents with a score equal to or above the 90th percentile were defined as depressed. A high response on any of the ASRS items was used to define the presence of an ADHD symptom, and the number of high scores was used to indicate severity. ADHD symptoms were frequently reported by the adolescents, with a higher frequency in girls than in boys. The gender differences were, however, minor when the analysis was restricted to the adolescents defined as depressed. Each severe symptom reported on the ASRS contributed significantly to increase the sum score on the sMFQ, and more than 20 % of the adolescents defined as depressed reported six or more symptoms within the ASRS inattention subscale. The results emphasize the importance of screening for symptoms associated with ADHD when assessing adolescents presenting symptoms indicating depression. Although girls reported higher frequency of symptoms within both domains, the gender bias was dependent on the overall symptom severity. Awareness of co-occurrence of symptoms and gender biases are of importance for both clinical work and future research on mental health and service use in

  15. Investigating Corrosion, Wear Resistance and Friction of AA5454-O Series after its Severe Deformation by Rolling

    Directory of Open Access Journals (Sweden)

    Sinan SEZEK

    2017-02-01

    Full Text Available AA5454-O is an easily wrought, or in other words, a ductile aluminium alloy, however, its mechanical properties are inferior as compared to those of other alloys. The change taking place in corrosion resistance of AA5454-O alloy as a result of its severe plastic deformation (SPD by rolling has been investigated in this study. It has been observed that significant changes occurred in abrasion wear and corrosion resistances of AA5454-O alloy, which was severely deformed up to 80 % by rolling process. Corrosion resistance of the alloy that was severely deformed by rolling has increased. The effect of deformation rate on corrosion has been investigated by applying potentiodynamic test whereas on the other hand such change has been evidenced also through corrosion test. It has been observed that friction coefficient of severely deformed AA5454-O alloy varied by around 10 %, and that, associated with such change, its wear resistance also increased considerably. It has been determined that, as a result of severe deformation by rolling, hardness values rose in areas where the alloy was in contact with rolling surface. In this study, wear resistance of severely deformed alloy has been investigated as well. It has been observed that deformation value contributed positively to the increase in wear resistance.DOI: http://dx.doi.org/10.5755/j01.ms.23.1.14650

  16. Severe forms of food allergy

    Directory of Open Access Journals (Sweden)

    Emanuel Sarinho

    Full Text Available Abstract Objectives: To guide the diagnostic and therapeutic management of severe forms of food allergy. Data sources: Search in the Medline database using the terms “severe food allergy,” “anaphylaxis and food allergy,” “generalized urticaria and food allergy,” and “food protein-induced enterocolitis syndrome” in the last ten years, searching in the title, abstract, or keyword fields. Summary of data: Food allergy can be serious and life-threatening. Milk, eggs, peanuts, nuts, walnuts, wheat, sesame seeds, shrimp, fish, and fruit can precipitate allergic emergencies. The severity of reactions will depend on associated cofactors such as age, drug use at the onset of the reaction, history and persistence of asthma and/or severe allergic rhinitis, history of previous anaphylaxis, exercise, and associated diseases. For generalized urticaria and anaphylaxis, intramuscular epinephrine is the first and fundamental treatment line. For the treatment in acute phase of food-induced enterocolitis syndrome in the emergency setting, prompt hydroelectrolytic replacement, administration of methylprednisolone and ondansetron IV are necessary. It is important to recommend to the patient with food allergy to maintain the exclusion diet, seek specialized follow-up and, in those who have anaphylaxis, to emphasize the need to carry epinephrine. Conclusion: Severe food allergy may occur in the form of anaphylaxis and food-protein-induced enterocolitis syndrome, which are increasingly observed in the pediatric emergency room; hence, pediatricians must be alert so they can provide the immediate diagnosis and treatment.

  17. Severe forms of food allergy.

    Science.gov (United States)

    Sarinho, Emanuel; Lins, Maria das Graças Moura

    To guide the diagnostic and therapeutic management of severe forms of food allergy. Search in the Medline database using the terms "severe food allergy," "anaphylaxis and food allergy," "generalized urticaria and food allergy," and "food protein-induced enterocolitis syndrome" in the last ten years, searching in the title, abstract, or keyword fields. Food allergy can be serious and life-threatening. Milk, eggs, peanuts, nuts, walnuts, wheat, sesame seeds, shrimp, fish, and fruit can precipitate allergic emergencies. The severity of reactions will depend on associated cofactors such as age, drug use at the onset of the reaction, history and persistence of asthma and/or severe allergic rhinitis, history of previous anaphylaxis, exercise, and associated diseases. For generalized urticaria and anaphylaxis, intramuscular epinephrine is the first and fundamental treatment line. For the treatment in acute phase of food-induced enterocolitis syndrome in the emergency setting, prompt hydroelectrolytic replacement, administration of methylprednisolone and ondansetron IV are necessary. It is important to recommend to the patient with food allergy to maintain the exclusion diet, seek specialized follow-up and, in those who have anaphylaxis, to emphasize the need to carry epinephrine. Severe food allergy may occur in the form of anaphylaxis and food-protein-induced enterocolitis syndrome, which are increasingly observed in the pediatric emergency room; hence, pediatricians must be alert so they can provide the immediate diagnosis and treatment. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Study of the emanation levels of 222Rn present in Naturally Occurring Radioactive Materials - NORM

    International Nuclear Information System (INIS)

    Miranda, Marcia Valeria de Fatima da Encarnacao Sa

    2009-01-01

    The presence of Naturally Occurring Radioactive Material (NORM), contaminating oil and gas facilities, is a common fact in the petroleum industry, and can be severe enough to expose the workers to elevated levels of radiation. Thus, contaminated residues need to be segregated but, this is still a problem without a satisfactory solution. Currently, the most practical and economic option for discarding this material is to stock it in areas of the facility whose access is controlled. Certain equipment used in the petroleum industry has scale and sludge that could be associated to important levels of radioactivity. Typically, the scale is a mixture of carbonate and sulphate minerals, such as barite (BaSO 4 ), that easily incorporates 226 Ra and 228 Ra in its structures. The objective of this work was to measure the emanations of the radon present in these NORM samples, via diffusion chambers containing a nuclear track detector (CR-39). The images of particle alpha tracks emanated by 222 Rn registered on CR-39 were observed with a Nikon E400 optic microscope and captured by a Nikon Coolpix digital camera and then stored in a database, to later count the tracks using the computational program, Image Pro plus. Being that the emanation rate of 222 Rn was proportional to the number of these tracks the methodology permitted the comparison of contamination levels of the analyzed samples. (author)

  19. [Characterization of severe acute occupational poisoning accidents related to organic solvents in China between 1989 and 2003].

    Science.gov (United States)

    Wang, Huan-Qiang; Li, Tao; Zhang, Min; Wang, Hong-Fei; Chen, Shu-Yang; Du, Xie-Yi; Wang, Dan; Zhang, Shuang; Qin, Jian

    2006-12-01

    To analyze severe acute occupational poisoning accidents related to organic solvents reported in China between 1989 and 2003, and to study the characteristics of severe acute occupational poisoning accidents and provide scientific evidences for prevention and control strategies. The data from the national occupational poisoning case reporting system were analyzed with descriptive methods. (1) There were 58 severe acute occupational poisoning accidents related to organic solvents for 15 years with 393 workers poisoned and 48 workers died. The total poisoning rate was 51.2%, and the total mortality was 12.2%. The average poisoning age was (30.9 +/- 8.8) years old and the average death age was (30.6 +/- 12.0) years old. (2) There were 11 types of chemicals that caused these poisoning accidents, and most of the accidents were caused by benzene and homologs. (3) Most of the accidents occurred in manufacture, chemical industry, construction industry, transportation and storage industry, service and commerce. The risk was higher in some jobs than in others, such as paint spraying and cleanout. The poisoning accidents occurred more frequently from April to July each year. (4) The main causes of the accidents were poor ventilation (23.6%), lack of personal protection equipment (21.2%), lack of safety education (19.2%), and lack of safety work practice (15.8%) etc. The ventilation at the workplace involved in organic solvents should be maintained and the skin contacting directly with the organic solvents should be avoided, and it is encouraged to replace the poison with the nontoxic or lower toxic chemicals.

  20. Predicting global variation in infectious disease severity

    DEFF Research Database (Denmark)

    Jensen, Per Moestrup; de Fine Licht, Henrik Hjarvard

    2016-01-01

    demographic and population data. Results: Birth rates were the best predictor for mumps and malaria CFR. For tuberculosis CFR death rates were the best predictor and for leptospirosis population density was a significant predictor. Conclusions and implications: CFR predictors differed among diseases according...... and leptospirosis and assessed these for association with a range of population characteristics, such as crude birth and death rates, median age of the population, mean body mass index, proportion living in urban areas and tuberculosis vaccine coverage. We then tested this predictive model on Danish his- torical...... have the opposite effect. Accordingly changes in CFR may occur in parallel with demographic transitions. Methodology: We explored the predictability of CFR using data obtained from the World Health Organization (WHO) disease databases for four human diseases: mumps, malaria, tuberculosis...

  1. Elevated Extinction Rates as a Trigger for Diversification Rate Shifts: Early Amniotes as a Case Study

    Science.gov (United States)

    Brocklehurst, Neil; Ruta, Marcello; Müller, Johannes; Fröbisch, Jörg

    2015-01-01

    Tree shape analyses are frequently used to infer the location of shifts in diversification rate within the Tree of Life. Many studies have supported a causal relationship between shifts and temporally coincident events such as the evolution of “key innovations”. However, the evidence for such relationships is circumstantial. We investigated patterns of diversification during the early evolution of Amniota from the Carboniferous to the Triassic, subjecting a new supertree to analyses of tree balance in order to infer the timing and location of diversification shifts. We investigated how uneven origination and extinction rates drive diversification shifts, and use two case studies (herbivory and an aquatic lifestyle) to examine whether shifts tend to be contemporaneous with evolutionary novelties. Shifts within amniotes tend to occur during periods of elevated extinction, with mass extinctions coinciding with numerous and larger shifts. Diversification shifts occurring in clades that possess evolutionary innovations do not coincide temporally with the appearance of those innovations, but are instead deferred to periods of high extinction rate. We suggest such innovations did not cause increases in the rate of cladogenesis, but allowed clades to survive extinction events. We highlight the importance of examining general patterns of diversification before interpreting specific shifts. PMID:26592209

  2. Design features which mitigate severe accident challenges in the GE ABWR and SBWR

    International Nuclear Information System (INIS)

    Buchholz, Carol E.

    2004-01-01

    A reduction of the requirements for the emergency planning zone (EPZ) is a goal of advanced light water reactors. The technical basis for reducing the EPZ requirements is based on a very low frequency of a severe accident and high confidence that the offsite dose would be low even if a severe accident was to occur. Design features have been included in both the ABWR and SBWR to ensure that both of these goals are achieved. Probabilistic Risk Assessments (PRAs) have been performed for both plants. The PRAs indicate a core damage frequency on the order of IE-7 for both plants. The PRAs also show that the containments will not fail even if a severe accident should occur. The potential offsite is extremely low. (author)

  3. Effect of Posttraumatic Serum Thyroid Hormone Levels on Severity and Mortality of Patients with Severe Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Forough Saki

    2012-02-01

    Full Text Available Traumatic brain injury (TBI is an important cause of death and disability in young adults ,and may lead to physical disabilities and long-term cognitive, behavioral psychological and social defects. There is a lack of definite result about the effect of thyroid hormones after traumatic brain injury in the severity and no data about their effect on mortality of the injury. The aim of this study is to evaluate the effect of thyroid hormones after traumatic brain injury in the severity and mortality and gain a clue in brain injury prognosis. In a longitudinal prospective study from February 2010 until February 2011, we checked serum levels of T3, T4, TSH and TBG of severely brain injured patients and compared the relationship of them with primary Glasgow Coma Scale (GCS score and mortality of patients. Statistical analysis used SPSS 11.5 software with using chi-square and Fisher exact test. Serum levels of T3 and T4 were decreased after brain trauma but not TSH and TBG. Mortality rates were higher in patients with lower T4 serum levels. The head injury was more severe in whom with low T3 and T4. Follow a severe brain injury a secondary hypothyroidism is happened due to pituitary dysfunction. Also, serum level of T3 and T4 on the first day admission affect on primary GCS score of patients which is an indicator of severity of brain injury. In addition, mortality rates of severely brain injured patients have a high correlation with the serum level of T4 in the first day admission.

  4. Fibrinogen-coated albumin microcapsules reduce bleeding in severely thrombocytopenic rabbits

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; Friederich, P. W.; Middleton, S.; de Groot, P. G.; Wu, Y. P.; Harris, R.; Biemond, B. J.; Heijnen, H. F.; Levin, J.; ten Cate, J. W.

    1999-01-01

    Severe thrombocytopenia frequently occurs in patients receiving chemotherapy and in patients with autoimmune disorders. Thrombocytopenia is associated with bleeding, which may be serious and life threatening. Current treatment strategies for thrombocytopenia may require transfusion of allogeneic

  5. Content and ratings of mature-rated video games.

    Science.gov (United States)

    Thompson, Kimberly M; Tepichin, Karen; Haninger, Kevin

    2006-04-01

    To quantify the depiction of violence, blood, sexual themes, profanity, substances, and gambling in video games rated M (for "mature") and to measure agreement between the content observed and the rating information provided to consumers on the game box by the Entertainment Software Rating Board. We created a database of M-rated video game titles, selected a random sample, recorded at least 1 hour of game play, quantitatively assessed the content, performed statistical analyses to describe the content, and compared our observations with the Entertainment Software Rating Board content descriptors and results of our prior studies. Harvard University, Boston, Mass. Authors and 1 hired game player. M-rated video games. Percentages of game play depicting violence, blood, sexual themes, gambling, alcohol, tobacco, or other drugs; use of profanity in dialogue, song lyrics, or gestures. Although the Entertainment Software Rating Board content descriptors for violence and blood provide a good indication of such content in the game, we identified 45 observations of content that could warrant a content descriptor in 29 games (81%) that lacked these content descriptors. M-rated video games are significantly more likely to contain blood, profanity, and substances; depict more severe injuries to human and nonhuman characters; and have a higher rate of human deaths than video games rated T (for "teen"). Parents and physicians should recognize that popular M-rated video games contain a wide range of unlabeled content and may expose children and adolescents to messages that may negatively influence their perceptions, attitudes, and behaviors.

  6. Autoimmune Polyendocrine Syndrome 3 Onset with Severe Ketoacidosis in a 74-Year-Old Woman

    Directory of Open Access Journals (Sweden)

    Stefano Benedini

    2015-01-01

    Full Text Available Type 1 diabetes mellitus (T1D, autoimmune thyroid disease, and autoimmune gastritis often occur together forming the so-called autoimmune polyendocrine syndrome type 3 (APS3. We here report a clinical case of a 74-year-old woman who presented for the first time with severe hyperglycemia and ketoacidosis diagnosed as T1D. Further clinical investigations revealed concomitant severe hypothyroidism with autoimmune thyroid disease and severe cobalamin deficiency due to chronic atrophic gastritis. The diagnosis of type 1 diabetes mellitus was confirmed by the detection of autoantibodies against glutamic acid decarboxylase 65, islet cell antibodies, and anti-insulin autoantibodies. Anti-thyroperoxidase, anti-thyroglobulin, and anti-gastric parietal cell antibodies were also clearly positive. The case emphasized that new onset diabetic ketoacidosis, hypothyroidism, and cobalamin deficiency may simultaneously occur, and one disease can mask the features of the other, thereby making diagnosis difficult. It is noteworthy that an APS3 acute episode occurred in an asymptomatic elder woman for any autoimmune diseases.

  7. The imaging findings and clinical manifestations of the esophagogastric anastomotic leak occurred after the surgery of esophageal cancer

    International Nuclear Information System (INIS)

    Shen Bin; Li Changjun; Shi Haibin; Li Jizhang; Guo Bin; Zhao Xinfu; Han Qingji

    2012-01-01

    Objective: To discuss the imaging findings of the esophagogastric anastomotic leak and their practical value in performing interventional therapy. Methods: A total of 68 patients with esophagogastric anastomotic leak were enrolled in this study. The occurring time, location and size of the peripheral abscess of the leak were determined. Under fluoroscopic guidance, the abscess drainage tube, jejunal feeding tube and gastrointestinal decompression tube were inserted through a transnasal route. According to the therapeutic results, esophageal stent implantation was carried out to closure the leak. Results: The placement of abscess drainage tube, jejunal feeding tube and gastrointestinal decompression tube was successful in all patients. Reexamination showed that cure and favourable change was obtained in 40 patients (58.5%, 40/68). The other 28 patients with esophagogastric anastomotic leak received stent implantation. Among them, six patients received 7 mushroom shaped covered stents, 22 patients received 24 woven double horns shaped covered stents. Technical success of stent placement was obtained in all patients. The drainage tubes were pulled out when the abscesses were healed. During the follow-up period, the leaks were completely occluded by the stents in 25 cases, the cure rate was 89.3% (25/28). Three months after the treatment, restenosis of the upper margin of the stents occurred in 2 patients, and the new stent placement had to be carried out. In one case the stent had to be removed due to reflux esophagitis which occurred two months after the treatment. One month after the stent placement, two patients died of massive hemorrhage. One patient died of severe lung infection one month after the stent placement. Conclusion: The therapeutic plan of esophagogastric anastomotic leak should be based on the imaging findings, and the placement of abscess drainage tube, jejunal feeding tube and gastrointestinal decompression tube should be properly and promptly

  8. X-ray evaluation of changes occurring in the bone under the influence of Gentamicin-Septopal

    International Nuclear Information System (INIS)

    Moron, K.; Misterka, S.; Dorobisz, U.

    1992-01-01

    On the basis of several-year experience it was acknowledged that in treatment of chronic blood-derived and traumatic inflammations of bones the introduction of chains of Septopal to treatment was an obvious progress. The changes occurring in the bones of the patients for whom Septopal was left for good in the marrow cavity under the influence of antibiotic were evaluated. The observation included 89 patients for whom X-ray examinations were made many times in various intervals. Initially the chains of antibiotic were surrounded with a thin layer of connective tissue, and after several new-generating osseous tissue grow into them. In none of the observed cases any reaction indicating recoil of the carrier of the antibiotic was noticed. (author). 9 refs, 6 figs, 2 tabs

  9. Etiology, clinical profile, severity and outcome of acute pancreatitis in relation to bed side index for severity of acute pancreatitis bisap and CT severity index [CTSI] scores

    Directory of Open Access Journals (Sweden)

    Bezwada Srinivasa Rao, Matta SreeVani, V.Sarat Chandra

    2014-11-01

    Full Text Available Background: Acute pancreatitis is an inflammatory process of the pancreas with involvement of regional tissues or remote organ systems and with potentially devastating consequences. Early prediction of outcome of acute pancreatitis within 24 hrs by clinically based bed Side Index of Severity of Acute Pancreatitis [BISAP] Score and radiological based CT Severity Index [CTSI] later on being useful in initiation of early treatment, assessing severity, to prevent morbidity and mortality. In those who survive, it can progress to chronic pancreatitis resulting in malabsorption and permanent diabetes. Aim: The aim was to study aetiology, clinical profile, severity, outcome of acute pancreatitis in relation to BISAP Score and CTSI. Materials and Methods: This was an observational and prospective study. The present study enrolled 55 patients who were diagnosed as acute pancreatitis and patients with chronic pancreatitis were excluded from the study. Vital data like pulse rate, blood Pressure, temperature, respiratory rate, conscious level using Glasgow coma scale, serum amylase, lipase, Chest x-ray, US abdomen and CT abdomen [both CECT & NCCT] were done. BISAP Score was obtained at the time of presentation or within 24 hours of presentation and radiological based CT Severity Index [CTSI] was calculated using the Balthazar grading system and Necrosis Scoring system to assess the severity, morbidity and mortality. The results: In this study, the most common aetiology being alcohol intake followed by gall stones. BISAP Score 3 had organ dysfunction and Score 4 had 100% mortality. The relation between CTSI score and Organ dysfunction showed increased organic dysfunction and higher mortality with higher CTSI Scores. p value < 0.0001 was calculated using Pearson Chi-square test and found to be statistically significant. Conclusions: Both BISAP and CTSI scores had positive correlation with morbidity and mortality.

  10. The Correlation of Human Development Index on Fertility and Mortality Rate: a Global Ecological Study

    Directory of Open Access Journals (Sweden)

    Amir Almasi-Hashiani

    2016-12-01

    Full Text Available BackgroundSeveral studies have examined the relationship between Human Development Index (HDI and various health outcomes. The aim of this study was to investigate the relationship between HDI, and infant mortality rate, mortality rate of children under one year and under 5 years, maternal mortality rate, and total fertility rate.Materials and MethodsIn this ecologic study, data on HDI, total fertility rate (TFR, maternal mortality rate (MMR, neonatal mortality rate (NMR, infant mortality rate (IMR and mortality rate in children under 5 years of age (< 5MR, were extracted from 188 countries in 2014 in the world. The data required in this study was obtained from the World Bank. Data analysis was performed using Pearson correlation in Stata version 12.0 software. ResultsIn this study, a negative significant correlation was observed between HDI and IMR (r = -0.878, P = 0.001, NMR (r = -0.870, 95% CI: -0.902, -0.828, P = 0.001, ConclusionIMR, children under one year old and under 5 years, and MMR mostly occur in developing countries. There was a correlation between HDI and its components, and the neonatal, infants, children under 5 years, maternal mortality rate and total fertility. The average annual percentage change of HDI also had a correlation with neonatal, infants, children under 5- year mortality rate, total fertility and maternal deaths.

  11. Predicting timing of clinical outcomes in patients with chronic kidney disease and severely decreased glomerular filtration rate.

    Science.gov (United States)

    Grams, Morgan E; Sang, Yingying; Ballew, Shoshana H; Carrero, Juan Jesus; Djurdjev, Ognjenka; Heerspink, Hiddo J L; Ho, Kevin; Ito, Sadayoshi; Marks, Angharad; Naimark, David; Nash, Danielle M; Navaneethan, Sankar D; Sarnak, Mark; Stengel, Benedicte; Visseren, Frank L J; Wang, Angela Yee-Moon; Köttgen, Anna; Levey, Andrew S; Woodward, Mark; Eckardt, Kai-Uwe; Hemmelgarn, Brenda; Coresh, Josef

    2018-03-24

    Patients with chronic kidney disease and severely decreased glomerular filtration rate (GFR) are at high risk for kidney failure, cardiovascular disease (CVD) and death. Accurate estimates of risk and timing of these clinical outcomes could guide patient counseling and therapy. Therefore, we developed models using data of 264,296 individuals in 30 countries participating in the international Chronic Kidney Disease Prognosis Consortium with estimated GFR (eGFR)s under 30 ml/min/1.73m 2 . Median participant eGFR and urine albumin-to-creatinine ratio were 24 ml/min/1.73m 2 and 168 mg/g, respectively. Using competing-risk regression, random-effect meta-analysis, and Markov processes with Monte Carlo simulations, we developed two- and four-year models of the probability and timing of kidney failure requiring kidney replacement therapy (KRT), a non-fatal CVD event, and death according to age, sex, race, eGFR, albumin-to-creatinine ratio, systolic blood pressure, smoking status, diabetes mellitus, and history of CVD. Hypothetically applied to a 60-year-old white male with a history of CVD, a systolic blood pressure of 140 mmHg, an eGFR of 25 ml/min/1.73m 2 and a urine albumin-to-creatinine ratio of 1000 mg/g, the four-year model predicted a 17% chance of survival after KRT, a 17% chance of survival after a CVD event, a 4% chance of survival after both, and a 28% chance of death (9% as a first event, and 19% after another CVD event or KRT). Risk predictions for KRT showed good overall agreement with the published kidney failure risk equation, and both models were well calibrated with observed risk. Thus, commonly-measured clinical characteristics can predict the timing and occurrence of clinical outcomes in patients with severely decreased GFR. Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

  12. Statistical approaches to forecast gamma dose rates by using measurements from the atmosphere

    International Nuclear Information System (INIS)

    Jeong, H.J.; Hwang, W. T.; Kim, E.H.; Han, M.H.

    2008-01-01

    In this paper, the results obtained by inter-comparing several statistical techniques for estimating gamma dose rates, such as an exponential moving average model, a seasonal exponential smoothing model and an artificial neural networks model, are reported. Seven years of gamma dose rates data measured in Daejeon City, Korea, were divided into two parts to develop the models and validate the effectiveness of the generated predictions by the techniques mentioned above. Artificial neural networks model shows the best forecasting capability among the three statistical models. The reason why the artificial neural networks model provides a superior prediction to the other models would be its ability for a non-linear approximation. To replace the gamma dose rates when missing data for an environmental monitoring system occurs, the moving average model and the seasonal exponential smoothing model can be better because they are faster and easier for applicability than the artificial neural networks model. These kinds of statistical approaches will be helpful for a real-time control of radio emissions or for an environmental quality assessment. (authors)

  13. Improving free play skills of severely retarded children.

    Science.gov (United States)

    Wehman, P; Marchant, J A

    1978-02-01

    Severely and profoundly retarded children are usually deficient in play skills. Since play facilitates socialization, language, and motor development, it is a vitally improtant skill to acquire. This pilot study examined the effects of a behavioral training program on the autistic, independent, and social types of play of four severely and profoundly retarded children. The training program involved the use of instructions, modeling, physical guidance, and verbal reinforcement. Results indicated that a marked increase in independent and social play occurred with the introduction of the training program with all four children. Occupational therapists can play an increasingly important role in helping educators formulate relevant educational programs for severely retarded children, particularly in the areas of play and motor skill development.

  14. Aspect-Aware Latent Factor Model: Rating Prediction with Ratings and Reviews

    OpenAIRE

    Cheng, Zhiyong; Ding, Ying; Zhu, Lei; Kankanhalli, Mohan

    2018-01-01

    Although latent factor models (e.g., matrix factorization) achieve good accuracy in rating prediction, they suffer from several problems including cold-start, non-transparency, and suboptimal recommendation for local users or items. In this paper, we employ textual review information with ratings to tackle these limitations. Firstly, we apply a proposed aspect-aware topic model (ATM) on the review text to model user preferences and item features from different aspects, and estimate the aspect...

  15. pPKCα mediated-HIF-1α activation related to the morphological modifications occurring in neonatal myocardial tissue in response to severe and mild hyperoxia

    Directory of Open Access Journals (Sweden)

    S. Zara

    2012-01-01

    Full Text Available In premature babies birth an high oxygen level exposure can occur and newborn hyperoxia exposure can be associated with free radical oxygen release with impairment of myocardial function, while in adult animal models short exposure to hyperoxia seems to protect heart against ischemic injury. Thus, the mechanisms and consequences which take place after hyperoxia exposure are different and related to animals age. The aim of our work has been to analyze the role played by HIF-1α in the occurrence of the morphological modifications upon hyperoxia exposure in neonatal rat heart. Hyperoxia exposure induces connective compartment increase which seems to allow enhanced blood vessels growth. An increased hypoxia inducible factor-1α (HIF-1α translocation and vascular endothelial growth factor (VEGF expression has been found upon 95% oxygen exposure to induce morphological modifications. Upstream pPKC-α expression increase in newborn rats exposed to 95% oxygen can suggest PKC involvement in HIF-1α activation. Since nitric oxide synthase (NOS are involved in heart vascular regulation, endothelial NOS (e-NOS and inducible NOS (i-NOS expression has been investigated: a lower eNOS and an higher iNOS expression has been found in newborn rats exposed to 95% oxygen related to the evidence that hyperoxia provokes a systemic vasoconstriction and to the iNOS pro-apoptotic action, respectively. The occurrence of apoptotic events, evaluated by TUNEL and Bax expression analyses, seems more evident in sample exposed to severe hyperoxia. All in all such results suggest that in newborn rats hyperoxia can trigger oxygen free radical mediated membrane injury through a pPKCα mediated HIF-1α signalling system, even though specificity of such response could be obtained by in vivo administration to the rats of specific inhibitors of PKCα. This intracellular signalling can switch molecular events leading to blood vessels development in parallel to pro-apoptotic events

  16. Prevalence and Severity of Malaria Parasitemia among Children ...

    African Journals Online (AJOL)

    induced anemia is much more common in younger children and may require blood transfusion with high mortality rates.[2,3]. In Sub-Saharan Africa (SSA), children admitted with severe anemia are more likely to die than those without anemia.[4,5]. Blood transfusion in severe malarial anemia can be important in preventing ...

  17. Relation between patients' and physicians' severity assessment of occupational hand eczema

    DEFF Research Database (Denmark)

    Cvetkovski, Rikke Skoet; Jensen, H; Olsen, J

    2005-01-01

    BACKGROUND: Severity assessment of occupational hand eczema (OHE) is important not only in clinical settings but also in research. Questionnaires with self-rated assessment of severity may be an attractive tool for assessing severity because of their cost efficiency in comparison with expensive...... clinical examinations. OBJECTIVES: To evaluate the relation between self-rated severity and severity assessment based on standardized medical certificates issued by dermatologists in a population of patients with OHE. METHODS: Between October 2001 and November 2002 (58 weeks) we identified all new cases...... of recognized OHE from the Danish National Board of Industrial Injuries (DNBII) registry. Each patient was examined by a dermatologist, who issued a standardized medical certificate. The severity assessment in the DNBII registry was based on this medical certificate, which comprised information on morphology...

  18. The effects of autogenic-feedback training on motion sickness severity and heart rate variability in astronauts

    Science.gov (United States)

    Toscano, William B.; Cowings, Patricia S.

    1994-01-01

    Space motion sickness (SMS) affects 50 percent of all people during early days of spaceflight. This study describes the results of two Shuttle flight experiments in which autogenic-feedback training (AFT), a physiological conditioning method, was tested as a treatment for this disorder. Of the six who were designated as flight subjects (two women and four men), three were given treatment and three served as controls (i.e., no AFT). Treatment subjects were given 6 hours of preflight AFT. Preflight results showed that AFT produced a significant increase in tolerance to rotating chair motion sickness tests. Further, this increased tolerance was associated with changes in specific physiological responses and reports of reduced malaise. Flight results showed that two of the three control subjects experienced repeated vomiting on the first mission day, while one subject experienced only moderate malaise. Of the three treatment subjects, one experienced mild discomfort, one moderate discomfort, and one severe motion sickness. Only the three control subjects took medication for symptom suppression. Measures of cardiac function reflective of vagal control were shown to be affected especially strongly on the first day of space flight. AFT given for control of heart rate, respiration, and other autonomic activity influenced both the vagal control measures and SMS. These data suggest that AFT may be an effective treatment for space motion sickness; however, this cannot be demonstrated conclusively with the small number of subjects described.

  19. Trauma patient adverse outcomes are independently associated with rib cage fracture burden and severity of lung, head, and abdominal injuries.

    Science.gov (United States)

    Dunham, C Michael; Hileman, Barbara M; Ransom, Kenneth J; Malik, Rema J

    2015-01-01

    We hypothesized that lung injury and rib cage fracture quantification would be associated with adverse outcomes. Consecutive admissions to a trauma center with Injury Severity Score ≥ 9, age 18-75, and blunt trauma. CT scans were reviewed to score rib and sternal fractures and lung infiltrates. Sternum and each anterior, lateral, and posterior rib fracture was scored 1 = non-displaced and 2 = displaced. Rib cage fracture score (RCFS) = total rib fracture score + sternal fracture score + thoracic spine Abbreviated Injury Score (AIS). Four lung regions (right upper/middle, right lower, left upper, and left lower lobes) were each scored for % of infiltrate: 0% = 0; ≤ 20% = 1, ≤ 50% = 2, > 50% = 3; total of 4 scores = lung infiltrate score (LIS). Of 599 patients, 193 (32%) had 854 rib fractures. Rib fracture patients had more abdominal injuries (p fractures (p = 0.0028) and death or need for mechanical ventilation ≥ 3 days (Death/Vdays ≥ 3) (p rib fracture patients, Glasgow Coma Score 3-12 or head AIS ≥ 2 occurred in 43%. A lung infiltrate or hemo/pneumothorax occurred in 55%. Thoracic spine injury occurred in 23%. RCFS was 6.3 ± 4.4 and Death/Vdays ≥ 3 occurred in 31%. Death/Vdays ≥ 3 rates correlated with RCFS values: 19% for 1-3; 24% for 4-6; 42% for 7-12 and 65% for ≥ 13 (p rib fracture score (p = 0.08) or number of fractured ribs (p = 0.80). Rib fracture patients have increased risk for truncal injuries and adverse outcomes. Adverse outcomes are independently associated with rib cage fracture burden. Severity of head, abdominal, and lung injuries also influence rib fracture outcomes.

  20. Procedural discourse performance in adults with severe traumatic brain injury at 3 and 6 months post injury.

    Science.gov (United States)

    Stubbs, Elin; Togher, Leanne; Kenny, Belinda; Fromm, Davida; Forbes, Margaret; MacWhinney, Brian; McDonald, Skye; Tate, Robyn; Turkstra, Lyn; Power, Emma

    2018-01-01

    There is limited research on communicative recovery during the early stages after a severe traumatic brain injury (TBI) in adults. In the current study 43 people with severe TBI described a simple procedure at 3 and 6 months post injury and this was compared to the description provided by 37 healthy speakers. Linguistic productivity and the presence of macrostructural discourse elements were analysed. No change occurred in productivity in the TBI group between the two time points. There was increased use of relevant information (macrostructure) over time for the TBI group, reflecting improvement. People with TBI differed from controls in speech rate and in two out of three macrostructural categories at both time points, indicating difficulties even after 12 weeks of recovery. Overall, the quality, rather than the quantity of discourse was disordered for participants with TBI. Findings indicate that procedural discourse is sensitive to discourse deficits of people with TBI and can be used to map recovery during the sub-acute phase.

  1. Field Test Evaluation of Effect on Cone Resistance Caused by Change in Penetration Rate

    DEFF Research Database (Denmark)

    Poulsen, Rikke; Nielsen, Benjaminn Nordahl; Ibsen, Lars Bo

    2012-01-01

    in the laboratory. A change in the measured cone resistance occurs by lowering the penetration rate. This is caused by the changes in drainage conditions. Compared to the normal penetration rate of 20 mm/s, this paper illustrates that lowering the penetration rate leads to an increase in the cone resistance from 1......This paper presents how a change in cone penetration rate affects the measured cone resistance during cone penetration testing in silty soils. Regardless of soil, type the standard rate of penetration is 20 mm/s and it is generally accepted that undrained penetration occurs in clay while drained...... penetration occurs in sand. In intermediate soils such as silty soils, the standard cone penetration rate may result in drainage conditions varying from undrained to partially or fully drained conditions. Field cone penetrations tests have been conducted with different penetration rates on a test site...

  2. Herding Behavior and Rating Convergence among Credit Rating Agencies : Evidence from the Subprime Crisis

    NARCIS (Netherlands)

    Lugo, Stefano; Croce, Annalisa; Faff, Robert

    2015-01-01

    This article examines how credit rating agencies (CRAs) react to rating decisions on mortgage-backed securities by rival agencies in the aftermath of the subprime crisis. While Fitch is on average the first mover, Moody’s and S&P perform more timely downgrades given a downgrade or a more severe

  3. Severe accident management. Prevention and Mitigation

    International Nuclear Information System (INIS)

    1992-01-01

    Effective planning for the management of severe accidents at nuclear power plants can produce both a reduction in the frequency of such accidents as well as the ability to mitigate their consequences if and when they should occur. This report provides an overview of accident management activities in OECD countries. It also presents the conclusions of a group of international experts regarding the development of accident management methods, the integration of accident management planning into reactor operations, and the benefits of accident management

  4. Severe Hemolysis in a Patient With Erythrocytosis During Coupled Plasma Filtration Adsorption Therapy Was Prevented by Changing From Membrane-Based Technique to a Centrifuge-Based One.

    Science.gov (United States)

    Fan, Rong; Wu, Buyun; Kong, Ling; Gong, Dehua

    2016-01-01

    Coupled plasma filtration adsorption (CPFA) usually adopts membrane to separate plasma from blood. Here, we reported a case with erythrocytosis experienced severe hemolysis and membrane rupture during CPFA, which was avoided by changing from membrane-based technique to a centrifuge-based one. A 66-year-old man was to receive CPFA for severe hyperbilirubinemia (total bilirubin 922 μmol/L, direct bilirubin 638 μmol/L) caused by obstruction of biliary tract. He had erythrocytosis (hemoglobin 230 g/L, hematocrit 0.634) for years because of untreated tetralogy of Fallot. Severe hemolysis and membrane rupture occurred immediately after blood entering into the plasma separator even at a low flow rate (50 mL/min) and persisted after changing a new separator. Finally, centrifugal plasma separation technique was used for CPFA in this patient, and no hemolysis occurred. After 3 sessions of CPFA, total bilirubin level decreased to 199 μmol/L with an average decline by 35% per session. Thereafter, the patient received endoscopic biliary stent implantation, and total bilirubin level returned to nearly normal. Therefore, centrifugal-based plasma separation can also be used in CPFA and may be superior to a membrane-based one in patients with hyperviscosity.

  5. Comparison of Younger and Older Adults' Acceptability of Treatment for Generalized Anxiety Disorder Co-Occurring with Parkinson's Disease

    Science.gov (United States)

    Lundervold, Duane A.; Ament, Patrick A.; Holt, Peter S.; Hunt, Lauren S.

    2013-01-01

    Acceptability ratings of medication or Behavioral Relaxation Training (BRT), for general anxiety disorder (GAD) co-occurring with Parkinson's Disease (PD) were obtained from younger ("n" = 79) and older ("n" = 54) adults. Participants read a case description of an older adult with PD and comorbid GAD followed by a description…

  6. Leaf Starch Turnover Occurs in Long Days and in Falling Light at the End of the Day.

    Science.gov (United States)

    Fernandez, Olivier; Ishihara, Hirofumi; George, Gavin M; Mengin, Virginie; Flis, Anna; Sumner, Dean; Arrivault, Stéphanie; Feil, Regina; Lunn, John E; Zeeman, Samuel C; Smith, Alison M; Stitt, Mark

    2017-08-01

    We investigated whether starch degradation occurs at the same time as starch synthesis in Arabidopsis ( Arabidopsis thaliana ) leaves in the light. Starch accumulated in a linear fashion for about 12 h after dawn, then accumulation slowed and content plateaued. Following decreases in light intensity, the rate of accumulation of starch declined in proportion to the decline in photosynthesis if the decrease occurred 14 h after dawn and in response to decreases in light intensity that occurred >10 h after dawn. Starch measurements in circadian clock mutants suggested that the clock influences the timing of onset of degradation. We conclude that the propensity for leaf starch to be degraded increases with time after dawn. The importance of this phenomenon for efficient use of carbon for growth in long days and for prevention of starvation during twilight is discussed. © 2017 American Society of Plant Biologists. All Rights Reserved.

  7. Analyses of severe accident scenarios in RBMK-1500

    International Nuclear Information System (INIS)

    Kaliatka, A.; Rimkevicius, S.; Uspuras, E.; Urbonavicius, E.

    2006-01-01

    Even though research of severe accidents in light water reactors is performed around the world for several decades many questions remain. Research is mostly performed for vessel-type reactors. RBMK is a channel type light water reactor, which differs from the vessel-type reactors in several aspects. These differences impose some specifics in the accident phenomena and processes that occur during severe accidents. Severe accident research for RBMK reactors is taking first steps and very little information is available in the open literature. The existing severe accident analysis codes are developed for vessel-type reactors and their application to the analysis of accidents in RBMK is not straightforward. This paper presents the results of an analysis of large loss-of-coolant accident scenarios with loss of coolant injection to the core of RBMK-1500. The analysis performed considers processes in the reactor core, in the reactor cooling system and in the confinement until the fuel melting started. This paper does not aim to answer all the questions regarding severe accidents in RBMK but rather to start a discussion, identify the expected timing of the key phenomena. (orig.)

  8. Effective chemotherapy of acute myelocytic leukemia occurring after alkylating agent or radiation therapy for prior malignancy

    International Nuclear Information System (INIS)

    Vaughan, W.P.; Karp, J.E.; Burke, P.J.

    1983-01-01

    Eleven consecutive patients with acute myelocytic leukemia occurring as a second malignancy were treated with high-dose, timed, sequential chemotherapy. Eight of the patients were felt to have ''secondary'' acute leukemia because they had received an alkylating agent or radiation therapy. The other three patients were considered controls. Despite a median age of 65, four of the eight secondary leukemia patients achieved complete remission with this regimen. One of the three control patients also achieved complete remission. This remission rate and duration are comparable to what was achieved with this treatment of ''primary'' acute myelocytic leukemia during the same period of time. These results suggest that patients with leukemia occurring after an alkylating agent or radiation therapy are not at especially high risk if treated aggressively

  9. Surgical Management of Severe Epistaxis.

    Science.gov (United States)

    Lin, Giant; Bleier, Benjamin

    2016-06-01

    Many patients with severe epistaxis benefit from endoscopic intervention for control of bleeding. Critical maneuvers to improve endoscopic visualization during surgery include head-of-bed elevation, application of topical vasoconstrictors, and local injection of vasonstrictors. Controlled, hypotensive anesthesia may also decrease intraoperative blood loss and improve visualization during surgery. Intractable posterior epistaxis can be controlled with high rates of success with endoscopic sphenopalatine artery ligation. Although less common, intractable anterior epistaxis may be controlled by anterior ethmoid artery ligation once this artery is identified as the primary source. Less common sources of severe epistaxis are also discussed in this article. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Estimating infection attack rates and severity in real time during an influenza pandemic: analysis of serial cross-sectional serologic surveillance data.

    Directory of Open Access Journals (Sweden)

    Joseph T Wu

    2011-10-01

    Full Text Available In an emerging influenza pandemic, estimating severity (the probability of a severe outcome, such as hospitalization, if infected is a public health priority. As many influenza infections are subclinical, sero-surveillance is needed to allow reliable real-time estimates of infection attack rate (IAR and severity.We tested 14,766 sera collected during the first wave of the 2009 pandemic in Hong Kong using viral microneutralization. We estimated IAR and infection-hospitalization probability (IHP from the serial cross-sectional serologic data and hospitalization data. Had our serologic data been available weekly in real time, we would have obtained reliable IHP estimates 1 wk after, 1-2 wk before, and 3 wk after epidemic peak for individuals aged 5-14 y, 15-29 y, and 30-59 y. The ratio of IAR to pre-existing seroprevalence, which decreased with age, was a major determinant for the timeliness of reliable estimates. If we began sero-surveillance 3 wk after community transmission was confirmed, with 150, 350, and 500 specimens per week for individuals aged 5-14 y, 15-19 y, and 20-29 y, respectively, we would have obtained reliable IHP estimates for these age groups 4 wk before the peak. For 30-59 y olds, even 800 specimens per week would not have generated reliable estimates until the peak because the ratio of IAR to pre-existing seroprevalence for this age group was low. The performance of serial cross-sectional sero-surveillance substantially deteriorates if test specificity is not near 100% or pre-existing seroprevalence is not near zero. These potential limitations could be mitigated by choosing a higher titer cutoff for seropositivity. If the epidemic doubling time is longer than 6 d, then serial cross-sectional sero-surveillance with 300 specimens per week would yield reliable estimates when IAR reaches around 6%-10%.Serial cross-sectional serologic data together with clinical surveillance data can allow reliable real-time estimates of IAR and

  11. How to measure a-few-nanometer-small LER occurring in EUV lithography processed feature

    Science.gov (United States)

    Kawada, Hiroki; Kawasaki, Takahiro; Kakuta, Junichi; Ikota, Masami; Kondo, Tsuyoshi

    2018-03-01

    For EUV lithography features we want to decrease the dose and/or energy of CD-SEM's probe beam because LER decreases with severe resist-material's shrink. Under such conditions, however, measured LER increases from true LER, due to LER bias that is fake LER caused by random noise in SEM image. A gap error occurs between the right and the left LERs. In this work we propose new procedures to obtain true LER by excluding the LER bias from the measured LER. To verify it we propose a LER's reference-metrology using TEM.

  12. Is There a Relationship Between Tic Frequency and Physiological Arousal? Examination in a Sample of Children with Co-Occurring Tic and Anxiety Disorders

    Science.gov (United States)

    Conelea, Christine A.; Ramanujam, Krishnapriya; Walther, Michael R.; Freeman, Jennifer B.; Garcia, Abbe M.

    2014-01-01

    Stress is the contextual variable most commonly implicated in tic exacerbations. However, research examining associations between tics, stressors, and the biological stress response has yielded mixed results. This study examined whether tics occur at a greater frequency during discrete periods of heightened physiological arousal. Children with co-occurring tic and anxiety disorders (n = 8) completed two stress induction tasks (discussion of family conflict, public speech). Observational (tic frequencies) and physiological (heart rate) data were synchronized using The Observer XT, and tic frequencies were compared across periods of high and low heart rate. Tic frequencies across the entire experiment did not increase during periods of higher heart rate. During the speech task, tic frequencies were significantly lower during periods of higher heart rate. Results suggest that tic exacerbations may not be associated with heightened physiological arousal and highlight the need for further tic research using integrated measurement of behavioral and biological processes. PMID:24662238

  13. Effects of a Staff Training Intervention on Seclusion Rates on an Adult Inpatient Psychiatric Unit.

    Science.gov (United States)

    Newman, Julie; Paun, Olimpia; Fogg, Louis

    2018-06-01

    The current article presents the effects of a 90-minute staff training intervention aimed at reducing inpatient psychiatric seclusion rates through strengthened staff commitment to seclusion alternatives and improved de-escalation skills. The intervention occurred at an 18-bed adult inpatient psychiatric unit whose seclusion rates in 2015 were seven times the national average. Although the project's primary outcome compared patient seclusion rates before and after the intervention, anonymous staff surveys measured several secondary outcomes. Seclusion rates were reduced from a 6-month pre-intervention average of 2.95 seclusion hours per 1,000 patient hours to a 6-month post-intervention average of 0.29 seclusion hours per 1,000 patient hours, a 90.2% reduction. Completed staff surveys showed significant staff knowledge gains, non-significant changes in staff attitudes about seclusion, non-significant changes in staff de-escalation skill confidence, and use of the new resource sheet by only 17% of staff. The key study implication is that time-limited, focused staff training interventions can have a measurable impact on reducing inpatient seclusion rates. [Journal of Psychosocial Nursing and Mental Health Services, 56(6), 23-30.]. Copyright 2018, SLACK Incorporated.

  14. A severe, late reaction to radiological contrast media mimicking a sepsis syndrome

    International Nuclear Information System (INIS)

    Burton, P.R.; Jarmolowski, E.; Raineri, F.; Buist, M.D.; Wriedt, H.R.

    1999-01-01

    An unusual, severe delayed reaction to non-ionic intravenous contrast media was observed. A 44-year-old man underwent a computed tomography scan with non-ionic contrast media. Four hours later the patient collapsed with hypotension and cardiovascular shock. Aggressive management (including inotropic support and fluid resuscitation) was instituted in the intensive care unit. Rigorous imaging and biochemical and microbiological investigation failed to identify a source of this man's circulatory collapse. A rapid recovery ensued and at 3 months follow-up the patient was suffering no residual effects from this event. To our knowledge, this is only the second report of a severe delayed reaction to radiological contrast media and the first that manifested as a prolonged hypotensive syndrome. Despite the introduction of non-ionic low osmolar radiological contrast media (NIM), the incidence of adverse reactions to these agents remains at between 3 and 12%. Most of these reactions are acute, self-limiting events (nausea, vomiting, urticaria, diarrhoea) and no treatment is required. The mortality rate of these adverse reactions has been quoted at 0.0020.009% of all procedures. Most of these severe reactions are acute anaphylactoid events manifested by hypotension and bronchospasm. Delayed adverse reactions to NIM have been reported to occur with a frequency of between 8.0 and 27.1%. These reactions are almost uniformly self-limiting and non-life threatening, requiring minimal intervention. We report an unusual late adverse reaction to NIM, which presented with many of the features of a severe sepsis syndrome. Non-ionic low osmolar radiological contrast media has the capacity to cause severe delayed reactions in rare instances, but the pathophysiological mechanisms of these reactions are poorly understood and, therefore, diagnosis and management of this clinical situation presented many difficulties. Copyright (1999) Blackwell Science Pty Ltd

  15. The influence of disturbance events on survival and dispersal rates of Florida box turtles

    Science.gov (United States)

    Dodd, C.K.; Ozgul, A.; Oli, M.K.

    2006-01-01

    Disturbances have the potential to cause long-term effects to ecosystem structure and function, and they may affect individual species in different ways. Long-lived vertebrates such as turtles may be at risk from such events, inasmuch as their life histories preclude rapid recovery should extensive mortality occur. We applied capture–mark–recapture models to assess disturbance effects on a population of Florida box turtles (Terrapene carolina bauri) on Egmont Key, Florida, USA. Near the midpoint of the study, a series of physical disturbances affected the island, from salt water overwash associated with several tropical storms to extensive removal of nonindigenous vegetation. These disturbances allowed us to examine demographic responses of the turtle population and to determine if they affected dispersal throughout the island. Adult survival rates did not vary significantly either between sexes or among years of the study. Survival rates did not vary significantly between juvenile and adult turtles, or among years of the study. Furthermore, neither adult nor juvenile survival rates differed significantly between pre- and post-disturbance. However, dispersal rates varied significantly among the four major study sites, and dispersal rates were higher during the pre-disturbance sampling periods compared to post-disturbance. Our results suggest few long-term effects on the demography of the turtle population. Florida box turtles responded to tropical storms and vegetation control by moving to favorable habitats minimally affected by the disturbances and remaining there. As long as turtles and perhaps other long-lived vertebrates can disperse to non-disturbed habitat, and high levels of mortality do not occur in a population, a long life span may allow them to wait out the impact of disturbance with potentially little effect on long-term population processes.

  16. Severe neurological complication following adjustable gastric banding.

    Science.gov (United States)

    Martines, G; Musa, N; Aquilino, F; Capuano, P

    2018-01-01

    In the last years with the increase of bariatric surgery, first of all as a result of new indications, a rise in the incidence of nutrient-related complications has been observed. Currently little is known about the impact of post-bariatric malnutrition and neurological complications. Wernicke's encephalopathy is a severe neurological syndrome which occurs as a result of thiamine deficiency. Wernicke-Korsakoff syndrome must be considered a serious neurological complication of bariatric surgery with significant morbidity and mortality, with rapidly progressing neurological symptoms, and must be treated immediately. We report the case of a 35 years-old male patient, affected by morbid obesity, anxious-depressive syndrome and alcohol use disorder, who after adjustable gastric banding implanted in another hospital developed a severe malnutrition and neurological syndrome. The patient showed poor adherence to the follow-up and to the dietary indications and after all, we needed to place a PEG for enteral nutrition in order to resolve the malnutrition condition and the neurological syndrome. Our experience emphasizes that preoperative selection and assessment of a patient's nutritional status according to guidelines, is required to identify potential problems, and that bariatric surgeons or physicians caring for patient who have undergone bariatric surgery should be familiar with the constellation of nutritional and neurological disorder that may occur after surgery. We want to remark the importance of preoperative selection of the patients, the follow-up and the cooperation between patient and physician in order to obtain the best result and avoid severe complications.

  17. Xamoterol in severe congestive heart failure

    DEFF Research Database (Denmark)

    Tangø, M; Lyngborg, K; Mehlsen, J

    1992-01-01

    Twelve patients in severe congestive heart failure were given placebo, 100 mg xamoterol (Corwin) twice daily and 200 mg xamoterol twice daily, respectively, in 3 two-week periods in a double-blind randomised study. At the end of each treatment period the patients were evaluated. No differences were...... found between placebo and xamoterol in the following parameters: New York Heart Association function group index, heart volume, body weight, exercise duration on bicycle and treadmill, heart rate and systolic and diastolic blood pressure at rest. However, during exercise we found significantly lower...... heart rate and rate-pressure product during xamoterol treatment. This reduction is probably indicating occupation of beta-adrenoreceptors with concomitant reduced oxygen consumption during exercise....

  18. Tryptophan hydroxylase type 2 variants modulate severity and outcome of addictive behaviors in Parkinson's disease.

    Science.gov (United States)

    Cilia, Roberto; Benfante, Roberta; Asselta, Rosanna; Marabini, Laura; Cereda, Emanuele; Siri, Chiara; Pezzoli, Gianni; Goldwurm, Stefano; Fornasari, Diego

    2016-08-01

    Impulse control disorders and compulsive medication intake may occur in a minority of patients with Parkinson's disease (PD). We hypothesize that genetic polymorphisms associated with addiction in the general population may increase the risk for addictive behaviors also in PD. Sixteen polymorphisms in candidate genes belonging to five neurotransmitter systems (dopaminergic, catecholaminergic, serotonergic, glutamatergic, opioidergic) and the BDNF were screened in 154 PD patients with addictive behaviors and 288 PD control subjects. Multivariate analysis investigated clinical and genetic predictors of outcome (remission vs. persistence/relapse) after 1 year and at the last follow-up (5.1 ± 2.5 years). Addictive behaviors were associated with tryptophan hydroxylase type 2 (TPH2) and dopamine transporter gene variants. A subsequent analysis within the group of cases showed a robust association between TPH2 genotype and the severity of addictive behaviors, which survived Bonferroni correction for multiple testing. At multivariate analysis, TPH2 genotype resulted the strongest predictor of no remission at the last follow-up (OR[95%CI], 7.4[3.27-16.78] and 13.2[3.89-44.98] in heterozygous and homozygous carriers, respectively, p medication dose reduction was not a predictor. TPH2 haplotype analysis confirmed the association with more severe symptoms and lower remission rates in the short- and the long-term (p addictive behaviors in PD, modulating the severity of symptoms and the rate of remission at follow-up. If confirmed in larger independent cohorts, TPH2 genotype may become a useful biomarker for the identification of at-risk individuals. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. The radiological impact of naturally-occurring radionuclides in foods from the wild

    International Nuclear Information System (INIS)

    Green, N.; Hammond, D.J.; Davidson, M.F.; Wilkins, B.T.; Williams, B.

    2002-01-01

    Habit surveys have been conducted to identify people who make use of foodstuffs collected from the wild (free foods) in two areas of the UK: in the area around Chipping Norton in Oxfordshire, where levels of naturally-occurring radionuclides in soil were expected to be typical of the UK, and in the vicinity of Okehampton in Devon, where levels were known to be elevated. Individuals who make regular use of these foodstuffs were specifically identified, so that an estimate of typical and higher than average consumption rates could be derived. The naturally-occurring radionuclides of interest were 210 Po, 210 Pb, 234 U, 235 U, 238 U, 230 Th, 232 Th and 226 Ra. Samples of important foodstuffs were collected and the radionuclides of interest determined. The consumption rates were combined with the measured activity concentrations and published dose coefficients to estimate doses to average and higher than average consumers. These doses were compared with estimated doses reported in the Food Standards Agency's ongoing monitoring programme and with average doses to the population of the UK reviewed by NRPB. In total, 400 people were identified and between them they collected 54 different types of free food. Blackberries were by far the most common species collected, although various types of mushroom and nuts were also popular. On average, each collector from around Chipping Norton collected 2.1 different foods, and each from around Okehampton collected 2.2. On the basis of the habit survey, therefore, it would be reasonable to expect that any site, nuclear or otherwise, chosen for habit surveys, whether for radiological purposes or for any other contaminant, could have substantial numbers of people collecting free foods. In addition, the pattern of foods collected was very similar to previous studies, indicating similarities across England and Wales. (author)

  20. Rate processes with non-Markovian dynamical disorder

    International Nuclear Information System (INIS)

    Goychuk, Igor

    2005-01-01

    Rate processes with dynamical disorder are investigated within a simple framework provided by unidirectional electron transfer (ET) with fluctuating transfer rate. The rate fluctuations are assumed to be described by a non-Markovian stochastic jump process which reflects conformational dynamics of an electron transferring donor-acceptor molecular complex. A tractable analytical expression is obtained for the relaxation of the donor population (in the Laplace-transformed time domain) averaged over the stationary conformational fluctuations. The corresponding mean transfer time is also obtained in an analytical form. The case of two-state fluctuations is studied in detail for a model incorporating substate diffusion within one of the conformations. It is shown that an increase of the conformational diffusion time results in a gradual transition from the regime of fast modulation characterized by the averaged ET rate to the regime of quasistatic disorder. This transition occurs at the conformational mean residence time intervals fixed much less than the inverse of the corresponding ET rates. An explanation of this paradoxical effect is provided. Moreover, its presence is also manifested for the simplest, exactly solvable non-Markovian model with a biexponential distribution of the residence times in one of the conformations. The nontrivial conditions for this phenomenon to occur are found

  1. Prevalence, severity, and clinical features of acute and chronic pancreatitis in patients with systemic lupus erythematosus.

    Science.gov (United States)

    Wang, Qiang; Shen, Min; Leng, Xiaomei; Zeng, Xiaofeng; Zhang, Fengchun; Qian, Jiaming

    2016-10-01

    Pancreatitis is a rare, life-threatening complication of systemic lupus erythematosus (SLE). This study aimed to describe the clinical features of acute pancreatitis (AP) and chronic pancreatitis (CP) in patients with SLE. Data of patients who fulfilled the revised criteria of the American Rheumatism Association for diagnosis of SLE were retrospectively analyzed. SLE activity was graded according to the SLE Disease Activity Index. Logistic regression analysis was conducted to find out independent associations. Survival rates were estimated by using Kaplan-Meier plots. This study included 5665 SLE patients admitted between January 1983 and January 2014, of whom 52 patients were diagnosed with pancreatitis. Pancreatitis prevalence in SLE patients was 0.92 % (52/5665). AP (0.8 %, 46/5665) was more prevalent than CP (0.1 %, 6/5665), presented mostly during active SLE, and affected more organs. Hypertriglyceridemia occurred in 76.9 % of AP patients and in none of the CP patients. AP patients were divided into severe (n = 10) or mild (n = 20) cases. The average triglyceride level in severe AP cases was higher than that in mild AP cases (P = 0.006), and the mortality rate of lupus-associated AP was 32.6 % (15/46). Concomitant infections and thrombocytopenia were independently associated with poor prognosis (P risk factors for poor prognosis.

  2. Grazing rate of zebra mussel in a shallow eutrophicated bay of the Baltic Sea.

    Science.gov (United States)

    Oganjan, Katarina; Lauringson, Velda

    2014-12-01

    Benthic suspension feeding is an important process in coastal ecosystems. Among all the World's oceans, coastal ecosystems are the most modified by human impact and changing at accelerating pace. It is complicated to understand, how various environmental factors affect feeding rates of suspension feeders in their natural habitats. Thus, shapes of such relationships are poorly described for several intersections of environmental gradients. In this study, relationships between grazing rates of an invasive bivalve Dreissena polymorpha and ambient environmental factors were investigated in a turbid eutrophic bay of the central Baltic Sea using a novel modelling method of Boosted Regression Trees (BRT), a statistical tool able to handle non-normal distributions, complex relationships, and interactive effects. Feeding rates of mussels were derived from field populations by measuring the content of algal pigments in specimens collected from their natural habitat. The content of pigments was converted to feeding rate separately each time using field experiments measuring simultaneously the content of pigments and biodeposition of mussels. The results suggest that feeding rates of D. polymorpha are related to several environmental factors which gradients outreach the optimal range for the local mussel population. All the observed effects were non-linear with complex shapes. Variability along the resource gradient was the most important predictor of mussel feeding, followed by salinity and disturbance caused by wind. The most important interaction occurred between disturbance and resource gradient, while feeding function showed more plasticity along the latter. Mapping of environmental tipping points with the aid of machine learning methods may enable to concentrate the most relevant information about ecological functions worldwide. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Relationship between cataract severity and socioeconomic status.

    Science.gov (United States)

    Wesolosky, Jason D; Rudnisky, Christopher J

    2013-12-01

    To determine the relationship between cataract severity and socioeconomic status (SES). Retrospective, observational case series. A total of 1350 eyes underwent phacoemulsification cataract extraction by a single surgeon using an Alcon Infiniti system. Cataract severity was measured using phaco time in seconds. SES was measured using area-level aggregate census data: median income, education, proportion of common-law couples, and employment rate. Preoperative best corrected visual acuity was obtained and converted to logarithm of the minimum angle of resolution values. For patients undergoing bilateral surgery, the generalized estimating equation was used to account for the correlation between eyes. Univariate analyses were performed using simple regression, and multivariate analyses were performed to account for variables with significant relationships (p < 0.05) on univariate testing. Sensitivity analyses were performed to assess the effect of including patient age in the controlled analyses. Multivariate analyses demonstrated that cataracts were more severe when the median income was lower (p = 0.001) and the proportion of common-law couples living in a patient's community (p = 0.012) and the unemployment rate (p = 0.002) were higher. These associations persisted even when controlling for patient age. Patients of lower SES have more severe cataracts. Copyright © 2013 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  4. Analysis on the occurrence rate of pneumothorax after percutaneous pneumocentesis

    International Nuclear Information System (INIS)

    Zhu Qi; Wang Kun; Ren Ran

    2001-01-01

    Objective: To analyze the influence of multiple variable factors on the occurrence rate of pneumothorax associated with transthoracic needle aspiration biopsy of the lung. Methods: Fluoroscopical guided lung biopsies were performed in 46 patients. Variable factors were analyzed including lesion size, location, number of puncture, presence of emphysema and patients position after needle biopsy of the lung. Results: Pneumothorax occurred at 9 (19.6%) of 46 patients and that occurred at 4(44.4%) of 9 emphysematous patients. Among them 2 necessitated chest drainage tube placement. The pneumothorax occurrence rate was 30% (3/10) for lesions of diameter 3 cm or less in size. In the dependent group, pneumothorax occurred in 4 of 20 patients (20%). In the non-dependent group, pneumothorax occurred in 5 of 26 patients (19.2%). Conclusion: The correlation showed that increasing frequency of pneumothorax with decreasing size of lesions. An increased rate of pneumothorax was correlated with presence of emphysema. Patients with emphysema are more likely to have a symptomatic pneumothorax. No significant differences were found in the incidence of pneumothorax between patients placed with the puncture site dependent after biopsy and those placed with the puncture site non-dependent

  5. Characterization of Contaminant Transport using Naturally-Occurring U-Series Disequilibria - Final Report

    International Nuclear Information System (INIS)

    Murrell, Michael T.; Ku, Teh-Lung

    2001-01-01

    The interactions of mixed wastes containing radionuclides with solid rock surface and the mobility of the radionuclides in aquifer systems depend not only on the chemistry of the nuclides and the physico-chemical effects of radioactive decay, but also on the site-specific hydrogeology. Thus, to characterize contaminant transport, it is best to cross-check figures derived from any small-scale laboratory experiments over limited times with that obtained from field-oriented, natural analog studies. We propose such a study using the naturally-occurring U and Th decay-series disequilibria. The work of ours and other researchers have shown that the parent/daughter disequilibrium patterns existing in groundwater systems can be modeled in terms of local nuclide mass balance to arrive at such information as the rock-water contact time (fluid flow) and rates of contaminant transport, taking into account the retardation effect due to nuclide/rock interaction contaminants at INEL by grouping them into three categories, represented by isotopes of (1) Th and Pa, (2) U and (3) Ra. Mass spectrometric measurements of these elements will be emphasized in order to minimize sample size requirements and to maximize precision. Results will form the data base for a model code for computing: (1) Fluid residence time (transport rates) in the basalt aquifers at various locations, (2) The in-situ adsorption and desorption rate constants, as well as the retardation factors, of various radionuclide wastes, and (3) Rock dissolution rate and its relation to preferential flow and contamination transport in the fractured rock

  6. Estimation of absorbed radiation dose rates in wild rodents inhabiting a site severely contaminated by the Fukushima Dai-ichi nuclear power plant accident.

    Science.gov (United States)

    Kubota, Yoshihisa; Takahashi, Hiroyuki; Watanabe, Yoshito; Fuma, Shoichi; Kawaguchi, Isao; Aoki, Masanari; Kubota, Masahide; Furuhata, Yoshiaki; Shigemura, Yusaku; Yamada, Fumio; Ishikawa, Takahiro; Obara, Satoshi; Yoshida, Satoshi

    2015-04-01

    The dose rates of radiation absorbed by wild rodents inhabiting a site severely contaminated by the Fukushima Dai-ichi Nuclear Power Plant accident were estimated. The large Japanese field mouse (Apodemus speciosus), also called the wood mouse, was the major rodent species captured in the sampling area, although other species of rodents, such as small field mice (Apodemus argenteus) and Japanese grass voles (Microtus montebelli), were also collected. The external exposure of rodents calculated from the activity concentrations of radiocesium ((134)Cs and (137)Cs) in litter and soil samples using the ERICA (Environmental Risk from Ionizing Contaminants: Assessment and Management) tool under the assumption that radionuclides existed as the infinite plane isotropic source was almost the same as those measured directly with glass dosimeters embedded in rodent abdomens. Our findings suggest that the ERICA tool is useful for estimating external dose rates to small animals inhabiting forest floors; however, the estimated dose rates showed large standard deviations. This could be an indication of the inhomogeneous distribution of radionuclides in the sampled litter and soil. There was a 50-fold difference between minimum and maximum whole-body activity concentrations measured in rodents at the time of capture. The radionuclides retained in rodents after capture decreased exponentially over time. Regression equations indicated that the biological half-life of radiocesium after capture was 3.31 d. At the time of capture, the lowest activity concentration was measured in the lung and was approximately half of the highest concentration measured in the mixture of muscle and bone. The average internal absorbed dose rate was markedly smaller than the average external dose rate (sampling area was estimated to be approximately 52 μGy h(-1) (1.2 mGy d(-1)), even 3 years after the accident. This dose rate exceeds 0.1-1 mGy d(-1) derived consideration reference level for Reference rat

  7. Recovery of severely compacted soils in the Mojave Desert, California, USA

    Science.gov (United States)

    Webb, R.H.

    2002-01-01

    Often as a result of large-scale military maneuvers in the past, many soils in the Mojave Desert are highly vulnerable to soil compaction, particularly when wet. Previous studies indicate that natural recovery of severely compacted desert soils is extremely slow, and some researchers have suggested that subsurface compaction may not recover. Poorly sorted soils, particularly those with a loamy sand texture, are most vulnerable to soil compaction, and these soils are the most common in alluvial fans of the Mojave Desert. Recovery of compacted soil is expected to vary as a function of precipitation amounts, wetting-and-drying cycles, freeze-thaw cycles, and bioturbation, particularly root growth. Compaction recovery, as estimated using penetration depth and bulk density, was measured at 19 sites with 32 site-time combinations, including the former World War II Army sites of Camps Ibis, Granite, Iron Mountain, Clipper, and Essex. Although compaction at these sites was caused by a wide variety of forces, ranging from human trampling to tank traffic, the data do not allow segregation of differences in recovery rates for different compaction forces. The recovery rate appears to be logarithmic, with the highest rate of change occurring in the first few decades following abandonment. Some higher-elevation sites have completely recovered from soil compaction after 70 years. Using a linear model of recovery, the full recovery time ranges from 92 to 100 years; using a logarithmic model, which asymptotically approaches full recovery, the time required for 85% recovery ranges from 105-124 years.

  8. Reduced heart rate variability in chronic severe traumatic brain injury: Association with impaired emotional and social functioning, and potential for treatment using biofeedback.

    Science.gov (United States)

    Francis, Heather M; Fisher, Alana; Rushby, Jacqueline A; McDonald, Skye

    2016-01-01

    Heart rate variability (HRV) may provide an index of capacity for social functioning and may be remediated by HRV biofeedback. Given reductions in HRV are found following traumatic brain injury (TBI), the present study aimed to determine whether lower HRV in TBI is associated with social function, and whether HRV biofeedback might be a useful remediation technique in this population. Resting state HRV and measures of social and emotional processing were collected in 30 individuals with severe TBI (3-34 years post-injury) and 30 controls. This was followed by a single session of HRV biofeedback. HRV was positively associated with social cognition and empathy, and negatively associated with alexithymia for the TBI group. Both TBI and control groups showed significantly increased HRV on both time-domain (i.e., SDNN, rMSSD) and frequency-domain measures (LF, HF, LF:HF ratio) during biofeedback compared to baseline. These results suggest that decreased HRV is linked to social and emotional function following severe TBI, and may be a novel target for therapy using HRV biofeedback techniques.

  9. Parameters identification in strain-rate and thermal sensitive visco-plastic material model for an alumina dispersion strengthened copper

    CERN Document Server

    Scapin, M; Peroni, M

    2011-01-01

    The main objective of this paper is getting strain-hardening, thermal and strain-rate parameters for a material model in order to correctly reproduce the deformation process that occurs in high strain-rate scenario, in which the material reaches also high levels of plastic deformation and temperature. In particular, in this work the numerical inverse method is applied to extract material strength parameters from experimental data obtained via mechanical tests at different strain-rates (from quasi-static loading to high strain-rate) and temperatures (between 20 C and 1000 C) for an alumina dispersion strengthened copper material, which commercial name is GLIDCOP. Thanks to its properties GLIDCOP finds several applications in particle accelerator technologies, where problems of thermal management, combined with structural requirements, play a key role. Currently, it is used for the construction of structural and functional parts of the particle beam collimation system. Since the extreme condition in which the m...

  10. Evaluation of the severity of malocclusions in children affected by osteogenesis imperfecta with the peer assessment rating and discrepancy indexes.

    Science.gov (United States)

    Rizkallah, Jean; Schwartz, Stephane; Rauch, Frank; Glorieux, Francis; Vu, Duy-Dat; Muller, Katia; Retrouvey, Jean-Marc

    2013-03-01

    Osteogenesis imperfecta is a heritable disorder affecting bone and tooth development. Malocclusion is frequent in those affected by osteogenesis imperfecta, but this has not been studied in detail. The purpose of this study was to describe and quantify the severity of malocclusions in patients with osteogenesis imperfecta. Articulated dental casts were obtained from 49 patients diagnosed with osteogenesis imperfecta (ages 5-19 years; 28 female) and 49 age- and sex-matched control subjects who did not have osteogenesis imperfecta. Both groups were seeking orthodontic treatment. Malocclusions were scored by using the peer assessment rating (PAR) and the discrepancy index (DI). The average United Kingdom weighted PAR scores were 31.1 (SD, 14.5) for the osteogenesis imperfecta group and 22.7 (SD, 10.7) for the control group (P osteogenesis imperfecta and 21.6 (SD, 9.6) for the controls (P osteogenesis imperfecta group and 12.4 (SD, 6.8) for the control group (P osteogenesis imperfecta group, 7.1; control group, 0.3) for the DI parameters and anterior crossbite (osteogenesis imperfecta group, 13.0; control group, 3.8 [United Kingdom]) for the PAR. Both the PAR and the DI showed that malocclusions were significantly more severe in patients with osteogenesis imperfecta than in the control group. There was a higher incidence of Class III malocclusion associated with anterior and lateral open bites in patients affected by osteogenesis imperfecta. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Why and Where do Large Shallow Slab Earthquakes Occur?

    Science.gov (United States)

    Seno, T.; Yoshida, M.

    2001-12-01

    Within a shallow portion (20-60 km depth) of subducting slabs, it has been believed that large earthquakes seldom occur because the differential stress is generally expected to be low between bending at the trench-outer rise and unbending at the intermediate-depth. However, there are several regions in which large ( M>=7.0 ) earthquakes, including three events early in this year, have occurred in this portion. Searching such events from published individual studies and Harvard University centroid moment tensor catalogue, we find nineteen events in eastern Hokkaido, Kyushu-SW Japan, Mariana, Manila, Sumatra, Vanuatu, Chile, Peru, El Salvador, Mexico, and Cascadia. Slab stresses revealed from the mechanism solutions of those large events and smaller events are tensional in a slab dip direction. However, ages of the subducting oceanic plates are generally young, which denies a possibility that the slab pull works as a cause. Except for Manila and Sumatra, the stresses in the overriding plates are characterized by the change in {σ }Hmax direction from arc-parallel in the back-arc to arc-perpendicular in the fore-arc, which implies that a horizontal stress gradient exists in the across-arc direction. Peru and Chile, where the back-arc is compressional, can be categorized into this type, because a horizontal stress gradient exists over the continent from tension in east to compression in the west. In these regions, it is expected that mantle drag forces are operating beneath the upper plates, which drive the upper plates to the trenchward overriding the subducting oceanic plates. Assuming that the mantle drag forces beneath the upper plates originate from the mantle convection currents or upwelling plumes, we infer that the upper plates driven by the convection suck the oceanic plates, making the shallow portion of the slabs in extra-tension, thus resulting in the large shallow slab earthquakes in this tectonic regime.

  12. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain : Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  13. High-speed radiation dose calculations for severe accidents using INDOS

    International Nuclear Information System (INIS)

    Davidson, G.R.; Godin-Jacqmin, L.J.; Raines, J.C.

    1992-01-01

    The computer code INDOS (in-plant dose) has been developed for the high-speed calculation of in-plant radiation dose rates and doses during and/or due to a severe accident at a nuclear power plant. This paper describes the current capabilities of the code and presents the results of calculations for several severe-accident scenarios. The INDOS code can be run either as a module of MAAP, a code widely used in the nuclear industry for simulating the response of a light water reactor system during severe accidents, or as a stand-alone code using output from an alternative companion code. INDOS calculates gamma dose rates and doses in major plant compartments caused by airborne and deposited fission products released during an accident. The fission product concentrations are determined by the companion code

  14. Canine osteosarcoma: a naturally occurring disease to inform pediatric oncology.

    Science.gov (United States)

    Fenger, Joelle M; London, Cheryl A; Kisseberth, William C

    2014-01-01

    Osteosarcoma (OSA) is the most common form of malignant bone cancer in children and dogs, although the disease occurs in dogs approximately 10 times more frequently than in people. Multidrug chemotherapy and aggressive surgical techniques have improved survival; however, new therapies for OSA are critical, as little improvement in survival times has been achieved in either dogs or people over the past 15 years, even with significant efforts directed at the incorporation of novel therapeutic approaches. Both clinical and molecular evidence suggests that human and canine OSA share many key features, including tumor location, presence of microscopic metastatic disease at diagnosis, development of chemotherapy-resistant metastases, and altered expression/activation of several proteins (e.g. Met, ezrin, phosphatase and tensin homolog, signal transducer and activator of transcription 3), and p53 mutations, among others. Additionally, canine and pediatric OSA exhibit overlapping transcriptional profiles and shared DNA copy number aberrations, supporting the notion that these diseases are similar at the molecular level. This review will discuss the similarities between pediatric and canine OSA with regard to histology, biologic behavior, and molecular genetic alterations that indicate canine OSA is a relevant, spontaneous, large animal model of the pediatric disease and outline how the study of naturally occurring OSA in dogs will offer additional insights into the biology and future treatment of this disease in both children and dogs. © The Author 2014. Published by Oxford University Press on behalf of the Institute for Laboratory Animal Research. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. High population increase rates.

    Science.gov (United States)

    1991-09-01

    In addition to its economic and ethnic difficulties, the USSR faces several pressing demographic problems, including high population increase rates in several of its constituent republics. It has now become clear that although the country's rigid centralized planning succeeded in covering the basic needs of people, it did not lead to welfare growth. Since the 1970s, the Soviet economy has remained sluggish, which as led to increase in the death and birth rates. Furthermore, the ideology that held that demography could be entirely controlled by the country's political and economic system is contradicted by current Soviet reality, which shows that religion and ethnicity also play a significant role in demographic dynamics. Currently, Soviet republics fall under 2 categories--areas with high or low natural population increase rates. Republics with low rates consist of Christian populations (Armenia, Moldavia, Georgia, Byelorussia, Russia, Lithuania, Estonia, Latvia, Ukraine), while republics with high rates are Muslim (Tadzhikistan, Uzbekistan, Turkmenistan, Kirgizia, Azerbaijan Kazakhstan). The later group has natural increase rates as high as 3.3%. Although the USSR as a whole is not considered a developing country, the later group of republics fit the description of the UNFPA's priority list. Another serious demographic issue facing the USSR is its extremely high rate of abortion. This is especially true in the republics of low birth rates, where up to 60% of all pregnancies are terminated by induced abortions. Up to 1/5 of the USSR's annual health care budget is spent on clinical abortions -- money which could be better spent on the production of contraceptives. Along with the recent political and economic changes, the USSR is now eager to deal with its demographic problems.

  16. Occurrence of chronic esophageal ulcer after high dose rate intraluminal radiation therapy for esophageal cancer

    International Nuclear Information System (INIS)

    Soejima, Toshinori; Hirota, Saeko; Okamoto, Yoshiaki; Obayashi, Kayoko; Takada, Yoshiki

    1995-01-01

    Ninety-eight patients with esophageal cancer were treated by high dose rate intraluminal radiation therapy at the Department of Radiology of the Hyogo Medical Center for Adults between January 1982 and December 1993. Twenty patients with complete response after intraluminal radiation therapy, who were followed up with esophageal fiberscopy in our institute, were reviewed. The one-year cumulative rate of occurrence of esophageal ulcers was 81%, and in 69% of the cases the ulcers occurred from 4 to 8 months after completion of intraluminal radiation therapy. We graded esophageal ulcer by fiberscopic findings. Grade 0 was defined as no ulcer, grade 1 as superficial ulcer, grade 2 as deep ulcer, grade 3 as circumferencial ulcer, and severe stenosis. Factors related to grade were studied, and shorter distances from the source to the surface of the mucosa and lower surface doses of intraluminal radiation therapy appear to reduce the severity as graded on the above scale, of the esophageal ulcer. Four of the five 2-year recurrence-free patients suffered esophageal ulcers, which were cured from 15 to 22 months after intraluminal radiation therapy. However ulcers recurred in two patients, ong term care was thought to be necessary. (author)

  17. slide positivity rate of malaria among patients attending two ...

    African Journals Online (AJOL)

    DR. AMINU

    Key words: malaria, slide positivity rate, Kano metropolis. INTRODUCTION. Malaria has a worldwide distribution, affecting people of all ages, with an enormous burden amounting to. 300-500 million clinical cases per year, 80% of which occur in Africa (Lucas & Gills, 2003). Globally ten (10) new cases of malaria occur every ...

  18. Radiological dose assessment of naturally occurring radioactive materials in concrete building materials

    International Nuclear Information System (INIS)

    Amran AB Majid; Aznan Fazli Ismail; Muhamad Samudi Yasir; Redzuwan Yahaya; Ismail Bahari

    2013-01-01

    Previous studies have shown that the natural radioactivity contained in building materials have significantly influenced the dose rates in dwelling. Exposure to natural radiation in building has been of concerned since almost 80 % of our daily live are spend indoor. Thus, the aim of the study is to assess the radiological risk associated by natural radioactivity in soil based building materials to dwellers. A total of 13 Portland cement, 46 sand and 43 gravel samples obtained from manufacturers or bought directly from local hardware stores in Peninsular of Malaysia were analysed for their radioactivity concentrations. The activity concentrations of 226 Ra, 232 Th and 40 K in the studied building materials samples were found to be in the range of 3.7-359.3, 2.0-370.8 and 10.3-1,949.5 Bq kg -1 respectively. The annual radiation dose rates (μSv year -1 ) received by dwellers were evaluated for 1 to 50 years of exposure using Resrad-Build Computer Code based on the activity concentration of 226 Ra, 232 Th and 40 K found in the studied building material samples. The rooms modelling were based on the changing parameters of concrete wall thickness and the room dimensions. The annual radiation dose rates to dwellers were found to increase annually over a period of 50 years. The concrete thicknesses were found to have significantly influenced the dose rates in building. The self-absorption occurred when the concrete thickness was thicker than 0.4 m. Results of this study shows that the dose rates received by the dwellers of the building are proportional to the size of the room. In general the study concludes that concrete building materials; Portland cements, sands, and gravels in Peninsular of Malaysia does not pose radiological hazard to the building dwellers. (author)

  19. Suppression and utilization of spurious pulse occurence in organic GM-counters

    International Nuclear Information System (INIS)

    Narita, Y.; Igarashi, R.; Akagami, H.; Ozawa, Y.

    1979-01-01

    The authors have made a study of suppression and utilization of spurious pulse occurrence in organic GM-counters. Almost all spurious pulses in the organic GM-counter are the delayed pulses which occur being dependent upon the radiation intensity. The occurrence rate of the delayed pulses against the radiation intensity is affected by the intensity of the electric field in the vicinity of the cathode of the GM-counter. The occurrence of the delayed pulses can be suppressed when the electric field in the vicinity of the cathode is kept at high value. On the contrary, the occurrence of the delayed pulses can be utilized for the dosimetry of the pulsed radiation by means of increasing the space of the weak electric field in the GM-counter. (Auth.)

  20. A methodology for the transfer of probabilities between accident severity categories

    International Nuclear Information System (INIS)

    Whitlow, J.D.; Neuhauser, K.S.

    1992-01-01

    Evaluation of the radiological risks of accidents involving vehicles transporting radioactive materials requires consideration of both accident probability and consequences. The probability that an accident will occur may be estimated from historical accident data for the given mode of transport. In addition to an overall accident rate, information regarding accident severity and the resulting package environments across the range of all credible accidents is needed to determine the potential for a release of radioactive material from the package or for an increase in direct radiation from the package caused by damage to packaging shielding. This information is usually obtained from a variety of sources such as historical data, experimental data, analyses of accident and package environments, and expert opinion. The consequences of an accident depend on a number of factors including the type, quantity, and physical form of radioactive material being transported; the response of the package to accident environments; the fraction of material released from the package; and the dispersion of any released material. One approach for the classification and treatment of transportation accidents in risk analysis divides the complete range of critical accident environments resulting from all credible accidents into some number of accident-severity categories. The types of accident environments that a package may be subjected to in transportation are often classified into the following five groups: impact, fire, crush, puncture, and immersion. A open-quotes criticalclose quotes accident environment is one of a type that could present a plausible threat to a package. Each severity category represents a portion of all credible accidents, and the total of all severity categories covers the complete range of critical accident environments. This approach is used in the risk assessment codes RADTRAN (Neuhauser and Kanipe 1992) and INTERTRAN (Ericsson and Elert 1983)

  1. Projected global health impacts from severe nuclear accidents: Conversion of projected doses to risks on a global scale: Experience from Chernobyl releases

    International Nuclear Information System (INIS)

    Catlin, R.J.; Goldman, M.; Anspaugh, L.R.

    1987-01-01

    Best estimates of possible additional health effects were projected for the Northern Hemisphere: (1) over the next 50 years, up to 28 thousand radiation-induced fatal cancers, compared to an expected 600 million cancer deaths from natural or spontaneous causes; (2) over the next year, up to 700 additional cases of severe mental retardation, compared to a normal expectation of 340 thousand cases; and (3) in the first generation, up to 1.9 thousand radiation-induced genetic disorders, compared to 180 million naturally-occurring cases. The possibility of zero health effects at very low doses and dose rates cannot be excluded. Due to the very large numbers of naturally-occurring health effects, it is unlikely that any additional health effects will be demonstrable except, perhaps, for the more highly exposed population in the immediate vicinity of Chernobyl. 13 refs., 4 figs., 6 tabs

  2. Medicare FFS 30 Day Readmission Rate PUF

    Data.gov (United States)

    U.S. Department of Health & Human Services — The hospital readmission rate PUF presents nation-wide information about inpatient hospital stays that occurred within 30 days of a previous inpatient hospital stay...

  3. Anorexia Nervosa Presented with Fever and Pancytopenia Due to Severe Constipation

    Directory of Open Access Journals (Sweden)

    Senay Akbay

    2014-06-01

    Full Text Available The prevalence of eating disorders is on the increase in adolescence and childhood. The peak age of onset occurs between 14 and 19 years. Anorexia nervosa is diagnosed approximately nine times more often in females than in males. Anorexia nervosa is a eating disorder that occurs mainly in female adolescents and young women. Eating disorders are associated with severe and sometimes life-threatening medical and psychiatric comorbidities. Hematological abnormalities are common in anorexia nervosa. But severe bone marrow supression has rarely been reported. To our knowledge, there is not any publication in the literature about bone marrow supression due to constipation.We reported here a 17 years old girl diagnosed as anorexia nervosa who was not wasted yet, presented with constipation and developed fever and pancytopenia.

  4. Varying Definitions for Periprocedural Myocardial Infarction Alter Event Rates and Prognostic Implications

    Science.gov (United States)

    Idris, Hanan; Lo, Sidney; Shugman, Ibrahim M.; Saad, Yousef; Hopkins, Andrew P.; Mussap, Christian; Leung, Dominic; Thomas, Liza; Juergens, Craig P.; French, John K.

    2014-01-01

    Background Periprocedural myocardial infarction (PMI) has had several definitions in the last decade, including the Society for Cardiovascular Angiography and Interventions (SCAI) definition, that requires marked biomarker elevations congruent with surgical PMI criteria. Methods and Results The aim of this study was to examine the definition‐based frequencies of PMI and whether they influenced the reported association between PMI and increased rates of late death/ myocardial infarction (MI). We studied 742 patients; 492 (66%) had normal troponin T (TnT) levels and 250 (34%) had elevated, but stable or falling, TnT levels. PMI, using the 2007 and the 2012 universal definition, occurred in 172 (23.2%) and in 99 (13.3%) patients, respectively, whereas 19 (2.6%) met the SCAI PMI definition (PPMI using the 2012 definition, occlusion of a side branch ≤1 mm occurred in 48 patients (48.5%) and was the most common angiographic finding for PMI. The rates of death/MI at 2 years in patients with, compared to those without, PMI was 14.7% versus 10.1% (P=0.087) based on the 2007 definition, 16.9% versus 10.3% (P=0.059) based on the 2012 definition, and 29.4% versus 10.7% (P=0.015) based on the SCAI definition. Conclusion In this study, PMI, according to the SCAI definition, was associated with more‐frequent late death/MI, with ≈20% of all patients, who had PMI using the 2007 universal MI definition, not having SCAI‐defined PMI. Categorizing these latter patients as SCAI‐defined no PMI did not alter the rate of death/MI among no‐PMI patients. PMID:25359403

  5. States with low non-fatal injury rates have high fatality rates and vice-versa.

    Science.gov (United States)

    Mendeloff, John; Burns, Rachel

    2013-05-01

    State-level injury rates or fatality rates are sometimes used in studies of the impact of various safety programs or other state policies. How much does the metric used affect the view of relative occupational risks among U.S. states? This paper uses a measure of severe injuries (fatalities) and of less severe injuries (non-fatal injuries with days away from work, restricted work, or job transfer-DART) to examine that issue. We looked at the correlation between the average DART injury rate (from the BLS Survey of Occupational Injuries and Illnesses) and an adjusted average fatality rate (from the BLS Census of Fatal Occupational Injuries) in the construction sector for states for 2003-2005 and for 2006-2008. The RAND Human Subjects Protection Committee determined that this study was exempt from review. The correlations between the fatal and non-fatal injury rates were between -0.30 and -0.70 for all construction and for the subsector of special trade contractors. The negative correlation was much smaller between the rate of fatal falls from heights and the rate of non-fatal falls from heights. Adjusting for differences in the industry composition of the construction sector across states had minor effects on these results. Although some have suggested that fatal and non-fatal injury rates should not necessarily be positively correlated, no one has suggested that the correlation is negative, which is what we find. We know that reported non-fatal rates are influenced by workers' compensation benefits and other factors. Fatality rates appear to be a more valid measure of risk. Efforts to explain the variations that we find should be undertaken. Copyright © 2012 Wiley Periodicals, Inc.

  6. Characterizing potentially induced earthquake rate changes in the Brawley Seismic Zone, southern California

    Science.gov (United States)

    Llenos, Andrea L.; Michael, Andrew J.

    2016-01-01

    The Brawley seismic zone (BSZ), in the Salton trough of southern California, has a history of earthquake swarms and geothermal energy exploitation. Some earthquake rate changes may have been induced by fluid extraction and injection activity at local geothermal fields, particularly at the North Brawley Geothermal Field (NBGF) and at the Salton Sea Geothermal Field (SSGF). We explore this issue by examining earthquake rate changes and interevent distance distributions in these fields. In Oklahoma and Arkansas, where considerable wastewater injection occurs, increases in background seismicity rate and aftershock productivity and decreases in interevent distance were indicative of fluid‐injection‐induced seismicity. Here, we test if similar changes occur that may be associated with fluid injection and extraction in geothermal areas. We use stochastic epidemic‐type aftershock sequence models to detect changes in the underlying seismogenic processes, shown by statistically significant changes in the model parameters. The most robust model changes in the SSGF roughly occur when large changes in net fluid production occur, but a similar correlation is not seen in the NBGF. Also, although both background seismicity rate and aftershock productivity increased for fluid‐injection‐induced earthquake rate changes in Oklahoma and Arkansas, the background rate increases significantly in the BSZ only, roughly corresponding with net fluid production rate increases. Moreover, in both fields the interevent spacing does not change significantly during active energy projects. This suggests that, although geothermal field activities in a tectonically active region may not significantly change the physics of earthquake interactions, earthquake rates may still be driven by fluid injection or extraction rates, particularly in the SSGF.

  7. Antioxidant effect of naturally occurring xanthines on the oxidative damage of DNA bases

    International Nuclear Information System (INIS)

    Vieira, A.J.S.C.; Telo, J.P.; Pereira, H.F.; Patrocinio, P.F.; Dias, R.M.B.

    1999-01-01

    The repair of the oxidised radicals of adenine and guanosine by several naturally occurring xanthines was studied. Each pair of DNA purine/xanthine was made to react with the sulphate radical and the decrease of the concentration of both compounds was measured by HPLC as a function of irradiation time. The results show that xanthine efficiently prevents the oxidation of the two DNA purines. Theophylline and para-xanthine repair the oxidizes radical of adenine but not the one from guanosine. Theobromine and caffeine to do not show any protecting effect. An order of the oxidation potentials of all the purines studied is proposed. (authors)

  8. Severe Slugging in Air-Water Hybrid Riser System

    Directory of Open Access Journals (Sweden)

    Jing Gong

    2014-11-01

    Full Text Available In the subsea pipeline gathering system, severe slugging flow is prone to occur. Severe slugging flow brings major threat to production and flow assurance in oil and gas industry due to periodical pressure oscillation and large liquid volume. Currently many researchers pay much more attention on L-shaped riser, catenaries, and S-shaped riser; little research has been made on hybrid riser, which is applied in the Africa West and Gulf of Mexico oil fields. Flow characteristics simulation for hybrid riser is made in this paper, using the one-dimensional and quasi-equilibrium model to simulate not only the riser-base pressure, severe slugging period, and the liquid slug length of the whole system but also base-pressure in the flexible pipe section. The calculated results match well with the experiment data. Besides, the influence of flexible pipe to the severe slugging characteristics of hybrid riser system is analyzed, which are significant for the determination of riser structure.

  9. Rate and extent of aqueous perchlorate removal by iron surfaces.

    Science.gov (United States)

    Moore, Angela M; De Leon, Corinne H; Young, Thomas M

    2003-07-15

    The rate and extent of perchlorate reduction on several types of iron metal was studied in batch and column reactors. Mass balances performed on the batch experiments indicate that perchlorate is initially sorbed to the iron surface, followed by a reduction to chloride. Perchlorate removal was proportional to the iron dosage in the batch reactors, with up to 66% removal in 336 h in the highest dosage system (1.25 g mL(-1)). Surface-normalized reaction rates among three commercial sources of iron filings were similar for acid-washed samples. The most significant perchlorate removal occurred in solutions with slightly acidic or near-neutral initial pH values. Surface mediation of the reaction is supported by the absence of reduction in batch experiments with soluble Fe2+ and also by the similarity in specific reaction rate constants (kSA) determined for three different iron types. Elevated soluble chloride concentrations significantly inhibited perchlorate reduction, and lower removal rates were observed for iron samples with higher amounts of background chloride contamination. Perchlorate reduction was not observed on electrolytic sources of iron or on a mixed-phase oxide (Fe3O4), suggesting that the reactive iron phase is neither pure zerovalent iron nor the mixed oxide alone. A mixed valence iron hydr(oxide) coating or a sorbed Fe2+ surface complex represent the most likely sites for the reaction. The observed reaction rates are too slow for immediate use in remediation system design, but the findings may provide a basis for future development of cost-effective abiotic perchlorate removal techniques.

  10. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, A.M.; Stewart, R.; Koke, A.J.A.; Oosterwijk, R.F.A.; Swaan, J.L.; Schreurs, Karlein Maria Gertrudis; Schiphorst Preuper, H.R.

    2016-01-01

    Objectives: The 0–10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  11. Early occurring and continuing effects

    International Nuclear Information System (INIS)

    Scott, B.R.; Hahn, F.F.

    1985-01-01

    This chapter deals with health-risk estimates for early and continuing effects of exposure to ionizing radiations that could be associated with light water nuclear power plants accidents. Early and continuing effects considered are nonneoplastic diseases and symptoms that normally occur soon after radiation exposure, but may also occur after years have passed. They are generally associated with relatively high (greater than 1 Gy) doses. For most of the effects considered, there is a practical dose threshold. Organs of primary interest, because of their high sensitivity or the likelihood of receiving a large radiation dose, are bone marrow, gastrointestinal tract, thyroid glands, lungs, skin, gonads, and eyes. In utero exposure of the fetus is also considered. New data and modeling techniques available since publication of the Reactor Safety Study (WASH 1400, 1975) were used along with data cited in the Study to develop improved health-risk models for morbidity and mortality. The new models are applicable to a broader range of accident scenarios, provide a more detailed treatment of dose protraction effects, and include morbidity effects not considered in the Reactor Safety Study. 115 references, 20 figures, 19 tables

  12. Consequences of severe radioactive releases to Nordic Marine environment

    Energy Technology Data Exchange (ETDEWEB)

    Iosjpe, M. [Norwegian Radiation Protection Authority (NRPA) (Norway); Isaksson, M. [Univ. of Gothenburg (Sweden); Joensen, H.P. [Froskaparsetur Foeroya. Faroe Islands, Torshavn (Denmark); Lahtinen, J. [Radiation and Nuclear Safety Authority (Finland); Logemann, K. [Univ. of Iceland (Iceland); Palsson, S.E. [Geislavarnir Rikisins (Iceland); Roos, P. [Technical Univ. of Denmark. Risoe DTU, Roskilde (Denmark); Suolanen, V. [Technical Research Centre of Finland (Finland)

    2013-02-15

    In the report, consequences of hypothetical severe nuclear accidents releases to Nordic marine environment are preliminary considered. The considered marine area comprises the Baltic Sea (Sweden, Denmark, Finland) and the North Atlantic (Iceland, Faroes, Norway) areas. The hypothetical severe nuclear accidents can be related to nuclear power plants, nuclear powered submarines or ice-breakers. Quite comprehensive survey on radioactive source terms of extremely severe nuclear power and submarine accidents has been done. This enables to estimate more realistically possible radioactive releases of various elements and nuclides to marine environment. One recent reference is of course the Fukushima accident and estimated releases there. The marine flows and dilution circumstances around the Nordic nuclear power plants and in the Baltic Sea area in general, has been studied. Respectively marine flows related to Iceland and Faroes coasts are considered with measured data and with preliminary 3D-model simulations. The substantial depth of sea water in the North Atlantic affect vertical concentration profiles to some extent. At Icelandic or Faroese waters, a potential submarine accident would likely occur in a well defined water mass, and radioactivity from the accident would be detected and spread with the flow regime of the water mass in the world ocean. Based on hypothetical severe accidents scenarios, preliminary consequence calculations has been done. It should be emphasised that the considered severe accident cases, considered in this study, do not directly attach any specific Nordic nuclear power plant or any specific submarine type. The considered radioactive releases will, however, provide specified references for more extensive consideration of environmental consequences of severe - or minor - radioactive releases to Nordic marine environment. As a reference, the release amounts from a 3000 MW{sub th} reactor size were used. Based on source term analyses, the

  13. Consequences of severe radioactive releases to Nordic Marine environment

    International Nuclear Information System (INIS)

    Iosjpe, M.; Isaksson, M.; Joensen, H.P.; Lahtinen, J.; Logemann, K.; Palsson, S.E.; Roos, P.; Suolanen, V.

    2013-02-01

    In the report, consequences of hypothetical severe nuclear accidents releases to Nordic marine environment are preliminary considered. The considered marine area comprises the Baltic Sea (Sweden, Denmark, Finland) and the North Atlantic (Iceland, Faroes, Norway) areas. The hypothetical severe nuclear accidents can be related to nuclear power plants, nuclear powered submarines or ice-breakers. Quite comprehensive survey on radioactive source terms of extremely severe nuclear power and submarine accidents has been done. This enables to estimate more realistically possible radioactive releases of various elements and nuclides to marine environment. One recent reference is of course the Fukushima accident and estimated releases there. The marine flows and dilution circumstances around the Nordic nuclear power plants and in the Baltic Sea area in general, has been studied. Respectively marine flows related to Iceland and Faroes coasts are considered with measured data and with preliminary 3D-model simulations. The substantial depth of sea water in the North Atlantic affect vertical concentration profiles to some extent. At Icelandic or Faroese waters, a potential submarine accident would likely occur in a well defined water mass, and radioactivity from the accident would be detected and spread with the flow regime of the water mass in the world ocean. Based on hypothetical severe accidents scenarios, preliminary consequence calculations has been done. It should be emphasised that the considered severe accident cases, considered in this study, do not directly attach any specific Nordic nuclear power plant or any specific submarine type. The considered radioactive releases will, however, provide specified references for more extensive consideration of environmental consequences of severe - or minor - radioactive releases to Nordic marine environment. As a reference, the release amounts from a 3000 MW th reactor size were used. Based on source term analyses, the chosen

  14. The fast food and obesity link: consumption patterns and severity of obesity.

    Science.gov (United States)

    Garcia, Ginny; Sunil, Thankam S; Hinojosa, Pedro

    2012-05-01

    Rates of extreme forms of obesity are rapidly rising, as is the use of bariatric surgery for its treatment. The aim of the present study was to examine selected behavioral factors associated with severity of obesity among preoperative bariatric surgery patients in the San Antonio area, focusing specifically on the effects of fast food consumption. We used ordered logistic regression to model behavioral and attitudinal effects on obesity outcomes among 270 patients. These outcomes were based on the severity of obesity and were measured on the basis of body mass index. Our results indicated that, among the behavioral factors, fast food consumption exerted the largest influence on higher levels of obesity. These remained after controlling for several social and demographic characteristics. Our findings suggest that higher rates of fast food consumption are connected to the increasing rates of severe obesity. Given that morbid and super morbid obesity rates are growing at a more advanced pace than moderate obesity, it is necessary to explore the behavioral characteristics associated with these trends.

  15. Ocular firework trauma: a systematic review on incidence, severity, outcome and prevention.

    Science.gov (United States)

    Wisse, R P L; Bijlsma, W R; Stilma, J S

    2010-12-01

    To provide a systematic review on ocular firework trauma with emphasis on incidence and patient demographics, the extent of ocular trauma and visual function loss, and firework regulation effects on injury rates. A literature search was performed using predetermined inclusion and exclusion criteria. Demographic characteristics of ocular firework casualties were obtained and incidence rates of sustained trauma and vision loss calculated. Twenty-six relevant articles were suitable for calculation of trauma incidence and patient demographics, of which 17 articles could be used for calculating trauma severity and vision loss. Victims were male (77%), young (82%) and often bystander (47%). Most of the trauma was mild and temporary. Penetrating eye trauma, globe contusions and burns accounted for 18.2%, with a 3.9% enucleation rate. Mean visual acuity was >10/20 in 56.8%, with severe vision loss (firework legislation show 87% less eye trauma (pfirework traumas show severe vision loss, mostly in young males. Bystanders are as frequently injured. Firework traumas are a preventable cause of severe ocular injury and blindness because countries using restrictive firework legislation have remarkable lower trauma incidence rates.

  16. Maximum Evaporation Rates of Water Droplets Approaching Obstacles in the Atmosphere Under Icing Conditions

    Science.gov (United States)

    Lowell, H. H.

    1953-01-01

    When a closed body or a duct envelope moves through the atmosphere, air pressure and temperature rises occur ahead of the body or, under ram conditions, within the duct. If cloud water droplets are encountered, droplet evaporation will result because of the air-temperature rise and the relative velocity between the droplet and stagnating air. It is shown that the solution of the steady-state psychrometric equation provides evaporation rates which are the maximum possible when droplets are entrained in air moving along stagnation lines under such conditions. Calculations are made for a wide variety of water droplet diameters, ambient conditions, and flight Mach numbers. Droplet diameter, body size, and Mach number effects are found to predominate, whereas wide variation in ambient conditions are of relatively small significance in the determination of evaporation rates. The results are essentially exact for the case of movement of droplets having diameters smaller than about 30 microns along relatively long ducts (length at least several feet) or toward large obstacles (wings), since disequilibrium effects are then of little significance. Mass losses in the case of movement within ducts will often be significant fractions (one-fifth to one-half) of original droplet masses, while very small droplets within ducts will often disappear even though the entraining air is not fully stagnated. Wing-approach evaporation losses will usually be of the order of several percent of original droplet masses. Two numerical examples are given of the determination of local evaporation rates and total mass losses in cases involving cloud droplets approaching circular cylinders along stagnation lines. The cylinders chosen were of 3.95-inch (10.0+ cm) diameter and 39.5-inch 100+ cm) diameter. The smaller is representative of icing-rate measurement cylinders, while with the larger will be associated an air-flow field similar to that ahead of an airfoil having a leading-edge radius

  17. Effect of a training programme on blood culture contamination rate in critical care.

    Science.gov (United States)

    Sánchez-Sánchez, M M; Arias-Rivera, S; Fraile-Gamo, P; Jareño-Collado, R; López-Román, S; Vadillo-Obesso, P; García-González, S; Pulido-Martos, M T; Sánchez-Muñoz, E I; Cacho-Calvo, J; Martín-Pellicer, A; Panadero-Del Olmo, L; Frutos-Vivar, F

    2018-03-30

    Blood culture contamination can occur from extraction to processing; its rate should not exceed 3%. To evaluate the impact of a training programme on the rate of contaminated blood cultures after the implementation of sample extraction recommendations based on the best evidence. Prospective before-after study in a polyvalent intensive care unit with 18 beds. Two phases were established (January-June 2012, October 2012-October 2015) with a training period between them. Main recommendations: sterile technique, surgical mask, double skin disinfection (70° alcohol and 2% alcoholic chlorhexidine), 70° alcohol disinfection of culture flasks and injection of samples without changing needles. Including all blood cultures of patients with extraction request. demographic, severity, pathology, reason for admission, stay and results of blood cultures (negative, positive and contaminated). Basic descriptive statistics: mean (standard deviation), median (interquartile range) and percentage (95% confidence interval). Calculated contamination rates per 100 blood cultures extracted. Bivariate analysis between periods. Four hundred and eight patients were included. Eight hundred and forty-one blood cultures were taken, 33 of which were contaminated. In the demographic variables, severity, diagnosis and stay of patients with contaminated samples, no differences were observed from those with uncontaminated samples. Pre-training vs post-training contamination rates: 14 vs 5.6 per 100 blood cultures extracted (P=.00003). An evidence-based training programme reduced the contamination of samples. It is necessary to continue working on the planning of activities and care to improve the detection of pollutants and prevent contamination of samples. Copyright © 2018 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Effect of Early Foliar Disease Control on Wheat Scab Severity (Fusarium graminearum in Argentina

    Directory of Open Access Journals (Sweden)

    Jorge David Mantecón

    2013-01-01

    Full Text Available Wheat scab is common in Argentina mainly durum wheat and some bread varieties. The epidemics occur every 5 to 7 years. During the 2007, 2008, and 2009 growing seasons, three trials were conducted at the INTA Balcarce Experimental Station. Each plot had six rows of 5 m long, spaced 0.15 m apart and was set up in a randomized complete block design with four replications. Trifloxystrobin plus cyproconazole was sprayed at Z3.1 stage. Treatments were sprayed at Z6.1 stage with tebuconazole, prochloraz, and metconazole to improve scab control. Artificial inoculations were made in Z6.1. Severity of Septoria leaf bloth and leaf rust was assessed in boot stage (Z3.9. Scab severity was rated at early dough stage (Z8.3. Yields were recorded each year. Fungicide only applied at Z3.1 stage did not reduce field scab severity but reduced the seeds infection and increased the yields. Early fungicide spray produced yield increase at about 22% and a decrease in seed infection of up to 40%. Yields increased in a 55.3% and in a 19.6% when compared with the inoculated and not inoculated check, respectively. The purpose of this study was to evaluate the effect of foliar disease control on scab, crop yield, and seed health.

  19. Management of severe hypertension in the newborn.

    Science.gov (United States)

    Dionne, Janis M; Flynn, Joseph T

    2017-12-01

    Blood pressure is considered a vital sign, as values too low or too high can be related with serious morbidity and mortality. In neonates, normal blood pressure values undergo rapid changes, especially in premature infants, making the recognition of abnormal blood pressures more challenging. Severe hypertension can occur in neonates and infants and is a medical emergency, often manifesting with congestive heart failure or other life-threatening complications. The cause or risk factors for the hypertension can usually be identified and may guide management. Most classes of antihypertensive medications have been used in the neonatal population. For severe hypertension, intravenous short-acting medications are preferred for a controlled reduction of blood pressure. In this article, we focus on identification, aetiology and management of severe hypertension in the newborn. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Wenckebach upper rate response in single chamber pacemaker.

    Science.gov (United States)

    Barold, S S

    2000-07-01

    The Medtronic Minix pacemaker during normal function in the VVT mode was found to exhibit a Wenckenbach upper rate response similar to that of dual chamber devices. This behavior occurred only when the upper rate interval was longer than the pacemaker refractory period. In a single chamber device this response may simulate pacemaker malfunction.

  1. Young Mania Rating Scale: how to interpret the numbers? Determination of a severity threshold and of the minimal clinically significant difference in the EMBLEM cohort.

    Science.gov (United States)

    Lukasiewicz, Michael; Gerard, Stephanie; Besnard, Adeline; Falissard, Bruno; Perrin, Elena; Sapin, Helene; Tohen, Mauricio; Reed, Catherine; Azorin, Jean-Michel

    2013-03-01

    The aim of this analysis was to identify Young Mania Rating Scale (YMRS) meaningful benchmarks for clinicians (severity threshold, minimal clinically significant difference [MCSD]) using the Clinical Global Impressions Bipolar (CGI-BP) mania scale, to provide a clinical perspective to randomized clinical trials (RCTs) results. We used the cohort of patients with acute manic/mixed state of bipolar disorders (N = 3459) included in the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM) study. A receiver-operating characteristic analysis was performed on randomly selected patients to determine the YMRS optimal severity threshold with CGI-BP mania score ≥ "Markedly ill" defining severity. The MCSD (clinically meaningful change in score relative to one point difference in CGI-BP mania for outcome measures) of YMRS, was assessed with a linear regression on baseline data. At baseline, YMRS mean score was 26.4 (±9.9), CGI-BP mania mean score was 4.8 (±1.0) and 61.7% of patients had a score ≥ 5. The optimal YMRS severity threshold of 25 (positive predictive value [PPV] = 83.0%; negative predictive value [NPV] = 66.0%) was determined. In this cohort, a YMRS score of 20 (typical cutoff for RCTs inclusion criteria) corresponds to a PPV of 74.6% and to a NPV of 77.6%, meaning that the majority of patients included would be classified as severely ill. The YMRS minimal clinically significant difference was 6.6 points. Copyright © 2013 John Wiley & Sons, Ltd.

  2. Diarrhea in severely burned children.

    Science.gov (United States)

    Thakkar, Kalpesh; Kien, C Lawrence; Rosenblatt, Judah I; Herndon, David N

    2005-01-01

    Diarrhea is a common problem in critically ill patients. Our patients are fed a high-carbohydrate enteral formula. We hypothesized that diarrhea in our patients may be related to the osmotic effects of unabsorbed carbohydrate in the small intestine and colon. We studied 19 patients, 3 months to 17 years, with burns >40% total body surface area. Each subject was studied weekly for up to 4 weeks postburn. Breath H2 concentration was measured. For the 24-hour period before the breath H2 measurement, the enteral carbohydrate intake, stool volume, and total enteral fluid volume were recorded. At each of several weekly intervals for each subject, the times when stool volume and enteral carbohydrate intake were each maximal were noted. Maximal stool volume ranged from 12 to 69 mL/kg/d. At the time point of maximal carbohydrate intake, diarrhea (stool volume >10 mL/kg/d) occurred in 18 of 19 patients, and maximal stool volume occurred in 10 of 19. Breath H2 concentration (ppm/5% CO2; mean +/- SEM) was 5.5 +/- 3.5 at the time of maximal carbohydrate intake, and was 25 +/- 20 at maximal stool volume. There were no correlations among breath H2 concentration, stool volume, enteral fluid intake, and enteral carbohydrate intake. Almost all the subjects had diarrhea over several weeks postburn. The lack of correlation of either carbohydrate intake or breath H2 with stool volume suggests that diarrhea in these patients may be caused by factors other than carbohydrate malabsorption. These data do not support altering nutrition support because of watery diarrhea.

  3. T-cell receptor Vbeta CDR3 oligoclonality frequently occurs in childhood refractory cytopenia (MDS-RC) and severe aplastic anemia

    DEFF Research Database (Denmark)

    Vries, A.C. de; Langerak, A.W.; Verhaaf, B.

    2008-01-01

    (Very) severe acquired aplastic anemia ((v)SAA) and myelodysplastic syndrome (MDS) are rare diseases in childhood. (V)SAA is a bone marrow (BM) failure syndrome characterized by immune-mediated destruction of hematopoietic progenitors. MDS is a malignant clonal stem cell disorder, of which...... the hypoplastic variant is, in case of absence of a cytogenetic clone, difficult to separate from (v)SAA. Recently, studies provided a molecular signature of autoimmunity in adult (v)SAA, by showing oligoclonality based on the length of the TCR Vbeta CDR3 region. We investigated retrospectively the frequency...... and the discriminative value of TCR Vbeta CDR3 oligoclonality in pediatric (v)SAA and MDS patients. Peripheral blood (PB) and/or BM mononuclear cell samples of pediatric patients with (v)SAA (n=38), refractory cytopenia (MDS-RC) (n=28) and 18 controls were analysed via TCR Vbeta heteroduplex PCR analysis of extracted...

  4. THE ABSOLUTE RATE OF LGRB FORMATION

    Energy Technology Data Exchange (ETDEWEB)

    Graham, J. F.; Schady, P. [Max-Planck Institute for Extraterrestrial Physics, Giessenbachstrasse 1, D-85748 Garching (Germany)

    2016-06-01

    We estimate the long-duration gamma-ray burst (LGRB) progenitor rate using our recent work on the effects of environmental metallically on LGRB formation in concert with supernovae (SNe) statistics via an approach patterned loosely off the Drake equation. Beginning with the cosmic star formation history, we consider the expected number of broad-line Type Ic events (the SNe type associated with LGRBs) that are in low-metallicity host environments adjusted by the contribution of high-metallicity host environments at a much reduced rate. We then compare this estimate to the observed LGRB rate corrected for instrumental selection effects to provide a combined estimate of the efficiency fraction of these progenitors to produce LGRBs and the fraction of which are beamed in our direction. From this we estimate that an aligned LGRB occurs for approximately every 4000 ± 2000 low-metallically broad-lined SNe Ic. Therefore, if one assumes a semi-nominal beaming factor of 100, then only about one such supernova out of 40 produce an LGRB. Finally, we propose an off-axis LGRB search strategy of targeting only broad-line Type Ic events that occur in low-metallicity hosts for radio observation.

  5. Multiple Primary Cancers: Simultaneously Occurring Prostate ...

    African Journals Online (AJOL)

    2016-05-20

    May 20, 2016 ... occurring prostate cancer and other primary tumors-our experience and literature ..... thyroid cancers, pancreatic tumors, renal cancers, and melanoma. ... Hsing AW, Yeboah E, Biritwum R, Tettey Y, De Marzo AM,. Adjei A, et ...

  6. Measurement of disintegration rates of small [60Co]Co sources in lead containers by the sum-peak method

    International Nuclear Information System (INIS)

    Kawano, Takao; Ebihara, Hiroshi

    1991-01-01

    The sum-peak method has been applied to determine the disintegration rates of two small [ 60 Co]Co sources (30 and 350 kBq) in lead containers with several thickness by using a NaI(Tl) detector. The experimental results showed that the sum-peak method was perfectly effective for the determination of the disintegration rates (unrelated to the thicknesses of the containers) of the 350 kBq source. The sum-peak method was also absolutely effective for the 30 kBq source in the case of containers with thicknesses of 15 mm and less, but in the cases of those with thicknesses of 21, 27 and 33 mm, the disintegration rates were under-estimated and the deviations from the true disintegration rate increased rapidly with increasing thicknesses of the containers. We presume that the under-estimation of the disintegration rates was the result of the over-estimation of the areas under the sum peaks, caused by the interference of the γ-ray (2614 keV) emitted from the naturally occurring radionuclide 208 Tl. (author)

  7. Severe Sepsis in Severely Malnourished Young Bangladeshi Children with Pneumonia: A Retrospective Case Control Study.

    Directory of Open Access Journals (Sweden)

    Mohammod Jobayer Chisti

    Full Text Available In developing countries, there is no published report on predicting factors of severe sepsis in severely acute malnourished (SAM children having pneumonia and impact of fluid resuscitation in such children. Thus, we aimed to identify predicting factors for severe sepsis and assess the outcome of fluid resuscitation of such children.In this retrospective case-control study SAM children aged 0-59 months, admitted to the Intensive Care Unit (ICU of the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh from April 2011 through July 2012 with history of cough or difficult breathing and radiologic pneumonia, who were assessed for severe sepsis at admission constituted the study population. We compared the pneumonic SAM children with severe sepsis (cases = 50 with those without severe sepsis (controls = 354. Severe sepsis was defined with objective clinical criteria and managed with fluid resuscitation, in addition to antibiotic and other supportive therapy, following the standard hospital guideline, which is very similar to the WHO guideline.The case-fatality-rate was significantly higher among the cases than the controls (40% vs. 4%; p<0.001. In logistic regression analysis after adjusting for potential confounders, lack of BCG vaccination, drowsiness, abdominal distension, acute kidney injury, and metabolic acidosis at admission remained as independent predicting factors for severe sepsis in pneumonic SAM children (p<0.05 for all comparisons.We noted a much higher case fatality among under-five SAM children with pneumonia and severe sepsis who required fluid resuscitation in addition to standard antibiotic and other supportive therapy compared to those without severe sepsis. Independent risk factors and outcome of the management of severe sepsis in our study children highlight the importance for defining optimal fluid resuscitation therapy aiming at reducing the case fatality in such children.

  8. A spatial generalized ordered response model to examine highway crash injury severity.

    Science.gov (United States)

    Castro, Marisol; Paleti, Rajesh; Bhat, Chandra R

    2013-03-01

    This paper proposes a flexible econometric structure for injury severity analysis at the level of individual crashes that recognizes the ordinal nature of injury severity categories, allows unobserved heterogeneity in the effects of contributing factors, as well as accommodates spatial dependencies in the injury severity levels experienced in crashes that occur close to one another in space. The modeling framework is applied to analyze the injury severity sustained in crashes occurring on highway road segments in Austin, Texas. The sample is drawn from the Texas Department of Transportation (TxDOT) crash incident files from 2009 and includes a variety of crash characteristics, highway design attributes, driver and vehicle characteristics, and environmental factors. The results from our analysis underscore the value of our proposed model for data fit purposes as well as to accurately estimate variable effects. The most important determinants of injury severity on highways, according to our results, are (1) whether any vehicle occupant is ejected, (2) whether collision type is head-on, (3) whether any vehicle involved in the crash overturned, (4) whether any vehicle occupant is unrestrained by a seat-belt, and (5) whether a commercial truck is involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Treatment of borderline personality disorder and co-occurring anxiety disorders

    Science.gov (United States)

    Valenstein, Helen R.

    2013-01-01

    Anxiety disorders are highly prevalent among individuals with borderline personality disorder, with comorbidity rates of up to 90%. Anxiety disorders have been found to reduce the likelihood of achieving remission from borderline personality disorder over time and to increase the risk of suicide and self-injury in this population. Evidence-based treatments for borderline personality disorder have not sufficiently focused on targeting anxiety disorders, and their effects on these disorders are either limited or unknown. Conversely, evidence-based treatments for anxiety disorders typically exclude suicidal, self-injuring, and seriously comorbid patients, thereby limiting their generalizability to individuals with borderline personality disorder. To address these limitations, recent research has begun to emerge focused on developing and evaluating treatments for individuals with co-occurring borderline personality disorder and anxiety disorders, specifically posttraumatic stress disorder (PTSD), with promising initial results. However, there is a need for additional research in this area, particularly studies evaluating the treatment of anxiety disorders among high-risk and complex borderline personality disorder patients. PMID:23710329

  10. Characteristics of scrub typhus, murine typhus, and Q fever among elderly patients: Prolonged prothrombin time as a predictor for severity.

    Science.gov (United States)

    Chang, Ko; Lee, Nan-Yao; Ko, Wen-Chien; Lin, Wei-Ru; Chen, Yen-Hsu; Tsai, Jih-Jin; Chen, Tun-Chieh; Lin, Chun-Yu; Chang, Ya-Ting; Lu, Po-Liang

    2017-06-22

    The clinical manifestations of scrub typhus, murine typhus and acute Q fever in the elderly are not clear. We conducted a retrospective study to identify the characteristics of the elderly aged ≥65 years with a comparison group aged 18-64 years among patients with scrub typhus, murine typhus, or acute Q fever who were serologically confirmed at three hospitals in Taiwan during 2002-2011. Among 441 cases, including 187 cases of scrub typhus, 166 acute Q fever, and 88 murine typhus, 68 (15.4%) cases were elderly patients. The elderly had a higher severe complication rate (10.3% vs. 3.5%, p = 0.022), but did not have a significantly higher mortality rate (1.47% vs. 0.54%, p = 0.396). Compared with those without severe complications, we found the elderly (p = 0.022), dyspnea (p = 0.006), less relative bradycardia (p = 0.004), less febrile illness (p = 0.004), prolonged prothrombin time (PT) (p = 0.002), higher levels of initial C-reactive protein (p = 0.039), blood leukocyte counts (p = 0.01), and lower platelet counts (p = 0.012) are significantly associated with severe complications. Only prolonged prothrombin time was associated with severe complications in multivariate analysis (p = 0.018, CI 95% 0.01-0.66). Among clinical symptoms and laboratory data, multivariate analysis revealed chills was less frequently occurred in the elderly (p = 0.012, 95% confidence interval [CI]: 1.33-9.99). The elderly cases with scrub typhus, murine typhus, or acute Q fever would be more likely to have severe complications, for which prothrombin time prolongation is an important predictor for severe complications. Copyright © 2017. Published by Elsevier B.V.

  11. Accelerated evolutionary rates in tropical and oceanic parmelioid lichens (Ascomycota

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    Blanco Oscar

    2008-09-01

    Full Text Available Abstract Background The rate of nucleotide substitutions is not constant across the Tree of Life, and departures from a molecular clock have been commonly reported. Within parmelioid lichens, the largest group of macrolichens, large discrepancies in branch lengths between clades were found in previous studies. Using an extended taxon sampling, we test for presence of significant rate discrepancies within and between these clades and test our a priori hypothesis that such rate discrepancies may be explained by shifts in moisture regime or other environmental conditions. Results In this paper, the first statistical evidence for accelerated evolutionary rate in lichenized ascomycetes is presented. Our results give clear evidence for a faster rate of evolution in two Hypotrachyna clades that includes species occurring in tropical and oceanic habitats in comparison with clades consisting of species occurring in semi-arid and temperate habitats. Further we explore potential links between evolutionary rates and shifts in habitat by comparing alternative Ornstein-Uhlenbeck models. Conclusion Although there was only weak support for a shift at the base of a second tropical clade, where the observed nucleotide substitution rate is high, overall support for a shift in environmental conditions at cladogenesis is very strong. This suggests that speciation in some lichen clades has proceeded by dispersal into a novel environment, followed by radiation within that environment. We found moderate support for a shift in moisture regime at the base of one tropical clade and a clade occurring in semi-arid regions and a shift in minimum temperature at the base of a boreal-temperate clade.

  12. Identification and assessment of BWR in-vessel severe accident mitigation strategies

    International Nuclear Information System (INIS)

    Hodge, S.A.; Kress, T.S.; Cleveland, J.C.; Petek, M.

    1992-01-01

    This paper briefly describes the results of work carried out in support of the US Nuclear Regulatory Commission Accident Management Research Program to evaluate the effectiveness and feasibility of current and proposed strategies for BWR severe accident management. These results are described in detail in the just-released report Identification and Assessment of BWR In-Vessel Severe Accident Mitigation Strategies, NUREG/CR-5869, which comprises three categories of findings. First, an assessment of the current status of accident management strategies for the mitigation of in-vessel events for BWR severe accident sequences is combined with a review of the BWR Owners' Group Emergency Procedure Guidelines (EPGs) to determine the extent to which they currently address the characteristic events of an unmitigated severe accident. Second, where considered necessary, new candidate accident management strategies are proposed for mitigation of the late-phase (after core damage has occurred) events. Finally, two of the four candidate strategies identified by this effort are assessed in detail. These are (1) preparation of a boron solution for reactor vessel refill should control blade damage occur during a period of temporary core dryout and (2) containment flooding to maintain the core debris within the reactor vessel if the injection systems cannot be restored

  13. Naturally occurring radioactive materials (NORM) in the oil and gas processing and production facilities

    International Nuclear Information System (INIS)

    Najera F, J.

    1994-01-01

    NORM contamination is produced by concentration in petroleum facilities of naturally occurring radioactive materials. The presence of NORM in petroleum reservoirs and in the oil and gas industry has been widely recognized. It's not a critical technical problem if you proceed timely to solve it. NORM is a great but controllable hazard to the human health and the environment, and represents a severe waste management problem. We suggest to the latino american oil companies to conduct studies to detect NORM contamination in their facilities an use to them to plan the appropriate actions to control the situation. (author). 15 refs

  14. Maternity care in the Netherlands: the changing home birth rate.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Keirse, M.J.N.C.

    1998-01-01

    In 1965 two-thirds of all births in The Netherlands occurred at home. In the next 25 years, that situation became reversed with more than two-thirds of births occurring in hospital and fewer than one-third at home. Several factors have influenced that change, including the introduction of short-stay

  15. Exacerbations of asthma - A descriptive study of 425 severe exacerbations

    NARCIS (Netherlands)

    Tattersfield, AE; Postma, DS; Barnes, PJ; Svensson, K; Bauer, CA; O'Byrne, PM; Lofdahl, CG; Pauwels, RA; Ullman, A

    The identification, prevention, and prompt treatment of exacerbations are major objectives of asthma management. We looked at change in PEF, symptoms, and use of rescue p-agonists during the 425 severe exacerbations that occurred during a 12-mo parallel group study (FACET) in which low and high

  16. Hospital differences in rates of cesarean deliveries in the Sardinian region: An observational study

    Directory of Open Access Journals (Sweden)

    Massimo Cannas

    2014-11-01

    Full Text Available Background: The rates of cesarean deliveries have been increasing steadily in several European countries in recent decades, with Italy having the second-highest rate (38% in 2010, causing concern and debate about the appropriateness of many interventions. Moreover, some recent studies suggest that rates of common obstetric interventions are not homogeneous across hospitals, maybe not only because of patient case mix but also possibly because of different hospital practices and cultures. Thus, it is important to investigate whether the variation in rates of cesarean sections can be traced back to patient characteristics or whether it depends upon context variables at the hospital level. Objective and method: Using official hospital abstracts on deliveries that occurred in Sardinia over a two-year period, we implement multilevel logistic regression models in order to assess whether the observed differences in cesarean rates across hospitals can be justified by case-mix differences across hospitals. Results: The between-hospital variation in rates of cesarean delivery is estimated to be 0.388 in the model with only the intercept and 0.382 in the model controlling for the mother’s clinical and sociodemographic characteristics. Conclusions: The results show that taking into account the individual characteristics of delivered mothers is not enough to justify the observed variation across hospital rates, suggesting the important role of unobserved variables at the hospital level in determining cesarean section rates.

  17. Outcome of Acute Pancreatic and Peripancreatic Collections Occurring in Patients With Acute Pancreatitis.

    Science.gov (United States)

    Manrai, Manish; Kochhar, Rakesh; Gupta, Vikas; Yadav, Thakur Deen; Dhaka, Narendra; Kalra, Naveen; Sinha, Saroj K; Khandelwal, Niranjan

    2018-02-01

    To study the outcome of acute collections occurring in patients with acute pancreatitis BACKGROUND:: There are limited data on natural history of acute collections arising after acute pancreatitis (AP). Consecutive patients of AP admitted between July 2011 and December 2012 were evaluated by imaging for development of acute collections as defined by revised Atlanta classification. Imaging was repeated at 1 and 3 months. Spontaneous resolution, evolution, and need for intervention were assessed. Of the 189 patients, 151 patients (79.9%) had acute collections with severe disease and delayed hospitalization being predictors of acute collections. Thirty-six patients had acute interstitial edematous pancreatitis, 8 of whom developed acute peripancreatic fluid collections, of which 1 evolved into pseudocyst. Among the 153 patients with acute necrotizing pancreatitis, 143 (93.4%) developed acute necrotic collection (ANC). Twenty-three of 143 ANC patients died, 21 had resolved collections, whereas 84 developed walled-off necrosis (WON), with necrosis >30% (P = 0.010) and Computed Tomographic Severity Index score ≥7 (P = 0.048) predicting development of WON. Of the 84 patients with WON, 8 expired, 53 patients required an intervention, and 23 were managed conservatively. Independent predictors of any intervention among all patients were Computed Tomographic Severity Index score ≥7 (P 7 days (P = 0.04). Patients with severe AP and delayed hospitalization more often develop acute collections. Pancreatic pseudocysts are a rarity in acute interstitial pancreatitis. A majority of patients with necrotising pancreatitis will develop ANC, more than half of whom will develop WON. Delay in hospitalization and higher baseline necrosis score predict need for intervention.

  18. Injuries observed in a prospective transition from traditional to minimalist footwear: correlation of high impact transient forces and lower injury severity.

    Science.gov (United States)

    Salzler, Matthew J; Kirwan, Hollie J; Scarborough, Donna M; Walker, James T; Guarino, Anthony J; Berkson, Eric M

    2016-11-01

    Minimalist running is increasing in popularity based upon a concept that it can reduce impact forces and decrease injury rates. The purpose of this investigation is to identify the rate and severity of injuries in runners transitioning from traditional to minimalist footwear. The secondary aims were to identify factors correlated with injuries. Fourteen habitually shod (traditional running shoes) participants were enrolled for this prospective study investigating injury prevalence during transition from traditional running shoes to 5-toed minimalist shoes. Participants were uninjured, aged between 22-41 years, and ran at least twenty kilometers per week in traditional running shoes. Participants were given industry recommended guidelines for transition to minimalist footwear and fit with a 5-toed minimalist running shoe. They completed weekly logs for identification of injury, pain using Visual Analogue Scale (VAS), injury location, and severity. Foot strike pattern and impact forces were collected using 3D motion analysis at baseline, 4 weeks, and 12 weeks. Injuries were scored according to a modified Running Injury Severity Score (RISS). Fourteen runners completed weekly training and injury logs over an average of 30 weeks. Twelve of 14 (86%) runners sustained injuries. Average injury onset was 6 weeks (range 1-27 weeks). Average weekly mileage of 23.9 miles/week prior to transition declined to 18.3 miles/week after the transition. The magnitude of the baseline impact transient peak in traditional shoes and in minimalist shoes negatively correlated with RISS scores (r = -0.45, p = 0.055 and r = -0.53, p = 0.026, respectively). High injury rates occurred during the transition from traditional to minimalist footwear. Non-compliance to transition guidelines and high injury rates suggest the need for improved education. High impact transient forces unexpectedly predicted lower modified RISS scores in this population.

  19. Analysis of two different types of hydrogen combustion during severe accidents in a typical pressurized water reactor

    International Nuclear Information System (INIS)

    Ko Yuchih; Lee Min

    2005-01-01

    Hydrogen combustion is an important phenomenon that may occur during severe accidents of Nuclear Power Plants (NPPs). Depending on the specific plant design, the initiating events, and mitigation actions executed, hydrogen combustion may have distinct characteristics and may damage the plant in various degrees. The worst scenario will be the catastrophic failure of containment. In this study two specific types of hydrogen combustion are analyzed to evaluate their impact on the containment integrity. In this paper, Station Blackout (SBO) and Loss of Coolant Accidents (LOCAs) sequences are analyzed using MAAP4 (Modular Accident Analysis Program) code. The former sequence is used to represent hydrogen combustion phenomenon under the condition that the reactor pressure vessel (RPV) breaches at high pressure and the latter sequence represents the phenomenon that RPV fails at low pressure. Two types of hydrogen combustion are observed in the simulation. The Type I hydrogen combustion represents global and instantaneous hydrogen combustion. Large pressure spike is created during the combustion and represents a threat to containment integrity. Type II hydrogen combustion is localized burn and burn continuously over a time period. There is hardly any impact of this type hydrogen burn on the containment pressurization rate. Both types of hydrogen combustion can occur in the severe accidents without any human intervention. From the accident mitigation point of view, operators should try to bring the containment into conditions that favor the Type II hydrogen combustion. (authors)

  20. Myocardial Autophagy after Severe Burn in Rats

    Science.gov (United States)

    Zhang, Qiong; Shi, Xiao-hua; Huang, Yue-sheng

    2012-01-01

    Background Autophagy plays a major role in myocardial ischemia and hypoxia injury. The present study investigated the effects of autophagy on cardiac dysfunction in rats after severe burn. Methods Protein expression of the autophagy markers LC3 and Beclin 1 were determined at 0, 1, 3, 6, and 12 h post-burn in Sprague Dawley rats subjected to 30% total body surface area 3rd degree burns. Autophagic, apoptotic, and oncotic cell death were evaluated in the myocardium at each time point by immunofluorescence. Changes of cardiac function were measured in a Langendorff model of isolated heart at 6 h post-burn, and the autophagic response was measured following activation by Rapamycin and inhibition by 3-methyladenine (3-MA). The angiotensin converting enzyme inhibitor enalaprilat, the angiotensin receptor I blocker losartan, and the reactive oxygen species inhibitor diphenylene iodonium (DPI) were also applied to the ex vivo heart model to examine the roles of these factors in post-burn cardiac function. Results Autophagic cell death was first observed in the myocardium at 3 h post-burn, occurring in 0.008 ± 0.001% of total cardiomyocytes, and continued to increase to a level of 0.022 ± 0.005% by 12 h post-burn. No autophagic cell death was observed in control hearts. Compared with apoptosis, autophagic cell death occurred earlier and in larger quantities. Rapamycin enhanced autophagy and decreased cardiac function in isolated hearts 6 h post-burn, while 3-MA exerted the opposite response. Enalaprilat, losartan, and DPI all inhibited autophagy and enhanced heart function. Conclusion Myocardial autophagy is enhanced in severe burns and autophagic cell death occurred early at 3 h post-burn, which may contribute to post-burn cardiac dysfunction. Angiotensin II and reactive oxygen species may play important roles in this process by regulating cell signaling transduction. PMID:22768082