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Sample records for positive pressure long-term

  1. Effects of continuous positive airway pressure on neurocognitive function in obstructive sleep apnea patients: The Apnea Positive Pressure Long-term Efficacy Study (APPLES).

    Science.gov (United States)

    Kushida, Clete A; Nichols, Deborah A; Holmes, Tyson H; Quan, Stuart F; Walsh, James K; Gottlieb, Daniel J; Simon, Richard D; Guilleminault, Christian; White, David P; Goodwin, James L; Schweitzer, Paula K; Leary, Eileen B; Hyde, Pamela R; Hirshkowitz, Max; Green, Sylvan; McEvoy, Linda K; Chan, Cynthia; Gevins, Alan; Kay, Gary G; Bloch, Daniel A; Crabtree, Tami; Dement, William C

    2012-12-01

    To determine the neurocognitive effects of continuous positive airway pressure (CPAP) therapy on patients with obstructive sleep apnea (OSA). The Apnea Positive Pressure Long-term Efficacy Study (APPLES) was a 6-month, randomized, double-blind, 2-arm, sham-controlled, multicenter trial conducted at 5 U.S. university, hospital, or private practices. Of 1,516 participants enrolled, 1,105 were randomized, and 1,098 participants diagnosed with OSA contributed to the analysis of the primary outcome measures. Active or sham CPAP MEASUREMENTS: THREE NEUROCOGNITIVE VARIABLES, EACH REPRESENTING A NEUROCOGNITIVE DOMAIN: Pathfinder Number Test-Total Time (attention and psychomotor function [A/P]), Buschke Selective Reminding Test-Sum Recall (learning and memory [L/M]), and Sustained Working Memory Test-Overall Mid-Day Score (executive and frontal-lobe function [E/F]) The primary neurocognitive analyses showed a difference between groups for only the E/F variable at the 2 month CPAP visit, but no difference at the 6 month CPAP visit or for the A/P or L/M variables at either the 2 or 6 month visits. When stratified by measures of OSA severity (AHI or oxygen saturation parameters), the primary E/F variable and one secondary E/F neurocognitive variable revealed transient differences between study arms for those with the most severe OSA. Participants in the active CPAP group had a significantly greater ability to remain awake whether measured subjectively by the Epworth Sleepiness Scale or objectively by the maintenance of wakefulness test. CPAP treatment improved both subjectively and objectively measured sleepiness, especially in individuals with severe OSA (AHI > 30). CPAP use resulted in mild, transient improvement in the most sensitive measures of executive and frontal-lobe function for those with severe disease, which suggests the existence of a complex OSA-neurocognitive relationship. Registered at clinicaltrials.gov. Identifier: NCT00051363. Kushida CA; Nichols DA; Holmes

  2. [Intraabdominal fat redistribution in long-term continuous positive airway pressure treatment in obstructive sleep apnea patients].

    Science.gov (United States)

    Català, Raquel; Ferré, Raimón; Sangenís, Sandra; Cabré, Anna; Hernández-Flix, Salvador; Masana, Lluís

    2016-06-03

    Obesity is the main risk factor for obstructive sleep apnoea (OSA). The aim was to evaluate the long-term effect of continuous positive airway pressure (CPAP) on intraabdominal fat distribution in OSA patients. Fifty OSA patients with and 35 without CPAP treatment criteria were followed-up for 2 years. Visceral and subcutaneous adipose tissue (VAT and SAT) and preaortic intraabdominal fat (PIF) were assessed by sonography. In the non CPAP treated group, SAT and VAT mean values didn't change, while a significantly PIF growth was observed (55.19 [23.44] vs. 63.45 [23.94] mm, P=.021). In the CPAP treated group, VAT and PIF mean were not changed, while SAT decreased significantly (11.29 [5.69] vs. 10.47 [5.71] mm, P=.012). Long-term CPAP treatment produces intraabdominal fat redistribution and is associated with an anthropometric profile of lower cardiovascular risk in OSA patients. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  3. Winning market positioning strategies for long term care facilities.

    Science.gov (United States)

    Higgins, L F; Weinstein, K; Arndt, K

    1997-01-01

    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

  4. A novel high pressure, high temperature vessel used to conduct long-term stability measurements of silicon MEMS pressure transducers

    Science.gov (United States)

    Wisniewiski, David

    2014-03-01

    The need to quantify and to improve long-term stability of pressure transducers is a persistent requirement from the aerospace sector. Specifically, the incorporation of real-time pressure monitoring in aircraft landing gear, as exemplified in Tire Pressure Monitoring Systems (TPMS), has placed greater demand on the pressure transducer for improved performance and increased reliability which is manifested in low lifecycle cost and minimal maintenance downtime through fuel savings and increased life of the tire. Piezoresistive (PR) silicon MEMS pressure transducers are the primary choice as a transduction method for this measurement owing to their ability to be designed for the harsh environment seen in aircraft landing gear. However, these pressure transducers are only as valuable as the long-term stability they possess to ensure reliable, real-time monitoring over tens of years. The "heart" of the pressure transducer is the silicon MEMS element, and it is at this basic level where the long-term stability is established and needs to be quantified. A novel High Pressure, High Temperature (HPHT) vessel has been designed and constructed to facilitate this critical measurement of the silicon MEMS element directly through a process of mechanically "floating" the silicon MEMS element while being subjected to the extreme environments of pressure and temperature, simultaneously. Furthermore, the HPHT vessel is scalable to permit up to fifty specimens to be tested at one time to provide a statistically significant data population on which to draw reasonable conclusions on long-term stability. With the knowledge gained on the silicon MEMS element, higher level assembly to the pressure transducer envelope package can also be quantified as to the build-effects contribution to long-term stability in the same HPHT vessel due to its accommodating size. Accordingly, a HPHT vessel offering multiple levels of configurability and robustness in data measurement is presented, along

  5. Long-term Outcomes After Flap Reconstruction in Pediatric Pressure Ulcers.

    Science.gov (United States)

    Firriolo, Joseph M; Ganske, Ingrid M; Pike, Carolyn M; Caillouette, Catherine; Faulkner, Heather R; Upton, Joseph; Labow, Brian I

    2018-02-01

    Pressure ulcers refractory to nonoperative management may undergo flap reconstruction. This study aims to evaluate the long-term outcomes and recurrence rates of flap reconstruction for pediatric pressure ulcers. We reviewed the records of patients who underwent flap reconstruction for pressure ulcer(s) from 1995 to 2013. Twenty-four patients with 30 pressure ulcers, requiring 52 flaps were included. Ulcers were stages III and IV and mostly involved either the ischia (15/30) or sacrum (8/30). Flaps were followed for a median of 4.9 years. Twenty-three patients were wheelchair dependent, and 20 had sensory impairment at their ulcer site(s). Ten patients had a history of noncompliance with preoperative management, 8 of whom experienced ulcer recurrence. Twenty-one ulcers had underlying osteomyelitis, associated with increased admissions (P = 0.019) and cumulative length of stay (P = 0.031). Overall, there was a 42% recurrence rate in ulceration after flap reconstruction. Recurrence was associated with a preoperative history of noncompliance with nonoperative therapy (P = 0.030), but not with flap type or location, age, sex, body mass index, osteomyelitis, or urinary/fecal incontinence (P > 0.05, all). Flap reconstruction can be beneficial in the management of pediatric pressure ulcers. Although high rates of long-term success with this intervention have been reported in children, we found rates of ulcer recurrence similar to that seen in adults. Poor compliance with nonoperative care and failure to modify the biopsychosocial perpetuators of pressure ulcers will likely eventuate in postoperative recurrence. Despite the many comorbidities observed in our patient sample, compliance was the best indicator of long-term skin integrity and flap success.

  6. Continuous positive airway pressure therapy: new generations.

    LENUS (Irish Health Repository)

    Garvey, John F

    2010-02-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS). However, CPAP is not tolerated by all patients with OSAS and alternative modes of pressure delivery have been developed to overcome pressure intolerance, thereby improving patient comfort and adherence. Auto-adjustable positive airway pressure (APAP) devices may be utilised for the long-term management of OSAS and may also assist in the initial diagnosis of OSAS and titration of conventional CPAP therapy. Newer modalities such as C-Flex and A-Flex also show promise as treatment options in the future. However, the evidence supporting the use of these alternative modalities remains scant, in particular with regard to long-term cardiovascular outcomes. In addition, not all APAP devices use the same technological algorithms and data supporting individual APAP devices cannot be extrapolated to support all. Further studies are required to validate the roles of APAP, C-Flex and A-Flex. In the interim, standard CPAP therapy should continue as the mainstay of OSAS management.

  7. Continuous positive airway pressure therapy: new generations.

    LENUS (Irish Health Repository)

    Garvey, John F

    2012-02-01

    Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS). However, CPAP is not tolerated by all patients with OSAS and alternative modes of pressure delivery have been developed to overcome pressure intolerance, thereby improving patient comfort and adherence. Auto-adjustable positive airway pressure (APAP) devices may be utilised for the long-term management of OSAS and may also assist in the initial diagnosis of OSAS and titration of conventional CPAP therapy. Newer modalities such as C-Flex and A-Flex also show promise as treatment options in the future. However, the evidence supporting the use of these alternative modalities remains scant, in particular with regard to long-term cardiovascular outcomes. In addition, not all APAP devices use the same technological algorithms and data supporting individual APAP devices cannot be extrapolated to support all. Further studies are required to validate the roles of APAP, C-Flex and A-Flex. In the interim, standard CPAP therapy should continue as the mainstay of OSAS management.

  8. Exploration of life experiences of positive growth in long-term childhood cancer survivors.

    Science.gov (United States)

    Kim, Yoonjung

    2017-10-01

    The aim of this study was to explore experiences of positive growth in long-term childhood cancer survivors, from their perspective. Fifteen long-term survivors of childhood cancer provided descriptions of their experiences. Data were collected through face-to-face interviews and the analysis was based on Giorgi's phenomenological research method. The analysis of positive growth experienced by long-term childhood cancer survivors revealed three themes: self-directed life, normalcy in life, and inner maturity. Long-term survivors defined positive growth as a successful transition to a self-satisfactory life based on motivation acquired through their cancer experience and on subjective goal-setting, as well as becoming cancer-free and living a normal life within society. They seemed to have acquired optimistic, flexible, active attitudes toward life while demonstrating profound gratefulness and consideration of people around them, as well as prudent approaches to health. The findings of this study verified that long-term survivors of childhood cancer have grown positively due to their negative past experience. We expect these findings to contribute to the development of programs that promote positive growth in long-term childhood cancer survivors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The effect of positive and negative message framing on short term continuous positive airway pressure compliance in patients with obstructive sleep apnea.

    Science.gov (United States)

    Pengo, Martino F; Czaban, Marcin; Berry, Marc P; Nirmalan, Prajeshan; Brown, Richard; Birdseye, Adam; Woroszyl, Asia; Chapman, Julia; Kent, Brian D; Hart, Nicholas; Rossi, Gian Paolo; Steier, Joerg

    2018-01-01

    Continuous positive airway pressure (CPAP), the best available treatment for obstructive sleep apnea (OSA), requires long-term compliance to be effective. Behavioral interventions may be used to improve adherence to CPAP. We aimed to investigate whether positive or negative message framing impacts on CPAP compliance in patients with OSA, when compared to standard care. Consenting patients with confirmed OSA were randomly allocated to receive along with their CPAP either positively or negatively framed messages (Pos; Neg), or standard care (Con). Standardized motivational messages were read out to patients during an initial teaching session and through weekly telephone calls. Patients' compliance data were reviewed 2 and 6 weeks following CPAP initiation. We randomized 112 patients to groups that were matched for age, BMI, and OSA severity. The positively framed group (Pos) showed greater CPAP usage after 2 weeks (total use 53.7±31.4 hours) as compared to the negatively framed and the control group (35.6±27.4 and 40.8±33.5 hours, Pframed groups (Pos n=5; Neg n=8; Con n=11; Pframed messages can improve CPAP adherence in patients with OSA in the short-term; however, strategies for implementing its long-term use need to be developed.

  10. Long-term follow-up of high-pressure injection injuries to the hand

    NARCIS (Netherlands)

    Wieder, Anat; Lapid, Oren; Plakht, Ygal; Sagi, Amiram

    2006-01-01

    High-pressure injection injury is an injury caused by accidental injection of substances by industrial equipment. This injury may have devastating sequelae. The goal of this study was to assess the long-term outcome of high-pressure injection injury to the hand. In this historical prospective study,

  11. A computational analysis of the long-term regulation of arterial pressure.

    Science.gov (United States)

    Beard, Daniel A; Pettersen, Klas H; Carlson, Brian E; Omholt, Stig W; Bugenhagen, Scott M

    2013-01-01

    The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production-the acute pressure-diuresis and pressure-natriuresis curves-physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the "Guyton-Coleman model", no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. representing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  12. Insomnia complaints in lean patients with obstructive sleep apnea negatively affect positive airway pressure treatment adherence.

    Science.gov (United States)

    Eysteinsdottir, Bjorg; Gislason, Thorarinn; Pack, Allan I; Benediktsdottir, Bryndís; Arnardottir, Erna S; Kuna, Samuel T; Björnsdottir, Erla

    2017-04-01

    The objective of this study was to evaluate the determinants of long-term adherence to positive airway pressure treatment among patients with obstructive sleep apnea, with special emphasis on patients who stop positive airway pressure treatment within 1 year. This is a prospective long-term follow-up of subjects in the Icelandic Sleep Apnea Cohort who were diagnosed with obstructive sleep apnea between 2005 and 2009, and started on positive airway pressure treatment. In October 2014, positive airway pressure adherence was obtained by systematically evaluating available clinical files (n = 796; 644 males, 152 females) with moderate to severe obstructive sleep apnea (apnea-hypopnea index ≥15 events per h). The mean follow-up time was 6.7 ± 1.2 years. In total, 123 subjects (15.5%) returned their positive airway pressure device within the first year, 170 (21.4%) returned it later and 503 (63.2%) were still using positive airway pressure. The quitters within the first year had lower body mass index, milder obstructive sleep apnea, less sleepiness, and more often had symptoms of initial and late insomnia compared with long-term positive airway pressure users at baseline. Both initial and late insomnia were after adjustment still significantly associated with being an early quitter among subjects with body mass index insomnia are associated with early quitting on positive airway pressure among non-obese subjects. © 2016 European Sleep Research Society.

  13. Hepatic Venous Pressure Gradient Predicts Long-Term Mortality in Patients with Decompensated Cirrhosis

    Science.gov (United States)

    Kim, Tae Yeob; Lee, Jae Gon; Kim, Ji Yeoun; Kim, Sun Min; Kim, Jinoo; Jeong, Woo Kyoung

    2016-01-01

    Purpose The present study aimed to investigate the role of hepatic venous pressure gradient (HVPG) for prediction of long-term mortality in patients with decompensated cirrhosis. Materials and Methods Clinical data from 97 non-critically-ill cirrhotic patients with HVPG measurements were retrospectively and consecutively collected between 2009 and 2012. Patients were classified according to clinical stages and presence of ascites. The prognostic accuracy of HVPG for death, survival curves, and hazard ratios were analyzed. Results During a median follow-up of 24 (interquartile range, 13-36) months, 22 patients (22.7%) died. The area under the receiver operating characteristics curves of HVPG for predicting 1-year, 2-year, and overall mortality were 0.801, 0.737, and 0.687, respectively (all p17 mm Hg, respectively (p=0.015). In the ascites group, the mortality rates at 1 and 2 years were 3.9% and 17.6% with HVPG ≤17 mm Hg and 17.5% and 35.2% with HVPG >17 mm Hg, respectively (p=0.044). Regarding the risk factors for mortality, both HVPG and model for end-stage liver disease were positively related with long-term mortality in all patients. Particularly, for the patients with ascites, both prothrombin time and HVPG were independent risk factors for predicting poor outcomes. Conclusion HVPG is useful for predicting the long-term mortality in patients with decompensated cirrhosis, especially in the presence of ascites. PMID:26632394

  14. Influence of marital status and employment status on long-term adherence with continuous positive airway pressure in sleep apnea patients.

    Science.gov (United States)

    Gagnadoux, Frédéric; Le Vaillant, Marc; Goupil, François; Pigeanne, Thierry; Chollet, Sylvaine; Masson, Philippe; Humeau, Marie-Pierre; Bizieux-Thaminy, Acya; Meslier, Nicole

    2011-01-01

    Long-term adherence is a major issue in patients receiving home continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea-hypopnea syndrome (OSAHS). In a multicenter prospective cohort (the Institut de Recherche en Santé Respiratoire des Pays de la Loire [IRSR] sleep cohort) of consecutive OSAHS patients in whom CPAP had been prescribed for at least 90 days, we studied the impact on long-term treatment adherence of socioeconomic factors, patients and disease characteristics prior to CPAP initiation. Among 1,141 patients in whom CPAP had been prescribed for an average of 504±251 days (range: 91 to 1035), 674 (59%) were adherent with a mean daily use of CPAP≥4 h (mean: 6.42±1.35 h). Stepwise regression analysis identified 4 independent factors of CPAP adherence including apnea-hypopnea index (AHI) (OR: 1.549, 95%CI 1.163 to 2.062 for AHI≥30 vs. AHIstatus (OR: 1.414, 95%CI 1.097-1.821 for retired vs. employed; p = 0.007) and marital status (OR: 1.482, 95%CI 1.088-2.019 for married or living as a couple vs. living alone; p = 0.01). Age, gender, Epworth sleepiness scale, depressive syndrome, associated cardiovascular morbidities, educational attainment and occupation category did not influence CPAP adherence. Marital status and employment status are independent factors of CPAP adherence in addition to BMI and disease severity. Patients living alone and/or working patients are at greater risk of non-adherence, whereas adherence is higher in married and retired patients. These findings suggest that the social context of daily life should be taken into account in risk screening for CPAP non-adherence. Future interventional studies targeting at-risk patients should be designed to address social motivating factors and work-related barriers to CPAP adherence.

  15. The Association between Malnutrition and Pressure Ulcers in Elderly in Long-Term Care Facility

    Directory of Open Access Journals (Sweden)

    Lenche Neloska

    2016-08-01

    Full Text Available BACKGROUND: Malnutrition is common in elderly and is a risk factor for pressure ulcers. AIM: The aim of the present study was to determine the prevalence of malnutrition in geriatric and palliative patients hospitalised in long-term care facility, and to examine the influence of nutritional status on the prevalence of pressure ulcers (PU. MATERIAL AND METHODS: Descriptive, observational and cross-sectional study including 2099 patients admitted to the Hospital during a 24 month period (January 2013 to December 2014. We recorded: demographic data, body mass index (BMI, Braden score, laboratory parameters of interest (albumin, total protein, RBC count, haemoglobin and iron levels and presence or absence of malnutrition and pressure ulcers. RESULTS: The pressure ulcer prevalence was 12.9% (256 out of 2099. Based on the BMI classification, 61.7% of patients had a good nutritional status, 27.4% were undernourished, and 2.1% were considered malnourished. Nutritional status was statistically significantly different between patients with and without PU (p < 0.0001. This study also showed that hypoproteinemia, hypoalbuminemia, low RBC was positively associated with PU prevalence. CONCLUSION: The results highlight the impact of nutritional status on the prevalence of pressure ulcers in hospitalised geriatric and palliative population. It is of paramount importance to correctly evaluate the presence of malnutrition in patients at risk of pressure ulcers.

  16. Long-term impact of sales promotion on brand image

    Directory of Open Access Journals (Sweden)

    Danijela Mandić

    2009-12-01

    Full Text Available Sales promotion (SP is an inevitable tool in the marketing communications mix, especially in the FMCG markets, due to pressures such as retailers’ growing demands and increasing competition. This has proven to be an issue for many companies, especially those with a premium brand positioning and those concerned about the impact that SP might have on the long-term image of the company. Despite the fact that literature is replete with research on SP, it seems to be vastly generalized and mostly focused on price reductions. Thus, this paper aims to analyze and discuss the issue of the long-term impact that SP has on companies, especially on premium brands in the FMCG markets. It concludes that, when used properly and strategically, SP may have a positive long-term impact on brands.

  17. Effects of long-term low atmospheric pressure on gas exchange and growth of lettuce

    Science.gov (United States)

    Tang, Yongkang; Guo, Shuangsheng; Dong, Wenping; Qin, Lifeng; Ai, Weidang; Lin, Shan

    2010-09-01

    The objectives of this research were to determine photosynthesis, evapotranspiration and growth of lettuce at long-term low atmospheric pressure. Lettuce ( Lactuca sativa L . cv. Youmaicai) plants were grown at 40 kPa total pressure (8.4 kPa p) or 101 kPa total pressure (20.9 kPa p) from seed to harvest for 35 days. Germination rate of lettuce seeds decreased by 7.6% at low pressure, although this was not significant. There was no significant difference in crop photosynthetic rate between hypobaria and ambient pressure during the 35-day study. The crop evapotranspiration rate was significantly lower at low pressure than that at ambient pressure from 20 to 30 days after planting (DAP), but it had no significant difference before 20 DAP or after 30 DAP. The growth cycle of lettuce plants at low pressure was delayed. At low pressure, lettuce leaves were curly at the seedling stage and this disappeared gradually as the plants grew. Ambient lettuce plants were yellow and had an epinastic growth at harvest. The shoot height, leaf number, leaf length and shoot/root ratio were lower at low pressure than those at ambient pressure, while leaf area and root growth increased. Total biomass of lettuce plants grown at two pressures had no significant difference. Ethylene production at low pressure decreased significantly by 38.8% compared with ambient pressure. There was no significant difference in microelements, nutritional phytochemicals and nitrate concentrations at the two treatments. This research shows that lettuce can be grown at long-term low pressure (40 kPa) without significant adverse effects on seed germination, gas exchange and plant growth. Furthermore, ethylene release was reduced in hypobaria.

  18. Long-term neuromuscular training and ankle joint position sense.

    Science.gov (United States)

    Kynsburg, A; Pánics, G; Halasi, T

    2010-06-01

    Preventive effect of proprioceptive training is proven by decreasing injury incidence, but its proprioceptive mechanism is not. Major hypothesis: the training has a positive long-term effect on ankle joint position sense in athletes of a high-risk sport (handball). Ten elite-level female handball-players represented the intervention group (training-group), 10 healthy athletes of other sports formed the control-group. Proprioceptive training was incorporated into the regular training regimen of the training-group. Ankle joint position sense function was measured with the "slope-box" test, first described by Robbins et al. Testing was performed one day before the intervention and 20 months later. Mean absolute estimate errors were processed for statistical analysis. Proprioceptive sensory function improved regarding all four directions with a high significance (pneuromuscular training has improved ankle joint position sense function in the investigated athletes. This joint position sense improvement can be one of the explanations for injury rate reduction effect of neuromuscular training.

  19. Continuous Positive Airway Pressure Strategies with Bubble Nasal Continuous Positive Airway Pressure: Not All Bubbling Is the Same: The Seattle Positive Airway Pressure System.

    Science.gov (United States)

    Welty, Stephen E

    2016-12-01

    Premature neonates are predisposed to complications, including bronchopulmonary dysplasia (BPD). BPD is associated with long-term pulmonary and neurodevelopmental consequences. Noninvasive respiratory support with nasal continuous positive airway pressure (CPAP) has been recommended strongly by the American Academy of Pediatrics. However, CPAP implementation has shown at least a 50% failure rate. Enhancing nasal CPAP effectiveness may decrease the need for mechanical ventilation and reduce the incidence of BPD. Bubble nasal CPAP is better than nasal CPAP using mechanical devices and the bubbling provides air exchange in distal respiratory units. The Seattle PAP system reduces parameters that assess work of breathing. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Preventing pressure ulcers in long-term care: a cost-effectiveness analysis.

    Science.gov (United States)

    Pham, Ba'; Stern, Anita; Chen, Wendong; Sander, Beate; John-Baptiste, Ava; Thein, Hla-Hla; Gomes, Tara; Wodchis, Walter P; Bayoumi, Ahmed; Machado, Márcio; Carcone, Steven; Krahn, Murray

    2011-11-14

    Pressure ulcers are common in many care settings, with adverse health outcomes and high treatment costs. We evaluated the cost-effectiveness of evidence-based strategies to improve current prevention practice in long-term care facilities. We used a validated Markov model to compare current prevention practice with the following 4 quality improvement strategies: (1) pressure redistribution mattresses for all residents, (2) oral nutritional supplements for high-risk residents with recent weight loss, (3) skin emollients for high-risk residents with dry skin, and (4) foam cleansing for high-risk residents requiring incontinence care. Primary outcomes included lifetime risk of stage 2 to 4 pressure ulcers, quality-adjusted life-years (QALYs), and lifetime costs, calculated according to a single health care payer's perspective and expressed in 2009 Canadian dollars (Can$1 = US$0.84). Strategies cost on average $11.66 per resident per week. They reduced lifetime risk; the associated number needed to treat was 45 (strategy 1), 63 (strategy 4), 158 (strategy 3), and 333 (strategy 2). Strategy 1 and 4 minimally improved QALYs and reduced the mean lifetime cost by $115 and $179 per resident, respectively. The cost per QALY gained was approximately $78 000 for strategy 3 and $7.8 million for strategy 2. If decision makers are willing to pay up to $50 000 for 1 QALY gained, the probability that improving prevention is cost-effective is 94% (strategy 4), 82% (strategy 1), 43% (strategy 3), and 1% (strategy 2). The clinical and economic evidence supports pressure redistribution mattresses for all long-term care residents. Improving prevention with perineal foam cleansers and dry skin emollients appears to be cost-effective, but firm conclusions are limited by the available clinical evidence.

  1. Parylene-on-oil packaging for long-term implantable pressure sensors.

    Science.gov (United States)

    Shapero, Aubrey M; Liu, Yang; Tai, Yu-Chong

    2016-08-01

    This paper reports and analyzes the feasibility study of a parylene-on-oil encapsulation packaging method of pressure sensors targeted for long-term implantation. Commercial barometric digital-output pressure sensors are enclosed in silicone oil and then encapsulated in situ with parylene-C or -D (PA-C, PA-D) chemical vapor deposition. Experimentally, sensors encapsulated with 30,000 cSt silicone oil and 27 μm PA-D show good performance for 6 weeks in 77 °C saline with >99 % of original sensitivity, corresponding to an extrapolated lifetime of around 21 months in 37 °C saline. This work shows that, with proper designs, such a packaging method can preserve the original pressure sensor sensitivity without offset, validated throughout accelerated lifetime tests. In experiments, wires on the prototypes are used for external electronics but it is found that they contributed to early failures, which would be absent in real wireless versions, indicating a potential for even longer lifetimes. Finally, a verified model is presented to predict the pressure sensor sensitivity of parylene-on-oil packaging with and without the presence of a bubble in the oil.

  2. Short- and long-term memory contributions to immediate serial recognition: evidence from serial position effects.

    Science.gov (United States)

    Purser, Harry; Jarrold, Christopher

    2010-04-01

    A long-standing body of research supports the existence of separable short- and long-term memory systems, relying on phonological and semantic codes, respectively. The aim of the current study was to measure the contribution of long-term knowledge to short-term memory performance by looking for evidence of phonologically and semantically coded storage within a short-term recognition task, among developmental samples. Each experimental trial presented 4-item lists. In Experiment 1 typically developing children aged 5 to 6 years old showed evidence of phonologically coded storage across all 4 serial positions, but evidence of semantically coded storage at Serial Positions 1 and 2. In a further experiment, a group of individuals with Down syndrome was investigated as a test case that might be expected to use semantic coding to support short-term storage, but these participants showed no evidence of semantically coded storage and evidenced phonologically coded storage only at Serial Position 4, suggesting that individuals with Down syndrome have a verbal short-term memory capacity of 1 item. Our results suggest that previous evidence of semantic effects on "short-term memory performance" does not reflect semantic coding in short-term memory itself, and provide an experimental method for researchers wishing to take a relatively pure measure of verbal short-term memory capacity, in cases where rehearsal is unlikely.

  3. Update: Non-Invasive Positive Pressure Ventilation in Chronic Respiratory Failure Due to COPD.

    Science.gov (United States)

    Altintas, Nejat

    2016-01-01

    Long-term non-invasive positive pressure ventilation (NPPV) has widely been accepted to treat chronic hypercapnic respiratory failure arising from different etiologies. Although the survival benefits provided by long-term NPPV in individuals with restrictive thoracic disorders or stable, slowly-progressing neuromuscular disorders are overwhelming, the benefits provided by long-term NPPV in patients with chronic obstructive pulmonary disease (COPD) remain under question, due to a lack of convincing evidence in the literature. In addition, long-term NPPV reportedly failed in the classic trials to improve important physiological parameters such as arterial blood gases, which might serve as an explanation as to why long-term NPPV has not been shown to substantially impact on survival. However, high intensity NPPV (HI-NPPV) using controlled NPPV with the highest possible inspiratory pressures tolerated by the patient has recently been described as a new and promising approach that is well-tolerated and is also capable of improving important physiological parameters such as arterial blood gases and lung function. This clearly contrasts with the conventional approach of low-intensity NPPV (LI-NPPV) that uses considerably lower inspiratory pressures with assisted forms of NPPV. Importantly, HI-NPPV was very recently shown to be superior to LI-NPPV in terms of improved overnight blood gases, and was also better tolerated than LI-NPPV. Furthermore, HI-NPPV, but not LI-NPPV, improved dyspnea, lung function and disease-specific aspects of health-related quality of life. A recent study showed that long-term treatment with NPPV with increased ventilatory pressures that reduced hypercapnia was associated with significant and sustained improvements in overall mortality. Thus, long-term NPPV seems to offer important benefits in this patient group, but the treatment success might be dependent on effective ventilatory strategies.

  4. C. elegans positive butanone learning, short-term, and long-term associative memory assays.

    Science.gov (United States)

    Kauffman, Amanda; Parsons, Lance; Stein, Geneva; Wills, Airon; Kaletsky, Rachel; Murphy, Coleen

    2011-03-11

    The memory of experiences and learned information is critical for organisms to make choices that aid their survival. C. elegans navigates its environment through neuron-specific detection of food and chemical odors, and can associate nutritive states with chemical odors, temperature, and the pathogenicity of a food source. Here, we describe assays of C. elegans associative learning and short- and long-term associative memory. We modified an aversive olfactory learning paradigm to instead produce a positive response; the assay involves starving ~400 worms, then feeding the worms in the presence of the AWC neuron-sensed volatile chemoattractant butanone at a concentration that elicits a low chemotactic index (similar to Toroyama et al.). A standard population chemotaxis assay1 tests the worms' attraction to the odorant immediately or minutes to hours after conditioning. After conditioning, wild-type animals' chemotaxis to butanone increases ~0.6 Chemotaxis Index units, its "Learning Index". Associative learning is dependent on the presence of both food and butanone during training. Pairing food and butanone for a single conditioning period ("massed training") produces short-term associative memory that lasts ~2 hours. Multiple conditioning periods with rest periods between ("spaced training") yields long-term associative memory (long-term memory across species. Our protocol also includes image analysis methods for quick and accurate determination of chemotaxis indices. High-contrast images of animals on chemotaxis assay plates are captured and analyzed by worm counting software in MatLab. The software corrects for uneven background using a morphological tophat transformation. Otsu's method is then used to determine a threshold to separate worms from the background. Very small particles are removed automatically and larger non-worm regions (plate edges or agar punches) are removed by manual selection. The software then estimates the size of single worm by ignoring

  5. Longitudinal variation in pressure injury incidence among long-term aged care facilities.

    Science.gov (United States)

    Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Westbrook, Johanna I

    2018-05-04

    To examine variation in pressure injury (PI) incidence among long-term aged care facilities and identify resident- and facility-level factors that explain this variation. Longitudinal incidence study using routinely-collected electronic care management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. About 6556 people aged 65 years and older who were permanent residents in 60 long-term care facilities between December 2014 and November 2016. Risk-adjusted PI incidence rates over eight study quarters. Incidence density over the study period was 1.33 pressure injuries per 1000 resident days (95% confidence interval (CI) = 1.29-1.37). Funnel plots were used to identify variation among facilities. On average, 14% of facilities had risk-adjusted PI rates that were higher than expected in each quarter (above 95% funnel plot control limits). Ten percent of facilities had persistently high rates in any three or more consecutive quarters (n = 6). The variation between facilities was only partly explained by resident characteristics in multilevel regression models. Residents were more likely to have higher-pressure injury rates in facilities in regional areas compared with major city areas (adjusted incidence rate ratio = 1.25, 95% CI = 1.04-1.51), and facilities with persistently high rates were more likely to be located in areas with low socioeconomic status (P = 0.038). There is considerable variation among facilities in PI incidence. This study demonstrates the potential of routinely-collected care management data to monitor PI incidence and to identify facilities that may benefit from targeted intervention.

  6. National Strength and Conditioning Association Position Statement on Long-Term Athletic Development.

    Science.gov (United States)

    Lloyd, Rhodri S; Cronin, John B; Faigenbaum, Avery D; Haff, G Gregory; Howard, Rick; Kraemer, William J; Micheli, Lyle J; Myer, Gregory D; Oliver, Jon L

    2016-06-01

    There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize

  7. Right ventricular pacemaker lead position is associated with differences in long-term outcomes and complications.

    Science.gov (United States)

    Witt, Chance M; Lenz, Charles J; Shih, Henry H; Ebrille, Elisa; Rosenbaum, Andrew N; van Zyl, Martin; Aung, Htin; Manocha, Kevin K; Deshmukh, Abhishek J; Hodge, David O; Mulpuru, Siva K; Cha, Yong-Mei; Espinosa, Raul E; Asirvatham, Samuel J; Mcleod, Christopher J

    2017-08-01

    Cardiac pacing from the right ventricular apex is associated with detrimental long-term effects and nonapical pacing locations may be associated with improved outcomes. There is little data regarding complications with nonapical lead positions. The aim of this study was to assess long-term outcomes and lead-related complications associated with differing ventricular lead tip position. All adult patients who underwent dual-chamber pacemaker implantation from 2004 to 2014 were included if they had postprocedure chest radiographs amenable to lead position determination. Long-term outcomes and lead-related complication rates were recorded. These were compared at 5 years between: (1) apical and septal leads, (2) apical and nonseptal nonapical (NSNA), and (3) apical and septal with >40% ventricular pacing. We retrospectively evaluated 3,450 patients, which included 238 with a septal position and 733 with NSNA lead positions. Septal lead position was associated with a lower mortality compared to apical leads (24% vs. 31%, P = 0.02). In patients with greater than 40% pacing, septal leads were associated with significantly higher rates of incident atrial fibrillation compared to apical leads (49% vs. 34%, P = 0.04). NSNA positions were associated with a significantly higher rate of lead dislodgement (4% vs. 2%, P = 0.005) and need for revision (8% vs. 5%, P = 0.005). Septal pacemaker lead position is associated with a lower mortality compared to apically placed leads, but a higher incidence of atrial fibrillation with higher percentage ventricular pacing. NSNA lead locations are associated with more complications and should be avoided. © 2017 Wiley Periodicals, Inc.

  8. Long-term use of neonatal helmet-CPAP: a case report.

    Science.gov (United States)

    Doglioni, N; Micaglio, M; Zanardo, V; Trevisanuto, D

    2009-12-01

    In a recent short-term physiological study, we demonstrated a new continuous positive airway pressure (CPAP) system (neonatal helmet-CPAP) that could be a feasible device for managing preterm infants needing continuous distending pressure with better tolerability than nasal-CPAP. However, its application for a long-term period has never been reported in neonates. Here, we describe the use of neonatal helmet-CPAP in a neonate with persistent pulmonary hypertension of the newborn. Twenty minutes after neonatal helmet-CPAP placement, the baseline post-ductal tcSaO2 (66%) and alveolar-arterial gradient O2 improved from 66% and 648 mmHg to 100% and 465 mmHg, respectively. The neonatal helmet-CPAP was applied for 48 hours and was well-tolerated by the patient without complications. Long-term use of neonatal helmet-CPAP appears feasible and well-tolerated. Comparative trials are needed.

  9. Modelling of long-term and short-term mechanisms of arterial pressure control in the cardiovascular system: an object-oriented approach.

    Science.gov (United States)

    Fernandez de Canete, J; Luque, J; Barbancho, J; Munoz, V

    2014-04-01

    A mathematical model that provides an overall description of both the short- and long-term mechanisms of arterial pressure regulation is presented. Short-term control is exerted through the baroreceptor reflex while renal elimination plays a role in long-term control. Both mechanisms operate in an integrated way over the compartmental model of the cardiovascular system. The whole system was modelled in MODELICA, which uses a hierarchical object-oriented modelling strategy, under the DYMOLA simulation environment. The performance of the controlled system was analysed by simulation in light of the existing hypothesis and validation tests previously performed with physiological data, demonstrating the effectiveness of both regulation mechanisms under physiological and pathological conditions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care.

    Science.gov (United States)

    Yap, Tracey L; Kennerly, Susan M; Bergstrom, Nancy; Hudak, Sandra L; Horn, Susan D

    2016-01-01

    Pressure ulcers have consistently resisted prevention efforts in long-term care facilities nationwide. Recent research has described cueing innovations that-when selected according to the assumptions and resources of particular facilities-support best practices of pressure ulcer prevention. This article synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a pressure ulcer prevention program.

  11. Long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores.

    Science.gov (United States)

    Lin, Haodong; Hou, Chunlin; Chen, Aimin; Xu, Zhen

    2010-08-01

    Among the many difficult problems presented by patients with spinal cord injuries, management of ischial pressure ulcers remains challenging for reconstructive surgeons. This study describes the long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores. Between January 1999 and June 2003, 12 patients with ischial sores were enrolled in this study. All the patients underwent early aggressive surgical debridement followed by surgical reconstruction with a laterally based posterior-thigh fasciocutaneous flap. The follow-up period ranged from 24 months to 97 months (mean, 62 months). All the flaps survived, and there were no partial flap losses. Primary-wound healing occurred in all the cases. In two patients, Grade II ischial pressure sores recurred 24 months and 27 months after the operation. There was no recurrence in the other 10 patients. The posterior-thigh fasciocutaneous pedicled flap was a good method for treating ischial bed sores. This flap could be used to treat recurrences observed after primary bed-sore treatment with other methods. The flap was easy to raise, and it did not cause any donor-site morbidity. The long-term outcome of using posterior-thigh fasciocutaneous flaps for the treatment of ischial pressure sores was generally good. (c) Thieme Medical Publishers.

  12. Delivery room continuous positive airway pressure and early pneumothorax in term newborn infants.

    Science.gov (United States)

    Clevenger, L; Britton, J R

    2017-01-01

    To assess the association between delivery room (DR) continuous positive airway pressure (CPAP) and pneumothorax (PT) in term newborns. Two studies performed in community hospitals used data extracted from computerized records of term newborns. Infants receiving positive pressure ventilation in the DR were excluded. Tabulated data included receipt of DR CPAP, PT on the day of birth, and gestational age (GA). In a case-control study from 2001-2013, infants with PT were compared to controls without PT but with respiratory distress or hypoxia persisting from birth for receipt of DR CPAP. In a cohort study from 2014-2016, infants receiving and not receiving DR CPAP were compared for the incidence of PT. In the case-control study, data were obtained for 169 cases and 850 controls. Compared to controls, PT infants were more likely to have received DR CPAP (16.8% vs. 40.2%, respectively, P CPAP (Adjusted Odds Ratio [AOR] = 3.30, 95% confidence interval [CI] = 2.31, 4.72, P CPAP and 4.8% of 228 infants receiving DR CPAP (P CPAP significantly predicted PT (OR = 59.59, 95% CI = 23.34, 147.12, P CPAP in delivery rooms are associated with increased risk of PT. A cause-and-effect relationship between CPAP and PT cannot be claimed in this study. Further research is needed to better understand this relationship.

  13. Long-term ageing effects in reactor pressure vessel steels investigated by positron annihilation spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Butterling, Maik; Anwand, Wolfgang; Wagner, Andreas [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiation Physics, Dresden (Germany); Bergner, Frank; Ulbricht, Andreas; Wagner, Arne [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Ion Beam Physics and Materials Research, Dresden (Germany)

    2014-07-01

    Neutron irradiation of reactor pressure vessel steels leads to the formation of nano-sized defects which can deteriorate the material. An understanding of the microstructural evolution of the material is important for making reliable security assessments about possible future long-term operation of nuclear power plants. So-called late-blooming phases are formed after long-term irradiation and lead to considerable material ageing effects. Encouraging factors for the formation of these phases are a low Cu-content, moderate to high contents of Mn and Ni, low irradiation temperatures and different neutron fluxes. Positron annihilation lifetime spectroscopy which is ideally suited for the detection and characterization of these irradiation-induced defects was applied for different selected materials which fulfill these conditions in order to investigate the occurrence and behavior of these phases.

  14. Short-Term and Long-Term Forecasting for the 3D Point Position Changing by Using Artificial Neural Networks

    Directory of Open Access Journals (Sweden)

    Eleni-Georgia Alevizakou

    2018-03-01

    Full Text Available Forecasting is one of the most growing areas in most sciences attracting the attention of many researchers for more extensive study. Therefore, the goal of this study is to develop an integrated forecasting methodology based on an Artificial Neural Network (ANN, which is a modern and attractive intelligent technique. The final result is to provide short-term and long-term forecasts for point position changing, i.e., the displacement or deformation of the surface they belong to. The motivation was the combination of two thoughts, the insertion of the forecasting concept in Geodesy as in the most scientific disciplines (e.g., Economics, Medicine and the desire to know the future position of any point on a construction or on the earth’s crustal. This methodology was designed to be accurate, stable and general for different kind of geodetic data. The basic procedure consists of the definition of the forecasting problem, the preliminary data analysis (data pre-processing, the definition of the most suitable ANN, its evaluation using the proper criteria and finally the production of forecasts. The methodology gives particular emphasis on the stages of the pre-processing and the evaluation. Additionally, the importance of the prediction intervals (PI is emphasized. A case study, which includes geodetic data from the year 2003 to the year 2016—namely X, Y, Z coordinates—is implemented. The data were acquired by 1000 permanent Global Navigation Satellite System (GNSS stations. During this case study, 2016 ANNs—with different hyper-parameters—are trained and tested for short-term forecasting and 2016 for long-term forecasting, for each of the GNSS stations. In addition, other conventional statistical forecasting methods are used for the same purpose using the same data set. Finally the most appropriate Non-linear Autoregressive Recurrent network (NAR or Non-linear Autoregressive with eXogenous inputs (NARX for the forecasting of 3D point

  15. The Womanly World of Long Term Care: The Plight of the Long Term Care Worker. Gray Paper.

    Science.gov (United States)

    Older Women's League, Washington, DC.

    Long-term care workers (those who are paid to provide custodial care for long-term patients in nursing homes or at home) must care for a growing number of increasingly disabled or dependent persons. They are working for agencies and institutions under growing pressure to increase productivity. They face new training and competency requirements,…

  16. Intermediate-term and long-term outcome of piggyback drainage: connecting glaucoma drainage device to a device in-situ for improved intraocular pressure control.

    Science.gov (United States)

    Dervan, Edward; Lee, Edward; Giubilato, Antonio; Khanam, Tina; Maghsoudlou, Panayiotis; Morgan, William H

    2017-11-01

    This study provides results of a treatment option for patients with failed primary glaucoma drainage device. The study aimed to describe and evaluate the long-term intraocular pressure control and complications of a new technique joining a second glaucoma drainage device directly to an existing glaucoma drainage device termed 'piggyback drainage'. This is a retrospective, interventional cohort study. Eighteen eyes of 17 patients who underwent piggyback drainage between 2004 and 2013 inclusive have been studied. All patients had prior glaucoma drainage device with uncontrolled intraocular pressure. The piggyback technique involved suturing a Baerveldt (250 or 350 mm) or Molteno3 glaucoma drainage device to an unused scleral quadrant and connecting the silicone tube to the primary plate bleb. Failure of intraocular pressure control defined as an intraocular pressure greater than 21 mmHg on maximal therapy on two separate occasions or further intervention to control intraocular pressure. The intraocular pressure was controlled in seven eyes (39%) at last follow-up with a mean follow-up time of 74.2 months. The mean preoperative intraocular pressure was 27.1 mmHg (95% confidence interval 23.8-30.3) compared with 18.4 mmHg (95% confidence interval 13.9-22.8) at last follow-up. The mean time to failure was 57.1 months (95% confidence interval 32.2-82), and the mean time to further surgery was 72.3 months (95% confidence interval 49.9-94.7). Lower preoperative intraocular pressure was associated with longer duration of intraocular pressure control (P = 0.048). If the intraocular pressure was controlled over 2 years, it continued to be controlled over the long term. Two eyes (11%) experienced corneal decompensation. Piggyback drainage represents a viable surgical alternative for the treatment of patients with severe glaucoma with failing primary glaucoma drainage device, particularly in those at high risk of corneal decompensation. © 2017 Royal Australian and New Zealand

  17. Long-Term Charge/Discharge Cycling Stability of MnO2 Aqueous Supercapacitor under Positive Polarization

    KAUST Repository

    Ataherian, Fatemeh; Wu, Nae-Lih

    2011-01-01

    The long-term charge/discharge cycling stability of MnO 2 electrode under positive polarization in aqueous KCl electrolyte has been studied over different potential windows spanning from the open circuit potential to varied higher-end potential

  18. Experimental Researches on Long-Term Strength of Granite Gneiss

    Directory of Open Access Journals (Sweden)

    Lin Liu

    2015-01-01

    Full Text Available It is important to confirm the long-term strength of rock materials for the purpose of evaluating the long-term stability of rock engineering. In this study, a series of triaxial creep tests were conducted on granite gneiss under different pore pressures. Based on the test data, we proposed two new quantitative methods, tangent method and intersection method, to confirm the long-term strength of rock. Meanwhile, the isochronous stress-strain curve method was adopted to make sure of the accuracy and operability of the two new methods. It is concluded that the new methods are suitable for the study of the long-term strength of rock. The effect of pore pressure on the long-term strength of rock in triaxial creep tests is also discussed.

  19. Heavy Alcohol Consumption Effects on Blood Pressure and on Kidney Structure Persist After Long-Term Withdrawal

    Directory of Open Access Journals (Sweden)

    Sandra Leal

    2017-11-01

    Full Text Available Background/Aims: Heavy ethanol consumption is a risk factor for hypertension and prompts organ damage. There is no information regarding the impact of long-term heavy ethanol consumption on kidney structure and function linking to their hypertensive effects nor the repercussions after withdrawal. Methods: Rats were exposed to ethanol for 24 weeks and, afterwards, a group was assigned to withdrawal for 8 weeks. Blood pressure (BP was measured and serum biochemical parameters were quantified. Glomerular volume density, areal density of glomerular tuft and renal corpuscles were determined. Angiotensin II type 1 receptor (AT1R protein expression was evaluated. Results: Twenty-four weeks of ethanol consumption causes atrophy of renal corpuscles and glomeruli and reduces the volume of glomeruli. Glomerular changes induced by ethanol consumption were still evident after withdrawal. Renal AT1R levels were increased in ethanol-treated rats and returned to control levels during withdrawal. Ethanol consumption also induced an increase in BP, uric acid and albumin levels. Upon withdrawal, systolic and mean arterial pressures decreased, but were still higher than in controls rats. Conclusion: Ethanol consumption induces changes in glomerular morphology associated with increased BP and AT1R expression. Long-term withdrawal was inefficient to restore the structural integrity of renal corpuscles and in lowering systolic pressure.

  20. Trophic position and metabolic rate predict the long-term decay process of radioactive cesium in fish: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Hideyuki Doi

    Full Text Available Understanding the long-term behavior of radionuclides in organisms is important for estimating possible associated risks to human beings and ecosystems. As radioactive cesium (¹³⁷Cs can be accumulated in organisms and has a long physical half-life, it is very important to understand its long-term decay in organisms; however, the underlying mechanisms determining the decay process are little known. We performed a meta-analysis to collect published data on the long-term ¹³⁷Cs decay process in fish species to estimate biological (metabolic rate and ecological (trophic position, habitat, and diet type influences on this process. From the linear mixed models, we found that 1 trophic position could predict the day of maximum ¹³⁷Cs activity concentration in fish; and 2 the metabolic rate of the fish species and environmental water temperature could predict ecological half-lives and decay rates for fish species. These findings revealed that ecological and biological traits are important to predict the long-term decay process of ¹³⁷Cs activity concentration in fish.

  1. Telemetric implantable pressure sensor for short- and long-term monitoring of intracranial pressure.

    Science.gov (United States)

    Frischholz, M; Sarmento, L; Wenzel, M; Aquilina, K; Edwards, R; Coakham, H B

    2007-01-01

    Patients with hydrocephalus, idiopathic intracranial hypertension and head injury frequently require monitoring of intracranial pressure (ICP) and may need repeated episodes of monitoring months or years apart. The gold standard for measurement of ICP remains the external ventricular catheter. This is a fluid-filled catheter transducer system that allows regular recalibration and correction of zero drift by its position relative to a fixed anatomical reference. It also allows drainage of cerebrospinal fluid (CSF), providing a means of lowering the ICP. Several catheter tip transducer systems are currently in clinical use, including using strain gauges or fiber-optical pressure sensing techniques. In these devices, zero drift and calibration cannot be checked in vivo. All the ICP monitoring devices in current clinical use require a physical connection between the brain and the external environment. This is a source of infection and limits the duration of monitoring. A number of telemetric monitoring devices, in which data is in some way transmitted transcutaneously, have been developed over the last twenty years, but significant technical problems have precluded their use in routine clinical practice. All current ICP monitors are temporary percutaneous implanted devices. Placement of these devices carries significant morbidity, particularly infection. Patients undergoing repeated monitoring require multiple surgical procedures. Apart from decreasing the risk of infection in patients with severe head injury, the clinical value of an accurate telemetric ICP monitoring system which maintains its reliability over a long period of implantation is high.

  2. Successful heel pressure ulcer prevention program in a long-term care setting.

    Science.gov (United States)

    Lyman, Vicky

    2009-01-01

    Heel pressure ulcers (PUs) are common in long-term healthcare settings. Early identification of risk and the use of preventive measures are central to reducing the morbidity, mortality, and high medical costs associated with heel PUs. A Quality Improvement Process was initated based on a tailored protocol, in-service education program, and a heel protective device was approved by the US Food and Drug Administration. The Braden Scale was used to evaluate PU risk in 550 patients in a long-term healthcare facility. Patients with a Braden Scale score of 18 or less and with 1 of 7 high-risk comorbidities were considered at high risk for PUs, and this prompted a more aggressive prevention program that included a protocol for reducing the risk of heel ulceration. The number of hospital-acquired heel PUs during the 6-month preintervention period was 39. Following the intervention, there were 2 occurrences, representing a 95% reduction in heel ulcers between the 2 periods. After the cost of 2 heel protectors for 550 at-risk patients was subtracted from the estimated cost of treating the 37 heel ulcers prevented, the estimated cost savings was calculated to be between $12,400 and $1,048,400.

  3. Long-Term Effects of Primary Schools on Educational Positions of Students 2 and 4 Years after the Start of Secondary Education

    Science.gov (United States)

    Vanwynsberghe, Griet; Vanlaar, Gudrun; Van Damme, Jan; De Fraine, Bieke

    2017-01-01

    Although the importance of primary schools in the long term is of interest in educational effectiveness research, few studies have examined the long-term effects of schools over the past decades. In the present study, long-term effects of primary schools on the educational positions of students 2 and 4 years after starting secondary education are…

  4. Associations of long-term fine particulate matter exposure with prevalent hypertension and increased blood pressure in older Americans.

    Science.gov (United States)

    Honda, Trenton; Pun, Vivian C; Manjourides, Justin; Suh, Helen

    2018-07-01

    Hypertension is a highly prevalent cardiovascular risk factor. It is possible that air pollution, also an established cardiovascular risk factor, may contribute to cardiovascular disease through increasing blood pressure. Previous studies evaluating associations between air pollution and blood pressure have had mixed results. We examined the association between long-term (one-year moving average) air pollutant exposures, prevalent hypertension and blood pressure in 4121 older Americans (57+ years) enrolled in the National Social Life, Health, and Aging Project. We estimated exposures to PM 2.5 using spatio-temporal models and used logistic regression accounting for repeated measures to evaluate the association between long-term average PM 2.5 and prevalence odds of hypertension. We additionally used linear regression to evaluate the associations between air pollutants and systolic, diastolic, mean arterial, and pulse pressures. Health effect models were adjusted for a number of demographic, health and socioeconomic covariates. An inter-quartile range (3.91 μg/m 3 ) increase in the one-year moving average of PM 2.5 was associated with increased: Odds of prevalent hypertension (POR 1.24, 95% CI: 1.11, 1.38), systolic blood pressure (0.93 mm Hg, 95% CI: 0.05, 1.80) and pulse pressure (0.89 mm Hg, 95% CI: 0.21, 1.58). Dose-response relationships were also observed. PM 2.5 was associated with increased odds of prevalent hypertension, and increased systolic pressure and pulse pressure in a cohort of older Americans. These findings add to the growing evidence that air pollution may be an important risk factor for hypertension and perturbations in blood pressure. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Bilateral diaphragmatic paralysis after cardiac surgery: ventilatory assistance by nasal mask continuous positive airway pressure.

    Science.gov (United States)

    Hoch, B; Zschocke, A; Barth, H; Leonhardt, A

    2001-01-01

    The case of an 8-month-old boy with bilateral diaphragmatic paralysis after surgical reoperation for congenital heart disease is presented. In order to avoid repeated intubation and long-term mechanical ventilation or tracheotomy, we used nasal mask continuous positive airway pressure (CPAP) as an alternative method for assisted ventilation. Within 24 hours the boy accepted the nasal mask and symptoms such as dyspnea and sweating disappeared. Respiratory movements became regular and oxygen saturation increased. Nasal mask CPAP may serve as an alternative treatment of bilateral diaphragmatic paralysis in infants, thereby avoiding tracheotomy or long-term mechanical ventilation.

  6. AB055. Long term NIV

    OpenAIRE

    Siopi, Dimitra

    2016-01-01

    During the last decades, non-invasive mechanical ventilation has evolved into one of the most evidence-based areas of respiratory medicine, with many indications in acute or chronic respiratory failure. From the first application of negative pressure models during poliomyelitis epidemics to the new sophisticated positive pressure models, and the development of the “intelligent ventilators”, there has been a long time course. Undoubtedly the spur was given by better understanding of respirator...

  7. The Myth That Insulating Boards Serves Long-Term Value

    OpenAIRE

    Bebchuk, Lucian Arye

    2013-01-01

    According to an influential view in corporate law writings and debates, pressure from shareholders leads companies to take myopic actions that are costly in the long term, and insulating boards from such pressure serves the long-term interests of companies as well as their shareholders. This board insulation claim has been regularly invoked in a wide range of contexts to support existing or tighter limits on shareholder rights and involvement. This paper subjects this view to a comprehensive ...

  8. Birthing positions during second stage of labor and long-term psychological outcomes in low-risk women

    NARCIS (Netherlands)

    Jonge, A. de; Rijnders, M.E.B.; Diem, M.T. van; Scheepers, P.L.H.; Lagro-Janssen, A.L.M.

    2011-01-01

    PURPOSE: To examine the long-term influence of birthing positions during the second stage of labor, as well as other factors, on birth satisfaction, self-esteem (based on the Rosenberg Self-esteem Scale [RSE]) and emotional well-being (based on the Edinburgh Postnatal Depression Scale [EPDS]). STUDY

  9. Rising Long-term Interest Rates

    DEFF Research Database (Denmark)

    Hallett, Andrew Hughes

    Rather than chronicle recent developments in European long-term interest rates as such, this paper assesses the impact of increases in those interest rates on economic performance and inflation. That puts us in a position to evaluate the economic pressures for further rises in those rates......, the first question posed in this assignment, and the scope for overshooting (the second question), and then make some illustrative predictions of future interest rates in the euro area. We find a wide range of effects from rising interest rates, mostly small and mostly negative, focused on investment...... till the emerging European recovery is on a firmer basis and capable of overcoming increases in the cost of borrowing and shrinking fiscal space. There is also an implication that worries about rising/overshooting interest rates often reflect the fact that inflation risks are unequally distributed...

  10. Noninvasive Positive Pressure Ventilatory Support Begins During Sleep.

    Science.gov (United States)

    Bach, John R

    2017-12-01

    The goal of sleep doctors has been to titrate away apneas and hypopneas using noninvasive ventilation, a term that has become synonymous with continuous positive airway pressure and bilevel positive airway pressure at the lowest effective bilevel settings. It is now time to appreciate noninvasive ventilatory support as an alternative to invasive mechanical ventilation. This article discusses mechanisms of action, two paradigms, and ancillary techniques for noninvasive ventilatory support. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Long-term field test of solar PV power generation using one-axis 3-position sun tracker

    KAUST Repository

    Huang, B.J.; Ding, W.L.; Huang, Y.C.

    2011-01-01

    The 1 axis-3 position (1A-3P) sun tracking PV was built and tested to measure the daily and long-term power generation of the solar PV system. A comparative test using a fixed PV and a 1A-3P tracking PV was carried out with two identical stand

  12. Strategic alliance: adapting to the business environment in long-term care.

    Science.gov (United States)

    Mara, Cynthia Massie; Ziegenfuss, James T

    2002-01-01

    This article is addressed to long-term-care administrators and planners as well as purchasers of long-term care. Believing the current and future business environment will force continued adaptation in long-term-care organizations, the authors utilize nine categories to map pressures for change: cultural, technological, educational, political, legal, natural resource, demographic, sociologic, and economic. Long-term-care organizations, especially those that are not-for-profit, are becoming members of alliances as one way of addressing these pressures. This article describes and presents a case example of a composite alliance to demonstrate the advantages of membership in a strategic alliance. We also present examples of ways in which alliance members use strategic partnerships to improve their ability to manage these forces.

  13. Positive expiratory pressure in patients with chronic obstructive pulmonary disease--a systematic review.

    Science.gov (United States)

    Fagevik Olsén, Monika; Westerdahl, Elisabeth

    2009-01-01

    Breathing exercises against a resistance during expiration are often used as treatment for patients with chronic obstructive pulmonary disease (COPD). Controversy still exists regarding the clinical application and efficacy. The aim of this systematic review was to determine the effects of chest physiotherapy techniques with positive expiratory pressure (PEP) for the prevention and treatment of pulmonary impairment in adults with COPD. The review was conducted on randomised, controlled clinical trials in which breathing exercises with positive expiratory pressure were compared with other chest physical therapy techniques or with no treatment, in adult patients with COPD. A computer-assisted literature search of available databases from 1970 to January 2008 was performed. Two reviewers extracted data independently and assessed the trials systematically with an instrument for measuring methodological quality. In total, 11 trials met the inclusion criteria, of which 5 reached an adequate level of internal validity. Several kinds of PEP techniques with a diversity of intensities and durations of treatment have been evaluated with different outcome measures and follow-up periods. Benefits of PEP were found in isolated outcome measures in separate studies with a follow-up period <1 month. Concerning long-term effects, the results are contradictory. Prior to widespread prescription of long-term PEP treatment, more research is required to establish the benefit of the technique in patients with COPD. (c) 2008 S. Karger AG, Basel.

  14. Mortality and recurrence rate after pressure ulcer operation for elderly long-term bedridden patients.

    Science.gov (United States)

    Kuwahara, Masamitsu; Tada, Hideyuki; Mashiba, Kumi; Yurugi, Satoshi; Iioka, Hiroshi; Niitsuma, Katsunori; Yasuda, Yukiko

    2005-06-01

    We operated on 16 sacral pressure ulcers in elderly and long-term residential patients who were immobile as a result of cerebral vascular disease. The mean age of patients was 76 years. Eight ulcers were treated with local fascial flaps and 8 by simple closure. The follow-up period was from 1 to 4 years. Recurrence and mortality rates were examined retrospectively. In the 16 patients, recurrence occurred in 37.5%, and 43.8% died without recurrence. The recurrence rate was 37.5% for local fascial flaps and 37.5% for simple closure. Overall mortality was 68.8% in the follow-up period. Because postoperative death was common, we should not only focus on reducing local pressure but also pay attention to any underlying disease. Because of this high mortality rate, the least invasive procedure possible should be used. Because the recurrence rate of simple closure was the same as for local fascial flaps, simple closure should be considered as a reconstructive method.

  15. Effects of long-term inhibition of neuronal nitric oxide synthase on blood pressure and renin release

    DEFF Research Database (Denmark)

    Ollerstam, A.; Skøtt, O.; Ek, J.

    2001-01-01

    Nitric oxide (NO) produced by neuronal NO-synthase (nNOS) in macula densa cells may be involved in the control of renin release. 7-Nitro indazole (7-NI) inhibits nNOS, and we investigated the effect of short- (4 days) and long-term (4 weeks) 7-NI treatment on blood pressure (BP), plasma renin...... LS rats (107 +/- 15 vs. 56 +/- 1 mGU mL(-1)). Stimulation of PRC in LS rats was further enhanced by 7-NI after 4 days of treatment, but not affected in rats treated for 4 weeks. This suggests that inhibition of nNOS stimulates renin release but that this stimulatory effect in the long run might...

  16. Long-term deconditioning of gas-filled surge arresters

    Science.gov (United States)

    Stanković, Koviljka; Brajović, Dragan; Alimpijević, Mališa; Lončar, Boris

    2016-07-01

    The aim of this paper is to identify parameters that influence the long-term deconditioning effect of gas-filled surge arrester (GFSA) and to provide practical recommendations for mitigating this effect. Namely, after some period of time, on order of hours or days, during which there is no activation due to overvoltage, the deconditioning of GFSA occurs. This effect was observed experimentally within the paper. The observed parameters that could influence the long-term deconditioning effect were the following: shape of voltage load, gas type, gas pressure, interelectrode distance, electrode material, electrode surface topography as well as GFSA design such as two- or three-electrode configuration. According to the results obtained, it has been shown that the occurrence of long-term deconditioning in an insulating system, insulated by a noble gas at a subpressure and with small interelectrode distances, is a phenomenon that always occurs when the insulating system is at rest for about an hour. It has been found that the type of noble gas does not influence the long-term deconditioning. Analysis of such insulating systems' parameters, with a prospect of being used as GFSAs, has demonstrated that this phenomenon is less pronounced at higher pressures (for the same value of the pressure (p) and interelectrode distance (d) product) and for electrodes with microscopically embossed surfaces. According to the results that were obtained by noble gases and their mixtures, as well as the results that were obtained by mixtures of SF6 gas with noble gasses, it can be claimed with confidence that the effect of the long-term deconditioning is an electrode effect. It has also been established that the deconditioning effect does not depend on the electrode material except in the case of electrodes made out of noble metals, which reduce the effect. Based on these results, it can be recommended that the working point of GFSAs be set (according to the DC breakdown voltage value) at a

  17. Effects of long-term vasodilator therapy in patients with carotid sinus hypersensitivity.

    Science.gov (United States)

    Brignole, M; Menozzi, C; Gaggioli, G; Musso, G; Foglia-Manzillo, G; Mascioli, G; Fradella, G; Bottoni, N; Mureddu, R

    1998-08-01

    In patients affected by carotid sinus hypersensitivity, long-term vasodilator therapy might increase the risk of syncopal episodes by reducing systolic blood pressure and venous return to the heart. Thirty-two patients (mean age 73 +/- 9 years; 20 men) who met all the following criteria were included: (1) one or more episodes of syncope occurring during long-term (>6 months) treatment with angiotensin-converting enzyme inhibitors, long-acting nitrates, calcium antagonists, or a combination of these; (2) a positive response to carotid sinus massage, defined as the reproduction of spontaneous syncope in the presence of ventricular asystole > or =3 seconds or a fall in systolic blood pressure > or =50 mm Hg; (3) negative workup for other causes of syncope. The patients were randomly assigned to continue or to discontinue use of vasodilators; carotid sinus massage was repeated 2 weeks after randomization. By the end of the study period, the baseline values of systolic blood pressure were significantly different between the 2 groups of patients both in supine (P=.01) and upright (P=.03) positions. Syncope had been induced by carotid sinus massage in 81% of patients in the "on-vasodilator" group and in 62% of patients in the "off-vasodilator" group (P=.21). The cardioinhibitory reflex was of similar magnitude in the 2 groups, being found in 50% of the patients in each group, with a maximum ventricular pause of 7.1 +/- 2.7 and 6.7 +/- 1.8 seconds, respectively. The percentage decrease of blood pressure did not differ between the 2 groups, even if, in absolute values, the baseline difference of blood pressure roughly persisted for the duration of the test. In consequence of that, the rise of blood pressure to similar values was delayed approximately 30 seconds in the "on-vasodilator" group and took more than 2 minutes to return to baseline values. In patients affected by carotid sinus hypersensitivity, chronic vasodilator therapy does not have a direct effect on carotid

  18. Pressure ulcer multidisciplinary teams via telemedicine: a pragmatic cluster randomized stepped wedge trial in long term care.

    Science.gov (United States)

    Stern, Anita; Mitsakakis, Nicholas; Paulden, Mike; Alibhai, Shabbir; Wong, Josephine; Tomlinson, George; Brooker, Ann-Sylvia; Krahn, Murray; Zwarenstein, Merrick

    2014-02-24

    The study was conducted to determine the clinical and cost effectiveness of enhanced multi-disciplinary teams (EMDTs) vs. 'usual care' for the treatment of pressure ulcers in long term care (LTC) facilities in Ontario, Canada We conducted a multi-method study: a pragmatic cluster randomized stepped-wedge trial, ethnographic observation and in-depth interviews, and an economic evaluation. Long term care facilities (clusters) were randomly allocated to start dates of the intervention. An advance practice nurse (APN) with expertise in skin and wound care visited intervention facilities to educate staff on pressure ulcer prevention and treatment, supported by an off-site hospital based expert multi-disciplinary wound care team via email, telephone, or video link as needed. The primary outcome was rate of reduction in pressure ulcer surface area (cm2/day) measured on before and after standard photographs by an assessor blinded to facility allocation. Secondary outcomes were time to healing, probability of healing, pressure ulcer incidence, pressure ulcer prevalence, wound pain, hospitalization, emergency department visits, utility, and cost. 12 of 15 eligible LTC facilities were randomly selected to participate and randomized to start date of the intervention following the stepped wedge design. 137 residents with a total of 259 pressure ulcers (stage 2 or greater) were recruited over the 17 month study period. No statistically significant differences were found between control and intervention periods on any of the primary or secondary outcomes. The economic evaluation demonstrated a mean reduction in direct care costs of $650 per resident compared to 'usual care'. The qualitative study suggested that onsite support by APN wound specialists was welcomed, and is responsible for reduced costs through discontinuation of expensive non evidence based treatments. Insufficient allocation of nursing home staff time to wound care may explain the lack of impact on healing

  19. A possible role of midbrain dopamine neurons in short- and long-term adaptation of saccades to position-reward mapping.

    Science.gov (United States)

    Takikawa, Yoriko; Kawagoe, Reiko; Hikosaka, Okihide

    2004-10-01

    Dopamine (DA) neurons respond to sensory stimuli that predict reward. To understand how DA neurons acquire such ability, we trained monkeys on a one-direction-rewarded version of memory-guided saccade task (1DR) only when we recorded from single DA neurons. In 1DR, position-reward mapping was changed across blocks of trials. In the early stage of training of 1DR, DA neurons responded to reward delivery; in the later stages, they responded predominantly to the visual cue that predicted reward or no reward (reward predictor) differentially. We found that such a shift of activity from reward to reward predictor also occurred within a block of trials after position-reward mapping was altered. A main effect of long-term training was to accelerate the within-block reward-to-predictor shift of DA neuronal responses. The within-block shift appeared first in the intermediate stage, but was slow, and DA neurons often responded to the cue that indicated reward in the preceding block. In the advanced stage, the reward-to-predictor shift occurred quickly such that the DA neurons' responses to visual cues faithfully matched the current position-reward mapping. Changes in the DA neuronal responses co-varied with the reward-predictive differentiation of saccade latency both in short-term (within-block) and long-term adaptation. DA neurons' response to the fixation point also underwent long-term changes until it occurred predominantly in the first trial within a block. This might trigger a switch between the learned sets. These results suggest that midbrain DA neurons play an essential role in adapting oculomotor behavior to frequent switches in position-reward mapping.

  20. Long-term efficacy of reverse pull headgear therapy.

    Science.gov (United States)

    Wells, Andrew P; Sarver, David M; Proffit, William R

    2006-11-01

    To add to the data for long-term reverse pull headgear (RPHG) outcomes and further explore possible variables that could be predictors of long-term failure. Cephalometric radiographs of 41 Class III malocclusion children treated with RPHG (face mask) were evaluated before and immediately after treatment; at 5 years posttreatment; and, for 18 patients, at 10 years posttreatment. Patients were assigned to success or failure groups according to positive or negative overjet at the longest available recall. Seventy-five percent of the patients maintained positive overjet, whereas 25% outgrew the correction. In a stepwise discriminant analysis, a large mandible and vertical positioning of the maxilla and mandible so that mandibular growth would be projected more horizontally were the major indicators of unfavorable later mandibular growth. Patients who experienced downward-backward rotation of the mandible during RPHG treatment were more likely to be categorized in the failure group. The age at which treatment began had no effect on long-term success and failure for patients younger than 10 years, but the percentage of successful treatment decreased after that age. When RPHG treatment is used for all but the most obviously prognathic children to correct anterior cross-bite in the early mixed dentition, positive overjet is maintained long-term in 70%-75% of cases, whereas 25%-30% of cases relapse into reverse overjet mainly because of increased horizontally directed and often late mandibular growth. Up to age 10, the time at which RPHG treatment began does not appear to be a major factor in long-term success in maintaining positive overjet.

  1. The global historical climatology network: Long-term monthly temperature, precipitation, and pressure data

    International Nuclear Information System (INIS)

    Vose, R.S.; Schmoyer, R.L.; Peterson, T.C.; Steurer, P.M.; Heim, R.R. Jr.; Karl, T.R.; Eischeid, J.K.

    1992-01-01

    Interest in global climate change has risen dramatically during the past several decades. In a similar fashion, the number of data sets available to study global change has also increased. Unfortunately, many different organizations and researchers have compiled these data sets, making it confusing and time consuming for individuals to acquire the most comprehensive data. In response to this rapid growth in the number of global data sets, DOE's Carbon Dioxide Information Analysis Center (CDIAC) and NOAA's National Climatic Data Center (NCDC) established the Global Historical Climatology Network (GHCN) project. The purpose of this project is to compile an improved data set of long-term monthly mean temperature, precipitation, sea level pressure, and station pressure for as dense a network of global stations as possible. Specifically, the GHCN project seeks to consolidate the numerous preexisting national-, regional-, and global-scale data sets into a single global data base; to subject the data to rigorous quality control; and to update, enhance, and distribute the data set at regular intervals. The purpose of this paper is to describe the compilation and contents of the GHCN data base (i.e., GHCN Version 1.0)

  2. An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long Term Care

    Science.gov (United States)

    Yap, Tracey L.; Kennerly, Susan M.; Bergstrom, Nancy; Hudak, Sandra L.; Horn, Susan D.

    2015-01-01

    Pressure ulcers (PrUs) have consistently resisted prevention efforts in long term care (LTC) facilities nationwide. Recent research has described cueing innovations that – when selected according to the assumptions and resources of particular facilities – support best practices of PrU prevention. This paper synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a PrU prevention program. PMID:26066791

  3. A Single Long-Term Acute Care Hospital Experience with a Pressure Ulcer Prevention Program.

    Science.gov (United States)

    Young, Daniel L; Borris-Hale, Cathy; Falconio-West, Margaret; Chakravarthy, Debashish

    2015-01-01

    The occurrence of pressure ulcers (PrUs) challenges care facilities. Few studies report PrU reduction efforts in long-term acute care (LTAC). This study described the PrU reduction efforts of a single, LTAC facility using the Medline Pressure Ulcer Prevention Program (mPUPP). This study was a quasi-experimental, quality improvement project, with pre- and postmeasurement design. Outcomes were tracked for 24 months. The mPUPP was implemented in month 11. Education for caregivers was provided through an interactive web-based suite. In addition, all Patient Care Technicians attended a 4-week 1-hour inservice. New skin care products were implemented. The facility also implemented an algorithm for treatment of wounds. There was a significant reduction in the mean monthly hospital-acquired PrU (nPrU) rate when preprogram is compared to postprogram. Sustainable nPrU reduction can be achieved with mPUPP. LTAC hospitals could expect to reduce nPrU with education and incentive of caregivers. © 2014 Association of Rehabilitation Nurses.

  4. Increased airway reactivity in a neonatal mouse model of Continuous Positive Airway Pressure (CPAP)

    OpenAIRE

    Mayer, Catherine A.; Martin, Richard J.; MacFarlane, Peter M.

    2015-01-01

    Background Continuous positive airway pressure (CPAP) is a primary form of respiratory support used in the intensive care of preterm infants, but its long-term effects on airway (AW) function are unknown. Methods We developed a neonatal mouse model of CPAP treatment to determine whether it modifies later AW reactivity. Un-anesthetized spontaneously breathing mice were fitted with a mask to deliver CPAP (6cmH2O, 3hrs/day) for 7 consecutive days starting at postnatal day 1. Airway reactivity to...

  5. LONG-TERM INTRAOCULAR PRESSURE AFTER UNCOMPLICATED PARS PLANA VITRECTOMY FOR IDIOPATHIC EPIRETINAL MEMBRANE.

    Science.gov (United States)

    Tognetto, Daniele; Pastore, Marco R; Cirigliano, Gabriella; DʼAloisio, Rossella; Borelli, Massimo; De Giacinto, Chiara

    2017-11-16

    To investigate long-term intraocular pressure trends after uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane. Three hundred and sixty-eight eyes of 368 consecutive patients were enrolled. Changes in intraocular pressure 1, 3, 6, and 12 months after surgery and during the final follow-up visit were evaluated in vitrectomized eyes and nonvitrectomized fellow eyes. The median follow-up period was 36 months (range 12-92 months). Longitudinal data analysis evidenced a 2.5-mmHg (2.2 mmHg; 2.7 mmHg, 95% confidence interval) statistically significant difference in intraocular pressure 30 days after surgery between treated and fellow untreated eyes, gradually recovering to a not significant 0.2-mmHg (-0.1 mmHg; 0.4 mmHg, 95% confidence interval) difference within 26 months. The incidence of late-onset ocular hypertension was 5.7% (21 over 347, 2%; 12%, 95% confidence interval) without difference between the treated eyes and the group control. No significant difference in the incidence of late-onset ocular hypertension and sex, lens status, or gauge of vitrectomy instruments was detected. Only patient's age was significantly higher (mean difference 4.2 years; 0.1-8.0 years, Monte Carlo, 95% confidence interval) in those who developed late-onset ocular hypertension in the vitrectomized eye. Uncomplicated pars plana vitrectomy for idiopathic epiretinal membrane seems not to increase the risk of late-onset ocular hypertension or open-angle glaucoma development.

  6. Postoperative CPAP use impacts long-term weight loss following bariatric surgery.

    Science.gov (United States)

    Collen, Jacob; Lettieri, Christopher J; Eliasson, Arn

    2015-03-15

    Obstructive sleep apnea (OSA) is common among bariatric surgery candidates. After surgical weight loss, OSA frequently persists and untreated OSA can lead to weight gain. Long-term continuous positive airway pressure (CPAP) adherence is unclear and poor adherence may worsen weight loss outcomes. We sought to determine the impact of CPAP use on long-term weight-loss outcomes in a cohort of bariatric patients. Long-term observational study of bariatric surgery patients with OSA. Patients were evaluated with polysomnography preoperatively and one-year postoperatively. The cohort was again evaluated a mean of 7.2 years later to determine the relationship between long-term CPAP use and subsequent regain of weight. Twenty-four consecutive patients (aged 48.5 ± 9.4 years at time of surgery; 73% female) were included in the initial assessment, and long-term outcome data were available on 22 subjects. Persistent OSA was documented in 21 of 22 subjects (95%) one year postoperatively. Final evaluation occurred 7.2 ± 2.3 years following surgery. Weight (213.3 ± 39.1 to 235.3 ± 47.1 lb, p = 0.10) and BMI (32.5 ± 5.4 to 37.3 ± 8.2 kg/m(2), p = 0.03) increased in most (n = 19, 86.4%) from postoperative to final evaluation. CPAP use declined from 83.3% (preoperatively) to 38.1% (one year) and to 23.8% (final evaluation). BMI increased among those not using CPAP at long-term follow-up compared to those with continued CPAP use (6.8% v -1.8%, p = 0.05). In our cohort of bariatric patients with OSA, long-term adherence to CPAP therapy was poor, and non-adherence was associated with weight gain. Ongoing follow-up of OSA in this population may help to preserve initial achievements after surgical weight loss. © 2014 American Academy of Sleep Medicine.

  7. Advancing nursing leadership in long-term care.

    Science.gov (United States)

    O'Brien, Jennifer; Ringland, Margaret; Wilson, Susan

    2010-05-01

    Nurses working in the long-term care (LTC) sector face unique workplace stresses, demands and circumstances. Designing approaches to leadership training and other supportive human-resource strategies that reflect the demands of the LTC setting fosters a positive work life for nurses by providing them with the skills and knowledge necessary to lead the care team and to address resident and family issues. Through the St. Joseph's Health Centre Guelph demonstration site project, funded by the Nursing Secretariat of Ontario's Ministry of Health and Long-Term Care, the Excelling as a Nurse Leader in Long Term Care training program and the Mentor Team program were developed to address these needs. Evaluation results show that not only have individual nurses benefitted from taking part in these programs, but also that the positive effects were felt in other parts of the LTC home (as reported by Directors of Care). By creating a generally healthier work environment, it is anticipated that these programs will also have a positive effect on recruitment and retention.

  8. Long-term effect of massage therapy on blood pressure in prehypertensive women.

    Science.gov (United States)

    Givi, Mahshid; Sadeghi, Masoumeh; Garakyaraghi, Mohammad; Eshghinezhad, Ameneh; Moeini, Mahin; Ghasempour, Zahra

    2018-01-01

    Prehypertension is one of the cardiovascular disease predicators. Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers. Massage therapy is primarily nonpharmacological treatment that is used to control blood pressure (BP). This study intends to investigate the long-term effect of massage therapy on BP in prehypertensive women. This was a single-blind clinical trial study conducted on 50 prehypertensive women who referred to Sedigheh Tahereh Cardiovascular Center, during 6 months in 2009. Participants were selected by simple random sampling and were divided into control and intervention groups. The test group (25 patients) received massage for 10-15 min, three times a week for 10 sessions, and the control group (25 patients) was relaxed in the same environment but with no massage. Their BP was measured before and after each session and 72 h and 2 weeks after finishing the massage therapy. Analyzing the data was done using descriptive and inferential statistical methods (Chi-square, Mann-Whitney, paired t -test, and Student's t -test) through SPSS software version 18 and a significant level was considered as P 0.05) between the two groups. Although massage therapy seems to be a safe, effective, applicable, and cost-effective intervention to control BP of prehypertensive women, its effects do not persist for a long time.

  9. Long-Term Effects of Ambient PM2.5 on Hypertension and Blood Pressure and Attributable Risk Among Older Chinese Adults.

    Science.gov (United States)

    Lin, Hualiang; Guo, Yanfei; Zheng, Yang; Di, Qian; Liu, Tao; Xiao, Jianpeng; Li, Xing; Zeng, Weilin; Cummings-Vaughn, Lenise A; Howard, Steven W; Vaughn, Michael G; Qian, Zhengmin Min; Ma, Wenjun; Wu, Fan

    2017-05-01

    Long-term exposure to ambient fine particulate pollution (PM 2.5 ) has been associated with cardiovascular diseases. Hypertension, a major risk factor for cardiovascular diseases, has also been hypothesized to be linked to PM 2.5 However, epidemiological evidence has been mixed. We examined long-term association between ambient PM 2.5 and hypertension and blood pressure. We interviewed 12 665 participants aged 50 years and older and measured their blood pressures. Annual average PM 2.5 concentrations were estimated for each community using satellite data. We applied 2-level logistic regression models to examine the associations and estimated hypertension burden attributable to ambient PM 2.5 For each 10 μg/m 3 increase in ambient PM 2.5 , the adjusted odds ratio of hypertension was 1.14 (95% confidence interval, 1.07-1.22). Stratified analyses found that overweight and obesity could enhance the association, and consumption of fruit was associated with lower risk. We further estimated that 11.75% (95% confidence interval, 5.82%-18.53%) of the hypertension cases (corresponding to 914, 95% confidence interval, 453-1442 cases) could be attributable to ambient PM 2.5 in the study population. Findings suggest that long-term exposure to ambient PM 2.5 might be an important risk factor of hypertension and is responsible for significant hypertension burden in adults in China. A higher consumption of fruit may mitigate, whereas overweight and obesity could enhance this effect. © 2017 American Heart Association, Inc.

  10. Long term storage techniques for 85Kr

    International Nuclear Information System (INIS)

    Foster, B.A.; Pence, D.T.; Staples, B.A.

    1975-01-01

    As new nuclear fuel reprocessing plants go on stream, the collection of fission product 85 Kr will be required to avoid potential local release problems and long-term atmospheric buildup. Storage of the collected 85 Kr for a period of at least 100 years will be necessary to allow approximately 99.9 percent decay before it is released. A program designed to develop and evaluate proposed methods for long-term storage of 85 Kr is discussed, and the results of a preliminary evaluation of three methods, high pressure steel cylinders, zeolite encapsulation, and clathrate inclusion are presented. (U.S.)

  11. Customer loyalty in the South African long-term insurance industry

    Directory of Open Access Journals (Sweden)

    Leon du Plessis

    2013-04-01

    Full Text Available The primary objective of this study is to investigate the influence of selected independent variables, two-way communication and conflict handling on intentional customer loyalty via Customer Relationship Management (CRM as the intervening variable within the South African long-term insurance environment. Primary data were gathered using a questionnaire, with items referring to Customer Relationship Management, customer loyalty, two-way communication and conflict handling. The sample consisted of 254 customers in four customer walk-in centres of a long-term insurance provider in South Africa. Data were factor-analysed. One independent variable, conflict handling, exerted a statistically significant positive influence on the intervening variable (CRM, whilst two-way communication exerted a statistically significant negative influence on the intervening variable. This variable (CRM positively influenced the dependent variable (customer loyalty. If long-term insurance organisations communicate timeously and accurately, and are skilled in conflict handling, greater loyalty will be created amongst customers. The study revealed that the majority of customers (51.53% strongly agree that two-way communication is an important dimension that underpins Customer Relationship Management and their relationship with a long-term insurance organisation. The empirical results indicate a negative relationship between the perceived two-way communication by a long-term insurance organisation and CRM at the insurance provider in South Africa. In terms of conflict handling, the study revealed that the majority of customers (45.69% strongly agree that conflict handling is an important dimension that underpins Customer Relationship Management and their relationship with a long-term insurance organisation. The empirical results indicate a positive relationship between perceived conflict handling by a long-term insurance provider and CRM at the organisation in South

  12. Contrastive Analysis and Research on Negative Pressure Beam Tube System and Positive Pressure Beam Tube System for Mine Use

    Science.gov (United States)

    Wang, Xinyi; Shen, Jialong; Liu, Xinbo

    2018-01-01

    Against the technical defects of universally applicable beam tube monitoring system at present, such as air suction in the beam tube, line clogging, long sampling time, etc., the paper analyzes the current situation of the spontaneous combustion fire disaster forecast of mine in our country and these defects one by one. On this basis, the paper proposes a research thought that improving the positive pressure beam tube so as to substitute the negative pressure beam tube. Then, the paper introduces the beam tube monitoring system based on positive pressure technology through theoretical analysis and experiment. In the comparison with negative pressure beam tube, the paper concludes the advantage of the new system and draws the conclusion that the positive pressure beam tube is superior to the negative pressure beam tube system both in test result and test time. At last, the paper proposes prospect of the beam tube monitoring system based on positive pressure technology.

  13. A computational analysis of the long-term regulation of arterial pressure [v1; ref status: indexed, http://f1000r.es/1xq

    Directory of Open Access Journals (Sweden)

    Daniel A. Beard

    2013-10-01

    Full Text Available The asserted dominant role of the kidneys in the chronic regulation of blood pressure and in the etiology of hypertension has been debated since the 1970s. At the center of the theory is the observation that the acute relationships between arterial pressure and urine production—the acute pressure-diuresis and pressure-natriuresis curves—physiologically adapt to perturbations in pressure and/or changes in the rate of salt and volume intake. These adaptations, modulated by various interacting neurohumoral mechanisms, result in chronic relationships between water and salt excretion and pressure that are much steeper than the acute relationships. While the view that renal function is the dominant controller of arterial pressure has been supported by computer models of the cardiovascular system known as the “Guyton-Coleman model”, no unambiguous description of a computer model capturing chronic adaptation of acute renal function in blood pressure control has been presented. Here, such a model is developed with the goals of: 1. capturing the relevant mechanisms in an identifiable mathematical model; 2. identifying model parameters using appropriate data; 3. validating model predictions in comparison to data; and 4. probing hypotheses regarding the long-term control of arterial pressure and the etiology of primary hypertension. The developed model reveals: long-term control of arterial blood pressure is primarily through the baroreflex arc and the renin-angiotensin system; and arterial stiffening provides a sufficient explanation for the etiology of primary hypertension associated with ageing. Furthermore, the model provides the first consistent explanation of the physiological response to chronic stimulation of the baroreflex.

  14. Chronically impaired autoregulation of cerebral blood flow in long-term diabetics

    DEFF Research Database (Denmark)

    Bentsen, N; Larsen, B; Lassen, N A

    1975-01-01

    Using the arteriovenous oxygen difference method autoregulation of cerebral blood flow (CBF) was tested in 16 long-term diabetics and eight control patients. Blood pressure was raised by angiotensin infusion and lowered by trimethaphan camsylate infusion, in some cases combined with head-up tilting...... of the patient. Regression analysis was carried out on the results in order to quantify autoregulatory capacity. In the control patients CBF did not vary with moderate blood pressure variations, indicating normal autoregulation. In four of the 16 diabetic patients CBF showed significant pressure dependency......, indicating impaired autoregulation. The cause of impaired autoregulation in some long-term diabetics is believed to be diffuse or multifocal dysfunction of cerebral arterioles due to diabetic vascular disease. Other conditions with impaired autoregulation are discussed and compared with that seen in long...

  15. Interaction between intra-abdominal pressure and positive-end expiratory pressure

    Directory of Open Access Journals (Sweden)

    Jamili Anbar Torquato

    2009-02-01

    Full Text Available OBJECTIVE: The aim of this study was to quantify the interaction between increased intra-abdominal pressure and Positive-End Expiratory Pressure. METHODS: In 30 mechanically ventilated ICU patients with a fixed tidal volume, respiratory system plateau and abdominal pressure were measured at a Positive-End Expiratory Pressure level of zero and 10 cm H2O. The measurements were repeated after placing a 5 kg weight on the patients' belly. RESULTS: After the addition of 5 kg to the patients' belly at zero Positive-End Expiratory Pressure, both intra-abdominal pressure (p<0.001 and plateau pressures (p=0.005 increased significantly. Increasing the Positive-End Expiratory Pressure levels from zero to 10 cm H2O without weight on the belly did not result in any increase in intra-abdominal pressure (p=0.165. However, plateau pressures increased significantly (p< 0.001. Increasing Positive-End Expiratory Pressure from zero to 10 cm H2O and adding 5 kg to the belly increased intra-abdominal pressure from 8.7 to 16.8 (p<0.001 and plateau pressure from 18.26 to 27.2 (p<0.001. Maintaining Positive-End Expiratory Pressure at 10 cm H2O and placing 5 kg on the belly increased intra-abdominal pressure from 12.3 +/- 1.7 to 16.8 +/- 1.7 (p<0.001 but did not increase plateau pressure (26.6+/-1.2 to 27.2 +/-1.1 -p=0.83. CONCLUSIONS: The addition of a 5kg weight onto the abdomen significantly increased both IAP and the airway plateau pressure, confirming that intra-abdominal hypertension elevates the plateau pressure. However, plateau pressure alone cannot be considered a good indicator for the detection of elevated intra-abdominal pressure in patients under mechanical ventilation using PEEP. In these patients, the intra-abdominal pressure must also be measured.

  16. Long-term inhibition of xanthine oxidase by febuxostat does not decrease blood pressure in deoxycorticosterone acetate (DOCA-salt hypertensive rats.

    Directory of Open Access Journals (Sweden)

    Theodora Szasz

    Full Text Available Xanthine oxidase and its products, uric acid and ROS, have been implicated in the pathogenesis of cardiovascular disease, such as hypertension. We have previously reported that allopurinol inhibition of XO does not alter the progression of deoxycorticosterone acetate (DOCA-salt hypertension in rats. However other researchers have observed a reduction in blood pressure after allopurinol treatment in the same model. To resolve this controversy, in this study we used the newer and more effective XO inhibitor febuxostat, and hypothesized that a more complete XO blockade might impair hypertension development and its end-organ consequences. We used DOCA-salt hypertensive rats and administered vehicle (salt water or febuxostat (orally, 5 mg/kg/day in salt water in a short-term "reversal" experiment (2 weeks of treatment 3 weeks after DOCA-salt beginning and a long-term "prevention" experiment (treatment throughout 4 weeks of DOCA-salt. We confirmed XO inhibition by febuxostat by measuring circulating and tissue levels of XO metabolites. We found an overall increase in hypoxanthine (XO substrate and decrease in uric acid (XO product levels following febuxostat treatment. However, despite a trend for reduced blood pressure in the last week of long-term febuxostat treatment, no statistically significant difference in hemodynamic parameters was observed in either study. Additionally, no change was observed in relative heart and kidney weight. Aortic media/lumen ratio was minimally improved by long-term febuxostat treatment. Additionally, febuxostat incubation in vitro did not modify contraction of aorta or vena cava to norepinephrine, angiotensin II or endothelin-1. We conclude that XO inhibition is insufficient to attenuate hypertension in the rat DOCA-salt model, although beneficial vascular effects are possible.

  17. Long-term inhibition of xanthine oxidase by febuxostat does not decrease blood pressure in deoxycorticosterone acetate (DOCA)-salt hypertensive rats.

    Science.gov (United States)

    Szasz, Theodora; Davis, Robert Patrick; Garver, Hannah S; Burnett, Robert J; Fink, Gregory D; Watts, Stephanie W

    2013-01-01

    Xanthine oxidase and its products, uric acid and ROS, have been implicated in the pathogenesis of cardiovascular disease, such as hypertension. We have previously reported that allopurinol inhibition of XO does not alter the progression of deoxycorticosterone acetate (DOCA)-salt hypertension in rats. However other researchers have observed a reduction in blood pressure after allopurinol treatment in the same model. To resolve this controversy, in this study we used the newer and more effective XO inhibitor febuxostat, and hypothesized that a more complete XO blockade might impair hypertension development and its end-organ consequences. We used DOCA-salt hypertensive rats and administered vehicle (salt water) or febuxostat (orally, 5 mg/kg/day in salt water) in a short-term "reversal" experiment (2 weeks of treatment 3 weeks after DOCA-salt beginning) and a long-term "prevention" experiment (treatment throughout 4 weeks of DOCA-salt). We confirmed XO inhibition by febuxostat by measuring circulating and tissue levels of XO metabolites. We found an overall increase in hypoxanthine (XO substrate) and decrease in uric acid (XO product) levels following febuxostat treatment. However, despite a trend for reduced blood pressure in the last week of long-term febuxostat treatment, no statistically significant difference in hemodynamic parameters was observed in either study. Additionally, no change was observed in relative heart and kidney weight. Aortic media/lumen ratio was minimally improved by long-term febuxostat treatment. Additionally, febuxostat incubation in vitro did not modify contraction of aorta or vena cava to norepinephrine, angiotensin II or endothelin-1. We conclude that XO inhibition is insufficient to attenuate hypertension in the rat DOCA-salt model, although beneficial vascular effects are possible.

  18. The role of pressure vessel embrittlement in the long term operation of nuclear power plants

    International Nuclear Information System (INIS)

    Ballesteros, A.; Ahlstrand, R.; Bruynooghe, C.; Estorff, U. von; Debarberis, L.

    2012-01-01

    Highlights: ► Relevant open scientific issues for the long term operation of RPVs are discussed (flux effect, late blooming phases, etc.). ► Several European and American research programmes dealing with these open issues are reviewed. ► A method for consolidation and preservation of knowledge in this field is presented. - Abstract: The lack of new build of plants over the last twenty years has resulted in a switch within the industry from design, construction and development of new systems to the strengthening of safety systems and to the life extension, or long term operation (LTO), of existing reactors. The most relevant component of any nuclear power plan (NPP) is the reactor pressure vessel (RPV). This is because currently the RPV is still considered irreplaceable or prohibitively expensive to replace. This means, that if it degrades sufficiently, it could be the operational life limiting feature of the NPP. A RPV operational life of 60 years is being considered frequently by many utilities in their plant life management programmes. Areas of improvement facing long term operation are the reduction of uncertainties in the embrittlement parameters of irradiated vessels, and the development of embrittlement trend curves at high fluence levels, where surveillance data are scarce. Different techniques can be used to upgrade the surveillance programmes, as the use of miniature or reconstituted specimens and the application of best estimate assessment tools (e.g. Master Curve). Several relevant international research projects are on-going or have been proposed to clarify the material condition of long operated vessels. Knowledge management is a complementary tool, but not for it less important. The general context for LTO of RPVs is presented in this paper. Starting with a review of relevant embrittlement issues still open, followed by presenting the different techniques and tools that can be used to support LTO, and summarising the scopes of relevant European

  19. Role of autonomic nervous activity, as measured by heart rate variability, on the effect of mortality in disabled older adults with low blood pressure in long-term care.

    Science.gov (United States)

    Shibasaki, Koji; Ogawa, Sumito; Yamada, Shizuru; Ouchi, Yasuyoshi; Akishita, Masahiro

    2018-04-11

    Previous studies have shown the relationship between low blood pressure and high mortality in frail, disabled older adults in long-term care. However, the mechanism of this relationship is still unclear. We hypothesized that autonomic nervous activity decline is involved in the relationship between low blood pressure and high mortality. The present prospective cohort study recruited 61 participants aged ≥75 years. The data from 24-h Holter monitoring and blood pressure recorded by ambulatory blood pressure monitoring were collected. Measured data were divided into three categories: 24-h, daytime and night-time. From power spectral density in the electrocardiogram, low frequency, high frequency and low frequency/high frequency ratio were calculated. The primary end-point was death. High blood pressure was connected to both high daytime low frequency and high frequency (partial correlation coefficients: 0.42, P blood pressure group had higher mortality than the high blood pressure group, and disabled older adults in long-term care and those with elevated daytime systolic and diastolic blood pressure had less risk of mortality compared with those without (systolic: hazard ratio 0.89, 95% confidence interval 0.83-0.96, P = 0.003; diastolic: hazard ratio 0.98, 95% confidence interval 0.79-1.00, P = 0.049). The average blood pressures in the high blood pressure groups were approximately 140/80 mmHg and were connected to low mortality. Attenuated autonomic nervous activity might lead to low blood pressure in the daytime and high mortality in disabled older adults in long-term care. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 Japan Geriatrics Society.

  20. Long-term outcomes of oral rehabilitation with dental implants in HIV-positive patients: A retrospective case series.

    Science.gov (United States)

    Gay-Escoda, C; Pérez-Álvarez, D; Camps-Font, O; Figueiredo, R

    2016-05-01

    The existing information on oral rehabilitations with dental implants in VIH-positive patients is scarce and of poor quality. Moreover, no long-term follow-up studies are available. Hence, the aims of this study were to describe the long-term survival and success rates of dental implants in a group of HIV-positive patients and to identify the most common postoperative complications, including peri-implant diseases. A retrospective case series of HIV-positive subjects treated with dental implants at the School of Dentistry of the University of Barcelona (Spain) was studied. Several clinical parameters were registered, including CD4 cell count, viral load and surgical complications. Additionally, the patients were assessed for implant survival and success rates and for the prevalence of peri-implant diseases. A descriptive statistical analysis of the data was performed. Nine participants (57 implants) were included. The patients' median age was 42 years (IQR=13.5 years). The implant survival and success rates were 98.3% and 68.4%, respectively, with a mean follow-up of 77.5 months (SD=16.1 months). The patient-based prevalence of peri-implant mucositis and peri-implantitis were 22.2% and 44.4% respectively at the last appointment. Patients that attended regular periodontal maintenance visits had significantly less mean bone loss than non-compliant patients (1.3 mm and 3.9 mm respectively). Oral rehabilitation with dental implants in HIV-positive patients seems to provide satisfactory results. In order to reduce the considerably high prevalence of peri-implant diseases, strict maintenance programmes must be implemented.

  1. Long-term risks of kidney living donation

    DEFF Research Database (Denmark)

    Maggiore, Umberto; Budde, Klemens; Heemann, Uwe

    2017-01-01

    Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science...... and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information...... to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors...

  2. Applicability of short-term accelerated biofouling studies to predict long-term biofouling accumulation in reverse osmosis membrane systems

    KAUST Repository

    Sanawar, Huma

    2018-02-02

    Biofouling studies addressing biofouling control are mostly executed in short-term studies. It is unclear whether data collected from these experiments are representative for long-term biofouling as occurring in full-scale membrane systems. This study investigated whether short-term biofouling studies accelerated by biodegradable nutrient dosage to feed water were predictive for long-term biofouling development without nutrient dosage. Since the presence of a feed spacer has an strong effect on the degree of biofouling, this study employed six geometrically different feed spacers. Membrane fouling simulators (MFSs) were operated with the same (i) membrane, (ii) feed flow and (iii) feed water, but with feed spacers varying in geometry. For the short-term experiment, biofilm formation was enhanced by nutrient dosage to the MFS feed water, whereas no nutrient dosage was applied in the long-term experiment. Pressure drop development was monitored to characterize the extent of biofouling, while the accumulated viable biomass content at the end of the experimental run was quantified by adenosine triphosphate (ATP) measurements. Impact of feed spacer geometry on biofouling was compared for the short-term and long-term biofouling study. The results of the study revealed that the feed spacers exhibited the same biofouling behavior for (i) the short-term (9-d) study with nutrient dosage and (ii) the long-term (96-d) study without nutrient dosage. For the six different feed spacers, the accumulated viable biomass content (pg ATP.cm) was roughly the same, but the biofouling impact in terms of pressure drop increase in time was significantly different. The biofouling impact ranking of the six feed spacers was the same for the short-term and long-term biofouling studies. Therefore, it can be concluded that short-term accelerated biofouling studies in MFSs are a representative and suitable approach for the prediction of biofouling in membrane filtration systems after long-term

  3. Continuous Positive Airway Pressure (CPAP)

    Science.gov (United States)

    ... ENT Doctor Near You Continuous Positive Airway Pressure (CPAP) Continuous Positive Airway Pressure (CPAP) Patient Health Information ... relations staff at newsroom@entnet.org . What Is CPAP? The most common and effective nonsurgical treatment for ...

  4. Long-term psychosocial consequences of false-positive screening mammography

    DEFF Research Database (Denmark)

    Brodersen, John; Siersma, Volkert Dirk

    2013-01-01

    Cancer screening programs have the potential of intended beneficial effects, but they also inevitably have unintended harmful effects. In the case of screening mammography, the most frequent harm is a false-positive result. Prior efforts to measure their psychosocial consequences have been limite...... by short-term follow-up, the use of generic survey instruments, and the lack of a relevant benchmark-women with breast cancer....

  5. Automated Long-Term Monitoring of Parallel Microfluidic Operations Applying a Machine Vision-Assisted Positioning Method

    Science.gov (United States)

    Yip, Hon Ming; Li, John C. S.; Cui, Xin; Gao, Qiannan; Leung, Chi Chiu

    2014-01-01

    As microfluidics has been applied extensively in many cell and biochemical applications, monitoring the related processes is an important requirement. In this work, we design and fabricate a high-throughput microfluidic device which contains 32 microchambers to perform automated parallel microfluidic operations and monitoring on an automated stage of a microscope. Images are captured at multiple spots on the device during the operations for monitoring samples in microchambers in parallel; yet the device positions may vary at different time points throughout operations as the device moves back and forth on a motorized microscopic stage. Here, we report an image-based positioning strategy to realign the chamber position before every recording of microscopic image. We fabricate alignment marks at defined locations next to the chambers in the microfluidic device as reference positions. We also develop image processing algorithms to recognize the chamber positions in real-time, followed by realigning the chambers to their preset positions in the captured images. We perform experiments to validate and characterize the device functionality and the automated realignment operation. Together, this microfluidic realignment strategy can be a platform technology to achieve precise positioning of multiple chambers for general microfluidic applications requiring long-term parallel monitoring of cell and biochemical activities. PMID:25133248

  6. Automated long-term monitoring of parallel microfluidic operations applying a machine vision-assisted positioning method.

    Science.gov (United States)

    Yip, Hon Ming; Li, John C S; Xie, Kai; Cui, Xin; Prasad, Agrim; Gao, Qiannan; Leung, Chi Chiu; Lam, Raymond H W

    2014-01-01

    As microfluidics has been applied extensively in many cell and biochemical applications, monitoring the related processes is an important requirement. In this work, we design and fabricate a high-throughput microfluidic device which contains 32 microchambers to perform automated parallel microfluidic operations and monitoring on an automated stage of a microscope. Images are captured at multiple spots on the device during the operations for monitoring samples in microchambers in parallel; yet the device positions may vary at different time points throughout operations as the device moves back and forth on a motorized microscopic stage. Here, we report an image-based positioning strategy to realign the chamber position before every recording of microscopic image. We fabricate alignment marks at defined locations next to the chambers in the microfluidic device as reference positions. We also develop image processing algorithms to recognize the chamber positions in real-time, followed by realigning the chambers to their preset positions in the captured images. We perform experiments to validate and characterize the device functionality and the automated realignment operation. Together, this microfluidic realignment strategy can be a platform technology to achieve precise positioning of multiple chambers for general microfluidic applications requiring long-term parallel monitoring of cell and biochemical activities.

  7. Automated Long-Term Monitoring of Parallel Microfluidic Operations Applying a Machine Vision-Assisted Positioning Method

    Directory of Open Access Journals (Sweden)

    Hon Ming Yip

    2014-01-01

    Full Text Available As microfluidics has been applied extensively in many cell and biochemical applications, monitoring the related processes is an important requirement. In this work, we design and fabricate a high-throughput microfluidic device which contains 32 microchambers to perform automated parallel microfluidic operations and monitoring on an automated stage of a microscope. Images are captured at multiple spots on the device during the operations for monitoring samples in microchambers in parallel; yet the device positions may vary at different time points throughout operations as the device moves back and forth on a motorized microscopic stage. Here, we report an image-based positioning strategy to realign the chamber position before every recording of microscopic image. We fabricate alignment marks at defined locations next to the chambers in the microfluidic device as reference positions. We also develop image processing algorithms to recognize the chamber positions in real-time, followed by realigning the chambers to their preset positions in the captured images. We perform experiments to validate and characterize the device functionality and the automated realignment operation. Together, this microfluidic realignment strategy can be a platform technology to achieve precise positioning of multiple chambers for general microfluidic applications requiring long-term parallel monitoring of cell and biochemical activities.

  8. The effect of positive end-expiratory pressure on pulse pressure ...

    African Journals Online (AJOL)

    The effect of positive end-expiratory pressure on pulse pressure variation. FJ Smith, M Geyser, I Schreuder, PJ Becker. Abstract. Objectives: To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV). Design: An observational study. Setting: Operating theatres of a ...

  9. CMS MDS 3.0 Section M Skin Conditions in Long-term Care: Pressure Ulcers, Skin Tears, and Moisture-Associated Skin Damage Data Update.

    Science.gov (United States)

    Ayello, Elizabeth A

    2017-09-01

    The purpose of this learning activity is to provide information about the updates to the Centers for Medicare & Medicaid Services (CMS) MDS 3.0 Section M, Skin Conditions documentation in long-term care. This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Explain the use of the CMS MDS 3.0 tool for documenting skin problems in long-term care.2. Demonstrate examples of proper documentation for specific skin problems. This manuscript reviews some of the key parts of the October 2016 revised Long-term Care Resident Assessment Instrument manual for Minimum Data Set (MDS) 3.0 Section M Skin Conditions. It also reports the Centers for Medicare & Medicaid's publicly reported frequency data in long-term care for selected items on the MDS 3.0 Section M Skin Conditions. Percentages and trends of pressure ulcers/injuries, skin tears, and moisture-associated skin damage are assessed.

  10. Association of perioperative blood pressure with long-term survival in rectal cancer patients.

    Science.gov (United States)

    Yu, Hui-Chuan; Luo, Yan-Xin; Peng, Hui; Wang, Xiao-Lin; Yang, Zi-Huan; Huang, Mei-Jin; Kang, Liang; Wang, Lei; Wang, Jian-Ping

    2016-04-11

    Several studies suggested that hypertension is positively related to cancer incidence and mortality. In this study, we investigated the association between perioperative blood pressure (BP) and long-term survival outcomes in patients with rectal cancer. This study included a cohort of 358 patients with stages I-III rectal cancer who underwent a curative resection between June 2007 and June 2011. Both pre- and postoperative BPs were measured, by which patients were grouped (low BP: cancer-specific survival (CSS). Univariate analysis showed that patients with high preoperative systolic BP had lower 3-year DFS (67.2% vs. 82.1%, P = 0.041) and CSS rates (81.9% vs. 94.8%, P = 0.003) than patients with low preoperative systolic BP, and the associations remained significant in the Cox multivariate analysis, with the adjusted hazard ratios equal to 1.97 [95% confidence interval (CI) = 1.08-3.60, P = 0.028] and 2.85 (95% CI = 1.00-8.25, P = 0.050), respectively. Similarly, in postoperative evaluation, patients with high systolic BP had significantly lower 3-year CSS rates than those with low systolic BP (78.3% vs. 88.9%, P = 0.032) in univariate analysis. Moreover, high pre- and/or postoperative systolic BP presented as risk factors for CSS in the subgroups of patients who did not have a history of hypertension, with and/or without perioperative administration of antihypertensive drugs. High preoperative systolic BP was an independent risk factor for both CSS and DFS rates, and high postoperative systolic BP was significantly associated with a low CSS rate in rectal cancer patients. Additionally, our results suggest that rectal cancer patients may get survival benefit from BP control in perioperative care. However, further studies should be conducted to determine the association between BP and CSS and targets of BP control.

  11. Design prediction for long term stress rupture service of composite pressure vessels

    Science.gov (United States)

    Robinson, Ernest Y.

    1992-01-01

    Extensive stress rupture studies on glass composites and Kevlar composites were conducted by the Lawrence Radiation Laboratory beginning in the late 1960's and extending to about 8 years in some cases. Some of the data from these studies published over the years were incomplete or were tainted by spurious failures, such as grip slippage. Updated data sets were defined for both fiberglass and Kevlar composite stand test specimens. These updated data are analyzed in this report by a convenient form of the bivariate Weibull distribution, to establish a consistent set of design prediction charts that may be used as a conservative basis for predicting the stress rupture life of composite pressure vessels. The updated glass composite data exhibit an invariant Weibull modulus with lifetime. The data are analyzed in terms of homologous service load (referenced to the observed median strength). The equations relating life, homologous load, and probability are given, and corresponding design prediction charts are presented. A similar approach is taken for Kevlar composites, where the updated stand data do show a turndown tendency at long life accompanied by a corresponding change (increase) of the Weibull modulus. The turndown characteristic is not present in stress rupture test data of Kevlar pressure vessels. A modification of the stress rupture equations is presented to incorporate a latent, but limited, strength drop, and design prediction charts are presented that incorporate such behavior. The methods presented utilize Cartesian plots of the probability distributions (which are a more natural display for the design engineer), based on median normalized data that are independent of statistical parameters and are readily defined for any set of test data.

  12. Short-term effects of positive expiratory airway pressure in patients being weaned from mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Marcelo de Mello Rieder

    2009-05-01

    Full Text Available OBJECTIVE: To investigate the feasibility and the cardiorespiratory effects of using positive expiratory airway pressure, a physiotherapeutic tool, in comparison with a T-tube, to wean patients from mechanical ventilation. METHODS/DESIGN: A prospective, randomized, cross-over study. SETTING: Two intensive care units. PATIENTS AND INTERVENTIONS: We evaluated forty patients who met weaning criteria and had been mechanically-ventilated for more than 48 hours, mean age 59 years, including 23 males. All patients were submitted to the T-tube and Expiratory Positive Airway Pressure devices, at 7 cm H2O, during a 30-minute period. Cardiorespiratory variables including work of breathing, respiratory rate (rr, peripheral oxygen saturation (SpO2, heart rate (hr, systolic, diastolic and mean arterial pressures (SAP, DAP, MAP were measured in the first and thirtieth minutes. The condition was analyzed as an entire sample set (n=40 and was also divided into subconditions: chronic obstructive pulmonary disease (n=14 and non-chronic obstructive pulmonary disease (non- chronic obstructive pulmonary disease (n=26 categories. Comparisons were made using a t-test and Analysis of Variance. The level of significance was p < 0.05. RESULTS: Our data showed an increase in work of breathing in the first and thirtieth minutes in the EPAP condition (0.86+ 0.43 and 1.02+1.3 as compared with the T-tube condition (0.25+0.26 and 0.26+0.35 (p<0.05, verified by the flow-sensor monitor (values in J/L. No statistical differences were observed when comparing the Expiratory Positive Airway Pressure and T-tube conditions with regard to cardiorespiratory measurements. The same result was observed for both chronic obstructive pulmonary disease and non- chronic obstructive pulmonary disease subconditions. CONCLUSIONS: Our study demonstrated that, in weaning patients from mechanical ventilation, the use of a fixed level of Expiratory Positive Airway Pressure caused an increase in work of

  13. Position-Invariant Robust Features for Long-Term Recognition of Dynamic Outdoor Scenes

    Science.gov (United States)

    Kawewong, Aram; Tangruamsub, Sirinart; Hasegawa, Osamu

    A novel Position-Invariant Robust Feature, designated as PIRF, is presented to address the problem of highly dynamic scene recognition. The PIRF is obtained by identifying existing local features (i.e. SIFT) that have a wide baseline visibility within a place (one place contains more than one sequential images). These wide-baseline visible features are then represented as a single PIRF, which is computed as an average of all descriptors associated with the PIRF. Particularly, PIRFs are robust against highly dynamical changes in scene: a single PIRF can be matched correctly against many features from many dynamical images. This paper also describes an approach to using these features for scene recognition. Recognition proceeds by matching an individual PIRF to a set of features from test images, with subsequent majority voting to identify a place with the highest matched PIRF. The PIRF system is trained and tested on 2000+ outdoor omnidirectional images and on COLD datasets. Despite its simplicity, PIRF offers a markedly better rate of recognition for dynamic outdoor scenes (ca. 90%) than the use of other features. Additionally, a robot navigation system based on PIRF (PIRF-Nav) can outperform other incremental topological mapping methods in terms of time (70% less) and memory. The number of PIRFs can be reduced further to reduce the time while retaining high accuracy, which makes it suitable for long-term recognition and localization.

  14. Long-term risks of kidney living donation: review and position paper by the ERA-EDTA DESCARTES working group.

    Science.gov (United States)

    Maggiore, Umberto; Budde, Klemens; Heemann, Uwe; Hilbrands, Luuk; Oberbauer, Rainer; Oniscu, Gabriel C; Pascual, Julio; Schwartz Sorensen, Soren; Viklicky, Ondrej; Abramowicz, Daniel

    2017-02-01

    Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  15. Long- and Short-Term Cryptocurrency Volatility Components: A GARCH-MIDAS Analysis

    Directory of Open Access Journals (Sweden)

    Christian Conrad

    2018-05-01

    Full Text Available We use the GARCH-MIDAS model to extract the long- and short-term volatility components of cryptocurrencies. As potential drivers of Bitcoin volatility, we consider measures of volatility and risk in the US stock market as well as a measure of global economic activity. We find that S&P 500 realized volatility has a negative and highly significant effect on long-term Bitcoin volatility. The finding is atypical for volatility co-movements across financial markets. Moreover, we find that the S&P 500 volatility risk premium has a significantly positive effect on long-term Bitcoin volatility. Finally, we find a strong positive association between the Baltic dry index and long-term Bitcoin volatility. This result shows that Bitcoin volatility is closely linked to global economic activity. Overall, our findings can be used to construct improved forecasts of long-term Bitcoin volatility.

  16. Surface protection of inner shells of cooling towers. Positive long-term experience with coating systems.; Oberflaechenschutz von Kuehlturminnenschalen. Positive Langzeiterfahrungen mit Beschichtungssystemen

    Energy Technology Data Exchange (ETDEWEB)

    Heine, Peer [MC-Bauchemie Mueller GmbH und Co.KG, Bottrop (Germany)

    2010-07-15

    Natural-draught cooling tower are modern power plant components with great importance for safe and reliable power supply. Due to the complex effects of operating and environmental conditions especially on the inner shell, the concrete must be protected by special resin-based surface coating systems. Parallel to the development of the power plant technology, also the coating systems are under constant improvement in order to ensure reliable and permanent protection. The positive long-term experience suggests that power plant operators may rely on a high level of safety here. (orig.)

  17. Development of Long-term Cooling Operation Strategy with H-SIT

    International Nuclear Information System (INIS)

    Jeon, In Seop; Kang, Hyun Gook

    2016-01-01

    In the current nuclear power plants (NPPs), most of the critical safety functions are provided by many active safety systems. Long-term cooling of core is an ultimate goal of all mitigation actions for plant safety and feed and bleed (F and B) operation strategy is one of long-term cooling strategies in conventional pressurized water reactor (PWR). The important point of F and B operation is that, in conventional mitigation strategy, injection for feed operation is performed by only high pressure injection (HPSI) pump. Low pressure injection (LPSI) pump such as shut down cooling pump (SCP) cannot be used for F and B operation. Thus, when F and B operation is needed, if high-pressure injection pump fails, core should be damaged. In this study, F and B operation strategy with LPSI and H-SIT is developed. This is a new concept for the long-term cooling operation. If this strategy is applied, low pressure injection pump can be successfully used for F and B operation thus operator has the additional mitigation way. As this strategy make plant safe even though HPSI and PAFS are both failed, it can effectively enhance the plant safety. For this strategy two RCGVSs and two POSRVs are needed as a depressurization system for bleed operation and only one LPSI is enough for feed operation. H-SIT operation is also needed to make up core inventory during bleed operation. For this operation, four H-SITs have to be used to make up core safely. Based on the risk analysis using PSA method, if this strategy is applied, core damage frequency is 1.868e-6 which declined 7 percent from original model.

  18. Long term outlook for gas supply and demand 2007-2030

    International Nuclear Information System (INIS)

    2010-05-01

    Given the economic crisis and the even greater focus of energy policy in recent years on energy efficiency and renewables, earlier expectations in respect of gas demand have to be lowered. Nonetheless, there are still good prospects for gas expanding its position in the EU energy market in the medium to long term. Environmental friendliness and highly efficient technologies in all areas of energy supply give gas a key role in a realistic EU climate policy, the goals of which cannot be achieved solely through increased use of renewables. Its green qualities make gas attractive in direct utilisation in homes and businesses, in centralised power generation, in local CHP plant (including micro-CHP), and - in some member states - in the transport sector too. The current slump in demand is accompanied by strong supply pressure on European procurement markets. Experts do not predict that the present excess supply situation will continue in the long term. It is expected that imports to Europe will rise in order to compensate for the impending fall in domestic European production and to supply additional gas. The procurement challenge cannot be considered in isolation from global developments. The increasing demand for gas worldwide will intensify the competition for global gas reserves on international markets. The European gas industry emphasises the importance of fostering long-term relationships with major suppliers, transit countries and key partners in the EU as well as with multilateral organisations and structures.

  19. Prevalence of hypertension determined by ambulatory blood pressure monitoring (ABPM) and body composition in long-term survivors of childhood cancer.

    Science.gov (United States)

    Guler, Elif; Col, Nilgun; Buyukcelik, Mithat; Balat, Ayse

    2018-02-01

    In recent years, survival rates of childhood cancers have significantly increased, and occurrence of long-term adverse late effects (eg, insulin resistance, diabetes mellitus, metabolic syndrome, hypertension) has become increasingly important. Early diagnosis of obesity/hypertension in childhood is essential to avoid morbidity in the adulthood. Therefore, this study was aimed to determine the blood pressure (BP) profile by ambulatory BP monitoring (ABPM) method, and prevalence of hypertension, obesity, abdominal obesity among childhood cancer survivors. The study was carried out with 52 cancer survivors. The ABPM measurement was performed during 24 hours. The anthropometric measurements of patients were performed using standardized protocols. The body composition analysis was performed with bioelectrical impedance analysis (BIA) method. Statistical significance was considered at p < 0.05. The mean age of patients was 12.84 ± 3.88 years. Time off therapy ranged 24-125 month. The prevalence of prehypertension and hypertension were 57.7% and 9.6%, respectively. There was no statistically significant relationship between diagnosis and BP status (p = 0.59). The prevalence of obesity, and abdominal obesity were 1.9% and 30.4%, respectively. There was a positive correlation between waist circumference (WC) and time off therapy (p = 0.046). The WC was found to be higher in patients who received cranial irradiation (p = 0.048). Weight/WC were higher in patients who used corticosteroids in the treatment (p = 0.019). Careful follow up of BP, weight and WC is necessary for long-term cancer survivors to prevent complications. Especially patients who receive cranial radiotherapy and use corticosteroid are at increased risk of abdominal obesity.

  20. Changes of the eye during long-term spaceflight. Review

    Directory of Open Access Journals (Sweden)

    I. A. Makarov

    2016-01-01

    Full Text Available The review includes the publications of the scientific literature on the eye change during long-term spaceflight. The any eye changes such as visual impairment, hyperopic shift in refraction, changes in the intraocular pressure, increased the intracranial pressure, globe flattening, choroidal folding, optic disc edema, and optic nerve kinking and other changes were reported. The main cause of eye disorders, in all probability, is the increase of the intracranial pressure during long-term spaceflight. The reasons of the increased intracranial pressure are a collection of various factors of adaptation mechanisms in the body to weightless conditions. The leading role in the development of intracranial hypertension takes a redistribution of the body fluids (blood and lymph in the direction of the head, but the opportunities and the effect of other factors are present. Also the displacement and increase of the internal organs volume of the chest can cause external compression of the jugular veins, increasing the pressure of the blood in them, and as the result to lead to the increase of the intracranial pressure. The role of trigger such mechanisms in the development of the intracranial hypertension in the microgravity environment as anatomical predisposition of the body, race, metabolic changes under the influence of high carbon dioxide content in the different compartments of the station, high sodium intake, the enzyme dysfunction, weight exercises of the astronauts was discussed. However, the pathogenic mechanisms is currently still under investigation. An important role in the study of the adaptation mechanisms is given to research not only before and after the flight, but also during the space flight. The accumulated knowledge and experience about the changes in organs and systems in the conditions of human adaptation to microgravity will help answer many questions related to the implementation of the long spaceflights.

  1. Magnitude of long-term non-lithostatic pressure variations in lithospheric processes: insight from thermo-mechanical subduction/collision models

    Science.gov (United States)

    Gerya, Taras

    2014-05-01

    On the one hand, the principle of lithostatic pressure is habitually used in metamorphic geology to calculate paleo-depths of metamorphism from mineralogical pressure estimates given by geobarometry. On the other hand, it is obvious that this lithostatic (hydrostatic) pressure principle should only be valid for an ideal case of negligible deviatoric stresses during the long-term development of the entire tectono-metamorphic system - the situation, which newer comes to existence in natural lithospheric processes. The question is therefore not "Do non-lithostatic pressure variations exist?" but " What is the magnitude of long-term non-lithostatic pressure variations in various lithospheric processes, which can be recorded by mineral equilibria of respective metamorphic rocks?". The later question is, in particular, relevant for various types of high-pressure (HP) and ultrahigh-pressure (UHP) rocks, which are often produced in convergent plate boundary settings (e.g., Hacker and Gerya, 2013). This question, can, in particular, be answered with the use of thermo-mechanical models of subduction/collision processes employing realistic P-T-stress-dependent visco-elasto-brittle/plastic rheology of rocks. These models suggest that magnitudes of pressure deviations from lithostatic values can range >50% underpressure to >100% overpressure, mainly in the regions of bending of rheologically strong mantle lithosphere (Burg and Gerya, 2005; Li et al., 2010). In particular, strong undepresures along normal faults forming within outer rise regions of subducting plates can be responsible for downward water suction and deep hydration of oceanic slabs (Faccenda et al., 2009). Weaker HP and UHP rocks of subduction/collision channels are typically subjected to lesser non-lithostatic pressure variations with characteristic magnitudes ranging within 10-20% from the lithostatic values (Burg and Gerya, 2005; Li et al., 2010). The strength of subducted crustal rocks and the degree of

  2. The position of the arm during blood pressure measurement in sitting position.

    Science.gov (United States)

    Adiyaman, Ahmet; Verhoeff, Rutger; Lenders, Jacques W M; Deinum, Jaap; Thien, Theo

    2006-12-01

    Determining the influence of the position of the arm on blood pressure measurement in the sitting position. Blood pressure of 128 individuals (the majority being treated hypertensive patients) visiting the outpatient clinic was measured simultaneously on both arms with arms in two different positions. First, both arms were placed at the chair support level and blood pressure was measured three times on both arms after 10 min of rest. Subsequently, while still remaining in the same sitting position, five blood pressure measurements were made simultaneously at both arms with one arm placed on the desk and one arm placed and supported at heart level (mid-sternal). The arm placed at heart level served as the reference arm. The choice of which arm was placed at desk level and which arm was placed at heart level was randomized. Both at desk level and at chair support level, mean (+/-SD) systolic and diastolic blood pressures were higher than blood pressure at heart level by 6.1/5.7+/-4.6/3.1 and 9.3/9.4+/-5.4/3.4 mmHg, respectively. The effect of the height differences between the arm positions on the blood pressure readings was smaller than predicted (0.49 mmHg/cm systolic and 0.47 mmHg/cm diastolic). No significant correlation was found between blood pressure difference in the different arm positions (desk and heart level) and age, sex, weight or baseline blood pressure. Different arm positions below heart level have significant effects on blood pressure readings. The leading guidelines about arm position during blood pressure measurement are not in accordance with the arm position used in the Framingham study, the most frequently used study for risk estimations.

  3. Economic and clinical benefit of collagenase ointment compared to a hydrogel dressing for pressure ulcer debridement in a long-term care setting.

    Science.gov (United States)

    Waycaster, Curtis; Milne, Catherine

    2013-06-01

    The purpose of this study is to determine the cost-effectiveness of collagenase ointment relative to autolysis with a hydrogel dressing when debriding necrotic pressure ulcers in a long-term care setting. A Markov decision process model with 2 states (necrotic nonviable wound bed transitioning to a granulated viable wound bed) was developed using data derived from a prospective, randomized, 6-week, single-center trial of 27 institutionalized subjects with pressure ulcers that were ≥ 85% necrotic nonviable tissue. Direct medical costs from the payer perspective included study treatments, wound treatment supplies, and nursing time. Clinical benefit was measured as "granulation days" and was derived from the time-dependent debridement rates of the alternative products. The average cost per patient for 42 days of pressure ulcer care was $1,817 in 2012 for the collagenase group and $1,611 for the hydrogel group. Days spent with a granulated wound were 3.6 times higher for collagenase (23.4 vs 6.5) than with the hydrogel. The estimated cost per granulation day was > 3.2 times higher for hydrogel ($249) vs collagenase ($78). In this economic analysis based on a randomized, controlled clinical trial, collagenase ointment resulted in a faster time to complete debridement and was more cost-effective than hydrogel autolysis for pressure ulcers in a long-term care setting. Even though collagenase ointment has a higher acquisition cost than hydrogel, the clinical benefit offsets the initial cost difference, resulting in lower cost per granulation day to the nursing home over the course of the 42-day analysis.

  4. LightForce Photon-pressure Collision Avoidance: Efficiency Analysis in the Current Debris Environment and Long-Term Simulation Perspective

    Science.gov (United States)

    Yang, Fan Y.; Nelson, Bron; Carlino, Roberto; Perez, Andres D.; Faber, Nicolas; Henze, Chris; Karacahoglu, Arif G.; O'Toole, Conor; Swenson, Jason; Stupl, Jan

    2015-01-01

    This work provides an efficiency analysis of the LightForce space debris collision avoidance scheme in the current debris environment and describes a simulation approach to assess its impact on the long-term evolution of the space debris environment. LightForce aims to provide just-in-time collision avoidance by utilizing photon pressure from ground-based industrial lasers. These ground stations impart minimal accelerations to increase the miss distance for a predicted conjunction between two objects. In the first part of this paper we will present research that investigates the short-term effect of a few systems consisting of 10kW class lasers directed by 1.5 m diameter telescopes using adaptive optics. The results found such a network of ground stations to mitigate more than 85 percent of conjunctions and could lower the expected number of collisions in Low Earth Orbit (LEO) by an order of magnitude. While these are impressive numbers that indicate LightForce's utility in the short-term, the remaining 15 percent of possible collisions contain (among others) conjunctions between two massive objects that would add large amount of debris if they collide. Still, conjunctions between massive objects and smaller objects can be mitigated. Hence we choose to expand the capabilities of the simulation software to investigate the overall effect of a network of LightForce stations on the long-term debris evolution. In the second part of this paper, we will present the planed simulation approach for that effort.

  5. Structural and functional responses of extremity veins to long-term gravitational loading or unloading—lessons from animal systems

    Science.gov (United States)

    Monos, Emil; Raffai, Gábor; Dörnyei, Gabriella; Nádasy, György L.; Fehér, Erzsébet

    2007-02-01

    Long, transparent tubular tilt-cages were developed to maintain experimental rats either in 45∘ head-up (orthostasis model), or in 45∘ head-down body position (antiorthostasis model) for several weeks. In order to study the functional and structural changes in extremity blood vessels, also novel pressure angiograph systems, as well as special quantitative electron microscopic methods were applied. It was found that several adaptive mechanisms are activated in the lower limb superficial veins and microvessels of muscles when an organism is exposed to long-term (1-2 weeks) orthostatic-type gravitational load including a reversible amplification of the pressure-dependent myogenic response, tuning of the myogenic tone by Ca++- and voltage-sensitive K+ channels in humans, augmentation of the intramural sympathetic innervation involving an increased nerve terminal density and synaptic vesicle count with functional remodeling, reorganization of vascular network properties (microvascular rarefaction in muscles, decreased branching angles in superficial veins), and responses of an endothelin and platelet-derived growth factor (PDGF) containing vesicle system in the endothelium. On the other hand, when applying long-term head-down tilting, the effects are dichotomous, e.g. it suppresses significantly the pressure-induced myogenic response, however does not diminish the adventitial sympathetic innervation density.

  6. Adherence to blood pressure measurement guidelines in long-term care facilities: A cross sectional study.

    Science.gov (United States)

    Ozone, Sachiko; Sato, Mikiya; Takayashiki, Ayumi; Sakamoto, Naoto; Yoshimoto, Hisashi; Maeno, Tetsuhiro

    2018-05-01

    To assess the extent to which long-term care facilities in Japan adhere to blood pressure (BP) measurement guidelines. Cross-sectional, observational survey. Japan (nationwide). Geriatric health service facilities that responded to a questionnaire among 701 facilities that provide short-time daycare rehabilitation services in Japan. A written questionnaire that asked about types of measurement devices, number of measurements used to obtain an average BP, resting time prior to measurement, and measurement methods when patients' arms were covered with thin (eg, a light shirt) or thick sleeves (eg, a sweater) was administered. Proportion of geriatric health service facilities adherent to BP measurement guidelines. The response rate was 63.2% (443/701). Appropriate upper-arm BP measurement devices were used at 302 facilities (68.2%). The number of measurements was appropriate at 7 facilities (1.6%). Pre-measurement resting time was appropriate (≥5 minutes) at 205 facilities (46.3%). Of the 302 facilities that used appropriate BP measurement devices, 4 (1.3%) measured BP on a bare arm if it was covered with a thin sleeve, while 266 (88.1%) measured BP over a thin sleeve. When arms were covered with thick sleeves, BP was measured on a bare arm at 127 facilities (42.1%) and over a sleeve at 78 facilities (25.8%). BP measurement guidelines were not necessarily followed by long-term care service facilities in Japan. Modification of guidelines regarding removing thick sweaters and assessing BP on a visit-to-visit basis might be needed.

  7. Long-term oceanographic observations in Massachusetts Bay, 1989-2006

    Science.gov (United States)

    Butman, Bradford; Alexander, P. Soupy; Bothner, Michael H.; Borden, Jonathan; Casso, Michael A.; Gutierrez, Benjamin T.; Hastings, Mary E.; Lightsom, Frances L.; Martini, Marinna A.; Montgomery, Ellyn T.; Rendigs, Richard R.; Strahle, William S.

    2009-01-01

    This data report presents long-term oceanographic observations made in western Massachusetts Bay at long-term site A (LT-A) (42 deg 22.6' N., 70 deg 47.0' W.; nominal water depth 32 meters) from December 1989 through February 2006 and long-term site B (LT-B) (42 deg 9.8' N., 70 deg 38.4' W.; nominal water depth 22 meters) from October 1997 through February 2004 (fig. 1). The observations were collected as part of a U.S. Geological Survey (USGS) study designed to understand the transport and long-term fate of sediments and associated contaminants in Massachusetts Bay. The observations include time-series measurements of current, temperature, salinity, light transmission, pressure, oxygen, fluorescence, and sediment-trapping rate. About 160 separate mooring or tripod deployments were made on about 90 research cruises to collect these long-term observations. This report presents a description of the 16-year field program and the instrumentation used to make the measurements, an overview of the data set, more than 2,500 pages of statistics and plots that summarize the data, and the digital data in Network Common Data Form (NetCDF) format. This research was conducted by the USGS in cooperation with the Massachusetts Water Resources Authority and the U.S. Coast Guard.

  8. Audit of long-term and short-term liabilities

    Directory of Open Access Journals (Sweden)

    Korinko M.D.

    2017-03-01

    Full Text Available The article determines the importance of long-term and short-term liabilities for the management of financial and material resources of an enterprise. It reviews the aim, objects and information generators for realization of audit of short-term and long-term obligations. The organizing and methodical providing of audit of long-term and short-term liabilities of an enterprise are generalized. The authors distinguish the stages of realization of audit of long-term and short-term liabilities, the aim of audit on each of the presented stages, and recommend methodical techniques. It is fixed that it is necessary to conduct the estimation of the systems of internal control and record-keeping of an enterprise by implementation of public accountant procedures for determination of volume and maintenance of selection realization. After estimating the indicated systems, a public accountant determines the methodology for realization of public accountant verification of long-term and short-term liabilities. The analytical procedures that public accountants are expedient to use for realization of audit of short-term and long-term obligations are determined. The authors suggest the classification of the educed defects on the results of the conducted public accountant verification of short-term and long-term obligations.

  9. Forecasting stock return volatility: A comparison between the roles of short-term and long-term leverage effects

    Science.gov (United States)

    Pan, Zhiyuan; Liu, Li

    2018-02-01

    In this paper, we extend the GARCH-MIDAS model proposed by Engle et al. (2013) to account for the leverage effect in short-term and long-term volatility components. Our in-sample evidence suggests that both short-term and long-term negative returns can cause higher future volatility than positive returns. Out-of-sample results show that the predictive ability of GARCH-MIDAS is significantly improved after taking the leverage effect into account. The leverage effect for short-term volatility component plays more important role than the leverage effect for long-term volatility component in affecting out-of-sample forecasting performance.

  10. Long-term facial artery catheter implantation for serial arterial blood sampling and invasive arterial blood pressure measurement in horses.

    Science.gov (United States)

    Dias, Deborah Penteado Martins; Teixeira, Luisa Gouvêa; Canola, Paulo Aléscio; Albernaz, Raquel Mincarelli; Marques, José Antônio; Neto, José Corrêa de Lacerda

    2012-06-01

    The purpose of this investigation was to evaluate surgical catheter implantation in the facial artery of horses and the long-term maintenance of such arteries using heparin and ascorbic acid as filling solution. Nine horses were implanted with a polyurethane catheter. The catheters were flushed with a heparin/ascorbic acid solution every 8h and remained patent for 25 days. Arterial blood samples were collected twice a day, and one exercise test that included serial blood samples and arterial pressure recordings was performed on a treadmill. Polyurethane catheters surgically implanted in the facial artery can be kept patent by filling with a heparin/ascorbic acid solution and provide convenient invasive arterial access in horses which is suitable for use for serial blood sampling and blood pressure recordings, even during exercise on treadmill. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. CONTEMPT-4MOD3, LWR Containment Long-Term Pressure Distribution and Temperature Distribution in LOCA

    International Nuclear Information System (INIS)

    Lin, C.C.; Economos, C.; Lehner, J.R.; Maise, G.; Ng, K.K.; Mirsky, S.M.

    2002-01-01

    1 - Description of problem or function: CONTEMPT-4/MOD5 describes the response of multi-compartment containment systems subjected to postulated loss-of-coolant accident (LOCA) conditions. The program can accommodate both pressurized water reactor (PWR) and boiling water reactor (BWR) containment systems. Also, both design basis accident (DBA) and degraded core type LOCA conditions can be analyzed. The program calculates the time variation of compartment pressures, temperatures, and mass and energy inventories due to inter-compartment mass and energy exchange taking into account user- supplied descriptions of compartments, inter-compartment junction flow areas, LOCA source terms, and user-selected problem features. Analytical models available to describe containment systems include models for containment fans and pumps, cooling sprays, heat conducting structures, sump drains, PWR ice condensers, and BWR pressure suppression systems. To accommodate degraded core type accidents, analytical models for hydrogen combustion within compartments and energy transfer due to gas radiation are also provided. CONTEMPT4/MOD6 is an update of previous CONTEMPT4 versions. Improvements in CONTEMPT4/MOD6 over CONTEMPT4/MOD3 include coding of a BWR pressure suppression system model, a hydrogen/carbon monoxide burn model, a gas radiation heat transfer model, a user specified variable junction (leakage) area as a function of pressure or time, additional heat transfer coefficient options for heat structures, generalized initial compartment conditions for inerted containment, an alternative containment spray model and spray carry-over capability. Also, the thermodynamic properties routines have been extended to accommodate the higher temperature and multicomponent gas mixtures associated with combustion. In addition, reduced running time is achieved by incorporation of an optional implicit numerical algorithm for junction flow. This makes economically feasible the analysis of very long

  12. Health economic potential of early nutrition programming: a model calculation of long-term reduction in blood pressure and related morbidity costs by use of long-chain polyunsaturated fatty acid-supplemented formula.

    Science.gov (United States)

    Straub, Niels; Grunert, Philipp; von Kries, Rüdiger; Koletzko, Berthold

    2011-12-01

    The reported effect sizes of early nutrition programming on long-term health outcomes are often small, and it has been questioned whether early interventions would be worthwhile in enhancing public health. We explored the possible health economic consequences of early nutrition programming by performing a model calculation, based on the only published study currently available for analysis, to evaluate the effects of supplementing infant formula with long-chain polyunsaturated fatty acids (LC-PUFAs) on lowering blood pressure and lowering the risk of hypertension-related diseases in later life. The costs and health effects of LC-PUFA-enriched and standard infant formulas were compared by using a Markov model, including all relevant direct and indirect costs based on German statistics. We assessed the effect size of blood pressure reduction from LC-PUFA-supplemented formula, the long-term persistence of the effect, and the effect of lowered blood pressure on hypertension-related morbidity. The cost-effectiveness analysis showed an increased life expectancy of 1.2 quality-adjusted life-years and an incremental cost-effectiveness ratio of -630 Euros (discounted to present value) for the LC-PUFA formula in comparison with standard formula. LC-PUFA nutrition was the superior strategy even when the blood pressure-lowering effect was reduced to the lower 95% CI. Breastfeeding is the recommended feeding practice, but infants who are not breastfed should receive an appropriate infant formula. Following this model calculation, LC-PUFA supplementation of infant formula represents an economically worthwhile prevention strategy, based on the costs derived from hypertension-linked diseases in later life. However, because our analysis was based on a single randomized controlled trial, further studies are required to verify the validity of this thesis.

  13. Complete Fiber/Copper Cable Solution for Long-Term Temperature and Pressure Measurement in Supercritical Reservoirs and EGS Wells

    Energy Technology Data Exchange (ETDEWEB)

    Pastouret, Alan [Draka Cableteq USA, Inc., North Dighton, MA (United States); Gooijer, Frans [Draka Cableteq USA, Inc., North Dighton, MA (United States); Overton, Bob [Draka Cableteq USA, Inc., North Dighton, MA (United States); Jonker, Jan [Draka Cableteq USA, Inc., North Dighton, MA (United States); Curley, Jim [Draka Cableteq USA, Inc., North Dighton, MA (United States); Constantine, Walter [Draka Cableteq USA, Inc., North Dighton, MA (United States); Waterman, Kendall Miller [Draka Cableteq USA, Inc., North Dighton, MA (United States)

    2015-11-13

    High Temperature insulated wire and optical fiber cable is a key enabling technology for the Geothermal Technologies Program (GTP). Without insulated electrical wires and optical fiber, downhole temperature and pressure sensors, flow meters and gauges cannot communicate with the surface. Unfortunately, there are currently no insulated electrical wire or fiber cable constructions capable of surviving for extended periods of deployment in a geothermal well (240-325°C) or supercritical (374°C) reservoir. This has severely hindered engineered reservoir creation, management and utilization, as hot zones and cool water intrusions cannot be understood over time. The lack of a insulated electrical wire and fiber cable solution is a fundamental limitation to the viability of this energy source. The High Temperature Downhole Tools target specification is development of tools and sensors for logging and monitoring wellbore conditions at depths of up to 10,000 meters and temperatures up to 374oC. It well recognized in the industry that no current electronic or fiber cable can be successfully deployed in a well and function successfully for more a few days at temperatures over 240oC. The goal of this project was to raise this performance level significantly. Prysmian Group’s objective in this project was to develop a complete, multi-purpose cable solution for long-term deployment in geothermal wells/reservoirs that can be used with the widest variety of sensors. In particular, the overall project objective was to produce a manufacturable cable design that can perform without serious degradation: • At temperatures up to 374°C; • At pressures up to 220 bar; • In a hydrogen-rich environment; and • For the life of the well (> 5 years). This cable incorporates: • Specialty optical fibers, with specific glass chemistry and high temperature and pressure protective coatings for data communication and distributed temperature and pressure sensing, and • High

  14. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  15. New Developments in Long-Term Downhole Monitoring Arrays

    Directory of Open Access Journals (Sweden)

    Jochem Kück

    2006-03-01

    Full Text Available The long-term observation of active geological processes is a major research goal in an increasing number of scientific drilling projects. An extended monitoring phase within a potentially hostile environment (e.g., temperature, pressure, salinity requires new long-lasting and robust instrumentation currently unavailable from either industry or academia. Extended exposure of instrument packages to extreme conditions will typically cause seals to weaken and fail,electronic parts to break under permanent load, and sensors to degrade or develop strong drift. In the framework of scientific exploration, there are currently several major research projects targeting fault zone drilling and in situ measurements to monitor physical and chemical conditions before, during, and after seismic events. Planning has now begun for tool development, testing, and continuous long-term monitoring for the San Andreas Fault Zone Observatory at Depth, SAFOD (Parkfi eld, Calif., U.S.A.; See article on page 32..

  16. Long-term intraocular pressure after combined trabeculotomy-trabeculectomy in glaucoma associated with Sturge-Weber syndrome.

    Science.gov (United States)

    Sood, Devindra; Rathore, Aanchal; Sood, Ishaana; Kumar, Dinesh; Sood, Narender N

    2018-03-01

    Vision loss in Sturge-Weber syndrome (SWS), a rare congenital disorder, is primarily due to glaucoma. We reviewed the data of all consecutive SWS-associated glaucoma cases in patients who had undergone combined trabeculotomy-trabeculectomy (CTT) at a tertiary glaucoma facility between January 1993 and December 2015. We analyzed the preoperative and postoperative intraocular pressure (IOP), corneal clarity, visual acuity, success rate, need for repeat surgery, and number of topical antiglaucoma medications needed at last follow-up. Twenty-six eyes of 20 patients with SWS (surgical age 0.7-96 months; mean 18.64 ± 29.74 months) had undergone primary CTT. The mean preoperative IOP was 32.76 ± 7.86 mm Hg (range 22-54 mm Hg) with medication (mean 3.11 ± 1.17; range 1-5). At the last follow-up (61-288 months); mean SD 134.73 ± 67.77 months), two eyes had IOP glaucoma in children. Long-term visual and surgical outcomes are encouraging.

  17. Long-term effect of prazosin administration on blood pressure, heart and structure of coronary artery of young spontaneously hypertensive rats.

    Science.gov (United States)

    Kristek, F; Koprdova, R

    2011-06-01

    The sympathetic nervous system belongs to the essential systems participating in blood pressure (BP) regulation. Inhibitory intervention into the key point of its operation (alfa 1 adrenoceptors) in the prehypertensive period of spontaneously hypertensive rats (SHR) might affect the development of the hypertension in later ontogenic periods. We studied the long-term effect of prazosin administration on the cardiovascular system of young Wistar rats and SHR. Four-week-old animals were used: Wistar rats, SHR, and Wistar rats and SHR receiving prazosin (10 mg/kg/day in tap water) by gavage. Blood pressure (BP) was measured weekly by the plethysmographic method. After six weeks under anaesthesia, the carotid artery was cannulated for BP registration, and the jugular vein was cannulated for administration of drugs. Afterwards, the animals were perfused with a glutaraldehyde fixative at a pressure of 120 mmHg. The septal branch of the left descending coronary artery was processed using electron microscopy. The prazosin administration evoked the following results in both groups: a decrease of BP and heart/body weight ratio, enhancement of hypotensive responses to acetylcholine (0.1 μg, 1 μg, and 10 μg), and an increase in the inner diameter of the coronary artery without changes in wall thickness, cross sectional area (CSA) (tunica intima+media), CSA of smooth muscle cells, and extracellular matrix. In the SHR group, a reduction was observed in BP increase after noradrenaline (1 μg) application. CSA of endothelial cells which was decreased in the SHR (compared to the control Wistar rats) was increased after prazosin treatment (up to control value). Long-term prazosin administration from early ontogeny partially prevented some pathological alterations in the cardiovascular system of SHR.

  18. Long-term field test of solar PV power generation using one-axis 3-position sun tracker

    KAUST Repository

    Huang, B.J.

    2011-09-01

    The 1 axis-3 position (1A-3P) sun tracking PV was built and tested to measure the daily and long-term power generation of the solar PV system. A comparative test using a fixed PV and a 1A-3P tracking PV was carried out with two identical stand-alone solar-powered LED lighting systems. The field test in the particular days shows that the 1A-3P tracking PV can generate 35.8% more electricity than the fixed PV in a partly-cloudy weather with daily-total solar irradiation HT=11.7MJ/m2day, or 35.6% in clear weather with HT=18.5MJ/m2day. This indicates that the present 1A-3P tracking PV can perform very close to a dual-axis continuous tracking PV (Kacira et al., 2004). The long-term outdoor test results have shown that the increase of daily power generation of 1A-3P tracking PV increases with increasing daily-total solar irradiation. The increase of monthly-total power generation for 1A-3P sun tracking PV is between 18.5-28.0%. The total power generation increase in the test period from March 1, 2010 to March 31, 2011, is 23.6% in Taipei (an area of low solar energy resource). The long-term performance of the present 1X-3P tracking PV is shown very close to the 1-axis continuous tracking PV in Taiwan (Chang, 2009). If the 1A-3P tracking PV is used in the area of high solar energy resource with yearly-average HT>17MJ/m2day, the increase of total long-term power generation with respect to fixed PV will be higher than 37.5%. This is very close to that of dual-axis continuous tracking PV. The 1A-3P tracker can be easily mounted on the wall of a building. The cost of the whole tracker is about the same as the regular mounting cost of a conventional rooftop PV system. This means that there is no extra cost for 1A-3P PV mounted on buildings. The 1A-3P PV is quite suitable for building-integrated applications. © 2011 Elsevier Ltd.

  19. A basic strategy for financing long term care.

    Science.gov (United States)

    Greenberg, J A; Leutz, W N

    1984-02-01

    As pressure mounts to contain Medicaid long term care spending, short-range "quick fixes" must be avoided. Three such false solutions in particular have shortcomings that may actually exacerbate long term care's financial dilemma because they are based on inadequate definitions of the problem. Two of these proposals--legislation to broaden family responsibility toward institutionalized elders on Medicaid and expanded state power to put liens on such elders' real property--err by trying to mandate "caring" and are predicated on a misunderstanding of the "spend-down" problem. The other proposal--to provide tax incentives to family members who care for elders--requires a large administrative apparatus, assumes an elasticity of supply that may not exist, and could disrupt the "gift relationship" on which family exchanges are often based. What is needed is a strategy with short term, intermediate, and long term objectives that move toward an insurance approach. The short term plan should lay the groundwork for intermediate strategy and control costs by changing rate-setting methods and putting limits on facility construction. The intermediate plan should change the problem's definition from one of merely controlling Medicaid long term care expenditures to one of efficiently managing state resources for the elderly through the development of state financing and local delivery systems that target older persons in greatest need. An effective means of doing this is through the creation of social/HMOs, which have five key features: integration of service responsibility and authority; flexibility in organizational design; balanced clientele; pooled prepaid funding; and financial risk for the provider organization. Finally, the long term strategy should transfer much of the long term care financial burden from individuals and state Medicaid agencies to insurance mechanisms. Many individuals would thus avoid impoverishment caused by health care spending and Medicaid would

  20. Comparison of manual versus automatic continuous positive airway pressure titration and the development of a predictive equation for therapeutic continuous positive airway pressure in Chinese patients with obstructive sleep apnoea.

    Science.gov (United States)

    Luo, Jiaying; Xiao, Sichang; Qiu, Zhihui; Song, Ning; Luo, Yuanming

    2013-04-01

    Whether the therapeutic nasal continuous positive airway pressure (CPAP) derived from manual titration is the same as derived from automatic titration is controversial. The purpose of this study was to compare the therapeutic pressure derived from manual titration with automatic titration. Fifty-one patients with obstructive sleep apnoea (OSA) (mean apnoea/hypopnoea index (AHI) = 50.6 ± 18.6 events/h) who were newly diagnosed after an overnight full polysomnography and who were willing to accept CPAP as a long-term treatment were recruited for the study. Manual titration during full polysomnography monitoring and unattended automatic titration with an automatic CPAP device (REMstar Auto) were performed. A separate cohort study of one hundred patients with OSA (AHI = 54.3 ± 18.9 events/h) was also performed by observing the efficacy of CPAP derived from manual titration. The treatment pressure derived from automatic titration (9.8 ± 2.2 cmH(2)O) was significantly higher than that derived from manual titration (7.3 ± 1.5 cmH(2)O; P titration (54.3 ± 18.9 events/h before treatment and 3.3 ± 1.7 events/h after treatment; P titration pressure derived from REMstar Auto is usually higher than the pressure derived from manual titration. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

  1. Short-term and long-term effects of violent media on aggression in children and adults.

    Science.gov (United States)

    Bushman, Brad J; Huesmann, L Rowell

    2006-04-01

    To test whether the results of the accumulated studies on media violence and aggressive behavior are consistent with the theories that have evolved to explain the effects. We tested for the existence of both short-term and long-term effects for aggressive behavior. We also tested the theory-driven hypothesis that short-term effects should be greater for adults and long-term effects should be greater for children. Meta-analysis. Children younger than 18 years and adults. Violent media, including TV, movies, video games, music, and comic books. Measures of aggressive behavior, aggressive thoughts, angry feelings, physiological arousal (eg, heart rate, blood pressure), and helping behavior. Effect size estimates were combined using meta-analytic procedures. As expected, the short-term effects of violent media were greater for adults than for children whereas the long-term effects were greater for children than for adults. The results also showed that there were overall modest but significant effect sizes for exposure to media violence on aggressive behaviors, aggressive thoughts, angry feelings, arousal levels, and helping behavior. The results are consistent with the theory that short-term effects are mostly due to the priming of existing well-encoded scripts, schemas, or beliefs, which adults have had more time to encode. In contrast, long-term effects require the learning (encoding) of scripts, schemas, or beliefs. Children can encode new scripts, schemas, and beliefs via observational learning with less interference and effort than adults.

  2. Long-term psychological sequelae of augmentation mammoplasty ...

    African Journals Online (AJOL)

    A request for elective surgery for augmentation mammoplasty (AM) is often associated with underlying psychopathology and high expectations of a positive psychological outcome. This study was designed to ascertain the long-term psychological sequelae of AM in a group of patients who were reassessed 3 years or more ...

  3. [Effects of long-term Tai Ji Quan exercise on automatic nervous modulation in the elderly].

    Science.gov (United States)

    Guo, Feng

    2015-03-01

    To examine the effects of long-term Tai Ji Quan (Chinnese Traditional Exercise) on automatic nervous modulation in the elders. The 18 subjects from Tai Ji Quan exercise class in Liaoning University of Retired Veteran Cadres were assigned into long-term Tai Ji Quan exercise group including 10 subjects and novice group including 8 subjects. Electrocardiography, respiratory and blood pressure data were collected on the following time points: at rest before Tai Ji Qhuan exercise and 30 min or 60 min after Tai Ji Quan exercise. The subjects at rest state in the long-term Tai Ji Quan exercise group showed higher than the subjects in the novice group in resperitory rate (RR), standard deviations of normal to normal intervals (SDNN), total power (TP), low frequency power (LFP), high frequency power (HFP), normalized high frequency power (nHFP), but lower in LFP/HFP, systolic and diastolic blood pressure, and heart rate. At rest state the respiratory rate of subjects in long-term Tai Ji Quan exercise group was significantly lower than the novices. After Tai Ji Quan exercise, TP, nHFP, LFP/HFP, heart rate and systolic pressure showed significantly changes, and the change level of Tai Ji Quan on these indices was larger in Tai Ji Quan exercise group than that in the novice group. Long-term Tai Ji Quan exercise can improve vagal modulations, and tend to reduce the sympathetic modulations.

  4. Long term adverse drug reaction to Efavirenz in a HIV infected ...

    African Journals Online (AJOL)

    There is only one published case of serious adverse reaction to Efavirenz in an adolescent after long-term use. The case of a male HIV Positive Nigerian patient aged 13 years. He presented with five-day history of Difficulty sleeping, abnormal dreams, inability to concentrate, restlessness, irrational behavior and long-term ...

  5. [Long-term psychiatric hospitalizations].

    Science.gov (United States)

    Plancke, L; Amariei, A

    2017-02-01

    Long-term hospitalizations in psychiatry raise the question of desocialisation of the patients and the inherent costs. Individual indicators were extracted from a medical administrative database containing full-time psychiatric hospitalizations for the period 2011-2013 of people over 16 years old living in the French region of Nord-Pas-de-Calais. We calculated the proportion of people who had experienced a hospitalization with a duration of 292 days or more during the study period. A bivariate analysis was conducted, then ecological data (level of health-care offer, the deprivation index and the size of the municipalities of residence) were included into a multilevel regression model in order to identify the factors significantly related to variability of long-term hospitalization rates. Among hospitalized individuals in psychiatry, 2.6% had had at least one hospitalization of 292 days or more during the observation period; the number of days in long-term hospitalization represented 22.5% of the total of days of full-time hospitalization in psychiatry. The bivariate analysis revealed that seniority in the psychiatric system was strongly correlated with long hospitalization rates. In the multivariate analysis, the individual indicators the most related to an increased risk of long-term hospitalization were: total lack of autonomy (OR=9.0; 95% CI: 6.7-12.2; P<001); diagnoses of psychological development disorders (OR=9.7; CI95%: 4.5-20.6; P<.001); mental retardation (OR=4.5; CI95%: 2.5-8.2; P<.001): schizophrenia (OR=3.0; CI95%: 1.7-5.2; P<.001); compulsory hospitalization (OR=1.7; CI95%: 1.4-2.1; P<.001); having experienced therapeutic isolation (OR=1.8; CI95%: 1.5-2.1; P<.001). Variations of long-term hospitalization rates depending on the type of establishment were very high, but the density of hospital beds or intensity of ambulatory activity services were not significantly linked to long-term hospitalization. The inhabitants of small urban units had

  6. Beat-by-beat analysis of cardiac output and blood pressure responses to short-term barostimulation in different body positions

    Science.gov (United States)

    Hildebrandt, Wulf; Schütze, Harald; Stegemann, J.

    Rapid quantification of the human baro-reflex control of heart rate has been achieved on a beat-by-beat basis using a neck-chamber with quick ECG-triggered pressure changes. Referring to recent findings on heart rate and stroke volume, the present study uses this technique to compare cardiac output as well as blood pressure changes in supine and upright position to investigate feedback effects and to confirm postural reflex modifications not revealed by RR-interval changes. A suction profile starting at +40 mmHg and running 7 steps of pressure decrease down to -65 mmHg was examined in 0° and 90° tilting position while beat-by-beat recordings were done of heart rate, stroke volume (impedance-cardiography) and blood pressure (Finapres tm) (n=16). The percentual heart rate decrease failed to be significantly different between positions. A suction-induced stroke volume increase led to a cardiac output almost maintained when supine and significantly increased when upright. A decrease in all blood pressure values was found during suction, except for systolic values in upright position which increased. Conclusively, (a) it is confirmed that different inotropy accounts for the seen gravitational effect on the cardiac output not represented by heart rate; (b) identical suction levels in different positions lead to different stimuli at the carotid receptor. This interference has to be considered in microgravity studies by beat-by-beat measurement of cardiac output and blood pressure.

  7. High blood pressure and long-term exposure to indoor noise and air pollution from road traffic.

    Science.gov (United States)

    Foraster, Maria; Künzli, Nino; Aguilera, Inmaculada; Rivera, Marcela; Agis, David; Vila, Joan; Bouso, Laura; Deltell, Alexandre; Marrugat, Jaume; Ramos, Rafel; Sunyer, Jordi; Elosua, Roberto; Basagaña, Xavier

    2014-11-01

    Traffic noise has been associated with prevalence of hypertension, but reports are inconsistent for blood pressure (BP). To ascertain noise effects and to disentangle them from those suspected to be from traffic-related air pollution, it may be essential to estimate people's noise exposure indoors in bedrooms. We analyzed associations between long-term exposure to indoor traffic noise in bedrooms and prevalent hypertension and systolic (SBP) and diastolic (DBP) BP, considering long-term exposure to outdoor nitrogen dioxide (NO2). We evaluated 1,926 cohort participants at baseline (years 2003-2006; Girona, Spain). Outdoor annual average levels of nighttime traffic noise (Lnight) and NO2 were estimated at postal addresses with a detailed traffic noise model and a land-use regression model, respectively. Individual indoor traffic Lnight levels were derived from outdoor Lnight with application of insulations provided by reported noise-reducing factors. We assessed associations for hypertension and BP with multi-exposure logistic and linear regression models, respectively. Median levels were 27.1 dB(A) (indoor Lnight), 56.7 dB(A) (outdoor Lnight), and 26.8 μg/m3 (NO2). Spearman correlations between outdoor and indoor Lnight with NO2 were 0.75 and 0.23, respectively. Indoor Lnight was associated both with hypertension (OR = 1.06; 95% CI: 0.99, 1.13) and SBP (β = 0.72; 95% CI: 0.29, 1.15) per 5 dB(A); and NO2 was associated with hypertension (OR = 1.16; 95% CI: 0.99, 1.36), SBP (β = 1.23; 95% CI: 0.21, 2.25), and DBP (β⊇= 0.56; 95% CI: -0.03, 1.14) per 10 μg/m3. In the outdoor noise model, Lnight was associated only with hypertension and NO2 with BP only. The indoor noise-SBP association was stronger and statistically significant with a threshold at 30 dB(A). Long-term exposure to indoor traffic noise was associated with prevalent hypertension and SBP, independently of NO2. Associations were less consistent for outdoor traffic Lnight and likely affected by

  8. Long-term sealing of openings in salt formations

    International Nuclear Information System (INIS)

    Walter, F.; Stockmann, N.; Yaramanci, U.; Laurens, J.F.

    1993-01-01

    Radioactive wastes can be disposed of in deep salt formations. Rock salt is a suitable geologic medium because of its unique characteristics. Open boreholes, shafts and drifts are created to provide physical access to the repository. Long-term seals must be emplaced in those potential pathways to prevent radioactive release to the biosphere. The sealing materials must be mechanically and, most important, geochemically stable within the host rock. Salt bricks made of compressed salt-powder are understood to be the first choice long-term sealing material. Seals built from salt bricks will be ductile. The permeability of the salt bricks is assumed to be in the order of 2*10 -15 m 2 . Large sealing systems are built by combining the individual bricks with mortar. Raw materials for mortar are fine-grained halite powder and ground saliferous clay. The permeability of the mortar decreases with its salt content to approx. 2*10 -14 m 2 . Moistened saliferous clay may show temporary swelling. Sealing experiments will be carried out in the Asse salt mine. Long-term seals will be built into holes of 1 m diameter. The contact and merging of the brick-wall with the surrounding rock salt will be investigated in long-term tests. Within the in situ sealing program a number of geophysical methods are applied. Acoustic emission measurements are used to study the effects of high pressure gas injection and a geoelectrical observation program is aiming to estimate the permeability in and around the long-term seal. High frequency electromagnetic methods contribute to the knowledge of the petrophysical rock properties. 11 refs., 12 figs

  9. Long-term potentiation and long-term depression: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Timothy V.P. Bliss

    2011-01-01

    Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

  10. Long-Term Positive and Negative Psychological Late Effects for Parents of Childhood Cancer Survivors: A Systematic Review

    Science.gov (United States)

    Ljungman, Lisa; Cernvall, Martin; Grönqvist, Helena; Ljótsson, Brjánn; Ljungman, Gustaf; von Essen, Louise

    2014-01-01

    Increasing survival rates in childhood cancer have yielded a growing population of parents of childhood cancer survivors (CCSs). This systematic review compiles the literature on positive and negative long-term psychological late effects for parents of CCSs, reported at least five years after the child's diagnosis and/or two years after the end of the child's treatment. Systematic searches were made in the databases CINAHL, EMBASE, PsycINFO, and PubMed. Fifteen studies, published between 1988 and 2010, from 12 projects were included. Thirteen studies used quantitative methodology, one quantitative and qualitative methodology, and one qualitative methodology. A total of 1045 parents participated in the reviewed studies. Mean scores were within normal ranges for general psychological distress, coping, and family functioning. However, a substantial subgroup reported a clinical level of general psychological distress, and 21–44% reported a severe level of posttraumatic stress symptoms. Worry, disease-related thoughts and feelings, marital strains, as well as posttraumatic growth was reported. Several factors were associated with the long-term late effects, such as parents' maladaptive coping during earlier stages of the childs disease trajectory and children's current poor adjustment. Quality assessments of reviewed studies and clinical implications of findings are discussed and recommendations for future research are presented. PMID:25058607

  11. Long-term Clinical Outcomes of Whole-Breast Irradiation Delivered in the Prone Position

    International Nuclear Information System (INIS)

    Stegman, Lauren D.; Beal, Katherine P.; Hunt, Margie A.; Fornier, Monica N.; McCormick, Beryl

    2007-01-01

    Purpose: The aim of this study was to evaluate retrospectively the effectiveness and toxicity of post-lumpectomy whole-breast radiation therapy delivered with prone positioning. Methods and Materials: Between September 1992 and August 2004, 245 women with 248 early-stage invasive or in situ breast cancers were treated using a prone breast board. Photon fields treated the whole breast to 46 to 50.4 Gy with standard fractionation. The target volume was clinically palpable breast tissue; no attempt was made to irradiate chest wall lymphatics. Tumor bed boosts were delivered in 85% of cases. Adjuvant chemotherapy and hormonal therapy were administered to 42% and 62% of patients, respectively. Results: After a median follow-up of 4.9 years, the 5 year actuarial true local and elsewhere ipsilateral breast tumor recurrence rates were 4.8% and 1.3%, respectively. The 5-year actuarial rates of regional nodal recurrence and distant metastases were 1.6% and 7.4%. Actuarial disease-free, disease-specific, and overall survival rates at 5 years were 89.4%, 97.3%, and 93%, respectively. Treatment breaks were required by 2.4% of patients. Grade 3 acute dermatitis and edema were each limited to 2% of patients. Only 4.9% of patients complained of acute chest wall discomfort. Chronic Grade 2 to 3 skin and subcutaneous tissue toxicities were reported in 4.4% and 13.7% of patients, respectively. Conclusions: Prone position breast radiation results in similar long-term disease control with a favorable toxicity profile compared with standard supine tangents. The anatomic advantages of prone positioning may contribute to improving the therapeutic ratio of post-lumpectomy radiation by improving dose homogeneity and minimizing incidental cardiac and lung dose

  12. Positive and Negative Syndrome Scale as a long-term outcome measurement tool in patients receiving clozapine ODT- A Pilot Study.

    Directory of Open Access Journals (Sweden)

    Shankar G

    2007-03-01

    Full Text Available Objective: This pilot, twelve-week, open-label study examined the effect of clozapine orally disintegrating tablet or ODT in patients with schizophrenia and schizoaffective disorder utilizing Positive and Negative Syndrome Scale (PANSS as a long-term outcome measurement tool.Methods: The final study sample consisted of nineteen subjects who were residents a long-term care psychiatric facility in Pomona, California. Subjects were using clozapine ODT (FazaClo® at the most clinically effective dosage depending on their symptoms and at the discretion of the psychiatrist and psychopharm consultant. PANSS were administered at baseline, week-4, week-8 and week-12. Paired sample t-tests were used to calculate the statistical significance of the mean differences for scores at baseline and week-12. Results: Mean differences from baseline indicated significant improvement on total score, as well as positive, negative, cognitive and general psychopathology subscales after twelve weeks of treatment. The greater average reduction in the negative syndrome subscale across the twelve weeks possibly illustrates the ability of clozapine ODT in improving negative symptoms, including cognitive function which is their ability to participate in their personal care and creative expressions in dance, arts, games, poetry to a greater extent their overall, quality of life and living along with the effect on positive symptoms.Conclusion: Overall, clozapine proved to affect a broad range of psychopathology including cognitive functions in this schizophrenic sample.

  13. [Effect of Dendrobium officinale granule on long-term-alcohol-induced hypertension rats].

    Science.gov (United States)

    Lv, Gui-Yuan; Xia, Chao-Qun; Chen, Su-Hong; Su, Jie; Liu, Xiao-Pang; Li, Bo; Gao, Jian-Li

    2013-10-01

    To observe the effect of Dendrobium officinale granule (DOG) on symptoms, blood pressure and serum biochemical indexes of long-term-alcohol-induced hypertension rats. The alcohol-induced hypertension rat model was established by feeding alcohol drink to normal rats (the alcohol volume fraction increases from 5% to 22%). Since the 4th week, DOG was administered for 32 weeks, once everyday. During the experiment, body weight, kinematic parameters (locomotor activities, grip strength, duration of vertigo) and blood pressures (systolic blood pressure, diastolic blood pressure and mean blood pressure) were detected regularly. On the 28th and 32nd weeks, blood samples were collected to determine serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), uric acid (UA), creatinine (Cr), cholesterol (CH) and triglycerides (TG). (1) Sign: The DOG-administered group showed reduction in the duration of vertigo and increase in appetite, body weight, locomotor activities and grip strength. (2) Blood pressure: The DOG-administered group showed significant decrease in blood pressure since the 8th week. (3) Biochemical indexes: The DOG-administered group showed notable decrease in serum ALT, AST, ALP, Cr, UA, TG level, but without significant change in TC level. The long-term administration of DOG can relieve alcohol-induced hypertension, while alleviating general signs, liver and kidney injuries and abnormal blood fat biochemical indexes.

  14. Microstructure and long-term creep properties of 9–12% Cr steels

    DEFF Research Database (Denmark)

    Hald, John

    2008-01-01

    Advanced microstructure characterisation and microstructure modelling has demonstrated that long-term microstructure stability in 9–12% Cr steels under technical loading conditions is equivalent to precipitate stability. Mo and W can have a positive influence on long-term creep strength of 9–12% Cr...

  15. Functional short- and long-term effects of nasal CPAP with and without humidification on the ciliary function of the nasal respiratory epithelium.

    Science.gov (United States)

    Sommer, J Ulrich; Kraus, Marius; Birk, Richard; Schultz, Johannes D; Hörmann, Karl; Stuck, Boris A

    2014-03-01

    Continuous positive airway pressure (CPAP) is the gold standard in the treatment of obstructive sleep apnea (OSA), but its impact on ciliary function is unclear to date. Furthermore, CPAP is associated with numerous side effects related to the nose and upper airway. Humidified CPAP is used to relieve these symptoms, but again, little is known regarding its effect on ciliary function of the nasal respiratory epithelium. In this prospective, randomized, crossover trial, 31 patients with OSA (AHI >15/h) were randomized to two treatment arms: nasal continuous positive airway pressure (nCPAP) with humidification or nCPAP without humidification for one night in each modality to assess short-term effects of ciliary beat frequency (CBF) and mucus transport time (MTT) and consecutively for 8 weeks in each modality to assess long-term effects in a crossover fashion. The baseline CBF was 4.8 ± 0.6 Hz, and baseline MTT was 540 ± 221 s. After one night of CPAP with and without humidification, ciliary function increased moderately yet with statistical significance (p humidification did not differ statistically significant. Regarding long-term effects of CPAP, a statistically significant increase in ciliary function above the baseline level and above the short-term level was shown without humidification (7.2 ± 0.4 Hz; 402 ± 176 s; p humidification (9.3 ± 0.7 Hz; 313 ± 95 s; p humidification, nCPAP has moderate effects on short-term ciliary function of the nasal respiratory epithelium. However, a significant increase in ciliary function-both in terms of an increased CBF and a decreased MTT-was detected after long-term use. The effect was more pronounced when humidification was used during nCPAP.

  16. Long-Term Symbolic Learning

    National Research Council Canada - National Science Library

    Kennedy, William G; Trafton, J. G

    2007-01-01

    What are the characteristics of long-term learning? We investigated the characteristics of long-term, symbolic learning using the Soar and ACT-R cognitive architectures running cognitive models of two simple tasks...

  17. Factors affecting long-term integrity of transmission pipelines; Facteurs affectant l'integrite a long terme des gazoducs

    Energy Technology Data Exchange (ETDEWEB)

    Hagiwara, N.; Masuda, T.; Oguchi, N. [Tokyo Gas Co., Ltd. (Japan)

    2000-07-01

    For upgrading long-term integrity of transmission pipelines, two types of delayed fracture in regions of mechanical damage in pipelines were investigated. Experimental and numerical studies clarified factors affecting the fatigue behavior of line pipes containing an idealized flaw under fluctuating internal pressure. To investigate fatigue cracking at mechanical damage in pipelines, degradation of fracture toughness and fatigue properties due to plastic pre-strain was also evaluated. A fracture mechanics-based study revealed conditions necessarily for initiation of hydrogen stress cracking (HSC) at a surface defect in line pipes under cathodic protection. (authors)

  18. Nuclear Energy, Long Term Requirements

    International Nuclear Information System (INIS)

    Knapp, V.

    2006-01-01

    status of the intermediate and long-term issues will be discussed, with special attention to the nuclear proliferation issue in view of unfavourable recent development, such as failure of 2005 NPT renewal conference and the Iran and North Korea cases. It will be argued that nuclear proliferation threat is the only really serious obstacle to the large-scale use of nuclear energy. In positive political environment solution of this problem could be possible on the lines of the very early US proposal (so called Baruch plan, UN 1946). Present political developments appear to demand renewed attempt to internationalize proliferation sensitive fuel cycle installations. Reasons will be discussed for a conviction that prospects for this may be better than in 1946. (author)

  19. Pediatric polytrauma : Short-term and long-term outcomes

    NARCIS (Netherlands)

    vanderSluis, CK; Kingma, J; Eisma, WH; tenDuis, HJ

    Objective: To assess the short-term and long-term outcomes of pediatric polytrauma patients and to analyze the extent to which short-term outcomes can predict long-term outcomes. Materials and Methods: Ail pediatric polytrauma patients (Injury Severity Score of greater than or equal to 16, less than

  20. Relationship between long-term exposure to low-level arsenic in drinking water and the prevalence of abnormal blood pressure.

    Science.gov (United States)

    Zhang, Chuanwu; Mao, Guangyun; He, Suxia; Yang, Zuopeng; Yang, Wei; Zhang, Xiaojing; Qiu, Wenting; Ta, Na; Cao, Li; Yang, Hui; Guo, Xiaojuan

    2013-11-15

    Arsenic increases the risk and incidence of cardiovascular disease. To explore the impact of long-term exposure to low-level arsenic in drinking water on blood pressure including pulse pressure (PP) and mean arterial blood pressure (MAP), a cross-sectional study was conducted in 2010 in which the blood pressure of 405 villagers was measured, who had been drinking water with an inorganic arsenic content 30-50 years of arsenic exposure and a 2.95-fold (95%CI: 1.31-6.67) increase in the group with >50 years exposure. Furthermore, the odds ratio for prevalence of abnormal PP and MAP were 1.06 (95%CI: 0.24-4.66) and 0.87 (95%CI: 0.36-2.14) in the group with >30-50 years of exposure, and were 2.46 (95%CI: 0.87-6.97) and 3.75 (95%CI: 1.61-8.71) for the group with >50 years exposure, compared to the group with arsenic exposure ≤ 30 years respectively. Significant trends for Hypertension (p<0.0001), PP (p<0.0001) and MAP (p=0.0016) were found. The prevalence of hypertension and abnormal PP as well as MAP is marked among a low-level arsenic exposure population, and significantly increases with the duration of arsenic exposure. Copyright © 2012 Elsevier B.V. All rights reserved.

  1. Tensile strength decreases and perfusion pressure of 3-holed polyamide epidural catheters increases in long-term epidural infusion.

    Science.gov (United States)

    Kim, Pascal; Meyer, Urs; Schüpfer, Guido; Rukwied, Roman; Konrad, Christoph; Gerber, Helmut

    2011-01-01

    Epidural analgesia is an established method for pain management. The failure rate is 8% to 12% due to technical difficulties (catheter dislocation and/or disconnection; partial or total catheter occlusion) and management. The mechanical properties of the catheters, like tensile strength and flow rate, may also be affected by the analgesic solution and/or the tissue environment. We investigated the tensile strength and perfusion pressure of new (n=20), perioperatively (n=30), and postoperatively (n=73) used epidural catheters (20-gauge, polyamide, closed tip, 3 side holes; Perifix [B. Braun]). To prevent dislocation, epidural catheters were taped (n=5) or fixed by suture (n=68) to the skin. After removal, mechanical properties were assessed by a tensile-testing machine (INSTRON 4500), and perfusion pressure was measured at flow rates of 10, 20, and 40 mL/h. All catheters demonstrated a 2-step force transmission. Initially, a minimal increase of length could be observed at 15 N followed by an elongation of several cm at additional forces (7 N). Breakage occurred in the control group at 23.5±1.5 N compared with 22.4±1.6 N in perioperative and 22.4±1.7 N in postoperative catheters (Ptensile strength, whereas perfusion pressure at clinically used flow rates (10 mL/h) increased significantly from 19±1.3 to 44±72 mm Hg during long-term (≥7 days) epidural analgesia (Ptensile strength or perfusion pressure. Epidural catheter use significantly increases the perfusion pressure and decreases the tensile strength. Copyright © 2011 by American Society of Regional Anesthesia and Pain Medicine

  2. Comparison of Short Term with Long Term Catheterization after Anterior Colporrhaphy Surgery

    Directory of Open Access Journals (Sweden)

    F. Movahed

    2010-07-01

    Full Text Available Introduction & Objective: This belief that overfilling the bladder after anterior colporrhaphy might have a negative influence on surgical outcome, causes routine catheterization after operation. This study was done to compare short term (24h with long term (72h catheterization after anterior colporrhaphy.Materials & Methods: This randomized clinical trial was carried out at Kosar Hospital , Qazvin (Iran in 2005-2006. One hundred cases candidating for anterior colporrhaphy , were divided in two equal groups . In the first group foley catheter was removed 24 hours and in the second group 72 hours after the operation. Before removing catheter, urine sample was obtained for culture . After removal and urination, residual volume was determinded. If the volume exceeded 200 ml or retention occured, the catheter would be fixed for more 72 hours. Need for recatheterization, urinary retention, positive urine culture,and hospital stay were surveyed. The data was analyzed using T and Fisher tests.Results: Residual volume exceeding 200 ml and the need for recatheterization occurred in one case (2% in the short term group but in the long term group none of the subjects needed recatheterization (P=1. Retention was not seen. In the both groups, one case (2% had positive urine culture with no statistically significant difference (P=1. Mean hospital stay was short in the first group (P=0.00.Conclusion: Short term catheterization after anterior colporrhaphy does not cause urinary retention and decreases hospital stay.

  3. The position of the arm during blood pressure measurement in sitting position.

    NARCIS (Netherlands)

    Adiyaman, A.; Verhoeff, R.; Lenders, J.W.M.; Deinum, J.; Thien, Th.

    2006-01-01

    OBJECTIVE: Determining the influence of the position of the arm on blood pressure measurement in the sitting position. METHODS: Blood pressure of 128 individuals (the majority being treated hypertensive patients) visiting the outpatient clinic was measured simultaneously on both arms with arms in

  4. Sleep apnea is associated with bronchial inflammation and continuous positive airway pressure-induced airway hyperresponsiveness.

    Science.gov (United States)

    Devouassoux, Gilles; Lévy, Patrick; Rossini, Eliane; Pin, Isabelle; Fior-Gozlan, Michèle; Henry, Mireille; Seigneurin, Daniel; Pépin, Jean-Louis

    2007-03-01

    Obstructive sleep apnea syndrome (OSA) is associated with systemic and upper airway inflammation. Pharyngeal inflammation has a potential role in upper airway collapse, whereas systemic inflammation relates to cardiovascular morbidity. However, the presence of an inflammatory involvement of lower airway has been poorly investigated. The aim of the study was to demonstrate an inflammatory process at the bronchial level in patients with OSA and to analyze effects of continuous positive airway pressure (CPAP) application and humidification on bronchial mucosa. The study was conducted by using sequential induced sputum for cell analysis and IL-8 production, nitric oxide exhalation measurement, and methacholine challenge before and after CPAP. Bronchial neutrophilia and a high IL-8 concentration were observed in untreated OSA compared with controls (75% +/- 20% vs 43% +/- 12%, P Obstructive sleep apnea syndrome is associated with bronchial inflammation. Our data demonstrate CPAP effect on the development of AHR, possibly facilitated by the pre-existing inflammation. Both issues should be evaluated during long-term CPAP use. Results showing a spontaneous bronchial inflammation in OSA and the development of a CPAP-related AHR require a long-term follow-up to evaluate consequences on chronic bronchial obstruction.

  5. Assessing the market for long-term care services.

    Science.gov (United States)

    Rice, J A; Taylor, S

    1984-02-01

    Traditionally, long-term care services have been used by a diverse marketplace. The chronically ill, developmentally disabled, mentally ill and aging population has looked to long-term care support services as a means of physical and emotional support. Much of the time these services were housed together for the sake of efficiency. The enormous burden these services are creating on the economy, and the growing aging population, have forced the recognition that long-term care service delivery systems must change. Alternate programming for long-term care services that reach out into the community and into individual homes is becoming an attractive approach to meeting the growing demands of the marketplace. Home health, specialized housing and creative funding mechanisms such as HMOs, are examples of initiatives undertaken by healthcare organizations that view diversification as a vehicle for survival. Market research techniques that have been used in other industries are being adapted to the healthcare industry to ensure the proper mix of services that are demanded by older, more knowledgeable consumers. The programs of the future will be market driven, with the ability of the individual to pay for such services playing a significant role. The healthcare provider of today is in a position to serve the community in new ways. By becoming an integral link in the long-term care system and by developing new programs, the organization can serve as a catalyst for change. It is up to the governing bodies and managers of these facilities to become visionaries and to accept responsibility for assessing the market for long-term care services and to guide their organization into the future.

  6. Long-Term Charge/Discharge Cycling Stability of MnO2 Aqueous Supercapacitor under Positive Polarization

    KAUST Repository

    Ataherian, Fatemeh

    2011-01-01

    The long-term charge/discharge cycling stability of MnO 2 electrode under positive polarization in aqueous KCl electrolyte has been studied over different potential windows spanning from the open circuit potential to varied higher-end potential limited by O 2 evolution. Cycling up to 1.2 V (vs Ag/AgCl (aq)) causes partial (35) capacitance fading to a plateau value within the initial cycles, accompanied by morphological reconstruction, reduction of surface Mn ions and oxygen evolution. The surface Mn-ion reduction has been attributed to a two-step oxidation-reduction mechanism involving OH oxidation in electrolyte, based on electrochemical analysis. When cycling potential extends to 1.4 V, extensive oxygen evolution takes place. The combination of surface passivation of current collector and extensive gas bubbling, which deteriorates electrical contact among the constituent particles within the electrode, results in further monotonic capacitance reduction. © 2011 The Electrochemical Society.

  7. Development of analysis model for mid and long-term effects of sodium water reaction event in LMR

    International Nuclear Information System (INIS)

    Eoh, Jae Hyuk; Sim, Yoon Sub; Kim, Seong O; Kim, Yeon Sik; Kim, Eui Kwang; Wi, Myung Hwan

    2002-04-01

    The Sodium-Water Reaction(SWR) is important in the design consideration of a LMR steam generator. To develop the analysis code for long-term effects of SWR, investigation on the characteristics of various SWR analysis code and the assessment of an analysis model for long term effects were performed. In an event of SWR, pressure spikes of wave propagation occur at its initial stage and last for a very short time, and then bulk motion of fluid and reaction products is progressed and lasts for a long time. In a case SWR occurs, a number of hydrogen bubbles produced and sodium is entrained into the bubbles through the gas-liquid bubble interfaces by evaporation or diffusion. The partial pressure of the sodium in a hydrogen bubble is determined as a function of the bubble size, temperature, and pressure, and is rapidly decreased as its size increased. From this, it can be considered that the bulk motion in the later phase of SWR is an axial motion caused by expansion of a single-phase hydrogen gas bubble produced by a reaction in the vicinity of the leak site. Through this investigation, a preliminary simple analysis model for long-term effects of SWR was set up and sensitivity study using the system design parameters such as pressure and temperature of IHTS for KALIMER was performed. Also, a simpler analysis model using the cover gas pressure change related to the production of a hydrogen bubble in a steam generator was developed from the analyses results. These simple analysis models of the reaction site and the pressure behavior with hydrogen production can be used to develop the mid and long-term analysis code for SWR in the KALIMER steam generator design

  8. Conversion of short-term to long-term memory in the novel object recognition paradigm.

    Science.gov (United States)

    Moore, Shannon J; Deshpande, Kaivalya; Stinnett, Gwen S; Seasholtz, Audrey F; Murphy, Geoffrey G

    2013-10-01

    It is well-known that stress can significantly impact learning; however, whether this effect facilitates or impairs the resultant memory depends on the characteristics of the stressor. Investigation of these dynamics can be confounded by the role of the stressor in motivating performance in a task. Positing a cohesive model of the effect of stress on learning and memory necessitates elucidating the consequences of stressful stimuli independently from task-specific functions. Therefore, the goal of this study was to examine the effect of manipulating a task-independent stressor (elevated light level) on short-term and long-term memory in the novel object recognition paradigm. Short-term memory was elicited in both low light and high light conditions, but long-term memory specifically required high light conditions during the acquisition phase (familiarization trial) and was independent of the light level during retrieval (test trial). Additionally, long-term memory appeared to be independent of stress-mediated glucocorticoid release, as both low and high light produced similar levels of plasma corticosterone, which further did not correlate with subsequent memory performance. Finally, both short-term and long-term memory showed no savings between repeated experiments suggesting that this novel object recognition paradigm may be useful for longitudinal studies, particularly when investigating treatments to stabilize or enhance weak memories in neurodegenerative diseases or during age-related cognitive decline. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. Increased airway reactivity in a neonatal mouse model of Continuous Positive Airway Pressure (CPAP)

    Science.gov (United States)

    Mayer, Catherine A.; Martin, Richard J.; MacFarlane, Peter M.

    2015-01-01

    Background Continuous positive airway pressure (CPAP) is a primary form of respiratory support used in the intensive care of preterm infants, but its long-term effects on airway (AW) function are unknown. Methods We developed a neonatal mouse model of CPAP treatment to determine whether it modifies later AW reactivity. Un-anesthetized spontaneously breathing mice were fitted with a mask to deliver CPAP (6cmH2O, 3hrs/day) for 7 consecutive days starting at postnatal day 1. Airway reactivity to methacholine was assessed using the in vitro living lung slice preparation. Results One week of CPAP increased AW responsiveness to methacholine in male, but not female mice, compared to untreated control animals. The AW hyper-reactivity of male mice persisted for 2 weeks (at P21) after CPAP treatment ended. 4 days of CPAP, however, did not significantly increase AW reactivity. Females also exhibited AW hyper-reactivity at P21, suggesting a delayed response to early (7 days) CPAP treatment. The effects of 7 days of CPAP on hyper-reactivity to methacholine were unique to smaller AWs whereas larger ones were relatively unaffected. Conclusion These data may be important to our understanding of the potential long-term consequences of neonatal CPAP therapy used in the intensive care of preterm infants. PMID:25950451

  10. Near-Term Actions to Address Long-Term Climate Risk

    Science.gov (United States)

    Lempert, R. J.

    2014-12-01

    Addressing climate change requires effective long-term policy making, which occurs when reflecting on potential events decades or more in the future causes policy makers to choose near-term actions different than those they would otherwise pursue. Contrary to some expectations, policy makers do sometimes make such long-term decisions, but not as commonly and successfully as climate change may require. In recent years however, the new capabilities of analytic decision support tools, combined with improved understanding of cognitive and organizational behaviors, has significantly improved the methods available for organizations to manage longer-term climate risks. In particular, these tools allow decision makers to understand what near-term actions consistently contribute to achieving both short- and long-term societal goals, even in the face of deep uncertainty regarding the long-term future. This talk will describe applications of these approaches for infrastructure, water, and flood risk management planning, as well as studies of how near-term choices about policy architectures can affect long-term greenhouse gas emission reduction pathways.

  11. [Preventing Facial Pressure Injuries in Patients Who Use Noninvasive Positive Pressure Ventilators: The Efficiency of Dressings].

    Science.gov (United States)

    Tai, Chia-Hua; Hsu, Mei-Yu

    2016-10-01

    Noninvasive positive pressure ventilation (NPPV) provides ventilation without tracheal intubation. Facial pressure injury is a recognized complication of this technique, making the prevention of facial pressure injuries an important issue for NPPV patients. The present study compared the effects of foam dressing and hydrocolloid dressing in preventing facial pressure injuries in NPPV patients. A randomized clinical trial was used to evaluate participants that were referred from the intensive care unit of a medical center in eastern Taiwan. Participants were randomized into two groups: the foam dressing group and the hydrocolloid dressing group. Statistics used in analysis were: analysis mean, standard deviation, chi-square, independent t-test, and the generalized estimating equation. Sixty participants were enrolled as participants. The incidence rate of facial pressure injury was 11.7% (7/60). No significant difference was found between the two groups in terms of duration of NPPV use, incidence of facial pressure injury, and occurrence time of facial pressure injury. However, the hydrocolloid dressing group had a higher usage amount than the foam dressing group (p < .05). Foam and hydrocolloid dressings are both helpful in preventing facial pressure injury when used in conjunction with regular skin assessments.

  12. Pilot study of long-term anaesthesia in broiler chickens.

    Science.gov (United States)

    O'Kane, Peter M; Connerton, Ian F; White, Kate L

    2016-01-01

    To provide stable anaesthesia of long duration in broiler chickens in order to perform a terminal caecal ligated loop procedure. Prospective experimental study. Seven clinically healthy broiler chickens (Gallus domesticus) aged 27-36 days, weighing 884-2000 g. Anaesthesia was induced and maintained with isoflurane in oxygen. All birds underwent intermittent positive pressure ventilation for the duration. End-tidal carbon dioxide, peripheral haemoglobin oxygen saturation, heart rate and oesophageal temperature were monitored continuously. All birds received intraosseous fluids. Butorphanol (2 mg kg(-1)) was administered intramuscularly at two hourly intervals. Euthanasia by parenteral pentobarbitone was performed at the end of procedure. Stable anaesthesia was maintained in four chickens for durations ranging from 435 to 510 minutes. One bird died and one was euthanized after 130 and 330 minutes, respectively, owing to surgical complications and another died from anaesthetic complication after 285 minutes. Long-term, stable anaesthesia is possible in clinically healthy chickens, provided complications such as hypothermia and hypoventilation are addressed and vital signs are carefully monitored. There are no known previous reports describing monitored, controlled anaesthesia of this duration in chickens. © 2015 The Authors Veterinary Anaesthesia and Analgesia published by John Wiley & Sons Ltd on behalf of Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.

  13. Prediction of the Long Term Cooling Performance for the 3-Pin Fuel Test Loop

    Energy Technology Data Exchange (ETDEWEB)

    Park, S. K.; Chi, D. Y.; Sim, B. S.; Park, K. N.; Ahn, S. H.; Lee, J. M.; Lee, C. Y.; Kim, H. R

    2005-12-15

    In the long term cooling phase that the emergency cooling water injection ends, the performance of the residual heat removal for the 3-pin fuel test loop has been predicted by a simplified heat transfer model. In the long term cooling phase the residual heat is 1323W for PWR fuel test mode and 1449W for CANDU fuel test mode. The each residual heat is assumed as 2% of the fission power of the test fuel used in the anticipated operational occurrence and design basis accident analyses. The each fission power used for the analyses is 105% of the rated fission power in the normal operation. In the long term cooling phase the residual heat is removed to the HANARO pool through the double pressure vessels of the in-pile test section. Saturate pooling boiling is assumed on the test fuel and condensation heat transfer is expected on the inner wall of the fuel carrier and the flow divider. Natural convection heat transfer on a heated vertical wall is also assumed on the outer wall of the outer pressure vessel. The conduction heat transfer is only considered in the gap between the double pressure vessels charged with neon gas and in the downcomer filled with coolant. The heat transfer rate between the coolant temperature of 152 .deg. C in the in-pile test section and the water temperature of 45 .deg. C in the HANARO pool is predicted as about 1666W. The 152 .deg. C is the saturate temperature of the coolant pressure predicted from the MARS code. The cooling capacity of 1666W is greater than the residual heats of 1323W and 1449W. Consequently the long term cooling performance of the 3-pin fuel test loop is sufficient for the anticipated operational occurrences and design basis accidents.

  14. Long-Term Musical Group Interaction Has a Positive Influence on Empathy in Children

    Science.gov (United States)

    Rabinowitch, Tal-Chen; Cross, Ian; Burnard, Pamela

    2013-01-01

    Musical group interaction (MGI) is a complex social setting requiring certain cognitive skills that may also elicit shared psychological states. We argue that many MGI-specific features may also be important for emotional empathy, the ability to experience another person's emotional state. We thus hypothesized that long-term repeated participation…

  15. ANMCO Position Paper: long-term follow-up of patients with pulmonary thromboembolism.

    Science.gov (United States)

    D'Agostino, Carlo; Zonzin, Pietro; Enea, Iolanda; Gulizia, Michele Massimo; Ageno, Walter; Agostoni, Piergiuseppe; Azzarito, Michele; Becattini, Cecilia; Bongarzoni, Amedeo; Bux, Francesca; Casazza, Franco; Corrieri, Nicoletta; D'Alto, Michele; D'Amato, Nicola; D'Armini, Andrea Maria; De Natale, Maria Grazia; Di Minno, Giovanni; Favretto, Giuseppe; Filippi, Lucia; Grazioli, Valentina; Palareti, Gualtiero; Pesavento, Raffaele; Roncon, Loris; Scelsi, Laura; Tufano, Antonella

    2017-05-01

    Venous thromboembolism (VTE), including pulmonary embolism and deep venous thrombosis, is the third most common cause of cardiovascular death. The management of the acute phase of VTE has already been described in several guidelines. However, the management of the follow-up (FU) of these patients has been poorly defined. This consensus document, created by the Italian cardiologists, wants to clarify this issue using the currently available evidence in VTE. Clinical and instrumental data acquired during the acute phase of the disease are the cornerstone for planning the FU. Acquired or congenital thrombophilic disorders could be identified in apparently unprovoked VTE during the FU. In other cases, an occult cancer could be discovered after a VTE. The main targets of the post-acute management are to prevent recurrence of VTE and to identify the patients who can develop a chronic thromboembolic pulmonary hypertension. Knowledge of pathophysiology and therapeutic approaches is fundamental to decide the most appropriate long-term treatment. Moreover, prognostic stratification during the FU should be constantly updated on the basis of the new evidence acquired. Currently, the cornerstone of VTE treatment is represented by both the oral and the parenteral anticoagulation. Novel oral anticoagulants should be an interesting alternative in the long-term treatment.

  16. Long Term Financing of Infrastructure

    OpenAIRE

    Sinha, Sidharth

    2014-01-01

    Infrastructure projects, given their long life, require long term financing. The main sources of long term financings are insurance and pension funds who seek long term investments with low credit risk. However, in India household financial savings are mainly invested in bank deposits. Insurance and pension funds account for only a small percentage of household financial savings. In addition most infrastructure projects do not qualify for investment by insurance and pension funds because of t...

  17. Long-term stability of the Leksell Gamma Knife® Perfexion™ patient positioning system (PPS)

    International Nuclear Information System (INIS)

    Novotny, J.; Bhatnagar, J. P.; Xu, Y.; Huq, M. S.

    2014-01-01

    Purpose: To assess the long-term mechanical stability and accuracy of the patient positioning system (PPS) of the Leksell Gamma Knife ® Perfexion™ (LGK PFX). Methods: The mechanical stability of the PPS of the LGK PFX was evaluated using measurements obtained between September 2007 and June 2011. Three methods were employed to measure the deviation of the coincidence of the radiological focus point (RFP) and the PPS calibration center point (CCP). In the first method, the onsite diode test tool with single diode detector was used together with the 4 mm collimator on a daily basis. In the second method, a service diode test tool with three diode detectors was used biannually at the time of the routine preventive maintenance. The test performed with the service diode test tool measured the deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. The third method employed the conventional film pin-prick method. This test was performed annually for the 4 mm collimator at the time of the routine annual QA. To estimate the effect of the patient weight on the performance of the PPS, the focus precision tests were also conducted with varying weights on the PPS using a set of lead bricks. Results: The average deviations measured from the 641 daily focus precision tests were 0.1 ± 0.1, 0.0 ± 0.0, and 0.0 ± 0.0 mm, respectively, for the 4 mm collimator in the X (left/right of the patient), Y (anterior/posterior of the patient), and Z (superior/inferior of the patient) directions. The average of the total radial deviations as measured during ten semiannual measurements with the service diode test tool were 0.070 ± 0.029, 0.060 ± 0.022, and 0.103 ± 0.028 mm, respectively for the central, long, and short diodes for the 4 mm collimator. Similarly, the average total radial deviations measured during the semiannual measurements for the 4, 8, and 16 mm collimators and using the central diode were 0.070 ± 0.029, 0.097 ± 0

  18. Short- and Long-Term Outcomes of Student Field Research Experiences in Special Populations.

    Science.gov (United States)

    Soliman, Amr S; Chamberlain, Robert M

    2016-06-01

    Global health education and training of biomedical students in international and minority health research is expending through U.S. academic institutions. This study addresses the short- and long-term outcomes of an NCI-funded R25 short-term summer field research training program. This program is designed for MPH and Ph.D. students in cancer epidemiology and related disciplines, in international and minority settings (special populations) in a recent 7-year period. Positive short-term outcome of 73 students was measured as publishing a manuscript from the field research data and having a job in special populations. Positive long-term outcome was measured as having a post-doc position, being in a doctoral program, and/or employment in special populations at least 3 years from finishing the program. Significant factors associated with both short- and long-term success included resourcefulness of the student and compatibility of personalities and interests between the student and the on-campus and off-campus mentors. Short-term-success of students who conducted international filed research was associated with visits of the on-campus mentor to the field site. Short-term success was also associated with extent of mentorship in the field site and with long-term success. Future studies should investigate how field research sites could enhance careers of students, appropriateness of the sites for specific training competencies, and how to maximize the learning experience of students in international and minority research sites.

  19. Long-term follow-up of bronchus-associated lymphoid tissue lymphomas (BALTOMA)

    International Nuclear Information System (INIS)

    Gaffke, G.; Jost, D.; Stroszcynski, C.; Puls, R.; Schlecht, I.; Felix, R.; Ludwig, W.D.; Hosten, N.

    2002-01-01

    Purpose: The purpose of this work was to describe the findings and the long term follow up of pathologically confirmed bronchus-associated lymphoid tissue lymphoma (BALTOMA) in 6 patients. Methods: CT examinations and conventional radiological examinations were reviewed and compared to describe typical radiological findings and patterns of pulmonary manifestations. It were described the number of lesions and characteristics like presence of airspace consolidation, ground-glass attenuation, bubble-like radio-lucencies, air bronchogram, bronchial dilatation, Infiltration and the long term behaviour of the manifestations. Results: Lesions with a positive air bronchogram, no infiltration of extrapulmonary tissue or extrapulmonary manifestations were revealed as typical findings. Only a slow or no progression of disease was shown in most patients over a term of up to twelve years. Conclusions: The lymphoma of the bronchus-associated lymphoid tissue of the lung is a rare tumor. A positive air bronchogram, a multiplicity of disease, bilateral lesions, a fibrotic transformation of the lung tissue and no growth or only a slow groth over al long term of observation are typical radiological findings. (orig.) [de

  20. HIV-related politics in long-term perspective.

    Science.gov (United States)

    Friedman, S R

    1998-06-01

    Some long-term, large-scale socio-economic changes may affect the politics of HIV and other emerging viruses such as hepatitis C. It is useful to ask why the potential peace dividend of the early 1990s failed to provide adequate resources for HIV-related social and medical service delivery in developed or developing nations. This failure can be understood by looking at long-term global economic trends and the pressures they put on governments and corporations. They have produced a period in which fundamental issues of political and economic structure are at stake and, often, the response is a divide-and-rule politics to promote stability. National politics differ in terms of the extent to which such a 'politics of scapegoating' is institutionalized and in terms of which groups are scapegoated. Groups such as drug injectors, gay and bisexual men and sex traders are particularly likely to be targeted both by the scapegoaters and by HIV. Given this framework, how should public health professionals and activists engaged in HIV-related issues respond? Under what circumstances should we orient efforts upwards towards corporate, political or bureaucratic leaders? Under what circumstances, and how, should we orient towards popular forces? Relatedly, we need to consider an issue we often ignore: What do we have to offer potential allies? That is, in terms of their goals, philosophies and needs, why should they ally with us?

  1. Uranium ... long-term confidence

    International Nuclear Information System (INIS)

    Anon.

    1983-01-01

    Half way through 1983 the outlook for the world's uranium producers was far from bright if one takes a short term view. The readily accessible facts present a gloomy picture. The spot prices of uranium over the past few years decreased from a high of $42-$43/lb to a low of $17 in 1982. It now hovers between $23 and $24. the contract prices negotiated between producers and consumers are not so accessible but they do not reflect the spot price. The reasons why contractual uranium prices do not follow the usual dictates of supply and demand are related to the position in which uranium and associated power industries find themselves. There is public reaction with strong emotional overtones as well as much reduced expectations about the electric power needs of the world. Furthermore the supply of uranium is not guaranteed despite present over production. However the people in the industry, taking the medium- and long-term view, are not despondent

  2. Containment long-term operational integrity

    International Nuclear Information System (INIS)

    Sammataro, R.F.

    1990-01-01

    Periodic integrated leak rate tests are required to assure that containments continue to meet allowable leakage limits. Although overall performance has been quite good to date, several major containment aging and degradation mechanisms have been identified. Two pilot plant life extension (PLEX) studies serve as models for extending the operational integrity of present containments for light-water cooled nuclear power plants in the United States. One study is for a Boiling-Water Reactor (BWR) and the second is for a Pressurized-Water Reactor (PWR). Research and testing programs for determining the ultimate pressure capacity and failure mechanisms for containments under severe loading conditions and studies for extending the life of current plants beyond the present 40-year licensed lifetime are under way. This paper presents an overview of containment designs in the United States. Also presented are a discussion of the American Society of Mechanical Engineers Boiler and Pressure Vessel Code (ASME Code) and regulatory authority requirements for the design, construction, inservice inspection, leakage testing and repair of steel and concrete containments. Findings for containments from the pilot PLEX studies and continuing containment integrity research and testing programs are discussed. The ASME Code and regulatory requirements together with recommendations from the PLEX studies and containment integrity research and testing provide a basis for continued containment long-term operational integrity. (orig./GL)

  3. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P; Gao, B [Powertech Labs. Inc., Surrey, BC (Canada)

    1994-12-31

    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  4. Long-term outcomes of kidney transplantation across a positive complement-dependent cytotoxicity crossmatch.

    Science.gov (United States)

    Riella, Leonardo V; Safa, Kassem; Yagan, Jude; Lee, Belinda; Azzi, Jamil; Najafian, Nader; Abdi, Reza; Milford, Edgar; Mah, Helen; Gabardi, Steven; Malek, Sayeed; Tullius, Stefan G; Magee, Colm; Chandraker, Anil

    2014-06-27

    More than 30% of potential kidney transplant recipients have pre-existing anti-human leukocyte antigen antibodies. This subgroup has significantly lower transplant rates and increased mortality. Desensitization has become an important tool to overcome this immunological barrier. However, limited data is available regarding long-term outcomes, in particular for the highest risk group with a positive complement-dependent cytotoxicity crossmatch (CDC XM) before desensitization. Between 2002 and 2010, 39 patients underwent living-kidney transplantation across a positive CDC XM against their donors at our center. The desensitization protocol involved pretransplant immunosuppression, plasmapheresis, and low-dose intravenous immunoglobulin±rituximab. Measured outcomes included patient survival, graft survival, renal function, rates of rejection, infection, and malignancy. The mean and median follow-up was 5.2 years. Patient survival was 95% at 1 year, 95% at 3 years, and 86% at 5 years. Death-censored graft survival was 94% at 1 year, 88% at 3 years, and 84% at 5 years. Uncensored graft survival was 87% at 1 year, 79% at 3 years, and 72% at 5 years. Twenty-four subjects (61%) developed acute antibody-mediated rejection of the allograft and one patient lost her graft because of hyperacute rejection. Infectious complications included pneumonia (17%), BK nephropathy (10%), and CMV disease (5%). Skin cancer was the most prevalent malignancy in 10% of patients. There were no cases of lymphoproliferative disorder. Mean serum creatinine was 1.7±1 mg/dL in functioning grafts at 5 years after transplantation. Despite high rates of early rejection, desensitization in living-kidney transplantation results in acceptable 5-year patient and graft survival rates.

  5. Impact of short-term severe accident management actions in a long-term perspective. Final Report

    International Nuclear Information System (INIS)

    2000-03-01

    The present systems for severe accident management are focused on mitigating the consequences of special severe accident phenomena and to reach a safe plant state. However, in the development of strategies and procedures for severe accident management, it is also important to consider the long-term perspective of accident management and especially to secure the safe state of the plant. The main reason for this is that certain short-term actions have an impact on the long-term scenario. Both positive and negative effects from short-term actions on the accident management in the long-term perspective have been included in this paper. Short-term actions are accident management measures taken within about 24 hours after the initiating event. The purpose of short-term actions is to reach a stable status of the plant. The main goal in the long-term perspective is to maintain the reactor in a stable state and prevent uncontrolled releases of activity. The purpose of this short Technical Note, deliberately limited in scope, is to draw attention to potential long-term problems, important to utilities and regulatory authorities, arising from the way a severe accident would be managed during the first hours. Its objective is to encourage discussions on the safest - and maybe also most economical - way to manage a severe accident in the long term by not making the situation worse through inappropriate short-term actions, and on the identification of short-term actions likely to make long-term management easier and safer. The Note is intended as a contribution to the knowledge base put at the disposal of Member countries through international collaboration. The scope of the work has been limited to a literature search. Useful further activities have been identified. However, there is no proposal, at this stage, for more detailed work to be undertaken under the auspices of the CSNI. Plant-specific applications would need to be developed by utilities

  6. Beneficial Effects of Long-Term CPAP Treatment on Sleep Quality and Blood Pressure in Adherent Subjects With Obstructive Sleep Apnea.

    Science.gov (United States)

    Yang, Mei-Chen; Huang, Yi-Chih; Lan, Chou-Chin; Wu, Yao-Kuang; Huang, Kuo-Feng

    2015-12-01

    Obstructive sleep apnea (OSA) is associated with increased risk of cardiovascular diseases. Although CPAP is the first treatment choice for moderate-to-severe OSA, acceptance of and adherence to CPAP remain problematic. High CPAP adherence is generally defined as ≥4 h of use/night for ≥70% of the nights monitored. We investigated the long-term beneficial effects of CPAP on sleep quality and blood pressure in subjects with moderate-to-severe OSA according to high or low CPAP adherence. We retrospectively analyzed 121 subjects with moderate-to-severe OSA from August 2008 to July 2012. These subjects were divided into 3 groups: (1) no CPAP treatment (n = 29), (2) low CPAP adherence (n = 28), and (3) high CPAP adherence (n = 64). All subjects were followed up for at least 1 y. The 3 groups were compared regarding anthropometric and polysomnographic variables, presence of cardiovascular comorbidities, and blood pressure at baseline and at the last follow-up. The no-treatment group showed significant increases in oxygen desaturation index and blood pressure. The high-adherence group showed significant improvement in daytime sleepiness, apnea-hypopnea index (AHI), oxygen desaturation index, and blood pressure. Although the AHI was also significantly decreased after CPAP treatment in the low-adherence group, blood pressure remained unchanged. CPAP treatment had beneficial effects on both sleep quality and blood pressure only in subjects with OSA and high CPAP adherence who used CPAP for ≥4 h/night for ≥70% of nights monitored. Subjects with low CPAP adherence received beneficial effects on AHI, but not blood pressure. Copyright © 2015 by Daedalus Enterprises.

  7. Long-term prognostic value of transesophageal atrial pacing stress echocardiography.

    Science.gov (United States)

    Płońska, Edyta; Kasprzak, Jarosław D; Kornacewicz-Jach, Zdzisława

    2005-07-01

    The aim of our study was to evaluate the long-term prognostic value of transesophageal atrial pacing stress echocardiography (TAPSE) for the prediction of cardiovascular events (myocardial infarction) and mortality at 10-year follow-up. TAPSE was applied as a diagnostic modality in 93 consecutive patients (mean age 45 +/- 8 years) who were diagnosed for the cause of chest pain. Long-term follow-up data were obtained from 87 (94%) patients with a mean duration of follow-up of 92 +/- 4 months. Stress echocardiography was performed using TAPSE with a mean pacing rate of 142 +/- 18/min. Predefined cardiac events occurred during the follow-up period in 45 (52%) patients, including 24 (28%) with hard end points: 10 (12%) with nonfatal myocardial infarction and 17 who died (events overlap). Positive result of TAPSE was found in 47 (54%) patients and among those with positive TAPSE result, 16 died (94% of total mortality) and 21 had a hard event (death or infarction-88% of total prevalence). Survival free from hard events was noted in 37 (92%) patients with negative TAPSE and only in 26 (55%) of those with positive TAPSE ( P = .001). Independent predictive factors for mortality were TAPSE positivity (relative risk with 95% confidence interval [RR/CI] = 39.6 [36.3-42.9], P = .0006) and diabetes (RR/CI = 10.2 [8.6-11.8], P = .0026). Independent predictive factors for myocardial infarction were diabetes (RR/CI = 8.1 [6.3-9.9], P = .0186) and significant coronary stenosis in angiography (RR/CI = 9.0 [6.8-11.2], P = .0479). Independent predictive factors for death or nonfatal myocardial infarction were TAPSE positivity (RR/CI = 12.3 [11.1-13.3], P = .0001) and diabetes (RR/CI = 7.0 [5.8-8.2], P = .0018). Positive TAPSE result carries long-term prognostic information regarding mortality and risk of myocardial infarction that can be used to identify patients requiring more aggressive treatment. Negative TAPSE allows highly accurate definition of low-risk population with

  8. Comparison of Efficacy and Tolerance of Automatic Continuous Positive Airway Pressure Devices With the Optimum Continuous Positive Airway Pressure.

    Science.gov (United States)

    Tommi, George; Aronow, Wilbert S; Sheehan, John C; McCleay, Matthew T; Meyers, Patrick G

    Patients diagnosed with obstructive sleep apnea syndrome were randomly placed on automatic continuous positive airway pressure (ACPAP) for 2 hours followed by manual titration for the rest of the night. One hundred sixty-one patients entered the study, with at least 50 patients titrated with each of 3 ACPAP devices. The optimum continuous positive airway pressure (CPAP) was defined as the lowest pressure with an apnea-hypoxia index of ≤5/hr, which ranged from 4 cm to 18 cm. Success with ACPAP was approximately 60%-80% when the optimum CPAP was 4-6 cm but fell to below 30% if the optimum CPAP was ≥8 cm (P = 0.001). Average ACPAP ranged from 2 to 10 cm below the optimum level if the optimum CPAP was ≥8 cm. Patients who responded to a low CPAP but deteriorated on higher pressures failed to respond to any of the automatic devices. We recommend that CPAP titration be performed manually before initiation of ACPAP in patients with obstructive sleep apnea. The basal pressure for ACPAP should be the optimum pressure obtained by manual titration. Limits on the upper level of ACPAP may be necessary for patients who deteriorate on higher positive pressures.

  9. Long-Term Effects of School Size on Students' Outcomes

    DEFF Research Database (Denmark)

    Humlum, Maria Knoth; Smith, Nina

    We estimate the effect of school size on students' long-term outcomes such as high school completion, being out of the labor market, and earnings at the age of 30. We use rich register data on the entire population of Danish children attending grade 9 in the period 1986-2004. This allows us...... school size and alternative measures of long-term success in the educational system and the labor market. The positive impact of school size seems mainly to be driven by boys, students from families with a low educational level and students attending schools in urban areas....

  10. Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study.

    Science.gov (United States)

    Andersén, Åsa; Ståhl, Christian; Anderzén, Ingrid; Kristiansson, Per; Larsson, Kjerstin

    2017-10-10

    The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy) may have an impact on an individual's ability to work. The aim of this study was to investigate clients' experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training and real jobs.

  11. Inert gas narcosis disrupts encoding but not retrieval of long term memory.

    Science.gov (United States)

    Hobbs, Malcolm; Kneller, Wendy

    2015-05-15

    Exposure to increased ambient pressure causes inert gas narcosis of which one symptom is long-term memory (LTM) impairment. Narcosis is posited to impair LTM by disrupting information encoding, retrieval (self-guided search), or both. The effect of narcosis on the encoding and retrieval of LTM was investigated by testing the effect of learning-recall pressure and levels of processing (LoP) on the free-recall of word lists in divers underwater. All participants (n=60) took part in four conditions in which words were learnt and then recalled at either low pressure (1.4-1.9atm/4-9msw) or high pressure (4.4-5.0atm/34-40msw), as manipulated by changes in depth underwater: low-low (LL), low-high(LH), high-high (HH), and high-low (HL). In addition, participants were assigned to either a deep or shallow processing condition, using LoP methodology. Free-recall memory ability was significantly impaired only when words were initially learned at high pressure (HH & HL conditions). When words were learned at low pressure and then recalled at low pressure (LL condition) or high pressure (LH condition) free-recall was not impaired. Although numerically superior in several conditions, deeper processing failed to significantly improve free-recall ability in any of the learning-recall conditions. This pattern of results support the hypothesis that narcosis disrupts encoding of information into LTM, while retrieval appears to be unaffected. These findings are discussed in relation to similar effects reported by some memory impairing drugs and the practical implications for workers in pressurised environments. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Unsaturated consolidation theory for the prediction of long-term municipal solid waste landfill settlement.

    Science.gov (United States)

    Liu, Chia-Nan; Chen, Rong-Her; Chen, Kuo-Sheng

    2006-02-01

    The understanding of long-term landfill settlement is important for landfill design and rehabilitation. However, suitable models that can consider both the mechanical and biodecomposition mechanisms in predicting the long-term landfill settlement are generally not available. In this paper, a model based on unsaturated consolidation theory and considering the biodegradation process is introduced to simulate the landfill settlement behaviour. The details of problem formulations and the derivation of the solution for the formulated differential equation of gas pressure are presented. A step-by-step analytical procedure employing this approach for estimating settlement is proposed. The proposed model can generally model the typical features of short-term and long-term behaviour. The proposed model also yields results that are comparable with the field measurements.

  13. [Stabilization and long-term effect of chromium contaminated soil].

    Science.gov (United States)

    Wang, Jing; Luo, Qi-Shi; Zhang, Chang-Bo; Tan, Liang; Li, Xu

    2013-10-01

    Short-term (3 d and 28 d) and long-term (1 a) stabilization effects of Cr contaminated soil were investigated through nature curing, using four amendments including ferrous sulfide, ferrous sulfate, zero-valent iron and sodium dithionite. The results indicated that ferrous sulfide and zero-valent iron were not helpful for the stabilization of Cr(VI) when directly used because of their poor solubility and immobility. Ferrous sulfate could effectively and rapidly decrease total leaching Cr and Cr(VI) content. The stabilization effect was further promoted by the generation of iron hydroxides after long-term curing. Sodium dithionite also had positive effect on soil stabilization. Appropriate addition ratio of the two chemicals could help maintain the soil pH in range of 6-8.

  14. MELCOR simulation of long-term station blackout at Peach Bottom

    International Nuclear Information System (INIS)

    Madni, I.K.

    1990-01-01

    This paper presents the results from MELCOR (Version 1.8BC) calculations of the Long-Term Station Blackout Accident Sequence, with failure to depressurize the reactor vessel, at the Peach Bottom (BWR Mark I) plant, and presents comparisons with Source Term Code Package (STCP) calculations of the same sequence. This sequence assumes that batteries are available for six hours following loss of all power to the plant. Following battery failure, the reactor coolant system (RCS) inventory is boiled off through the relief valves by continued decay heat generation. This leads to core uncovery, heatup, clad oxidation, core degradation, relocation, and, eventually, vessel failure at high pressure. STCP has calculated the transient out to 13.5 hours after core uncovery. The results include the timing of key events, pressure and temperature response in the reactor vessel and containment, hydrogen production, and the release of source terms to the environment. 12 refs., 23 figs., 3 tabs

  15. Extubation success in premature infants with respiratory distress syndrome treated with bi-level nasal continuous positive airway pressure versus nasal intermittent positive pressure ventilation.

    Science.gov (United States)

    Thomas, Patricia E; LeFlore, Judy

    2013-01-01

    Infants born prematurely with respiratory distress syndrome are at high risk for complications from mechanical ventilation. Strategies are needed to minimize their days on the ventilator. The purpose of this study was to compare extubation success rates in infants treated with 2 different types of continuous positive airway pressure devices. A retrospective cohort study design was used. Data were retrieved from electronic medical records for patients in a large, metropolitan, level III neonatal intensive care unit. A sample of 194 premature infants with respiratory distress syndrome was selected, 124 of whom were treated with nasal intermittent positive pressure ventilation and 70 with bi-level variable flow nasal continuous positive airway pressure (bi-level nasal continuous positive airway pressure). Infants in both groups had high extubation success rates (79% of nasal intermittent positive pressure ventilation group and 77% of bi-level nasal continuous positive airway pressure group). Although infants in the bi-level nasal continuous positive airway pressure group were extubated sooner, there was no difference in duration of oxygen therapy between the 2 groups. Promoting early extubation and extubation success is a vital strategy to reduce complications of mechanical ventilation that adversely affect premature infants with respiratory distress syndrome.

  16. Evaluation of a method to measure long term cortisol levels.

    Science.gov (United States)

    Manenschijn, Laura; Koper, Jan W; Lamberts, Steven W J; van Rossum, Elisabeth F C

    2011-01-01

    Elevated levels of cortisol are known to induce various symptoms and diseases, e.g. abdominal obesity, type 2 diabetes, osteoporosis and cardiovascular disease. Measuring serum, saliva and urine cortisol is limited to one time point. Measurement of cortisol in scalp hair is a recently developed method to measure long term cortisol levels. The aim of this study was to investigate whether hair cortisol is a feasible parameter to measure cortisol exposure. We collected hair samples of 195 healthy individuals, 9 hypercortisolemic and one hypocortisolemic patient and measured hair cortisol levels. Cortisol was extracted from scalp hair using methanol and cortisol levels were measured using a salivary ELISA kit. Measurement of waist and hip circumferences and blood pressure was performed in 46 healthy subjects. We found a positive correlation between hair cortisol and both waist circumference (r=0.392, p=0.007) and waist-to-hip ratio (WHR) (r=0.425, p=0.003). No correlations were found between hair cortisol levels and BMI, blood pressure or age. There was no decline in cortisol levels in six consecutive hair segments. Hair cortisol levels were elevated in patients with known hypercortisolism (pcortisol was positively correlated with WHR, suggesting that hair cortisol reflects cortisol exposure at tissue level, which was also supported by elevated hair cortisol levels in hypercortisolemic patients and concordance between hair cortisol levels and clinical disease course. Cortisol levels in hair are slightly influenced by hair treatment but not by natural hair colour, use of hair products, gender or age. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Long-term storage of spent nuclear fuel

    International Nuclear Information System (INIS)

    Kempe, T.F.; Martin, A.; Thorne, M.C.

    1980-06-01

    This report presents the results of a study on the storage of spent nuclear fuel, with particular reference to the options which would be available for long-term storage. Two reference programmes of nuclear power generation in the UK are defined and these are used as a basis for the projection of arisings of spent fuel and the storage capacity which might be needed. The characteristics of spent fuel which are relevant to long-term storage include the dimensions, materials and physical construction of the elements, their radioactive inventory and the associated decay heating as a function of time after removal from the reactor. Information on the behaviour of spent fuel in storage ponds is reviewed with particular reference to the corrosion of the cladding. The review indicates that, for long-term storage, both Magnox and AGR fuel would need to be packaged because of the high rate of cladding corrosion and the resulting radiological problems. The position on PWR fuel is less certain. Experience of dry storage is less extensive but it appears that the rate of corrosion of cladding is much lower than in water. Unit costs are discussed. Consideration is given to the radiological impact of fuel storage. (author)

  18. Long-term urethral catheterisation.

    Science.gov (United States)

    Turner, Bruce; Dickens, Nicola

    This article discusses long-term urethral catheterisation, focusing on the relevant anatomy and physiology, indications for the procedure, catheter selection and catheter care. It is important that nurses have a good working knowledge of long-term catheterisation as the need for this intervention will increase with the rise in chronic health conditions and the ageing population.

  19. Linking women who test HIV-positive in pregnancy-related services to long-term HIV care and treatment services: a systematic review.

    Science.gov (United States)

    Ferguson, Laura; Grant, Alison D; Watson-Jones, Deborah; Kahawita, Tanya; Ong'ech, John O; Ross, David A

    2012-05-01

    To quantify attrition between women testing HIV-positive in pregnancy-related services and accessing long-term HIV care and treatment services in low- or middle-income countries and to explore the reasons underlying client drop-out by synthesising current literature on this topic. A systematic search in Medline, EMBASE, Global Health and the International Bibliography of the Social Sciences of literature published 2000-2010. Only studies meeting pre-defined quality criteria were included. Of 2543 articles retrieved, 20 met the inclusion criteria. Sixteen (80%) drew on data from sub-Saharan Africa. The pathway between testing HIV-positive in pregnancy-related services and accessing long-term HIV-related services is complex, and attrition was usually high. There was a failure to initiate highly active antiretroviral therapy (HAART) among 38-88% of known-eligible women. Providing 'family-focused care', and integrating CD4 testing and HAART provision into prevention of mother-to-child HIV transmission services appear promising for increasing women's uptake of HIV-related services. Individual-level factors that need to be addressed include financial constraints and fear of stigma. Too few women negotiate the many steps between testing HIV-positive in pregnancy-related services and accessing HIV-related services for themselves. Recent efforts to stem patient drop-out, such as the MTCT-Plus Initiative, hold promise. Addressing barriers and enabling factors both within health facilities and at the levels of the individual woman, her family and society will be essential to improve the uptake of services. © 2012 Blackwell Publishing Ltd.

  20. Evaluation of a continuous-positive pressure generating system

    Directory of Open Access Journals (Sweden)

    Herrera N

    2016-03-01

    Full Text Available Nestor Herrera,1,2 Roberto Regnícoli,1,2 Mariel Murad1,2 1Neonatology Unit, Italian Hospital Garibaldi, Rosario, Argentina; 2Experimental Medicine and Surgery Unit, Italian University Institute of Rosario, Argentina Abstract: The use of systems that apply continuous-positive airway pressure by means of noninvasive methods is widespread in the neonatal care practice and has been associated with a decrease in the use of invasive mechanical ventilation, less administration of exogenous surfactant, and bronchopulmonary dysplasia. Few experimental studies on the functioning of the neonatology systems that generate continuous-positive airway pressure have been reported. A flow resistor system associated with an underwater seal resistor in a lung test model was described, and it was compared with an underwater seal threshold resistor system. Important differences in the pressures generated in the different systems studied were verified. The generation of pressure was associated with the immersion depth and the diameter of the bubble tubing. The flow resistor associated with an underwater seal, with small bubble tubing, showed no important differences in the evaluated pressures, exerting a stabilizing effect on the generated pressures. The importance of measuring the pressure generated by the different systems studied was verified, due to the differences between the working pressures set and the pressures measured. Keywords: continuous-positive pressure, flow and threshold resistor, BCPAP

  1. Positive experiences of a vocational rehabilitation intervention for individuals on long-term sick leave, the Dirigo project: a qualitative study

    Directory of Open Access Journals (Sweden)

    Åsa Andersén

    2017-10-01

    Full Text Available Abstract Background The process of returning to work after long-term sick leave can sometimes be complex. Many factors, (e.g. cooperation between different authorities and the individual as well as individual factors such as health, emotional well-being and self-efficacy may have an impact on an individual’s ability to work. The aim of this study was to investigate clients’ experiences with an individually tailored vocational rehabilitation, the Dirigo project, and encounters with professionals working on it. The Dirigo project was based on collaboration between rehabilitation authorities, individually tailored interventions and a motivational interviewing approach. Methods A descriptive qualitative design was used with data collected through interviews. Fourteen individuals on long-term sick leave took part in individual semi-structured interviews. The interviews were analysed using content analysis. Results The analysis showed overall positive experience of methods and encounters with professionals in a vocational rehabilitation project. The positive experiences were based on four key factors: 1. Opportunities for receiving various dimensions of support. 2. Good overall treatment by the professionals. 3. Satisfaction with the working methods of the project, and 4. Opportunities for personal development. Conclusions The main result showed that the clients had an overall positive experience of a vocational rehabilitation project and encounters with professionals who used motivational interviewing as a communication method. The overall positive experience indicated that their interactions with the different professionals may have affected their self-efficacy in general and in relation to transition to work. The knowledge is essential for the professionals working in the area of vocational rehabilitation. However, vocational rehabilitation interventions also need a societal approach to be able to offer clients opportunities for job training

  2. Long-term associative learning predicts verbal short-term memory performance.

    Science.gov (United States)

    Jones, Gary; Macken, Bill

    2018-02-01

    Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term memory system separate from long-term knowledge. Using natural language corpora, we show experimentally and computationally that performance on three widely used measures of short-term memory (digit span, nonword repetition, and sentence recall) can be predicted from simple associative learning operating on the linguistic environment to which a typical child may have been exposed. The findings support the broad view that short-term verbal memory performance reflects the application of long-term language knowledge to the experimental setting.

  3. Study of Duchenne muscular dystrophy long-term survivors aged 40 years and older living in specialized institutions in Japan.

    Science.gov (United States)

    Saito, Toshio; Kawai, Mitsuru; Kimura, En; Ogata, Katsuhisa; Takahashi, Toshiaki; Kobayashi, Michio; Takada, Hiroto; Kuru, Satoshi; Mikata, Takashi; Matsumura, Tsuyoshi; Yonemoto, Naohiro; Fujimura, Harutoshi; Sakoda, Saburo

    2017-02-01

    The national muscular dystrophy wards database of Japan lists 118 long-term Duchenne muscular dystrophy (DMD) patients who were at least 40 years old as of October 1, 2013. To elucidate the clinical features of DMD patients aged 40 years and older, we obtained gene analysis and muscle biopsy findings, as well as medical condition information. Ninety-four of the registered patients consented to participate, of whom 55 meeting genetic or biochemical criteria confirming DMD were analyzed. The mean age at the time of the study was 43.6 ± 3.0 years, while at the time of independent ambulation loss it was 10.6 ± 1.5 years and at mechanical ventilation introduction it was 24.1 ± 5.5 years. All were receiving continuous ventilation support, 27 with non-invasive positive pressure ventilation and 28 with tracheal intermittent positive pressure ventilation. Thirty-eight were receiving β-blockers or a renin-angiotensin system inhibitor, while 9 were free from those agents. Forty had maintained oral nutrition. The 55 analyzed patients had survived into their 40s by receiving multidisciplinary intervention. Our findings emphasize the need of future studies to investigate disease modifiers and the mechanism of long-term survival. In addition, establishment of a worldwide care standard with focus on quality of life for adult males with DMD is important. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Differential functions of NR2A and NR2B in short-term and long-term memory in rats.

    Science.gov (United States)

    Jung, Ye-Ha; Suh, Yoo-Hun

    2010-08-23

    N-methyl-D-aspartate receptors (NMDARs) are glutamate receptors implicated in synaptic plasticity and memory function. The specific functions of NMDA receptor subunits NR2A and NR2B have not yet been fully determined in the different types of memory. Nine Wistar rats (8-weeks-old) were subjected to the Morris water maze task to evaluate the memory behaviorally. Quantitative analysis of NR1, NR2A, and NR2B levels in the right and left forebrain of rats was performed and subunit associations with different types of memory were investigated using the Morris water maze task. Right forebrain NR2A expression was significantly increased and correlated with faster escape time onto a hidden platform, indicating involvement of short-term memory, because of the training time interval. Right forebrain NR2B expression was positively associated with long-term memory lasting 24-h (h). In the left forebrain, NR2B expression was positively related to 72-h long-term memory. In conclusion, the functions of NR2A and NR2B receptors were differentially specialized in short-term and long-term memory, depending on the right or left forebrain.

  5. A Facility for Long-Term Mars Simulation Experiments: The Mars Environmental Simulation Chamber (MESCH)

    Science.gov (United States)

    Jensen, Lars Liengaard; Merrison, Jonathan; Hansen, Aviaja Anna; Mikkelsen, Karina Aarup; Kristoffersen, Tommy; Nørnberg, Per; Lomstein, Bente Aagaard; Finster, Kai

    2008-06-01

    We describe the design, construction, and pilot operation of a Mars simulation facility comprised of a cryogenic environmental chamber, an atmospheric gas analyzer, and a xenon/mercury discharge source for UV generation. The Mars Environmental Simulation Chamber (MESCH) consists of a double-walled cylindrical chamber. The double wall provides a cooling mantle through which liquid N2 can be circulated. A load-lock system that consists of a small pressure-exchange chamber, which can be evacuated, allows for the exchange of samples without changing the chamber environment. Fitted within the MESCH is a carousel, which holds up to 10 steel sample tubes. Rotation of the carousel is controlled by an external motor. Each sample in the carousel can be placed at any desired position. Environmental data, such as temperature, pressure, and UV exposure time, are computer logged and used in automated feedback mechanisms, enabling a wide variety of experiments that include time series. Tests of the simulation facility have successfully demonstrated its ability to produce temperature cycles and maintain low temperature (down to -140°C), low atmospheric pressure (5 10 mbar), and a gas composition like that of Mars during long-term experiments.

  6. An efficient fluorescent single-particle position tracking system for long-term pulsed measurements of nitrogen-vacancy centers in diamond

    Science.gov (United States)

    Kim, Kiho; Yun, Jiwon; Lee, Donghyuck; Kim, Dohun

    2018-02-01

    A simple and convenient design enables real-time three-dimensional position tracking of nitrogen-vacancy (NV) centers in diamond. The system consists entirely of commercially available components (a single-photon counter, a high-speed digital-to-analog converter, a phase-sensitive detector-based feedback device, and a piezo stage), eliminating the need for custom programming or rigorous optimization processes. With a large input range of counters and trackers combined with high sensitivity of single-photon counting, high-speed position tracking (upper bound recovery time of 0.9 s upon 250 nm of step-like positional shift) not only of bright ensembles, but also of low-photon-collection-efficiency single to few NV centers (down to 103 s-1) is possible. The tracking requires position modulation of only 10 nm, which allows simultaneous position tracking and pulsed measurements in the long term. Therefore, this tracking system enables measuring a single-spin magnetic resonance and Rabi oscillations at a very high resolution even without photon collection optimization. The system is widely applicable to various fields related to NV center quantum manipulation research such as NV optical trapping, NV tracking in fluid dynamics, and biological sensing using NV centers inside a biological cell.

  7. Archiving Primary Data: Solutions for Long-Term Studies.

    Science.gov (United States)

    Mills, James A; Teplitsky, Céline; Arroyo, Beatriz; Charmantier, Anne; Becker, Peter H; Birkhead, Tim R; Bize, Pierre; Blumstein, Daniel T; Bonenfant, Christophe; Boutin, Stan; Bushuev, Andrey; Cam, Emmanuelle; Cockburn, Andrew; Côté, Steeve D; Coulson, John C; Daunt, Francis; Dingemanse, Niels J; Doligez, Blandine; Drummond, Hugh; Espie, Richard H M; Festa-Bianchet, Marco; Frentiu, Francesca; Fitzpatrick, John W; Furness, Robert W; Garant, Dany; Gauthier, Gilles; Grant, Peter R; Griesser, Michael; Gustafsson, Lars; Hansson, Bengt; Harris, Michael P; Jiguet, Frédéric; Kjellander, Petter; Korpimäki, Erkki; Krebs, Charles J; Lens, Luc; Linnell, John D C; Low, Matthew; McAdam, Andrew; Margalida, Antoni; Merilä, Juha; Møller, Anders P; Nakagawa, Shinichi; Nilsson, Jan-Åke; Nisbet, Ian C T; van Noordwijk, Arie J; Oro, Daniel; Pärt, Tomas; Pelletier, Fanie; Potti, Jaime; Pujol, Benoit; Réale, Denis; Rockwell, Robert F; Ropert-Coudert, Yan; Roulin, Alexandre; Sedinger, James S; Swenson, Jon E; Thébaud, Christophe; Visser, Marcel E; Wanless, Sarah; Westneat, David F; Wilson, Alastair J; Zedrosser, Andreas

    2015-10-01

    The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (Pls) with long-term studies revealed positive attitudes towards sharing data with the agreement or involvement of the PI, and 93% of PIs have historically shared data. Only 8% were in favor of uncontrolled, open access to primary data while 63% expressed serious concern. We present here their viewpoint on an issue that can have non-trivial scientific consequences. We discuss potential costs of public data archiving and provide possible solutions to meet the needs of journals and researchers. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Differences in the association between sickness absence and long-term sub-optimal health by occupational position: a 14-year follow-up in the GAZEL cohort.

    Science.gov (United States)

    Ferrie, Jane E; Kivimäki, Mika; Westerlund, Hugo; Head, Jenny; Melchior, Maria; Singh-Manoux, Archana; Zins, Marie; Goldberg, Marcel; Alexanderson, Kristina; Vahtera, Jussi

    2011-10-01

    Although sickness absence is a strong predictor of health, whether this association varies by occupational position has rarely been examined. The aim of this study was to investigate overall and diagnosis-specific sickness absence as a predictor of future long-term sub-optimal health by occupational position. This was a prospective occupational cohort study of 15 320 employees (73% men) aged 37-51. Sickness absences (1990-1992), included in 13 diagnostic categories, were examined by occupational position in relation to self-rated health measured annually during 1993-2006. 60% of employees in higher occupational positions and 22% in lower positions had no sickness absence. Conversely, 9.5% of employees in higher positions and 40% in lower positions had over 30 sick-leave days. Repeated-measures logistic regression analyses adjusted for age, sex and chronic disease showed employees with over 30 days absence, compared to those with no absence, had approximately double the risk of sub-optimal health over the 14-year follow-up in all occupational positions. 1-30 days sick-leave was associated with greater odds of sub-optimal health in the high (OR 1.48; 95% CI 1.27 to 1.72) and intermediate (1.29; 1.15 to 1.45) but not lower occupational positions (1.06; 0.82 to 1.38). Differences by occupational position in the association between sickness absence in 13 specific diagnostic categories and sub-optimal health over the ensuing 14 years were limited to stronger associations observed with cancer and mental disorders in the higher occupational positions. The association between sickness absence of more than 30 days over 3 years and future long-term self-rated health appears to differ little by occupational position.

  9. Working memory, long-term memory, and medial temporal lobe function

    Science.gov (United States)

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance in patients with MTL lesions on tasks with short retention intervals, or no retention interval, and neuroimaging findings with similar tasks have been interpreted to mean that the MTL is sometimes needed for working memory and possibly even for visual perception itself. We present a reappraisal of this interpretation. Our main conclusion is that, if the material to be learned exceeds working memory capacity, if the material is difficult to rehearse, or if attention is diverted, performance depends on long-term memory even when the retention interval is brief. This fundamental notion is better captured by the terms subspan memory and supraspan memory than by the terms short-term memory and long-term memory. We propose methods for determining when performance on short-delay tasks must depend on long-term (supraspan) memory and suggest that MTL lesions impair performance only when immediate memory and working memory are insufficient to support performance. In neuroimaging studies, MTL activity during encoding is influenced by the memory load and correlates positively with long-term retention of the material that was presented. The most parsimonious and consistent interpretation of all the data is that subspan memoranda are supported by immediate memory and working memory and are independent of the MTL. PMID:22180053

  10. Pre-learning stress differentially affects long-term memory for emotional words, depending on temporal proximity to the learning experience.

    Science.gov (United States)

    Zoladz, Phillip R; Clark, Brianne; Warnecke, Ashlee; Smith, Lindsay; Tabar, Jennifer; Talbot, Jeffery N

    2011-07-06

    Stress exerts a profound, yet complex, influence on learning and memory and can enhance, impair or have no effect on these processes. Here, we have examined how the administration of stress at different times before learning affects long-term (24-hr) memory for neutral and emotional information. Participants submerged their dominant hand into a bath of ice cold water (Stress) or into a bath of warm water (No stress) for 3 min. Either immediately (Exp. 1) or 30 min (Exp. 2) after the water bath manipulation, participants were presented with a list of 30 words varying in emotional valence. The next day, participants' memory for the word list was assessed via free recall and recognition tests. In both experiments, stressed participants exhibited greater blood pressure, salivary cortisol levels, and subjective pain and stress ratings than non-stressed participants in response to the water bath manipulation. Stress applied immediately prior to learning (Exp. 1) enhanced the recognition of positive words, while stress applied 30 min prior to learning (Exp. 2) impaired free recall of negative words. Participants' recognition of positive words in Experiment 1 was positively associated with their heart rate responses to the water bath manipulation, while participants' free recall of negative words in Experiment 2 was negatively associated with their blood pressure and cortisol responses to the water bath manipulation. These findings indicate that the differential effects of pre-learning stress on long-term memory may depend on the temporal proximity of the stressor to the learning experience and the emotional nature of the to-be-learned information. Copyright © 2011. Published by Elsevier Inc.

  11. Continuous positive airway pressure reduces blood pressure in patients with obstructive sleep apnea; a systematic review and meta-analysis with 1000 patients.

    Science.gov (United States)

    Schein, Andressa S O; Kerkhoff, Alessandra C; Coronel, Christian C; Plentz, Rodrigo D M; Sbruzzi, Graciele

    2014-09-01

    Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. The search was conducted in the following databases, from their beginning until February 2013: MEDLINE, Embase, Cochrane CENTRAL, Lilacs and PEDro. In addition, a manual search was performed on references of published studies. Randomized clinical trials (RCTs) that used CPAP compared with placebo CPAP or subtherapeutic CPAP for treatment of patients with OSA and that evaluated office SBP and DBP and 24-h ambulatory blood pressure were selected. Sixteen RCTs were included among 3409 publications, totaling 1166 patients. The use of CPAP resulted in reductions in office SBP [-3.20  mmHg; 95% confidence interval (CI) -4.67 to -1.72] and DBP (-2.87  mmHg; 95% CI -5.18 to -0.55); in night-time SBP (-4.92  mmHg; 95% CI -8.70 to -1.14); in mean 24-h blood pressure (-3.56  mmHg; 95% CI -6.79 to -0.33), mean night-time blood pressure (-2.56  mmHg; 95% CI -4.43 to -0.68) and 24-h DBP (-3.46  mmHg; 95% CI -6.75 to -0.17). However, no significant change was observed in daytime SBP (-0.74  mmHg; 95% CI -3.90 to 2.41) and daytime DBP (-1.86  mmHg; 95% CI -4.55 to 0.83). Treatment with CPAP promoted significantly but small reductions in blood pressure in individuals with OSA. Further studies should be performed to evaluate the effects of long-term CPAP and the impact on cardiovascular risk.

  12. Life-long diseases need life-long treatment: long-term safety of ciclosporin in canine atopic dermatitis

    Science.gov (United States)

    Nuttall, Tim; Reece, Douglas; Roberts, Elizabeth

    2014-01-01

    Ciclosporin (Atopica; Novartis Animal Health) has been licensed for canine atopic dermatitis (AD) since 2002. Adverse events (AEs) have been reported in 55 per cent of 759 dogs in 15 clinical trials, but are rare in pharmacovigilance data (71.81 AEs/million capsules sold). Gastrointestinal reactions were most common, but were mild and rarely required intervention. Other AEs were rare (≤1 per cent in clinical trials; metabolism is not clinically significant for normal dogs. Concomitant treatment with most drugs is safe. Effects on cytochrome P450 and MDR1 P-glycoprotein activity may elevate plasma ciclosporin concentrations, but short-term changes are not clinically significant. Monitoring of complete blood counts, urinalysis or ciclosporin levels is not justified except with higher than recommended doses and/or long-term concurrent immunosuppressive drugs. Ciclosporin is not a contraindication for killed (including rabies) vaccines, but the licensed recommendation is that live vaccination is avoided during treatment. In conclusion, ciclosporin has a positive risk-benefit profile for the long-term management of canine AD. PMID:24682696

  13. Long-Term Prediction of Satellite Orbit Using Analytical Method

    Directory of Open Access Journals (Sweden)

    Jae-Cheol Yoon

    1997-12-01

    Full Text Available A long-term prediction algorithm of geostationary orbit was developed using the analytical method. The perturbation force models include geopotential upto fifth order and degree and luni-solar gravitation, and solar radiation pressure. All of the perturbation effects were analyzed by secular variations, short-period variations, and long-period variations for equinoctial elements such as the semi-major axis, eccentricity vector, inclination vector, and mean longitude of the satellite. Result of the analytical orbit propagator was compared with that of the cowell orbit propagator for the KOREASAT. The comparison indicated that the analytical solution could predict the semi-major axis with an accuarcy of better than ~35meters over a period of 3 month.

  14. Computerized working memory training has positive long-term effect in very low birthweight preschool children.

    Science.gov (United States)

    Grunewaldt, Kristine Hermansen; Skranes, Jon; Brubakk, Ann-Mari; Lähaugen, Gro C C

    2016-02-01

    Working memory deficits are frequently found in children born preterm and have been linked to learning disabilities, and cognitive and behavioural problems. Our aim was to evaluate if a computerized working memory training program has long-term positive effects on memory, learning, and behaviour in very-low-birthweight (VLBW) children at age 5 to 6 years. This prospective, intervention study included 20 VLBW preschool children in the intervention group and 17 age-matched, non-training VLBW children in the comparison group. The intervention group trained with the Cogmed JM working memory training program daily for 5 weeks (25 training sessions). Extensive neuropsychological assessment and parental questionnaires were performed 4 weeks after intervention and at follow-up 7 months later. For most of the statistical analyses, general linear models were applied. At follow-up, higher scores and increased or equal performance gain were found in the intervention group than the comparison group on memory for faces (p=0.012), narrative memory (p=0.002), and spatial span (p=0.003). No group differences in performance gain were found for attention and behaviour. Computerized working memory training seems to have positive and persisting effects on working memory, and visual and verbal learning, at 7-month follow-up in VLBW preschool children. We speculate that such training is beneficial by improving the ability to learn from the teaching at school and for further cognitive development. © 2015 Mac Keith Press.

  15. Long term cardiovascular consequences of chronic lung disease of prematurity.

    Science.gov (United States)

    Poon, Chuen Yeow; Edwards, Martin Oliver; Kotecha, Sailesh

    2013-12-01

    Pulmonary arterial (PA) hypertension in preterm infant is an important consequence of chronic lung disease of prematurity (CLD) arising mainly due to impaired alveolar development and dysregulated angiogenesis of the pulmonary circulation. Although PA pressure and resistance in these children normalise by school age, their pulmonary vasculature remains hyper-reactive to hypoxia until early childhood. Furthermore, there is evidence that systemic blood pressure in preterm born children with or without CLD is mildly increased at school age and in young adulthood when compared to term-born children. Arterial stiffness may be increased in CLD survivors due to increased smooth muscle tone of the pre-resistance and resistance vessels rather than the loss of elasticity in the large arteries. This review explores the long term effects of CLD on the pulmonary and systemic circulations along with their clinical correlates and therapeutic approaches. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Long-Run Impact of Increased Wage Pressure

    DEFF Research Database (Denmark)

    Hansen, Claus Thustrup

    1999-01-01

    An unanticipated permanent increase in wage pressure is analyzed in a dynamic general-equilibrium model combining standard theory of capital accumulation and monopolistic wage setting. The long-run (steady-state) implications are identical percentage reduction in employment, consumption, and capi......An unanticipated permanent increase in wage pressure is analyzed in a dynamic general-equilibrium model combining standard theory of capital accumulation and monopolistic wage setting. The long-run (steady-state) implications are identical percentage reduction in employment, consumption...

  17. Clinical and Biochemical Characteristics of Brain-Dead Donors as Predictors of Early- and Long-Term Renal Function After Transplant.

    Science.gov (United States)

    Kwiatkowska, Ewa; Domański, Leszek; Bober, Joanna; Safranow, Krzysztof; Pawlik, Andrzej; Ciechanowski, Kazimierz; Wiśniewska, Magda; Kędzierska, Karolina

    2017-08-01

    Organs from brain-dead donors are the main source of allografts for transplant. Comparisons between living-donor and brain-dead donor kidneys show that the latter are more likely to demonstrate delayed graft function and lower long-term survival. This study aimed to assess the effects of various clinical and biochemical factors of donors on early- and long-term renal function after transplant. We analyzed data from kidney recipients treated between 2006 and 2008 who received organs from brain-dead donors. Data from 54 donors and 89 recipients were analyzed. No relation was observed between donor sodium concentration and the presence of delayed graft function. Donor height was positively correlated with creatinine clearance in recipients in the 1 to 3 months after renal transplant. Donor diastolic blood pressure was negatively correlated with estimated glomerular filtration rate throughout the observation period. Donor age was negatively correlated with the allograft recipient's estimated glomerular filtration rate throughout 4 years of observation. Donor estimated glomerular filtration rate was positively correlated with that of the recipient throughout 3 years of observation. The results of this study indicate that various factors associated with allograft donors may influence graft function.

  18. Young Long-term Unemployed and the Individualization of Responsibility

    Directory of Open Access Journals (Sweden)

    Jennifer Hobbins

    2016-06-01

    Full Text Available In Sweden, as in most Western societies, a common belief is that unemployment is somehow linked to the individual, her lack of work ethic, or other personal shortcomings rather than to structural causes. This is not only manifested in public arenas such as the media or political debates but also in our social surroundings. In recent years, these views have gained importance, indicating a shift in the location of responsibilities from the welfare state to the individual. This shift entails high demands and expectations on unemployed people and is something they have to deal with and relate to. One of the most exposed groups is young long-term unemployed. The aim of this article is to highlight how the discourse of individualized responsibility is reflected in unemployed peoples’ stories, and to shed light on the ways in which young long-term unemployed adults relate to and position themselves toward this discourse. Based on 18 qualitative interviews with young Swedish long-term unemployed people, the findings show three approaches to the discourse: conformity, distancing, and resistance.

  19. Long-Term Problems of Nuclear Energy, October 1976

    International Nuclear Information System (INIS)

    Broda, E.

    1976-01-01

    The Text was written by Enelbert Broda in Oktober 1976. In this report, the physicist and chemist Engelbert Broda discusses various areas of peaceful uses of nuclear energy and concludes that the negative aspects outweigh the positive and that the use of nuclear energy has to be rejected in the long term. In 16 chapters the biggest and most dangerous problems are discussed. Include the unresolved question of disposal, problems of reprocessing and transport of fissile materials, the proliferation of nuclear weapons technology, risks of terrorism, dismantling and decontamination of old nuclear power plants, the toxicity of fissile material, as well as the general unprofitable use of nuclear power plants. As a long-term alternative the author suggests an intensification of the exploitation of solar energy, as well as a deliberate restriction of the rising demand for energy.(roessner) [de

  20. Long-Term Problems of Nuclear Energy, December 1976

    International Nuclear Information System (INIS)

    Broda, E.

    1976-01-01

    The Text was written by Enelbert Broda in Oktober 1976. In this report, the physicist and chemist Engelbert Broda discusses various areas of peaceful uses of nuclear energy and concludes that the negative aspects outweigh the positive and that the use of nuclear energy has to be rejected in the long term. In 16 chapters the biggest and most dangerous problems are discussed. Include the unresolved question of disposal, problems of reprocessing and transport of fissile materials, the proliferation of nuclear weapons technology, risks of terrorism, dismantling and decontamination of old nuclear power plants, the toxicity of fissile material, as well as the general unprofitable use of nuclear power plants. As a long-term alternative the author suggests an intensification of the exploitation of solar energy, as well as a deliberate restriction of the rising demand for energy.(roessner)

  1. Reforming Long-Term Care Funding in Alberta.

    Science.gov (United States)

    Crump, R Trafford; Repin, Nadya; Sutherland, Jason M

    2015-01-01

    Like many provinces across Canada, Alberta is facing growing demand for long-term care. Issues with the mixed funding model used to pay long-term care providers had Alberta Health Services concerned that it was not efficiently meeting the demand for long-term care. Consequently, in 2010, Alberta Health Services introduced the patient/care-based funding (PCBF) model. PCBF is similar to activity-based funding in that it directly ties the complexity and care needs of long-term care residents to the payment received by long-term care providers. This review describes PCBF and discusses some of its strengths and weaknesses. In doing so, this review is intended to inform other provinces faced with similar long-term care challenges and contemplating their own funding reforms.

  2. Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model.

    Directory of Open Access Journals (Sweden)

    Laura A Cagle

    Full Text Available Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury.To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation.5-12 week-old female BALB/c mice (n = 85 were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg or high tidal volume (15 ml/kg with or without positive end-expiratory pressure and recruitment maneuvers.Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation.Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours and lung injury worsens with longer-term ventilation (4 hrs. Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide

  3. Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model

    Science.gov (United States)

    Franzi, Lisa M.; Linderholm, Angela L.; Last, Jerold A.; Adams, Jason Y.; Harper, Richart W.

    2017-01-01

    Background Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. Objectives To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. Methods 5–12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Results Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Conclusions Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points

  4. Effects of positive end-expiratory pressure and recruitment maneuvers in a ventilator-induced injury mouse model.

    Science.gov (United States)

    Cagle, Laura A; Franzi, Lisa M; Linderholm, Angela L; Last, Jerold A; Adams, Jason Y; Harper, Richart W; Kenyon, Nicholas J

    2017-01-01

    Positive-pressure mechanical ventilation is an essential therapeutic intervention, yet it causes the clinical syndrome known as ventilator-induced lung injury. Various lung protective mechanical ventilation strategies have attempted to reduce or prevent ventilator-induced lung injury but few modalities have proven effective. A model that isolates the contribution of mechanical ventilation on the development of acute lung injury is needed to better understand biologic mechanisms that lead to ventilator-induced lung injury. To evaluate the effects of positive end-expiratory pressure and recruitment maneuvers in reducing lung injury in a ventilator-induced lung injury murine model in short- and longer-term ventilation. 5-12 week-old female BALB/c mice (n = 85) were anesthetized, placed on mechanical ventilation for either 2 hrs or 4 hrs with either low tidal volume (8 ml/kg) or high tidal volume (15 ml/kg) with or without positive end-expiratory pressure and recruitment maneuvers. Alteration of the alveolar-capillary barrier was noted at 2 hrs of high tidal volume ventilation. Standardized histology scores, influx of bronchoalveolar lavage albumin, proinflammatory cytokines, and absolute neutrophils were significantly higher in the high-tidal volume ventilation group at 4 hours of ventilation. Application of positive end-expiratory pressure resulted in significantly decreased standardized histology scores and bronchoalveolar absolute neutrophil counts at low- and high-tidal volume ventilation, respectively. Recruitment maneuvers were essential to maintain pulmonary compliance at both 2 and 4 hrs of ventilation. Signs of ventilator-induced lung injury are evident soon after high tidal volume ventilation (as early as 2 hours) and lung injury worsens with longer-term ventilation (4 hrs). Application of positive end-expiratory pressure and recruitment maneuvers are protective against worsening VILI across all time points. Dynamic compliance can be used guide the frequency

  5. Long-term archives reveal shifting extinction selectivity in China's postglacial mammal fauna

    Science.gov (United States)

    Crees, Jennifer J.; Li, Zhipeng; Bielby, Jon; Yuan, Jing

    2017-01-01

    Ecosystems have been modified by human activities for millennia, and insights about ecology and extinction risk based only on recent data are likely to be both incomplete and biased. We synthesize multiple long-term archives (over 250 archaeological and palaeontological sites dating from the early Holocene to the Ming Dynasty and over 4400 historical records) to reconstruct the spatio-temporal dynamics of Holocene–modern range change across China, a megadiverse country experiencing extensive current-day biodiversity loss, for 34 mammal species over three successive postglacial time intervals. Our combined zooarchaeological, palaeontological, historical and current-day datasets reveal that both phylogenetic and spatial patterns of extinction selectivity have varied through time in China, probably in response both to cumulative anthropogenic impacts (an ‘extinction filter’ associated with vulnerable species and accessible landscapes being affected earlier by human activities) and also to quantitative and qualitative changes in regional pressures. China has experienced few postglacial global species-level mammal extinctions, and most species retain over 50% of their maximum estimated Holocene range despite millennia of increasing regional human pressures, suggesting that the potential still exists for successful species conservation and ecosystem restoration. Data from long-term archives also demonstrate that herbivores have experienced more historical extinctions in China, and carnivores have until recently displayed greater resilience. Accurate assessment of patterns of biodiversity loss and the likely predictive power of current-day correlates of faunal vulnerability and resilience is dependent upon novel perspectives provided by long-term archives. PMID:29167363

  6. Time-series modeling of long-term weight self-monitoring data.

    Science.gov (United States)

    Helander, Elina; Pavel, Misha; Jimison, Holly; Korhonen, Ilkka

    2015-08-01

    Long-term self-monitoring of weight is beneficial for weight maintenance, especially after weight loss. Connected weight scales accumulate time series information over long term and hence enable time series analysis of the data. The analysis can reveal individual patterns, provide more sensitive detection of significant weight trends, and enable more accurate and timely prediction of weight outcomes. However, long term self-weighing data has several challenges which complicate the analysis. Especially, irregular sampling, missing data, and existence of periodic (e.g. diurnal and weekly) patterns are common. In this study, we apply time series modeling approach on daily weight time series from two individuals and describe information that can be extracted from this kind of data. We study the properties of weight time series data, missing data and its link to individuals behavior, periodic patterns and weight series segmentation. Being able to understand behavior through weight data and give relevant feedback is desired to lead to positive intervention on health behaviors.

  7. Industrial Foundations as Long-Term Owners

    DEFF Research Database (Denmark)

    Thomsen, Steen; Poulsen, Thomas; Børsting, Christa Winther

    Short-termism has become a serious concern for corporate governance, and this has inspired a search for institutional arrangements to promote long-term decision-making. In this paper, we call attention to long-term ownership by industrial foundations, which is common in Northern Europe but little...... known in the rest of the world. We use a unique Danish data set to document that industrial foundations are long-term owners that practice long-term governance. We show that foundation ownership is highly stable compared to other ownership structures. Foundation-owned companies replace managers less...... frequently. They have conservative capital structures with low financial leverage. They score higher on an index of long-termism in finance, investment, and employment. They survive longer. Overall, our paper supports the hypothesis that corporate time horizons are influenced by ownership structures...

  8. Long-term associative learning predicts verbal short-term memory performance

    OpenAIRE

    Jones, Gary; Macken, Bill

    2017-01-01

    Studies using tests such as digit span and nonword repetition have implicated short-term memory across a range of developmental domains. Such tests ostensibly assess specialized processes for the short-term manipulation and maintenance of information that are often argued to enable long-term learning. However, there is considerable evidence for an influence of long-term linguistic learning on performance in short-term memory tasks that brings into question the role of a specialized short-term...

  9. Long term contracts signed in Slovak timber business

    International Nuclear Information System (INIS)

    Haluza, I.

    2005-01-01

    The Slovak timber business is changing. The state-owned company, SR Forests, which cuts more then 50% of Slovak timber has signed long term agreements with major domestic timber processing companies - Smrecina, the Rettenmeier Tatra Timber saw mill in Liptovsky Mikulas and two paper mills - Mondi SCP Ruzomberok and Kappa Sturovo. In the past, only quarterly contracts were signed. Now, for the first time, two-year contracts have been signed that should help the timber processing industry and the forestry sector. The General Director of Lesy SR (SR Forests), Karol Vins, hopes for better sale prices. Company headquarters wants to maintain better control of prices than under the old system of timber sales by its branches. In the opinion of the General Director of the Forestry Section at the Ministry of Agriculture, long term contracts will guarantee a stable delivery of timber to processing companies, giving investors in new production capacity a better position in negotiations with banks regarding financing. According to K. Vins, long term contracts have so far only been negotiated with major timber processing companies which are mostly controlled by foreign capital and therefore have good payment discipline. The Association of the Timber Processing Industry is unhappy regarding developments and Lesy SR has not invited domestic companies to these negotiations

  10. An ionization pressure gauge with LaB6 emitter for long-term operation in strong magnetic fields

    Science.gov (United States)

    Wenzel, U.; Pedersen, T. S.; Marquardt, M.; Singer, M.

    2018-03-01

    We report here on a potentially significant improvement in the design of neutral pressure gauges of the so-called ASDEX-type which were first used in the Axially Symmetric Divertor EXperiment (ASDEX). Such gauges are considered state-of-the-art and are in wide use in fusion experiments, but they nonetheless suffer from a relatively high failure rate when operated at high magnetic field strengths for long times. This is therefore a significant concern for long-pulse, high-field experiments such as Wendelstein 7-X (W7-X) and ITER. The new design is much more robust. The improvement is to use a LaB6 crystal instead of a tungsten wire as the thermionic emitter of electrons in the gauge. Such a LaB6 prototype gauge was successfully operated for a total of 60 h in B = 3.1 T, confirming the significantly improved robustness of the new design and qualifying it for near-term operation in W7-X. With the LaB6 crystal, an order of magnitude reduction in heating current is achieved, relative to the tungsten filament based gauges, from 15-20 A to 1-2 A. This reduces the Lorenz forces and the heating power by an order of magnitude also and is presumably the reason for the much improved robustness. The new gauge design, test environment setup at the superconducting magnet, and results from test operation are described.

  11. Catalytic heat exchangers - a long-term evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Silversand, Fredrik A. [CATATOR AB, Lund (Sweden)

    2003-10-01

    A long-term evaluation concerning catalytic heat exchangers (CHEs) has been performed. The idea concerning CHEs was originally described in a number of reports issued by Catator almost a decade ago. The general idea with CHEs is to combust a fuel with a catalyst inside a heat exchanger to enable an effective heat transfer. The first design approaches demonstrated the function and the possibilities with CHEs but were defective concerning the heat exchanger design. Consequently, a heat exchanger company (SWEP International AB), which was specialised on brazed plate-type heat exchangers, joined the continued development project. Indeed, the new design approach containing Catator's wire-mesh catalysts and SWEP's plate-type heat exchangers enabled us to improve the concept considerably. The new design complied with a number of relevant technical demands, e.g.: Simplicity; Compactness and integration (few parts); High thermal efficiency; Low pressure drop; Excellent emissions; High turn-down ratio; Reasonable production cost. Spurred by the technical progresses, the importance of a long-term test under realistic conditions was clear. A long-term evaluation was initialised at Sydkraft Gas premises in Aastorp. The CHE was installed on a specially designed rig to enable accelerated testing with respect to the number of transients. The rig was operated continuously for 5000 hours and emission mapping was carried out at certain time intervals. Following some problems during the initial phase of the long-term evaluation, which unfortunately also delayed the project, the results indicated very stable conditions of operation. The emissions have been rather constant during the course of the test and we cannot see any tendencies to decreased performances. Indeed, the test verifies the function, operability and reliability of the CHE-concept. Apart from domestic boilers we foresee a number of interesting and relevant applications in heating and process technology. Since

  12. Long-term Advertising Effects and Optimal Budgeting

    DEFF Research Database (Denmark)

    Hansen, Flemming; Bech Christensen, Lars

    2004-01-01

    Using pure single-source data, this paper provides evidence for theexistence and magnitude of long-term advertising effects across FMCG productcategories. Furthermore, we focus on the difficulties that arise for wellestablishedbrands when new products are introduced into the market andproduct...... innovations take place. Our research shows that such occurrencesdrastically alter the relationship between share of voice and share of market inany given FMCG market, hence making it pivotal for marketers to focus on suchrelationships in order to maintain market position....

  13. Long-term impact of perfusion CT data after subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Mathys, Christian; Martens, Daniel; Reichelt, Dorothea C.; Caspers, Julian; Aissa, Joel; May, Rebecca; Antoch, Gerald; Turowski, Bernd [University Duesseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, Duesseldorf (Germany); Haenggi, Daniel [University Duesseldorf, Medical Faculty, Department of Neurosurgery, Duesseldorf (Germany)

    2013-11-15

    Dynamic perfusion computed tomography (PCT) has been established as a diagnostic instrument for the detection of vasospasm after subarachnoid hemorrhage (SAH). The purpose of this study was to assess the prognostic impact of PCT parameters after SAH on the long-term outcome of patients. Three hundred twelve patients were retrospectively interrogated with a questionnaire 23.06 {+-} 14.33 months after spontaneous subarachnoid hemorrhage. The modified Rankin scale (mRS) was determined, respectively. Scheduled PCT data sets from the first days after ictus were available for all patients. The maximum mean transit time over several examinations per hemisphere (MTT{sub PEAK}) values were significantly correlated (p {<=} 0.001, r = 0.422) with the clinical long-term outcome (mRS). Corresponding to our linear regression analysis, MTT{sub PEAK} is the second most important regressor (behind clinical severity of the initial hemorrhage) for the prediction of long-term mRS. An MTT{sub PEAK} threshold of 3.98 s (identified by receiver operating characteristic analysis, area under the curve = 0.75) predicted an unfavorable long-term outcome (mRS {>=} 2) with a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 67.3, 74.3, 84.5, 52.1, and 69.6 %, respectively. The presented data corroborate the relevance of PCT data for the clinical long-term outcome of SAH patients. By identification of patients who are at risk for a bad outcome and may need escalation of therapy, risk-benefit analysis is supported. (orig.)

  14. Impaired autoregulation of cerebral blood flow in long-term type I (insulin-dependent) diabetic patients with nephropathy and retinopathy

    DEFF Research Database (Denmark)

    Kastrup, J; Rørsgaard, S; Parving, H H

    1986-01-01

    Autoregulation of cerebral blood flow, i.e., the maintenance of cerebral blood flow within narrow limits during changes in arterial perfusion pressure, was studied in nine healthy control subjects and in 12 long-term Type I (insulin-dependent) diabetic patients with clinical microangiopathy...... the previous findings suggesting that autoregulation of cerebral blood flow is impaired in some long-term Type I diabetic patients with clinical microangiopathy (arteriolar hyalinosis)........ Cerebral blood flow was measured by the intravenous 133Xenon method. Mean arterial blood pressure was elevated approximately 30 mmHg by intravenous infusion of angiotensin amide II and lowered about 10 mmHg by intravenous infusion of trimethaphan camsylate. In the control subjects the flow/pressure curve...

  15. Pressure Sores

    Science.gov (United States)

    Pressure sores are areas of damaged skin caused by staying in one position for too long. They commonly ... wheelchair, or are unable to change your position. Pressure sores can cause serious infections, some of which are ...

  16. Interfaces and ventilator settings for long-term noninvasive ventilation in COPD patients

    Directory of Open Access Journals (Sweden)

    Callegari J

    2017-06-01

    Full Text Available Jens Callegari,1 Friederike Sophie Magnet,1 Steven Taubner,1 Melanie Berger,2 Sarah Bettina Schwarz,1 Wolfram Windisch,1 Jan Hendrik Storre3,4 1Department of Pneumology, Cologne-Merheim Hospital, Kliniken der Stadt Koeln, Witten/Herdecke University Hospital, 2Department of Pneumology, Malteser Hospital St Hildegardis, Cologne, 3Department of Pneumology, University Medical Hospital, Freiburg, 4Department of Intensive Care, Sleep Medicine and Mechanical Ventilation, Asklepios Fachkliniken Munich-Gauting, Gauting, Germany Introduction: The establishment of high-intensity (HI noninvasive ventilation (NIV that targets elevated PaCO2 has led to an increase in the use of long-term NIV to treat patients with chronic hypercapnic COPD. However, the role of the ventilation interface, especially in more aggressive ventilation strategies, has not been systematically assessed.Methods: Ventilator settings and NIV compliance were assessed in this prospective cross-sectional monocentric cohort study of COPD patients with pre-existing NIV. Daytime ­arterialized blood gas analyses and lung function testing were also performed. The primary end point was the distribution among study patients of interfaces (full-face masks [FFMs] vs nasal masks [NMs] in a real-life setting.Results: The majority of the 123 patients studied used an FFM (77%, while 23% used an NM. Ventilation settings were as follows: mean ± standard deviation (SD inspiratory positive airway pressure (IPAP was 23.2±4.6 mbar and mean ± SD breathing rate was 16.7±2.4/minute. Pressure support ventilation (PSV mode was used in 52.8% of patients, while assisted pressure-controlled ventilation (aPCV was used in 47.2% of patients. Higher IPAP levels were associated with an increased use of FFMs (IPAP <21 mbar: 73% vs IPAP >25 mbar: 84%. Mean compliance was 6.5 hours/day, with no differences between FFM (6.4 hours/day and NM (6.7 hours/day users. PaCO2 assessment of ventilation quality revealed

  17. Emergency planning and long-term care: least paid, least powerful, most responsible.

    Science.gov (United States)

    Covan, Eleanor Krassen; Fugate-Whitlock, Elizabeth

    2010-11-01

    As disasters can occur anywhere, planning to avoid emergencies is an international concern. Our research specifically addresses planning for the needs and safety of a vulnerable population, long-term care residents. Our initial purposes in this evaluation research were to assess the utility of a template to gather emergency management information for individual long-term care communities, to report on how prepared they are to cope with emergencies that have occurred elsewhere in areas like ours, and to assess the effectiveness of employing gerontology students in the planning process. As we began analyzing our data, we realized that it is imperative to consider whether it is possible for long-term care communities to respond effectively to disasters. In our findings we focus on the impact of gender in the planning process, the importance of size with regard to template utility, the positive and negative consequences of student aid, and the fact that gathering plans for individual long-term care communities may have detracted from collaborative community planning.

  18. Predicting long-term risk for relationship dissolution using nonparametric conditional survival trees.

    Science.gov (United States)

    Kliem, Sören; Weusthoff, Sarah; Hahlweg, Kurt; Baucom, Katherine J W; Baucom, Brian R

    2015-12-01

    Identifying risk factors for divorce or separation is an important step in the prevention of negative individual outcomes and societal costs associated with relationship dissolution. Programs that aim to prevent relationship distress and dissolution typically focus on changing processes that occur during couple conflict, although the predictive ability of conflict-specific variables has not been examined in the context of other factors related to relationship dissolution. The authors examine whether emotional responding and communication during couple conflict predict relationship dissolution after controlling for overall relationship quality and individual well-being. Using nonparametric conditional survival trees, the study at hand simultaneously examined the predictive abilities of physiological (systolic and diastolic blood pressure, heart rate, cortisol) and behavioral (fundamental frequency; f0) indices of emotional responding, as well as observationally coded positive and negative communication behavior, on long-term relationship stability after controlling for relationship satisfaction and symptoms of depression. One hundred thirty-six spouses were assessed after participating in a randomized clinical trial of a relationship distress prevention program as well as 11 years thereafter; 32.5% of the couples' relationships had dissolved by follow up. For men, the only significant predictor of relationship dissolution was cortisol change score (p = .012). For women, only f0 range was a significant predictor of relationship dissolution (p = .034). These findings highlight the importance of emotional responding during couple conflict for long-term relationship stability. (c) 2015 APA, all rights reserved).

  19. Long-Term Environmental Research Programs - Evolving Capacity for Discovery

    Science.gov (United States)

    Swanson, F. J.

    2008-12-01

    research sites and networks, agencies and universities 1) need to encourage collaboration among sites and between science and land manager communities while 2) maintaining long- term studies and monitoring efforts, and staffing the collaboration in each partner organization, including positions specifically designated as liaisons among the participating communities.

  20. Long-term collections

    CERN Multimedia

    Collectes à long terme

    2007-01-01

    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  1. Long-Term Capital Goods Importation and Minimum Wage Relationship in Turkey: Bounds Testing Approach

    Directory of Open Access Journals (Sweden)

    Tastan Serkan

    2015-04-01

    Full Text Available In order to examine the long-term relationship between capital goods importation and minimum wage, autoregressive distributed lag (ARDL bounds testing approach to the cointegration is used in the study. According to bounds test results, a cointegration relation exists between the capital goods importation and the minimum wage. Therefore an ARDL(4,0 model is estimated in order to determine the long and short term relations between variables. According to the empirical analysis, there is a positive and significant relationship between the capital goods importation and the minimum wage in Turkey in the long term. A 1% increase in the minimum wage leads to a 0.8% increase in the capital goods importation in the long term. The result is similar for short term coefficients. The relationship observed in the long term is preserved in short term, though in a lower level. In terms of error correction model, it can be concluded that error correction mechanism works as the error correction term is negative and significant. Short term deviations might be resolved with the error correction mechanism in the long term. Accordingly, approximately 75% of any deviation from equilibrium which might arise in the previous six month period will be resolved in the current six month period. This means that returning to long term equilibrium progresses rapidly.

  2. Fluctuation-Coupling of Cathode Cavity Pressure and Arc Voltage in a dc Plasma Torch with a Long Inter-Electrode Channel at Reduced Pressure

    International Nuclear Information System (INIS)

    Cao Jin-Wen; Huang He-Ji; Pan Wen-Xia

    2014-01-01

    Fluctuations of cathode cavity pressure and arc voltage are observed experimentally in a dc plasma torch with a long inter-electrode channel. The results show that they have the same frequency of around 4 kHz under typical experimental conditions. The observed phase difference between the pressure and the voltage, which is influenced by the path length between the pressure sensor and the cathode cavity, varies with different input powers. Combined with numerical simulation, the position of the pressure perturbation origin is estimated, and the results show that it is located at 0.01–0.05 m upstream of the inter-electrode channel outlet

  3. Pickering NGS A reactor building 1 dome refurbishment long-term monitoring of coating

    International Nuclear Information System (INIS)

    Deans, J.J.; Chan, P.; Gomme, R.

    2006-01-01

    requirements, and on this basis, the list was reduced to five possible systems. Finally, a series of exacting laboratory tests were conducted by Kinectrics to examine the following properties: ease and method of application; adhesion and crack bridging ability (-35 to 40 o C); freeze/thaw resistance, thermal stability (-25 to 40 o C), wetting/drying resistance, ageing characteristics, ultra violet resistance; abrasion resistance; water absorption; resistance to air pressure up to 82 kPa(g) (-25 to 40 o C). Of the five products tested, elastomeric, single component polyurethane met all the necessary requirements and following further tests, it was ultimately specified for use on the dome. Kinectrics customised the application procedures for polyurethane coating. The concrete was prepared using high pressure water blasting techniques, pre-treated with an Epoxy Zinc Phosphate Primer, followed by five coats of the coating resulting in a membrane with a nominal dry film thickness of 3.5 mm. Stringent QA/QC standards, especially developed by Kinectrics for nuclear facilities, were followed. To help ensure continued reliable performance of the coating, a long-term monitoring program was also initiated. The program consists of regularly inspecting the coating on the dome and testing a set of companion specimens that have been stored 'on or near' the RB 1 Dome as well as in Kinectrics laboratory and outdoor exposure site. The long-term performance of the coating has been and will continue to be monitored and assessed by comparing the initial inspection observations and companion specimen test results to those which are obtained during all future inspections and tests. The selection process followed to identify promising coatings, the extensive laboratory testing and the modelling undertaken to simulate the field conditions will be presented. The results from the 'one through ten' -year in-service inspections and accompanying tests will be reported. The principal conclusions to date are

  4. Spatial coding of ordinal information in short- and long-term memory

    Directory of Open Access Journals (Sweden)

    Veronique eGinsburg

    2015-01-01

    Full Text Available The processing of numerical information induces a spatial response bias: Faster responses to small numbers with the left hand and faster responses to large numbers with the right hand. Most theories agree that long-term representations underlie this so called SNARC effect (Spatial Numerical Association of Response Codes; Dehaene, Bossini, & Giraux, 1993. However, a spatial response bias was also observed with the activation of temporary position-space associations in working memory (ordinal position effect; van Dijck & Fias, 2011. Items belonging to the beginning of a memorized sequence are responded to faster with the left hand side while items at the end of the sequence are responded to faster with the right hand side. The theoretical possibility was put forward that the SNARC effect is an instance of the ordinal position effect, with the empirical consequence that the SNARC effect and the ordinal position effect cannot be observed simultaneously. In two experiments we falsify this claim by demonstrating that the SNARC effect and the ordinal position effect are not mutually exclusive. Consequently, this suggests that the SNARC effect and the ordinal position effect result from the activation of different representations. We conclude that spatial response biases can result from the activation of both pre-existing positions in long-term memory and from temporary space associations in working memory at the same time.

  5. Spatial coding of ordinal information in short- and long-term memory.

    Science.gov (United States)

    Ginsburg, Véronique; Gevers, Wim

    2015-01-01

    The processing of numerical information induces a spatial response bias: Faster responses to small numbers with the left hand and faster responses to large numbers with the right hand. Most theories agree that long-term representations underlie this so called SNARC effect (Spatial Numerical Association of Response Codes; Dehaene et al., 1993). However, a spatial response bias was also observed with the activation of temporary position-space associations in working memory (ordinal position effect; van Dijck and Fias, 2011). Items belonging to the beginning of a memorized sequence are responded to faster with the left hand side while items at the end of the sequence are responded to faster with the right hand side. The theoretical possibility was put forward that the SNARC effect is an instance of the ordinal position effect, with the empirical consequence that the SNARC effect and the ordinal position effect cannot be observed simultaneously. In two experiments we falsify this claim by demonstrating that the SNARC effect and the ordinal position effect are not mutually exclusive. Consequently, this suggests that the SNARC effect and the ordinal position effect result from the activation of different representations. We conclude that spatial response biases can result from the activation of both pre-existing positions in long-term memory and from temporary space associations in working memory at the same time.

  6. Spatial coding of ordinal information in short- and long-term memory

    Science.gov (United States)

    Ginsburg, Véronique; Gevers, Wim

    2015-01-01

    The processing of numerical information induces a spatial response bias: Faster responses to small numbers with the left hand and faster responses to large numbers with the right hand. Most theories agree that long-term representations underlie this so called SNARC effect (Spatial Numerical Association of Response Codes; Dehaene et al., 1993). However, a spatial response bias was also observed with the activation of temporary position-space associations in working memory (ordinal position effect; van Dijck and Fias, 2011). Items belonging to the beginning of a memorized sequence are responded to faster with the left hand side while items at the end of the sequence are responded to faster with the right hand side. The theoretical possibility was put forward that the SNARC effect is an instance of the ordinal position effect, with the empirical consequence that the SNARC effect and the ordinal position effect cannot be observed simultaneously. In two experiments we falsify this claim by demonstrating that the SNARC effect and the ordinal position effect are not mutually exclusive. Consequently, this suggests that the SNARC effect and the ordinal position effect result from the activation of different representations. We conclude that spatial response biases can result from the activation of both pre-existing positions in long-term memory and from temporary space associations in working memory at the same time. PMID:25688199

  7. Long-term effects of a home-visiting intervention for depressed mothers and their infants

    NARCIS (Netherlands)

    Kersten-Alvarez, L.E.; Hosman, C.M.H.; Riksen-Walraven, J.M.A.; Doesum, K.T.M. van; Hoefnagels, C.C.J.

    2010-01-01

    Background - Whereas preventive interventions for depressed mothers and their infants have yielded positive short-term outcomes, few studies have examined their long-term effectiveness. The present follow-up of a randomised controlled trial (RCT) is one of the first to examine the longer-term

  8. Compensation for PKMζ in long-term potentiation and spatial long-term memory in mutant mice.

    Science.gov (United States)

    Tsokas, Panayiotis; Hsieh, Changchi; Yao, Yudong; Lesburguères, Edith; Wallace, Emma Jane Claire; Tcherepanov, Andrew; Jothianandan, Desingarao; Hartley, Benjamin Rush; Pan, Ling; Rivard, Bruno; Farese, Robert V; Sajan, Mini P; Bergold, Peter John; Hernández, Alejandro Iván; Cottrell, James E; Shouval, Harel Z; Fenton, André Antonio; Sacktor, Todd Charlton

    2016-05-17

    PKMζ is a persistently active PKC isoform proposed to maintain late-LTP and long-term memory. But late-LTP and memory are maintained without PKMζ in PKMζ-null mice. Two hypotheses can account for these findings. First, PKMζ is unimportant for LTP or memory. Second, PKMζ is essential for late-LTP and long-term memory in wild-type mice, and PKMζ-null mice recruit compensatory mechanisms. We find that whereas PKMζ persistently increases in LTP maintenance in wild-type mice, PKCι/λ, a gene-product closely related to PKMζ, persistently increases in LTP maintenance in PKMζ-null mice. Using a pharmacogenetic approach, we find PKMζ-antisense in hippocampus blocks late-LTP and spatial long-term memory in wild-type mice, but not in PKMζ-null mice without the target mRNA. Conversely, a PKCι/λ-antagonist disrupts late-LTP and spatial memory in PKMζ-null mice but not in wild-type mice. Thus, whereas PKMζ is essential for wild-type LTP and long-term memory, persistent PKCι/λ activation compensates for PKMζ loss in PKMζ-null mice.

  9. Diversity in Long-Term Synaptic Plasticity at Inhibitory Synapses of Striatal Spiny Neurons

    Science.gov (United States)

    Rueda-Orozco, Pavel E.; Mendoza, Ernesto; Hernandez, Ricardo; Aceves, Jose J.; Ibanez-Sandoval, Osvaldo; Galarraga, Elvira; Bargas, Jose

    2009-01-01

    Procedural memories and habits are posited to be stored in the basal ganglia, whose intrinsic circuitries possess important inhibitory connections arising from striatal spiny neurons. However, no information about long-term plasticity at these synapses is available. Therefore, this work describes a novel postsynaptically dependent long-term…

  10. Long-term remission in BCR/ABL-positive AML-M6 patient treated with Imatinib Mesylate.

    Science.gov (United States)

    Pompetti, Franca; Spadano, Antonio; Sau, Antonella; Mennucci, Antonio; Russo, Rosa; Catinella, Virginia; Franchi, Paolo Guanciali; Calabrese, Giuseppe; Palka, Giandomenico; Fioritoni, Giuseppe; Iacone, Antonio

    2007-04-01

    BCR/ABL-positive acute myeloid leukemia (AML) is a rare disease, characterized by a poor prognosis, with resistance to induction chemotherapy and frequent relapses in responsive patients. Here we report a case of BCR/ABL-positive AML-M6 who, after relapse, was treated with Imatinib Mesylate (600 mg/die) and within 4 months achieved a cytogenetic and molecular complete response. After more than 4 years of continuous Imatinib therapy, nested RT-PCR for BCR/ABL is persistently negative. The case reported shows that the response obtained with Imatinib Mesylate in BCR/ABL-positive AML may be long lasting, offering a chance of successful treatment for this poor prognosis group of patients.

  11. Medical Underwriting In Long-Term Care Insurance: Market Conditions Limit Options For Higher-Risk Consumers.

    Science.gov (United States)

    Cornell, Portia Y; Grabowski, David C; Cohen, Marc; Shi, Xiaomei; Stevenson, David G

    2016-08-01

    A key feature of private long-term care insurance is that medical underwriters screen out would-be buyers who have health conditions that portend near-term physical or cognitive disability. We applied common underwriting criteria based on data from two long-term care insurers to a nationally representative sample of individuals in the target age range (50-71 years) for long-term care insurance. The screening criteria put upper bounds on the current proportion of Americans who could gain coverage in the individual market without changes to medical underwriting practice. Specifically, our simulations show that in the target age range, approximately 30 percent of those whose wealth meets minimum industry standards for suitability for long-term care insurance would have their application for such insurance rejected at the underwriting stage. Among the general population-without considering financial suitability-we estimated that 40 percent would have their applications rejected. The predicted rejection rates are substantially higher than the rejection rates of about 20-25 percent of applicants in the actual market. In evaluating reforms for long-term care financing and their potential to increase private insurance rates, as well as to reduce financial pressure on public safety-net programs, policy makers need to consider the role of underwriting in the market for long-term care insurance. Project HOPE—The People-to-People Health Foundation, Inc.

  12. Efficacy of a low-pressure laparoscopic adjustable gastric band for morbid obesity: patients at long term in a multidisciplinary center.

    Science.gov (United States)

    Toouli, Jim; Kow, Lilian; Collins, Jane; Schloithe, Ann; Oppermann, Chris

    2008-01-01

    Obesity is an increasingly common condition with serious associated morbidity and decreased life expectancy. Laparoscopic adjustable gastric banding (LAGB) has demonstrated its safety and efficacy as a surgical therapy for morbid obesity over the short term. The current study sought to determine the long-term safety and efficacy of a low-pressure LAGB. Between August 1996 and July 2007, 1,000 consecutive patients underwent LAGB implantation with the Swedish Adjustable Gastric Band (SAGB). This series was retrospectively reviewed with regard to weight loss and morbidity. Patients served as their own controls. Preoperatively, there were 808 women (81.0%) and 192 men (19.0%) with a mean age of 46 +/- 11 years (range 13-81 yrs) and mean body mass index (BMI) of 42.0 +/- 7.0 kg/m2 (range 27-82 kg/m2). At 1-, 3-, 6-, and 8-year follow-up, mean percent excess weight loss was 41% (n = 600), 56% (n = 367), 51% (n = 114), and 52% (n = 43), respectively. At the same time points, BMI decreased, from 42.0 to 31.0, 32.5, and 30.5 kg/m2, respectively. Complications occurred in 197 patients. There were 2 operative complications (i.e., stomach perforation and vascular injury) and 25 conversions (2.4%) to open surgery. Major and minor wound infection in the perioperative period occurred in 47 (4.7%) and 43 (4.3%) patients, respectively. There was 1 death from a myocardial infarct 1 week after surgery. Long term, there were 30 (3.0%) band slippages, 31 (3.1%) erosions, 67 (6.7%) port problems, and 12 (1.2%) incisional hernias. LAGB with the SAGB is effective in achieving a mean sustainable weight loss of >50% at 8 years after surgery, with an acceptably low morbidity.

  13. Airway pressure release ventilation and biphasic positive airway pressure: a systematic review of definitional criteria.

    Science.gov (United States)

    Rose, Louise; Hawkins, Martyn

    2008-10-01

    The objective of this study was to identify the definitional criteria for the pressure-limited and time-cycled modes: airway pressure release ventilation (APRV) and biphasic positive airway pressure (BIPAP) available in the published literature. Systematic review. Medline, PubMed, Cochrane, and CINAHL databases (1982-2006) were searched using the following terms: APRV, BIPAP, Bilevel and lung protective strategy, individually and in combination. Two independent reviewers determined the paper eligibility and abstracted data from 50 studies and 18 discussion articles. Of the 50 studies, 39 (78%) described APRV, and 11 (22%) described BIPAP. Various study designs, populations, or outcome measures were investigated. Compared to BIPAP, APRV was described more frequently as extreme inverse inspiratory:expiratory ratio [18/39 (46%) vs. 0/11 (0%), P = 0.004] and used rarely as a noninverse ratio [2/39 (5%) vs. 3/11 (27%), P = 0.06]. One (9%) BIPAP and eight (21%) APRV studies used mild inverse ratio (>1:1 to branding may further add to confusion. Generic naming of modes and consistent definitional parameters may improve consistency of patient response for a given mode and assist with clinical implementation.

  14. Sexuality and Physical Intimacy in Long Term Care: Sexuality, long term care, capacity assessment

    OpenAIRE

    Lichtenberg, Peter A.

    2014-01-01

    Sexuality and sexual needs in older adults remains a neglected area of clinical intervention, particularly so in long term care settings. Because older adults in medical rehabilitation and long term care beds present with significant frailties, and often significant neurocognitive disorders it makes it difficult for occupational therapists and other staff to evaluate the capacity of an older adult resident to participate in sexual relationships. The current paper reviews the current literatur...

  15. Medical hypnosis as a tool to acclimatize children to noninvasive positive pressure ventilation: a pilot study.

    Science.gov (United States)

    Delord, Vincent; Khirani, Sonia; Ramirez, Adriana; Joseph, Erick Louis; Gambier, Clotilde; Belson, Maryse; Gajan, Francis; Fauroux, Brigitte

    2013-07-01

    Patient cooperation is crucial for the success of noninvasive positive pressure ventilation (NPPV). This study evaluated the efficacy of medical hypnosis to reduce anticipatory anxiety and acclimatization time in children who are candidates for long-term NPPV. Medical hypnosis was performed by a trained nurse. The acclimatization time and long-term compliance with NPPV were evaluated. Hypnosis was performed in nine children aged 2 to 15 years. Seven children had a high level of anticipatory anxiety because of a tracheotomy since birth (n=2), a history of maxillofacial surgery (n=2), severe dyspnea because of lung disease (n=2), and morbid obesity and depression (n=1), and two children with obstructive sleep apnea failed standard NPPV initiation. The hypnosis techniques were based on distraction in the youngest patient and indirect or direct hypnotic suggestions in the older children to obtain a progressive psychocorporal relaxation. All patients accepted the interface and the NPPV after the first hypnosis session. A median of three sessions was needed for overnight (>6 h) NPPV acceptance. The 6-month compliance with NPPV was excellent, with a median use of 7.5 h per night. Medical hypnosis is an effective, safe, noninvasive, and inexpensive tool for reducing the anticipatory distress and acclimatization time for NPPV. This therapy is particularly useful in children with traumatic experiences, such as a tracheotomy or facial surgical procedures.

  16. Differences in health status between long-term and short-term benzodiazepine users.

    NARCIS (Netherlands)

    Zandstra, S.M.; Furer, J.W.; Lisdonk, E.H. van de; Bor, J.H.J.; Zitman, F.G.; Weel, C. van

    2002-01-01

    BACKGROUND: Despite generally accepted advice to keep treatment short, benzodiazepines are often prescibed for more than six months. Prevention of long-term benzodiazepine use could be facilitated by the utilisation of risk indicators for long-term use. However, the characteristics of long-term

  17. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program

    Science.gov (United States)

    Gosz, J.

    2001-12-01

    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  18. The long-term outcomes of epilepsy surgery

    Science.gov (United States)

    Keller, Simon; Nicolson, Andrew; Biswas, Shubhabrata; Smith, David; Osman Farah, Jibril; Eldridge, Paul; Wieshmann, Udo

    2018-01-01

    Objective Despite modern anti-epileptic drug treatment, approximately 30% of epilepsies remain medically refractory and for these patients, epilepsy surgery may be a treatment option. There have been numerous studies demonstrating good outcome of epilepsy surgery in the short to median term however, there are a limited number of studies looking at the long-term outcomes. The aim of this study was to ascertain the long-term outcome of resective epilepsy surgery in a large neurosurgery hospital in the U.K. Methods This a retrospective analysis of prospectively collected data. We used the 2001 International League Against Epilepsy (ILAE) classification system to classify seizure freedom and Kaplan-Meier survival analysis to estimate the probability of seizure freedom. Results We included 284 patients who underwent epilepsy surgery (178 anterior temporal lobe resections, 37 selective amygdalohippocampectomies, 33 temporal lesionectomies, 36 extratemporal lesionectomies), and had a prospective median follow-up of 5 years (range 1–27). Kaplan-Meier estimates showed that 47% (95% CI 40–58) remained seizure free (apart from simple partial seizures) at 5 years and 38% (95% CI 31–45) at 10 years after surgery. 74% (95% CI 69–80) had a greater than 50% seizure reduction at 5 years and 70% (95% CI 64–77) at 10 years. Patients who had an amygdalohippocampectomy were more likely to have seizure recurrence than patients who had an anterior temporal lobe resection (p = 0.006) and temporal lesionectomy (p = 0.029). There was no significant difference between extra temporal and temporal lesionectomies. Hippocampal sclerosis was associated with a good outcome but declined in relative frequency over the years. Conclusion The vast majority of patients who were not seizure free experienced at least a substantial and long-lasting reduction in seizure frequency. A positive long-term outcome after epilepsy surgery is possible for many patients and especially those with

  19. Human Behaviour in Long-Term Missions

    Science.gov (United States)

    1997-01-01

    In this session, Session WP1, the discussion focuses on the following topics: Psychological Support for International Space Station Mission; Psycho-social Training for Man in Space; Study of the Physiological Adaptation of the Crew During A 135-Day Space Simulation; Interpersonal Relationships in Space Simulation, The Long-Term Bed Rest in Head-Down Tilt Position; Psychological Adaptation in Groups of Varying Sizes and Environments; Deviance Among Expeditioners, Defining the Off-Nominal Act in Space and Polar Field Analogs; Getting Effective Sleep in the Space-Station Environment; Human Sleep and Circadian Rhythms are Altered During Spaceflight; and Methodological Approach to Study of Cosmonauts Errors and Its Instrumental Support.

  20. Long-term storage of radioactive waste: IAEA perspectives on safety and sustainability

    International Nuclear Information System (INIS)

    Rowat, J.H.; Louvat, D.; Metcalf, P.E.

    2006-01-01

    As the amounts of radioactive waste in surface storage have increased, concern has grown over the safety and sustainability of storage in the long term. In response to increasing concerns, the International Atomic Energy Agency (IAEA) has included an action to address the safety implications of the long-term storage (LTS) of radioactive waste in its action plan for waste safety; the action plan was endorsed by the IAEA's Member States in 2001. In 2003, the IAEA published a position paper on the safety and sustainability of LTS as part fulfilment of the action in question. A key theme of the position paper is the contrast of safety and sustainability implications of LTS with those of disposal. The present paper provides a summary of the position paper, describes current IAEA activities that deal with the subject of LTS, and discusses findings from the 2004 Cordoba symposium on disposal of low activity radioactive waste that pertain to LTS. (author)

  1. Very long-term sequelae of craniopharyngioma.

    Science.gov (United States)

    Wijnen, Mark; van den Heuvel-Eibrink, Marry M; Janssen, Joseph A M J L; Catsman-Berrevoets, Coriene E; Michiels, Erna M C; van Veelen-Vincent, Marie-Lise C; Dallenga, Alof H G; van den Berge, J Herbert; van Rij, Carolien M; van der Lely, Aart-Jan; Neggers, Sebastian J C M M

    2017-06-01

    Studies investigating long-term health conditions in patients with craniopharyngioma are limited by short follow-up durations and generally do not compare long-term health effects according to initial craniopharyngioma treatment approach. In addition, studies comparing long-term health conditions between patients with childhood- and adult-onset craniopharyngioma report conflicting results. The objective of this study was to analyse a full spectrum of long-term health effects in patients with craniopharyngioma according to initial treatment approach and age group at craniopharyngioma presentation. Cross-sectional study based on retrospective data. We studied a single-centre cohort of 128 patients with craniopharyngioma treated from 1980 onwards (63 patients with childhood-onset disease). Median follow-up since craniopharyngioma presentation was 13 years (interquartile range: 5-23 years). Initial craniopharyngioma treatment approaches included gross total resection ( n  = 25), subtotal resection without radiotherapy ( n  = 44), subtotal resection with radiotherapy ( n  = 25), cyst aspiration without radiotherapy ( n  = 8), and 90 Yttrium brachytherapy ( n  = 21). Pituitary hormone deficiencies (98%), visual disturbances (75%) and obesity (56%) were the most common long-term health conditions observed. Different initial craniopharyngioma treatment approaches resulted in similar long-term health effects. Patients with childhood-onset craniopharyngioma experienced significantly more growth hormone deficiency, diabetes insipidus, panhypopituitarism, morbid obesity, epilepsy and psychiatric conditions compared with patients with adult-onset disease. Recurrence-/progression-free survival was significantly lower after initial craniopharyngioma treatment with cyst aspiration compared with other therapeutic approaches. Survival was similar between patients with childhood- and adult-onset craniopharyngioma. Long-term health conditions were comparable after

  2. Long-term prisoner in prison isolation

    Directory of Open Access Journals (Sweden)

    Karolina Grudzińska

    2013-06-01

    Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

  3. Longitudinal associations of long-term exposure to ultrafine particles with blood pressure and systemic inflammation in Puerto Rican adults.

    Science.gov (United States)

    Corlin, Laura; Woodin, Mark; Hart, Jaime E; Simon, Matthew C; Gute, David M; Stowell, Joanna; Tucker, Katherine L; Durant, John L; Brugge, Doug

    2018-04-05

    Few longitudinal studies have examined the association between ultrafine particulate matter (UFP, particles blood pressure and high sensitivity C-reactive protein (hsCRP, a biomarker of systemic inflammation). Residential annual average UFP exposure (measured as particle number concentration, PNC) was assigned using a model accounting for spatial and temporal trends. We also adjusted PNC values for participants' inhalation rate to obtain the particle inhalation rate (PIR) as a secondary exposure measure. Multilevel linear models with a random intercept for each participant were used to examine the association of UFP with blood pressure and hsCRP. Overall, in adjusted models, an inter-quartile range increase in PNC was associated with increased hsCRP (β = 6.8; 95% CI = - 0.3, 14.0%) but not with increased systolic blood pressure (β = 0.96; 95% CI = - 0.33, 2.25 mmHg), pulse pressure (β = 0.70; 95% CI = - 0.27, 1.67 mmHg), or diastolic blood pressure (β = 0.55; 95% CI = - 0.20, 1.30 mmHg). There were generally stronger positive associations among women and never smokers. Among men, there were inverse associations of PNC with systolic blood pressure and pulse pressure. In contrast to the primary findings, an inter-quartile range increase in the PIR was positively associated with systolic blood pressure (β = 1.03; 95% CI = 0.00, 2.06 mmHg) and diastolic blood pressure (β = 1.01; 95% CI = 0.36, 1.66 mmHg), but not with pulse pressure or hsCRP. We observed that exposure to PNC was associated with increases in measures of CVD risk markers, especially among certain sub-populations. The exploratory PIR exposure metric should be further developed.

  4. Long-term impact of systolic blood pressure and glycemia on the development of microalbuminuria in essential hypertension.

    Science.gov (United States)

    Pascual, Jose Maria; Rodilla, Enrique; Gonzalez, Carmen; Pérez-Hoyos, Santiago; Redon, Josep

    2005-06-01

    The objective was to assess the temporal impact of factors related to the development of microalbuminuria during the follow-up of young adult normoalbuminurics with high-normal blood pressure or at stage 1 of essential hypertension. Prospective follow-up was conducted on 245 normoalbuminuric hypertensive subjects (mean age 40.9 years; 134 men; blood pressure 139.7/88.6 mm Hg; body mass index 28.5 kg/m2) never treated previously with antihypertensive drugs, with yearly urinary albumin excretion measurements, until the development of microalbuminuria. After enrollment, patients were placed on usual care including nonpharmacological treatment or with an antihypertensive drug regime to achieve a blood pressure of 15 mg per 24-hour systolic blood pressure >139 mm Hg and a positive trend in fasting glucose were observed in the univariate analyses. However, in the multivariate analysis, only the baseline urinary albumin excretion and the trend of fasting glucose were independently related to the risk of developing microalbuminuria. In mild hypertensives, the development of microalbuminuria was linked to insufficient blood pressure control and to a progressive increment of glucose values.

  5. Competitive short-term and long-term memory processes in spatial habituation.

    Science.gov (United States)

    Sanderson, David J; Bannerman, David M

    2011-04-01

    Exposure to a spatial location leads to habituation of exploration such that, in a novelty preference test, rodents subsequently prefer exploring a novel location to the familiar location. According to Wagner's (1981) theory of memory, short-term and long-term habituation are caused by separate and sometimes opponent processes. In the present study, this dual-process account of memory was tested. Mice received a series of exposure training trials to a location before receiving a novelty preference test. The novelty preference was greater when tested after a short, rather than a long, interval. In contrast, the novelty preference was weaker when exposure training trials were separated by a short, rather than a long interval. Furthermore, it was found that long-term habituation was determined by the independent effects of the amount of exposure training and the number of exposure training trials when factors such as the intertrial interval and the cumulative intertrial interval were controlled. A final experiment demonstrated that a long-term reduction of exploration could be caused by a negative priming effect due to associations formed during exploration. These results provide evidence against a single-process account of habituation and suggest that spatial habituation is determined by both short-term, recency-based memory and long-term, incrementally strengthened memory.

  6. Long term liquidity analysis of the firm

    Directory of Open Access Journals (Sweden)

    Jaroslav Gonos

    2009-09-01

    Full Text Available Liquidity control is a very difficult and important function. If the business is not liquid in the long term, it is under threatof bankruptcy, and on the other hand surplus of the cash in hand threaten its future efficiency, because the cash in hand is a sourceof only limited profitability. Long term liquidity is related to the ability of the short term and long term liabilities payment. Articleis trying to point out to the monitoring and analyzing of the long term liquidity in the concrete business, in this case the printing industrycompany. Hereby at the end of the article mentioned monitored and analyzed liquidity is evaluated in the five years time period.

  7. Long-term monitoring FBG-based cable load sensor

    Science.gov (United States)

    Zhang, Zhichun; Zhou, Zhi; Wang, Chuan; Ou, Jinping

    2006-03-01

    Stay cables are the main load-bearing components of stayed-cable bridges. The cables stress status is an important factor to the stayed-cable bridge structure safety evaluation. So it's very important not only to the bridge construction, but also to the long-term safety evaluation for the bridge structure in-service. The accurate measurement for cable load depends on an effective sensor, especially to meet the long time durability and measurement demand. FBG, for its great advantage of corrosion resistance, absolute measurement, high accuracy, electro-magnetic resistance, quasi-distribution sensing, absolute measurement and so on, is the most promising sensor, which can cater for the cable force monitoring. In this paper, a load sensor has been developed, which is made up of a bushing elastic supporting body, 4 FBGs uniformly-spaced attached outside of the bushing supporting body, and a temperature compensation FBG for other four FBGs, moreover a cover for protection of FBGs. Firstly, the sensor measuring principle is analyzed, and relationship equation of FBG wavelength shifts and extrinsic load has also been gotten. And then the sensor calibration experiments of a steel cable stretching test with the FBG load sensor and a reference electric pressure sensor is finished, and the results shows excellent linearity of extrinsic load and FBG wavelength shifts, and good repeatability, which indicates that such kind of FBG-based load sensor is suitable for load measurement, especially for long-term, real time monitoring of stay-cables.

  8. Long-term memory of hierarchical relationships in free-living greylag geese

    NARCIS (Netherlands)

    Weiss, Brigitte M.; Scheiber, Isabella B. R.

    Animals may memorise spatial and social information for many months and even years. Here, we investigated long-term memory of hierarchically ordered relationships, where the position of a reward depended on the relationship of a stimulus relative to other stimuli in the hierarchy. Seventeen greylag

  9. Noninvasive Positive Pressure Ventilation or Conventional Mechanical Ventilation for Neonatal Continuous Positive Airway Pressure Failure

    Directory of Open Access Journals (Sweden)

    Zohreh Badiee

    2014-01-01

    Full Text Available Background: The aim of this study was to assess the success rate of nasal intermittent positive pressure ventilation (NIPPV for treatment of continuous positive airway pressure (CPAP failure and prevention of conventional ventilation (CV in preterm neonates. Methods: Since November 2012 to April 2013, a total number of 55 consecutive newborns with gestational ages of 26-35 weeks who had CPAP failure were randomly assigned to one of the two groups. The NIPPV group received NIPPV with the initial peak inspiratory pressure (PIP of 16-20 cmH 2 O and frequency of 40-60 breaths/min. The CV group received PIP of 12-20 cmH 2 O and frequency of 40-60 breaths/min. Results: About 74% of newborns who received NIPPV for management of CPAP failure responded to NIPPV and did not need intubation and mechanical ventilation. Newborns with lower postnatal age at entry to the study and lower 5 min Apgar score more likely had NIPPV failure. In addition, treatment failure was higher in newborns who needed more frequent doses of surfactant. Duration of oxygen therapy was 9.28 days in CV group and 7.77 days in NIPPV group (P = 0.050. Length of hospital stay in CV group and NIPPV groups were 48.7 and 41.7 days, respectively (P = 0.097. Conclusions: NIPPV could decrease the need for intubation and mechanical ventilation in preterm infants with CPAP failure.

  10. The long-term consequences of previous hyperthyroidism

    DEFF Research Database (Denmark)

    Hjelm Brandt Kristensen, Frans

    2015-01-01

    Thyroid hormones affect every cell in the human body, and the cardiovascular changes associated with increased levels of thyroid hormones are especially well described. As an example, short-term hyperthyroidism has positive chronotropic and inotropic effects on the heart, leading to a hyperdynamic...... with CVD, LD and DM both before and after the diagnosis of hyperthyroidism. Although the design used does not allow a stringent distinction between cause and effect, the findings indicate a possible direct association between hyperthyroidism and these morbidities, or vice versa....... vascular state. While it is biologically plausible that these changes may induce long-term consequences, the insight into morbidity as well as mortality in patients with previous hyperthyroidism is limited. The reasons for this are a combination of inadequately powered studies, varying definitions...

  11. Association of positive screening for dysphagia with nutritional status and long-term mortality in hospitalized elderly patients.

    Science.gov (United States)

    Mañas-Martínez, Ana B; Bucar-Barjud, Marina; Campos-Fernández, Julia; Gimeno-Orna, José Antonio; Pérez-Calvo, Juan; Ocón-Bretón, Julia

    2018-04-24

    To assess the prevalence of oropharyngeal dysphagia (OD) using the Eating Assessment Tool (EAT-10) and its association with malnutrition and long-term mortality. A retrospective cohort study of patients admitted to the general internal medicine ward. In the first 48hours after hospital admission, OD was assessed using the EAT-10, and presence of malnutrition with the Mini Nutritional Assessment-Short Form (MNA-SF). Association of OD to malnutrition and long-term mortality was analyzed. Ninety patients with a mean age of 83 (SD: 11.8) years were enrolled. Of these, 56.7% were at risk of OD according to EAT-10. This group of patients had greater prevalence rates of malnutrition (88.2% vs. 48.7%; P=.001) and mortality (70% vs 35.9%; P=.001). During follow-up for 872.71 (SD: 642.89) days, risk of DO according to EAT-10 was an independent predictor of mortality factor in a multivariate analysis (HR: 2.8; 95%CI: 1.49-5.28; P=.001). The EAT-10 is a useful tool for screening OD. Adequate screening for OD is important because of its associated risks of malnutrition and long-term mortality. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Long-term durability testing of ceramic cross-flow filter. Final report, September 29, 1987--December 31, 1992

    Energy Technology Data Exchange (ETDEWEB)

    Lippert, T.E.; Smeltzer, E.E.; Alvin, M.A.; Bachovchin, D.M.

    1993-08-01

    Long term durability testing of the cross flow filter is described. Two high temperature, high pressure test facilities were built and operated. The facilities were designed to simulate dirty gas environments typical of Pressurized Fluidized Bed Combustion (PFBC) and coal gasification. Details of the design and operation of the test facilities and filter testing results are described.

  13. On the Beat Detection Performance in Long-Term ECG Monitoring Scenarios

    Directory of Open Access Journals (Sweden)

    Francisco-Manuel Melgarejo-Meseguer

    2018-05-01

    Full Text Available Despite the wide literature on R-wave detection algorithms for ECG Holter recordings, the long-term monitoring applications are bringing new requirements, and it is not clear that the existing methods can be straightforwardly used in those scenarios. Our aim in this work was twofold: First, we scrutinized the scope and limitations of existing methods for Holter monitoring when moving to long-term monitoring; Second, we proposed and benchmarked a beat detection method with adequate accuracy and usefulness in long-term scenarios. A longitudinal study was made with the most widely used waveform analysis algorithms, which allowed us to tune the free parameters of the required blocks, and a transversal study analyzed how these parameters change when moving to different databases. With all the above, the extension to long-term monitoring in a database of 7-day Holter monitoring was proposed and analyzed, by using an optimized simultaneous-multilead processing. We considered both own and public databases. In this new scenario, the noise-avoid mechanisms are more important due to the amount of noise that exists in these recordings, moreover, the computational efficiency is a key parameter in order to export the algorithm to the clinical practice. The method based on a Polling function outperformed the others in terms of accuracy and computational efficiency, yielding 99.48% sensitivity, 99.54% specificity, 99.69% positive predictive value, 99.46% accuracy, and 0.85% error for MIT-BIH arrhythmia database. We conclude that the method can be used in long-term Holter monitoring systems.

  14. Improvised bubble continuous positive airway pressure (BCPAP ...

    African Journals Online (AJOL)

    Improvised bubble continuous positive airway pressure (BCPAP) device at the National Hospital Abuja gives immediate improvement in respiratory rate and oxygenation in neonates with respiratory distress.

  15. Running on a lower-body positive pressure treadmill

    DEFF Research Database (Denmark)

    Raffalt, Peter C; Hovgaard-Hansen, Line; Jensen, Bente Rona

    2013-01-01

    This study investigated maximal oxygen consumption (VO2max) and time to exhaustion while running on a lower-body positive pressure treadmill (LBPPT) at normal body weight (BW) as well as how BW support affects respiratory responses, ground reaction forces, and stride characteristics.......This study investigated maximal oxygen consumption (VO2max) and time to exhaustion while running on a lower-body positive pressure treadmill (LBPPT) at normal body weight (BW) as well as how BW support affects respiratory responses, ground reaction forces, and stride characteristics....

  16. Long-term trends of foE and geomagnetic activity variations

    Directory of Open Access Journals (Sweden)

    A. V. Mikhailov

    2003-03-01

    Full Text Available A relationship between foE trends and geomagnetic activity long-term variations has been revealed for the first time. By analogy with earlier obtained results on the foF2 trends it is possible to speak about the geomagnetic control of the foE long-term trends as well. Periods of increasing geomagnetic activity correspond to negative foE trends, while these trends are positive for the decreasing phase of geomagnetic activity. This "natural" relationship breaks down around 1970 (on some stations later when pronounced positive foE trends have appeared on most of the stations considered. The dependence of foE trends on geomagnetic activity can be related with nitric oxide variations at the E-layer heights. The positive foE trends that appeared after the "break down" effect may also be explained by the [NO] decrease which is not related to geomagnetic activity variations. But negative trends or irregular foE variations on some stations for the same time period require some different mechanism. Chemical pollution of the lower thermosphere due to the anthropogenic activity may be responsible for such abnormal foE behavior after the end of the 1960s.Key words. Ionosphere (ionosphere-atmosphere interactions; ionospheric disturbances

  17. Aphakia correction with retropupillary fixated iris-claw lens (Artisan – long-term results

    Directory of Open Access Journals (Sweden)

    Schallenberg M

    2013-12-01

    Full Text Available Maurice Schallenberg,1,2 Dirk Dekowski,1 Angela Hahn,1 Thomas Laube,1,3 Klaus-Peter Steuhl,1 Daniel Meller11Department of Ophthalmology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; 2HELIOS Klinikum Wuppertal, Wuppertal, Germany; 3Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, GermanyPurpose: To evaluate the technique, safety, and efficacy of the retropupillary implantation of iris-claw intraocular lenses in a long-term follow-up study.Patients and methods: This retrospective study included 31 eyes of 31 patients who underwent an Artisan aphakic intraocular lens implantation between January 2006 and February 2011 at the University Hospital Essen, Essen, Germany and at the Zentrum für Augenheilkunde PD Dr Laube, Düsseldorf, Germany. Preoperative data collected included demographics, etiology of aphakia, previous surgeries, preoperative eye pathology, intraocular pressure, clinical signs of endothelial cell loss, and best corrected visual acuity. Operative data and postoperative outcomes included the best corrected visual acuity, lens position, intraocular pressure, pigment dispersion, clinical signs of endothelial cell loss, development of macular edema, and other complications.Results: Thirty-one patients were included. The mean follow-up was 25.2 months (range: 4–48 months. The mean best corrected visual acuity postoperatively was 0.64 logarithm of the minimum angle of resolution (logMAR and varied from 0 logMAR to 3 logMAR. Some patients had a low visual acuity preoperatively because of preoperative eye pathologies. In 22 patients the visual acuity improved, in two patients the visual acuity remained unchanged, and seven patients showed a decreased visual acuity. Complications were peaked pupils (n=10 and retinal detachment in one case. Four patients showed an iris atrophy and high intraocular pressure was observed only in one patient. Subluxation of the intraocular lens, endothelial cell loss, and

  18. What to Do with a Second Chance in Life? Long-Term Experiences of Non-carriers of Huntington's Disease.

    Science.gov (United States)

    Winnberg, Elisabeth; Winnberg, Ulrika; Pohlkamp, Lilian; Hagberg, Anette

    2018-04-07

    Little is known about how people's lives are influenced when going from a 50% risk status of Huntington's disease (HD) to no risk after performing predictive testing. In this study, 20 interviews were conducted to explore the long-term (> 5 years) experiences after receiving predictive test results as a non-carrier of HD. The results showed a broad variety of both positive and negative reactions. The most prominent positive reaction reported was feelings of relief and gratitude, of not carrying the HD mutation for themselves and for their children. Also, the non-carrier status promoted in some individuals' significant life changes such as a wishing to have (more) children, pursuing a career or breaking up from an unhappy relationship. However, negative reactions on their psychological well-being were also described. Some had experienced psychological pressure of needing to do something extraordinary in their lives; others expressed feelings of guilt towards affected or untested siblings, resulting in sadness or clinical depression. The new genetic risk status could generate a need of re-orientation, a process that for some persons took several years to accomplish. The results of the present study show the importance of offering long-term post-result counselling for non-carriers in order to deal with the psychological consequences that may follow predictive testing.

  19. Long-term contracts vs. short-term trade of natural gas - a European perspective

    International Nuclear Information System (INIS)

    Neuhoff, Karsten; Hirschhausen, Christian von

    2005-01-01

    This paper analyses the economics of long-term gas contracts under changing institutional conditions, mainly gas sector liberalisation. The paper is motivated by the increasingly tense debate in continental Europe, UK and the US on the security of long-term gas supply. We discuss the main issues regarding long-term contracts, i.e. the changing role of the flexibility clause, the effect of abandoning the destination clause, and the strategic behaviour of producers between long-term sales and spot-sales. The literature suggests consumers and producers benefit from risk hedging through long-term contracts. Furthermore long-term contracts may reduce exercise of market power. Our analysis adds an additional benefit if the long-run demand elasticity is significantly lower than the short-run elasticity, both strategic producers and consumers benefit from lower prices and larger market volume. Some policy implications of the findings are also discussed. (Author)

  20. The uranium industry: long-term planning for short-term competition

    International Nuclear Information System (INIS)

    Vottero, X.; Georges Capus, G.

    2001-01-01

    Long term planning for short term competition Today, uranium producers face new challenges in terms of both production (new regulatory, environmental and social constraints) and market conditions (new sources of uranium supply, very low prices and tough competition). In such a context, long-term planning is not just a prerequisite to survive in the nuclear fuel cycle industry. In fact, it also contributes to sustaining nuclear electricity generation facing fierce competition from other energy sources in increasingly deregulated markets. Firstly, the risk of investing in new mining projects in western countries is growing because, on the one hand, of very erratic market conditions and, on the other hand, of increasingly lengthy, complex and unpredictable regulatory conditions. Secondly, the supply of other sources of uranium (uranium derived from nuclear weapons, uranium produced in CIS countries, ...) involve other risks, mainly related to politics and commercial restrictions. Consequently, competitive uranium supply requires not only technical competence but also financial strength and good marketing capabilities in order to anticipate long-term market trends, in terms of both demand and supply. It also requires taking into account new parameters such as politics, environment, regulations, etc. Today, a supplier dedicated to the sustainable production of nuclear electricity must manage a broad range of long-term risks inherent to the procurement of uranium. Taking into account all these parameters in a context of short-term, fast-changing market is a great challenge for the future generation. World Uranium Civilian Supply and Demand. (authors)

  1. Long term results of trabeculectomy surgery

    Directory of Open Access Journals (Sweden)

    Ferhat Evliyaoğlu

    2015-09-01

    Full Text Available Objective: Evaluation of long-term results of primary trabeculectomy operation Methods: The cases that are followed up with diagnosis of glaucoma in Okmeydanı Training and Research Hospital Eye Clinic between January 2000 and December 2001 were evaluated retrospectively. All of the cases, despite maximum therapy, have high intraocular pressure (IOP, undergone primary trabeculectomy operation, are followed at least 6 months and regularly followed through 10 years were included in this study. IOP with or without medical treatment 18mmg or less than 18 mmHg accepted as successful. IOL pressure measured with applanation tonometry. Results: 89 eyes of 70 cases were included in this study. The cases included in the study, 42 male (60%, and 28 (40% were female. The mean age was 63.65±12.18 years. Preoperative intraocular pressure determined as 30.36 ± 3.2 mmHg. In the follow up examination mean intra ocular pressure was 15.31 ± 1.2 mmHg at 1st month, 15.47± 1.1mmHg at 3rd month, 15.02±1.8 mmHg at 6th month, 15.34± 2.1 mmHg at 1st year, 15.82 ± 2.1mmHg at 2nd year, 17.06 ± 2.3mmHg at 5th year and 18.02 ± 2.2 mmHg at 10th year. Statistical analysis of these data showed significant decreased of intra ocular pressure in the post operative period in compare to the preoperative period, 1st month, 3rd month, 6th month, 1st year, 2nd year, 5th year an 10th year (p < 0.01. The follow-up period in the study was 91.10 ± 40.15 months (6-120 months. Conclusion: Primary trabeculectomy can be considered as an alternative treatment procedure especially in patients who does not use drugs regularly and unable to attend regular medical examination. J Clin Exp Invest 2015; 6 (3: 263-268

  2. Human cardiomyocyte progenitor cell transplantation preserves long-term function of the infarcted mouse myocardium

    NARCIS (Netherlands)

    Smits, Anke M.; van Laake, Linda W.; den Ouden, Krista; Schreurs, Chantal; Szuhai, Karoly; van Echteld, Cees J.; Mummery, Christine L.; Doevendans, Pieter A.; Goumans, Marie-Jose

    2009-01-01

    Recent clinical studies revealed that positive results of cell transplantation on cardiac function are limited to the short- and mid-term restoration phase following myocardial infarction (MI), emphasizing the need for long-term follow-up. These transient effects may depend on the transplanted

  3. Long-term biodosimetry Redux

    International Nuclear Information System (INIS)

    Simon, Steven L.; Bouville, Andre

    2016-01-01

    This paper revisits and reiterates the needs, purposes and requirements of bio-dosimetric assays for long-term dose and health risk assessments. While the most crucial need for bio-dosimetric assays is to guide medical response for radiation accidents, the value of such techniques for improving our understanding of radiation health risk by supporting epidemiological (long-term health risk) studies is significant. As new cohorts of exposed persons are identified and new health risk studies are undertaken with the hopes that studying the exposed will result in a deeper understanding of radiation risk, the value of reliable dose reconstruction is underscored. The ultimate application of biodosimetry in long-term health risk studies would be to completely replace model-based dose reconstruction-a complex suite of methods for retrospectively estimating dose that is commonly fraught with large uncertainties due to the absence of important exposure-related information, as well as imperfect models. While biodosimetry could potentially supplant model-based doses, there are numerous limitations of presently available techniques that constrain their widespread application in health risk research, including limited ability to assess doses received far in the past, high cost, great inter-individual variability, invasiveness, higher than preferred detection limits and the inability to assess internal dose (for the most part). These limitations prevent the extensive application of biodosimetry to large cohorts and should be considered a challenge to researchers to develop new and more flexible techniques that meet the demands of long-term health risk research. Events in recent years, e.g. the Fukushima reactor accident and the increased threat of nuclear terrorism, underscore that any event that results in significant radiation exposures of a group of people will also produce a much larger population, exposed at lower levels, but that likewise needs (or demands) an exposure

  4. Long-Range Lightning Products for Short Term Forecasting of Tropical Cyclogenesis

    Science.gov (United States)

    Businger, S.; Pessi, A.; Robinson, T.; Stolz, D.

    2010-12-01

    This paper will describe innovative graphical products derived in real time from long-range lightning data. The products have been designed to aid in short-term forecasting of tropical cyclone development for the Tropical Cyclone Structure Experiment 2010 (TCS10) held over the western Pacific Ocean from 17 August to 17 October 2010 and are available online at http://www.soest.hawaii.edu/cgi-bin/pacnet/tcs10.pl. The long-range lightning data are from Vaisala’s Global Lightning Data 360 (GLD360) network and include time, location, current strength, polarity, and data quality indication. The products currently provided in real time include i. Infrared satellite imagery overlaid with lighting flash locations, with color indication of current strength and polarity (shades of blue for negative to ground and red for positive to ground). ii. A 15x15 degree storm-centered tile of IR imagery overlaid with lightning data as in i). iii. A pseudo reflectivity product showing estimates of radar reflectivity based on lightning rate - rain rate conversion derived from TRMM and PacNet data. iv. A lightning history product that plots each hour of lightning flash locations in a different color for a 12-hour period. v. Graphs of lightning counts within 50 or 300 km radius, respectively, of the storm center vs storm central sea-level pressure. vi. A 2-D graphic showing storm core lightning density along the storm track. The first three products above can be looped to gain a better understanding of the evolution of the lightning and storm structure. Examples of the graphics and their utility will be demonstrated and discussed. Histogram of lightning counts within 50 km of the storm center and graph of storm central pressure as a function of time.

  5. Long-term exposure to traffic pollution and hospital admissions in London

    International Nuclear Information System (INIS)

    Halonen, Jaana I.; Blangiardo, Marta; Toledano, Mireille B.; Fecht, Daniela; Gulliver, John; Anderson, H. Ross; Beevers, Sean D.; Dajnak, David; Kelly, Frank J.; Tonne, Cathryn

    2016-01-01

    Evidence on the effects of long-term exposure to traffic pollution on health is inconsistent. In Greater London we examined associations between traffic pollution and emergency hospital admissions for cardio-respiratory diseases by applying linear and piecewise linear Poisson regression models in a small-area analysis. For both models the results for children and adults were close to unity. In the elderly, linear models found negative associations whereas piecewise models found non-linear associations characterized by positive risks in the lowest and negative risks in the highest exposure category. An increased risk was observed among those living in areas with the highest socioeconomic deprivation. Estimates were not affected by adjustment for traffic noise. The lack of convincing positive linear associations between primary traffic pollution and hospital admissions agrees with a number of other reports, but may reflect residual confounding. The relatively greater vulnerability of the most deprived populations has important implications for public health. - Highlights: • Evidence concerning associations between traffic pollutants and morbidity is scarce. • We addressed this using state of the art small-area statistical methods. • There was no convincing evidence of positive linear associations with admissions. - In this study, there was no convincing evidence of positive linear associations between long-term exposure to primary traffic pollutants and cardio-respiratory hospitalizations.

  6. Proportional positive airway pressure: a new concept to treat obstructive sleep apnoea.

    Science.gov (United States)

    Juhász, J; Becker, H; Cassel, W; Rostig, S; Peter, J H

    2001-03-01

    Proportional positive airway pressure (PPAP) was designed to optimize airway pressure for the therapy of obstructive sleep apnoea (OSA). In a randomized crossover prospective study, the clinical feasibility of PPAP and its immediate effects on the breathing disorder and sleep in comparison with continuous positive airway pressure (CPAP) was evaluated. Twelve patients requiring CPAP therapy underwent CPAP and PPAP titration in a random order. Obstructive and mixed respiratory events could be completely abolished with both forms of treatment. This efficacy could be achieved at a significantly lower mean mask pressure during PPAP titration (8.45+/-2.42 cmH2O) compared to CPAP (9.96+/-2.7 cmH2O) (p=0.002). The mean minimal arterial oxygen saturation (Sa,O2) (82.8+/-6.5%) on the diagnostic night increased significantly (pPPAP titration. Total sleep time, slow wave sleep and rapid eye movement (REM) sleep increased significantly by the same amount during both CPAP and PPAP titration (pPPAP titration night, four patients did not have a preference, and two patients preferred CPAP. The present data show that proportional positive airway pressure is as effective as continuous positive airway pressure in eliminating obstructive events and has the same immediate effect on sleep. The lower average mask pressure during proportional positive airway pressure implies potential advantages compared to continuous positive airway pressure. Proportional positive airway pressure presents a new effective therapeutic approach to obstructive sleep apnoea.

  7. Long term radioactive waste management

    International Nuclear Information System (INIS)

    Lavie, J.M.

    1984-01-01

    In France, waste management, a sensitive issue in term of public opinion, is developing quickly, and due to twenty years of experience, is now reaching maturity. With the launching of the French nuclear programme, the use of radioactive sources in radiotherapy and industry, waste management has become an industrial activity. Waste management is an integrated system dealing with the wastes from their production to the long term disposal, including their identification, sortage, treatment, packaging, collection and transport. This system aims at guaranteing the protection of present and future populations with an available technology. In regard to their long term management, and the design of disposals, radioactive wastes are divided in three categories. This classification takes into account the different radioisotopes contained, their half life and their total activity. Presently short-lived wastes are stored in the shallowland disposal of the ''Centre de la Manche''. Set up within the French Atomic Energy Commission (CEA), the National Agency for waste management (ANDRA) is responsible within the framework of legislative and regulatory provisions for long term waste management in France [fr

  8. Development of Hybrid pH sensor for long-term seawater pH monitoring.

    Science.gov (United States)

    Nakano, Y.; Egashira, T.; Miwa, T.; Kimoto, H.

    2016-02-01

    We have been developing the in situ pH sensor (Hybrid pH sensor: HpHS) for the long-term seawater pH monitoring. We are planning to provide the HpHS for researchers and environmental consultants for observation of the CCS (Carbon dioxide Capture and Storage) monitoring system, the coastal environment monitoring system (e.g. Blue Carbon) and ocean acidification. The HpHS has two types of pH sensors (i.e. potentiometric pH sensor and spectrophotometric pH sensor). The spectrophotometric pH sensor can measure pH correctly and stably, however it needs large power consumption and a lot of reagents in a long period of observation. The pH sensor used m-cresol purple (mCP) as an indicator of pH (Clayton and Byrne, 1993 and Liu et al., 2011). We can choose both coefficients before deployment. On the other hand, although the potentiometric pH sensor is low power consumption and high-speed response (within 10 seconds), drifts in the pH of the potentiometric measurements may possibly occur for a long-term observation. The HpHS can measure in situ pH correctly and stably combining advantage of both pH sensors. The HpHS consists of an aluminum pressure housing with optical cell (main unit) and an aluminum silicon-oil filled, pressure-compensated vessel containing pumps and valves (diaphragm pump and valve unit) and pressure-compensated reagents bags (pH indicator, pure water and Tris buffer or certified reference material: CRM) with an ability to resist water pressure to 3000m depth. The main unit holds system control boards, pump drivers, data storage (micro SD card), LED right source, photodiode, optical cell and pressure proof windows. The HpHS also has an aluminum pressure housing that holds a rechargeable lithium-ion battery or a lithium battery for the power supply (DC 24 V). The HpHS is correcting the value of the potentiometric pH sensor (measuring frequently) by the value of the spectrophotometric pH sensor (measuring less frequently). It is possible to calibrate in

  9. Modeling long-term dynamics of electricity markets

    International Nuclear Information System (INIS)

    Olsina, Fernando; Garces, Francisco; Haubrich, H.-J.

    2006-01-01

    In the last decade, many countries have restructured their electricity industries by introducing competition in their power generation sectors. Although some restructuring has been regarded as successful, the short experience accumulated with liberalized power markets does not allow making any founded assertion about their long-term behavior. Long-term prices and long-term supply reliability are now center of interest. This concerns firms considering investments in generation capacity and regulatory authorities interested in assuring the long-term supply adequacy and the stability of power markets. In order to gain significant insight into the long-term behavior of liberalized power markets, in this paper, a simulation model based on system dynamics is proposed and the underlying mathematical formulations extensively discussed. Unlike classical market models based on the assumption that market outcomes replicate the results of a centrally made optimization, the approach presented here focuses on replicating the system structure of power markets and the logic of relationships among system components in order to derive its dynamical response. The simulations suggest that there might be serious problems to adjust early enough the generation capacity necessary to maintain stable reserve margins, and consequently, stable long-term price levels. Because of feedback loops embedded in the structure of power markets and the existence of some time lags, the long-term market development might exhibit a quite volatile behavior. By varying some exogenous inputs, a sensitivity analysis is carried out to assess the influence of these factors on the long-run market dynamics

  10. Short-term memory and long-term memory are still different.

    Science.gov (United States)

    Norris, Dennis

    2017-09-01

    A commonly expressed view is that short-term memory (STM) is nothing more than activated long-term memory. If true, this would overturn a central tenet of cognitive psychology-the idea that there are functionally and neurobiologically distinct short- and long-term stores. Here I present an updated case for a separation between short- and long-term stores, focusing on the computational demands placed on any STM system. STM must support memory for previously unencountered information, the storage of multiple tokens of the same type, and variable binding. None of these can be achieved simply by activating long-term memory. For example, even a simple sequence of digits such as "1, 3, 1" where there are 2 tokens of the digit "1" cannot be stored in the correct order simply by activating the representations of the digits "1" and "3" in LTM. I also review recent neuroimaging data that has been presented as evidence that STM is activated LTM and show that these data are exactly what one would expect to see based on a conventional 2-store view. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. [Domiciliary noninvasive positive pressure ventilation in chronic alveolar hypoventilation].

    Science.gov (United States)

    Casas, J P; Robles, A M; Pereyra, M A; Abbona, H L; López, A M

    2000-01-01

    Effectiveness of treatment with domiciliary nocturnal noninvasive positive pressure ventilation is analyzed in a group of patients with chronic alveolar hypoventilation of different etiologies. It was applied with two levels of pressure (BiPAP) via nasal mask. Criteria for evaluation were symptomatology and improvement in gas exchange. Data were analyzed by Student t tests. A total of 13 patients were included, mean age 55.7 range 20 to 76 years (5 male 8 female). Main diagnosis was tuberculosis in 6, four of them having had surgical procedure (thoracoplasty 2, frenicectomy 1 and neumonectomy 1), myopathy 3 (myasthenia gravis 1, muscular dystrophy 1 and diaphragmatic paralysis 1), obesity-hypoventilation syndrome 1, escoliosis 1, bronchiectasis 1 and cystic fibrosis 1. These last two patients were on waiting list for lung transplantation. At the moment of consultation, the symptoms were: dysnea 13/13 (100%), astenia 13/13 (100%), hypersomnolency 10/13 (77%), cephalea 9/13 (69%), leg edema 6/13 (46%), loss of memory 6/13 (46%). Regarding gas exchange, they showed hypoxemia and hypercapnia. Mean follow up was of 2.2 years (range 6 months to 4 years). Within the year, all 13 patients became less dyspneic. Astenia, hypersomnolency, cephalea, leg edema and memory loss disappeared. Improvement in gas exchange was: PaO2/FiO2 from 269 +/- 65.4 (basal) to 336.7 +/- 75.3 post-treatment (p = 0.0018). PaCO2 from 70.77 +/- 25.48 mmHg (basal) to 46.77 +/- 8.14 mmHg (p = 0.0013). Ventilatory support was discontinued en 5 patients: three because of pneumonia requiring intubation and conventional mechanical ventilation, two of them died and one is still with tracheostomy; One patient with bronchiectasis and one with cystic fibrosis were transplanted. The remaining eight patients are stable. In conclusion, chronic alveolar hypoventilation can be effectively treated with domiciliary nocturnal noninvasive ventilation. Long term improvement in symptomatology and arterial blood gases

  12. Long-Term Follow-Up of Class II Adults Treated with Orthodontic Camouflage: A Comparison with Orthognathic Surgery Outcomes

    National Research Council Canada - National Science Library

    Mihalik, Colin

    2002-01-01

    .... These were compared to similar data for long-term outcomes in patients who had surgical correction. Small mean changes in skeletal landmark positions did occur long-term, but were in general much smaller than in the surgery patients...

  13. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme

    2011-01-01

    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  14. Evaluation of Long Term Behaviour of Polymers for Offshore Oil and Gas Applications

    Directory of Open Access Journals (Sweden)

    Le Gac P.-Y.

    2015-02-01

    Full Text Available Polymers and composites are very attractive for underwater applications, but it is essential to evaluate their long term behaviour in sea water if structural integrity of offshore structures is to be guaranteed. Accelerated test procedures are frequently required, and this paper will present three examples showing how the durability of polymers, in the form of fibres, matrix resins in fibre reinforced composites for structural elements, and thermal insulation coatings of flow-lines, have been evaluated for offshore use. The influence of the ageing medium, temperature, and hydrostatic pressure will be discussed first, then an example of the application of ageing test results to predict long term behavior of the thermal insulation coating of a flowline will be presented.

  15. Syphilis sero-positivity in recently admitted and long-term psychiatric inpatients: Screening, prevalence and diagnostic profile

    Directory of Open Access Journals (Sweden)

    Maria P Henning

    2012-12-01

    Full Text Available Background. Syphilis research has neglected the prevalence of the disease among psychiatric patients, and traditional syphilis screening has been reported as inadequate. Objectives. (i To assess the syphilis prevalence among psychiatric patients; (ii to compare psychiatric diagnoses of syphilis-infected and -uninfected patients; (iii to assess self-reported high-risk sexual behaviour; (iv to establish syphilis/HIV co-morbidity; and (v to investigate the performance of the rapid plasma reagin (RPR test in syphilis screening, compared with the Treponema pallidum haemagglutination (TPHA test. Methods. Psychiatric inpatients at Weskoppies Hospital, Pretoria, who consented to participate in the study (N=195 were categorised according to gender and length of admission (long-term or recent. Non-treponemal RPR, confirmatory TPHA, HIV-rapid and HIV enzyme-linked immunosorbent assay (ELISA tests were performed. A reactive TPHA test was used to diagnose syphilis. Results. The estimated prevalence of syphilis was 11.7%. There was no significant association between TPHA sero-positivity and primary psychiatric diagnosis or self-reported high-risk sexual behaviour. Significant co-morbidity existed between syphilis and HIV (p=0.012. Compared with the TPHA test, the RPR test performed poorly, identifying only 2/23 patients who had a sero-positive TPHA test (8.7% sensitivity and 100% specificity. Conclusions. The prevalence of syphilis was higher than anticipated, supporting the need for routine testing. The significant co-morbidity and alarming prevalence of HIV and syphilis warrant testing for both conditions in all psychiatric admissions. Current syphilis screening with a single RPR test is inadequate; both RPR and TPHA tests should be performed.

  16. Long-Term Memory Performance in Adult ADHD.

    Science.gov (United States)

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya

    2017-02-01

    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  17. Long-Term Use of Aldosterone-Receptor Antagonists in Uncontrolled Hypertension: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Pieter M. Jansen

    2011-01-01

    Full Text Available Background. The long-term efficacy of aldosterone-receptor antagonists (ARAs as add-on treatment in uncontrolled hypertension has not yet been reported. Methods. Data from 123 patients (21 with primary aldosteronism, 102 with essential hypertension with difficult-to-treat hypertension who received an ARA between May 2005 and September 2009 were analyzed retrospectively for their blood pressure (BP and biochemical response at first followup after start with ARA and the last follow-up available. Results. Systolic BP decreased by 22±20 and diastolic BP by 9.4±12 mmHg after a median treatment duration of 25 months. In patients that received treatment >5 years, SBP was 33±20 and DBP was 16 ± 13 mmHg lower than at baseline. Multivariate analysis revealed that baseline BP and follow-up duration were positively correlated with BP response. Conclusion. Add-on ARA treatment in difficult-to-treat hypertension results in a profound and sustained BP reduction.

  18. Long-term indoor air conditioner filtration and cardiovascular health: A randomized crossover intervention study.

    Science.gov (United States)

    Chuang, Hsiao-Chi; Ho, Kin-Fai; Lin, Lian-Yu; Chang, Ta-Yuan; Hong, Gui-Bing; Ma, Chi-Ming; Liu, I-Jung; Chuang, Kai-Jen

    2017-09-01

    The association of short-term air pollution filtration with cardiovascular health has been documented. However, the effect of long-term indoor air conditioner filtration on the association between air pollution and cardiovascular health is still unclear. We recruited 200 homemakers from Taipei and randomly assigned 100 of them to air filtration or control intervention; six home visits were conducted per year from 2013 to 2014. The participants under air filtration intervention during 2013 were reassigned to control intervention in 2014. The air pollution measurements consisted of particulate matter less than or equal to 2.5μm in diameter (PM 2.5 ) and total volatile organic compounds (VOCs); blood pressure was monitored for each participant during each visit. The following morning, blood samples were collected after air pollution monitoring. The blood samples were used to analyze biological markers, including high sensitivity-C-reactive protein (hs-CRP), 8-hydroxy-2'-deoxyguanosine (8-OHdG) and fibrinogen. Household information, including cleaning, cooking, and air conditioning, was collected by a questionnaire. Mixed-effects models were used to investigate the associations among air pollution measurements, blood pressure and biological markers. The results showed that increased levels of PM 2.5 and total VOCs were associated with increased hs-CRP, 8-OHdG and blood pressure. The health variables were higher among participants in the control intervention phase than among those in the air filtration intervention phase. We concluded that air pollution exposure was associated with systemic inflammation, oxidative stress and elevated blood pressure. The long-term filtration of air pollution with an air conditioner filter was associated with cardiovascular health of adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. The role of the laparoscopy on circumferential resection margin positivity in patients with rectal cancer: long-term outcomes at a single high-volume institution.

    Science.gov (United States)

    Dural, Ahmet C; Keskin, Metin; Balik, Emre; Akici, Murat; Kunduz, Enver; Yamaner, Sumer; Asoglu, Oktar; Gulluoglu, Mine; Bugra, Dursun

    2015-04-01

    The aim of this study was to evaluate the influence of laparoscopic rectal cancer surgery on circumferential resection margin (CRM) involvement. The data from 579 consecutive patients who underwent laparoscopic or open resection of rectal cancer from October 2002 to August 2008 were analyzed retrospectively. The primary endpoint was CRM status. The secondary endpoints were morbidity, local recurrence rate, overall survival, and disease-free survival. Laparoscopic resections were performed in 266 patients (46%), and the remainder of the patients underwent open resection. The rates of CRM involvement were similar between the laparoscopic and open groups (5.6% vs. 5.4%). The perioperative morbidity rates between the 2 groups were not significantly different (P=0.2). The incidence of local recurrence for the CRM-negative group was 8.4% (8.3% laparoscopic vs. 8.45% open; P=0.99), whereas the local recurrence rate was 34.3% for the CRM-positive group. The local recurrence rate was 20% for the CRM-positive patients in the laparoscopic group and 47% for the CRM-positive patients in the open group (PCRM status. CRM positivity was correlated with both 5-year survival and the 5-year disease-free survival rate (P=0.009 and P=0.001, respectively). We did not observe any significant differences in morbidity, local recurrence, or overall or disease-free survival rates between the overall laparoscopic and open resection groups. Laparoscopic surgery for rectal cancer is associated with similar complication rates, CRM involvement status, and long-term outcomes as those associated with open surgery but with the advantages of minimally invasive surgery. Although laparoscopic surgery might necessitate more advanced technical skills, similar long-term oncological results can be obtained with this technique.

  20. Preeclampsia: long-term consequences for vascular health

    Directory of Open Access Journals (Sweden)

    Amaral LM

    2015-07-01

    Full Text Available Lorena M Amaral, Mark W Cunningham Jr, Denise C Cornelius, Babbette LaMarca Department of Pharmacology, University of Mississippi Medical Center, Jackson, MS, USA Abstract: Preeclampsia (PE is a pregnancy-specific syndrome and one of the leading causes of preterm birth, neonatal and maternal morbidity and mortality. This disease is characterized by new onset hypertension usually in the third trimester of pregnancy and is sometimes associated with proteinuria, although proteinuria is not a requirement for the diagnosis of PE. In developing countries, women have a higher risk of death due to PE than more affluent countries and one of the most frequent causes of death is high blood pressure and stroke. Although PE only affects approximately 2%–8% of pregnancies worldwide it is associated with severe complications such as eclampsia, hemorrhagic stroke, hemolysis, elevated liver enzymes and low platelets (HELLP syndrome, renal failure and pulmonary edema. Importantly, there is no “cure” for the disease except for early delivery of the baby and placenta, leaving PE a health care risk for babies born from PE moms. In addition, PE is linked to the development of cardiovascular disease and stroke in women after reproductive age, leaving PE a risk factor for long-term health in women. This review will highlight factors implicated in the pathophysiology of PE that may contribute to long-term effects in women with preeclamptic pregnancies. Keywords: preeclampsia, endothelial dysfunction, AT1-AA, CD4+ T helper cells

  1. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)

    2017-01-01

    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...

  2. Virtual Models of Long-Term Care

    Science.gov (United States)

    Phenice, Lillian A.; Griffore, Robert J.

    2012-01-01

    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  3. Closing the gap between short- and long-term scenarios for nuclear energy

    International Nuclear Information System (INIS)

    Toth, F. L.; Rogner, H.-H.

    2005-01-01

    reserves and resources, long-term marginal costs), and environmental issues (no CO 2 constraint until recently). Marked changes in recent years in all four domains indicate that the gap should be closed by augmenting near-term estimates rather than by reducing long-term projections. These changes include: entry into force of the Kyoto Protocol, pressure for more ambitious CO 2 reduction targets for the second commitment period under the United Nations Framework Convention on Climate Change, and propositions of stabilization targets around 2 degrees of C global mean temperature increase, 550 ppmv CO 2 concentration, and alike in the environmental domain; increasing demand for energy (especially in fast-growing developing countries), high oil prices and supply security concerns (especially in developed countries) in the economic field; recovering social acceptance of nuclear power (despite waste and proliferation worries) in the social area; and changing government positions (partly in response to the above) in the political domain. The presentation elaborates the above reasons for the gap between the projections for different time scales. It examines the changing trends in the economic field (ample and geographically dispersed resource base for nuclear energy, drying up of the excess capacities, improving technical features and economic performance of nuclear reactors), in the environmental domain (policy declarations about the need for prices to reflect the social costs, the low greenhouse gas emissions from nuclear energy and the need for hedging against stricter CO 2 emission reductions in the future, progress in operating safety and waste disposal of nuclear power in recent years) and in social acceptance (presenting results of recent opinion polls in Switzerland, Finland, Germany, Sweden, Japan, and the USA). The presentation concludes that the balance of the changing trends suggests the need for upward correction of medium-term projections and calls for comprehensive

  4. Sleep facilitates long-term face adaptation

    OpenAIRE

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

  5. Atmospheric pressure loading parameters from very long baseline interferometry observations

    Science.gov (United States)

    Macmillan, D. S.; Gipson, John M.

    1994-01-01

    Atmospheric mass loading produces a primarily vertical displacement of the Earth's crust. This displacement is correlated with surface pressure and is large enough to be detected by very long baseline interferometry (VLBI) measurements. Using the measured surface pressure at VLBI stations, we have estimated the atmospheric loading term for each station location directly from VLBI data acquired from 1979 to 1992. Our estimates of the vertical sensitivity to change in pressure range from 0 to -0.6 mm/mbar depending on the station. These estimates agree with inverted barometer model calculations (Manabe et al., 1991; vanDam and Herring, 1994) of the vertical displacement sensitivity computed by convolving actual pressure distributions with loading Green's functions. The pressure sensitivity tends to be smaller for stations near the coast, which is consistent with the inverted barometer hypothesis. Applying this estimated pressure loading correction in standard VLBI geodetic analysis improves the repeatability of estimated lengths of 25 out of 37 baselines that were measured at least 50 times. In a root-sum-square (rss) sense, the improvement generally increases with baseline length at a rate of about 0.3 to 0.6 ppb depending on whether the baseline stations are close to the coast. For the 5998-km baseline from Westford, Massachusetts, to Wettzell, Germany, the rss improvement is about 3.6 mm out of 11.0 mm. The average rss reduction of the vertical scatter for inland stations ranges from 2.7 to 5.4 mm.

  6. Prevalence of Long-Term Opioid Use in Long-Stay Nursing Home Residents.

    Science.gov (United States)

    Hunnicutt, Jacob N; Chrysanthopoulou, Stavroula A; Ulbricht, Christine M; Hume, Anne L; Tjia, Jennifer; Lapane, Kate L

    2018-01-01

    Overall and long-term opioid use among older adults have increased since 1999. Less is known about opioid use in older adults in nursing homes (NHs). Cross-sectional. U.S. NHs (N = 13,522). Long-stay NH resident Medicare beneficiaries with a Minimum Data Set 3.0 (MDS) assessment between April 1, 2012, and June 30, 2012, and 120 days of follow-up (N = 315,949). We used Medicare Part D claims to measure length of opioid use in the 120 days from the index assessment (short-term: ≤30 days, medium-term: >30-89 days, long-term: ≥90 days), adjuvants (e.g., anticonvulsants), and other pain medications (e.g., corticosteroids). MDS assessments in the follow-up period were used to measure nonpharmacological pain management use. Modified Poisson models were used to estimate adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) for age, gender, race and ethnicity, cognitive and physical impairment, and long-term opioid use. Of all long-stay residents, 32.4% were prescribed any opioid, and 15.5% were prescribed opioids long-term. Opioid users (versus nonusers) were more commonly prescribed pain adjuvants (32.9% vs 14.9%), other pain medications (25.5% vs 11.0%), and nonpharmacological pain management (24.5% vs 9.3%). Long-term opioid use was higher in women (aPR = 1.21, 95% CI = 1.18-1.23) and lower in racial and ethnic minorities (non-Hispanic blacks vs whites: APR = 0.93, 95% CI = 0.90-0.94) and those with severe cognitive impairment (vs no or mild impairment, aPR = 0.82, 95% CI = 0.79-0.83). One in seven NH residents was prescribed opioids long-term. Recent guidelines on opioid prescribing for pain recommend reducing long-term opioid use, but this is challenging in NHs because residents may not benefit from nonpharmacological and nonopioid interventions. Studies to address concerns about opioid safety and effectiveness (e.g., on pain and functional status) in NHs are needed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics

  7. Long-Term Engagement in Formal Volunteering and Well-Being: An Exploratory Indian Study.

    Science.gov (United States)

    Elias, Jereesh K; Sudhir, Paulomi; Mehrotra, Seema

    2016-09-27

    Sustained engagement in volunteering and its correlates have been examined in many studies across the globe. However, there is a dearth of research that explores the perspectives of long-term formal volunteers on the nature of changes perceived in oneself as a result of volunteering. Moreover, the linkages between psychological well-being and volunteering have been insufficiently explored. The present study was aimed at addressing these gaps. A heterogeneous sample of 20 long-term formal volunteer engaged in volunteering across different voluntary organisations in a southern metropolitan Indian city formed the primary sample for the study. In addition, a group of 21 short-term volunteers, matched on age, income and gender, was utilised for comparison with long-term volunteers on well-being indices. A semi structured interview schedule was used to explore self-perceived changes attributable to volunteering experience. In addition, a few standardised measures were used to comprehensively assess subjective well-being and psychological well-being. The interview data provided rich descriptions of perceived positive changes in self across cognitive, behavioral and emotional domains. Mirroring these patterns, the quantitative analyses indicated that long-term volunteers experienced higher levels of psychological well-being (sense of mastery and competence, self-acceptance and sense of engagement and growth) than short-term volunteers. The potential mechanisms involved in beneficial outcomes of long-term volunteering and implications for further research are highlighted.

  8. Beneficial long term effect of a phosphodiesterase-5-inhibitor in cirrhotic portal hypertension: A case report with 8 years follow-up.

    Science.gov (United States)

    Deibert, Peter; Lazaro, Adhara; Stankovic, Zoran; Schaffner, Denise; Rössle, Martin; Kreisel, Wolfgang

    2018-01-21

    Non-selective beta-blockers are the mainstay of medical therapy for portal hypertension in liver cirrhosis. Inhibitors of phosphodiesterase-5 (PDE-5-inhibitors) reduce portal pressure in the acute setting by > 10% which may suggest a long-term beneficial effect. Currently, there is no available data on long-term treatment of portal hypertension with PDE-5-inhibitors. This case of a patient with liver cirrhosis secondary to autoimmune liver disease with episodes of bleeding from esophageal varices is the first documented case in which a treatment with a PDE-5-inhibitor for eight years was monitored. In the acute setting, the PDE-5-inhibitor Vardenafil lowered portal pressure by 13%. The portal blood flow increased by 28% based on Doppler sonography and by 16% using MRI technique. As maintenance medication the PDE-5-inhibitor Tadalafil was used for eight consecutive years with comparable effects on portal pressure and portal blood flow. There were no recurrence of bleeding and no formation of new varices. Influencing the NO-pathway by the use of PDE-5 inhibitors may have long-term beneficial effects in compensated cirrhosis.

  9. Unconstrained monitoring of long-term heart and breath rates during sleep

    International Nuclear Information System (INIS)

    Chen, Wenxi; Zhu, Xin; Wei, Daming; Nemoto, Tetsu; Sugitani, Kayo; Kitamura, Kei-ichiro

    2008-01-01

    An unconstrained method for the long-term monitoring of heart and breath rates during sleep is proposed. The system includes a sensor unit and a web-based network module. The sensor unit is set beneath a pillow to pick up the pressure variations from the head induced by inhalation/exhalation movements and heart pulsation during sleep. The measured pressure signal was digitized and transferred to a remote database server via the network module. A wavelet-based algorithm was employed to detect the heart and breath rates, as well as body movement, during sleep. The overall system was utilized for a total six-month trial operation delivered to a female subject. The profiles of the heart and breath rates on a beat-by-beat and daily basis were obtained. Movements during sleep were also estimated. The results show that the daily average percentage of undetectable periods (UPs) during 881.6 sleep hours over a 180 day period was 17.2%. A total of 89.2% of sleep hours had a UP of not more than 25%. The profile of the heart rate revealed a periodic property that corresponded to the female monthly menstrual cycle. Our system shows promise as a long-term unconstrained monitor for heart and breath rates, and for other physiological parameters related to the quality of sleep and the regularity of the menstrual cycle. (note)

  10. Effect of zinc supplementation of pregnant rats on short-term and long-term memory of their offspring

    International Nuclear Information System (INIS)

    Ali, M.A.; Ghotbeddin, Z.; Parham, G.H.

    2007-01-01

    To see the dose dependent effects of zinc chloride on the short-term and long-term memory in a shuttle box (rats). Six pair adult wistar rats were taken for this experiment. One group of pregnant rats received a daily oral dose of 20 mg/kg Zn as zinc chloride and the remaining groups received a daily oral dose of (30, 50, 70,100 mg/kg) zinc chloride for two weeks by gavage. One month after birth, a shuttle box was used to test short-term and long-term memory. Two criteria were considered to behavioral test, including latency in entering dark chamber and time spent in the dark chamber. This experiment showed that oral administration of ZnCl/sub 2/ with (20, 30, 50 mg/kg/day) doses after 2 weeks at the stage of pregnancy, can improve the working memory of their offspring (p<0.05). Where as ZnCl/sub 2/ with 30 mg/kg/day dose has been more effective than other doses (p<0.001). But rat which received ZnCl/sub 2/ with 100 mg/kg/day at the stage of pregnancy, has shown significant impairment in working (short-term) memory of their offspring (p<0.05) and there was no significant difference in reference (long-term) memory 3 for any of groups. This study has demonstrated that zinc chloride consumption with 30 mg/kg/day dose for two weeks at the stage of pregnancy in rats, has positive effect on short-term memory on their offspring. But consumption of enhanced zinc 100 mg/kg/day in pregnant rats can cause short-term memory impairment. On the other hand, zinc supplementation such as zinc chloride has no effect on long-term memory. (author)

  11. Role of spousal involvement in continuous positive airway pressure (CPAP adherence in patients with obstructive sleep apnea (OSA

    Directory of Open Access Journals (Sweden)

    Batool-Anwar S

    2017-05-01

    Full Text Available Introduction: Little is known about the impact of spousal involvement on continuous positive airway pressure (CPAP adherence. The aim of this study was to determine whether spouse involvement affects adherence with CPAP therapy, and how this association varies with gender. Methods: 194 subjects recruited from Apnea Positive Pressure Long Term Efficacy Study (APPLES completed the Dyadic Adjustment Scale (DAS. The majority of participants were Caucasian (83%, and males (73%, with mean age of 56 years, mean BMI of 31 kg/m2. & 62% had severe OSA. The DAS is a validated 32-item self-report instrument measuring dyadic consensus, satisfaction, cohesion, and affectional expression. A high score in the DAS is indicative of a person’s adjustment to the marriage. Additionally, questions related to spouse involvement with general health and CPAP use were asked. CPAP use was downloaded from the device and self-report, and compliance was defined as usage > 4 h per night. Results: There were no significant differences in overall marital quality between the compliant and noncompliant subjects. However, level of spousal involvement was associated with increased CPAP adherence at 6 months (p=0.01. After stratifying for gender these results were significant only among males (p=0.03. Three years after completing APPLES, level of spousal involvement was not associated with CPAP compliance even after gender stratification. Conclusion: Spousal involvement is important in determining CPAP compliance in males in the 1st 6 months after initiation of therapy but is not predictive of longer-term adherence. Involvement of the spouse should be considered an integral part of CPAP initiation procedures.

  12. Effects of body position and sex group on tongue pressure generation.

    Science.gov (United States)

    Dietsch, Angela M; Cirstea, Carmen M; Auer, Ed T; Searl, Jeff P

    2013-11-01

    Fine control of orofacial musculature is necessary to precisely accelerate and decelerate the articulators across exact distances for functional speech and coordinated swallows (Amerman & Parnell, 1990; Benjamin, 1997; Kent, Duffy, Slama, Kent, & Clift, 2001). Enhanced understanding of neural control for such movements could clarify the nature of and potential remediation for some dysarthrias and other orofacial myofunctional impairments. Numerous studies have measured orolingual force and accuracy during speech and nonspeech tasks, but have focused on young adults, maximum linguapalatal pressures, and upright positioning (O'Day, Frank, Montgomery, Nichols, & McDade, 2005; Solomon & Munson, 2004; Somodi, Robin, & Luschei, 1995; Youmans, Youmans, & Stierwalt, 2009). Patients' medical conditions or testing procedures such as concurrent neuroimaging may preclude fully upright positioning during oral motor assessments in some cases. Since judgments about lingual strength and coordination can influence clinical decisions regarding the functionality of swallowing and speech, it is imperative to understand any effects of body positioning differences. In addition, sex differences in the control of such tasks are not well defined. Therefore, this study evaluated whether pressures exerted during tongue movements differ in upright vs. supine body position in healthy middle-aged men and women. Twenty healthy middle-aged adults compressed small air-filled plastic bulbs in the oral cavity at predetermined fractions of task-specific peak pressure in a randomized block design. Tasks including phoneme repetitions and nonspeech isometric contractions were executed in upright and supine positions. Participants received continuous visual feedback regarding targets and actual exerted pressures. Analyses compared average pressure values for each subject, task, position, and effort level. Speech-like and nonspeech tongue pressures did not differ significantly across body position or sex

  13. Long-Term Stewardship Baseline Report and Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith

    2001-11-01

    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  14. [Falls and fractures among older adults living in long-term care].

    Science.gov (United States)

    Del Duca, Giovâni Firpo; Antes, Danielle Ledur; Hallal, Pedro Curi

    2013-03-01

    To investigate the prevalence of falls and fractures over the past 12 months and associated factors among older adults living in long-term care. Census of all long-term care located in the city of Pelotas, Brazil, in 2008. Falls over the past 12 months were assessed using the following question: "Over the last 12 months, have you fallen?" For those who replied positively, another question was asked: "In any of these falls, have you fractured a bone?" Sex, age, schooling, disability relating to basic activities of daily living, type of financing of the long-term care and hospital admissions were the independent variables. We used chi-square tests for heterogeneity and linear trend in the unadjusted analysis, and Poisson regression with robust variance in the adjusted one. Within the 24 long-term care studied, we collected data for 466 individuals. The prevalence of falls in the past year was 38.9% (95%CI 34.5; 43.4). Among those who have fallen, 19.2% had fractures. Femur (hip) was the most frequent site fractured (43.4%), followed by wrist (10%). In the adjusted analysis, older age, disability for 1-5 basic activities of daily living, living in public institutions and hospital admissions in the last year were associated with higher risk of falls. The high prevalence of falls and fractures highlights the fragility of the individuals living in long-term care. Special attention should be paid to older adults and those with hospital admissions in the last year.

  15. Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Joon Woo; Myung, Jae Sung; Kang, Heung Sik [Seoul National University Bundang Hospital, Department of Radiology, Seong Nam, Gyeongi-do (Korea); Park, Kun Woo; Yeom, Jin S. [Seoul National University Bundang Hospital, Department of Orthopaedic Surgery, Seong Nam, Gyeongi-do (Korea); Kim, Ki-Jeong; Kim, Hyun-Jib [Seoul National University Bundang Hospital, Department of Neurosurgery, Seong Nam, Gyeongi-do (Korea)

    2010-07-15

    To evaluate the short-term and long-term effects of fluoroscopically guided caudal epidural steroid injection (ESI) for the management of degenerative lumbar spinal stenosis (DLSS) and to analyze outcome predictors. All patients who underwent caudal ESI in 2006 for DLSS were included in the study. Response was based on chart documentation (aggravated, no change, slightly improved, much improved, no pain). In June 2009 telephone interviews were conducted, using formatted questions including the North American Spine Society (NASS) patient satisfaction scale. For short-term and long-term effects, age difference was evaluated by the Mann-Whitney U test, and gender, duration of symptoms, level of DLSS, spondylolisthesis, and previous operations were evaluated by Fisher's exact test. Two hundred and sixteen patients (male: female = 75:141; mean age 69.2 years; range 48{proportional_to}91 years) were included in the study. Improvements (slightly improved, much improved, no pain) were seen in 185 patients (85.6%) after an initial caudal ESI and in 189 patients (87.5%) after a series of caudal ESIs. Half of the patients (89/179, 49.8%) replied positively to the NASS patient satisfaction scale (1 or 2). There were no significant outcome predictors for either the short-term or the long-term responses. Fluoroscopically guided caudal ESI was effective for the management of DLSS (especially central canal stenosis) with excellent short-term and good long-term results, without significant outcome predictors. (orig.)

  16. [Possibilities of bi-level positive pressure ventilation in chronic hypoventilation].

    Science.gov (United States)

    Saaresranta, Tarja; Anttalainen, Ulla; Polo, Olli

    2011-01-01

    During the last decade, noninvasive bi-level positive pressure ventilation has enabled respiratory support in inpatient wards and at home. In many cases, a bi-level airway pressure ventilator can be used to avoid artificial airway and respirator therapy, and may shorten hospital stay and save costs. The treatment alleviates the patient's dyspnea and fatigue, whereby the quality of life improves, and in certain situations also the life span increases. The implementation of bi-level positive pressure ventilation by the physician requires knowledge of the basics of respiratory physiology and familiarization with the bi-level airway pressure ventilator.

  17. Asystole following positive pressure insufflation of right pleural cavity: a case report

    Directory of Open Access Journals (Sweden)

    Konia Mojca R

    2011-06-01

    Full Text Available Abstract Introduction Adverse hemodynamic effects with severe bradycardia have been previously reported during positive pressure insufflation of the right thoracic cavity in humans. To the best of our knowledge, this is the first report of asystole during thoracoscopic surgery with positive pressure insufflation. Case presentation A 63-year-old Caucasian woman developed asystole at the onset of positive pressure insufflation of her right hemithorax during a thoracoscopic single-lung ventilation procedure. Immediate deflation of pleural cavity, intravenous glycopyrrolate and atropine administration returned her heart rhythm to normal sinus rhythm. The surgery proceeded in the absence of positive pressure insufflation without any further complications. Conclusions We discuss the proposed mechanisms of hemodynamic instability with positive pressure thoracic insufflation, and anesthetic and insufflation techniques that decrease the likelihood of adverse hemodynamic events.

  18. The importance of clinical monitoring for compliance with Continuous Positive Airway Pressure.

    Science.gov (United States)

    Pelosi, Lucas B; Silveira, Mariana L C; Eckeli, Alan L; Chayamiti, Emilia M P C; Almeida, Leila A; Sander, Heidi H; Küpper, Daniel S; Valera, Fabiana C P

    Obstructive sleep apnea syndrome is currently a public health problem of great importance. When misdiagnosed or improperly treated, it can lead to serious consequences on patients' quality of life. The gold standard treatment for cases of obstructive sleep apnea syndrome, especially in mild to severe and symptomatic cases, is continuous positive airway pressure therapy. Compliance with continuous positive airway pressure therapy is directly dependent on the active participation of the patient, which can be influenced by several factors. The objective of this study is to describe the factors related to compliance with continuous positive airway pressure therapy, and to analyze which associated factors directly influence the efficiency of the treatment. Patients who received continuous positive airway pressure therapy through the Municipal Health Department of the city of Ribeirão Preto were recruited. A structured questionnaire was administered to the patients. Compliance with continuous positive airway pressure therapy was assessed by average hours of continuous positive airway pressure therapy usage per night. Patients with good compliance (patients using continuous positive airway pressure therapy ≥4h/night) were compared to those with poor compliance (patients using <4h/night). 138 patients were analyzed: 77 (55.8%) were considered compliant while 61 (44.2%) were non-compliant. The comparison between the two groups showed that regular monitoring by a specialist considerably improved compliance with continuous positive airway pressure therapy (odds ratio, OR=2.62). Compliance with continuous positive airway pressure therapy is related to educational components, which can be enhanced with continuous and individualized care to patients with obstructive sleep apnea syndrome. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. [Cost-effectiveness research in elderly residents in long-term care: prevention is better than cure, but not always cheaper].

    Science.gov (United States)

    Achterberg, Wilco P; Gussekloo, Jacobijn; van den Hout, Wilbert B

    2015-01-01

    Cost-effectiveness research in elderly residents in long-term care facilities is based on general principals of cost-effectiveness research; these have been developed primarily from the perspective of relatively healthy adults in curative medicine. These principals are, however, inadequate when evaluating interventions for the fragile elderly in long-term care, both in terms of the value attached to the health of patients and to the specific decision-making context of the institution. Here we discuss the pitfalls of cost-effectiveness research in long-term care facilities, illustrated by two prevention interventions for prevalent conditions in nursing homes: pressure ulcers and urinary tract infections. These turned out to be effective, but not cost-effective.

  20. Positioning bedridden patients to reduce interface pressures over the sacrum and great trochanter.

    Science.gov (United States)

    Yoshikawa, Y; Maeshige, N; Sugimoto, M; Uemura, M; Noguchi, M; Terashi, H

    2015-07-01

    In this study, we evaluated the effect of hip-joint rotation on the interface pressure over the sacrum and greater trochanter with a new protocol for positioning of bedridden elderly patients. The interface pressure values over the sacrum and greater trochanter in bedridden patients were evaluated. These were collected in the supine position, 90° lateral position, and 30° and 40° laterally inclined positions with external rotation or neutral positioning of the hip joint. Each interface pressure was assessed with a device measuring pressure distribution, after which, the peak pressure index (PPI) was calculated. In the 17 patients examined, the PPI over the sacrum in the supine position was significantly greater than that in other positions. In the 30° and 40° laterally inclined positions, the PPIs over the greater trochanter were significantly lower in the neutral position of the hip joint compared with those in the external rotation position. Our findings revealed the effects of hip-joint rotation on the interface pressure for the greater trochanter, possibly due to the increased distance between the greater trochanter and the sacrum caused by neutral position of the hip joint. The results demonstrate that it is to best place the hip joint in a neutral position when the legs are in contact with the bed in order to distribute the pressure over the greater trochanter in the 30° and 40° laterally inclined positions. These results can be applied to the clinical setting to improve patient positioning and decrease pressure ulcers. The authors declare that they have no competing financial interests.

  1. Long-Term Prognosis of Plantar Fasciitis

    DEFF Research Database (Denmark)

    Hansen, Liselotte; Krogh, Thøger Persson; Ellingsen, Torkell

    2018-01-01

    , exercise-induced symptoms, bilateral heel pain, fascia thickness, and presence of a heel spur) could predict long-term outcomes, (3) to assess the long-term ultrasound (US) development in the fascia, and (4) to assess whether US-guided corticosteroid injections induce atrophy of the heel fat pad. Study....... The risk was significantly greater for women (P heel...... regardless of symptoms and had no impact on prognosis, and neither did the presence of a heel spur. Only 24% of asymptomatic patients had a normal fascia on US at long-term follow-up. A US-guided corticosteroid injection did not cause atrophy of the heel fat pad. Our observational study did not allow us...

  2. Long-term dependence in exchange rates

    Directory of Open Access Journals (Sweden)

    A. Karytinos

    2000-01-01

    Full Text Available The extent to which exchange rates of four major currencies against the Greek Drachma exhibit long-term dependence is investigated using a R/S analysis testing framework. We show that both classic R/S analysis and the modified R/S statistic if enhanced by bootstrapping techniques can be proven very reliable tools to this end. Our findings support persistence and long-term dependence with non-periodic cycles for the Deutsche Mark and the French Franc series. In addition a noisy chaos explanation is favored over fractional Brownian motion. On the contrary, the US Dollar and British Pound were found to exhibit a much more random behavior and lack of any long-term structure.

  3. Improvised bubble continuous positive airway pressure

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2014-08-15

    Aug 15, 2014 ... Abstract: Background: Prematur- ity accounts for 25% of Neonatal mortality in Nigeria and Respira- tory Distress Syndrome is respon- sible for half of these deaths. Introducing continuous positive airway pressure for the treatment of RDS in Nigeria where health care financing is predominantly out-of-pocket ...

  4. Short-term versus long-term contracting for uranium enrichment services

    International Nuclear Information System (INIS)

    Rudy, G.P.

    1990-01-01

    The US Department of Energy (US DOE) is the world's largest and most experienced supplier of uranium enrichment services. Through the late 1970s and early 1980s, emerging market forces transformed what was once a monopoly into a highly competitive industry. In the early 1980's the DOE lost market share. But as we enter the 1990s, new market forces have emerged. The US DOE believes a responsible balance between long-term and short-term contracting will be the key to success and the key to assuring the long-term health and reliability of the nuclear fuel industry. The US DOE intends to be in this nuclear business for a long time and will continue to offer reliable and responsive services second to none

  5. Long-Term Dynamics of Autonomous Fractional Differential Equations

    Science.gov (United States)

    Liu, Tao; Xu, Wei; Xu, Yong; Han, Qun

    This paper aims to investigate long-term dynamic behaviors of autonomous fractional differential equations with effective numerical method. The long-term dynamic behaviors predict where systems are heading after long-term evolution. We make some modification and transplant cell mapping methods to autonomous fractional differential equations. The mapping time duration of cell mapping is enlarged to deal with the long memory effect. Three illustrative examples, i.e. fractional Lotka-Volterra equation, fractional van der Pol oscillator and fractional Duffing equation, are studied with our revised generalized cell mapping method. We obtain long-term dynamics, such as attractors, basins of attraction, and saddles. Compared with some existing stability and numerical results, the validity of our method is verified. Furthermore, we find that the fractional order has its effect on the long-term dynamics of autonomous fractional differential equations.

  6. The isolated burned palm in children : Epidemiology and long-term sequelae

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    The isolated burn of the palm is a typical injury in young children. Positioning and splinting in small hands is difficult, and long-term sequelae of these injuries are not uncommon. The objective of the present study was to assess the outcome of palm burns and to identify the risk factors for

  7. Ministers of Health: short-term tenure for long-term goals?

    Science.gov (United States)

    Ferraz, Marcos Bosi; Azevedo, Rafael Teixeira

    2011-03-01

    Healthcare investments should consider short and long-term demands. The objectives here were to compare the average tenures of ministers of health in Brazil and in another 22 countries and to evaluate the relationship between ministers' tenures and a number of indicators. Descriptive study conducted at Centro Paulista de Economia da Saúde (CPES). Twenty-two countries with the highest Human Development Indices (HDIs) and Brazil were included. The number of ministers over the past 20 years was investigated through each country's Ministry of Health website. Pearson's correlation coefficient was used to compare the number of ministers in each country with that country's indicators. The Mann-Whitney test was used to compare ministers' tenures in Brazil and other countries. The mean tenure (standard deviation, SD) of Brazilian ministers of health was 15 (12) months, a period that is statistically significantly shorter than the mean tenure of 33 (18) months in the other 22 countries (P < 0.05). There was a moderate and statistically significant positive correlation between the number of ministers and mortality rates for several conditions. The number of ministers also presented moderate and statistically significant negative correlations with per capita total healthcare expenditure (r = -0.567) and with per capita government healthcare expenditure (r = -0.530). On average, ministers of health have extremely short tenures. There is an urgent need to think and plan healthcare systems from a long-term perspective.

  8. Long term performance of radon mitigation systems

    International Nuclear Information System (INIS)

    Prill, R.; Fisk, W.J.

    2002-01-01

    Researchers installed radon mitigation systems in 12 houses in Spokane, Washington and Coeur d'Alene, Idaho during the heating season 1985--1986 and continued to monitor indoor radon quarterly and annually for ten years. The mitigation systems included active sub-slab ventilation, basement over-pressurization, and crawlspace isolation and ventilation. The occupants reported various operational problems with these early mitigation systems. The long-term radon measurements were essential to track the effectiveness of the mitigation systems over time. All 12 homes were visited during the second year of the study, while a second set 5 homes was visited during the fifth year to determine the cause(s) of increased radon in the homes. During these visits, the mitigation systems were inspected and measurements of system performance were made. Maintenance and modifications were performed to improve system performance in these homes

  9. Long-term semantic representations moderate the effect of attentional refreshing on episodic memory.

    Science.gov (United States)

    Loaiza, Vanessa M; Duperreault, Kayla A; Rhodes, Matthew G; McCabe, David P

    2015-02-01

    The McCabe effect (McCabe, Journal of Memory and Language 58:480-494, 2008) refers to an advantage in episodic memory (EM) retrieval for memoranda studied in complex span versus simple span tasks, particularly for memoranda presented in earlier serial positions. This finding has been attributed to the necessity to refresh memoranda during complex span tasks that, in turn, promotes content-context binding in working memory (WM). Several frameworks have conceptualized WM as being embedded in long-term memory. Thus, refreshing may be less efficient when memoranda are not well-established in long-term semantic memory (SM). To investigate this, we presented words and nonwords in simple and complex span trials in order to manipulate the long-term semantic representations of the memoranda with the requirement to refresh the memoranda during WM. A recognition test was administered that required participants to make a remember-know decision for each memorandum recognized as old. The results replicated the McCabe effect, but only for words, and the beneficial effect of refreshing opportunities was exclusive to recollection. These results extend previous research by indicating that the predictive relationship between WM refreshing and long-term EM is specific to recollection and, furthermore, moderated by representations in long-term SM. This supports the predictions of WM frameworks that espouse the importance of refreshing in content-context binding, but also those that view WM as being an activated subset of and, therefore, constrained by the contents of long-term memory.

  10. A new device for administration of continuous positive airway pressure in preterm infants: comparison with a standard nasal CPAP continuous positive airway pressure system.

    Science.gov (United States)

    Trevisanuto, Daniele; Grazzina, Nicoletta; Doglioni, Nicoletta; Ferrarese, Paola; Marzari, Francesco; Zanardo, Vincenzo

    2005-06-01

    We compared the effectiveness of a new continuous positive airway pressure (CPAP) device (neonatal helmet CPAP) with a conventional nasal CPAP system in preterm neonates needing continuous distending pressure. Randomized, physiological, cross-over study in a tertiary referral, neonatal intensive care unit in a university teaching hospital. Twenty very low birth weight infants with a postnatal age greater than 24 h who were receiving nasal CPAP for apnea and/or mild respiratory distress were enrolled. CPAP delivered by neonatal helmet CPAP and nasal CPAP in random order for two subsequent 90-min periods. Were continuously measured the Neonatal Infant Pain Scale (NIPS) score, oxygen requirements, respiratory rate, heart rate, oxygen saturation, transcutaneous PO(2) (tcPO(2)) and PCO(2) (tcPCO(2)), blood pressure, and desaturations. NIPS scores were significantly lower when the infants were on the neonatal helmet CPAP than when they were on nasal CPAP (0.26+/-0.07 vs. 0.63+/-0.12). The other studied parameters did not differ between the two CPAP modes. The number of desaturations was reduced during the neonatal helmet CPAP treatment (18 vs. 32), although this difference was not significant. In this short-term physiological study the neonatal helmet CPAP appears to be as good as the golden standard for managing preterm infants needing continuous distending pressure, with enhanced tolerability. Further evaluation in a randomized clinical trial is needed to confirm these findings.

  11. Design and validation of a clinical-scale bioreactor for long-term isolated lung culture.

    Science.gov (United States)

    Charest, Jonathan M; Okamoto, Tatsuya; Kitano, Kentaro; Yasuda, Atsushi; Gilpin, Sarah E; Mathisen, Douglas J; Ott, Harald C

    2015-06-01

    The primary treatment for end-stage lung disease is lung transplantation. However, donor organ shortage remains a major barrier for many patients. In recent years, techniques for maintaining lungs ex vivo for evaluation and short-term (advance to more complex interventions for lung repair and regeneration, the need for a long-term organ culture system becomes apparent. Herein we describe a novel clinical scale bioreactor capable of maintaining functional porcine and human lungs for at least 72 h in isolated lung culture (ILC). The fully automated, computer controlled, sterile, closed circuit system enables physiologic pulsatile perfusion and negative pressure ventilation, while gas exchange function, and metabolism can be evaluated. Creation of this stable, biomimetic long-term culture environment will enable advanced interventions in both donor lungs and engineered grafts of human scale. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Atmospheric pressure loading effects on Global Positioning System coordinate determinations

    Science.gov (United States)

    Vandam, Tonie M.; Blewitt, Geoffrey; Heflin, Michael B.

    1994-01-01

    Earth deformation signals caused by atmospheric pressure loading are detected in vertical position estimates at Global Positioning System (GPS) stations. Surface displacements due to changes in atmospheric pressure account for up to 24% of the total variance in the GPS height estimates. The detected loading signals are larger at higher latitudes where pressure variations are greatest; the largest effect is observed at Fairbanks, Alaska (latitude 65 deg), with a signal root mean square (RMS) of 5 mm. Out of 19 continuously operating GPS sites (with a mean of 281 daily solutions per site), 18 show a positive correlation between the GPS vertical estimates and the modeled loading displacements. Accounting for loading reduces the variance of the vertical station positions on 12 of the 19 sites investigated. Removing the modeled pressure loading from GPS determinations of baseline length for baselines longer than 6000 km reduces the variance on 73 of the 117 baselines investigated. The slight increase in variance for some of the sites and baselines is consistent with expected statistical fluctuations. The results from most stations are consistent with approximately 65% of the modeled pressure load being found in the GPS vertical position measurements. Removing an annual signal from both the measured heights and the modeled load time series leaves this value unchanged. The source of the remaining discrepancy between the modeled and observed loading signal may be the result of (1) anisotropic effects in the Earth's loading response, (2) errors in GPS estimates of tropospheric delay, (3) errors in the surface pressure data, or (4) annual signals in the time series of loading and station heights. In addition, we find that using site dependent coefficients, determined by fitting local pressure to the modeled radial displacements, reduces the variance of the measured station heights as well as or better than using the global convolution sum.

  13. Maternal Beliefs as Long-Term Predictors of Mother-Child Interaction and Report.

    Science.gov (United States)

    Kochanska, Grazyna

    1990-01-01

    Two kinds of parental beliefs, endorsed rearing philosophy (authoritative-authoritarian dimension) and affective attitude toward child (positive-negative affect dimension), were examined in 20 normal and 36 depressed mothers as long-term predictors of child rearing behaviors and interaction patterns with their children. (BC)

  14. Long term wet spent nuclear fuel storage

    International Nuclear Information System (INIS)

    1987-04-01

    The meeting showed that there is continuing confidence in the use of wet storage for spent nuclear fuel and that long-term wet storage of fuel clad in zirconium alloys can be readily achieved. The importance of maintaining good water chemistry has been identified. The long-term wet storage behaviour of sensitized stainless steel clad fuel involves, as yet, some uncertainties. However, great reliance will be placed on long-term wet storage of spent fuel into the future. The following topics were treated to some extent: Oxidation of the external surface of fuel clad, rod consolidation, radiation protection, optimum methods of treating spent fuel storage water, physical radiation effects, and the behaviour of spent fuel assemblies of long-term wet storage conditions. A number of papers on national experience are included

  15. Long-Term Collections

    CERN Multimedia

    Staff Association

    2016-01-01

    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  16. Long-Term Collection

    CERN Multimedia

    Staff Association

    2016-01-01

    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  17. Long-term decline of radiocaesium in Fennoscandian reindeer

    International Nuclear Information System (INIS)

    Skuterud, L.; Aahman, B.; Solatie, D.; Gaare, E.

    2009-06-01

    The NKS-B project REIN was established to synthesize the available information on contamination levels and effective half-times for 137Cs in reindeer in Finland, Sweden and Norway. Several studies of radiocaesium contamination in reindeer have been carried out in the Nordic countries over the last 50 years. However, the current slow decline in concentrations, which will maintain the consequences of the Chernobyl deposition for Swedish and Norwegian reindeer husbandry for at least another 10-20 years, have not previously been observed nor predicted. In the Chernobyl affected areas 137Cs concentrations in reindeer initially declined by effective half-times of 3-4 years, whereas the current decline appears to be mainly governed by the nuclide's physical half-life (30 years). The review of effective half-times of 137Cs in reindeer across Fennoscandia suggests that concentrations declined more rapidly in the northernmost areas. The reason(-s) remains unclear, and demonstrates the need for more long-term sampling of the various components of reindeer's diet. Such sampling should aim at covering climatically different areas, as climate may influence transfer of radiocaesium to reindeer via lichen growth and weathering rates, composition of plant communities and lichen availability, as well as soil-to-plant radiocaesium uptake. The lack of long-term data on radiocaesium in natural vegetation in the Nordic countries is one of the main limitations for the development of mechanistic models for radiocaesium in reindeer, and for further elucidation of the observed long-term trends in 137Cs concentrations in reindeer. Currently our understanding of the long-term trends observed in various areas is not good enough to predict how future radiocaesium deposition will behave. The high transfer of nuclides to reindeer, the geographical extension of reindeer herding and the special position of the Sami population in Finland, Sweden and Norway, demonstrates the need for maintaining

  18. Long-term decline of radiocaesium in Fennoscandian reindeer

    Energy Technology Data Exchange (ETDEWEB)

    Skuterud, L. (Norwegian Radiation Protection Authority, Norwegian Reindeer Husbandry Administration (Norway)); AAhman, B. (Swedish Univ. of Agricultural Sciences (Sweden)); Solatie, D. (STUK-Radiation and Nuclear Safety Authority (Finland)); Gaare, E. (Norwegian Institute for Nature Researc (Norway))

    2009-06-15

    The NKS-B project REIN was established to synthesize the available information on contamination levels and effective half-times for 137Cs in reindeer in Finland, Sweden and Norway. Several studies of radiocaesium contamination in reindeer have been carried out in the Nordic countries over the last 50 years. However, the current slow decline in concentrations, which will maintain the consequences of the Chernobyl deposition for Swedish and Norwegian reindeer husbandry for at least another 10-20 years, have not previously been observed nor predicted. In the Chernobyl affected areas 137Cs concentrations in reindeer initially declined by effective half-times of 3-4 years, whereas the current decline appears to be mainly governed by the nuclide's physical half-life (30 years). The review of effective half-times of 137Cs in reindeer across Fennoscandia suggests that concentrations declined more rapidly in the northernmost areas. The reason(-s) remains unclear, and demonstrates the need for more long-term sampling of the various components of reindeer's diet. Such sampling should aim at covering climatically different areas, as climate may influence transfer of radiocaesium to reindeer via lichen growth and weathering rates, composition of plant communities and lichen availability, as well as soil-to-plant radiocaesium uptake. The lack of long-term data on radiocaesium in natural vegetation in the Nordic countries is one of the main limitations for the development of mechanistic models for radiocaesium in reindeer, and for further elucidation of the observed long-term trends in 137Cs concentrations in reindeer. Currently our understanding of the long-term trends observed in various areas is not good enough to predict how future radiocaesium deposition will behave. The high transfer of nuclides to reindeer, the geographical extension of reindeer herding and the special position of the Sami population in Finland, Sweden and Norway, demonstrates the need for

  19. Cardiovascular Autonomic Responses in the VCD Rat Model of Menopause: Effects of Short- and Long-Term Ovarian Failure.

    Science.gov (United States)

    Huber, Domitila A; Bazilio, Darlan; Lorenzon, Flaviano; Sehnem, Sibele; Pacheco, Lucas; Anselmo-Franci, Janete A; Lima, Fernanda B

    2017-01-01

    After menopause, hypertension elevates the risk of cardiac diseases, one of the major causes of women's morbidity. The gradual depletion of ovarian follicles in rats, induced by 4-vinylcyclohexene diepoxide (VCD), is a model for studying the physiology of menopause. 4-Vinylcyclohexene diepoxide treatment leads to early ovarian failure (OF) and a hormonal profile comparable to menopause in humans. We have hypothesized that OF can compromise the balance between sympathetic and parasympathetic tones of the cardiovascular system, shifting toward dominance of the former. We aimed to study the autonomic modulation of heart and blood vessels and the cardiovascular reflexes in rats presenting short-term (80 days) or long-term (180 days) OF induced by VCD. Twenty-eight-day-old Wistar rats were submitted to VCD treatment (160 mg/kg, intraperitoneally) or vehicle (control) for 15 consecutive days and experiments were conducted at 80 or 180 days after the onset of treatment. Long-term OF led to an increase in the sympathetic activity to blood vessels and an impairment in the baroreflex control of the heart, evoked by physiological changes in arterial pressure. Despite that, long-term OF did not cause hypertension during the 180 days of exposure. Short-term OF did not cause any deleterious effect on the cardiovascular parameters analyzed. These data indicate that long-term OF does not disrupt the maintenance of arterial pressure homeostasis in rats but worsens the autonomic cardiovascular control. In turn, this can lead to cardiovascular complications, especially when associated with the aging process seen during human menopause.

  20. Long-Term Experience with First-Generation Implantable Neurostimulation Device in Central Sleep Apnea Treatment.

    Science.gov (United States)

    Fox, Henrik; Bitter, Thomas; Horstkotte, Dieter; Oldenburg, Olaf; Gutleben, Klaus-Jürgen

    2017-05-01

    Sleep-disordered breathing (SDB) and Cheyne-Stokes respiration (CSR) are associated with shorter survival in patients with heart failure. A novel treatment method for this patient group is unilateral phrenic nerve stimulation by the remedē® system (Respicardia Inc., Minnetonka, MN, USA), a transvenously implantable neurostimulation device, which has recently been studied in a large randomized, controlled trial. Previous literature has shown efficacy and safety of the treatment with this first-generation device, but hardly any data are available on long-term clinical parameters, the remedē® device's battery lifetime, device exchangeability, lead position stability, surgical accessibility, and manageability. We performed remedē® device replacements in consecutive patients for battery depletion, and documented clinical parameters, longevity, operation procedure, complications, and difficulties. All patients were on neurostimulation treatment by phrenic nerve neurostimulation when device replacement became necessary. Apnea-hypopnea index (from 45 ± 4/h to 9 ± 4/h), oxygen-desaturation index (from 35 ± 7/h to 7 ± 6/h), and time spent with oxygen saturation of ray documentation of stable lead positions in a long-term setting, no radiation or contrast dye usage was needed and no major complications occurred. In addition, clinical exercise capacity and sleepiness symptoms improved. Novel remedē® device shows sustained therapy efficacy and safety in terms of stable lead positions over 4 years. Long-term phrenic nerve neurostimulation therapy for central SDB/CSR appears feasible in a clinical routine setting. © 2017 Wiley Periodicals, Inc.

  1. Long-term stability of diurnal salivary cortisol and alpha-amylase secretion patterns.

    Science.gov (United States)

    Skoluda, Nadine; La Marca, Roberto; Gollwitzer, Mario; Müller, Andreas; Limm, Heribert; Marten-Mittag, Birgitt; Gündel, Harald; Angerer, Peter; Nater, Urs M

    2017-06-01

    This study aimed to investigate long-term stability and variability of diurnal cortisol and alpha-amylase patterns. Diurnal cortisol and alpha-amylase secretion patterns were assessed on a single workday with three waves of measurement across a total time period of 24months in 189 participants. Separate hierarchical linear models were analyzed, with and without a number of potential predictor variables (age, BMI, smoking, chronic stress, stress reactivity). While low long-term stability was found in diurnal cortisol, the stability of diurnal alpha-amylase was moderate across the time period of 24months. Several predictor variables had a positive impact on diurnal cortisol and alpha-amylase secretion patterns averaged across waves. Our findings underpin the notion that long-term stability is not necessarily warranted in longitudinal studies. It is important to choose an appropriate study design when attempting to disentangle clinically and biologically relevant changes from naturally occurring variations in diurnal cortisol and alpha-amylase. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Circulating sclerostin is elevated in short-term and reduced in long-term SCI.

    Science.gov (United States)

    Battaglino, Ricardo A; Sudhakar, Supreetha; Lazzari, Antonio A; Garshick, Eric; Zafonte, Ross; Morse, Leslie R

    2012-09-01

    Spinal cord injury (SCI) causes profound bone loss due to muscle paralysis resulting in the inability to walk. Sclerostin, a Wnt signaling pathway antagonist produced by osteocytes, is a potent inhibitor of bone formation. Short-term studies in rodent models have demonstrated increased sclerostin in response to mechanical unloading that is reversed with reloading. Although sclerostin inhibition has been proposed as a potential therapy for bone loss, it is not known if sclerostin levels vary with duration of SCI in humans. We analyzed circulating sclerostin in 155 men with varying degrees of SCI who were 1 year or more post-injury. We report that sclerostin levels are greatest in subjects with short-term SCI (≤5 years post-injury) and decrease significantly over the first 5 years post-injury. There was no association between sclerostin and injury duration in subjects with long-term SCI (>5 years post-injury). In subjects with long-term SCI, sclerostin levels were positively associated with lower extremity bone density and bone mineral content. These data suggest that sclerostin levels are initially increased after SCI in response to mechanical unloading. This response is time-limited and as bone loss progresses, circulating sclerostin is lowest in subjects with severe osteoporosis. These findings support a dual role for sclerostin after SCI: a therapeutic target in acute SCI, and a biomarker of osteoporosis severity in chronic SCI. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Long-Term Follow-Up after Treatment of Cryptorchidism

    DEFF Research Database (Denmark)

    Thorup, Jorgen; Cortes, Dina

    2016-01-01

    -known knowledge on the field is presented.To some extent a smaller testis in a higher scrotal position than normal must be accepted as a fair cosmetic result after orchidopexy in childhood. The smaller testis size is related to the impaired fertility potential of the testis. In cases with atrophy, testicular......When considering long-term prognosis and results in adult age following treatment of cryptorchidism in childhood there are three main issues to be discussed: cosmetics, fertility, and malignancy. In the present review, the most recent research on the topics related to summaries of well...

  4. The role and position of nuclear energy in the long-term energy supply of China

    International Nuclear Information System (INIS)

    Bao Yunqiao

    1992-03-01

    The history for development of world nuclear energy and policies in various countries are retrospected, and the development of world nuclear energy is reviewed. On the basis of analysis for the economy of nuclear power in abroad, it is verified that the cost of nuclear power is cheaper than that of coal-fired power. In the future, the nuclear power is still competitive in economy. The prospect for long-term energy supply in China is predicted on the present situation of energy industry. It is estimated that the gap between energy demands and supply will become larger and larger. The solution is to develop nuclear energy in south-east area. The long-term demands of electricity and electrical resources are estimated in China, and if nuclear energy is utilized, it will optimize the constitution of electricity. The economy of nuclear power is also evaluated. It is expected that the nuclear power will be cheaper than that of coal-fired power in China after equipment are made domestically and serially. From the analysis of the conditions of communication, transportation and pollution, the development of nuclear energy will reduce the tension of transportation and improve the environmental quality. Finally, the prospect of developing nuclear heating and the supply level of uranium resources in China are analyzed

  5. Changing incentives for long-term gas contracts

    International Nuclear Information System (INIS)

    Bohi, D.R.

    1992-01-01

    There is much concern about the absence of long-term gas contracts with fixed price and quantity conditions, which until recent years was the standard way of doing business in the gas industry. These types of contracts performed a valuable service in the development of the gas industry, and there comparative absence today is sometimes thought to be one reason for the current malaise in the industry. One hears the argument that there must be some kind of 'market failure' that prevents buyers and sellers from entering into these long term arrangements, and recent changes in state and federal regulations are often cited as the cause of the problem. The purpose of the author's remarks is to argue that what is taken as a breakdown in the market may be simply a reaction to a decline in economic incentives to enter into long-term contracts with rigid price and quantity terms. This is, in other words, simply one more aspect of change in the gas business that Frank Heintz referred to in his opening remarks this morning. The author starts by giving a brief description of the motives for engaging in long-term contracts, and then describes how incentives to use long-term contracts have declined for both gas buyers and gas sellers. He concludes that the decline in the use of long-term contracts is not cause for regulatory concern, but a result of the continuing transformation of the gas business to one that more closely resembles other commodity markets

  6. Energy in 2010 - 2020. Long term challenges; Energie 2010-2020. Les defis du long terme

    Energy Technology Data Exchange (ETDEWEB)

    Dessus, Benjamin [ed.] [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France)

    2000-02-02

    This report presents the results of a workshop intending to anticipate the long term challenges, to guide better the short term power options, to understand the available political, economical and technical assumptions for the prospective world situation, to give some strategic hints on the necessary transition. Indeed, the difficult issue which the workshop tried to tackle was how should we prepare to reveal the energetic challenge of the development of the eight to ten billion inhabitants of our Planet in the next century without jeopardizing its existence. The energetic problems, a hardcore of the international preoccupation of both growth and environment, as it was recently evidenced by the climatic conference in Kyoto, have ever been the object of a particular attention on the part of General Commissariat of Plan. Thus, the commission 'Energy in 2010 - 2020' has been instituted in April 1996 in order to update the works done in 1990 - 1991 by the commission 'Energy 2010'. Soon it occurred to this new commission the task of illuminating its works by a long term (2050 - 2100) world prospective analysis of the challenges and problems linked to energy, growth and environment. In conclusion, this document tried to find answers to questions like: - which are the risks the energy consumption augmentation entail? - can we control them by appropriate urbanism and transport policies or technological innovation?. Four options for immediate action are suggested: - the energy efficiency should become a priority objective of policies; -coping with the long term challenges requires acting at present; - building the transition between governmental leadership and market; - taking profit of all the possible synergies between short and long term planning.

  7. Opening remarks for a panel discussion on short-term vs long-term procurement

    International Nuclear Information System (INIS)

    Courtenay, R.H.

    1990-01-01

    Long-term contracting in the late 1970's and early 1980's is blamed for some of the inequities that plague the uranium industry today. Utilities are obliged to pay prices far above prevailing levels and relatively low cost producers are forced to shut down while watching less efficient suppliers stay in business thanks to their long term supply agreements. Furthermore, it is argued that long-term contracts have contributed to supply instability by forcing the buildup of surplus inventories and by supporting excess incremental production by suppliers who have a baseload of long-term contracts. The depressed prices resulting from this oversupply are in turn jeopardizing future resource development and damaging supply reliability. In summary, the author's argument is that supply reliability will be greatly enhanced by the assurance of adequate primary supply from traditional sources such as Canada. This will not happen without long-term contracts. This conclusion may not be expected coming from a representative of Canada's largest uranium producer. But the final comment is less self serving. Many of the critics of long term contracts apparently expect a continuing and plentiful supply of East Bloc uranium to the spot market. A further question is to what extent East Bloc suppliers will eventually require long-term contracts in order to maintain production facilitates in economies that are no longer centrally planned, and where there is open competition for capital. Ultimately, reliability of supply from the non-traditional suppliers may also depend on long-term contracts

  8. Long-term outcome of neuroparacoccidioidomycosis treatment

    Directory of Open Access Journals (Sweden)

    Fabio Francesconi

    2011-02-01

    Full Text Available INTRODUCTION: Neuroparacoccidioidomycosis (NPCM is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8% cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM. A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed.

  9. Intermediate Leg SBLOCA - Long Lasting Pressure Transient

    International Nuclear Information System (INIS)

    Konjarek, D.; Bajs, T.; Vukovic, J.

    2010-01-01

    The basic phenomenology of Small Break Loss of Coolant Accident (SBLOCA) for PWR plant is described with focus on analysis of scenario in which reactor coolant pressure decreases below secondary system pressure. Best estimate light water reactor transient analysis code RELAP5/mod3.3 was used in calculation. Rather detailed model of the plant was used. The break occurs in intermediate leg on lowest elevation near pump suction. The size of the break is chosen to be small enough to cause cycling of safety valves (SVs) on steam generators (SGs) for some time, but, afterwards, it is large enough to remove decay heat through the break, causing cooling the secondary side. In this case of SBLOCA, when primary pressure decreases below secondary pressure, long lasting pressure transients with significant amplitude occur. Reasons for such behavior are explained.(author).

  10. Blood pressure patterns in women with gestational hypertension or mild preeclampsia at term.

    Science.gov (United States)

    van der Tuuk, K; Tajik, P; Koopmans, C M; van den Berg, P P; Mol, B W J; van Pampus, M G; Groen, H

    2017-03-01

    Gestational hypertension (GH) and mild preeclampsia (PE) represent the most common medical complications of pregnancy, with the majority of cases developing at or near term. There is little knowledge of the course of blood pressure over time in these women. We explored the pattern of systolic and diastolic blood pressure over time in women with GH or mild PE at term participating in the HYPITAT trial, and we attempted to identify clinical factors influencing these blood pressure patterns and the impact of severe hypertension on clinical management. We used data from the HYPITAT trial, that included women with a singleton pregnancy with a fetus in cephalic position between 36 and 41 weeks of gestation with the diagnosis of GH or mild PE. Blood pressure measurements were performed from randomization or admission until delivery or discharge from the hospital. We included the highest blood pressure of each day. We evaluated systolic and diastolic blood pressure change over time, as well as the influence of clinical characteristics and laboratory findings on the course of blood pressure. We used univariate and multivariate regression analysis with a backward stepwise algorithm for the selection of variables. The model with the best fit (lowest AIC) was selected as the final model. We also compared mode of delivery for women with and without severe hypertension. We studied 1076 women who had 4188 blood pressure measurements done. The systolic blood pressure showed a significant non-linear increase over time and for the diastolic blood pressure the pattern was also non-linear. In the multivariable model of systolic blood pressure change over time, nulliparity, ethnicity, systolic blood pressure (at baseline), BMI and LDH at randomization influenced the course of blood pressure. In the diastolic blood pressure model ALT and the baseline diastolic blood pressure had a significant influence. When we explored the association between blood pressure and mode of delivery, it

  11. Long-term effects of radiation

    International Nuclear Information System (INIS)

    Smith, J.; Smith, T.

    1981-01-01

    It is pointed out that sources of long-term damage from radiation are two-fold. People who have been exposed to doses of radiation from initial early fallout but have recovered from the acute effects may still suffer long-term damage from their exposure. Those who have not been exposed to early fallout may be exposed to delayed fallout, the hazards from which are almost exclusively from ingesting strontium, caesium and carbon isotopes present in food; the damage caused is relatively unimportant compared with that caused by the brief doses from initial radiation and early fallout. A brief discussion is presented of the distribution of delayed long-lived isotope fallout, and an outline is sketched of late biological effects, such as malignant disease, cataracts, retarded development, infertility and genetic effects. (U.K.)

  12. [Effectiveness of nasal positive pressure ventilation in the management of acute refractory left ventricular insufficiency].

    Science.gov (United States)

    Chesi, G; Pinelli, G; Galimberti, D; Navazio, A; Montanari, P

    1994-04-01

    Ehen refractory to optimal medical treatment cardiogenic pulmonary edema requires mechanical ventilation as a last therapeutic resource. In recent years an increasing number of authors reported their experience in the management of acute or subacute respiratory failure with non-invasive mechanical ventilation by nasal mask. Encouraged by the first promising results reported in literature we experimented this new therapeutic tool in a first group of seven elderly patients (mean age: 76.57--range: 65-89); they all had been admitted for severe cardiogenic pulmonary edema unresponsive to maximal doses of the conventional drugs available for treating acute decompensated heart failure. The enrolled patients were treated with intermittent ventilation administered by nasal mask at selected values of inspiratory positive airway pressure (IPAP) that were comprised between 10 and 20 cm H2O. At the same time an expiratory positive airway pressure (EPAP) at values comprised between 3 and 8 cm H2O was applied. Ventilation was continued for variable periods of 3-24 hours until acceptable values of PaO2 and PaCO2 were obtained. The ventilation modality was spontaneous, spontaneous-time or timed depending on the patients' level of consciousness at starting time. A good short-term outcome was achieved in all the patients regardless of the ventilation modality applied. The main blood gas alteration was severe hypercapnia with acidosis in three patients, while the other four presented critical hypoxemia unresponsive to simple oxygen supply even if delivered by high-flow Venturi mask. Four of our seven patients were discharged from hospital in satisfactory haemodynamic conditions; the remaining three died during hospitalization from refractory heart failure. In this our preliminary experience the therapeutic approach with nasal positive pressure ventilation (NPPV) and EPAP proved to be very effective to improve the signs and symptoms of acute refractory cardiogenic pulmonary edema as

  13. Home continuous positive airway pressure for cardiopulmonary indications in infants and children.

    Science.gov (United States)

    Al-Iede, Montaha; Kumaran, Radhagini; Waters, Karen

    2018-04-30

    A number of reports exist regarding the use of continuous positive airway pressure (CPAP) to manage obstructive sleep apnoea (OSA) in children, which we term 'conventional CPAP'. In contrast, there are few reports of home CPAP use for other indications, which we have grouped under the term 'cardiopulmonary'. The aims of this study were to (1) document cardiopulmonary indications for CPAP use in a cohort of infants and children, and (2) evaluate its effectiveness in this group. Hospital records were reviewed for 645 patients who were commenced on long-term CPAP over a 10-year period at a single-tertiary hospital (Children's Hospital at Westmead). This study evaluated the group where the primary indication for CPAP was not OSA ('cardiopulmonary CPAP'). Data evaluated included: demographics, diagnoses, indications for CPAP, hours of use (compliance) and sleep study results at baseline and on CPAP. Of 645 children, 148 (23%) used home CPAP for cardiopulmonary indications; and 130 (87.8%) of these were included. For this group, mean age at CPAP initiation was 18.6 ± 33.6 months (range one week to 16.8 years). Cardiopulmonary indications for CPAP use included: primary airway diseases 65 (50%), chronic lung diseases 33 (25.4%), congenital heart disease (CHD) 20 (15.4%), and both CHD and airway malacia 12 (9.2%). All sleep study variables improved on CPAP relative to the diagnostic sleep study (p 4 h/night). Interstitial lung diseases and other cardiorespiratory disorders, often of congenital origin, can be effectively treated with home CPAP whether they are associated with OSA or not. Sleep studies demonstrated improved gas exchange, sleep and reduced work of breathing with CPAP use. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Bed-side inferior vena cava diameter and mean arterial pressure predict long-term mortality in hospitalized patients with heart failure: 36 months of follow-up.

    Science.gov (United States)

    Torres, Daniele; Cuttitta, Francesco; Paterna, Salvatore; Garofano, Alessandro; Conti, Giosafat; Pinto, Antonio; Parrinello, Gaspare

    2016-03-01

    In discharged patients with heart failure (HF), diverse conditions can intervene to worsen outcome. We would investigate whether such factors present on hospital admission can affect long-term mortality in subjects hospitalized for acute HF. One hundred twenty-three consecutive patients hospitalized for acute HF (mean age 74.8 years; 57% female) were recruited and followed for 36 months after hospitalization. At multivariate Cox model, only inferior vena cava (IVC) diameter and mean arterial pressure (MAP) registered bed-side on admission, resulted, after correction for all confounders factors, the sole factors significantly associated with a higher risk of all-cause mortality in long-term (HR 1.06, p=0.0057; HR 0.97, p=0.0218; respectively). Study population was subdivided according to median values of IVC diameter (23 mm) and MAP (93.3 mm Hg). The Kaplan–Meier curve showed that HF patients with both IVC ≥ 23 mm and MAP b93.3 mm Hg on admission had reduced probability of survival free from all-cause death (log rank p = 0.0070 and log rank p = 0.0028, respectively). In patients hospitalized for acute HF, IVC diameter, measured by hand-carried ultrasound (HCU), and MAP detected on admission are strong predictors of long-term all-cause mortality. The data suggest the need for a careful clinical-therapeutic surveillance on these patients during the post-discharge period. IVC diameter and MAP can be utilized as parameters to stratify prognosis on admission and to be supervised during follow-up. Copyright © 2015 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  15. The short- and long-term effects of development projects:evidence from Ethiopia

    OpenAIRE

    Petrikova, Ivica

    2014-01-01

    This paper examines the short-term and long-term impact of development projects on recipients’ wellbeing in Ethiopia. Specifically, it compares the effects of five types of development projects – unconditional and conditional direct transfers, agricultural and social-infrastructure knowledge transfers, and credit projects – on children’s nutrition and on household consumption and income levels. The main finding is that knowledge transfers have the largest positive impact on children’s nutriti...

  16. Cancer risk in long-term users of valproate: a population-based case-control study

    DEFF Research Database (Denmark)

    Hallas, Jesper; Friis, Søren; Bjerrum, Lars

    2009-01-01

    logistic regression. RESULTS: Among the cases and controls, 81 (0.05%) and 260 (0.04%), respectively, were long-term users of valproate. For cancer overall, the crude and adjusted odds ratios were 1.25 [95% confidence interval (95% CI), 0.97-1.60] and 1.21 (95% CI, 0.95-1.56), respectively. Subgroup...... analyses revealed no dose or duration effect for overall cancer incidence, and no specific cancer site was found to be inversely associated with long-term use of valproate. For lung cancer, we found a positive but imprecise association (adjusted odds ratio, 2.32; 95% CI, 1.12-4.79). CONCLUSION: Long...

  17. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  18. Analysing long term discursive processes

    DEFF Research Database (Denmark)

    Horsbøl, Anders

    which extend beyond the single interaction, for instance negotiations or planning processes, seems to have played a less important role, with studies such as Iedema 2001 and Wodak 2000 as exceptions. These long term processes, however, are central to the constitution and workings of organizations......What do timescales - the notion that processes take place or can be viewed within a shorter or longer temporal range (Lemke 2005) - mean for the analysis of discourse? What are the methodological consequences of analyzing discourse at different timescales? It may be argued that discourse analysis...... in general has favored either the analysis of short term processes such as interviews, discussions, and lessons, or the analysis of non-processual entities such as (multimodal) texts, arguments, discursive repertoires, and discourses (in a Foucaultian sense). In contrast, analysis of long term processes...

  19. What are the differences between long-term, short-term, and working memory?

    OpenAIRE

    Cowan, Nelson

    2008-01-01

    In the recent literature there has been considerable confusion about the three types of memory: long-term, short-term, and working memory. This chapter strives to reduce that confusion and makes up-to-date assessments of these types of memory. Long- and short-term memory could differ in two fundamental ways, with only short-term memory demonstrating (1) temporal decay and (2) chunk capacity limits. Both properties of short-term memory are still controversial but the current literature is rath...

  20. Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water

    Directory of Open Access Journals (Sweden)

    Danize Aparecida Rizzetti

    Full Text Available ABSTRACT Objective: To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. Methods: This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP; CPAP5 (CPAP at 5 cmH2O; and CPAP10 (CPAP at 10 cmH2O. We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR, and FEF25-75% at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. Results: We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. Conclusions: When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile.

  1. Impact of continuous positive airway pressure on the pulmonary changes promoted by immersion in water.

    Science.gov (United States)

    Rizzetti, Danize Aparecida; Quadros, Janayna Rodembuch Borba; Ribeiro, Bruna Esmerio; Callegaro, Letícia; Veppo, Aline Arebalo; Wiggers, Giulia Alessandra; Peçanha, Franck Maciel

    2017-01-01

    To determine whether different levels of CPAP improve the lung volumes and capacities of healthy subjects immersed in water. This was a randomized clinical trial, conducted between April and June of 2016, involving healthy female volunteers who were using oral contraceptives. Three 20-min immersion protocols were applied: control (no CPAP); CPAP5 (CPAP at 5 cmH2O); and CPAP10 (CPAP at 10 cmH2O). We evaluated HR, SpO2, FVC, FEV1, the FEV1/FVC ratio, peak expiratory flow rate (PEFR), and FEF25-75%) at three time points: pre-immersion; 10 min after immersion; and 10 min after the end of each protocol. We evaluated 13 healthy volunteers. The CPAP10 protocol reversed the restrictive pattern of lung function induced by immersion in water, maintaining pulmonary volumes and capacities for a longer period than did the CPAP5 protocol. When the hemodynamic change causing a persistent lung disorder, only the application of higher positive pressures is effective in maintaining long-term improvements in the pulmonary profile.

  2. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko

    2010-01-01

    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  3. Upregulation of CREB-mediated transcription enhances both short- and long-term memory.

    Science.gov (United States)

    Suzuki, Akinobu; Fukushima, Hotaka; Mukawa, Takuya; Toyoda, Hiroki; Wu, Long-Jun; Zhao, Ming-Gao; Xu, Hui; Shang, Yuze; Endoh, Kengo; Iwamoto, Taku; Mamiya, Nori; Okano, Emiko; Hasegawa, Shunsuke; Mercaldo, Valentina; Zhang, Yue; Maeda, Ryouta; Ohta, Miho; Josselyn, Sheena A; Zhuo, Min; Kida, Satoshi

    2011-06-15

    Unraveling the mechanisms by which the molecular manipulation of genes of interest enhances cognitive function is important to establish genetic therapies for cognitive disorders. Although CREB is thought to positively regulate formation of long-term memory (LTM), gain-of-function effects of CREB remain poorly understood, especially at the behavioral level. To address this, we generated four lines of transgenic mice expressing dominant active CREB mutants (CREB-Y134F or CREB-DIEDML) in the forebrain that exhibited moderate upregulation of CREB activity. These transgenic lines improved not only LTM but also long-lasting long-term potentiation in the CA1 area in the hippocampus. However, we also observed enhanced short-term memory (STM) in contextual fear-conditioning and social recognition tasks. Enhanced LTM and STM could be dissociated behaviorally in these four lines of transgenic mice, suggesting that the underlying mechanism for enhanced STM and LTM are distinct. LTM enhancement seems to be attributable to the improvement of memory consolidation by the upregulation of CREB transcriptional activity, whereas higher basal levels of BDNF, a CREB target gene, predicted enhanced shorter-term memory. The importance of BDNF in STM was verified by microinfusing BDNF or BDNF inhibitors into the hippocampus of wild-type or transgenic mice. Additionally, increasing BDNF further enhanced LTM in one of the lines of transgenic mice that displayed a normal BDNF level but enhanced LTM, suggesting that upregulation of BDNF and CREB activity cooperatively enhances LTM formation. Our findings suggest that CREB positively regulates memory consolidation and affects memory performance by regulating BDNF expression.

  4. Long-term orbit prediction for Tiangong-1 spacecraft using the mean atmosphere model

    Science.gov (United States)

    Tang, Jingshi; Liu, Lin; Cheng, Haowen; Hu, Songjie; Duan, Jianfeng

    2015-03-01

    China is planning to complete its first space station by 2020. For the long-term management and maintenance, the orbit of the space station needs to be predicted for a long period of time. Since the space station is expected to work in a low-Earth orbit, the error in the a priori atmosphere model contributes significantly to the rapid increase of the predicted orbit error. When the orbit is predicted for 20 days, the error in the a priori atmosphere model, if not properly corrected, could induce a semi-major axis error of up to a few kilometers and an overall position error of several thousand kilometers respectively. In this work, we use a mean atmosphere model averaged from NRLMSISE00. The a priori reference mean density can be corrected during the orbit determination. For the long-term orbit prediction, we use sufficiently long period of observations and obtain a series of the diurnal mean densities. This series contains the recent variation of the atmosphere density and can be analyzed for various periodic components. After being properly fitted, the mean density can be predicted and then applied in the orbit prediction. Here we carry out the test with China's Tiangong-1 spacecraft at the altitude of about 340 km and we show that this method is simple and flexible. The densities predicted with this approach can serve in the long-term orbit prediction. In several 20-day prediction tests, most predicted orbits show semi-major axis errors better than 700 m and overall position errors better than 400 km.

  5. Long-Term Patency of Lymphovenous Anastomoses: A Systematic Review.

    Science.gov (United States)

    Tourani, Saam S; Taylor, G Ian; Ashton, Mark W

    2016-08-01

    With advancements in technology and microsurgical techniques, lymphovenous anastomosis has become a popular reconstructive procedure in the treatment of chronic lymphedema. However, the long-term patency of these anastomoses is not clear in the literature. A systematic review of the MEDLINE and EMBASE databases was performed to assess the reported long-term patency of lymphovenous anastomoses. A total of eight studies satisfied the inclusion criteria. Pooled data from four similar experiments in normal dogs showed an average long-term (≥5 months) patency of 52 percent. The only experiment in dogs with chronic lymphedema failed to show any long-term patency. The creation of peripheral lymphovenous anastomoses with a moderate long-term patency rate has become technically possible. However, the long-term results in chronic lymphedema are limited.

  6. Long-Term Orientation in Trade

    NARCIS (Netherlands)

    Hofstede, G.J.; Jonker, C.M.; Verwaart, D.

    2008-01-01

    Trust does not work in the same way across cultures. This paper presents an agent model of behavior in trade across Hofstedes cultural dimension of long-term vs. short-term orientation. The situation is based on a gaming simulation, the Trust and Tracing game. The paper investigates the

  7. Implementation of an Open-Scenario, Long-Term Space Debris Simulation Approach

    Science.gov (United States)

    Nelson, Bron; Yang Yang, Fan; Carlino, Roberto; Dono Perez, Andres; Faber, Nicolas; Henze, Chris; Karacalioglu, Arif Goktug; O'Toole, Conor; Swenson, Jason; Stupl, Jan

    2015-01-01

    This paper provides a status update on the implementation of a flexible, long-term space debris simulation approach. The motivation is to build a tool that can assess the long-term impact of various options for debris-remediation, including the LightForce space debris collision avoidance concept that diverts objects using photon pressure [9]. State-of-the-art simulation approaches that assess the long-term development of the debris environment use either completely statistical approaches, or they rely on large time steps on the order of several days if they simulate the positions of single objects over time. They cannot be easily adapted to investigate the impact of specific collision avoidance schemes or de-orbit schemes, because the efficiency of a collision avoidance maneuver can depend on various input parameters, including ground station positions and orbital and physical parameters of the objects involved in close encounters (conjunctions). Furthermore, maneuvers take place on timescales much smaller than days. For example, LightForce only changes the orbit of a certain object (aiming to reduce the probability of collision), but it does not remove entire objects or groups of objects. In the same sense, it is also not straightforward to compare specific de-orbit methods in regard to potential collision risks during a de-orbit maneuver. To gain flexibility in assessing interactions with objects, we implement a simulation that includes every tracked space object in Low Earth Orbit (LEO) and propagates all objects with high precision and variable time-steps as small as one second. It allows the assessment of the (potential) impact of physical or orbital changes to any object. The final goal is to employ a Monte Carlo approach to assess the debris evolution during the simulation time-frame of 100 years and to compare a baseline scenario to debris remediation scenarios or other scenarios of interest. To populate the initial simulation, we use the entire space

  8. Unemployment and Long-Term Unemployment of Immigrants in Croatia

    Directory of Open Access Journals (Sweden)

    Valerija Botrić

    2016-04-01

    Full Text Available Migration issues in Croatia have been mostly discussed in relation to the recent increase in emigration, in particular related to the emigration of young and highly educated persons. However, active migration policy should consider immigration dynamics as well. In the framework of long-term prospects of the Croatian labour market, and taking into consideration the advanced effects of the demographic aging process, the issue of active immigration policy is expected to become more important in the future. The main goal of the paper is to analyse the existing position of immigrants on the Croatian labour market. Important characteristics of the Croatian labour market in recent years have been a high unemployment rate and high share of long-term unemployment. The effects of these adverse conditions are manifold, not only at the level of the economy (in terms of under-utilisation of available resources, but also at the level of affected individuals. Regarding individuals, the consequences of long-term unemployment frequently incorporate increased distance from the labour market due to the (perceived loss of skills. The aim of the paper is to investigate individual characteristics that predict either unemployment or long-term unemployment of the immigrant population in Croatia. The empirical analysis is based on the Labour Force Survey conducted by the Croatian Central Bureau of Statistics. Due to the data source used, the immigrant population is not defined on the basis of their nationality or citizenship. It entails all persons who were born outside Croatia and currently have permanent residence in the country. The second condition is directly related to the nature of the sample used for the Survey, where the sample frame relies on permanent residency. This implies that any short-term circular migrations (due to, for example, increased labour market during the tourist season are probably not covered by the data. To the extent that this is important

  9. Do long-term tongue piercings affect speech quality?

    Science.gov (United States)

    Heinen, Esther; Birkholz, Peter; Willmes, Klaus; Neuschaefer-Rube, Christiane

    2017-10-01

    To explore possible effects of tongue piercing on perceived speech quality. Using a quasi-experimental design, we analyzed the effect of tongue piercing on speech in a perception experiment. Samples of spontaneous speech and read speech were recorded from 20 long-term pierced and 20 non-pierced individuals (10 males, 10 females each). The individuals having a tongue piercing were recorded with attached and removed piercing. The audio samples were blindly rated by 26 female and 20 male laypersons and by 5 female speech-language pathologists with regard to perceived speech quality along 5 dimensions: speech clarity, speech rate, prosody, rhythm and fluency. We found no statistically significant differences for any of the speech quality dimensions between the pierced and non-pierced individuals, neither for the read nor for the spontaneous speech. In addition, neither length nor position of piercing had a significant effect on speech quality. The removal of tongue piercings had no effects on speech performance either. Rating differences between laypersons and speech-language pathologists were not dependent on the presence of a tongue piercing. People are able to perfectly adapt their articulation to long-term tongue piercings such that their speech quality is not perceptually affected.

  10. Long-term effects of childbirth in MS

    NARCIS (Netherlands)

    D'hooghe, M.B.; Nagels, G.; Uitdehaag, B.M.J.

    2010-01-01

    Background: The uncertainty about long-term effects of childbirth presents MS patients with dilemmas. Methods: Based on clinical data of 330 female MS patients, the long-term effects of childbirth were analysed, using a cross-sectional study design. Four groups of patients were distinguished: (1)

  11. Long-Term Impact of a Cell Phone-Enhanced Parenting Intervention.

    Science.gov (United States)

    Lefever, Jennifer E Burke; Bigelow, Kathryn M; Carta, Judith J; Borkowski, John G; Grandfield, Elizabeth; McCune, Luke; Irvin, Dwight W; Warren, Steven F

    2017-11-01

    Home visiting programs support positive parenting in populations at-risk of child maltreatment, but their impact is often limited by poor retention and engagement. The current study assessed whether a cellular phone-supported version (PCI-C) of the Parent-Child Interactions (PCI) intervention improved long-term parenting practices, maternal depression, and children's aggression. Low-income mothers ( n = 371) of preschool-aged children were assigned to one of the three groups: PCI-C, PCI, and a wait-list control (WLC) group. Parenting improved in both intervention groups between baseline and 12-month follow-up compared to the WLC. Children in the PCI-C group were rated to be more cooperative and less aggressive than children in the WLC. The results offer evidence of the long-term effectiveness of PCI and the additional benefits of cellular phone supports for promoting intervention retention and improving children's behavior.

  12. PEBS. Long-term performance of engineered barrier systems

    Energy Technology Data Exchange (ETDEWEB)

    Wieczorek, Klaus; Czaikowski, Oliver; Miehe, Ruediger

    2014-12-15

    The evolution of the engineered barrier system (EBS) of geological repositories for radioactive waste has been the subject of many national and international research programmes. The emphasis of the research activities was on the elaboration of a detailed understanding of the complex THMC processes, which are expected to evolve in the early post closure period in the near field. From the perspective of radiological long-term safety, an in-depth understanding of these coupled processes is of great significance, because the evolution of the EBS during the early post-closure phase may have a non-negligible impact on the radiological safety functions at the time when the canisters breach. Unexpected process interactions during the resaturation phase could impair the safety-relevant parameters in the EBS (e. g. swelling pressure, hydraulic conductivity, diffusivity).

  13. Continuous positive airway pressure (CPAP).

    Science.gov (United States)

    Sahni, R; Wung, J T

    1998-01-01

    Progress in neonatal intensive care is closely linked to improvements in the management of respiratory failure in small infants. This applies to the care of the preterm infants with immature lungs, and also to treatment of the preterm or full term infants with specific diseases that are associated with respiratory failure. Respiratory distress of the newborn continues to account for significant morbidity in the intensive care unit. The spectrum of disease ranges from mild distress to severe respiratory failure requiring varying degrees of support. The current modalities of ventilatory assistance range from the more benign continuous positive airway pressure (CPAP) to conventional mechanical ventilation, and on to high frequency ventilation. It is a reasonable supposition that the type of ventilatory assistance provided to these infants should be graded according to the severity of the disease. However, the principal objective in selecting the mode of respiratory support should be to use a modality which results in minimal volo- or barotrauma to the infant. The following detailed description on CPAP explains its physiological effects, delivery system, indications for use, application, maintenance, and associated complications. The equipment described is simple to use, has a greater cost benefit, and has a more universal application, which is of help to smaller units including those in the developing parts of the world. We have also included our institutional clinical experience of CPAP usage in very low birth weight infants from the periods before and after commercial availability of surfactant in the United States.

  14. Hippocampal Focal Knockout of CBP Affects Specific Histone Modifications, Long-Term Potentiation, and Long-Term Memory

    Science.gov (United States)

    Barrett, Ruth M; Malvaez, Melissa; Kramar, Eniko; Matheos, Dina P; Arrizon, Abraham; Cabrera, Sara M; Lynch, Gary; Greene, Robert W; Wood, Marcelo A

    2011-01-01

    To identify the role of the histone acetyltransferase (HAT) CREB-binding protein (CBP) in neurons of the CA1 region of the hippocampus during memory formation, we examine the effects of a focal homozygous knockout of CBP on histone modifications, gene expression, synaptic plasticity, and long-term memory. We show that CBP is critical for the in vivo acetylation of lysines on histones H2B, H3, and H4. CBP's homolog p300 was unable to compensate for the loss of CBP. Neurons lacking CBP maintained phosphorylation of the transcription factor CREB, yet failed to activate CREB:CBP-mediated gene expression. Loss of CBP in dorsal CA1 of the hippocampus resulted in selective impairments to long-term potentiation and long-term memory for contextual fear and object recognition. Together, these results suggest a necessary role for specific chromatin modifications, selectively mediated by CBP in the consolidation of memories. PMID:21508930

  15. Effects of recruitment maneuver and positive end-expiratory pressure on respiratory mechanics and transpulmonary pressure during laparoscopic surgery.

    Science.gov (United States)

    Cinnella, Gilda; Grasso, Salvatore; Spadaro, Savino; Rauseo, Michela; Mirabella, Lucia; Salatto, Potito; De Capraris, Antonella; Nappi, Luigi; Greco, Pantaleo; Dambrosio, Michele

    2013-01-01

    The authors tested the hypothesis that during laparoscopic surgery, Trendelenburg position and pneumoperitoneum may worsen chest wall elastance, concomitantly decreasing transpulmonary pressure, and that a protective ventilator strategy applied after pneumoperitoneum induction, by increasing transpulmonary pressure, would result in alveolar recruitment and improvement in respiratory mechanics and gas exchange. In 29 consecutive patients, a recruiting maneuver followed by positive end-expiratory pressure 5 cm H(2)O maintained until the end of surgery was applied after pneumoperitoneum induction. Respiratory mechanics, gas exchange, blood pressure, and cardiac index were measured before (T(BSL)) and after pneumoperitoneum with zero positive end-expiratory pressure (T(preOLS)), after recruitment with positive end-expiratory pressure (T(postOLS)), and after peritoneum desufflation with positive end-expiratory pressure (T(end)). Esophageal pressure was used for partitioning respiratory mechanics between lung and chest wall (data are mean ± SD): on T(preOLS), chest wall elastance (E(cw)) and elastance of the lung (E(L)) increased (8.2 ± 0.9 vs. 6.2 ± 1.2 cm H(2)O/L, respectively, on T(BSL); P = 0.00016; and 11.69 ± 1.68 vs. 9.61 ± 1.52 cm H(2)O/L on T(BSL); P = 0.0007). On T(postOLS), both chest wall elastance and E(L) decreased (5.2 ± 1.2 and 8.62 ± 1.03 cm H(2)O/L, respectively; P = 0.00015 vs. T(preOLS)), and Pao(2)/inspiratory oxygen fraction improved (491 ± 107 vs. 425 ± 97 on T(preOLS); P = 0.008) remaining stable thereafter. Recruited volume (the difference in lung volume for the same static airway pressure) was 194 ± 80 ml. Pplat(RS) remained stable while inspiratory transpulmonary pressure increased (11.65 + 1.37 cm H(2)O vs. 9.21 + 2.03 on T(preOLS); P = 0.007). All respiratory mechanics parameters remained stable after abdominal desufflation. Hemodynamic parameters remained stable throughout the study. In patients submitted to laparoscopic surgery in

  16. [Psychosocial issues of long-term cancer survivors].

    Science.gov (United States)

    Weis, J; Faller, H

    2012-04-01

    Although cancer incidence rates are increasing, recent statistical studies suggest that cancer patients are showing higher cure rates as well as improved overall survival rates for most cancer locations. These advances are explained by improved strategies in early diagnoses as well as improved cancer therapies. Therefore, the number of long-term cancer survivors has also increased, but only few studies, especially within the last years, have focused on psychosocial issues of this subgroup. Some studies show that overall quality of life of long-term cancer survivors is quite high and comparable to that of the normal population. Nevertheless, a substantial percentage of former patients shows reduced quality of life and suffers from various sequelae of cancer and its treatment. This review focuses on the most common psychosocial issue of long-term survivors such as reduced psychological wellbeing, neuropsychological deficits and cancer-related fatigue syndrome. Finally, recommendations for problem-oriented interventions as well as improvement of psychosocial care of long-term survivors are given.

  17. Are long-term bisphosphonate users a reality?

    DEFF Research Database (Denmark)

    Abrahamsen, B

    2012-01-01

    The prevalence of long-term bisphosphonate use may be low due to low refill compliance and gaps in treatment. An analysis of the prescription history of 58,674 bisphosphonate users in Denmark found that only 2.8 % had received ten dose years of treatment or above. INTRODUCTION: This study aims...... to describe the demographics of present bisphosphonate (BP) users, to determine the prevalence of long-term BP use, and to establish if long-term use (a 10-year history of osteoporosis treatment) translated to ten dose years of bisphosphonate prescriptions filled, given the propensity for treatment gaps...... more than ten dose years of a BP. For any osteoporosis drug, 3.0 % had received ten dose years or more, while 23.2 % had received between 5 and 10 years of treatment. CONCLUSION: Long-term users with ten dose years or more of a BP are rare due to periods of low compliance and gaps, with a discrepancy...

  18. A security/safety survey of long term care facilities.

    Science.gov (United States)

    Acorn, Jonathan R

    2010-01-01

    What are the major security/safety problems of long term care facilities? What steps are being taken by some facilities to mitigate such problems? Answers to these questions can be found in a survey of IAHSS members involved in long term care security conducted for the IAHSS Long Term Care Security Task Force. The survey, the author points out, focuses primarily on long term care facilities operated by hospitals and health systems. However, he believes, it does accurately reflect the security problems most long term facilities face, and presents valuable information on security systems and practices which should be also considered by independent and chain operated facilities.

  19. [Effects of long-term fertilization on enzyme activities in black soil of Northeast China].

    Science.gov (United States)

    Wang, Shu-Qi; Han, Xiao-Zeng; Qiao, Yun-Fa; Wang, Shou-Yu

    2008-03-01

    In this paper, black soil samples at the depths of 0-20 cm and 20-40 cm were collected from the Hailun Agricultural Ecology Station of Chinese Academy of Sciences to study the effects of long-term fertilization on their urease, invertase, phosphatase and catalase activities and total C and N contents. The results showed that long-term application of chemical fertilizers and organic manure increased the activities of urease, invertase and phosphatase in 0-20 cm and 20-40 cm soil layers in different degree, and the combined application of them increased the activities of the three enzymes significantly, with an increment of 43.6%-113.2%, 25.9%-79.5% and 14.7%-134.4% in 0-20 cm soil layer and 56.1%-127.2%, 14.5%-113.8% and 16.2%-207.2% in 20-40 cm soil layer, respectively. However, long-term application of chemical fertilizers without organic manure had little effects on catalase activity. The activities of urease, invertase and phosphatase decreased with increasing soil depth. Long-term application of N fertilizer increased urease activity, and P fertilization had obvious positive effect on phosphatase activity. Long-term fertilization also had obvious effects on the soil total C and N contents and C/N ratio.

  20. EVAHEART: an implantable centrifugal blood pump for long-term circulatory support.

    Science.gov (United States)

    Yamazaki, Kenji; Kihara, Shinichiro; Akimoto, Takehide; Tagusari, Osamu; Kawai, Akihiko; Umezu, Mitsuo; Tomioka, Jun; Kormos, Robert L; Griffith, Bartley P; Kurosawa, Hiromi

    2002-11-01

    We developed "EVAHEART": a compact centrifugal blood pump system as an implantable left ventricular assist device for long-term circulatory support. The 55 x 64 mm pump is made from pure titanium, and weighs 370 g. The entire blood-contacting surface is covered with an anti-thrombogenic coating of diamond like carbon (DLC) or 2-methacryloyloxyethyl phosphorylcholine (MPC) to improve blood compatibility. Flows exceeding 12 L/min against 100 mmHg pressure at 2600 rpm was measured. A low-temperature mechanical seal with recirculating cooling system is used to seal the shaft. EVAHEART demonstrated an acceptably low hemolysis rate with normalized index of hemolysis of 0.005 +/- 0.002 g/100L. We evaluated the pump in long-term in-vivo experiments with seven calves. Via left thoracotomy, we conducted left ventricular apex-descending aorta bypass, placing the pump in the left thoracic cavity. Pump flow rates was maintained at 5-9 L/min, pump power consumption remained stable at 9-10 W in all cases, plasma free Hb levels were less than 15 mg/dl, and the seal system showed good seal capability throughout the experiments. The calves were sacrificed on schedule on postoperative day 200, 222, 142, 90, 151, 155, and 133. No thrombi formed on the blood contacting surface with either the DLC or MPC coating, and no major organ thromboembolisms occurred except for a few small renal infarcts. EVAHEART centrifugal blood pump demonstrated excellent performance in long-term in-vivo experiments.

  1. Carbon storage and long-term rate of accumulation in high-altitude Andean peatlands of Bolivia

    Science.gov (United States)

    J.A. Hribljan; D.J. Cooper; J. Sueltenfuss; E.C. Wolf; K.A. Heckman; Erik Lilleskov; R.A. Chimner

    2015-01-01

    The high-altitude (4,500+ m) Andean mountain range of north-western Bolivia contains many peatlands. Despite heavy grazing pressure and potential damage from climate change, little is known about these peatlands. Our objective was to quantify carbon pools, basal ages and long-term peat accumulation rates in peatlands in two areas of the arid puna ecoregion of Bolivia:...

  2. The Structure and Content of Long-Term and Short-Term Mate Preferences

    Directory of Open Access Journals (Sweden)

    Peter K. Jonason

    2013-12-01

    Full Text Available This study addresses two limitations in the mate preferences literature. First, research all-too-often relies on single-item assessments of mate preferences precluding more advanced statistical techniques like factor analysis. Second, when factor analysis could be done, it exclusively has done for long-term mate preferences, at the exclusion of short-term mate preferences. In this study (N = 401, we subjected 20 items designed to measure short- and long-term mate preferences to both principle components (n = 200 and confirmatory factor analysis (n = 201. In the long-term context, we replicated previous findings that there are three different categories of preferences: physical attractiveness, interpersonal warmth, and social status. In the short-term context, physical attractiveness occupied two parts of the structure, social status dropped out, and interpersonal warmth remained. Across short- and long-term contexts, there were slight changes in what defined the shared dimensions (i.e., physical attractiveness and interpersonal warmth, suggesting prior work that applies the same inventory to each context might be flawed. We also replicated sex differences and similarities in mate preferences and correlates with sociosexuality and mate value. We adopt an evolutionary paradigm to understand our results.

  3. Effects of trawl selectivity and genetic parameters on fish body length under long-term trawling

    Science.gov (United States)

    Yu, Yang; Sun, Peng; Cui, He; Sheng, Huaxiang; Zhao, Fenfang; Tang, Yanli; Chen, Zelin

    2015-10-01

    Long-term fishing pressure affects the biological characteristics of exploited fish stocks. The biological characteristics of hairtail ( Trichiurus lepturus) in the East China Sea are unable to recover because of long-term trawling. Fishing induces evolutionary effects on the fish's biological characteristics. Evidence of these changes includes small size at age, a shift to earlier age structure, and early maturation. Natural and artificial selection usually affect the fish's life history. Selection can induce different chances of reproduction, and individual fish can give a different genetic contribution to the next generation. In this study, analysis of time-dependent probability of significance and test of sensitivity were used to explore the effects of fish exploitation rate, mesh size, and heritability with long-term trawling. Results showed that fishing parameters were important drivers to exploited fish population. However, genetic traits altered by fishing were slow, and the changes in biological characteristics were weaker than those caused by fishing selection. Exploitation rate and mesh size exhibited similar evolutionary trend tendency under long-term fishing. The time-dependent probability of significance trend showed a gradual growth and tended to be stable. Therefore, the direction of fishing-induced evolution and successful management of fish species require considerable attention to contribute to sustainable fisheries in China.

  4. Long-Term Memory and Learning

    Science.gov (United States)

    Crossland, John

    2011-01-01

    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  5. Does the Position or Contact Pressure of the Stethoscope Make Any Difference to Clinical Blood Pressure Measurements

    Science.gov (United States)

    Pan, Fan; Zheng, Dingchang; He, Peiyu; Murray, Alan

    2014-01-01

    Abstract This study aimed to investigate the effect of stethoscope position and contact pressure on auscultatory blood pressure (BP) measurement. Thirty healthy subjects were studied. Two identical stethoscopes (one under the cuff, the other outside the cuff) were used to simultaneously and digitally record 2 channels of Korotkoff sounds during linear cuff pressure deflation. For each subject, 3 measurements with different contact pressures (0, 50, and 100 mm Hg) on the stethoscope outside the cuff were each recorded at 3 repeat sessions. The Korotkoff sounds were replayed twice on separate days to each of 2 experienced listeners to determine systolic and diastolic BPs (SBP and DBP). Variance analysis was performed to study the measurement repeatability and the effect of stethoscope position and contact pressure on BPs. There was no significant BP difference between the 3 repeat sessions, between the 2 determinations from each listener, between the 2 listeners and between the 3 stethoscope contact pressures (all P > 0.06). There was no significant SBP difference between the 2 stethoscope positions at the 2 lower stethoscope pressures (P = 0.23 and 0.45), but there was a small (0.4 mm Hg, clinically unimportant) significant difference (P = 0.005) at the highest stethoscope pressure. The key result was that, DBP from the stethoscope under the cuff was significantly lower than that from outside the cuff by 2.8 mm Hg (P stethoscope outside the cuff, tends to give a higher DBP than the true intra-arterial pressure, this study could suggest that the stethoscope position under the cuff, and closer to the arterial occlusion, might yield measurements closer to the actual invasive DBP. PMID:25546675

  6. A least squares approach for efficient and reliable short-term versus long-term optimization

    DEFF Research Database (Denmark)

    Christiansen, Lasse Hjuler; Capolei, Andrea; Jørgensen, John Bagterp

    2017-01-01

    The uncertainties related to long-term forecasts of oil prices impose significant financial risk on ventures of oil production. To minimize risk, oil companies are inclined to maximize profit over short-term horizons ranging from months to a few years. In contrast, conventional production...... optimization maximizes long-term profits over horizons that span more than a decade. To address this challenge, the oil literature has introduced short-term versus long-term optimization. Ideally, this problem is solved by a posteriori multi-objective optimization methods that generate an approximation...... the balance between the objectives, leaving an unfulfilled potential to increase profits. To promote efficient and reliable short-term versus long-term optimization, this paper introduces a natural way to characterize desirable Pareto points and proposes a novel least squares (LS) method. Unlike hierarchical...

  7. Long-term evaluation of cardiac and vascular toxicity in patients with Philadelphia chromosome-positive leukemias treated with bosutinib.

    Science.gov (United States)

    Cortes, Jorge E; Jean Khoury, H; Kantarjian, Hagop; Brümmendorf, Tim H; Mauro, Michael J; Matczak, Ewa; Pavlov, Dmitri; Aguiar, Jean M; Fly, Kolette D; Dimitrov, Svetoslav; Leip, Eric; Shapiro, Mark; Lipton, Jeff H; Durand, Jean-Bernard; Gambacorti-Passerini, Carlo

    2016-06-01

    Vascular and cardiac safety during tyrosine kinase inhibitor (TKI) therapy is an emerging issue. We evaluated vascular/cardiac toxicities associated with long-term bosutinib treatment for Philadelphia chromosome-positive (Ph+) leukemia based on treatment-emergent adverse events (TEAEs) and changes in QTc intervals and ejection fraction in two studies: a phase 1/2 study of second-/third-/fourth-line bosutinib for Ph+ leukemia resistant/intolerant to prior TKIs (N = 570) and a phase 3 study of first-line bosutinib (n = 248) versus imatinib (n = 251) in chronic phase chronic myeloid leukemia. Follow-up time was ≥48 months (both studies). Incidences of vascular/cardiac TEAEs in bosutinib-treated patients were 7%/10% overall with similar incidences observed with first-line bosutinib (5%/8%) and imatinib (4%/6%). Few patients had grade ≥3 vascular/cardiac events (4%/4%) and no individual TEAE occurred in >2% of bosutinib patients. Exposure-adjusted vascular/cardiac TEAE rates (patients with events/patient-year) were low for second-line or later bosutinib (0.037/0.050) and not significantly different between first-line bosutinib (0.015/0.024) and imatinib (0.011/0.017; P ≥ 0.267). Vascular/cardiac events were managed mainly with concomitant medications (39%/44%), bosutinib treatment interruptions (18%/21%), or dose reductions (4%/8%); discontinuations due to these events were rare (0.7%/1.0%). Based on logistic regression modelling, performance status >0 and history of vascular or cardiac disorders were prognostic of vascular/cardiac events in relapsed/refractory patients; hyperlipidemia/hypercholesterolemia and older age were prognostic of cardiac events. In newly diagnosed patients, older age was prognostic of vascular/cardiac events; history of diabetes was prognostic of vascular events. Incidences of vascular and cardiac events were low with bosutinib in the first-line and relapsed/refractory settings following long-term treatment in patients

  8. Sacrococcygeal teratoma: Clinical characteristics and long-term ...

    African Journals Online (AJOL)

    Background/Purpose : The excision of sacrococcygeal teratoma (SCT) may be associated with significant long-term morbidity for the child. We reviewed our experience with SCT in a tertiary health care facility in a developing country with particular interest on the long-term sequelae. Methods : Between January 1990 and ...

  9. Managerial Long-Term Responsibility in Family-Controlled Firms

    Directory of Open Access Journals (Sweden)

    Dietmar Sternad

    2013-01-01

    Full Text Available Evidence suggests that long-term orientation (LTO as a dominantstrategic logic contributes to the sustainable performance offamily-controlled firms (FCFS. Combining a review of the literatureon lto with stewardship theory and upper echelons theoryreasoning, this article presents a typology of managerial responsibilityand introduces the concept of long-term responsibility as amanagerial characteristic constituting a major driving force behindcreating lto. The antecedents of long-term responsibilityunder family firm-specific conditions (stemming from the familysystem, the governance system, and family-firm managers’ personalcharacteristics are also identified and presented in an integratedmodel. The paper contributes to a more comprehensiveunderstanding of intertemporal choice in fcfs and explains whythey tend to be more long-term oriented than other types of firms.

  10. Instrument packages to study long-term sediment transport processes in a shallow bay

    Science.gov (United States)

    Strahle, William J.; Martini, Marinna A.; Davis, Ray E.

    1994-01-01

    Pressure and near-surface and near-bottom measurements of current, temperature, salinity and light transmission were required in Mobile Bay, a 3 m deep estuary on the Gulf of Mexico. This environment presented several obstacles to obtaining long term observations. Boat traffic, soft estuary bottom, heavy biofouling, rapid sample rates and large data storage were overcome by using instrumentation techniques that are applicable to other estuary systems. Nearly two years of continuous data was collected.

  11. Collectes à long terme

    CERN Multimedia

    Collectes à long terme

    2014-01-01

    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  12. Positive muon diffusion in iron and nickel pressure dependence

    CERN Document Server

    Butz, T; Dufresne, J F; Hartmann, O; Karlsson, E; Lindgren, B; Longobardi, R; Norlin, L O; Pezzetti, J P; Yaouanc, A

    1980-01-01

    The hyperfine field B/sub hf/ at positive muon ( mu /sup +/) in iron and nickel was previously found. Exhibits marked deviations from the bulk magnetization as a function of temperature. For substitutional impurities in Fe and Ni matrices the volume dependence of B/sub hf/ has been considered as a possible reason for such deviations. Therefore the authors have measured at CERN the local magnetic field at mu /sup +/, B/sub mu /, in high purity polycrystalline Fe and Ni samples at room temperature and at pressures up to 7 kbar by the positive muon spin rotation ( mu /sup +/ SR) technique. To their knowledge, this is the first mu /sup +/SR experiment performed under hydrostatic pressure. The authors observe a linear pressure dependence for both samples but slopes are of opposite signs. (12 refs).

  13. Long-term energy supply contracts in European competition policy: Fuzzy not crazy

    International Nuclear Information System (INIS)

    Hauteclocque, Adrien de; Glachant, Jean-Michel

    2009-01-01

    Long-term supply contracts often have ambiguous effects on the competitive structure, investment and consumer welfare in the long term. In the new market context, these effects are likely to be worsened and thus even harder to assess. Since liberalization and especially since the release of the Energy Sector Inquiry in early 2007, the portfolio of long-term supply contracts of the former incumbents have become a priority for review by the European Commission and the national competition authorities. It is widely believed that European Competition authorities take a dogmatic view on these contracts and systemically emphasize the risk of foreclosure over their positive effects on investment and operation. This paper depicts the methodology that has emerged in the recent line of cases and argues that this interpretation is largely misguided. It shows that a multiple-step approach is used to reduce regulation costs and balance anti-competitive effects with potential efficiency gains. However, if an economic approach is now clearly implemented, competition policy is constrained by the procedural aspect of the legal process and the remedies imposed remain open for discussion.

  14. Long-term biatrial recordings in post-operative atrial fibrillation.

    Science.gov (United States)

    Masè, M; Graffigna, A; Sinelli, S; Pallaoro, G; Nollo, G; Ravelli, F

    2010-01-01

    Although atrial fibrillation (AF) is a common complication of cardiac surgery, its pathophysiology remains unclear. The study of post-operative AF demands for the recording of cardiac electrical activity in correspondence of AF onset and progression. Long-term recordings in post-surgery patients could provide this information, but, to date, have been limited to surface signals, which precludes a characterization of the arrhythmic triggers and substrate. In this study we demonstrate the feasibility of a continuous long-term recording of atrial electrical activities from the right and left atria in post-surgery patients. Local atrial epicardial electrograms are acquired by positioning temporary pacing wires in the right and left atria at the end of the intervention, while three day recordings are obtained by a digital holter recorder, adapted to epicardial signal features. The capability of the system to map local atrial activity and the possibility to obtain quantitative information on atrial rate and synchronization from the processed epicardial signals are proven in representative examples. The quantitative description of local atrial properties opens new perspective in the investigation of post-surgery AF.

  15. Long-term MRA follow-up after coiling of intracranial aneurysms: impact on mood and anxiety

    International Nuclear Information System (INIS)

    Ferns, Sandra P.; Nieuwkerk, Pythia T.; Majoie, Charles B.L.M.; Rooij, Willem Jan J. van; Rinkel, Gabriel J.E.

    2011-01-01

    Magnetic resonance angiography (MRA) screening for recurrence of a coiled intracranial aneurysm and formation of new aneurysms long-term after coiling may induce anxiety and depression. In coiled patients, we evaluated effects on mood and level of anxiety from long-term follow-up MRA in comparison to general population norms. Of 162 patients participating in a long-term (>4.5 years) MRA follow-up after coiling, 120 completed the EQ-5D questionnaire, a visual analog health scale and a self-developed screening related questionnaire at the time of MRA. Three months later, the same questionnaires were completed by 100 of these 120 patients. Results were compared to general population norms adjusted for gender and age. Any problem with anxiety or depression was reported in 56 of 120 patients (47%; 95%CI38 56%) at baseline and 42 of 100 patients (42%; 95%CI32 52%) at 3 months, equally for screen-positives and -negatives. Compared to the reference population, participants scored 38% (95%CI9 67%) and 27% (95%CI4 50%) more often any problem with anxiety or depression. Three months after screening, 21% (20 of 92) of screen-negatives and 13% (one of eight) of screen-positives reported to be less afraid of subarachnoid hemorrhage (SAH) compared to before screening. One of eight screen-positives reported increased fear of SAH. Patients with coiled intracranial aneurysms participating in long-term MRA screening reported significantly more often to be anxious or depressed than a reference group. Screening did not significantly increase anxiety or depression temporarily. However, subjectively, patients did report an increase in anxiety caused by screening, which decreased after 3 months. (orig.)

  16. Long-term MRA follow-up after coiling of intracranial aneurysms: impact on mood and anxiety

    Energy Technology Data Exchange (ETDEWEB)

    Ferns, Sandra P.; Nieuwkerk, Pythia T.; Majoie, Charles B.L.M. [Academic Medical Center, Department of Radiology, Amsterdam (Netherlands); Rooij, Willem Jan J. van [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Rinkel, Gabriel J.E. [University Medical Center, Department of Neurology, Rudolf Magnus Institute of Neuroscience, Utrecht (Netherlands)

    2011-05-15

    Magnetic resonance angiography (MRA) screening for recurrence of a coiled intracranial aneurysm and formation of new aneurysms long-term after coiling may induce anxiety and depression. In coiled patients, we evaluated effects on mood and level of anxiety from long-term follow-up MRA in comparison to general population norms. Of 162 patients participating in a long-term (>4.5 years) MRA follow-up after coiling, 120 completed the EQ-5D questionnaire, a visual analog health scale and a self-developed screening related questionnaire at the time of MRA. Three months later, the same questionnaires were completed by 100 of these 120 patients. Results were compared to general population norms adjusted for gender and age. Any problem with anxiety or depression was reported in 56 of 120 patients (47%; 95%CI38<->56%) at baseline and 42 of 100 patients (42%; 95%CI32<->52%) at 3 months, equally for screen-positives and -negatives. Compared to the reference population, participants scored 38% (95%CI9<->67%) and 27% (95%CI4<->50%) more often any problem with anxiety or depression. Three months after screening, 21% (20 of 92) of screen-negatives and 13% (one of eight) of screen-positives reported to be less afraid of subarachnoid hemorrhage (SAH) compared to before screening. One of eight screen-positives reported increased fear of SAH. Patients with coiled intracranial aneurysms participating in long-term MRA screening reported significantly more often to be anxious or depressed than a reference group. Screening did not significantly increase anxiety or depression temporarily. However, subjectively, patients did report an increase in anxiety caused by screening, which decreased after 3 months. (orig.)

  17. Branching of positive discharge streamers in air at varying pressures

    NARCIS (Netherlands)

    Briels, T.M.P.; Veldhuizen, van E.M.; Ebert, U.M.

    2005-01-01

    The formation of positive streamers in a 17-mm gap in air is studied at pressures varying in the range from 1010 to 100 mbar. An intensified charge coupled device camera is used to image the discharge. At high pressures, the discharge shows many branches, while at low pressure, fewer branches arise.

  18. CLIMATE CHANGE: LONG-TERM TRENDS AND SHORT-TERM OSCILLATIONS

    Institute of Scientific and Technical Information of China (English)

    GAO Xin-quan; ZHANG Xin; QIAN Wei-hong

    2006-01-01

    Identifying the Northern Hemisphere (NH) temperature reconstruction and instrumental data for the past 1000 years shows that climate change in the last millennium includes long-term trends and various oscillations. Two long-term trends and the quasi-70-year oscillation were detected in the global temperature series for the last 140 years and the NH millennium series. One important feature was emphasized that temperature decreases slowly but it increases rapidly based on the analysis of different series. Benefits can be obtained of climate change from understanding various long-term trends and oscillations. Millennial temperature proxies from the natural climate system and time series of nonlinear model system are used in understanding the natural climate change and recognizing potential benefits by using the method of wavelet transform analysis. The results from numerical modeling show that major oscillations contained in numerical solutions on the interdecadal timescale are consistent with that of natural proxies. It seems that these oscillations in the climate change are not directly linked with the solar radiation as an external forcing. This investigation may conclude that the climate variability at the interdecadal timescale strongly depends on the internal nonlinear effects in the climate system.

  19. Hyperspectral Estimation of the Chlorophyll Content in Short-Term and Long-Term Restorations of Mangrove in Quanzhou Bay Estuary, China

    Directory of Open Access Journals (Sweden)

    Zhiguo Dou

    2018-04-01

    Full Text Available The chlorophyll content can indicate the general health of vegetation, and can be estimated from hyperspectral data. The aim of this study is to estimate the chlorophyll content of mangroves at different stages of restoration in a coastal wetland in Quanzhou, China, using proximal hyperspectral remote sensing techniques. We determine the hyperspectral reflectance of leaves from two mangrove species, Kandelia candel and Aegiceras corniculatum, from short-term and long-term restoration areas with a portable spectroradiometer. We also measure the leaf chlorophyll content (SPAD value. We use partial-least-squares stepwise regression to determine the relationships between the spectral reflectance and the chlorophyll content of the leaves, and establish two models, a full-wave-band spectrum model and a red-edge position regression model, to estimate the chlorophyll content of the mangroves. The coefficients of determination for the red-edge position model and the full-wave-band model exceed 0.72 and 0.82, respectively. The inverted chlorophyll contents are estimated more accurately for the long-term restoration mangroves than for the short-term restoration mangroves. Our results indicate that hyperspectral data can be used to estimate the chlorophyll content of mangroves at different stages of restoration, and could possibly be adapted to estimate biochemical constituents in leaves.

  20. [Prevalence of hypertension in elderly long-term care residents in Spain. The Geriatric HTA study].

    Science.gov (United States)

    Martín-Baranera, Montserrat; Sánchez Ferrín, Pau; Armario, Pedro

    2006-11-11

    This study aimed to estimate the prevalence of hypertension in elderly long-term care residents in Spain and to describe such population in terms of comorbidity and hypertension treatment and control. A countrywide cross-sectional study was conducted in May 2003 among long-term care residents aged 65 or more. Patients in palliative care units were excluded. Hypertension was defined in patients who fulfilled at least one of the following criteria: diagnosis of hypertension on the medical record, antihypertensive medication and/or highest blood pressure values during the previous year > or = 140/90 mmHg. Overall, 13,272 subjects - mean age (standard deviation) 82.9 (7.5) years (range: 65-106 years) - were included from 223 centres; 70.6% were women. Almost 2 thirds of patients met at least one hypertension criterion (8,242 patients, 62.1%; 95% confidence interval, 61.3-62.9%). In those patients, other frequent cardiovascular risk factors were obesity (26.3%), diabetes (25.7%) and dislipemia (23.8%). A concomitant diagnosis of dementia, peripheral vascular disease, stroke or congestive heart failure was present in 37.1%, 28.3%, 26.0% and 25.1%, respectively. The proportion of hypertensive patients receiving at least one antihypertensive drug was 69.7%. Diuretics were the most commonly used agents (46.3%), followed by angiotensine converting enzyme inhibitors (34.6%). The latest blood pressure measurement was < 140/90 mmHg in 60.4% of the hypertensive patients. Elderly long-term care residents in Spain showed a high prevalence of hypertension and other cardiovascular risk factors, and a substantial degree of associated clinical conditions. The proportion of antihypertensive drug therapy was comparable to those reported in similar studies.

  1. Impact of long-term and short-term therapies on seminal parameters

    Directory of Open Access Journals (Sweden)

    Jlenia Elia

    2013-04-01

    Full Text Available Aim: The aim of this work was: i to evaluate the prevalence of male partners of subfertile couples being treated with long/short term therapies for non andrological diseases; ii to study their seminal profile for the possible effects of their treatments on spermatogenesis and/or epididymal maturation. Methods: The study group was made up of 723 subjects, aged between 25 and 47 years. Semen analysis was performed according to World Health Organization (WHO guidelines (1999. The Superimposed Image Analysis System (SIAS, which is based on the computerized superimposition of spermatozoa images, was used to assess sperm motility parameters. Results: The prevalence of subjects taking pharmacological treatments was 22.7% (164/723. The prevalence was 3.7% (27/723 for the Short-Term Group and 18.9% (137/723 for the Long-Term Group. The subjects of each group were also subdivided into subgroups according to the treatments being received. Regarding the seminal profile, we did not observe a significant difference between the Long-Term, Short-Term or the Control Group. However, regarding the subgroups, we found a significant decrease in sperm number and progressive motility percentage in the subjects receiving treatment with antihypertensive drugs compared with the other subgroups and the Control Group. Conclusions: In the management of infertile couples, the potential negative impact on seminal parameters of any drugs being taken as Long-Term Therapy should be considered. The pathogenic mechanism needs to be clarified.

  2. Mask pressure effects on the nasal bridge during short-term noninvasive ventilation

    Science.gov (United States)

    Brill, Anne-Kathrin; Pickersgill, Rachel; Moghal, Mohammad; Morrell, Mary J.; Simonds, Anita K.

    2018-01-01

    The aim of this study was to assess the influence of different masks, ventilator settings and body positions on the pressure exerted on the nasal bridge by the mask and subjective comfort during noninvasive ventilation (NIV). We measured the pressure over the nasal bridge in 20 healthy participants receiving NIV via four different NIV masks (three oronasal masks, one nasal mask) at three different ventilator settings and in the seated or supine position. Objective pressure measurements were obtained with an I-Scan pressure-mapping system. Subjective comfort of the mask fit was assessed with a visual analogue scale. The masks exerted mean pressures between 47.6±29 mmHg and 91.9±42.4 mmHg on the nasal bridge. In the supine position, the pressure was lower in all masks (57.1±31.9 mmHg supine, 63.9±37.3 mmHg seated; pmasks, a change of inspiratory positive airway pressure (IPAP) did not influence the objective pressure over the nasal bridge. Subjective discomfort was associated with higher IPAP and positively correlated with the pressure on the skin. Objective measurement of pressure on the skin during mask fitting might be helpful for mask selection. Mask fitting in the supine position should be considered in the clinical routine. PMID:29637077

  3. A cost of long-term memory in Drosophila

    OpenAIRE

    Mery, Frederic; Kawecki, Tadeusz J.

    2005-01-01

    Two distinct forms of consolidated associative memory are known in Drosophila: long-term memory and so-called anesthesia-resistant memory. Long-term memory is more stable, but unlike anesthesia-resistant memory, its formation requires protein synthesis. We show that flies induced to form long-term memory become more susceptible to extreme stress (such as desiccation). In contrast, induction of anesthesia-resistant memory had no detectable effect on desiccation resistance. This finding may hel...

  4. A study of the long-term effect of malar fat repositioning in face lift surgery: short-term success but long-term failure.

    Science.gov (United States)

    Hamra, Sam T

    2002-09-01

    In 1990, the author reported on a series of 403 cases of deep plane face lifts, the first published technique describing the repositioning of the cheek fat, known as malar fat, in face lift surgery. This study examines the long-term results of 20 of the original series in an attempt to determine what areas of the rejuvenated face (specifically, the malar fat) showed long-term improvement. The results were judged by comparing the preoperative and long-term postoperative views in a half-and-half same-side hemiface photograph. The anatomy of the jawline (superficial musculoaponeurotic system [SMAS]), the nasolabial fold (malar fat), and the periorbital diameter were evaluated. The results confirmed that repositioning of the SMAS remained for longer than improvement in the nasolabial fold and that the vertical diameter of the periorbit did not change at all. The early results of malar fat repositioning shown at 1 to 2 years were successful, but the long-term results showed failure of the early improvement, manifested by recurrence of the nasolabial folds. There was, however, continuation of the improved results of the forehead lift and SMAS maneuvers of the original procedure. The conclusion is that only a direct excision will produce a permanent correction of the aging nasolabial fold.

  5. Percutaneous bioprosthetic venous valve: a long-term study in sheep.

    Science.gov (United States)

    Pavcnik, Dusan; Uchida, Barry T; Timmermans, Hans A; Corless, Christopher L; O'Hara, Michael; Toyota, Naoyuki; Moneta, Gregory L; Keller, Frederick S; Rösch, Josef

    2002-03-01

    A long-term evaluation of a new percutaneously placed bioprosthetic, bicuspid venous valve (BVV) consisting of a square stent and small intestinal submucosa (SIS) covering was performed in 12 sheep. Of 26 BVVs placed into the jugular veins, 25 exhibited good valve function on immediate venography and 22 on venograms obtained before the sheep were killed. Gross and histologic examination results demonstrated incorporation of remodeled and endothelialized SIS BVVs into the vein wall. Slight to moderate leaflet thickening was found mostly at their bases. Percutaneously placed SIS BVV is a promising one-way, competent valve that resists venous back-pressure while allowing forward flow.

  6. The vascular basis of the positional influence of the intraocular pressure.

    Science.gov (United States)

    Krieglstein, G K; Waller, W K; Leydhecker, W

    1978-05-02

    By measuring intraocular pressure in different body positions from 60 degrees semiupright to 30 degrees head down, a nonlinear relationship between IOP increase and body position was confirmed. IOP postural response in individual subjects was roughly correlated to ophthalmic arterial pressure and to the episcleral venous pressure postural response. In one series of subjects, the episcleral venous pressure increments due to posture wa; parallel to the applanation-indentation disparity in the same individual eyes. Differential tonometry with applanation or indentation procedures under blind conditions gave significantly low indentation readings. It is concluded that IOP postural response depends on arterial and venous vascular changes when subjects move from an erect to a horizontal body position. Blood expulsion from the choroid by indentation tonometry might be the reason that this tonometric procedure does not measure IOP changes based on vascular changes.

  7. Developmental Dyslexia and Explicit Long-Term Memory

    Science.gov (United States)

    Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano

    2010-01-01

    The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

  8. Fiscal 1999 survey report on survey of long-term strategy on energy technology. Long-term energy technological strategy survey (Long-term energy technological strategy survey); 1999 nendo choki energy gijutsu senryaku nado ni kansuru chosa hokokusho. Choki energy gijutsu senryaku chosa (choki energy gijutsu senryaku chosa))

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-03-01

    To enhance still more effectively the research and development of energy-related/environmental technologies, research and development strategies have to be worked out from a long-term view point and policy resources such as investment in research and development should be optimally distributed after clarifying and defining the course to follow toward the achievement of research and development goals. This project aims to conduct studies, and to show the course to follow in the future, towards the establishment of a long-term energy technological strategy by investigating energy systems for around 2050, interim energy systems at the intermediate stage, and innovative energy technologies for realizing such energy systems. In Chapter 1, the position of the survey and its purpose and prerequisites are shown. In Chapter 2, the history of social and economic conditions surrounding energy/environmental technologies and of energy situation up to the present time is compiled, and the outlook is analyzed and predicted. In Chapter 3, formulation of a long-term energy technological strategy is discussed. In Chapter 5, how to embody such a strategy is shown. (NEDO)

  9. Advancing an ethical framework for long-term care.

    Science.gov (United States)

    Carter, Mary Whelan

    2002-02-01

    This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

  10. Long-term memory, sleep, and the spacing effect.

    Science.gov (United States)

    Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody

    2014-01-01

    Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

  11. Long-term course of opioid addiction.

    Science.gov (United States)

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas

    2015-01-01

    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  12. Microclimatic effects on outdoor radon and its progeny in a long-term study

    International Nuclear Information System (INIS)

    Schuetz, M.; Keller, G.; Kappel, R.J.A.

    1994-01-01

    The dose due to the long term radon exposure is estimated from the radon concentration and from an equilibrium factor that in the literature is reported with a wide uncertainty. Therefore the radon equilibrium factor outdoors and its dependence on climatic effects should be investigated in a long-term study. Both the outdoor concentrations of radon and of its progeny near Ellweiler/Hunsrueck were measured continuously during 12 months and the resulting equilibrium factors were determined. Simultaneously to the every 2 hour's radon data many meterological parameters as temperature and relative to humidity of the air, barometric pressure and duration and amount of rainfall were recorded. At a height of 6 meters above ground and in 10 minute intervals the local wind direction and velocity were registered. By that a set of more than 3000 single measurements of the equilibrium factor and of the corresponding weather conditions was collected

  13. Pressure Indication of 3013 Inner Containers Using Digital Radiography

    International Nuclear Information System (INIS)

    HENSEL, SJ

    2004-01-01

    Plutonium bearing materials packaged for long term storage per the Department of Energy Standard 3013 (DOE-STD-3013) are required to be examined periodically in a non-destructive manner (i.e. without compromising the storage containers) for pressure buildup. Radiography is the preferred technology for performing the examinations. The concept is to measure and record the container lid position. As a can pressurizes the lid will deflect outward and thus provide an indication of the internal pressure. A radiograph generated within 30 days of creation of each storage container serves as the baseline from which future surveillance examinations will be compared. A problem with measuring the lid position was discovered during testing of a digital radiography system. The solution was to provide a distinct feature upon the lower surface of the container lid from which the digital radiography system could easily track the lid position

  14. Effects of positive end-expiratory pressure on renal function.

    Science.gov (United States)

    Järnberg, P O; de Villota, E D; Eklund, J; Granberg, P O

    1978-01-01

    The effects were studied positive end-expiratory pressure (PEEP) on renal function in eight patients with acute respiratory failure, requiring mechanical ventilation. On application of PEEP + 10 cm H2O, central venous pressure increased, systolic blood pressure decreased, urine flow and PAH-clearance were reduced, while inulin clearance remained stable. There was a marked increase in fractional sodium reabsorption and a concurrent decrease in fractional osmolal excretion. Fractional free-water clearance and the ratio UOsm/POsm did change.

  15. Long-term (1993-2013) changes in macrozooplankton off the Western Antarctic Peninsula

    Science.gov (United States)

    Steinberg, Deborah K.; Ruck, Kate E.; Gleiber, Miram R.; Garzio, Lori M.; Cope, Joseph S.; Bernard, Kim S.; Stammerjohn, Sharon E.; Schofield, Oscar M. E.; Quetin, Langdon B.; Ross, Robin M.

    2015-07-01

    The Western Antarctic Peninsula (WAP) is one of the most rapidly warming regions on Earth, and where a high apex predator biomass is supported in large part by macrozooplankton. We examined trends in summer (January-February) abundance of major taxa of macrozooplankton along the WAP over two decades (1993-2013) and their relationship with environmental parameters (sea ice, atmospheric climate indices, sea surface temperature, and phytoplankton biomass and productivity). Macrozooplankton were collected from the top 120 m of the water column in a mid-Peninsula study region divided into latitudinal (North, South, and Far South) and cross-shelf (coastal, shelf, slope) sub-regions. Trends for krill species included a 5-year cycle in abundance peaks (positive anomalies) for Euphausia superba, but no directional long-term trend, and an increase in Thysanoessa macrura in the North; variability in both species was strongly influenced by primary production 2-years prior. E. crystallorophias abundance was best explained by the Southern Annular Mode (SAM) and Multivariate El Niño Southern Oscillation Index (MEI), and was more abundant in higher ice conditions. The salp Salpa thompsoni and thecosome pteropod Limacina helicina cycled between negative and positive anomalies in the North, but showed increasing positive anomalies in the South over time. Variation in salp and pteropod abundance was best explained by SAM and the MEI, respectively, and both species were more abundant in lower ice conditions. There was a long-term increase in some carnivorous gelatinous zooplankton (polychaete worm Tomopteris spp.) and amphipods. Abundance of Pseudosagitta spp. chaetognaths was closely related to SAM, with higher abundance tied to lower ice conditions. Long-term changes and sub-decadal cycles of WAP macrozooplankton community composition may affect energy transfer to higher trophic levels, and alter biogeochemical cycling in this seasonally productive and sensitive polar ecosystem.

  16. Essays on long-term mortality and interest rate risk

    NARCIS (Netherlands)

    de Kort, J.P.

    2017-01-01

    This dissertation comprises a study of long-term risks which play a major role in actuarial science. In Part I we analyse long-term mortality risk and its impact on consumption and investment decisions of economic agents, while Part II focuses on the mathematical modelling of long-term interest

  17. A novel stent inflation protocol improves long-term outcomes compared with rapid inflation/deflation deployment method.

    Science.gov (United States)

    Vallurupalli, Srikanth; Kasula, Srikanth; Kumar Agarwal, Shiv; Pothineni, Naga Venkata K; Abualsuod, Amjad; Hakeem, Abdul; Ahmed, Zubair; Uretsky, Barry F

    2017-08-01

    High-pressure inflation for coronary stent deployment is universally performed. However, the duration of inflation is variable and does not take into account differences in lesion compliance. We developed a standardized "pressure optimization protocol" (POP) using inflation pressure stability rather than an arbitrary inflation time or angiographic balloon appearance for stent deployment. Whether this approach improves long-term outcomes is unknown. 792 patients who underwent PCI using either rapid inflation/deflation (n = 376) or POP (n = 416) between January 2009 and March 2014 were included. Exclusion criteria included PCI for acute myocardial infarction, in-stent restenosis, chronic total occlusion, left main, and saphenous vein graft lesions. Primary endpoint was target vessel failure [TVF = combined end point of target vessel revascularization (TVR), myocardial infarction, and cardiac death]. Outcomes were analyzed in the entire cohort and in a propensity analysis. Stent implantation using POP with a median follow-up of 1317 days was associated with lower TVF compared with rapid inflation/deflation (10.1 vs. 17.8%, P inflation/deflation (10 vs. 18%, P < 0.0001). Stent deployment using POP led to reduced TVF compared to rapid I/D. These results recommend this method to improve long-term outcomes. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Ambulatory blood pressure monitoring-derived short-term blood pressure variability in primary hyperparathyroidism.

    Science.gov (United States)

    Concistrè, A; Grillo, A; La Torre, G; Carretta, R; Fabris, B; Petramala, L; Marinelli, C; Rebellato, A; Fallo, F; Letizia, C

    2018-04-01

    Primary hyperparathyroidism is associated with a cluster of cardiovascular manifestations, including hypertension, leading to increased cardiovascular risk. The aim of our study was to investigate the ambulatory blood pressure monitoring-derived short-term blood pressure variability in patients with primary hyperparathyroidism, in comparison with patients with essential hypertension and normotensive controls. Twenty-five patients with primary hyperparathyroidism (7 normotensive,18 hypertensive) underwent ambulatory blood pressure monitoring at diagnosis, and fifteen out of them were re-evaluated after parathyroidectomy. Short-term-blood pressure variability was derived from ambulatory blood pressure monitoring and calculated as the following: 1) Standard Deviation of 24-h, day-time and night-time-BP; 2) the average of day-time and night-time-Standard Deviation, weighted for the duration of the day and night periods (24-h "weighted" Standard Deviation of BP); 3) average real variability, i.e., the average of the absolute differences between all consecutive BP measurements. Baseline data of normotensive and essential hypertension patients were matched for age, sex, BMI and 24-h ambulatory blood pressure monitoring values with normotensive and hypertensive-primary hyperparathyroidism patients, respectively. Normotensive-primary hyperparathyroidism patients showed a 24-h weighted Standard Deviation (P blood pressure higher than that of 12 normotensive controls. 24-h average real variability of systolic BP, as well as serum calcium and parathyroid hormone levels, were reduced in operated patients (P blood pressure variability is increased in normotensive patients with primary hyperparathyroidism and is reduced by parathyroidectomy, and may potentially represent an additional cardiovascular risk factor in this disease.

  19. ERDA's long-term waste management goals and programs

    International Nuclear Information System (INIS)

    Perge, A.F.; Trice, V.G. Jr.; Walton, R.D. Jr.

    1976-01-01

    This paper presents an overview of the ERDA's major program for the long-term waste management of radioactive waste and provides a perspective for symposium participants with regard to the interrelationship of specific components of the program that are discussed in detail in other ERDA-sponsored papers. Needs, goals, and plans are reviewed for ERDA's management of the commercially generated wastes which are expected to be delivered to ERDA in accordance with Federal regulations. At present, ERDA responsibilities include long-term management of commercial-level wastes. Possible future regulations may give ERDA responsibility for the long-term management of commercial low-level solid wastes contaminated with transuranic nuclides. Primary planning goals and programs for the development of terminal storage facilities and waste processing technology to produce acceptable waste forms for long-term management are reviewed for each of the waste types identified above. The status of development programs for the long-term management of airborne radionuclides, which may be required at some time in the future, is also reviewed. (author)

  20. Long-term Care in Denmark and Lithuania

    DEFF Research Database (Denmark)

    Poskute, Virginija; Greve, Bent

    2017-01-01

    , at the outset, seemingly dissimilar, the analysis also shows similarities especially in the expectation of the role of the civil society, and that the elderly will want to stay as long as possible in their own home. There is also expected pressure from demography change, and, especially, a possible pressure...... on women as they, more often than men, provide informal care and will have a higher risk of living alone when they become elderly. Lastly, the use of rehabilitation and re-enablement is a central parameter for a possible reduction in the pressure on spending as well as improving quality of life...

  1. Long-Term Clock Behavior of GPS IIR Satellites

    National Research Council Canada - National Science Library

    Epstein, Marvin; Dass, Todd; Rajan, John; Gilmour, Paul

    2007-01-01

    .... Rubidium clocks, as opposed to cesium clocks, have significant long-term drift. The current literature describes an initial model of drift aging for rubidium atomic clocks followed by a long-term characteristic...

  2. Continuous positive airway pressure: Physiology and comparison of devices.

    Science.gov (United States)

    Gupta, Samir; Donn, Steven M

    2016-06-01

    Nasal continuous positive airway pressure (CPAP) is increasingly used for respiratory support in preterm babies at birth and after extubation from mechanical ventilation. Various CPAP devices are available for use that can be broadly grouped into continuous flow and variable flow. There are potential physiologic differences between these CPAP systems and the choice of a CPAP device is too often guided by individual expertise and experience rather than by evidence. When interpreting the evidence clinicians should take into account the pressure generation sources, nasal interface, and the factors affecting the delivery of pressure, such as mouth position and respiratory drive. With increasing use of these devices, better monitoring techniques are required to assess the efficacy and early recognition of babies who are failing and in need of escalated support. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Impact of Short-Term Training Camp on Aortic Blood Pressure in Collegiate Endurance Runners

    Directory of Open Access Journals (Sweden)

    Tsubasa Tomoto

    2018-03-01

    Full Text Available To investigate the influence of short-term vigorous endurance training on aortic blood pressure (BP, pulse wave analysis was performed in 36 highly trained elite collegiate endurance runners before and after a 7-day intense training camp. Subjects participated three training sessions per day, which mainly consisted of long distance running and sprint training to reach the daily target distance of 26 km. After the camp, they were divided into two groups based on whether the target training was achieved. Aortic systolic BP, pulse pressure, and tension-time index (TTI, a surrogate index of the myocardial oxygen demand were significantly elevated after the camp in the accomplished group but not in the unaccomplished group, whereas the brachial BP remained unchanged in both groups. The average daily training distance was significantly correlated with the changes in aortic systolic BP (r = 0.608, p = 0.0002, pulse pressure (r = 0.415, p = 0.016, and TTI (r = 0.438, p = 0.011. These results suggest that aortic BP is affected by a short-term vigorous training camp even in highly trained elite endurance athletes presumably due to a greater training volume compared to usual.

  4. Long-term properties of bituminized waste products

    International Nuclear Information System (INIS)

    Snellman, M.; Valkiainen, M.

    1985-10-01

    This study is a survey of the factors of importance for the long term behaviour of bituminized ion exchange resins. Phenomena occurring in bituminized waste products affected by the treatment, storage and disposal are identified. Test methods have been developed for characterizing product properties, which are important for the long-term behaviour. The long-term properties of bituminized ion-exchange resins are studied in a repository environment with access of water equilibrated with concrete. In these circumstances the most important properties are related to the interactions of bituminized waste with the surrounding barriers. The most important phenomena are water uptake due to rehydration of the resins and subsequent swelling of the product

  5. Long-term properties of bituminized waste products

    International Nuclear Information System (INIS)

    Snellman, M.; Valkiainen, M.

    1985-10-01

    This study is a survey of the factors of importance for long term behaviour of bituminized ion exchange resins. Phenomena occurring in bituminized waste products affected by the treatment, storage and disposal are identified. Test methods have been developed for characterizing product properties, which are important for the long-term behaviour. The long-term properties of bituminized ion-exchange resins are studied in a repository environment with access of water equilibrated with concrete. In these circumstances the most important properties are ralated to the interactions of bituminized waste with the surrounding barriers. The most important phenomena are water uptake due to rehydration of the resins and subsequent swelling of the product. (author)

  6. Space ventures and society long-term perspectives

    Science.gov (United States)

    Brown, W. M.

    1985-01-01

    A futuristic evaluation of mankind's potential long term future in space is presented. Progress in space will not be inhibited by shortages of the Earth's physical resources, since long term economic growth will be focused on ways to constrain industrial productivity by changing social values, management styles, or government competence. Future technological progress is likely to accelerate with an emphasis on international cooperation, making possible such large joint projects as lunar colonies or space stations on Mars. The long term future in space looks exceedingly bright even in relatively pessimistic scenarios. The principal driving forces will be technological progress, commercial and public-oriented satellites, space industrialization, space travel, and eventually space colonization.

  7. Microcrack growing and long-term mechanical stability in a HLW deep-borehole repository in granite

    International Nuclear Information System (INIS)

    Biurrun, E.; Hahne, K.

    1989-01-01

    The long-term host rock integrity assessment of a deep borehole emplacement for HLW in granite has been addressed with a detailed new constitutive model considering temperature and pressure effects on microscale phenomena (as microcracking) under repository conditions. The results of these finite element calculations have been compared with results obtained using conventional, state-of-the-art constitutive modelling. While the results of conventional modelling did suggest the existence of an important safety margin before failure, the improved calculations with the new model predict a thin but very long region of degradated host rock along the waste canister column. The results obtained up to now may well be considered as safety relevant, because they suggest that the actual long-term granite strength lies well below the conventionally determined failure limits, thus challenging the barrier properties of this host rock if the actual strength is not properly considered in the repository design

  8. Decreased "ineffective erythropoiesis" preserves polycythemia in mice under long-term hypoxia.

    Science.gov (United States)

    Harada, Tomonori; Tsuboi, Isao; Hirabayashi, Yukio; Kosaku, Kazuhiro; Naito, Michiko; Hara, Hiroyuki; Inoue, Tohru; Aizawa, Shin

    2015-05-01

    Hypoxia induces innumerable changes in humans and other animals, including an increase in peripheral red blood cells (polycythemia) caused by the activation of erythropoiesis mediated by increased erythropoietin (EPO) production. However, the elevation of EPO is limited and levels return to normal ranges under normoxia within 5-7 days of exposure to hypoxia, whereas polycythemia continues for as long as hypoxia persists. We investigated erythropoiesis in bone marrow and spleens from mouse models of long-term normobaric hypoxia (10 % O2) to clarify the mechanism of prolonged polycythemia in chronic hypoxia. The numbers of erythroid colony-forming units (CFU-E) in the spleen remarkably increased along with elevated serum EPO levels indicating the activation of erythropoiesis during the first 7 days of hypoxia. After 14 days of hypoxia, the numbers of CFU-E returned to normoxic levels, whereas polycythemia persisted for >140 days. Flow cytometry revealed a prolonged increase in the numbers of TER119-positive cells (erythroid cells derived from pro-erythroblasts through mature erythrocyte stages), especially the TER119 (high) CD71 (high) population, in bone marrow. The numbers of annexin-V-positive cells among the TER119-positive cells particularly declined under chronic hypoxia, suggesting that the numbers of apoptotic cells decrease during erythroid cell maturation. Furthermore, RT-PCR analysis showed that the RNA expression of BMP-4 and stem cell factor that reduces apoptotic changes during erythroid cell proliferation and maturation was increased in bone marrow under hypoxia. These findings indicated that decreased apoptosis of erythroid cells during erythropoiesis contributes to polycythemia in mice during chronic exposure to long-term hypoxia.

  9. Short- to long-term results of Ahmed glaucoma valve in the management of elevated intraocular pressure in patients with pediatric uveitis.

    Science.gov (United States)

    Eksioglu, Umit; Yakin, Mehmet; Sungur, Gulten; Satana, Banu; Demirok, Gulizar; Balta, Ozgur; Ornek, Firdevs

    2017-06-01

    The aim of this study was to evaluate the long-term outcome of Ahmed glaucoma valve (AGV) implant for elevated intraocular pressure (IOP) in pediatric patients with uveitis. This was a retrospective chart review. The study included 16 eyes (11 children) with uveitis. Success was defined as having IOP between 6 and 21 mm Hg with (qualified success) or without (complete success) antiglaucoma medications and without the need for further glaucoma or tube extraction surgery. Mean age of patients at the time of AGV implantation was 14.19 ± 3.25 years. AGV implantation was the first glaucoma surgical procedure in 12 eyes (75%). Average postoperative follow-up period was 64.46 ± 33.56 months. Mean preoperative IOP was 33.50 ± 7.30 mm Hg versus 12.69 ± 3.20 mm Hg at the last follow-up visit (p < 0.001). Three eyes (18.7%) were determined as cases of "failure" because of tube removal in 2 eyes and a second AGV implantation in 1 eye. The cumulative probability of complete success was 68.8% at 6 months, 56.3% at 12 months, 49.2% at 36 months, 42.2% at 48 months, and 35.2% at 84 months, and the cumulative probability of eyes without complication was 75.0% at 6 months, 66.7% at 24 months, 58.3% at 36 months, 48.6% at 48 months and 24.3% at 108 months based on Kaplan-Meier survival analysis. Although AGV implant is an effective choice in the management of elevated IOP in pediatric uveitis, antiglaucoma medications are frequently needed for control of IOP. Tube exposure is an important complication in the long term. Differential diagnosis between relapse of uveitis and endophthalmitis is important in patients who received AGV implantation. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

  10. Stability of rapid maxillary expansion and facemask therapy: a long-term controlled study.

    Science.gov (United States)

    Masucci, Caterina; Franchi, Lorenzo; Defraia, Efisio; Mucedero, Manuela; Cozza, Paola; Baccetti, Tiziano

    2011-10-01

    The aim of this prospective controlled study was to evaluate the long-term effects of rapid maxillary expansion and facemask therapy in Class III subjects. Twenty-two subjects (9 boys, 13 girls; mean age, 9.2 years ± 1.6) with Class III disharmony were treated consecutively with rapid maxillary expansion and facemask therapy followed by fixed appliances. The patients were reevaluated at the end of the 2-phase treatment (mean age, 14.5 years ± 1.9) and then recalled about 8.5 years after the end of rapid maxillary expansion and facemask treatment (mean age, 18.7 years ± 2.1). Two groups of controls with untreated Class III malocclusion were used for statistical comparisons of the short-term and long-term intervals. Statistical comparisons were performed with the Mann-Whitney U test. In the long term, no significant differences in maxillary changes were recorded, whereas the treatment group showed significantly smaller increases in mandibular protrusion. The sagittal maxillomandibular skeletal variables maintained significant improvements in the treatment group vs the control groups. In the long term, rapid maxillary expansion and facemask therapy led to successful outcomes in about 73% of the Class III patients. Favorable skeletal changes were mainly due to significant improvements in the sagittal position of the mandible. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  11. Study on long-term behavior of weak rock

    International Nuclear Information System (INIS)

    Okubo, Seisuke

    2003-03-01

    Using the boring core obtained in the Horonobe region, the beta in triaxial compression stress state was acquired, and the examination was carried out on the effect of the confirming pressure on long-term deformation or stability of the sample rock. At first, triaxial compression tests were carried out. In the test, loading rate (strain rate) was changed several times to obtain viscoelastic properties of the sample rock. Multi-stage creep tests were also performed in triaxial compression stress. The parameter set of a constitutive equation of variable compliance type was obtained based on the testing results. In this study, a transparent triaxial cell recently developed by this author was used. The external cylinder of this vessel was made of the transparent acrylic resin. Therefore, gradual deformation of the sample under testing was easily and clearly observed. (author)

  12. Short-term and long-term sick-leave in Sweden

    DEFF Research Database (Denmark)

    Blank, N; Diderichsen, Finn

    1995-01-01

    The primary aim of the study was to analyse similarities and differences between repeated spells of short-term sick-leave (more than 3 spells of less than 7 days' duration in a 12-month period) and long-term absence through sickness (at least 1 spell of more than 59 days' duration in a 12-month p...

  13. The Association between Physical Activity During the Day and Long-Term Memory Stability.

    Science.gov (United States)

    Pontifex, Matthew B; Gwizdala, Kathryn L; Parks, Andrew C; Pfeiffer, Karin A; Fenn, Kimberly M

    2016-12-02

    Despite positive associations between chronic physical activity and memory; we have little understanding of how best to incorporate physical activity during the day to facilitate the consolidation of information into memory, nor even how time spent physically active during the day relates to memory processes. The purpose of this investigation was to examine the relation between physical activity during the day and long-term memory. Ninety-two young adults learned a list of paired-associate items and were tested on the items after a 12-hour interval during which heart rate was recorded continuously. Although the percentage of time spent active during the day was unrelated to memory, two critical physical activity periods were identified as relating to the maintenance of long-term memory. Engaging in physical activity during the period 1 to 2-hours following the encoding of information was observed to be detrimental to the maintenance of information in long-term memory. In contrast, physical activity during the period 1-hour prior to memory retrieval was associated with superior memory performance, likely due to enhanced retrieval processing. These findings provide initial evidence to suggest that long-term memory may be enhanced by more carefully attending to the relative timing of physical activity incorporated during the day.

  14. eLearning, knowledge brokering, and nursing: strengthening collaborative practice in long-term care.

    Science.gov (United States)

    Halabisky, Brenda; Humbert, Jennie; Stodel, Emma J; MacDonald, Colla J; Chambers, Larry W; Doucette, Suzanne; Dalziel, William B; Conklin, James

    2010-01-01

    Interprofessional collaboration is vital to the delivery of quality care in long-term care settings; however, caregivers in long-term care face barriers to participating in training programs to improve collaborative practices. Consequently, eLearning can be used to create an environment that combines convenient, individual learning with collaborative experiential learning. Findings of this study revealed that learners enjoyed the flexibility of the Working Together learning resource. They acquired new knowledge and skills that they were able to use in their practice setting to achieve higher levels of collaborative practice. Nurses were identified as team leaders because of their pivotal role in the long-term care home and collaboration with all patient care providers. Nurses are ideal as knowledge brokers for the collaborative practice team. Quantitative findings showed no change in learner's attitudes regarding collaborative practice; however, interviews provided examples of positive changes experienced. Face-to-face collaboration was found to be a challenge, and changes to organizations, systems, and technology need to be made to facilitate this process. The Working Together learning resource is an important first step toward strengthening collaboration in long-term care, and the pilot implementation provides insights that further our understanding of both interprofessional collaboration and effective eLearning.

  15. Long-term associations of modeled and self-reported measures of exposure to air pollution and noise at residence on prevalent hypertension and blood pressure.

    Science.gov (United States)

    Pitchika, Anitha; Hampel, Regina; Wolf, Kathrin; Kraus, Ute; Cyrys, Josef; Babisch, Wolfgang; Peters, Annette; Schneider, Alexandra

    2017-09-01

    Air pollution, traffic noise and noise annoyance are suggested to be associated with hypertension and blood pressure (BP); however, the evidence remains inconsistent. Our study examined the long-term associations of modeled and self-reported measures of air pollution and traffic noise on prevalent hypertension and BP. We analyzed cross-sectional data from 2552 participants aged 31-72years from the KORA F4 (2006-2008) study conducted in the region of Augsburg, Germany. Land-use regression models were used to estimate residential long-term exposure to particulate matter residences. Participants filled-in a questionnaire on noise annoyance and heavy traffic passing their residence. Linear and logistic regression models adjusting for confounders were used to assess the association between exposure measures and hypertension and BP. An interquartile increase in annual mean PM 2.5 (1μg/m 3 ) was significantly associated with 15% higher prevalence of hypertension, without (95% CI: 2.5; 28.0%) and with (95% CI: 0.7; 30.8%) adjustment for traffic noise. Diastolic blood pressure (DBP) was associated with air pollutants and traffic noise with percent increases in mean of 0.7 (95% CI: 0.2; 1.2), 0.6 (95% CI: 0.1; 1.1) and 0.3 (95% CI: 0.0; 0.7) for an interquartile increase in PM 2.5 (1μg/m 3 ) and PM 2.5 abs (0.2∗10 -5 /m), and 5dB(A) increase in 24-hour road traffic noise, respectively. Associations of PM 2.5 abs and NO 2 with hypertension or DBP were stronger in men and diabetic individuals. No clear associations were seen with systolic BP or noise annoyance. In conclusion, self-reported measures of air pollution or noise did not perform better than the objective measures. Our findings provide further evidence for a link between air pollution, noise and cardiovascular disease and indicate a stronger association for men and diabetic individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Long-term bedrock behavior research for soft rock

    International Nuclear Information System (INIS)

    Inoue, Hiroyuki; Noda, Kenji

    2002-02-01

    When a formation disposal system is thought about, it is important to evaluate long-term dynamics behavior of boundary condition and near field bedrock of an artificial barrier adequately. In this study, three matters were executed for improvement of a dependability of the evaluation as follows. (1) Creep test was executed as purpose by dependability improvement of evaluation technique of creep problem by Okubo model. Okubo model constant was calculated than the unconfined compression test which let strain rate change with true rock, and the creep test which the constant was used, and estimated breaking time was done. As a result, the estimation of breaking time by Okubo model almost suffered according to the estimation although a variation of test-piece influenced it. (2) A tunnel model apparatus was produced in the purpose which grasped near field bedrock behavior, and it was tested. Simulation rock test body of 1 m * 1 m * 0.5 m was used for a test, and 15 cm tunnel excavation was carried out in an initial stress bottom. Quantities of inner space displacement were measured in a test, and a hardness-test was done after dismantlement, and looseness area was grasped quantitatively. As a result, the looseness area was able to be estimated with about 17.5 cm than tunnel center position. (3) A test approach in deep underground laboratory was examined, and examination/the in situ test which took advantage of rock core analysis/borehole as purpose and done examination item by grip of long-term bedrock behavior (a bord is taken advantage of, and bord itself is used) was shown. In addition, layout of the deep underground laboratory which carried out various tests about long-term behavior in 3 depth was shown. (author)

  17. [Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals].

    Science.gov (United States)

    Kim, Yunmi; Lee, Ji Yun; Kang, Hyuncheol

    2014-02-01

    This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

  18. Effects of unconsciousness during spinal immobilization on tissue-interface pressures: A randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard.

    Science.gov (United States)

    Hemmes, Baukje; Brink, Peter R G; Poeze, Martijn

    2014-11-01

    Immobilization of the spine of patients with trauma at risk of spinal damage is usually performed using a rigid long spineboard or vacuum mattress, both during prehospital and in-hospital care. However, disadvantages of these immobilization devices in terms of discomfort and tissue-interface pressures have guided the development of soft-layered long spineboards. We compared tissue-interface pressures between awake and anaesthetized (unconscious) patients during immobilization on a rigid spineboard and a soft-layered long spineboard. In this comparative study, 30 anaesthetized patients were randomized to immobilization on either the rigid spineboard or the soft-layered spineboard for the duration of their elective surgery. Tissue-interface pressures measured using an Xsensor pressure-mapping device were compared with those of 30 healthy volunteers who were immobilized sequentially on the rigid spineboard and the soft-layered spineboard. Redness of the sacrum was also recorded for the anaesthetized patients immediately after the surgery. For both anaesthetized patients and awake volunteers, tissue-interface pressures were significantly lower on the soft-layered spineboard than on the rigid spineboard, both at start and after 15min. On the soft-layered spineboard, tissue interface pressure and peak pressure index (PPI) for the sacrum were significantly lower for anaesthetized patients than for awake volunteers. Peak pressures and PPI on the rigid spineboard were equal for both groups. Tissue-interface pressures did not change significantly over time. Redness of the sacrum was significantly more pronounced on the rigid spineboard than on the soft-layered spineboard. This prospective randomized controlled trial shows that using a soft-layered spineboard compared to a rigid spineboard for spinal immobilization resulted in lower tissue-interface pressures in both awake volunteers and anaesthetized patients. Moreover, tissue-interface pressures on the soft

  19. Long-term Conventionally Dosed Vancomycin Therapy In Patients With Orthopaedic Implant-related Infections Seems As Effective And Safe As Long-term Penicillin Or Clindamycin Therapy. A Retrospective Cohort Study Of 103 Patients.

    Science.gov (United States)

    Aleman, Jacomien; Moojen, Dirk Jan F; van Ogtrop, Marc L; Poolman, Rudolf W; Franssen, Eric J F

    2018-01-01

    Objectives : Antimicrobial therapy is one of the cornerstones of orthopaedic implant-related infections (OIRI) treatment. Infections with Gram-positive bacteria are often treated with vancomycin, penicillin or clindamycin. A recent IDSA guideline suggests increasing the dose of vancomycin to increase the trough vancomycin target serum concentrations. This is deemed necessary because of an observed decrease in vancomycin susceptibility among Gram-positive bacteria. However, elevated vancomycin concentrations are correlated with the risk of nephrotoxicity, especially with prolonged therapy. Compared to most countries, rates of resistance against antibiotics among bacteria in the Netherlands are lower for currently available antibiotics, therefore lower target concentrations of vancomycin are probably efficacious for the treatment of infections. In this study we evaluated the efficacy and safety of long-term conventionally dosed vancomycin therapy, as an initial therapy for OIRI, and compared this with long-term penicillin and clindamycin therapy, as initial therapy, in patients with Gram-positive orthopaedic implant-related infections. Methods : A retrospective, observational study was conducted in 103 adult patients treated for OIRI, with vancomycin, penicillin or clindamycin for at least 10 days. The target trough serum concentration of vancomycin was 10-15 mg/l. Results : 74% of our patients were treated successfully with vancomycin, as initial therapy, (no reinfection within 1 year) versus 55% of our patients treated with either an antibiotic of the penicillin class (mostly flucloxacillin) or clindamycin (p=0.08), as initial therapy. For patients treated with vancomycin we observed a serum creatinine increase of 6 μmol/l, for patients treated with either an antibiotic of the penicillin class or clindamycin the serum creatinine increase was 4 μmol/l (p=0.395). Conclusions : In our population of patients with OIRI long-term treatment with conventionally dosed

  20. Long-term skeletal findings in Menkes disease

    International Nuclear Information System (INIS)

    Amador, Eva; Domene, Ruth; Fuentes, Cristian; Carreno, Juan-Carlos; Enriquez, Goya

    2010-01-01

    Skeletal findings in infants with Menkes disease, the most characteristic of which are metaphyseal spurs, long-bone fractures and wormian bones, have been widely reported. However, the changes in skeletal features over time are not well known. The long-term findings differ completely from those initially observed and consist of undertubulation and metaphyseal flaring, similar to the findings seen in some types of bone dysplasia. The initial and long-term radiological features in an 8-year-old boy with Menkes disease are illustrated. (orig.)

  1. Severe bronchopulmonary dysplasia improved by noninvasive positive pressure ventilation: a case report

    Directory of Open Access Journals (Sweden)

    Mann Christian

    2011-09-01

    Full Text Available Abstract Introduction This is the first report to describe the feasibility and effectiveness of noninvasive positive pressure ventilation in the secondary treatment of bronchopulmonary dysplasia. Case presentation A former male preterm of Caucasian ethnicity delivered at 29 weeks gestation developed severe bronchopulmonary dysplasia. At the age of six months he was in permanent tachypnea and dyspnea and in need of 100% oxygen with a flow of 2.0 L/minute via a nasal cannula. Intermittent nocturnal noninvasive positive pressure ventilation was then administered for seven hours daily. The ventilator was set at a positive end-expiratory pressure of 6 cmH2O, with pressure support of 4 cmH2O, trigger at 1.4 mL/second, and a maximum inspiratory time of 0.7 seconds. Over the course of seven weeks, the patient's maximum daytime fraction of inspired oxygen via nasal cannula decreased from 1.0 to 0.75, his respiratory rate from 64 breaths/minute to 50 breaths/minute and carbon dioxide from 58 mmHg to 44 mmHg. Conclusion Noninvasive positive pressure ventilation may be a novel therapeutic option for established severe bronchopulmonary dysplasia. In the case presented, noninvasive positive pressure ventilation achieved sustained improvement in ventilation and thus prepared our patient for safe home oxygen therapy.

  2. The interaction of short-term and long-term memory in phonetic category formation

    Science.gov (United States)

    Harnsberger, James D.

    2002-05-01

    This study examined the role that short-term memory capacity plays in the relationship between novel stimuli (e.g., non-native speech sounds, native nonsense words) and phonetic categories in long-term memory. Thirty native speakers of American English were administered five tests: categorial AXB discrimination using nasal consonants from Malayalam; categorial identification, also using Malayalam nasals, which measured the influence of phonetic categories in long-term memory; digit span; nonword span, a short-term memory measure mediated by phonetic categories in long-term memory; and paired-associate word learning (word-word and word-nonword pairs). The results showed that almost all measures were significantly correlated with one another. The strongest predictor for the discrimination and word-nonword learning results was nonword (r=+0.62) and digit span (r=+0.51), respectively. When the identification test results were partialed out, only nonword span significantly correlated with discrimination. The results show a strong influence of short-term memory capacity on the encoding of phonetic detail within phonetic categories and suggest that long-term memory representations regulate the capacity of short-term memory to preserve information for subsequent encoding. The results of this study will also be discussed with regards to resolving the tension between episodic and abstract models of phonetic category structure.

  3. Association of metabolic syndrome with atypical antipsychotic drug (olanzapine) short term versus long term use

    International Nuclear Information System (INIS)

    Ikram, H.; Ahmed, T.M.; Hayat, A.; Ullah, Q.I.; Nawaz, A.

    2017-01-01

    Objective: To determine the association of metabolic syndrome with atypical antipsychotic drug (olanzapine) short term versus long term use. Study Design: Case control study. Place and Duration of Study: Chemical pathology department Army Medical College Rawalpindi, from Nov 2014 to Oct 2015. Material and Methods: The study was carried out on 240 subjects, 120 cases and 120 controls. For the purpose of the study cases were divided into four groups A, B, C and D according to the duration of drug use. Group A patients included those who the last the drug olanzapine for the last three months. Group B patients included those who were using the drug olanzapine for the last six months. Group C and D included those who were using the drug for last 1 year and more than one year (2-5 years) respectively. By employing non probability convenience sampling technique the data was collected from patients having the diagnosis of psychosis as per DSM IV modified criteria through a proforma and fasting blood samples were drawn. These samples were tested for fasting serum lipid profile and fasting plasma glucose. The data obtained were analyzed using SPSS version 21. For quantitative data Mean and SD were calculated. For qualitative data frequency and percentages were calculated. Qualitative data was compared using chi square test whereas quantitative data was compared using independent sample t-test. Results: There was statistically no significant difference in fasting plasma glucose between group A and B and their controls whereas in group C and D these levels were significantly high as compared to controls. Triglyceride levels were significantly higher and HDL cholesterol levels were significantly lower in all four groups as compared to controls. Comparison of qualitative data which included waist circumference and blood pressure showed statistically no significant rise for group A whereas waist circumference showed insignificant rise and blood pressure showed statistically

  4. Long-term memory of hierarchical relationships in free-living greylag geese.

    Science.gov (United States)

    Weiss, Brigitte M; Scheiber, Isabella B R

    2013-01-01

    Animals may memorise spatial and social information for many months and even years. Here, we investigated long-term memory of hierarchically ordered relationships, where the position of a reward depended on the relationship of a stimulus relative to other stimuli in the hierarchy. Seventeen greylag geese (Anser anser) had been trained on discriminations between successive pairs of five or seven implicitly ordered colours, where the higher ranking colour in each pair was rewarded. Geese were re-tested on the task 2, 6 and 12 months after learning the dyadic colour relationships. They chose the correct colour above chance at all three points in time, whereby performance was better in colour pairs at the beginning or end of the colour series. Nonetheless, they also performed above chance on internal colour pairs, which is indicative of long-term memory for quantitative differences in associative strength and/or for relational information. There were no indications for a decline in performance over time, indicating that geese may remember dyadic relationships for at least 6 months and probably well over 1 year. Furthermore, performance in the memory task was unrelated to the individuals' sex and their performance while initially learning the dyadic colour relationships. We discuss possible functions of this long-term memory in the social domain.

  5. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency].

    Science.gov (United States)

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert

    2017-01-01

    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  6. A new image for long-term care.

    Science.gov (United States)

    Wager, Richard; Creelman, William

    2004-04-01

    To counter widely held negative images of long-term care, managers in the industry should implement quality-improvement initiatives that include six key strategies: Manage the expectations of residents and their families. Address customers' concerns early. Build long-term customer satisfaction. Allocate resources to achieve exceptional outcomes in key areas. Respond to adverse events with compassion. Reinforce the facility's credibility.

  7. Understanding the use of continuous oscillating positive airway pressure (bubble CPAP) to treat neonatal respiratory disease: an engineering approach.

    Science.gov (United States)

    Manilal-Reddy, P I; Al-Jumaily, A M

    2009-01-01

    A continuous oscillatory positive airway pressure with pressure oscillations incidental to the mean airway pressure (bubble CPAP) is defined as a modified form of traditional continuous positive airway pressure (CPAP) delivery where pressure oscillations in addition to CPAP are administered to neonates with lung diseases. The mechanical effect of the pressure oscillations on lung performance is investigated by formulating mathematical models of a typical bubble CPAP device and a simple representation of a neonatal respiratory system. Preliminary results of the respiratory system's mechanical response suggest that bubble CPAP may improve lung performance by minimizing the respiratory system impedance and that the resonant frequency of the respiratory system may be a controlling factor. Additional steps in terms of clinical trials and a more complex respiratory system model are required to gain a deeper insight into the mechanical receptiveness of the respiratory system to pressure oscillations. However, the current results are promising in that they offer a deeper insight into the trends of variations that can be expected in future extended models as well as the model philosophies that need to be adopted to produce results that are compatible with experimental verification.

  8. Long-term damage management strategies for optimizing steam generator performance

    International Nuclear Information System (INIS)

    Egan, G.R.; Besuner, P.M.; Fox, J.H.; Merrick, E.A.

    1991-01-01

    Minimizing long-term impact of steam generator operating, maintenance, outage, and replacement costs is the goal of all pressurized water reactor utilities. Recent research results have led to deterministic controls that may be implemented to optimize steam generator performance and to minimize damage accumulation. The real dilemma that utilities encounter is the decision process that needs to be made in the face of uncertain data. Some of these decisions involve the frequency and extent of steam generator eddy current tube inspections; the definition of operating conditions to minimize the rate of corrosion reactions (T (hot) , T (cold) ; and the imposition of strict water quality management guidelines. With finite resources, how can a utility decide which damage management strategy provides the most return for its investment? Aptech Engineering Services, Inc. (APTECH) developed a damage management strategy that starts from a deterministic analysis of a current problem- primary water stress corrosion cracking (PWSCC). The strategy involves a probabilistic treatment that results in long-term performance optimization. By optimization, we refer to minimizing the total cost of operating the steam generator. This total includes the present value costs of operations, maintenance, outages, and replacements. An example of the application of this methodology is presented. (author)

  9. Long-term multipactor discharge in multicarrier systems

    International Nuclear Information System (INIS)

    Anza, S.; Vicente, C.; Gimeno, B.; Boria, V. E.; Armendariz, J.

    2007-01-01

    A new mechanism of long-term multipactor in multicarrier systems is studied employing both analytical and numerical methods. In particular, the investigation is focused on the impact that a realistic secondary emission yield at low energies produces on the development of long term multipactor. A novel analytical model for this interperiod charge accumulation is presented using the traditional multipactor theory for parallel plates, and approximating the multicarrier signal as a single-carrier signal modulated by a pulsed signal envelope. The analytical predictions are verified by numerical simulations for a typical rectangular waveguide. The analytical and numerical results demonstrate that the susceptibility of the system to develop a long-term multipactor discharge increases with higher values of low-energy secondary emission yield

  10. Long-term characteristics of nuclear emulsion

    International Nuclear Information System (INIS)

    Naganawa, N; Kuwabara, K

    2010-01-01

    Long-term characteristics of the nuclear emulsion so called 'OPERA film' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  11. Long-term characteristics of nuclear emulsion

    Science.gov (United States)

    Naganawa, N.; Kuwabara, K.

    2010-02-01

    Long-term characteristics of the nuclear emulsion so called ``OPERA film'' used in the neutrino oscillation experiment, OPERA, has been studied for 8 years since its production or refreshing after it. In the results, it turned out to be excellent in sensitivity, amount of random noise, and refreshing characteristics. The retention capacity of latent image of tracks was also studied. The result will open the way to the recycling of 7,000,000 emulsion films which will remain not developed after 5 years of OPERA's run, and other long-term experiments with emulsion.

  12. A novel inclusion of intermittent generation resources in long term energy auctions

    International Nuclear Information System (INIS)

    Marambio, Rodrigo; Rudnick, Hugh

    2017-01-01

    Long term energy auctions are positioning as a valuable tool in order to attract new investments into power systems, especially in Latin American countries where emergent economies characteristics and their correspondent risks are usually present. Even though the focus of these auctions is the long term, there are short term issues involved which actual auction designs fail to include, resulting in an energy allocation that is not necessarily optimal for the system, a condition which becomes more evident in the presence of intermittent renewable technologies. A novel mechanism is formulated to obtain the optimal allocation in long term energy auctions, considering short term generation profiles from both intermittent and conventional base load technologies, and also their risk aversions. The proposed mechanism is developed and simulations are made for some scenarios in the Chilean power market, with different levels of renewable penetration. Significant cost savings are achieved for the final consumers in relation to energy purchases, in comparison with a mechanism that follows the demand profile. As more renewable intermittent capacity enters the power system it is evident the need for changes in the energy auctions allocation mechanisms, including elements to exploit the synergies among participants in the short term. - Highlights: • Risk management consideration in technology neutral auctions allocation. • Allocation mechanism in technology neutral auctions with intermittent technologies. • Renewable and conventional technologies energy auction offer curves. • Increase bid prices in auctions as a consequence of solar technology support.

  13. Lower Placebo Responses After Long-Term Exposure to Fibromyalgia Pain.

    Science.gov (United States)

    Kosek, Eva; Rosen, Annelie; Carville, Serena; Choy, Ernest; Gracely, Richard H; Marcus, Hanke; Petzke, Frank; Ingvar, Martin; Jensen, Karin B

    2017-07-01

    Knowledge about placebo mechanisms in patients with chronic pain is scarce. Fibromyalgia syndrome (FM) is associated with dysfunctions of central pain inhibition, and because placebo analgesia entails activation of endogenous pain inhibition, we hypothesized that long-term exposure to FM pain would negatively affect placebo responses. In our study we examined the placebo group (n = 37, mean age 45 years) from a 12-week, randomized, double-blind, placebo-controlled trial investigating the effects of milnacipran or placebo. Twenty-two patients were classified as placebo nonresponders and 15 as responders, according to the Patient Global Impression of Change scale. Primary outcome was the change in pressure pain sensitivity from baseline to post-treatment. Secondary outcomes included ratings of clinical pain (visual analog scale), FM effect (Fibromyalgia Impact Questionnaire), and pain drawing. Among placebo responders, longer FM duration was associated with smaller reductions in pressure pain sensitivity (r = .689, P = .004), but not among nonresponders (r = -.348, P = .112). In our study we showed that FM duration influences endogenous pain regulation, because pain levels and placebo-induced analgesia were negatively affected. Our results point to the importance of early FM interventions, because endogenous pain regulation may still be harnessed at that early time. Also, placebo-controlled trials should take FM duration into consideration when interpreting results. This study presents a novel perspective on placebo analgesia, because placebo responses among patients with chronic pain were analyzed. Long-term exposure to fibromyalgia pain was associated with lower placebo analgesia, and the results show the importance of taking pain duration into account when interpreting the results from placebo-controlled trials. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Predicting Discharge to Institutional Long-Term Care After Stroke: A Systematic Review and Metaanalysis.

    Science.gov (United States)

    Burton, Jennifer K; Ferguson, Eilidh E C; Barugh, Amanda J; Walesby, Katherine E; MacLullich, Alasdair M J; Shenkin, Susan D; Quinn, Terry J

    2018-01-01

    Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed. Acute and rehabilitation hospitals. Adults hospitalized for stroke who were newly admitted directly to long-term institutional care at the time of hospital discharge. Factors associated with new institutionalization. From 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long-term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long-term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long-term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long-term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined. Age and stroke severity are important predictors of institutional long-term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long-term care setting.

  15. In search of the elusive long-term price

    International Nuclear Information System (INIS)

    Connor, M.J.; Combs, J.

    1989-01-01

    The Uranium Institute, WNFM, and past USCEA sessions described and compared existing price reporting systems. The McGraw-Hill conference led to a rather heated discussion as to the propriety of spot prices having the influence they do on amounts paid in long-term contracts. The Ux representative proposed a future's market as a way that producers could hedge against some of the uncertainty of volatile spot market. In discussing the search for the elusive long-term price, there are two interrelated issues. The first is obvious-the search for a starting or initializing price that is representative of recently-signed or pending long-term contracts. The second is less obvious, but perhaps more important-the search for a successful mechanism for determining later delivery values in long-term contracts. This paper addresses the question of pricing mechanisms first

  16. Binaural auditory beats affect long-term memory.

    Science.gov (United States)

    Garcia-Argibay, Miguel; Santed, Miguel A; Reales, José M

    2017-12-08

    The presentation of two pure tones to each ear separately with a slight difference in their frequency results in the perception of a single tone that fluctuates in amplitude at a frequency that equals the difference of interaural frequencies. This perceptual phenomenon is known as binaural auditory beats, and it is thought to entrain electrocortical activity and enhance cognition functions such as attention and memory. The aim of this study was to determine the effect of binaural auditory beats on long-term memory. Participants (n = 32) were kept blind to the goal of the study and performed both the free recall and recognition tasks after being exposed to binaural auditory beats, either in the beta (20 Hz) or theta (5 Hz) frequency bands and white noise as a control condition. Exposure to beta-frequency binaural beats yielded a greater proportion of correctly recalled words and a higher sensitivity index d' in recognition tasks, while theta-frequency binaural-beat presentation lessened the number of correctly remembered words and the sensitivity index. On the other hand, we could not find differences in the conditional probability for recall given recognition between beta and theta frequencies and white noise, suggesting that the observed changes in recognition were due to the recollection component. These findings indicate that the presentation of binaural auditory beats can affect long-term memory both positively and negatively, depending on the frequency used.

  17. Very-long-term and short-term chromatic adaptation: are their influences cumulative?

    Science.gov (United States)

    Belmore, Suzanne C; Shevell, Steven K

    2011-02-09

    Very-long-term (VLT) chromatic adaptation results from exposure to an altered chromatic environment for days or weeks. Color shifts from VLT adaptation are observed hours or days after leaving the altered environment. Short-term chromatic adaptation, on the other hand, results from exposure for a few minutes or less, with color shifts measured within seconds or a few minutes after the adapting light is extinguished; recovery to the pre-adapted state is complete in less than an hour. Here, both types of adaptation were combined. All adaptation was to reddish-appearing long-wavelength light. Shifts in unique yellow were measured following adaptation. Previous studies demonstrate shifts in unique yellow due to VLT chromatic adaptation, but shifts from short-term chromatic adaptation to comparable adapting light can be far greater than from VLT adaptation. The question considered here is whether the color shifts from VLT adaptation are cumulative with large shifts from short-term adaptation or, alternatively, does simultaneous short-term adaptation eliminate color shifts caused by VLT adaptation. The results show the color shifts from VLT and short-term adaptation together are cumulative, which indicates that both short-term and very-long-term chromatic adaptation affect color perception during natural viewing. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. Marketing in the long-term care continuum.

    Science.gov (United States)

    Laurence, J Nathan; Kash, Bita A

    2010-04-01

    Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

  19. Long-Term Outcomes of Homografts in the Aortic Valve and Root Position: A 20-Year Experience

    Directory of Open Access Journals (Sweden)

    Joo Yeon Kim

    2016-08-01

    Full Text Available Background: The advantages of using a homograft in valve replacement surgery are the excellent hemodynamic profile, low risk of thromboembolism, and low risk of prosthetic valve infection. The aim of this study was to evaluate the long-term outcomes of homograft implantation in the aortic valve position. Methods: This is a retrospective study of 33 patients (>20 years old who underwent aortic valve replacement or root replacement with homografts between April 1995 and May 2015. Valves were collected within 24 hours from explanted hearts of heart transplant recipients (<60 years and organ donors who were not suitable for heart transplantation. The median follow-up duration was 35.6 months (range, 0 to 168 months. Results: Aortic homografts were used in all patients. The 30-day mortality rate was 9.1%. The 1- and 5-year survival rates were 80.0%±7.3% and 60.8%±10.1%, respectively. The 1-, 5-, and 10-year freedom from reoperation rates were 92.3%±5.2%, 68.9%±10.2%, and 50.3%±13.6%, respectively. The 1-, 5-, and 10-year freedom from significant aortic dysfunction rates were 91.7%±8.0%, 41.7%±14.2%, and 25.0%±12.5%, respectively. Conclusion: Homografts had the advantages of a good hemodynamic profile and low risk of thromboembolic events, and with good outcomes in cases of aortitis.

  20. Designing indicators of long-term energy supply security

    International Nuclear Information System (INIS)

    Jansen, J.C.; Van Arkel, W.G.; Boots, M.G.

    2004-01-01

    To our knowledge, so far amazingly little research work has been undertaken to construct meaningful indicators of long-run energy supply security for a particular nation or region. Currently, in addressing energy supply security, policy makers tend to emphasise short-term supply disruptions. In contrast, this pre-study accords with the broader Sustainability Outlook in considering the long-term perspective. This report starts with taking stock, in a concise way, of the official EU energy outlook and issues related to the opportunities to administer changes in the energy mix at the level of major energy use categories. Then a brief survey of relevant literature is made on long-term strategies to ensure survival of systems - be it biological, social, etc. - in an environment largely characterised by high uncertainty and a lot of unchartered territory. We found the work of Andrew Stirling very inspiring in this context. Based on his work and considering the limitations of the present research activity, we retained the Shannon index as the best 'simple' indicator of diversity. In the core of the report, the Shannon index is elaborated into four indicators of long-term energy supply security. Stepwise, additional aspects of long-term energy supply security are introduced. These aspects are: Diversification of energy sources in energy supply; Diversification of imports with respect to imported energy sources; Long-term political stability in regions of origin; The resource base in regions of origin, including the home region/country itself. After small adjustments to allow for data availability, these indicators were applied to the reference year 2030 of four long-term scenarios with data of base year 1995 and projections for underlying variables provided by the Netherlands Environmental Assessment Agency (MNP). Preliminary interpretation of the results suggests the usefulness of the indicators presented in this report. A second activity undertaken in this report was

  1. Stress and glucocorticoid receptor-dependent mechanisms in long-term memory: from adaptive responses to psychopathologies.

    Science.gov (United States)

    Finsterwald, Charles; Alberini, Cristina M

    2014-07-01

    A proper response against stressors is critical for survival. In mammals, the stress response is primarily mediated by secretion of glucocorticoids via the hypothalamic-pituitary-adrenocortical (HPA) axis and release of catecholamines through adrenergic neurotransmission. Activation of these pathways results in a quick physical response to the stress and, in adaptive conditions, mediates long-term changes in the brain that lead to the formation of long-term memories of the experience. These long-term memories are an essential adaptive mechanism that allows an animal to effectively face similar demands again. Indeed, a moderate stress level has a strong positive effect on memory and cognition, as a single arousing or moderately stressful event can be remembered for up to a lifetime. Conversely, exposure to extreme, traumatic, or chronic stress can have the opposite effect and cause memory loss, cognitive impairments, and stress-related psychopathologies such as anxiety disorders, depression and post-traumatic stress disorder (PTSD). While more effort has been devoted to the understanding of the negative effects of chronic stress, much less has been done thus far on the identification of the mechanisms engaged in the brain when stress promotes long-term memory formation. Understanding these mechanisms will provide critical information for use in ameliorating memory processes in both normal and pathological conditions. Here, we will review the role of glucocorticoids and glucocorticoid receptors (GRs) in memory formation and modulation. Furthermore, we will discuss recent findings on the molecular cascade of events underlying the effect of GR activation in adaptive levels of stress that leads to strong, long-lasting memories. Our recent data indicate that the positive effects of GR activation on memory consolidation critically engage the brain-derived neurotrophic factor (BDNF) pathway. We propose and will discuss the hypothesis that stress promotes the formation of

  2. Stress and glucocorticoid receptor-dependent mechanisms in long-term memory: from adaptive responses to psychopathologies

    Science.gov (United States)

    Finsterwald, Charles; Alberini, Cristina M.

    2013-01-01

    A proper response against stressors is critical for survival. In mammals, the stress response is primarily mediated by secretion of glucocorticoids via the hypothalamic-pituitaryadrenocortical (HPA) axis and release of catecholamines through adrenergic neurotransmission. Activation of these pathways results in a quick physical response to the stress and, in adaptive conditions, mediates long-term changes in the brain that lead to the formation of long-term memories of the experience. These long-term memories are an essential adaptive mechanism that allows an animal to effectively face similar demands again. Indeed, a moderate stress level has a strong positive effect on memory and cognition, as a single arousing or moderately stressful event can be remembered for up to a lifetime. Conversely, exposure to extreme, traumatic, or chronic stress can have the opposite effect and cause memory loss, cognitive impairments, and stress-related psychopathologies such as anxiety disorders, depression and post-traumatic stress disorder (PTSD). While more effort has been devoted to the understanding of the effects of the negative effects of chronic stress, much less has been done thus far on the identification of the mechanisms engaged in the brain when stress promotes long-term memory formation. Understanding these mechanisms will provide critical information for use in ameliorating memory processes in both normal and pathological conditions. Here, we will review the role of glucocorticoids and glucocorticoid receptors (GRs) in memory formation and modulation. Furthermore, we will discuss recent findings on the molecular cascade of events underlying the effect of GR activation in adaptive levels of stress that leads to strong, long-lasting memories. Our recent data indicate that the positive effects of GR activation on memory consolidation critically engage the brain-derived neurotrophic factor (BDNF) pathway. We propose and will discuss the hypothesis that stress promotes the

  3. Association of vascular access flow with short-term and long-term mortality in chronic haemodialysis patients: a retrospective cohort study.

    Science.gov (United States)

    Wu, Chung-Kuan; Wu, Chia-Lin; Lin, Chia-Hsun; Leu, Jyh-Gang; Kor, Chew-Teng; Tarng, Der-Cherng

    2017-09-24

    To investigate the impact of vascular access flow (Qa) on vascular and all-cause mortality in chronic haemodialysis (HD) patients. Observational cohort study. Single centre. Adult chronic HD patients at the HD unit of Shin Kong Wu Ho-Su Memorial Hospital between 1 January 2003 and 31 December 2003 were recruited. Patients were excluded if they had arteriovenous fistula or arteriovenous graft failure within 3 months before the date of Qa measurement, were aged Short-term and long-term vascular (cardiovascular or cerebrovascular) and all-cause mortality. Qa was positively correlated with CI ( r =0.48, plong-term all-cause mortality (adjusted HR, 1.62; 95% CI 1.11 to 2.37; p=0.013); however, the risk of vascular mortality did not significantly increase after adjustment for confounders. Qa is moderately correlated with cardiac function, and a Qa level of short-term and long-term all-cause mortality in chronic HD patients. © 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.

  4. Sleep Quality, Short-Term and Long-Term CPAP Adherence

    Science.gov (United States)

    Somiah, Manya; Taxin, Zachary; Keating, Joseph; Mooney, Anne M.; Norman, Robert G.; Rapoport, David M.; Ayappa, Indu

    2012-01-01

    Study Objectives: Adherence to CPAP therapy is low in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS). The purpose of the present study was to evaluate the utility of measures of sleep architecture and sleep continuity on the CPAP titration study as predictors of both short- and long-term CPAP adherence. Methods: 93 patients with OSAHS (RDI 42.8 ± 34.3/h) underwent in-laboratory diagnostic polysomnography, CPAP titration, and follow-up polysomnography (NPSG) on CPAP. Adherence to CPAP was objectively monitored. Short-term (ST) CPAP adherence was averaged over 14 days immediately following the titration study. Long-term (LT) CPAP adherence was obtained in 56/93 patients after approximately 2 months of CPAP use. Patients were grouped into CPAP adherence groups for ST ( 4 h) and LT adherence ( 4 h). Sleep architecture, sleep disordered breathing (SDB) indices, and daytime outcome variables from the diagnostic and titration NPSGs were compared between CPAP adherence groups. Results: There was a significant relationship between ST and LT CPAP adherence (r = 0.81, p CPAP adherence groups had significantly lower %N2 and greater %REM on the titration NPSG. A model combining change in sleep efficiency and change in sleep continuity between the diagnostic and titration NPSGs predicted 17% of the variance in LT adherence (p = 0.006). Conclusions: These findings demonstrate that characteristics of sleep architecture, even on the titration NPSG, may predict some of the variance in CPAP adherence. Better sleep quality on the titration night was related to better CPAP adherence, suggesting that interventions to improve sleep on/prior to the CPAP titration study might be used as a therapeutic intervention to improve CPAP adherence. Citation: Somiah M; Taxin Z; Keating J; Mooney AM; Norman RG; Rapoport DM; Ayappa I. Sleep quality, short-term and long-term CPAP adherence. J Clin Sleep Med 2012;8(5):489-500. PMID:23066359

  5. On the relationship between short- and long-term memory

    DEFF Research Database (Denmark)

    Sørensen, Thomas Alrik

    James (1890) divided memory into separate stores; primary and secondary – or short-term and long-term memory. The interaction between the two stores often assumes that information initially is represented in volatile short-term store before entering and consolidating in the more durable long-term......, accepted). Counter to popular beliefs this suggest that long-term memory precedes short-term memory and not vice versa....... memory system (e.g. Atkinson & Shiffrin, 1968). Short-term memory seems to provide a surprising processing bottleneck where only a very limited amount of information can be represented at any given moment (Miller, 1956; Cowan, 2001). A number of studies have investigated the nature of this processing...

  6. The impact of arm position on the measurement of orthostatic blood pressure.

    Science.gov (United States)

    Guss, David A; Abdelnur, Diego; Hemingway, Thomas J

    2008-05-01

    Blood pressure is a standard vital sign in patients evaluated in an Emergency Department. The American Heart Association has recommended a preferred position of the arm and cuff when measuring blood pressure. There is no formal recommendation for arm position when measuring orthostatic blood pressure. The objective of this study was to assess the impact of different arm positions on the measurement of postural changes in blood pressure. This was a prospective, unblinded, convenience study involving Emergency Department patients with complaints unrelated to cardiovascular instability. Repeated blood pressure measurements were obtained using an automatic non-invasive device with each subject in a supine and standing position and with the arm parallel and perpendicular to the torso. Orthostatic hypotension was defined as a difference of >or= 20 mm Hg systolic or >or= 10 mm Hg diastolic when subtracting standing from supine measurements. There were four comparisons made: group W, arm perpendicular supine and standing; group X, arm parallel supine and standing; group Y, arm parallel supine and perpendicular standing; and group Z, arm perpendicular supine and parallel standing. There were 100 patients enrolled, 55 men, mean age 44 years. Four blood pressure measurements were obtained on each patient. The percentage of patients meeting orthostatic hypotension criteria in each group was: W systolic 6% (95% CI 1%, 11%), diastolic 4% (95% CI 0%, 8%), X systolic 8% (95% CI 3%, 13%), diastolic 9% (95% CI 3%, 13%), Y systolic 19% (95% CI 11%, 27%), diastolic 30% (95% CI 21%, 39%), Z systolic 2% (95% CI 0%, 5%), diastolic 2% (95% CI 0%, 5%). Comparison of Group Y vs. X, Z, and W was statistically significant (p postural changes in blood pressure. The combination of the arm parallel when supine and perpendicular when standing may significantly overestimate the orthostatic change. Arm position should be held constant in supine and standing positions when assessing for orthostatic

  7. PSA modeling of long-term accident sequences

    International Nuclear Information System (INIS)

    Georgescu, Gabriel; Corenwinder, Francois; Lanore, Jeanne-Marie

    2014-01-01

    In the context of the extension of PSA scope to include external hazards, in France, both operator (EDF) and IRSN work for the improvement of methods to better take into account in the PSA the accident sequences induced by initiators which affect a whole site containing several nuclear units (reactors, fuel pools,...). These methodological improvements represent an essential prerequisite for the development of external hazards PSA. However, it has to be noted that in French PSA, even before Fukushima, long term accident sequences were taken into account: many insight were therefore used, as complementary information, to enhance the safety level of the plants. IRSN proposed an external events PSA development program. One of the first steps of the program is the development of methods to model in the PSA the long term accident sequences, based on the experience gained. At short term IRSN intends to enhance the modeling of the 'long term' accident sequences induced by the loss of the heat sink or/and the loss of external power supply. The experience gained by IRSN and EDF from the development of several probabilistic studies treating long term accident sequences shows that the simple extension of the mission time of the mitigation systems from 24 hours to longer times is not sufficient to realistically quantify the risk and to obtain a correct ranking of the risk contributions and that treatment of recoveries is also necessary. IRSN intends to develop a generic study which can be used as a general methodology for the assessment of the long term accident sequences, mainly generated by external hazards and their combinations. This first attempt to develop this generic study allowed identifying some aspects, which may be hazard (or combinations of hazards) or related to initial boundary conditions, which should be taken into account for further developments. (authors)

  8. Long-term care financing: lessons from France.

    Science.gov (United States)

    Doty, Pamela; Nadash, Pamela; Racco, Nathalie

    2015-06-01

    POLICY POINTS: France's model of third-party coverage for long-term services and supports (LTSS) combines a steeply income-adjusted universal public program for people 60 or older with voluntary supplemental private insurance. French and US policies differ: the former pay cash; premiums are lower; and take-up rates are higher, in part because employer sponsorship, with and without subsidization, is more common-but also because coverage targets higher levels of need and pays a smaller proportion of costs. Such inexpensive, bare-bones private coverage, especially if marketed as a supplement to a limited public benefit, would be more affordable to those Americans currently most at risk of "spending down" to Medicaid. An aging population leads to a growing demand for long-term services and supports (LTSS). In 2002, France introduced universal, income-adjusted, public long-term care coverage for adults 60 and older, whereas the United States funds means-tested benefits only. Both countries have private long-term care insurance (LTCI) markets: American policies create alternatives to out-of-pocket spending and protect purchasers from relying on Medicaid. Sales, however, have stagnated, and the market's viability is uncertain. In France, private LTCI supplements public coverage, and sales are growing, although its potential to alleviate the long-term care financing problem is unclear. We explore whether France's very different approach to structuring public and private financing for long-term care could inform the United States' long-term care financing reform efforts. We consulted insurance experts and conducted a detailed review of public reports, academic studies, and other documents to understand the public and private LTCI systems in France, their advantages and disadvantages, and the factors affecting their development. France provides universal public coverage for paid assistance with functional dependency for people 60 and older. Benefits are steeply income

  9. What Legislators Need to Know about Long-Term Care Insurance.

    Science.gov (United States)

    Landes, David

    This booklet discusses the potential importance to states of long-term care insurance, describes general policy characteristics, and summarizes state actions to both regulate and promote long-term care insurance. It is intended as a resource for legislators and others involved in long-term care financing and public policy formulation. Long-term…

  10. Private long-term care insurance and state tax incentives.

    Science.gov (United States)

    Stevenson, David G; Frank, Richard G; Tau, Jocelyn

    2009-01-01

    To increase the role of private insurance in financing long-term care, tax incentives for long-term care insurance have been implemented at both the federal and state levels. To date, there has been surprisingly little study of these initiatives. Using a panel of national data, we find that market take-up for long-term care insurance increased over the last decade, but state tax incentives were responsible for only a small portion of this growth. Ultimately, the modest ability of state tax incentives to lower premiums implies that they should be viewed as a small piece of the long-term care financing puzzle.

  11. Long-term excess fat and/or fructose ingestion causes changes in small artery K+ transporter expression and function with effects on blood pressure

    DEFF Research Database (Denmark)

    Olsen, A. K.; Salomonsson, M.; Sørensen, C. M.

    + channels, Na/K-ATPase, and voltage-gated Ca2+ channels are crucial determinants of resistance artery tone. Only scarce information is available on the role of K+ transporters in pathophysiological mechanisms induced by long-term feeding of laboratory rats with either high-fat, high-fructose or high-fat/high-fructose...... diet. HYPOTHESIS: A 28-week diet consisting of high-fat or high-fructose, or both, will lead to changes in K+ transporter expression and function, which will be linked with changes in blood pressure, arterial smooth muscle function, endothelial function and passive structural/mechanical properties....... METHODS: Male Sprague Dawley rats (4 weeks) were randomized into 4 diet groups receiving a diet with normal chow (CTR, N=19), high-fat chow (60% saturated fat, FAT, N=18), high-fructose (10% in drinking water; FRUC, N=15), or a combination of fat/fructose (FAT/FRUC, N=15) for 28 weeks. Systolic blood...

  12. Positive association between short-term ambient air pollution exposure and children blood pressure in China-Result from the Seven Northeast Cities (SNEC) study.

    Science.gov (United States)

    Zeng, Xiao-Wen; Qian, Zhengmin Min; Vaughn, Michael G; Nelson, Erik J; Dharmage, Shyamali C; Bowatte, Gayan; Perret, Jennifer; Chen, Duo-Hong; Ma, Huimin; Lin, Shao; de Foy, Benjamin; Hu, Li-Wen; Yang, Bo-Yi; Xu, Shu-Li; Zhang, Chuan; Tian, Yan-Peng; Nian, Min; Wang, Jia; Xiao, Xiang; Bao, Wen-Wen; Zhang, Ya-Zhi; Dong, Guang-Hui

    2017-05-01

    The impact of ambient air pollution on health causes concerns in China. However, little is known about the association of short-term air pollution exposure with blood pressure (BP) in children. The goal of present study was to assess the association between short-term air pollution and BP in children from a highly polluted area in China. This study enrolled 9354 children in 24 elementary and middle schools (aged 5-17 years) from the Seven Northeast Cities (SNEC) study, respectively, during the period of 2012-2013. Ambient air pollutants, including particulate matter with an aerodynamic diameter of ≤10 μm (PM 10 ), sulfur dioxide (SO 2 ), nitrogen dioxide (NO 2 ) and ozone (O 3 ) on the days (1-5 days) preceding BP examination were collected from local air monitoring stations. Generalized additive models and two-level regression analyses were used to evaluate the relationship between air pollution and BP after adjusting for other covariates. Results showed that with an interquartile range (IQR) increase in PM 10 (50.0 μg/m 3 ) and O 3 (53.0 μg/m 3 ) level during the 5-day mean exposure, positive associations with elevated BP were observed, with an odds ratio of 2.17 (95% CI, 1.61-2.93) for PM 10 and 2.77 (95% CI, 1.94-3.95) for O 3 . Both systolic BP and diastolic BP levels were positively associated with an IQR increase of four air pollutants at different lag times. Specifically, an IQR increase in the 5-day mean of PM 10 and O 3 was associated with elevation of 2.07 mmHg (95% CI, 1.71-2.44) and 3.29 mmHg (95% CI, 2.86-3.72) in systolic BP, respectively. When stratified by sex, positive relationships were observed for elevated BP with NO 2 exposure only in males. This is the first report on the relationship between ambient short-term air pollution exposure and children BP in China. Findings indicate a need to control air pollutants and protect children from heavy air pollution exposure in China. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. The Long-Term Conditions Questionnaire: conceptual framework and item development.

    Science.gov (United States)

    Peters, Michele; Potter, Caroline M; Kelly, Laura; Hunter, Cheryl; Gibbons, Elizabeth; Jenkinson, Crispin; Coulter, Angela; Forder, Julien; Towers, Ann-Marie; A'Court, Christine; Fitzpatrick, Ray

    2016-01-01

    To identify the main issues of importance when living with long-term conditions to refine a conceptual framework for informing the item development of a patient-reported outcome measure for long-term conditions. Semi-structured qualitative interviews (n=48) were conducted with people living with at least one long-term condition. Participants were recruited through primary care. The interviews were transcribed verbatim and analyzed by thematic analysis. The analysis served to refine the conceptual framework, based on reviews of the literature and stakeholder consultations, for developing candidate items for a new measure for long-term conditions. Three main organizing concepts were identified: impact of long-term conditions, experience of services and support, and self-care. The findings helped to refine a conceptual framework, leading to the development of 23 items that represent issues of importance in long-term conditions. The 23 candidate items formed the first draft of the measure, currently named the Long-Term Conditions Questionnaire. The aim of this study was to refine the conceptual framework and develop items for a patient-reported outcome measure for long-term conditions, including single and multiple morbidities and physical and mental health conditions. Qualitative interviews identified the key themes for assessing outcomes in long-term conditions, and these underpinned the development of the initial draft of the measure. These initial items will undergo cognitive testing to refine the items prior to further validation in a survey.

  14. Activity involvement and quality of life of people at different stages of dementia in long term care facilities.

    Science.gov (United States)

    Smit, Dieneke; de Lange, Jacomine; Willemse, Bernadette; Twisk, Jos; Pot, Anne Margriet

    2016-01-01

    Involvement in activities is assumed to positively influence the quality of life of people with dementia, yet activity provision in long-term care remains limited. This study aims to provide more insight into the value of activity involvement for domains of the quality of life of long-term dementia care residents, taking resident characteristics and cognitive status into account. Data were derived from 144 long-term care facilities participating in the second measurement (2010/2011) of the living arrangements for dementia study. Amongst 1144 residents, the relationship between time involved in activities (activity pursuit patterns; RAI-MDS) and quality of life (Qualidem) was studied using multilevel linear regression analyses. Analyses were adjusted for residents' age, gender, neuropsychiatric symptoms, ADL dependency and cognition. To check for effect modification of cognition, interactions terms of the variables activity involvement and cognitive status were added to the analyses. Despite resident's cognitive status, their activity involvement was significantly related to better scores on care relationship, positive affect, restless tense behaviour, social relations, and having something to do. A negative relationship existed between the activity involvement and positive self-image. The explained variance in the quality of life between residents caused by the activity involvement was small. Activity involvement seems to be a small yet important contributor to higher well-being in long-term care resident at all stages of dementia. Adjusting activities to individual preferences and capabilities might enlarge this relationship. Further research is needed to confirm this hypothesis, using measurement instruments less sensitive to recall bias and differentiating between the active and passive activity involvement.

  15. Characteristics of asthma attack with long-term management for bronchial asthma.

    Science.gov (United States)

    Kawahara, Noriko; Hasegawa, Shunji; Hashimoto, Kunio; Matsubara, Tomoyo; Ichiyama, Takashi; Furukawa, Susumu

    2009-10-01

    There have been no reports on the evaluation of the usefulness of long-term asthma management based on the Japanese Pediatric Guideline for the Treatment and Management of Bronchial Asthma 2005 (JPGL 2005). The purpose of the present study was to retrospectively investigate the records of 350 patients admitted to Yamaguchi University Hospital who had asthma attacks from January 2006 to June 2008. There were 149 patients who were treated for more than 3 months in accordance with the guideline (long-term management group) and 201 who were not (non-long-term management group). The patients were divided into three age groups: 100 infants, 159 toddlers, and 91 schoolchildren. The onset age of asthma in the long-term management group was earlier than that in the non-long-term management group in toddlers and schoolchildren. The white blood cell counts and C-reactive protein levels were higher in the non-long-term management group in schoolchildren, suggesting the complication of some infections. The severity of asthma in the long-term management group was greater than that in the non-long-term management group among all three age groups. There were no significant differences, however, in the severity of asthma attack at admission between the long-term and non-long-term management groups in the three age groups. Patients who had severe asthma tended to be treated with long-term management, which suggests that long-term asthma management according to JPGL 2005 may reduce the severity of asthma attack at that admission, because the severity of asthma in patients undergoing long-term management correlates with the severity of asthma attack.

  16. Ni/YSZ microstructure optimization for long-term stability of solid oxide electrolysis cells

    DEFF Research Database (Denmark)

    Hauch, Anne; Brodersen, Karen; Karas, Filip

    2014-01-01

    of keeping the Ni particles in their required positions in the porous Ni/YSZ cermet close to the electrolyte. In this work we report cell tests and microstructures from reference and long-term tested SOEC with varied initial Ni/YSZ ratio with the aim of investigating the effect of changed Ni/YSZ ratio...

  17. Long-term variations of fumarole temperatures on Vulcano Island (Italy

    Directory of Open Access Journals (Sweden)

    Iole Serena Diliberto

    2011-06-01

    Full Text Available Fumarole temperatures are the ultimate results of many processes that are encountered by deep fluids during their passage to the surface. Here, the time variations of high-temperature fumaroles acquired by continuous monitoring are presented, to show the effects of the forces that act on the system. Data acquired by continuous monitoring of fumaroles and the time relationships with the different parameters related to the activity of the volcanic system are discussed. From 1998 to 2010, the temperature and compositional changes of fumarolic gases were monitored at the same time as variations in the number of volcano-seismic events, which indicate frequent variations of energy release (heat and mass flow, and seismic strain release. Geochemical modeling applied to the volcanic system of Vulcano Island suggests that the overall expansion of magmatic gas through the fractured system is an almost iso-enthalpic process at depth, which shifts to an adiabatic process at shallow depth, where the rock permeability increases. Thus, the time variations of the fumarole temperatures reflect various physical variations of the system that can either occur at depth or close to the surface. The temperature monitoring performed in the fumarolic area of La Fossa Cone showed short-term effects related to rain events, and negligible effects related to other external agents (ambient temperature and atmospheric pressure variations. At the same time, the long-term monitoring highlighted some mean-term and long-term variations. These last are the main characters observed in the time-series, and they both appear to be related to endogenous forces that perturb the equilibrium of this complex geochemical system.

  18. Cardiovascular responses to orthostasis: methods, assessments, and their association with falls in older adults in long-term care

    OpenAIRE

    Shaw, Brett Harrison

    2013-01-01

    Background: Orthostatic hypotension (OH) refers to a significant decline in blood pressure that occurs upon assuming an upright posture and represents an intrinsic risk factor for falls in older adults. Methods: Beat-to-beat blood pressure and cerebral blood flow velocity responses were assessed during a passive seated orthostatic stress test (PSOST). In healthy controls, PSOST responses were compared to head up tilt (the ‘gold-standard’). In a cohort of long-term care residents, data from PS...

  19. Quantification of long term emission potential from landfills

    NARCIS (Netherlands)

    Heimovaara, T.J.

    2011-01-01

    Novel approaches for the after-care of Municipal Solid Waste (MSW) landfills are based on technological measures to reduce the long term emission potential in a short time period. Biological degradation in landfills is a means to significantly reduce the long term emission potential. Leachate

  20. Duration of continuous positive airway pressure in premature infants

    OpenAIRE

    Bamat, Nicolas; Jensen, Erik A.; Kirpalani, Haresh

    2016-01-01

    Continuous positive airway pressure (CPAP) has been used for respiratory support in premature infants for more than 40 years and is now a cornerstone of modern neonatal care. Clinical research on CPAP has primarily focused on understanding which devices and pressure sources best implement this therapy. In contrast, less research has examined the optimal duration over which CPAP is administered. We review this aspect of CPAP therapy.

  1. Update Knowledge Base for Long-term Core Cooling Reliability

    International Nuclear Information System (INIS)

    Agrell, Maria; Sandervag, Oddbjoern; Amri, Abdallah; ); Bang, Young S.; Blomart, Philippe; Broecker, Annette; Pointner, Winfried; Ganzmann, Ingo; Lenogue, Bruno; Guzonas, David; Herer, Christophe; Mattei, Jean-Marie; Tricottet, Matthieu; Masaoka, Hideaki; Soltesz, Vojtech; Tarkiainen, Seppo; Ui, Atsushi; Villalba, Cristina; Zigler, Gilbert

    2013-11-01

    This revision of the Knowledge Base for Emergency Core Cooling System Recirculation Reliability (NEA/CSNI/R (95)11) describes the current status (late 2012) of the knowledge base on emergency core cooling system (ECCS) and containment spray system (CSS) suction strainer performance and long-term cooling in operating power reactors. New reactors, such as the AP1000, EPR and APR1400 that are under construction in some Organization for Economic Co-operation and Development (OECD) member countries, are not addressed in detail in this revision. The containment sump (also known as the emergency or recirculation sump in pressurized water reactors (PWRs) and pressurized heavy water reactors (PHWRs) or the suppression pools or wet wells in boiling water reactors (BWRs)) and associated ECCS strainers are parts of the ECCS in both reactor types. All nuclear power plants (NPPs) are required to have an ECCS that is capable of mitigating a design basis accident (DBA). The containment sump collects reactor coolant, ECCS injection water, and containment spray solutions, if applicable, after a loss-of-coolant accident (LOCA). The sump serves as the water source to support long-term recirculation for residual heat removal, emergency core cooling, and containment atmosphere clean-up. This water source, the related pump suction inlets, and the piping between the source and inlets are important safety-related components. In addition, if fibrous material is deposited at the fuel element spacers, core cooling can be endangered. The performance of ECCS/CSS strainers was recognized many years ago as an important regulatory and safety issue. One of the primary concerns is the potential for debris generated by a jet of high-pressure coolant during a LOCA to clog the strainer and obstruct core cooling. The issue was considered resolved for all reactor types in the mid-1990s and the OECD/NEA/CSNI published report NEA/CSNI/R(95)11 in 1996 to document the state of knowledge of ECCS performance

  2. Hydrocephalus treatment in children: long-term outcome in 975 consecutive patients.

    Science.gov (United States)

    Beuriat, Pierre-Aurelien; Puget, Stephanie; Cinalli, Giuseppe; Blauwblomme, Thomas; Beccaria, Kevin; Zerah, Michel; Sainte-Rose, Christian

    2017-07-01

    OBJECTIVE Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgical units. Endoscopic third ventriculostomy (ETV) has an advantage over ventriculoperitoneal shunting as it enables patients to remain device free. Multiple shunt devices with various valve designs exist, with no one valve proven to be superior to another. The aim of this study was to describe the management of hydrocephalus and its long-term outcome. METHODS The authors retrospectively reviewed the medical records of all patients who had been treated for hydrocephalus at the Hôpital Necker-Enfants Malades in the period from 1985 to 1995. RESULTS Nine hundred seventy-five children had been treated for hydrocephalus. The mean follow-up was 11 ± 7.4 years (mean ± standard deviation). The most common cause of hydrocephalus was tumor related (32.3%), followed by malformative (24.5%) and inflammatory (20.9%) causes. Two hundred eighty patients underwent ETV as the first-line treatment. The procedure was effective in controlling hydrocephalus due to posterior fossa tumors and aqueductal stenosis. Six hundred ninety-five children had initial shunt insertion, with the majority receiving an Orbis-Sigma valve (OSV). The overall OSV shunt survival was 70% at 1 year, 58% at 10 years, and 49% at 20 years. The most common cause for mechanical shunt failure was obstruction (50.7%). Overall shunt survival was statistically different between the OSV and the differential-pressure valve (p = 0.009). CONCLUSIONS Endoscopic third ventriculostomy is effective in the management of childhood hydrocephalus. Its success is directly related to the underlying pathology. In the long term, the OSV has significantly higher event-free shunt survival than the classic differential-pressure valve systems.

  3. Long-term care financing through Federal tax incentives.

    Science.gov (United States)

    Moran, D W; Weingart, J M

    1988-12-01

    Congress and the Administration are currently exploring various methods of promoting access to long-term care. In this article, an inventory of recent legislative proposals for using the Federal tax code to expand access to long-term care services is provided. Proposals are arrayed along a functional typology that includes tax mechanisms to encourage accumulation of funds, promote purchase of long-term care insurance, or induce the diversion of funds accumulated for another purpose (such as individual retirement accounts). The proposals are evaluated against the public policy objective of encouraging risk pooling to minimize social cost.

  4. Evaluation of long term leaching of borosilicate glasses

    International Nuclear Information System (INIS)

    Lanza, F.; Parnisari, E.

    1978-01-01

    For the evaluation of long term hazard of glass, data on long term glass leaching are needed. Moreover for long term leaching a model of homogeneous dissolution seems reasonable and ask for confirmation. Tests were performed at 30 0 , 80 0 , 100 0 , using an apparatus of the Soxhlet type, to 3.600 hours. Results were obtained as a weight loss and analysed following a relation with time composed by a parabolic and a linear part. Analysis of the surface layer using energy dispersion X ray spectrometry were performed. A critical analysis of the results and of the apparatus is presented

  5. Long-Term Stewardship Program Science and Technology Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Joan McDonald

    2002-09-01

    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  6. Long-term psychosocial consequences of surgical congenital malformations.

    Science.gov (United States)

    Diseth, Trond H; Emblem, Ragnhild

    2017-10-01

    Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

  7. The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

    Science.gov (United States)

    Klarica, Marijan; Radoš, Milan; Erceg, Gorislav; Petošić, Antonio; Jurjević, Ivana; Orešković, Darko

    2014-01-01

    Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF) pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

  8. The influence of body position on cerebrospinal fluid pressure gradient and movement in cats with normal and impaired craniospinal communication.

    Directory of Open Access Journals (Sweden)

    Marijan Klarica

    Full Text Available Intracranial hypertension is a severe therapeutic problem, as there is insufficient knowledge about the physiology of cerebrospinal fluid (CSF pressure. In this paper a new CSF pressure regulation hypothesis is proposed. According to this hypothesis, the CSF pressure depends on the laws of fluid mechanics and on the anatomical characteristics inside the cranial and spinal space, and not, as is today generally believed, on CSF secretion, circulation and absorption. The volume and pressure changes in the newly developed CSF model, which by its anatomical dimensions and basic biophysical features imitates the craniospinal system in cats, are compared to those obtained on cats with and without the blockade of craniospinal communication in different body positions. During verticalization, a long-lasting occurrence of negative CSF pressure inside the cranium in animals with normal cranio-spinal communication was observed. CSF pressure gradients change depending on the body position, but those gradients do not enable unidirectional CSF circulation from the hypothetical site of secretion to the site of absorption in any of them. Thus, our results indicate the existence of new physiological/pathophysiological correlations between intracranial fluids, which opens up the possibility of new therapeutic approaches to intracranial hypertension.

  9. Short-term and long-term deflection of reinforced hollow core ...

    African Journals Online (AJOL)

    This paper presents a study on different methods of analysis that are currently used by design codes to predict the short-term and long-term deflection of reinforced concrete slab systems and compares the predicted deflections with measured deflections. The experimental work to measure deflections involved the testing of ...

  10. Renal Oxidative Stress Induced by Long-Term Hyperuricemia Alters Mitochondrial Function and Maintains Systemic Hypertension

    Directory of Open Access Journals (Sweden)

    Magdalena Cristóbal-García

    2015-01-01

    Full Text Available We addressed if oxidative stress in the renal cortex plays a role in the induction of hypertension and mitochondrial alterations in hyperuricemia. A second objective was to evaluate whether the long-term treatment with the antioxidant Tempol prevents renal oxidative stress, mitochondrial alterations, and systemic hypertension in this model. Long-term (11-12 weeks and short-term (3 weeks effects of oxonic acid induced hyperuricemia were studied in rats (OA, 750 mg/kg BW, OA+Allopurinol (AP, 150 mg/L drinking water, OA+Tempol (T, 15 mg/kg BW, or vehicle. Systolic blood pressure, renal blood flow, and vascular resistance were measured. Tubular damage (urine N-acetyl-β-D-glucosaminidase and oxidative stress markers (lipid and protein oxidation along with ATP levels were determined in kidney tissue. Oxygen consumption, aconitase activity, and uric acid were evaluated in isolated mitochondria from renal cortex. Short-term hyperuricemia resulted in hypertension without demonstrable renal oxidative stress or mitochondrial dysfunction. Long-term hyperuricemia induced hypertension, renal vasoconstriction, tubular damage, renal cortex oxidative stress, and mitochondrial dysfunction and decreased ATP levels. Treatments with Tempol and allopurinol prevented these alterations. Renal oxidative stress induced by hyperuricemia promoted mitochondrial functional disturbances and decreased ATP content, which represent an additional pathogenic mechanism induced by chronic hyperuricemia. Hyperuricemia-related hypertension occurs before these changes are evident.

  11. Teaching Positive Networking for Life-Long Impact

    Science.gov (United States)

    Addams, Lon; Woodbury, Denise; Addams, Lindsey

    2010-01-01

    As college communication instructors, we could further assist students by teaching the value of positive networking. This article provides (1) a foundation for positive networking and (2) several successful ways in which students can begin building a strong long-lasting network of professional relationships during the semester…and for their entire…

  12. Do Short-Term Managerial Objectives Lead to Under- or Over-Investment in Long-Term Projects

    OpenAIRE

    Lucian Arye Bebchuk; Lars A. Stole

    1994-01-01

    This paper studies managerial decisions about investment in long-run projects in the presence of imperfect information (the market knows less about such investments than the firm's managers) and short-term managerial objectives (the managers are concerned about the short-term stock price as well as the long-term stock price). Prior work has suggested that imperfect information and short-term managerial objectives induce managers to underinvest in long-run projects. We show that either underin...

  13. Influence of long-term drinking alcohol on the cytokines in the rats with endogenous and exogenous lung injury.

    Science.gov (United States)

    Liu, Y D; Liu, W; Liu, Z

    2013-02-01

    Acute lung injury (ALI) and the acute respiratory distress syndrome (ARDS) are syndromes of acute respiratory failure. Exploration of the impacts of long-term drinking alcohol on the cytokines of rats with endogenous and exogenous lung injuries. Through giving the model rats long-term drinking alcohol or water, we acquired the changes of the cytokines in the serum and bronchoalveolar lavage fluid (BALF) of these rats with lung injuries due to different incentives. The partial pressure of oxygen in rats with lung damage after long-term drinking alcohol were significantly lower than those drinking water group (p exogenous lung injury were higher than those of rats with endogenous lung injury (p endogenous lung injury were higher than those with exogenous lung injury (p exogenous lung injury. The expression of TNF-α, IL-6 and IL-10 are different according to the different ways that lead to the acute lung injury.

  14. Observation of long term potentiation in papain-based memory devices

    KAUST Repository

    Bag, A.; Hota, Mrinal Kanti; Mallik, Sandipan B.; Maì ti, Chinmay Kumar

    2014-01-01

    Biological synaptic behavior in terms of long term potentiation has been observed in papain-based (plant protein) memory devices (memristors) for the first time. Improvement in long term potentiation depends on pulse amplitude and width (duration). Continuous/repetitive dc voltage sweep leads to an increase in memristor conductivity leading to a long term memory in the 'learning' processes.

  15. Observation of long term potentiation in papain-based memory devices

    KAUST Repository

    Bag, A.

    2014-06-01

    Biological synaptic behavior in terms of long term potentiation has been observed in papain-based (plant protein) memory devices (memristors) for the first time. Improvement in long term potentiation depends on pulse amplitude and width (duration). Continuous/repetitive dc voltage sweep leads to an increase in memristor conductivity leading to a long term memory in the \\'learning\\' processes.

  16. Modeling Wettability Variation during Long-Term Water Flooding

    Directory of Open Access Journals (Sweden)

    Renyi Cao

    2015-01-01

    Full Text Available Surface property of rock affects oil recovery during water flooding. Oil-wet polar substances adsorbed on the surface of the rock will gradually be desorbed during water flooding, and original reservoir wettability will change towards water-wet, and the change will reduce the residual oil saturation and improve the oil displacement efficiency. However there is a lack of an accurate description of wettability alternation model during long-term water flooding and it will lead to difficulties in history match and unreliable forecasts using reservoir simulators. This paper summarizes the mechanism of wettability variation and characterizes the adsorption of polar substance during long-term water flooding from injecting water or aquifer and relates the residual oil saturation and relative permeability to the polar substance adsorbed on clay and pore volumes of flooding water. A mathematical model is presented to simulate the long-term water flooding and the model is validated with experimental results. The simulation results of long-term water flooding are also discussed.

  17. WOMEN'S AGE AT FIRST MARRIAGE AND LONG-TERM ECONOMIC EMPOWERMENT IN EGYPT.

    Science.gov (United States)

    Yount, Kathryn M; Crandall, AliceAnn; Cheong, Yuk Fai

    2018-02-01

    Sustainable Development Goal (SDG) 5 calls on nations to promote gender equality and to empower women and girls. SDG5 also recognizes the value of women's economic empowerment, entailing equal rights to economic resources and full participation at all levels in economic decisions. Also according to SDG5, eliminating harmful practices-such as child marriage before age 18-is a prerequisite for women's economic empowerment. Using national data for 4,129 married women 15-43 years who took part in the Egypt Labor Market Panel Survey (ELMPS 1998-2012), we performed autoregressive, cross-lagged panel analyses to assess whether women's first marriage in adulthood (at 18 years or older, as reported in 2006), was positively associated with their long-term post-marital economic empowerment, measured as their engagement in market work and latent family economic agency in 2012. Women's first marriage in adulthood had positive unadjusted associations with their market work and family economic agency in 2012. These associations persisted after accounting for market work and family economic agency in 2006, pre-marital resources for empowerment, and cumulative fertility. Policies to discourage child marriage may show promise to enhance women's long-term post-marital economic empowerment.

  18. Applying of Decision Tree Analysis to Risk Factors Associated with Pressure Ulcers in Long-Term Care Facilities.

    Science.gov (United States)

    Moon, Mikyung; Lee, Soo-Kyoung

    2017-01-01

    The purpose of this study was to use decision tree analysis to explore the factors associated with pressure ulcers (PUs) among elderly people admitted to Korean long-term care facilities. The data were extracted from the 2014 National Inpatient Sample (NIS)-data of Health Insurance Review and Assessment Service (HIRA). A MapReduce-based program was implemented to join and filter 5 tables of the NIS. The outcome predicted by the decision tree model was the prevalence of PUs as defined by the Korean Standard Classification of Disease-7 (KCD-7; code L89 * ). Using R 3.3.1, a decision tree was generated with the finalized 15,856 cases and 830 variables. The decision tree displayed 15 subgroups with 8 variables showing 0.804 accuracy, 0.820 sensitivity, and 0.787 specificity. The most significant primary predictor of PUs was length of stay less than 0.5 day. Other predictors were the presence of an infectious wound dressing, followed by having diagnoses numbering less than 3.5 and the presence of a simple dressing. Among diagnoses, "injuries to the hip and thigh" was the top predictor ranking 5th overall. Total hospital cost exceeding 2,200,000 Korean won (US $2,000) rounded out the top 7. These results support previous studies that showed length of stay, comorbidity, and total hospital cost were associated with PUs. Moreover, wound dressings were commonly used to treat PUs. They also show that machine learning, such as a decision tree, could effectively predict PUs using big data.

  19. Group long-term care insurance: decision-making factors and implications for financing long-term care.

    Science.gov (United States)

    Stum, Marlene S

    2008-01-01

    This study proposes and tests a systemic family decision-making framework to understand group long-term care insurance (LTCI) enrollment decisions. A random sample of public employees who were offered group LTCI as a workplace benefit were examined. Findings reveal very good predictive efficacy for the overall conceptual framework with a pseudo R2 value of .687, and reinforced the contributions of factors within the family system. Enrollees were more likely to have discussed the decision with others, used information sources, and had prior experience when compared to non-enrollees. Perceived health status, financial knowledge, attitudes regarding the role of private insurance, risk taking, and coverage features were additional factors related to enrollment decisions. The findings help to inform policymakers about the potential of LTCI as one strategy for financing long-term care.

  20. Long-Term Resveratrol Supplementation as a Secondary Prophylaxis for Stroke

    Directory of Open Access Journals (Sweden)

    Katalin Fodor

    2018-01-01

    Full Text Available Stroke is a leading cause of mortality worldwide, as well as a source of long-term disabilities and huge socioeconomic costs. This study investigates the effects of resveratrol, an antioxidant supplement, on blood pressure, weight status, glucose, and lipid profile in patients who had a stroke in the last 12 months. Two hundred and twenty-eight patients were divided into three groups: group I received only allopathic treatment (control group, while groups II and III received allopathic treatment with a daily supplementation of oral resveratrol (100 and 200 mg, resp. for 12 months. In all groups, the changes of the studied parameters were monitored at 6 and 12 months from the initial evaluation. In groups II and III, resveratrol induced significant changes (p<0.05 in the blood pressure, body mass index, as well as all parameters of the lipid profile, and glucose (in nondiabetic patients, compared to the control group. The supplementation of the allopathic treatment with resveratrol had a beneficial effect on all monitored parameters, which serve as major risk factors for stroke.

  1. PKA-CREB-BDNF signaling pathway mediates propofol-induced long-term learning and memory impairment in hippocampus of rats.

    Science.gov (United States)

    Zhong, Yu; Chen, Jing; Li, Li; Qin, Yi; Wei, Yi; Pan, Shining; Jiang, Yage; Chen, Jialin; Xie, Yubo

    2018-04-20

    Studies have found that propofol can induce widespread neuroapoptosis in developing brains, which leads to cause long-term learning and memory abnormalities. However, the specific cellular and molecular mechanisms underlying propofol-induced neuroapoptosis remain elusive. The aim of the present study was to explore the role of PKA-CREB-BDNF signaling pathway in propofol-induced long-term learning and memory impairment during brain development. Seven-day-old rats were randomly assigned to control, intralipid and three treatment groups (n = 5). Rats in control group received no treatment. Intralipid (10%, 10 mL/kg) for vehicle control and different dosage of propofol for three treatment groups (50, 100 and 200 mg/kg) were administered intraperitoneally. FJB staining, immunohistochemistry analysis for neuronal nuclei antigen and transmission electron microscopy were used to detect neuronal apoptosis and structure changes. MWM test examines the long-term spatial learning and memory impairment. The expression of PKA, pCREB and BDNF was quantified using western blots. Propofol induced significant increase of FJB-positive cells and decrease of PKA, pCREB and BDNF protein levels in the immature brain of P7 rats. Using the MWM test, propofol-treated rats demonstrated long-term spatial learning and memory impairment. Moreover, hippocampal NeuN-positive cell loss, long-lasting ultrastructural abnormalities of the neurons and synapses, and long-term down-regulation of PKA, pCREB and BDNF protein expression in adult hippocampus were also found. Our results indicated that neonatal propofol exposure can significantly result in long-term learning and memory impairment in adulthood. The possible mechanism involved in the propofol-induced neuroapoptosis was related to down-regulation of PKA-CREB-BDNF signaling pathway. Copyright © 2018. Published by Elsevier B.V.

  2. Effects of Modes, Obesity, and Body Position on Non-invasive Positive Pressure Ventilation Success in the Intensive Care Unit: A Randomized Controlled Study.

    Science.gov (United States)

    Türk, Murat; Aydoğdu, Müge; Gürsel, Gül

    2018-01-01

    Different outcomes and success rates of non-invasive positive pressure ventilation (NPPV) in patients with acute hypercapnic respiratory failure (AHRF) still pose a significant problem in intensive care units. Previous studies investigating different modes, body positioning, and obesity-associated hypoventilation in patients with chronic respiratory failure showed that these factors may affect ventilator mechanics to achieve a better minute ventilation. This study tried to compare pressure support (BiPAP-S) and average volume targeted pressure support (AVAPS-S) modes in patients with acute or acute-on-chronic hypercapnic respiratory failure. In addition, short-term effects of body position and obesity within both modes were analyzed. We conducted a randomized controlled study in a 7-bed intensive care unit. The course of blood gas analysis and differences in ventilation variables were compared between BiPAP-S (n=33) and AVAPS-S (n=29), and between semi-recumbent and lateral positions in both modes. No difference was found in the length of hospital stay and the course of PaCO2, pH, and HCO3 levels between the modes. There was a mean reduction of 5.7±4.1 mmHg in the PaCO2 levels in the AVAPS-S mode, and 2.7±2.3 mmHg in the BiPAP-S mode per session (ppositioning had no notable effect in both modes. Although the decrease in the PaCO2 levels in the AVAPS-S mode per session was remarkably high, the course was similar in both modes. Furthermore, obesity and body positioning had no prominent effect on the PaCO2 response and ventilator mechanics. Post hoc power analysis showed that the sample size was not adequate to detect a significant difference between the modes.

  3. School-based smoking prevention programs with the promise of long-term effects

    Directory of Open Access Journals (Sweden)

    Flay Brian R

    2009-03-01

    Full Text Available Abstract I provide a systematic review of trials of school-based smoking prevention programs that had at least 15 sessions, preferably with some in high school, that reported significant short-term effects, and that included long-term follow-up. This is supplemented with a description of some other programs that produce short-term effects that portend large long-term effects. I conclude that school-based programs can have long-term effects of practical importance it they: include 15 or more sessions over multiple years, including some in high school; use the social influence model and interactive delivery methods; include components on norms, commitment not to use, intentions not to use, and training and practice in the use of refusal and other life skills; and use peer leaders in some role. School-based programs of this type can reduce smoking onset by 25–30%, and school plus community programs can reduce smoking onset by 35–40% by the end of high school. Some early childhood programs that do not have smoking prevention as their main aim, including home nursing, the Good Behavior Game, the Positive Action program and others, seem to change the developmental trajectories of children so that they are less likely to engage in multiple problem behaviors, including smoking, as adolescents. This review makes it clear that effective school-based smoking prevention programs exist and can be adopted, adapted and deployed with success – and should be.

  4. Effects of long- and short-term management on the functional structure of meadows through species turnover and intraspecific trait variability.

    Science.gov (United States)

    Volf, Martin; Redmond, Conor; Albert, Ágnes J; Le Bagousse-Pinguet, Yoann; Biella, Paolo; Götzenberger, Lars; Hrázský, Záboj; Janeček, Štěpán; Klimešová, Jitka; Lepš, Jan; Šebelíková, Lenka; Vlasatá, Tereza; de Bello, Francesco

    2016-04-01

    The functional structures of communities respond to environmental changes by both species replacement (turnover) and within-species variation (intraspecific trait variability; ITV). Evidence is lacking on the relative importance of these two components, particularly in response to both short- and long-term environmental disturbance. We hypothesized that such short- and long-term perturbations would induce changes in community functional structure primarily via ITV and turnover, respectively. To test this we applied an experimental design across long-term mown and abandoned meadows, with each plot containing a further level of short-term management treatments: mowing, grazing and abandonment. Within each plot, species composition and trait values [height, shoot biomass, and specific leaf area (SLA)] were recorded on up to five individuals per species. Positive covariations between the contribution of species turnover and ITV occurred for height and shoot biomass in response to both short- and long-term management, indicating that species turnover and intraspecific adjustments selected for similar trait values. Positive covariations also occurred for SLA, but only in response to long-term management. The contributions of turnover and ITV changed depending on both the trait and management trajectory. As expected, communities responded to short-term disturbances mostly through changes in intraspecific trait variability, particularly for height and biomass. Interestingly, for SLA they responded to long-term disturbances by both species turnover and intraspecific adjustments. These findings highlight the importance of both ITV and species turnover in adjusting grassland functional trait response to environmental perturbation, and show that the response is trait specific and affected by disturbance regime history.

  5. Adverse event reporting in Czech long-term care facilities.

    Science.gov (United States)

    Hěib, Zdenřk; Vychytil, Pavel; Marx, David

    2013-04-01

    To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

  6. Financial Analysis of an Intensive Pediatric Continuous Positive Airway Pressure Program.

    Science.gov (United States)

    Riley, E Brooks; Fieldston, Evan S; Xanthopoulos, Melissa S; Beck, Suzanne E; Menello, Mary Kate; Matthews, Edward; Marcus, Carole L

    2017-02-01

    Continuous positive airway pressure (CPAP) is effective in treating obstructive sleep apnea in children, but adherence to therapy is low. Our center created an intensive program that aimed to improve adherence. Our objective was to estimate the program's efficacy, cost, revenue and break-even point in a generalizable manner relative to a standard approach. The intensive program included device consignment, behavioral psychology counseling, and follow-up telephone calls. Economic modeling considered the costs, revenue and break-even point. Costs were derived from national salary reports and the Pediatric Health Information System. The 2015 Medicare reimbursement schedule provided revenue estimates. Prior to the intensive CPAP program, only 67.6% of 244 patients initially prescribed CPAP appeared for follow-up visits and only 38.1% had titration polysomnograms. In contrast, 81.4% of 275 patients in the intensive program appeared for follow-up visits (p break-even points would need to be 1.29-2.08 times higher to cover the costs. An intensive CPAP program leads to substantially higher follow-up and CPAP titration rates, but costs are higher. While affordable at our institution due to the local payer mix and revenue, Medicare reimbursement levels would not cover estimated costs. This study highlights the need for enhanced funding for pediatric CPAP programs, due to the special needs of this population and the long-term health risks of suboptimally treated obstructive sleep apnea. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  7. Long-term EEG in children.

    Science.gov (United States)

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D

    2015-03-01

    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

  8. Long term complications of diabetes

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000327.htm Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  9. Continuous Positive Airway Pressure Adherence In Patients with Obstructive Sleep Apnea & Symptomatic BPH.

    Science.gov (United States)

    Metta, Ramesh V V S; Zaka, Awais; Lee, Vincent C; Mador, M Jeffery

    2017-04-01

    Purpose To determine the short-term and long-term adherence rates with continuous positive airway pressure (CPAP) therapy in sleep apnea patients with benign prostatic hyperplasia (BPH) compared to matched controls. Methods A case-control retrospective analysis was performed in a veterans affairs hospital. All symptomatic patients with BPH (n = 107) ever started on CPAP therapy between 2006 and 2012 were compared with controls matched for severity of sleep apnea (AHI). Adherence measures were obtained at the third and twelfth month visits. The cases included symptomatic BPH patients on active medical therapy. Diuretic use among cases and controls, and severity of nocturia among the cases were also analyzed. Results The mean AHI among cases and controls was 35.6 ± 27.3 and 35.5 ± 31 (p = 0.96). The population was male and predominantly Caucasian. There was no statistically significant difference in percent days CPAP device use ≥4 h. between symptomatic BPH patients and controls at 3-month (51.6 ± 38 vs. 47.2 ± 36; p = 0.43) and 1-year (64 ± 40.5 vs. 64.7 ± 31.3; p = 0.90) visits. The use of diuretics in the cases and controls, and the severity of nocturia in the cases did not influence adherence with CPAP therapy. Conclusions BPH or diuretic use did not affect adherence with CPAP therapy in obstructive sleep apnea. Severity of nocturia did not have any influence on adherence among the cases. BPH, regardless of the severity of nocturia, and diuretic use does not influence CPAP adherence in patients with OSA.

  10. Duration of continuous positive airway pressure in premature infants

    Science.gov (United States)

    Bamat, Nicolas; Jensen, Erik A.; Kirpalani, Haresh

    2016-01-01

    SUMMARY Continuous positive airway pressure (CPAP) has been used for respiratory support in premature infants for more than 40 years and is now a cornerstone of modern neonatal care. Clinical research on CPAP has primarily focused on understanding which devices and pressure sources best implement this therapy. In contrast, less research has examined the optimal duration over which CPAP is administered. We review this aspect of CPAP therapy. PMID:26948885

  11. Perceived service quality, perceived value, overall satisfaction and happiness of outlook for long-term care institution residents.

    Science.gov (United States)

    Lin, Jesun; Hsiao, Chih-Tung; Glen, Robert; Pai, Jar-Yuan; Zeng, Sin-Huei

    2014-06-01

    To investigate the psychometric properties and relationships of perceived service quality, perceived value and overall satisfaction for residents with respect to their long-term care institutions. The five-point Likert scale questionnaire administered through facetoface interviews. Fourteen long-term care institutions located in central and southern Taiwan stratified according to services and accommodation population. One hundred and eighty long-term institutional care residents. Perceived service quality (the SERVPERF model), perceived value and overall satisfaction (models based on the literature on perceived value and satisfaction). Student's t-test on institutional location shows a significant difference between overall satisfaction for central and southern institution long-term care recipients. The correlation test revealed that the higher a resident's level of education, the higher the scores for perceived value. The factor loading results of confirmation factor analysis show acceptable levels of reliability and index-of-model fits for perceived service, perceived value and overall satisfaction. In addition, the results suggest that an additional construct, a positive attitude (happiness of outlook) towards long-term care institutions, is also an important factor in residents' overall satisfaction. The primary goal of long-term institutional care policy in Taiwan, as in other countries, is to provide residents with practical, cost-effective but high-quality care. On the basis of the results of in-depth interviews with long-term institutional care residents, this study suggests long-term care institutions arrange more family visit days to increase the accessibility and interaction of family and residents and thereby increase the happiness of outlook of the residents. © 2012 John Wiley & Sons Ltd.

  12. Blood pressure regulation V: in vivo mechanical properties of precapillary vessels as affected by long-term pressure loading and unloading.

    Science.gov (United States)

    Eiken, Ola; Mekjavic, Igor B; Kölegård, Roger

    2014-03-01

    Recent studies are reviewed, concerning the in vivo wall stiffness of arteries and arterioles in healthy humans, and how these properties adapt to iterative increments or sustained reductions in local intravascular pressure. A novel technique was used, by which arterial and arteriolar stiffness was determined as changes in arterial diameter and flow, respectively, during graded increments in distending pressure in the blood vessels of an arm or a leg. Pressure-induced increases in diameter and flow were smaller in the lower leg than in the arm, indicating greater stiffness in the arteries/arterioles of the leg. A 5-week period of intermittent intravascular pressure elevations in one arm reduced pressure distension and pressure-induced flow in the brachial artery by about 50%. Conversely, prolonged reduction of arterial/arteriolar pressure in the lower body by 5 weeks of sustained horizontal bedrest, induced threefold increases of the pressure-distension and pressure-flow responses in a tibial artery. Thus, the wall stiffness of arteries and arterioles are plastic properties that readily adapt to changes in the prevailing local intravascular pressure. The discussion concerns mechanisms underlying changes in local arterial/arteriolar stiffness as well as whether stiffness is altered by changes in myogenic tone and/or wall structure. As regards implications, regulation of local arterial/arteriolar stiffness may facilitate control of arterial pressure in erect posture and conditions of exaggerated intravascular pressure gradients. That increased intravascular pressure leads to increased arteriolar wall stiffness also supports the notion that local pressure loading may constitute a prime mover in the development of vascular changes in hypertension.

  13. Short-term versus long-term market opportunities and financial constraints

    International Nuclear Information System (INIS)

    Ferrari, Angelo

    1999-01-01

    This presentation discusses gas developments in Europe, the European Gas Directive, short term vs. long term, and Snam's new challenges. The European gas market is characterized by (1) The role of gas in meeting the demand for energy, which varies greatly from one country to another, (2) A growing market, (3) Decreasing role of domestic production, and (4) Increasing imports. Within the European Union, the Gas Directive aims to transform single national markets into one integrated European market by introducing third party access to the network for eligible clients as a means of increasing the competition between operators. The Gas Directive would appear to modify the form of the market rather than its size, and in particular the sharing of responsibility and risk among operators. The market in the future will offer operators the possibility to exploit opportunities deriving mainly from demands for increased flexibility. Opportunities linked to entrepreneurial initiatives require long-term investments characteristic of the gas business. Risks and opportunities must be balanced evenly between different operators. If everyone takes on their own risks and responsibilities, this means a wider distribution of the risks of long-term vs. short-term, currently borne by the gas companies that are integrated, into a market that tends to favour the short-term. A gradual liberalization process should allow incumbent operators to gradually diversify their activities in new gas market areas or enter new business activities. They could move beyond their local and European boundaries in pursuit of an international dimension. The market will have to make the transition from the national to the European dimension: as an example, Snam covers 90% of the Italian market, but its share of an integrated European market will be about 15%

  14. Strategies to meet the need for long-term data.

    Science.gov (United States)

    Chalmers, John; Woodward, Mark; Borghi, Claudio; Manolis, Athanasios; Mancia, Giuseppe

    2016-08-01

    Chronic diseases afflict patients for many years, often to the end of life, and there is increasing need for estimating lifelong risk and for evaluating the effects of treatment in the long term. Yet recommendations for lifelong treatment are most frequently based on findings from randomized clinical trials lasting only a few years. There is therefore a clear need for much longer term data, and here we present the advantages and disadvantages of many strategies, including the use of long-term posttrial follow-up, of long-term prospective cohort studies, registry databases, and of administrative databases. We also emphasize the need for long-term cost-effectiveness studies. One of the most promising strategies comes from linkage of data gathered through the ever-expanding pool of administrative databases worldwide with data from other sources, including randomized trials and the many forms of observational study.

  15. Numerical study on xenon positive column discharges of mercury-free lamp

    International Nuclear Information System (INIS)

    Ouyang, Jiting; He, Feng; Miao, Jinsong; Wang, Jianqi; Hu, Wenbo

    2007-01-01

    In this paper, the numerical study has been performed on the xenon positive column discharges of mercury-free fluorescent lamp. The plasma discharge characteristics are analyzed by numerical simulation based on two-dimensional fluid model. The effects of cell geometry, such as the dielectric layer, the electrode width, the electrode gap, and the cell height, and the filling gas including the pressure and the xenon percentage are investigated in terms of discharge current and discharge efficiency. The results show that a long transient positive column will form in the xenon lamp when applying ac sinusoidal power and the lamp can operate in a large range of voltage and frequency. The front dielectric layer of the cell plays an important role in the xenon lamp while the back layer has little effect. The ratio of electrode gap to cell height should be large to achieve a long positive column xenon lamp and higher efficiency. Increase of pressure or xenon concentration results in an increase of discharge efficiency and voltage. The discussions will be helpful for the design of commercial xenon lamp cells

  16. Underlying Mechanisms of Cooperativity, Input Specificity, and Associativity of Long-Term Potentiation Through a Positive Feedback of Local Protein Synthesis

    Directory of Open Access Journals (Sweden)

    Lijie Hao

    2018-05-01

    Full Text Available Long-term potentiation (LTP is a specific form of activity-dependent synaptic plasticity that is a leading mechanism of learning and memory in mammals. The properties of cooperativity, input specificity, and associativity are essential for LTP; however, the underlying mechanisms are unclear. Here, based on experimentally observed phenomena, we introduce a computational model of synaptic plasticity in a pyramidal cell to explore the mechanisms responsible for the cooperativity, input specificity, and associativity of LTP. The model is based on molecular processes involved in synaptic plasticity and integrates gene expression involved in the regulation of neuronal activity. In the model, we introduce a local positive feedback loop of protein synthesis at each synapse, which is essential for bimodal response and synapse specificity. Bifurcation analysis of the local positive feedback loop of brain-derived neurotrophic factor (BDNF signaling illustrates the existence of bistability, which is the basis of LTP induction. The local bifurcation diagram provides guidance for the realization of LTP, and the projection of whole system trajectories onto the two-parameter bifurcation diagram confirms the predictions obtained from bifurcation analysis. Moreover, model analysis shows that pre- and postsynaptic components are required to achieve the three properties of LTP. This study provides insights into the mechanisms underlying the cooperativity, input specificity, and associativity of LTP, and the further construction of neural networks for learning and memory.

  17. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    Science.gov (United States)

    Hahlweg, Kurt; Heinrichs, Nina; Kuschel, Annett; Bertram, Heike; Naumann, Sebastian

    2010-05-16

    Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers.

  18. Long-term outcome of a randomized controlled universal prevention trial through a positive parenting program: is it worth the effort?

    Directory of Open Access Journals (Sweden)

    Bertram Heike

    2010-05-01

    Full Text Available Abstract Background Approximately 20% of children experience internalizing or externalizing DSM-IV-TR disorders. This prevalence rate cannot be reduced through treatment only. Effective preventive interventions are therefore urgently needed. The aim of the current investigation is to evaluate the two-year efficacy of the group Triple P parenting program administered universally for the prevention of child behavior problems. Methods Based on their respective preschool, N = 280 families were randomly assigned either to the parent training or to the control group. The efficacy was analyzed using multi-source assessments, including questionnaires by mother and father, behavioral observation of mother-child interaction, and teacher evaluations. Results At the 2-year follow-up, both parents in the Triple P intervention reported significant reductions in dysfunctional parenting behavior, and mothers also an increase in positive parenting behavior. In addition, mothers reported significant reductions in internalizing and externalizing child behavior. Single-parent mothers in the Triple P intervention did not report significant changes in parenting or child problem behavior which is primarily due to inexplicable high positive effects in single parent mothers of the control group. Neither mother-child interactions nor teacher ratings yielded significant results. Conclusions The results support the long-term efficacy of the Triple P - group program as a universal prevention intervention for changing parenting behavior in two-parent households, but not necessarily in single-parent mothers.

  19. Intermediate-term and long-term mortality among acute medical patients hospitalized with community-acquired sepsis

    DEFF Research Database (Denmark)

    Henriksen, Daniel P; Pottegård, Anton; Laursen, Christian B

    2017-01-01

    OBJECTIVE: Admission with severe sepsis is associated with an increased short-term mortality, but it is unestablished whether sepsis severity has an impact on intermediate-term and long-term mortality following admission to an acute medical admission unit. PATIENTS AND METHODS: This was a populat......OBJECTIVE: Admission with severe sepsis is associated with an increased short-term mortality, but it is unestablished whether sepsis severity has an impact on intermediate-term and long-term mortality following admission to an acute medical admission unit. PATIENTS AND METHODS......: This was a population-based study of all adults admitted to an acute medical admission unit, Odense University Hospital, Denmark, from September 2010 to August 2011, identified by symptoms and clinical findings. We categorized the mortality periods into intermediate-term (31-180 days) and long-term (181-365, 366...

  20. Self-concept and quality of object relations as predictors of outcome in short- and long-term psychotherapy.

    Science.gov (United States)

    Lindfors, Olavi; Knekt, Paul; Heinonen, Erkki; Virtala, Esa

    2014-01-01

    Quality of object relations and self-concept reflect clinically relevant aspects of personality functioning, but their prediction as suitability factors for psychotherapies of different lengths has not been compared. This study compared their prediction on psychiatric symptoms and work ability in short- and long-term psychotherapy. Altogether 326 patients, 20-46 years of age, with mood and/or anxiety disorder, were randomized to short-term (solution-focused or short-term psychodynamic) psychotherapy and long-term psychodynamic psychotherapy. The Quality of Object Relations Scale (QORS) and the Structural Analysis of Social Behavior (SASB) self-concept questionnaire were measured at baseline, and their prediction on outcome during the 3-year follow-up was assessed by the Symptom Check List Global Severity Index and the Anxiety Scale, the Beck Depression Inventory and by the Work Ability Index, Social Adjustment Scale work subscale and the Perceived Psychological Functioning scale. Negative self-concept strongly and self-controlling characteristics modestly predicted better 3-year outcomes in long-term therapy, after faster early gains in short-term therapy. Patients with a more positive or self-emancipating self-concept, or more mature object relations, experienced more extensive benefits after long-term psychotherapy. The importance of length vs. long-term therapy technique on the differences found is not known. Patients with mild to moderate personality pathology, indicated by poor self-concept, seem to benefit more from long-term than short-term psychotherapy, in reducing risk of depression. Long-term therapy may also be indicated for patients with relatively good psychological functioning. More research is needed on the relative importance of these characteristics in comparison with other patient-related factors. © 2013 Published by Elsevier B.V.